Research Briefs

Cummings, S.M., Savitz, L.A., and Konrad, T.R. (2001, February). "Reported response rates to mailed physician questionnaires." (AHRQ grant HS06745). Health Services Research 35(6), pp. 1347-1355.

The mailed questionnaire is probably the most frequently used method used by health services researchers to survey physicians. Mailed surveys are less costly than other alternatives, such as telephone surveys and face-to-face interviews. However, they tend to result in lower response rates. These investigators examined a random sample of studies from 1986 through 1995 on physician responses to written questionnaires. They found that the average response rate was 61 percent (52 percent for large sample surveys). Only 44 percent of the abstracted articles reported a discussion of survey response bias, and only 54 percent reported any type of followup. The researchers conclude that physician response rates to mailed questionnaires have remained somewhat constant over time, and that researchers need to document efforts to increase response rates to mailed questionnaires.

Dalton, K., Norton, E.C., and Kilpatrick, K. (2001, February). "A longitudinal study of the effects of graduate medical education on hospital operating costs." (AHRQ National Research Service Award training grant T32 HS00032). Health Services Research 35(6), pp. 1267-1291.

These researchers used Medicare cost and payment data from FY 1989 through FY 1995 for all short-stay hospitals receiving case payments from Medicare based on diagnosis-related groups (DRGs) to examine the effect of graduate medical education sponsorship on hospital operating costs over a 7-year period. They wanted to test for a longitudinal association between teaching intensity and cost and to determine whether the indirect medical education (IME) payment adjustments made under Medicare's Prospective Payment System were appropriate. They found no evidence of a significant within-hospital association between increased sponsorship of medical residents and increased cost per case. Operating costs were positively related to teaching activity, but the association showed a decline in strength over time. The researchers conclude that longitudinal models do not provide evidence to support a payment adjustment formula that allows individual hospitals to recompute their IME adjustment rates as their teaching ratios rise or fall from year to year. Re-estimations of the teaching effect may be appropriate after significant improvements in Medicare case-mix measurement.

Ostrove, J.M., Adler, N.E., Kuppermann, M., and Washington, A.E. (2000). "Objective and subjective assessments of socioeconomic status and their relationship to self-rated health in an ethnically diverse sample of pregnant women." (AHRQ grant HS07373). Health Psychology 19(6), pp. 613-618.

The relationship between socioeconomic status (SES) and health is strong and well-established. However, very few studies have explored the relationship between subjective SES (how individuals perceive their SES) and health. In this study, the investigators examine a new measure of subjective SES in relation to self-rated physical health among an ethnically diverse group of pregnant women. Except among blacks, subjective SES was significantly related to education, household income, and occupation. Subjective SES was significantly related to self-rated health among all groups. After accounting for the effects of subjective SES on health, objective indicators made no additional contribution to explaining health among white and Chinese-American women. However, household income continued to predict health after accounting for subjective SES among Hispanic and black women.

Stewart, M.G., Friedman, E.M., Sulek, M., and others. (2001, January). "Validation of an outcomes instrument for tonsil and adenoid disease." (AHRQ grant HS09829). Archives of Otolaryngology and Head and Neck Surgery 127, pp. 29-35.

The benefits of adenotonsillectomy, a frequently performed pediatric surgery that removes both the tonsils and adenoids, are still much debated. Further research is needed to better define the effects of this surgery on the health status and quality of life (QOL) of affected children. There are few validated instruments available that measure global QOL in children, and there are no instruments that measure disease-specific health status in children with tonsil and adenoid disease. These researchers designed and validated a disease-specific health status instrument, the Tonsil and Adenoid Health Status Instrument, in 224 children with the disease. Factor analysis confirmed six distinct subscales measuring different constructs of disease-specific health status that are affected by tonsil and adenoid disease: eating and swallowing, airway and breathing, infections, health care use, cost of care, and behavior. For each subscale, the instrument demonstrated excellent test-retest reliability and internal consistency. Construct validity and criterion validity were satisfactory, and the instrument was appropriately sensitive.

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Current as of April 2001
AHRQ Publication No. 01-0028