Health services research
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Health services research · Feb 2017
Estimating Surgical Procedure Times Using Anesthesia Billing Data and Operating Room Records.
The median time required to perform a surgical procedure is important in determining payment under Medicare's physician fee schedule. Prior studies have demonstrated that the current methodology of using physician surveys to determine surgical times results in overstated times. To measure surgical times more accurately, we developed and validated a methodology using available data from anesthesia billing data and operating room (OR) records. ⋯ Anesthesia and OR times can be used to measure surgical time and thereby improve the payment for surgical procedures in the Medicare fee schedule.
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Health services research · Feb 2017
Identifying Older Adults with Serious Illness: A Critical Step toward Improving the Value of Health Care.
To create and test three prospective, increasingly restrictive definitions of serious illness. ⋯ Prospective identification of older adults with serious illness is feasible using clinically accessible criteria and may be a critical step toward improving health care value. These definitions may aid clinicians and health systems in targeting patients who could benefit from additional services.
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Health services research · Feb 2017
Impact of State Public Health Spending on Disease Incidence in the United States from 1980 to 2009.
To understand the relationship between state-level spending by public health departments and the incidence of three vaccine preventable diseases (VPDs): mumps, pertussis, and rubella in the United States from 1980 to 2009. ⋯ Our analysis indicates that there is evidence of a significant, negative relationship between a state's public health spending and the incidence of two VPDs, mumps and rubella, in the United States.
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Health services research · Feb 2017
Understanding Racial and Ethnic Disparities in Postsurgical Complications Occurring in U.S. Hospitals.
To examine the role of patient, hospital, and community characteristics on racial and ethnic disparities in in-hospital postsurgical complications. ⋯ Race does not appear to be an important determinant of in-hospital postsurgical complications, but insurance and community characteristics have an effect. A population-based approach that includes improving the socioeconomic context may help reduce disparities in these outcomes.
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Health services research · Feb 2017
Perspectives: Using Results from HRSA's Health Workforce Simulation Model to Examine the Geography of Primary Care.
Inform health planning and policy discussions by describing Health Resources and Services Administration's (HRSA's) Health Workforce Simulation Model (HWSM) and examining the HWSM's 2025 supply and demand projections for primary care physicians, nurse practitioners (NPs), and physician assistants (PAs). ⋯ Primary care physician shortages are projected for all parts of the United States, while primary care PA shortages are generally confined to Midwestern and Southern states. No state is projected to have shortages of all three provider types. Projected shortages must be considered in the context of baseline assumptions regarding current supply, demand, provider-service ratios, and other factors. Still, these findings suggest geographies with possible primary care workforce shortages in 2025 and offer opportunities for targeting efforts to enhance workforce flexibility.