This study estimates a fixed effects ordered logit model physician office visit billing using claims data from South Carolina Medicaid and the State Employees Health Plan. The results find code creep increasing expenditures on physician office visits at a rate of 2.2 percent annually for both programs, with no significant difference in the rate between the two. The models also indicate that phy...

OBJECTIVES We assessed the impact of interpreter services on the cost and the utilization of health care services among patients with limited English proficiency. METHODS We measured the change in delivery and cost of care provided to patients enrolled in a health maintenance organization before and after interpreter services were implemented. RESULTS Compared with English-speaking patients...

OBJECTIVE To estimate the average number of outpatient visits, emergency department visits, and hospitalizations for injured patients. METHODS The Medical Expenditure Panel Survey Household Component of 1996 is a weighted sample designed to represent the United States population. For each episode of injury the average number of office visits or outpatient contacts, emergency department visits...

BACKGROUND Children may fall behind on preventive services because they do not receive needed services at the time of an office visit (a missed opportunity). However, methods are needed to measure problems in the care delivery process that lead to missed opportunities. We developed a method to examine the key steps in the preventive service delivery process and identify problems; we assessed th...

School nurses cite barriers to collecting comprehensive data on the care they provide. This study evaluated the feasibility of collecting school nurse data on selected child health and education outcomes. Outcome variables included school health office visits; health provider, parent, and staff communication; early dismissal; and medications administered. On an average day, the school nurses ca...

OBJECTIVE To determine if the belief that thirdhand smoke is harmful to children is associated with smoking parents' attitudes, home or car smoking policies, and quitting behaviors. METHODS Data from a national randomized controlled trial, Clinical Effort Against Secondhand Smoke Exposure, assessed thirdhand smoke beliefs of 1947 smoking parents in an exit survey after a pediatric office visi...

CONTEXT Using a patient and clinician educational intervention, we successfully reduced antibiotic use for uncomplicated acute bronchitis. The impact of this intervention on patient satisfaction is not known. OBJECTIVE To evaluate whether a strategy for reducing antibiotic use in acute bronchitis affects satisfaction among adult patients. DESIGN Telephone survey administered 1 to 4 weeks af...

Learning to ride a bicycle and enjoying the pleasures of cycling are synonymous with childhood; unfortunately, cycling does not come without risk of serious injury. Children under 15 years old account for the majority of cycling time in the United States, and on average, 1 child dies every day from a bicycle-related injury. Health care professionals can play an important role in making cycling ...

BACKGROUND AND OBJECTIVE Recent years have witnessed substantial gains in health insurance coverage for children, but few studies have examined trends across a diverse set of access indicators. We examine US children's access to health services and whether trends vary by race/ethnicity and income. METHODS Analysis of 178 038 children ages 0 to 17 from the 2000 to 2014 National Health Intervie...

CONTEXT Many clinicians have called for an increased emphasis on the patient's role in clinical decision making. However, little is known about the extent to which physicians foster patient involvement in decision making, particularly in routine office practice. OBJECTIVE To characterize the nature and completeness of informed decision making in routine office visits of both primary care phys...