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Azen, S.P., Palmer, J.M., Carlson, M., and others (1999, May). "Psychometric properties of a Chinese translation of the SF-36 health survey questionnaire in the well elderly study." (Interagency agreement AG11810). Journal of Aging and Health 11(2), pp. 240-251.

More than 80 percent of Chinese elders in the United States were born abroad, and the majority are not fluent in English. This has led to their isolation and reduced access to health care and other services. This study shows that the 36-item Short Form Health Survey (SF-36), a health status questionnaire, can be used to assess multiple dimensions of health in older Chinese adults. The researchers used translation and back-translation procedures to obtain appropriate meanings for the SF-36 survey questions and to ensure face, functional, and conceptual equivalence. Moreover, because there is only one written Chinese language, this translation of the SF-36 can be administered to both Mandarin and Cantonese speakers.

Bradley, E.H., and Rizzo, J.A. (1999, April). "Public information and private search: Evaluating the Patient Self-Determination Act." (National Research Service Award training grant T32 HS00052). Journal of Health Politics, Policy and Law 24(2), pp. 239-273.

Substantial regulatory efforts have been made by Government agencies and within the health care sector to improve consumer information regarding health and health care. Yet little is known about the impact of such efforts on consumer behavior. This paper examines the effect of Federal legislation—the Patient Self-Determination Act—to enhance consumer information regarding the use of life-sustaining technology in end-of-life medical treatment decisionmaking. The researchers used a unique set of data abstracted from the medical records of 600 elderly patients in nursing homes. They found that the law substantially improved documentation of patient wishes for end-of-life medical care. Further, the data revealed that the effect of the law varied among identifiable subgroups. The authors note that individuals who benefited most from these regulatory efforts were those who most needed the information but would have found it costly to search for and obtain the information on their own.

Coyle, Y.M., and Battles, J.B. (1999). "Using antecedents of medical care to develop valid quality of care measures." (AHCPR grant HS09461). International Journal on Quality of Health Care 11(1), pp. 5-12.

Past studies assessing patient outcomes have not consistently demonstrated a correlation between the processes and the outcomes of care. This was probably because these studies lacked the inclusion of medical care antecedents (primarily patient and environmental risk factors) that had a significant influence on the outcomes measured, according to the authors of this study. They present a new model for using the antecedents of medical care in outcomes assessment to develop valid quality of care measures. They believe the model advances quality of care measure development by using qualitative research to characterize as many of the pertinent antecedents of medical care as possible. These in turn can then be used to develop risk-adjustment models for measuring outcomes, which are more apt to identify the true linkages between the processes and outcomes of care.

Manski, R.J., Moeller, J.F., and Maas, W.R. (1999, April). "Dental services: Use, expenditures, and sources of payment, 1987." Journal of the American Dental Association 130, pp. 500-508.

Dental expenditures have increased by almost $45 billion during the past 35 years. Despite advances in preventive dentistry, dental disease continues to be a substantial health problem. Although the dental care market is substantial, many Americans did not visit a dentist in 1987, according to this study. The researchers analyzed household data from the 1987 National Medical Expenditure Survey to examine use of dental services. They found that less than 50 percent of Americans visited a dental office during 1987. Americans made about 292 million dental visits and received about $30 billion worth of dental care, of which $10 billion was paid by insurers, $17 billion was paid out of pocket, and $1.6 billion was not reimbursed. The type of care received varied among people in distinct socioeconomic and demographic groups. Reprints (AHCPR Publication No. 99-R070) are available from AHCPR.

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AHCPR Publication No. 99-0038
Current as of August 1999

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