Thomas T. H. Wan

Exploring Hospitals' Adoption of Information Technology

This study explores the adoption of information technology (IT) and the association between organizational and market factors, and IT adoption in hospitals. Results suggest that a wide range of amounts and types of IT are adopted. Hospitals with higher overall IT adoption adopt strategic IT most often. Hospitals with lower IT adoption adopt administrative IT most often. Results also show hospital IT adoption to be positively associated with hospital size, location, system membership, ownership, and market competition.

Effects and Costs of Day-Care Services for the Chronically Ill A Randomized Experiment

Two long-term care settings not now covered by Medicare—adult day care and homemaker services—were studied in a randomized experiment to test the effects on patient outcomes and costs of using these new services. This article reports findings for day care. Patients’ physical, psychosocial and health functions were assessed quarterly, and their Medicare bill files were obtained. Medicaid data were obtained on most patients, but few used many Medicaidcovered long-term care services. Multistage analysis was performed to mitigate effects of departures from the randomized design. Day-care patients showed no benefits in physical functioning ability at the end of the study, compared with the control group. Institutionalization in skilled nursing facilities was lower for the experimental group than the control group, but factors other than the treatment variable appeared to explain most of the variance. There was a possibility that life was extended for some day-care patients. The new services averaged

Factors Affecting the Use of Social and Health Services Among the Elderly

52 per day or

Use of Health Services by the Elderly in Low-Income Communities

3,235 per year. When costs for existing Medicare services used were added, the yearly cost of the experimental group was

Differential Use of Health Services among Disabled Elderly

6,501, compared with

A Systems Framework for Evaluating Nursing Care Quality in Nursing Homes

3,809 for the control group—an increase of

Goal Continuity as a Mediator of Early Retirement Adjustment: Testing a Multidimensional Model.

2,692 or 71 per cent.

Functionally Disabled Elderly Health Status, Social Support, and Use of Health Services

This study has systematically examined the use of health and social services among non-institutionalized elderly people according to the Andersen model which groups factors influencing use into predisposing, enabling and need variables. Need for service as evidenced by physical and psychological functioning was the most important predictor of use of physician services and hospitalization. Predisposing factors had the most effect on use of dental services. On the other hand, knowledge of services, an enabling factor, was most relevant to use of social services. Since this factor is manipulable to planned change, several program strategies were suggested for increasing awareness of social services particularly among the impaired elderly.

Health Information Technology Adoption in U.S. Acute Care Hospitals

Although it is generally assumed that there has been a narrowing of the gap in health care between poor and nonpoor families, the relative contributions of improved fiscal and geographic access are not well documented. Almost 2,000 elderly poor persons were studied to examine factors affecting their use of health services. A number of personal and structural problems are identified when cultural and ethnic backgrounds are considered.

Improving Doctor---Patient Communication: Examining Innovative Modalities Vis-à-vis Effective Patient-Centric Care Management Technology

In order to facilitate program planning for the chronically ill, it is essential to understand their propensity to use health and social services. This study has systematically examined the use of ambulatory services among the noninstitutionalized elderly (N = 772) who reported with one or more activity-limiting chronic conditions in a statewide survey of older Virginians in 1979. The determinants of differential use of physician services are investigated. The independent variables included in the analysis are: (1) personal attributes that may predispose individuals to seek care; (2) need for care factors as evidenced by the number of health disorders, physical functioning limitations, and perceived health; and (3) enabling factors such as income, insurance status, regular source of care, perceived service needs, and transportation barriers. Findings show that a significantly large number of physician visits may be generated in response to the psychological needs of disabled elderly. The eighteen predictors accounted for a relatively larger amount of variance (39%o) in use of social services than in physican visits (14%o). Furthermore, there is a strong complementary relationship between physician visits and use of social services.