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Inpatient Care Experiences Differ for VA and Non-VA Hospitals, With Different Patterns by Health, Race, and Ethnicity. 退伍军人医院和非退伍军人医院的住院护理经验不同，健康、种族和民族的模式不同。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-12-05 DOI: 10.1177/10775587241300645
Marc N Elliott, Megan K Beckett, Christopher W Cohea, William G Lehrman, Elizabeth Goldstein, James H Schaefer, Laura A Giordano, Debra Saliba
{"title":"Inpatient Care Experiences Differ for VA and Non-VA Hospitals, With Different Patterns by Health, Race, and Ethnicity.","authors":"Marc N Elliott, Megan K Beckett, Christopher W Cohea, William G Lehrman, Elizabeth Goldstein, James H Schaefer, Laura A Giordano, Debra Saliba","doi":"10.1177/10775587241300645","DOIUrl":"10.1177/10775587241300645","url":null,"abstract":"<p><p>This article estimates differences and difference-in-differences in patient experiences for Veterans Health Administration (VA) compared to non-VA patients in 2017, when there was concern about the health quality of VA hospitals, and in 2021, the second year of the COVID-19 pandemic, both overall, and for specific patient groups. We used data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In 2017, HCAHPS performance was somewhat better for non-VA than for VA hospitals, with Care Transition being the only measure for which VA hospitals performed better on average. By 2021, HCAHPS performance was better for VA than for non-VA hospitals for all but two measures (Quietness and Discharge Information), for which there were no differences from non-VA hospitals. In 2017, the VA provided worse experiences than non-VA hospitals for Black and poor-health patients; in 2021, VA hospitals outperformed non-VA hospitals for these, and all patient subgroups examined.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"195-200"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effect of Extending the Window to Disenroll From Medicare Advantage Among Post-Acute Users. 延长窗口退出医疗保险优势在急性后用户中的影响。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2025-01-23 DOI: 10.1177/10775587241313092
Emma M Achola, Amal N Trivedi, Daeho Kim, David J Meyers, Hiren Varma, Laura M Keohane
{"title":"The Effect of Extending the Window to Disenroll From Medicare Advantage Among Post-Acute Users.","authors":"Emma M Achola, Amal N Trivedi, Daeho Kim, David J Meyers, Hiren Varma, Laura M Keohane","doi":"10.1177/10775587241313092","DOIUrl":"10.1177/10775587241313092","url":null,"abstract":"<p><p>Post-acute care users in Medicare Advantage (MA) plans may seek coverage changes if facing issues with plan benefits. In 2019, the Centers for Medicare and Medicaid Services extended the deadline to disenroll from an MA plan from February 14 to March 31 and, for the first time, permitted beneficiaries to switch to a different MA plan instead of traditional Medicare. Using 2016-2019 Medicare administrative data, we implemented a difference-in-differences approach to evaluate the impact of this policy on disenrollment from a plan within 1 month of initiating skilled nursing facility or home health services. When MA disenrollment rules became more flexible, overall rates of exiting MA plans did not change. Switching to a different MA plan increased after the policy change, but this outcome was so rare that this increase did not affect overall rates of exiting MA plans.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"165-172"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 Provider Relief Funds Distribution by Hospital Characteristics. COVID-19提供者救济资金按医院特点分配。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2025-01-19 DOI: 10.1177/10775587241308934
Michael D Rosko, Kate J Li, Mona Al-Amin
{"title":"COVID-19 Provider Relief Funds Distribution by Hospital Characteristics.","authors":"Michael D Rosko, Kate J Li, Mona Al-Amin","doi":"10.1177/10775587241308934","DOIUrl":"10.1177/10775587241308934","url":null,"abstract":"<p><p>This study assessed the distribution of Covid Provider Relief Funds (PRFs) to 3,886 private and public general acute care hospitals during 2020-2022. Marginal effects from two-part regression were analyzed. More than 13% of study hospitals did not receive PRFs. Some targeted groups of hospitals, that is, safety-net hospitals and high-impact hospitals (those with high COVID-19 admissions), were the most likely to receive PRFs. Hospitals providing the most uncompensated care, and facilities serving counties with high concentrations of Black or Hispanic populations, were less likely to receive PRFs. Among facilities receiving subsidies, rural, high-impact, safety-net, and financially vulnerable hospitals received more PRFs in relation to their total revenues. Those serving impoverished communities received a larger proportion of PRFs relative to their total revenues, while those in areas with a high concentration of Hispanics received a smaller proportionate subsidy.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"173-183"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Urban and Rural Disparities in COVID-19 Outcomes in the United States: A Systematic Review. 美国城乡COVID-19结果差异：系统评价
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-12-10 DOI: 10.1177/10775587241298566
Jung A Kang, Denise D Quigley, Ashley M Chastain, Hsin S Ma, Jingjing Shang, Patricia W Stone
{"title":"Urban and Rural Disparities in COVID-19 Outcomes in the United States: A Systematic Review.","authors":"Jung A Kang, Denise D Quigley, Ashley M Chastain, Hsin S Ma, Jingjing Shang, Patricia W Stone","doi":"10.1177/10775587241298566","DOIUrl":"10.1177/10775587241298566","url":null,"abstract":"<p><p>This systematic review investigates disparities in COVID-19 outcomes (infections, hospitalizations, and deaths) between urban and rural populations in the United States. Of the 3,091 articles screened, 55 were selected. Most studies (<i>n</i> = 43) conducted national analyses, using 2020 data, with some extending into 2021. Findings show urban areas had higher COVID-19 cases and hospitalizations in 2020, while rural areas saw increased cases in 2021 and mixed hospitalization results. Urban areas also had higher mortality rates in 2020, with rural rates rising in 2021 and 2022. Most studies did not explore reasons for urban/rural differences. The few that did found that vulnerable groups, including racially and ethnically minoritized populations, older adults, and those with comorbidities and lower socioeconomic status and vaccination rates, experienced exacerbated disparities in rural regions. COVID-19 outcomes varied over time and by area due to population density, healthcare infrastructure, and socioeconomic factors. Tailored interventions are essential for health equity and effective policies.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"119-136"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in Caregivers' Use of the Online Medical Record Pre- and Post-COVID: Analysis of the Health Information National Trends Survey, 2018-2022. covid前后护理人员使用在线病历的变化：2018-2022年卫生信息全国趋势调查分析
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-12-09 DOI: 10.1177/10775587241298029
Minakshi Raj, TsungYen Chen, Bradley Iott, Denise Anthony
{"title":"Changes in Caregivers' Use of the Online Medical Record Pre- and Post-COVID: Analysis of the Health Information National Trends Survey, 2018-2022.","authors":"Minakshi Raj, TsungYen Chen, Bradley Iott, Denise Anthony","doi":"10.1177/10775587241298029","DOIUrl":"10.1177/10775587241298029","url":null,"abstract":"<p><p>Little is known about online medical record (OMR) use among caregivers, including changes in OMR use through the COVID-19 pandemic. This study compares OMR use among caregivers and non-caregivers before and during the COVID-19 pandemic, identifies reasons for non-use, and examines the association between caregiving status and characteristics with OMR use. Secondary data analysis of the nationally representative Health Information National Trends Survey data from 2018 to 2022 (<i>n</i> = 14,034). Caregivers were more likely to use the OMR post-COVID (51.8%) compared with pre-COVID (44.7%). Caregiving was significantly associated with increased likelihood of OMR use post-COVID (odds ratio = 1.67), but not pre-COVID. The increased use of OMR among caregivers during COVID-19 highlights the potential of OMRs as a support tool for caregivers' health and well-being. Interventions and policies to improve OMR engagement must address persisting disparities across demographic groups and encourage caregivers' OMR use to support their role and enhance their personal health management.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"184-194"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing Narrative Patterns in Health Access, Outcomes, and Behaviors Across Three Data Sets From England, the United States, and California for Sexual Minority Adults. 评估英格兰、美国和加利福尼亚三个数据集中性少数群体成年人的健康获取、结果和行为的叙述模式。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-04-01 Epub Date: 2024-10-14 DOI: 10.1177/10775587241285135
Sarah MacCarthy, Peyton Miller, Ninez A Ponce, Marc N Elliott
{"title":"Assessing Narrative Patterns in Health Access, Outcomes, and Behaviors Across Three Data Sets From England, the United States, and California for Sexual Minority Adults.","authors":"Sarah MacCarthy, Peyton Miller, Ninez A Ponce, Marc N Elliott","doi":"10.1177/10775587241285135","DOIUrl":"10.1177/10775587241285135","url":null,"abstract":"<p><p>We examined peer-reviewed publications analyzing data from the English GP Patient Survey (GPPS), U.S. National Health Interview Survey (NHIS), and California Health Interview Survey (CHIS) to explore how the health of sexual minority populations varies across settings and subgroups. We searched for English language articles published 2011-2022, screening abstracts (<i>n</i> = 112), reviewing full text (<i>n</i> = 97), and extracting data (<i>n</i> = 85). We conducted a content analysis to identify patterns across settings for sexual minority people compared with heterosexual counterparts and each other. Across all settings, sexual minority adults had poorer health care access, worse health outcomes and patient experiences, more detrimental health behaviors, and greater health care services utilization (reflecting risk awareness and need). When subgroup data were reported, differences were greater among women, except for HIV and related cancers, which were most prevalent among sexual minority men. Sexual minority people generally reported significantly worse health access, outcomes, and behaviors in all three settings.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"137-152"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evolving Dynamics of Relational Coordination: A Study of Progression of Care Huddles in Hospital Observation Services. 关系协调的演变动态：医院观察服务中的护理分组进展研究》（Progressive of Care Huddles in Hospital Observation Services）。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-02-01 Epub Date: 2024-10-12 DOI: 10.1177/10775587241284328
Paulo J Gomes, Tala Mirzaei
{"title":"Evolving Dynamics of Relational Coordination: A Study of Progression of Care Huddles in Hospital Observation Services.","authors":"Paulo J Gomes, Tala Mirzaei","doi":"10.1177/10775587241284328","DOIUrl":"10.1177/10775587241284328","url":null,"abstract":"<p><p>Health care organizations are increasingly using team huddles to enhance communication, improve patient experience, and deliver timely care. However, established practices, resource constraints, and hierarchical role dynamics can hinder the effectiveness of huddling. This study investigates the dynamics of care huddle implementation through interviews with care providers and managers of an observation unit in a U.S. hospital. Qualitative analysis of interview data reveals that huddle adoption enhances relational coordination (RC), thus highlighting the importance of both coaching interventions in fostering proactive behavior and the building of a work environment aligned toward shared goals. The findings affirm RC as a dynamic change model, examining its interplay with organizational processes and structure. The study underscores the significance of adaptations in work processes, the role of informal boundary spanners in facilitating cross-departmental coordination, and structural changes that increase autonomy for low-power actors. We offer actionable recommendations for health care organizations aiming to improve care coordination.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"88-99"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Framework for the Design of Risk-Adjustment Models in Health care Provider Payment Systems. 医疗服务提供者支付系统中风险调整模型的设计框架》（A Framework for the Design of Risk-Adjustment Models in Health Care Provider Payment Systems）。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-02-01 Epub Date: 2024-09-03 DOI: 10.1177/10775587241273355
Andreea Panturu, Richard van Kleef, Frank Eijkenaar, Daniëlle Cattel
{"title":"A Framework for the Design of Risk-Adjustment Models in Health care Provider Payment Systems.","authors":"Andreea Panturu, Richard van Kleef, Frank Eijkenaar, Daniëlle Cattel","doi":"10.1177/10775587241273355","DOIUrl":"10.1177/10775587241273355","url":null,"abstract":"<p><p>Prospective payments for health care providers require adequate risk adjustment (RA) to address systematic variation in patients' health care needs. However, the design of RA for provider payment involves many choices and difficult trade-offs between incentives for risk selection, incentives for cost control, and feasibility. Despite a growing literature, a comprehensive framework of these choices and trade-offs is lacking. This article aims to develop such a framework. Using literature review and expert consultation, we identify key design choices for RA in the context of provider payment and subsequently categorize these choices along two dimensions: (a) the choice of risk adjusters and (b) the choice of payment weights. For each design choice, we provide an overview of options, trade-offs, and key references. By making design choices and associated trade-offs explicit, our framework facilitates customizing RA design to provider payment systems, given the objectives and other characteristics of the context of interest.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"43-57"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Specialized Are Special Needs Plans? Evidence From Provider Networks. 特殊需求计划的专业化程度如何？来自医疗服务提供者网络的证据。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-02-01 Epub Date: 2024-11-19 DOI: 10.1177/10775587241296194
Grace McCormack, Rachel Wu, Mark Meiselbach
{"title":"How Specialized Are Special Needs Plans? Evidence From Provider Networks.","authors":"Grace McCormack, Rachel Wu, Mark Meiselbach","doi":"10.1177/10775587241296194","DOIUrl":"10.1177/10775587241296194","url":null,"abstract":"<p><p>Enrollment in Medicare Advantage (MA) Dual-Eligible Special Needs Plans (D-SNPs) among individuals dually eligible for Medicare and Medicaid has more than tripled over the past decade. Little is known about whether D-SNP plan design differs from standard MA plan design nor whether this design reflects the needs of dual-eligible enrollees. We characterize the degree to which D-SNPs specialize in an important plan design dimension-provider networks. We find that in 2022, 46% of D-SNPs offer networks that are distinct from the insurer's standard MA plan networks. Compared with D-SNP networks that are shared with standard MA plans, specialized D-SNP networks include more psychiatrists, Ob/Gyn's, and neurologists, providers that specialize in treating conditions more common among dually eligible enrollees. Network specialization is more common among insurers participating in the local Medicaid market and less common in provider shortage areas, suggesting investment in Medicaid and reduced provider negotiation costs may facilitate specialization.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"58-67"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Growth in Pennsylvania Hospital Administrators 1991-2020. 1991-2020 年宾夕法尼亚州医院管理人员的增长情况。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2025-02-01 Epub Date: 2024-11-19 DOI: 10.1177/10775587241297351
Lynn Unruh, Aishwarya Joshi
{"title":"Growth in Pennsylvania Hospital Administrators 1991-2020.","authors":"Lynn Unruh, Aishwarya Joshi","doi":"10.1177/10775587241297351","DOIUrl":"10.1177/10775587241297351","url":null,"abstract":"<p><p>This study describes trends in the number of administrators in Pennsylvania hospitals from 1991 to 2020, and in the proportion of administrators to other hospital staff. Data are from the Pennsylvania Department of Health and the American Hospital Association. We find that between 1991 and 2020, the average number of administrators increased by 102% (60% when adjusted for patient volume). RNs, all nurses, and total hospital staff did not increase to the same extent, so the proportion of administrators to these staff increased by 24%, 33%, and 70% respectively. Common policies for reducing administrative costs may or may not apply to reducing administrator growth. Other policies should be explored as we discover specifics about this growth. Future studies should include data from other states and lower-level administrative staff. Studies should also examine the relationship between the number and proportion of administrators and nurse staffing, costs and quality of care.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"107-113"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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