Health services research
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Health services research · Aug 2010
The relationship between patients' perception of care and measures of hospital quality and safety.
The extent to which patient experiences with hospital care are related to other measures of hospital quality and safety is unknown. METHODS; We examined the relationship between Hospital Consumer Assessment of Healthcare Providers and Systems scores and technical measures of quality and safety using service-line specific data in 927 hospitals. We used data from the Hospital Quality Alliance to assess technical performance in medical and surgical processes of care and calculated Patient Safety Indicators to measure medical and surgical complication rates. ⋯ Patient experiences of care were related to measures of technical quality of care, supporting their validity as summary measures of hospital quality. Further study may elucidate implications of these relationships for improving hospital care.
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Health services research · Jun 2010
Relationship between clinical conditions and use of Veterans Affairs health care among Medicare-enrolled veterans.
To determine how reliance on Veterans Affairs (VA) for medical care among veterans enrolled in Medicare is affected by medical conditions, access, and patient characteristics. ⋯ Many dually enrolled Veterans use both Medicare and VA health care. Age, accessibility, and priority level for VA services have a clear relationship with VA reliance. Because dual use is common, coordination of care among health care settings for such patients should be a policy priority.
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Health services research · Jun 2010
Comparative StudyReexploring differences among for-profit and nonprofit dialysis providers.
To determine whether profit status is associated with differences in hospital days per patient, an outcome that may also be influenced by provider financial goals. ⋯ Hospital days per patient-year were statistically and clinically significantly lower among nonprofit dialysis providers. These findings suggest that the indirect incentives in Medicare's current payment system may provide insufficient incentive for for-profit providers to achieve optimal patient outcomes.
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Health services research · Jun 2010
Market variations in intensity of Medicare service use and beneficiary experiences with care.
Examine associations between patient experiences with care and service use across markets. ⋯ Medicare beneficiaries in markets characterized by high service use did not report better experiences with care. This trend was strongest for those in managed care.
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Health services research · Feb 2010
Assessing Heterogeneity of Treatment Effects: Are Authors Misinterpreting Their Results?
To determine whether investigations of heterogeneity of treatment effects (HTE) in randomized-controlled trials (RCTs) are prespecified and whether authors' interpretations of their analyses are consistent with the objective evidence. ⋯ Inconsistencies in performance and reporting may limit the potential of HTE analysis as a tool for identifying HTE and individualizing care in diverse populations. Recommendations for future studies on the reporting and interpretation of HTE analyses are provided.