FN Thomson Reuters Web of Science™ VR 1.0 PT J AU NAYLOR, M BROOTEN, D JONES, R LAVIZZOMOUREY, R MEZEY, M PAULY, M AF NAYLOR, M BROOTEN, D JONES, R LAVIZZOMOUREY, R MEZEY, M PAULY, M TI COMPREHENSIVE DISCHARGE PLANNING FOR THE HOSPITALIZED ELDERLY - A RANDOMIZED CLINICAL-TRIAL SO ANNALS OF INTERNAL MEDICINE LA English DT Article DE COST SAVINGS; OUTCOME ASSESSMENT (HEALTH CARE) ID PROSPECTIVE PAYMENT SYSTEM; POSTHOSPITAL NEEDS; CARE; READMISSIONS; QUALITY AB Objective: To study the effects of a comprehensive discharge planning protocol, designed specifically for the elderly and implemented by nurse specialists, on patient and caregiver outcomes and cost of care. Design: Randomized clinical trial. Setting: Hospital of the University of Pennsylvania. Patients: 276 patients and 125 caregivers. Patients were 70 years and older and were placed in selected medical and surgical cardiac diagnostic-related groups. Measurements: Group differences in patient outcomes (length of initial hospital stay, length of time between initial hospital discharge and readmission, and rehospitalization rates) and charges for care (charges for initial hospitalization, rehospitalizations, health services after discharge, and nurse specialist services) were measured 2, 6, and 12 weeks after discharge. Results: From the initial hospital discharge to 6 weeks after discharge, patients in the medical intervention group had fewer readmissions, fewer total days rehospitalized, lower readmission charges, and lower charges for health care services after discharge. No differences in these outcomes were found between the surgical intervention and control groups during this period. Conclusions: Study findings support the need for comprehensive discharge planning designed for the elderly and implemented by nurse specialists to improve their outcomes after hospital discharge and to achieve cost savings. The findings also suggest that this intervention had its greatest effect in delaying or preventing rehospitalization of patients in the medical intervention group during the first 6 weeks after discharge. C1 US DEPT HHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. NYU,DIV NURSING,NEW YORK,NY 10003. UNIV PENN,WHARTON SCH,PHILADELPHIA,PA 19104. UNIV PENN,LEONARD DAVIS INST HLTH ECON,PHILADELPHIA,PA 19104. RP NAYLOR, M (reprint author), UNIV PENN,SCH NURSING,420 GUARDIAN DR,PHILADELPHIA,PA 19104, USA. FU NINR NIH HHS [NR02095-05, R01 NR002095] NR 21 TC 363 Z9 369 U1 2 U2 10 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 15 PY 1994 VL 120 IS 12 BP 999 EP 1006 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA NQ964 UT WOS:A1994NQ96400005 PM 8185149 ER PT J AU GREENE, R BONDY, PK MAKLAN, CW AF GREENE, R BONDY, PK MAKLAN, CW TI THE NATIONAL MEDICAL EFFECTIVENESS RESEARCH INITIATIVE - THE SEARCH FOR WHAT REALLY WORKS IN TREATING COMMON CLINICAL CONDITIONS SO DIABETES CARE LA English DT Article; Proceedings Paper CT Symposium on Diabetes Translation: A Blueprint for the Future CY SEP 24-25, 1992 CL INT DIABETES CTR, MINNEAPOLIS, MN HO INT DIABETES CTR AB In 1989, Congress established the Agency for Health Care Policy and Research within the U.S. Public Health Service and gave it the lead in a national effort to produce reliable evidence of which medical treatments are effective and which are not. The research program addresses the effectiveness of different available strategies for diagnosis, prevention, treatment, and management of common conditions, including diabetes, and emphasizes outcomes that matter to patients. The modest size of this program and the eagerness for its results have led to the development and use of innovative research methods. Illustrations of these methods and early findings are provided. RP GREENE, R (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,CTR MED EFFECTIVENESS RES,2101 E JEFFERSON ST,SUITE 605,ROCKVILLE,MD 20852, USA. NR 4 TC 1 Z9 1 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JUN PY 1994 VL 17 SU 1 BP 45 EP 49 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA NP865 UT WOS:A1994NP86500009 PM 8088223 ER PT J AU SHORT, PF KEMPER, P AF SHORT, PF KEMPER, P TI NURSING-HOME FINANCING REFORM - HOW WOULD IT AFFECT EXPENDITURES FOR NURSING-HOME CARE SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID LONG-TERM CARE AB There are a number of proposals to expand substantially public financing of nursing home care. Included among the major elements of these proposals are front-end benefits limited to three or six months, back-end benefits with waiting periods of one or two years, and coverage of all nursing home days with or without substantial income-related cost sharing. Using data from the 1987 National Medical Expenditure Survey, this paper simulates the effect of these proposed changes in nursing home financing on public expenditures, Medicaid expenditures, and private expenditures (in total and by marital status and income group). The incentive for increased use of nursing home care also is examined. A short front-end benefit, the least expensive option in terms of public expenditures, increases public expenditures by $1 billion to $2 billion in 1987. Comprehensive coverage of all nursing home days increases public costs by $9 billion to $10 billion dollars, depending on the cost-sharing arrangement. There is wide variation in the range of plausible estimates because of uncertainty about the effect of increased public coverage of nursing home care on utilization. RP SHORT, PF (reprint author), AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,DIV LONG TERM CARE STUDIES,SUITE 500,ROCKVILLE,MD 20852, USA. NR 18 TC 2 Z9 2 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSOC PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD SUM PY 1994 VL 31 IS 2 BP 141 EP 152 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA NW868 UT WOS:A1994NW86800005 PM 8021020 ER PT J AU GAUS, CR AF GAUS, CR TI HEALTH-CARE DATA SO ISSUES IN SCIENCE AND TECHNOLOGY LA English DT Letter RP GAUS, CR (reprint author), US DEPT HHS,PUBL HLTH SERV,AGCY HLTH CARE POLICY & RES,WASHINGTON,DC 20201, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 SN 0748-5492 J9 ISSUES SCI TECHNOL JI Issues Sci. Technol. PD SUM PY 1994 VL 10 IS 4 BP 10 EP & PG 0 WC Engineering, Multidisciplinary; Engineering, Industrial; Multidisciplinary Sciences; Social Issues SC Engineering; Science & Technology - Other Topics; Social Issues GA NX340 UT WOS:A1994NX34000010 ER PT J AU SELDEN, T AF SELDEN, T TI SUING FOR MEDICAL MALPRACTICE - SLOAN,FA, GITHENS,PB, CLAYTON,EW, HICKSON,GB, GENTILE,DA, PARTLETT,DF SO JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION LA English DT Book Review RP SELDEN, T (reprint author), AGCY HLTH CARE POLICY RES,ROCKVILLE,MD 20852, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-2681 J9 J ECON BEHAV ORGAN JI J. Econ. Behav. Organ. PD JUN PY 1994 VL 24 IS 1 BP 122 EP 125 DI 10.1016/0167-2681(94)90059-0 PG 4 WC Economics SC Business & Economics GA NY357 UT WOS:A1994NY35700009 ER PT J AU SPECTOR, WD AF SPECTOR, WD TI CORRELATES OF PRESSURE SORES IN NURSING-HOMES - EVIDENCE FROM THE NATIONAL MEDICAL EXPENDITURE SURVEY SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Article; Proceedings Paper CT Workshop on the Epidemiology of Skin Diseases CY MAR 25-26, 1993 CL BETHESDA, MD SP NIAMSD DE NURSING HOMES; LONG TERM CARE; SKIN ULCERS; QUALITY ID ULCERS; RISK AB Pressure sores are a serious medical problem that is most commonly found in nursing homes and hospitals. Most sores can be prevented. To prevent pressure sores in nursing homes through intervention, it is first necessary to identify factors associated with sore formation. Factors associated with the formation of pressure sores relate to skin susceptibility combined with the presence of moisture, constant pressure, and shear force or friction on the skin. This paper is the first to study the correlates of pressure sores for a nationally representative sample of nursing home residents. The paper estimates the relative contribution of resident health characteristics to the probability of having had a pressure sore during a nursing home stay for a cross-sectional sample of residents. Data are from 699 facilities and 2803 residents in nursing homes included in the 1987 Institutional Population Component of the National Medical Expenditure Survey. The principal caregiver in the facility was asked if ''during the current stay'' the resident had a ''bed sore (decubitus ulcer).'' Findings indicate that having diagnoses of Parkinson's disease, diabetes, or paraplegia, being underweight, older, male, unable to walk, needing help feeding or unable to feed, having frequent fecal and urinary incontinence accidents, and being admitted from a hospital increase the likelihood of having had a pressure sore during the stay. Cognitively impaired residents who could feed themselves independently or with help were less likely to have had a sore, but cognitively impaired residents who were unable to feed themselves at all were at more risk than cognitively intact residents. RP SPECTOR, WD (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,DIV LONG TERM CARE STUDIES,2101 E JEFFERSON ST,SUITE 500,ROCKVILLE,MD 20852, USA. NR 17 TC 13 Z9 13 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI CAMBRIDGE PA 238 MAIN ST, CAMBRIDGE, MA 02142 SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD JUN PY 1994 VL 102 IS 6 BP S42 EP S45 DI 10.1111/1523-1747.ep12388560 PG 4 WC Dermatology SC Dermatology GA NT864 UT WOS:A1994NT86400044 PM 8006435 ER PT J AU FOX, SH KOEPSELL, TD DALING, JR AF FOX, SH KOEPSELL, TD DALING, JR TI BIRTH-WEIGHT AND SMOKING DURING PREGNANCY - EFFECT MODIFICATION BY MATERNAL AGE SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE BIRTH WEIGHT; INFANT, LOW BIRTH WEIGHT; MATERNAL AGE; MATERNAL AGE 35 AND OVER; PREGNANCY; PRENATAL EXPOSURE DELAYED EFFECTS; SMOKING ID CARBON-MONOXIDE EXPOSURE; FETAL GROWTH; GESTATIONAL-AGE; NICOTINE; INFANT AB Cigarette smoking during pregnancy is an important, avoidable factor associated with low birth weight. Maternal age is also associated with variations in birth weight. Using birth certificate data from all 347,650 singleton births for which maternal age and birth weight were recorded during 1984-1988 in Washington State, this study investigated birth weight and smoking during pregnancy (yes/no) for mothers of different ages. In multiple linear regressions adjusted for race, marital status, parity, adequacy of prenatal care, and urban/rural residence, the decrement in mean birth weight associated with smoking grew steadily from 117 g for the youngest mothers (age less than 16 years) to 376 g for the oldest (age 40 years or more). Similarly, the adjusted relative risk of having a low weight birth (less than 2,500 g) for smokers compared with nonsmokers was lowest for mothers aged 16-17 years, at 1.43 (95% confidence interval 1.22-1.68), and increased steadily to 2.63 (95% confidence interval 1.77-3.90) for mothers aged 40 or more. This result suggests that the effect of exposure to cigarette smoking during pregnancy is modified by advancing maternal age. Further research using data that more precisely measure the exposure (cigarettes per day, years smoked) could help further clarify this issue and better address the public health question of whether smoking cessation programs ought to focus limited resources more selectively toward pregnant smokers in particular age groups. C1 UNIV WASHINGTON,SCH PUBL HLTH & COMMUNITY MED,DEPT EPIDEMIOL,SEATTLE,WA 98195. RP FOX, SH (reprint author), AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON ST, ROOM 605,ROCKVILLE,MD 20852, USA. NR 29 TC 55 Z9 55 U1 1 U2 3 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD MAY 15 PY 1994 VL 139 IS 10 BP 1008 EP 1015 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA NM178 UT WOS:A1994NM17800005 PM 8178780 ER PT J AU BENSON, J FLEISHMAN, JA AF BENSON, J FLEISHMAN, JA TI THE ROBUSTNESS OF MAXIMUM-LIKELIHOOD AND DISTRIBUTION-FREE ESTIMATORS TO NONNORMALITY IN CONFIRMATORY FACTOR-ANALYSIS SO QUALITY & QUANTITY LA English DT Article ID IMPROPER SOLUTIONS; LIKERT VARIABLES; METHODOLOGIES AB The present Monte Carlo compares the estimates produced by maximum likelihood (ML) and asymptotically distribution-free (ADF) methods. The study extends prior research by investigating the combined effects of sample size, magnitude of correlation among observed indicators, number of indicators, magnitude of skewness and kurtosis, and proportion of indicators with non-normal distributions. Results indicate that both ML and ADF showed little bias in estimates of factor loadings under all conditions studied. As the number of indicators in the model increased, ADF produced greater negative bias in estimates of uniquenesses than ML. In addition, the bias in standard errors for both ML and ADF estimation increased in models with more indicators, and this effect was more pronounced for ADF than ML. Increases in skewness and kurtosis resulted in greater underestimating of standard errors; ML standard errors showed greater bias than ADF under conditions of non-normality, and ML chi-square statistics were also inflated. However, when only half the indicators departed from normality, the inflation in ML chi-square decreased. C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. RP BENSON, J (reprint author), UNIV GEORGIA,COLL EDUC,DEPT EDUC PSYCHOL RES & MEASUREMENT,325 ADERHOLD HALL,ATHENS,GA 30602, USA. NR 20 TC 17 Z9 17 U1 0 U2 4 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA SPUIBOULEVARD 50, PO BOX 17, 3300 AA DORDRECHT, NETHERLANDS SN 0033-5177 J9 QUAL QUANT JI Qual. Quant. PD MAY PY 1994 VL 28 IS 2 BP 117 EP 136 DI 10.1007/BF01102757 PG 20 WC Social Sciences, Interdisciplinary; Statistics & Probability SC Social Sciences - Other Topics; Mathematics GA NT304 UT WOS:A1994NT30400001 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI BENIGN PROSTATIC HYPERPLASIA (BPH) - DIAGNOSIS AND TREATMENT SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material RP CLINTON, JJ (reprint author), AGCY HLTH CARE POLICY & RES,POB 8547,SILVER SPRING,MD 20907, USA. NR 0 TC 3 Z9 3 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 20 PY 1994 VL 271 IS 15 BP 1151 EP 1151 DI 10.1001/jama.271.15.1151 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA NF207 UT WOS:A1994NF20700006 PM 7512166 ER PT J AU ALEXANDER, G CLANCY, C AF ALEXANDER, G CLANCY, C TI PRACTICE-BASED RESEARCH - LABORATORIES FOR HEALTH-CARE REFORM SO JOURNAL OF FAMILY PRACTICE LA English DT Editorial Material RP ALEXANDER, G (reprint author), AGCY HLTH CARE POLICY & RES,DIV PRIMARY CARE,2101 E JEFFERSON ST,SUITE 502,ROCKVILLE,MD 20852, USA. NR 9 TC 7 Z9 7 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD APR PY 1994 VL 38 IS 4 BP 428 EP 430 PG 3 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA NF559 UT WOS:A1994NF55900020 PM 8163970 ER PT J AU MONHEIT, AC VISTNES, JP AF MONHEIT, AC VISTNES, JP TI IMPLICIT POOLING OF WORKERS FROM LARGE AND SMALL FIRMS SO HEALTH AFFAIRS LA English DT Article AB Risk pools for small employers have become an integral part of proposals for national health care reform and have been implemented by a number of states. These explicit attempts to pool small employers are occurring at the same time that many small-firm employees obtain health insurance through implicit pooling arrangements as the dependent of a policyholder insured by a large firm. We use data from the 1987 National Medical Expenditure Survey to document the extent of implicit pooling arrangements, to examine whether small-firm employees and their dependents are adverse health risks, and to assess the cost implications of pooling small- and large-firm employees and dependents. RP MONHEIT, AC (reprint author), CTR GEN HLTH SERV INTRAMURAL RES,DIV MED EXPENDITURE STUDIES,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD, USA. NR 7 TC 9 Z9 9 U1 0 U2 0 PU PROJECT HOPE-HEALTH AFFAIRS PI SYRACUSE PA PO BOX 8015, SYRACUSE, NY 13217 SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD SPR PY 1994 VL 13 IS 1 BP 301 EP 314 DI 10.1377/hlthaff.13.1.301 PG 14 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA MX788 UT WOS:A1994MX78800033 PM 8188150 ER PT J AU MURTAUGH, CM AF MURTAUGH, CM TI DISCHARGE PLANNING IN NURSING-HOMES SO HEALTH SERVICES RESEARCH LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Public-Health-Association CY SEP 30-OCT 04, 1990 CL NEW YORK, NY SP AMER PUBLIC HLTH ASSOC DE NURSING HOMES; DISCHARGE PLANNING ID UTILIZATION PATTERN; ADMISSION COHORT; CARE; DETERMINANTS; OUTCOMES AB Objective. The purpose of this study is to identify nursing home residents who vary in their discharge planning needs. Data Sources and Study Setting. Administrative records from a database maintained by the National Health Corporation were the primary data source. The 3,883 persons studied were admitted in 1982 to one of 48 nursing homes located in Tennessee, other southern states, and Missouri. Study Design. Residents were followed until discharge or for one year, whichever occurred first. A multinomial logistic regression model was used to identify the characteristics at the time of admission of persons likely to go home and the characteristics of those who may be able to be discharged to other residential care facilities. Data Extraction Methods. A data tape with resident information was supplied by the National Health Corporation, which also provided data on the 48 nursing homes. Market data were obtained from the Area Resource File. Principal Findings. Health status measures are important predictors of discharge status. Financial status (i.e., primary payer) also had a large effect on discharge status; a measure of potential informal care in the community did not. Conclusions. It is possible to identify at admission nursing home residents likely to have very different discharge planning needs. Nursing home staff can use the results to focus their discharge planning efforts. Regulators can use them to assess how well nursing homes are meeting the discharge planning needs of their residents. RP MURTAUGH, CM (reprint author), AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,SUITE 500,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 21 TC 15 Z9 15 U1 5 U2 5 PU HEALTH ADMINISTRATION PRESS PI MELROSE PARK PA C/O FOUNDATION AMER COLL HEALTHCARE EXECUTIVES 1951 CORNELL AVE, MELROSE PARK, IL 60160 SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 1994 VL 28 IS 6 BP 751 EP 769 PG 19 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA MY440 UT WOS:A1994MY44000008 PM 8113056 ER PT J AU BRODY, H ALEXANDER, G AF BRODY, H ALEXANDER, G TI ETHICS AND HEALTH-CARE REFORM SO JOURNAL OF FAMILY PRACTICE LA English DT Editorial Material RP BRODY, H (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,EXECUT OFF CTR,ROOM 502,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD FEB PY 1994 VL 38 IS 2 BP 192 EP 194 PG 3 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA MW680 UT WOS:A1994MW68000019 PM 8308512 ER PT J AU LEON, J SIEGENTHALER, LA AF LEON, J SIEGENTHALER, LA TI PERSPECTIVES ON THE MAJOR SPECIAL CARE UNITS SURVEYS SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Article C1 US PHS,AGCY HLTH CARE POLICY & RES,WASHINGTON,DC. RP LEON, J (reprint author), GEORGE WASHINGTON UNIV,MED CTR,DIV AGING STUDIES & SERV,2150 PENN AVE NW,WASHINGTON,DC 20037, USA. NR 7 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0893-0341 J9 ALZ DIS ASSOC DIS JI Alzheimer Dis. Assoc. Dis. PY 1994 VL 8 SU 1 BP S58 EP S71 PG 14 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA NL737 UT WOS:A1994NL73700007 PM 8068295 ER PT J AU SAGE, WM HASTING, SKE BERENSON, RA AF SAGE, WM HASTING, SKE BERENSON, RA TI ENTERPRISE LIABILITY FOR MEDICAL MALPRACTICE AND HEALTH-CARE QUALITY IMPROVEMENT SO AMERICAN JOURNAL OF LAW & MEDICINE LA English DT Article ID COST CONTAINMENT; PROFESSIONAL LIABILITY; CONSUMER EXPECTATIONS; DOCTORS ROLE; REFORM; TORT; MANAGEMENT; PHYSICIANS; STANDARDS; ACCESS C1 US DEPT HHS,LEGAL MED PROGRAM,AGCY HLTH CARE POLICY & RES,WASHINGTON,DC 20201. NATL CAPITAL PPO,WASHINGTON,DC. RP SAGE, WM (reprint author), OMELVENY & MEYERS,LOS ANGELES,CA, USA. NR 118 TC 43 Z9 43 U1 0 U2 0 PU AMER SOC LAW MEDICINE ETHICS PI BOSTON PA 765 COMMONWEALTH AVE, 16TH FL, BOSTON, MA 02215 SN 0098-8588 J9 AM J LAW MED JI Am. J. Law Med. PY 1994 VL 20 IS 1-2 BP 1 EP 28 PG 28 WC Law SC Government & Law GA PF513 UT WOS:A1994PF51300001 PM 7801972 ER PT J AU CLINTON, JJ MCCORMICK, K BESTEMAN, J AF CLINTON, JJ MCCORMICK, K BESTEMAN, J TI ENHANCING CLINICAL-PRACTICE - THE ROLE OF PRACTICE GUIDELINES SO AMERICAN PSYCHOLOGIST LA English DT Article AB Health service researchers believe that significant practice variations occur, in part, because there is no strong consensus on best practices for managing a specific condition. The Agency for Health Care Policy and Research (AHCPR) supports the development of science-based clinical guidelines, performance measures, and standards of quality. Since 1992, it has published 6 clinical guidelines and is supporting development of more than 20 others. Each has a consumer version, in English and Spanish, to educate patients and describe care options. Widespread use of these guidelines will improve the quality of health care by assisting providers in making more informed decisions, thereby reducing unnecessary health care practices; will reduce some costs; and will provide feedback on knowledge gaps that merit the attention and support of researchers and policymakers. RP CLINTON, JJ (reprint author), AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON ST,EXECUT OFF CTR,SUITE 600,ROCKVILLE,MD 20852, USA. NR 1 TC 26 Z9 26 U1 0 U2 1 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD JAN PY 1994 VL 49 IS 1 BP 30 EP 33 DI 10.1037//0003-066X.49.1.30 PG 4 WC Psychology, Multidisciplinary SC Psychology GA MR298 UT WOS:A1994MR29800004 PM 8122815 ER PT B AU COHEN, SB POTTER, DEB AF COHEN, SB POTTER, DEB GP AMER STAT ASSOC TI An estimation strategy for the combined population represented by the NMES household and nursing home surveys SO AMERICAN STATISTICAL ASSOCIATION 1994 PROCEEDINGS OF THE SECTION ON SURVEY RESEARCH METHODS, VOLS I AND II LA English DT Proceedings Paper CT 49th Annual Meeting of the American-Association-for-Public-Opinion-Research CY MAY 11-15, 1994 CL DANVERS, MA SP Amer Assoc Public Opin Res DE INSTITUTIONAL SURVEYS; ADMISSIONS; DUAL REPRESENTATION C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 BN 1-883276-10-1 PY 1994 BP 276 EP 281 PG 6 WC Social Sciences, Mathematical Methods; Statistics & Probability SC Mathematical Methods In Social Sciences; Mathematics GA BD50X UT WOS:A1994BD50X00042 ER PT B AU SOMMERS, JP AF SOMMERS, JP GP AMER STAT ASSOC TI Analysis of the effects of imputation on variance estimates for the National Medical Expenditure Survey SO AMERICAN STATISTICAL ASSOCIATION 1994 PROCEEDINGS OF THE SECTION ON SURVEY RESEARCH METHODS, VOLS I AND II LA English DT Proceedings Paper CT 49th Annual Meeting of the American-Association-for-Public-Opinion-Research CY MAY 11-15, 1994 CL DANVERS, MA SP Amer Assoc Public Opin Res DE VARIANCE; HOT DECK; IMPUTATION C1 AGCY HLTH CARE POLICY & RES,CTR EXECUT OFF,ROCKVILLE,MD 20852. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 BN 1-883276-10-1 PY 1994 BP 400 EP 405 PG 6 WC Social Sciences, Mathematical Methods; Statistics & Probability SC Mathematical Methods In Social Sciences; Mathematics GA BD50X UT WOS:A1994BD50X00065 ER PT B AU DOYLE, P FARLEY, D AF DOYLE, P FARLEY, D GP AMER STAT ASSOC TI Alternative strategies for imputing premiums and predicting expenditures under health care reform SO AMERICAN STATISTICAL ASSOCIATION 1994 PROCEEDINGS OF THE SECTION ON SURVEY RESEARCH METHODS, VOLS I AND II LA English DT Proceedings Paper CT 49th Annual Meeting of the American-Association-for-Public-Opinion-Research CY MAY 11-15, 1994 CL DANVERS, MA SP Amer Assoc Public Opin Res DE MICROSIMULATION; VALIDATION; HEALTH CARE REFORM; EXPENDITURES C1 US DEPT HHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 BN 1-883276-10-1 PY 1994 BP 517 EP 522 PG 6 WC Social Sciences, Mathematical Methods; Statistics & Probability SC Mathematical Methods In Social Sciences; Mathematics GA BD50X UT WOS:A1994BD50X00086 ER PT B AU SWAMY, M AF SWAMY, M GP AMER STAT ASSOC TI Analysis of self and proxy responses in the assessment of health status SO AMERICAN STATISTICAL ASSOCIATION 1994 PROCEEDINGS OF THE SECTION ON SURVEY RESEARCH METHODS, VOLS I AND II LA English DT Proceedings Paper CT 49th Annual Meeting of the American-Association-for-Public-Opinion-Research CY MAY 11-15, 1994 CL DANVERS, MA SP Amer Assoc Public Opin Res DE SELF/PROXY RESPONSE; RESPONSE QUALITY; HEALTH STATUS RATING C1 US DEPT HHS,AGCY HLTH CARE POLICY & RES,CTR EXECTUT OFF,ROCKVILLE,MD 20852. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 BN 1-883276-10-1 PY 1994 BP 719 EP 724 PG 6 WC Social Sciences, Mathematical Methods; Statistics & Probability SC Mathematical Methods In Social Sciences; Mathematics GA BD50X UT WOS:A1994BD50X00122 ER PT B AU MOELLER, JF AF MOELLER, JF GP AMER STAT ASSOC TI Prescription drug coverage and the demand for outpatient prescription drugs by the elderly SO AMERICAN STATISTICAL ASSOCIATION 1994 PROCEEDINGS OF THE SOCIAL STATISTICS SECTION LA English DT Proceedings Paper CT Annual Meeting of the American-Statistical-Association, Social-Statistics-Section CY AUG 13-18, 1994 CL TORONTO, CANADA SP Amer Stat Assoc, Social Stat Sect DE INDUCTION EFFECT; SELECTION EFFECT; SUPPLEMENTARY INSURANCE; MEDIGAP C1 AGCY HLTH CARE POLICY & RES,CTR EXECUT OFF,ROCKVILLE,MD 20852. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 BN 1-883276-09-8 PY 1994 BP 147 EP 152 PG 6 WC Social Sciences, Mathematical Methods; Statistics & Probability SC Mathematical Methods In Social Sciences; Mathematics GA BD51B UT WOS:A1994BD51B00028 ER PT B AU CARLSON, BL COHEN, SB JOHNSON, AE AF CARLSON, BL COHEN, SB JOHNSON, AE GP AMER STAT ASSOC TI Family unit constructs, dynamics, and analysis in the household component of the NMES SO AMERICAN STATISTICAL ASSOCIATION 1994 PROCEEDINGS OF THE SOCIAL STATISTICS SECTION LA English DT Proceedings Paper CT Annual Meeting of the American-Statistical-Association, Social-Statistics-Section CY AUG 13-18, 1994 CL TORONTO, CANADA SP Amer Stat Assoc, Social Stat Sect DE FAMILY UNIT; MEDICAL EXPENDITURES; NATIONAL SURVEY C1 US DEPT HHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 BN 1-883276-09-8 PY 1994 BP 257 EP 262 PG 6 WC Social Sciences, Mathematical Methods; Statistics & Probability SC Mathematical Methods In Social Sciences; Mathematics GA BD51B UT WOS:A1994BD51B00050 ER PT J AU MONHEIT, AC AF MONHEIT, AC TI UNDERINSURED AMERICANS - A REVIEW SO ANNUAL REVIEW OF PUBLIC HEALTH LA English DT Review DE UNINSURED; HEALTH INSURANCE; ACCESS TO CARE ID HEALTH-INSURANCE; UNINSURED AMERICANS; PUBLIC-POLICY; NUMBER; SPELLS; EMPLOYMENT; COVERAGE; MARKET RP MONHEIT, AC (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON ST,SUITE 500,ROCKVILLE,MD 20852, USA. NR 52 TC 22 Z9 22 U1 0 U2 0 PU ANNUAL REVIEWS INC PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 SN 0163-7525 J9 ANNU REV PUBL HEALTH JI Annu. Rev. Public Health PY 1994 VL 15 BP 461 EP 485 PG 25 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA NK763 UT WOS:A1994NK76300023 PM 8054095 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI AGENCY FOR HEALTH-CARE POLICY AND RESEARCH - OVERVIEW OF PURPOSE AND PROGRAMS SO FOOD AND DRUG LAW JOURNAL LA English DT Article; Proceedings Paper CT 37th Annual Educational Conference of the Food-and-Drug-Law-Institute CY DEC 13-15, 1993 CL WASHINGTON, DC SP FOOD & DRUG LAW INST C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. NR 0 TC 1 Z9 1 U1 0 U2 0 PU FOOD DRUG LAW INST PI WASHINGTON PA 1000 VERMONT AVE NW, SUITE 1200, WASHINGTON, DC 20005-4903 J9 FOOD DRUG LAW J JI Food Drug Law J. PY 1994 VL 49 IS 3 BP 449 EP 461 PG 13 WC Food Science & Technology; Law; Nutrition & Dietetics; Pharmacology & Pharmacy SC Food Science & Technology; Government & Law; Nutrition & Dietetics; Pharmacology & Pharmacy GA PY699 UT WOS:A1994PY69900003 ER PT J AU FITZMAURICE, JM AF FITZMAURICE, JM TI HEALTH-CARE DATA STANDARDS ARE REQUIRED FOR MEDICALLY EFFECTIVE USE OF WORKSTATIONS SO INTERNATIONAL JOURNAL OF BIO-MEDICAL COMPUTING LA English DT Article; Proceedings Paper CT Working Conference on the Health Care Professional Workstation CY JUN 14-16, 1993 CL WASHINGTON, DC SP INT MED INFORMATICS ASSOC DE STANDARDS; HEALTH DATA; COMMUNICATION; CODING; WORKSTATION; INFRASTRUCTURE AB Uniform, accurate, and longitudinal patient care data is needed for greater quality and efficiency in institutional and ambulatory care. Further, the knowledge to be gained from medical effectiveness research methods, applied to large quantities of such clinical data about the practice of medicine in the community, is immense. National standards for the coding, content, and electronic transfer of patient care data are needed to achieve uniformity and accuracy. These standards are slow in developing because no single private organization can capture sufficient benefit. Yet, the general public can benefit substantially. Consequently, there may be a role for the Federal Government to work with the private sector to accelerate needed health care data standards. This paper suggests activities that help to define this role. RP FITZMAURICE, JM (reprint author), AGCY HLTH CARE POLICY & RES,OFF SCI & DATA DEV,ROCKVILLE,MD 20852, USA. NR 8 TC 2 Z9 2 U1 0 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0020-7101 J9 INT J BIOMED COMPUT JI Int. J. Bio-Med. Comput. PD JAN PY 1994 VL 34 IS 1-4 BP 331 EP 334 PG 4 WC Computer Science, Interdisciplinary Applications; Computer Science, Theory & Methods; Engineering, Biomedical; Medical Informatics SC Computer Science; Engineering; Medical Informatics GA MQ423 UT WOS:A1994MQ42300029 PM 8125646 ER PT J AU NEWMAN, SJ RESCHOVSKY, JD KANEDA, K HENDRICK, AM AF NEWMAN, SJ RESCHOVSKY, JD KANEDA, K HENDRICK, AM TI THE EFFECTS OF INDEPENDENT LIVING ON PERSONS WITH CHRONIC MENTAL-ILLNESS - AN ASSESSMENT OF THE SECTION-8 CERTIFICATE PROGRAM SO MILBANK QUARTERLY LA English DT Article ID PSYCHIATRIC-PATIENT; CARE; PLACEMENT; IMPACT; URBAN AB The feasibility of the Section 8 certificate program for individuals with chronic mental illness (CMI) and the outcomes associated with independent housing are examined. The analysis is based on data from a longitudinal survey of Section 8 certificate users in Baltimore and Hamilton County (Cincinnati) and on information from Section 8 application forms in each site. A pre-post research design was used to examine changes in hospitalization, residential stability, and mental health service outcomes. Four key dimensions of the CMI certificate program are examined: affordability, housing conditions, neighborhood conditions, and service gaps. Results suggest that the certificate program has a positive effect on independent living, that certificate use is associated with positive mental health outcomes, and that there is no evidence of ''creaming'' among program applicants. C1 JOHNS HOPKINS UNIV,DEPT GEOG & ENVIRONM ENGN,BALTIMORE,MD 21218. JOHNS HOPKINS UNIV,HOMEWOOD COMP INFORMAT CTR,BALTIMORE,MD 21218. AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. RP NEWMAN, SJ (reprint author), JOHNS HOPKINS UNIV,INST POLICY STUDIES,SHRIVER HALL,BALTIMORE,MD 21218, USA. NR 31 TC 48 Z9 48 U1 0 U2 2 PU BLACKWELL PUBLISHERS PI CAMBRIDGE PA 350 MAIN STREET, STE 6, CAMBRIDGE, MA 02148-5023 SN 0887-378X J9 MILBANK Q JI Milbank Q. PY 1994 VL 72 IS 1 BP 171 EP 198 DI 10.2307/3350343 PG 28 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA NF121 UT WOS:A1994NF12100011 PM 8164607 ER PT J AU MOR, V BRANCO, K FLEISHMAN, J HAWES, C PHILLIPS, C MORRIS, J FRIES, B AF MOR, V BRANCO, K FLEISHMAN, J HAWES, C PHILLIPS, C MORRIS, J FRIES, B TI THE STRUCTURE OF SOCIAL ENGAGEMENT AMONG NURSING-HOME RESIDENTS SO NEUROBIOLOGY OF AGING LA English DT Meeting Abstract C1 BROWN UNIV,CTR GERONTOL & HLTH CARE RES,PROVIDENCE,RI 02912. STONEHILL COLL,DEPT SOCIOL,N EASTON,MA. AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. RES TRIANGLE INST,RES TRIANGLE PK,NC 27709. UNIV MICHIGAN,CTR GERONTOL,ANN ARBOR,MI 48109. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PY 1994 VL 15 SU 1 BP S136 EP S136 PG 1 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA NV609 UT WOS:A1994NV60900563 ER PT J AU WILLIAMS, DR LAVIZZOMOUREY, R WARREN, RC AF WILLIAMS, DR LAVIZZOMOUREY, R WARREN, RC TI THE CONCEPT OF RACE AND HEALTH-STATUS IN AMERICA SO PUBLIC HEALTH REPORTS LA English DT Article; Proceedings Paper CT CDC-ATSDR Workshop on the Use of Race and Ethnicity in Public Health Surveillance CY MAR 01-02, 1993 CL ATLANTA, GA SP CTR DIS CONTROL & PREVENT, AGCY TAX SUBSTANCES & DIS REGISTRY ID BLACK-WHITE DIFFERENCES; BLOOD-PRESSURE; STANDARDIZED TERMINOLOGY; SOCIOECONOMIC-STATUS; NATIVE-AMERICANS; RISK-FACTORS; EPIDEMIOLOGY; WOMEN; MORTALITY; ACCESS AB Race is an unscientific, societally constructed taxonomy that is based on an ideology that views some human population groups as inherently superior to others on the basis of external physical characteristics or geographic origin. The concept of race is socially meaningful but of limited biological significance. Racial or ethnic variations in health status result primarily from variations among races in exposure or vulnerability to behavioral, psychosocial, material, and environmental risk factors and resources. Additional data that capture the specific factors that contribute to group differences in disease must be collected. However, reductions in racial disparities in health will ultimately require change in the larger societal institutions and structures that determine exposure to pathogenic conditions. More attention needs to be given to the ways that racism, in its multiple forms, affects health status. Socioeconomic status is a central determinant of health status, overlaps the concept of race, but is not equivalent to race. Inadequate attention has been given to the range of variation in social, cultural, and health characteristics within and between racial or ethnic minority populations. There is a growing emphasis, both within and without the Federal Government, on the collection of racial or ethnic identifiers in health data systems, but noncoverage of the Asian and Pacific Islander population, Native Americans, and subgroups of the Hispanic population is still a major problem. However, for all racial or ethnic groups, we need not only more data but better data. We must be more active in directly measuring the health-related aspects of belonging to these social categories. C1 UNIV MICHIGAN,DEPT SOCIOL,ANN ARBOR,MI 48106. CTR DIS CONTROL,AGCY HLTH CARE POLICY & RES,ATLANTA,GA 30333. RP WILLIAMS, DR (reprint author), UNIV MICHIGAN,INST SOCIAL RES,SURVEY RES CTR,POB 1248,ANN ARBOR,MI 48106, USA. FU NIA NIH HHS [AG07904] NR 104 TC 250 Z9 253 U1 1 U2 11 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPT OF DOCUMENTS, WASHINGTON, DC 20402-9325 SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD JAN-FEB PY 1994 VL 109 IS 1 BP 26 EP 41 PG 16 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA MW864 UT WOS:A1994MW86400005 PM 8303011 ER PT B AU FITZMAURICE, JM AF FITZMAURICE, JM BE Grundfest, WS TI TECHNOLOGY - QUALITY AT WHAT COST SO ROLE OF TECHNOLOGY IN THE COST OF HEALTH CARE: HEALTH CARE TECHNOLOGY POLICY I SE PROCEEDINGS OF THE SOCIETY OF PHOTO-OPTICAL INSTRUMENTATION ENGINEERS (SPIE) LA English DT Proceedings Paper CT Conference on Health Care Technology Policy I - The Role of Technology in the Cost of Health Care CY APR 27-29, 1994 CL ARLINGTON, VA SP IEEE, USA ACTIV BOARD, WHITAKER FDN, MEDALLIONS CHARITABLE FUND, SOC PHOTO OPT INSTRUMENTAT ENGINEERS, HAMAMATSU CORP C1 US DEPT HHS,AGCY HLTH CARE POLICY & RES,OFF SCI & DATA DEV,WASHINGTON,DC 20201. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPIE - INT SOC OPTICAL ENGINEERING PI BELLINGHAM PA PO BOX 10, BELLINGHAM, WA 98227-0010 BN 0-8194-1631-2 J9 P SOC PHOTO-OPT INS PY 1994 VL 2307 BP 2 EP 13 DI 10.1117/12.195446 PG 12 WC Health Policy & Services SC Health Care Sciences & Services GA BC03K UT WOS:A1994BC03K00001 ER PT B AU HOLOHAN, TV AF HOLOHAN, TV BE Grundfest, WS TI TECHNOLOGY ASSESSMENT AND THE COST OF HEALTH CARE SO ROLE OF TECHNOLOGY IN THE COST OF HEALTH CARE: HEALTH CARE TECHNOLOGY POLICY I SE PROCEEDINGS OF THE SOCIETY OF PHOTO-OPTICAL INSTRUMENTATION ENGINEERS (SPIE) LA English DT Proceedings Paper CT Conference on Health Care Technology Policy I - The Role of Technology in the Cost of Health Care CY APR 27-29, 1994 CL ARLINGTON, VA SP IEEE, USA ACTIV BOARD, WHITAKER FDN, MEDALLIONS CHARITABLE FUND, SOC PHOTO OPT INSTRUMENTAT ENGINEERS, HAMAMATSU CORP C1 US PHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPIE - INT SOC OPTICAL ENGINEERING PI BELLINGHAM PA PO BOX 10, BELLINGHAM, WA 98227-0010 BN 0-8194-1631-2 J9 P SOC PHOTO-OPT INS PY 1994 VL 2307 BP 150 EP 157 DI 10.1117/12.195442 PG 8 WC Health Policy & Services SC Health Care Sciences & Services GA BC03K UT WOS:A1994BC03K00017 ER PT J AU BOSCO, LA GERSTMAN, BB TOMITA, DK AF BOSCO, LA GERSTMAN, BB TOMITA, DK TI VARIATIONS IN THE USE OF MEDICATION FOR THE TREATMENT OF CHILDHOOD ASTHMA IN THE MICHIGAN MEDICAID POPULATION, 1980 TO 1986 SO CHEST LA English DT Article ID UNITED-STATES; PREVALENCE; CHILDREN AB Asthma is a leading cause of morbidity in the United States and is a leading cause of disability in children. Prevalence has been shown to be highest in male children, blacks, and urban residents. Racial and residential differences have been attributed to economics. Medicaid claims data allow for the comparison of asthma morbidity and treatment of patients with different demography but of low socioeconomic status. Michigan Medicaid claims data for recipient children between 5 and 14 years of age were used to ascertain demographic factors associated with asthma treatment from 1980 through 1986. A cross-sectional analysis was used. Black asthmatics were found to receive medical care more frequently, but to obtain asthma drugs less frequently than other groups. The prevalence of different prescription asthma preparations also varied by race and residence. Black, urban residents obtained fixed-combination drugs more frequently and steroids less frequently than other groups. Rural patients, in general, had fewer medical contacts but obtained more prescription products per provider contact, whether black or white. Possible reasons for this variation are discussed. C1 SAN JOSE STATE UNIV,DEPT HLTH SCI,SAN JOSE,CA 95192. AMGEN CTR,THOUSAND OAKS,CA. RP BOSCO, LA (reprint author), US DEPT HHS,PUBL HLTH SERV,AGCY HLTH CARE POLICY & RES,CTR MED EFFECTIVENESS RES,ROCKVILLE,MD 20852, USA. NR 16 TC 45 Z9 45 U1 0 U2 1 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 SN 0012-3692 J9 CHEST JI Chest PD DEC PY 1993 VL 104 IS 6 BP 1727 EP 1733 DI 10.1378/chest.104.6.1727 PG 7 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA ML308 UT WOS:A1993ML30800023 PM 8252952 ER PT J AU HELLINGER, FJ AF HELLINGER, FJ TI THE USE OF HEALTH-SERVICES BY WOMEN WITH HIV-INFECTION SO HEALTH SERVICES RESEARCH LA English DT Article DE HIV; AIDS; WOMEN WITH HIV AIDS; ACCESS ID HOSPITAL EXPERIENCE; MEDICAL-CARE; AIDS; COSTS; ZIDOVUDINE; MORTALITY AB Objective. The purpose of this study is to determine whether women who have been diagnosed with HIV utilize the same volume of medical care services as men who have been diagnosed with HIV. Data Sources. This study uses data from the first wave of interviews of the AIDS Cost and Service Utilization Survey (ACSUS) conducted between May and July of 199 1. The first wave of interviews involved 1,949 adults and adolescents, of whom 359 were women. Study Design. The ACSUS sample was selected from 26 sites (hospitals, clinics, and physician offices) in ten cities chosen from the 25 cities with the most AIDS cases. Cities are located throughout the nation, and in low, medium, and high prevalence areas. The sites in each city are generally those that treat the highest number of persons with HIV infection. Patients at each site were chosen using disease stage (asymptomatic, symptomatic, and AIDS) and gender as the selection criteria. Utilization equations are estimated for AZT use, outpatient care, and hospitalization. Data Collection. The ACSUS involves six in-person interviews over an 18-month period. Interviews include questions about the use of medical and support services, insurance status, functional status, and barriers to care during the prior three-month period. Principal Findings. A male injection drug user (IDU) with AIDS is 20 percent more likely to be hospitalized than a woman with AIDS, and the hospital cost of treating a male IDU with AIDS is $9,180 more per year than the hospital cost of treating a woman with AIDS. Conclusions. This study shows that, even after being diagnosed and after having accessed the medical care system, women with AIDS receive fewer services than men with AIDS. RP HELLINGER, FJ (reprint author), CGHSER, AGCY HLTH CARE POLICY & RES, DIV COST & FINANCING, SUITE 502, 2101 E JEFFERSON ST, ROCKVILLE, MD 20852 USA. NR 26 TC 73 Z9 73 U1 0 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 1993 VL 28 IS 5 BP 543 EP 561 PG 19 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA MN647 UT WOS:A1993MN64700004 PM 8270420 ER PT J AU SINGER, E MATHIOWETZ, NA COUPER, MP AF SINGER, E MATHIOWETZ, NA COUPER, MP TI THE IMPACT OF PRIVACY AND CONFIDENTIALITY CONCERNS ON SURVEY PARTICIPATION - THE CASE OF THE 1990 UNITED-STATES CENSUS SO PUBLIC OPINION QUARTERLY LA English DT Article AB This study investigates the relationship between concerns about confidentiality and privacy, on the one hand, and mail returns to the 1990 census, on the other. Such concerns significantly affect mail returns, even when demographic variables known to be related to both concerns and survey participation are controlled. However, their impact is not very large, and the effects of confidentiality and privacy concerns vary for black and white respondents. C1 UNIV MICHIGAN,AGCY HLTH CARE POLICY & RES,DIV STAT & RES METHODOL,ANN ARBOR,MI 48109. UNIV MICHIGAN,SURVEY RES CTR,ANN ARBOR,MI 48109. US BUR CENSUS,WASHINGTON,DC 20233. RP SINGER, E (reprint author), COLUMBIA UNIV,NEW YORK,NY 10027, USA. NR 23 TC 61 Z9 62 U1 1 U2 4 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0033-362X J9 PUBLIC OPIN QUART JI Public Opin. Q. PD WIN PY 1993 VL 57 IS 4 BP 465 EP 482 DI 10.1086/269391 PG 18 WC Communication; Political Science; Social Sciences, Interdisciplinary SC Communication; Government & Law; Social Sciences - Other Topics GA MZ096 UT WOS:A1993MZ09600001 ER PT J AU WALL, EM AF WALL, EM TI FAMILY-PRACTICE RESEARCH AT THE NATIONAL-INSTITUTES-OF-HEALTH SO AMERICAN FAMILY PHYSICIAN LA English DT Letter RP WALL, EM (reprint author), AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD NOV 1 PY 1993 VL 48 IS 6 BP 1026 EP & PG 0 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA MF796 UT WOS:A1993MF79600007 PM 8237727 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI AGENCY-FOR-HEALTH-CARE-POLICY-AND-RESEARCH - IMPROVING HEALTH-CARE THROUGH GUIDELINES AND OUTCOMES RESEARCH SO HOSPITAL FORMULARY LA English DT Editorial Material AB The Agency for Health Care Policy and Research (AHCPR), a part of the Public Health Service, was set up to fund and conduct research on the effectiveness and appropriateness of health care, facilitate development of clinical practice guidelines, assess health care technology, and undertake widespread dissemination of research findings and clinical guidelines. In this exclusive interview with Hospital Formulary, AHCPR Administrator J. Jarrett Clinton discusses how the Agency carries out its research responsibilities and describes how clinical practice guidelines are developed. RP CLINTON, JJ (reprint author), AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ADVANSTAR COMMUNICATIONS PI DULUTH PA 131 W FIRST ST, DULUTH, MN 55802 SN 0098-6909 J9 HOSP FORMUL PD NOV PY 1993 VL 28 IS 11 BP 933 EP & PG 0 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA MH632 UT WOS:A1993MH63200004 PM 10130235 ER PT J AU OZMINKOWSKI, RJ FRIEDMAN, B TAYLOR, Z AF OZMINKOWSKI, RJ FRIEDMAN, B TAYLOR, Z TI ACCESS TO HEART AND LIVER-TRANSPLANTATION IN THE LATE 1980S SO MEDICAL CARE LA English DT Article ID ORGAN-TRANSPLANTATION; UNITED-STATES; TECHNOLOGY; DISEASE; SEX AB Because of a shortage of usable organs, many who require heart or liver transplants for survival will not have access to them. Access to care may reflect demographic factors and ability to pay, as well as medical considerations. Receipt of an organ may be influenced by expected survival with and without a transplant, age, gender, race, ability to pay, and distance to a transplant center. Discharge abstract data from a national sample of over 500 hospitals in 1986 and 1987 were used to select heart and liver recipients and others with end-stage diseases who did not receive a transplant. Multivariate logistic regression analyses were then used to estimate how receipt of a transplant was influenced by expected years of survival after transplantation (YAT), expected ability to pay, age, sex, race, and distance to a transplant center. Controlling for differences in expected YAT, age, sex, race, and distance to the transplant center, those expected to have the most ability to pay were more likely to receive heart and liver transplants, compared to those expected to have medium ability to pay. Third-party coverage was particularly important in receipt of a transplant for those with absolute contraindications. Expected YAT and age were significant, with some evidence of a tradeoff between urgency and expected YAT in the case of hearts. Men were more likely to obtain heart transplants and women were more likely to get liver transplants. The effect of distance were small. Existing regularly incentives and biological, medical, and cultural reasons may justify the age-, sex-, race-, and prognosis-related differences in the odds of receiving a transplant. The importance of ability to pay may not have been adequately observed in previous studies restricted to the patients screened at major transplant centers. Hospital discharge records with personal identifiers, linkage to official waiting lists, and better patient level socioeconomic information would permit more definitive analysis. C1 USDHHS,AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,DIV PROVIDER STUDIES,ROCKVILLE,MD. CDC,AGCY TOX SUBST & DIS RES,DIV HLTH STUDIES,ATLANTA,GA. RP OZMINKOWSKI, RJ (reprint author), ABT ASSOCIATES INC,4800 MONTGOMERY LANE,SUITE 500,BETHESDA,MD 20814, USA. NR 32 TC 21 Z9 21 U1 1 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD NOV PY 1993 VL 31 IS 11 BP 1027 EP 1042 DI 10.1097/00005650-199311000-00005 PG 16 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA MF862 UT WOS:A1993MF86200005 PM 8231335 ER PT J AU FOX, S AF FOX, S TI PARITY WITH WHOM - THE ASSOCIATION BETWEEN BIRTH-WEIGHT AND BIRTH-ORDER AMONG MOTHERS OF DIFFERENT AGES SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20552. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD OCT 15 PY 1993 VL 138 IS 8 BP 615 EP 615 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA MH147 UT WOS:A1993MH14700109 ER PT J AU FREIMAN, MP MURTAUGH, CM AF FREIMAN, MP MURTAUGH, CM TI THE DETERMINANTS OF THE HOSPITALIZATION OF NURSING-HOME RESIDENTS SO JOURNAL OF HEALTH ECONOMICS LA English DT Note RP FREIMAN, MP (reprint author), AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,2101 E JEFFERSON ST,SUITE 500,ROCKVILLE,MD 20852, USA. NR 4 TC 31 Z9 31 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-6296 J9 J HEALTH ECON JI J. Health Econ. PD OCT PY 1993 VL 12 IS 3 BP 349 EP 359 DI 10.1016/0167-6296(93)90017-9 PG 11 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA MG284 UT WOS:A1993MG28400008 PM 10129842 ER PT J AU FRANKS, P NUTTING, PA CLANCY, CM AF FRANKS, P NUTTING, PA CLANCY, CM TI HEALTH-CARE REFORM, PRIMARY-CARE, AND THE NEED FOR RESEARCH SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID MEDICARE PHYSICIAN EXPENDITURES; LOW-BACK-PAIN; FAMILY PHYSICIANS; RANDOMIZED TRIAL; AMBULATORY CARE; RESOURCE USE; QUALITY; SERVICES; COST; INTERNISTS AB Health care reform proposals that seek to increase access for almost 40 million uninsured Americans will require an expansion of primary care. Simply expanding available primary care services is likely to be prohibitively expensive. Developing a rational and efficient strategy for the provision of primary care to all Americans will require understanding of the relationships among primary care and access, costs, and quality-relationships that are often obscured by the complexity of the US health care system. Those relationships are examined to identify some key areas of research needed to inform policy development and improve primary care services. Despite significant gaps in our knowledge, the evidence strongly suggests that restructuring and strengthening the role of primary care practitioners in the health care system will facilitate access to affordable, high-quality health care for all Americans. C1 AGCY HLTH CARE POLICY & RES, DIV PRIMARY CARE, ROCKVILLE, MD USA. RP FRANKS, P (reprint author), UNIV ROCHESTER, DEPT FAMILY MED, 885 SOUTH AVE, ROCHESTER, NY 14620 USA. NR 72 TC 59 Z9 59 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD SEP 22 PY 1993 VL 270 IS 12 BP 1449 EP 1453 DI 10.1001/jama.270.12.1449 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA LX173 UT WOS:A1993LX17300029 PM 8371445 ER PT J AU FRANKS, P CLANCY, CM GOLD, MR NUTTING, PA AF FRANKS, P CLANCY, CM GOLD, MR NUTTING, PA TI HEALTH-INSURANCE AND SUBJECTIVE HEALTH-STATUS - DATA FROM THE 1987 NATIONAL MEDICAL EXPENDITURE SURVEY SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID WORKING-AGE ADULTS; RHEUMATOID-ARTHRITIS; HOSPITAL PATIENTS; FUNCTIONAL STATUS; CARE; ACCESS; MORTALITY; CONSEQUENCES; AMERICANS; SERVICES AB Objectives. The relationship between health insurance and subjective health status was investigated. it was hypothesized that persons without health insurance would have lower levels of subjective health status than those with health insurance and that this relationship would hold for both poor and nonpoor persons. Methods. Data from the 1987 National Medical Expenditure Survey were analyzed to examine the relationship between health insurance and self-reported health status. The analysis controlled for sociodemographic and attitudinal variables and medical conditions. Results. Persons without health insurance had significantly lower levels of subjective health status than did persons with insurance. This adverse effect persisted after adjustments were made for the effects of age, sex, race, income, attitude toward the value of medical care and health insurance, and medical conditions. The detrimental effect of lacking health insurance on subjective health status was present for persons at all income levels and was greater than the effect on subjective health status found for 2 of the 11 reported medical conditions. Conclusions. Lacking health insurance is associated with clinically significant lower levels of subjective health status in both poor and non-poor persons. C1 OFF DIS PREVENT & HLTH PROMOT,WASHINGTON,DC. AGCY HLTH CARE POLICY & RES,DIV PRIMARY CARE,ROCKVILLE,MD. RP FRANKS, P (reprint author), UNIV ROCHESTER,DEPT FAMILY MED,885 SOUTH AVE,ROCHESTER,NY 14620, USA. NR 38 TC 49 Z9 50 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD SEP PY 1993 VL 83 IS 9 BP 1295 EP 1299 DI 10.2105/AJPH.83.9.1295 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA LV708 UT WOS:A1993LV70800020 PM 8363006 ER PT J AU ALTMAN, BM CUNNINGHAM, PJ AF ALTMAN, BM CUNNINGHAM, PJ TI DYNAMIC PROCESS OF MOVEMENT IN RESIDENTIAL SETTINGS SO AMERICAN JOURNAL ON MENTAL RETARDATION LA English DT Article ID MENTALLY-RETARDED PERSONS; COMMUNITY PLACEMENT; ADAPTIVE-BEHAVIOR; RETARDATION; FACILITIES; ADULTS; DEINSTITUTIONALIZATION; SATISFACTION; ABUSE; LIFE AB Findings from the 1987 National Medical Expenditure Survey show that almost 16% of individuals who spent some time in a residential facility during 1987 moved into other living arrangements during 1987. A smaller number had multiple moves during that period. However this level of movement did not result in significant changes in the residential population between the beginning and end of 1987. Most movement that occurred was between residential facilities of the same type. For the most part, individuals ended the year in the same type of residential setting where they began the year. These findings suggest that there is considerably more mobility among residential populations than can be observed by examining annual rates of change in residential populations. RP ALTMAN, BM (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20857, USA. NR 34 TC 2 Z9 2 U1 1 U2 1 PU AMER ASSOC MENTAL RETARDATION PI WASHINGTON PA 444 N CAPITOL ST, NW, STE 846, WASHINGTON, DC 20001-1512 SN 0895-8017 J9 AM J MENT RETARD JI Am. J. Ment. Retard. PD SEP PY 1993 VL 98 IS 2 BP 304 EP 316 PG 13 WC Education, Special; Rehabilitation SC Education & Educational Research; Rehabilitation GA LX424 UT WOS:A1993LX42400010 PM 8398089 ER PT J AU CUNNINGHAM, PJ AF CUNNINGHAM, PJ TI ACCESS TO CARE IN THE INDIAN HEALTH-SERVICE SO HEALTH AFFAIRS LA English DT Article AB The Indian Health Service (IHS) is unique among U.S. private and public health programs in that free comprehensive health services are provided to eligible American Indians and Alaska Natives regardless of their ability to pay. However, resource limitations may compel some eligible persons to go outside of the IHS system to receive health care. Although IHS eligibles have comparatively low rates of private or public health care coverage, and much of this population lives in underserved areas, over half of IHS-eligible persons had some type of out-of-plan use in 1987. Furthermore, services received through private providers appear to supplement those received through IHS-sponsored providers. Overall, persons who use both IHS and non-IHS providers have higher levels of health care use than do those who rely exclusively on the IHS. RP CUNNINGHAM, PJ (reprint author), AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,ROCKVILLE,MD, USA. NR 9 TC 33 Z9 33 U1 0 U2 0 PU PROJECT HOPE-HEALTH AFFAIRS PI SYRACUSE PA PO BOX 8015, SYRACUSE, NY 13217 SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD FAL PY 1993 VL 12 IS 3 BP 224 EP 233 DI 10.1377/hlthaff.12.3.224 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA MA420 UT WOS:A1993MA42000022 PM 8244235 ER PT J AU COHEN, JW AF COHEN, JW TI MEDICAID PHYSICIAN FEES AND USE OF PHYSICIAN AND HOSPITAL SERVICES SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID ACCESS; CARE; PARTICIPATION; OUTPATIENT; EMERGENCY AB This paper examines how physician fees affect use of physician and hospital services under the Medicaid program. Using data from the 1987 National Medical Expenditure Survey (NMES), it examines how Medicaid physician fee levels affect beneficiaries' probability of using ambulatory physician services, the site at which ambulatory physician care is usually received, and how that site affects level of use and probability of hospital admission. The results indicate that low Medicaid fees hamper access to office-based physicians and encourage use of hospital outpatient departments and emergency rooms. They also indicate that having an office-based doctor as a usual source of ambulatory physician care is associated with a higher frequency of visits and a lower probability of having an inpatient hospitalization. RP COHEN, JW (reprint author), US DEPT HLTH & HUMAN SERV,AGCY HLTH CARE POLICY & RES,DIV MED EXPENDITURE STUDIES,ROCKVILLE,MD 20852, USA. NR 30 TC 27 Z9 27 U1 0 U2 1 PU BLUE CROSS BLUE SHIELD ASSOC PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD FAL PY 1993 VL 30 IS 3 BP 281 EP 292 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA MA765 UT WOS:A1993MA76500008 PM 8406785 ER PT J AU MONHEIT, AC HARVEY, PH AF MONHEIT, AC HARVEY, PH TI SOURCES OF HEALTH-INSURANCE FOR THE SELF-EMPLOYED - DOES DIFFERENTIAL TAXATION MAKE A DIFFERENCE SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID MARKET AB Health insurance obtained through employment has enabled many workers to take advantage of the favorable tax treatment of employer contributions to these benefits. However, the full deductibility of such employer payments as a business expense and their exemption from income taxation are not available to self-employed owners of unincorporated businesses. We identify the sources of health insurance for the self employed and examine how this disparity in tax treatment is associated with health insurance status. Analyses of data from the 1987 National Medical Expenditure Survey reveal that the differential taxation of the unincorporated self employed is associated with lower rates of employment-related coverage for themselves and their workers. RP MONHEIT, AC (reprint author), AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,DIV MED EXPENDITURE STUDIES,ROCKVILLE,MD 20852, USA. NR 17 TC 10 Z9 10 U1 0 U2 1 PU BLUE CROSS BLUE SHIELD ASSOC PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD FAL PY 1993 VL 30 IS 3 BP 293 EP 305 PG 13 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA MA765 UT WOS:A1993MA76500009 PM 8406786 ER PT J AU FRANKS, P CLANCY, CM GOLD, MR AF FRANKS, P CLANCY, CM GOLD, MR TI HEALTH-INSURANCE AND MORTALITY - EVIDENCE FROM A NATIONAL COHORT SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID WORKING-AGE ADULTS; MEDICAL-CARE; SOCIOECONOMIC-STATUS; HOSPITAL PATIENTS; FOLLOW-UP; ACCESS; SERVICES; MASSACHUSETTS; CONSEQUENCES; POOR AB Objective.-To examine the relationship between lacking health insurance and the risk of subsequent mortality. Design.-Adults older than 25 years who reported they were uninsured or privately insured in the first National Health and Nutrition Examination Survey, a representative cohort of the US population, were followed prospectively from initial interview in 1971 through 1975 until 1987. Participants.-Complete baseline and follow-up information was obtained on 4694 (91%) persons of the 5161 who reported not receiving publicly funded insurance at baseline. Main Outcome Measure.-The relationship between insurance status and subsequent mortality was examined using Cox proportional hazards survival analysis. The analysis adjusted for gender, race, and baseline age, education, income, employment status, the presence of morbidity on examination, self-rated health, smoking status, leisure exercise, alcohol consumption, and obesity. The effects of interactions between insurance and all other baseline variables were also examined. Results.-By the end of the follow-up period, 9.6% of the insured and 18.4% of the uninsured had died. After adjustment for all other baseline variables, the hazard ratio for lacking insurance was 1.25 (95% confidence interval [CI], 1.00 to 1.55). The effect of insurance on mortality was comparable to that of education, income, and self-rated health. There were no statistically significant (P<.05) interactions. Conclusions.-Lacking health insurance is associated with an increased risk of subsequent mortality, an effect that is evident in all sociodemographic health insurance and mortality groups examined. C1 AGCY HLTH CARE POLICY & RES, DIV PRIMARY CARE, ROCKVILLE, MD USA. UNIV ROCHESTER, DEPT FAMILY MED, ROCHESTER, NY 14627 USA. OFF DIS PREVENT & HLTH PROMOT, WASHINGTON, DC USA. NR 47 TC 229 Z9 229 U1 3 U2 12 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 11 PY 1993 VL 270 IS 6 BP 737 EP 741 DI 10.1001/jama.270.6.737 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA LQ338 UT WOS:A1993LQ33800029 PM 8336376 ER PT J AU ELIXHAUSER, A WESCHLER, JM KITZMILLER, JL MARKS, JS BENNERT, HW COUSTAN, DR GABBE, SG HERMAN, WH KAUFMANN, RC OGATA, ES SEPE, SJ AF ELIXHAUSER, A WESCHLER, JM KITZMILLER, JL MARKS, JS BENNERT, HW COUSTAN, DR GABBE, SG HERMAN, WH KAUFMANN, RC OGATA, ES SEPE, SJ TI COST-BENEFIT-ANALYSIS OF PRECONCEPTION CARE FOR WOMEN WITH ESTABLISHED DIABETES-MELLITUS SO DIABETES CARE LA English DT Article ID DIAGNOSIS-RELATED GROUPS; CONGENITAL-MALFORMATIONS; SPONTANEOUS-ABORTION; GLYCEMIC CONTROL; INTENSIVE-CARE; INFANTS; PREGNANCY; MOTHERS; PREVENTION; MANAGEMENT AB OBJECTIVE - To determine whether the additional costs of preconception care are balanced by the savings from averted complications. Several studies have demonstrated the efficacy of preconception care in reducing congenital anomalies in infants born of mothers with pre-existing diabetes mellitus. RESEARCH DESIGN AND METHODS - This study used literature review, consensus development among an expert panel of physicians, and surveys of medical care personnel to obtain information about the costs and consequences of preconception plus prenatal care compared with prenatal care only for women with established diabetes. Preconception care involves close interaction between the patient and an interdisciplinary health-care team as well as intensified evaluation, follow-up, testing, and monitoring. The outcome measures assessed in this study are the medical costs of preconception care versus prenatal care only and the benefit-cost ratio. RESULTS- The costs of preconception plus prenatal care are $17,519/delivery, whereas the costs of prenatal care only are $13,843/delivery. Taking into account maternal and neonatal adverse outcomes, the net savings of preconception care are $1720/enrollee over prenatal care only and the benefit-cost ratio is 1.86. The preconception care program remained cost saving across a wide range of assumptions regarding incidence of adverse outcomes and program cost components. CONCLUSIONS - Despite significantly higher per delivery costs for participants in a hypothetical preconception care program, intensive medical care before conception resulted in cost savings compared with prenatal care only. Third- party payers can expect to realize cost savings by reimbursing preconception care in this high-risk population. C1 BATTELLE MED TECHNOL ASSESSMENT & POLICY RES CTR,WASHINGTON,DC. GOOD SAMARITAN HOSP,SAN JOSE,CA. UNIV VERMONT,COLL MED,BURLINGTON,VT 05405. WOMEN & INFANTS HOSP RHODE ISL,PROVIDENCE,RI 02908. BROWN UNIV,PROGRAM MED,PROVIDENCE,RI 02912. OHIO STATE UNIV,COLL MED,COLUMBUS,OH 43210. NORTHWESTERN UNIV,SCH MED,CHICAGO,IL 60611. SO ILLINOIS UNIV,SCH MED,SPRINGFIELD,IL 62708. UNIV CALIF SAN FRANCISCO,SAN FRANCISCO,CA 94143. CTR DIS CONTROL,ATLANTA,GA 30333. MAINE MED CTR,PORTLAND,ME 04102. MERCY HOSP,PORTLAND,ME. RP ELIXHAUSER, A (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,DIV PROVIDER STUDIES,ROCKVILLE,MD 20852, USA. FU PHS HHS [200-88-0644] NR 44 TC 64 Z9 64 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD AUG PY 1993 VL 16 IS 8 BP 1146 EP 1157 DI 10.2337/diacare.16.8.1146 PG 12 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA LN778 UT WOS:A1993LN77800013 PM 8375245 ER PT J AU HELLINGER, FJ AF HELLINGER, FJ TI THE LIFETIME COST OF TREATING A PERSON WITH HIV SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID MEDICAL-CARE COSTS; AIDS; EXPERIENCE; FORECASTS AB Objective.-To estimate the cost (total charges for services) of medical care for persons with human immunodeficiency virus (HIV) from the time of infection until death. Design and Setting.-Data from the AIDS (acquired immunodeficiency syndrome) Cost and Service Utilization Survey were used. Patients.-Data from interviews conducted during the spring and early summer of 1992 with 1164 respondents with HIV were analyzed. The respondents were recruited at 26 sites (hospitals, clinics, and physicians' offices) in 10 cities. Billing data from a survey of providers also were used. Outcome Measures.-Estimates of the mean occupancy time in each of four disease stages were obtained from the San Francisco Men's Health Study. These estimates were multiplied by the monthly cost in each stage and summed to derive a synthetic estimate of the lifetime medical care costs of treating a person with HIV. Results.-It is estimated herein that the lifetime cost of treating a person with HIV from the time of infection until death is approximately $119 000. The estimated cost of care from HIV infection until the development of AIDS is $50 000, while the estimated cost from Al DS development until death is approximately $69 000. These estimates define upper bounds because they assume persons receive treatment continuously from the moment of infection until death. Conclusions.-This study found that the cost of treating a person with AIDS, which has risen rapidly in the past, has fallen as a result of a reduction in the use of inpatient hospital services. RP HELLINGER, FJ (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV EXTRAMURAL RES,ROCKVILLE,MD 20852, USA. NR 18 TC 232 Z9 234 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 28 PY 1993 VL 270 IS 4 BP 474 EP 478 DI 10.1001/jama.270.4.474 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA LN426 UT WOS:A1993LN42600027 PM 8320787 ER PT J AU MCLEOD, DC COLN, WG THAYER, CF PERFETTO, EM HARTZEMA, AG AF MCLEOD, DC COLN, WG THAYER, CF PERFETTO, EM HARTZEMA, AG TI PHARMACOEPIDEMIOLOGY OF BLEEDING EVENTS AFTER USE OF R-ALTEPLASE OR STREPTOKINASE IN ACUTE MYOCARDIAL-INFARCTION SO ANNALS OF PHARMACOTHERAPY LA English DT Article ID TISSUE PLASMINOGEN-ACTIVATOR; INTRAVENOUS STREPTOKINASE; RANDOMIZED TRIAL; THROMBOLYSIS AB OBJECTIVE: To determine in nonresearch, general medical practice conditions the comparative incidence and types of bleeding complications after the use of streptokinase (SK) and r-alteplase (recombinant tissue plasminogen activator, rt-PA) to treat acute myocardial infarction (AMI). DESIGN: Retrospective medical record review of concurrently treated patients (96-hour observation posttreatment) in 32 participating hospitals in the US. MAIN OUTCOME MEASURES: The medical record description of all bleeding events regarding the body site affected, changes in hemoglobin concentrations, blood products administered, and clinical outcome (permanent sequelae or death). Bleeding severity was determined by defined criteria. CONTROL DATA: Comorbidity and concomitant medications (e.g., aspirin, heparin, warfarin) likely to predispose or contribute to bleeding events were analyzed. DATA ANALYSIS: Logistic regression analysis. RESULTS: Data from 419 patients who received rt-PA and 207 who received SK were evaluated. In the 96-hour period after initiation of thrombolytic therapy, 30.5 and 31.9 percent of rt-PA and SK patients, respectively, experienced one or more bleeding events (crude risk ratio [CRR] = 1.04; 95 percent confidence interval [CI] 0.91-1.14; p = 0.73). In the first 24-hour period, 21.5 percent of rt-PA and 15.9 percent of SK patients experienced bleeding events (CRR = 0.74; 95 percent CI 0.42-1.15; p = 0.08). The leading types of bleeding and percents of all patients affected were: perivascular access site (18.4 percent), gastrointestinal (6.4 percent), skin/soft tissue/muscle (5.0 percent), urinary (3.4 percent), pulmonary (2.2 percent), systemic (1.9 percent), and oral (I A percent). Intracranial bleeding occurred in 4 rt-PA arid 2 SK patients; 4 of these patients died. Events deemed clinically significant occurred in 15 rt-PA and 9 SK patients (3.8 percent of all patients). Ten patients likely died from these events, 6 within the first 24 hours. Three rt-PA patients and 1 who received SK (0.6 percent) died of cerebrovascular events within the first 24 hours. After controlling for demographic factors and therapeutic variables, using logistic regression analyses, no thrombolytic-related differences were found in the incidence or severity of bleeding following use of the two thrombolytics. CONCLUSIONS: These clinical data do not support a theoretical advantage of rt-PA to cause less bleeding propensity than SK. C1 CAROLINA RES GRP,RALEIGH,NC. HOECHST ROUSSEL PHARMACEUT PROPRIETARY LTD,DRUG SURVEILLANCE,SOMERVILLE,NJ 08876. AGCY HLTH CARE POLICY & RES,CTR MED EFFECT RES,ROCKVILLE,MD. UNIV N CAROLINA,SCH PHARM,CHAPEL HILL,NC 27514. UNIV N CAROLINA,SCH PUBL HLTH,CHAPEL HILL,NC 27514. NR 20 TC 12 Z9 12 U1 0 U2 1 PU HARVEY WHITNEY BOOKS CO PI CINCINNATI PA PO BOX 42696, CINCINNATI, OH 45242 SN 1060-0280 J9 ANN PHARMACOTHER JI Ann. Pharmacother. PD JUL-AUG PY 1993 VL 27 IS 7-8 BP 956 EP 962 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA LP297 UT WOS:A1993LP29700028 PM 8364282 ER PT J AU WALL, EM AF WALL, EM TI PRACTICE GUIDELINES - PROMISE OR PANACEA SO JOURNAL OF FAMILY PRACTICE LA English DT Editorial Material ID CARE; APPROPRIATENESS; FEEDBACK; SYSTEMS C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. NR 25 TC 16 Z9 16 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD JUL PY 1993 VL 37 IS 1 BP 17 EP 19 PG 3 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA LM269 UT WOS:A1993LM26900004 PM 8345333 ER PT J AU FRIEDMAN, B ELIXHAUSER, A AF FRIEDMAN, B ELIXHAUSER, A TI INCREASED USE OF AN EXPENSIVE, ELECTIVE PROCEDURE - TOTAL HIP REPLACEMENTS IN THE 1980S SO MEDICAL CARE LA English DT Article ID TECHNOLOGY; VOLUME AB Between 1980 and 1987, the number of hospital discharges with total hip replacement (THR) increased by more than 90%, while total hospital discharges fell by more than 10%. Total hip replacement is one of the most costly hospital inpatient procedures, both per case and in total Medicare expenses. Explanations for the growth in use of THR may clarify some of the major forces driving national health care costs. This study assumes that treatment choices are made by (or for) each patient to maximize expected net benefits. Within this framework, the use of THR might have increased because of improved safety for the procedure, longer life expectancy and better control of many serious illnesses that led to increased demand for quality-enhancing procedures, and increased out-of-pocket cost for alternative treatments that are not covered well by insurance. These possible explanations imply changes in the characteristics of THR recipients over time. An upward shift was found in the age distribution of patients, more than simply because of an aging of the population. Sharply increased proportions of patients were also found with serious comorbidities such as cancer and dementia. The safety of the procedure seems to have improved, in terms of the death rate in the hospital. The results suggest that demands for expensive, elective procedures have been increasing for patients previously regarded as too old or impaired to benefit sufficiently. This process leads to continuing increases in real health care expenses even without the invention of new technologies. C1 AGCY HLTH CARE POLICY & RES,DIV PROVIDER STUDIES,INTRAMURAL RES,ROCKVILLE,MD. NR 25 TC 31 Z9 32 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD JUL PY 1993 VL 31 IS 7 BP 581 EP 599 DI 10.1097/00005650-199307000-00002 PG 19 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA LN840 UT WOS:A1993LN84000002 PM 8326773 ER PT J AU CUNNINGHAM, PJ ALTMAN, BM AF CUNNINGHAM, PJ ALTMAN, BM TI THE USE OF AMBULATORY HEALTH-CARE SERVICES BY AMERICAN-INDIANS WITH DISABILITIES SO MEDICAL CARE LA English DT Article ID ACCESS AB Although most American Indians and Alaska Natives have access to health care through the Indian Health Service (IHS), it is uncertain whether IHS is able to provide all necessary health services to those with disabilities. Although IHS eligibles can use health services other than those provided or sponsored by IHS, this may be precluded by high rates of poverty, low rates of other health insurance coverage, and the lack of private providers in many areas inhabited by this population. Using data from the 1987 Survey of American Indians and Alaska Natives-the only nationally representative health care survey of persons eligible for IHS-this study examines the use of ambulatory health care for IHS eligibles with disabilities. Comparisons with the total US population showed similar rates of ambulatory care use for most categories of disability, but a higher frequency of use for the total US population. Findings also show that IHS provides most of the health care for its eligible population, although non-IHS care is also used. After controlling for the effects of sociodemographic characteristics and health insurance coverage, variables indicating disabilities due to health problems were found to have statistically significant effects on the likelihood of using non-IHS care. Furthermore, persons with activity limitations had a higher than average likelihood of using most of their health care at non-IHS providers. These findings suggest that for some persons with disabilities, it is necessary to supplement IHS care with services from other providers. RP CUNNINGHAM, PJ (reprint author), AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,EXECUT OFF CTR,SUITE 500,ROCKVILLE,MD 20852, USA. NR 22 TC 17 Z9 17 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD JUL PY 1993 VL 31 IS 7 BP 600 EP 616 DI 10.1097/00005650-199307000-00003 PG 17 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA LN840 UT WOS:A1993LN84000003 PM 8326774 ER PT J AU ELIXHAUSER, A LUCE, BR TAYLOR, WR REBLANDO, J AF ELIXHAUSER, A LUCE, BR TAYLOR, WR REBLANDO, J TI HEALTH-CARE CBA CEA - AN UPDATE ON THE GROWTH AND COMPOSITION OF THE LITERATURE SO MEDICAL CARE LA English DT Article ID COST-EFFECTIVENESS ANALYSIS; BENEFIT AB Cost-benefit (CBA) and cost-effectiveness analyses (CEA) are methods that enumerate the costs and consequences associated with health-related technologies, services, and programs. This article examines the trends in published CBA and CEA of personal health services from 1979 through 1990. It is based on a bibliography that was compiled to help address the immense need for information on the variation and effectiveness of medical practices, particularly as researchers expand their analysis to a study of the cost effectiveness of medical and surgical interventions, health care technologies, preventive practices, and other health programs. A systematic search was conducted for all articles under the heading ''cost-benefit analysis'' (which includes cost-effectiveness analysis) and ''costs and cost analysis.'' Data sources included the MEDLARS (National Library of Medicine) database, other bibliographies in specialized areas, reference lists in key articles, and contacts with researchers in the field. All titles and abstracts were scanned to determine if the articles pertained to personal health services and if both costs and consequences were assessed. If both criteria were met, the article was included in the bibliography. This search resulted in 3,206 eligible CBA/CEA publications from 1979 through 1990. The publications were subdivided into two major categories: reports of studies and ''other'' publications, including reviews, descriptions of methodology, letters, and editorials. Reports of studies and ''other'' publications were classified into approximately 250 different topic areas. The studies were further classified by parameters, such as study type, publication vehicle, and medical function. This article describes the results of this classification and describes trends during 1979 to 1990 compared with 1966 to 1978. The classification of study reports and ''other'' publications into 250 topic areas is presented in Appendix A. The entire bibliography is reproduced in Appendix B. Detailed tables of findings are presented in Appendix C, and the results are illustrated graphically in Appendix D. Appendix E provides the coding scheme used in the bibliography's data base. C1 BATTELLE HUMAN AFFAIRS RES CTR,MED TECHNOL ASSESSMENT & POLICY RES CTR,370 LENFANT PROMENADE,WASHINGTON,DC 20024. AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,DIV PROVIDER SERV,ROCKVILLE,MD. CTR DIS CONTROL,OH PROGRAM PLANNING & EVALUAT,ATLANTA,GA 30333. NR 12 TC 81 Z9 82 U1 0 U2 2 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD JUL PY 1993 VL 31 IS 7 SU S BP JS1 EP JS11 DI 10.1097/00005650-199307001-00001 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA LP326 UT WOS:A1993LP32600001 PM 8326780 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI CLINICAL-PRACTICE GUIDELINES - ENHANCING QUALITY OF CARE SO MILITARY MEDICINE LA English DT Article RP CLINTON, JJ (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON ST,SUITE 601,ROCKVILLE,MD 20852, USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 SN 0026-4075 J9 MIL MED JI Milit. Med. PD JUL PY 1993 VL 158 IS 7 BP 446 EP 447 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA LM843 UT WOS:A1993LM84300009 PM 8351045 ER PT J AU DUFFY, SQ FRIEDMAN, B AF DUFFY, SQ FRIEDMAN, B TI HOSPITALS WITH CHRONIC FINANCIAL LOSSES - WHAT CAME NEXT SO HEALTH AFFAIRS LA English DT Article ID HEALTH AB Hospitals with chronic losses might respond by closing, by drastically changing their services and patient mix, or by increasing efficiency. These possible responses are examined by studying a cohort of hospitals that were losing money between 1980 and 1984 as measured by their five-year average total revenue margins. These ''negative-cohort'' hospitals were followed through 1988 to see if they survived, and if they did, what changes they made. Only about 10 percent of hospitals in the negative cohort closed. The remainder did not alter their service mix or select in favor of easier, better-paying patients. However, there was a reduced rate of investment in new technologies. RP DUFFY, SQ (reprint author), AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,DIV PROVIDER STUDIES,ROCKVILLE,MD, USA. NR 19 TC 29 Z9 29 U1 0 U2 0 PU PROJECT HOPE-HEALTH AFFAIRS PI SYRACUSE PA PO BOX 8015, SYRACUSE, NY 13217 SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD SUM PY 1993 VL 12 IS 2 BP 151 EP 163 DI 10.1377/hlthaff.12.2.151 PG 13 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA LN681 UT WOS:A1993LN68100015 PM 8375810 ER PT J AU RESCHOVSKY, JD RUCHLIN, HS AF RESCHOVSKY, JD RUCHLIN, HS TI QUALITY OF BOARD AND CARE HOMES SERVING LOW-INCOME ELDERLY - STRUCTURAL AND PUBLIC-POLICY CORRELATES SO JOURNAL OF APPLIED GERONTOLOGY LA English DT Article ID RESIDENTIAL CARE; ADULTS AB From data on 205 board and care homes that serve the poor elderly in seven states, structural and process variables were used to construct seven indexes covering dimensions of quality that contribute to the safety and quality of life of residents. Systematic differences were found in the indexes among homes of differing size and staffing patterns, as well as between proprietary and nonprofit facilities. For several dimensions of quality, state funding appears to result in improved quality. Overall, governmental regulatory policies did not significantly effect board and care home quality. C1 CORNELL UNIV,MED CTR,COLL MED,DEPT PUBL HLTH & MED,NEW YORK,NY 10021. RP RESCHOVSKY, JD (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON ST,SUITE 500,ROCKVILLE,MD 20852, USA. NR 25 TC 6 Z9 6 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 SN 0733-4648 J9 J APPL GERONTOL JI J. Appl. Gerontol. PD JUN PY 1993 VL 12 IS 2 BP 225 EP 245 DI 10.1177/073346489301200207 PG 21 WC Gerontology SC Geriatrics & Gerontology GA LZ295 UT WOS:A1993LZ29500007 ER PT J AU HSIA, DC AF HSIA, DC TI APPLICATION OF QUI-TAM TO THE QUALITY OF HEALTH-CARE SO JOURNAL OF LEGAL MEDICINE LA English DT Article ID ADVERSE EVENTS; MEDICAL-CARE; MALPRACTICE; IMPROVEMENT; NEGLIGENCE; CLAIMS RP HSIA, DC (reprint author), AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 83 TC 3 Z9 3 U1 0 U2 0 PU TAYLOR & FRANCIS PI BRISTOL PA 1900 FROST ROAD, SUITE 101, BRISTOL, PA 19007-1598 SN 0194-7648 J9 J LEGAL MED JI J. Legal Med. PD JUN PY 1993 VL 14 IS 2 BP 301 EP 317 PG 17 WC Law; Social Sciences, Biomedical SC Government & Law; Biomedical Social Sciences GA LJ296 UT WOS:A1993LJ29600006 PM 8340713 ER PT J AU LAVIZZOMOUREY, RJ CLINTON, JJ AF LAVIZZOMOUREY, RJ CLINTON, JJ TI CLINICAL-PRACTICE GUIDELINES - A KEY TO IMPROVING HEALTH-CARE FOR ALL POPULATIONS SO JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION LA English DT Editorial Material RP LAVIZZOMOUREY, RJ (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON ST,STE 600,ROCKVILLE,MD 20852, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0027-9684 J9 J NATL MED ASSOC JI J. Natl. Med. Assoc. PD JUN PY 1993 VL 85 IS 6 BP 425 EP 426 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA LF784 UT WOS:A1993LF78400002 PM 8366531 ER PT J AU HAHN, BA AF HAHN, BA TI MARITAL-STATUS AND WOMENS HEALTH - THE EFFECT OF ECONOMIC MARITAL ACQUISITIONS SO JOURNAL OF MARRIAGE AND THE FAMILY LA English DT Article ID SELF-RATED HEALTH; SOCIAL INTEGRATION; PHYSICAL HEALTH; DIVORCED WOMEN; FOLLOW-UP; MORTALITY; STRESS; MEN AB Research has established an inverse relationship between marriage and poor health for both men and women. Although to date no clear explanation emerges for why this relationship exists, one hypothesis that may appear the most relevant for interpreting this relationship for women is that married women have more economic resources compared to single women, and as a result, better health. Using data from the 1987 National Medical Expenditure Survey, this study examines the extent to which economic assets gained through marriage explain the relationship. The findings indicate that much though not all of the variation is explained by economic factors. RP HAHN, BA (reprint author), US DEPT HHS,DMES,CGHSIR,AGCY HLTH CARE POLICY & RES,2101 E JEFFERSON,SUITE 500,ROCKVILLE,MD 20852, USA. NR 52 TC 51 Z9 51 U1 0 U2 1 PU NATL COUNCIL FAMILY RELATIONS PI MINNEAPOLIS PA 3989 CENTRAL AVE NE #550, MINNEAPOLIS, MN 55421 SN 0022-2445 J9 J MARRIAGE FAM JI J. Marriage Fam. PD MAY PY 1993 VL 55 IS 2 BP 495 EP 504 DI 10.2307/352818 PG 10 WC Family Studies; Sociology SC Family Studies; Sociology GA LE130 UT WOS:A1993LE13000019 ER PT J AU LAVIZZOMOUREY, RJ HILLMAN, AL DISERENS, D SCHWARTZ, JS AF LAVIZZOMOUREY, RJ HILLMAN, AL DISERENS, D SCHWARTZ, JS TI HOSPITALS MOTIVATIONS IN ESTABLISHING OR CLOSING GERIATRIC EVALUATION MANAGEMENT UNITS - DIFFUSION OF A NEW PATIENT-CARE TECHNOLOGY IN A CHANGING HEALTH-CARE ENVIRONMENT SO JOURNALS OF GERONTOLOGY LA English DT Article ID TRIAL; MRI AB Background. Although Geriatric Evaluation Management Units (GEMs) are beneficial to patients, they are still new and their adoption by hospitals is unknown. This study describes the adoption of GEMs in a large sample of hospitals, and explores the reasons underlying hospitals' decisions to open (and sometimes close) an inpatient GEM. Methods. A nationwide mail survey was conducted of 3,655 hospitals. The survey asked whether the hospital had an operating GEM, had a GEM that closed, had considered opening a GEM (but had not done so), or had not considered opening a GEM. The survey also requested specific information about operating or closed GEMs. Descriptive statistics, chi-square, t-tests, one-way analysis of variance, and Tukey's standardized range test for multiple comparison of means were used to analyze the responses. Results. Among the 1,639 responding hospitals, 159 had established GEMs, 200 were evaluating the possibility of opening a GEM, and 1,263 had neither opened nor considered opening a GEM. Adopters were more likely to be large, urban, teaching hospitals. Evaluators were more optimistic than adopters about GEM's potential to meet financial goals. GEMs that closed tended to be located in hospitals experiencing budget deficits. Among adopters, space and nonphysician staffing were the most critical barriers to establishing a GEM whereas, for evaluators, identifying reimbursement sources and physician staffing were the greatest barriers. VA GEMs are smaller and initiated for different reasons than non-VA hospital GEMs. Conclusions. Despite their demonstrated usefulness, the adoption of GEMs has been limited. The reasons underlying decisions to adopt this new technology or close a GEM are often related to financial, not clinical concerns. C1 UNIV PENN,LEONARD DAVIS INST,3641 LOCUST WALK,PHILADELPHIA,PA 19104. AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. NR 19 TC 13 Z9 13 U1 1 U2 1 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 SN 0022-1422 J9 J GERONTOL JI J. Gerontol. PD MAY PY 1993 VL 48 IS 3 BP M78 EP M83 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA LA889 UT WOS:A1993LA88900014 PM 8482815 ER PT J AU PAUL, JE WEIS, KA EPSTEIN, RA AF PAUL, JE WEIS, KA EPSTEIN, RA TI DATA-BASES FOR VARIATIONS RESEARCH SO MEDICAL CARE LA English DT Editorial Material CT 4TH BIENNIAL REGENSTRIEF CONF ON METHODS FOR COMPARING PATTERNS OF CARE CY OCT 27-29, 1991 CL INDIANAPOLIS, IN SP DIABET RES & TRAINING CTR, ELI LILLY C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. MERCK SHARP & DOHME LTD,W POINT,PA 19486. RP PAUL, JE (reprint author), RES TRIANGLE INST,CTR POLICY STUDIES,POB 12194,RES TRIANGLE PK,NC 27709, USA. NR 14 TC 8 Z9 8 U1 1 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD MAY PY 1993 VL 31 IS 5 SU S BP YS96 EP YS102 DI 10.1097/00005650-199305001-00016 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA LC936 UT WOS:A1993LC93600016 PM 8492595 ER PT J AU BARTMAN, BA WOLFSTHAL, SD FAIRCHILD, ES CLANCY, C AF BARTMAN, BA WOLFSTHAL, SD FAIRCHILD, ES CLANCY, C TI RESIDENTS ROLE PERCEPTIONS IN PROVIDING HEALTH-CARE TO WOMEN SO CLINICAL RESEARCH LA English DT Meeting Abstract C1 UNIV MARYLAND,BALTIMORE,MD 21201. AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0009-9279 J9 CLIN RES JI Clin. Res. PD APR PY 1993 VL 41 IS 2 BP A554 EP A554 PG 1 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA KW761 UT WOS:A1993KW76102527 ER PT J AU FISHBEIN, HA AF FISHBEIN, HA TI PATIENT OUTCOMES RESEARCH AND TYPE-II DIABETES - THE AGENCY FOR HEALTH-CARE POLICY AND RESEARCH FOCUSES ON IMPROVING PATIENT OUTCOMES SO DIABETES CARE LA English DT Note RP FISHBEIN, HA (reprint author), AGCY HLTH CARE POLICY & RES,CTR MED EFFECTIVENESS RES,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 1 TC 2 Z9 2 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD APR PY 1993 VL 16 IS 4 BP 656 EP 657 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA KU330 UT WOS:A1993KU33000021 PM 8462397 ER PT J AU CLANCY, C GOLD, M WALL, E AF CLANCY, C GOLD, M WALL, E TI PRIMARY CARE AND HEALTH-CARE REFORM - THE NEXT 100 DAYS SO JOURNAL OF FAMILY PRACTICE LA English DT Article ID PREVENTIVE CARE C1 US DEPT HHS,OFF DIS PREVENT & HLTH PROMOT,ROCKVILLE,MD 20852. RP CLANCY, C (reprint author), US DEPT HHS,DIV PRIMARY CARE,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852, USA. NR 9 TC 3 Z9 3 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD FEB PY 1993 VL 36 IS 2 BP 233 EP 235 PG 3 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA KL864 UT WOS:A1993KL86400026 PM 8426146 ER PT J AU LAVIZZOMOUREY, R AF LAVIZZOMOUREY, R TI CLINICS IN GERIATRIC-MEDICINE - HEALTH PROMOTION AND DISEASE PREVENTION - OMENN,GS, LARSON,E, WAGNER,E, ABRASS,I SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Book Review RP LAVIZZOMOUREY, R (reprint author), AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD, USA. NR 1 TC 0 Z9 0 U1 0 U2 1 PU WILLIAMS & WILKINS PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD FEB PY 1993 VL 41 IS 2 BP 200 EP 200 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA KL148 UT WOS:A1993KL14800024 ER PT S AU CLINTON, JJ AF CLINTON, JJ BE Warren, KS Mosteller, F TI FINANCING MEDICAL EFFECTIVENESS RESEARCH - ROLE OF THE AGENCY FOR HEALTH-CARE POLICY AND RESEARCH SO DOING MORE GOOD THAN HARM: THE EVALUATION OF HEALTH CARE INTERVENTIONS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Doing More Good Than Harm: The Evaluation of Health Care Interventions CY MAR 22-25, 1993 CL NEW YORK, NY SP NEW YORK ACAD SCI, L W FROHLICH CHARITABLE TRUST RP CLINTON, JJ (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,PUBL HLTH SERV,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 SN 0077-8923 BN 0-89766-833-2 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 1993 VL 703 BP 295 EP 297 DI 10.1111/j.1749-6632.1993.tb26365.x PG 3 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA BA22S UT WOS:A1993BA22S00034 PM 8192310 ER PT J AU SELBYHARRINGTON, ML DONAT, PL HIBBARD, HD AF SELBYHARRINGTON, ML DONAT, PL HIBBARD, HD TI GUIDANCE FOR MANAGING A RESEARCH GRANT SO NURSING RESEARCH LA English DT Article C1 US PHYS,AGCY HLTH CARE POLICY & RES,CTR MED EFFECTIVENESS RES,ROCKVILLE,MD. RP SELBYHARRINGTON, ML (reprint author), UNIV N CAROLINA,SCH NURSING,GREENSBORO,NC 27412, USA. FU AHRQ HHS [5 R01 HS 06507] NR 5 TC 3 Z9 3 U1 0 U2 0 PU AMER J NURSING CO PI NEW YORK PA 555 W 57TH ST, NEW YORK, NY 10019-2961 SN 0029-6562 J9 NURS RES JI Nurs. Res. PD JAN-FEB PY 1993 VL 42 IS 1 BP 54 EP 58 PG 5 WC Nursing SC Nursing GA KQ376 UT WOS:A1993KQ37600010 PM 8424070 ER PT J AU WEIS, KA EPSTEIN, RS HUSE, DM DEVERKA, PA OSTER, G AF WEIS, KA EPSTEIN, RS HUSE, DM DEVERKA, PA OSTER, G TI THE COSTS OF PROSTATECTOMY FOR BENIGN PROSTATIC HYPERPLASIA SO PROSTATE LA English DT Article DE POSTOPERATIVE COMPLICATIONS; COST ANALYSIS; ECONOMICS ID CARE OUTCOMES; REOPERATION; MORTALITY; SURGERY AB Using claims data for a 5% random sample of Medicare beneficiaries, we estimated the costs of surgical treatment for benign prostatic hyperplasia (BPH), including those related to the initial prostatectomy, the treatment of postsurgical complications, and reoperation within one year. We identified 14,480 men who underwent prostatectomy for BPH during 1986-1987, including 13,730 transurethral and 750 open procedures. Mean total inpatient costs (including all hospital charges and professional service fees) for these procedures were estimated to be $6,501 and $10,223, respectively. Among patients who underwent trans-urethral and open prostatectomy, we identified 938 (6.8%) and 39 (5.2%) individuals who had at least one readmission for postsurgical complications or reoperation. Total expected costs of transurethral and open prostatectomy, inclusive of readmissions for complications and reoperations within one year, were estimated to be $6,823 and $10,477, respectively. Our study indicates the economic burden represented by surgical treatment of BPH. (C) 1993 Wiley-Liss, Inc. C1 MERCK SHARP & DOHME LTD,W POINT,PA 19486. UNIV MARYLAND,BALTIMORE,MD 21201. POLICY ANAL INC,BOSTON,MA. RP WEIS, KA (reprint author), AGCY HLTH CARE POLICY & RES,CTR MED EFFECT RES,2101 E JEFFERSON ST,SUITE 605,ROCKVILLE,MD 20857, USA. NR 17 TC 20 Z9 25 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0270-4137 J9 PROSTATE JI Prostate PY 1993 VL 22 IS 4 BP 325 EP 334 DI 10.1002/pros.2990220407 PG 10 WC Endocrinology & Metabolism; Urology & Nephrology SC Endocrinology & Metabolism; Urology & Nephrology GA LJ565 UT WOS:A1993LJ56500006 PM 7684526 ER PT J AU BERK, ML MONHEIT, AC AF BERK, ML MONHEIT, AC TI THE CONCENTRATION OF HEALTH EXPENDITURES - AN UPDATE SO HEALTH AFFAIRS LA English DT Article AB An earlier study tracing trends in health spending from 1928 to 1980 found health expenditures concentrated among the top 1 percent of those spending money for health care. In an update to that study, the authors found that that trend toward concentration has increased. In 1987 the top 1 percent of spenders accounted for 30 percent of health spending, up from 26 percent in 1970 and 29 percent in 1980. In contrast, the bottom half of the population in terms of spending accounted for only 3 percent of total spending in 1987. The average expenditure for the top 1 percent of spenders in 1987 was $47,331. Nearly half of those top spenders in 1987 were elderly. Also, more than 16 percent were black, up from nearly 10 percent in 1980. C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. RP BERK, ML (reprint author), PROJECT HOPE CTR HLTH AFFAIRS,CHEVY CHASE,MD, USA. NR 3 TC 64 Z9 64 U1 0 U2 4 PU PROJECT HOPE-HEALTH AFFAIRS PI SYRACUSE PA PO BOX 8015, SYRACUSE, NY 13217 SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD WIN PY 1992 VL 11 IS 4 BP 145 EP 149 DI 10.1377/hlthaff.11.4.145 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA KG733 UT WOS:A1992KG73300010 PM 1483633 ER PT J AU SPILLMAN, BC AF SPILLMAN, BC TI THE IMPACT OF BEING UNINSURED ON UTILIZATION OF BASIC HEALTH-CARE SERVICES SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article AB Recent proposals to increase access to health insurance suggest the need to know what the magnitude of responses would be if the one in five nonelderly persons uninsured for all or part of the year were to become insured. This paper finds that an additional commitment of resources to hospital and ambulatory care on the order of $26 billion (in 1989 dollars), or about 4% of total national health care spending, would be required if those now uninsured were to use these services on a par with the privately insured. The primary inputs to this result are new estimates of the impact of being uninsured which indicate a substantial potential response to insurance, particularly by adults. RP SPILLMAN, BC (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,ROCKVILLE,MD 20852, USA. NR 27 TC 52 Z9 52 U1 0 U2 1 PU BLUE CROSS BLUE SHIELD ASSOC PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD WIN PY 1992 VL 29 IS 4 BP 457 EP 466 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA KG140 UT WOS:A1992KG14000009 PM 1473869 ER PT J AU SANCHEZ, ME MORCHIO, G AF SANCHEZ, ME MORCHIO, G TI PROBING DONT KNOW ANSWERS - EFFECTS ON SURVEY ESTIMATES AND VARIABLE RELATIONSHIPS SO PUBLIC OPINION QUARTERLY LA English DT Article AB Don't Know responses to survey questions are ambiguous because the same words are used by respondents to mean different things--ignorance, indecision, or uncertainty about the meaning of the question asked. In order to clarify the meaning of such answers, survey interviewers are frequently trained to probe Don't Know answers at least once before the answer is considered final. We argue that unconditional probing of Don't Know answers may not be a desirable practice, particularly as regards knowledge items. Large unintended effects on responses to four knowledge items resulted when two groups of interviewers, who administered the same survey questions, probed Don't Know responses at different rates. Strong evidence is provided in the article that the probing of Don't Know answers encouraged guesswork on the part of uninformed respondents, giving rise to significant distributional differences and differences in means across half samples for the affected variables. However, relationships between variables appear to be largely unaffected by probing effects. In order to formulate valid probing guidelines for interviewer training, fur-ther research is needed to establish whether the findings for knowledge questions generalize to factual questions. C1 UNIV MICHIGAN,INST SOCIAL RES,ANN ARBOR,MI 48109. RP SANCHEZ, ME (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,WASHINGTON,DC, USA. NR 4 TC 25 Z9 25 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0033-362X J9 PUBLIC OPIN QUART JI Public Opin. Q. PD WIN PY 1992 VL 56 IS 4 BP 454 EP 474 DI 10.1086/269337 PG 21 WC Communication; Political Science; Social Sciences, Interdisciplinary SC Communication; Government & Law; Social Sciences - Other Topics GA KM551 UT WOS:A1992KM55100003 ER PT J AU FRANKS, P CLANCY, CM NUTTING, PA AF FRANKS, P CLANCY, CM NUTTING, PA TI GATEKEEPING - REPLY SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. RP FRANKS, P (reprint author), UNIV ROCHESTER,SCH MED,ROCHESTER,NY 14642, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD NOV 19 PY 1992 VL 327 IS 21 BP 1533 EP 1533 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA JY165 UT WOS:A1992JY16500027 ER PT J AU SCHONE, BS AF SCHONE, BS TI DO MEANS TESTED TRANSFERS REDUCE LABOR SUPPLY SO ECONOMICS LETTERS LA English DT Article AB It is frequently argued that recipients of means tested government transfers work less than they would in the absence of the transfer. This note shows that this conclusion may not be accurate for many participants in a major housing program. RP SCHONE, BS (reprint author), AGCY HLTH CARE POLICY & RES,SUITE 500,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 6 TC 7 Z9 7 U1 1 U2 2 PU ELSEVIER SCIENCE SA LAUSANNE PI LAUSANNE 1 PA PO BOX 564, 1001 LAUSANNE 1, SWITZERLAND SN 0165-1765 J9 ECON LETT JI Econ. Lett. PD NOV PY 1992 VL 40 IS 3 BP 353 EP 357 PG 5 WC Economics SC Business & Economics GA KZ199 UT WOS:A1992KZ19900017 ER PT J AU CLANCY, CM MASSION, CT AF CLANCY, CM MASSION, CT TI AMERICAN WOMENS HEALTH-CARE - A PATCHWORK QUILT WITH GAPS SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID PSYCHOTROPIC-DRUG USE; SEX-DIFFERENCES; INSURANCE; DISEASE; ABUSE RP CLANCY, CM (reprint author), AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV EXTRAMURAL RES,DIV PRIMARY CARE,EOC 502,ROCKVILLE,MD 20852, USA. NR 47 TC 84 Z9 85 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 14 PY 1992 VL 268 IS 14 BP 1918 EP 1920 DI 10.1001/jama.268.14.1918 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA JR439 UT WOS:A1992JR43900044 PM 1404719 ER PT J AU MCCORMICK, KA AF MCCORMICK, KA TI ACKNOWLEDGMENT OF PRACTICE GUIDELINES PANELS SO AMERICAN FAMILY PHYSICIAN LA English DT Letter RP MCCORMICK, KA (reprint author), AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD OCT PY 1992 VL 46 IS 4 BP 1039 EP 1039 PG 1 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA JR198 UT WOS:A1992JR19800001 ER PT J AU KEMPER, P AF KEMPER, P TI THE USE OF FORMAL AND INFORMAL HOME CARE BY THE DISABLED ELDERLY SO HEALTH SERVICES RESEARCH LA English DT Article; Proceedings Paper CT 1989 ANNUAL MEETING OF THE ALLIED SOCIAL SCIENCE ASSOC CY DEC 28-30, 1989 CL ATLANTA, GA SP ALLIED SOCIAL SCI ASSOC ID HEALTH-SERVICES; COMMUNITY CARE; SUBSTITUTION AB Using data from the Channeling experiment, this article analyzes the factors associated with the amount of formal and informal home care received by the disabled elderly. The amounts of formal and informal home care used increase with disability, as well as with other measures of need for care. The use of formal care increases, and the use of informal care decreases, with income. The availability of immediate family increases reliance on informal care and reduces reliance on formal care. The findings have implications for the design of proposed programs to expand publicly financed home care for the disabled elderly. RP KEMPER, P (reprint author), AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,POB 8547,SILVER SPRING,MD 20907, USA. NR 28 TC 185 Z9 187 U1 0 U2 10 PU HEALTH ADMINISTRATION PRESS PI MELROSE PARK PA C/O FOUNDATION AMER COLL HEALTHCARE EXECUTIVES 1951 CORNELL AVE, MELROSE PARK, IL 60160 SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 1992 VL 27 IS 4 BP 421 EP 451 PG 31 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA JR905 UT WOS:A1992JR90500001 PM 1399651 ER PT J AU YOUNG, G BEEKUN, RI GINN, GO AF YOUNG, G BEEKUN, RI GINN, GO TI GOVERNING BOARD STRUCTURE, BUSINESS STRATEGY, AND PERFORMANCE OF ACUTE CARE HOSPITALS - A CONTINGENCY PERSPECTIVE SO HEALTH SERVICES RESEARCH LA English DT Article ID ORGANIZATION; ENVIRONMENT; DIRECTORS; LINKAGE; SIZE AB Contingency theory suggests that for a hospital governing board to be effective in taking on a more active role in strategic management, the board needs to be structured to complement the overall strategy of the organization. A survey study was conducted to examine the strategies of acute care hospitals as related to the structural characteristics of their governing boards. After controlling for organizational size and system membership, results indicated a significant relationship between the governing board structure of 109 acute care hospitals and their overall business strategy. Strategy also accounted for more of the variance in board structure than either organization size or system membership. Finally, the greater the match between board structure and hospital strategy, the stronger the hospitals' financial performance. C1 US DEPT HHS,AGCY HLTH CARE POLICY & RES,WASHINGTON,DC 20201. UNIV CENT TEXAS,HLTH SERV ADM,KILLEEN,TX. UNIV NEVADA,COLL BUSINESS ADM,DEPT MANAGERIAL SCI,RENO,NV 89557. RP YOUNG, G (reprint author), LEWIN ICF,9300 LEE HIGHWAY,FAIRFAX,VA 22031, USA. NR 41 TC 16 Z9 16 U1 4 U2 8 PU HEALTH ADMINISTRATION PRESS PI MELROSE PARK PA C/O FOUNDATION AMER COLL HEALTHCARE EXECUTIVES 1951 CORNELL AVE, MELROSE PARK, IL 60160 SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 1992 VL 27 IS 4 BP 543 EP 564 PG 22 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA JR905 UT WOS:A1992JR90500006 PM 1399656 ER PT J AU TURNER, BJ BALL, JK AF TURNER, BJ BALL, JK TI VARIATIONS IN INPATIENT MORTALITY FOR AIDS IN A NATIONAL SAMPLE OF HOSPITALS SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Article DE MORTALITY; HOSPITALIZATION; VARIATIONS, REGIONAL ID ACQUIRED IMMUNODEFICIENCY SYNDROME; INTRAVENOUS DRUG-USERS; NEW-YORK-CITY; IMMUNE-DEFICIENCY SYNDROME; PNEUMONIA; SURVIVAL; HOSPITALIZATIONS; EXPERIENCE; BACTEREMIA; INFECTION AB In this project, we examined the spectrum of AIDS-related conditions and variations in associated inpatient mortality for AIDS patients treated in a national sample of hospitals. We identified 10,538 adult discharges with a diagnosis indicating AIDS from 258 hospitals from a national sample of 438 acute-care hospitals with 6 million discharges in 1986-1987. Opportunistic and other infections occurred in 55.9 and 37.9%, respectively, of AIDS discharges, and inpatient fatality rates varied considerably depending on complication type(s) and comorbidities. Clinical conditions were more important predictors of inpatient death than demographic or treatment site characteristics. Among opportunistic infections, odds of inpatient death were significantly increased for progressive multifocal leukoencephalopathy (odds ratio [OR] = 2.8), Pneumocystis carinii pneumonia (OR = 2.4), cryptococcosis (OR = 1.6), atypical mycobacterial infections (OR = 1.6), and toxoplasmosis (OR = 1.3). Odds of inpatient death were also significantly increased by non-AIDS-defining infections causing septicemia (OR = 3.1) or CNS involvement (OR = 1.6) or pulmonary involvement (OR = 1.5). After controlling for clinical conditions, significant differences in odds of death persisted across regions, age, and ethnic groups. Increases in hospitals' AIDS treatment experience were associated with a significant decrease in odds of inpatient death. These analyses provide a national perspective on the diversity of AIDS-related clinical conditions and their relative effects on inpatient mortality. C1 US DEPT HHS,AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,ROCKVILLE,MD 20852. THOMAS JEFFERSON UNIV,JEFFERSON MED COLL,DEPT MED,PHILADELPHIA,PA 19107. NR 42 TC 47 Z9 47 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD OCT PY 1992 VL 5 IS 10 BP 978 EP 987 PG 10 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA JN550 UT WOS:A1992JN55000003 PM 1453327 ER PT J AU DOR, A HELD, PJ PAULY, MV AF DOR, A HELD, PJ PAULY, MV TI THE MEDICARE COST OF RENAL DIALYSIS - EVIDENCE FROM A STATISTICAL COST FUNCTION SO MEDICAL CARE LA English DT Article DE COST; MEDICARE; RENAL DIALYSIS; HEMODIALYSIS ID MULTIPLE-OUTPUT ANALYSIS; HOSPITAL COSTS; UNITED-STATES; COMPETITION AB Medicare's End Stage Renal Dialysis Program currently costs more than $6 billion per year, which covers renal dialysis, kidney transplants and other life-saving medical care for 190,000 patients of all ages suffering from chronic renal failures. Medicare reimburses dialysis units for dialysis treatments using a formula based on accounting costs reported by a small sample of facilities. However, accounting methods may obscure the true economic costs of providing the different type of dialysis treatments such as hemodialysis, continuous ambulatory peritoneal dialysis, and continuous cycling peritoneal dialysis. In this study, a multiproduct, statistical cost function approach to obtain cost estimates was used. Results obtained in this study show that the average cost and marginal cost of hemodialysis treatments are generally in line with current reimbursement rates, whereas the average and marginal costs of continuous ambulatory peritoneal dialysis treatments may be below this rate. For in-center hemodialysis, which is the mainstay of all dialysis units, the authors found evidence of decreasing economies of scale at the mean facility size, but found constant returns to scale for other modalities. Some evidence of economies of scale from chain ownership of dialysis centers was discovered. Finally, the analysis indicates that the Medicare reimbursement formula may be outdated, and further research that could lead to the design of more "rational" payment rules is suggested. C1 URBAN INST,RENAL PROGRAM,2100 M ST NW,WASHINGTON,DC 20037. AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. UNIV PENN,LEONARD DAVIS INST HLTH ECON,PHILADELPHIA,PA 19104. NR 20 TC 28 Z9 28 U1 0 U2 3 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD OCT PY 1992 VL 30 IS 10 BP 879 EP 891 DI 10.1097/00005650-199210000-00001 PG 13 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA JT382 UT WOS:A1992JT38200001 PM 1405794 ER PT J AU HELLINGER, FJ AF HELLINGER, FJ TI FORECASTS OF THE COSTS OF MEDICAL-CARE FOR PERSONS WITH HIV - 1992-1995 SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID UNITED-STATES; AIDS; EPIDEMIC; TRENDS AB This study concludes that the cumulative (national) cost of treating all persons with the human immunodeficiency virus (HIV) rose considerably over the past year and will continue to rise over the next several years. It is forecast that the cumulative cost of treating all persons with HIV will increase 48% from 1992 to 1995 (from $10.3 billion to $15.2 billion). It is estimated that the average yearly cost of treating a person with AIDS is $38,300 and of treating an infected person without AIDS is $10,000. The lifetime cost of treating a PWA is calculated to be $102,000. This is the first study to use, along with other data, data from the AIDS Cost and Service Utilization Survey to estimate the cost of treating persons with the HIV. The study also projects the number of AIDS cases to be 66,300 in 1992, 76,200 in 1993, 86,800 in 1994, and 97,800 in 1995. RP HELLINGER, FJ (reprint author), AGCY HLTH CARE POLICY & RES,CGHSER,DIV COST & FINANCING,SUITE 502,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 39 TC 74 Z9 75 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSOC PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD FAL PY 1992 VL 29 IS 3 BP 356 EP 365 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA JR248 UT WOS:A1992JR24800009 PM 1356925 ER PT J AU SHORT, PF LEFKOWITZ, DC AF SHORT, PF LEFKOWITZ, DC TI ENCOURAGING PREVENTIVE SERVICES FOR LOW-INCOME CHILDREN - THE EFFECT OF EXPANDING MEDICAID SO MEDICAL CARE LA English DT Article ID VACCINE AB Every year since 1984, Congress has expanded Medicaid to cover an increasing proportion of low-income children. In this study, a multivariate analysis of data from the 1987 National Medical Expenditure Survey was used to determine whether expanded Medicaid eligibility is likely to be effective in encouraging recommended preventive visits for low-income, preschool children. For low-income children who would otherwise be uninsured, a full year of Medicaid increased the probability of any well-child visits by 17 percentage points, and compliance with the guidelines of the American Academy of Pediatrics for well-child visits increased by 13 percentage points. The generosity of Medicaid fees did not alter the magnitude of these effects. However, even if all uninsured children under 200% of the poverty line were eligible for Medicaid, low-income children would continue to lag behind other children in their use of preventive services. Factors other than insurance and income, such as the lower educational attainment of low-income mothers, explain approximately 80% of the gap between children above and below 200% of poverty. The rate of compliance with the American Academy of Pediatrics guidelines was less than 50% for all preschool children. Departures from the recommended schedule of visits were particularly pronounced in the second year of life and may interfere with children receiving the recommended immunizations in a timely manner. C1 AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,ROCKVILLE,MD. NR 25 TC 76 Z9 76 U1 0 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD SEP PY 1992 VL 30 IS 9 BP 766 EP 780 DI 10.1097/00005650-199209000-00002 PG 15 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA JN029 UT WOS:A1992JN02900002 PM 1518310 ER PT J AU BROWN, R COREA, J LUCE, B ELIXHAUSER, A SHEINGOLD, S AF BROWN, R COREA, J LUCE, B ELIXHAUSER, A SHEINGOLD, S TI ESTIMATED NATIONAL SPENDING ON DISEASE AND INJURY PREVENTION - UNITED-STATES, 1988 (REPRINTED FROM MORBIDITY AND MORTALITY WEEKLY REPORT, VOL 41, PG 529-531, 1992) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CTR DIS CONTROL,OFF DIRECTOR,OFF PROGRAM PLANNING & EVALUAT,ATLANTA,GA 30333. HLTH CARE FINANCING ADM,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. RP BROWN, R (reprint author), BATTELLE MEM INST,MED TECHNOL & POLICY RES CTR,ARLINGTON,VA 22217, USA. NR 7 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 26 PY 1992 VL 268 IS 8 BP 969 EP 970 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA JK129 UT WOS:A1992JK12900010 ER PT J AU FRANKS, P CLANCY, CM NUTTING, PA AF FRANKS, P CLANCY, CM NUTTING, PA TI GATEKEEPING REVISITED - PROTECTING PATIENTS FROM OVERTREATMENT SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID FEE-FOR-SERVICE; RANDOMIZED CONTROLLED TRIAL; PREPAID GROUP-PRACTICE; PRIMARY CARE; FINANCIAL INCENTIVES; AMBULATORY CARE; PHYSICIAN SPECIALTY; HEALTH-INSURANCE; MEDICAL-CARE; HOSPITALIZED-PATIENTS C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852. RP FRANKS, P (reprint author), UNIV ROCHESTER,DEPT FAMILY MED,885 SOUTH AVE,ROCHESTER,NY 14620, USA. NR 109 TC 233 Z9 234 U1 1 U2 12 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD AUG 6 PY 1992 VL 327 IS 6 BP 424 EP 429 DI 10.1056/NEJM199208063270613 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA JG356 UT WOS:A1992JG35600013 PM 1625720 ER PT J AU GOLDFARB, MG COFFEY, RM AF GOLDFARB, MG COFFEY, RM TI CHANGE IN THE MEDICARE CASE-MIX INDEX IN THE 1980S AND THE EFFECT OF THE PROSPECTIVE PAYMENT SYSTEM SO HEALTH SERVICES RESEARCH LA English DT Article; Proceedings Paper CT MEETING OF THE AMERICAN ECONOMIC ASSOC CY DEC 30, 1987 CL CHICAGO, IL SP AMER ECON ASSOC AB Persistent increases in the Medicare case-mix index over the 1980s have been ascribed to changes both in medical treatment ("real changes") and in the way medical information is recorded ("coding changes") in hospitals. These changes have been attributed, in the absence of appropriate data and analyses, to the incentives of the Medicare prospective payment system (PPS). Using data for 1980-1986 from 235 hospitals, we estimate the effect on the Medicare case-mix index of a series of variables that reflect medical treatments and coding practices. Each of these underlying real or coding variables was changing prior to PPS and would likely have continued to change even in the absence of PPS. Furthermore, PPS may have had a distinct effect on these variables. These underlying trends and the PPS effects must each be estimated. Thus, the analysis begins by developing separate estimates for each of these real and coding variables (1) in the absence of PPS (autonomous effects) and (2) as a result of PPS (induced effects). Then, changes in the case-mix index are regressed against all of these variables to determine the degree to which specific autonomous real or coding variables or induced real or coding variables actually influenced measured case mix. Results show that real and coding changes each accounted for about half of the change in the Medicare case-mix index between 1980 and 1986, with the influence of coding starting to wane by 1986. PPS-induced factors explain about 80 percent of the change in measured case mix over time, autonomous factors about 20 percent. Especially powerful determinants of case-mix change included PPS-induced substitution of surgical for medical care and PPS-induced improvements in the accuracy of coding that led to assignment of patients to higher-weighted DRGs. Also, stringent Medicare peer review organizations appeared to restrain rises in case-mix indexes for their hospitals. Outpatient substitution for inpatient treatment, which others attributed to PPS, was well underway before PPS was announced. C1 AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,DIV PROVIDER STUDIES,ROCKVILLE,MD. UNIV MARYLAND,ECON,CATONSVILLE,MD 21228. NR 10 TC 17 Z9 17 U1 0 U2 1 PU HEALTH ADMINISTRATION PRESS PI MELROSE PARK PA C/O FOUNDATION AMER COLL HEALTHCARE EXECUTIVES 1951 CORNELL AVE, MELROSE PARK, IL 60160 SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD AUG PY 1992 VL 27 IS 3 BP 385 EP 415 PG 31 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA JJ748 UT WOS:A1992JJ74800006 PM 1500292 ER PT J AU DUFFY, SQ FARLEY, DE AF DUFFY, SQ FARLEY, DE TI THE PROTRACTED DEMISE OF MEDICAL TECHNOLOGY - THE CASE OF INTERMITTENT POSITIVE PRESSURE BREATHING SO MEDICAL CARE LA English DT Article DE MEDICAL TECHNOLOGY; IPPB; CHRONIC OBSTRUCTIVE PULMONARY DISEASE ID DIFFUSION; INNOVATION; HOSPITALS; THERAPY AB In this study, the effects of hospital, staff, and patient characteristics on the rates of use and abandonment of an outmoded medical technology, intermittent positive pressure breathing (IPPB) are analyzed. The study focuses specifically on the use of IPPB to treat inpatients with chronic obstructive pulmonary disease in a national sample of more than 500 community hospitals from 1980 to 1987. Cross-sectionally, hospitals with shorter case-mix-adjusted lengths of stay, private nonprofit or investor-owned hospitals, and hospitals located outside of the north central United States were more likely to abandon IPPB by 1980. Teaching status, location, ownership, volume, and source of payment all appeared to affect rates of IPPB use in 1980. The longitudinal analysis examines both the probability a hospital abandoned IPPB and declines in rates of IPPB use over the study period, conditioned on the availability of IPPB in 1980. The results show that changes in the characteristics of hospitals, patients, and physicians all help to explain variations in the abandonment of IPPB. These findings contrast with previous studies of technological change, which find hospital size to be the most important variable. Size is important in explaining the rate of use in 1980, but it has no effect on the rate of decline in use or abandonment after 1980. In general, the analysis demonstrates that a combination of factors, economic incentives as well as information, contribute to the abandonment of outmoded medical technologies. Given the surprisingly long time periods required for this process to occur, the analysis underscores the need to strengthen financial incentives that encourage appropriate medical decisions and to disseminate information about the efficacy of specific procedures more widely and effectively. RP DUFFY, SQ (reprint author), AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,DIV PROVIDER STUDIES,SUITE 500,2101 EXECUT BLVD,ROCKVILLE,MD 20852, USA. NR 49 TC 17 Z9 17 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD AUG PY 1992 VL 30 IS 8 BP 718 EP 736 DI 10.1097/00005650-199208000-00004 PG 19 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA JG552 UT WOS:A1992JG55200004 PM 1640767 ER PT J AU NUTTING, PA AF NUTTING, PA TI AHCPR CLINICAL-PRACTICE GUIDELINES SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material RP NUTTING, PA (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV,DIV PRIMARY CARE,ROCKVILLE,MD, USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUL PY 1992 VL 46 IS 1 BP 57 EP 58 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA JD743 UT WOS:A1992JD74300007 PM 1621640 ER PT J AU MOORE, SR AF MOORE, SR TI PHARMACY IMPLICATIONS OF CLINICAL GUIDELINE DEVELOPMENT SO AMERICAN JOURNAL OF HOSPITAL PHARMACY LA English DT Editorial Material RP MOORE, SR (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,OFF FORUM QUAL & EFFECT HLTH CARE,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 2 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC HEALTH-SYSTEM PHARMACISTS PI BETHESDA PA 7272 WISCONSIN AVE, BETHESDA, MD 20814 SN 0002-9289 J9 AM J HOSP PHARM JI Am. J. Hosp. Pharm. PD JUL PY 1992 VL 49 IS 7 BP 1763 EP 1764 PG 2 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA JC010 UT WOS:A1992JC01000033 PM 1621737 ER PT J AU NUTTING, PA FRANKS, P CLANCY, CM AF NUTTING, PA FRANKS, P CLANCY, CM TI REFERRAL AND CONSULTATION IN PRIMARY CARE - DO WE UNDERSTAND WHAT WERE DOING SO JOURNAL OF FAMILY PRACTICE LA English DT Editorial Material ID GENERAL-PRACTITIONERS; FAMILY PHYSICIANS; ECONOMIC-IMPACT; RATES; COMMUNICATION; INTERNISTS; DECISIONS; PATTERNS RP NUTTING, PA (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV EXTRAMURAL RES,SUITE 502 EXECUT OFF CTR,ROCKVILLE,MD 20852, USA. NR 41 TC 42 Z9 42 U1 0 U2 1 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD JUL PY 1992 VL 35 IS 1 BP 21 EP 23 PG 3 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA JD412 UT WOS:A1992JD41200008 PM 1613471 ER PT J AU SAMUELS, BE BEGAY, ME HAZAN, AR GLANTZ, SA AF SAMUELS, BE BEGAY, ME HAZAN, AR GLANTZ, SA TI PHILIP-MORRIS FAILED EXPERIMENT IN PITTSBURGH SO JOURNAL OF HEALTH POLITICS POLICY AND LAW LA English DT Article AB The campaign for passage and implementation of Pittsburgh's Smoking Control Ordinance in 1987 illustrates the role controversy plays in tobacco control. Proponents of the ordinance sought at first to keep it noncontroversial, while the tobacco industry tried to defeat the ordinance by generating controversy, claiming that severe economic and social disruption would occur. After the ordinance had been in force for a year, Philip Morris tried to take over its implementation, seeking to redefine the central issue as one of social accommodation rather than health. To succeed, Philip Morris's effort had to be widely accepted and noncontroversial. Proponents of the ordinance countered with controversy to undermine the campaign and expose the company's intentions. The controversy made the established health organizations uncomfortable, causing them to play only a marginal role. Surprisingly, the people who prevailed were the nonsmokers' rights activists, a small group with limited resources. C1 UNIV CALIF SAN FRANCISCO,CARDIOVASC RES INST,SAN FRANCISCO,CA 94143. RP SAMUELS, BE (reprint author), UNIV CALIF SAN FRANCISCO,INST HLTH POLICY STUDIES,AGCY HLTH CARE POLICY & RES,SAN FRANCISCO,CA 94143, USA. FU AHRQ HHS [2T32HS00026-06] NR 29 TC 15 Z9 15 U1 0 U2 0 PU DUKE UNIV PRESS PI DURHAM PA BOX 90660, DURHAM, NC 27708-0660 SN 0361-6878 J9 J HEALTH POLIT POLIC JI J. Health Polit. Policy Law PD SUM PY 1992 VL 17 IS 2 BP 329 EP 351 DI 10.1215/03616878-17-2-329 PG 23 WC Health Care Sciences & Services; Health Policy & Services; Medicine, Legal; Social Issues; Social Sciences, Biomedical SC Health Care Sciences & Services; Legal Medicine; Social Issues; Biomedical Social Sciences GA JB476 UT WOS:A1992JB47600008 PM 1500653 ER PT J AU SANCHEZ, ME AF SANCHEZ, ME TI EFFECTS OF QUESTIONNAIRE DESIGN ON THE QUALITY OF SURVEY DATA SO PUBLIC OPINION QUARTERLY LA English DT Article AB The importance of format, graphic layout, and question routing instructions on the quality of survey data has been acknowledged for self-administered survey instruments, but the significance of these factors for questionnaires administered by interviewers has not been recognized equally. This paper examines two studies in which interviewers used different questionnaire designs to administer the same set of survey questions to randomly selected adult respondents in housing units that made up area probability samples of the Detroit metropolitan area. The paper presents empirical evidence of specific effects (questions skipped in error, unprobed answers) directly attributable to the choice of questionnaire design. The analysis shows that questionnaire design choices can either help or hurt the quality of data collected by interviewers. Furthermore, the behaviors of experienced and inexperienced interviewers are affected in similar ways. In other words, interviewing experience does not compensate for format deficits in the design of survey instruments. RP SANCHEZ, ME (reprint author), AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD, USA. NR 7 TC 22 Z9 22 U1 1 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0033-362X J9 PUBLIC OPIN QUART JI Public Opin. Q. PD SUM PY 1992 VL 56 IS 2 BP 206 EP 217 DI 10.1086/269311 PG 12 WC Communication; Political Science; Social Sciences, Interdisciplinary SC Communication; Government & Law; Social Sciences - Other Topics GA JD719 UT WOS:A1992JD71900004 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI ACUTE PAIN MANAGEMENT CAN BE IMPROVED SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material RP CLINTON, JJ (reprint author), AGCY HLTH CARE POLICY & RES,OFF FORUM,SUITE 401,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 2 TC 6 Z9 6 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 20 PY 1992 VL 267 IS 19 BP 2580 EP 2580 DI 10.1001/jama.267.19.2580 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA HT823 UT WOS:A1992HT82300004 PM 1573734 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI IMPROVING CLINICAL-PRACTICE SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material RP CLINTON, JJ (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852, USA. NR 5 TC 6 Z9 6 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 20 PY 1992 VL 267 IS 19 BP 2652 EP 2653 DI 10.1001/jama.267.19.2652 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA HT823 UT WOS:A1992HT82300037 PM 1573757 ER PT J AU COHEN, SB JOHNSON, AE AF COHEN, SB JOHNSON, AE TI ADDRESS SAMPLE EFFECTS IN THE NATIONAL MEDICAL EXPENDITURE SURVEY SO AMERICAN STATISTICIAN LA English DT Article DE ATTRITION; SCREENING AB The 1987 National Medical Expenditure Survey (NMES) included an initial screener interview to facilitate the oversampling of groups of particular policy interest: Blacks, Hispanics, the poor and near poor, the elderly, and persons with functional limitations. Although households were then selected based on the characteristics of their members, the sampling unit for the first round of NMES data collection was the household address. The first core interview was then conducted with persons residing at the sample address at the time of the interview, whether or not they lived there at the time of the screening interview. This article examines the consequences of this strategy in terms of meeting specified survey design goals. RP COHEN, SB (reprint author), AGCY HLTH CARE POLICY & RES,DIV STAT & RES METHODOL,ROCKVILLE,MD 20852, USA. NR 8 TC 0 Z9 0 U1 0 U2 0 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 SN 0003-1305 J9 AM STAT JI Am. Stat. PD MAY PY 1992 VL 46 IS 2 BP 100 EP 105 DI 10.2307/2684173 PG 6 WC Statistics & Probability SC Mathematics GA HR034 UT WOS:A1992HR03400005 ER PT J AU BERGNER, M BARRY, MJ BOWMAN, MA DOYLE, MA GUESS, HA NUTTING, PA AF BERGNER, M BARRY, MJ BOWMAN, MA DOYLE, MA GUESS, HA NUTTING, PA TI WHERE DO WE GO FROM HERE - OPPORTUNITIES FOR APPLYING HEALTH-STATUS ASSESSMENT MEASURES IN CLINICAL SETTINGS SO MEDICAL CARE LA English DT Article; Proceedings Paper CT 3RD CONF ON ADVANCES IN HEALTH STATUS ASSESSMENT CY SEP 12-14, 1991 CL GEORGETOWN UNIV CONF CTR, WASHINGTON, DC SP NATL ACAD SCI, INST MED, AGCY HLTH CARE POLICY & RES, CTR DIS CONTROL, NIH, ELI LILLY, GLAXO, PFIZER HO GEORGETOWN UNIV CONF CTR C1 MASSACHUSETTS GEN HOSP,CTR MED PRACTICES EVALUAT,BOSTON,MA 02114. PK NICOLLET MED FDN,MINNEAPOLIS,MN. MERCK SHARP & DOHME LTD,CHAPEL HILL,NC. WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT FAMILY & COMMUNITY MED,WINSTON SALEM,NC 27103. UNIV N CAROLINA,CHAPEL HILL,NC 27514. US DEPT HHS,AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV RES,ROCKVILLE,MD 20852. RP BERGNER, M (reprint author), JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,DIV HLTH POLICY & MANAGEMENT,ROOM 606,HAMPTON HOUSE,BALTIMORE,MD 21205, USA. RI bowman, marjorie/F-7235-2013 OI bowman, marjorie/0000-0002-1945-9212 NR 6 TC 9 Z9 9 U1 0 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD MAY PY 1992 VL 30 IS 5 SU S BP MS219 EP MS230 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA HU834 UT WOS:A1992HU83400022 ER PT J AU BERGNER, M BOWMAN, M DOYLE, MA FEINSTEIN, A GOLDEN, W NUTTING, P PANTELL, R PATRICK, D SPILKER, B TUTEUR, P TURNER, R WASSON, J WARE, J AF BERGNER, M BOWMAN, M DOYLE, MA FEINSTEIN, A GOLDEN, W NUTTING, P PANTELL, R PATRICK, D SPILKER, B TUTEUR, P TURNER, R WASSON, J WARE, J TI WHERE DO WE GO FROM HERE - GENERAL AUDIENCE DISCUSSION SO MEDICAL CARE LA English DT Discussion C1 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,WINSTON SALEM,NC 27103. PK NICOLLET MED FDN,MINNEAPOLIS,MN. YALE UNIV,SCH MED,NEW HAVEN,CT 06510. UNIV ARKANSAS MED SCI HOSP,LITTLE ROCK,AR 72205. AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV RES,ROCKVILLE,MD. UNIV CALIF SAN FRANCISCO,SAN FRANCISCO,CA 94143. UNIV WASHINGTON,SCH PUBL HLTH & COMMUNITY MED,SEATTLE,WA 98195. BURROUGHS WELLCOME CO,RES TRIANGLE PK,NC 27709. WASHINGTON UNIV,SCH MED,ST LOUIS,MO 63110. PFIZER INC,PFIZER CENT RES,GROTON,CT 06340. DARTMOUTH COLL,HITCHCOCK MED CTR,DARTMOUTH MED SCH,HANOVER,NH 03756. NEW ENGLAND MED CTR INC,INST HLTH,BOSTON,MA. AGCY HLTH CARE POLICY & RES,DIV PRIMARY CARE,ROCKVILLE,MD. RP BERGNER, M (reprint author), JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,HAMPTON HOUSE,624 N BROADWAY,BALTIMORE,MD 21205, USA. NR 5 TC 1 Z9 1 U1 0 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD MAY PY 1992 VL 30 IS 5 SU S BP MS231 EP MS239 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA HU834 UT WOS:A1992HU83400023 ER PT J AU RICE, T THOMAS, K AF RICE, T THOMAS, K TI EVALUATING THE NEW MEDIGAP STANDARDIZATION REGULATIONS SO HEALTH AFFAIRS LA English DT Article C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. RP RICE, T (reprint author), UNIV CALIF LOS ANGELES,SCH PUBL HLTH,DEPT HLTH SERV,LOS ANGELES,CA 90024, USA. NR 7 TC 15 Z9 15 U1 0 U2 0 PU PROJECT HOPE-HEALTH AFFAIRS PI SYRACUSE PA PO BOX 8015, SYRACUSE, NY 13217 SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD SPR PY 1992 VL 11 IS 1 BP 194 EP 207 DI 10.1377/hlthaff.11.1.194 PG 14 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA HP670 UT WOS:A1992HP67000012 PM 1577375 ER PT J AU SHORT, PF VISTNES, JP AF SHORT, PF VISTNES, JP TI MULTIPLE SOURCES OF MEDICARE SUPPLEMENTARY INSURANCE SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article AB Estimates from the National Medical Expenditure Survey imply that in 1987 only two-thirds of elderly Medicare beneficiaries held the amount and type of insurance that is generally recommended to supplement Medicare, namely, 57.7% with private hospital/medical insurance from one source and 6.6% with only Medicaid. Of the remainder, 19.8% had more than one source of private insurance; slightly more than 1% had one source of extra-cash or disease-specific insurance as their only supplementary coverage; and 12.9% had no supplementary coverage at all. In addition, more than 500,000 Medicaid enrollees had purchased private insurance, despite the comprehensive coverage offered by Medicaid. Although the issue of multiple coverage has been dramatized by stories of poor, very elderly persons who have purchased numerous Medigap plans, beneficiaries who purchase coverage from more than one source are likely to be relatively young, more highly educated, and financially better off. RP SHORT, PF (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,DIV MED EXPENDITURE STUDIES,CGHSIR,ROCKVILLE,MD 20852, USA. NR 18 TC 9 Z9 9 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSOC PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD SPR PY 1992 VL 29 IS 1 BP 33 EP 43 PG 11 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA HP832 UT WOS:A1992HP83200006 PM 1559722 ER PT J AU CLANCY, CM GELFMAN, D POSES, RM AF CLANCY, CM GELFMAN, D POSES, RM TI A STRATEGY TO IMPROVE THE UTILIZATION OF PNEUMOCOCCAL VACCINE SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE PNEUMOCOCCAL VACCINE; PREVENTIVE SERVICES; PHYSICIANS; COMPUTER REMINDERS; UTILIZATION AB Objective: To evaluate the effectiveness of a computerized reminder for pneumococcal vaccination at hospital discharge and to determine patient and physician characteristics associated with increased use of the vaccine. Design: Pre- and postintervention study. Setting: All medical services in a university teaching hospital. Participants: All patients with at least one indication for pneumococcal vaccination discharged from the hospital during one of two three-month time periods; resident and faculty physicians caring for the same patients. Intervention: Incorporation of a predischarge reminder for pneumococcal vaccination in the hospital information system. Measurements and main results: Of 539 eligible patients discharged during the three months after the intervention, 244 (45%) received the vaccine compared with 16 of 474 (3.4%) before the intervention (p < 0.0001). Following the intervention, patients discharged with a diagnosis of alcoholism were more likely to receive the vaccine than were those without that diagnosis (58.1% vs. 42.7%, p < 0.05), while patients with a diagnosis of cancer were less likely to get the vaccine (42 of 130, or 32.3%) than were those without cancer (202 of 409, 49.3%) (p < 0.01). Patients whose attending physicians specialized in hematology-oncology or cardiology were also less likely to receive the vaccine than were all other patients. With the intervention in place, physicians were more likely to vaccinate patients with more than one indication for pneumococcal vaccine. Conclusions: 1) A predischarge reminder is an inexpensive, effective method to improve physicians' utilization of pneumococcal vaccine in high-risk patients; 2) additional improvements in pneumococcal vaccine utilization will require selective components directed toward specific diagnoses or attending physician subspecialties. RP CLANCY, CM (reprint author), AGCY HLTH CARE POLICY & RES,CTR EXECUT OFF,ROOM 678,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 0 TC 35 Z9 35 U1 0 U2 1 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JAN-FEB PY 1992 VL 7 IS 1 BP 14 EP 18 DI 10.1007/BF02599095 PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA HA095 UT WOS:A1992HA09500004 PM 1548543 ER PT J AU FARLEY, DE OZMINKOWSKI, RJ AF FARLEY, DE OZMINKOWSKI, RJ TI VOLUME-OUTCOME RELATIONSHIPS AND INHOSPITAL MORTALITY - THE EFFECT OF CHANGES IN VOLUME OVER TIME SO MEDICAL CARE LA English DT Article; Proceedings Paper CT 4TH ANNUAL RESEARCH SYMP OF THE AMERICAN MEDICAL REVIEW RESEARCH CENTER CY NOV 02, 1989 CL ATLANTA, GA SP AMER MED REVIEW RES CTR DE VOLUME-OUTCOME RELATIONSHIP; OUTCOMES ASSIGNMENT; INHOSPITAL MORTALITY ID HOSPITAL VOLUME; SURGICAL VOLUME; PERFECT; CARE; CATEGORIES; OPERATIONS; DISEASE; QUALITY AB This study examines whether patient outcomes are affected by changes in volume over time within hospitals and whether such effects are consistent with cross-sectional results previously reported in the literature. Investigating the existence of volume-outcome relationships longitudinally for specific groups of patients relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. The analysis uses up to 8 years of observations from a national sample of nearly 500 community hospitals. Outcomes are measured as inhospital mortality adjusted for case severity. Instrumental variables techniques are used to test and control for the possibility of selective referral. The results suggest that higher volume leads to better outcomes for certain groups of patients. Among the groups studied here, increases in volume lowered adjusted mortality rates for acute myocardial infarction, hernia repair, and respiratory distress syndrome in neonates; correlations were observed between volume and outcome for coronary artery bypass grafts, which seemed to be due primarily to referral patterns; and, no significant findings were found for hip replacements. In general, the effects of volume on outcome appear to be larger when estimated from longitudinal, rather than cross-sectional, data. C1 ABT ASSOCIATES INC,CAMBRIDGE,MA. RP FARLEY, DE (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,ROCKVILLE,MD 20852, USA. NR 27 TC 98 Z9 98 U1 0 U2 4 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 1992 VL 30 IS 1 BP 77 EP 94 DI 10.1097/00005650-199201000-00009 PG 18 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA GZ535 UT WOS:A1992GZ53500009 PM 1729589 ER PT J AU SHORT, PF KEMPER, P CORNELIUS, LJ WALDEN, DC AF SHORT, PF KEMPER, P CORNELIUS, LJ WALDEN, DC TI PUBLIC AND PRIVATE RESPONSIBILITY FOR FINANCING NURSING-HOME CARE - THE EFFECT OF MEDICAID ASSET SPEND-DOWN SO MILBANK QUARTERLY LA English DT Article; Proceedings Paper CT 1990 MEETING OF THE AMERICAN PUBLIC HEALTH ASSOC CY OCT, 1990 CL NEW YORK, NY SP AMER PUBLIC HLTH ASSOC ID ELIGIBILITY AB Data from a nationally representative sample of nursing-home residents at the beginning of 1987 are used to assess the interaction of Medicaid asset spend-down, the distribution of nursing-home days by payment source, and the effect of proposed changes in public financing of nursing-home care. Three out of five nursing-home residents were covered by Medicaid in January 1987; nearly all of the remainder were private-pay. Most Medicaid recipients were covered by Medicaid when they entered the care facility at the start of an episode, but 18 percent had spent down and were originally admitted as private-pay. A universal nursing-home benefit that insured the first six months of each nursing-home episode would cover 16 percent of the people in nursing homes on a given day, disproportionately those who are private-pay. A universal benefit with a 24-month waiting period would cover 56 percent of nursing-home residents on a given day, and would tend to favor those financed by Medicaid. RP SHORT, PF (reprint author), AGCY HLTH CARE POLICY & RES,DIV NATL MED EXPENDITURE STUDIES,2101 E JEFFERSON ST,SUITE 500,ROCKVILLE,MD 20852, USA. NR 19 TC 16 Z9 16 U1 0 U2 0 PU BLACKWELL PUBLISHERS PI CAMBRIDGE PA 350 MAIN STREET, STE 6, CAMBRIDGE, MA 02148-5023 SN 0887-378X J9 MILBANK Q JI Milbank Q. PY 1992 VL 70 IS 2 BP 277 EP 298 DI 10.2307/3350060 PG 22 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA JB510 UT WOS:A1992JB51000002 PM 1614380 ER PT J AU HERRERA, C DAGOSTINO, RD BOSCO, L BELANGER, A GERSTMAN, B KANNEL, W AF HERRERA, C DAGOSTINO, RD BOSCO, L BELANGER, A GERSTMAN, B KANNEL, W TI BALDNESS AND CORONARY HEART-DISEASE IN FRAMINGHAM MEN SO CLINICAL RESEARCH LA English DT Meeting Abstract C1 UNIV TEXAS,AUSTIN,TX 78712. BOSTON UNIV,AGCY HLTH CARE POLICY & RES,BOSTON,MA 02215. SAN JOSE STATE UNIV,SAN JOSE,CA 95192. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0009-9279 J9 CLIN RES JI Clin. Res. PD DEC PY 1991 VL 39 IS 4 BP A829 EP A829 PG 1 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA GW912 UT WOS:A1991GW91200183 ER PT J AU KEMPER, P SPILLMAN, BC MURTAUGH, CM AF KEMPER, P SPILLMAN, BC MURTAUGH, CM TI A LIFETIME PERSPECTIVE ON PROPOSALS FOR FINANCING NURSING-HOME CARE SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID RISK; FALLACY AB In this paper data from the National Mortality Followback Survey and the National Nursing Home Survey are used to estimate the lifetime cost of nursing home care. The expected discounted cost for persons turning 65 in 1990 is $27,600. However, variation around this average is high. The 9% of persons expected to use at least 5 years of nursing home care will account for 64% of aggregate cost for the cohort; the 68% using less than 3 months of care will account for only about 1% of cost. The percentage of costs covered under alternative financing strategies also varies widely. An entitlement covering the first 3 months of care subject to 30% coinsurance would cover 5% of aggregate cost; an entitlement with a 2-year deductible and the same coinsurance would cover 41% of cost. RP KEMPER, P (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,CTR INTRAMURAL RES,DIV LONG TERM CARE,ROCKVILLE,MD 20852, USA. NR 37 TC 17 Z9 17 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSOC PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD WIN PY 1991 VL 28 IS 4 BP 333 EP 344 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA GZ408 UT WOS:A1991GZ40800004 PM 1761306 ER PT J AU RESCHOVSKY, JD AF RESCHOVSKY, JD TI THE EMERGENCY FOOD RELIEF SYSTEM - AN EMPIRICAL-STUDY SO JOURNAL OF CONSUMER AFFAIRS LA English DT Article ID NEW-YORK-STATE; SOUP KITCHENS AB The emergency food relief system provides free food to needy persons through soup kitchens and food pantries. The system is described and models of the supply of food distributed are estimated using data from upstate New York. Results suggest that the system responds to the demand for free food by recipients. The system's performance in meeting this demand is associated with characteristics of the nonpoor population and size of the poverty population. C1 CORNELL UNIV,DEPT CONSUMER ECON & HOUSING,ITHACA,NY 14853. RP RESCHOVSKY, JD (reprint author), AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD, USA. NR 27 TC 3 Z9 3 U1 1 U2 1 PU UNIV WISCONSIN PRESS PI MADISON PA JOURNAL DIVISION, 114 N MURRAY ST, MADISON, WI 53715 SN 0022-0078 J9 J CONSUM AFF JI J. Consum. Aff. PD WIN PY 1991 VL 25 IS 2 BP 258 EP 277 PG 20 WC Business; Economics SC Business & Economics GA JC298 UT WOS:A1991JC29800005 ER PT J AU NUTTING, PA AF NUTTING, PA TI THE SCOPE OF RESEARCH IN FAMILY-PRACTICE AND PRIMARY CARE SO JOURNAL OF FAMILY PRACTICE LA English DT Article RP NUTTING, PA (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,DIV PRIMARY CARE,ROCKVILLE,MD 20852, USA. NR 3 TC 1 Z9 1 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD OCT PY 1991 VL 33 IS 4 BP 413 EP 414 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA GM111 UT WOS:A1991GM11100019 PM 1919460 ER PT J AU HOLOHAN, TV AF HOLOHAN, TV TI LAPAROSCOPIC CHOLECYSTECTOMY SO LANCET LA English DT Review ID LITHOTRIPSY; GALLSTONES; CHOLECYSTOSTOMY RP HOLOHAN, TV (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,OFF HLTH TECHNOL ASSESSMENT,ROCKVILLE,MD 20857, USA. NR 25 TC 57 Z9 57 U1 0 U2 0 PU LANCET LTD PI LONDON PA 42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL SN 0140-6736 J9 LANCET JI Lancet PD SEP 28 PY 1991 VL 338 IS 8770 BP 801 EP 803 DI 10.1016/0140-6736(91)90678-I PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA GG979 UT WOS:A1991GG97900015 PM 1681171 ER PT J AU CUNNINGHAM, PJ MUELLER, CD AF CUNNINGHAM, PJ MUELLER, CD TI INDIVIDUALS WITH MENTAL-RETARDATION IN RESIDENTIAL FACILITIES - FINDINGS FROM THE 1987 NATIONAL MEDICAL EXPENDITURE SURVEY SO AMERICAN JOURNAL ON MENTAL RETARDATION LA English DT Article ID PATTERNS C1 PHYSICIAN PAYMENT REVIEW COMMISS,WASHINGTON,DC. RP CUNNINGHAM, PJ (reprint author), AGCY HLTH CARE POLICY & RES,5600 FISHERS LANE,ROCKVILLE,MD 20851, USA. NR 15 TC 9 Z9 9 U1 0 U2 0 PU AMER ASSN MENTAL RETARDATION PI WASHINGTON PA 444 N CAPITOL ST, NW, STE 846, WASHINGTON, DC 20001-1512 SN 0895-8017 J9 AM J MENT RETARD JI Am. J. Ment. Retard. PD SEP PY 1991 VL 96 IS 2 BP 109 EP 117 PG 9 WC Education, Special; Rehabilitation SC Education & Educational Research; Rehabilitation GA GD141 UT WOS:A1991GD14100001 PM 1930944 ER PT J AU HELLINGER, FJ AF HELLINGER, FJ TI FORECASTING THE MEDICAL-CARE COSTS OF THE HIV EPIDEMIC - 1991-1994 SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID ACQUIRED IMMUNODEFICIENCY SYNDROME; UNITED-STATES; VIRUS INFECTION; AIDS; ZIDOVUDINE RP HELLINGER, FJ (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,DIV COST & FINANCING,RM 678,ROCKVILLE,MD 20852, USA. NR 49 TC 51 Z9 52 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSN PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD FAL PY 1991 VL 28 IS 3 BP 213 EP 225 PG 13 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA GK446 UT WOS:A1991GK44600003 PM 1833332 ER PT J AU YOUNG, GJ COHEN, BB AF YOUNG, GJ COHEN, BB TI INEQUITIES IN HOSPITAL-CARE, THE MASSACHUSETTS EXPERIENCE SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID INTENSITY; SERVICES RP YOUNG, GJ (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,MAXIMA BLDG,RM 678,2101 E JEFFERSON ST,ROCKVILLE,MD 20852, USA. NR 15 TC 54 Z9 54 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSN PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD FAL PY 1991 VL 28 IS 3 BP 255 EP 262 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA GK446 UT WOS:A1991GK44600007 PM 1833336 ER PT J AU RESCHOVSKY, JD NEWMAN, SJ AF RESCHOVSKY, JD NEWMAN, SJ TI HOME UPKEEP AND HOUSING QUALITY OF OLDER HOMEOWNERS SO JOURNALS OF GERONTOLOGY LA English DT Article ID REHABILITATION AB Among older homeowners, successive cohorts exhibit lower levels of home upkeep. This research explores several possible sources of these age-related differences in home upkeep as well as the potential effects on the quality of the elderly population's housing. Analysis of data from the Survey of Housing Adjustments suggests that only income has sizable effects on the quantity of home upkeep conducted, and that lower upkeep appears to reflect cutbacks in discretionary, as opposed to vital repairs. C1 JOHNS HOPKINS UNIV,BALTIMORE,MD 21218. RP RESCHOVSKY, JD (reprint author), AGCY HLTH CARE POLICY & RES,DIV LONG TERM CARE STUDIES,PARKLAWN BLDG,RM 18A-31,5600 FISHERS LANE,ROCKVILLE,MD 20857, USA. FU NIA NIH HHS [5 R01 AG04375-04] NR 24 TC 10 Z9 10 U1 0 U2 2 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 SN 0022-1422 J9 J GERONTOL JI J. Gerontol. PD SEP PY 1991 VL 46 IS 5 BP S288 EP S297 PG 10 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA GE787 UT WOS:A1991GE78700023 PM 1890300 ER PT J AU HERNANDEZ, GA HASTINGS, KE AF HERNANDEZ, GA HASTINGS, KE TI THE EFFECTIVENESS INITIATIVE - IMPLICATIONS FOR NURSING PRACTICE AND RESEARCH SO NURSING OUTLOOK LA English DT Editorial Material RP HERNANDEZ, GA (reprint author), AGCY HLTH CARE POLICY & RES,OFF FORUM QUAL & EFFECTIVENESS HLTH CARE,WASHINGTON,DC, USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 SN 0029-6554 J9 NURS OUTLOOK JI Nurs. Outlook PD SEP-OCT PY 1991 VL 39 IS 5 BP 198 EP 199 PG 2 WC Nursing SC Nursing GA GJ485 UT WOS:A1991GJ48500002 PM 1896309 ER PT J AU JACKSON, MN NUTTING, PA AF JACKSON, MN NUTTING, PA TI CLINICAL GUIDELINES DEVELOPMENT - OPPORTUNITIES FOR FAMILY PHYSICIANS SO JOURNAL OF FAMILY PRACTICE LA English DT Article RP JACKSON, MN (reprint author), US DEPT HHS,US PUBL HLTH SERV,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20852, USA. NR 6 TC 4 Z9 4 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD AUG PY 1991 VL 33 IS 2 BP 129 EP & PG 0 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA GA263 UT WOS:A1991GA26300005 PM 1890394 ER PT J AU CORNELIUS, LJ AF CORNELIUS, LJ TI ACCESS TO MEDICAL-CARE FOR BLACK-AMERICANS WITH AN EPISODE OF ILLNESS SO JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION LA English DT Article DE MINORITIES; BLACKS; ACCESS; UTILIZATION; HEALTH STATUS AB Blacks have been directly or indirectly affected by changes in policies such as cutbacks in the Medicaid program or decreases in the funding of graduate medical education. Yet there is considerable disagreement over whether blacks have achieved equity of access to medical care. Descriptive and multivariate regression analyses were conducted to examine the use of ambulatory and inpatient medical care by 1150 whites and blacks under the age of 65 who experienced an episode of illness and lived around sites serviced by the Community Hospital Program, which was developed to increase primary care in underserved communities. After controlling for demographic factors, health status, and aspects of the usual source of care, multivariate analyses revealed that race was not a determinant of differences found in the use of ambulatory and inpatient medical care or the likelihood that an individual was cured of the condition causing him or her the most worry. Differences in the use of care for blacks were believed to have occurred because blacks were disproportionately found in groups that used less medical care, ie, low-income groups, the uninsured, and those without a usual source of care. RP CORNELIUS, LJ (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,PARKLAWN BLDG,RM 18A-55,5600 FISHERS LN,ROCKVILLE,MD 20857, USA. NR 0 TC 29 Z9 29 U1 0 U2 2 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0027-9684 J9 J NATL MED ASSOC JI J. Natl. Med. Assoc. PD JUL PY 1991 VL 83 IS 7 BP 617 EP 626 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA FW342 UT WOS:A1991FW34200012 PM 1920519 ER PT J AU TAYLOR, Z KRAKAUER, H AF TAYLOR, Z KRAKAUER, H TI MORTALITY AND REOPERATION FOLLOWING PROSTATECTOMY - OUTCOMES IN A MEDICARE POPULATION SO UROLOGY LA English DT Article; Proceedings Paper CT SYMP AT THE 47TH ANNUAL MEETING OF THE AMERICAN GERIATRICS SOC / 11TH ANNUAL MEETING OF THE AMERICAN FEDERATION FOR AGING RESEARCH : BENIGN PROSTATIC HYPERPLASIA CY MAY 18, 1990 CL ATLANTA, GA SP AMER GERIATR SOC, AMER FEDERAT AGING RES ID BENIGN PROSTATIC HYPERPLASIA; CARE OUTCOMES AB Data from a series of pilot projects undertaken by the Health Care Financing Administration and seven peer review organizations were used to evaluate the outcomes of prostatectomy. Outcomes in both the original random sample of 3,641 patients and subsample of 2,617 patients that had a diagnosis of benign prostatic hyperplasia and did not have a diagnosis of prostatic carcinoma were examined. Patients undergoing a transurethral resection had increased probabilities of reoperation and mortality. However, the increased risk associated with having a transurethral resection was not statistically significant after controlling for other variables associated with mortality. C1 UNIV MARYLAND,BALTIMORE,MD 21201. HLTH CARE FINANCING ADM,AGCY HLTH CARE POLICY & RES,BALTIMORE,MD. NR 13 TC 14 Z9 14 U1 0 U2 0 PU CAHNERS PUBL CO PI NEW YORK PA 249 WEST 17 STREET, NEW YORK, NY 10011 SN 0090-4295 J9 UROLOGY JI UROLOGY PD JUL PY 1991 VL 38 IS 1 SU S BP 27 EP 31 DI 10.1016/0090-4295(91)80195-D PG 5 WC Urology & Nephrology SC Urology & Nephrology GA FX094 UT WOS:A1991FX09400006 PM 1714655 ER PT J AU BROUSSARD, BA JOHNSON, A HIMAS, JH STORY, M FICHTNER, R HAUCK, F BACHMANCARTER, K HAYES, J FROHLICH, K GRAY, N VALWAY, S GOHDES, D AF BROUSSARD, BA JOHNSON, A HIMAS, JH STORY, M FICHTNER, R HAUCK, F BACHMANCARTER, K HAYES, J FROHLICH, K GRAY, N VALWAY, S GOHDES, D TI PREVALENCE OF OBESITY IN AMERICAN-INDIANS AND ALASKA NATIVES SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article; Proceedings Paper CT CONF ON OBESITY AND CARDIOVASCULAR DISEASE IN MINORITY POPULATIONS CY AUG 28-29, 1990 CL BETHESDA, MD SP NHLBI DE OBESITY; NORTH AMERICAN INDIANS ID DEPENDENT DIABETES-MELLITUS; BODY-WEIGHT; CHILDHOOD OBESITY; NUTRIENT INTAKE; RISK FACTOR; HEALTH; HEIGHT; CHILDREN; DISEASE; WOMEN AB Obesity is an important risk factor for cardiovascular diseases and non-insulin-dependent diabetes, which are chronic diseases that afflict American Indians and Alaska Natives today. Because American Indians are not represented in most national health and nutrition surveys, there is a paucity of data on actual prevalence of obesity in American Indians. We estimated prevalence of overweight and obesity for American Indian adults, school-age children, and preschool children from existing data. The prevalence of obesity in adults was estimated from self-reported weights and heights obtained from a special survey of American Indians performed as part of the 1987 National Medical Expenditure Survey. Prevalence of obesity in American Indians was 13.7% for men and 16.5% for women, which was higher than the US rates of 9.1% and 8.2%, respectively. Obesity rates in American Indian adolescents and preschool children were higher than the respective rates for US all-races combined. C1 US PHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. US PHS,CTR CHRON DIS PREVENT & HLTH PROMOT,DIV NUTR STAT BRANCH,ATLANTA,GA. DIABETES PROGRAM,TUCSON,AZ. US PHS INDIAN HLTH CTR,DIABET PROGRAM FT TOTTEN,FT TOTTEN,ND. PSYCHOL COUNSELING SERV LTD,TUCSON,AZ. US PHS INDIAN HOSP,WINNEBAGO OMAHA DIABET PROGRAM,WINNEBAGO,NE. LOYOLA UNIV,DEPT PREVENT MED & EPIDEMIOL,CHICAGO,IL 60611. UNIV MINNESOTA,SCH PUBL HLTH,DIV HUMAN DEV & NUTR,MINNEAPOLIS,MN 55455. RP BROUSSARD, BA (reprint author), US PHS,INDIAN HLTH SERV DIABET PROGRAM,ALBUQUERQUE,NM, USA. NR 65 TC 138 Z9 139 U1 0 U2 7 PU AMER SOC CLIN NUTRITION INC PI BETHESDA PA 9650 ROCKVILLE PIKE SUBSCRIPTIONS, RM L-2310, BETHESDA, MD 20814-3998 SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JUN PY 1991 VL 53 IS 6 SU S BP S1535 EP S1542 PG 8 WC Nutrition & Dietetics SC Nutrition & Dietetics GA FP059 UT WOS:A1991FP05900007 PM 2031484 ER PT J AU NUTTING, PA AF NUTTING, PA TI RESEARCH IN PROGRESS BY FAMILY PHYSICIANS SO JOURNAL OF FAMILY PRACTICE LA English DT Article ID COOPERATIVE INFORMATION PROJECT; PRACTICE NETWORK; CARE RP NUTTING, PA (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,DIV PRIMARY CARE,ROCKVILLE,MD 20852, USA. NR 12 TC 1 Z9 1 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD APR PY 1991 VL 32 IS 4 BP 361 EP 363 PG 3 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA FH038 UT WOS:A1991FH03800007 PM 2010731 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI PHYSICIAN INPUT INVITED ON CLINICAL GUIDELINE DEVELOPMENT SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20857. NR 1 TC 5 Z9 5 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 27 PY 1991 VL 265 IS 12 BP 1508 EP 1508 DI 10.1001/jama.265.12.1508 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA FC604 UT WOS:A1991FC60400005 PM 1999893 ER PT J AU SCHUR, CL TAYLOR, AK AF SCHUR, CL TAYLOR, AK TI CHOICE OF HEALTH-INSURANCE AND THE 2-WORKER HOUSEHOLD SO HEALTH AFFAIRS LA English DT Article C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. RP SCHUR, CL (reprint author), CTR HLTH AFFAIRS,HOPE PROJECT,CHEVY CHASE,MD, USA. NR 10 TC 11 Z9 11 U1 0 U2 0 PU PROJECT HOPE-HEALTH AFFAIRS PI SYRACUSE PA PO BOX 8015, SYRACUSE, NY 13217 SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD SPR PY 1991 VL 10 IS 1 BP 155 EP 163 DI 10.1377/hlthaff.10.1.155 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA FH121 UT WOS:A1991FH12100011 PM 2045047 ER PT J AU FRIEDMAN, MA FARAG, ZE AF FRIEDMAN, MA FARAG, ZE TI GAPS IN THE DISSEMINATION KNOWLEDGE UTILIZATION BASE SO KNOWLEDGE-CREATION DIFFUSION UTILIZATION LA English DT Article ID HEALTH-SCIENCES LIBRARIES; INFORMATION; TECHNOLOGY; COMMUNICATION; DIFFUSION; ADOPTION; POLICY; ACCESS C1 US PHS,AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD. RP FRIEDMAN, MA (reprint author), HLTH CARE FINANCING ADM,OFF PUBL AFFAIRS,BALTIMORE,MD 21207, USA. NR 84 TC 2 Z9 2 U1 0 U2 2 PU SAGE SCIENCE PRESS PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 SN 0164-0259 J9 KNOWLEDGE PD MAR PY 1991 VL 12 IS 3 BP 266 EP 288 PG 23 WC Social Sciences, Interdisciplinary SC Social Sciences - Other Topics GA FA476 UT WOS:A1991FA47600004 ER PT J AU KEMPER, P MURTAUGH, CM AF KEMPER, P MURTAUGH, CM TI LIFETIME USE OF NURSING-HOME CARE SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID LONG-TERM CARE; RISK; INSTITUTIONALIZATION; POPULATION; STATISTICS; MORTALITY; FALLACY AB Background and Methods. Despite the growth in the number of Americans in nursing homes, there are only limited data on the total amount of time that people spend in such facilities. We estimate the amount of time the average person spends in nursing homes over his or her lifetime (lifetime nursing home use), using data from the National Mortality Followback Survey of the next of kin of a sample of persons 25 years of age or older who died in 1986. On the basis of these data, we estimated the likelihood that Americans will use nursing home care during the course of their lifetimes and the total duration of such care. Current data on life expectancy were then used to reweight the sample to project lifetime nursing home use for those who became 65 years old in 1990. Results. Of those who died in 1986 at 25 years of age or older, 29 percent had at some time been residents in a nursing home, and almost half of those who entered a nursing home spent a cumulative total of at least one year there. The probability of nursing home use increased sharply with age at death: 17 percent for age 65 to 74, 36 percent for age 75 to 84, and 60 percent for age 85 to 94. For persons who turned 65 in 1990, we project that 43 percent will enter a nursing home at some time before they die. Of those who enter nursing homes, 55 percent will have total lifetime use of at least one year, and 21 percent will have total lifetime use of five years or more. We also project that more women than men will enter nursing homes (52 percent vs. 33 percent), and among them, more women than men will have total lifetime nursing home use of five years or more (25 percent vs. 13 percent). Conclusions. Our projections indicate that over a lifetime, the risk of entering a nursing home and spending a long time there is substantial. With the elderly population growing, this has important implications for both medical practice and the financing of long-term care. RP KEMPER, P (reprint author), AGCY HLTH CARE POLICY RES,CTR INTRAMURAL RES,DIV LONG TERM CARE STUDIES,ROCKVILLE,MD 20857, USA. NR 53 TC 257 Z9 259 U1 0 U2 4 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD FEB 28 PY 1991 VL 324 IS 9 BP 595 EP 600 DI 10.1056/NEJM199102283240905 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA EY886 UT WOS:A1991EY88600005 PM 1992320 ER PT J AU SPECTOR, WD AF SPECTOR, WD TI COGNITIVE IMPAIRMENT AND DISRUPTIVE BEHAVIORS AMONG COMMUNITY-BASED ELDERLY PERSONS - IMPLICATIONS FOR TARGETING LONG-TERM CARE SO GERONTOLOGIST LA English DT Article DE HOME CARE; FUNCTIONAL DISABILITIES; ELIGIBILITY CRITERIA ID MENTAL STATUS QUESTIONNAIRE; OLD-AGE; DEMENTIA; PREVALENCE; SERVICES; SEVERITY RP SPECTOR, WD (reprint author), AGCY HLTH CARE POLICY & RES,5600 FISHERS LANE,PARKLAWN BLDG,ROOM 18A-19,ROCKVILLE,MD 20857, USA. NR 45 TC 39 Z9 39 U1 2 U2 4 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD FEB PY 1991 VL 31 IS 1 BP 51 EP 59 PG 9 WC Gerontology SC Geriatrics & Gerontology GA FJ237 UT WOS:A1991FJ23700008 PM 1901046 ER PT J AU NUTTING, PA AF NUTTING, PA TI AHCPR STUDIES EXAMINE IMPACT OF DISABILITIES IN THE ELDERLY SO JOURNAL OF FAMILY PRACTICE LA English DT Article RP NUTTING, PA (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,DIV PRIMARY CARE,ROCKVILLE,MD 20852, USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD FEB PY 1991 VL 32 IS 2 BP 131 EP 132 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA EX537 UT WOS:A1991EX53700007 PM 1824947 ER PT J AU SHORT, PF CUNNINGHAM, P MUELLER, C AF SHORT, PF CUNNINGHAM, P MUELLER, C TI STANDARDIZING NURSING-HOME ADMISSION DATES FOR SHORT-TERM HOSPITAL STAYS SO MEDICAL CARE LA English DT Article DE NURSING-HOME ADMISSIONS; INSTITUTIONALIZATION; UTILIZATION; LONG-TERM CARE ID LIFETIME RISK; RESIDENCY AB In the Institutional Population Component of the 1987 National Medical Expenditure Survey, the definition of a nursing home admission was standardized to ignore the readmission of patients discharged for short-term hospital care. Approximately one out of six persons residing in nursing homes on the survey reference date (January 1, 1987) had been readmitted for this reason. The effect of the standardization was to increase the average length of stay of residents prior to the reference date by approximately 5 months. The percentage of long-stay residents, those living in the facility for more than three years, increased from 31% to 36%. The percentage admitted from the community during the previous year increased from 32% of those admitted in 1986 to 41%. C1 PHYSICIAN PAYMENT REVIEW COMMISS,WASHINGTON,DC. RP SHORT, PF (reprint author), AGCY HLTH CARE POLICY & RES,18A-55,5600 FISHERS LANE,ROCKVILLE,MD 20857, USA. NR 11 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 1991 VL 29 IS 2 BP 97 EP 103 DI 10.1097/00005650-199102000-00002 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA EX225 UT WOS:A1991EX22500002 PM 1899712 ER PT J AU KEYES, M ANDREWS, R MASON, ML AF KEYES, M ANDREWS, R MASON, ML TI A METHODOLOGY FOR BUILDING AN AIDS RESEARCH FILE USING MEDICAID CLAIMS AND ADMINISTRATIVE DATA-BASES SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Article DE RESEARCH; MEDICAID; MANAGEMENT INFORMATION SYSTEMS; DATA BASE DEVELOPMENT; CALIFORNIA; NEW-YORK ID COSTS; CARE AB There is a current and continuing need for health services research on the epidemiology of AIDS and its impact on health care systems. However, large data bases designed for other purposes, such as hospital discharge abstract systems and medical claims systems, are the primary source of data for AIDS research. Thus, methodologies must be developed that enable researchers to investigate AIDS using data bases designed for other purposes. In this report, we describe a methodology for utilizing Medicaid Management Information Systems (MMIS) data to conduct health services research on AIDS. We developed an ICD-9-CM diagnosis-based algorithm that accurately identified the majority of AIDS cases, both before and after AIDS-specific ICD-9-CM codes became available in October 1986. Using diagnostic categories that we had developed previously to identify AIDS cases among disabled young men in California on Medicaid, we expanded the methodology to include children, men, and women of all ages in California and New York. The algorithm worked best with young disabled males, older males, and females between 18 and 50 years of age. The algorithm worked least well with nondisabled males, females over age 50 years, and children. We also developed methodologies for defining Medicaid AIDS onset, risk group, and date of death. Our research resulted in the identification of a study population representing the majority of Medicaid AIDS cases between 1983 and 1986 in California and New York. The AIDS study population data base was used in further research on eligibility patterns, the epidemiology of the AIDS epidemic, lifetime Medicaid utilization and expenditures, and the development of a survival-based severity index for Medicaid recipients with AIDS. C1 AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,ROCKVILLE,MD. RP KEYES, M (reprint author), SYSTEMETR MCGRAW HILL,HLTH CARE POLICY RES DIV,4401 CONNECTICUT AVE NW,SUITE 400,WASHINGTON,DC 20008, USA. NR 28 TC 39 Z9 39 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PY 1991 VL 4 IS 10 BP 1015 EP 1024 PG 10 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA GF673 UT WOS:A1991GF67300019 PM 1832459 ER PT J AU ANDREWS, RM KEYES, MA FANNING, TR KIZER, KW AF ANDREWS, RM KEYES, MA FANNING, TR KIZER, KW TI LIFETIME MEDICAID SERVICE UTILIZATION AND EXPENDITURES FOR AIDS IN NEW-YORK AND CALIFORNIA SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Article DE MEDICAID; COSTS; OUTPATIENT SERVICES; HOME HEALTH CARE; DRUG USERS; WOMEN; CHILDREN ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; SEMI-LOGARITHMIC EQUATIONS; DUMMY VARIABLES; SURVIVAL; COSTS; INFECTION; PATTERNS; DURATION; STATES AB Several important gaps exists in information on the health care resources used by people with AIDS, including patterns of outpatient care, differences between populations at risk of the disease, and services paid for by Medicaid. To address the shortage of information in these areas, this study examined average Medicaid expenditures and service use for the time period a person has AIDS. The study population was Medicaid enrollees with AIDS in New York and California who died between October 1985 and September 1986. The study focused on the differences between the two states and between four groups that were proxies for at-risk populations: children, women, drug-using men, and non-drug-using men. Mean lifetime Medicaid expenditures were about $30,000 in New York and $20,000 in California. Inpatient use was higher and outpatient service use was lower in New York than in California after controlling for risk group, diagnosis, and Medicaid eligibility group (a proxy for income level). In California, women had higher expenditures and inpatient use than men. In New York, women and drug-using men had higher expenditures and use of inpatient and outpatient services (except home health care) than the non-drug-using men. Children in New York had higher expenditures and hospital use than adults but similar outpatient service use. Multivariate analyses suggest that differences between risk groups were largely attributable to differences in diagnosis and income level (as measured by Medicaid eligibility group). C1 CALIF HLTH & WELFARE AGCY,DEPT HLTH SERV,SACRAMENTO,CA. SYSTEMETR MCGRAW HILL INC,DIV HLTH CARE POLICY & RES,WASHINGTON,DC. NEW YORK STATE DEPT SOCIAL SERV,DIV MED ASSISTANCE,ALBANY,NY. RP ANDREWS, RM (reprint author), AGCY HLTH CARE POLICY & RES,CTR GEN HLTH SERV INTRAMURAL RES,5600 FISHERS LANE,13A-54,ROCKVILLE,MD 20857, USA. NR 50 TC 23 Z9 23 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PY 1991 VL 4 IS 10 BP 1046 EP 1058 PG 13 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA GF673 UT WOS:A1991GF67300022 PM 1890599 ER PT J AU NUTTING, PA AF NUTTING, PA TI THE PRIMARY CARE RESEARCH-PROGRAM OF AHCPR SO JOURNAL OF FAMILY PRACTICE LA English DT Article RP NUTTING, PA (reprint author), DEPT HLTH & HUMAN SERV,AGCY HLTH CARE POLICY & RES,DIV PRIMARY CARE,ROCKVILLE,MD, USA. NR 0 TC 3 Z9 3 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD JAN PY 1991 VL 32 IS 1 BP 27 EP 28 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA ET525 UT WOS:A1991ET52500006 PM 1985131 ER PT J AU BERK, ML CUNNINGHAM, P BEAUREGARD, K AF BERK, ML CUNNINGHAM, P BEAUREGARD, K TI THE HEALTH-CARE OF POOR PERSONS LIVING IN WEALTHY AREAS SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE POVERTY; HEALTH INSURANCE; ACCESS ID CHILDREN C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20857. RP BERK, ML (reprint author), CTR HLTH AFFAIRS,PROJECT HOPE,2 WISCONSIN CIRCLE,CHEVY CHASE,MD 20815, USA. NR 25 TC 7 Z9 7 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PY 1991 VL 32 IS 10 BP 1097 EP 1103 DI 10.1016/0277-9536(91)90085-Q PG 7 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA FM182 UT WOS:A1991FM18200003 PM 2068592 ER PT J AU KEMPER, P AF KEMPER, P TI CASE-MANAGEMENT AGENCY SYSTEMS OF ADMINISTERING LONG-TERM CARE - EVIDENCE FROM THE CHANNELING DEMONSTRATION SO GERONTOLOGIST LA English DT Article DE COMMUNITY CARE; HOME CARE; IMPLEMENTATION; ADMINISTRATION; HOME HEALTH CARE ID HOME RP KEMPER, P (reprint author), AGCY HLTH CARE POLICY & RES,DIV LONG TERM CARE STUDIES,PARKLAWN BLDG,ROOM 18A-55,ROCKVILLE,MD 20857, USA. NR 14 TC 18 Z9 18 U1 0 U2 0 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD DEC PY 1990 VL 30 IS 6 BP 817 EP 824 PG 8 WC Gerontology SC Geriatrics & Gerontology GA FD975 UT WOS:A1990FD97500015 PM 2126776 ER PT J AU FARLEY, DE HOGAN, C AF FARLEY, DE HOGAN, C TI CASE-MIX SPECIALIZATION IN THE MARKET FOR HOSPITAL SERVICES SO HEALTH SERVICES RESEARCH LA English DT Article; Proceedings Paper CT 1987 ANNUAL MEETING OF THE ALLIED SOCIAL SCIENCE ASSOC AND THE AMERICAN ECONOMIC ASSOC CY DEC 27-30, 1987 CL CHICAGO, IL SP ALLIED SOCIAL SCI ASSOC, AMER ECON ASSOC ID INFORMATION-THEORY; VOLUME; COST; COMPETITION; CARE; PERFECT RP FARLEY, DE (reprint author), AGCY HLTH CARE POLICY & RES,HOSP STUDIES PROGRAM,ROOM 13A-54,5600 FISHERS LANE,ROCKVILLE,MD 20857, USA. NR 30 TC 19 Z9 19 U1 0 U2 1 PU HEALTH ADMINISTRATION PRESS PI MELROSE PARK PA C/O FOUNDATION AMER COLL HEALTHCARE EXECUTIVES 1951 CORNELL AVE, MELROSE PARK, IL 60160 SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 1990 VL 25 IS 5 BP 757 EP 783 PG 27 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EP327 UT WOS:A1990EP32700009 PM 2123838 ER PT J AU DOR, A HOLAHAN, J AF DOR, A HOLAHAN, J TI URBAN-RURAL DIFFERENCES IN MEDICARE PHYSICIAN EXPENDITURES SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article C1 URBAN INST,CTR HLTH POLICY,WASHINGTON,DC 20037. RP DOR, A (reprint author), AGCY HLTH CARE POLICY & RES,HOSP STUDIES PROGRAM,ROOM 13A-54,PARKLAWN BLDG,5600 FISHERS LANE,ROCKVILLE,MD 20857, USA. NR 7 TC 29 Z9 29 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSN PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD WIN PY 1990 VL 27 IS 4 BP 307 EP 318 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA ET834 UT WOS:A1990ET83400003 PM 2148304 ER PT J AU SALIVE, ME BENJAMIN, K RASKIN, IE AF SALIVE, ME BENJAMIN, K RASKIN, IE TI COMMITMENT TO QUALITY CARE SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Letter RP SALIVE, ME (reprint author), US PHS,AGCY HLTH CARE POLICY & RES,CTR MED EFFECTIVENESS RES,18A-19 PARKLAWN BLDG,ROCKVILLE,MD 20857, USA. NR 4 TC 0 Z9 0 U1 1 U2 1 PU AMER PUBLIC HEALTH ASSN INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD OCT PY 1990 VL 80 IS 10 BP 1276 EP 1277 DI 10.2105/AJPH.80.10.1276-a PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA EA291 UT WOS:A1990EA29100035 PM 2400051 ER PT J AU MURTAUGH, CM KEMPER, P SPILLMAN, BC AF MURTAUGH, CM KEMPER, P SPILLMAN, BC TI THE RISK OF NURSING-HOME USE IN LATER LIFE SO MEDICAL CARE LA English DT Article RP MURTAUGH, CM (reprint author), AGCY HLTH CARE POLICY & RES,DIV LONG TERM CARE STUDIES,ROOM 18A-55,5600 FISHERS LANE,ROCKVILLE,MD 20857, USA. NR 33 TC 93 Z9 93 U1 1 U2 2 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD OCT PY 1990 VL 28 IS 10 BP 952 EP 962 DI 10.1097/00005650-199010000-00009 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA EF792 UT WOS:A1990EF79200009 PM 2232925 ER PT J AU HELLINGER, FJ AF HELLINGER, FJ TI FORECASTING THE NUMBER OF AIDS CASES - AN ANALYSIS OF 2 TECHNIQUES SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article RP HELLINGER, FJ (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,ROOM 678,MAXIMA BLDG,ROCKVILLE,MD 20852, USA. NR 24 TC 4 Z9 4 U1 0 U2 0 PU BLUE CROSS BLUE SHIELD ASSN PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD FAL PY 1990 VL 27 IS 3 BP 212 EP 224 PG 13 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EC429 UT WOS:A1990EC42900003 PM 2145222 ER PT J AU STONE, RI MURTAUGH, CM AF STONE, RI MURTAUGH, CM TI THE ELDERLY POPULATION WITH CHRONIC FUNCTIONAL DISABILITY - IMPLICATIONS FOR HOME CARE ELIGIBILITY SO GERONTOLOGIST LA English DT Article RP STONE, RI (reprint author), AGCY HLTH CARE POLICY & RES,5600 FISHERS LANE,PARKLAWN BLDG,ROOM 18A-55,ROCKVILLE,MD 20857, USA. NR 23 TC 42 Z9 42 U1 1 U2 1 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD AUG PY 1990 VL 30 IS 4 BP 491 EP 496 PG 6 WC Gerontology SC Geriatrics & Gerontology GA DR794 UT WOS:A1990DR79400009 PM 2144254 ER PT J AU COHEN, JW DUBAY, LC AF COHEN, JW DUBAY, LC TI THE EFFECTS OF MEDICAID REIMBURSEMENT METHOD AND OWNERSHIP ON NURSING-HOME COSTS, CASE MIX, AND STAFFING SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article C1 URBAN INST,CTR HLTH POLICY,WASHINGTON,DC 20037. RP COHEN, JW (reprint author), US DEPT HHS,AGCY HLTH CARE POLICY & RES,PARKLAWN BLDG,RM 18-A-55,5600 FISHERS LANE,ROCKVILLE,MD 20857, USA. NR 19 TC 83 Z9 83 U1 3 U2 3 PU BLUE CROSS BLUE SHIELD ASSN PI CHICAGO PA 676 N ST CLAIR ST, CHICAGO, IL 60611 SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD SUM PY 1990 VL 27 IS 2 BP 183 EP 200 PG 18 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DM642 UT WOS:A1990DM64200009 PM 2142136 ER PT J AU STONE, RI SHORT, PF AF STONE, RI SHORT, PF TI THE COMPETING DEMANDS OF EMPLOYMENT AND INFORMAL CAREGIVING TO DISABLED ELDERS SO MEDICAL CARE LA English DT Article RP STONE, RI (reprint author), AGCY HLTH CARE POLICY & RES,5600 FISHERS LANE,ROOM 18A-55,ROCKVILLE,MD 20857, USA. NR 19 TC 103 Z9 105 U1 0 U2 5 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0025-7079 J9 MED CARE JI Med. Care PD JUN PY 1990 VL 28 IS 6 BP 513 EP 526 DI 10.1097/00005650-199006000-00004 PG 14 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA DK277 UT WOS:A1990DK27700004 PM 2355757 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI MEDICAL-TREATMENT EFFECTIVENESS RESEARCH-PROGRAM DESCRIBED SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20857. NR 0 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 25 PY 1990 VL 263 IS 16 BP 2158 EP 2158 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA CZ676 UT WOS:A1990CZ67600007 PM 2319677 ER PT J AU CLINTON, JJ AF CLINTON, JJ TI TEACHING PHYSICIANS TO IMPROVE PATIENT COMPLIANCE SEEMS EFFECTIVE SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material C1 AGCY HLTH CARE POLICY & RES,ROCKVILLE,MD 20857. NR 1 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 25 PY 1990 VL 263 IS 16 BP 2158 EP 2158 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA CZ676 UT WOS:A1990CZ67600008 PM 2319677 ER EF