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1 During the past two decades, several public and private organizations have initiated programs to report publicly on the quality of medical care provided by specific hospitals and physicians. These programs have sparked broad debate among economists and policy makers. At issue is the question of whether, and to what extent, these " report card " programs(More)
Recent litigation against the major tobacco companies culminated in a master settlement agreement (MSA) under which the participating companies agreed to compensate most states for Medicaid expenses. Here the terms of the settlement are outlined and its economic implications analyzed using data from Massachusetts. The financial compensation to Massachusetts(More)
OBJECTIVE To evaluate measures that could use existing administrative data to assess the intensity of end-of-life cancer care. METHODS Benchmarking standards and statistical variation were evaluated using Medicare claims of 48,906 patients who died from cancer from 1991 through 1996 in 11 regions of the United States. We assessed accuracy by comparing(More)
BACKGROUND Racial/ethnic disparities in health care are well documented, but less is known about whether disparities occur within or between hospitals for specific inpatient processes of care. We assessed racial/ethnic disparities using the Hospital Quality Alliance Inpatient Quality of Care Indicators. METHODS We performed an observational study using(More)
Propensity score methods are being increasingly used as a less parametric alternative to traditional regression to balance observed differences across groups in both descriptive and causal comparisons. Data collected in many disciplines often have analytically relevant multilevel or clustered structure. The propensity score, however, was developed and has(More)
BACKGROUND Overuse of anti-cancer therapy is an important quality-of-care issue. An aggressive approach to treatment can have negative effects on quality of life and cost, but its effect on survival is not well-defined. METHODS Using the Surveillance, Epidemiology, and End Results-Medicare database, we identified 7,879 Medicare-enrolled patients aged 65(More)
BACKGROUND Increases in the market share of managed care in an area are associated with decreases in expenditures in the fee-for-service sector (i.e., a spillover effect). Given concerns that these decreases in expenditures result from reductions in necessary care, we examined associations between increases in managed care market share and changes in the(More)
BACKGROUND Use of cholesterol-lowering drugs reduces mortality and adverse cardiac events among people aged 65 to 75 years with coronary heart disease, but previous studies have shown that most patients have not received this treatment. METHODS We conducted a telephone survey during 1999 and 2000 of 815 Medicare beneficiaries aged 65 to 74 years(More)
OBJECTIVE This study examined whether presenting diagnosis and treatment in intensive settings (hospitalization, partial hospitalization, or residential programs) are correlated with the subsequent treatment of bipolar I disorder. METHODS Claims data were studied retrospectively (fiscal years 1994-2000) for 2,644 patients with bipolar I disorder who had(More)