There is an increasing demand for acute care services due in part to rising proportions of older people and increasing rates of chronic diseases. To reduce pressure and costs in the hospital system, community-based post-acute care discharge services for older people have evolved as one method of reducing length of stay in hospital and preventing readmissions. However, it is unclear whether they...

BACKGROUND Asthma education and action plans (AP) have been recognized as important components in the optimal management of asthma. Studies have differed on the importance of a peak flow-based self-management plans in reducing health care costs and use due to asthma exacerbation. OBJECTIVE To analyze the cost-effectiveness of peak flow-based action plans in reducing costs associated with ER v...

OBJECTIVE Nulliparous women are frequently hospitalized for treatment of pelvic inflammatory disease (PID). GOAL The goal of this study was to determine the economic feasibility of hospitalizing adolescents and young women for PID. STUDY DESIGN The authors conducted a Markov decision model, estimating the cost-effectiveness of hospitalization compared with outpatient therapy for mild to mod...

In the Medicare program, increases in cost sharing by a supplemental insurer can exert financial externalities. We study a policy change that raised patient cost sharing for the supplemental insurer for retired public employees in California. We find that physician visits and prescription drug usage have elasticities that are similar to those of the RAND Health Insurance Experiment (HIE). Unlik...

OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patien...

OBJECTIVE To characterize the frequency, cost, and hospital-reported outcomes of cachexia and debility in children and adolescents with complex chronic conditions (CCCs). METHODS We identified children and adolescents (aged ≤20 years) with CCCs, cachexia, and debility in the Kids' Inpatient Database [Healthcare Cost and Utilization Project, Agency for Healthcare Research & Quality]. We then c...

As the patient-centered medical home model emerges as a key vehicle to improve the quality of health care and to control costs, the experience of Seattle-based Group Health Cooperative with its medical home pilot takes on added importance. This paper examines the effects of the medical home prototype on patients' experiences, quality, burnout of clinicians, and total costs at twenty-one to twen...

BACKGROUND Diabetes mellitus is a serious, costly and growing public health problem. Very few studies have been published on the economic impact of diabetes in Israel. OBJECTIVE To estimate health fund expenditures and rates of hospitalization for general conditions among the diabetic population in Israel. METHODS The total number of hospitalizations in Israel in 1998 of beneficiaries of th...