Health services research
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Health services research · Jun 2003
Comparative StudyLength of stay, conditional length of stay, and prolonged stay in pediatric asthma.
To understand differences in length of stay for asthma patients between New York State and Pennsylvania across children's and general hospitals in order to better guide policy. ⋯ Management of asthma appears more efficient in Pennsylvania than New York: Less severe patients are discharged faster in Pennsylvania than New York; once discharged, patients are less likely to be readmitted in Pennsylvania than New York. However, once a stay is prolonged, there is little difference between New York and Pennsylvania, suggesting medical care for severely ill patients is similar across states. Differences between children's and general hospitals were small as compared to differences between states. We conclude that policy initiatives in New York, and other states, should focus their efforts on improving the care provided to less severe patients in order to help reduce overall length of stay.
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Health services research · Jun 2003
Race/ethnicity, language, and patients' assessments of care in Medicaid managed care.
Consumer assessments of health care provide important information about how well health plans and clinicians meet the needs of the people they serve. The purpose of this study was to examine whether consumer reports and ratings of care in Medicaid managed care vary by race/ethnicity and language. ⋯ This study suggests that racial and ethnic minorities and persons with limited English proficiency face barriers to care, despite Medicaid-enabled financial access. Health care organizations should address the observed disparities in access to care for racial/ethnic and linguistic minorities as part of their quality improvement efforts.
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Health services research · Jun 2003
The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care.
To examine the extent to which health insurance coverage and available safety net resources reduced racial and ethnic disparities in access to care. ⋯ Lack of health insurance was the single most important factor in white-Hispanic differences for all three measures and for two of the white-African American differences. Income differences were the second most important factor, with one exception. Community characteristics generally were much less important, with one exception. The positive effects of insurance coverage in reducing disparities outweigh benefits of increasing physician charity care or access to emergency rooms.