Health services research
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Health services research · Jun 2000
Comparative StudyChildren of working low-income families in California: does parental work benefit children's insurance status, access, and utilization of primary health care?
To examine financial and nonfinancial access to care and utilization of primary health care services among children of working low-income families earning below 200 percent of the federal poverty level in California, and to compare them to children in nonworking low-income families and in families earning over 200 percent of poverty. ⋯ Children in working low-income families in California have some of the worst access problems. Even full attachment to the workforce does not guarantee health insurance benefits, access to care, or improved health care use for children of low-income parents. These children are not better off than other low-income children of nonworking parents and are much worse off than nonpoor children. Expansion of health insurance coverage through Healthy Families and Medi-Cal, and attention to nonfinancial barriers to care for working low-income families may help to reduce these disparities.
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Health services research · Jun 2000
Effect of multiple-source entry on price competition after patent expiration in the pharmaceutical industry.
To analyze the effect of multiple-source drug entry on price competition after patent expiration in the pharmaceutical industry. ⋯ After patent expiration, multiple-source drugs compete largely with other multiple-source drugs in the price-sensitive sector, but indirectly with the originator in the price-insensitive sector. Originators have first-mover advantages, and therefore have a market that is less price sensitive after multiple-source drugs enter. On the other hand, multiple-source drugs target the price-sensitive sector, using their lower-priced drugs. This trend may indicate that the off-patented market is imperfectly segmented between the price-sensitive and insensitive sector. Consumers as a whole can gain from the entry of multiple-source drugs because the average price of the market continually declines after patent expiration.
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Health services research · Apr 2000
Uninsured and unstably insured: the importance of continuous insurance coverage.
To examine the importance of continuous health insurance for access to care by comparing the access and cost experiences of insured adults with a recent time uninsured to the experiences of currently uninsured adults and experiences of adults with no time uninsured within a reference time period (continuously insured). ⋯ Studies that focus on current insurance status alone will underestimate the extent to which having a time uninsured during the year contributes to access difficulties and undermines quality of care, and will underestimate the proportion of the population at risk because they are uninsured. Policy reforms are needed to maintain continuous insurance coverage and avoid spells uninsured. Currently uninsured and unstably insured adults are both at high risk.
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Health services research · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialAre nonspecific practice guidelines potentially harmful? A randomized comparison of the effect of nonspecific versus specific guidelines on physician decision making.
To test the ability of two different clinical practice guideline formats to influence physician ordering of electrodiagnostic tests in low back pain. ⋯ The clarity and clinical applicability of a guideline may be important attributes that contribute to the effects of practice guidelines.
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Health services research · Mar 2000
Comparative StudyMultiple approaches to assessing the effects of delays for hip fracture patients in the United States and Canada.
To examine the determinants of postsurgery length of stay (LOS) and inpatient mortality in the United States (California and Massachusetts) and Canada (Manitoba and Quebec). ⋯ Statistical models that account for censoring and confounding yield conclusions that differ from those implied by descriptive statistics in administrative data. Longer wait time for hip fracture surgery does not explain the difference in postsurgery outcomes across countries.