John A. Nyman

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OBJECTIVE The purpose of this study was to determine whether implementation of a multicomponent organizational intervention can produce significant change in diabetes care and outcomes in community primary care practices. RESEARCH DESIGN AND METHODS This was a group-randomized, controlled clinical trial evaluating the practical effectiveness of a(More)
BACKGROUND Treatment guidelines recommend drug treatment to prevent fractures for some postmenopausal women who have low bone mass (osteopenia) but do not have osteoporosis or a history of clinical fractures. OBJECTIVE To estimate the societal costs and health benefits of alendronate drug treatment to prevent fractures in postmenopausal women with(More)
The objective of this review was to synthesize existing information regarding the effects of petroleum hydrocarbons on marsh macrophytes in a manner that will help guide research and improve spill-response efficiency. Petroleum hydrocarbons affect plants chemically and physically. Although plants sometime survive fouling by producing new leaves, even(More)
The for-profit nursing home's incentive to minimize costs has been maligned as a major cause of the quality problems that have traditionally plagued the nursing home care industry. Yet, profit-maximizing firms in other industries are able to produce products of adequate quality. In most other industries, however, firms are constrained from reducing costs to(More)
Survivor costs are those costs associated with a treatment because it extends the patient's life. A controversy exists regarding whether survivor consumption costs should be included in cost-utility analyses. The present paper uses this controversy to motivate a general reexamination of what costs to include in cost-utility analyses. Rather than the ad hoc(More)
Recent debates over health policy have tended to be between procompetitive solutions and proregulatory ones. This dichotomy, however, seems to be less descriptive of the policy debate over ways to improve nursing home quality. This article argues that a more useful distinction may be between adequacy- and incentive-oriented policies. The nursing home(More)
This paper hypothesizes that the Medicaid reimbursement payment discourages quality nursing home care in markets with excess demand. It further shows that an increase in the prospective payment or an increase in the return on capital portion of a retrospective cost-plus payment decreases the quality provided when there is excess demand. Finally, it argues(More)
CONTEXT Patients who have received solid organ transplants continue to experience a myriad of complex symptoms related to their underlying disease and to chronic immunosuppression that reduce the quality of life. Beneficial nonpharmacologic therapies to address these symptoms have not been established in the transplant population. OBJECTIVE Assess the(More)
Women with inadequate health insurance have lower mammography rates than the general population. Finding successful strategies to enroll eligible women is an ongoing challenge for the National Breast and Cervical Cancer Early Detection Program. To test the effectiveness of a population-based strategy to increase mammography utilization among low-income(More)
Conventional theory holds that moral hazard--the additional health care purchased as a result of becoming insured--is an opportunistic price response and is welfare-decreasing because the value of the additional health care purchased is less than its costs. The theory of the demand for health insurance presented here suggests that moral hazard is primarily(More)