The Influence of Patient Characteristics on Ratings of Managed Behavioral Health Care

Carlson, Matthew J.; Shaul, James A.; Eisen, Susan V.; Cleary, Paul D.

doi:10.1097/00075484-200211000-00012

Cited by 24 publications

(27 citation statements)

References 28 publications

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“…In addition, the HCT questions are parent reported and based on perceived need, which may bias the prevalence of HCT services. 37,38 The cross-sectional point-in-time methodology of this and previous surveys does not permit examination of a causal relationship between explanatory variables and HCT.…”

Section: Discussionmentioning

confidence: 93%

Disparities in Transition Planning for Youth With Autism Spectrum Disorder

Cheak‐Zamora¹,

Yang²,

Farmer

et al. 2013

Pediatrics

110

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WHAT'S KNOWN ON THIS SUBJECT: Health care transition services assist youth with special health care needs (YSHCN) in transitioning to adult care without gaps in services or health insurance coverage. Less than half of YSHCN receive anticipatory assistance in this transition; receipt of these services for youth with autism spectrum disorder is unknown. WHAT THIS STUDY ADDS:Youth with autism spectrum disorder receive transition services half as often as youth with special health care needs. Quality of health care is associated with increased receipt of health care transition services. Presence of comorbid conditions decreased receipt of transition services. abstract OBJECTIVE: Little is known about accessibility to health care transition (HCT) services for youth with autism spectrum disorder (ASD). This study expands our understanding by examining the receipt of HCT services in youth with ASD compared with youth with other special health care needs (OSHCN). METHODS:We used the 2005-2006 National Survey of Children with Special Health Care Needs to examine receipt of HCT services for youth (aged 12-17 years) with ASD and youth with OSHCN. Logistic regression analyses explored whether individual, family, or health system factors were associated with receipt of HCT services for youth with ASD. RESULTS:Whereas half of youth with OSHCN received HCT services, less than a quarter of youth with ASD did. Only 14% of youth with ASD had a discussion with their pediatrician about transitioning to an adult provider, less than a quarter had a discussion about health insurance retention, and just under half discussed adult health care needs or were encouraged to take on appropriate responsibility. Logistic regression analyses indicated that having a developmental disability or multiple health conditions in addition to ASD and quality of health care were strong predictors of HCT, whereas demographic and family variables accounted for little variance. CONCLUSIONS:Youth with ASD experience disparities in access to HCT services. Youth with comorbid conditions are at greatest risk for poor access to HCT services and increased quality of care has a positive effect. Research is needed to understand barriers to care and develop policy and practice guidelines tailored for youth with ASD. Pediatrics 2013;131:447-454

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Section: Discussionmentioning

confidence: 93%

Disparities in Transition Planning for Youth With Autism Spectrum Disorder

Cheak‐Zamora¹,

Yang²,

Farmer

et al. 2013

Pediatrics

110

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“…The most consistent findings relate to age, with older patients reporting more positively (8,9,29,66) across health plans, both commercial and public (Medicaid, Medicare). Overall, research indicates also that patients in better health (which can be defined to include not only physical health status but also disability, low quality of life, and psychological distress) give higher ratings to their care (10,16,29,43,66,87), although this may not hold for dimensions directly related to care, including daily care, medical care, and information (87).…”

Section: Findings On Factors Influencing Patient Responses To Carementioning

confidence: 87%

“…For example, Carlson and colleagues (8), using the Consumer Assessment of Behavioral Health Survey (CAHBS), compared the responses of members of commercial and five public-managed behavioral health plans. Although unadjusted global ratings of commercial and public plans were statistically significant, significant differences disappeared when the analysis controlled for patient characteristics such as educational level, self-reported health and mental health status, use patterns, and whether coverage paid for all or only some of the costs of care.…”

Section: Health Plansmentioning

confidence: 99%

“…Thus, the extent and nature of variations across race and ethnicity, in perceptions of health care, remain unclear, as does the issue of what drives these variations. Two studies that examined educational level both found that more-educated patients rate their health plans lower (8,66). Gender differences exist but are not particularly large; in general, women have slightly higher ratings than do men (11,92).…”

Section: Figurementioning

confidence: 99%

See 1 more Smart Citation

Patient Perceptions of the Quality of Health Services

Sofaer

Firminger

2005

Annu. Rev. Public Health

465

405

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■ Abstract As calls are made for a more patient-centered health care system, it becomes critical to define and measure patient perceptions of health care quality and to understand more fully what drives those perceptions. This chapter identifies conceptual and methodological issues that make this task difficult, including the confusion between patient perceptions and patient satisfaction and the difficulty of determining whether systematic variations in patient perceptions should be attributed to differences in expectations or actual experiences. We propose a conceptual model to help unravel these knotty issues; review qualitative studies that report directly from patients on how they define quality; provide an overview of how health plans, hospitals, physicians, and health care in general are currently viewed by patients; assess whether and how patient health status and demographic characteristics relate to perceptions of health care quality; and identify where further, or more appropriately designed, research is needed.Our aim is to find out what patients want, need and experience in health care, not what professionals (however well-motivated) believe they need or get.Through the Patient's Eyes (23)

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“…These differences disappeared after adjusting for enrollee characteristics and coverage, illustrating the importance of adjusting ratings for these factors when comparing plans. 10 The type of health plan and care management practices is another possible source of variation in enrollees' ratings of their care, and these effects have been found after controlling for enrollee characteristics and location. Moving from low to high management of care (indemnity plans, preferred provider organizations, open-model HMOs, and closed-model HMOs), enrollees' assessments of their care were found to be lower under the more managed products, especially the closed-model HMOs, reflecting problems with provider access, convenience, and organizational factors.…”

Section: Evidence On Group Differences In Experiences and Perceptionsmentioning

confidence: 99%