Puerto Rico Health Services Research Institute

Research Projects

Pilot Project 1 -- Patterns of Health Service Utilization by Insurance Status Among Children and Adolescents with Asthma in Puerto Rico

This study examines the patterns of health services use in a youth population (18 years of age or younger) with a diagnosis of asthma from a sample of beneficiaries of Puerto Rico Health Care Reform and a sample of beneficiaries in the private sector (insured by the same company). These two samples will be compared in terms of possible differences in how predisposing, enabling, and need characteristics of the population at risk (structure component) may exert an effect on patterns of health care use (process component). In the context of our model, utilization is an action that corresponds to the receipt of care by the individual or population. Utilization may be initiated by the patient, as guidance from a health care provider or as the result of some administrative requirement. It is also referred to as realized access (Aday et al., 1998).

Pilot Project 1 Conclusions (Spanish)

Pilot Project 2 -- Psychometric Properties of Two Potential Indicators of the Performance of Mental Health Services for Children and Adolescents

This study aims to assess the psychometric properties of two measures of health care system factors, organizational climate and quality of the therapeutic relationship, and their potential applicability as valid indicators of quality of mental health care services for children and adolescents. The development of valid and reliable measures of both constructs will facilitate exploring the extent to which factors within the context of mental health services delivery systems are amenable to policy changes affect organizational climate and the quality of the therapeutic relationship. In addition, the findings from this pilot study will contribute to the design of a more comprehensive study to determine the effects of contextual factors within the formal system of mental health care services for children and adolescents, on four types of treatment outcomes: diagnosis and symptoms, functional impairment, family burden and functioning, and service-related restrictiveness.

Pilot Project 2 Conclusions (Spanish)

Pilot Project 3 -- The Effect of Health Care Reform on Infant Mortality: The Case of Puerto Rico

This study hypothesizes that health care reform could have had an effect on infant mortality indirectly through increased access to prenatal care, which improved the birth weight of the infants. But it is also possible that there is a direct effect of the reform on infant mortality or on birth weight that is not accounted by prenatal care. The implementation of health care reform in Puerto Rico had a profound impact on how the health care system works in relation to the availability, organization, and financing of services. The reform also has affected the demand for health services by the Medicaid population by enabling individuals to purchase private health services that were not accessible previous to the implementation of the health care reform. The physical, social, and economic factors to be considered in this study include the variables related to supply of health services within the region of residence and the socio-economic characteristics of the municipality of residence of the mother. The characteristics of the population at risk for this project are the socio-demographic characteristics of the mother and the infant. All of these variables could have an effect, directly or indirectly, on the utilization of prenatal care (the process component), in birth weight (intermediate outcome), and infant mortality (final outcome). Infant mortality will be measured in three manners: general infant mortality, neonatal mortality, and post-neonatal mortality.

Pilot Project 3 Conclusions (Spanish)

This website is supported by the Agency of Healthcare Research and Quality, Grant No. 1 R24 HS1 4060-02 and by a Research Centers in Minority Institutions Award, G12RR-03051, from the National Center for Research Resources, National Institutes of Health

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