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At least 91 records · Page 5Linked to original sources
PubMed1992

Medicare hospital outpatient services and costs: implications for prospective payment.

Medicare expenditures of hospital outpatient department (HOPD) services are growing rapidly, prompting congressional interest in a prospective payment system. In this article, the authors identify frequently provided services and examine service volume and charges in the HOPD. Relatively few services drive Medicare HOPD spending, and volume is dominated by visits, imaging and laboratory tests, whereas surgery accounts for a large proportion of charges. Hospital-level variations in charges, costs, case mix, and outliers are also explored. There is substantial variation in charges and costs across hospital types. However, after case-mix adjustment, all hospital types have average costs within 6 percent of the national average.

Ambulatory Surgical Procedures↗
PubMed1998

Past utilization of geriatric psychiatry outpatient services by a cohort of patients with major depression.

The authors examined past utilization of outpatient psychiatric services by elderly depressed patients. A chart review identified 49 patients (mean age = 69.4) who had ceased active treatment, of whom 28 were successfully contacted. Reasons for discontinuation were 1) patient perception that care was no longer needed (51.5%); 2) existence of barriers to care (33.3%); and 3) perception that treatment was ineffective (15.2%). Findings included 1) a higher number of visits by patients referred from a non-healthcare source and by married patients; 2) lower Beck Depression Inventory scores among those who reported that they did not need additional treatment; and 3) a greater willingness to re-engage in treatment by those patients with a higher number of visits during their previous treatment. Patient characteristics and source of referral were associated with both past service utilization and likelihood of future usage; however, many individuals do not access treatment because of both practical and attitudinal barriers to care.

Aged↗
PubMed1988

Use and cost of hospital outpatient services under Medicare, 1985.

Presented in this article are program data on the use and cost of hospital outpatient (HOP) services rendered to aged and disabled Medicare beneficiaries during calendar year 1985. Trend data are also presented for calendar years 1974-85. The data shown in this article focus on charges, reimbursements, and reimbursements per enrollee as a means of measuring the cost of HOP services. The data provide information to help identify trends and patterns of care for monitoring the Medicare HOP benefit and for evaluating the impact of the inpatient hospital prospective payment system (PPS) on the use and cost of HOP services.

Ambulatory Care↗
PubMed1998

[Identification of the types of touching during nursing care in an outpatient service].

This study was realized in the outpatient ward of bone marrow transplantation. The sample consisted of 17 adult patients and six workers. The data was collected from October to December, 1996, being obtained through filming, decodification of the films, a questionnaire and interview with the workers. The purposes were to identify in what situations the different types occurred, and which regions of the body were involved. It was found that most of the touching was of the instrumental type. The regions touched were the thorax and upper limbs.

Adult↗
PubMed1988

A document-based review of treatment in outpatient services.

OBJECTIVE: To determine criteria for Accident and Emergency outpatient documentation, to review current practice and to overcome identified deficiencies. METHOD: Retrospective criteria audit of 160 records from a random sample of outpatient attendances over one week at four hospitals. The distribution to medical and nursing representatives of questionnaires accompanied by the audit results. RESULTS: The overall standard of outpatient documentation was high. Problem areas included the recording of cause of injury, significant laboratory and radiological findings, discharge instructions and time of disposal. Forms design was criticised by some users. Overall, however, non-compliance was seen to be less of a problem than lack of awareness by staff of what is important to document in an outpatient setting.

Data Collection↗
PubMed1998

Hospital-based rehabilitative care versus outpatient services: effect on functioning and health status.

PURPOSE: The goal of this clinical trial was to examine the long-term impact of rehabilitative care on the health status of patients diagnosed with a disabling disorder. METHOD: Study patients consisted of first-time hospitalizations from diagnostic groups commonly admitted for inpatient rehabilitation, including nervous, circulatory, and musculoskeletal disorders or injury. Patients were randomly assigned to inpatient rehabilitation (n = 43) or to outpatient follow-up (n = 42) in which the usual medical services were provided but no scheduled rehabilitative therapies were offered. Specific objectives of the study were to determine the effects of impatient rehabilitation on: (1) functional ability, (2) health and mental health status, (3) personal adjustment, and (4) family function. Cost and use of health-care resources were descriptively assessed. RESULTS: Analysis of covariance found no significant treatment effects, either at 6 months or at 1 year, for any of the variables under study. In addition, there were no differences between groups in their use of nursing homes, length of hospital stay, mortality, or in the number of hospital readmissions or clinic visits during the first year after hospital discharge. Use of rehabilitation services and cost of care was significantly higher than outpatient services. The findings were consistent with previous studies for most outcomes, with the major exception being functional improvements. Contrary to earlier studies, rehabilitation was not found to effectively produce lasting functional outcomes. However, study conditions may not have fully corresponded to those of previous studies, and further research is needed. The patient sample was representative of a full inpatient service and therefore more heterogeneous than samples reported in prior studies, but the small sample size (due to reductions in the number of admitted patients to the rehabilitation unit during the course of the study) precluded subgroup analysis of diagnostic groupings. CONCLUSION: The findings suggest that hospital-based rehabilitative care does not have lasting benefits, and that alternative care or supportive follow-up by a subacute-care facility may be needed to assist patients in maintaining functional gains and health benefits.

Adult↗
PubMedDate not supplied

Aging and outpatient service use among persons with schizophrenia-spectrum disorders in a statewide behavioral healthcare system.

This investigation explored the demographic and service use correlates of age among young, midlife, and older adults diagnosed with schizophrenia-spectrum disorders (N = 513), using the administrative data set of a statewide behavioral healthcare system. More African Americans persons were represented in the younger groups (age 18-35, 36-44) than in the older group (age 45 and older). Nearly two thirds of persons with schizophrenia-spectrum disorders seeking outpatient treatment were younger than 45. With the exception of crisis/emergency department services, persons in different age groups did not differ in the amount and type of outpatient service utilized and in the likelihood of dropping out of services early. However, persons aged between 18 and 44 used significantly more crisis/emergency department services than did those aged 45 and older. The findings suggest the importance of relapse prevention for persons aged 18-44 treated in outpatient settings.

Adult↗