Association of Medicare's Bundled Payments for Care Improvement initiative with patient-reported outcomes.

Objective: To determine whether the Bundled Payments for Care Improvement (BPCI) initiative affected patient-reported measures of quality.

Data Sources: Surveys of Medicare fee-for-service beneficiaries discharged from acute care hospitals participating in BPCI Model 2 and comparison hospitals between October 2014 and June 2017. Variables from Medicare administrative data and the Provider of Services file were used for sampling and risk adjustment.

Factors associated with interest in receiving help for mental health problems in combat veterans returning from deployment to Iraq.

Mental health problems in service members often go untreated. This study focused on factors related to interest in receiving help in a survey sample of 577 combat veterans who were screened positive for posttraumatic stress disorder, depression, or generalized anxiety disorder 3 months after returning from Iraq. Over three quarters of respondents recognized that they had a current problem, but only 40% were interested in receiving help.

Factors related to HIV-testing behavior and interest in testing in Namibia.

HIV testing remains an important part of HIV prevention and treatment programs. Interventions to encourage testing may be more effective if they can be tailored to audiences with different readiness for testing. We sought to determine characteristics differentiating people who had tested from those who had not but were interested, and people who were interested from people who had not tested and were not interested in testing.

Audience segmentation as a social-marketing tool in health promotion: use of the risk perception attitude framework in HIV prevention in Malawi.

Objectives: We sought to determine whether individuals' risk perceptions and efficacy beliefs could be used to meaningfully segment audiences to assist interventions that seek to change HIV-related behaviors.

Methods: A household-level survey of individuals (N=968) was conducted in 4 districts in Malawi. On the basis of responses about perceptions of risk and beliefs about personal efficacy, we used cluster analysis to create 4 groups within the risk perception attitude framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy).

Applying social marketing principles to understand the effects of the radio diaries program in reducing HIV/AIDS stigma in Malawi.

Relatively little is known about the extent to which health campaigns can play a constructive role in reducing HIV/AIDS-related stigma. The Malawi Radio Diaries is a program in which HIV-positive men and women openly discuss day-to-day events in their lives with the goal of reducing stigma in the population. Adopting a social marketing perspective, we analyze the various components of the Radio Diaries program in terms of three of the "Four P's": product (stigma reduction), place (radio), and promotion (the program itself).

Association of hospital and surgeon procedure volume with patient-centered outcomes of total knee replacement in a population-based cohort of patients age 65 years and older.

Objective: To study the association between procedure volume and patient-centered outcomes such as functional status.

Methods: We performed an observational study of a stratified random sample of Medicare beneficiaries who underwent primary total knee replacement (TKR) in 2000. Low-volume surgeons were defined as surgeons performing < or =6 TKRs per year in the Medicare population, and low-volume centers were defined as those in which < or =25 TKRs per year were performed.

Neighborhoods matter: use of hospitals with worse outcomes following total knee replacement by patients from vulnerable populations.

Background: Neighborhood sociodemographic characteristics are associated with health care utilization across many conditions. There has been little study of whether total knee replacement (TKR) recipients from vulnerable populations, including racial and ethnic minorities, the poor, the elderly, and the less well educated, are more likely to use low-volume hospitals (LVHs).

Methods: We used Medicare claims and census data to identify a national cohort of Medicare beneficiaries who had elective TKR.

Geographic diversity of low-volume hospitals in total knee replacement: implications for regionalization policies.

Background/objectives: Centers performing low volumes of total knee replacements (TKR) have worse outcomes of TKR than higher volume centers. Regionalization policies that shift patients to higher volume centers are being considered as a means of improving TKR outcomes. We sought to describe geographic diversity in the distribution of low-volume centers and examine state level characteristics associated with states that have a higher proportion of low-volume centers and/or a higher proportion of TKRs performed in low-volume centers.

Offering patients the opportunity to choose their hospital for total knee replacement: impact on satisfaction with the surgery.

Objective: To describe the extent to which patients were offered a choice between 2 or more hospitals for total knee replacement (TKR); to examine the association between having a choice of hospital for TKR and satisfaction with the surgery; and to identify population groups less likely to be offered a choice.

Methods: We studied a population-based sample of 932 Medicare beneficiaries who underwent elective TKR in 2000. We surveyed patients about their participation in choosing a hospital and their satisfaction with surgery.

An assessment of willingness to participate in a randomized trial of arthroscopic knee surgery in patients with osteoarthritis.

Identifying barriers to recruitment into a randomized clinical trial can help researchers adjust recruitment strategies to maximize enrollment. To determine barriers to enrollment of patients in trials of knee osteoarthritis treatments, we recruited from three centers patients over age 45 who had both knee osteoarthritis and a meniscal tear. We described a hypothetical randomized trial of arthroscopic partial meniscectomy versus non-operative management and assessed patients' willingness to participate in such a trial.