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Medical care research and review : MCRR最新文献

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Race and ethnic disparities in health care access and utilization: an examination of state variation. 种族和民族在医疗保健获取和利用方面的差异:对各州差异的检查。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755800773743600
T. Waidmann, S. Rajan
{"title":"Race and ethnic disparities in health care access and utilization: an examination of state variation.","authors":"T. Waidmann, S. Rajan","doi":"10.1177/107755800773743600","DOIUrl":"https://doi.org/10.1177/107755800773743600","url":null,"abstract":"Health disparities among racial and ethnic groups have a long history and continue to exist in the United States. The U.S. government has established as a goal for the year 2010 the elimination of racial/ethnic health differences in six areas. This article examines disparities in one of those areas: access to high-quality health care. Several measures of access to and use of health care services are studied both nationally and in 13 diverse states. The authors find that both the magnitude of racial and ethnic disparity and the reasons behind it depend significantly on the state, the ethnic group, and the type of outcome measure being studied. Such information can be valuable for state and national policy makers in targeting resources and in designing effective strategies for the elimination of racial and ethnic disparities.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129515391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 137
Health care consumers: choices and constraints. 医疗保健消费者:选择与约束。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755899773743855
C. Mclaughlin
{"title":"Health care consumers: choices and constraints.","authors":"C. Mclaughlin","doi":"10.1177/107755899773743855","DOIUrl":"https://doi.org/10.1177/107755899773743855","url":null,"abstract":"This article summarizes the research and data currently available on different dimensions of consumer choice. These dimensions include not only whether to participate in a health care plan and which plan to select if given a choice but also the decisions that lead to having a choice and the implications of making the choice. Data are presented on what choices consumers face, how many are given what kinds of choices, what constraints they face, what we know about how they make these choices, and what information they are given and what they use. The majority of Americans are offered some kind of health insurance plan either through their place of employment or as a dependent on someone else's employer-sponsored health plan. About half of those offered health insurance are offered a choice, usually of only two or three plans. The majority elect to participate in one of those plans.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"205 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132152276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 24
Quality measures for mental health care: results from a national inventory. 精神卫生保健质量措施:国家清单结果。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755800773743763
R. Hermann, H. S. Leff, R. Palmer, D. Yang, T. Teller, S. Provost, C. Jakubiak, J. Chan
{"title":"Quality measures for mental health care: results from a national inventory.","authors":"R. Hermann, H. S. Leff, R. Palmer, D. Yang, T. Teller, S. Provost, C. Jakubiak, J. Chan","doi":"10.1177/107755800773743763","DOIUrl":"https://doi.org/10.1177/107755800773743763","url":null,"abstract":"The National Inventory of Mental Health Quality Measures was funded by the Agency for Healthcare Research and Quality to (1) inventory process measures for assessing the quality of mental health care; (2) identify clinical, administrative, and quality domains where measures have been developed; and (3) identify areas where further research and development is needed. Among the 86 measures identified, most evaluated treatment of major mental disorders, for example, schizophrenia (24 percent) and major depression (21 percent). A small proportion focused on children (8 percent) or the elderly (9 percent). Domains of quality included treatment appropriateness (65 percent), continuity (26 percent), access (26 percent), coordination (13 percent), detection (12 percent), and prevention (6 percent). Few measures were evaluated for reliability (12 percent) or validity (3 percent). Measures imposing a lower burden were more likely to be in use (chi 2 = 4.41, p = .036). Further measures are needed to assess care for several priority clinical and demographic groups. Research should focus on measure validity, reliability, and implementation costs. In order to foster quality improvement activities and use of common measures and specifications for mental health care, the inventory of quality measures will be made available at www.challiance.org/cqaimh.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121771190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 50
Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. 文化能力能减少种族和民族健康差异吗?回顾和概念模型。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/1077558700574009
Cindy Brach, Irene Fraser
{"title":"Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model.","authors":"Cindy Brach, Irene Fraser","doi":"10.1177/1077558700574009","DOIUrl":"https://doi.org/10.1177/1077558700574009","url":null,"abstract":"This article develops a conceptual model of cultural competency's potential to reduce racial and ethnic health disparities, using the cultural competency and disparities literature to lay the foundation for the model and inform assessments of its validity. The authors identify nine major cultural competency techniques: interpreter services, recruitment and retention policies, training, coordinating with traditional healers, use of community health workers, culturally competent health promotion, including family/community members, immersion into another culture, and administrative and organizational accommodations. The conceptual model shows how these techniques could theoretically improve the ability of health systems and their clinicians to deliver appropriate services to diverse populations, thereby improving outcomes and reducing disparities. The authors conclude that while there is substantial research evidence to suggest that cultural competency should in fact work, health systems have little evidence about which cultural competency techniques are effective and less evidence on when and how to implement them properly.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128600099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 772
Choice and representation in health care. 保健方面的选择和代表权。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755899773743909
E. Emanuel
{"title":"Choice and representation in health care.","authors":"E. Emanuel","doi":"10.1177/107755899773743909","DOIUrl":"https://doi.org/10.1177/107755899773743909","url":null,"abstract":"Choice is often thought to be critical in health care, especially to foster quality improvements and lower costs. However, it is also recognized that in the current system there is significant representation of consumers, members, and patients by physicians, employers, and health plans. Consent, accountability, and protections against conflicts of interest are necessary to ensure legitimate and effective representation. This article discusses the roles and responsibilities of physicians, employers, and other parties with respect to serving as representatives of health care consumers. The author concludes that to make representation more legitimate and effective in health care will require significant changes, which include (1) changing business to a stakeholder theory, (2) involving employees in health care coverage decisions, and (3) involving members of health plans in policy decisions.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121087464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Racial and ethnic differences in preventable hospitalizations across 10 states. 10个州可预防住院的种族和民族差异。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755800773743619
D. Gaskin, C. Hoffman
{"title":"Racial and ethnic differences in preventable hospitalizations across 10 states.","authors":"D. Gaskin, C. Hoffman","doi":"10.1177/107755800773743619","DOIUrl":"https://doi.org/10.1177/107755800773743619","url":null,"abstract":"Using discharge data from 10 states, this study estimates the effects of race and ethnicity on the likelihood of being hospitalized for a preventable condition--an indicator of limited access to primary care. The authors find that African Americans and Hispanics are more likely to be hospitalized for preventable conditions. In particular, controlling for differences in patients' health care needs, socioeconomic status, insurance coverage, and the availability of primary care, Hispanic children, working-age African American adults, and elderly patients from both minority groups are at greater risk than are similar white patients.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114303226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 92
The effect of race on the referral process for invasive cardiac procedures. 种族对有创心脏手术转诊过程的影响。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755800773743646
Lynne C. Einbinder, K. Schulman
{"title":"The effect of race on the referral process for invasive cardiac procedures.","authors":"Lynne C. Einbinder, K. Schulman","doi":"10.1177/107755800773743646","DOIUrl":"https://doi.org/10.1177/107755800773743646","url":null,"abstract":"Coronary artery disease is the leading cause of death in the United States. Blacks are more likely than whites to experience premature disease, and they have poorer prognosis after acute myocardial infarction. Multiple studies have demonstrated that blacks are less likely to be referred for certain invasive cardiac procedures. Few studies have examined the effect of race on physician and patient decision making in referrals for cardiac procedures. The authors present a framework for the complex series of steps involved in obtaining invasive cardiac care. Patient race can affect each of these steps, and differences in physician and patient race may be a particular impediment to effective communication about symptoms and preferences and to the establishment of a therapeutic partnership. The potential role of communication in race-discordant physician-patient relationships suggests a need for more research in physician decision making and for efforts to promote cultural competency as a core component of medical education.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134367729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 74
Race/ethnicity and health insurance status: 1987 and 1996. 种族/族裔和健康保险状况:1987年和1996年。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755800773743583
A. Monheit, J. Vistnes
{"title":"Race/ethnicity and health insurance status: 1987 and 1996.","authors":"A. Monheit, J. Vistnes","doi":"10.1177/107755800773743583","DOIUrl":"https://doi.org/10.1177/107755800773743583","url":null,"abstract":"Health insurance confers important private and social benefits. Disparities in coverage among the population remain an important public policy issue. The authors focus on the health insurance status of white, black, and Hispanic Americans in both 1987 and 1996 and identify gaps in minority health care coverage relative to white Americans. They also investigate the access of workers in these groups to employment-based health insurance. Identified are factors underlying changes in the insurance status of workers during the past decade in terms of changes in population characteristics and structural shifts underlying the demand for and supply of health insurance. The authors find that while coverage has declined for workers in most racial/ethnic groups, the experience of Hispanic males appears to be unique in that changes in their characteristics as well as structural shifts account for their decline in employment-related coverage. Structural shifts dominated the changes in coverage rates for other groups.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133320708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 88
Management by objection? Public policies to protect choice in health plans. 反对管理?保护健康计划选择权的公共政策。
Medical care research and review : MCRR Pub Date : 1900-01-01 DOI: 10.1177/107755899773743927
L. Brown
{"title":"Management by objection? Public policies to protect choice in health plans.","authors":"L. Brown","doi":"10.1177/107755899773743927","DOIUrl":"https://doi.org/10.1177/107755899773743927","url":null,"abstract":"Consumer choice is a watchword of the market reforms now sweeping the U.S. health care system. Policy makers, however, must grapple with an important ambiguity; is the objective to expand choice or protect choosers, and what should be done if the two goals conflict? Concerns about health care market malfunctions trigger a politics of consumer protection that may emphasize regulatory standards over market flexibility. To complicate matters further, hopes that deluging consumers with information can ensure that choices are at once ample and prudent are likely to be disappointed.","PeriodicalId":169610,"journal":{"name":"Medical care research and review : MCRR","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121134435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
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