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Research Studies is a compilation of published research articles funded by 大象APPor authored by 大象APPresearchers.

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1 to 25 of 575 Research Studies Displayed
Ghosh K, Beaulieu ND, Dalton M
Integrated health systems and medical care quality during the COVID-19 pandemic.
The objective of this study was to examine differences between patients treated in and outside of integrated systems of care during the COVID pandemic. Results indicated that health systems were associated with reduced deaths and adverse medical events, although this reduction appeared unrelated to use of primary care.
AHRQ-funded; HS024072.
Citation: Ghosh K, Beaulieu ND, Dalton M . Integrated health systems and medical care quality during the COVID-19 pandemic. Health Serv Res 2025 Jun; 60(3):e14433. doi: 10.1111/1475-6773.14433..
Keywords: COVID-19, Quality of Care, Healthcare Delivery, Primary Care, Health Systems
Colquhoun DA, Janda AM, Mentz G
Accounting for healthcare structures when measuring variation in care.
The purpose of this 鈥淩eader鈥檚 Toolbox鈥 was to explain how accounting for healthcare structural factors can improve measurement of variation in clinical care. The authors describe healthcare systems as multilevel structures where hospitals, clinicians, and patients interact, emphasizing that mixed-effect statistical models can effectively partition variation among these different levels. This analytical approach allows researchers to validly estimate the impact of health system features, clinician practices, or patient characteristics on care processes and outcomes. The paper serves as a methodological guide, detailing the rationale for considering healthcare structures when assessing clinical practice variation, along with statistical considerations and methods for analyzing structured healthcare data and assessing variance components.
AHRQ-funded; HS029172.
Citation: Colquhoun DA, Janda AM, Mentz G . Accounting for healthcare structures when measuring variation in care. Anesthesiology 2025 May; 142(5):793-805. doi: 10.1097/aln.0000000000005395.
Keywords: Healthcare Delivery, Health Services Research (HSR)
Encinosa W, Dor A
Does physician-hospital vertical integration signal care-coordination? Evidence from mover-stayer analysis of commercially insured enrollees.
The purpose of this study was to evaluate whether hospital acquisition of physician groups improves care coordination. Researchers addressed the lack of evidence on 鈥渧ertical integration鈥 by examining commercially insured PPO patients who relocated between different metropolitan statistical areas with varying levels of physician-hospital integration. The researchers assessed whether integrated practices deliver care differently or simply serve different patient populations. The analysis found that moving to markets with higher specialty care integration resulted in increased team referrals between primary and specialty providers, reduced laboratory and imaging utilization, decreased out-of-network care, and lower overall spending. Conversely, markets with more integrated primary care showed increased preventive care use and reduced inpatient utilization among women, but higher overall spending.
AHRQ-funded.
Citation: Encinosa W, Dor A . Does physician-hospital vertical integration signal care-coordination? Evidence from mover-stayer analysis of commercially insured enrollees. J Health Econ 2025 May; 101:102997. doi: 10.1016/j.jhealeco.2025.102997..
Keywords: Care Coordination, Healthcare Delivery, Health Insurance
Buckley DI, Hsu F, Dana T
Health care delivery of clinical preventive services for people with disabilities : a systematic review.
The purpose of this systematic review was to evaluate barriers and facilitators affecting preventive healthcare services for people with disabilities and assess intervention effectiveness. Researchers reviewed literature from five electronic databases through September 2024, identifying 74 studies addressing 20 recommended preventive services. Most evidence focused on breast and cervical cancer screening. Six randomized controlled trials examined educational interventions targeting patients, caregivers, and providers for people with various disabilities, yielding mixed effectiveness results. The researchers noted significant limitations including high methodological heterogeneity and limited data for most preventive services and disability types. They concluded that while barriers and facilitators are well-documented for certain cancer screenings, additional research is needed on interventions addressing these factors to improve preventive care access for people with disabilities.
Citation: Buckley DI, Hsu F, Dana T . Health care delivery of clinical preventive services for people with disabilities : a systematic review. Ann Intern Med 2025 May; 178(5):671-86. doi: 10.7326/annals-24-02446..
Keywords: Healthcare Delivery, Disabilities, Prevention
Diaz A, Mead M, Rohde S
Hospitals acquired by private equity firms: increased postoperative mortality for common inpatient surgeries.
The purpose of this study was to evaluate the impact of private equity acquisition on surgical outcomes in acute care hospitals. Using a difference-in-differences approach, researchers compared outcomes for Medicare beneficiaries undergoing four common general surgical operations across 67 private equity-acquired hospitals and 634 control hospitals. Results revealed that private equity acquisition was associated with a 2.7-percentage-point increase in thirty-day postoperative mortality compared to control hospitals. This higher mortality was primarily driven by a 3.9-percentage-point increase in failure to rescue, with no observed change in complication rates. Further analysis showed that mortality increases were particularly pronounced for emergency surgeries, while no significant changes occurred for elective procedures.
AHRQ-funded; HS028606.
Citation: Diaz A, Mead M, Rohde S . Hospitals acquired by private equity firms: increased postoperative mortality for common inpatient surgeries. Health Aff 2025 May; 44(5):554-62. doi: 10.1377/hlthaff.2024.01102.
Keywords: Hospitals, Surgery, Inpatient Care, Mortality, Healthcare Delivery
Michael SS, Bruna S, Sessums L
大象APPAuthor: S Bruna and LL Sessums
Building a public-private partnership to confront the emergency department boarding crisis.
This AHRQ-authored paper is the first in the Health Affairs Scholar Featured series that highlights the importance of a public-private partnership approach and lays the foundation for a series that will further present a holistic evaluation of topics. This article discusses the emergency department boarding crisis, which physically keeps a patient in an emergency department after the clinical decision to admit the individual to the hospital. This article encourages a multi-faceted approach toward resolving this critical health system issue.
AHRQ-authored.
Citation: Michael SS, Bruna S, Sessums L . Building a public-private partnership to confront the emergency department boarding crisis. Health Aff Sch 2025 Apr; 3(4):qxaf014. doi: 10.1093/haschl/qxaf014.
Keywords: Emergency Department, Healthcare Delivery
Post B, Alinezhad F, Young GJ
Impact of hospital-physician integration on Medicare patient mix.
Researchers compared pre- and post-employment patient panels of primary care physicians to assess whether hospital employment inclines the case mix of physicians toward higher-complexity patients with chronic conditions. Conditions measured included arthritis, depression, diabetes, hypertension, and ischemic heart disease. The findings indicated that hospital employment of physicians resulted in neither higher numbers nor higher proportions of complex patients treated by integrated physicians, at least among traditional Medicare patients.
AHRQ-funded; HS029278.
Citation: Post B, Alinezhad F, Young GJ . Impact of hospital-physician integration on Medicare patient mix. Am J Manag Care 2025 Apr; 31(4):e95-e101. doi: 10.37765/ajmc.2025.89724.
Keywords: Hospitals, Medicare, Healthcare Delivery, Provider: Physician
Salhi RA, Kocher KE, Greenwood-Ericksen M
Precision emergency medicine in health care delivery and access: framework development and research priorities.
As part of the Society for Academic Emergency Medicine Consensus Conference, the authors conducted a rapid literature review to characterize the state of knowledge related to the intersection of precision emergency medicine with health care delivery and access. They identified core domains including expedited/personalized prehospital care, delivery to the right level of care, personalized emergency department (ED) care, alternatives to ED care/post-ED care, prediction tools for system readiness, and creation of equitable systems of care. They used their findings to develop a conceptual model and research agenda with four priority research questions that defined identification of the core domains.
AHRQ-funded; HS029275.
Citation: Salhi RA, Kocher KE, Greenwood-Ericksen M . Precision emergency medicine in health care delivery and access: framework development and research priorities. Acad Emerg Med 2025 Apr; 32(4):444-53. doi: 10.1111/acem.15028.
Keywords: Emergency Department, Healthcare Delivery, Access to Care
Tawfik D, Rule A, Alexanian A
Emerging domains for measuring health care delivery with electronic health record metadata.
This article鈥檚 aim was to introduce emerging measurement domains made feasible through the electronic health record (EHR) use metadata to inform the changing landscape of health care delivery. The authors reviewed emerging domains in which EHR metadata may be used to measure health care delivery, outlining a framework for evaluating measures based on desirability, feasibility, and viability. They argued that EHR use metadata may be leveraged to develop and operationalize novel measures in the domains of team structure and dynamics, workflows, and cognitive environment to provide a clearer understanding of modern health care delivery. They provided examples of measures feasible using metadata including quantification of teamwork and collaboration, patient continuity measures, workflow conformity measures, and attention switching. They make the case that by enabling measures that can be used to inform the next generation of health care delivery, EHR metadata may be used to improve the quality of patient care and support clinician well-being.
AHRQ-funded; HS027837.
Citation: Tawfik D, Rule A, Alexanian A . Emerging domains for measuring health care delivery with electronic health record metadata. J Med Internet Res 2025 Mar 6; 27:e64721. doi: 10.2196/64721..
Keywords: Electronic Health Records (EHRs), Healthcare Delivery, Health Information Technology (HIT)
Post B, Kitsakos A, Alinezhad F
Hospital-physician integration and Medicare spending: evidence from stable angina.
The objective of this retrospective cohort study was to examine association between hospital-cardiologist integration and Medicare spending for stable angina patients. Data on Medicare beneficiaries was taken from Medicare Standard Analytic Files and the CMS National Downloadable File. Patients of integrated cardiologists were shown to incur comparable spending relative to patients of independent cardiologists, indicating that the impact of hospital-physician integration may depend on clinical context.
AHRQ-funded; HS029278.
Citation: Post B, Kitsakos A, Alinezhad F . Hospital-physician integration and Medicare spending: evidence from stable angina. Health Serv Res 2025 Feb; 60(1):e14383. doi: 10.1111/1475-6773.14383..
Keywords: Medicare, Hospitals, Healthcare Costs, Cardiovascular Conditions, Healthcare Delivery
Decker SL, Gourevitch RA, Meille G
大象APPAuthor: Decker SL, Meille G
Patient travel patterns and concordance with geographic market boundaries.
This cross-sectional study examines patient travel patterns across different healthcare settings and evaluates how commonly used geographic market boundaries reflect these patterns. Using 2018-2021 Medical Expenditure Panel Survey data, researchers analyzed travel times for office visits, emergency department visits, and inpatient stays. For primary care visits, the median travel time was 12.7 minutes, while specialty care required longer travel (17.1 minutes), particularly for patients outside metropolitan areas (41.8 minutes). For ambulatory care, 73.8% of visits occurred within patients' county, 81.5% within 30 minutes, and 93.3% within 60 minutes. Inpatient care showed greater travel distances, with only 63.3% occurring within patients' county. Common geographic market definitions captured varying proportions of care: 50.9% of primary care visits fell within primary care service areas, while 85.4% of inpatient stays were within hospital referral regions. The findings demonstrate that smaller geographic units often exclude substantial care utilization, while larger units may overestimate access and competition.
AHRQ-authored.
Citation: Decker SL, Gourevitch RA, Meille G . Patient travel patterns and concordance with geographic market boundaries. Ann Intern Med 2024 Dec; 177(12):1732-34. doi: 10.7326/annals-24-00857.
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Delivery
Aaron MB, Kerrissey M, Novikov Z
The association between care integration and care quality.
The purpose of this study was to examine how care integration relates to care quality and whether this relationship varies by patient risk. The study analyzed data from 59 practice sites across 17 health systems, encompassing 41,966 Medicare beneficiaries. Researchers evaluated both functional integration (administrative and clinical systems) and social integration (patient integration, professional cooperation, and coordination). Quality measures included colorectal cancer screening, 30-day readmission rates, and a Healthcare Effectiveness Data and Information Set (HEDIS) composite score of ambulatory clinical quality. Results revealed that social integration, particularly patient integration, had a strong positive association with care quality. The study also found that relationships between integration aspects and care quality varied depending on patient risk levels.
AHRQ-funded; HS024067.
Citation: Aaron MB, Kerrissey M, Novikov Z . The association between care integration and care quality. Health Serv Res 2024 Dec; 59(6):e14214. doi: 10.1111/1475-6773.14214.
Keywords: Quality of Care, Healthcare Delivery, Patient-Centered Healthcare
Whaley CM, Zhao X
The effects of physician vertical integration on referral patterns, patient welfare, and market dynamics.
This study investigates the impact of physician vertical integration on patient referral patterns and welfare, focusing on two common surgical procedures using 100% Medicare data. The analysis reveals that physician-hospital integration leads to a roughly 10% increase in referrals to higher-priced facilities over lower-priced providers. If all primary care physicians were to integrate, total Medicare spending could rise by $315 million, raising concerns about cost implications and market dynamics.
AHRQ-funded; HS024067.
Citation: Whaley CM, Zhao X . The effects of physician vertical integration on referral patterns, patient welfare, and market dynamics. J Public Econ 2024 Oct; 238. doi: 10.1016/j.jpubeco.2024.105175..
Keywords: Healthcare Delivery, Patient-Centered Outcomes Research
Ouayogod茅 MH, Hardy B, Mullahy J
Care transition management and patient outcomes in hospitalized Medicare beneficiaries.
Research investigated care transition activities and transitional care management among 424,115 Medicare beneficiaries discharged to community settings in 2017. The study examined data from 659 hospitals participating in the National Survey of Healthcare Organizations and Systems. Analysis focused on the relationship between hospital-reported transition activities, management claims, and patient outcomes. Hospitals with high transition activity implementation showed increased probability of transitional care management claims. The research evaluated impacts on patient spending, healthcare utilization, and outcomes among participating Medicare beneficiaries.
AHRQ-funded; HS024075.
Citation: Ouayogod茅 MH, Hardy B, Mullahy J . Care transition management and patient outcomes in hospitalized Medicare beneficiaries. Am J Manag Care 2024 Sep; 30(9):e266-e73. doi: 10.37765/ajmc.2024.89605..
Keywords: Transitions of Care, Medicare, Hospital Discharge, Evidence-Based Practice, Patient-Centered Outcomes Research, Healthcare Delivery
Rhodes KV, Sessums LL, Valdez RB
大象APPAuthor: Rhodes KV, Sessums LL, Valdez RB
AHRQ's healthcare extension service-state-based solutions to health care improvement.
The 大象APP (AHRQ) is launching a Healthcare Extension Service to enhance health care delivery using funds from the Patient-Centered Outcomes Research Trust Fund. This initiative will support state-level transformations by engaging stakeholders, providing actionable knowledge, and aligning payment incentives. Targeting urgent health issues, particularly in behavioral health, the program will include training and technical assistance to improve the implementation and sustainability of evidence-based practices, aiming to reduce the gap between research findings and clinical practice.
AHRQ-authored.
Citation: Rhodes KV, Sessums LL, Valdez RB . AHRQ's healthcare extension service-state-based solutions to health care improvement. JAMA 2024 Aug 6; 332(5):371-72. doi: 10.1001/jama.2023.23600.
Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Healthcare Delivery, Quality Improvement, Quality of Care
Okado I, Liu M, Elhajj C
Patient reports of cancer care coordination in rural Hawaii.
This study examined cancer care coordination experiences among 80 rural Hawaiian patients undergoing active treatment during 2020-2021. Participants completed the Care Coordination Instrument to assess their care experiences. The study population averaged 63 years old, predominantly female, with breast and GI cancers being most common. While overall coordination perceptions were similar between rural and urban patients, notable differences emerged in communication and navigation aspects. Key disparities involved second opinion consultations, clinical trial access, and after-hours care. A significant portion of rural patients required air travel for treatment access.
AHRQ-funded; HS027286.
Citation: Okado I, Liu M, Elhajj C . Patient reports of cancer care coordination in rural Hawaii. J Rural Health 2024 Aug; 40(4):595-601. doi: 10.1111/jrh.12821..
Keywords: Cancer, Care Coordination, Rural Health, Rural/Inner-City Residents, Healthcare Delivery
Massarweh NN, Ibrahim AM
When getting bigger is too big: challenges of growing health care systems.
This article presented a surgical perspective outlining emerging challenges associated with the growth of health systems and potential strategies to address potential adverse impacts of these changes. Trends toward fewer independent hospitals and smaller, local health systems in favor of larger, regional networks were likely to continue. The authors noted that it will be critical to ensure that changes do not erode patient鈥檚 confidence in the care they receive, providers鈥 satisfaction with their work, or the quality of education provided by Graduate Medical Education training programs.
AHRQ-funded; HS028606.
Citation: Massarweh NN, Ibrahim AM . When getting bigger is too big: challenges of growing health care systems. Ann Surg 2024 Aug 1; 280(2):190-92. doi: 10.1097/sla.0000000000006286.
Keywords: Health Systems, Healthcare Delivery
Roberts ET, Duggan C, Stein R
Quality, spending, utilization, and outcomes among dual-eligible Medicare-Medicaid beneficiaries in integrated care programs: a systematic review.
This review examined the impact of integrated care plans (ICPs) on health care spending, quality, utilization, and outcomes for dual-eligible Medicare-Medicaid beneficiaries. Analyzing 26 evaluations, the findings indicated that ICPs like PACE and FIDE-SNPs generally reduced long-term nursing home stays, while MMPs were linked to higher Medicare spending. Evidence on care coordination and patient satisfaction was mixed or insufficient, highlighting the need for further research to address these gaps and improve integrated coverage for dual-eligible beneficiaries.
AHRQ-funded; HS029453.
Citation: Roberts ET, Duggan C, Stein R . Quality, spending, utilization, and outcomes among dual-eligible Medicare-Medicaid beneficiaries in integrated care programs: a systematic review. JAMA Health Forum 2024 Jul 5; 5(7):e242187. doi: 10.1001/jamahealthforum.2024.2187..
Keywords: Medicare, Medicaid, Outcomes, Healthcare Costs, Healthcare Delivery
Chandanabhumma PP, Swaminathan S, Cabrera LM
Enhancing qualitative and quantitative data linkages in complex mixed methods designs: illustrations from a multi-phase healthcare delivery study.
This article described refining strategies to enhance the linkage between qualitative and quantitative dimensions of a mixed methods healthcare delivery research study. These strategies used mediating allocation concealment to facilitate qualitative sampling, informing qualitative inquiry through quantitative analytics, and training multidisciplinary researchers in qualitative data collection and analysis. They concluded that the development and implementation of strategies in mixed methods healthcare delivery research could advance methodological rigor and strengthen multidisciplinary collaboration.
AHRQ-funded; HS026003.
Citation: Chandanabhumma PP, Swaminathan S, Cabrera LM . Enhancing qualitative and quantitative data linkages in complex mixed methods designs: illustrations from a multi-phase healthcare delivery study. J Mix Methods Res 2024 Jul; 18(3):235-46. doi: 10.1177/15586898241257549..
Keywords: Healthcare Delivery, Health Services Research (HSR), Research Methodologies
Chou R, Herman E, Ahmed A
Long COVID definitions and models of care : a scoping review.
The authors performed a scoping review on definitions of long COVID to provide an overview of care models and to propose a framework to describe and distinguish models. Seven characteristics provided the framework: home department or clinical setting, clinical lead, collocation of other specialties, primary care role, population managed, use of teleservices, and whether the model was practice- or systems-based. Using this framework, the authors identified ten representative practice-based and three systems-based models of care.
AHRQ-funded; 75Q80120D00006.
Citation: Chou R, Herman E, Ahmed A . Long COVID definitions and models of care : a scoping review. Ann Intern Med 2024 Jul; 177(7):929-40. doi: 10.7326/m24-0677..
Keywords: COVID-19, Healthcare Delivery
Weaver SJ, Breslau ES, Russell LE
Health-care organization characteristics in cancer care delivery: an integrated conceptual framework with content validation.
This article introduces a new framework for identifying organizational characteristics relevant to cancer care delivery research. The authors developed this framework by synthesizing concepts from health services, organizational behavior, and management science. To refine their approach, they conducted a systematic review of existing literature and incorporated input from key informants in the field. The proposed framework serves as a tool to organize current research and guide future studies in cancer care delivery. It aims to help researchers identify and examine crucial organizational factors that may influence cancer outcomes at various levels, from individual patients to entire healthcare systems. This work builds upon previous efforts, including a 2012 National Cancer Institute monograph, and complements ongoing initiatives to stimulate research on the relationships between cancer outcomes and contextual factors. By providing this conceptual groundwork, the authors seek to address an understudied area in cancer research and enhance understanding of how organizational characteristics impact care delivery across the cancer continuum.
AHRQ-funded; 75Q80120D00003.
Citation: Weaver SJ, Breslau ES, Russell LE . Health-care organization characteristics in cancer care delivery: an integrated conceptual framework with content validation. J Natl Cancer Inst 2024 Jun 7; 116(6):800-11. doi: 10.1093/jnci/djae048.
Keywords: Cancer, Healthcare Delivery
Janczewski LM, Chandrasekaran A, Abahuje E
Barriers and facilitators to end-of-life care delivery in ICUs: a qualitative study.
This qualitative study explored frontline ICU clinicians' perceptions of end-of-life care delivery in intensive care units. The research team conducted 27 semi-structured interviews with various ICU clinicians across seven ICUs in three hospitals within an integrated academic health system. Using thematic analysis anchored on the Systems Engineering Initiative for Patient Safety model, the researchers identified four main themes that acted as barriers or facilitators to end-of-life care. First, work system barriers were found to delay end-of-life care communication among clinicians and between clinicians and families. Second, the study revealed significant clinician-level variability in end-of-life communication tasks. Third, the researchers identified misalignment between clinician, family, and patient priorities or treatment goals as a barrier. Conversely, regular discussions and joint decision-making facilitated greater family confidence in the end-of-life care delivery process. The fourth theme highlighted clinician moral distress resulting from providing nonbeneficial care. Interviewees reported that standardized end-of-life care discussion processes, involving patients, families, and clinicians, were fundamental to delivering end-of-life care that reduced both patient and family suffering, as well as clinician moral distress.
AHRQ-funded; HS027724.
Citation: Janczewski LM, Chandrasekaran A, Abahuje E . Barriers and facilitators to end-of-life care delivery in ICUs: a qualitative study. Crit Care Med 2024 Jun; 52(6):e289-e98. doi: 10.1097/ccm.0000000000006235..
Keywords: Intensive Care Unit (ICU), Healthcare Delivery, Palliative Care
Kimpel CC, Myer EA, Cupples A A
Identifying barriers and facilitators to Veterans Affairs Whole Health Integration using the updated consolidated framework for implementation research.
This study examined the Veteran Affairs (VA) Whole Health Integration System initiative across VA sites with approaches to implementation varying by site. The authors used the Consolidated Framework for Implementation Research (CFIR) to synthesize systemic barriers and facilitators to Veteran use with the initiative. Advanced fellows from 11 VA Quality Scholars sites performed the initial data collection. The final report included CFIR-organized results from six sites. Cost, complexity, offerings, and accessibility were key innovation findings. They also found inner setting barriers and facilitators including relational connections and communication, compatibility, structure and resources, learning centeredness, and information and knowledge access. Results regarding individuals included innovation deliverers, implementation leaders and team, and individual capability, opportunity, and motivation to implement and deliver whole health care.
AHRQ-funded; HS026122.
Citation: Kimpel CC, Myer EA, Cupples A A . Identifying barriers and facilitators to Veterans Affairs Whole Health Integration using the updated consolidated framework for implementation research. J Healthc Qual 2024 May-Jun; 46(3):137-49. doi: 10.1097/jhq.0000000000000419..
Keywords: Implementation, Quality Improvement, Healthcare Delivery, Quality of Care
Nkodo AF, Gonzalez MM, Reves S
Telemedicine adoption during COVID-19 pandemic: perspectives from primary care clinicians in safety-net settings.
This study described the facilitators and barriers of telemedicine during the COVID-19 pandemic for primary care clinicians in safety-net settings. The authors selected 5 surveys fielded between September 2020 and March 2023 from the national "Quick COVID-19 Primary Care Survey" by the Larry A. Green Center, with the Primary Care Collaborative. They used an explanatory sequential mixed method approach. They compared safety-net practices (free & charitable organization, federally qualified health center (FQHC), clinics with a 50% or greater Medicaid) to all other settings. They discussed: 1) telemedicine services provided; 2) clinician motivations; 3) and telemedicine access. All clinicians were similarly motivated to implement telemedicine, but safety-net clinicians were more likely to report use of phone visits. These clinicians felt less "confident in my use of telemedicine" (covariate-adjusted OR = 0.611) and were more likely to report struggles with televisits in March 2023 (covariate-adjusted OR = 1.73), particularly with physical examinations. Safety-net clinicians were more likely to endorse reductions in no-shows (covariate-adjusted OR = 1.77).
AHRQ-funded; HS028253.
Citation: Nkodo AF, Gonzalez MM, Reves S . Telemedicine adoption during COVID-19 pandemic: perspectives from primary care clinicians in safety-net settings. J Am Board Fam Med 2024 May-Jun; 37(3):409-17. doi: 10.3122/jabfm.2023.230339R1..
Keywords: Telehealth, Health Information Technology (HIT), COVID-19, Primary Care, Healthcare Delivery
Meille G, Koch T, Wendling B
大象APPAuthor: Meille G, Zuvekas S
The consequences of firm scope and scale on patient access to healthcare.
The objective of this study was to quantify changes in the market structure of primary care physicians and to examine its relationship with access to care. Researchers created measures of market structure from a 5% sample of Medicare fee-for-service claims and examined access to care using MEPS data. The findings showed that respondents in highly concentrated ZIP codes were less likely to report having access to immediate care than respondents in unconcentrated ZIP codes; the association was largest among Medicaid beneficiaries. No association between HHI and indicators for having a usual source of care and annual checkups were found. Multispecialty market share was negatively associated with checkups, but not other measures of access.
AHRQ-authored.
Citation: Meille G, Koch T, Wendling B . The consequences of firm scope and scale on patient access to healthcare. Health Serv Res 2024 Apr; 59(2):e14228. doi: 10.1111/1475-6773.14228..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Healthcare Delivery, Medicare

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