Predicting Fragmented Care: Beneficiary, Physician, Practice, and Market Characteristics
Conclusions: Variation in fragmentation was not explained by observed beneficiary, primary care provider, practice site, or market characteristics. Instead, the aggregate behavior of diverse health care providers beyond primary care, along with unmeasured patient preferences and behaviors, seem to be important predictors. (Source: Medical Care)
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Original Articles Source Type: research

A Systematic Review of Strategies to Enhance Response Rates and Representativeness of Patient Experience Surveys
Conclusions: Sequential mixed-mode administration yields higher patient survey response rates than a single mode. Including telephone in sequential mixed-mode administration improves response among those with historically lower response rates; including web in mixed-mode administration may increase response at lower cost. Other promising strategies to improve response rates include in-person survey administration during hospital discharge, incentives, minimizing survey language complexity, and prenotification before survey administration. (Source: Medical Care)
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Original Articles Source Type: research

Naloxone Prescribing Associated With Reduced Emergency Department Visits in the Military Health System
Purpose: The aim was to determine the association between the receipt of naloxone and emergency department (ED) visits within 60 days after the receipt of an opioid. Methods: A retrospective cohort of individuals 18 years of age or above, enrolled in TRICARE, and were dispensed an opioid at any time from January 1, 2019, through September 30, 2020 was identified within the United States Military Health System. Individuals receiving naloxone within 5 days of the opioid dispensing date were propensity score matched with individuals receiving opioids only. A logistic regression was used to estimate the odds of an E...
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Original Articles Source Type: research

Patient Experience for Hispanic Older Adults Varies by Language Preference
Conclusions: Regardless of language preference, Hispanic people with Medicare experience disparities in patient care relative to non-Hispanic White English-preferring counterparts. Hispanic Spanish-preferring English-respondents report the worse experiences, followed by Hispanic English-preferring respondents. Hispanic Spanish-respondents experienced the least disparities of the three Hispanic language subgroups. (Source: Medical Care)
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Brief Reports Source Type: research

Effect of the 2012 US Preventive Services Task Force Recommendations on Prostate-Specific Antigen Screening in a Medicare Advantage Population
Conclusions: Although the 2012 US Preventive Service Task Force’s recommendations were expected to only change behaviors among men aged 70–74, our analysis found that men aged 70–74 and aged 75+ exhibited similar trends from 2009 to 2019, including the increased use of low-value PSA screening since 2016. Multifaceted efforts to discourage low-value PSA screening would be important for a sustained impact. (Source: Medical Care)
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Brief Reports Source Type: research

Electronic Connectivity Among US Hospitals Treating Shared Patients
Conclusions: While the majority of shared patients received care from connected hospitals, remaining gaps could be filled by connecting HIE networks to each other and by incentivizing certain types of hospitals that may not participate because of competitive concerns. (Source: Medical Care)
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Original Articles Source Type: research

Association of Medicare Advantage Star Ratings With Racial and Ethnic Disparities in Hospitalizations for Ambulatory Care Sensitive Conditions
Conclusions: Substantial disparities in ACSC hospitalizations exist between White and Black enrollees in MA plans, especially for lower-rated plans. Policies aimed at reducing racial disparities in ACSC hospitalizations could include improving access to high-rated plans. (Source: Medical Care)
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Original Articles Source Type: research

Psychosocial Data: A Pillar of Integrated and Accountable Care Systems
No abstract available (Source: Medical Care)
Source: Medical Care - November 12, 2022 Category: Health Management Tags: Editorial Source Type: research

Veterans’ Use of Telehealth for Veterans Health Administration Community Care Urgent Care During the Early COVID-19 Pandemic
Conclusions: CC urgent care via telehealth played an important role in providing Veterans with care access early in the COVID-19 pandemic. Use of telehealth differed by Veteran characteristics; lack of in-person care availability was a driver. Future work should assess for changes in telehealth use with pandemic progression, geographic differences, and impact on care quality, care coordination, outcomes, and costs to ensure Veterans’ optimal and equitable access to care. (Source: Medical Care)
Source: Medical Care - October 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Identifying Medicare Beneficiaries With Delirium
Background: Each year, thousands of older adults develop delirium, a serious, preventable condition. At present, there is no well-validated method to identify patients with delirium when using Medicare claims data or other large datasets. We developed and assessed the performance of classification algorithms based on longitudinal Medicare administrative data that included International Classification of Diseases, 10th Edition diagnostic codes. Methods: Using a linked electronic health record (EHR)-Medicare claims dataset, 2 neurologists and 2 psychiatrists performed a standardized review of EHR records between 2...
Source: Medical Care - October 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Depressive Symptoms and Caregiving Intensity Before and After Onset of Dementia in Partners: A Retrospective, Observational Study
Background: Caring for a partner with dementia poses significant emotional burden and high care demands, but changes in impacts before and after dementia onset is unclear. Objective: Examine changes in depressive symptoms and hours of care provided by caregivers through the course of their partners’ cognitive decline. Methods: Retrospective, observational study using household survey data from 2000–2016 Health and Retirement Study and count models to evaluate older individuals’ (ages ≥51 y) depressive symptoms (measured using the shortened Center for Epidemiologic Studies Depression Scale) and we...
Source: Medical Care - October 15, 2022 Category: Health Management Tags: Original Articles Source Type: research

Louisiana Medicaid Expansion and Pent-Up Demand
Background: Nearly half a million newly eligible people enrolled in Louisiana Medicaid following its expansion. Objectives: To evaluate postexpansion utilization trends in Louisiana Medicaid. Research Design: We plotted utilization trends for expansion and traditional Medicaid beneficiaries and conducted regression analyses to evaluate differences in monthly trends for over 2 years following expansion. Subjects: We restricted our sample to a balanced panel of beneficiaries aged 18–64. The expansion population included beneficiaries who enrolled in the first month of eligibility. The nonexpansion ...
Source: Medical Care - October 15, 2022 Category: Health Management Tags: Brief Reports Source Type: research

US Generalist Physicians and Groups That Focused Practice in a Single Care Setting: 2014–2017
Background: Some generalist physicians whose training prepared them for primary care practice increasingly practice in a facility (eg, hospitals, nursing homes); however, whether this trend was accompanied by a complimentary rise in generalist physicians who focused their practice on office-based care is unknown. Objectives: Our objective in this study was to examine trends in the prevalence of generalist physicians and physician groups that practice in a single setting. Research Design: This was a retrospective cross-sectional study of generalist physicians trained in family medicine, internal medicine, ...
Source: Medical Care - October 15, 2022 Category: Health Management Tags: Brief Reports Source Type: research

Post–Affordable Care Act Improvements in Cancer Stage Among Ohio Medicaid Beneficiaries Resulted From an Increase in Stable Coverage
Conclusion: We provide the first evidence that post-expansion improvements in cancer stage were caused by an increased reliance on Medicaid as a source of stable insurance coverage. (Source: Medical Care)
Source: Medical Care - October 15, 2022 Category: Health Management Tags: From the States Source Type: research

Quality of Care for US Adults With Medicaid Insurance and Type 2 Diabetes in Federally Qualified Health Centers Compared With Other Primary Care Settings
Conclusions: This national analysis identified opportunities to improve diabetes management among Medicaid enrollees with type 2 diabetes, especially for retinal examinations or diabetes education. Overall, we found slightly lower rates of most diabetes care process measures for FQHC patients versus non-FQHC patients. Despite having higher rates of emergency department visits, FQHC patients were significantly less likely to be hospitalized than non-FQHC patients. These findings emphasize the need to identify innovative, effective approaches to improve diabetes care for Medicaid enrollees, especially in FQHC settings. (...
Source: Medical Care - October 15, 2022 Category: Health Management Tags: Original Articles Source Type: research