Health services research
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Health services research · Aug 2016
Effects of Expanded California Health Coverage on Hospitals: Implications for ACA Medicaid Expansions.
To assess the effects on hospitals of early California actions to expand insurance coverage for low-income uninsured adults after passage of the Affordable Care Act. ⋯ California hospitals that treated the most uninsured prior to insurance expansions did not as a group experience substantial benefit in terms of reduced uninsured burden or better financial performance after program expansions occurred.
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To understand hospital- and county-level factors for rural obstetric unit closures, using mixed methods. ⋯ Rural obstetric unit closures are more common in smaller hospitals and communities with a limited obstetric workforce. Concerns about continuity of rural maternity care arise for women with local prenatal care but distant intrapartum care.
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Health services research · Jun 2016
The Quality of Surgical and Pneumonia Care in Minority-Serving and Racially Integrated Hospitals.
To explore the association between quality of care for surgical and pneumonia patients and the racial/ethnic composition of hospitals' patients. ⋯ Efforts to improve quality of care for patients in minority-serving and racially integrated hospitals should focus on the lowest performers.
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Health services research · Apr 2016
Office-Based Tools and Primary Care Visit Communication, Length, and Preventive Service Delivery.
The use of physician office-based tools such as electronic health records (EHRs), health risk appraisal (HRA) instruments, and written patient reminder lists is encouraged to support efficient, high-quality, patient-centered care. We evaluate the association of exam room use of EHRs, HRA instruments, and self-generated written patient reminder lists with patient-physician communication behaviors, recommended preventive health service delivery, and visit length. ⋯ Office-based tools intended to facilitate the implementation of desired primary care practice redesign are associated with both positive and negative cost and quality outcomes. Findings highlight the need for monitoring both intended and unintended consequences of office-based tools commonly used in primary care practice redesign.
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Health services research · Dec 2015
Effect of Medicaid Expansions on Health Insurance Coverage and Access to Care among Low-Income Adults with Behavioral Health Conditions.
To examine the effect of Medicaid expansions on health insurance coverage and access to care among low-income adults with behavioral health conditions. ⋯ The ongoing implementation of Medicaid expansions has the potential to improve health insurance coverage and access to care for low-income adults with behavioral health conditions.