Geography And The Debate Over Medicare Reform

Wennberg, John E.; Fisher, Elliott S.; Skinner, Jonathan

doi:10.1377/hlthaff.w2.96

Cited by 468 publications

(389 citation statements)

References 14 publications

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“…Although these procedures are of unquestionable value to many who undergo them, net benefits are much less clear for a subset of patients, either for clinical reasons or because those patients would have opted against surgery had they been fully informed of its potential costs and benefits. 12 We also examined end-of-life care (including intensive care unit, or ICU, admissions and hospital days), which tends to be associated with the supply of health care resources such as hospital beds or physician capacity rather than with patients' preferences or underlying severity of illness. These measures provide partial risk adjustment for the underlying illness of the population, since everyone in the sample has a life span of only six months.…”

Section: Methodsmentioning

confidence: 99%

Who You Are And Where You Live: How Race And Geography Affect The Treatment Of Medicare Beneficiaries

et al. 2004

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There is no simple story that explains the regional patterns of racial disparities in health care.by Katherine Baicker, Amitabh Chandra, Jonathan S. Skinner, and John E. Wennberg ABSTRACT: The existence of overall racial and ethnic disparities in health care is well documented, but this average effect masks variation across regions and types of care. Medicare claims data are used to document the extent of these variations. Regions with high racial disparities in one procedure are not more likely to be high in other procedures. Unusually large racial disparities in surgery are often the result of high white rates rather than low black rates. Differences in end-of-life care are driven more by residence than by race. Policies should focus on getting the rates right, rather than solely on racial differences.T h e r e i s an e x t e n s i v e l i t e r at u r e documenting racial and ethnic disparities in the use of health care in the United States. A recent Institute of Medicine (IOM) report concluded that there are large, significant disparities in the quality and quantity of health care received by minority groups. 1 Most studies have used national samples to study racial disparities in health care, so their results represent an average across U.S. regions. Other studies extrapolate from the experiences of a single area or a single hospital. 2 One might reasonably infer from these studies' findings that racial and ethnic disparities in health care use are pervasive in every region and for all types of care. However, recent studies have shown that overall national differences mask sizable variation across regions and across procedures in racial and ethnic disparities in utilization rates.

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Section: Methodsmentioning

confidence: 99%

Who You Are And Where You Live: How Race And Geography Affect The Treatment Of Medicare Beneficiaries

et al. 2004

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“…Moreover, various policies, if properly implemented, could improve quality while reducing spending. 3 Comparisons across countries also support these conclusions. 4 The analysis presented in this report seeks to illustrate a range of federal policy options that could begin to be implemented now to generate savings.…”

Section: Introductionmentioning

confidence: 76%

Giving Teeth to Comparative-Effectiveness Research — The Oregon Experience

Saha

Coffman²,

Smits³

2010

N Engl J Med

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T h e C o m m o n w e a lT h F u n d C o m m i s s i o n o n a h i g h P e r F o r m a n C e h e a lT h s y s T e m d e C e m b e r 2 0 0 7 B E N D I N G T H E C U R V EOptions for Achieving Savings and Improving Value in U.S. Health SpendingThe Commonwealth Fund, among the first private foundations started by a woman philanthropist-Anna M. Harknesswas established in 1918 with the broad charge to enhance the common good.The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries. t h e co m m o n w e a lt h f u n d t h e c o m m o n w e a l t h f u n d c o m m i s s i o n o n a h i g h p e r f o r m a n c e h e a l t h s y s t e m Membership

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“…For instance, patients with schizophrenia, those who participated in a printed decision aid, obtained better knowledge about their conditions and had elevated perceived involvement in health decisions (Hamann et al, 2006). There are also multiple evidence that shared decision making for preference-sensitive conditions (e.g., back pain, early breast/prostate cancer, and angina) leading to reduced rates of surgery, lesser nonsurgical admissions, and cost savings (Stacey et al, 2014;Veroff et al, 2013;Wennberg, Fisher, & Skinner, 2002). Towle and Godolphin (1999) clearly describe "informed shared decision making" as an interactive process where the connection between the informed patient and the informed clinician plays a critical role in achieving informed preferences.…”

Section: Shared Decision Makingmentioning

confidence: 99%

Analysis and design of mobile health interventions towards informed shared decision making: an activity theory-driven perspective

Nguyen

Poo²

2016

Journal of Decision Systems

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With the rapid advancement of mobile technologies, mobile health is going through a massive digital revolution that is reshaping the current way of health decision making. This study takes initiatives to investigate the manifestation of shared decision making model in mobile health for better decision quality and outcome. Hence, we propose an Activity Theory-driven framework for analysing mobile health management to achieve informed health choices. It establishes strong theoretical foundations and comprehensive requirements for designing mobile health interventions in the direction of supportive and collaborative decision making. The study contributes to the cumulative theoretical development of mobile health and shared decision making. It also provides an agenda for automated mobile health and a number of implications for academic bodies, healthcare practitioners, and developers of mobile health.

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Geography And The Debate Over Medicare Reform

Cited by 468 publications

References 14 publications

Who You Are And Where You Live: How Race And Geography Affect The Treatment Of Medicare Beneficiaries

Who You Are And Where You Live: How Race And Geography Affect The Treatment Of Medicare Beneficiaries

Giving Teeth to Comparative-Effectiveness Research — The Oregon Experience

Analysis and design of mobile health interventions towards informed shared decision making: an activity theory-driven perspective

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