Articles: hospitals.
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Multicenter Study
Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis.
To examine whether the introduction of payment by results (a fixed tariff case mix based payment system) was associated with changes in key outcome variables measuring volume, cost, and quality of care between 2003/4 and 2005/6. ⋯ Reductions in unit costs may have been achieved without detrimental impact on the quality of care, at least in as far as these are measured by the proxy variables used in this study.
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The Journal of pediatrics · Dec 2008
Multicenter StudyQuality of care of children in the emergency department: association with hospital setting and physician training.
To investigate differences in the quality of emergency care for children related to differences in hospital setting, physician training, and demographic factors. ⋯ The quality of care provided to children is associated with age, hospital setting, and physician training.
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Federal policy changes and tightened state budgets may reduce Medicaid enrollment in many states. In March 2003, the Oregon Health Plan (Oregon's Medicaid expansion program) made substantial changes in its benefit package that resulted in the disenrollment of more than 50,000 beneficiaries. We sought to study the impact of these Oregon Health Plan policy changes on statewide emergency department (ED) use. ⋯ Oregon's Medicaid cutbacks were followed by increases in ED use and hospitalizations by the uninsured. Recent federal legislation facilitating similar Medicaid changes in other states may lead to replication of these events elsewhere.
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Multicenter Study
Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score.
To develop, in patients referred for syncope to an emergency department (ED), a diagnostic score to identify those patients likely to have a cardiac cause. ⋯ A simple score derived from clinical history can be usefully employed for the triage and management of patients with syncope in an ED.
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Multicenter Study
Cryoprecipitate use in 25 Canadian hospitals: commonly used outside of the published guidelines.
Canadian Blood Services' disposition reports suggested considerable variation in cryoprecipitate use and prompted this national audit. ⋯ A 2-month audit of cryoprecipitate use in Canada revealed that the majority of cryoprecipitate use in Canada is not in accordance with published guidelines.