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At least 703 records · Page 39Linked to original sources
PubMed2004

A longitudinal study of Medicaid payment, private-pay price and nursing home quality.

Quality of care problems have persisted for decades within U.S. nursing homes. A potential state-level policy towards addressing this concern is the level of Medicaid payment. However, a number of studies have found that an increase in Medicaid payment is associated with lower quality in the presence of certificate-of-need (CON) laws and bed construction moratorium regulations, which serve as barriers to entry within the nursing home industry. Instead of relying on potentially confounded cross-sectional comparisons, this study presents novel, panel-based evidence that incorporates aggregate private-pay price data. These estimates almost uniformly indicate that an increase in the Medicaid payment rate raises nursing home quality. When compared to the earlier literature, these new findings are attributed to changes over time in the market for nursing home care related to the growth in nursing home substitutes.

Financing, Personal↗
PubMed2004

New evidence on hospital profitability by payer group and the effects of payer generosity.

This study provides (a) new estimates of U.S. hospital profitability by payer group, controlling for hospital characteristics, and (b) evidence about the intensity of care for particular diseases associated with the generosity of the patient's payer and other payers at the same hospital. The conceptual framework is a variant of the well-known model of a local monopolist selling in a segmented market. Effects of two kinds of regulation are considered. The data are taken from hospital accounting reports in four states in FY2000, and detailed discharge summaries from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. The profitability of inpatient care for privately insured patients was found to be about 4% less than for Medicare, but 14% higher than for Medicaid and only 9% higher than for self-pay patients. We found significant direct associations but not external effects of payer generosity on the intensity of care.

Facility Regulation and Control↗
PubMed2004

Multiple prior years of health expenditures and Medicare health plan choice.

This study examines the effect of multiple prior years of health expenditures on the probability of enrollment in a Medicare HMO. Beneficiaries may require more than one year of prior expenditure data to form a reliable estimate of future expenditures if health expenditures have a significant transitory component. We used a logit model to estimate the influence of 1991-1993 Part A expenditures and demographic data on the choice of health plans in 1994. The results indicate that beneficiaries use multiple years of expenditures in their choice of health plan and the effect of prior spending declined with time.

Aged↗
PubMed1998

Financing of IVF/ET in the Nordic countries.

BACKGROUND: The need for calculations of costs of health care has increased during the last few years. When priorities within the national health services in the five Nordic countries are discussed, treatment of infertility is often one of the issues. AIM AND METHODS: The aim of this study was to evaluate cost effectiveness and calculate the proportion of publicly financed in-vitro fertilization/embryo transfers in the Nordic countries. The mean direct and indirect costs of the treatments were calculated in both public and private clinics. The total cost of in-vitro fertilization was calculated and compared with the proportion financed through the national health services in the five countries. RESULTS: The cost analysis showed a direct and indirect cost of 3,300 Pounds per started treatment and 12,700 Pounds per term pregnancy for the whole Nordic material. The publicly financed costs were calculated at 27,342,300 Pounds, which is 66% of the total cost for in-vitro fertilization treatments. When these costs were compared with the total cost of health care in the countries, the proportion used for in-vitro fertilization treatments was between 0.08 and 0.16%. CONCLUSION: It will be difficult for the national health services in the five countries to make large savings by limiting the number of treatments financed within the system.

Costs and Cost Analysis↗
PubMed2003

Cost-effectiveness of different caries preventive measures in a high-risk population of Swedish adolescents.

OBJECTIVES: A total of 3373 12-year-olds agreed to participate in an intervention study evaluating different caries preventive measures. The study, titled 'Evaluation of caries preventive measures', was performed between 1995 and 1999 at 26 dental health clinics throughout Sweden. At the start of the study, the subjects were classified as individuals at high or low risk of developing caries. The high-risk group consisted of 1165 subjects. The children in the high-risk group were randomly assigned to one of four preventive programs. The programs represent a step-wise increase in fluoride content, contact with dental personnel and cost. The aim of the present cost-effectiveness analysis (CEA) study performed from a societal perspective is to compare costs and consequences of caries preventive programs in a caries high-risk population. By 'costs' is meant both treatment costs and costs contributed by the patient and the patient's family. Costs contributed by patients and their families consist of out-of-pocket expenses, transportation costs, and time. Conclusions are that it is important to consider the perspective from which a study is carried out. Costs contributed by the patient and the patient's family have a high impact on total costs for children and younger adolescents but decrease with time as the adolescents get older. The present study shows an incremental cost-effectiveness of 2043 SEK (8.54 SEK = 1 US dollar, December 1999) per averted decayed enamel and dentine missing and filled surface (DeMFS), of which treatment costs represent 1337 SEK using the unit cost for a nurse. This means a yearly cost of approximately 334 SEK.

Adolescent↗
PubMed1998

Financial strain, received support, anticipated support, and depressive symptoms in the People's Republic of China.

The purpose of this study is to examine the interface between financial strain, informal received economic support, informal anticipated financial support, and psychological distress in later life. Data provided by a large probability sample of older adults in the People's Republic of China reveal that the relationship between financial difficulty and psychological distress is stronger for older adults who receive more economic assistance. However, the results involving anticipated support are in the opposite direction. More specifically, the association between financial problems and psychological distress is lower for older adults who believe that others stand ready to help in the future should the need arise. A detailed theoretical rationale is developed to explain these results.

Aged↗
PubMed2003

When success breeds failure: history, hysteresis, and delayed exit decisions.

The effects of feedback equivocality, information availability, and prior decision-making history on escalation and persistence were investigated. Replicating the findings of J.L. Bragger, D.H. Bragger, D.A. Hantula, and J.P. Kirnan (1998), this study found that participants receiving equivocal feedback on their decisions invested more money and invested across more opportunities; those who could purchase information invested fewer resources than did participants who did not have the opportunity to purchase information. There was an inverse linear relationship between the percentage of opportunities in which participants purchased information and the delay to exit decisions and total resources invested. Six weeks earlier, some participants took part in a more profitable investment scenario, and prior experience led to later increased investing when participants were faced with failure, even above that invested in a preceding, succeeding scenario. These results are consistent with an equivocality theory account of escalation.

Adult↗
PubMed2004

What difference does a civil union make? Changing public policies and the experiences of same-sex couples: comment on Solomon, Rothblum, and Balsam (2004).

When Vermont became the first state in the United States to legalize civil unions for same-sex couples, it marked an important milestone in lesbian and gay Americans' struggle for equal rights. Against this background, S. E. Solomon, E. D. Rothblum, and K. F. Balsam's (2004) study, the first to examine experiences of same-sex couples who have undertaken civil unions, is a significant effort. The study provides valuable data about these couples, yet much remains to be learned. Further study of the impact of changing legal landscapes on experiences of same-sex couples and their families has the potential to add significantly to knowledge about contemporary family lives.

Female↗