Medical Care Research and Review最新文献_第7页

Administrator Perspectives on the Impact of COVID-19 on the Administration of the Patient Driven Payment Model in U.S. Skilled Nursing Facilities. 管理者对 COVID-19 对美国专业护理机构患者驱动付费模式管理影响的看法。

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-06-01 Epub Date: 2024-02-29 DOI: 10.1177/10775587241233018

Amy Meehan, Joan F Brazier, David C Grabowski, Momotazur Rahman, Renee R Shield, Emily A Gadbois

{"title":"Administrator Perspectives on the Impact of COVID-19 on the Administration of the Patient Driven Payment Model in U.S. Skilled Nursing Facilities.","authors":"Amy Meehan, Joan F Brazier, David C Grabowski, Momotazur Rahman, Renee R Shield, Emily A Gadbois","doi":"10.1177/10775587241233018","DOIUrl":"10.1177/10775587241233018","url":null,"abstract":"The Patient Driven Payment Model (PDPM) was implemented in U.S. skilled nursing facilities (SNFs) in October 2019, shortly before COVID-19. This new payment model aimed to reimburse SNFs for patients' nursing needs rather than the previous model which reimbursed based on the volume of therapy received. Through 156 semi-structured interviews with 40 SNF administrators from July 2020 to December 2021, this qualitative study clarifies the impact of COVID-19 on the administration of PDPM at SNFs. Interview data were analyzed using modified grounded theory and thematic analysis. Our findings show that SNF administrators shifted focus from management of the PDPM to COVID-19-related delivery of care adaptations, staff shortfalls, and decreased admissions. As the pandemic abated, administrators re-focused their attention to PDPM. Policy makers should consider the continued impacts of the pandemic at SNFs, particularly on delivery of care, admissions, and staffing, on the ability of SNF administrators to administer a new payment model.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"223-232"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991789","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

Interventions and Hospital Characteristics Associated With Patient Experience: An Update of the Evidence. 与患者体验相关的干预措施和医院特征：最新证据。

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-06-01 Epub Date: 2024-01-18 DOI: 10.1177/10775587231223292

Megan K Beckett, Denise D Quigley, William G Lehrman, Laura A Giordano, Christopher W Cohea, Elizabeth H Goldstein, Marc N Elliott

{"title":"Interventions and Hospital Characteristics Associated With Patient Experience: An Update of the Evidence.","authors":"Megan K Beckett, Denise D Quigley, William G Lehrman, Laura A Giordano, Christopher W Cohea, Elizabeth H Goldstein, Marc N Elliott","doi":"10.1177/10775587231223292","DOIUrl":"10.1177/10775587231223292","url":null,"abstract":"Patient experience is a key hospital quality measure. We review and characterize the literature on interventions, care and management processes, and structural characteristics associated with better inpatient experiences as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Prior reviews identified several promising interventions. We update these previous efforts by including more recent peer-reviewed literature and expanding the review's scope to include observational studies of HCAHPS measures with process measures and structural characteristics. We used PubMed to identify U.S. English-language peer-reviewed articles published in 2017 to 2020 and focused on hospital patient experience. The two HCAHPS domains for which we found the fewest potential quality improvement interventions were Communication with Doctors and Quietness. We identified several modifiable processes that could be rigorously evaluated in the future, including electronic health record patient engagement functionality, care management processes, and nurse-to-patient ratios. We describe implications for future policy, practice, and research.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"195-208"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492868","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

Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes. 养老院护理员的职业倦怠及其对住院结果的影响。

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-06-01 Epub Date: 2023-12-30 DOI: 10.1177/10775587231220072

Andrea Gruneir, Stephanie A Chamberlain, Charlotte Jensen, Greta Cummings, Matthias Hoben, Sheila Boamah, Clarisse Bosco, Sadaf Ekhlas, Sascha R Bolt, Tim Rappon, Whitney B Berta, Janet Squires, Carole A Estabrooks

{"title":"Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes.","authors":"Andrea Gruneir, Stephanie A Chamberlain, Charlotte Jensen, Greta Cummings, Matthias Hoben, Sheila Boamah, Clarisse Bosco, Sadaf Ekhlas, Sascha R Bolt, Tim Rappon, Whitney B Berta, Janet Squires, Carole A Estabrooks","doi":"10.1177/10775587231220072","DOIUrl":"10.1177/10775587231220072","url":null,"abstract":"While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014-2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work-life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"233-244"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075793","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

Assessing Health Care Utilization and Spending Among Older Medicare Beneficiaries With and Without HIV. 评估感染和未感染艾滋病毒的老年医疗保险受益人的医疗保健利用和支出。

IF 2.4 3区医学

Medical Care Research and Review Pub Date : 2024-06-01 Epub Date: 2023-09-28 DOI: 10.1177/10775587231198903

Gina Turrini, Stephanie S Chan, Pamela W Klein, Stacy M Cohen, Sally C Stearns, Antigone Dempsey, Heather Hauck, Laura W Cheever, Andre R Chappel

引用次数: 0

Investing in Child Health Through Alternative Payment Models: Lessons From North Carolina Integrated Care for Kids. 通过替代支付模式投资儿童健康：北卡罗来纳州儿童综合护理的经验教训。

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-06-01 Epub Date: 2023-12-29 DOI: 10.1177/10775587231217178

Greeshma James, Elizabeth Kasper, Charlene A Wong, David M Anderson, Sarah Allin, Michael J Steiner, Kori B Flower, Daniel Kimberg, Rushina Cholera

{"title":"Investing in Child Health Through Alternative Payment Models: Lessons From North Carolina Integrated Care for Kids.","authors":"Greeshma James, Elizabeth Kasper, Charlene A Wong, David M Anderson, Sarah Allin, Michael J Steiner, Kori B Flower, Daniel Kimberg, Rushina Cholera","doi":"10.1177/10775587231217178","DOIUrl":"10.1177/10775587231217178","url":null,"abstract":"Pediatric value-based payment reform has been hindered by limited return on investment (ROI) for child-focused measures and the accrual of financial benefits to non-health care sectors. States participating in the federally-funded Integrated Care for Kids (InCK) models are required to design child-centered alternative payment models (APMs) for Medicaid-enrolled children. The North Carolina InCK pediatric APM launched in January 2023 and includes innovative measures focused on school readiness and social needs. We interviewed experts at NC Medicaid managed care organizations, NC Medicaid, and actuaries with pediatric value-based payment experience to assess the NC InCK APM design process and develop strategies for future child-focused value-based payment reform. Key principles emerging from conversations included: accounting for payer priorities and readiness to implement measures; impact of data uncertainty on investment in novel measures; misalignment of a short-term ROI framework with whole child health measures; and state levers like mandates and financial incentives to promote implementation.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"259-270"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075794","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

Scope and Incentives for Risk Selection in Health Insurance Markets With Regulated Competition: A Conceptual Framework and International Comparison. 有监管竞争的健康保险市场中风险选择的范围和激励机制：概念框架与国际比较》。

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-06-01 Epub Date: 2024-01-29 DOI: 10.1177/10775587231222584

Richard C van Kleef, Mieke Reuser, Thomas G McGuire, John Armstrong, Konstantin Beck, Shuli Brammli-Greenberg, Randall P Ellis, Francesco Paolucci, Erik Schokkaert, Juergen Wasem

{"title":"Scope and Incentives for Risk Selection in Health Insurance Markets With Regulated Competition: A Conceptual Framework and International Comparison.","authors":"Richard C van Kleef, Mieke Reuser, Thomas G McGuire, John Armstrong, Konstantin Beck, Shuli Brammli-Greenberg, Randall P Ellis, Francesco Paolucci, Erik Schokkaert, Juergen Wasem","doi":"10.1177/10775587231222584","DOIUrl":"10.1177/10775587231222584","url":null,"abstract":"In health insurance markets with regulated competition, regulators face the challenge of preventing risk selection. This paper provides a framework for analyzing the scope (i.e., potential actions by insurers and consumers) and incentives for risk selection in such markets. Our approach consists of three steps. First, we describe four types of risk selection: (a) selection by consumers in and out of the market, (b) selection by consumers between high- and low-value plans, (c) selection by insurers via plan design, and (d) selection by insurers via other channels such as marketing, customer service, and supplementary insurance. In a second step, we develop a conceptual framework of how regulation and features of health insurance markets affect the scope and incentives for risk selection along these four dimensions. In a third step, we use this framework to compare nine health insurance markets with regulated competition in Australia, Europe, Israel, and the United States.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"175-194"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571034","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

Corrigendum to “Coding Intensity through Health Risk Assessments and Chart Reviews in Medicare Advantage: Does It Explain Resource Use?” 医疗保险优势计划中通过健康风险评估和病历审查进行的编码强度：它能解释资源使用情况吗？

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-04-29 DOI: 10.1177/10775587241245200

引用次数: 0

The Impact of Medicaid Accountable Care Organizations on Health Care Utilization, Quality Measures, Health Outcomes and Costs from 2012 to 2023: A Scoping Review 2012 年至 2023 年医疗补助责任医疗组织对医疗保健使用、质量措施、健康结果和成本的影响：范围审查

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-04-15 DOI: 10.1177/10775587241241984

Julie Holm, José A. Pagán, Diana Silver

引用次数: 0

Commercial Insurer Market Power and Medicaid Managed Care Networks 商业保险公司的市场力量与医疗补助管理式医疗网络

IF 2.5 3区医学

Medical Care Research and Review Pub Date : 2024-04-05 DOI: 10.1177/10775587241241975

Jeffrey Marr, Daniel Polsky, Mark K. Meiselbach

引用次数: 0

The Impact of Prescription Drug Coverage on Disparities in Adherence and Medication Use: A Systematic Review. 处方药保险对坚持用药和用药差异的影响：系统回顾。

IF 2.4 3区医学

Medical Care Research and Review Pub Date : 2024-04-01 Epub Date: 2024-01-04 DOI: 10.1177/10775587231218050

Cameron M Kaplan, Teresa M Waters, Emily R Clear, Elizabeth E Graves, Stephanie Henderson

{"title":"The Impact of Prescription Drug Coverage on Disparities in Adherence and Medication Use: A Systematic Review.","authors":"Cameron M Kaplan, Teresa M Waters, Emily R Clear, Elizabeth E Graves, Stephanie Henderson","doi":"10.1177/10775587231218050","DOIUrl":"10.1177/10775587231218050","url":null,"abstract":"Prescription drug cost-sharing is a barrier to medication adherence, particularly for low-income and minority populations. In this systematic review, we examined the impact of prescription drug cost-sharing and policies to reduce cost-sharing on racial/ethnic and income disparities in medication utilization. We screened 2,145 titles and abstracts and identified 19 peer-reviewed papers that examined the interaction between cost-sharing and racial/ethnic and income disparities in medication adherence or utilization. We found weak but inconsistent evidence that lower cost-sharing is associated with reduced disparities in adherence and utilization, but studies consistently found that significant disparities remained even after adjusting for differences in cost-sharing across individuals. Study designs varied in their ability to measure the causal effect of policy or cost-sharing changes on disparities, and a wide range of policies were examined across studies. Further research is needed to identify the types of policies that are best suited to reduce disparities in medication adherence.","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":" ","pages":"87-95"},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089339","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