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Biomedical subjects

S Stearns

Publications and source records attributed to S Stearns.

5 recordsLinked to original sources
PubMed1996

Do physicians cost shift?

This study analyzes whether physicians charge their privately insured patients more-a practice known as cost shifting-in response to Medicare payment reductions. As part of congressional legislation in 1989 and 1990, Medicare reduced its payment rates for selected procedures by as much as 30 percent. Here we examine whether reductions in Medicare rates increase how much physicians charge privately insured patients. Our data provide no evidence that physicians respond to Medicare payment reductions by shifting costs to their privately insured patients.

Aged↗
PubMed1991

Prevention and early detection activities in primary care: new directions for implementation.

Physicians in primary care generally do not perform recommended prevention and early detection services. Many factors influence the utilization of these services; however, often not considered and/or well understood is the very process whereby these services are adopted within the primary care setting. Understanding the process, and factors affecting the process, suggest new directions for designing and implementing effective intervention strategies which increase the use of such services. New directions include the importance of identifying a discrepancy between what the practice is doing vis-à-vis what it should be doing as the first stage in the adoption process; the identification of the particular stage within the overall adoption process which best characterizes the practice and tailoring specific interventions to the requirements of that stage; emphasizing the reshaping of work actually performed within the practice beyond simply changing knowledge and attitudes of physicians and support personnel; recognition that there is a changing set of expectations to which the practice is at risk to be held accountable in any litigation; and finally that the interventions have realistic time expectations.

Health Services Administration↗
PubMedDate not supplied

Analysis of chronic emergency department use.

This retrospective emergency department (ED) chart review study examined the relationship between acuity level and the type of insurance in a patient population who used the ED on a chronic basis (seven or more times in the calendar year 1996). Of 1,185 patients seen in the ED in 1996, 122 had between 7 and 29 visits. In the study population: 62.5% of their visits were classified as nonurgent; 42.6% of the nonurgent visits were made by those with insurance; the highest frequency of visits took place between 8:00 am and 4:00 pm when most alternative nonemergency facilities are open. Some of the factors seen as influencing overuse of the ED include: the fact that some chronic use appeared to be associated with psychiatric conditions including substance abuse and patients with recurrent chest pain; and patient's perceptions that access to lab and X-ray facilities are readily available within the ED.

Adolescent↗