Health Services Research

New study in #HSR from Alyna T. Chien MD, MS et al investigate primary care practice ownership and specialist-use patterns for commercially insured children with disabilities.  WHAT IS KNOWN Children with disabilities face difficulties accessing specialist care WHAT THIS STUDY ADDS For those who deliver frontline care coordination or provide population management support, this study illustrates the range of pediatric and nonpediatric specialists caring for privately insured children with disabilities.    CONCLUSION Recognizing how privately insured children with disabilities use pediatric primary care from pediatric and nonpediatric primary care specialists through both independent and system-owned practices is important for improving care quality and value. #HSR Wiley AcademyHealth Read Full Article: https://lnkd.in/gwEDT4zU 

Visit HSR's Sponsorships page to learn more about the benefits of sponsoring a special issue or section: https://lnkd.in/d3NbBfks #HSR #HealthServicesResearch

New study in #HSR from Alice J. Chen PhD et al examine how variation in physicians' treatment decisions for newborn deliveries responds to changes in the hospital-level norms for obstetric clinical decision-making.  WHAT IS KNOWN Wide variation in approaches to newborn deliveries, especially use of C-section WHAT THIS STUDY ADDS Leveraging a unique study design, hospital environment causally impacts physician treatment intensity CONCLUSION Obstetric physician behavior change appears highly malleable and sensitive to the practice patterns of other physicians delivering newborns at the same hospital. Incentives and policies that encourage more appropriate clinical care norms hospital-wide could sharply improve physician treatment decisions, with benefits for maternal and infant outcomes. FULL ARTICLE: https://lnkd.in/gGmuckWE #HealthServicesResearch AcademyHealth Wiley

New study in #HSR from Ari Ne'eman BA  et al  understand trends in the long-term services and supports (LTSS) workforce and assess workforce data as a measure of progress in shifting LTSS resources from institutional to community-based settings.   WHAT IS KNOWN State Medicaid programs have increasingly shifted people with LTSS needs and LTSS expenditures from institutional settings to community-based settings. WHAT THIS STUDY ADDS LTSS rebalancing is visible in ACS workforce data, permitting comparability across all states from 2008 to 2022, exceeding the reach of all existing data sources. CONCLUSION Workforce data can serve as an effective measure of changes in LTSS utilization for older adults. This offers researchers and policymakers a useful alternative to administrative claims, bypassing threats to comparability from coding changes and the shift to managed care. Additional data is needed on workforce trends in services for younger LTSS consumers. FULL ARTICLE: https://lnkd.in/g4yhsMvy #HealthServicesResearch Wiley AcademyHealth  

New study in #HSR from Dana B. Mukamel PhD et al estimate and contrast the relationships between nurse staffing and health outcomes in nursing homes with low and high dementia census, to understand the association of staffing hours with dementia care quality. WHAT IS KNOWN Studies to-date compared the health outcomes of nursing home residents with dementia cared for in special care units to residents with dementia in general care. WHAT THIS STUDY ADDS Access This study examines the relationship between nursing homes staffing and outcomes in general care. CONCLUSION findings suggest that increasing staffing will improve outcomes by similar increments in both low- and high-dementia facilities for all outcomes. However, at any given level of staffing, absolute differences in outcomes between low- and high-dementia facilities remain, suggesting that additional staffing alone will not suffice to close these gaps. Further studies are required to identify opportunities for improvement in performance for both low- and high-dementia census facilities. FULL ARTICLE: https://lnkd.in/gKNxi8YP #HealthServicesResearch Wiley AcademyHealth

Did you know that #HSR reduced first decision time by more than a month between 2017 and 2022? On top of that, did you know that the journal lowered final acceptance time by more than three months over the same time span? These improvements reflect efforts by HSR's editorial staff, as well as by reviewers and authors, to reach faster decisions and improve publishing processes. Learn more about HSR's work to improve its decision and publishing processes by reading this commentary piece: https://ow.ly/NVzp50SIGzV #HealthServicesResearch

New study in #HSR from Daniel Marthey PhD et al describe characteristics of emergency department visits to Texas satellite and independent freestanding emergency departments (FrEDs) relative to hospital emergency departments (EDs).  WHAT IS KNOWN Freestanding emergency departments (FrEDs) have expanded rapidly in Texas, targeting patients in non-rural areas who are higher income and privately insured. WHAT THIS STUDY ADDS This study is the first to describe the universe of care delivered at FrEDs. CONCLUSION results underscore the need to address potentially avoidable utilization of emergency services. FULL ARTICLE: https://lnkd.in/gJfbaZQy  #HealthServiceesResearch Wiley AcademyHealth

New study in #HSR from Nima Khodakarami PhD et al examine the impact of the Affordable Care Act (ACA) health insurance exchanges (Marketplace) on the rate of uninsured discharges in Texas. WHAT IS KNOWN The Affordable Care Act (ACA) increased insurance coverage; however, the impact of the ACA has not been well studied in non-Medicaid expansion states. WHAT THIS STUDY ADDS The study provides evidence that the ACA Marketplace has increased insured hospital stays in Texas. CONCLUSION Findings indicate that the ACA facilitated a shift in hospital payor mix from uninsured to insured. FULL ARTICLE: https://lnkd.in/gwbNzjMD #HealthServicesResearch Wiley AcademyHealth 

The call for abstracts is open for Social Interventions Research and Evaluation Network (SIREN)'s 2025 National Research Meeting: Advancing the Science of Social Care, taking place February 2-4, 2025, in San Diego. Abstracts for posters, podium presentations and workshops should focus on the implementation or effectiveness of healthcare policies / practices related to collecting data about social conditions and/or interventions informed by data about social conditions. These health care policies and practices may be targeted at the patient, system or community level. Organizers are particularly interested in research that examines equity-related outcomes. Learn more and submit your abstract by August 5: https://lnkd.in/gg9vU_qB

New study in #HSR from Hannah Crook BSPH et al  quantify the degree to which health care service area (HCSA) definitions captured hospitalizations and heterogeneity in social determinants of health (SDOH). WHAT IS KNOWN Health care service area (HCSA) definitions are important for a variety of regulatory, policy, and research purposes. WHAT THIS STUDY ADDS This study finds that different HCSA definitions capture a wide range of inpatient discharges, with Metropolitan Statistical Areas capturing the largest proportion (93%–97%). CONCLUSION The proportion of hospital discharges captured by each HCSA varied, with MSAs capturing the highest proportion of discharges and PUMAs capturing the lowest. Additionally, researchers face a trade-off between capture rate and population homogeneity when deciding which HCSA to use. FULL ARTICLE: https://lnkd.in/gMFShE7s #HealthServicesResearch Wiley AcademyHealth