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 Medicare takes into account that private practice clinics pay for their own overhead and therefore provides a higher payment to assist in these costs. The average wholesale costs of medications for the treatment modalities reviewed were obtained from the 2001 Drug Topics Red Book (18) (Table 4).A hypothetical cost model was then constructed for each of the five treatment modalities by combining the average number of estimated treatments required to achieve wart clearance, physician costs, and medication costs (Table 5). Utilizing this cost model based on the Arkansas Medicare non-facility fee schedule, the CPT codes were added to the cost of medication to determine the final cost for the treatment of a patient with a moderate wart burden as previously defined. The ASUI was significantly correlated with [FEV.sub.1] percent predicted and [FEV.sub.1]/FVC. In addition, the measure was capable of differentiating patient groups of known disease severity. Similar results were demonstrated using physician-generated ratings of severity of asthma and an asthma disease severity rating system based on emergency medical service use, spirometry, and symptoms. ASUI scores produced a stair-step pattern of decreasing scores with increasing disease severity. Patients categorized as having mild disease according to the physician rating scheme scored the highest on the ASUI at 0.88 and were distinguishable from the groups with moderate and moderate-to-severe disease by 0.24 and 0.41 points, respectively. Patients with mild/ moderate, moderate, and moderate/severe disease were also distinguishable with a value of 0.30 separating the mild/moderate from the moderate/severe. This suggests the instrument is sensitive to subtle differences in disease severity, a characteristic necessary for responsiveness to change with treatment and meaningful cost-effectiveness studies. Further research is needed to quantify the responsiveness of the ASUI to clinically meaningful change. Based on the conceptualization illustrated in Figure 1, this study focused on how having a regular doctor differs from having a regular site in affecting the use of five preventive services: mammograms, pap smears, blood pressure checkups, cholesterol level checkups, and flu shots. The probabilities of having a usual doctor, a regular site, and no usual source of care were analyzed first in the selection stage. It was followed by the examination of the impact of having a regular doctor and having a regular site on the utilization of each above-mentioned preventive service, while incorporating individuals'' unobservable preferences in the selection stage. With Doctor-Finder.biz you can find and compare docotor's in your area! Check it out!
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