Health services research
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Health services research · Feb 2005
Comparative Study Clinical Trial Controlled Clinical TrialIncentives in a Medicaid carve-out: impact on children with special health care needs.
To evaluate whether a specialty care payment "carve-out" from Medicaid managed care affects caseloads and expenditures for children with chronic conditions. ⋯ The carve-out policy increased identification of children with special health care needs. The policy may have improved children's access to prevailing standards of care by motivating health plans and providers to identify and refer children to an important national program.
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Health services research · Feb 2005
Multicenter Study Clinical Trial Controlled Clinical TrialThe "minimizing antibiotic resistance in Colorado" project: impact of patient education in improving antibiotic use in private office practices.
To assess the marginal impact of patient education on antibiotic prescribing to children with pharyngitis and adults with acute bronchitis in private office practices. ⋯ In office practices, there appears to be little room for improvement in antibiotic prescription rates for children with pharyngitis. In contrast, patient education helps reduce antibiotic use for adults with acute bronchitis beyond that achieved by physician-directed efforts.
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Health services research · Feb 2005
Self-medication of mental health problems: new evidence from a national survey.
To evaluate the association between past 30-day use of alcohol, marijuana, and other illicit drugs and past year unmet need for and use of mental health care. ⋯ Substance use varies with past year unmet need for mental health care and mental health care use in ways consistent with the self-medication hypothesis. Results suggest that timely screening and treatment of mental health problems may prevent the development of substance-use disorders among those with mental disorders. Further research should identify subgroups of individuals for whom timely and appropriate mental health treatment would prevent the development of substance-use disorders.
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Health services research · Feb 2005
Comparative StudyApplication of a propensity score approach for risk adjustment in profiling multiple physician groups on asthma care.
To develop a propensity score-based risk adjustment method to estimate the performance of 20 physician groups and to compare performance rankings using our method to a standard hierarchical regression-based risk adjustment method. ⋯ We developed and tested a propensity score method for profiling multiple physician groups. We found that our method could balance the distributions of covariates across groups and yielded substantially different profiles compared with conventional methods. Propensity score-based risk adjustment should be considered in studies examining quality comparisons.
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Health services research · Dec 2004
To prevent, react, and rebuild: health research and the prevention of genocide.
To develop an approach to the primary prevention of genocide, based on established public health-based violence prevention methods derived from a variety of high-risk settings. ⋯ Our analysis suggests that genocide is one of the most pressing threats to the health of populations in the twenty-first century. Recent advances in the public health discipline of violence prevention provide a blueprint for approaches to primary genocide prevention based on epidemiological methods.