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Essays on cardiologists' behavior: M...

Hu, Teng-yuan.

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Essays on cardiologists' behavior: Medical variations, impact of PSROs, and response to PPS.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Essays on cardiologists' behavior: Medical variations, impact of PSROs, and response to PPS./
Author:	Hu, Teng-yuan.
Description:	126 p.
Notes:	Source: Dissertation Abstracts International, Volume: 57-04, Section: A, page: 1750.
Contained By:	Dissertation Abstracts International57-04A.
Subject:	Economics, General. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9627322

Essays on cardiologists' behavior: Medical variations, impact of PSROs, and response to PPS.
Hu, Teng-yuan.

Essays on cardiologists' behavior: Medical variations, impact of PSROs, and response to PPS. - 126 p.

Source: Dissertation Abstracts International, Volume: 57-04, Section: A, page: 1750.

Thesis (Ph.D.)--University of Rochester, 1996.

This dissertation examines three issues regarding how cardiologists behave: medical variations, the impact of the Professional Standards Review Organizations (PSROs), and the response to the Prospective Payment System (PPS). It develops and uses econometric techniques and economic models.Subjects--Topical Terms:

1017424
Economics, General.

Essays on cardiologists' behavior: Medical variations, impact of PSROs, and response to PPS.
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100 1 $a Hu, Teng-yuan. $3 1685303
245 1 0 $a Essays on cardiologists' behavior: Medical variations, impact of PSROs, and response to PPS.
300 $a 126 p.
500 $a Source: Dissertation Abstracts International, Volume: 57-04, Section: A, page: 1750.
500 $a Supervisor: Charles E. Phelps.
502 $a Thesis (Ph.D.)--University of Rochester, 1996.
520 $a This dissertation examines three issues regarding how cardiologists behave: medical variations, the impact of the Professional Standards Review Organizations (PSROs), and the response to the Prospective Payment System (PPS). It develops and uses econometric techniques and economic models.
520 $a It begins with examining the variations in hospital admission rates for atherosclerosis in New York State by testing for the random effects, conditional on population and policy characteristics. The admission rates for those counties with large population levels are more stable than those with small population levels. By taking this feature into account, it derives a Lagrange multiplier statistic, which is based on the residuals from weighted least squares, for testing whether the variance of random effects reduces to zero. The results show that the medical variations are indeed real for cardiologists in New York State.
520 $a The significance of medical variations disappears when it adds the dummy variables for the PSROs to the model. The results of testing whether the practice patterns are different across counties within the first eight PSRO areas show that medical variations do not appear within each of those PSRO areas. Among the areas of the PSROs, the lowest net admission rates during the testing period (1986-1989), taking population and policy characteristics into account, persistently appeared in the Albany area, which includes the capital of New York State; the highest net admission rates persistently appeared in the Buffalo area, which is in western New York. The evidence supports the hypothesis that the farther a PSRO area was away from the Albany County, the capital of New York, the higher the net admission rate was. The medical variations hence reflected differences in implementation of the law.
520 $a It also constructs a model to demonstrate the possibility that, in response to PPS, hospitals relabel two similar types of discharges, and it takes heart disease as evidence. By examining specific categories of heart disease, it shows that cardiologists may have helped their hospitals relabel the cases of angina pectoris (ICD-9-CM 413) as other forms of chronic ischemic heart disease (ICD-9-CM 414) so that their hospitals may receive more reimbursement.
590 $a School code: 0188.
650 4 $a Economics, General. $3 1017424
650 4 $a Health Sciences, Medicine and Surgery. $3 1017756
650 4 $a Health Sciences, Health Care Management. $3 1017922
690 $a 0501
690 $a 0564
690 $a 0769
710 2 $a University of Rochester. $3 515736
773 0 $t Dissertation Abstracts International $g 57-04A.
790 1 0 $a Phelps, Charles E., $e advisor
790 $a 0188
791 $a Ph.D.
792 $a 1996
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9627322