Matthew Leonard Maciejewski

Journal article Med Care · December 2012 Featured Publication BACKGROUND: Self-report measures of medication nonadherence confound the extent of and reasons for medication nonadherence. Each construct is assessed with a different type of psychometric model, which dictates how to establish reliability and validity. OB ... Full text Link to item Cite

Informing the dosing of interventions in randomized trials.

Journal article Contemp Clin Trials · November 2012 Featured Publication Dosing is potentially the most important decision that must be made when building or refining behavioral interventions. In this paper, we propose standardized terminology and reporting of dosing information, which would inform intervention development, ref ... Full text Link to item Cite

Adherence to antipsychotics and cardiometabolic medication: association with health care utilization and costs.

Journal article Psychiatr Serv · September 1, 2012 Featured Publication OBJECTIVE: This study examined the association between adherence to antipsychotic and cardiometabolic medication and annual use of health care services and expenditures. METHODS: MarketScan Medicaid files from 2004 to 2008 were used to evaluate annual cros ... Full text Link to item Cite

How price responsive is the demand for specialty care?

Journal article Health Econ · August 2012 Featured Publication OBJECTIVES: Outpatient visit co-payments have increased in recent years. We estimate the patient response to a price change for specialty care, based on a co-payment increase from $15 to $50 per visit for veterans with hypertension. DESIGN, SETTING, AND PA ... Full text Link to item Cite

Examining the impact of genetic testing for type 2 diabetes on health behaviors: study protocol for a randomized controlled trial.

Journal article Trials · August 1, 2012 Featured Publication BACKGROUND: We describe the study design, procedures, and development of the risk counseling protocol used in a randomized controlled trial to evaluate the impact of genetic testing for diabetes mellitus (DM) on psychological, health behavior, and clinical ... Full text Link to item Cite

Implementation of automated reporting of estimated glomerular filtration rate among Veterans Affairs laboratories: a retrospective study.

Journal article BMC Med Inform Decis Mak · July 12, 2012 Featured Publication BACKGROUND: Automated reporting of estimated glomerular filtration rate (eGFR) is a recent advance in laboratory information technology (IT) that generates a measure of kidney function with chemistry laboratory results to aid early detection of chronic kid ... Full text Open Access Link to item Cite

Health expenditures among high-risk patients after gastric bypass and matched controls.

Journal article Arch Surg · July 2012 Featured Publication OBJECTIVE: To determine whether bariatric surgery is associated with reduced health care expenditures in a multisite cohort of predominantly older male patients with a substantial disease burden. DESIGN: Retrospective cohort study of bariatric surgery. Out ... Full text Link to item Cite

Measures of adherence to oral hypoglycemic agents at the primary care clinic level: the role of risk adjustment.

Journal article Med Care · July 2012 Featured Publication BACKGROUND: Prior research found that in the Veterans Affairs health care system (VA), the proportion of patients adherent to oral hypoglycemic agents varies from 50% to 80% across primary care clinics. This study examined whether variation in patient and ... Full text Link to item Cite

Medication adherence changes following value-based insurance design.

Journal article Am J Manag Care · May 2012 Featured Publication OBJECTIVES: To determine whether participation in a value-based insurance design (VBID) program was associated with improved medication adherence in 8 drug classes 2 years after implementation and to examine whether adherence changes varied by baseline adh ... Link to item Cite

Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients.

Journal article BMC Health Serv Res · March 5, 2012 Featured Publication BACKGROUND: More than half of veterans who use Veterans Health Administration (VA) care are also eligible for Medicare via disability or age, but no prior studies have examined variation in use of outpatient services by Medicare-eligible veterans across he ... Full text Link to item Cite

State disparities in time trends of adolescent body mass index percentile and weight-related behaviors in the United States.

Journal article J Community Health · February 2012 Featured Publication Evidence is conflicting as to whether youth obesity prevalence has reached a plateau in the United States overall. Trends vary by state, and experts recommend exploring whether trends in weight-related behaviors are associated with changes in weight status ... Full text Link to item Cite

Medicare part D information seeking: the role of recognition of need and patient activation.

Journal article Res Social Adm Pharm · 2012 Featured Publication BACKGROUND: In 2006, Medicare beneficiaries had the opportunity to choose from multiple newly available Medicare prescription drug plans (PDPs). Many beneficiaries reported difficulty in finding helpful information, whereas others reported they never looke ... Full text Link to item Cite

Does medication adherence following a copayment increase differ by disease burden?

Journal article Health Serv Res · December 2011 Featured Publication OBJECTIVES: To compare changes in medication adherence between patients with high- or low-comorbidity burden after a copayment increase. METHODS: We conducted a retrospective observational study at four Veterans Affairs (VA) medical centers by comparing ve ... Full text Link to item Cite

Early evidence on the quality of care provided by special needs plans.

Journal article Med Care · October 2011 Featured Publication BACKGROUND: Medicare Advantage special needs plans (SNPs) have grown significantly over the past 7 years, but patient outcomes have only recently been publicly reported. METHODS: Reporting rates and scores on 4 publicly reported Healthcare Effectiveness Da ... Full text Link to item Cite

Reliance on Veterans Affairs outpatient care by Medicare-eligible veterans.

Journal article Med Care · October 2011 Featured Publication OBJECTIVE: To examine longitudinal changes in Medicare-eligible veterans' reliance on the Department of Veterans Affairs (VA) healthcare system for primary and specialty care over 4 years. METHODS: We merged VA administrative and Medicare claims data to ex ... Full text Link to item Cite

Longitudinal analysis of market factors associated with provision of peritoneal dialysis services.

Journal article Med Care Res Rev · October 2011 Featured Publication Despite the appeal of peritoneal dialysis (PD) among patients, payers, and providers, its use in the United States has been limited and declining. Prior research has found that patient factors explain little variation in PD utilization, and little is known ... Full text Link to item Cite

State policies targeting junk food in schools: racial/ethnic differences in the effect of policy change on soda consumption.

Journal article Am J Public Health · September 2011 Featured Publication OBJECTIVES: We estimated the association between state policy changes and adolescent soda consumption and body mass index (BMI) percentile, overall and by race/ethnicity. METHODS: We obtained data on whether states required or recommended that schools proh ... Full text Link to item Cite

A budget impact analysis of telemedicine-based collaborative care for depression.

Journal article Med Care · September 2011 Featured Publication BACKGROUND: Patients with depression use more health services than patients without depression. However, when depression symptoms respond to treatment, use of health services declines. Most depression quality improvement studies increase total cost in the ... Full text Link to item Cite

Strict hand hygiene and other practices shortened stays and cut costs and mortality in a pediatric intensive care unit.

Journal article Health Aff (Millwood) · September 2011 Featured Publication Efforts to reduce infections acquired during a hospital stay through improvements in the quality of care have had measurable results in many hospital settings. In pediatric intensive care units, the right quality interventions can save lives and money. We ... Full text Link to item Cite

Nurse staffing and patient care costs in acute inpatient nursing units.

Journal article Med Care · August 2011 Featured Publication OBJECTIVE: Studies suggest that a business case for improving nurse staffing can be made to increase registered nurse (RN) skill mix without changing total licensed nursing hours. It is unclear whether a business case for increasing RN skill mix can be jus ... Full text Link to item Cite

Continuity of antipsychotic medication management for Medicaid patients with schizophrenia.

Journal article Psychiatr Serv · July 2011 Featured Publication OBJECTIVE: The purpose of this study was to examine whether medication refill behavior varies by the number of prescribers of antipsychotic medication a patient has. METHODS: A total of 7,868 patients with schizophrenia were identified from North Carolina ... Full text Link to item Cite

Survival among high-risk patients after bariatric surgery.

Journal article JAMA · June 15, 2011 Featured Publication CONTEXT: Existing evidence of the survival associated with bariatric surgery is based on cohort studies of predominantly younger women with a low inherent obesity-related mortality risk. The association of survival and bariatric surgery for older men is le ... Full text Link to item Cite

Health plan enrollment and mortality in the Medicare program.

Journal article Health Econ · June 2011 Featured Publication Prior studies have found that Medicare health maintenance organization (HMO) enrollees have lower mortality (over a fixed observation period) than beneficiaries in traditional fee-for-service (FFS) Medicare. We use Medicare Current Beneficiary Survey (MCBS ... Full text Link to item Cite

Repeat experience with the doughnut hole in Medicare Part D: when the doughnut hole becomes a tunnel.

Journal article Med Care · May 2011 Featured Publication OBJECTIVE: To describe the proportion of elderly Medicare advantage prescription drug plan (MAPDP) enrollees who meet or exceed the Medicare Part D doughnut hole (DH) entry threshold in 2 consecutive years and which characteristics put them at risk for rep ... Full text Link to item Cite

Cost-related nonadherence in the Medicare program: the impact of Part D.

Journal article Med Care · May 2011 Featured Publication BACKGROUND: Cost-related nonadherence (CRN) among Medicare beneficiaries declined after the implementation of the Part D program, but it is unknown whether CRN changes varied on the basis of beneficiaries' change in drug coverage. OBJECTIVE: To determine h ... Full text Link to item Cite

Synonyms in health services research methodology.

Journal article Med Care Res Rev · April 2011 Featured Publication There are often multiple discipline-specific terms for a given statistical concept, which can sow confusion in multidisciplinary teams or study sections if researchers are not aware of the synonyms from other disciplines. This article incorporates synonyms ... Full text Link to item Cite

Improving the measurement of self-reported medication nonadherence.

Journal article J Clin Epidemiol · March 2011 Featured Publication OBJECTIVE: Medication nonadherence is a significant clinical problem in chronic disease management. Self-report measures have inadequate reliability and poor distributional properties. We demonstrate how two fundamental measurement issues have limited the ... Full text Link to item Cite

Importance of health system context for evaluating utilization patterns across systems.

Journal article Health Econ · February 2011 Featured Publication Measuring health services provided to patients can be difficult when patients see providers across multiple health systems and all visits are rarely captured in a single data source covering all systems where patients receive care. Studies that account for ... Full text Link to item Cite

Health-care expenditures of overweight and obese males and females in the medical expenditures panel survey by age cohort.

Journal article Obesity (Silver Spring) · January 2011 Featured Publication Age- and sex-specific annual health-care expenditures (total, in-patient, ambulatory care, and outpatient prescription drug) were estimated within established weight classifications in a nationally representative sample of children and adults aged 6-85 yea ... Full text Link to item Cite

Are smoking and alcohol misuse associated with subsequent hospitalizations for ambulatory care sensitive conditions?

Journal article J Behav Health Serv Res · January 2011 Featured Publication Hospitalizations for ambulatory care sensitive conditions (ACSCs) are used to assess quality of care, but studies rarely adjust for health behaviors. This study evaluated whether results of smoking or alcohol screening were associated with hospitalizations ... Full text Link to item Cite

Relationship of pharmaceutical promotion to antidepressant switching and adherence: a retrospective cohort study.

Journal article Psychiatr Serv · December 2010 Featured Publication OBJECTIVE: Patient nonadherence and early discontinuation of antidepressant treatment are common. Pharmaceutical promotion to consumers and physicians may influence this behavior. The objectives of this study were to explore whether promotional spending is ... Full text Link to item Cite

Health care utilization and expenditure changes associated with bariatric surgery.

Journal article Med Care · November 2010 Featured Publication CONTEXT: Bariatric surgery provides significant reductions in weight and comorbidity, and has the potential to reduce health care utilization. It is unknown whether health care utilization and expenditures are reduced for veterans after bariatric surgery. ... Full text Link to item Cite

Copayment reductions generate greater medication adherence in targeted patients.

Journal article Health Aff (Millwood) · November 2010 Featured Publication A large value-based insurance design program offered by Blue Cross Blue Shield of North Carolina eliminated generic medication copayments and reduced copayments for brand-name medications. Our study showed that the program improved adherence to medications ... Full text Link to item Cite

Use of outpatient care in Veterans Health Administration and Medicare among veterans receiving primary care in community-based and hospital outpatient clinics.

Journal article Health Serv Res · October 2010 Featured Publication OBJECTIVE: To examine differences in use of Veterans Health Administration (VA) and Medicare outpatient services by VA primary care patients. DATA SOURCES/STUDY SETTING: VA administrative and Medicare claims data from 2001 to 2004. STUDY DESIGN: Retrospect ... Full text Link to item Cite

US hospitalizations and costs for illicit drug users with soft tissue infections.

Journal article J Behav Health Serv Res · October 2010 Featured Publication Skin and soft tissue infections (SSTIs) are common complications of illicit drug use. Studies at single, urban hospitals demonstrate high rates of emergency department visits and hospitalizations for these infections. This study sought to estimate nationwi ... Full text Link to item Cite

Animal, vegetable, or ... clinical trial?

Journal article Ann Intern Med · September 7, 2010 Featured Publication Full text Link to item Cite

Cost-effectiveness analysis of a rural telemedicine collaborative care intervention for depression.

Journal article Arch Gen Psychiatry · August 2010 Featured Publication CONTEXT: Collaborative care interventions for depression in primary care settings are clinically beneficial and cost-effective. Most prior studies were conducted in urban settings. OBJECTIVE: To examine the cost-effectiveness of a rural telemedicine-based ... Full text Link to item Cite

The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control: The HTN-IMPROVE study protocol (01295).

Journal article Implement Sci · July 16, 2010 Featured Publication BACKGROUND: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success. OBJECTIVES: We describe the design of a 'translational' study that examines the implemen ... Full text Open Access Link to item Cite

An examination of Alzheimer's disease case definitions using Medicare claims and survey data.

Journal article Alzheimers Dement · July 2010 Featured Publication BACKGROUND: The prevalence and expenditure estimates of Alzheimer's disease (AD) from studies using one data source to define cases vary widely. The objectives of this study were to assess agreement between AD case definitions classified with Medicare clai ... Full text Link to item Cite

A retrospective cohort study of economic outcomes and adherence to monotherapy with metformin, pioglitazone, or a sulfonylurea among patients with type 2 diabetes mellitus in the United States from 2003 to 2005.

Journal article Clin Ther · July 2010 Featured Publication OBJECTIVES: The aims of this study were to compare all-cause total health care costs and diabetes mellitus (DM)-specific health care costs between patients who were adherent or nonadherent to monotherapy with metformin, pioglitazone, or a sulfonylurea and ... Full text Link to item Cite

Risk adjustment for Medicare beneficiaries with Alzheimer's disease and related dementias.

Journal article Am J Manag Care · March 2010 Featured Publication OBJECTIVE: To compare prospective risk adjustment measures on their ability to predict expenditures for Medicare beneficiaries with Alzheimer's disease and related dementias (ADRD). METHODS: Data were obtained from the 1999-2004 Medicare Current Beneficiar ... Link to item Cite

Part D plan enrollment by uninsured medicare beneficiaries.

Journal article Med Care · February 2010 Featured Publication OBJECTIVES: The objective of the study was to examine the patient factors and medication acquisition strategies that impacted PDP enrollment in early 2006 by Medicare beneficiaries without prior drug coverage. RESEARCH DESIGN AND SUBJECTS: A retrospective ... Full text Link to item Cite

Increasing copayments and adherence to diabetes, hypertension, and hyperlipidemic medications.

Journal article Am J Manag Care · January 1, 2010 Featured Publication OBJECTIVE: To examine the impact of a medication copayment increase on adherence to diabetes, hypertension, and hyperlipidemic medications. STUDY DESIGN: Retrospective pre-post observational study. METHODS: This study compared medication adherence at 4 Vet ... Link to item Cite

Testing social cognitive mechanisms of exercise in college students.

Journal article Am J Health Behav · 2010 Featured Publication OBJECTIVES: To determine if different dimensions of outcome expectations are mediators between self-efficacy and exercise among college students. METHODS: Students (n = 290) reported exercise levels, self-efficacy, and expectations using a Web-based questi ... Full text Link to item Cite

Follow-up visits by provider specialty for patients with major depressive disorder initiating antidepressant treatment.

Journal article Psychiatr Serv · January 2010 Featured Publication OBJECTIVES: This study examined the association between provider specialty and guideline-concordant care after the initiation of antidepressant treatment. METHODS: Medical and prescription claims were analyzed from adults newly diagnosed as having major de ... Full text Link to item Cite

Guideline-concordant antidepressant use among patients with major depressive disorder.

Journal article Gen Hosp Psychiatry · 2010 Featured Publication OBJECTIVES: To examine whether prescriber specialty and guideline-concordant follow-up visits were associated with antidepressant treatment completion among patients with major depressive disorder (MDD). METHODS: This study analyzed medical and prescriptio ... Full text Link to item Cite

Discontinuation of diabetes and lipid-lowering medications after bariatric surgery at Veterans Affairs medical centers.

Journal article Surg Obes Relat Dis · 2010 Featured Publication BACKGROUND: Bariatric surgery has largely been performed on middle-age female populations and been associated with significant medication discontinuation; however, it is unknown whether similar medication discontinuation rates could be achieved in men. The ... Full text Link to item Cite

Community-based aquatic exercise and quality of life in persons with osteoarthritis.

Journal article Med Sci Sports Exerc · January 2010 Featured Publication PURPOSE: To evaluate the effectiveness of a community-based aquatic exercise program for improved quality of life among persons with osteoarthritis. METHOD: Two hundred forty-nine adults with osteoarthritis were enrolled in a 20-wk randomized controlled tr ... Full text Link to item Cite

The concentration and persistence of health care expenditures and prescription drug expenditures in Medicare beneficiaries with Alzheimer disease and related dementias.

Journal article Med Care · November 2009 Featured Publication BACKGROUND: Alzheimer disease and related dementias (ADRD) have become a major concern for Medicare because of the increasing prevalence rate and the associated high cost of care. OBJECTIVES: This study investigated the extent of concentration and persiste ... Full text Link to item Cite

Medicare managed care enrollment by disability-eligible and age-eligible veterans.

Journal article Med Care · November 2009 Featured Publication OBJECTIVE: To assess factors associated with enrollment in a Medicare advantage (MA) plan versus Medicare fee-for-service plan in 2000-2004 by Medicare-eligible veterans. We also assessed whether these factors differed between disability-eligible veterans ... Full text Link to item Cite

Equivalence of two healthcare costing methods: bottom-up and top-down.

Journal article Health Econ · October 2009 Featured Publication This paper compares two quite different approaches to estimating costs: a 'bottom-up' approach, represented by the US Department of Veterans Affairs' (VA) Decision Support System that uses local costs of specific inputs; and a 'top-down' approach, represen ... Full text Link to item Cite

Predictors of long-term mortality after bariatric surgery performed in Veterans Affairs medical centers.

Journal article Arch Surg · October 2009 Featured Publication HYPOTHESIS: The purpose of this study was to examine patient factors associated with mortality among veterans who undergo bariatric surgery. DESIGN: Prospective study that uses data from the Veterans Affairs (VA) National Surgical Quality Improvement Progr ... Full text Link to item Cite

The Cholesterol, Hypertension, and Glucose Education (CHANGE) study for African Americans with diabetes: study design and methodology.

Journal article Am Heart J · September 2009 Featured Publication BACKGROUND: Cardiovascular disease (CVD) and diabetes account for over one third of the mortality difference between African Americans and white patients. The increased CVD risk in African Americans is due in large part to the clustering of multiple CVD ri ... Full text Link to item Cite

Adult asthma disease management: an analysis of studies, approaches, outcomes, and methods.

Journal article Respir Care · July 2009 Featured Publication BACKGROUND: Disease management has been implemented for patients with asthma in various ways. We describe the approaches to and components of adult asthma disease-management interventions, examine the outcomes evaluated, and assess the quality of published ... Full text Link to item Cite

Suboptimal nutritional intake for hypertension control in 4 ethnic groups.

Journal article Arch Intern Med · April 13, 2009 Featured Publication BACKGROUND: This study compared intake of specific nutrients based on the Dietary Approaches to Stop Hypertension (DASH) guidelines for hypertension management among multiethnic middle-aged and older adults. METHODS: We conducted quantitative analysis usin ... Full text Link to item Cite

Medication acquisition and self-reported adherence in veterans with hypertension.

Journal article Med Care · April 2009 Featured Publication OBJECTIVES: To examine factors associated with oversupply and undersupply of antihypertensive medication, and examine evidence for medication acquisition as distinct from self-reported adherence. RESEARCH DESIGN: Analysis of pharmacy refill records, medica ... Full text Link to item Cite

Effects of two weight-loss diets on health-related quality of life.

Journal article Qual Life Res · April 2009 Featured Publication PURPOSE: To compare the effects of two diets on health-related quality of life (HRQOL). METHODS: Overweight volunteers (n = 119) were randomized to follow a low-carbohydrate, ketogenic diet (LCKD) or a low-fat diet (LFD) for 24 weeks. HRQOL was measured ev ... Full text Link to item Cite

Health care costs in the last week of life: associations with end-of-life conversations.

Journal article Arch Intern Med · March 9, 2009 Featured Publication BACKGROUND: Life-sustaining medical care of patients with advanced cancer at the end of life (EOL) is costly. Patient-physician discussions about EOL wishes are associated with lower rates of intensive interventions. METHODS: Funded by the National Institu ... Full text Link to item Cite

Performance of comorbidity, risk adjustment, and functional status measures in expenditure prediction for patients with diabetes.

Journal article Diabetes Care · January 2009 Featured Publication OBJECTIVE: To compare the ability of generic comorbidity and risk adjustment measures, a diabetes-specific measure, and a self-reported functional status measure to explain variation in health care expenditures for individuals with diabetes. RESEARCH DESIG ... Full text Link to item Cite

Challenges in merging Medicaid and Medicare databases to obtain healthcare costs for dual-eligible beneficiaries: using diabetes as an example.

Journal article Pharmacoeconomics · 2009 Featured Publication Dual-eligible Medicaid-Medicare beneficiaries represent a group of people who are in the lowest income bracket in the US, have numerous co-morbidities and place a heavy financial burden on the US healthcare system. As cost-effectiveness analyses are used t ... Full text Link to item Cite

Line authority for nurse staffing and costs for acute inpatient care.

Journal article Inquiry · 2009 Featured Publication There is little empirical evidence evaluating the effects of recent, widespread changes in nurse executive roles and nursing management structures on the costs of patient care. This retrospective cross-sectional study examined the relationship between line ... Full text Link to item Cite

Healthcare cost differences with participation in a community-based group physical activity benefit for medicare managed care health plan members.

Journal article J Am Geriatr Soc · August 2008 Featured Publication OBJECTIVES: To determine whether participation in a physical activity benefit by Medicare managed care enrollees is associated with lower healthcare utilization and costs. DESIGN: Retrospective cohort study. SETTING: Medicare managed care. PARTICIPANTS: A ... Full text Link to item Cite

Health care use and costs associated with use of a health club membership benefit in older adults with diabetes.

Journal article Diabetes Care · August 2008 Featured Publication OBJECTIVE: The purpose of this study was to determine whether elective use of a health plan-sponsored health club membership had an impact on health care use and costs among older adults with diabetes. RESEARCH DESIGN AND METHODS: Administrative claims for ... Full text Link to item Cite

The impact of contract primary care on health care expenditures and quality of care.

Journal article Med Care Res Rev · June 2008 Featured Publication The Department of Veterans Affairs (VA) established community-based outpatient clinics to improve veterans' access to primary care. This article compares VA use and expenditures among primary care users at 76 VA-staffed community clinics (n = 17,060) and 3 ... Full text Link to item Cite

Managed-Medicare health club benefit and reduced health care costs among older adults.

Journal article Prev Chronic Dis · January 2008 Featured Publication INTRODUCTION: Our study was undertaken to determine the association between use of a health plan-sponsored health club benefit by older adults and total health care costs over 2 years. METHODS: This retrospective cohort study used administrative and claims ... Link to item Cite

Utilization and expenditures of veterans obtaining primary care in community clinics and VA medical centers: an observational cohort study.

Journal article BMC Health Serv Res · April 18, 2007 Featured Publication BACKGROUND: To compare VA inpatient and outpatient utilization and expenditures of veterans seeking primary care in community-based outpatient clinics (CBOCs) and VA medical centers (VAMCs) in fiscal years 2000 (FY00) and 2001. METHODS: The sample included ... Full text Link to item Cite

Impact of a managed-Medicare physical activity benefit on health care utilization and costs in older adults with diabetes.

Journal article Diabetes Care · January 2007 Featured Publication OBJECTIVE: The purpose of this article was to determine the effects of a managed-Medicare physical activity benefit on health care utilization and costs among older adults with diabetes. RESEARCH DESIGN AND METHODS: This retrospective cohort study used adm ... Full text Link to item Cite

Cost and utilization outcomes of patients receiving hospital-based palliative care consultation.

Journal article J Palliat Med · August 2006 Featured Publication OBJECTIVE: To compare per diem total direct, ancillary (laboratory and radiology) and pharmacy costs of palliative care (PC) compared to usual care (UC) patients during a terminal hospitalization; to examine the association between PC and ICU admission. DE ... Full text Link to item Cite

Distance as a barrier to using a fitness-program benefit for managed Medicare enrollees.

Journal article J Aging Phys Act · July 2006 Featured Publication This study evaluated the effect of distance on the likelihood of initiating and maintaining regular use of a fitness-program benefit in a population of managed Medicare seniors. We studied 8,162 participants and nonparticipants in a managed-care fitness-pr ... Full text Link to item Cite

Correlates of health-related quality of life in overweight and obese adults with type 2 diabetes.

Journal article Obesity (Silver Spring) · May 2006 Featured Publication OBJECTIVE: This paper describes and examines conceptually relevant correlates of health-related quality of life (HRQL) in overweight or obese persons with type 2 diabetes. Research Design and Procedures: The investigation was a cross-sectional study of 514 ... Full text Link to item Cite

Are primary care services a substitute or complement for specialty and inpatient services?

Journal article Health Serv Res · October 2005 Featured Publication OBJECTIVE: To determine whether strategies designed to increase members' use of primary care services result in decreases (substitution) or increases (complementation) in the use and cost of other types of health services. STUDY SETTING: Encounter and cost ... Full text Link to item Cite

A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life.

Journal article J Clin Epidemiol · June 2005 Featured Publication OBJECTIVE: To estimate the effect of weight-loss interventions on health-related quality of life (HrQoL) in randomized controlled trials (RCTs); to conduct a meta-analysis of weight-loss treatment on depressive symptoms; and, to examine methodological and ... Full text Link to item Cite

The performance of administrative and self-reported measures for risk adjustment of Veterans Affairs expenditures.

Journal article Health Serv Res · June 2005 Featured Publication OBJECTIVE: To evaluate the performance of different prospective risk adjustment models of outpatient, inpatient, and total expenditures of veterans who regularly use Veterans Affairs (VA) primary care. DATA SOURCES: We utilized administrative, survey and e ... Full text Link to item Cite

An analysis of disenrollment from Medicare managed care plans by Medicare beneficiaries with diabetes.

Journal article Med Care · May 2005 Featured Publication RESEARCH OBJECTIVE: The purpose of this work is to determine whether high-cost high-risk Medicare patients with diabetes in managed care plans disenroll more quickly than lower-cost lower-risk Medicare patients with diabetes. If high-cost high-risk patient ... Full text Link to item Cite

Changes in characteristics of veterans using the VHA health care system between 1996 and 1999.

Journal article Health Res Policy Syst · April 18, 2005 Featured Publication BACKGROUND: The Department of Veterans Affairs' Veterans Health Administration (VHA) provides a health care safety net to veterans. This study examined changes in characteristics of veterans using the VHA health care system between 1996 and 1999 when VHA i ... Full text Link to item Cite

Impact of morbid obesity on medical expenditures in adults.

Journal article Int J Obes (Lond) · March 2005 Featured Publication CONTEXT: Morbid obesity (body mass index (BMI) > or =40 kg/m2) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morb ... Full text Link to item Cite

Predicting costs of Veterans Affairs health care in Gulf War veterans with medically unexplained physical symptoms.

Journal article Mil Med · January 2005 Featured Publication Measures of post-traumatic stress disorder (PTSD) and depression were used to predict Veterans Affairs outpatient treatment costs among Persian Gulf War veterans with medically unexplained physical symptoms. Patients (N = 206) enrolled in a Veterans Affair ... Full text Link to item Cite

Does improving geographic access to VA primary care services impact patients' patterns of utilization and costs?

Journal article Inquiry · 2005 Featured Publication The Department of Veterans Affairs (VA) has been establishing community-based outpatient clinics (CBOCs) across the country to improve veterans' access to and use of primary care services, thereby decreasing the need for costly specialty outpatient and inp ... Full text Link to item Cite

Multiple prior years of health expenditures and Medicare health plan choice.

Journal article Int J Health Care Finance Econ · September 2004 Featured Publication This study examines the effect of multiple prior years of health expenditures on the probability of enrollment in a Medicare HMO. Beneficiaries may require more than one year of prior expenditure data to form a reliable estimate of future expenditures if h ... Full text Link to item Cite

Effectiveness of diabetic therapeutic footwear in preventing reulceration.

Journal article Diabetes Care · July 2004 Featured Publication OBJECTIVE: To review the evidence for the effectiveness of therapeutic footwear in preventing foot reulceration in individuals with diabetes and foot risk factors. RESEARCH DESIGN AND METHODS: We conducted a structured literature review based on a Medline ... Full text Link to item Cite

Diabetes-related utilization and costs for inpatient and outpatient services in the Veterans Administration.

Journal article Diabetes Care · May 2004 Featured Publication OBJECTIVE: -The purpose of this study was to calculate the total number of inpatient hospitalizations, outpatient clinic visits, and total direct health care costs associated with veterans with diabetes receiving care in Veterans Administration (VA) facili ... Full text Link to item Cite

Disability and health care costs in the Medicare population.

Journal article Arch Phys Med Rehabil · September 2002 Featured Publication OBJECTIVE: To determine the effect of activity limitations on health care expenditures. DESIGN: Cross-sectional. SETTING: National survey. PARTICIPANTS: Data from the 1997 Medicare Current Beneficiary Survey (n=9298), a nationally representative sample of ... Full text Link to item Cite

VA community-based outpatient clinics: cost performance measures.

Journal article Med Care · July 2002 Featured Publication OBJECTIVE: To examine the direct costs of treating veterans in Community-Based Outpatient Clinics (CBOC) and primary care clinics operated by VA medical centers (VAMCs) between April 1998 and September 1998. RESEARCH DESIGN: In a retrospective observationa ... Full text Link to item Cite

Evaluation of the Department of Veterans Affairs community-based outpatient clinics.

Journal article Med Care · July 2002 Featured Publication OBJECTIVE: This paper describes the history of the Department of Veterans Affairs (VA) Community-Based Outpatient Clinics (CBOCs), CBOC Performance Evaluation Project, and characteristics of CBOCs within the VA, and summarizes the findings and implications ... Full text Link to item Cite

VA community-based outpatient clinics: access and utilization performance measures.

Journal article Med Care · July 2002 Featured Publication OBJECTIVES: The purpose of this study was to compare access and utilization performance measures between Community-Based Outpatient Clinics (CBOC) and primary care clinics at parent VA Medical Centers (VAMC) and between VA-staff CBOCs and contract CBOCs. M ... Full text Link to item Cite

Common methodological terms in health services research and their synonyms [correction of symptoms].

Journal article Med Care · June 2002 Featured Publication OBJECTIVE: Health services researchers use methods and terminology from a variety of disciplines to understand individual and organizational behavior related to health, health care, and health insurance. Although this diversity benefits the process of rese ... Full text Link to item Cite

Effect of therapeutic footwear on foot reulceration in patients with diabetes: a randomized controlled trial.

Journal article JAMA · May 15, 2002 Featured Publication CONTEXT: Many people with diabetes experience lower-limb ulcers. Footwear has been implicated as a primary cause of foot ulcers, yet research is limited on the efficacy of shoe and insert combinations to prevent reulceration. OBJECTIVE: To determine whethe ... Full text Link to item Cite

Footwear used by individuals with diabetes and a history of foot ulcer.

Journal article J Rehabil Res Dev · 2002 Featured Publication OBJECTIVE: To describe footwear preferences of people with diabetes and a history of foot ulcer from two large western Washington State healthcare organizations. METHODS: As part of a clinical trial of footwear, self-reported information on footwear prefer ... Link to item Cite

Comparing mortality and time until death for medicare HMO and FFS beneficiaries.

Journal article Health Serv Res · February 2001 Featured Publication OBJECTIVE: To compare adjusted mortality rates of TEFRA-risk HMO enrollees and disenrollees with rates of beneficiaries enrolled in the Medicare fee-for-service sector (FFS), and to compare the time until death for decedents in these three groups. DATA SOU ... Link to item Cite

Disenrollment from Medicare HMOs.

Journal article Am J Manag Care · January 2001 Featured Publication BACKGROUND: Since the program's inception, there has been great interest in determining whether beneficiaries who enter and subsequently leave Medicare health maintenance organizations (HMOs) are more or less costly than those remaining in fee-for-service ... Link to item Cite

A demand-side view of risk adjustment.

Journal article Inquiry · 2001 Featured Publication This paper analyzes the efficient allocation of consumers to health plans. Specifically, we address the question of why employers that offer multiple health plans often make larger contributions to the premiums of the high-cost plans. Our perspective is th ... Full text Link to item Cite

Selection experiences in Medicare HMOs: pre-enrollment expenditures.

Journal article Health Care Financ Rev · 1999 Featured Publication Using 1993 and 1994 data, the authors examine whether beneficiaries who enroll in a Medicare health maintenance organization (HMO), including those enrolling for only a short period of time, have lower expenditures than continuous fee-for-service (FFS) ben ... Link to item Cite

The relationship of patient satisfaction with care and clinical outcomes.

Journal article Med Care · July 1997 Featured Publication OBJECTIVES: The authors examine the relationship between three dimensions of patient satisfaction (quality of care, hospital care, and physician time) and two ways of looking at outcomes: absolute (status at 6 months after surgery) and relative (difference ... Full text Link to item Cite

How do states buy health insurance for their own employees?

Journal article Manag Care Q · 1997 Featured Publication State governments play many roles in local health insurance markets. This paper focuses on the role of states as employers. As managed care and health care costs continue to grow, state governments engage in a variety of health insurance purchasing practic ... Link to item Cite