Health services research
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Health services research · Jan 1983
Comparative StudyA comparison of alternative medicare reimbursement policies under optimal hospital pricing.
This paper applies and extends the use of a nonlinear hospital pricing model, recently posited in the literature by Dittman and Morey [1]. That model applied a hospital profit-maximizing behavior and studied the effects of optimal pricing of hospital ancillary services on the incidence of payment by private insurance companies and the Medicare trust fund. ⋯ The policies differ according to hospital size and whether cross-subsidies are allowed. We are interested in determining the effects of profit-maximizing and -satisficing behaviors of these three reimbursement policies on the levels of profits received, and on the respective implications for private payors and the Medicare trust fund.
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Health services research · Jan 1982
Quality assurance as a managerial innovation: a research perspective.
Quality assurance is defined and concepts from innovation theory are applied to the study of quality assurance programs. Two distinct although not mutually exclusive perspectives on innovation are considered--the diffusion perspective, focusing on the innovation itself and its implementation, and the adoption perspective, highlighting factors characteristic of the adoption unit (i.e., the organization or individuals within it) that facilitate or impede the adoption process. Directions for future research are suggested.
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A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose.
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A recent paper on the concepts underlying six indexes of severity that have been proposed for health services research claimed to identify deficiencies in each. A close examination reveals that the criticisms are generally without substance, and that the claim that the indexes "violate some of the principles implied by their formulation" is in error. ⋯ Two of the indexes in question, the Abbreviated Injury Scale AIS) and the Injury Severity Score (ISS), have been validated and are being used widely both in the United States and elsewhere as the principal descriptors of trauma in motor vehicle crashes. The use of these indexes has contributed significantly to motor vehicle crash research and to the improvements in vehicles and highways that are reducing the trauma resulting from such crashes.