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Biomedical subjects

Jan P Clement

Publications and source records attributed to Jan P Clement.

4 recordsLinked to original sources
PubMed2007

Does the patient's payer matter in hospital patient safety?: a study of urban hospitals.

BACKGROUND: Previous studies have documented that hospitals decrease costs in response to reimbursement cutbacks. However, research concerning how this may affect quality of care has produced mixed results. Until recently, the ability to study changes in patient safety and payment has been limited. OBJECTIVE: The objective of the study was to determine whether changes in 4 hospital patient safety indicator (PSI) rates are related to changes in the generosity of payers over time. DATA AND METHODS: Study data are drawn from 1995-2000 hospital discharges in 11 states in the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project State Inpatient Database. Following the same organizations over time, we estimate hospital fixed-effects regression models of the association of payer-specific time and post Balanced Budget Act (BBA) payment changes with risk-adjusted hospital PSI rates controlling for patient, organizational, and market characteristics. Four PSIs relevant to a large number of patients and hospitals that reflect general care processes are studied. RESULTS: The time trend during 1995-2000 is consistently significantly positive for private and Medicare hospital PSI rates. Thus, after controlling for patient characteristics and organizational and market factors, performance worsened. The trend is less consistent for Medicaid and does not exist for self-pay hospital PSI rates. After adjusting for multiple comparisons, we also find that the Medicare trend is fairly consistently higher than that of the other payers. In contrast, there is a less consistent BBA effect, especially for Medicare.

Financing, Personal↗
PubMed2003

Hantavirus.

When hantaviruses hit the headlines with the advent in May 1993 of a new disease in the USA, and later in the New World from Canada to south Argentina, called "hantavirus pulmonary syndrome" (HPS), speculations in the lay press rose from the very beginning around the possibilities of a biological warfare (BW) weapon. Indeed, the responsible agent of HPS, hantavirus, was almost unknown at that moment in the New World, was airborne, seemed to target preferentially young adults, and induced a devastating cardio-pulmonary collapse with a high case-fatality rate (50%), often within hours. It quickly became clear, however, that the same scourge had been known for many years in the Old World under different and mostly milder presentations. With the rapidly increasing knowledge about hantaviruses, it also became clear that they lack many of the potentials of an "ideal" BW weapon, as will be explained in this paper.

Animals↗
PubMed2002

Charity care: do not-for-profits influence for-profits?

This study further examines whether not-for-profit hospitals exert pressure on for-profit hospitals to provide charity care and whether for-profit hospitals react differently than not-for-profit hospitals to managed care pressures and hospital competition in providing charity care. A two equation model is estimated using 1996 data from California hospitals. The results indicate that in mixed ownership markets, for-profit hospitals provide significantly less charity care as not-for-profit hospitals in the market provide more. Unexpectedly, study for-profit hospitals were not more influenced by price competition than other hospitals with respect to charity care. Having a unique role in providing charity care may justify continuing tax exemption for not-for-profit hospitals and enhance interest in payment and other policies with regard to conversions to ensure that not-for-profit hospitals continue to be represented in market areas.

California↗