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Longitudinal studies are often concerned with estimating the rate of an event that may recur. Examples are nonmelanoma skin cancer rates, screening rates for breast cancer using mammography and hospital admission rates. We propose simple estimators for directly and indirectly standardized summary rates and relative rates of recurrent events and their(More)
BACKGROUND Rates of many surgical procedures vary widely across both large and small geographic regions. Although variation in health care use has long been described, few studies have systematically compared variation profiles across surgical procedures. The goal of this study was to examine current patterns of regional variation in the rates of common(More)
How well can hospital discharge abstracts be used to estimate patient health status? This paper compares information on comorbidity obtained from hospital discharge abstracts for patients undergoing prostatectomy or cholecystectomy at a Winnipeg teaching hospital with clinical data on preoperative medical conditions prospectively collected during an(More)
OBJECTIVE To explore whether geographic variations in Medicare hospital utilization rates are due to differences in local hospital capacity, after controlling for socioeconomic status and disease burden, and to determine whether greater hospital capacity is associated with lower Medicare mortality rates. DATA SOURCES/STUDY SETTING The study population: a(More)
This study was conducted to assess the readability and length of informed consent documents used in clinical trials in oncology. One hundred seven consent documents from clinical protocols open to accrual at the Emory University Winship Cancer Institute were quantitatively analyzed. These included trials sponsored or organized internally, by commercial(More)
This study illustrates that Medicare claims can be used to measure population-based, provider-specific rates of resource inputs, utilization, and Medicare spending. The target populations are seventy-seven cohorts of chronically ill Medicare enrollees who received most of their care from seventy-seven well-known U.S. hospitals. Striking variations are(More)
In this paper we compare the relative efficiency of health care providers in managing patients with severe chronic illnesses over fixed periods of time. To minimize the contribution of differences in severity of illness to differences in care management, we evaluate performance over fixed intervals prior to death for patients who died during a five-year(More)
BACKGROUND Reports of better results at national referral centers than at low-volume community hospitals have prompted calls for regionalizing pancreaticoduodenectomy (the Whipple procedure). We examined the relationship between hospital volume and mortality with this procedure across all US hospitals. METHODS Using information from the Medicare claims(More)
OBJECTIVE To examine the degree to which variation in place of death is explained by differences in the characteristics of patients, including preferences for dying at home, and by differences in the characteristics of local health systems. DESIGN We drew on a clinically rich database to carry out a prospective study using data from the observational(More)
CONTEXT Although drug-eluting stents reduce restenosis rates relative to bare-metal stents, concerns have been raised that drug-eluting stents may also be associated with an increased risk of stent thrombosis. Our study focused on the effect of stent type on population-based interventional outcomes. OBJECTIVE To compare outcomes of Medicare beneficiaries(More)