Health services research

Current Opinion in Rheumatology

Volumn 9, Issue 2, 1997, Pages 118-125

  Saag, Kenneth G ^a  

^a UNIVERSITY OF IOWA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTHRITIS; BACKACHE; COST EFFECTIVENESS ANALYSIS; DISABILITY; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SERVICES RESEARCH; MANAGED CARE ORGANIZATION; MANIPULATIVE MEDICINE; PRIORITY JOURNAL; REVIEW; RHEUMATOLOGY; RURAL AREA; UNITED STATES; URBAN AREA;

COMPLEMENTARY THERAPIES; COST-BENEFIT ANALYSIS; DELIVERY OF HEALTH CARE, INTEGRATED; HEALTH SERVICES RESEARCH; HUMANS; INCIDENCE; MANAGED CARE PROGRAMS; PRACTICE GUIDELINES; PRIMARY HEALTH CARE; RHEUMATIC DISEASES; RURAL HEALTH SERVICES; UNITED STATES;

EID: 0030966535     PISSN: 10408711     EISSN: None     Source Type: Journal    
DOI: 10.1097/00002281-199703000-00007     Document Type: Review

References (51)

1. Freeman JB, Blalock SJ, Holman HR, Liang MH, Meenan RF: Advances rought by health services research to patients with arthritis. Summary of the workshop on health services research in arthritis: from research to practice. Arthritis Care Res 1996, 9:142-150. A review of recent progress in health services research funded by the National Institutes of Health Multipurpose Arthritis and Musculoskeletal Disease Centers.
2. DeFriese GH: Requiem or reveille for health services research? Health Serv Res 1996, 31:1-4. Words of encouragement, yet caution for future health service research due to funding instability.
3. Van Nostrand JF: Common Beliefs About the Rural Elderly: What Do National Data Tell Us? Hyattsville, MD: National Center for Health Statistics; 1993. [PHS publication no. 1412, series III, no. 28.]
4. Rogers CC: Health Status and Use of Health Care Services by the Older Population: A Residential Comparison. Washington DC: Agriculture and Rural Economy Division, Economic Research Service, US Department of Agriculture; 1993. [Rural development research report no. 86.]
5. US National Center for Health Statistics: Current Estimates from the National Health Survey, 1984. Washington, DC: US Government Printing Office; 1986.
6. US Department of Health and Human Services: Vital and Health Statistics: Current Estimates From the National Health Interview Survey, 1991. Hyattsville, MD: Department of Health and Human Services; 1992.
7. Braden J, Reauregard K: Health Status and Access to Care of Rural and Urban Populations. Rockville, MD: Agency for Health Care Policy and Research; 1994. [Publication no. 94-0031:2-19.]
8. Jordan JM, Linder GF, Renner JB, Fryer JG: The impact of arthritis in rural populations. Arthritis Care Res 1995, 8:242-250. A good review of arthritis epidemiology in the rural United States. Emphasizes urban-rural disparities in osteoarthritis incidence and their societal impact.
9. Maurer K: Basic data on arthritis of knee, hip, and sacroiliac joints in adults ages 25-74 years: United States, 1971-1975. Vital Health Stat [11] 1979:no. 213.
10. Felson DT: The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum 1990, 20:42-50.
11. Connor RA, Hillson SD, Krawelski JE: Competition, professional synergism, and the geographic distribution of rural physicians. Med Care 1995, 33:1067-1078. A new model is proposed to explain geographic distribution of rural generalists and specialists. Synergism is a stronger factor for primary care physicians and competition operates over greater distances among subspecialists.
12. McPherson K, Wennberg JE, Hovind OB, Clifford P: Small-area variations in the use of common surgical procedures: an international comparison of New England, England, and Norway. N Engl J Med 1982, 307:1310-1314.
13. Chassin MR, Brook RH, Park RE, Keesey J, Fink A, Kosecoff J, Kahn K, Merrick N, Soloman DH: Variations in the use of medical and surgical services by the medicare population. N Engl J Med 1986, 314:285-290.
14. Coyte PC, Hawker G, Wright JG: Variations in knee replacement utilization rates and the supply of health professionals in Ontario, Canada. J Rheumatol 1996, 23:1214-1220. A well-conducted analysis showing no overall urban-rural variation in knee replacement surgeries, but suggesting that a paucity of arthritis medical specialists in rural areas was associated with an increased rate of this procedure.
15. Culler SD, Holmes AM, Gutierrez B: Expected hospital costs of knee replacement for rural residents by location of service. Med Care 1995, 33:1188-1209. An analysis of administrative claims data showing that rural hospitals may perform knee replacement surgery as effectively and efficiently as more urban centers, provided the procedural volume is adequate.
16. McGee R, Tangalos EG: Delivery of health care to the underserved: potential contributions of telecommunications technology. Mayo Clin Proc 1994, 69:113-1136.
17. Perednia DA, Allen A: Telemedicine technology and clinical applications. JAMA 1995, 273:483-488.
18. Scaletti JV: Telecommunications and rural health communities. Ann Intern Med 1995, 122:379.
19. Willkens RF, Rowberg AH: Future opportunities using technical advantages in picture processing and data transfer. J Rheumatol 1995, 22:2001-2003. A brief overview of telemedicine and its potential applications to the management of rheumatology patients.
20. Yelin E, Bernhard G, Pflugrad D: Access to medical care among persons with musculoskeletal conditions. Arthritis Rheum 1995, 38:1128-1133.
21. Callahan LF, Yelin EH: The transition to managed care: implications for the rheumatology community. Arthritis Care Res 1995, 8:129-131. A thoughtful editorial and literature review discussing the impact of managed care on the rheumatologist.
22. Clement DG, Retchin SM, Brown RS, Stegall MH: Access and outcomes of elderly patients enrolled in managed care. JAMA 1994, 271:1487-1492.
23. Reisine S, Fifield J: Health insurance problems among insured rheumatoid arthritis patients. Arthritis Care Res 1995, 8:155-160.
24. Feinglass J, Schroeder J, Gifford B, Manheim L: Gate-keepers and the medical specialist: the impact of managed care on rheumatologists. J Am Assoc Pref Prov Org 1992, 2:13-36.
25. Yelin EH, Henke CJ, Kramer JS, Nevitt MC, Shearn M, Epstein MV: A comparison of the treatment of rheumatoid arthritis in health maintenance organizations and fee-for-service practices. N Engl J Med 1985, 312:962-967.
26. Yelin EH, Shearn MA, Epstein WV: Health outcomes for a chronic disease in prepaid group practice and fee for service setting. Med Care 1986, 24:236-247.
27. Hughes E, Gifford B, Manheim L: HMO Contracting with Rheumatologists in the United States. Chicago: Northwestern University, Center for Health Services and Policy Research; 1991. [Working paper #223.]
28. Emanuel EJ, Dubler NN: Preserving the physician-patient relationship in the era of managed care. JAMA 1995, 273:323-329.
29. Manheim LM: Managed care and arthritis care: patients and providers under the new medical care organizations. Arthritis Care Res 1995, 8:298-303. A thorough review of managed care's impact on arthritis health services delivery. The author highlights the presence of only a few studies demonstrating the important role of rheumatologists and arthritis health professionals.
30. Committee of the American College of Rheumatology Council on Health Care Research: Role of specialty care for chronic diseases: a report from an ad hoc committee of the American College of Rheumatology. Mayo Clin Proc 1996, 71:1179-1181. This is a complete and authoritative overview of the literature supporting the important role of subspeciality care in the management of the rheumatic diseases.
31. Mazzuca SA, Brandt KD, Anderson SL, Musick BS, Katz BP: The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient J Rheumatol 1991, 18:1593-1600.
32. Ward MM, Leigh JP, Fries JF: Progression of functional disability in patients with rheumatoid arthritis. Associations with rheumatology subspecialty care. Arch Intern Med 1993, 153:2229-2237.
33. Ward MM, Rao R: Interruptions in rheumatology subspecialty care among patients with rheumatoid arthritis. J Rheumatol 1995, 22:2319-2326. A cohort analysis of predictors of interruption in rheumatologist care. Improvements in functional status, older age, and absence of insurance coverage were the factors most strongly associated with interruptions of rheumatologist care. In contrast, interruptions in primary provider care were not affected by changes in insurance status, suggesting that rheumatologist care may be more discretionary.
34. Helliwell PS, O'Hara M: Shared care between hospital and general practice: an audit of disease modifying drug monitoring in rheumatoid arthritis. Br J Rheumatol 1995, 34:673-676. Much of the monitoring of anti-rheumatic therapies is currently conducted by primary care providers. The authors examined monitoring practices in a community relatively underserved by rheumatologists. For certain antirheumatic agents such as intramuscular gold injections, the majority (74%) of persons were receiving substandard monitoring according to the protocols used in the study.
35. Kay EA, Pullar T: Variations among rheumatologists in prescribing and monitoring of disease modifying anti-rheumatoid drugs. Br J Rheumatol 1992, 31:477-483.
36. Coyte PC, Hawker G, Croxford R, Attard C, Wright JG: Variation in rheumatologists' and family physicians' perceptions of the indications for and outcomes of knee replacement surgery. J Rheumatol 1996, 23:730-738. Practice pattern variation is strongly influenced by variations in clinical opinions surrounding therapeutic decisions. This paper identified significant disagreements among both generalists and specialists with regard to indications and anticipated outcomes of knee replacement surgery and its alternatives.
37. Williams MH: Challenges for clinical decision making in the management of osteoarthritis of the knee. J Rheumatol 1996, 23:586-589. This editorial accompanying Coyte et al. (J Rheumatol 1996, 23:730-738) reviews referral practices and other clinical decisions in osteoarthritis.
38. Williams MH: Challenges for clinical decision making in the management of osteoarthritis of the knee. J Rheumatol 1996, 23:586-589. This editorial accompanying Coyte et al. (J Rheumatol 1996, 23:730-738) reviews referral practices and other clinical decisions in osteoarthritis.
39. Liang MH: The American College of Rheumatology practice guidelines strategy. Arthritis Care Res 1995, 85:132-133. A nice overview of the rationale, strengths, and limitations of practice guidelines in rheumatologic diseases.
40. Vierhout WPM, Knottnerus JA, van Ooij A, Crebolder HFJM, Pop P, Wesselingh-Megens AMK, Beusmans GHMI: Effectiveness of joint consultation sessions of general practitioners and orthopaedic surgeons for locomotor-system disorders. Lancet 1995, 346:990-994. A new paradigm is presented for joint management of musculoskeletal diseases utilizing consultation sessions between generalists and orthopedic subspecialists. This program may have value for both cost reductions and continuing medical education.
41. Vlieland TPMV, Zwinderman AH, Vandenbroucke JP, Breedveld FC, Hazes JMW: In-patient treatment for active rheumatoid arthritis: clinical course and predictors of improvement. Br J Rheumatol 1995, 34.847-853. An inpatient treatment program for refractory rheumatoid arthritis showed that 43% of patients who had failed conventional outpatient regimens responded to this program heavily focused on nonpharmacologic treatment modalities.
42. Paulus HE, Egger MJ, Ward JR, Williams HJ, and the Cooperative Systematic Studies of Rheumatic Diseases Group: Analysis of improvement in individual rheumatoid arthritis patients treated with disease-modifying antirheumatic drugs, based on the findings in patients treated with placebo. Arthritis Rheum 1990, 33:477-484.
43. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL: Unconventional medicine in the United States. N Engl J Med 1993, 328:246-252.
44. Boisset M, Fitzcharles M: Alternative medicine use by rheumatology patients in a universal health care setting. J Rheumatol 1994, 21:148-152.
45. Visser GJ, Peters L, Rasker JJ: Rheumatologists and their patients who seek alternative care: an agreement to disagree. Br J Rheumatol 1992, 31:485-490.
46. US Department of Health and Human Services: Clinical Practice Guideline #14: Acute Low Back Problems in Adults. Rockville, MD: Agency for Health Care Policy and Research; 1994. [AHCPR publication no. 95-0642.]
47. Stano M, Smith M: Chiropractic and medical costs of low back care. Med Care 1996, 34:19-204. Analysis of administrative claims data showing that chiropractic care may be less costly compared with conventional care for similar back ailments.
48. Gonnella J, Hornbrook M, Louis D: Staging of disease: a case-mix measurement JAMA 1984, 251:637.
49. Tugwell P, Boers M, Brooks P: OMERACT II conference: outcome measures In rheumatoid arthritis clinical trials: conclusion. J Rheumatol 1995, 22:143-1432. A call for more investigations into generic health status and utility measurements in rheumatologic clinical trials.
50. Rutten-Van Mölken MPMH, Bakker CH, van Doorslaer EKA, van der Linden S: Methodological issues of patient utility measurement: experience from two clinical trials. Med Care 1995, 33:922-937. An excellent methodologic evaluation of directly measured patient preferences using the standard gamble and rating scales. Both methods demonstrated considerable measurement error and poor test-retest reliability, but group means remained relatively stable over time.
51. Bakker C, Rutten M, van Santen-Hoeufft M, Bolwijn P, van Doorslaer E, Bennett K, van der Linden S: Patient utilities in fibromyalgia and the association with other outcome measures. J Rheumatol 1995, 22:1536-1543. An example of utility measurement in a chronic rheumatic disease with assessment of many of the methodologic nuances of these instruments. This study adds to the literature indicating utility values are very sensitive to the method chosen to elicit patient preference.