From: Annette_Schwabe@dcf.state.fl.us
To: MedSoc@csf.colorado.edu, Phil_Brown@brown.edu
Message-ID: <8525648E.004DD7DE.00@notesmta.dcf.state.fl.us>
Date: Mon, 5 May 1997 09:55:29 -0400
Subject: Re: research help for Canadian colleague
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I second the idea of asking providers about their patient mix in terms of
payer type and proportion "indigent" and uninsured.  These providers should
have, via the hospital or local governmental health agency, relatively easy
access to a breakdown of recipient/patient mix. I am not sure that asking
providers to get those data would enhance your return rate, but you could
put in a comment such as "based on your hospital's reporting data or your
best estimate."

Also, you ,as the surveyors, could get the data from local governmental
reporting agencies by provider.  For example, the Agency for Health Care
Administration in the state of Florida might have data like that for the
entire state, and there are likely corresponding instituitions in each of
the other states.
Best of luck.  Annette Schwabe  annette_schwabe@dcf.state.fl.us

______________________________ Reply Separator ____________________________
_____
Subject: research help for Canadian colleague
Author:  Phil_Brown@brown.edu at INTERNET-MAIL
Date:    5/2/1997 7:41 PM


A Canadian colleague has a request for help with a reserach questionnaire.
I am forwarding his request to MEDSOC in the hopes that some people may
have some ideas for him.  Reply directly -to him- not to the whole list.
His email address is at the end.

-Phil

------------

I'm a Canadian sociologist working in a clinical epidemiology unit. We are
about to survey amercian and canadian emergency physicians about
their attitudes toward radiographic clinical decision rules.

The use of these rules have been shown in prospective implementation
studies to reduce the the ordering of xrays without missing fractures. I
believe that for the American emergency physicians, there may be
considerable economic incesntive to use the rules in managemed care
institutions to save money and disincentive to use the rule in insitutions
generating profit from the ordering xrays. Unfortunately none of us know
enough about he US health system to know what we want to ask respondents.

This is the question we have come up with, does the question seem
reasonable and are the response categories appropriate?

In what type of hosptial do you practice Emergency mediicine?
private for profit
private not for profit
managed care owned (eg HMO)
municipla (city or county)
private not for profit
public academic medical center
private academic medical center
federal Governement (eg military, VA)
other__________________

Some of my colleagues have suggested asking the respodnet to estimate the %
of emergency department patients insured by: public/federal payer, state
payer, managed care, private insurance, unisured

Is this a better approach? Would respodents know this?

Should we ask if the respondent is salaried or fee for service?

Any thoughts you might have or suggestions about who I should contact who
might be helpful are greatly appreciated.

ian graham
Clincial Epidemiology Unit
Ottawa Civic Hosptia
ph:613-798-5555 x8273
fax:613-761-5492l

igraham@civich.ottawa.on.ca
Phil Brown, Ph.D.
Professor of Sociology
Brown University
Box 1916
Providence RI 02912
(401) 863-2633 (secretary 863-2367)
fax (401) 863-3213