Bryan Dowd
Biographic Data
| ID | 5536598 |
|---|---|
| NAME | Bryan Dowd |
| GIVEN NAMES | Bryan |
| FAMILY NAME | Dowd |
| SIGNATURE | DOWD B |
| AFFILIATIONS | University of Minnesota |
| ORCID | 0000-0002-3384-5144 |
| VERIFIED | Yes |
| TOTAL WORKS | 18 |
| TOTAL CITATIONS | 4 |
| AUTHOR COUNT | 18 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1982 |
| LATEST PUBLICATION YEAR | 2022 |
| H-INDEX | 1 |
Analysis of Affordable Health Care
BACKGROUND: Lack of affordable health care affects the uninsured, commercially insured, and Medicare beneficiaries. Yet, the wide variation in providers' prices and practice styles suggests that more affordable care already may be available and data on low value and wasteful care suggest that lower cost care need not come at the expense of better quality. Although price variation has received the most attention in the literature and legislation, …
Marginal Effects—Quantifying the Effect of Changes in Risk Factors in Logistic Regression Models
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolary…
Log Odds and the Interpretation of Logit Models
OBJECTIVE: We discuss how to interpret coefficients from logit models, focusing on the importance of the standard deviation (σ) of the error term to that interpretation. STUDY DESIGN: We show how odds ratios are computed, how they depend on the standard deviation (σ) of the error term, and their sensitivity to different model specifications. We also discuss alternatives to odds ratios. PRINCIPAL FINDINGS: There is no single odds ratio; instead, a…
How Effective is Health Coaching in Reducing Health Services Expenditures
BACKGROUND: Health coaching interventions aim to identify high-risk enrollees and encourage them to play a more proactive role in improving their health, improve their ability to navigate the health care system, and reduce costs. OBJECTIVES: Evaluate the effect of health coaching on inpatient, emergency room, outpatient, and prescription drug expenditures. RESEARCH DESIGN: Quasiexperimental pre-post design. Health coaching participants were ident…
Interaction Terms in Nonlinear Models
OBJECTIVES: To explain the use of interaction terms in nonlinear models. STUDY DESIGN: We discuss the motivation for including interaction terms in multivariate analyses. We then explain how the straightforward interpretation of interaction terms in linear models changes in nonlinear models, using graphs and equations. We extend the basic results from logit and probit to difference-in-differences models, models with higher powers of explanatory v…
Predictors of Patients’ Perceived Need for Medication to Prevent Fracture
BACKGROUND: Adherence with medications to prevent fractures is suboptimal. Patients' perceived need for medication is an important predictor of medication-use behavior. OBJECTIVE: Estimate the associations of patients' perceived need of medication for fracture prevention with objective indicators of fracture risk, patients' concerns about medications, and the quality of the patient-physician relationship. RESEARCH DESIGN: Cross-sectional medical …
Quality-of-Life Weights for the US Population
BACKGROUND: Many of the large ongoing national surveys of the US population contain a question that asks for the respondent's self-reported health status: "excellent," "very good," "good," "fair," or "poor." These surveys could be used to conduct cost-utility analyses of health care policies, treatments or other interventions if quality-of-life (QOL) weights for the self-reported health statuses were also available. OBJECTIVE: The objective of th…
The Influence of the Structure and Culture of Medical Group Practices on Prescription Drug Errors
BACKGROUND: This project was designed to identify the magnitude of prescription drug errors in medical group practices and to explore the influence of the practice structure and culture on those error rates. Seventy-eight practices serving an upper Midwest managed care (Care Plus) plan during 2001 were included in the study. METHODS: Using Care Plus claims data, prescription drug error rates were calculated at the enrollee level and then were agg…
A Demand-Side View of Risk Adjustment
This paper analyzes the efficient allocation of consumers to health plans. Specifically, we address the question of why employers that offer multiple health plans often make larger contributions to the premiums of the high-cost plans. Our perspective is that the subsidy for high-cost plans represents a form of demand-side risk adjustment that improves efficiency. Without such subsidies (and in the absence of formal risk adjustment), too few emplo…
Some Observations about Risk Adjustment Research
Research on risk adjustment has made an important contribution to the health economics and health pol? icy literature. Currently, however, there is a pressing need for improved communication among research? ers and their readers. We suggest improvements in three areas: more precise terminology; agreement on some simple results; and clarification of the assump? tions underlying specific analyses. In this note, we make modest proposals for each are…
Time Off Work and the Postpartum Health of Employed Women
OBJECTIVES: Parental and maternity leave policies are a popular fringe benefit among childbearing employed women and a benefit employers frequently are required to offer. However, few rigorous evaluations of the effect of maternal leave on maternal health exist. METHODS: Using a hybrid of the household and health production theories of Becker and Grossman and a sample of women identified from state vital statistics records, a nonlinear relationsh…
Mammogram Utilization Among Farm Women
Utilization of preventive health care services is lower in rural populations than in urban populations, possibly as a result of barriers to preventive health care that are characteristic of rural settings. This study was conducted to identify factors associated with mammogram utilization among farm women. Mammogram utilization among farm women from six southern Minnesota counties was examined as part of a larger community‐based cancer interventio…
The impact of the 1987 federal regulations on the use of psychotropic drugs in Minnesota nursing homes
OBJECTIVES. The purpose of this study was to examine prevalence rates of psychotropic drug use by elderly nursing home residents 3 years before and 1 year after implementation of the 1987 Omnibus Budget Reconciliation Act drug regulations throughout the United States on October 1, 1990. METHODS. A cohort study was conducted of elderly nursing home residents, for each of 4 study years (approximately 33,000 residents per year), of all nursing homes…
Health Plan Choice in the Twin Cities Medicare Market
This paper examines the relationship between characteristics of Medicare beneficiaries and their choice of health plan in the Twin Cities during 1988. This analysis provides the first comparison of beneficiaries in the basic fee-for-service (FFS) Medicare sector (without a supplementary policy) to beneficiaries in the FFS sector with a supplementary policy, enrollees in independent practice associations (IPAs), and network health maintenance orga…
Specialty Differences in the ??July Phenomenon?? for Twin Cities Teaching Hospitals
This study evaluated changes over the academic year in the cost and the outcome of inpatient care to investigate the effect of housestaff experience in teaching hospitals. Patients with 25 preselected discharge diagnoses, admitted between January 1, 1983 and December 31, 1987 to acute-care, nonfederal, non-pediatric hospitals in the Minneapolis/St. Paul metropolitan area (total number available for analysis 240,467) were examined. Level of houses…
Health Plan Choice and the Utilization of Health Care Services
The effect of health-plan membership on the utilization of health-care services is of interest to both consumers and policymakers. Often estimation of that effect is difficult because data are nonexperimental and the dependent variable exhibits a high proportion of zeros. The authors propose a model of utilization that addresses both problems. After controlling for chronic illness and other observed variables, they find no evidence of further sel…
Inpatient Length of Stay in Twin Cities Health Plans
In this paper we examine the relationship between inpatient length of stay and the patient's type of health insurance. The data consist of discharges in seven diagnosis-related groups (DRGs) from community hospitals in Minneapolis and St. Paul during 1982. After controlling for the effects of the patient's age, sex, medical condition, and severity of illness, as well as the hospital's size, teaching and ownership status, and average annual occupa…
Disenrollment Effects in Insurer-Based Utilization Studies
From the Center for Health Services Research, School of Public Health, University of Minnesota, Minneapolis, Minnesota
The impact of the 1987 federal regulations on the use of psychotropic drugs in Minnesota nursing homes
OBJECTIVES. The purpose of this study was to examine prevalence rates of psychotropic drug use by elderly nursing home residents 3 years before and 1 year after implementation of the 1987 Omnibus Budget Reconciliation Act drug regulations throughout the United States on October 1, 1990. METHODS. A cohort study was conducted of elderly nursing home residents, for each of 4 study years (approximately 33,000 residents per year), of all nursing homes…
Disenrollment Effects in Insurer-Based Utilization Studies
From the Center for Health Services Research, School of Public Health, University of Minnesota, Minneapolis, Minnesota
Inpatient Length of Stay in Twin Cities Health Plans
In this paper we examine the relationship between inpatient length of stay and the patient's type of health insurance. The data consist of discharges in seven diagnosis-related groups (DRGs) from community hospitals in Minneapolis and St. Paul during 1982. After controlling for the effects of the patient's age, sex, medical condition, and severity of illness, as well as the hospital's size, teaching and ownership status, and average annual occupa…
Health Plan Choice and the Utilization of Health Care Services
The effect of health-plan membership on the utilization of health-care services is of interest to both consumers and policymakers. Often estimation of that effect is difficult because data are nonexperimental and the dependent variable exhibits a high proportion of zeros. The authors propose a model of utilization that addresses both problems. After controlling for chronic illness and other observed variables, they find no evidence of further sel…
Specialty Differences in the ??July Phenomenon?? for Twin Cities Teaching Hospitals
This study evaluated changes over the academic year in the cost and the outcome of inpatient care to investigate the effect of housestaff experience in teaching hospitals. Patients with 25 preselected discharge diagnoses, admitted between January 1, 1983 and December 31, 1987 to acute-care, nonfederal, non-pediatric hospitals in the Minneapolis/St. Paul metropolitan area (total number available for analysis 240,467) were examined. Level of houses…
Health Plan Choice in the Twin Cities Medicare Market
This paper examines the relationship between characteristics of Medicare beneficiaries and their choice of health plan in the Twin Cities during 1988. This analysis provides the first comparison of beneficiaries in the basic fee-for-service (FFS) Medicare sector (without a supplementary policy) to beneficiaries in the FFS sector with a supplementary policy, enrollees in independent practice associations (IPAs), and network health maintenance orga…
The impact of the 1987 federal regulations on the use of psychotropic drugs in Minnesota nursing homes
OBJECTIVES. The purpose of this study was to examine prevalence rates of psychotropic drug use by elderly nursing home residents 3 years before and 1 year after implementation of the 1987 Omnibus Budget Reconciliation Act drug regulations throughout the United States on October 1, 1990. METHODS. A cohort study was conducted of elderly nursing home residents, for each of 4 study years (approximately 33,000 residents per year), of all nursing homes…
Mammogram Utilization Among Farm Women
Utilization of preventive health care services is lower in rural populations than in urban populations, possibly as a result of barriers to preventive health care that are characteristic of rural settings. This study was conducted to identify factors associated with mammogram utilization among farm women. Mammogram utilization among farm women from six southern Minnesota counties was examined as part of a larger community‐based cancer interventio…
Time Off Work and the Postpartum Health of Employed Women
OBJECTIVES: Parental and maternity leave policies are a popular fringe benefit among childbearing employed women and a benefit employers frequently are required to offer. However, few rigorous evaluations of the effect of maternal leave on maternal health exist. METHODS: Using a hybrid of the household and health production theories of Becker and Grossman and a sample of women identified from state vital statistics records, a nonlinear relationsh…
A Demand-Side View of Risk Adjustment
This paper analyzes the efficient allocation of consumers to health plans. Specifically, we address the question of why employers that offer multiple health plans often make larger contributions to the premiums of the high-cost plans. Our perspective is that the subsidy for high-cost plans represents a form of demand-side risk adjustment that improves efficiency. Without such subsidies (and in the absence of formal risk adjustment), too few emplo…
Some Observations about Risk Adjustment Research
Research on risk adjustment has made an important contribution to the health economics and health pol? icy literature. Currently, however, there is a pressing need for improved communication among research? ers and their readers. We suggest improvements in three areas: more precise terminology; agreement on some simple results; and clarification of the assump? tions underlying specific analyses. In this note, we make modest proposals for each are…
The Influence of the Structure and Culture of Medical Group Practices on Prescription Drug Errors
BACKGROUND: This project was designed to identify the magnitude of prescription drug errors in medical group practices and to explore the influence of the practice structure and culture on those error rates. Seventy-eight practices serving an upper Midwest managed care (Care Plus) plan during 2001 were included in the study. METHODS: Using Care Plus claims data, prescription drug error rates were calculated at the enrollee level and then were agg…
Quality-of-Life Weights for the US Population
BACKGROUND: Many of the large ongoing national surveys of the US population contain a question that asks for the respondent's self-reported health status: "excellent," "very good," "good," "fair," or "poor." These surveys could be used to conduct cost-utility analyses of health care policies, treatments or other interventions if quality-of-life (QOL) weights for the self-reported health statuses were also available. OBJECTIVE: The objective of th…
Interaction Terms in Nonlinear Models
OBJECTIVES: To explain the use of interaction terms in nonlinear models. STUDY DESIGN: We discuss the motivation for including interaction terms in multivariate analyses. We then explain how the straightforward interpretation of interaction terms in linear models changes in nonlinear models, using graphs and equations. We extend the basic results from logit and probit to difference-in-differences models, models with higher powers of explanatory v…
Predictors of Patients’ Perceived Need for Medication to Prevent Fracture
BACKGROUND: Adherence with medications to prevent fractures is suboptimal. Patients' perceived need for medication is an important predictor of medication-use behavior. OBJECTIVE: Estimate the associations of patients' perceived need of medication for fracture prevention with objective indicators of fracture risk, patients' concerns about medications, and the quality of the patient-physician relationship. RESEARCH DESIGN: Cross-sectional medical …
How Effective is Health Coaching in Reducing Health Services Expenditures
BACKGROUND: Health coaching interventions aim to identify high-risk enrollees and encourage them to play a more proactive role in improving their health, improve their ability to navigate the health care system, and reduce costs. OBJECTIVES: Evaluate the effect of health coaching on inpatient, emergency room, outpatient, and prescription drug expenditures. RESEARCH DESIGN: Quasiexperimental pre-post design. Health coaching participants were ident…
Log Odds and the Interpretation of Logit Models
OBJECTIVE: We discuss how to interpret coefficients from logit models, focusing on the importance of the standard deviation (σ) of the error term to that interpretation. STUDY DESIGN: We show how odds ratios are computed, how they depend on the standard deviation (σ) of the error term, and their sensitivity to different model specifications. We also discuss alternatives to odds ratios. PRINCIPAL FINDINGS: There is no single odds ratio; instead, a…
Marginal Effects—Quantifying the Effect of Changes in Risk Factors in Logistic Regression Models
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolary…
Analysis of Affordable Health Care
BACKGROUND: Lack of affordable health care affects the uninsured, commercially insured, and Medicare beneficiaries. Yet, the wide variation in providers' prices and practice styles suggests that more affordable care already may be available and data on low value and wasteful care suggest that lower cost care need not come at the expense of better quality. Although price variation has received the most attention in the literature and legislation, …
Medicine (15 works) · Health care (9 works) · Family medicine (8 works) · Healthcare Policy and Management (7 works) · Economics (6 works) · Global Health Care Issues (6 works) · Actuarial science (5 works) · Environmental health (5 works) · Nursing (5 works) · Psychology (5 works)