Health services research
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Health services research · Aug 2018
Meta AnalysisEffectiveness of Interventions for Breast Cancer Screening in African American Women: A Meta-Analysis.
The purpose of this study was to report the results of a meta-analysis conducted on the effects of clinical trials in breast cancer screening for African American women between 1997 and 2017. ⋯ Screening interventions are at least minimally effective for promoting mammography among African American women, but research in this area is limited to a small number of studies. More research is needed to enhance the efficacy of existing interventions and reduce the high morbidity and mortality rate of this underserved population.
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Health services research · Aug 2018
GP Practices as a One-Stop Shop: How Do Patients Perceive the Quality of Care? A Cross-Sectional Study in Thirty-Four Countries.
To contribute to the current knowledge on how a broad range of services offered by general practitioners (GPs) may contribute to the patient perceived quality and, hence, the potential benefits of primary care. ⋯ This study showed that in countries where GP practices serve as a "one-stop shop," patients perceive better quality of care, especially in the areas of accessibility and continuity of care. Therefore, primary care in a country is expected to benefit from investments in a broader range of services of GPs or other primary care physicians.
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Health services research · Aug 2018
Financial Incentives and Physician Practice Participation in Medicare's Value-Based Reforms.
To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. ⋯ Physicians organizations' prior experience and success with performance incentives were related to participation in Medicare ACO arrangements and participation in the meaningful use criteria but not to participation in Physician Compare. We conclude that Medicare must complement financial incentives with additional efforts to address the needs of practices with less experience with such incentives to promote value-based payment on a broader scale.
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Health services research · Jun 2018
Payment Reform and Health Disparities: Changes in Dialysis Modality under the New Medicare Dialysis Payment System.
To evaluate the effect of the Medicare dialysis payment reform on potential disparities in the selection of peritoneal dialysis (PD) for the treatment of end-stage renal disease (ESRD). ⋯ Despite recent growth in PD, there may be ongoing disparities in access to PD that have largely not been mitigated by the payment reform. There is potential for modifying provider financial incentives to achieve policy goals related to cost and quality of care. However, even with a substantial shift in financial incentives, separate initiatives to reduce existing disparities in care may be needed.
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Health services research · Jun 2018
Hospital Variation in Utilization of Life-Sustaining Treatments among Patients with Do Not Resuscitate Orders.
To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. ⋯ Hospitals vary widely in the scope of invasive or organ-supporting treatments provided to patients with DNR orders.