Objective. To develop and characterize utilization‐based service areas for the United States which reflect travel of Medicare beneficiaries to primary care clinicians. Data Source/Study Setting. The 1996–1997 Part B 1996 Outpatient File claims fee‐for‐service aged 65 older. 1995 Medicaid from six states (1995) commercial Blue Cross Shield Michigan (1996). Study Design. A patient origin study was conducted assign 1999 U.S. zip codes Primary Care Service Areas on basis plurality beneficiaries'...

Older patients with multiple chronic conditions are often faced increased health care needs and subsequent higher medical costs, posing significant financial burden to patients, their caregivers, the system. The increasing adoption of electronic record systems proliferation clinical data offer new opportunities for prevalence studies population assessment. last few years have witnessed an number research networks focused on building large collections from records claims make it easier less...

Objective: To examine care system choices for Veterans dually-eligible VA and Medicare FFS following changes in eligibility policy, which expanded availability of

Purpose: To analyze the extent to which rural-urban differences in breast cancer stage at diagnosis are explained by factors including age, race, tumor grade, receptor status, and insurance status. Methods: Using National Cancer Institute's Surveillance, Epidemiology, End Results (SEER) 18 database, analysis was performed using data from women aged 50-74 diagnosed with between years 2013 2016. Patient rurality of residence coded according SEER's Rural-Urban Continuum Code 2013: Large Urban...

Implementation of accountable care organizations (ACOs) is currently underway, but there limited empirical evidence on the merits ACO model.The aim was to study associations between delivery system characteristics and competencies, including centralization strategies manage organizations, hospital integration with physicians outpatient facilities, health information technology, infrastructure monitor community report quality, risk-adjusted 30-day all-cause mortality case-mixed-adjusted...

OBJECTIVE: Identifying racial and ethnic differences in perceived need for treatment among families of children with autism spectrum disorder (ASD) will improve understanding disparities care seeking. We described services that ASD their frequently use. METHODS: conducted bivariate analyses categories 6 common used by as found the 2005 to 2006 (n = 2123) 2009 2010 3055) National Survey Children With Special Health Care Needs data sets. Multivariate logistic regressions within concatenated...

Aim This study examined cross‐sectional population‐based rates in reported need and unmet for occupational, physical, speech therapy services children with autism spectrum disorder ( ASD ) compared attention‐deficit–hyperactivity ADHD cerebral palsy CP ). Method The 2005–2006 2009–2010 USA National Survey of Children Special Health Care data sets were used to compare among younger than 18 years n =5178), =20 566), =1183). Bivariate approaches multivariate logistic regression using imputed...

Research on children and youth the autism spectrum reveal racial ethnic disparities in access to healthcare utilization, but there is less research understand how persist as autistic adults age. We need racial-ethnic inequities obtaining eligibility for Medicare and/or Medicaid coverage, well spending enrollees under these public programs.We conducted a cross-sectional cohort study of U.S. publicly-insured using 2012 Medicare-Medicaid Linked Enrollee Analytic Data Source (n = 172,071)....

Few studies have examined subgroup differences regarding the role of collective cultural strengths among Latinos, largest minority population in United States today. Based on and social psychologists’ emphasis their importance to minorities, this study explored association three factors with self-reported mental physical health for Latino subgroups identified National Asian American Study (NLAAS). Relative Cubans, Mexicans Puerto Ricans experienced poorer and, not surprisingly, more...

Emails securely exchanged between patients and clinicians offer the promise of improved access to care indirectly health outcomes. Yet research date is mixed on who-among both clinicians-is using secure messaging.Using data from two large nationally representative cross-sectional surveys, this study aimed compare prevalence messaging use among their functionality through physicians, explore clinical practice physician characteristics patient sociodemographic associated with messaging.We...

Due to the prevalence, severity, and costs associated with autism spectrum disorders (ASDs), it has become a public health issue. In response, state governments have adopted ASD-specific private insurance mandates requiring coverage of ASD screening, diagnosis, treatment. Despite rapid uptake these laws, differences exist in type levels coverage, especially for allied services including occupational therapy. We piloted structured legal research methodology code that impact service...

The study objective was to examine hospital mortality outcomes and structure using 2008 patient-level discharges from general community hospitals. Discharges Florida administrative files were merged the state registry. A cross-sectional analysis of inpatient conducted Inpatient Quality Indicators (IQIs) for acute myocardial infarction (AMI), congestive heart failure (CHF), stroke, pneumonia, all-payer 30-day postdischarge mortality. Structural characteristics included bed size, volume,...

We studied characteristics of all, occasional, and frequent emergency department (ED) visits due to ambulatory care-sensitive conditions (ACSCs). used a cross-sectional, split-sample design with multivariate logistic regressions using encounter-level, all-payer ED data from all Florida hospitals for the year 2005. evaluated associations key patient characteristics, utilization, availability primary care physicians in area, ACSCs. concluded that factors associated use ACSCs were similar...

Objective There has been little research to examine the association of post-discharge adverse events (AEs) with timely follow-up visits after hospital discharge. We aimed whether having a outpatient visit would reduce risk for AEs. Methods This was methods study patients at AEs from December 2011 through October 2012. Five hundred and forty-five who were under care hospitalist physicians discharged home community hospital, spoke English, could be contacted discharge evaluated. The aim based...

In Brief Context: The Multi-State Learning Collaborative: Lead States in Public Health Quality Improvement (MLC) brought state and local health departments 16 states together with public system national partners to prepare for voluntary accreditation implement quality improvement (QI) practices. Objective: MLC has collected the single largest repository of qualitative QI data date. A preliminary study was conducted explore potential merits further mining sets this size scope examining them...

Medicare is a public insurer for whom many autistic adults are eligible in the United States, but little known about beneficiaries who covered. A challenge using claim data identification of autism spectrum disorder (ASD) cases to ensure accurate characterization. Some work suggests that relying on one could identify probable ASD, although other works indicate two claims necessary case identification. The purpose current study was describe sample young adult beneficiaries, and determine...

Anxiety is an under-investigated comorbidity in heart disease patients. Optimism/hope a character strength that indicates confidence or favorable expectation about the future. Previous research has consistently reported optimal health outcomes among optimists. However, many studies have lacked adjustment for medical confounders and/or used small clinical samples. To bridge this gap, we tested hypothesis optimism/hope was inversely related to anxiety 400+ patients with advanced during...

Background: Florida's nursing home industry has experienced significant financial pressure over the past decade. One of primary reasons is dramatic increase in litigation activity for providers claiming negligent care and abuse. Although anecdotal reports indicate a higher cost because malpractice facilities, few studies have examined extent paid losses their effect on performance homes. Purpose: The purpose this study was to examine impact Methodology/Approach: Medicare Cost Report data...