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Ambler, G., Royston, P., and Head, J. (2003). "Non-linear models for the relation between cardiovascular risk factors and intake of wine, beer and spirits." Statistics in Medicine 22, pp. 363-383.

Substantial evidence suggests that moderate consumption of alcohol is associated with reduced risk of coronary heart disease (CHD). However, it is not clear whether this benefit is derived by consuming a particular type of alcoholic drink, for example, wine. These authors propose two types of models designed to detect differential effects of beverage type on known CHD risk factors, such as cholesterol and blood pressure, using data from a large longitudinal study of British civil servants. The results suggest that gram for gram of alcohol, the effect of wine differs from that of beer and spirits, particularly for systolic blood pressure. In particular, increasing wine consumption was associated with slightly more favorable levels of all three risk factors studied: high density lipoprotein cholesterol, fibrinogen, and systolic blood pressure in men (only systolic blood pressure for women). Nevertheless, these findings are tentative, and the apparent benefit of consuming wine instead of other alcoholic beverages may be relatively small.

Cho, S-H. (2003, January). "Using multilevel analysis in patient and organizational outcomes research." Nursing Research 52(1), pp. 61-65.

A traditional approach to analyzing multilevel data has been to aggregate individual-level variables at the institutional level. However, multilevel modeling allows researchers to examine simultaneously the effect of individual-level as well as group-level predictors on the variable of interest. These researchers present a two-level model employing multilevel logistic regression analysis to examine the relationship between nurse staffing and the probability of pneumonia developing in patients after surgery. The level 1 model compared patients with pneumonia who were discharged from the same hospital. The level 2 model took into account the differences between hospitals and explained those differences in terms of hospital characteristics. Model 3 (the combined model) indicated that patient characteristics had strong relationships with risk for developing pneumonia. Contrary to previous studies, the combined model, which accounted for both individual and hospital differences, did not suggest that greater nurse staffing would reduce postsurgical pneumonia.

Farley, D.O., Elliott, M.N., Short, P.F., and others (2002, September). "Effect of CAHPS® performance information on health plan choices by Iowa Medicaid beneficiaries." Medical Care Research and Review 59(3), pp. 319-336.

This study examined whether Consumer Assessment of Health Plans Study (CAHPS®) information on health plan performance affected health plan choices by new beneficiaries in Iowa Medicaid. The investigators randomly assigned new cases entering Medicaid in selected counties during February through May 2000 to experimental or control groups. The control group received standard Medicaid enrollment materials, and the experimental group received these materials plus a CAHPS® report. The CAHPS® information did not affect health plan choices by Iowa Medicaid beneficiaries, similar to its impact on New Jersey Medicaid beneficiaries. However, CAHPS® information did affect plan choice in an earlier laboratory experiment. The value of this information may be limited to receptive consumers who actively study the information received, and even then, only when ratings of available plans differ greatly, ratings differ from prior beliefs about plan quality, and reports are easy to understand.

Jensvold, N.G., Lieu, T.A., Chi, F.W., and others (2003). "Strategies for surveying families of Medicaid-insured children by telephone." Journal of Health Care for the Poor and Underserved 14(1), pp. 17-22.

The growing use of managed care for impoverished Medicaid populations has raised concerns that quality of care will suffer due to cost-containment efforts. It is difficult to collect data from Medicaid-insured individuals about their quality of care, since they are very unresponsive to surveys. However, telephone interviewing can complete an acceptable rate of interviews with this group at a reasonable cost, concludes this study. The authors describe strategies used for locating families and completing telephone and mail surveys with parents of Medicaid-insured children in five health plans in a study of the quality of pediatric asthma care. They analyzed the proportion of completed interviews contributed by each strategy, stratified by health plan. Completed interviews required a median of five calls, using as many as seven different telephone numbers in some cases. Nevertheless, the researchers completed 1,889 interviews using 3,611 interviewer hours for a total interviewing cost of $67,792 and an average cost of $36 per completed interview.

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Current as of April 2003
AHRQ Publication No. 03-0031

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