HEALTH INSURANCE INFORMATION-SEEKING BEHAVIORS AMONG INTERNET USERS: AN EXPLORATORY ANALYSIS TO INFORM POLICIES.

The purpose of this study was to explore characteristics of Internet users who seek health insurance information online, as well as factors affecting their behaviors in seeking health insurance information. Secondary data analysis was conducted using data from the 2012 Pew Internet Health Tracking Survey. Of 2,305 Internet user adults, only 29% were seeking health insurance information online. Bivariate analyses were conducted to test differences in characteristics of those who seek health insurance information online and those who do not. A logistic regression model was used to determine significant predictors of health insurance information-seeking behavior online. Findings suggested that factors such as being a single parent, having a high school education or less, and being uninsured were significant and those individuals were less likely to seek health insurance information online. Being a family caregiver of an adult and those who bought private health insurance or were entitled to Medicare were more likely to seek health insurance information online than non-caregivers and the uninsured. The findings suggested the need to provide quality health insurance information online is critical for both the insured and uninsured population.

Cost structure of osteopathic hospitals and their local counterparts in the USA: are they any different?

Due to the emphasis on preventive care and less invasive solutions to medical problems, osteopathic hospitals may deliver cost efficient and cost effective care. This study examines the cost structure of osteopathic hospitals and compares their performance to a local control group selected from allopathic hospitals. Osteopathic hospitals are identified in the 1999 American Hospital Association (AHA) data and matched to local allopathic hospitals with respect to location, bed size, system, for-profit and teaching status. Cost functions are estimated for both groups of hospitals, and significant differences in input, output and costs are highlighted. Results show that osteopathic hospitals are more costly and less productive in comparison to their counterparts. Inefficient production of outpatient services and high cost of medical education are two reasons for the poor performance. The study has important policy implications on two fronts: first, osteopathic hospitals are more costly to operate than their counterparts, and subsequently this requires further analysis of the osteopathic treatments and techniques. In an environment where health care revenues are shrinking and costs are rising, this is probably much needed information for osteopathic hospitals. Secondly, there is an emerging concern among osteopathic medical schools and osteopathic physicians due to the declining number of osteopathic hospitals, which translates to a smaller number of residency positions for osteopathic medical school graduates. Analyzing cost, input and output variables reveal some of the contributing factors to the decline of osteopathic hospitals and help preserve this rich tradition.

Access to quality health services: determinants of access.

Access to health care has been the focus of national health policy in recent years, but little attention has been given to local communities and their access issues. This study offers a conceptual framework and an empirical analysis to identify the independent effect of predisposing, enabling, and medical need factors on access to care in a local community. In addition, access limitations related to the health plan and individual providers are incorporated into the access model. A hierarchical logistic regression is used in which the dichotomous dependent variable-residents' overall satisfaction with access to health care is regressed on five blocks of predictor variables. The most influential variables on access are enabling and health plan variables.

Strategies for more efficient performance through hospital merger.

This article compares the operating performance of merged and non-merged local hospitals during the late 1980s and early 1990s, a period not unlike that being experienced in hospitals today. A matched case-control design is employed to create "synthetically" merged hospitals--to represent them as if they had effected a merger--and compares their performance to a group of similar hospitals that did merge.