This study examined the impact of four domains upon quality life (QOL) senior residents living in assisted homes: (a) demographic characteristics and health status, (b) social involvement, (c) facility characteristics, (d) climate. Participants were 201 with functional impairments 55 different facilities California. QOL was measured three scales depression, satisfaction, satisfaction. Bivariate correlations ANOVAs found significant relations between at least one measures age, family...

Measurement error may be an important source of bias in studies using self-reported health indicators to explain work behavior. As a test measurement error, the tetrachoric correlation coefficient is used examine relationship between two alternative measures arthritis, standard measure and simulated clinical measure. While are highly correlated, found. Regression analysis demonstrates that it varies systematically across different socioeconomic groups. In particular, individuals who not...

Recent reports by the Medicare Payment Advisory Commission have highlighted sharp increases in use of advanced diagnostic imaging procedures among fee-for-service population. Little research has examined whether such trends also exist persons with generous private insurance coverage. Moreover, documenting changes share utilization linked to self-referral is nonexistent.Using data from a large insurer California, we document for magnetic resonance (MRI), computed tomography (CT), and positron...

Some urology groups have integrated intensity-modulated radiation therapy (IMRT), a treatment with high reimbursement rate, into their practice. This is permitted by the exception for in-office ancillary services in federal prohibition against self-referral. I examined association between ownership of IMRT and use to treat prostate cancer.Using Medicare claims from 2005 through 2010, constructed two samples: one comprising 35 self-referring private practice matched control group...

Abstract A population‐based survey designed to be representative of the entire US population working age (18–64 years) includes data on pain and swelling specific joints in each subject. We analyzed these estimate work status disability status, as well earnings losses, associated with Symmetric Polyarthritis. Subjects identified having Polyarthritis were similar age, race, sex, marital rheumatoid arthritis patients seen clinical settings. Overall, 51% women 47% men severely disabled,...

Use of bone marrow transplantation (BMT), a complex, costly treatment for many forms cancers, has increased significantly in recent years. The increasingly competitive health care marketplace raises concerns about patient access to medical procedures such as BMT. We attempted evaluate BMT the leukemias and lymphomas.We analyzed inpatient hospital discharge data from four states (California, Maryland, Massachusetts, New York) 2 years (1988 1991) examine whether use patients with either...

Background and Purpose. Access to physical therapy in many states is contingent on prescription or referral by a physician. Other have enacted direct access legislation enabling consumers obtain without physician referral. Critics of cite potential overutilization services, increased costs, inappropriate care. Methods Results. Using paid claims data for the period 1989 1993 from Blue Cross-Blue Shield Maryland, state, we compiled episodes acute musculoskeletal disorders categorized them as...

Physicians are increasingly the owners of health care facilities to which they refer patients for services but at do not practice. We studied such ownership arrangements, known as "joint ventures," in field radiation therapy, examining their effects on access, use services, costs, and quality.Because 44 percent free-standing providing therapy Florida 1989 were joint ventures, compared with 7 elsewhere (95 confidence interval, 3 10 percent), we data comparable remainder United States. also...

To evaluate the effects of physician ownership freestanding physical therapy and rehabilitation facilities on utilization, charges, profits, three measures service characteristics for treatments.Statistical comparison by joint venture status comprehensive providing treatments in Florida.A total 118 outpatient 63 services Florida during 1989. The data from were collected under a legislative mandate.Visits per patient, average revenue percent operating income, markup, profits licensed...

<h3>Background</h3> Physician-owned specialty hospitals and ambulatory surgery centers have become commonplace in many markets throughout the United States. Little is known about whether financial incentives linked to ownership affect frequency of outpatient surgery. <h3>Objective</h3> To evaluate if physician influence orthopedic surgical procedures. <h3>Design Setting</h3> We analyzed 5 years claims data from a large private insurer Idaho compare by surgeon owners nonowners procedures that...

Using data from a large insurer in California, we identified the self-referral status of providers who billed for advanced imaging 2004. Nearly 33 percent submitted bills magnetic resonance (MRI) scans, 22 those computed tomography (CT) and 17 positron-emission (PET) scans were classified as "self-referral." Among them, 61 MRI 64 CT did not own equipment. Rather, they involved lease or payment-per-scan referral arrangements that might violate federal state laws.

The authors estimate the effects of market structure on hospital costs using a translog multiproduct cost function. Recognizing multiplicity services provided by hospitals, results show that are substantially determined service configuration, and there distinct economies size sco pe. model also distinguishes concentration measures servic e type, including obstetrics, radiation therapy, diagnostic imaging, nd surgery. Estimates that, after controlling for other determinants cost, degree...

Since the late 1990s, use of advanced diagnostic imaging modalities has increased by double-digit rates, outpacing rate increase medical spending overall. In an attempt to assure appropriate procedures, private insurers are increasingly contracting with radiology benefit management programs (RBMs) reduce overall and expenditures for services. This article describes services offered RBMs then presents trends in utilization procedures from three health plans that adopted RBM prior...

Although physician-owned specialty hospitals have become increasingly prevalent in recent years, little research has examined whether the financial incentives linked to ownership influence physicians' referral rates for services performed at hospital.We compared practice patterns of physician owners Oklahoma, before and after ownership, nonowners who treated similar cases over same time period Oklahoma markets without hospitals.We constructed episodes care injured workers with a primary...

Federal law allows physicians in some circumstances to refer patients for additional services a facility which the physician has financial interest. The practice of self-referral imaging and pathology been criticized because it can lead increased use escalating health care expenditures, with little or no benefit patients. This study examined Medicare claims men set geographically dispersed counties determine how "in-office ancillary services" exception affected surgical cancer detection...

This paper analyzes two competing explanations for the ownership of ancillary facilities by referring physicians: indirect demand inducement and quality assurance. Consistent with demand-inducement explanation we find physician-owned clinics treat patients 50 percent more visits than do independent differential is directly related to factors facilitating inducement. We no difference in care across structures, however. In further support hypothesis that physical therapists are less likely...

In recent years physician ownership of so-called limited-service hospitals has become commonplace in many states lacking certificate-of-need regulations. Empirical evidence documenting the effects these facilities is sparse. This study compares practice patterns physician-owners cardiac and physician-nonowners who treat patients at competing full-service community hospitals. Analyses six Arizona inpatient discharge data show that higher volumes profitable surgical diagnosis-related groups...

Physician ownership of specialty hospitals has become commonplace in recent years several states where certificate-of-need laws do not exist. The study examines trends utilization rates for complex and simple spinal fusion procedures performed on injured workers with back/spine disorders two markets Oklahoma. During the time period we examine, physician-owned spine or orthopedic entered both market areas Because there were no Oklahoma without to use as a comparison group, also analyzed these...

We examine the effect of undiagnosed memory disorders on credit outcomes using nationally representative reporting data merged with Medicare data. Years prior to eventual diagnosis, average scores begin weaken and payment delinquency begins increase, overall for mortgage card accounts specifically. Credit consistently deteriorate over quarters leading up diagnosis. The harmful financial effects exacerbate already substantial pressure households face upon diagnosis a disorder. Our findings...

<h3>Background</h3> Recently published research based on selected samples of patients treated at human immunodeficiency virus clinics documents that use more intensive antiretroviral drug therapies is responsible for significant declines in morbidity and mortality persons living with or acquired syndrome (PLWHAs). In this study, we evaluate whether receipt recently developed varies by sex race/ethnicity a large population-based sample PLWHAs such drugs has any impact survival....