메뉴 건너뛰기




Volumn 13, Issue 4, 1998, Pages 203-212

Developing a Tool for Analyzing Medical Care Utilization of Adult Asthma Patients in Indemnity and Managed Care Plans: Can an Episodes of Care Framework Be Used?

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ALGORITHM; ANALYSIS OF VARIANCE; ARTICLE; ASTHMA; COMORBIDITY; COMPARATIVE STUDY; FEMALE; HEALTH CARE PLANNING; HEALTH INSURANCE; HOSPITALIZATION; HUMAN; MALE; MEDICAL FEE; MIDDLE AGED; PATIENT CARE; REGRESSION ANALYSIS; RISK ASSESSMENT; RISK FACTOR; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

EID: 0032406808     PISSN: 10628606     EISSN: None     Source Type: Journal    
DOI: 10.1177/106286069801300406     Document Type: Article
Times cited : (6)

References (53)
  • 1
    • 0346812197 scopus 로고    scopus 로고
    • Supporting national standards of accountability for access and quality in managed health care. Position paper
    • American Public Health Association. Supporting national standards of accountability for access and quality in managed health care. Position paper. Am J Public Health 1997;87:510-515.
    • (1997) Am J Public Health , vol.87 , pp. 510-515
  • 2
    • 0022127016 scopus 로고
    • Health care episodes: Definition, measurement and use
    • Hornbrook M, Hurtado A, Johnson R. Health care episodes: Definition, measurement and use. Med Care Rev 1985;42:163-217.
    • (1985) Med Care Rev , vol.42 , pp. 163-217
    • Hornbrook, M.1    Hurtado, A.2    Johnson, R.3
  • 4
    • 0347442923 scopus 로고
    • Chap. VI: Integrative analysis based on episodes of care for hypertension and diabetes (Final Report). Seattle, WA: Department of Health Services, School of Public Health and Community Medicine, University of Washington, November
    • Shortell SM, Williams SJ, Richardson WC, et al. The Seattle Prepaid Health Care Project: Comparison of Health Services Delivery. Chap. VI: Integrative analysis based on episodes of care for hypertension and diabetes (Final Report). Seattle, WA: Department of Health Services, School of Public Health and Community Medicine, University of Washington, November, 1976.
    • (1976) The Seattle Prepaid Health Care Project: Comparison of Health Services Delivery
    • Shortell, S.M.1    Williams, S.J.2    Richardson, W.C.3
  • 5
    • 0018858026 scopus 로고
    • Quality of care in episodes of respiratory illness among Medicaid patients in New Mexico
    • Lohr KN, Brook RH. Quality of care in episodes of respiratory illness among Medicaid patients in New Mexico. Ann Intern Med 1980;92:99-106.
    • (1980) Ann Intern Med , vol.92 , pp. 99-106
    • Lohr, K.N.1    Brook, R.H.2
  • 6
    • 0017565517 scopus 로고
    • A method for analyzing resource use in ambulatory care settings
    • Moscovice I. A method for analyzing resource use in ambulatory care settings. Med Care 1977;15:1024-1044.
    • (1977) Med Care , vol.15 , pp. 1024-1044
    • Moscovice, I.1
  • 7
    • 0027233613 scopus 로고
    • Computer-based longitudinal recording of episodes of care in general practice using the international classification of primary care (ICPC)
    • Kristensen FB, Kelstrup J, Kholbau C, Lassen LC. Computer-based longitudinal recording of episodes of care in general practice using the international classification of primary care (ICPC). Scand J Prim Health Care 1993;11(suppl):53-56.
    • (1993) Scand J Prim Health Care , vol.11 , Issue.SUPPL. , pp. 53-56
    • Kristensen, F.B.1    Kelstrup, J.2    Kholbau, C.3    Lassen, L.C.4
  • 8
    • 0019408391 scopus 로고
    • Assessing the performance of medical care systems: A method and its application
    • Nutting PA, Shorr GI, Burkhalter BR. Assessing the performance of medical care systems: A method and its application. Med Care 1981;19:281-296.
    • (1981) Med Care , vol.19 , pp. 281-296
    • Nutting, P.A.1    Shorr, G.I.2    Burkhalter, B.R.3
  • 9
    • 0029354080 scopus 로고
    • Factors associated with choosing a chiropractor for episodes of back pain care
    • Shekelle PG, Markovich M, Louie R. Factors associated with choosing a chiropractor for episodes of back pain care. Med Care 1995;33:842-849.
    • (1995) Med Care , vol.33 , pp. 842-849
    • Shekelle, P.G.1    Markovich, M.2    Louie, R.3
  • 11
    • 0020029382 scopus 로고
    • Episode-based efficiency comparisons for physicians and nurse practitioners
    • Salkever DS, Skinner EA, Steinwachs DM, Katz H. Episode-based efficiency comparisons for physicians and nurse practitioners. Med Care 1982;20:143-153.
    • (1982) Med Care , vol.20 , pp. 143-153
    • Salkever, D.S.1    Skinner, E.A.2    Steinwachs, D.M.3    Katz, H.4
  • 12
    • 0025242058 scopus 로고
    • Frequency and costs of diagnostic imaging in office practice - A comparison of self-referring and radiologist-referring physicians
    • Hillman B, Joseph C, Mabry M. Frequency and costs of diagnostic imaging in office practice - a comparison of self-referring and radiologist-referring physicians. N Engl J Med 1990;323:1604-1608.
    • (1990) N Engl J Med , vol.323 , pp. 1604-1608
    • Hillman, B.1    Joseph, C.2    Mabry, M.3
  • 13
    • 0025499635 scopus 로고
    • Services and charges by PPO physicians for PPO and indemnity patients
    • Garnick D, Luft HS, Gardner LB, et al. Services and charges by PPO physicians for PPO and indemnity patients. Med Care 1990;28:894-906.
    • (1990) Med Care , vol.28 , pp. 894-906
    • Garnick, D.1    Luft, H.S.2    Gardner, L.B.3
  • 14
    • 0029299338 scopus 로고
    • Profiling physician practice patterns using diagnostic clusters
    • Cave D. Profiling physician practice patterns using diagnostic clusters. Med Care 1995;33:463-486.
    • (1995) Med Care , vol.33 , pp. 463-486
    • Cave, D.1
  • 15
    • 0019812341 scopus 로고
    • Effects of hospital-based primary care setting on internists' treatment of primary care episodes
    • Gold M. Effects of hospital-based primary care setting on internists' treatment of primary care episodes. Health Serv Res 1981;16:383-405.
    • (1981) Health Serv Res , vol.16 , pp. 383-405
    • Gold, M.1
  • 16
    • 0017331545 scopus 로고
    • Evaluating cost effectiveness using episodes of care
    • Lasdon GS, Sigmann P. Evaluating cost effectiveness using episodes of care. Med Care 1977;15:260-264.
    • (1977) Med Care , vol.15 , pp. 260-264
    • Lasdon, G.S.1    Sigmann, P.2
  • 17
    • 0023605676 scopus 로고
    • Episode-of-care physician payment: A study of coronary artery bypass graft surgery
    • Showstack JA, Garnick DW, Rosenfeld DE et al. Episode-of-care physician payment: A study of coronary artery bypass graft surgery. Inquiry 1987;24:376-383.
    • (1987) Inquiry , vol.24 , pp. 376-383
    • Showstack, J.A.1    Garnick, D.W.2    Rosenfeld, D.E.3
  • 19
    • 17144459651 scopus 로고
    • Integrating outcomes measurement into clinical practice improvement across the continuum of care: A disease-specific episode of care model
    • Lucas J, Gunter M, Byrnes J, et al. Integrating outcomes measurement into clinical practice improvement across the continuum of care: a disease-specific episode of care model. Managed Care Q 1995;3:14-22.
    • (1995) Managed Care Q , vol.3 , pp. 14-22
    • Lucas, J.1    Gunter, M.2    Byrnes, J.3
  • 20
    • 0027917053 scopus 로고
    • Employers are using "episodes of care" to improve benefits
    • Bennett L. Employers are using "episodes of care" to improve benefits. Business and Health 1993;20-25.
    • (1993) Business and Health , pp. 20-25
    • Bennett, L.1
  • 21
    • 0026912856 scopus 로고
    • Postoperative adverse events of common surgical procedures in the Medicare population
    • Rosen AK, Geraci JM, Ash AS, et al. Postoperative adverse events of common surgical procedures in the Medicare population. Med Care 1992;30:753-765.
    • (1992) Med Care , vol.30 , pp. 753-765
    • Rosen, A.K.1    Geraci, J.M.2    Ash, A.S.3
  • 22
    • 0025086930 scopus 로고
    • Illness severity and costs of admissions at teaching and nonteaching hospitals
    • Iezzoni LJ, Schwartz M, Moskowitz MA, et al. Illness severity and costs of admissions at teaching and nonteaching hospitals. JAMA 1990;264:1426-1431.
    • (1990) JAMA , vol.264 , pp. 1426-1431
    • Iezzoni, L.J.1    Schwartz, M.2    Moskowitz, M.A.3
  • 23
    • 0026813129 scopus 로고
    • A description and clinical assessment of the computerized severity index
    • Iezzoni LI, Daley J. A description and clinical assessment of the computerized severity index. Qual Rev Bull 1992;18:44-52.
    • (1992) Qual Rev Bull , vol.18 , pp. 44-52
    • Iezzoni, L.I.1    Daley, J.2
  • 24
    • 0028451913 scopus 로고
    • Measuring quality of care: Fundamental information from administrative datasets
    • Garnick DW, Hendricks AM, Comstock CB. Measuring quality of care: Fundamental information from administrative datasets. Int J Qual Health Care 1994;6:163-177.
    • (1994) Int J Qual Health Care , vol.6 , pp. 163-177
    • Garnick, D.W.1    Hendricks, A.M.2    Comstock, C.B.3
  • 25
    • 0028845996 scopus 로고
    • Outcomes of patients with hypertension and non-insulin-dependent diabetes mellitus treated by different systems and specialties
    • Greenfield S, Rogers W, Mangotich M, et al. Outcomes of patients with hypertension and non-insulin-dependent diabetes mellitus treated by different systems and specialties. JAMA 1995;274:1436-1444.
    • (1995) JAMA , vol.274 , pp. 1436-1444
    • Greenfield, S.1    Rogers, W.2    Mangotich, M.3
  • 27
    • 0022771248 scopus 로고
    • Risk adjusting health care outcomes: A methodological review
    • Blumberg MS. Risk adjusting health care outcomes: a methodological review. Med Care Rev 1986;43:351-393.
    • (1986) Med Care Rev , vol.43 , pp. 351-393
    • Blumberg, M.S.1
  • 28
    • 0029553593 scopus 로고    scopus 로고
    • Constructing episodes of care from encounter and claims data: Some methodological issues
    • Wingert TD, Kralewski JE, Linquist TJ, Knutson DJ. Constructing episodes of care from encounter and claims data: some methodological issues. Inquiry 1996:430-443.
    • (1996) Inquiry , pp. 430-443
    • Wingert, T.D.1    Kralewski, J.E.2    Linquist, T.J.3    Knutson, D.J.4
  • 29
    • 0032014450 scopus 로고    scopus 로고
    • Developing episodes of care for adult asthma patients: A cautionary tale
    • Rosen A, Houchens R, Gibson T, Mayer-Oakes A. Developing episodes of care for adult asthma patients: A cautionary tale. Am J Med Qual 1998;13:25-35.
    • (1998) Am J Med Qual , vol.13 , pp. 25-35
    • Rosen, A.1    Houchens, R.2    Gibson, T.3    Mayer-Oakes, A.4
  • 30
    • 0038699089 scopus 로고
    • Bethesda, MD: National Heart, Lung, and Blood Institute, National Institutes of Health, August
    • Guidelines for the Diagnosis and Management of Asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, National Institutes of Health, August, 1991.
    • (1991) Guidelines for the Diagnosis and Management of Asthma
  • 31
    • 0030987765 scopus 로고    scopus 로고
    • Specialty differences in the management of asthma. a cross-sectional assessment of allergists' patients and generalists' patients in a large HMO
    • Vollmer WM, O'Hollaren M, Ettinger K, et al. Specialty differences in the management of asthma. A cross-sectional assessment of allergists' patients and generalists' patients in a large HMO. Arch Intern Med 1997;157:1201-1208.
    • (1997) Arch Intern Med , vol.157 , pp. 1201-1208
    • Vollmer, W.M.1    O'Hollaren, M.2    Ettinger, K.3
  • 32
    • 0026566147 scopus 로고
    • An economic evaluation of asthma in the United States
    • Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med 1992;326:862-866.
    • (1992) N Engl J Med , vol.326 , pp. 862-866
    • Weiss, K.B.1    Gergen, P.J.2    Hodgson, T.A.3
  • 33
    • 0026034764 scopus 로고
    • Fatal and near-fatal asthma
    • McFadden ER. Fatal and near-fatal asthma. N Engl J Med 1991;324:409-412.
    • (1991) N Engl J Med , vol.324 , pp. 409-412
    • McFadden, E.R.1
  • 34
    • 0025358041 scopus 로고
    • Results of a program to reduce admissions for adult asthma
    • Mayo PH, Richman J, Harris HW. Results of a program to reduce admissions for adult asthma. Ann Intern Med 1990;112:864-871.
    • (1990) Ann Intern Med , vol.112 , pp. 864-871
    • Mayo, P.H.1    Richman, J.2    Harris, H.W.3
  • 35
    • 0021334295 scopus 로고
    • Staging of disease: A case-mix measurement
    • Gonnella JS, Hombrook MC, Louis DZ. Staging of disease: a case-mix measurement. JAMA 1984;251:637-644.
    • (1984) JAMA , vol.251 , pp. 637-644
    • Gonnella, J.S.1    Hombrook, M.C.2    Louis, D.Z.3
  • 38
    • 0020083498 scopus 로고
    • The meaning and use of the area under a receiver operation characteristic (ROC) curve
    • Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operation characteristic (ROC) curve. Radiology 1982;143:29-36.
    • (1982) Radiology , vol.143 , pp. 29-36
    • Hanley, J.A.1    McNeil, B.J.2
  • 40
    • 0028471864 scopus 로고
    • Analyzing patterns-of-treatment data to provide feedback to physicians
    • Cave DG, Geehr EC. Analyzing patterns-of-treatment data to provide feedback to physicians. Med Interface 1994;7:117-126.
    • (1994) Med Interface , vol.7 , pp. 117-126
    • Cave, D.G.1    Geehr, E.C.2
  • 41
    • 84942950665 scopus 로고
    • Managed care plan performance since 1980
    • Miller RH, Luft HS. Managed care plan performance since 1980. JAMA 1994;271:1512-1519.
    • (1994) JAMA , vol.271 , pp. 1512-1519
    • Miller, R.H.1    Luft, H.S.2
  • 42
    • 0348039191 scopus 로고    scopus 로고
    • Modifying managed competition to address cost and quality
    • Luft HS. Modifying managed competition to address cost and quality. Health Affairs 1996;15:23-38.
    • (1996) Health Affairs , vol.15 , pp. 23-38
    • Luft, H.S.1
  • 43
    • 0025457046 scopus 로고
    • The cost of acute outpatient primary care in a preferred provider organization
    • Wouters AV. The cost of acute outpatient primary care in a preferred provider organization. Med Care 1990;28:573-585.
    • (1990) Med Care , vol.28 , pp. 573-585
    • Wouters, A.V.1
  • 44
    • 0024380521 scopus 로고
    • How do financial incentives affect physicians' clinical decisions and the financial performance of health maintenance organizations?
    • Hillman AL, Pauly MV, Kerstein JJ. How do financial incentives affect physicians' clinical decisions and the financial performance of health maintenance organizations? N Engl J Med 1989;321:86-92.
    • (1989) N Engl J Med , vol.321 , pp. 86-92
    • Hillman, A.L.1    Pauly, M.V.2    Kerstein, J.J.3
  • 45
    • 0029846146 scopus 로고    scopus 로고
    • Payment by capitation and the quality of care
    • Berwick D. Payment by capitation and the quality of care. N Engl J Med 1996;335:1227-1231.
    • (1996) N Engl J Med , vol.335 , pp. 1227-1231
    • Berwick, D.1
  • 46
    • 0026831303 scopus 로고
    • Ambulatory testing for capitation and fee-for-service patients in the same practice setting: Relationship to outcomes
    • Murray JP, Greenfield S, Kaplan SH, Yano EM. Ambulatory testing for capitation and fee-for-service patients in the same practice setting: relationship to outcomes. Med Care 1992;30:252-261.
    • (1992) Med Care , vol.30 , pp. 252-261
    • Murray, J.P.1    Greenfield, S.2    Kaplan, S.H.3    Yano, E.M.4
  • 47
    • 0026800726 scopus 로고
    • Health policy report, the American health care system, managed care
    • Inglehart JK. Health policy report, The American health care system, managed care. N Engl J Med 1992;327:742-747.
    • (1992) N Engl J Med , vol.327 , pp. 742-747
    • Inglehart, J.K.1
  • 48
    • 0026741725 scopus 로고
    • Medicare reimbursement accuracy under the prospective payment system 1985 to 1988
    • Hsia DC, Ahern CA, Ritchie BP, Moscoe LM, Krshat WM. Medicare reimbursement accuracy under the prospective payment system 1985 to 1988. JAMA 1992;268:896-899.
    • (1992) JAMA , vol.268 , pp. 896-899
    • Hsia, D.C.1    Ahern, C.A.2    Ritchie, B.P.3    Moscoe, L.M.4    Krshat, W.M.5
  • 49
    • 0025145772 scopus 로고
    • Diagnostic coding quality and its impact on healthcare reimbursement: Research perspectives
    • Waterstaat FL, Barlow J, Newman F. Diagnostic coding quality and its impact on healthcare reimbursement: Research perspectives. J Am Rec Assoc 1990;61:52-59.
    • (1990) J Am Rec Assoc , vol.61 , pp. 52-59
    • Waterstaat, F.L.1    Barlow, J.2    Newman, F.3
  • 50
    • 0023847702 scopus 로고
    • Accuracy of diagnostic coding for Medicare patients under the prospective-payment system
    • Hsia DC, Krushat WM, Fagan AB, et al. Accuracy of diagnostic coding for Medicare patients under the prospective-payment system. N Engl J Med 1988;318:352-355.
    • (1988) N Engl J Med , vol.318 , pp. 352-355
    • Hsia, D.C.1    Krushat, W.M.2    Fagan, A.B.3
  • 51
    • 0023739813 scopus 로고
    • Assessing hospital-associated deaths from discharge data: The role of length of stay and comorbidities
    • Jencks SF, Williams DK, Kay TL. Assessing hospital-associated deaths from discharge data: The role of length of stay and comorbidities. JAMA 1988;260:2240-2246.
    • (1988) JAMA , vol.260 , pp. 2240-2246
    • Jencks, S.F.1    Williams, D.K.2    Kay, T.L.3
  • 52
    • 0030969007 scopus 로고    scopus 로고
    • Guidelines and realities of asthma management: The Philadelphia story
    • Lang D, Sherman M, Polansky M. Guidelines and realities of asthma management: The Philadelphia story. Arch Intern Med 1997;157:1193-1200.
    • (1997) Arch Intern Med , vol.157 , pp. 1193-1200
    • Lang, D.1    Sherman, M.2    Polansky, M.3
  • 53
    • 0029810846 scopus 로고    scopus 로고
    • Quality and the medical marketplace
    • Angell M, Kassirer J. Quality and the medical marketplace. N Engl J Med 1996;335:883-885.
    • (1996) N Engl J Med , vol.335 , pp. 883-885
    • Angell, M.1    Kassirer, J.2


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.