Health services research
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Health services research · Feb 2010
The role of outpatient facilities in explaining variations in risk-adjusted readmission rates between hospitals.
Validate risk-adjusted readmission rates as a measure of inpatient quality of care after accounting for outpatient facilities, using premature infants as a test case. ⋯ Ignoring outpatient facilities leads to an overstatement of the effect of NICUs on readmissions and ignores a significant cause of variations in readmissions.
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Health services research · Dec 2009
Comparative StudyVariation in emergency department wait times for children by race/ethnicity and payment source.
To quantify the variation in emergency department (ED) wait times by patient race/ethnicity and payment source, and to divide the overall association into between- and within-hospital components. ⋯ There are sizable racial/ethnic differences in children's ED wait times that can be attributed to both the racial/ethnic mix of children in EDs and to differential treatment by race/ethnicity inside the ED.
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Health services research · Dec 2009
Hospice characteristics and the disenrollment of patients with cancer.
To characterize the types of hospices with higher rates of patient disenrollment from the Medicare Hospice Benefit and the markets in which these hospices operate. ⋯ The reasons for higher disenrollment rates for newer hospices, for smaller hospices, and for hospices in highly competitive markets are likely complex; however, results suggest that there are organizational-level barriers to keeping patients with cancer enrolled with hospice. Variation across fiscal intermediaries may indicate that regulatory oversight, particularly of long-stay patients, influences hospice disenrollment.
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Health services research · Dec 2009
Role and involvement of life end information forum physicians in euthanasia and other end-of-life care decisions in Flanders, Belgium.
To describe role and involvement of Life End Information Forum (LEIF) physicians in end-of-life care decisions and euthanasia in Flanders. ⋯ LEIF physicians provide a forum for information and advice for physicians and patients. A similar health service providing support to physicians for all end-of-life decisions could also be beneficial for countries without a euthanasia law.
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Health services research · Oct 2009
Comparative StudyValidating household reports of health care use in the medical expenditure panel survey.
The Medical Expenditure Panel Survey (MEPS) is a widely used nationally representative survey of health care use and expenditures. Numerous studies raise concerns that use is underreported in household surveys. ⋯ Household respondents in the validation sample accurately report inpatient hospitalizations but underreport ED and office visits. Behavioral analyses are largely unaffected because underreporting cuts across all sociodemographic groups.