The American journal of managed care
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Our goal was to present detailed descriptive data on transaction prices paid by commercial insurers and their enrollees for inpatient hospital care. ⋯ Unadjusted inpatient hospital prices per admission grew by 8.2% per year from 2008 to 2010 for the commercially insured population (under age 65 years) in the MarketScan data set. We estimate that approximately 1.3 to 1.9 percentage points of the growth in prices can be attributed to increased intensity per admission. Thus, we estimate that intensity-adjusted price increases ranged from 6.2% to 6.8% annually in the 2008-2010 period. Price levels and trends varied considerably across admission types, states, and localities.
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Many patients experience difficulty in adhering to medication for both physical and mental health. Our objective was to compare selfreported adherence and electronic monitoring of adherence to oral hypoglycemic agents and antidepressants and to examine the relationship of adherence with clinical outcomes. ⋯ Compared with electronic monitoring of adherence, self-reported adherence tended to overestimate medication adherence. Electronic monitoring of adherence to oral hypoglycemic agents predicted glycemic control, but self-reported adherence did not predict clinical outcomes.
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To examine patient, hospital, and geographic characteristics influencing variation in computed tomography (CT) scan use in inpatients in New York State. ⋯ After controlling for patient and hospital characteristics, significant geographic variation remained at the level of the county, which indicates that additional research investigating the use of CT scans is necessary to understand the reasons behind small-area variation. Understanding the distribution and practice patterns of specific physician specialties may be helpful in curtailing underuse and overuse.
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To determine patient, clinical, and hospital factors associated with receiving total hip arthroplasty (THA) and hemiarthroplasty (HA) in the United States. ⋯ Similarities and differences in patient, clinical, and hospital factors associated with surgical treatments of hip fracture warrant the attention of providers and payers.