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CONTEXT Substantial racial disparities in the use of some health services exist; however, much less is known about racial disparities in the quality of care. OBJECTIVE To assess racial disparities in the quality of care for enrollees in Medicare managed care health plans. DESIGN AND SETTING Observational study, using the 1998 Health Plan Employer Data(More)
OBJECTIVE To determine whether uninsured and Medicaid patients have higher rates of avoidable hospitalizations than do insured patients. DESIGN We used 1987 computerized hospital discharge data to select a cross-sectional sample of hospitalized patients. Population estimates from the Current Population Survey were used to estimate rates of admission,(More)
BACKGROUND Spending on prescription drugs is the fastest growing component of the health care budget. There is public concern about the possibility that direct-to-consumer advertising of prescription drugs will result in inappropriate prescribing and higher costs of care. Guidelines issued in 1997 by the Food and Drug Administration (FDA) regarding(More)
OBJECTIVES Although there has been substantial policy interest in interventions to improve the neonatal outcomes of disadvantaged women, little attention has been paid to the health status of pregnant women themselves. We therefore examined whether the provision of health coverage to uninsured low-income pregnant women affects maternal health status or the(More)
A randomized clinical trial was recently conducted to investigate whether a new antiplatelet agent could prevent restenosis in patients who had undergone percutaneous transluminal coronary artery angioplasty (PTCA). Approximately 1,200 patients were enrolled at 13 separate clinical sites. To assess the impact of this intervention on health-related quality(More)
CONTEXT The adoption of pay-for-performance mechanisms for quality improvement is growing rapidly. Although there is intense interest in and optimism about pay-for-performance programs, there is little published research on pay-for-performance in health care. OBJECTIVE To evaluate the impact of a prototypical physician pay-for-performance program on(More)
To examine interracial differences in the utilization of coronary angiography, coronary artery bypass grafting, and coronary angioplasty for white and black patients, we examined all admissions for circulatory diseases or chest pain to Massachusetts hospitals in 1985. After controlling for age, sex, payer, income, primary diagnoses, and the number of(More)
This article reports a study of variations in the utilization of angiography for Medicare recipients who had an acute myocardial infarction. The study cohort consisted of 1987 Medicare beneficiaries who had a recent acute myocardial infarction. Variations were examined from three perspectives: patient characteristics, regional practice patterns, and on-site(More)
BACKGROUND Many employers and health plans have adopted incentive-based formularies in an attempt to control prescription-drug costs. METHODS We used claims data to compare the utilization of and spending on drugs in two employer-sponsored health plans that implemented changes in formulary administration with those in comparison groups of enrollees(More)
Instruments using interview data to measure health status have been increasingly used to measure patient outcomes. To assess the potential utility of proxy responses about health status when subjects are unable to respond, the authors compared the responses of 60 subject and proxy pairs on instruments measuring overall current health, functional status,(More)