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Agency for Healthcare Research Quality

Schnaier, Jenny

Authors: Steiner CA, Elixhauser A, and Schnaier J.
Title: The Healthcare Cost and Utilization Project: An Overview.
Publication: Effective Clinical Practice 5(3):143-51.
Date: 2002.
Abstract: Healthcare Cost and Utilization Project (HCUP)-a family of databases including the State Inpatient Databases (SID), the Nationwide Inpatient Sample (NIS), the Kids' Inpatient Database (KID), and the outpatient databases State Ambulatory Surgery Data (SASD) and State Emergency Department Data (SEDD). Multistate, inpatient (SID, NIS, KID) and outpatient (SASD, SEDD) discharge records on insured and uninsured patients. Partnership between the Agency for Healthcare Research and Quality (AHRQ) and public and private statewide data organizations. Selected data elements from inpatient and outpatient discharge records, including patient demographic, clinical, disposition and diagnostic/procedural information; hospital identification (ID); facility charges; and other facility information. Varies by database: NIS 1988-2000; SID 1995-2000; KID 1997 and 2000; SASD 1995-2000; and SEDD in pilot phase. Future data years anticipated for all datasets and back years for SID and SASD. UNITS OF ANALYSIS: Patient (in states with encrypted patient identification), physician, market, and state. Quality assessment, use and cost of hospital services, medical treatment variations, use of ambulatory surgery services, diffusion of medical technology, impact of health policy changes, access to care (inference), study of rare illness or procedures, small area variations, and care of special populations. Largest collection of all-payer, uniform, state-based inpatient and ambulatory surgery administrative data. Lacks clinical detail (e.g., stage of disease, vital statistics) and laboratory and pharmacy data. Ability to track patients across time and setting varies by state. Access available to all users who sign and abide by the Data Use Agreement. Application kits available at HCUPnet, an online interactive query tool, allows access to data without purchase (
Topics: Hospitals, Methods.

Authors: Carman K, Short P, Farley D, et al.
Title: Early lessons from CAHPS®: Demonstrations and evaluations.
Publication: Med Care 37(3 Suppl):MS97-MS105.
Date: 1999
Abstract: The main goal of the Consumer Assessments of Health Plans (CAHPS®) survey is to develop an integrated set of tested, standardized surveys to obtain meaningful information from health plan enrollees about their experiences. The CAHPS® project benefits from the complementary strengths of psychometric and cognitive testing. The CAHPS® team conducted 150 cognitive interviews across 3 organizations, in different geographic locations, using multiple interview methods with different consumer populations. This article explains how cognitive testing was used in the CAHPS® survey development process and shares the main findings across the cognitive interviews.
Topics: Methods, Purchasing.

Authors: Harris-Kojetin L, Fowler F, Schnaier J, et al.
Title: The use of cognitive testing for developing and evaluating CAHPS® survey items.
Publication: Med Care 37(3 Suppl):MS10-MS21.
Date: 1999
Abstract: The main goal of the Consumer Assessments of Health Plans (CAHPS®) survey is to develop an integrated set of tested, standardized surveys to obtain meaningful information from health plan enrollees about their experiences. The CAHPS® project benefits from the complementary strengths of psychometric and cognitive testing. The authors found that cognitive testing was integral in developing and refining the CAHPS® instrument. The cognitive testing findings contributed to an improved instrument that should capture consumers' health care and plan experiences with less response error than one not subjected to such testing.
Topics: Chronic Conditions, Medicaid, Medicare, Methods, Purchasing.

Authors: Schnaier J, Sweeny S, Williams W, et al.
Title: Special issues addressed in the CAHPS® survey of Medicare managed care beneficiaries.
Publication: Med Care 37(3 Suppl):MS69-MS78.
Date: 1999
Abstract: This article describes the process through which the Medicare Managed Care plan (MMC) survey was developed and examines issues in using this survey with Medicare beneficiaries that have implications for all CAHPS® surveys. These implications include the ability of Medicare beneficiaries to use MMC navigational features, whether access measures are meaningful for this population, and whether beneficiaries' familiarity with managed care influences their health plan assessments.
Topics: Managed Care, Medicare, Methods, Purchasing.

Authors: McCormack L, Garfinkel S, Schnaier J, et al.
Title: Consumer information development and use.
Publication: Health Care Financing Review 18(1):15-30.
Date: 1996
Abstract: The availability of informational materials to aid consumer health care purchasing decisions is increasing. Organizations developing and disseminating materials include public and private sector employers, agencies, counseling programs, and accreditation bodies. Based on case study interviews with 24 organizations, the authors learned that 10 organizations included consumer satisfaction ratings and performance measures based on medical developed materials with consumer satisfaction ratings exclusively. Printed materials were the most common medium used to convey information to consumers. However, other mechanisms for conveying the information were also employed. On the whole, the materials have not been rigorously evaluated. Evaluations are needed to determine if consumers find the information useful and how different individuals prefer to receive the information.
Topics: Methods, Purchasing.

Authors: McCormack L, Schnaier J, Lee A, et al.
Title: Medicare beneficiary counseling programs: What are they and do they work?
Publication: Health Care Financing Review 18(1):127-40.
Date: 1996
Abstract: Medicare beneficiaries face myriad rules, conditions, and exceptions under the Medicare program. As a result, State Information, Counseling, and Assistance (ICA) programs were established or enhanced with Federal funding as part of the Omnibus Budget Reconciliation Act (OBRA) of 1990. ICA programs use a volunteer-based and locally-sponsored support system to deliver free and unbiased counseling on the Medicare program and related health insurance issues. This article discusses the effectiveness of the ICA model. Because the ICA programs serve as a vital link between the Health Care Financing Administration (HCFA) and its beneficiaries, information about the programs' success may be useful to HCFA and other policymakers during this era of consumer information.
Topics: Medicare, Purchasing.

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