Association Between Physician Risk Assessment, Hierarchical Condition Categories, and Utilization of Medical Services.

Hierarchical Condition Categories (HCCs) are a common risk adjustment tool that may support alignment of care management resources with the clinical needs of a population. The authors examined the association between HCC scores and physician-determined clinical risk (CR) scores, annual charges, and utilization of medical care. CR score was defined as the anticipated risk for "ED or a hospital admission" within the following year.

Reducing Cardiovascular Disease Risk for Employees Through Participation in a Wellness Program.

The objective was to evaluate the long-term impact that the University of Rochester Employee Wellness program has made in reducing cardiovascular disease risk. The authors conducted a 5-year retrospective study to measure change in health outcomes for more than 16,000 employees who participated in the program for more than 1 year between January 2013 and December 2017. A logistic regression model was applied to estimate the impact of participation on improvement in cardiovascular disease risk.

Differences in opioid prescribing in low back pain patients with and without depression: a cross-sectional study of a national sample from the United States.

Introduction: Low back pain (LBP) is among the leading indications for the prescription of opioid analgesics in clinical practice. There is increasing evidence suggesting that these agents may have diminished efficacy in the treatment of LBP.

Objectives: We evaluated the relationship between depression, the probability of receiving an opioid prescription, and the amount of morphine equivalent amounts prescribed per year among patients with LBP using nationwide data.

Making difficult decisions: the role of quality of care in choosing a nursing home.

Objectives: We investigated how quality of care affects choosing a nursing home.

Methods: We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked.

Variations in patterns of care activities for nursing home residents with heart failure.

Early clues of change in heart failure (HF) status, such as weight gain or reduced exercise tolerance, may be missed by caregivers in nursing homes (NHs) since daily weight measurement and functional assessments may not be performed routinely. These factors are likely to contribute to a delay in non-emergent care for the resident. The purpose of this study was to examine patterns of care activities provided in the NH setting to residents with HF and document variations in these care patterns across a random national sample of NHs.

Peer-led team learning model in a graduate-level nursing course.

The peer-led team learning (PLTL) model was introduced into a graduate-level course in health economics at our school of nursing. We believed this collaborative learning program, emphasizing peer-to-peer interaction to solve complex problems, would increase student engagement and mastery of course content. The course was redesigned to accommodate a weekly 1-hour workshop conducted by peer leaders.

Cost benefits of a peer-led asthma self-management program for adolescents.

Objective: Frequent use of health-care services associated with pediatric asthma places substantial economic burden on families and society. The purpose of this study is to examine the cost-saving effects of a peer-led program through reduction in health-care utilization in comparison to an adult-led program.

Methods: Randomly assigned adolescents (13-17 years) participated in either peer-led (n = 59) or adult-led (n = 53) asthma self-management program.

Cost-effectiveness of intensive tobacco dependence intervention based on self-determination theory.

Objectives: To evaluate cost-effectiveness of a tobacco dependence intervention based on self-determination theory (SDT) and consistent with the Public Health Service (PHS)-sponsored Clinical Practice Guideline for Treating Tobacco Use and Dependence.

Study Design: Adult smokers were recruited into a randomized cessation-induction trial of an intensive intervention versus community care. Seven-day point prevalence (7dPP) tobacco abstinence and cost-effectiveness of the intervention were examined using 737 participants with health insurance.

Mortality of white Americans, African Americans, and Canadians: the causes and consequences for health of welfare state institutions and policies.

The life expectancy of African Americans has been substantially lower than that of white Americans for as long as records are available. The life expectancy of all Americans has been lower than that of all Canadians since the beginning of the 20th century. Until the 1970s this disparity was the result of the low life expectancy of African Americans.

Trends in geographic disparities in allocation of health care resources in the US.

Objectives: This study aimed to examine current level and historical trends in health resources distribution in the US; to investigate the relationships between both levels and trends of inequality with--geographic location, inequality of income and rates per capita of hospital-beds and physicians.

Methods: The Gini Coefficient was used to measure variations in distribution of physicians and hospital-beds (at the county level) during three decades.

Results: Physician distribution has become less equitable, while hospital-beds' equity has increased.

Home care before and after the Balanced Budget Act of 1997: shifts in financing and services.

Purpose: This article describes the pattern of change in home-care use and expenditures, the distribution of payments by source, and the mix of skilled versus nonskilled services before and after 1996.

Design And Methods: The analysis is based on tabulations of the 1987 National Medical Expenditure Survey and the 1996, 1998, and 1999 Medical Expenditure Panel Surveys. Estimates are weighted to represent the U.