Impact of Medicare policies on utilization and outcomes.

描述（由申请人提供）：候选人是董事会认证的 风湿病学家感兴趣的应用卫生经济学的方法， 研究财政政策，影响病人的护理患有 关节炎和其他风湿性疾病。他正在寻求外部资金支持 这样他就有时间去上正式课程 研究，研究时间对拟议的项目，并获得他的导师。他 有商业背景，目前就读于加州大学洛杉矶分校的 公共卫生，卫生服务博士学位课程，重点是 卫生经济学。 加州大学洛杉矶分校为他的职业发展提供了良好的环境。的 医学部为其年轻研究人员提供正式支持 通过科学培训和高级研究计划。加州大学洛杉矶分校 优秀的卫生服务研究人员和卫生经济学家在学校的 公共卫生和医学。加州大学洛杉矶分校与兰德公司有着密切的工作关系 和兰德研究生院。 在获奖期间，候选人将参加完成其学业所需的课程。 博士℃下一部分拟议的研究将作为他的 论文他招募了一个健康经济学家小组， 研究人员，流变学家和统计学家教他的技能， 需要完成拟议的研究，并发展他的职业生涯， 拥有健康经济学和关节炎专业知识的独立研究员。 他建议研究平衡预算法案支出的影响 在100%的样本中， 接受过选择性关节置换手术或 髋部骨折手术治疗他还建议审查管理 通过研究管理式护理的退出，将护理成本转移到服务部门的费用 计划手术（择期关节置换术）和退出前 在计划外手术（髋部骨折）之前。

DESCRIPTION (provided by applicant): The candidate is a board-certified rheumatologist interested in applying the methodology of health economics to study fiscal policies that impact the care of patients suffering from arthritis and other rheumatic diseases. He is seeking external funding support so that he might have the protected time to avail himself of formal course studies, research time on the proposed project, and access to his mentors. He has a business background and is currently enrolled in the UCLA School of Public Health, Health Services Ph.D. degree program, with an emphasis on Health Economics. UCLA provides an excellent environment for the development of his career. The Department of Medicine provides formal support for its young investigators through the Scientific Training and Advanced Research program. UCLA has excellent health service researchers and health economists in the Schools of Public Health and Medicine. UCLA has a close working relationship with RAND and the RAND Graduate School. During the award, the candidate will take classes required to complete his Ph.D. degree. A portion of the proposed research will serve as his dissertation. He has enlisted a team of health economists, health service researchers, a rheumatologist and a statistician to teach him the skills he needs to complete the proposed research and to develop his career as an independent researcher with health economic and arthritis expertise. He has proposed to study the impact of the Balanced Budget Act expenditure cuts on post-acute care utilization and clinical outcomes on a 100% sample of Medicare patients who have undergone elective joint replacement surgery or surgical management of hip fracture. He has also proposed to examine managed care cost-shifting to the fee for service sector by studying managed care disenrollment prior to planned surgery (elective joint replacement) and disenrollment prior to unplanned surgery (hip fracture).