Health services research
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Health services research · Jun 2009
The within-year concentration of medical care: implications for family out-of-pocket expenditure burdens.
To examine the within-year concentration of family health care and the resulting exposure of families to short periods of high expenditure burdens. ⋯ Within-year spikes in health care utilization can create financial pressures missed by conventional annual burden analyses. Within-year health-related financial pressures may be especially acute among lower-income families due to low asset holdings.
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Health services research · Jun 2009
Effects of the Premier Hospital Quality Incentive Demonstration on Medicare patient mortality and cost.
To evaluate the effects of the Premier Inc. and Centers for Medicare and Medicaid Services Hospital Quality Incentive Demonstration (PHQID), a public quality reporting and pay-for-performance (P4P) program, on Medicare patient mortality, cost, and outlier classification. ⋯ By not reducing mortality or cost growth, this study suggests that the PHQID has made little impact on the value of inpatient care purchased by Medicare.
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Health services research · Jun 2009
The relationship between hospital volume and mortality in mechanical ventilation: an instrumental variable analysis.
To examine the relationship between hospital volume and mortality for nonsurgical patients receiving mechanical ventilation. ⋯ Care in higher volume hospitals is independently associated with a reduction in mortality for patients receiving mechanical ventilation. Adequate risk adjustment is essential in order to obtained unbiased estimates of the volume-outcome relationship.