Improving the imputation of race: evaluating the benefits of stratifying by age.

Health plans and other health care institutions may use indirect methods such as geocoding and surname analysis to estimate race, ethnicity, and socioeconomic status in an effort to measure disparities in care or target specific demographics. This study investigated whether stratifying by age improved imputations of race and ethnicity made through geocoding. Self-reported race and ethnicity from Medicaid enrollment records and from a health risk assessment administered by a large employer were used to validate imputation results from both an age-stratified model and a standard model.

Plan designs that encourage the use of generic drugs over brand-name drugs: an analysis of a free generic benefit.

Objective: To evaluate the effect on adherence and medical care expenditures of a pharmacy benefit change that included free generic drugs and higher copayments for brand-name drugs.

Study Design: Quasi-experimental pre-post study of patients with ischemic heart disease (1286 control and 555 intervention) and patients with diabetes mellitus (4089 control and 1846 intervention).

Methods: Medical and pharmacy claims data were analyzed for continuously enrolled members from January 1, 2005, through December 31, 2008.

Comparing quality of care between a consumer-directed health plan and a traditional plan: an analysis of HEDIS measures related to management of chronic diseases.

A cross-sectional, retrospective medical and pharmaceutical claims data analysis was conducted to determine if Healthcare Effectiveness Data and Information Set (HEDIS) measures related to care for chronic conditions differed between enrollees in a traditional comprehensive major medical plan (CMM) and a consumer-directed health plan (CDHP). Eleven HEDIS measures for 2006 were compared for CMM and CDHP enrollees in a health plan. Measures included care for persons with diabetes, asthma, depression, cardiovascular disease, and low back pain, and for persons taking persistent medications for specific conditions.

More preventive care, and fewer emergency room visits and prescription drugs--health care utilization in a consumer-driven health plan.

Although consumer-driven health plans (CDHPs) have grown dramatically, the question of whether CDHPs have reduced health care costs has not been answered definitively. This article presents what the authors believe to be the first study to analyze a large sample of claims data and to look in detail at different types of utilization among enrollees in a CDHP and those in a traditional comprehensive major medical (CMM) plan. After adjusting for the finding that CDHP enrollees are both younger and healthier than those in CMM plans, the authors found that CDHP enrollees show no consistent or significant utilization differences for measures over which consumers have little control (e.

Principles for assessing disease management outcomes.

Disease management (DM) is rapidly becoming an important force in the late 20th and early 21st century as a strategy for managing the chronic illness of large populations. Given the increasing visibility of DM programs, the clinical, economic and financial impact of this support are vital to DM program accountability and its acceptance as a solution to the twin challenges of achieving affordable, quality health care. Measuring and reporting outcomes in DM is difficult.

Effect of a multiple-site intensive care unit telemedicine program on clinical and economic outcomes: an alternative paradigm for intensivist staffing.

Objective: To examine whether a supplemental remote intensive care unit (ICU) care program, implemented by an integrated delivery network using a commercial telemedicine and information technology system, can improve clinical and economic performance across multiple ICUs.

Design: Before-and-after trial to assess the effect of adding the supplemental remote ICU telemedicine program.

Setting: Two adult ICUs of a large tertiary care hospital.