Health Care Quality

"Improving Health Care Quality Reporting: Lessons from the California HealthCare Foundation." Beth Stevens, Tim Lake, and Erin Fries Taylor, December 2006. The California HealthCare Foundation has devoted substantial resources to promoting public reporting on the quality of California hospitals, physician groups, and nursing homes. Mathematica conducted an evaluation of the foundation's work from 1998 through 2005, identifying lessons from its experience in fostering quality information and exploring avenues for future foundation involvement in the field. This brief looks at the measurement and reporting activities funded and how they changed over time; factors that contribute to the evolution of quality strategies; and the role that regional, state, and local foundations can play in the development of accurate and useful quality measurement and reporting systems.

Health Literacy

"Estimating the Proportion of Health-Related Websites Disclosing Information That Can Be Used to Assess Their Quality."

Pediatric Obesity

"Commentary: Should I Blame Mom or Dad? Identifying the Relative Contribution of Each Parent’s Body Size to That of Their Offspring." Robert C. Whitaker, International Journal of Epidemiology, February 2007. The author responds to an article that proposes a mechanism to statistically test the difference in the relative contribution of the size of each parent to a child’s birth weight and rate of weight gain during infancy—two factors associated with the development of obesity—urging care in applying the study’s methodological innovation. Epidemiological research that assigns a relative contribution of each parent to a child’s weight poses the risk that some might use this information to split parents over an issue on which they need to be united in support of their child. The author also cautions that as researchers make advances in epidemiological research, they should remain vigilant about unintended harms.

Health Care Spending

"Impact of Influenza Immunization on Medical Expenditures Among Medicare Elderly, 1999-2003." Boyd H. Gilman, Arthur J. Bonito, and Celia Eicheldinger, American Journal of Preventive Medicine, February 2007. This study examines the impact of influenza immunization on medical expenditures for acute and chronic respiratory conditions among elderly Medicare beneficiaries between 1999 and 2003. The study advances the literature by using self-reported survey data from the fee-for-service module of the Medicare Consumer Assessment of Health Plans Survey, linked with respondents’ Medicare claims for inpatient, outpatient, and professional services. The researchers found that total expenditures were lower among the immunized population during all four annual influenza seasons. The amount and statistical significance of the savings varied with the severity of the virus and the vaccine match to the prevalent influenza strains. The relative reduction in expenditures among vaccinated beneficiaries is attributable to less frequent use of inpatient services. The authors conclude that in addition to improving the health of older Americans, meeting the Healthy People 2010 influenza immunization goal of 90 percent among the elderly should also result in lower Medicare expenditures.