FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Hung, DY Harrison, MI Martinez, MC Luft, HS AF Hung, Dorothy Y. Harrison, Michael I. Martinez, Meghan C. Luft, Harold S. TI Scaling Lean in Primary Care: Impacts on System Performance SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID HEALTH-CARE; QUALITY IMPROVEMENT; DIABETES CARE; PATIENT-CARE; INTERVENTIONS; MANAGEMENT; LESSONS C1 [Hung, Dorothy Y.; Martinez, Meghan C.; Luft, Harold S.] Palo Alto Med Fdn, Res Inst, 2350 W El Camino Real 447, Mountain View, CA 94040 USA. [Harrison, Michael I.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Hung, DY (reprint author), Palo Alto Med Fdn, Res Inst, 2350 W El Camino Real 447, Mountain View, CA 94040 USA. EM hungd@pamfri.org FU Agency for Healthcare Research and Quality under its ACTION II contract [HHSA2902010000221, 2] FX The research reported in this paper was funded by the Agency for Healthcare Research and Quality under its ACTION II contract HHSA2902010000221, Task Order 2. The views expressed in this paper are solely those of the authors and do not represent any US government agency or any institutions with which the authors are affiliated. NR 41 TC 0 Z9 0 U1 0 U2 0 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD MAR PY 2017 VL 23 IS 3 PG 4 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA EO0OP UT WOS:000396398000008 ER PT J AU Agwu, AL Fleishman, JA Mahiane, G Nonyane, BAS Althoff, KN Yehia, BR Berry, SA Rutstein, R Nijhawan, A Mathews, C Aberg, JA Keruly, JC Moore, RD Gebo, KA AF Agwu, Allison L. Fleishman, John A. Mahiane, Guy Nonyane, Bareng Aletta Sanny Althoff, Keri N. Yehia, Baligh R. Berry, Stephen A. Rutstein, Richard Nijhawan, Ank Mathews, Christopher Aberg, Judith A. Keruly, Jeanne C. Moore, Richard D. Gebo, Kelly A. CA HIV Res Network TI Comparing longitudinal CD4 responses to cART among non-perinatally HIV-infected youth versus adults: Results from the HIVRN Cohort SO PLOS ONE LA English DT Article ID ACTIVE ANTIRETROVIRAL THERAPY; HUMAN-IMMUNODEFICIENCY-VIRUS; YOUNG-ADULTS; CELL COUNT; FOLLOW-UP; VIROLOGICAL SUPPRESSION; IMMUNOLOGICAL OUTCOMES; IMMUNE RECONSTITUTION; INITIATING HAART; UNITED-STATES AB Background Youth have residual thymic tissue and potentially greater capacity for immune reconstitution than adults after initiation of combination antiretroviral therapy (cART). However, youth face behavioral and psychosocial challenges that may make them more likely than adults to delay ART initiation and less likely to attain similar CD4 outcomes after initiating cART. This study compared CD4 outcomes over time following cART initiation between ART-naive non-perinatally HIV-infected (nPHIV) youth (13-24 years-old) and adults (>= 25-44 years-old). Methods Retrospective analysis of ART-naive nPHIV individuals 13-44 years-old, who initiated their first cART between 2008 and 2011 at clinical sites in the HIV Research Network. A linear mixed model was used to assess the association between CD4 levels after cART initiation and age (13-24, 25-34, 35-44 years), accounting for random variation within participants and between sites, and adjusting for key variables including gender, race/ethnicity, viral load, gaps in care (defined as >365 days between CD4 tests), and CD4 levels prior to cART initiation (baseline CD4). Results Among 2,595 individuals (435 youth; 2,160 adults), the median follow-up after cART initiation was 179 weeks (IQR 92-249). Baseline CD4 was higher for youth (320 cells/mm(3)) than for ages 25-34 (293) or 35-44 (258). At 239 weeks after cART initiation, median unadjusted CD4 was higher for youth than adults (576 vs. 539 and 476 cells/mm(3), respectively), but this difference was not significant when baseline CD4 was controlled. Compared to those with baseline CD4 <= 200 cells/mm(3), individuals with baseline CD4 of 201-500 and >500 cells/mm(3) had greater predicted CD4 levels: 390, 607, and 831, respectively. Additionally, having no gaps in care and higher viral load were associated with better CD4 outcomes. Conclusions Despite having residual thymic tissue, youth attain similar, not superior, CD4 gains as adults. Early ART initiation with minimal delay is as essential to optimizing outcomes for youth as it is for their adult counterparts. C1 [Agwu, Allison L.] Johns Hopkins Sch Med, Dept Pediat, Div Pediat Infect Dis, Baltimore, MD 21205 USA. [Agwu, Allison L.; Berry, Stephen A.; Keruly, Jeanne C.; Gebo, Kelly A.] Johns Hopkins Sch Med, Div Infect Dis, Dept Med, Baltimore, MD 21205 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Mahiane, Guy] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD USA. [Nonyane, Bareng Aletta Sanny] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA. [Althoff, Keri N.] Johns Hopkins Med Inst, Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA. [Yehia, Baligh R.] Univ Penn, Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. [Rutstein, Richard] Childrens Hosp Philadelphia, Div Gen Pediat, Philadelphia, PA 19104 USA. [Nijhawan, Ank] UT Southwestern Med Ctr, Dept Internal Med, Parkland Hlth & Hosp Syst, Dallas, TX USA. [Mathews, Christopher] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. [Aberg, Judith A.] Icahn Sch Med Mt Sinai, Dept Med, Div Infect Dis, New York, NY 10029 USA. [Moore, Richard D.] Johns Hopkins Sch Med, Dept Med, Div Gen Internal Med, Baltimore, MD USA. RP Agwu, AL (reprint author), Johns Hopkins Sch Med, Dept Pediat, Div Pediat Infect Dis, Baltimore, MD 21205 USA. EM ageorg10@jhmi.edu NR 52 TC 0 Z9 0 U1 1 U2 1 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD FEB 9 PY 2017 VL 12 IS 2 AR e0171125 DI 10.1371/journal.pone.0171125 PG 17 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA EK9GJ UT WOS:000394231800035 PM 28182675 ER PT J AU Hines, AL Raetzman, SO Barrett, ML Moy, E Andrews, RM AF Hines, Anika L. Raetzman, Susan O. Barrett, Marguerite L. Moy, Ernest Andrews, Roxanne M. TI Managed care and inpatient mortality in adults: effect of primary payer SO BMC HEALTH SERVICES RESEARCH LA English DT Article DE Managed care; Inpatient mortality; Fee for service ID MEDICARE AB Background: Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor. This study provides a comprehensive assessment of the association between managed care and inpatient mortality for Medicare and privately insured patients. Methods: A cross-sectional design was used to examine the association between managed care and inpatient mortality for four common inpatient conditions. Data from the 2009 Healthcare Cost and Utilization Project State Inpatient Databases for 11 states were linked to data from the American Hospital Association Annual Survey Database. Hospital discharges were categorized as managed care or fee for service. A phased approach to multivariate logistic modeling examined the likelihood of inpatient mortality when adjusting for individual patient and hospital characteristics and for county fixed effects. Results: Results showed different effects of managed care for Medicare and privately insured patients. Privately insured patients in managed care had an advantage over their fee-for-service counterparts in inpatient mortality for acute myocardial infarction, stroke, pneumonia, and congestive heart failure; no such advantage was found for the Medicare managed care population. To the extent that the study showed a protective effect of privately insured managed care, it was driven by individuals aged 65 years and older, who had consistently better outcomes than their non-managed care counterparts. Conclusions: Privately insured patients in managed care plans, especially older adults, had better outcomes than those in fee-for-service plans. Patients in Medicare managed care had outcomes similar to those in Medicare FFS. Additional research is needed to understand the role of patient selection, hospital quality, and differences among county populations in the decreased odds of inpatient mortality among patients in private managed care and to determine why this result does not hold for Medicare. C1 [Hines, Anika L.; Raetzman, Susan O.] Truven Hlth Analyt, 7700 Old Georgetown Rd, Bethesda, MD 20814 USA. [Hines, Anika L.] Johns Hopkins Sch Med, Baltimore, MD USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Moy, Ernest; Andrews, Roxanne M.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Moy, Ernest] Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Raetzman, SO (reprint author), Truven Hlth Analyt, 7700 Old Georgetown Rd, Bethesda, MD 20814 USA. EM sraetzma@us.ibm.com FU Agency for Healthcare Research and Quality (AHRQ) [HHSA-290-2013-00002-C] FX This study was funded by the Agency for Healthcare Research and Quality (AHRQ) under a contract with Truven Health Analytics to develop and support the Healthcare Cost and Utilization Project (HCUP) (Contract No. HHSA-290-2013-00002-C). The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality, the National Center for Health Statistics, or the U.S. Department of Health and Human Services. NR 12 TC 0 Z9 0 U1 1 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD FEB 8 PY 2017 VL 17 AR 121 DI 10.1186/s12913-017-2062-1 PG 17 WC Health Care Sciences & Services SC Health Care Sciences & Services GA EK7MN UT WOS:000394110000001 PM 28178979 ER PT J AU Witt, WP Coffey, RM Lopez-Gonzalez, L Barrett, ML Moore, BJ Andrews, RM Washington, RE AF Witt, Whitney P. Coffey, Rosanna M. Lopez-Gonzalez, Lorena Barrett, Marguerite L. Moore, Brian J. Andrews, Roxanne M. Washington, Raynard E. TI Understanding Racial and Ethnic Disparities in Postsurgical Complications Occurring in US Hospitals SO HEALTH SERVICES RESEARCH LA English DT Article DE Postsurgical complications; surgery; racial; ethnic differences in health care; community socioeconomic status; health insurance; health disparities ID PATIENT SAFETY INDICATORS; MORTALITY PARADOX; OUTCOMES; CANCER; QUALITY; ACCULTURATION; SURGERY; HEALTH; ADULTS; VOLUME AB ObjectiveTo examine the role of patient, hospital, and community characteristics on racial and ethnic disparities in in-hospital postsurgical complications. Data SourcesHealthcare Cost and Utilization Project, 2011 State Inpatient Databases; American Hospital Association Annual Survey of Hospitals; Area Health Resources Files; Centers for Medicare & Medicaid Services Hospital Compare database. MethodsNonlinear hierarchical modeling was conducted to examine the odds of patients experiencing any in-hospital postsurgical complication, as defined by Agency for Healthcare Research and Quality Patient Safety Indicators. Principal FindingsA total of 5,474,067 inpatient surgical discharges were assessed using multivariable logistic regression. Clinical risk, payer coverage, and community-level characteristics (especially income) completely attenuated the effect of race on the odds of postsurgical complications. Patients without private insurance were 30 to 50 percent more likely to have a complication; patients from low-income communities were nearly 12 percent more likely to experience a complication. Private, not-for-profit hospitals in small metropolitan or micropolitan areas and higher nurse-to-patient ratios led to fewer postsurgical complications. ConclusionsRace does not appear to be an important determinant of in-hospital postsurgical complications, but insurance and community characteristics have an effect. A population-based approach that includes improving the socioeconomic context may help reduce disparities in these outcomes. C1 [Witt, Whitney P.] Truven Hlth Analyt Inc, Maternal & Child Hlth Res, 4819 Emperor Blvd,Suite 125, Durham, NC 27703 USA. [Coffey, Rosanna M.; Moore, Brian J.] Truven Hlth Analyt Inc, Fed Govt, Bethesda, MD USA. [Lopez-Gonzalez, Lorena] Truven Hlth Analyt Inc, Life Sci, Austin, TX USA. [Barrett, Marguerite L.] ML Barrett INC, San Diego, CA USA. [Andrews, Roxanne M.] Agcy Healthcare Res & Qual, Ctr Org & Delivery Studies, Rockville, MD USA. [Washington, Raynard E.] Agcy Healthcare Res & Qual, Dept Hlth & Human Serv, Rockville, MD USA. RP Witt, WP (reprint author), Truven Hlth Analyt Inc, Maternal & Child Hlth Res, 4819 Emperor Blvd,Suite 125, Durham, NC 27703 USA. EM whitney.witt@truvenhealth.com FU Agency for Healthcare Research and Quality [HHSA-290-2013-00002-C] FX The authors thank Robert L. Houchens, Timothy Kenney, and Minya Sheng for their methodological contributions to this paper and Linda Lee for her editorial comments on the paper. We also acknowledge the following HCUP Partner organizations for contributing data to the HCUP State Inpatient Databases used in this study: Arizona Department of Health Services, Arkansas Department of Health, California Office of Statewide Health Planning and Development, Colorado Hospital Association, Florida Agency for Health Care Administration, Georgia Hospital Association, Hawaii Health Information Corporation, Illinois Department of Public Health, Indiana Hospital Association, Iowa Hospital Association, Kansas Hospital Association, Kentucky Cabinet for Health and Family Services, Maine Health Data Organization, Massachusetts Center for Health Information and Analysis, Michigan Health & Hospital Association, Nevada Department of Health and Human Services, New Jersey Department of Health, New Mexico Department of Health, New York State Department ofHealth, Oregon Association of Hospitals and Health Systems, Pennsylvania Health Care Cost Containment Council, Rhode Island Department of Health, South Carolina Revenue and Fiscal Affairs Office, South Dakota Association of Healthcare Organizations, Tennessee Hospital Association, Texas Department of State Health Services, Vermont Association of Hospitals and Health Systems, Virginia Health Information, Washington State Department of Health, and Wisconsin Department of Health Services. A full list of HCUP Data Partners can be found at https://www.hcup-us.ahrq.gov/db/hcupdatapartners.jsp. This study was funded by the Agency for Healthcare Research and Quality under contract HHSA-290-2013-00002-C (Contract PI: Gary Pickens). The views expressed herein are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality of the U.S. Department of Department of Health and Human Services. NR 35 TC 0 Z9 0 U1 1 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2017 VL 52 IS 1 BP 220 EP 243 DI 10.1111/1475-6773.12475 PG 24 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EJ9XC UT WOS:000393579500013 PM 26969578 ER PT J AU Lindly, OJ Zuckerman, KE Mistry, KB AF Lindly, Olivia J. Zuckerman, Katharine E. Mistry, Kamila B. TI Clarifying the Predictive Value of Family-Centered Care and Shared Decision Making for Pediatric Healthcare Outcomes Using the Medical Expenditure PanelSurvey SO HEALTH SERVICES RESEARCH LA English DT Article DE Family-centered care; health services utilization; medical expenditures; shared decision making; unmet health care needs ID IDENTIFYING CHILDREN; BEHAVIORAL-MODEL; EARLY-CHILDHOOD; SERVICES USE; NEEDS; HOME; QUALITY; ACCESS; ASSOCIATIONS; EXPERIENCES AB ObjectivesTo estimate (1) family-centered care (FCC) and shared decision-making (SDM) prevalence, and (2) associations of FCC and SDM (FCC/SDM) with health care outcomes among U.S. children. Data SourceThe Medical Expenditure PanelSurvey Household Component (MEPS-HC), a nationally representative survey of the noninstitutionalized, civilian population. Study DesignSecondary analyses of prospectively collected data on 15,764 U.S. children were conducted to examine FCC/SDM prevalence in year 1 and associations of FCC/SDM in year 1 with health services utilization, medical expenditures, and unmet health care needs in year 2. Data Collection/Extraction MethodsWe combined four MEPS-HC longitudinal files from 2007 to 2011. Principal FindingsFCC/SDM prevalence in year 1 varied from 38.6 to 93.7 percent, and it was lower for composites with more stringent scoring approaches. FCC/SDM composites with stringent scoring approaches in year 1 were associated with reduced unmet needs in year 2. FCC/SDM, across all year 1 composites, was not associated with health services utilization or medical expenditures in year 2. FCC/SDM year 1 subcomponents describing consensus building and mutual agreement were consistently associated with unmet health care needs in year 2. ConclusionsFCC/SDM composites with stringent scoring approaches measuring consensus building and mutual agreement may have the greatest utility for pediatric health care quality improvement efforts. C1 [Lindly, Olivia J.] Oregon State Univ, Sch Social & Behav Hlth Sci, Coll Publ Hlth & Human Sci, 401 Waldo Hall, Corvallis, OR 97331 USA. [Lindly, Olivia J.; Zuckerman, Katharine E.] Oregon Hlth & Sci Univ, Div Gen Pediat, Portland, OR 97201 USA. [Mistry, Kamila B.] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD USA. RP Lindly, OJ (reprint author), Oregon State Univ, Sch Social & Behav Hlth Sci, Coll Publ Hlth & Human Sci, 401 Waldo Hall, Corvallis, OR 97331 USA.; Lindly, OJ (reprint author), Oregon Hlth & Sci Univ, Div Gen Pediat, Portland, OR 97201 USA. EM lindlyo@oregonstate.edu FU Agency for Healthcare Research and Quality Junior Summer Fellows Program FX This project was supported by the Agency for Healthcare Research and Quality Junior Summer Fellows Program. The views expressed in this article are those of the authors, and no official endorsement by the U.S. Department of Health and Human Services or the Agency for Healthcare Research and Quality is intended or should be inferred. We thank Drs. Sheryl Thorburn, Adam Branscum, and Kari-Lyn Sakuma for their constructive feedback on an initial draft of the manuscript, as well as Drs. Ernest Moy and Denise Dougherty for their initial involvement in the study's conceptualization. We also thank Dr. Barbara Schone for her thoughtful feedback on a revised version of this manuscript. NR 69 TC 0 Z9 0 U1 3 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2017 VL 52 IS 1 BP 313 EP 345 DI 10.1111/1475-6773.12488 PG 33 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EJ9XC UT WOS:000393579500017 PM 27072197 ER PT J AU Cryer, C Miller, TR Lyons, RA Macpherson, AK Perez, K Petridou, ET Dessypris, N Davie, GS Gulliver, PJ Lauritsen, J Boufous, S Lawrence, B de Graaf, B Steiner, CA AF Cryer, Colin Miller, Ted R. Lyons, Ronan A. Macpherson, Alison K. Perez, Katherine Petridou, Eleni Th Dessypris, Nick Davie, Gabrielle S. Gulliver, Pauline J. Lauritsen, Jens Boufous, Soufiane Lawrence, Bruce de Graaf, Brandon Steiner, Claudia A. TI Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates SO INJURY PREVENTION LA English DT Article ID FRACTURE; SURVEILLANCE; POPULATION; BURDEN AB Background Governments wish to compare their performance in preventing serious injury. International comparisons based on hospital inpatient records are typically contaminated by variations in health services utilisation. To reduce these effects, a serious injury case definition has been proposed based on diagnoses with a high probability of inpatient admission (PrA). The aim of this paper was to identify diagnoses with estimated high PrA for selected developed countries. Methods The study population was injured persons of all ages who attended emergency department (ED) for their injury in regions of Canada, Denmark, Greece, Spain and the USA. International Classification of Diseases (ICD)-9 or ICD-10 4-digit/character injury diagnosis-specific ED attendance and inpatient admission counts were provided, based on a common protocol. Diagnosis-specific and region-specific PrAs with 95% CIs were calculated. Results The results confirmed that femoral fractures have high PrA across all countries studied. Strong evidence for high PrA also exists for fracture of base of skull with cerebral laceration and contusion; intracranial haemorrhage; open fracture of radius, ulna, tibia and fibula; pneumohaemothorax and injury to the liver and spleen. Slightly weaker evidence exists for cerebellar or brain stem laceration; closed fracture of the tibia and fibula; open and closed fracture of the ankle; haemothorax and injury to the heart and lung. Conclusions Using a large study size, we identified injury diagnoses with high estimated PrAs. These diagnoses can be used as the basis for more valid international comparisons of life-threatening injury, based on hospital discharge data, for countries with well-developed healthcare and data collection systems. C1 [Cryer, Colin; Davie, Gabrielle S.; de Graaf, Brandon] Univ Otago, Dept Prevent & Social Med, POB 913, Dunedin 9054, New Zealand. [Miller, Ted R.; Lawrence, Bruce] Pacific Inst Res & Evaluat, Calverton, MD USA. [Miller, Ted R.] Curtin Univ, Ctr Hlth Policy Res, Perth, WA, Australia. [Lyons, Ronan A.] Swansea Univ, Farr Inst, Sch Med, Swansea, W Glam, Wales. [Macpherson, Alison K.] York Univ, Sch Kinesiol & Hlth Sci, Toronto, ON, Canada. [Perez, Katherine] ASPB, Barcelona, Spain. [Perez, Katherine] Inst Biomed Res IIBSP, CIBER Epidemiol & Salud Publ, Barcelona, Spain. [Petridou, Eleni Th; Dessypris, Nick] Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, Athens, Greece. [Gulliver, Pauline J.] Univ Auckland, Sch Populat Hlth, Auckland, New Zealand. [Lauritsen, Jens] Odense Univ Hosp, Injury Prevent Grp, Odense, Denmark. [Lauritsen, Jens] Univ Southern Denmark, Dept Clin Med, Odense, Denmark. [Boufous, Soufiane] Univ New South Wales, Transport & Rd Safety Res, Sydney, NSW, Australia. [Steiner, Claudia A.] AHRQ, HCUP, Div Healthcare Delivery Data Measures & Res, Rockville, MD USA. RP Cryer, C (reprint author), Univ Otago, Dept Prevent & Social Med, POB 913, Dunedin 9054, New Zealand. EM colin.cryer@otago.ac.nz FU Accident Compensation Corporation of New Zealand [105155.05.P.NF] FX Accident Compensation Corporation of New Zealand (105155.05.P.NF Cryer). NR 20 TC 0 Z9 0 U1 0 U2 0 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1353-8047 EI 1475-5785 J9 INJURY PREV JI Inj. Prev. PD FEB PY 2017 VL 23 IS 1 BP 47 EP 57 DI 10.1136/injuryprev-2016-042020 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA EJ6IT UT WOS:000393323400009 PM 27501735 ER PT J AU Decker, SL Lipton, BJ AF Decker, Sandra L. Lipton, Brandy J. TI Most Newly Insured People In 2014 Were Long-Term Uninsured SO HEALTH AFFAIRS LA English DT Article ID SERVICE USE; COVERAGE; ACCESS; CARE AB In 2014-after the implementation of most of the Affordable Care Act provisions, including Medicaid expansions in some states and subsidies to purchase Marketplace coverage in all states-adults who had been uninsured for more than three years represented a larger share of the newly insured, compared to adults who had been insured for shorter periods of time. C1 [Decker, Sandra L.; Lipton, Brandy J.] Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. RP Decker, SL (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. EM Sandra.decker@ahrq.hhs.gov NR 6 TC 0 Z9 0 U1 1 U2 1 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JAN PY 2017 VL 36 IS 1 BP 16 EP 20 DI 10.1377/hlthaff.2016.0984 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EN9RE UT WOS:000396336500003 PM 28069842 ER PT J AU Jacobs, PD Hill, SC Abdus, S AF Jacobs, Paul D. Hill, Steven C. Abdus, Salam TI Adults Are More Likely To Become Eligible For Medicaid During Future Recessions If Their State Expanded Medicaid SO HEALTH AFFAIRS LA English DT Article ID EXPANSION; REFORM AB Eligibility for and enrollment in Medicaid can vary with economic recessions, recoveries, and changes in personal income. Understanding how Medicaid responds to such forces is important to budget analysts and policy makers tasked with forecasting Medicaid enrollment. We simulated eligibility for Medicaid for the period 2005-14 in two scenarios: assuming that each state's eligibility rules in 2009, the year before passage of the Affordable Care Act (ACA), were in place during the entire study period; and assuming that the ACA's expanded eligibility rules were in place during the entire period for all states. Then we correlated the results with unemployment rates as a measure of the economy. Each percentage-point increase in the unemployment rate was associated with an increase in the share of people eligible for Medicaid of 0.32 percentage point under the 2009 eligibility rules and 0.77 percentage point under the ACA rules. Our simulations showed that the ACA expansion increased Medicaid's responsiveness to changes in unemployment. For states that have not expanded Medicaid eligibility, our analysis demonstrates that increased responsiveness to periods of high unemployment is one benefit of expansion. C1 [Jacobs, Paul D.] AHRQ, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. [Hill, Steven C.; Abdus, Salam] AHRQ, Rockville, MD USA. RP Jacobs, PD (reprint author), AHRQ, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. EM paul.jacobs@ahrq.hhs.gov NR 11 TC 0 Z9 0 U1 0 U2 0 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JAN PY 2017 VL 36 IS 1 BP 32 EP 39 DI 10.1377/hlthaff.2016.1076 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EN9RE UT WOS:000396336500005 PM 28069844 ER PT J AU Gounder, PP Holman, RC Seeman, SM Rarig, AJ McEwen, M Steiner, CA Bartholomew, ML Hennessy, TW AF Gounder, Prabhu P. Holman, Robert C. Seeman, Sara M. Rarig, Alice J. McEwen, Mary Steiner, Claudia A. Bartholomew, Michael L. Hennessy, Thomas W. TI Infectious Disease Hospitalizations Among American Indian/Alaska Native and Non-American Indian/Alaska Native Persons in Alaska, 2010-2011 SO PUBLIC HEALTH REPORTS LA English DT Article DE minority health; epidemiology; Indian Health Service; Native American ID PNEUMOCOCCAL CONJUGATE VACCINE; RESPIRATORY-TRACT; STREPTOCOCCUS-PNEUMONIAE; UNITED-STATES; RURAL ALASKA; RISK-FACTORS; CHILDREN; POPULATION; INDIANS; TRENDS AB Objective: Reports about infectious disease (ID) hospitalization rates among American Indian/Alaska Native (AI/AN) persons have been constrained by data limited to the tribal health care system and by comparisons with the general US population. We used a merged state database to determine ID hospitalization rates in Alaska. Methods: We combined 2010 and 2011 hospital discharge data from the Indian Health Service and the Alaska State Inpatient Database. We used the merged data set to calculate average annual age-adjusted and age-specific ID hospitalization rates for AI/AN and non-AI/AN persons in Alaska. We stratified the ID hospitalization rates by sex, age, and ID diagnosis. Results: ID diagnoses accounted for 19% (6501 of 34 160) of AI/AN hospitalizations, compared with 12% (7397 of 62059) of non-AI/AN hospitalizations. The average annual age-adjusted hospitalization rate was >3 times higher for AI/AN persons (2697 per 100 000 population) than for non-AI/AN persons (730 per 100 000 population; rate ratio = 3.7, P < .001). Lower respiratory tract infection (LRTI), which occurred in 38% (2486 of 6501) of AI/AN persons, was the most common reason for ID hospitalization. AI/AN persons were significantly more likely than non-AI/AN persons to be hospitalized for LRTI (rate ratio = 5.2, P < .001). Conclusions: A substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was LRTI. Public health programs and policies that address the risk factors for LRTI are likely to benefit AI/AN persons. C1 [Gounder, Prabhu P.; Holman, Robert C.; Hennessy, Thomas W.] Ctr Dis Control & Prevent, Arctic Invest Program, Div Preparedness & Emerging Infect, Natl Ctr Emerging & Zoonot Infect Dis, 4055 Tudor Ctr Dr, Anchorage, AK 99508 USA. [Seeman, Sara M.] Ctr Dis Control & Prevent, Div High Consequence Pathogens & Pathol, Natl Ctr Emerging & Zoonot Infect Dis, Atlanta, GA USA. [Rarig, Alice J.; McEwen, Mary] Alaska Dept Hlth & Social Serv, Div Publ Hlth, Juneau, AK USA. [Steiner, Claudia A.] Agcy Healthcare & Res & Qual, Ctr Delivery Org & Markets, Healthcare Cost & Utilizat Project, Rockville, MD USA. [Bartholomew, Michael L.] Indian Hlth Serv, Div Epidemiol & Dis Prevent, Rockville, MD USA. RP Gounder, PP (reprint author), Ctr Dis Control & Prevent, Arctic Invest Program, Div Preparedness & Emerging Infect, Natl Ctr Emerging & Zoonot Infect Dis, 4055 Tudor Ctr Dr, Anchorage, AK 99508 USA. EM pgounder@cdc.gov FU Centers for Disease Control and Prevention, Indian Health Service; Agency for Healthcare Research and Quality FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study received in-kind support (no grant support) from the Centers for Disease Control and Prevention, Indian Health Service, and Agency for Healthcare Research and Quality. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Agency for Healthcare Research and Quality. Preliminary results from this study were presented at the 16th International Congress on Circumpolar Health, Oulu, Finland, June 10, 2015. NR 36 TC 0 Z9 0 U1 0 U2 0 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0033-3549 EI 1468-2877 J9 PUBLIC HEALTH REP JI Public Health Rep. PD JAN-FEB PY 2017 VL 132 IS 1 BP 65 EP 75 DI 10.1177/0033354916679807 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA EI3AW UT WOS:000392363100012 PM 28005485 ER PT J AU Magnusson, DM Mistry, KB AF Magnusson, Dawn M. Mistry, Kamila B. TI Racial and Ethnic Disparities in Unmet Need for Pediatric Therapy Services: The Role of Family-Centered Care SO ACADEMIC PEDIATRICS LA English DT Article DE cultural sensitivity; developmental delay; shared decision making ID AUTISM SPECTRUM DISORDERS; EARLY INTERVENTION SERVICES; HEALTH-CARE; MEDICAL HOME; LATINO CHILDREN; DEVELOPMENTAL-DISABILITIES; RACIAL/ETHNIC DISPARITIES; DECISION-MAKING; YOUNG-CHILDREN; US CHILDREN AB OBJECTIVE: To examine whether individual elements of family-centered care (FCC) mediate racial/ethnic disparities in parent-reported unmet therapy need. METHODS: We conducted a secondary data analysis using the 2009-2010 National Survey of Children With Special Health Care Needs. A total of 6478 black, Hispanic, and white children ages 0 to 5 years had complete data on parent-reported unmet need and FCC. Five measured indicators of FCC included whether the child's health care provider spent enough time with the child (time), listened carefully to the child's parents (listening), was sensitive to family culture and values (sensitivity), delivered information specific to the child's health (information), and helped parents feel like partners (partnership). We performed staged multivariate logistic regression to test the association between race/ethnicity and parent-reported unmet therapy need, and to explore whether this association was mediated by elements of FCC using the Baron-Kenny mediation framework. RESULTS: Eighteen percent of children with special health care needs 0 to 5 years old with reported therapy need experienced unmet need. Black and Hispanic children were more likely than white children to have parent-reported unmet therapy need (adjusted odds ratio 1.59, 95% confidence interval 1.08-2.36). This disparity was no longer significant after adjustment for the FCC elements of time, sensitivity, or partnership. CONCLUSIONS: The provision of FCC is likely an important factor in meeting the therapy needs of children with developmental delay and in reducing racial/ethnic disparities in parent-reported unmet therapy need. Interventions aimed at fostering parent provider relationships through improved cultural sensitivity and engagement of parents as partners are necessary to ensure equitable utilization of these services. C1 [Magnusson, Dawn M.; Mistry, Kamila B.] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA. [Mistry, Kamila B.] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD USA. RP Magnusson, DM (reprint author), 3647 Xanthia St, Denver, CO 80238 USA. EM dmransom@gmail.com FU Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under Training for Careers in Pediatric Primary Care Research - National Research Service Award [HRSA T32HP10004]; Agency for Healthcare Research and Quality FX Supported in part by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under HRSA T32HP10004: Training for Careers in Pediatric Primary Care Research sponsored by a National Research Service Award, and the Agency for Healthcare Research and Quality. The funding sources were not involved in the study design; in the collection, analysis, or interpretation of the data; in the writing of the report; or in the decision to submit the article for publication. The views expressed in this article are those of the authors, and no official endorsement by the Agency for Healthcare Research and Quality or the Department of Health and Human Services is intended or should be inferred. NR 41 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD JAN-FEB PY 2017 VL 17 IS 1 BP 27 EP 33 PG 7 WC Pediatrics SC Pediatrics GA EG9AJ UT WOS:000391349100005 PM 27368126 ER PT J AU Cohen, MD AF Cohen, Monique D. TI Engaging patients in understanding and using evidence to inform shared decision making SO PATIENT EDUCATION AND COUNSELING LA English DT Editorial Material ID FACILITATORS; PERCEPTIONS; BARRIERS; HEALTH C1 [Cohen, Monique D.] Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. RP Cohen, MD (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. NR 16 TC 0 Z9 0 U1 3 U2 3 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD JAN PY 2017 VL 100 IS 1 BP 2 EP 3 DI 10.1016/j.pec.2016.11.013 PG 2 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA EG7JU UT WOS:000391224200001 PM 27986242 ER PT J AU Strollo, S Lionakis, MS Adjemian, J Steiner, CA Prevots, DR AF Strollo, Sara Lionakis, Michail S. Adjemian, Jennifer Steiner, Claudia A. Prevots, D. Rebecca TI Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002-2012 SO EMERGING INFECTIOUS DISEASES LA English DT Article ID BLOOD-STREAM INFECTIONS; NONCULTURE DIAGNOSTICS; CANDIDEMIA; CARE; SURVEILLANCE; COST AB Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis associated hospitalizations in the United States. We extracted data for 33 states for 2002-2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >= 65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005-2012 for men (annual change -3.9%) and women (annual change -4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease. C1 [Strollo, Sara; Lionakis, Michail S.; Adjemian, Jennifer; Prevots, D. Rebecca] NIH, Bldg 10, Bethesda, MD 20892 USA. [Adjemian, Jennifer] US PHS, Rockville, MD USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Strollo, Sara] Amer Canc Soc, Atlanta, GA 30329 USA. RP Prevots, DR (reprint author), NIAID, Lab Clin Infect Dis, NIH, 8 West Dr,MSC 2665, Bethesda, MD 20892 USA. EM rprevots@niaid.nih.gov FU Intramural Research Program of the National Institute of Allergy and Infectious Diseases, National Institutes of Health; Intramural Research Training Award fellow at the National Institutes of Health, Bethesda, MD FX This study was supported by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases, National Institutes of Health.; At the time of this study, Ms. Strollo was Intramural Research Training Award fellow at the National Institutes of Health, Bethesda, MD. She is currently a research analyst at the American Cancer Society, Atlanta, GA. Her research interests are epidemiology and population health. NR 24 TC 0 Z9 0 U1 7 U2 7 PU CENTERS DISEASE CONTROL PI ATLANTA PA 1600 CLIFTON RD, ATLANTA, GA 30333 USA SN 1080-6040 EI 1080-6059 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JAN PY 2017 VL 23 IS 1 BP 7 EP 13 DI 10.3201/eid2301.161198 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA EG2AV UT WOS:000390836400002 PM 27983497 ER PT J AU Manojlovich, M Ratz, D Miller, MA Krein, SL AF Manojlovich, Milisa Ratz, David Miller, Melissa A. Krein, Sarah L. TI Use of Daily Interruption of Sedation and Early Mobility in US Hospitals SO JOURNAL OF NURSING CARE QUALITY LA English DT Article DE Awakening and Breathing Coordination; Delirium assessment; and Early exercise/mobility bundle; early mobility; organizational characteristics; sedation; safety culture ID EARLY EXERCISE/MOBILITY BUNDLE; DELIRIUM MONITORING/MANAGEMENT; BREATHING COORDINATION; CRITICAL-CARE; INFECTIONS; AGITATION; OUTCOMES; PAIN AB Although the Awakening and Breathing Coordination, Delirium assessment, and Early exercise/mobility (ABCDE) bundle may be effective, individual components of ABCDE may not be implemented as intended. We examined the use of daily interruption of sedation (DIS) and early mobility, looking for an association between these bundle elements. Despite the growing use of DIS and early mobility, the two do not seem to be adopted together, with serious implications for the effectiveness of the ABCDE bundle. Key words: Awakening and Breathing Coordination, Delirium assessment, and Early exercise/mobility bundle, early mobility, organizational characteristics, sedation, safety culture C1 [Manojlovich, Milisa] Univ Michigan, Sch Nursing, 400 N Ingalls,Room 4306, Ann Arbor, MI 48109 USA. [Ratz, David] VA Ann Arbor Healthcare Syst, VA Ctr Clin Management Res, Ann Arbor, MI USA. [Miller, Melissa A.] Agcy Healthcare Res & Qual, Div Healthcare Associated Infect, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Krein, Sarah L.] Univ Michigan, Sch Med, VA Ctr Clin Management Res, VA Ann Arbor Healthcare Syst, Ann Arbor, MI USA. [Krein, Sarah L.] Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI USA. RP Manojlovich, M (reprint author), Univ Michigan, Sch Nursing, 400 N Ingalls,Room 4306, Ann Arbor, MI 48109 USA. EM mmanojlo@umich.edu FU Blue Cross Blue Shield of Michigan Foundation [1907.II]; US Department of Veterans Affairs National Center for Patient Safety FX This project was supported by the Blue Cross Blue Shield of Michigan Foundation grant 1907.II and the US Department of Veterans Affairs National Center for Patient Safety. Dr Miller participated in this project as an outside activity. The views expressed are those of the authors and no official endorsement by the Agency for Healthcare Research and Quality, US Department of Health and Human Services, Department of Veterans Affairs, or Federal government is intended or should be inferred. NR 16 TC 0 Z9 0 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1057-3631 EI 1550-5065 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JAN-MAR PY 2017 VL 32 IS 1 BP 71 EP 76 DI 10.1097/NCQ.0000000000000222 PG 6 WC Nursing SC Nursing GA EE0EL UT WOS:000389246500012 PM 27482874 ER PT J AU Califf, RM Robb, MA Bindman, AB Briggs, JP Collins, FS Conway, PH Coster, TS Cunningham, FE De Lew, N DeSalvo, KB Dymek, C Dzau, VJ Fleurence, RL Frank, RG Gaziano, M Kaufmann, P Lauer, M Marks, PW McGinnis, JM Richards, C Selby, JV Shulkin, DJ Shuren, J Slavitt, AM Smith, SR Washington, BV White, PJ Woodcock, J Woodson, J Sherman, RE AF Califf, Robert M. Robb, Melissa A. Bindman, Andrew B. Briggs, Josephine P. Collins, Francis S. Conway, Patrick H. Coster, Trinka S. Cunningham, Francesca E. De Lew, Nancy DeSalvo, Karen B. Dymek, Christine Dzau, Victor J. Fleurence, Rachael L. Frank, Richard G. Gaziano, Michael Kaufmann, Petra Lauer, Michael Marks, Peter W. McGinnis, J. Michael Richards, Chesley Selby, Joe V. Shulkin, David J. Shuren, Jeffrey Slavitt, Andrew M. Smith, Scott R. Washington, B. Vindell White, P. Jon Woodcock, Janet Woodson, Jonathan Sherman, Rachel E. TI Transforming Evidence Generation to Support Health and Health Care Decisions SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID TECHNOLOGY; GUIDELINES; SYSTEM C1 [Califf, Robert M.; Sherman, Rachel E.] US FDA, Off Commissioner, Silver Spring, MD USA. [Robb, Melissa A.; Sherman, Rachel E.] US FDA, Ctr Drug Evaluat & Res, Silver Spring, MD USA. [Marks, Peter W.] US FDA, Biol Evaluat & Res, Silver Spring, MD USA. [Shuren, Jeffrey] US FDA, Devices & Radiol Hlth, Silver Spring, MD USA. [Bindman, Andrew B.] Agcy Healthcare Res & Qual, Off Director, Rockville, MD USA. [Dymek, Christine] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD USA. [Briggs, Josephine P.] NIH, Natl Ctr Complementary & Integrat Hlth, Bldg 10, Bethesda, MD 20892 USA. [Collins, Francis S.] NIH, Off Director, Bldg 10, Bethesda, MD 20892 USA. [Kaufmann, Petra] NIH, Natl Ctr Adv Translat Sci, Bldg 10, Bethesda, MD 20892 USA. [Lauer, Michael] NIH, Off Extramural Res Act, Bldg 10, Bethesda, MD 20892 USA. [Conway, Patrick H.; Slavitt, Andrew M.] Ctr Medicare & Medicaid Serv, Baltimore, MD USA. [Coster, Trinka S.] US Army, Off Surg Gen Pharmacovigilance Ctr, Falls Church, VA USA. [Shulkin, David J.] Dept Vet Affairs, Off Secretary Hlth, Washington, DC USA. [De Lew, Nancy; DeSalvo, Karen B.] Off Assistant Secretary Planning & Evaluat, Off Hlth Policy, Washington, DC USA. [DeSalvo, Karen B.] Off Assistant Secretary Hlth, Washington, DC USA. [Washington, B. Vindell; White, P. Jon] Off Natl Coordinator Hlth Informat Technol, Washington, DC USA. [Dzau, Victor J.; McGinnis, J. Michael] Natl Acad Med, Dept Hlth & Human Serv, Washington, DC USA. [Fleurence, Rachael L.; Selby, Joe V.] Patient Centered Outcomes Res Inst, Washington, DC USA. [Cunningham, Francesca E.] Dept Vet Affairs, Ctr Medicat Safety, Hines, IL USA. [Frank, Richard G.] Harvard Univ, Dept Hlth Care Policy, Boston, MA 02115 USA. [McGinnis, J. Michael] Brigham & Womens Hosp, Div Aging, Mill Veteran Program, Vet Affairs Boston Healthcare Syst, Boston, MA 02115 USA. [McGinnis, J. Michael] Harvard Med Sch, Boston, MA USA. [Woodson, Jonathan] Boston Univ, Sch Med, Dept Surg, Boston, MA 02118 USA. [Richards, Chesley] Ctr Dis Control & Prevent, Off Publ Hlth Sci Serv, Atlanta, GA USA. RP Califf, RM (reprint author), US FDA, Off Commissioner, Silver Spring, MD USA. NR 13 TC 0 Z9 0 U1 1 U2 1 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 EI 1533-4406 J9 NEW ENGL J MED JI N. Engl. J. Med. PD DEC 15 PY 2016 VL 375 IS 24 BP 2395 EP 2400 DI 10.1056/NEJMsb1610128 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA EF0SO UT WOS:000390036500014 PM 27974039 ER PT J AU Metersky, ML Wang, Y Klompas, M Eckenrode, S Bakullari, A Eldridge, N AF Metersky, Mark L. Wang, Yun Klompas, Michael Eckenrode, Sheila Bakullari, Anila Eldridge, Noel TI Trend in Ventilator-Associated Pneumonia Rates Between 2005 and 2013 SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID NETWORK NHSN REPORT; SAFETY C1 [Metersky, Mark L.] Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, 263 Farmington Ave, Farmington, CT 06030 USA. [Wang, Yun] Harvard Sch Publ Hlth, Dept Biostat, Boston, MA USA. [Klompas, Michael] Harvard Med Sch, Dept Populat Med, Boston, MA USA. [Eckenrode, Sheila; Bakullari, Anila] Qualidigm, Wethersfield, CT USA. [Eldridge, Noel] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. RP Metersky, ML (reprint author), Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, 263 Farmington Ave, Farmington, CT 06030 USA. EM Metersky@uchc.edu NR 6 TC 0 Z9 0 U1 3 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 13 PY 2016 VL 316 IS 22 BP 2427 EP 2429 DI 10.1001/jama.2016.16226 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA EE8OE UT WOS:000389884600025 PM 27835709 ER PT J AU Bierman, AS Tinetti, ME AF Bierman, Arlene S. Tinetti, Mary E. TI Precision medicine to precision care: managing multimorbidity SO LANCET LA English DT Editorial Material ID CLINICAL-PRACTICE GUIDELINES; MULTIPLE CHRONIC CONDITIONS; DISEASE C1 [Bierman, Arlene S.] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD 20857 USA. [Tinetti, Mary E.] Yale Sch Med, Dept Med, New Haven, CT USA. [Tinetti, Mary E.] Yale Sch Publ Hlth, Dept Chron Dis Epidemiol, New Haven, CT USA. RP Bierman, AS (reprint author), Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD 20857 USA. EM arlene.bierman@ahrq.hhs.gov NR 13 TC 2 Z9 2 U1 6 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0140-6736 EI 1474-547X J9 LANCET JI Lancet PD DEC 3 PY 2016 VL 388 IS 10061 BP 2721 EP 2723 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA EE5FB UT WOS:000389629800008 PM 27924764 ER PT J AU Rettler, H Klevens, RM Haney, G Randall, L DeMaria, A Goderre, J AF Rettler, Hannah Klevens, R. Monina Haney, Gillian Randall, Liisa DeMaria, Alfred Goderre, Johanna TI Building Health IT Capacity to Improve HIV Infection Health Outcomes SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article AB Eighty-six percent of those engaged in HIV medical care in Massachusetts achieved viral suppression, making Massachusetts's long-term goal of eliminating new infections of HIV a real possibility. In order to achieve this goal, Massachusetts is working to engage all individuals living with HIV/AIDS in HIV medical care, keep them retained in care, and render their viral load non-detectable. Currently, in Massachusetts, the data elements necessary to monitor the HIV care continuum are documented in siloed health information systems that do not communicate with each other. Massachusetts has engaged in a pilot project to enhance their health information technology (IT) capacity to monitor the HIV care continuum and identify gaps in care. Massachusetts Virtual Epidemiologic Network (MAVEN) will be enhanced to perform as a consolidated electronic system to document and triage clinic-, laboratory-, and patient-level surveillance, field epidemiology and HIV care continuum data. The consolidation will enhance identification of patients infected with HIV and provide timely, actionable data for engagement and retention in HIV medical care. C1 [Rettler, Hannah; Klevens, R. Monina; Haney, Gillian; Randall, Liisa; DeMaria, Alfred] Bur Infect Dis & Lab Sci, Massachusetts Dept Publ Hlth, 305 South St, Boston, MA 02130 USA. Agcy Healthcare Res & Qual, Rockville, MD USA. RP Rettler, H (reprint author), Bur Infect Dis & Lab Sci, Massachusetts Dept Publ Hlth, 305 South St, Boston, MA 02130 USA. EM Hannah.Rettler@massmail.state.ma.us FU HHS, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau's Special Projects of National Significance Program [H97HA27536] FX This publication was made possible by grant number H97HA27536 from HHS, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau's Special Projects of National Significance Program. The views expressed in this article are those of the authors and no official endorsement by the HRSA, HHS, or the federal government is intended or should be inferred. NR 5 TC 0 Z9 0 U1 0 U2 0 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD DEC PY 2016 VL 22 IS 12 BP 821 EP 825 PG 5 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA EF2AP UT WOS:000390126900010 PM 27982665 ER PT J AU Lipton, BJ Wherry, LR Miller, S Kenney, GM Decker, S AF Lipton, Brandy J. Wherry, Laura R. Miller, Sarah Kenney, Genevieve M. Decker, Sandra TI Previous Medicaid Expansion May Have Had Lasting Positive Effects On Oral Health Of Non-Hispanic Black Children SO HEALTH AFFAIRS LA English DT Article ID EARLY-CHILDHOOD CARIES; DENTAL VISITS; ELIGIBILITY; BIRTH; ACCESS; TRIAL; WOMEN; CARE AB Healthy tooth development starts early in life, beginning even before birth. We present new evidence suggesting that a historic public health insurance expansion for pregnant women and children in the United States in the 1980s and 1990s may have had long-lasting effects on the oral health of the children gaining eligibility. We estimated the relationship between adult oral health and the extent of state public health insurance eligibility for pregnant women, infants, and children throughout childhood separately for non-Hispanic whites, non-Hispanic blacks, and Hispanics. We found that expanded Medicaid coverage geared toward pregnant women and children during their first year of life was linked to better oral health in adulthood among non-Hispanic blacks. Our results also suggested that there might be a benefit to expanded public health insurance eligibility for children at ages 1-6 among non-Hispanic blacks and Hispanics. Medicaid expansions appear to have had long-lasting effects for certain low-income children and helped narrow racial/ethnic disparities in adult oral health. C1 [Lipton, Brandy J.; Decker, Sandra] Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. [Wherry, Laura R.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Miller, Sarah] Univ Michigan, Stephen M Ross Sch Business, Ann Arbor, MI 48109 USA. [Kenney, Genevieve M.] Urban Inst, Ctr Hlth Policy, Washington, DC 20037 USA. RP Lipton, BJ (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. EM Brandy.lipton@ahrq.hhs.gov NR 26 TC 0 Z9 0 U1 3 U2 3 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD DEC PY 2016 VL 35 IS 12 BP 2249 EP 2258 DI 10.1377/hlthaff.2016.0865 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EF4UR UT WOS:000390328000013 PM 27920313 ER PT J AU Abdus, S Selden, TM Keenan, P AF Abdus, Salam Selden, Thomas M. Keenan, Patricia TI The Financial Burdens Of High-Deductible Plans SO HEALTH AFFAIRS LA English DT Article ID CARE AB The increased prevalence of high-deductible health plans raises concerns regarding high financial burdens from health care, particularly for low-income adults. C1 [Abdus, Salam] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. [Selden, Thomas M.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Div Res & Modeling, Rockville, MD USA. [Keenan, Patricia] Agcy Healthcare Res & Qual, Off Director, Rockville, MD USA. RP Abdus, S (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. EM salam.abdus@ahrq.hhs.gov NR 14 TC 0 Z9 0 U1 1 U2 1 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD DEC PY 2016 VL 35 IS 12 BP 2297 EP 2301 DI 10.1377/hlthaff.2016.0842 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EF4UR UT WOS:000390328000019 PM 27920319 ER PT J AU Lee, KC Ngo-Metzger, Q Wolff, T Chowdhury, J Lefevre, ML Meyers, DS AF Lee, Karen C. Ngo-Metzger, Quyen Wolff, Tracy Chowdhury, Joya Lefevre, Michael L. Meyers, David S. TI Sexually Transmitted Infections: Recommendations from the US Preventive Services Task Force SO AMERICAN FAMILY PHYSICIAN LA English DT Article ID B-VIRUS INFECTION; UNITED-STATES; AFRICAN-AMERICAN; PRIMARY-CARE; HEPATITIS; INTERVENTIONS; CHLAMYDIA; GONORRHEA; ADOLESCENTS; TRIAL AB The U.S. Preventive Services Task Force (USPSTF) has issued recommendations on behavioral counseling to prevent sexually transmitted infections (STIs) and recommendations about screening for individual STIs. Clinicians should obtain a sexual history to assess for behaviors that increase a patient's risk. Community and population risk factors should also be considered. The USPSTF recommends intensive behavioral counseling for all sexually active adolescents and for adults whose history indicates an increased risk of STIs. These interventions can reduce STI acquisition and risky sexual behaviors, and increase condom use and other protective behaviors. The USPSTF recommends screening for chlamydia and gonorrhea in all sexually active women 24 years and younger, and in older women at increased risk. It recommends screening for human immunodeficiency virus (HIV) infection in all patients 15 to 65 years of age regardless of risk, as well as in younger and older patients at increased risk of HIV infection. The USPSTF also recommends screening for hepatitis B virus infection and syphilis in persons at increased risk. All pregnant women should be tested for hepatitis B virus infection, HIV infection, and syphilis. Pregnant women 24 years and younger, and older women with risk factors should be tested for gonorrhea and chlamydia. The USPSTF recommends against screening for asymptomatic herpes simplex virus infection. There is inadequate evidence to determine the optimal interval for repeat screening; clinicians should rescreen patients when their sexual history reveals new or persistent risk factors. Copyright (C) 2016 American Academy of Family Physicians. C1 [Lee, Karen C.; Ngo-Metzger, Quyen; Wolff, Tracy; Chowdhury, Joya] Agcy Healthcare Res & Qual, Task Force Program, Rockville, MD USA. [Lefevre, Michael L.] Univ Missouri, Sch Med, Columbia, MO USA. [Meyers, David S.] Agcy Healthcare Res & Qual, 5600 Fishers Ln, Rockville, MD 20857 USA. RP Ngo-Metzger, Q (reprint author), Agcy Healthcare Res & Qual, 5600 Fishers Ln, Rockville, MD 20857 USA. EM quyen.ngo-metzger@ahrq.hhs.gov NR 36 TC 0 Z9 0 U1 1 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD DEC 1 PY 2016 VL 94 IS 11 BP 907 EP 915 PG 9 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA EE0TP UT WOS:000389292100006 PM 27929270 ER PT J AU Beckman, MG Abe, K Barnes, K Bartman, B Brady, PJ Hooper, WC AF Beckman, Michele G. Abe, Karon Barnes, Kelly Bartman, Barbara Brady, P. Jeffrey Hooper, W. Craig TI Strategies and Partnerships Toward Prevention of Healthcare-Associated Venous Thromboembolism SO JOURNAL OF HOSPITAL MEDICINE LA English DT Article ID EVENTS C1 [Beckman, Michele G.; Abe, Karon; Hooper, W. Craig] Ctr Dis Control & Prevent, Div Blood Disorders, 4770 Buford Highway,MS E-64, Atlanta, GA 30341 USA. [Barnes, Kelly] Joint Commiss Ctr Transforming Healthcare, Oak Brook Terrace, IL USA. [Bartman, Barbara; Brady, P. Jeffrey] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Beckman, MG (reprint author), Ctr Dis Control & Prevent, Div Blood Disorders, 4770 Buford Highway,MS E-64, Atlanta, GA 30341 USA. EM mbeckman@cdc.gov NR 10 TC 0 Z9 0 U1 1 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1553-5592 EI 1553-5606 J9 J HOSP MED JI J. Hosp. Med. PD DEC PY 2016 VL 11 IS SUPP 2 BP S5 EP S7 DI 10.1002/jhm.2659 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA EE2MT UT WOS:000389419200005 PM 27925420 ER PT J AU Martsolf, GR Gibson, TB Benevent, R Jiang, HJ Stocks, C Ehrlich, ED Kandrack, R Auerbach, DI AF Martsolf, Grant R. Gibson, Teresa B. Benevent, Richele Jiang, H. Joanna Stocks, Carol Ehrlich, Emily D. Kandrack, Ryan Auerbach, David I. TI An Examination of Hospital Nurse Staffing and Patient Experience with Care: Differences between Cross-Sectional and Longitudinal Estimates SO HEALTH SERVICES RESEARCH LA English DT Article DE Patient care; nursing care; nurse staffing; patient satisfaction ID QUALITY-OF-CARE; 30-DAY READMISSIONS; PATIENTS PERCEPTION; MEDICARE PATIENTS; HCAHPS SURVEY; OUTCOMES; SATISFACTION; SAFETY; ASSOCIATION; PREDICTORS AB Objective. To study the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Data Sources. State hospital financial and utilization reports, Healthcare Cost and Utilization Project State Inpatient Databases, HCAHPS survey, and American Hospital Association Annual Survey of Hospitals. Study Design. Retrospective study using cross-sectional and longitudinal models to estimate the effect of nurse staffing levels and skill mix on seven HCAHPS measures. Data Collection/Extraction Methods. Hospital-level data measuring nurse staffing, patient experience, and hospital characteristics from 2009 to 2011 for 341 hospitals (977 hospital years) in California, Maryland, and Nevada. Principal Findings. Nurse staffing level (i.e., number of licensed practical nurses and registered nurses per 1,000 inpatient days) was significantly and positively associated with all seven HCAHPS measures in cross-sectional models and three of seven measures in longitudinal models. Nursing skill mix (i.e., percentage of all staff who are registered nurses) was significantly and negatively associated with scores on one measure in cross-sectional models and none in longitudinal models. Conclusions. After controlling for unobserved hospital characteristics, the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience. C1 [Martsolf, Grant R.; Kandrack, Ryan] RAND Corp, 4570 Fifth Ave,Suite 600, Pittsburgh, PA 15213 USA. [Gibson, Teresa B.] Truven Hlth Analyt, Hlth Outcomes Res, Ann Arbor, MI USA. [Benevent, Richele] Truven Hlth Analyt, Hlth Outcomes Res, Santa Barbara, CA USA. [Jiang, H. Joanna; Stocks, Carol] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Ehrlich, Emily D.] Math Policy Res, Hlth Res Div, Ann Arbor, MI USA. [Auerbach, David I.] Montana State Univ, Ctr Interdisciplinary Hlth Workforce Studies, Bozeman, MT 59717 USA. RP Martsolf, GR (reprint author), RAND Corp, 4570 Fifth Ave,Suite 600, Pittsburgh, PA 15213 USA. EM martsolf@rand.org FU Agency for Healthcare Research and Quality FX This study was funded by the Agency for Healthcare Research and Quality through intramural research. The views expressed herein are those of the authors. No official endorsement by any agency of the federal or state governments, RAND Corporation, or Truven Health Analytics, is intended or should be inferred. The authors have no conflicts of interest to report. NR 50 TC 0 Z9 0 U1 15 U2 15 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 2016 VL 51 IS 6 BP 2221 EP 2241 DI 10.1111/1475-6773.12462 PG 21 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA ED8UP UT WOS:000389146700010 PM 26898946 ER PT J AU Battles, JB Reback, KA Azam, I AF Battles, James B. Reback, Kathryn A. Azam, Irim TI Paving the Way for Progress: The Agency for Healthcare Research and Quality Patient Safety and Medical Liability Demonstration Initiative Introduction SO HEALTH SERVICES RESEARCH LA English DT Article ID RESOLUTION PROGRAMS C1 [Battles, James B.; Reback, Kathryn A.; Azam, Irim] Agcy Healthcare Res & Qual, 5600 Fishers Lane MS 06N100B, Rockville, MD 20857 USA. RP Battles, JB (reprint author), Agcy Healthcare Res & Qual, 5600 Fishers Lane MS 06N100B, Rockville, MD 20857 USA. EM James.Battles@ahrq.hhs.gov NR 29 TC 1 Z9 1 U1 2 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 2016 VL 51 SU S3 BP 2401 EP 2413 DI 10.1111/1475-6773.12632 PG 13 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA ED8UL UT WOS:000389146300001 PM 27892624 ER PT J AU Kirby, JB Davidoff, AJ Basu, J AF Kirby, James B. Davidoff, Amy J. Basu, Jayasree TI The ACA's Zero Cost-Sharing Mandate and Trends in Out-of-Pocket Expenditures on Well-Child and Screening Mammography Visits SO MEDICAL CARE LA English DT Article DE preventive care; out-of-pocket costs; affordable care act; cost-sharing ID AFFORDABLE CARE ACT; PREVENTIVE SERVICES; ELIMINATION; CANCER; RECEIPT; IMPACT AB Background:Starting in September of 2010, the Patient Protection and Affordable Care Act required most health insurance policies to cover evidence-based preventive care with no cost-sharing (no copays, coinsurance, or deductibles). It is unknown, however, whether declines in out-of-pocket costs for preventive services are large enough to prompt increases in utilization, the ultimate goal of the policy.Methods:In this study, we use a nationally representative sample of ambulatory care visits to estimate the impact of the zero cost-sharing mandate on out-of-pocket expenditures on well-child and screening mammography visits. Estimates are made using 2-part interrupted time-series models, with well-woman visits serving as the control group because they were not covered under the zero cost-sharing mandate until after our study period.Results:Results indicate a substantial reduction in out-of-pocket costs attributable to the Affordable Care Act. Between January 2011 and September 2012, the zero cost-sharing mandate reduced per-visit out-of-pocket costs for well-child visits from $18.46 to $8.08 (56%) and out-of-pocket costs for screening mammography visits from $25.43 to $6.50 (74%). No reduction was apparent for well-woman visits.Conclusions:The Affordable Care Act's zero cost-sharing mandate for preventive care has had a large impact on out-of-pocket expenditures for well-child and mammography visits. To increase preventive service use, research is needed to better understand barriers to obtaining preventive care that are not directly related to cost. C1 [Kirby, James B.; Basu, Jayasree] Agcy Healthcare Res & Qual, 5600 Fishers Lane, Rockville, MD 20857 USA. [Davidoff, Amy J.] Yale Sch Publ Hlth, New Haven, CT USA. RP Kirby, JB (reprint author), Agcy Healthcare Res & Qual, 5600 Fishers Lane, Rockville, MD 20857 USA. EM james.kirby@ahrq.hhs.gov NR 19 TC 0 Z9 0 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD DEC PY 2016 VL 55 IS 12 BP 1056 EP 1062 DI 10.1097/MLR.0000000000000610 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA ED6JW UT WOS:000388962900007 PM 27479595 ER PT J AU O'Shea, L Bindman, AB AF O'Shea, Luke Bindman, Andrew B. TI Personal Health Budgets for Patients with Complex Needs SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material C1 [O'Shea, Luke; Bindman, Andrew B.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Bindman, Andrew B.] AHRQ, Rockville, MD USA. RP O'Shea, L (reprint author), Univ Calif San Francisco, San Francisco, CA 94143 USA. NR 4 TC 0 Z9 0 U1 1 U2 1 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 EI 1533-4406 J9 NEW ENGL J MED JI N. Engl. J. Med. PD NOV 10 PY 2016 VL 375 IS 19 BP 1815 EP 1817 DI 10.1056/NEJMp1606040 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA EB6ZK UT WOS:000387534200003 PM 27959646 ER PT J AU Riehle-Colarusso, TJ Bergersen, L Broberg, CS Cassell, CH Gray, DT Grosse, SD Jacobs, JP Jacobs, ML Kirby, RS Kochilas, L Krishnaswamy, A Marelli, A Pasquali, SK Wood, T Oster, ME AF Riehle-Colarusso, Tiffany J. Bergersen, Lisa Broberg, Craig S. Cassell, Cynthia H. Gray, Darryl T. Grosse, Scott D. Jacobs, Jeffrey P. Jacobs, Marshall L. Kirby, Russell S. Kochilas, Lazaros Krishnaswamy, Asha Marelli, Arianne Pasquali, Sara K. Wood, Thalia Oster, Matthew E. CA MPH Congenital Heart Public Hlth TI Databases for Congenital Heart Defect Public Health Studies Across the Lifespan SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Review DE congenital heart defects; databases; public health science ID BIRTH-DEFECTS; UNITED-STATES; METROPOLITAN ATLANTA; RACIAL/ETHNIC DIFFERENCES; SURVEILLANCE PROGRAMS; DISEASE; SURGERY; POPULATION; PREVENTION; MORTALITY C1 [Riehle-Colarusso, Tiffany J.; Cassell, Cynthia H.; Krishnaswamy, Asha; Oster, Matthew E.] Ctr Dis Control & Prevent, Div Congenital & Dev Disorders, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA USA. [Grosse, Scott D.] Ctr Dis Control & Prevent, Div Congenital & Dev Disorders, Off Director, Atlanta, GA USA. [Bergersen, Lisa] Harvard Med Sch, Childrens Hosp Boston, Dept Cardiol, Boston, MA USA. [Broberg, Craig S.] Oregon Hlth & Sci Univ, Adult Congenital Heart Program, Knight Cardiovasc Inst, Portland, OR 97201 USA. [Gray, Darryl T.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Jacobs, Jeffrey P.; Jacobs, Marshall L.] Johns Hopkins All Childrens Hosp, Div Cardiovasc Surg, Dept Surg, Johns Hopkins All Childrens Heart Inst, St Petersburg, FL USA. [Jacobs, Jeffrey P.; Jacobs, Marshall L.] Johns Hopkins All Childrens Hosp, Div Cardiovasc Surg, Dept Surg, Johns Hopkins All Childrens Heart Inst, Tampa, FL USA. [Jacobs, Jeffrey P.; Jacobs, Marshall L.] Johns Hopkins All Childrens Hosp, Div Cardiovasc Surg, Dept Surg, Johns Hopkins All Childrens Heart Inst, Orlando, FL USA. [Jacobs, Jeffrey P.; Jacobs, Marshall L.] Florida Hosp Children, St Petersburg, FL USA. [Jacobs, Jeffrey P.; Jacobs, Marshall L.] Florida Hosp Children, Tampa, FL USA. [Jacobs, Jeffrey P.; Jacobs, Marshall L.] Florida Hosp Children, Orlando, FL USA. [Jacobs, Jeffrey P.; Jacobs, Marshall L.] Johns Hopkins Univ, Dept Surg, Div Cardiac Surg, Baltimore, MD USA. [Kirby, Russell S.] Univ S Florida, Coll Publ Hlth, Dept Community & Family Hlth, Tampa, FL USA. [Kochilas, Lazaros; Oster, Matthew E.] Emory Univ, Sch Med, Childrens Healthcare Atlanta, Atlanta, GA USA. [Marelli, Arianne] McGill Adult Unit Congenital Heart Dis, Montreal, PQ, Canada. [Pasquali, Sara K.] Univ Michigan, CS Mott Childrens Hosp, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA. [Wood, Thalia] Assoc Publ Hlth Labs, Silver Spring, MD USA. RP Riehle-Colarusso, TJ (reprint author), Ctr Dis Control & Prevent, 4770 Buford Highway,Mailstop E-86, Atlanta, GA 30341 USA. EM tcolarusso@cdc.gov NR 67 TC 0 Z9 0 U1 2 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD NOV PY 2016 VL 5 IS 11 AR e004148 DI 10.1161/JAHA.116.004148 PG 15 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA EG1IU UT WOS:000390786600033 ER PT J AU Nocon, RS Lee, SM Sharma, R Ngo-Metzger, Q Mukamel, DB Gao, Y White, LM Shi, LY Chin, MH Laiteerapong, N Huang, ES AF Nocon, Robert S. Lee, Sang Mee Sharma, Ravi Ngo-Metzger, Quyen Mukamel, Dana B. Gao, Yue White, Laura M. Shi, Leiyu Chin, Marshall H. Laiteerapong, Neda Huang, Elbert S. TI Health Care Use and Spending for Medicaid Enrollees in Federally Qualified Health Centers Versus Other Primary Care Settings SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID SERVICES AB Objectives. To compare health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non-health center settings in a context of significant growth. Methods. Using fee-for-service Medicaid claims from 13 states in 2009, we compared patients receiving the majority of their primary care in federally qualified health centers with propensity score-matched comparison groups receiving primary care in other settings. Results. We found that health center patients had lower use and spending than did non-health center patients across all services, with 22% fewer visits and 33% lower spending on specialty care and 25% fewer admissions and 27% lower spending on inpatient care. Total spending was 24% lower for health center patients. Conclusions. Our analysis of 2009 Medicaid claims, which includes the largest sample of states and more recent data than do previous multistate claims studies, demonstrates that the health center program has provided a cost-efficient setting for primary care for Medicaid enrollees. C1 [Nocon, Robert S.; Lee, Sang Mee] Univ Chicago, Dept Publ Hlth Sci, Chicago, IL 60637 USA. [Chin, Marshall H.; Laiteerapong, Neda; Huang, Elbert S.] Univ Chicago, Dept Med, 5841 S Maryland Ave, Chicago, IL 60637 USA. [Sharma, Ravi] US Dept HHS, Bur Primary Hlth Care Hlth Resources & Serv Adm, Rockville, MD USA. [Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, Rockville, MD USA. [Mukamel, Dana B.; White, Laura M.] Univ Calif Irvine, Dept Med, Irvine, CA 92717 USA. [Shi, Leiyu] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA. RP Nocon, RS (reprint author), Univ Chicago, Dept Med, Gen Internal Med Sect, 5841 S Maryland Ave,MC2007, Chicago, IL 60637 USA. EM rnocon@medicine.bsd.uchicago.edu FU Chicago Center for Diabetes Translation Research [P30DK20595]; Diabetes Research and Training Center [P60 DK20595]; Agency for Healthcare Research and Quality (AHRQ) [T32 HS000084]; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Midcareer Investigator Awards in Patient-Oriented Research [K24 DK071933, K24 DK105340] FX This work was funded under a contract to the Health Resources and Services Administration (HRSA), and R. Sharma is an HRSA employee. The work was also supported by the Chicago Center for Diabetes Translation Research (grant P30DK20595) and the Diabetes Research and Training Center (grant P60 DK20595). R. S. Nocon. is supported by an Agency for Healthcare Research and Quality (AHRQ) training grant (T32 HS000084). M. H. Chin and E. S. Huang are supported by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Midcareer Investigator Awards in Patient-Oriented Research (K24 DK071933, K24 DK105340). NR 26 TC 0 Z9 0 U1 1 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 EI 1541-0048 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD NOV PY 2016 VL 106 IS 11 BP 1981 EP 1989 DI 10.2105/AJPH.2016.303341 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA EC4IE UT WOS:000388090200033 PM 27631748 ER PT J AU Hinkle, SN Mumford, SL Grantz, KL Silver, RM Mitchell, EM Sjaarda, LA Radin, RG Perkins, NJ Galai, N Schisterman, EF AF Hinkle, Stefanie N. Mumford, Sunni L. Grantz, Katherine L. Silver, Robert M. Mitchell, Emily M. Sjaarda, Lindsey A. Radin, Rose G. Perkins, Neil J. Galai, Noya Schisterman, Enrique F. TI Association of Nausea and Vomiting During Pregnancy With Pregnancy Loss A Secondary Analysis of a Randomized Clinical Trial SO JAMA INTERNAL MEDICINE LA English DT Article ID LOW-DOSE ASPIRIN; RISK-FACTORS; SYMPTOMS; TIME AB IMPORTANCE Nausea and vomiting during pregnancy have been associated with a reduced risk for pregnancy loss. However, most prior studies enrolled women with clinically recognized pregnancies, thereby missing early losses. OBJECTIVE To examine the association of nausea and vomiting during pregnancy with pregnancy loss. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial, Effects of Aspirin in Gestation and Reproduction, enrolled women with 1 or 2 prior pregnancy losses at 4 US clinical centers from June 15, 2007, to July 15, 2011. This secondary analysis was limited to women with a pregnancy confirmed by positive results of a human chorionic gonadotropin (hCG) test. Nausea symptoms were ascertained from daily preconception and pregnancy diaries for gestational weeks 2 to 8. From weeks 12 to 36, participants completed monthly questionnaires summarizing symptoms for the preceding 4 weeks. A week-level variable included nausea only, nausea with vomiting, or neither. MAIN OUTCOMES AND MEASURES Peri-implantation (hCG-detected pregnancy without ultrasonographic evidence) and clinically recognized pregnancy losses. RESULTS A total of 797 women (mean [SD] age, 28.7 [4.6] years) had an hCG-confirmed pregnancy. Of these, 188 pregnancies (23.6%) ended in loss. At gestational week 2, 73 of 409 women (17.8%) reported nausea without vomiting and 11 of 409 women (2.7%), nausea with vomiting. By week 8, the proportions increased to 254 of 443 women (57.3%) and 118 of 443 women (26.6%), respectively. Hazard ratios (HRs) for nausea (0.50; 95% CI, 0.32-0.80) and nausea with vomiting (0.25; 95% CI, 0.12-0.51) were inversely associated with pregnancy loss. The associations of nausea (HR, 0.59; 95% CI, 0.29-1.20) and nausea with vomiting (HR, 0.51; 95% CI, 0.11-2.25) were similar for peri-implantation losses but were not statistically significant. Nausea (HR, 0.44; 95% CI, 0.26-0.74) and nausea with vomiting (HR, 0.20; 95% CI, 0.09-0.44) were associated with a reduced risk for clinical pregnancy loss. CONCLUSIONS AND RELEVANCE Among women with 1 or 2 prior pregnancy losses, nausea and vomiting were common very early in pregnancy and were associated with a reduced risk for pregnancy loss. These findings overcome prior analytic and design limitations and represent the most definitive data available to date indicating the protective association of nausea and vomiting in early pregnancy and the risk for pregnancy loss. C1 [Hinkle, Stefanie N.; Mumford, Sunni L.; Grantz, Katherine L.; Mitchell, Emily M.; Sjaarda, Lindsey A.; Radin, Rose G.; Perkins, Neil J.; Schisterman, Enrique F.] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Epidemiol Branch, Div Intramural Populat Hlth Res, NIH, 6710B Rockledge Dr,MSC 7004, Bethesda, MD 20817 USA. [Silver, Robert M.] Univ Utah, Hlth Sci Ctr, Sch Med, Dept Obstet & Gynecol, Salt Lake City, UT USA. [Mitchell, Emily M.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Galai, Noya] Univ Haifa, Dept Stat, Haifa, Israel. RP Schisterman, EF (reprint author), Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Epidemiol Branch, Div Intramural Populat Hlth Res, NIH, 6710B Rockledge Dr,MSC 7004, Bethesda, MD 20817 USA. EM schistee@mail.nih.gov OI Schisterman, Enrique/0000-0003-3757-641X FU Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health [HHSN267200603423, HHSN267200603424, HHSN267200603426] FX This study was supported by contracts HHSN267200603423, HHSN267200603424, and HHSN267200603426 from the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health. NR 23 TC 1 Z9 1 U1 2 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 2168-6106 EI 2168-6114 J9 JAMA INTERN MED JI JAMA Intern. Med. PD NOV PY 2016 VL 176 IS 11 BP 1621 EP 1627 DI 10.1001/jamainternmed.2016.5641 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA EC4KK UT WOS:000388097700011 PM 27669539 ER PT J AU Vo, H Cheng, D Cheng, TL Mistry, KB AF Vo, Holly Cheng, Diana Cheng, Tina L. Mistry, Kamila B. TI Health Behaviors Among Women Using Fertility Treatment SO MATERNAL AND CHILD HEALTH JOURNAL LA English DT Article DE Fertility treatment; Perinatal behaviors; PRAMS; Pregnancy intention; Preventable behaviors ID RANDOMIZED-TRIAL; ALCOHOL-USE; PREGNANCY; DISCONTINUATION; PRECONCEPTION; INTERVENTION; INFERTILITY; PREVALENCE; REASONS; CARE AB Objective To describe associated perinatal behaviors among women using fertility treatment. Methods Data were obtained for 12,197 Maryland women who delivered live neonates from 2004 to 2011 and completed the Pregnancy Risk Assessment Monitoring System survey postpartum. We conducted weighted descriptive and multivariable analyses. Results Among 1368 women using fertility treatments, 28.4 % did not take folic acid daily 1 month before pregnancy, 58.1 % consumed alcohol, 16.0 % were binge drinking, and 7.5 % smoked 3 months before pregnancy, and 12.9 % consumed alcohol and 3.7 % smoked during pregnancy. Additionally, among those who consumed alcohol and smoked before pregnancy, 36.0 % and 25.7 %, respectively, reported not receiving prenatal counseling about alcohol use and smoking. Lack of counseling for these women was higher than for women with unintended pregnancies who consumed alcohol (36.0 % vs. 26.3 %, P < .001) or smoked (25.7 % vs. 15.0 %, P < .001). Women using fertility treatments were less likely to have inadequate folic acid intake [adjusted odds ratio (aOR) 0.14, 95 % confidence interval (CI) 0.10-0.18), consume alcohol (aOR 0.52, 95 % CI 0.40-0.69), and smoke (aOR 0.35, 95 % CI 0.21-0.59) before pregnancy, and no statistically significant differences were found during pregnancy for alcohol consumption (aOR 0.89, 95 % CI 0.59-1.33) or smoking (aOR 0.64, 95 % CI 0.28-1.45) compared to women with unintended pregnancies. Conclusion A significant proportion of women using fertility treatments were not practicing recommended perinatal behaviors or receiving prenatal counseling on preventable risk factors. Ongoing counseling before and during pregnancy may be especially effective for optimizing healthy behaviors among these motivated women undergoing often stressful treatments for fertility. C1 [Vo, Holly] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA. [Vo, Holly] Univ Calif San Diego, Sch Med, 9500 Gilman Dr MC 0606, La Jolla, CA 92093 USA. [Cheng, Diana] Maryland Dept Hlth & Mental Hyg, Maternal & Child Hlth Bur, 201 W Preston St,Room 313, Baltimore, MD 21201 USA. [Cheng, Tina L.] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Populat Family & Reprod Hlth, Baltimore, MD USA. [Cheng, Tina L.] Johns Hopkins Univ, Sch Med, Dept Pediat, 1800 Orleans St 8941, Baltimore, MD 21287 USA. [Mistry, Kamila B.] Johns Hopkins Univ, Sch Med, Dept Pediat, Div Gen Pediat & Adolescent Med, Baltimore, MD 21205 USA. [Mistry, Kamila B.] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, 5600 Fishers Lane,Room 06N03, Rockville, MD 20857 USA. RP Vo, H (reprint author), Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA.; Vo, H (reprint author), Univ Calif San Diego, Sch Med, 9500 Gilman Dr MC 0606, La Jolla, CA 92093 USA. EM holly.vo@ucsf.edu; dcheng22@comcast.net; tcheng2@jhmi.edu; kmistry2@jhmi.edu NR 25 TC 0 Z9 0 U1 2 U2 2 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1092-7875 EI 1573-6628 J9 MATERN CHILD HLTH J JI Matern. Child Health J. PD NOV PY 2016 VL 20 IS 11 BP 2328 EP 2335 DI 10.1007/s10995-016-2056-3 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA EB8VV UT WOS:000387670300014 PM 27473090 ER PT J AU McNellis, RJ Beswick-Escanlar, V AF McNellis, Robert J. Beswick-Escanlar, Vincent TI Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [McNellis, Robert J.] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20857 USA. [Beswick-Escanlar, Vincent] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP McNellis, RJ (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20857 USA. NR 2 TC 0 Z9 0 U1 9 U2 9 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD OCT 15 PY 2016 VL 94 IS 8 BP 661 EP 662 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DZ5PR UT WOS:000385914500008 PM 27929225 ER PT J AU Martsolf, GR Barrett, ML Weiss, AJ Washington, R Steiner, CA Mehrotra, A Coffey, RM AF Martsolf, Grant R. Barrett, Marguerite L. Weiss, Audrey J. Washington, Raynard Steiner, Claudia A. Mehrotra, Ateev Coffey, Rosanna M. TI Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Readmission Rates: Implications for the Hospital Readmissions Reduction Program SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article DE readmissions; risk adjustment; Medicare; value-based payment; race and socioeconomic status ID ACUTE MYOCARDIAL-INFARCTION; HEART-FAILURE; CARE; PENALTIES; OUTCOMES AB Under the Hospital Readmissions Reduction Program (HRRP) of the Centers for Medicare & Medicaid Services (CMS), hospitals with excess readmissions for select conditions and procedures are penalized. However, readmission rates are not risk adjusted for socioeconomic status (SES) or race/ethnicity. We examined how adding SES and race/ethnicity to the CMS risk-adjustment algorithm would affect hospitals' excess readmission ratios and potential penalties under the HRRP. For each HRRP measure, we compared excess readmission ratios with and without SES and race/ethnicity included in the CMS standard risk-adjustment algorithm and estimated the resulting effects on overall penalties across a number of hospital characteristics. For the 5 HRRP measures (heart failure, acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, and total hip or knee arthroplasty), we used data from the Healthcare Cost and Utilization Project's State Inpatient Databases for 2011-2012 to calculate the excess readmission ratio with and without SES and race/ethnicity included in the model. With these ratios, we estimated the impact on HRRP penalties and found that risk adjusting for SES and race/ethnicity would affect Medicare payments for 83.8% of hospitals. The effect on the size of HRRP penalties ranged from - 14.4% to 25.6%, but the impact on overall Medicare base payments was small-ranging from -0.09% to 0.06%. Including SES and race/ethnicity in the calculation had a disproportionately favorable effect on safety-net and rural hospitals. Any financial effects on hospitals and on the Medicare program of adding SES and race/ethnicity to the HRRP risk-adjustment calculation likely would be small. C1 [Martsolf, Grant R.] RAND Corp, 4570 Fifth Ave,Suite 600, Pittsburgh, PA 15213 USA. [Barrett, Marguerite L.] ML Barrett Inc, San Diego, CA USA. [Weiss, Audrey J.; Coffey, Rosanna M.] Truven Hlth Analyt Inc, Santa Barbara, CA USA. [Washington, Raynard] Council Affordable Qual Healthcare, Washington, DC USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Mehrotra, Ateev] Harvard Med Sch, Boston, MA USA. [Mehrotra, Ateev] RAND Corp, Boston, MA USA. RP Martsolf, GR (reprint author), RAND Corp, 4570 Fifth Ave,Suite 600, Pittsburgh, PA 15213 USA. EM martsolf@rand.org FU Agency for Healthcare Research and Quality (AHRQ); Center for Delivery, Organization, and Markets; Healthcare Cost and Utilization Project (HCUP) FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Agency for Healthcare Research and Quality (AHRQ); Center for Delivery, Organization, and Markets; and Healthcare Cost and Utilization Project (HCUP). NR 22 TC 0 Z9 0 U1 4 U2 4 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0046-9580 EI 1945-7243 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD OCT 5 PY 2016 VL 53 AR 0046958016667596 DI 10.1177/0046958016667596 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EA6OW UT WOS:000386749500001 ER PT J AU Hsieh, HL Patel, C Pearson, W Huppert, J Tao, GY AF Hsieh, Hsien-Lin Patel, Chirag Pearson, William Huppert, Jill Tao, Guoyu TI IMPACT OF PAP GUIDELINE CHANGES ON ANNUAL CHLAMYDIA TESTING AMONG YOUNG WOMEN: 2007 TO 2014 SO SEXUALLY TRANSMITTED DISEASES LA English DT Meeting Abstract CT Sexually Transmitted Diseases (STD) Prevention Conference CY SEP 20-23, 2016 CL Atlanta, GA C1 [Hsieh, Hsien-Lin; Patel, Chirag; Pearson, William; Tao, Guoyu] Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA USA. [Huppert, Jill] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD USA. EM yve5@cdc.gov NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0148-5717 EI 1537-4521 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD OCT PY 2016 VL 43 SU 2 MA 6C5 BP S154 EP S154 PG 1 WC Infectious Diseases SC Infectious Diseases GA EG0BO UT WOS:000390695900106 ER PT J AU Patel, C Huppert, J Kidd, S Tao, GY AF Patel, Chirag Huppert, Jill Kidd, Sarah Tao, Guoyu TI PROVIDER ADHERENCE TO SYPHILIS TESTING RECOMMENDATIONS FOR WOMEN WITH STILLBIRTH SO SEXUALLY TRANSMITTED DISEASES LA English DT Meeting Abstract CT Sexually Transmitted Diseases (STD) Prevention Conference CY SEP 20-23, 2016 CL Atlanta, GA C1 [Patel, Chirag; Kidd, Sarah; Tao, Guoyu] Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA USA. [Huppert, Jill] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD USA. EM wyp3@cdc.gov NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0148-5717 EI 1537-4521 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD OCT PY 2016 VL 43 SU 2 MA 5C4 BP S149 EP S149 PG 1 WC Infectious Diseases SC Infectious Diseases GA EG0BO UT WOS:000390695900088 ER PT J AU Spicknall, I Huppert, J Gift, T AF Spicknall, Ian Huppert, Jill Gift, Thomas TI MODELING THE TRADE-OFF BETWEEN AZITHROMYCIN AND DOXYCYCLINE FOR TREATMENT OF UROGENITAL CHLAMYDIA IN WOMEN SO SEXUALLY TRANSMITTED DISEASES LA English DT Meeting Abstract CT Sexually Transmitted Diseases (STD) Prevention Conference CY SEP 20-23, 2016 CL Atlanta, GA C1 [Spicknall, Ian; Gift, Thomas] Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA USA. [Huppert, Jill] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD USA. EM xfu0@cdc.gov NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0148-5717 EI 1537-4521 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD OCT PY 2016 VL 43 SU 2 MA 4A5 BP S141 EP S142 PG 2 WC Infectious Diseases SC Infectious Diseases GA EG0BO UT WOS:000390695900062 ER PT J AU Vistnes, JP Cohen, JW AF Vistnes, Jessica P. Cohen, Joel W. TI Gaining Coverage In 2014: New Estimates Of Marketplace And Medicaid Transitions SO HEALTH AFFAIRS LA English DT Article AB We used data from the Medical Expenditure Panel Survey-Household Component to examine coverage transitions for nonelderly US adults. We found that 71.5 percent of Marketplace enrollees in 2014 had some period of uninsurance before enrollment. In Medicaid expansion states, 17.4 percent of adults who were uninsured throughout 2013 gained Medicaid coverage in 2014, compared with only 5.6 percent in those states between 2012 and 2013. C1 [Vistnes, Jessica P.; Cohen, Joel W.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. RP Vistnes, JP (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. EM Jessica.Vistnes@ahrq.hhs.gov NR 3 TC 1 Z9 1 U1 0 U2 0 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD OCT PY 2016 VL 35 IS 10 BP 1825 EP 1829 DI 10.1377/hlthaff.2016.0500 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EB1NA UT WOS:000387118000013 PM 27702955 ER PT J AU Kirby, JB Vistnes, JP AF Kirby, James B. Vistnes, Jessica P. TI Access To Care Improved For People Who Gained Medicaid Or Marketplace Coverage In 2014 SO HEALTH AFFAIRS LA English DT Article ID ACT; HEALTH AB Newly available longitudinal survey data show that people who lacked health insurance in 2013 and gained coverage through Medicaid or the Marketplaces in 2014 were far more likely to obtain a usual source of care and receive preventive care services than their counterparts who remained uninsured in 2014. C1 [Kirby, James B.; Vistnes, Jessica P.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. RP Kirby, JB (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. EM jkirby@ahrq.gov NR 10 TC 1 Z9 1 U1 4 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD OCT PY 2016 VL 35 IS 10 BP 1830 EP 1834 DI 10.1377/hlthaff.2016.0716 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA EB1NA UT WOS:000387118000014 PM 27702956 ER PT J AU Kemper, AR Mabry-Hernandez, IR Grossman, DC AF Kemper, Alex R. Mabry-Hernandez, Iris R. Grossman, David C. TI US Preventive Services Task Force Approach to Child Cognitive and Behavioral Health SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID RECOMMENDATION STATEMENT; PRIMARY-CARE; SPECTRUM DISORDER; INTERVENTIONS; ADOLESCENTS AB An important component of routine preventive care for children is the monitoring of growth and development. Although cognitive, affective, and behavioral health problems are commonly encountered in pediatric primary care, there is debate around issues related to early detection of significant problems of this type, including the accuracy of screening and the benefits and harms of early diagnosis and treatment. The U.S. Preventive Services Task Force makes recommendations regarding clinical preventive services for primary care clinicians based on the best available scientific evidence. The Task Force has found important gaps related to the validity of commonly used screening tools and significant gaps related to the evidence regarding early treatment. This review describes the meaning of the grades used by the Task Force, how these grades are determined, and the grades assigned to childhood cognitive, affective, and behavioral health recommendations. The review summarizes common themes in the evidence gaps and the future research necessary to advance the field and improve child health outcomes. (C) 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. C1 [Kemper, Alex R.] Duke Clin Res Inst, Durham, NC USA. [Kemper, Alex R.] Dept Pediat, 2400 Pratt St,Room 0311 Terrace Level, Durham, NC 27705 USA. [Mabry-Hernandez, Iris R.] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD USA. [Grossman, David C.] Grp Hlth Res Inst, Seattle, WA USA. RP Kemper, AR (reprint author), Dept Pediat, 2400 Pratt St,Room 0311 Terrace Level, Durham, NC 27705 USA. EM alex.kemper@duke.edu NR 17 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD OCT PY 2016 VL 51 IS 4 SU 2 BP S119 EP S123 DI 10.1016/j.amepre.2016.05.016 PG 5 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA EA7BM UT WOS:000386783100003 PM 27402186 ER PT J AU Upadhya, KK Jalazo, ER Connor, KA Mistry, KB Cheng, TL AF Upadhya, Krishna K. Jalazo, Elizabeth R. Connor, Katherine A. Mistry, Kamila B. Cheng, Tina L. TI Optimizing Preconception Health among Young Women: What Are We Missing? SO JOURNAL OF PEDIATRIC AND ADOLESCENT GYNECOLOGY LA English DT Article DE Preconception health; Teen pregnancy; Unintended pregnancy ID UNITED-STATES AB Study Objective: To evaluate whether receipt of specific preconception counseling topics differs between teen, young adult, and older mothers. Design, Setting, Participants, Interventions, and Main Outcome Measures: A survey of 291 primarily low-income, minority mothers with young children at pediatric practices in Baltimore, Maryland was conducted. Multivariable logistic regression models generated relative odds of preconception counseling receipt comparing teens (ages 14-19 years) and young adults (ages 20-24 years) to adult women (age >= 25 years) controlling for demographic characteristics, parity, and pregnancy intention. Results: Teen mothers were less than half as likely to be counseled about taking folic acid, 4 times more likely to be counseled about vaccines, and twice as likely to be counseled about mental health before pregnancy compared with adult mothers. Conclusion: Adolescent preventive care might promote some aspects of preconception health, but topics related specifically to pregnancy outcomes might be missed. Because of the high rate of unplanned teen pregnancy in the United States, additional strategies to promote preconception health in this population are warranted. C1 [Upadhya, Krishna K.; Jalazo, Elizabeth R.; Connor, Katherine A.; Mistry, Kamila B.; Cheng, Tina L.] Johns Hopkins Univ, Dept Pediat, 200 N Wolfe St,Room 2060, Baltimore, MD 21287 USA. [Mistry, Kamila B.] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD USA. RP Upadhya, KK (reprint author), Johns Hopkins Univ, Dept Pediat, 200 N Wolfe St,Room 2060, Baltimore, MD 21287 USA. EM kupadhy2@jhmi.edu FU Johns Hopkins Healthcare; Aetna Foundation; Abell Foundation; Straus Foundation; Zanvyl and Isabelle Krieger Fund FX We would like to acknowledge funding support for this project from Johns Hopkins Healthcare, The Aetna, Abell, and Straus Foundations, and The Zanvyl and Isabelle Krieger Fund. The content is solely the responsibility of the authors and do not necessarily represent the U.S. Department of Health and Human Services or its component, the Agency for Healthcare Research and Quality or the funding agencies. NR 11 TC 0 Z9 0 U1 6 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1083-3188 EI 1873-4332 J9 J PEDIATR ADOL GYNEC JI J. Pediatr Adolesc. Gynecol. PD OCT PY 2016 VL 29 IS 5 BP 464 EP 466 DI 10.1016/j.jpag.2016.02.010 PG 3 WC Obstetrics & Gynecology; Pediatrics SC Obstetrics & Gynecology; Pediatrics GA DV0EX UT WOS:000382591900012 PM 26964518 ER PT J AU Moore, BJ Coffey, RM Heslin, KC Moy, E AF Moore, Brian J. Coffey, Rosanna M. Heslin, Kevin C. Moy, Ernest TI Admissions after discharge from an emergency department for chest symptoms SO DIAGNOSIS LA English DT Article DE acute myocardial infarction; chest pain; emergency department; mental disorders; subsequent admission ID ACUTE MYOCARDIAL-INFARCTION; COMORBIDITY MEASURES; MISSED DIAGNOSIS; PATIENT AB Background: Often patients who present to the emergency department (ED) with chest symptoms return to the hospital within 30 days with the same or closely related symptoms and are admitted, raising questions about quality of care, timeliness of diagnosis, and patient safety. This study examined the frequency of and patient characteristics associated with subsequent inpatient admissions for related symptoms after discharge from an ED for chest symptoms. Methods: We used data from the 2012 and 2013 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) and State Emergency Department Databases (SEDD) from eight states to identify over 1.8 million ED discharges for chest symptoms. Results: Approximately 3% of ED discharges experienced potentially related subsequent admissions within 30 days - 0.2% for acute myocardial infarction (AMI), 1.7% for other cardiovascular conditions, 0.5% for respiratory conditions, and 0.6% for mental disorders. Logistic regression results showed higher odds of subsequent admission for older patients and those residing in low-income areas, and lower odds for females and non White racial/ethnic groups. Privately insured patients had lower odds of subsequent admission than did those who were uninsured or covered by other programs. Conclusions: Because we included multiple diagnostic categories of subsequent admissions, our results show a more complete picture of patients presenting to the ED with chest symptoms compared with previous studies. In particular, we show a lower rate of subsequent admission for AMI versus other diagnoses. ED physicians and administrators can use the results to identify characteristics associated with increased odds of subsequent admission to target at-risk populations. C1 [Moore, Brian J.] Truven Hlth Analyt, 100 Phoenix Dr Ann Arbor, Ann Arbor, MI 48108 USA. [Coffey, Rosanna M.] Truven Hlth Analyt, Bethesda, MD USA. [Heslin, Kevin C.] Ctr Qual Improvement & Patient Safety, Agcy Healthcare Res & Qual, Rockville, MD USA. [Moy, Ernest] Natl Ctr Hlth Stat, Off Anal & Epidemiol, Hyattsville, MD USA. RP Moore, BJ (reprint author), Truven Hlth Analyt, 100 Phoenix Dr Ann Arbor, Ann Arbor, MI 48108 USA. EM brian.moore@truvenhealth.com FU Agency for Healthcare Research and Quality, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP) FX This research was supported by the Agency for Healthcare Research and Quality, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP). NR 13 TC 0 Z9 0 U1 0 U2 0 PU WALTER DE GRUYTER GMBH PI BERLIN PA GENTHINER STRASSE 13, D-10785 BERLIN, GERMANY SN 2194-8011 EI 2194-802X J9 DIAGNOSIS JI Diagnosis PD SEP PY 2016 VL 3 IS 3 BP 103 EP 113 DI 10.1515/dx-2016-0014 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA EG3HR UT WOS:000390934900003 ER PT J AU Shah, AY LLanos, K Dougherty, D Cha, S Conway, PH AF Shah, Ankoor Y. LLanos, Karen Dougherty, Denise Cha, Stephen Conway, Patrick H. TI State challenges to child health quality measure reporting and recommendations for improvement SO HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION LA English DT Article DE Medicaid; CHIP; Quality ID CARE QUALITY; MEDICAID AB Objective: The Children's Health Insurance Program (CHIP) was re-authorized in 2009, ushering in an unprecedented focus on children's health care quality one of which includes identifying a core set of performance measures for voluntary reporting by states' Medicaid/CHIP programs. However, there is a wide variation in the quantity and quality of measures states chose to report to the Center's for Medicare & Medicaid Services (CMS). The objective of this study is to assess reporting barriers and to identify potential opportunities for improvement. Methods: From 2013 to 2014 a questionnaire developed in coordination with CMS and the Agency for Healthcare Research and Quality (AHRQ) was sent to state Medicaid and CHIP officials to assess barriers to child health quality reporting for Federal Fiscal Year 2012. States were categorized as high, medium, or low reporting for comparative analysis. Results: Twenty-five of the 50 states and the District of Columbia agreed to participate in the study and completed the questionnaire. States placed a high priority on children's health care quality reporting (4.2 of 5 point Likert Scale, SD 0.99) and 96% plan to use measurement results to further improve their quality initiatives. However, low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming than high reporting states. Conclusion: Based on state responses, possible solutions to improve reporting includes funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction. Realistic and tangible improvements are within reach and opportunities for CMS and states to collaborate to improve child health care quality. (C) 2016 Elsevier Inc. All rights reserved. C1 [Shah, Ankoor Y.] Childrens Natl Hlth Syst, 111 Michigan Ave NW,W3-5-700A, Washington, DC 20010 USA. [LLanos, Karen; Cha, Stephen; Conway, Patrick H.] Ctr Medicare Serv, Baltimore, MD USA. [LLanos, Karen; Cha, Stephen; Conway, Patrick H.] Ctr Medicaid Serv, Baltimore, MD USA. [Dougherty, Denise] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Shah, AY (reprint author), Childrens Natl Hlth Syst, 111 Michigan Ave NW,W3-5-700A, Washington, DC 20010 USA. EM Anshah@cnmc.org NR 16 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 2213-0764 EI 2213-0772 J9 HEALTHCARE JI HealthCare PD SEP PY 2016 VL 4 IS 3 BP 217 EP 224 DI 10.1016/j.hjdsi.2016.03.001 PG 8 WC Health Care Sciences & Services SC Health Care Sciences & Services GA EC4NE UT WOS:000388107800019 PM 27637829 ER PT J AU Ali, MM Chen, J Mutter, R Novak, P Mortensen, K AF Ali, Mir M. Chen, Jie Mutter, Ryan Novak, Priscilla Mortensen, Karoline TI The ACA's Dependent Coverage Expansion and Out-of-Pocket Spending by Young Adults With Behavioral Health Conditions SO PSYCHIATRIC SERVICES LA English DT Article ID AFFORDABLE CARE ACT; INSURANCE-COVERAGE; IMPACT; POPULATION; DEPRESSION; OUTCOMES AB Objective: Young adults with behavioral health conditions (mental or substance use disorders) often lack access to care. In 2010, the Affordable Care Act (ACA) extended eligibility for dependent coverage under private health insurance, allowing young adults to continue on family plans until age 26. The objective of this study was to analyze out-of-pocket (OOP) spending as a share of total health care expenditures for young adults with behavioral health conditions before and after the implementation of the ACA dependent care provision. The study examined the population of young adults with behavioral health conditions overall and by race and ethnicity. Methods: The study analyzed 2008-2009 and 2011-2012 nationally representative data from the Medical Expenditure Panel Survey with zero-or-one inflated beta regression models in a difference-in-differences framework to estimate the impact of the ACA's dependent coverage expansion. OOP spending was examined as a share of total health care expenditures among young adults with behavioral health disorders. The study compared the treatment group of individuals ages 19-25 (unweighted N = 1,158) with a group ages 27-29 (unweighted N = 668). Results: Young adults ages 19-25 with behavioral health disorders were significantly less likely than the older group to have high levels of OOP spending after the implementation of the ACA's dependent coverage expansion. The reduction was pronounced among young adults from racial-ethnic minority groups. Conclusions: The extension of health insurance coverage to young adults with behavioral health disorders has provided them with additional financial protection, which can be important given the low incomes and high debt burden that characterize the age group. C1 [Ali, Mir M.; Mutter, Ryan] Subst Abuse & Mental Hlth Serv Adm, Ctr Behav Hlth Stat & Qual, Rockville, MD USA. [Chen, Jie; Novak, Priscilla] Univ Maryland, Sch Publ Hlth, Dept Hlth Serv Adm, College Pk, MD 20742 USA. [Novak, Priscilla] Agcy Healthcare Res & Qual, Rockville, MD USA. [Mortensen, Karoline] Univ Miami, Sch Business Adm, Dept Hlth Sect Management & Policy, Coral Gables, FL 33124 USA. RP Ali, MM (reprint author), Subst Abuse & Mental Hlth Serv Adm, Ctr Behav Hlth Stat & Qual, Rockville, MD USA. FU NIMH NIH HHS [R21 MH106813] NR 33 TC 1 Z9 1 U1 7 U2 7 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 EI 1557-9700 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD SEP 1 PY 2016 VL 67 IS 9 BP 977 EP 982 DI 10.1176/appi.ps.201500346 PG 6 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA EC6SS UT WOS:000388267600008 PM 27181735 ER PT J AU Biegler, K Mollica, R Sim, SE Nicholas, E Chandler, M Ngo-Metzger, Q Paigne, K Paigne, S Nguyen, DV Sorkin, DH AF Biegler, Kelly Mollica, Richard Sim, Susan Elliott Nicholas, Elisa Chandler, Maria Ngo-Metzger, Quyen Paigne, Kittya Paigne, Sompia Nguyen, Danh V. Sorkin, Dara H. TI Rationale and study protocol for a multi-component Health Information Technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting SO CONTEMPORARY CLINICAL TRIALS LA English DT Article DE Health Information Technology; Primary care; Limited English proficiency; Cambodian refugees; Depression; post-traumatic stress disorder (PTSD) ID HARVARD TRAUMA QUESTIONNAIRE; RANDOMIZED CONTROLLED-TRIAL; MENTAL-HEALTH; CAMBODIAN REFUGEES; CONSUMER ASSESSMENT; DECISION-MAKING; SUPPORT-SYSTEMS; PATIENT; PREVALENCE; PHYSICIANS AB The prevalence rate of depression in primary care is high. Primary care providers serve as the initial point of contact for the majority of patients with depression, yet, approximately 50% of cases remain unrecognized. The under-diagnosis of depression may be further exacerbated in limited English-language proficient (LEP) populations. Language barriers may result in less discussion of patients' mental health needs and fewer referrals to mental health services, particularly given competing priorities of other medical conditions and providers' time pressures. Recent advances in Health Information Technology (HIT) may facilitate novel ways to screen for depression and other mental health disorders in LEP populations. The purpose of this paper is to describe the rationale and protocol of a clustered randomized controlled trial that will test the effectiveness of an HIT intervention that provides a multi-component approach to delivering culturally competent, mental health care in the primary care setting. The HIT intervention has four components: 1) web-based provider training, 2) multimedia electronic screening of depression and PTSD in the patients' primary language, 3) Computer generated risk assessment scores delivered directly to the provider, and 4) clinical decision support. The outcomes of the study include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder (PTSD) among LEP Cambodian refugees who experienced war atrocities and trauma during the Khmer Rouge. This technology has the potential to be adapted to any LEP population in order to facilitate mental health screening and treatment in the primary care setting. (C) 2016 Elsevier Inc. All rights reserved. C1 [Biegler, Kelly; Nguyen, Danh V.; Sorkin, Dara H.] Univ Calif Irvine, Dept Med, Irvine, CA 92717 USA. [Mollica, Richard] Harvard Med Sch, Dept Psychiat, Boston, MA USA. [Sim, Susan Elliott] Univ Toronto, Fac Informat, Toronto, ON, Canada. [Nicholas, Elisa; Chandler, Maria] Univ Calif Irvine, Dept Pediat, Irvine, CA 92717 USA. [Nicholas, Elisa; Chandler, Maria] Childrens Clin, Serving Children & Their Families, Long Beach, CA USA. [Ngo-Metzger, Quyen] US Prevent Serv Task Force, Agcy Healthcare Res & Qual, Rockville, MD USA. [Paigne, Kittya; Paigne, Sompia] Community Med Wellness Ctr, Long Beach, CA USA. [Nguyen, Danh V.] Univ Calif Irvine, Biostat Epidemiol & Res Design, Irvine, CA USA. RP Sorkin, DH (reprint author), Univ Calif Irvine, 100 Theory, Irvine, CA 92697 USA. EM dsorkin@uci.edu FU National Institute of Mental Health [R01 MH091221]; National Center for Advancing Translational Sciences, through the UC Irvine Biostatistics, Epidemiology and Research Design Unit [UL1 TR0001414] FX This research was supported by the National Institute of Mental Health (R01 MH091221, D.H. Sorkin, PI). This work was partially supported by the grant UL1 TR0001414 from the National Center for Advancing Translational Sciences, through the UC Irvine Biostatistics, Epidemiology and Research Design Unit. NR 56 TC 0 Z9 0 U1 15 U2 15 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1551-7144 EI 1559-2030 J9 CONTEMP CLIN TRIALS JI Contemp. Clin. Trials PD SEP PY 2016 VL 50 BP 66 EP 76 DI 10.1016/j.cct.2016.07.001 PG 11 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA DY7PM UT WOS:000385321600009 PM 27394385 ER PT J AU Tate, JE Yen, C Steiner, CA Cortese, MM Parashar, UD AF Tate, Jacqueline E. Yen, Catherine Steiner, Claudia A. Cortese, Margaret M. Parashar, Umesh D. TI Intussusception Rates Before and After the Introduction of Rotavirus Vaccine SO PEDIATRICS LA English DT Article ID IMMUNIZATION PRACTICES ACIP; US INFANTS; ADVISORY-COMMITTEE; UNITED-STATES; GASTROENTERITIS; CHILDREN; SAFETY; RISK; PENTAVALENT; HOSPITALIZATIONS AB BACKGROUND: Recent US studies have identified a small increased risk of intussusception after rotavirus vaccination, mainly after the first dose. We examined trends in intussusception hospitalizations before (2000-2005) and after (2007-2013) rotavirus vaccine introduction to assess whether this observed temporal risk translates into more hospitalized cases at the population level. METHODS: Intussusception hospitalizations in children <12 months of age were abstracted from the State Inpatient Database maintained by the Healthcare Cost and Utilization Project for 26 states that provided data from 2000 to 2013. Rates were calculated using bridged-race postcensal population estimates. Trends were analyzed by age groups (6-14 weeks, 15-24 weeks, and 25-34 weeks) based on the recommended ages for vaccine administration as well as 8-11 weeks when the majority of first doses are given. Rate ratios were calculated by using Poisson regression. RESULTS: No consistent change in intussusception hospitalization rates was observed among all children <12 months of age and among children 15 to 24 weeks and 25 to 34 weeks of age. The intussusception hospitalization rate for children aged 8 to 11 weeks was significantly elevated by 46% to 101% (range: 16.7-22.9 per 100 000) in all postvaccine years except 2011 and 2013 compared with the prevaccine baseline (11.7 per 100 000). CONCLUSIONS: The increase in the intussusception hospitalization rate in children 8 to 11 weeks when the majority of first doses of vaccine are given is consistent with recent US postlicensure studies. Given the magnitude of declines in rotavirus disease compared with this small increase in intussusception, the benefits of rotavirus vaccination outweigh the increase risk of intussusception. C1 [Tate, Jacqueline E.; Yen, Catherine; Cortese, Margaret M.; Parashar, Umesh D.] Ctr Dis Control & Prevent, Natl Ctr Immunizat & Resp Dis, Div Viral Dis, Atlanta, GA USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. RP Tate, JE (reprint author), Ctr Dis Control & Prevent, 1600 Clifton Rd NE MS-A34, Atlanta, GA 30333 USA. EM jqt8@cdc.gov NR 22 TC 1 Z9 1 U1 1 U2 1 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 EI 1098-4275 J9 PEDIATRICS JI Pediatrics PD SEP PY 2016 VL 138 IS 3 AR e20161082 DI 10.1542/peds.2016-1082 PG 7 WC Pediatrics SC Pediatrics GA DW9SE UT WOS:000384002100044 ER PT J AU Diehl, A Yang, T Speck, K Battles, J Cosgrove, SE Berenholtz, S Klompas, M AF Diehl, Adam Yang, Ting Speck, Kathleen Battles, James Cosgrove, Sara E. Berenholtz, Sean Klompas, Michael TI Evaluating the Accuracy of Sampling Strategies for Estimation of Compliance Rate for Ventilator-Associated Pneumonia Process Measures SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID SURVEILLANCE AB BACKGROUND. Measuring processes of care performance rates is an invaluable tool for quality improvement; however, collecting daily process measure data is time-consuming and burdensome. OBJECTIVE. To evaluate the accuracy of sampling strategies to estimate monthly compliance rates with ventilator-associated pneumonia prevention measures. SETTING AND PARTICIPANTS. A total of 37 intensive care units affiliated with 29 hospitals participating in a 2-state 35-month ventilator associated pneumonia prevention collaborative. Analysis was limited to 325 unit-months with complete data entry rates. METHODS. We calculated unit-month level actual and sample monthly compliance rates for 6 ventilator-associated pneumonia prevention measures, using 4 sampling strategies: sample 1 day per month, sample 1 day per week, sample 7 consecutive days per month, and sample 7 consecutive days per month plus additional consecutive days as necessary to obtain at least 30 ventilator-days for that month whenever possible. We compared sample versus actual rates using paired t test and chi(2) test. RESULTS. Mean sampling accuracy ranged 84%-97% for 1 day per month, 91%-98% for 1 day per week, 92%-98% for 7 consecutive days per month, and 96%-99% for 7 consecutive days with at least 30 days per month if possible. The most accurate sampling strategy was to sample 7 consecutive days with at least 30 ventilator-days per month if possible. With this strategy, sample rates were within 10% of actual rates in 88%-99% of unit-months and within 5% of actual rates in 74%-97% of unit-months. CONCLUSION. Sampling process measures intermittently rather than continually can yield accurate estimates of process measure performance rates. C1 [Diehl, Adam] Johns Hopkins Univ Hosp, Dept Med, Baltimore, MD 21287 USA. [Yang, Ting; Speck, Kathleen; Berenholtz, Sean] Johns Hopkins Univ, Sch Med, Armstrong Inst Patient Safety & Qual, Baltimore, MD USA. [Yang, Ting; Speck, Kathleen; Berenholtz, Sean] Johns Hopkins Univ, Sch Med, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21205 USA. [Battles, James] AHRQ, Rockville, MD USA. [Cosgrove, Sara E.] Johns Hopkins Univ, Sch Med, Dept Med, Div Infect Dis, Baltimore, MD 21205 USA. [Klompas, Michael] Harvard Med Sch, Dept Populat Med, Boston, MA USA. [Klompas, Michael] Harvard Pilgrim Hlth Care Inst, Boston, MA USA. [Klompas, Michael] Brigham & Womens Hosp, Dept Med, Div Infect Dis, 75 Francis St, Boston, MA 02115 USA. RP Yang, T (reprint author), Johns Hopkins Univ, Armstrong Inst Patient Safety & Qual, 750 E Pratt St,15th Fl, Baltimore, MD 21202 USA. EM tyang6@jhu.edu FU AHRQ Action II grant [HHSA29032002T, HHSA290201000027I]; National Institutes of Health-YAP grant [R01HL105903] FX The CUSP for VAP: EVAP Project is funded by the AHRQ Action II grant (HHSA29032002T) and National Institutes of Health-YAP grant (R01HL105903). The national VAP prevention initiative is funded by AHRQ Action II grant (HHSA290201000027I). Authors report AHRQ Action II VAP grant (to T.Y., K.S., and S.B.), the National Institutes of Health VAP grant (to T.Y., K.S., and S.B.), and the AHRQ Action II National VAP grant (to T.Y., K.S., S.B., and M.K.). NR 5 TC 0 Z9 0 U1 1 U2 1 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD SEP PY 2016 VL 37 IS 9 BP 1037 EP 1043 DI 10.1017/ice.2016.136 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA DV4LJ UT WOS:000382896800005 PM 27322932 ER PT J AU Gao, Y Nocon, RS Gunter, KE Sharma, R Ngo-Metzger, Q Casalino, LP Chin, MH AF Gao, Yue Nocon, Robert S. Gunter, Kathryn E. Sharma, Ravi Ngo-Metzger, Quyen Casalino, Lawrence P. Chin, Marshall H. TI Characteristics Associated with Patient-Centered Medical Home Capability in Health Centers: A Cross-Sectional Analysis SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE health center; medical home; vulnerable populations; disparities; financial incentives ID PRIMARY-CARE PRACTICES; QUALITY-OF-CARE; CHILDREN; INFRASTRUCTURE; READINESS; CAPACITY; VIRGINIA AB The patient-centered medical home (PCMH) model is being implemented in health centers (HCs) that provide comprehensive primary care to vulnerable populations. To identify characteristics associated with HCs' PCMH capability. Cross-sectional analysis of a national dataset of Federally Qualified Health Centers (FQHCs) in 2009. Data for PCMH capability, HC, patient, neighborhood, and regional characteristics were combined from multiple sources. A total of 706 (70 %) of 1014 FQHCs from the Health Resources and Services Administration Community Health Center Program, representing all 50 states and the District of Columbia. PCMH capability was scored via the Commonwealth Fund National Survey of FQHCs through the Safety Net Medical Home Scale (0 [worst] to 100 [best]). HC, patient, neighborhood, and regional characteristics (all analyzed at the HC level) were measured from the Commonwealth survey, Uniform Data System, American Community Survey, American Medical Association physician data, and National Academy for State Health Policy data. Independent correlates of high PCMH capability included having an electronic health record (EHR) (11.7-point [95 % confidence interval, CI 10.2-13.3]), more types of financial performance incentives (0.7-point [95 % CI 0.2-1.1] higher total score per one additional type, maximum possible = 10), more types of hospital-HC affiliations (1.6-point [95 % CI 1.1-2.1] higher total score per one additional type, maximum possible = 6), and location in certain US census divisions. Among HCs with an EHR, location in a state with state-supported PCMH initiatives and PCMH payments was associated with high PCMH capability (2.8-point, 95 % CI 0.2-5.5). Other characteristics had small effect size based on the measure unit (e.g. 0.04-point [95 % CI 0-0.08] lower total score per one percentage point more minority patients), but the effects could be practically large at the extremes. EHR adoption likely played a role in HCs' improvement in PCMH capability. Factors that appear to hold promise for supporting PCMH capability include a greater number of types of financial performance incentives, more types of hospital-HC affiliations, and state-level support and payment for PCMH activities. C1 [Gao, Yue; Nocon, Robert S.; Gunter, Kathryn E.; Chin, Marshall H.] Univ Chicago, Gen Internal Med Sect, Dept Med, 5841 S Maryland Ave,MC 2007,Room B216, Chicago, IL 60637 USA. [Sharma, Ravi] Bur Primary Hlth Care, Hlth Resources & Serv Adm, US Dept HHS, Rockville, MD USA. [Ngo-Metzger, Quyen] US Dept HHS, US Prevent Serv Task Force Program, Agcy Healthcare Res & Qual, Rockville, MD USA. [Casalino, Lawrence P.] Weill Cornell Med Coll, Dept Healthcare Policy & Res, New York, NY USA. RP Chin, MH (reprint author), Univ Chicago, Gen Internal Med Sect, Dept Med, 5841 S Maryland Ave,MC 2007,Room B216, Chicago, IL 60637 USA. EM mchin@medicine.bsd.uchicago.edu FU Commonwealth Fund [20080366]; Chicago Center for Diabetes Translation Research [NIDDK P30 DK092949]; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Midcareer Investigator Award in Patient-Oriented Research [NIDDK K24 DK071933]; Agency for Healthcare Research and Quality (AHRQ) [AHRQ T32 HS000084] FX This project was supported by the Commonwealth Fund (Grant 20080366). Dr. Chin was supported by the Chicago Center for Diabetes Translation Research (NIDDK P30 DK092949) and a National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Midcareer Investigator Award in Patient-Oriented Research (NIDDK K24 DK071933). Mr. Nocon was supported by an Agency for Healthcare Research and Quality (AHRQ) training grant (AHRQ T32 HS000084). NR 41 TC 1 Z9 1 U1 9 U2 9 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2016 VL 31 IS 9 BP 1041 EP 1051 DI 10.1007/s11606-016-3729-8 PG 11 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA DT6NJ UT WOS:000381600700013 PM 27216480 ER PT J AU Spector, WD Limcangco, R Owens, PL Steiner, CA AF Spector, William D. Limcangco, Rhona Owens, Pamela L. Steiner, Claudia A. TI Marginal Hospital Cost of Surgery-related Hospital-acquired Pressure Ulcers SO MEDICAL CARE LA English DT Article DE pressure ulcer; hospital costs; adverse events; administrative data; risk factors; hospitalization; adverse drug event surveillance ID PATIENT SAFETY; UNITED-STATES; OUTCOMES; IMPACT; RISK AB Background: Patients who develop hospital-acquired pressure ulcers (HAPUs) are more likely to die, have longer hospital stays, and are at greater risk of infections. Patients undergoing surgery are prone to developing pressure ulcers (PUs). Objective: To estimate the hospital marginal cost of a HAPU for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics. Research Design and Subjects: Data are from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and the Medicare Patient Safety Monitoring System for 2011 and 2012. PU information was obtained using retrospective structured record review from trained MPMS data abstractors. Costs are derived using HCUP hospital-specific cost-to-charge ratios. Marginal cost estimates were made using Extended Estimating Equations. We estimated the marginal cost at the 25th, 50th, and 75th percentiles of the cost distribution using Simultaneous Quantile Regression. Results: We find that 3.5% of major surgical patients developed HAPUs and that the HAPUs added similar to$8200 to the cost of a surgical stay after adjusting for comorbidities, patient characteristics, procedures, and hospital characteristics. This is an similar to 44% addition to the cost of a major surgical stay but less than half of the unadjusted cost difference. In addition, we find that for high-cost stays (75th percentile) HAPUs added similar to$12,100, whereas for low-cost stays (25th percentile) HAPUs added similar to$3900. Conclusions: This paper suggests that HAPUs add similar to 44% to the cost of major surgical hospital stays, but the amount varies depending on the total cost of the visit. C1 [Spector, William D.; Owens, Pamela L.; Steiner, Claudia A.] US Dept HHS, Agcy Healthcare Res & Qual, 5600 Fishers Lane,Mailstop 7W25B, Rockville, MD 20857 USA. [Limcangco, Rhona] Social & Sci Syst Inc, Silver Spring, MD USA. RP Spector, WD (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, 5600 Fishers Lane,Mailstop 7W25B, Rockville, MD 20857 USA. EM william.spector@ahrq.hhs.gov NR 35 TC 0 Z9 0 U1 3 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD SEP PY 2016 VL 54 IS 9 BP 845 EP 851 DI 10.1097/MLR.0000000000000558 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA DU5JJ UT WOS:000382247700006 PM 27219637 ER PT J AU Martsolf, GR Barrett, ML Weiss, AJ Kandrack, R Washington, R Steiner, CA Mehrotra, A SooHoo, NF Coffey, R AF Martsolf, Grant R. Barrett, Marguerite L. Weiss, Audrey J. Kandrack, Ryan Washington, Raynard Steiner, Claudia A. Mehrotra, Ateev SooHoo, Nelson F. Coffey, Rosanna TI Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Hospital Readmission Rates Following Hip and Knee Arthroplasty SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME LA English DT Article ID RACIAL DISPARITIES; UNITED-STATES; HEALTH-CARE; REPLACEMENT; OUTCOMES; COST AB Background: Readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are increasingly used to measure hospital performance. Readmission rates that are not adjusted for race/ethnicity and socioeconomic status, patient risk factors beyond a hospital's control, may not accurately reflect a hospital's performance. In this study, we examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following THA and TKA. Methods: We calculated 2 sets of risk-adjusted readmission rates by (1) using the Centers for Medicare & Medicaid Services standard risk-adjustment algorithm that incorporates patient age, sex, comorbidities, and hospital effects and (2) adding race/ethnicity and socioeconomic status to the model. Using data from the Healthcare Cost and Utilization Project, 2011 State Inpatient Databases, we compared the relative performances of 1,194 hospitals across the 2 methods. Results: Addition of race/ethnicity and socioeconomic status to the risk-adjustment algorithm resulted in (1) little or no change in the risk-adjusted readmission rates at nearly all hospitals; (2) no change in the designation of the readmission rate as better, worse, or not different from the population mean at >99% of the hospitals; and (3) no change in the excess readmission ratio at >97% of the hospitals. Conclusions: Inclusion of race/ethnicity and socioeconomic status in the risk-adjustment algorithm led to a relative-performance change in readmission rates following THA and TKA at <3% of the hospitals. We believe that policy-makers and payers should consider this result when deciding whether to include race/ethnicity and socioeconomic status in risk-adjusted THA and TKA readmission rates used for hospital accountability, payment, and public reporting. C1 [Martsolf, Grant R.; Barrett, Marguerite L.; Weiss, Audrey J.; Kandrack, Ryan; Washington, Raynard; Steiner, Claudia A.; Mehrotra, Ateev; SooHoo, Nelson F.; Coffey, Rosanna] Truven Hlth Analyt Inc, Santa Barbara, CA USA. [Martsolf, Grant R.; Kandrack, Ryan] RAND Corp, Pittsburgh, PA 15213 USA. [Barrett, Marguerite L.] ML Barrett Inc, San Diego, CA USA. [Washington, Raynard; Steiner, Claudia A.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Mehrotra, Ateev] RAND Corp, Boston, MA USA. [Mehrotra, Ateev] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA. [SooHoo, Nelson F.] Univ Calif Los Angeles, Med Ctr, Dept Orthopaed Surg, Los Angeles, CA 90024 USA. [Coffey, Rosanna] Truven Hlth Analyt Inc, Bethesda, MD USA. RP Martsolf, GR (reprint author), RAND Corp, Pittsburgh, PA 15213 USA. EM martsolf@rand.org; kandrack@rand.org FU Agency for Healthcare Research and Quality (AHRQ) Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP) [HHSA-290-2013-00002-C] FX This work was supported by the Agency for Healthcare Research and Quality (AHRQ) Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP) under contract HHSA-290-2013-00002-C. NR 20 TC 1 Z9 1 U1 2 U2 2 PU JOURNAL BONE JOINT SURGERY PI NEEDHAM PA 20 PICKERING ST, NEEDHAM, MA 02492 USA SN 0021-9355 EI 1535-1386 J9 J BONE JOINT SURG AM JI J. Bone Joint Surg.-Am. Vol. PD AUG 17 PY 2016 VL 98 IS 16 BP 1385 EP 1391 DI 10.2106/JBJS.15.00884 PG 7 WC Orthopedics; Surgery SC Orthopedics; Surgery GA EN4AG UT WOS:000395948800011 PM 27535441 ER PT J AU Kato, E Beswick-Escanlar, V AF Kato, Elisabeth Beswick-Escanlar, Vincent TI Screening for Depression in Adults SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Kato, Elisabeth] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20857 USA. [Beswick-Escanlar, Vincent] Uniformed Serv Univ Hlth Sci, Gen Prevent Med Resident, Bethesda, MD 20814 USA. RP Kato, E (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20857 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD AUG 15 PY 2016 VL 94 IS 4 BP 305 EP 306 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DT8XZ UT WOS:000381780300006 PM 27548596 ER PT J AU Kronick, R Arnold, S Brady, J AF Kronick, Richar Arnold, Sharon Brady, Jeffrey TI Improving Safety for Hospitalized Patients Much Progress but Many Challenges Remain SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material C1 [Kronick, Richar] Univ Calif San Diego, Dept Family Med & Publ Hlth, San Diego, CA 92103 USA. [Kronick, Richar; Arnold, Sharon; Brady, Jeffrey] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Kronick, R (reprint author), Univ Calif San Diego, Dept Family Med & Publ Hlth, 9500 Gilman Dr, La Jolla, CA 92093 USA. EM rkronick@ucsd.edu NR 6 TC 0 Z9 0 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 2 PY 2016 VL 316 IS 5 BP 489 EP 490 DI 10.1001/jama.2016.7887 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA DS9AU UT WOS:000381075000010 PM 27295371 ER PT J AU Berry, SA Fleishman, JA Yehia, BR Cheever, LW Hauck, H Korthuis, PT Mathews, WC Keruly, J Nijhawan, AE Agwu, AL Somboonwit, C Moore, RD Gebo, KA AF Berry, Stephen A. Fleishman, John A. Yehia, Baligh R. Cheever, Laura W. Hauck, Heather Korthuis, P. Todd Mathews, W. Christopher Keruly, Jeanne Nijhawan, Ank E. Agwu, Allison L. Somboonwit, Charurut Moore, Richard D. Gebo, Kelly A. CA HIV Res Network TI Healthcare Coverage for HIV Provider Visits Before and After Implementation of the Affordable Care Act SO CLINICAL INFECTIOUS DISEASES LA English DT Article DE HIV; Ryan White HIV/AIDS Program; Affordable Care Act; Medicaid; insurance ID UNITED-STATES; MORTALITY; HIV/AIDS; PREVENTION; RETENTION; INFECTION; PROGRAM; SYSTEM AB Background. Before implementation of the Patient Protection and Affordable Care Act (ACA) in 2014, 100 000 persons living with human immunodeficiency virus (HIV) (PLWH) lacked healthcare coverage and relied on a safety net of Ryan White HIV/AIDS Program support, local charities, or uncompensated care (RWHAP/Uncomp) to cover visits to HIV providers. We compared HIV provider coverage before (2011-2013) versus after (first half of 2014) ACA implementation among a total of 28 374 PLWH followed up in 4 sites in Medicaid expansion states (California, Oregon, and Maryland), 4 in a state (New York) that expanded Medicaid in 2001, and 2 in nonexpansion states (Texas and Florida). Methods. Multivariate multinomial logistic models were used to assess changes in RWHAP/Uncomp, Medicaid, and private insurance coverage, using Medicare as a referent. Results. In expansion state sites, RWHAP/Uncomp coverage decreased (unadjusted, 28% before and 13% after ACA; adjusted relative risk ratio [ARRR], 0.44; 95% confidence interval [CI], .40-.48). Medicaid coverage increased (23% and 38%; ARRR, 1.82; 95% CI, 1.70-1.94), and private coverage was unchanged (21% and 19%; 0.96;.89-1.03). In New York sites, both RWHAP/Uncomp (20% and 19%) and Medicaid (50% and 50%) coverage were unchanged, while private coverage decreased (13% and 12%; ARRR, 0.86; 95% CI, .80-.92). In nonexpansion state sites, RWHAP/Uncomp (57% and 52%) and Medicaid (18% and 18%) coverage were unchanged, while private coverage increased (4% and 7%; ARRR, 1.79; 95% CI, 1.62-1.99). Conclusions. In expansion state sites, half of PLWH relying on RWHAP/Uncomp coverage shifted to Medicaid, while in New York and nonexpansion state sites, reliance on RWHAP/Uncomp remained constant. In the first half of 2014, the ACA did not eliminate the need for RWHAP safety net provider visit coverage. C1 [Berry, Stephen A.; Keruly, Jeanne; Moore, Richard D.; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Internal Med, Baltimore, MD USA. [Agwu, Allison L.] Johns Hopkins Univ, Dept Pediat, Baltimore, MD 21218 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Cheever, Laura W.; Hauck, Heather] HIV AIDS Bur, Hlth Resources & Serv Adm, Rockville, MD USA. [Yehia, Baligh R.] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA. [Korthuis, P. Todd] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA. [Mathews, W. Christopher] Univ Calif San Diego, Sch Med, Dept Med, La Jolla, CA 92093 USA. [Nijhawan, Ank E.] Univ Texas Southwestern Med Ctr, Dept Internal Med, Dallas, TX USA. [Somboonwit, Charurut] Univ S Florida, Morsani Coll Med, Dept Internal Med, Tampa, FL USA. RP Berry, SA (reprint author), Johns Hopkins Univ, Sch Med, 725 N Wolfe St,Off 217, Baltimore, MD 21205 USA. EM sberry8@jhmi.edu FU AHRQ [HHSA290201100007C]; HRSA [HHSH250201200008C]; National Institutes of Health [K23 AI084854, K23-MH097647, U01 DA036945, P30 AI094189, U01 HD068070, 2UM1 AI068632-09]; Clinical Investigation and Biostatistics Core of the UC San Diego Center for AIDS Research [AI036214] FX This work was supported by the AHRQ (contract HHSA290201100007C), the HRSA (contract HHSH250201200008C), the National Institutes of Health (grants K23 AI084854, K23-MH097647, U01 DA036945, P30 AI094189, U01 HD068070, and 2UM1 AI068632-09), and the Clinical Investigation and Biostatistics Core of the UC San Diego Center for AIDS Research (AI036214). NR 26 TC 1 Z9 1 U1 4 U2 4 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 EI 1537-6591 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG 1 PY 2016 VL 63 IS 3 BP 387 EP 395 DI 10.1093/cid/ciw278 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA DV8QP UT WOS:000383201900015 PM 27143660 ER PT J AU Hinton, CF Homer, CJ Thompson, AA Williams, A Hassell, KL Feuchtbaum, L Berry, SA Comeau, AM Therrell, BL Brower, A Harris, KB Brown, C Monaco, J Ostrander, RJ Zuckerman, AE Kaye, C Dougherty, D Greene, C Green, NS AF Hinton, Cynthia F. Homer, Charles J. Thompson, Alexis A. Williams, Andrea Hassell, Kathryn L. Feuchtbaum, Lisa Berry, Susan A. Comeau, Anne Marie Therrell, Bradford L. Brower, Amy Harris, Katharine B. Brown, Christine Monaco, Jana Ostrander, Robert J. Zuckerman, Alan E. Kaye, Celia Dougherty, Denise Greene, Carol Green, Nancy S. CA Follow Up Treatment Subcomm ACHDNC TI A framework for assessing outcomes from newborn screening: on the road to measuring its promise SO MOLECULAR GENETICS AND METABOLISM LA English DT Editorial Material DE Newborn screening; Long-term follow-up; Outcomes; Quality improvement ID TERM-FOLLOW-UP; SERVICES ADVISORY-COMMITTEE; HERITABLE DISORDERS; INFORMATION-SYSTEM; CYSTIC-FIBROSIS; US SECRETARY; CHILDREN; GUIDELINES; STATEMENT; PROGRAMS AB Newborn screening (NBS) is intended to identify congenital conditions prior to the onset of symptoms in order to provide early intervention that leads to improved outcomes. NBS is a public health success, providing reduction in mortality and improved developmental outcomes for screened conditions. However, it is less clear to what extent newborn screening achieves the long-term goals relating to improved health, growth, development and function. We propose a framework for assessing outcomes for the health and well-being of children identified through NBS programs. The framework proposed here, and this manuscript, were approved for publication by the Secretary of Health and Human Services' Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC). This framework can be applied to each screened condition within the Recommended Uniform Screening Panel (RUSP), recognizing that the data elements and measures will vary by condition. As an example, we applied the framework to sickle cell disease and phenylketonuria (PKU), two diverse conditions with different outcome measures and potential sources of data. Widespread and consistent application of this framework across state NBS and child health systems is envisioned as useful to standardize approaches to assessment of outcomes and for continuous improvement of the NBS and child health systems. Significance: Successful interventions for newborn screening conditions have been a driving force for public health newborn screening for over fifty years. Organizing interventions and outcome measures into a standard framework to systematically assess outcomes has not yet come into practice. This paper presents a customizable outcomes framework for organizing measures for newborn screening condition-specific health outcomes, and an approach to identifying sources and challenges to populating those measures. Published by Elsevier Inc. C1 [Hinton, Cynthia F.] Ctr Dis Control & Prevent, Atlanta, GA 30329 USA. [Homer, Charles J.] Off Assistant Secretary Planning & Evaluat, Washington, DC USA. [Thompson, Alexis A.] Northwestern Univ, Dept Pediat, Chicago, IL 60611 USA. [Williams, Andrea] Childrens Sickle Cell Fdn Inc, Pittsburgh, PA USA. [Hassell, Kathryn L.] Univ Colorado, Div Hematol, Boulder, CO 80309 USA. [Feuchtbaum, Lisa] Calif Dept Publ Hlth, Richmond, CA USA. [Berry, Susan A.] Univ Minnesota, Dept Pediat, Minneapolis, MN 55455 USA. [Comeau, Anne Marie] Univ Massachusetts, Sch Med, New England Newborn Screening Program, Boston, MA 02125 USA. [Comeau, Anne Marie] Univ Massachusetts, Sch Med, Dept Pediat, Boston, MA 02125 USA. [Therrell, Bradford L.] Univ Texas Hlth Sci Ctr San Antonio, Dept Pediat, San Antonio, TX 78229 USA. [Brower, Amy] Amer Coll Med Genet & Genom, Bethesda, MD USA. [Harris, Katharine B.] New York State Dept Hlth, Albany, NY USA. [Brown, Christine] Natl PKU Alliance, Tomahawk, WI USA. [Monaco, Jana] Organ Acidemia Assoc, Woodbridge, VA USA. [Ostrander, Robert J.] SUNY Upstate Med Univ, Dept Family Med, Syracuse, NY 13210 USA. [Zuckerman, Alan E.] Georgetown Univ, Dept Pediat, Washington, DC 20057 USA. [Kaye, Celia] Univ Colorado, Sch Med, Dept Pediat, Aurora, CO USA. [Dougherty, Denise] Agcy Healthcare Res & Qual, Rockville, MD USA. [Greene, Carol] Univ Maryland, Dept Pediat, Baltimore, MD 21201 USA. [Green, Nancy S.] Columbia Univ, Dept Pediat, New York, NY 10027 USA. RP Hinton, CF (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30329 USA. EM ceh9@cdc.gov OI Green, Nancy/0000-0002-9877-1561 FU Intramural CDC HHS [CC999999] NR 36 TC 0 Z9 0 U1 2 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1096-7192 EI 1096-7206 J9 MOL GENET METAB JI Mol. Genet. Metab. PD AUG PY 2016 VL 118 IS 4 BP 221 EP 229 DI 10.1016/j.ymgme.2016.05.017 PG 9 WC Endocrinology & Metabolism; Genetics & Heredity; Medicine, Research & Experimental SC Endocrinology & Metabolism; Genetics & Heredity; Research & Experimental Medicine GA DT2RL UT WOS:000381328000001 PM 27268406 ER PT J AU Fleishman, JA Monroe, AK Voss, CC Moore, RD Gebo, KA AF Fleishman, John A. Monroe, Anne K. Voss, Cindy C. Moore, Richard D. Gebo, Kelly A. TI Expenditures for Persons Living With HIV Enrolled in Medicaid, 2006-2010 SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV; Medicaid; expenditures ID CLAIMS DATA; CARE; MODELS; COSTS AB Background:Costs of care for persons living with HIV have been high historically. Cost estimates based on data from 1 health care site may underestimate total expenditures; using insurance claims avoids this limitation. We used Medicaid claims data to comprehensively assess payments for care for persons living with HIV between 2006 and 2010.Methods:Five sites from the HIV Research Network (HIVRN) provided information on patients with Medicaid coverage. Medicaid data were obtained from the sites' states (MD, NY, and MA) and 3 surrounding states and matched to HIVRN medical record-based data. Individuals less than 18, those with Medicare, and those in Medicaid managed care plans were excluded. Medicaid and HIVRN data were compared to ascertain concordance in capturing any inpatient event and any antiretroviral (ART) medication use.Results:Of 6892 unique HIVRN identifiers, 6196 (90%) were linked to Medicaid data. The analytic sample included 11,341 person-years of Medicaid claims data from 3695 individuals in fee-for-service (FFS) programs. The mean annual FFS payment for all services was $47,434; mean annual FFS payment for only medical services was $38,311. Concordance between Medicaid and HIVRN data was excellent for ART use, but HIVRN data did not record a substantial proportion of years in which Medicaid recorded inpatient use.Conclusions:Estimated Medicaid payment amounts in this study are higher than some previous estimates. More complete capture of expensive inpatient hospitalizations in Medicaid data may partially explain this finding. Although inpatient care and ART medications contribute the most, expenditures for nonmedical services are substantial. C1 [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, 5600 Fishers Lane, Rockville, MD 20857 USA. [Monroe, Anne K.; Voss, Cindy C.; Moore, Richard D.] Johns Hopkins Sch Med, Div Gen Internal Med, Dept Med, Baltimore, MD USA. [Gebo, Kelly A.] Johns Hopkins Sch Med, Div Infect Dis, Dept Med, Baltimore, MD USA. RP Fleishman, JA (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, 5600 Fishers Lane, Rockville, MD 20857 USA. EM john.fleishman@ahrq.hhs.gov FU Agency for Healthcare Research and Quality, Rockville, MD; Health Resources and Services Administration, Rockville, MD FX Agency for Healthcare Research and Quality, Rockville, MD (Fred; Hellinger, PhD, John Fleishman, PhD); Health Resources and Services Administration, Rockville, MD (Robert Mills, PhD). NR 14 TC 0 Z9 0 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1525-4135 EI 1077-9450 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD AUG 1 PY 2016 VL 72 IS 4 BP 408 EP 415 DI 10.1097/QAI.0000000000000985 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA DS1PH UT WOS:000380367900009 PM 26977747 ER PT J AU Garner, P Hopewell, S Chandler, J MacLehose, H Schunemann, HJ Akl, EA Beyene, J Chang, S Churchill, R Dearness, K Guyatt, G Lefebvre, C Liles, B Marshall, R Garcia, LM Mavergames, C Nasser, M Qaseem, A Sampson, M Soares-Weiser, K Takwoingi, Y Thabane, L Trivella, M Tugwell, P Welsh, E Wilson, EC AF Garner, Paul Hopewell, Sally Chandler, Jackie MacLehose, Harriet Schunemann, Holger J. Akl, Elie A. Beyene, Joseph Chang, Stephanie Churchill, Rachel Dearness, Karin Guyatt, Gordon Lefebvre, Carol Liles, Beth Marshall, Rachel Martinez Garcia, Laura Mavergames, Chris Nasser, Mona Qaseem, Amir Sampson, Margaret Soares-Weiser, Karla Takwoingi, Yemisi Thabane, Lehana Trivella, Marialena Tugwell, Peter Welsh, Emma Wilson, Ed C. TI When and how to update systematic reviews: consensus and checklist SO BMJ-BRITISH MEDICAL JOURNAL LA English DT Article ID COCHRANE REVIEWS; HEALTH-CARE; RANDOMIZED-TRIAL; FINDINGS TABLES; QUALITY; TOOL; INFORMATION; GRADE; SUFFICIENT; STRATEGY C1 [Garner, Paul] Univ Liverpool Liverpool Sch Trop Med, Dept Clin Sci, Cochrane Infect Dis Grp, Liverpool L3 5QA, Merseyside, England. [Hopewell, Sally] Univ Oxford, Oxford Clin Trials Res Unit, Oxford, England. [Chandler, Jackie; MacLehose, Harriet; Marshall, Rachel; Soares-Weiser, Karla] Cochrane Cent Execut, Cochrane Editorial Unit, London, England. [Schunemann, Holger J.; Guyatt, Gordon; Thabane, Lehana; Wilson, Ed C.] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada. [Schunemann, Holger J.; Guyatt, Gordon; Thabane, Lehana; Wilson, Ed C.] McMaster Univ, Dept Med, Hamilton, ON, Canada. [Schunemann, Holger J.; Akl, Elie A.] Cochrane GRADEing Methods Grp, Ottawa, ON, Canada. [Akl, Elie A.] Amer Univ Beirut, Dept Internal Med, Beirut, Lebanon. [Beyene, Joseph] McMaster Univ, Dept Math & Stat, Hamilton, ON, Canada. [Chang, Stephanie] Agcy Healthcare & Res Qual, Evidence Based Practice Ctr Program, Rockville, MD USA. [Churchill, Rachel] Univ York, Ctr Reviews & Disseminat, York, N Yorkshire, England. [Dearness, Karin] Cochrane Upper Gastrointestinal & Pancreat Dis Gr, Hamilton, ON, Canada. [Lefebvre, Carol] Lefebvre Associates, Oxford, England. [Liles, Beth] Kaiser Permanente Natl Guideline Program, Portland, OR USA. [Martinez Garcia, Laura] Iberoamer Cochrane Ctr, Barcelona, Spain. [Mavergames, Chris] Cochrane Cent Execut, Cochrane Informat & Knowledge Management, Freiburg, Germany. [Nasser, Mona] Univ Plymouth, Peninsula Sch Dent, Plymouth, Devon, England. [Qaseem, Amir] Amer Coll Physicians, Dept Clin Policy, Philadelphia, PA USA. [Qaseem, Amir] Guidelines Int Network, Pitlochry, Scotland. [Sampson, Margaret] Childrens Hosp Eastern Ontario, Ottawa, ON, Canada. [Takwoingi, Yemisi] Univ Birmingham, Inst Appl Hlth Res, Birmingham, W Midlands, England. [Thabane, Lehana] McMaster Univ, Biostat Unit, Ctr Evaluat, Hamilton, ON, Canada. [Trivella, Marialena] Univ Oxford, Ctr Stat Med, Oxford, England. [Tugwell, Peter] Univ Ottawa, Ottawa, ON, Canada. [Welsh, Emma] St Georges Univ London, Populat Hlth Res Inst, Cochrane Airways Grp, London, England. [Wilson, Ed C.] Univ Cambridge, Cambridge Ctr Hlth Serv Res, Cambridge, England. RP Garner, P (reprint author), Univ Liverpool Liverpool Sch Trop Med, Dept Clin Sci, Cochrane Infect Dis Grp, Liverpool L3 5QA, Merseyside, England. EM Paul.Garner@lstmed.ac.uk RI Wilson, Ed/N-9341-2014; OI Wilson, Ed/0000-0002-8369-1577; Garner, Paul/0000-0002-0607-6941; Tugwell, Peter/0000-0001-5062-0556 FU US Agency for Healthcare Research and Quality; US Department of Health and Human Services FX Attendance at this meeting, for those attendees not directly employed by Cochrane, was not funded by Cochrane beyond the reimbursement of out of pocket expenses for those attendees for whom this was appropriate. Expenses were not reimbursed for US federal government attendees, in line with US government policy. Statements in the manuscript should not be construed as endorsement by the US Agency for Healthcare Research and Quality or the US Department of Health and Human Services. NR 63 TC 5 Z9 5 U1 3 U2 5 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1756-1833 J9 BMJ-BRIT MED J JI BMJ-British Medical Journal PD JUL 20 PY 2016 VL 354 AR i3507 DI 10.1136/bmj.i3507 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA DS0WA UT WOS:000380316300001 PM 27443385 ER PT J AU Croswell, J Owings, J AF Croswell, Jennifer Owings, John TI Screening for Breast Cancer SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID TASK-FORCE RECOMMENDATION C1 [Croswell, Jennifer] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD USA. [Owings, John] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Croswell, J (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD USA. NR 2 TC 1 Z9 1 U1 1 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUL 15 PY 2016 VL 94 IS 2 BP 143 EP 144 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DR7MC UT WOS:000380082800012 PM 27419331 ER PT J AU Wang, Y Eldridge, N Metersky, ML Sonnenfeld, N Fine, JM Pandolfi, MM Eckenrode, S Bakullari, A Galusha, DH Jaser, L Verzier, NR Nuti, SV Hunt, D Normand, SLT Krumholz, HM AF Wang, Yun Eldridge, Noel Metersky, Mark L. Sonnenfeld, Nancy Fine, Jonathan M. Pandolfi, Michelle M. Eckenrode, Sheila Bakullari, Anila Galusha, Deron H. Jaser, Lisa Verzier, Nancy R. Nuti, Sudhakar V. Hunt, David Normand, Sharon-Lise T. Krumholz, Harlan M. TI Association Between Hospital Performance on Patient Safety and 30-Day Mortality and Unplanned Readmission for Medicare Fee-for-Service Patients With Acute Myocardial Infarction SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE Medicare; mortality; myocardial infarction; patient safety; readmission ID HEART-FAILURE; QUALITY; RATES; CARE; OUTCOMES; PROGRAM; BENEFICIARIES; REDUCTION; TRENDS AB Background-Little is known regarding the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). Methods and Results-Using 2009-2013 medical record-abstracted patient safety data from the Agency for Healthcare Research and Quality's Medicare Patient Safety Monitoring System and hospital mortality and readmission data from the Centers for Medicare & Medicaid Services, we fitted a mixed-effects model, adjusting for hospital characteristics, to evaluate whether hospital performance on patient safety, as measured by the hospital-specific risk-standardized occurrence rate of 21 common adverse event measures for which patients were at risk, is associated with hospital-specific 30-day all-cause risk-standardized mortality and unplanned readmission rates for Medicare patients with AMI. The unit of analysis was at the hospital level. The final sample included 793 acute care hospitals that treated 30 or more Medicare patients hospitalized for AMI and had 40 or more adverse events for which patients were at risk. The occurrence rate of adverse events for which patients were at risk was 3.8%. A 1% point change in the risk-standardized occurrence rate of adverse events was associated with average changes in the same direction of 4.86% points (95% CI, 0.79-8.94) and 3.44% points (95% CI, 0.19-6.68) for the risk-standardized mortality and unplanned readmission rates, respectively. Conclusions-For Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions. C1 [Wang, Yun; Normand, Sharon-Lise T.] Harvard TH Chan Sch Publ Hlth, Dept Biostat, SPH 2 Room 437F,655 Huntington Ave, Boston, MA 02115 USA. [Normand, Sharon-Lise T.] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA. [Fine, Jonathan M.] Norwalk Hosp, Sect Pulm & Crit Care Med, Norwalk, CT USA. [Metersky, Mark L.] Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, Farmington, CT USA. [Pandolfi, Michelle M.; Eckenrode, Sheila; Bakullari, Anila; Verzier, Nancy R.] Qualidigm, Wethersfield, CT USA. [Jaser, Lisa] Griffin Hosp, Dept Pharm, Derby, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Robert Wood Johnson Fdn Clin Scholars Program, New Haven, CT 06510 USA. [Galusha, Deron H.; Nuti, Sudhakar V.; Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Gen Internal Med Sect, New Haven, CT 06510 USA. [Krumholz, Harlan M.] Yale Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA. [Wang, Yun; Nuti, Sudhakar V.; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, 20 York St, New Haven, CT 06504 USA. [Eldridge, Noel] US Dept Hlth & Human Serv, Agcy Healthcare Res & Qual, Rockville, MD USA. [Sonnenfeld, Nancy] US Dept Hlth & Human Serv, Ctr Medicare & Medicaid Serv, Rockville, MD USA. [Hunt, David] US Dept Hlth & Human Serv, Off Natl Coordinator Hlth Informat Technol, Rockville, MD USA. RP Wang, Y (reprint author), Harvard TH Chan Sch Publ Hlth, Dept Biostat, SPH 2 Room 437F,655 Huntington Ave, Boston, MA 02115 USA. EM yunwang@hsph.harvard.edu FU Agency for Healthcare Research and Quality, US Department of Health and Human Services (Rockville, MD) [HHSA290201200003C, K18 HS021991]; National Heart, Lung, and Blood Institute [1U01HL105270-02]; National Institutes of Health [R01 GM111339, R21 ES022585-01, R21 ES024012, R01 ES024332]; US Environmental Protection Agency [RD83490001] FX This work was supported by contract HHSA290201200003C from the Agency for Healthcare Research and Quality, US Department of Health and Human Services (Rockville, MD). Qualidigm was the contractor. Dr Krumholz is partially funded by grant 1U01HL105270-02 (Krumholz, Center for Cardiovascular Outcomes Research at Yale University) from the National Heart, Lung, and Blood Institute. Dr Normand is partially supported by a grant (R01 GM111339, Normand) from the National Institutes of Health, and Dr Wang is partially supported by the US Environmental Protection Agency (RD-83490001, Dominici), National Institutes of Health (R21 ES022585-01, Dominici; R21 ES024012, Zanobetti; R01 GM111339, Normand; R01 ES024332, Zanobetti), and the Agency for Healthcare Research and Quality (K18 HS021991, Dominici). NR 44 TC 1 Z9 1 U1 1 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD JUL PY 2016 VL 5 IS 7 AR e003731 DI 10.1161/JAHA.116.003731 PG 13 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA EA6CT UT WOS:000386713800058 ER PT J AU Jacobs, PD Duchovny, N Lipton, BJ AF Jacobs, Paul D. Duchovny, Noelia Lipton, Brandy J. TI Changes In Health Status And Care Use After ACA Expansions Among The Insured And Uninsured SO HEALTH AFFAIRS LA English DT Article ID ADULTS C1 [Jacobs, Paul D.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. [Duchovny, Noelia] Congress Budget Off, Hlth Retirement & Long Term Anal Div, Washington, DC USA. [Lipton, Brandy J.] Social & Sci Syst, Rockville, MD USA. RP Jacobs, PD (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. EM paul.jacobs@ahrq.hhs.gov NR 5 TC 0 Z9 0 U1 1 U2 1 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JUL PY 2016 VL 35 IS 7 BP 1184 EP 1188 DI 10.1377/hlthaff.2015.1539 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DY0QN UT WOS:000384801400006 PM 27385232 ER PT J AU Brady, J AF Brady, Jeffrey TI Why We Study Disparities: The Human Stories Behind the Data SO JOURNAL OF NURSING CARE QUALITY LA English DT Editorial Material C1 [Brady, Jeffrey] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, 5600 Fishers Labe, Rockville, MD 20857 USA. RP Brady, J (reprint author), Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, 5600 Fishers Labe, Rockville, MD 20857 USA. EM Jeffrey.Brady@ahrq.hhs.gov NR 13 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1057-3631 EI 1550-5065 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JUL-SEP PY 2016 VL 31 IS 3 BP 197 EP 200 DI 10.1097/NCQ.0000000000000188 PG 4 WC Nursing SC Nursing GA DT4TR UT WOS:000381474500002 PM 27219626 ER PT J AU Shoemaker, SJ Parchman, ML Fuda, KK Schaefer, J Levin, J Hunt, M Ricciardi, R AF Shoemaker, Sarah J. Parchman, Michael L. Fuda, Kathleen Kerwin Schaefer, Judith Levin, Jessica Hunt, Meaghan Ricciardi, Richard TI A review of instruments to measure interprofessional team-based primary care SO JOURNAL OF INTERPROFESSIONAL CARE LA English DT Review DE Instruments; interprofessional practice; primary care; surveys; team-based care; teamwork ID QUALITY-OF-CARE; PSYCHOLOGICAL SAFETY; MANAGEMENT TEAMS; TOOL; VALIDATION; SCALE; COLLABORATION; MODEL; QUESTIONNAIRE; ORGANIZATIONS AB Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care settings. C1 [Shoemaker, Sarah J.; Hunt, Meaghan] Abt Associates Inc, Hlth Policy, 55 Wheeler St, Cambridge, MA 02138 USA. [Parchman, Michael L.; Schaefer, Judith] Grp Hlth Res Inst, Seattle, WA USA. [Levin, Jessica] Brandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA. [Ricciardi, Richard] Ctr Evidence & Practice Improvement, Agcy Healthcare Res & Qual, Rockville, MD USA. RP Shoemaker, SJ (reprint author), Abt Associates Inc, Hlth Policy, 55 Wheeler St, Cambridge, MA 02138 USA. EM sarah_shoemaker@abtassoc.com OI Parchman, Michael/0000-0001-7129-2889 NR 86 TC 2 Z9 2 U1 13 U2 17 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 530 WALNUT STREET, STE 850, PHILADELPHIA, PA 19106 USA SN 1356-1820 EI 1469-9567 J9 J INTERPROF CARE JI J. Interprofessional Care PD JUL PY 2016 VL 30 IS 4 BP 423 EP 432 DI 10.3109/13561820.2016.1154023 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DQ9OL UT WOS:000379539100004 PM 27212003 ER PT J AU Shah, MP Tate, JE Steiner, CA Parashar, UD AF Shah, Minesh P. Tate, Jacqueline E. Steiner, Claudia A. Parashar, Umesh D. TI Decline in Emergency Department Visits for Acute Gastroenteritis Among Children in 10 US States After Implementation of Rotavirus Vaccination, 2003 to 2013 SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE rotavirus; gastroenteritis; diarrhea; rotavirus vaccines; utilization ID UNITED-STATES; HOSPITALIZATIONS; VACCINES; DIARRHEA; PROGRAM; PENTAVALENT; NOROVIRUS; EFFICACY; INFANTS; DISEASE AB Background: Rotavirus vaccination of all infants began in the United States in 2006. Although the effect of vaccination on childhood hospitalizations for rotavirus has been well described, the effects of rotavirus vaccine on emergency department (ED) visits are less well documented. Methods: Using the State Emergency Department Databases for 10 US states, we compared the rates of gastroenteritis-and rotavirus-coded ED visits among children <5 years of age in prevaccine (2003 to 2006) with those in postvaccine (2008-2013) years; 2007 was excluded as a transition year. We analyzed ED visit rates by age group, sex, race and rotavirus season. Results: The prevaccine annual gastroenteritis-coded ED visit rate among children <5 years of age of 426 per 10,000 (annual range, 396-477 per 10,000) declined to 382 per 10,000 in postvaccine years, a 10.3% (+/- 0.3%, P < 0.0001) rate reduction overall. Compared with prevaccine years, annual ED visit rates for gastroenteritis decreased by 6.5% (+/- 0.6%) in 2008, 12.3% (+/- 0.6%) in 2010, 14.8% (+/- 0.5%) in 2011, 20.4% (+/- 0.5%) in 2012 and 10.1% (+/- 0.6%) in 2013; a small increase of 1.8% (+/- 0.6%) was seen in 2009 (P < 0.0001 for all individual comparisons). Declines were similar by sex and race and were greater in children <2 years of age (range 14.1%-20.6%, P < 0.0001) than in older children (increase of 3.3% +/- 0.6%, P < 0.0001). A decline of 21.2% (+/- 0.4%, P < 0.0001) in ED visits was seen during the rotavirus season months from January through June versus an increase of 9.5% (+/- 0.6%, P < 0.0001) during July to December. ED visits specifically coded for rotavirus showed more prominent declines than for all gastroenteritis. Conclusions: ED visits for gastroenteritis in US children have declined since the introduction of rotavirus vaccine. C1 [Shah, Minesh P.; Tate, Jacqueline E.; Parashar, Umesh D.] Ctr Dis Control & Prevent, Div Viral Dis, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA. [Shah, Minesh P.] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Off Publ Hlth Sci Serv, Atlanta, GA USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. RP Shah, MP (reprint author), Ctr Dis Control & Prevent, 1600 Clifton Rd NE,M-S A-34, Atlanta, GA 30329 USA. EM mpshah@cdc.gov FU Intramural CDC HHS [CC999999] NR 30 TC 1 Z9 1 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0891-3668 EI 1532-0987 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD JUL PY 2016 VL 35 IS 7 BP 782 EP 786 DI 10.1097/INF.0000000000001175 PG 5 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA DQ6VY UT WOS:000379344800018 PM 27088585 ER PT J AU Jiang, HJ Reiter, KL Wang, J AF Jiang, H. Joanna Reiter, Kristin L. Wang, Jia TI Measuring Mortality Performance How Did Safety-Net Hospitals Compare With Other Hospitals? SO MEDICAL CARE LA English DT Article DE safety-net hospitals; quality; mortality measures; teaching hospitals ID QUALITY-OF-CARE; ACUTE MYOCARDIAL-INFARCTION; MEDICAL CONDITIONS; 30-DAY MORTALITY; VOLUME; RECESSION AB Background: Safety-net hospitals (SNHs) tend to be weaker in financial condition than other hospitals, leading to a concern about how the quality of care at these hospitals would compare to other hospitals. Objectives: To assess mortality performance of SNHs using all-payer databases and measures for a broad range of conditions and procedures. Design: Longitudinal analysis of hospitals from 2006 through 2011 with data from the Healthcare Cost and Utilization Project State Inpatient Databases, the American Hospital Association Annual Survey, and the Area Health Resources File. Subjects: A total of 1891 urban, nonfederal, general acute hospitals from 31 states. Methods: SNHs were identified by the percentage of Medicaid and uninsured patients. Hospital mortality performance was measured by 2 composites covering 6 common medical conditions and 4 surgical procedures with risk adjustment for patient characteristics. Differences in each composite between SNHs and non-SNHs were estimated through generalized estimating equations to control for hospital factors and community resources. Results: Inpatient mortality rates declined over time for all hospitals. Small differences in risk-adjusted mortality rates between SNHs and non-SNHs were found only among teaching hospitals. After controlling for hospital factors, these differences were substantially reduced and remained significant only for surgical mortality rates. The small gap in surgical mortality rates diminished in later years. Conclusions: SNHs appeared to perform equally well as other hospitals in medical and surgical mortality measures. Policymakers should continue to monitor the quality of care at SNHs and ensure that it would not decline under the current value-based purchasing program. C1 [Jiang, H. Joanna] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 5600 Fishers Lane, Rockville, MD 20857 USA. [Reiter, Kristin L.] Univ N Carolina, Chapel Hill, NC USA. [Wang, Jia] Data & Analyt Solut Inc, Rockville, MD USA. RP Jiang, HJ (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 5600 Fishers Lane, Rockville, MD 20857 USA. EM joanna.jiang@ahrq.hhs.gov FU Agency for Healthcare Research and Quality FX Supported by the Agency for Healthcare Research and Quality through intramural research. NR 27 TC 1 Z9 1 U1 4 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD JUL PY 2016 VL 54 IS 7 BP 648 EP 656 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA DO8UW UT WOS:000378061000003 PM 27299951 ER PT J AU John-Baptiste, A Schapira, MM Cravens, C Chambers, JD Neumann, PJ Siegel, J Lawrence, W AF John-Baptiste, Ava Schapira, Marilyn M. Cravens, Catherine Chambers, James D. Neumann, Peter J. Siegel, Joanna Lawrence, William TI The Role of Decision Models in Health Care Policy: A Case Study SO MEDICAL DECISION MAKING LA English DT Article DE health care policy; decision models; policy discussion; colorectal cancer ID COST-EFFECTIVENESS ANALYSIS; MAKERS; IMPACT; TRANSPARENCY; NEED AB Background. In 2009, the Centers for Medicare and Medicaid Services (CMS) underwent a National Coverage Determination on computed tomography colonography (CTC) to screen for colorectal cancer. The Cancer Intervention & Surveillance Network developed decision models to inform this decision. The purpose of our study was to investigate the role of models in this decision. Methods. We performed a descriptive case study. We conducted semistructured telephone interviews with members of the CMS coverage and analysis group (CAG) and Medicare Coverage and Analysis Advisory Committee (MEDCAC) panelists. Informed by previously published literature, we developed a coding scheme to analyze interview transcripts, MEDCAC meeting transcripts, and the final CMS decision memo. Results. Four members of the CAG and 8 MEDCAC panelists were interviewed. The total number of codes across all study documents was 772. We found evidence that decision makers believed in the adequacy of models to inform decision making. In interview transcripts, the code Models Are Adequate to Inform was more frequent than the code Models Are Inadequate to Inform (47 times v. 5). Discussion of model conceptualization dominated the MEDCAC meeting (Model Conceptualization assigned 113 times) and was frequently discussed during interviews (Model Conceptualization assigned 84 times). We also found evidence that the models helped to focus the policy discussion. Across study documents, the codes Focus on Cost, Focus on ClinicalHealth Impact, and Focus on Inadequacy of Evidence Base were assigned 99, 98, and 97 times, respectively. Conclusions. Decision makers involved in the CTC decision believed in the adequacy of models to inform coverage decisions. The model played a role in focusing the CTC coverage policy discussion. C1 [John-Baptiste, Ava; Cravens, Catherine; Siegel, Joanna; Lawrence, William] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Dept Hlth & Human Serv, Rockville, MD USA. [John-Baptiste, Ava] Univ Western Ontario, Dept Anesthesia & Perioperat Med, Schulich Sch Med & Dent, Interfac Program Publ Hlth, London, ON, Canada. [John-Baptiste, Ava] Univ Western Ontario, Dept Epidemiol & Biostat, Schulich Sch Med & Dent, Interfac Program Publ Hlth, London, ON, Canada. [John-Baptiste, Ava] Ctr Med Evidence Decis Integr Clin MEDICI, London, ON, Canada. [John-Baptiste, Ava] Lawson Hlth Res Inst, London, ON, Canada. [John-Baptiste, Ava; Chambers, James D.; Neumann, Peter J.] Tufts Med Ctr, Ctr Evaluat Value & Risk Hlth, Inst Clin Res & Hlth Policy Studies, Boston, MA USA. [Schapira, Marilyn M.] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. [Schapira, Marilyn M.] Philadelphia VA Med Ctr, Ctr Hlth Equ & Res Program, Philadelphia, PA USA. RP John-Baptiste, A (reprint author), Western Ctr Publ Hlth & Family Med, Rm 4111,1465 Richmond St, London, ON N6G 2M1, Canada. EM ajohnbap@uwo.ca FU Society for Medical Decision Making (SMDM); Agency for Healthcare Research and Policy Health Policy Fellowship in Comparative Effectiveness; Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes [OTG-88591]; Cancer Care Ontario; Ontario Institute for Cancer Research through Ministry of Health and Long-Term Care; Ontario Institute for Cancer Research through Ministry of Economic Development and Innovation of the Government of Ontario; Canadian Institutes of Health Research through Ministry of Health and Long-Term Care FX This article was presented at the 32nd Annual Meeting of the Society for Medical Decision Making (Toronto, Ontario, Canada, 2010) and the annual symposium of the Canadian Agency for Drugs and Technologies in Health (Vancouver, British Columbia, Canada, 2011). During the conduct of the study, Ava John-Baptiste was funded by the Society for Medical Decision Making (SMDM), Agency for Healthcare Research and Policy Health Policy Fellowship in Comparative Effectiveness, and hosted in the Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center. The funding agreement ensured the author's independence in designing the study, interpreting the data, writing, and publishing the report. The following authors were employed by the Agency for Healthcare Research and Policy: Catherine Cravens, Joanna Siegel, and William Lawrence. Ava John-Baptiste was subsequently supported by a Team Grant (grant OTG-88591) from the Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes, Cancer Care Ontario and the Ontario Institute for Cancer Research (through funding provided by the Ministry of Health and Long-Term Care and the Ministry of Economic Development and Innovation of the Government of Ontario). Ava John-Baptiste was also supported by a postdoctoral fellowship from the Canadian Institutes of Health Research (through funding provided by the Ministry of Health and Long-Term Care). Revision accepted for publication 26 March 2016. NR 30 TC 0 Z9 0 U1 2 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0272-989X EI 1552-681X J9 MED DECIS MAKING JI Med. Decis. Mak. PD JUL PY 2016 VL 36 IS 5 BP 666 EP 679 DI 10.1177/0272989X16646732 PG 14 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA DN5XL UT WOS:000377144900010 PM 27225487 ER PT J AU Ngo-Metzger, Q Owings, J AF Ngo-Metzger, Quyen Owings, John TI Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Owings, John] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Ngo-Metzger, Q (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUN 15 PY 2016 VL 93 IS 12 BP 1025 EP 1026 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DO2TU UT WOS:000377633800009 PM 27304773 ER PT J AU Saint, S Greene, T Krein, SL Rogers, MAM Ratz, D Fowler, KE Edson, BS Watson, SR Meyer-Lucas, B Masuga, M Faulkner, K Gould, CV Battles, J Fakih, MG AF Saint, Sanjay Greene, Todd Krein, Sarah L. Rogers, Mary A. M. Ratz, David Fowler, Karen E. Edson, Barbara S. Watson, Sam R. Meyer-Lucas, Barbara Masuga, Marie Faulkner, Kelly Gould, Carolyn V. Battles, James Fakih, Mohamad G. TI A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID BLOOD-STREAM INFECTIONS; COLLABORATION; SAFETY AB BACKGROUND Catheter-associated urinary tract infection (UTI) is a common device-associated infection in hospitals. Both technical factors - appropriate catheter use, aseptic insertion, and proper maintenance - and socioadaptive factors, such as cultural and behavioral changes in hospital units, are important in preventing catheter-associated UTI. METHODS The national Comprehensive Unit-based Safety Program, funded by the Agency for Healthcare Research and Quality, aimed to reduce catheter-associated UTI in intensive care units (ICUs) and non-ICUs. The main program features were dissemination of information to sponsor organizations and hospitals, data collection, and guidance on key technical and socioadaptive factors in the prevention of catheter-associated UTI. Data on catheter use and catheter-associated UTI rates were collected during three phases: baseline (3 months), implementation (2 months), and sustainability (12 months). Multilevel negative binomial models were used to assess changes in catheter use and catheter-associated UTI rates. RESULTS Data were obtained from 926 units (59.7% were non-ICUs, and 40.3% were ICUs) in 603 hospitals in 32 states, the District of Columbia, and Puerto Rico. The unadjusted catheter-associated UTI rate decreased overall from 2.82 to 2.19 infections per 1000 catheterdays. In an adjusted analysis, catheter-associated UTI rates decreased from 2.40 to 2.05 infections per 1000 catheter-days (incidence rate ratio, 0.86; 95% confidence interval [CI], 0.76 to 0.96; P = 0.009). Among non-ICUs, catheter use decreased from 20.1% to 18.8% (incidence rate ratio, 0.93; 95% CI, 0.90 to 0.96; P<0.001) and catheter-associated UTI rates decreased from 2.28 to 1.54 infections per 1000 catheter-days (incidence rate ratio, 0.68; 95% CI, 0.56 to 0.82; P<0.001). Catheter use and catheter-associated UTI rates were largely unchanged in ICUs. Tests for heterogeneity (ICU vs. non-ICU) were significant for catheter use (P = 0.004) and catheter-associated UTI rates (P = 0.001). CONCLUSIONS A national prevention program appears to reduce catheter use and catheter-associated UTI rates in non-ICUs. (Funded by the Agency for Healthcare Research and Quality.) C1 [Saint, Sanjay; Greene, Todd; Krein, Sarah L.; Ratz, David; Fowler, Karen E.] Vet Affairs VA Ann Arbor Healthcare Syst, Hosp Outcomes Program Excellence, Ann Arbor, MI USA. [Saint, Sanjay; Greene, Todd; Krein, Sarah L.; Rogers, Mary A. M.] Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI USA. [Saint, Sanjay; Greene, Todd; Krein, Sarah L.; Rogers, Mary A. M.; Ratz, David; Fowler, Karen E.] VA UM Patient Safety Enhancement Program, Ann Arbor, MI USA. [Watson, Sam R.; Meyer-Lucas, Barbara; Masuga, Marie] Michigan Hlth & Hosp Assoc, Okemos, MI USA. [Fakih, Mohamad G.] St John Hosp & Med Ctr, Detroit, MI USA. [Edson, Barbara S.; Faulkner, Kelly] Hlth Res & Educ Trust, Chicago, IL USA. [Gould, Carolyn V.] Ctr Dis Control & Prevent, Atlanta, GA USA. [Battles, James] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Saint, S (reprint author), Univ Michigan, Dept Internal Med, 2800 Plymouth Rd,Bldg 16,Rm 430W, Ann Arbor, MI 48109 USA. EM saint@med.umich.edu FU Agency for Healthcare Research and Quality FX Funded by the Agency for Healthcare Research and Quality. NR 29 TC 1 Z9 2 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 EI 1533-4406 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUN 2 PY 2016 VL 374 IS 22 BP 2111 EP 2119 DI 10.1056/NEJMoa1504906 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA EB2RP UT WOS:000387209900004 PM 27248619 ER PT J AU Klembczyk, JJ Jalalpour, M Levin, S Washington, RE Pines, JM Rothman, RE Dugas, AF AF Klembczyk, Joseph Jeffrey Jalalpour, Mehdi Levin, Scott Washington, Raynard E. Pines, Jesse M. Rothman, Richard E. Dugas, Andrea Freyer TI Google Flu Trends Spatial Variability Validated Against Emergency Department Influenza-Related Visits SO JOURNAL OF MEDICAL INTERNET RESEARCH LA English DT Article DE influenza; surveillance; emergency department; google flu trends; infoveillance ID UNITED-STATES; OUTBREAKS; ASSOCIATION; TEMPERATURE; HOSPITALS; SERVICES; OUTCOMES; GENDER; IMPACT; VIRUS AB Background: Influenza is a deadly and costly public health problem. Variations in its seasonal patterns cause dangerous surges in emergency department (ED) patient volume. Google Flu Trends (GFT) can provide faster influenza surveillance information than traditional CDC methods, potentially leading to improved public health preparedness. GFT has been found to correlate well with reported influenza and to improve influenza prediction models. However, previous validation studies have focused on isolated clinical locations. Objective: The purpose of the study was to measure GFT surveillance effectiveness by correlating GFT with influenza-related ED visits in 19 US cities across seven influenza seasons, and to explore which city characteristics lead to better or worse GFT effectiveness. Methods: Using Healthcare Cost and Utilization Project data, we collected weekly counts of ED visits for all patients with diagnosis (International Statistical Classification of Diseases 9) codes for influenza-related visits from 2005-2011 in 19 different US cities. We measured the correlation between weekly volume of GFT searches and influenza-related ED visits (ie, GFT ED surveillance effectiveness) per city. We evaluated the relationship between 15 publically available city indicators (11 sociodemographic, two health care utilization, and two climate) and GFT surveillance effectiveness using univariate linear regression. Results: Correlation between city-level GFT and influenza-related ED visits had a median of .84, ranging from .67 to .93 across 19 cities. Temporal variability was observed, with median correlation ranging from .78 in 2009 to .94 in 2005. City indicators significantly associated (P<.10) with improved GFT surveillance include higher proportion of female population, higher proportion with Medicare coverage, higher ED visits per capita, and lower socioeconomic status. Conclusions: GFT is strongly correlated with ED influenza-related visits at the city level, but unexplained variation over geographic location and time limits its utility as standalone surveillance. GFT is likely most useful as an early signal used in conjunction with other more comprehensive surveillance techniques. City indicators associated with improved GFT surveillance provide some insight into the variability of GFT effectiveness. For example, populations with lower socioeconomic status may have a greater tendency to initially turn to the Internet for health questions, thus leading to increased GFT effectiveness. GFT has the potential to provide valuable information to ED providers for patient care and to administrators for ED surge preparedness. C1 [Klembczyk, Joseph Jeffrey] Johns Hopkins Univ, Sch Med, 128 S Belvedere Dr, Hampstead, NC 28443 USA. [Jalalpour, Mehdi] Cleveland State Univ, Dept Civil & Environm Engn, Cleveland, OH 44115 USA. [Levin, Scott; Rothman, Richard E.; Dugas, Andrea Freyer] Johns Hopkins Univ, Dept Emergency Med, Baltimore, MD USA. [Washington, Raynard E.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Pines, Jesse M.] George Washington Univ, Dept Emergency Med, Washington, DC USA. [Pines, Jesse M.] George Washington Univ, Dept Hlth Policy, Washington, DC USA. RP Klembczyk, JJ (reprint author), Johns Hopkins Univ, Sch Med, 128 S Belvedere Dr, Hampstead, NC 28443 USA. EM jjklem@gmail.com OI Rothman, Richard/0000-0002-1017-9505 FU US Department of Health and Human Services [IDSEP130014-01-00]; National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) [TL1 TR001078]; NIH Roadmap for Medical Research FX This work was supported by the Cooperative Agreement IDSEP130014-01-00 from The Assistant Secretary for Preparedness and Response within the US Department of Health and Human Services. Contents do not necessarily represent the official views of the US Department of Health and Human Services. Use of trade names and commercial sources is for identification only and does not imply endorsement by the US Department of Health and Human Services.; This publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by Grant Number TL1 TR001078 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS, or NIH. NR 44 TC 1 Z9 1 U1 2 U2 2 PU JMIR PUBLICATIONS, INC PI TORONTO PA 59 WINNERS CIRCLE, TORONTO, ON M4L 3Y7, CANADA SN 1438-8871 J9 J MED INTERNET RES JI J. Med. Internet Res. PD JUN PY 2016 VL 18 IS 6 AR e175 DI 10.2196/jmir.5585 PG 10 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA EC9WO UT WOS:000388495200045 PM 27354313 ER PT J AU Sandmeyer, B Fraser, I AF Sandmeyer, Brent Fraser, Irene TI New Evidence on What Works in Effective Public Reporting Introduction SO HEALTH SERVICES RESEARCH LA English DT Editorial Material DE Consumer information; public reporting; quality of care/patient safety AB Objective. To describe the current state of the public reporting field and provide guidance to public report producers based on the evidence. Principal Findings. Public reports should address the questions and priorities that consumers actually have; present information credibly and in a way that is understood by the intended audience; reach the intended audience; and enable consumers to act on the information. Conclusions. Public reports have advanced greatly in recent years, but there remains much room for improvement. Report producers should continually evaluate their reports and apply the latest evidence to maximize their usefulness and impact. C1 [Sandmeyer, Brent] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Washington, DC 20857 USA. [Fraser, Irene] Univ Chicago, NORC, Chicago, IL 60637 USA. RP Sandmeyer, B (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Washington, DC 20857 USA. EM brent.sandmeyer@ahrq.hhs.gov FU Agency for Healthcare Research and Quality FX The studies that are described in the articles in this issue were financially supported by the Agency for Healthcare Research and Quality, as was the editorial support of production of the issue. Brent Sandmeyer is a current AHRQ employee. Irene Fraser is a former AHRQ employee, current employee of NORC and the University of Chicago, and board member of the Leapfrog Group. The findings and conclusions in this article are those of the authors, who are responsible for its content, and do not represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ, of the U.S. Department of Health and Human Services, NORC, or the Leapfrog Group. NR 7 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD JUN PY 2016 VL 51 SU 2 BP 1159 EP 1166 DI 10.1111/1475-6773.12502 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DX9UY UT WOS:000384743500001 PM 27120996 ER PT J AU Basu, J Avila, R Ricciardi, R AF Basu, Jayasree Avila, Rosa Ricciardi, Richard TI Hospital Readmission Rates in US States: Are Readmissions Higher Where More Patients with Multiple Chronic Conditions Cluster? SO HEALTH SERVICES RESEARCH LA English DT Article DE Hospital readmissions; multiple chronic conditions; small area analysis; comorbidities; US states ID QUALITY-OF-CARE; MEDICARE BENEFICIARIES; 30-DAY READMISSION; FOLLOW-UP; ASSOCIATION; LENGTH; COSTS; STAY AB Research Objective. This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. Study Design. The study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, linked to contextual and provider data from Health Resources and Services Administration. A multivariate cross sectional design at primary care service area (PCSA) level is used. Principal Findings. Adjusting for area characteristics, the readmission rates were significantly higher in PCSAs having higher proportions of patients with 2-3 chronic conditions and those with 4+ chronic conditions, compared with areas with a higher concentration of patients with 0-1 chronic conditions. Conclusions. Using small area analysis, the study shows that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates. C1 [Basu, Jayasree; Ricciardi, Richard] Agcy Hlth Care Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. [Avila, Rosa] Univ Washington, Dept Hlth Serv, Sch Publ Hlth, Seattle, WA 98195 USA. RP Basu, J (reprint author), Agcy Hlth Care Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. EM jayasree.basu@ahrq.hhs.gov FU Agency for Healthcare Research and Quality (AHRQ); Social and Scientific Systems, Inc. in Maryland FX This research is funded wholly by the authors' employer, the Agency for Healthcare Research and Quality (AHRQ). The views expressed in this paper are those of the authors. No official endorsement by any agency of the federal government is intended or should be inferred. The authors acknowledge the state data organizations that participate in the HCUP State Inpatient Databases in California, Florida, New York, Tennessee, Missouri, and Nevada. The authors also acknowledge the data and programming support provided by Social and Scientific Systems, Inc. in Maryland. NR 28 TC 1 Z9 1 U1 1 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD JUN PY 2016 VL 51 IS 3 BP 1135 EP 1151 DI 10.1111/1475-6773.12401 PG 17 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DX9UN UT WOS:000384741900018 PM 26481190 ER PT J AU Moriya, AS Simon, K AF Moriya, Asako S. Simon, Kosali TI IMPACT OF PREMIUM SUBSIDIES ON THE TAKE-UP OF HEALTH INSURANCE Evidence from the 2009 American Recovery and Reinvestment Act (ARRA) SO AMERICAN JOURNAL OF HEALTH ECONOMICS LA English DT Article DE insurance subsidy; price elasticity of insurance demand; COBRA ID TAX INCENTIVES; COVERAGE; DEMAND; ECONOMICS; BENEFITS; DECISION; EMPLOYER; MARKET; COBRA AB We study the coverage impacts of a 65 percent health insurance premium subsidy that targeted employer-insured workers who lost their jobs between September 2008 and May 2010. Our research represents the first econometric analysis of the American Recovery and Reinvestment Act (ARRA) COBRA subsidy and contributes to a better understanding of consumer responses to government-subsidized private health insurance and discussions surrounding Affordable Care Act (ACA) policies. Using data from the Survey of Income and Program Participation (SIPP) and a difference-in-differences estimation strategy, we find that the subsidy is associated with a substantial increase in own-name employer coverage among the targeted group. We estimate a -0.38 to -0.27 price elasticity of demand for health insurance, depending on the specification. This suggests that consumers are somewhat more price sensitive than previously thought, although there are caveats to generalizing from past settings to individuals affected by ACA subsidies. We also find that part of the increase in subsidized coverage was offset by a decrease in unsubsidized non-group insurance. C1 [Moriya, Asako S.] AHRQ, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. [Moriya, Asako S.; Simon, Kosali] Indiana Univ, SPEA, Bloomington, IN 47405 USA. [Simon, Kosali] NBER, Cambridge, MA 02138 USA. RP Moriya, AS (reprint author), AHRQ, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. EM Asako.Moriya@ahrq.hhs.gov NR 42 TC 0 Z9 0 U1 5 U2 5 PU MIT PRESS PI CAMBRIDGE PA ONE ROGERS ST, CAMBRIDGE, MA 02142-1209 USA SN 2332-3493 EI 2332-3507 J9 AM J HEALTH ECON JI AM. J. HEALTH ECON. PD SUM PY 2016 VL 2 IS 3 BP 318 EP 343 DI 10.1162/ajhe_a_00047 PG 26 WC Economics; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA DS1PS UT WOS:000380369000003 ER PT J AU Hellinger, FJ AF Hellinger, Fred J. TI Hospital Use by Persons With HIV in the 21st Century A 5-State Study SO MEDICAL CARE LA English DT Article DE HIV/AIDS; hospitalization; cost ID HEALTH-SERVICES UTILIZATION; UNITED-STATES; COHORT; CARE; TRENDS; RATES; COST; AIDS AB Objective: The purpose of this study is to determine whether reductions in hospital utilization observed immediately after the availability of highly active antiretroviral therapy (between 1995 and 2000) have persisted into the 21st century. Data Sources: Data on all human immunodeficiency virus (HIV)-related hospital admissions in 5 states (California, Florida, New Jersey, New York, and South Carolina) in 2000, 2005, 2010, and 2013 were obtained from the State Inpatient Database, which is administered by the Agency for Healthcare Research and Quality. In addition, data on the number of persons living with HIV were obtained from the Centers for Disease Control and Prevention and from the California Department of Public Health. Study Design: This study compares the average number of hospitalizations per person living with HIV in each of the 5 states as well as the average cost for hospital care per person with HIV in 2000, 2005, 2010, and 2013. Results: The total number of hospitalizations by persons with HIV in the 5 study states fell by one third between 2000 and 2013 even though the number of persons living with HIV increased by > 50%. Conclusions: Persons with HIV disease were 64% less likely to be hospitalized in 2013 than they were in 2000. In addition, the probability of a person with HIV being hospitalized fell 44% between 2000 and 2010 and 29% between 2010 and 2013. C1 [Hellinger, Fred J.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 5600 Fishers Lane, Rockville, MD 20857 USA. RP Hellinger, FJ (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 5600 Fishers Lane, Rockville, MD 20857 USA. EM fred.hellinger@ahrq.hhs.gov NR 33 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD JUN PY 2016 VL 54 IS 6 BP 639 EP 644 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA DO8UR UT WOS:000378060400014 PM 26918402 ER PT J AU Pronovost, PJ Cleeman, JI Wright, D Srinivasan, A AF Pronovost, Peter J. Cleeman, James I. Wright, Donald Srinivasan, Arjun TI Fifteen years after To Err is Human: a success story to learn from SO BMJ QUALITY & SAFETY LA English DT Editorial Material ID BLOOD-STREAM INFECTIONS; INTENSIVE-CARE UNITS; PATIENT SAFETY PROGRAM; QUALITY IMPROVEMENT; MATCHING-MICHIGAN; INTERVENTION; EXPERIENCE; HOSPITALS; IMPACT; ICU C1 [Pronovost, Peter J.] Johns Hopkins Univ, Armstrong Inst Patient Safety & Qual, Johns Hopkins Med, Anesthesiol & Crit Care Med Surg & Hlth Policy &, 750 E Pratt St,15th Floor, Baltimore, MD 21202 USA. [Cleeman, James I.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Wright, Donald] US Dept HHS, Off Dis Prevent & Hlth Promot, Rockville, MD USA. [Srinivasan, Arjun] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Atlanta, GA USA. RP Pronovost, PJ (reprint author), Johns Hopkins Univ, Anesthesiol & Crit Care Med, 750 E Pratt St,15th Floor, Baltimore, MD 21202 USA. EM ppronovo@jhmi.edu FU Agency for Healthcare Research and Quality; Gordon and Betty Moore Foundation; National Institutes of Health; American Medical Association, Inc. FX PJP reports the following potential conflicts of interest: grant or contract support from the Agency for Healthcare Research and Quality, the Gordon and Betty Moore Foundation (research related to patient safety and quality of care), the National Institutes of Health (research on long-term outcomes for acute lung injury patients) and the American Medical Association, Inc. (research to improve blood pressure control); honoraria from various healthcare organisations for speaking on patient safety and quality (the Leigh Bureau manages these engagements); book royalties from the Penguin Group for his book, Safe Patients, Smart Hospitals; and stock and fees to serve as a director for Cantel Medical. PJP is a founder of Patient Doctor Technologies, a startup company that seeks to enhance the partnership between patients and clinicians with an application called Doctella. NR 29 TC 2 Z9 2 U1 5 U2 5 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 2044-5415 EI 2044-5423 J9 BMJ QUAL SAF JI BMJ Qual. Saf. PD JUN PY 2016 VL 25 IS 6 BP 396 EP 399 DI 10.1136/bmjqs-2015-004720 PG 4 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DN2WT UT WOS:000376924400003 PM 26669931 ER PT J AU Kaplan, RM Milstein, A AF Kaplan, Robert M. Milstein, Arnold TI Financial Strain and Cancer Outcomes SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Editorial Material ID EDUCATIONAL-ATTAINMENT C1 [Kaplan, Robert M.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Milstein, Arnold] Stanford Univ, Stanford, CA 94305 USA. RP Kaplan, RM (reprint author), Agcy Healthcare Res & Qual, Rockville, MD USA. NR 7 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X EI 1527-7755 J9 J CLIN ONCOL JI J. Clin. Oncol. PD MAY 20 PY 2016 VL 34 IS 15 BP 1711 EP + DI 10.1200/JCO.2016.66.8079 PG 4 WC Oncology SC Oncology GA DL3NS UT WOS:000375541100004 PM 27022120 ER PT J AU Fan, T Blitz, J AF Fan, Tina Blitz, Jason TI Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Washington, DC USA. [Blitz, Jason] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Fan, T (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Washington, DC USA. NR 2 TC 0 Z9 0 U1 3 U2 4 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD MAY 15 PY 2016 VL 93 IS 10 BP 861 EP 862 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DL8KO UT WOS:000375891100006 PM 27175721 ER PT J AU Bae, J Encinosa, WE AF Bae, Jaeyong Encinosa, William E. TI National estimates of the impact of electronic health records on the workload of primary care physicians SO BMC HEALTH SERVICES RESEARCH LA English DT Article DE Electronic health records; Physician workload; Efficiency of care; Primary care ID PATIENT SATISFACTION; FAMILY PHYSICIANS; OFFICE VISITS; TIME SPENT; EFFICIENCY AB Background: Eighty-four thousand primary care physicians have received $1.3 billion in HITECH payments for EHR adoption. However, little is known about how this will impact primary care workload efficiency and the national primary care shortage. This study examines whether EHR is associated with increases in face time with the patient per visit and increases in the physician's patient volume per week. Methods: We used a nationally representative sample of 37,962 patient visits to 1470 primary care physicians during the pre-HITECH years 2006-2009 from the restricted-access version of the National Ambulatory Medical Care Survey. Quantile regressions were used to estimate the effects of EHR use on patient face time per visit and physician's patient volume per week at different points of the time and volume distributions. Results: Primary care physicians with EHR spend an extra 1.3 face time minutes per visit, or 1.5 extra hours per week. This is 34,000 extra hours of face time per week in the U.S. However, physician age matters. Among young physicians, EHR use is associated with a decline in weekly patient volume, while EHR use among older physicians is associated with an increase in volume, regardless of initial practice size. If younger physicians behaved like older physicians when adopting EHR, there would be 37,600 additional patient visits per week in the U.S., the equivalent of adding 500 more primary care physicians to the U.S. workforce. Conclusion: EHR can enhance productivity/efficiency in primary care physician workloads. C1 [Bae, Jaeyong] No Illinois Univ, Sch Nursing & Hlth Studies, Wirtz Hall 257, De Kalb, IL 60115 USA. [Encinosa, William E.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 5600 Fishers Ln, Rockville, MD 20857 USA. [Encinosa, William E.] Georgetown Univ, McCourt Sch Publ Policy, Washington, DC USA. RP Bae, J (reprint author), No Illinois Univ, Sch Nursing & Hlth Studies, Wirtz Hall 257, De Kalb, IL 60115 USA. EM jaeyong.bae@niu.edu FU Research Data Center, the National Center for Health Statistics FX The authors gratefully acknowledge the support of the Research Data Center, the National Center for Health Statistics for the use of restricted NAMCS data. They thank Ajay Yesupriya for help with the restricted NAMCS data. NR 23 TC 0 Z9 0 U1 6 U2 6 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD MAY 10 PY 2016 VL 16 AR 172 DI 10.1186/s12913-016-1422-6 PG 11 WC Health Care Sciences & Services SC Health Care Sciences & Services GA DM7WZ UT WOS:000376572000001 PM 27160147 ER PT J AU Morris, AM Ricci, KA Griffin, AR Heslin, KC Dobalian, A AF Morris, Andrea M. Ricci, Karen A. Griffin, Anne R. Heslin, Kevin C. Dobalian, Aram TI Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives SO BMC EMERGENCY MEDICINE LA English DT Article DE Disaster response; Recovery; Hospital; Professional duty; Veterans; US Department of Veterans Affairs ID CARE; WILLINGNESS; DISASTERS; VETERANS AB Background: Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Methods: Semi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System's response to Superstorm Sandy and during the facility's initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting ("Barriers"), 2) Facilitators to reporting ("Facilitators"), and 3) Responses to staff needs and concerns ("Responses"). Atlas. ti 7.1.6 software program was used for the management and analysis of the transcripts. Results: Results indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm. Conclusions: During and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff encountered following a major natural disaster from the management perspective. Insights gained from this study can be used to inform future disaster planning and preparedness efforts, and help ensure that there is adequate staffing to mount an effective response when a disaster occurs, and to recover from its aftermath. C1 [Morris, Andrea M.; Dobalian, Aram] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA USA. [Morris, Andrea M.; Griffin, Anne R.; Dobalian, Aram] US Dept Vet Affairs, Vet Emergency Management Evaluat Ctr, North Hills, CA USA. [Ricci, Karen A.] Baystate Med Ctr, Dept OB GYN Res, Springfield, MA USA. [Heslin, Kevin C.] US Dept Hlth & Human Serv, Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD USA. [Dobalian, Aram] Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. RP Dobalian, A (reprint author), Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA USA.; Dobalian, A (reprint author), US Dept Vet Affairs, Vet Emergency Management Evaluat Ctr, North Hills, CA USA.; Dobalian, A (reprint author), Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. EM aram.dobalian@va.gov FU AHRQ HHS [T32 HS000046] NR 30 TC 1 Z9 1 U1 4 U2 4 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-227X J9 BMC EMERG MED JI BMC Emerg. Med. PD MAY 5 PY 2016 VL 16 AR 18 DI 10.1186/s12873-016-0082-5 PG 7 WC Emergency Medicine SC Emergency Medicine GA DO9RQ UT WOS:000378124900001 PM 27151172 ER PT J AU Paynter, RA Banez, LL Berliner, E Erinoff, E Lege-Matsuura, JM Potter, S AF Paynter, R. A. Banez, L. L. Berliner, E. Erinoff, E. Lege-Matsuura, J. M. Potter, S. TI USE OF TEXT-MINING TOOLS FOR SYSTEMATIC REVIEWS SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Paynter, R. A.] AHRQ Effect Hlth Care Program, Portland, OR USA. [Banez, L. L.; Berliner, E.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Erinoff, E.; Lege-Matsuura, J. M.] ECRI Inst, Plymouth Meeting, PA USA. [Potter, S.] Vanderbilt Univ, 221 Kirkland Hall, Nashville, TN 37235 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2016 VL 19 IS 3 MA PRM211 BP A108 EP A108 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA EL9HJ UT WOS:000394931000038 ER PT J AU Hines, AL Heslin, K Barrett, ML Moy, E Coffey, RM AF Hines, Anika L. Heslin, Kevin Barrett, Marguerite L. Moy, Ernest Coffey, Rosanna M. TI THE ASSOCIATION OF PATIENTS' PRIMARY LANGUAGE WITH READMISSION FOR HIGH-VOLUME HOSPITAL CONDITIONS SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT Meeting of the Society-of-General-Internal-Medicine (SGIM) CY MAY 11-14, 2015-2016 CL Hollywood, FL SP Soc Gen Internal Med C1 [Hines, Anika L.] Johns Hopkins Sch Med, Baltimore, MD USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Heslin, Kevin; Moy, Ernest] Agcy Healthcare Res & Qual, Rockville, MD USA. [Coffey, Rosanna M.] Truven Hlth Analyt Inc, Bethesda, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD MAY PY 2016 VL 31 SU 2 BP S413 EP S414 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA EI0YL UT WOS:000392201601216 ER PT J AU Sommers, BD Lipton, B Decker, S AF Sommers, Benjamin D. Lipton, Brandy Decker, Sandra TI IMPACTS OF THE 2014 MEDICAID EXPANSION ON COVERAGE, ACCESS TO CARE, AND HEALTH SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT Meeting of the Society-of-General-Internal-Medicine (SGIM) CY MAY 11-14, 2015-2016 CL Hollywood, FL SP Soc Gen Internal Med C1 [Sommers, Benjamin D.] Harvard Sch Publ Hlth, Brookline, MA USA. [Sommers, Benjamin D.] Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA. [Lipton, Brandy; Decker, Sandra] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD MAY PY 2016 VL 31 SU 2 BP S266 EP S266 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA EI0YL UT WOS:000392201600322 ER PT J AU Steiner, C Martsolf, G Barrett, ML Weiss, A Washington, R Mehrotra, A Coffey, RM AF Steiner, Claudia Martsolf, Grant Barrett, Marguerite L. Weiss, Audrey Washington, Raynard Mehrotra, Ateev Coffey, Rosanna M. TI IMPACT OF RACE/ETHNICITYAND SOCIOECONOMIC STATUS ON RISK-ADJUSTED READMISSION RATES: IMPLICATIONS FOR THE CMS HOSPITAL READMISSIONS REDUCTION PROGRAM SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT Meeting of the Society-of-General-Internal-Medicine (SGIM) CY MAY 11-14, 2015-2016 CL Hollywood, FL SP Soc Gen Internal Med C1 [Steiner, Claudia] Agcy Healthcare Res & Qual, Rockville, MD USA. [Martsolf, Grant; Mehrotra, Ateev] RAND, Pitssburgh, PA USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Weiss, Audrey; Coffey, Rosanna M.] Truven Hlth Analyt, Santa Barbara, CA USA. [Washington, Raynard] Council Affordable Qual Healthcare, Washington, DC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD MAY PY 2016 VL 31 SU 2 BP S264 EP S264 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA EI0YL UT WOS:000392201600318 ER PT J AU Jenkins, KJ Kupiec, JK Owens, PL Romano, PS Geppert, JJ Gauvreau, K AF Jenkins, Kathy J. Kupiec, Jennifer Koch Owens, Pamela L. Romano, Patrick S. Geppert, Jeffrey J. Gauvreau, Kimberlee TI Development and Validation of an Agency for Healthcare Research and Quality Indicator for Mortality After Congenital Heart Surgery Harmonized With Risk Adjustment for Congenital Heart Surgery (RACHS-1) Methodology SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE congenital heart defects; mortality; pediatrics; risk factors ID PEDIATRIC CARDIAC-SURGERY; IN-HOSPITAL MORTALITY; CATEGORIES REFLECT MORTALITY; ADMINISTRATIVE DATA; COMPLEX RELATIONSHIP; ETHNIC DISPARITIES; UNITED-STATES; DISEASE; OUTCOMES; CHILDREN AB Background-The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by the Agency for Healthcare Research and Quality (AHRQ). Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies. Methods and Results-Parameters that were identical between the 2 methods were retained. AHRQ's Healthcare Cost and Utilization Project State Inpatient Databases (SID) 2008 were used to select optimal parameters where differences existed, with a goal to maximize model performance and face validity. Inclusion criteria were not changed and included all discharges for patients < 18 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes for congenital heart surgery or nonspecific heart surgery combined with congenital heart disease diagnosis codes. The final model includes procedure risk group, age (0-28 days, 29-90 days, 91-364 days, 1-17 years), low birth weight (500-2499 g), other congenital anomalies (Clinical Classifications Software 217, except for 758. xx), multiple procedures, and transfer-in status. Among 17 945 eligible cases in the SID 2008, the c statistic for model performance was 0.82. In the SID 2013 validation data set, the c statistic was 0.82. Risk-adjusted mortality rates by center ranged from 0.9% to 4.1% (5th-95th percentile). Conclusions-Congenital heart surgery programs can now obtain national benchmarking reports by applying AHRQ Quality Indicator software to hospital administrative data, based on the harmonized RACHS-1 method, with high discrimination and face validity. C1 [Jenkins, Kathy J.; Kupiec, Jennifer Koch; Gauvreau, Kimberlee] Boston Childrens Hosp, Boston, MA USA. [Owens, Pamela L.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Romano, Patrick S.] Univ Calif Davis, Sch Med, Sacramento, CA 95817 USA. [Geppert, Jeffrey J.] Battelle Mem Inst, 505 King Ave, Columbus, OH 43201 USA. RP Jenkins, KJ (reprint author), Boston Childrens Hosp, Dept Cardiol, 300 Longwood Ave,Farley 135, Boston, MA 02115 USA. EM kathy.jenkins@childrens.harvard.edu FU AHRQ [HHSA290201200001C]; Battelle Memorial Institute [HHSA290201200001C] FX This work was funded partially by contract No. HHSA290201200001C between the AHRQ and Battelle Memorial Institute, with a subaward to the University of California Davis School of Medicine. NR 42 TC 0 Z9 0 U1 6 U2 6 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD MAY PY 2016 VL 5 IS 5 AR e003028 DI 10.1161/JAHA.115.003028 PG 12 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA EA6BY UT WOS:000386711200019 ER PT J AU Gray, CP Harrison, MI Hung, D AF Gray, Caroline P. Harrison, Michael I. Hung, Dorothy TI Medical Assistants as Flow Managers in Primary Care: Challenges and Recommendations SO JOURNAL OF HEALTHCARE MANAGEMENT LA English DT Article AB As healthcare organizations look for ways to reduce costs and improve quality, many rely increasingly on allied healthcare professionals and, in particular, medical assistants (MAs) to supplement the work of physicians and other health professionals. MAs usually work in primary care, where they often play important roles on healthcare teams. Drawing on an empirical study of a large, multispecialty delivery system engaged in reconfiguration of primary care, we found that using MAs as flow managers required overcoming several challenges. These included entrenched social and occupational hierarchies between physicians and MAs, a lack of adequate training and mentorship, and difficulty attracting and retaining talented MAs. We offer several recommendations for healthcare organizations interested in using MAs as flow managers in their practices. C1 [Gray, Caroline P.; Hung, Dorothy] Palo Alto Med Fdn Res Inst, Mountain View, CA USA. [Harrison, Michael I.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Gray, CP (reprint author), Palo Alto Med Fdn Res Inst, Mountain View, CA USA. EM grayc@pamfri.org FU Agency for Healthcare Research and Quality [HHSA2902010000221] FX The research reported in this article was funded by the Agency for Healthcare Research and Quality under contract HHSA2902010000221, Task Order 2. The views expressed are solely those of the authors and do not represent any U.S. government agency or any institutions with which the authors are affiliated. NR 15 TC 0 Z9 0 U1 1 U2 1 PU AMER COLL HEALTHCARE EXEC HEALTH ADMINISTRATION PRESS PI CHICAGO PA ONE NORTH FRANKLIN ST SUITE 1700, CHICAGO, IL 60606 USA SN 1096-9012 EI 1944-7396 J9 J HEALTHC MANAG JI J. Healthc. Manag. PD MAY-JUN PY 2016 VL 61 IS 3 BP 181 EP 191 PG 11 WC Health Policy & Services SC Health Care Sciences & Services GA DM6PM UT WOS:000376474900005 PM 27356444 ER PT J AU Groessl, EJ Kaplan, RM Sweet, CMC Church, T Espeland, MA Gill, TM Glynn, NW King, AC Kritchevsky, S Manini, T McDermott, MM Reid, KF Rushing, J Pahor, M AF Groessl, Erik J. Kaplan, Robert M. Sweet, Cynthia M. Castro Church, Timothy Espeland, Mark A. Gill, Thomas M. Glynn, Nancy W. King, Abby C. Kritchevsky, Stephen Manini, Todd McDermott, Mary M. Reid, Kieran F. Rushing, Julia Pahor, Marco CA LIFE Study Grp TI Cost-effectiveness of the LIFE Physical Activity Intervention for Older Adults at Increased Risk for Mobility Disability SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article DE Cost-effectiveness; Physical activity; Older adults ID STYLE INTERVENTIONS; COMMUNITY; INDEPENDENCE; PREVENTION; EXERCISE; QUALITY; ELDERS; DESIGN; TRIAL AB Background: Losing the ability to walk safely and independently is a major concern for many older adults. The Lifestyle Interventions and Independence for Elders study recently demonstrated that a physical activity (PA) intervention can delay the onset of major mobility disability. Our objective is to examine the resources required to deliver the PA intervention and calculate the incremental cost-effectiveness compared with a health education intervention. Methods: The Lifestyle Interventions and Independence for Elders study enrolled 1,635 older adults at risk for mobility disability. They were recruited at eight field centers and randomly assigned to either PA or health education. The PA program consisted of 50-minute center-based exercise 2x weekly, augmented with home-based activity to achieve a goal of 150 min/wk of PA. Health education consisted of weekly workshops for 26 weeks, and monthly sessions thereafter. Analyses were conducted from a health system perspective, with a 2.6-year time horizon. Results: The average cost per participant over 2.6 years was US$3,302 and US$1,001 for the PA and health education interventions, respectively. PA participants accrued 0.047 per person more Quality-Adjusted Life-Years (QALYs) than health education participants. PA interventions costs were slightly higher than other recent PA interventions. The incremental cost-effectiveness ratios were US$42,376/major mobility disability prevented and US$49,167/QALY. Sensitivity analyses indicated that results were relatively robust to varied assumptions. Conclusions: The PA intervention costs and QALYs gained are comparable to those found in other studies. The ICERS are less than many commonly recommended medical treatments. Implementing the intervention in non-research settings may reduce costs further. C1 [Groessl, Erik J.] Univ Calif San Diego, Dept Family Med & Publ Hlth, La Jolla, CA 92093 USA. [Groessl, Erik J.] VA San Diego Healthcare Syst, San Diego, CA USA. [Kaplan, Robert M.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Sweet, Cynthia M. Castro] Stanford Univ, Sch Med, Dept Med, Stanford Prevent Res Ctr, Stanford, CA 94305 USA. [Church, Timothy] Louisiana State Univ Syst, Pennington Biomed Res Ctr, Baton Rouge, LA USA. [Espeland, Mark A.; Rushing, Julia] Wake Forest Sch Med, Dept Biostat Sci, Winston Salem, NC USA. [Gill, Thomas M.] Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. [Glynn, Nancy W.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. [King, Abby C.] Stanford Univ, Sch Med, Dept Hlth Res & Policy & Med, Stanford, CA 94305 USA. [Kritchevsky, Stephen] Wake Forest Sch Med, Sticht Ctr Aging, Winston Salem, NC USA. [Manini, Todd] Univ Florida, Dept Aging & Geriatr Res, Gainesville, FL USA. [McDermott, Mary M.] Northwestern Univ, Dept Med & Prevent Med, Feinberg Sch Med, Chicago, IL 60611 USA. [Reid, Kieran F.] Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Nutr Exercise Physiol & Sarcopenia Lab, Boston, MA 02111 USA. RP Groessl, EJ (reprint author), Univ Calif San Diego, Dept Family Med & Publ Hlth, 9500 Gilman Dr,0994, San Diego, CA 92093 USA. EM egroessl@ucsd.edu OI Glynn, Nancy/0000-0003-2265-0162 FU National Institutes of Health/National Institute on Aging Cooperative Agreement [UO1 AG22376]; Intramural Research Program, National Institute on Aging [1I01CX000927-01A1]; National Institutes of Health; Claude D. Pepper Older Americans Independence Centers at the University of Florida [1 P30 AG028740]; Wake Forest University [1 P30 AG21332]; Tufts University [1P30AG031679]; University of Pittsburgh [P30 AG024827]; Yale University [P30AG021342]; National Institutes of Health/National Center for Research Resources Clinical and Translational Science Awards at Stanford University [UL1 RR025744]; Boston Rehabilitation Outcomes Center [1R24HD065688-01A1] FX The Lifestyle Interventions and Independence for Elders Study is funded by a National Institutes of Health/National Institute on Aging Cooperative Agreement (#UO1 AG22376) and a supplement from the National Heart, Lung and Blood Institute (3U01AG022376-05A2S), and sponsored in part by the Intramural Research Program, National Institute on Aging (No. 1I01CX000927-01A1) and National Institutes of Health. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (1 P30 AG028740), Wake Forest University (1 P30 AG21332), Tufts University (1P30AG031679), University of Pittsburgh (P30 AG024827), and Yale University (P30AG021342); and the National Institutes of Health/National Center for Research Resources Clinical and Translational Science Awards at Stanford University (UL1 RR025744). Tufts University is also supported by the Boston Rehabilitation Outcomes Center (1R24HD065688-01A1). NR 31 TC 0 Z9 0 U1 3 U2 6 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1079-5006 EI 1758-535X J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD MAY PY 2016 VL 71 IS 5 BP 656 EP 662 DI 10.1093/gerona/glw001 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA DM5OE UT WOS:000376398400015 PM 26888433 ER PT J AU Berdahl, T Hudson, J Simpson, L McCormick, MC AF Berdahl, Terceira Hudson, Julie Simpson, Lisa McCormick, Marie C. TI Annual Report on Children's Health Care: Dental and Orthodontic Utilization and Expenditures for Children, 2010-2012 SO ACADEMIC PEDIATRICS LA English DT Article DE dental care; dental utilization; disparities; eligibility; expenditures; low income; public insurance; race/ethnicity ID UNITED-STATES; ORAL-HEALTH; US CHILDREN; RACIAL/ETHNIC DISPARITIES; RECENT TRENDS; YOUTH; ACCESS; QUALITY; MEDICAID; COVERAGE AB OBJECTIVE: To examine general dental and orthodontic utilization and expenditures by health insurance status, public health insurance eligibility, and sociodemographic characteristics among children aged 0 to 17 years using data from 2010-2012. METHODS: Nationally representative data from the Medical Expenditure Panel Survey (2010-2012) provided data on insurance status, public health insurance eligibility, and visits to dental providers for both general dental care and orthodontic care. RESULTS: Overall, 41.9% of US children reported an annual dental office-based visit for general (nonorthodontic) dental care. Fewer Hispanic (34.7%) and non-Latino black children (34.8%) received dental care compared to non-Hispanic whites (47.3%) and Asians (40.3%). Children living in families with the lowest income were also the least likely to have a visit (32.9%) compared to children in the highest income families (54.7%). Among children eligible for public coverage, Medicaid-eligible children had the lowest percentage of preventive dental visits (29.2%). Socioeconomic and racial/ethnic disparities in use and expenditures for orthodontic care are much greater than those for general and preventive dental care. Average expenditures for orthodontic care were $1,823, of which 56% ($1,023) was paid out of pocket by families. CONCLUSIONS: Our findings provide a baseline assessment for examining trends in the future, especially as coverage patterns for children may change as the Affordable Care Act is implemented and the future of the State Child Health Insurance Program remains uncertain beyond 2017. C1 [Berdahl, Terceira; Hudson, Julie] Agcy Healthcare Res & Qual, Dept Hlth & Human Serv, Rockville, MD USA. [McCormick, Marie C.] Harvard Univ, Sch Publ Hlth, Dept Social & Behav Sci, 665 Huntington Ave, Boston, MA 02115 USA. [Simpson, Lisa] AcademyHealth, Washington, DC USA. RP Berdahl, T (reprint author), Agcy Healthcare Res & Qual, Ctr Finance Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20850 USA. EM terceira.berdahl@ahrq.hhs.gov NR 49 TC 0 Z9 0 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD MAY-JUN PY 2016 VL 16 IS 4 BP 314 EP 326 PG 13 WC Pediatrics SC Pediatrics GA DL1DQ UT WOS:000375372800002 PM 27154430 ER PT J AU Hu, TY Decker, SL Chou, SY AF Hu, Tianyan Decker, Sandra L. Chou, Shin-Yi TI Medicaid Pay for Performance Programs and Childhood Immunization Status SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID PHYSICIAN FINANCIAL INCENTIVES; MANAGED CARE; HEALTH-INSURANCE; CHILDRENS HEALTH; COVERAGE; ADOLESCENTS; ELIGIBILITY; VACCINATION; DISPARITIES; INCREASE AB Introduction: Although pay for performance (P4P) programs are being increasingly used by state Medicaid programs to provide incentives for managed care plans to provide high-quality care, no national study has examined the effects of these plans on commonly targeted outcomes such as childhood immunization rates. Methods: Information from the 1999-2011 National Immunization Survey combined with information on state Medicaid P4P programs from the Centers for Medicare and Medicaid Services was used to study the effect of Medicaid P4P programs on the immunization status of children aged 19-35 months. Difference-in-difference-in-difference models were used to study whether adoption of Medicaid P4P programs was associated with higher immunization rates among Medicaid-eligible children relative to non Medicaid eligible children within states that adopted Medicaid P4P programs compared with states that did not. Linear probability models were used in all estimations, and models controlled for demographic factors. Results: The study found no overall effect of Medicaid P4P on the chance that children aged 19-35 months had completed the 4:3:1:3:3:1 vaccination series. However, there was a 4 percentage point increase in the chance that a child 19-23 months had completed the series. Conclusions: This study provides some evidence that Medicaid P4P programs may be helpful in improving childhood vaccination rates. Further study of the effects on other targeted outcomes as well as the effects of different P4P program designs may increase understanding of the potential role of these programs in improving the quality of health care. Published by Elsevier Inc. C1 [Hu, Tianyan] Florida Int Univ, Dept Hlth Policy & Management, Miami, FL 33199 USA. [Decker, Sandra L.] Agcy Hlth Res Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Chou, Shin-Yi] Lehigh Univ, Dept Econ, Bethlehem, PA 18015 USA. RP Decker, SL (reprint author), Natl Ctr Hlth Stat, 5600 Fishers Lane, Rockville, MD 20852 USA.; Decker, SL (reprint author), Agcy Healthcare Res & Qual, 5600 Fishers Lane, Rockville, MD 20852 USA. EM sandra.decker@ahrq.hhs.gov FU Centers for Disease Control and Prevention (CDC), Office of the Associate Director for Policy FX Publication of this article has been sponsored by the Centers for Disease Control and Prevention (CDC), Office of the Associate Director for Policy. NR 34 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 2016 VL 50 IS 5 SU 1 BP S51 EP S57 DI 10.1016/j.amepre.2016.01.012 PG 7 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA DJ5VL UT WOS:000374278100009 PM 27102859 ER PT J AU Smith, MW Owens, PL Andrews, RM Steiner, CA Coffey, RM Skinner, HG Miyamura, J Popescu, I AF Smith, Mark W. Owens, Pamela L. Andrews, Roxanne M. Steiner, Claudia A. Coffey, Rosanna M. Skinner, Halcyon G. Miyamura, Jill Popescu, Ioana TI Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data SO BMC HEALTH SERVICES RESEARCH LA English DT Article DE Heart failure; Severity of illness; Clinical laboratory results; Discharge data; Rural hospitals; Urban hospitals ID AMBULATORY PATIENTS; BETA-BLOCKERS; RISK-MODEL; MORTALITY; SURVIVAL; PERFORMANCE; OUTPATIENTS; VALIDATION; PREDICTION; INPATIENT AB Background: Rural/urban variations in admissions for heart failure may be influenced by severity at hospital presentation and local practice patterns. Laboratory data reflect clinical severity and guide hospital admission decisions and treatment for heart failure, a costly chronic illness and a leading cause of hospitalization among the elderly. Our main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. Methods: We retrospectively analyzed discharge data on 13,998 hospital discharges for heart failure from three states, Hawai'i, Minnesota, and Virginia. Hospital discharge records from 2008 to 2012 were derived from the State Inpatient Databases of the Healthcare Cost and Utilization Project, and were merged with results of laboratory tests performed on the admission day or up to two days before admission. Regression models evaluated the relationship between clinical severity at admission and patient urban/rural residence. Models were estimated with and without use of laboratory data. Results: Patients residing in rural areas were more likely to have missing laboratory data on admission and less likely to have abnormal or severely abnormal tests. Rural patients were also less likely to be admitted with high levels of severity as measured by the All Patient Refined Diagnosis Related Groups (APR-DRG) severity subclass, derivable from discharge data. Adding laboratory data to discharge data improved model fit. Also, in models without laboratory data, the association between urban compared to rural residence and APR-DRG severity subclass was significant for major and extreme levels of severity (OR 1.22, 95 % CI 1.03-1.43 and 1.55, 95 % CI 1.26-1.92, respectively). After adding laboratory data, this association became non-significant for major severity and was attenuated for extreme severity (OR 1.12, 95 % CI 0.94-1.32 and 1.43, 95 % CI 1.15-1.78, respectively). Conclusion: Heart failure patients from rural areas are hospitalized at lower severity levels than their urban counterparts. Laboratory test data provide insight on clinical severity and practice patterns beyond what is available in administrative discharge data. C1 [Smith, Mark W.; Coffey, Rosanna M.] Truven Hlth Analyt, 7700 Old Georgetown Rd,Suite 650, Bethesda, MD 20814 USA. [Owens, Pamela L.; Andrews, Roxanne M.; Steiner, Claudia A.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 5600 Fishers Lane,Room 07W25C,Mail Stop 7W25B, Rockville, MD 20857 USA. [Skinner, Halcyon G.] Truven Hlth Analyt, 4819 Emperor Blvd, Durham, NC 27703 USA. [Miyamura, Jill] Hawaii Hlth Informat Corp, 733 Bishop St,Suite 1870, Honolulu, HI 96813 USA. [Popescu, Ioana] Univ Calif Los Angeles, Dept Internal Med, 200 UCLA Med Plaza, Los Angeles, CA 90095 USA. [Popescu, Ioana] RAND Corp, Santa Monica, CA USA. RP Smith, MW (reprint author), Truven Hlth Analyt, 7700 Old Georgetown Rd,Suite 650, Bethesda, MD 20814 USA. EM mark.w.smith@truvenhealth.com FU Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services [HHSA-290-2006-0009] FX This study was funded under contract HHSA-290-2006-0009 by the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. State data were provided by Hawai'i Health Information Corporation, the Minnesota Hospital Association, and Virginia Health Information. The authors of this work are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. The authors are grateful to Yu Sun for programming support. NR 28 TC 0 Z9 0 U1 1 U2 12 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD APR 18 PY 2016 VL 16 AR 133 DI 10.1186/s12913-016-1380-z PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA DJ9AF UT WOS:000374505400001 PM 27089888 ER PT J AU Tilson, H Hines, LE McEvoy, G Weinstein, DM Hansten, PD Matuszewski, K le Comte, M Higby-Baker, S Hanlon, JT Pezzullo, L Vieson, K Helwig, AL Huang, SM Perre, A Bates, DW Poikonen, J Wittie, MA Grizzle, AJ Brown, M Malone, DC AF Tilson, Hugh Hines, Lisa E. McEvoy, Gerald Weinstein, David M. Hansten, Philip D. Matuszewski, Karl le Comte, Marianne Higby-Baker, Stefanie Hanlon, Joseph T. Pezzullo, Lynn Vieson, Kathleen Helwig, Amy L. Huang, Shiew-Mei Perre, Anthony Bates, David W. Poikonen, John Wittie, Michael A. Grizzle, Amy J. Brown, Mary Malone, Daniel C. TI Recommendations for selecting drug-drug interactions for clinical decision support SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article ID ELECTRONIC HEALTH RECORDS; PHYSICIAN ORDER ENTRY; REDUCE ALERT FATIGUE; AMBULATORY-CARE; SAFETY ALERTS; SYSTEMS; MANAGEMENT; SOFTWARE; RISK; INTERVENTIONS AB Purpose. Recommendations for including drug-drug interactions (DDIs) in clinical decision support (CDS) are presented. Summary. A conference series was conducted to improve CDS for DDIs. A work group consisting of 20 experts in pharmacology, drug information, and CDS from academia, government agencies, health information vendors, and healthcare organizations was convened to address (1) the process to use for developing and maintaining a standard set of DDIs, (2) the information that should be included in a knowledge base of standard DDIs, (3) whether a list of contraindicated drug pairs can or should be established, and (4) how to more intelligently filter DDI alerts. We recommend a transparent, systematic, and evidence-driven process with graded recommendations by a consensus panel of experts and oversight by a national organization. We outline key DDI information needed to help guide clinician decision-making. We recommend judicious classification of DDIs as contraindicated and more research to identify methods to safely reduce repetitive and less-relevant alerts. Conclusion: An expert panel with a centralized organizer or convener should be established to develop and maintain a standard set of DDIs for CDS in the United States. The process should be evidence driven, transparent, and systematic, with feedback from multiple stakeholders for continuous improvement. The scope of the expert panel's work should be carefully managed to ensure that the process is sustainable. Support for research to improve DDI alerting in the future is also needed. Adoption of these steps may lead to consistent and clinically relevant content for interruptive DDIs, thus reducing alert fatigue and improving patient safety. C1 [Tilson, Hugh] Univ N Carolina, Gillings Sch Global Publ Hlth, Publ Hlth Leadership & Epidemiol, Chapel Hill, NC USA. [Hines, Lisa E.; Pezzullo, Lynn] Pharm Qual Alliance, Performance Measurement, Springfield, VA USA. [McEvoy, Gerald] Amer Soc Hlth Syst Pharmacists, Drug Informat, Bethesda, MD USA. [Weinstein, David M.] Lexi Comp, Clin Content, Metab Interact & Genom Grp, Cleveland, OH USA. [Hansten, Philip D.] Univ Washington, Sch Pharm, Dept Pharm, Seattle, WA 98195 USA. [Matuszewski, Karl] First Databank, Clin & Editorial Knowledge Base Serv, San Francisco, CA USA. [le Comte, Marianne] Drug Informat Ctr, Royal Dutch Assoc Adv Pharm, The Hague, Netherlands. [Higby-Baker, Stefanie] Cerner Multum, Denver, CO USA. [Hanlon, Joseph T.] Univ Pittsburgh, Div Geriatr, Pittsburgh, PA USA. [Hanlon, Joseph T.] Univ Pittsburgh, Dept Pharm & Therapeut, Pittsburgh, PA USA. [Vieson, Kathleen] Elsevier Clin Solut, Diag Treatment & Care Decis, Tampa, FL USA. [Helwig, Amy L.] US Dept HHS, Ctr Qual Improvement & Patient Safety, Agcy Healthcare Res & Qual, Washington, DC 20201 USA. [Helwig, Amy L.] Agcy Healthcare Res & Qual, Qual Improvement & Patient Safety, Human Serv, Washington, DC USA. [Huang, Shiew-Mei] US FDA, Off Clin Pharmacol, Ctr Drug Evaluat & Res, Silver Spring, MD USA. [Perre, Anthony] Canc Treatment Ctr Amer, Eastern Reg Med Ctr, New Patient Intake, Philadelphia, PA USA. [Bates, David W.] Harvard Univ, Sch Med, Boston, MA USA. [Poikonen, John] Univ Massachusetts, Lowell, MA USA. [Wittie, Michael A.] US Dept HHS, Off Natl Coordinator Hlth Informat Technol, Washington, DC 20201 USA. [Grizzle, Amy J.] Univ Arizona, Coll Pharm, Ctr Hlth Outcomes & PharmacoEcon Res, Tucson, AZ 85721 USA. [Brown, Mary; Malone, Daniel C.] Univ Arizona, Coll Pharm, Dept Pharm Practice & Sci, Tucson, AZ 85721 USA. RP Malone, DC (reprint author), Univ Arizona, Coll Pharm, Dept Pharm Practice & Sci, Tucson, AZ 85721 USA. EM malone@pharmacy.arizona.edu FU Agency for Healthcare Research and Quality [1R13HS021826-01]; Cerner; Elsevier Clinical Solutions; Epocrates; First Databank; Truven Health Analytics; Wolters-Kluwer; Agency for Healthcare Research and Quality; Epocrates (athenahealth, Inc.); FDB; Wolters Kluwer FX Financial support for this study was provided by the Agency for Healthcare Research and Quality under a grant (1R13HS021826-01) obtained by Dr. Malone. Unrestricted support for this study was provided by Cerner, Elsevier Clinical Solutions, Epocrates, First Databank, Truven Health Analytics, and Wolters-Kluwer. Dr. McEvoy is Assistant Vice President, Drug Information, and Editor in Chief, AHFS Drug Information, ASHP. Dr. Weinstein is an employee of Wolters Kluwer Health. Dr. Matuszewski is an employee of First Databank. Ms. Higby-Baker is an employee of Cerner Multum. Dr. Vieson is an employee of Elsevier Clinical Solutions. Dr. Malone reports grants from the Agency for Healthcare Research and Quality and unrestricted support for this project from Cerner, Elsevier Clinical Solutions, Epocrates (athenahealth, Inc.), FDB, Truven Health Analytics, and Wolters Kluwer. The authors have declared no other conflicts of interest. NR 61 TC 3 Z9 3 U1 8 U2 13 PU AMER SOC HEALTH-SYSTEM PHARMACISTS PI BETHESDA PA 7272 WISCONSIN AVE, BETHESDA, MD 20814 USA SN 1079-2082 EI 1535-2900 J9 AM J HEALTH-SYST PH JI Am. J. Health-Syst. Pharm. PD APR 15 PY 2016 VL 73 IS 8 BP 576 EP 585 DI 10.2146/ajhp150565 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA DJ5VO UT WOS:000374278400017 PM 27045070 ER PT J AU Harrison, MI Paez, K Carman, KL Stephens, J Smeeding, L Devers, KJ Garfinkel, S AF Harrison, Michael I. Paez, Kathryn Carman, Kristin L. Stephens, Jennifer Smeeding, Lauren Devers, Kelly J. Garfinkel, Steven TI Effects of organizational context on Lean implementation in five hospital systems SO HEALTH CARE MANAGEMENT REVIEW LA English DT Article DE context; implementation; Lean; quality improvement ID HEALTH-CARE; CONSOLIDATED FRAMEWORK; UNDERSTANDING SUCCESS; QUALITY IMPROVEMENT; THINKING; MODEL AB Background: Despite broad agreement among researchers about the value of examining how context shapes implementation of improvement programs and projects, limited attention has been paid to contextual effects on implementation of Lean. Purpose: To help reduce gaps in knowledge of effects of intraorganizational context, we researched Lean implementation initiatives in five organizations and examined 12 of their Lean rapid improvement projects. All projects aimed at improving clinical care delivery. Methodology/Approach: On the basis of the literature on Lean, innovation, and quality improvement, we developed a framework of factors likely to affect Lean implementation and outcomes. Drawing on the framework, we conducted semistructured interviews and applied qualitative codes to the transcribed interviews. Available documents, data, and observations supplemented the interviews. We constructed case studies of Lean implementation in each organization, compared implementation across organizations, and compared the 12 projects. Findings: Intraorganizational characteristics affecting organization-wide Lean initiatives and often also shaping project outcomes included CEO commitment to Lean and active support for it, prior organizational capacity for quality improvement-based performance improvement, alignment of the Lean initiative with the organizational mission, dedication of resources and experts to Lean, staff training before and during projects, establishment of measurable and relevant project targets, planning of project sequences that enhance staff capabilities and commitment without overburdening them, and ensuring communication between project members and other affected staff. Dependence of projects on inputs of new information technology was a barrier to project success. Incremental implementation of Lean produced reported improvements in operational efficiency and occasionally in care quality. However, even under the relatively favorable circumstances prevailing in our study sites, incremental implementation did not readily change organizational culture. Practice Implications: This study should alert researchers, managers, and teachers of management to ways that contexts shape Lean implementation and may affect other types of process redesign and quality improvement. C1 [Harrison, Michael I.] Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. [Paez, Kathryn; Carman, Kristin L.; Stephens, Jennifer] Amer Inst Res, Washington, DC USA. [Smeeding, Lauren] Kurt Salmon, Atlanta, GA USA. [Devers, Kelly J.] Urban Inst, Washington, DC 20037 USA. [Garfinkel, Steven] Amer Inst Res, Chapel Hill, NC USA. RP Harrison, MI (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. EM Michael.Harrison@ahrq.hhs.gov FU Agency for Healthcare Research and Quality [HHSA290200600019, 5] FX The research reported in this paper was funded by the Agency for Healthcare Research and Quality under contract HHSA290200600019, Task Order 5. The views expressed in this paper are solely those of the authors and do not represent any U.S. government agency or any institutions with which the authors are affiliated. NR 34 TC 1 Z9 1 U1 13 U2 17 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0361-6274 EI 1550-5030 J9 HEALTH CARE MANAGE R JI Health Care Manage. Rev. PD APR-JUN PY 2016 VL 41 IS 2 BP 127 EP 144 DI 10.1097/HMR.0000000000000049 PG 18 WC Health Policy & Services SC Health Care Sciences & Services GA DR7WE UT WOS:000380109600005 PM 25539057 ER PT J AU Brach, C AF Brach, Cindy TI Even In An Emergency, Doctors Must Make Informed Consent An Informed Choice SO HEALTH AFFAIRS LA English DT Editorial Material C1 [Brach, Cindy] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. RP Brach, C (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. EM cindy.brach@ahrq.hhs.gov FU Intramural AHRQ HHS [HS999999] NR 0 TC 1 Z9 1 U1 0 U2 0 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD APR PY 2016 VL 35 IS 4 BP 739 EP 743 DI 10.1377/HLTHAFF.2015.1407 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DK2SG UT WOS:000374764100026 PM 27044976 ER PT J AU Sommers, BD Kronick, R AF Sommers, Benjamin D. Kronick, Richard TI Measuring Medicaid Physician Participation Rates and Implications for Policy SO JOURNAL OF HEALTH POLITICS POLICY AND LAW LA English DT Article DE Medicaid; access to care; primary care; physician participation ID PRIMARY-CARE PHYSICIANS; APPOINTMENT AVAILABILITY; FEES; ACCESS; EXPANSION; WORKFORCE AB Policy makers continue to debate Medicaid expansion under the Affordable Care Act, and concerns remain about low provider participation in the program. However, there has been little research on how various measures of physician participation may reflect different elements of capacity for care within the Medicaid program and how these distinct measures correlate with one another across states. Our objectives were to describe several alternative measures of provider participation in Medicaid using recently publicly available data, to compare state rankings across these different metrics, and to discuss potential advantages and disadvantages of each measure for research and policy purposes. Overall, we find that Medicaid participation as measured by raw percentages of physicians taking new Medicaid patients is only weakly correlated with population-based measures that account for both participation rates and the numbers of physicians per capita or physicians per Medicaid beneficiary. Participation rates for all physicians versus primary care physicians also offer different information about state-level provider capacity. Policy makers should consider multiple dimensions of provider access in assessing policy options in Medicaid, and further research is needed to evaluate the linkages between these provider-based measures and beneficiaries' perceptions of access to care in the program. C1 [Sommers, Benjamin D.] Harvard Univ, TH Chan Sch Publ Hlth, Hlth Policy & Econ, Cambridge, MA 02138 USA. [Sommers, Benjamin D.] Harvard Univ, Sch Med, Med, Cambridge, MA 02138 USA. [Kronick, Richard] Agcy Healthcare Res & Qual, US Dept Hlth & Human Serv HHS, Washington, DC USA. RP Sommers, BD (reprint author), Harvard Univ, TH Chan Sch Publ Hlth, Hlth Policy & Econ, Cambridge, MA 02138 USA.; Sommers, BD (reprint author), Harvard Univ, Sch Med, Med, Cambridge, MA 02138 USA. NR 31 TC 2 Z9 2 U1 3 U2 3 PU DUKE UNIV PRESS PI DURHAM PA 905 W MAIN ST, STE 18-B, DURHAM, NC 27701 USA SN 0361-6878 J9 J HEALTH POLIT POLIC JI J. Health Polit. Policy Law PD APR PY 2016 VL 41 IS 2 BP 211 EP 224 DI 10.1215/03616878-3476117 PG 14 WC Health Care Sciences & Services; Health Policy & Services; Medicine, Legal; Social Issues; Social Sciences, Biomedical SC Health Care Sciences & Services; Legal Medicine; Social Issues; Biomedical Social Sciences GA DJ0BW UT WOS:000373867400004 PM 26732320 ER PT J AU Metersky, ML Eldridge, N Wang, Y Jaser, L Bona, R Eckenrode, S Bakullari, A Andrawis, M Classen, D Krumholz, HM AF Metersky, Mark L. Eldridge, Noel Wang, Yun Jaser, Lisa Bona, Robert Eckenrode, Sheila Bakullari, Anila Andrawis, Mary Classen, David Krumholz, Harlan M. TI Predictors of warfarin-associated adverse events in hospitalized patients: Opportunities to prevent patient harm SO JOURNAL OF HOSPITAL MEDICINE LA English DT Article ID PROPENSITY SCORE METHODS; ANTICOAGULATION SERVICE; ANTITHROMBOTIC THERAPY; MANAGEMENT; SAFETY AB BACKGROUNDThe optimum international normalized ratio (INR) monitoring frequency for hospitalized patients receiving warfarin is unknown. OBJECTIVEAssess relationship between daily versus less frequent INR monitoring and overanticoagulation and warfarin-related adverse events. DESIGNRetrospective cohort study using Medicare Patient Safety Monitoring System data. SETTINGRandomly selected acute care hospitals across the United States. PATIENTSPatients hospitalized from 2009 to 2013 for pneumonia, acute cardiac disease, or surgery who received warfarin. INTERVENTIONSNone. MEASUREMENTS(1) Association between frequency of INR monitoring and an INR 6.0 or warfarin-related adverse event. (2) Association between the rate of change of the INR and a subsequent INR 5.0 and 6.0. RESULTSAmong 8529 patients who received warfarin for 3 days, for 1549 (18.2%) the INR was not measured on 2 or more days. These patients had higher propensity-adjusted odds ratios (ORs) of having a warfarin-associated adverse event (OR: 1.48, 95% confidence interval [CI]: 1.02-2.17) for cardiac patients and surgical patients (OR: 1.73, 95% CI: 1.20-2.48), with no significant association for pneumonia patients. Cardiac and pneumonia patients with 1 day or more without an INR measurement had higher propensity-adjusted ORs of having an INR 6.0 (OR: 1.61, 95% CI: 1.07-2.41 and OR: 1.92, 95% CI: 1.36-2.71, respectively). A 1-day increase in the INR of 0.9 occurred in 621 patients (12.5%) and predicted a subsequent INR of 6.0 (positive likelihood ratio of 4.2). CONCLUSIONDaily INR measurement and recognition of a rapidly rising INR might decrease the frequency of warfarin-associated adverse events in hospitalized patients. Journal of Hospital Medicine 2016;11:276-282. (c) 2015 Society of Hospital Medicine C1 [Metersky, Mark L.; Jaser, Lisa; Eckenrode, Sheila; Bakullari, Anila] Qualidigm, Wethersfield, CT USA. [Metersky, Mark L.] Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, 263 Farmington Ave, Farmington, CT 06030 USA. [Eldridge, Noel] Agcy Healthcare Res & Qual, US Dept Hlth & Human Serv, Rockville, MD USA. [Wang, Yun] Harvard Univ, TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Jaser, Lisa] Griffin Hosp, Dept Pharm, Derby, CT USA. [Bona, Robert] Frank H Netter MD Sch Med Quinnipiac, Hamden, CT USA. [Andrawis, Mary] US Dept Hlth & Human Serv, Ctr Medicare, Baltimore, MD USA. [Andrawis, Mary] US Dept Hlth & Human Serv, Ctr Medicaid, Baltimore, MD USA. [Classen, David] Univ Utah, Sch Med, Dept Internal Med, Salt Lake City, UT USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Gen Internal Med Sect, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Sect Cardiovasc Med, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Robert Wood Johnson Fdn Clin Scholars Program, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA. [Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, 20 York St, New Haven, CT 06504 USA. RP Metersky, ML (reprint author), Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, 263 Farmington Ave, Farmington, CT 06030 USA. EM metersky@uchc.edu FU Agency for Healthcare Research and Quality, United States Department of Health and Human Services, Rockville, Maryland [HHSA290201200003C]; Medtronic, Inc. through Yale University FX This work was supported by contract HHSA290201200003C from the Agency for Healthcare Research and Quality, United States Department of Health and Human Services, Rockville, Maryland. Qualidigm was the contractor. The authors assume full responsibility for the accuracy and completeness of the ideas. Dr. Metersky has worked on various quality improvement and patient safety projects with Qualidigm, Centers for Medicare & Medicaid Services, and the Agency for Healthcare Research and Quality. His employer has received remuneration for this work. Dr. Krumholz works under contract with the Centers for Medicare & Medicaid Services to develop and maintain performance measures. Dr. Krumholz is the chair of a cardiac scientific advisory board for United-Health and the recipient of a research grant from Medtronic, Inc. through Yale University. The other authors report no conflicts of interest. NR 24 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1553-5592 EI 1553-5606 J9 J HOSP MED JI J. Hosp. Med. PD APR PY 2016 VL 11 IS 4 BP 276 EP 282 DI 10.1002/jhm.2528 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA DJ0TE UT WOS:000373916500006 PM 26662851 ER PT J AU Fierman, AH Beck, AF Chung, EK Tschudy, MM Coker, TR Mistry, KB Siegel, B Chamberlain, LJ Conroy, K Federico, SG Flanagan, PJ Garg, A Gitterman, BA Grace, AM Gross, RS Hole, MK Klass, P Kraft, C Kuo, A Lewis, G Lobach, KS Long, D Ma, CT Messito, M Navsaria, D Northrip, KR Osman, C Sadof, MD Schickedanz, AB Cox, J AF Fierman, Arthur H. Beck, Andrew F. Chung, Esther K. Tschudy, Megan M. Coker, Tumaini R. Mistry, Kamila B. Siegel, Benjamin Chamberlain, Lisa J. Conroy, Kathleen Federico, Steven G. Flanagan, Patricia J. Garg, Arvin Gitterman, Benjamin A. Grace, Aimee M. Gross, Rachel S. Hole, Michael K. Klass, Perri Kraft, Colleen Kuo, Alice Lewis, Gena Lobach, Katherine S. Long, Dayna Ma, Christine T. Messito, Mary Navsaria, Dipesh Northrip, Kimberley R. Osman, Cynthia Sadof, Matthew D. Schickedanz, Adam B. Cox, Joanne TI Redesigning Health Care Practices to Address Childhood Poverty SO ACADEMIC PEDIATRICS LA English DT Article DE child poverty; practice redesign; social determinants of health ID PEDIATRIC PRIMARY-CARE; HOME-VISITING PROGRAMS; INCOME-TAX CREDIT; YOUNG-CHILDREN; VIDEOTAPED INTERACTIONS; HOUSEHOLD DYSFUNCTION; SOCIAL DETERMINANTS; CONTROLLED-TRIAL; FOOD INSECURITY; AGED CHILDREN AB Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address,them. Identification of needs can be accomplished with a variety of established screening tools. Interventions may include resource directories, best maintained in collaboration with local/regional public health, community, and/or professional organizations; programs embedded in the practice (eg, Reach Out and Read, Healthy Steps for Young Children, Medical-Legal Partnership, Health Leads); and collaboration with home visiting programs. Changes to health care financing are needed to support the delivery of these enhanced services, and active advocacy by child health providers continues to be important in effecting change. We highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty. C1 [Fierman, Arthur H.; Klass, Perri; Messito, Mary; Osman, Cynthia] NYU, Sch Med, Dept Pediat, New York, NY 10016 USA. [Beck, Andrew F.; Kraft, Colleen] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cincinnati, OH 45229 USA. [Chung, Esther K.] Thomas Jefferson Univ & Nemours, Sidney Kimmel Med Coll, Dept Pediat, Philadelphia, PA USA. [Tschudy, Megan M.; Mistry, Kamila B.] Johns Hopkins Sch Med, Dept Pediat, Baltimore, MD USA. [Coker, Tumaini R.; Kuo, Alice; Schickedanz, Adam B.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Mistry, Kamila B.] US Dept Hlth & Human Serv, Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD USA. [Siegel, Benjamin; Garg, Arvin] Boston Univ, Sch Med, Boston Med Ctr, Dept Pediat, Boston, MA 02215 USA. [Chamberlain, Lisa J.] Stanford Sch Med, Dept Pediat, Stanford, CA USA. [Conroy, Kathleen; Hole, Michael K.; Cox, Joanne] Harvard Univ, Sch Med, Boston Childrens Hosp, Div Gen Pediat, Boston, MA 02115 USA. [Federico, Steven G.] Denver Hlth, Dept Pediat, Gen Pediat, Denver, CO USA. [Flanagan, Patricia J.] Brown Univ, Hasbro Childrens Hosp, Warren Alpert Med Sch, Dept Pediat, Providence, RI 02912 USA. [Gitterman, Benjamin A.; Grace, Aimee M.] George Washington Univ, Dept Pediat, Washington, DC 20052 USA. [Gross, Rachel S.; Lobach, Katherine S.] Childrens Hosp Montefiore, Albert Einstein Coll Med, Dept Pediat, Bronx, NY USA. [Kuo, Alice] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. [Lewis, Gena; Long, Dayna; Ma, Christine T.] UCSF Benioff Childrens Hosp Oakland, Dept Pediat, San Francisco, CA USA. [Long, Dayna] UCSF Benioff Childrens Hosp Oakland, Ctr Community Hlth & Engagement, San Francisco, CA USA. [Navsaria, Dipesh] Univ Wisconsin, Dept Pediat, Sch Med & Publ Hlth, Madison, WI USA. [Northrip, Kimberley R.] Univ Kentucky, Coll Med, Dept Pediat, Lexington, KY USA. Tufts Univ, Sch Med, Dept Pediat, Boston, MA 02111 USA. [Sadof, Matthew D.] Baystate Childrens Hosp, Springfield, MA USA. RP Fierman, AH (reprint author), NYU, Sch Med, Bellevue Hosp Ctr, Dept Pediat, 462 First Ave,Room A321, New York, NY 10016 USA. EM ahf1@nyumc.org NR 69 TC 5 Z9 5 U1 3 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD APR PY 2016 VL 16 IS 3 SU S BP S136 EP S146 PG 11 WC Pediatrics SC Pediatrics GA DI3SA UT WOS:000373417600023 PM 27044692 ER PT J AU Bernard, D Selden, T Yeh, S AF Bernard, Didem Selden, Thomas Yeh, Susan TI Financial burdens and barriers to care among nonelderly adults: The role of functional limitations and chronic conditions SO DISABILITY AND HEALTH JOURNAL LA English DT Article DE Financial burdens; Chronic conditions; Functional limitations; Financial barriers to care ID HEALTH-CARE; EXPENDITURE BURDENS AB Background: People with functional limitations and chronic conditions account for the greatest resource use within the health care system. Objective: To examine financial burdens and barriers to care among nonelderly adults, focusing on the role of functional limitations and chronic conditions. Methods: High financial burden is defined as medical spending exceeding 20 percent of family income. Financial barriers are defined as delaying care/being unable to get care for financial reasons, and reporting that delaying care/going without was a big problem. Data are from the Medical Expenditure Panel Survey (2008-2012). Results: Functional limitations are associated with increased prevalence of financial burdens. Among single adults, the frequency of high burdens is 20.3% for those with functional limitations, versus 7.8% for those without. Among those with functional limitations, those with 3 or more chronic conditions are twice as likely to have high burdens compared to those without chronic conditions (22.2% versus 11.1%, respectively). Similar patterns occur among persons in multi-person families whose members have functional limitations and chronic conditions. Having functional limitations and chronic conditions is also strongly associated with financial barriers to care: 40.2% among the uninsured, 21.9% among those with public coverage, and 13.6% among those with private group insurance were unable to get care. Conclusions: Functional limitations and chronic conditions are associated with increased prevalence of burdens and financial barriers in all insurance categories, with the exception that an association between functional limitations and the prevalence of burdens was not observed for public coverage. Published by Elsevier Inc. C1 [Bernard, Didem; Selden, Thomas] Agcy Healthcare Res & Qual, Rockville, MD USA. [Yeh, Susan] Johns Hopkins Sch Publ Hlth, Baltimore, MD USA. RP Bernard, D (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD USA. EM Didem.Bernard@ahrq.hhs.gov OI Yeh, Susan/0000-0001-9916-7799 NR 19 TC 1 Z9 1 U1 3 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1936-6574 EI 1876-7583 J9 DISABIL HEALTH J JI Disabil. Health J. PD APR PY 2016 VL 9 IS 2 BP 256 EP 264 DI 10.1016/j.dhjo.2015.09.003 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health; Rehabilitation SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Rehabilitation GA DH3WT UT WOS:000372718200013 PM 26564557 ER PT J AU Mukamel, DB White, LM Nocon, RS Huang, ES Sharma, R Shi, LY Ngo-Metzger, Q AF Mukamel, Dana B. White, Laura M. Nocon, Robert S. Huang, Elbert S. Sharma, Ravi Shi, Leiyu Quyen Ngo-Metzger TI Comparing the Cost of Caring for Medicare Beneficiaries in Federally Funded Health Centers to Other Care Settings SO HEALTH SERVICES RESEARCH LA English DT Article DE Federally funded health centers; costs; primary care; specialty care; Medicare ID PHYSICIANS OFFICES; SERVICES; QUALITY AB ObjectiveTo compare total annual costs for Medicare beneficiaries receiving primary care in federally funded health centers (HCs) to Medicare beneficiaries in physician offices and outpatient clinics. Data Sources/Study SettingsPart A and B fee-for-service Medicare claims from 14 geographically diverse states. The sample was restricted to beneficiaries residing within primary care service areas (PCSAs) with at least one HC. Study DesignWe modeled separately total annual costs, annual primary care costs, and annual nonprimary care costs as a function of patient characteristics and PCSA fixed effects. Data CollectionData were obtained from the Centers for Medicare & Medicaid Services. Principal FindingsTotal median annual costs (at $2,370) for HC Medicare patients were lower by 10 percent compared to patients in physician offices ($2,667) and by 30 percent compared to patients in outpatient clinics ($3,580). This was due to lower nonprimary care costs in HCs, despite higher primary care costs. ConclusionsHCs may offer lower total cost practice style to the Centers for Medicare & Medicaid Services, which administers Medicare. Future research should examine whether these lower costs reflect better management by HC practitioners or more limited access to specialty care by HC patients. C1 [Mukamel, Dana B.] Univ Calif Irvine, Dept Med, 100 Theory,Suite 100, Irvine, CA 92697 USA. [White, Laura M.] Univ Calif Irvine, Irvine, CA 92697 USA. [Nocon, Robert S.; Huang, Elbert S.] Univ Chicago, Gen Internal Med, Div Biol Sci, Med, Chicago, IL 60637 USA. [Sharma, Ravi] Hlth Resources & Serv Adm, Bur Primary Hlth Care, Dept Hlth & Human Serv, Rockville, MD USA. [Shi, Leiyu] Johns Hopkins Univ, Dept Hlth Policy & Management, Bloomberg Sch Publ Hlth, Baltimore, MD 21218 USA. [Quyen Ngo-Metzger] Agcy Healthcare Res & Qual, Dept Hlth & Human Serv, Rockville, MD USA. RP Mukamel, DB (reprint author), Univ Calif Irvine, Dept Med, 100 Theory,Suite 100, Irvine, CA 92697 USA. EM dmukamel@uci.edu FU Health Resources and Services Administration's Bureau of Primary Health Care; BPHC FX Funding for this project was sponsored by the Health Resources and Services Administration's Bureau of Primary Health Care. The sponsor (BPHC) was involved in the design and conduct of the study, analysis and interpretation of the data, and review and approval of the manuscript. The sponsor was not involved in the collection or management of data. NR 26 TC 1 Z9 1 U1 2 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD APR PY 2016 VL 51 IS 2 BP 625 EP 644 DI 10.1111/1475-6773.12339 PG 20 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DH6HA UT WOS:000372890400008 PM 26213167 ER PT J AU Jiang, HJ Boutwell, AE Maxwell, J Bourgoin, A Regenstein, M Andres, E AF Jiang, H. Joanna Boutwell, Amy E. Maxwell, James Bourgoin, Angel Regenstein, Marsha Andres, Ellie TI Understanding Patient, Provider, and System Factors Related to Medicaid Readmissions SO JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY LA English DT Article ID HOSPITAL READMISSIONS; CARE AB Background: Efforts on reducing hospital readmissions, which are intended to improve quality and reduce costs, tend to focus on elderly Medicare beneficiaries without recognition of another high-risk population-adult nonmaternal Medicaid patients. This study was undertaken to understand the complexity of Medicaid readmission issues at the patient, provider, and system levels. Methods: Multiple qualitative methods, including site visits to nine safety-net hospitals, patient/family/caregiver inter-views, and semistructured interviews with health plans and state Medicaid agencies, were used in 2012 and 2013 to obtain information on patient, provider, and system issues related to Medicaid readmissions; strategies considered or currently used to address those issues; and any perceived financial, regulatory or, other policy factors inhibiting or facilitating readmission reduction efforts. Results: Significant risk factors for Medicaid readmissions included financial stress, high prevalence of mental health and substance abuse disorders, medication nonadherence, and housing instability. Lacking awareness on Medicaid patients' high risk, a sufficient business case, and proven strategies for reducing readmissions were primary barriers for providers. Major hurdles at the system level included shortage of primary care and mental health providers, lack of coordination among providers, lack of partnerships between health plans and providers, and limited data capacity for real-time monitoring of readmissions. Conclusions: The intertwining of behavioral, socioeconomic, and health factors; the difficulty of accessing appropriate care in the outpatient setting; the lack of clear financial incentives for health care providers to reduce readmissions; and the fragmentation of the current health care system warrant greater attention and more concerted efforts from all stakeholders to reduce Medicaid readmissions. C1 [Jiang, H. Joanna] Agcy Hlth Care Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20857 USA. [Boutwell, Amy E.] Collaborat Healthcare Strategies, Boston, MA USA. [Maxwell, James] John Snow Inc, Res & Policy, Boston, MA USA. [Bourgoin, Angel] John Snow Inc, Boston, MA USA. [Regenstein, Marsha] George Washington Univ, Dept Hlth Policy, Washington, DC USA. RP Jiang, HJ (reprint author), Agcy Hlth Care Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20857 USA. EM Joanna.Jiang@ahrq.hhs.gov NR 17 TC 1 Z9 1 U1 5 U2 5 PU JOINT COMMISSION RESOURCES INC PI OAK BROOK PA 1515 W 22 ST, STE 1300W, OAK BROOK, IL 60523 USA SN 1553-7250 EI 1938-131X J9 JT COMM J QUAL PATIE JI Jt. Comm. J. Qual. Patient Saf. PD MAR PY 2016 VL 42 IS 3 BP 115 EP 121 PG 7 WC Health Care Sciences & Services SC Health Care Sciences & Services GA EB7FO UT WOS:000387552100003 PM 26892700 ER PT J AU Farmer, C Yehia, BR Fleishman, JA Rutstein, R Mathews, WC Nijhawan, A Moore, RD Gebo, KA Agwu, AL AF Farmer, Charles Yehia, Baligh R. Fleishman, John A. Rutstein, Richard Mathews, W. Christopher Nijhawan, Ank Moore, Richard D. Gebo, Kelly A. Agwu, Allison L. CA HIV Res Network TI Factors Associated With Retention Among Non-Perinatally HIV-Infected Youth in the HIV Research Network SO JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY LA English DT Article DE adolescents; HIV Research Network; retention; youth ID MEDICAL-CARE; ADOLESCENTS; ADULTS; PREDICTORS; TRANSITION; ENGAGEMENT; PREVENTION; CHALLENGE; ADHERENCE; SERVICES AB Background. The transmission of human immunodeficiency virus (HIV) among youth through high-risk behaviors continues to increase. Retention in Care is associated with positive clinical outcomes and a decrease in HIV transmission risk behaviors. We evaluated the clinical and demographic characteristics of non-perinatally HIV (nPHIV)-infected youth associated with retention 1 year after initiating care and in the 2 years thereafter. We also assessed the impact retention in year 1 had on retention in years 2 and 3. Methods. This was a retrospective analysis of treatment-naive nPHIV-infected 12-to 24-year-old youth presenting for care in 16 US HIV clinical sites within the HIV Research Network between 2002 and 2008. Multivariate logistic regression identified factors associated with retention. Results. Of 1160 nPHIV-infected youth, 44.6% were retained in care during the first year, and 22.4% were retained in all 3 years. Retention in the first year was associated with starting antiretroviral therapy in the first year (adjusted odds ratio [AOR], 3.47 [95% confidence interval (CI), 2.57-4.67]), Hispanic ethnicity (AOR, 1.66 [95% CI, 1.08-2.56]), men who have sex with men (AOR, 1.59 [95% CI, 1.07-2.36]), and receiving care at a pediatric site (AOR, 5.37 [95% CI, 3.20-9.01]). Retention in years 2 and 3 was associated with being retained 1 year after initiating care (AOR, 7.44 [95% CI, 5.11-10.83]). Conclusion. A high proportion of newly enrolled nPHIV-infected youth were not retained for 1 year, and only 1 in 4 were retained for 3 years. Patients who were Hispanic, were men who have sex with men, or were seen at pediatric clinics were more likely to be retained in care. Interventions that target those at risk of being lost to follow up are essential for this high-risk population. C1 [Farmer, Charles] Johns Hopkins Sch Med, Baltimore, MD USA. [Yehia, Baligh R.] Univ Penn, Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Rutstein, Richard] Childrens Hosp Philadelphia, Div Gen Pediat, Philadelphia, PA 19104 USA. [Mathews, W. Christopher] Univ Calif San Diego, Dept Clin Med, Med Ctr, La Jolla, CA 92093 USA. [Nijhawan, Ank] UT Southwestern Med Ctr, Dept Internal Med, Dallas, TX USA. [Moore, Richard D.] Johns Hopkins Sch Med, Div Gen Internal Med, Dept Med, Baltimore, MD USA. [Gebo, Kelly A.; Agwu, Allison L.] Johns Hopkins Sch Med, Div Infect Dis, Dept Med, Baltimore, MD USA. [Agwu, Allison L.] Johns Hopkins Sch Med, Dept Pediat, Div Pediat Infect Dis, Baltimore, MD USA. RP Agwu, AL (reprint author), Johns Hopkins Med Inst, Div Pediat Infect Dis, 200 N Wolfe St,Room 3145, Baltimore, MD 21287 USA. EM ageorg10@jhmi.edu FU NIAID NIH HHS [K23 AI084549, K23 AI112477, P30 AI094189, 1K23AI084549-01A1]; NIMH NIH HHS [K23-MH097647, K23 MH097647]; PHS HHS [90051652, 290-11-00007C] NR 35 TC 1 Z9 1 U1 1 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 2048-7193 EI 2048-7207 J9 J PEDIATR INFECT DIS JI J. Pediatr. Infect. Dis. Soc. PD MAR PY 2016 VL 5 IS 1 BP 39 EP 46 DI 10.1093/jpids/piu102 PG 8 WC Infectious Diseases SC Infectious Diseases GA DZ8PS UT WOS:000386133900008 PM 26908490 ER PT J AU Marier, A Olsho, LEW Rhodes, W Spector, WD AF Marier, Allison Olsho, Lauren E. W. Rhodes, William Spector, William D. TI Improving prediction of fall risk among nursing home residents using electronic medical records SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Article DE electronic medical records; minimum data set 3.0; nursing home falls; prediction; meaningful use ID MINIMUM DATA SET; FRACTURE RISK; OLDER-ADULTS; PREVENTION; INJURIES; FACILITY; EPILEPSY; PEOPLE; CARE AB Objective Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls. Methods The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data. Results In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification. Conclusions Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables. C1 [Marier, Allison] Abt Associates Inc, US Hlth Div, Bethesda, MD USA. [Olsho, Lauren E. W.; Rhodes, William] Abt Associates Inc, US Hlth Div, Cambridge, MA USA. [Spector, William D.] Agcy Healthcare Res & Qual, US Dept HHS, Rockville, MD USA. RP Marier, A (reprint author), 4550 Montgomery Ave 800N, Bethesda, MD 20814 USA. EM Allison_Marier@abtassoc.com FU Agency for Healthcare Research & Quality (AHRQ), Department of Health & Human Services (DHHS) [HHSA290201000031I] FX This study was funded by the Agency for Healthcare Research & Quality (AHRQ), Department of Health & Human Services (DHHS), under contract # HHSA290201000031I. The content of this article is solely the responsibility of the authors and does not represent the official views or recommendations of AHRQ or DHHS. NR 30 TC 1 Z9 1 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1067-5027 EI 1527-974X J9 J AM MED INFORM ASSN JI J. Am. Med. Inf. Assoc. PD MAR PY 2016 VL 23 IS 2 BP 276 EP 282 DI 10.1093/jamia/ocv061 PG 7 WC Computer Science, Information Systems; Computer Science, Interdisciplinary Applications; Health Care Sciences & Services; Information Science & Library Science; Medical Informatics SC Computer Science; Health Care Sciences & Services; Information Science & Library Science; Medical Informatics GA DW6SN UT WOS:000383781600006 PM 26104743 ER PT J AU Bernard, DM Selden, TM AF Bernard, Didem M. Selden, Thomas M. TI Access to Care Among Nonelderly Veterans SO MEDICAL CARE LA English DT Article DE Veterans; access barriers; access to care ID SERIOUS MENTAL-ILLNESS; AFFAIRS HEALTH SYSTEM; EXPENDITURE BURDENS; OUTPATIENT CARE; BARRIERS; INSURANCE; MEDICARE; ADULTS AB Background: Veteran access to care is an important policy issue that has not previously been examined with population-based survey data. Objectives: This study compares access to care for nonelderly adult Veterans versus comparable non-Veterans, overall and within subgroups defined by simulated eligibility for health care from the Veterans Health Administration and by insurance status. Research Design: We use household survey data from the Medical Expenditure Panel Survey from 2006 to 2011. We use iterative proportional fitting to standardize (control for) differences in age, sex, income, medical conditions, disability, Census region, and Metropolitan Statistical Area. Subjects: Nonelderly Veterans and comparable non-Veterans. Measures: For medical, dental, and prescription medicine treatments, we use 4 access measures: delaying care, inability to obtain care, perceiving delay as a big problem, and perceiving inability to obtain care as a big problem. We also examine having a usual source of care. Results: Frequencies of access barriers are similar for nonelderly Veterans and comparable non-Veterans for dental and prescription medicine treatments. For medical treatment, we find that Veterans eligible for VA health care and Veterans with VA use who are uninsured report fewer access problems than the comparable non-Veteran populations for 2 measures: inability to obtain care and reporting inability to obtain care as a big problem. Conclusions: Our results show that uninsured Veterans, the most policy-relevant group, have better access to care than comparable non-Veterans. Our results highlight the importance of adjusting Veteran and non-Veteran comparisons to account for the higher than average health care needs of Veterans. C1 [Bernard, Didem M.; Selden, Thomas M.] Agcy Healthcare Res & Qual, Div Modeling & Res, Ctr Financing Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20850 USA. RP Bernard, DM (reprint author), Agcy Healthcare Res & Qual, Div Modeling & Res, Ctr Financing Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20850 USA. EM didem.bernard@ahrq.hhs.gov NR 23 TC 1 Z9 1 U1 2 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD MAR PY 2016 VL 54 IS 3 BP 243 EP 252 DI 10.1097/MLR.0000000000000508 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA DH6XM UT WOS:000372935400005 PM 26871642 ER PT J AU Friedman, B Barbash, GI Glied, SA Steiner, CA AF Friedman, Bernard Barbash, Gabriel I. Glied, Sherry A. Steiner, Claudia A. TI Hospital Revisits Within 30 Days After Conventional and Robotically Assisted Hysterectomy SO MEDICAL CARE LA English DT Article DE Robotic Hysterectomy; hospital revisits ID INSTRUMENTAL VARIABLE METHODS; TREATMENT-SELECTION BIAS; LENGTH-OF-STAY; PROPENSITY SCORE; MORTALITY; READMISSION; SURGERY; IMPACT AB Objectives: To compare the rates of hospital readmissions, emergency department, and outpatient clinic visits after discharge for robotically assisted (RA) versus nonrobotic hysterectomy in women age 30 or more with nonmalignant conditions. Data Sources: Discharges for 2011 for 8 states (CA, FL, GA, IA, MO, NE, NY, TN) (> 86,000 inpatient hysterectomies) were drawn from the statewide databases of the Healthcare Cost and Utilization Project. Data from 4 of these states were used to study revisits after 29,000 outpatient hysterectomies. Methods: Matched pairs of patients were constructed with propensity scores derived from each patient's age group, severity of illness, insurance coverage, and type of procedure. Both the full set of revisits and a set limited to diagnoses for revisits judged in other research to be related to the initial surgery (about 70% of all revisits) were analyzed. The analyses were repeated with an instrumental variables regression design. Key Results: Using the propensity score matched pairs, revisits, and specifically readmissions, after inpatient hysterectomy were greater for RA versus non-RA patients (relative risk of readmission=124%, P < 0.01). Similar results were found for readmissions after outpatient hysterectomy, and readmissions after inpatient hysterectomy for the restricted set of related revisits. In the method with instrumental variables, RA was associated with an increase of 32% in the likelihood of any revisit (P < 0.01). Conclusions: Using 2 different methods to control for selection, this study found higher rates of revisits among women undergoing RA versus non-RA hysterectomy for benign conditions. While selection bias cannot be ruled out completely in an observational study, the study supports broader use of revisits for analyses of outcomes of hysterectomy. C1 [Friedman, Bernard; Steiner, Claudia A.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Barbash, Gabriel I.] Tel Aviv Sourasky Med Ctr, Rehovot, Israel. [Barbash, Gabriel I.] Weitzmann Inst Sci, Rehovot, Israel. [Glied, Sherry A.] NYU, Wagner Sch Publ Serv, New York, NY USA. RP Friedman, B (reprint author), Agcy Healthcare Res & Qual, Ctr Org Delivery & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM econobarry@gmail.com NR 26 TC 0 Z9 0 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD MAR PY 2016 VL 54 IS 3 BP 311 EP 318 DI 10.1097/MLR.0000000000000482 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA DH6XM UT WOS:000372935400013 PM 26759976 ER PT J AU Kroch, E Duan, M Martin, J Bankowitz, RA AF Kroch, Eugene Duan, Michael Martin, John Bankowitz, Richard A. TI Patient Factors Predictive of Hospital Readmissions Within 30 Days SO JOURNAL FOR HEALTHCARE QUALITY LA English DT Article DE hospital readmissions; risk adjustment; benchmarking; performance measurement ID ACUTE MYOCARDIAL-INFARCTION; MEDICARE BENEFICIARIES; 30-DAY READMISSION; HEART-FAILURE; RATES; RISK; CARE AB Background:Under the Affordable Care Act, the Congress has mandated that the Centers for Medicare and Medicaid Services reduce payments to hospitals subject to their Inpatient Prospective Payment System that exhibits excess readmissions. Using hospital-coded discharge abstracts, we constructed a readmission measure that accounts for cross-hospital variation that enables hospitals to monitor their entire inpatient populations and evaluate their readmission rates relative to national benchmarks.Methods:Multivariate logistic regressions are applied to determine which patient factors increase the odds of a readmission within 30 days and by how much. This study uses deidentified discharge abstract data from a database of approximately 15 million inpatient discharges representing 611 acute care hospitals from Premier healthcare alliance over a 2-year period (2008q4-2010q3). The hospitals are geographically diverse and represent large urban academic centers and small rural community hospitals.Results:This study demonstrates that meaningful risk-adjusted readmission rates can be tracked in a dynamic database. The clinical conditions responsible for the index admission were the strongest predictive factor of readmissions, but factors such as age and accompanying comorbid conditions were also important. Socioeconomic factors, such as race, income, and payer status, also showed strong statistical significance in predicting readmissions.Conclusions:Payment models that are based on stratified comparisons might result in a more equitable payment system while at the same time providing transparency regarding disparities based on these factors. No model, yet available, discriminates potentially modifiable readmissions from those not subject to intervention highlighting the fact that the optimum readmission rate for any given condition is yet to be identified. C1 [Kroch, Eugene] Booz Allen Hamilton, Hamilton, ON, Canada. [Kroch, Eugene; Duan, Michael; Bankowitz, Richard A.] Premier Inc, Philadelphia, PA 19104 USA. [Kroch, Eugene] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Kroch, Eugene] AHRQ, CMS, US Dept Hlth & Human Serv, Rockville, MD 20852 USA. [Kroch, Eugene] ONC, Silver Spring, MD USA. [Martin, John] Premier Res Inst, W Palm Beach, FL USA. [Martin, John] PCORI, Improving Hlth Syst Advisory Panel, Washington, DC USA. RP Kroch, E (reprint author), Booz Allen Hamilton, Hamilton, ON, Canada.; Kroch, E (reprint author), Premier Inc, Philadelphia, PA 19104 USA.; Kroch, E (reprint author), Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA.; Kroch, E (reprint author), AHRQ, CMS, US Dept Hlth & Human Serv, Rockville, MD 20852 USA. EM ekroch@wharton.upenn.edu NR 15 TC 4 Z9 4 U1 1 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1062-2551 EI 1945-1474 J9 J HEALTHC QUAL JI J. Healthc. Qual. PD MAR-APR PY 2016 VL 38 IS 2 BP 106 EP 115 DI 10.1097/JHQ.0000000000000003 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DH4XR UT WOS:000372789400007 PM 26042742 ER PT J AU Kronick, R AF Kronick, Richard TI AHRQ'S ROLE IN IMPROVING QUALITY, SAFETY, AND HEALTH SYSTEM PERFORMANCE SO PUBLIC HEALTH REPORTS LA English DT Editorial Material C1 [Kronick, Richard] US Dept HHS, Agcy Healthcare Res & Qual, 5600 Fishers Ln,7th Fl, Rockville, MD 20857 USA. RP Kronick, R (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, 5600 Fishers Ln,7th Fl, Rockville, MD 20857 USA. EM richard.kronick@ahrq.hhs.gov NR 16 TC 1 Z9 1 U1 0 U2 1 PU ASSOC SCHOOLS PUBLIC HEALTH PI WASHINGTON PA 1900 M ST NW, STE 710, WASHINGTON, DC 20036 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD MAR-APR PY 2016 VL 131 IS 2 BP 229 EP 232 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA DG9HH UT WOS:000372392900004 PM 26957656 ER PT J AU Adesanya, MR Bailey, W Belcher, DC Beltran, M Branch, T Brand, MK Craft, EM Donahue, AH Dye, BA Thornton-Evans, G Garcia, I Hyman, F Joskow, R Lester, AM Makrides, NS Manski, RJ Mehegan, M Mouden, LD Nelson, D Norris, L O'Hara, J Cherry-Peppers, G Ricks, TL Rollins, R AF Adesanya, Margo R. Bailey, William Belcher, Donald C. Beltran, Marco Branch, Tracy Brand, Marcia K. Craft, Edwin M. Donahue, Agnes H. Dye, Bruce A. Thornton-Evans, Gina Garcia, Isabel Hyman, Frederick Joskow, Renee Lester, Arlene M. Makrides, Nicholas S. Manski, Richard J. Mehegan, Marian Mouden, Lynn Douglas Nelson, Danielle Norris, Laurie O'Hara, Jessica Cherry-Peppers, Gail Ricks, Timothy L. Rollins, Rochelle CA US Dept Hlth Human Serv TI US Department of Health and Human Services Oral Health Strategic Framework, 2014-2017 SO PUBLIC HEALTH REPORTS LA English DT Editorial Material ID DENTAL-CARE; CARIES C1 [Adesanya, Margo R.] Natl Inst Dent & Craniofacial Res, NIH, Off Sci Policy & Anal, Rockville, MD USA. [Bailey, William] Ctr Dis Control & Prevent, Atlanta, GA USA. [Belcher, Donald C.] US Coast Guard, Qual & Performance Improvement, Washington, DC USA. [Beltran, Marco; Rollins, Rochelle] Adm Children & Families, Washington, DC USA. [Branch, Tracy; Lester, Arlene M.] OS Off Minor Hlth, Washington, DC USA. [Brand, Marcia K.; Joskow, Renee] Hlth Resources & Serv Adm, Rockville, MD USA. [Craft, Edwin M.] Subst Abuse & Mental Hlth Serv Adm, Rockville, MD USA. [Donahue, Agnes H.] OS Off Assistant Secretary Hlth, OASH Intergovt Affairs RHA, Washington, DC USA. [Dye, Bruce A.] Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. [Thornton-Evans, Gina] Ctr Dis Control & Prevent, Div Oral Hlth, Atlanta, GA USA. [Garcia, Isabel] Natl Inst Dent & Craniofacial Res, NIH, Rockville, MD USA. [Hyman, Frederick] US FDA, Ctr Drug Evaluat & Res, Div Dermatol & Dent Prod, Silver Spring, MD USA. [Makrides, Nicholas S.] Fed Bur Prisons, Washington, DC USA. [Manski, Richard J.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Mehegan, Marian] Off Assistant Secretary Hlth, Off Womens Hlth, Washington, DC USA. [Mouden, Lynn Douglas] Ctr Medicare & Medicaid Serv, Div Qual Evaluat & Hlth Outcomes, Children & Adults Hlth Programs Grp, Washington, DC USA. [Nelson, Danielle] Adm Community Living, Washington, DC USA. [Norris, Laurie] Ctr Medicare & Medicaid Serv, Oral Hlth Initiat, Div Qual Evaluat & Hlth Outcomes, Washington, DC USA. [O'Hara, Jessica] Off Secretary, Off Assistant Secretary Planning & Evaluat, Washington, DC USA. [Cherry-Peppers, Gail] US FDA, Ctr Tobacco Prod, Off Sci, Silver Spring, MD USA. [Ricks, Timothy L.] Indian Hlth Serv, Nashville Area Off Publ Hlth, Nashville, TN USA. RP Adesanya, MR (reprint author), Natl Inst Dent & Craniofacial Res, NIH, Off Sci Policy & Anal, Rockville, MD USA. NR 56 TC 0 Z9 0 U1 2 U2 2 PU ASSOC SCHOOLS PUBLIC HEALTH PI WASHINGTON PA 1900 M ST NW, STE 710, WASHINGTON, DC 20036 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD MAR-APR PY 2016 VL 131 IS 2 BP 242 EP 257 PG 16 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA DG9HH UT WOS:000372392900007 ER PT J AU Zuvekas, SH Cohen, JW AF Zuvekas, Samuel H. Cohen, Joel W. TI Fee-For-Service, While Much Maligned, Remains The Dominant Payment Method For Physician Visits SO HEALTH AFFAIRS LA English DT Editorial Material ID CAPITATION; PROVIDERS; REFORMS; CARE C1 [Zuvekas, Samuel H.; Cohen, Joel W.] AHRQ, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Zuvekas, SH (reprint author), AHRQ, Ctr Financing Access & Cost Trends, Rockville, MD USA. EM samuel.zuvekas@ahrq.hhs.gov NR 15 TC 2 Z9 2 U1 0 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD MAR PY 2016 VL 35 IS 3 BP 411 EP 414 DI 10.1377/hlthaff.2015.1291 PG 4 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DG1KA UT WOS:000371825000007 PM 26953294 ER PT J AU Beck, AF Tschudy, MM Coker, TR Mistry, KB Cox, JE Gitterman, BA Chamberlain, LJ Grace, AM Hole, MK Klass, PE Lobach, KS Ma, CT Navsaria, D Northrip, KD Sadof, MD Shah, AN Fierman, AH AF Beck, Andrew F. Tschudy, Megan M. Coker, Tumaini R. Mistry, Kamila B. Cox, Joanne E. Gitterman, Benjamin A. Chamberlain, Lisa J. Grace, Aimee M. Hole, Michael K. Klass, Perri E. Lobach, Katherine S. Ma, Christine T. Navsaria, Dipesh Northrip, Kimberly D. Sadof, Matthew D. Shah, Anita N. Fierman, Arthur H. TI Determinants of Health and Pediatric Primary Care Practices SO PEDIATRICS LA English DT Article ID WELL-CHILD CARE; MEDICAL-LEGAL PARTNERSHIP; QUALITY-OF-CARE; SOCIAL DETERMINANTS; COMMUNITY PEDIATRICS; HOME VISITATION; LIFE-COURSE; VIDEOTAPED INTERACTIONS; CLINICAL-PRACTICE; YOUNG-CHILDREN AB More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association's Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty's negative impact on child health and well-being. The present article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. Attention is paid to both facilitators of and barriers to successful redesign strategies. We also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health. In addition, ways in which practices can advocate for families in their communities and nationally are identified. Finally, given the relative dearth of evidence for many poverty-focused interventions in primary care, areas that would benefit from more in-depth study are considered. Such a focus is especially relevant as practices consider how they can best help families mitigate the impact of poverty-related risks in ways that promote long-term health and well-being for children. C1 [Beck, Andrew F.; Shah, Anita N.] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, 3333 Burnet Ave,MLC 7035, Cincinnati, OH 45229 USA. [Tschudy, Megan M.; Mistry, Kamila B.] Johns Hopkins Sch Med, Dept Pediat, Baltimore, MD USA. [Coker, Tumaini R.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Coker, Tumaini R.] Mattel Childrens Hosp, Los Angeles, CA USA. [Mistry, Kamila B.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Cox, Joanne E.; Hole, Michael K.] Boston Childrens Hosp, Div Gen Pediat, Boston, MA USA. [Gitterman, Benjamin A.] Childrens Natl Hlth Syst, Dept Pediat, Washington, DC USA. [Chamberlain, Lisa J.] Lucile Packard Childrens Hosp, Dept Pediat, Palo Alto, CA USA. [Grace, Aimee M.] Off US Senator Brian Schatz D HI, Washington, DC USA. [Grace, Aimee M.] George Washington Univ, Sch Med, Washington, DC USA. [Klass, Perri E.] NYU, Sch Med, Dept Pediat, New York, NY USA. [Lobach, Katherine S.] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Pediat, Bronx, NY 10467 USA. [Ma, Christine T.] UCSF Benioff Childrens Hosp Oakland, Dept Pediat, Oakland, CA USA. [Navsaria, Dipesh] Univ Wisconsin, Dept Pediat, Sch Med & Publ Hlth, Madison, WI USA. [Northrip, Kimberly D.] Univ Kentucky, Coll Med, Dept Pediat, Lexington, KY USA. [Sadof, Matthew D.] Baystate Childrens Hosp, Dept Pediat, Springfield, MA USA. RP Beck, AF (reprint author), Cincinnati Childrens Hosp Med Ctr, Dept Pediat, 3333 Burnet Ave,MLC 7035, Cincinnati, OH 45229 USA. EM andrew.beck1@cchmc.org NR 89 TC 1 Z9 1 U1 4 U2 5 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 EI 1098-4275 J9 PEDIATRICS JI Pediatrics PD MAR PY 2016 VL 137 IS 3 AR e20153673 DI 10.1542/peds.2015-3673 PG 11 WC Pediatrics SC Pediatrics GA DF5MK UT WOS:000371395800056 PM 26933205 ER PT J AU Berry, SA Fleishman, JA Moore, RD Gebo, KA AF Berry, S. A. Fleishman, J. A. Moore, R. D. Gebo, K. A. TI Thirty-day hospital readmissions for adults with and without HIV infection SO HIV MEDICINE LA English DT Article DE health care utilization; hospital readmission; Medicaid; Medicare ID HUMAN-IMMUNODEFICIENCY-VIRUS; UNITED-STATES; ANTIRETROVIRAL THERAPY; INPATIENT ADMISSIONS; LUNG-CANCER; RISK; TRENDS; COHORT; CARE; DISEASE AB ObjectivesRisk-adjusted 30-day hospital readmission rate is a commonly used benchmark for hospital quality of care and for Medicare reimbursement. Persons living with HIV (PLWH) may have high readmission rates. This study compared 30-day readmission rates by HIV status in a multi-state sample with planned subgroup comparisons by insurance and diagnostic categories. MethodsData for all acute care, nonmilitary hospitalizations in nine states in 2011 were obtained from the Healthcare Costs and Utilization Project. The primary outcome was readmission for any cause within 30 days of hospital discharge. Factors associated with readmission were evaluated using multivariate logistic regression. ResultsA total of 5484245 persons, including 33556 (0.6%) PLWH, had a total of 6441695 index hospitalizations, including 45382 (0.7%) among PLWH. Unadjusted readmission rates for hospitalizations of HIV-uninfected persons and PLWH were 11.2% [95% confidence interval (CI) 11.2, 11.2%] and 19.7% (95% CI 19.3, 20.0%), respectively. After adjustment for age, gender, race, insurance, and diagnostic category, HIV infection was associated with 1.50 (95% CI 1.46, 1.54) times higher odds of readmission. Predicted, adjusted readmission rates were higher for PLWH within every insurance category, including Medicaid [12.9% (95% CI 12.8, 13.0%) and 19.1% (95% CI 18.4, 19.7%) for HIV-uninfected persons and PLWH, respectively] and Medicare [13.2% (95% CI 13.1, 13.3%) and 18.0% (95% CI 17.4, 18.7%), respectively], and within every diagnostic category. ConclusionsHIV infection is associated with significantly increased readmission risk independent of demographics, insurance, and diagnostic category. The 19.7% 30-day readmission rate may serve as a preliminary benchmark for assessing quality of care of PLWH. Policy-makers may consider adjusting for HIV infection when calculating a hospital's expected readmission rate. C1 [Berry, S. A.; Moore, R. D.; Gebo, K. A.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD USA. [Fleishman, J. A.] Agcy Healthcare Res & Qual, Financing Access & Cost Trends, Rockville, MD USA. RP Berry, SA (reprint author), Johns Hopkins Univ, Sch Med, 725 N,Wolfe St,Off 217, Baltimore, MD 21205 USA. EM sberry8@jhmi.edu FU NIH [K23 AI084854]; National Institute of Allergy and Infectious Diseases [P30 AI094189]; Agency for Healthcare Research and Quality [HHSA290201100007C] FX Sources of funding: This work was supported by NIH grant K23 AI084854 to SAB and grant P30 AI094189 to RDM from the National Institute of Allergy and Infectious Diseases, and by the Agency for Healthcare Research and Quality (HHSA290201100007C). The views expressed in this paper are those of the authors. No official endorsement by the Agency for Healthcare Research and Quality is intended or should be inferred. NR 44 TC 1 Z9 1 U1 1 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1464-2662 EI 1468-1293 J9 HIV MED JI HIV Med. PD MAR PY 2016 VL 17 IS 3 BP 167 EP 177 DI 10.1111/hiv.12287 PG 11 WC Infectious Diseases SC Infectious Diseases GA DF5ZB UT WOS:000371431400001 PM 26176492 ER PT J AU Irvin, VL Kaplan, RM AF Irvin, Veronica L. Kaplan, Robert M. TI Effect Sizes and Primary Outcomes in Large-Budget, Cardiovascular-Related Behavioral Randomized Controlled Trials Funded by NIH Since 1980 SO ANNALS OF BEHAVIORAL MEDICINE LA English DT Article DE Behavior; Intervention; Cardiovascular; Trial registration; Publication statistics; Effect sizes; Periodicals as topics/statistics; Randomized controlled trials as topics/statistics ID FACTOR INTERVENTION TRIAL; CORONARY-HEART-DISEASE; PERIPHERAL ARTERIAL-DISEASE; LIFE-STYLE MODIFICATION; BLOOD-PRESSURE CONTROL; PRIMARY-CARE PRACTICE; RISK FACTOR CHANGES; CLINICAL-TRIAL; WEIGHT-LOSS; OBESITY TREATMENT AB Purpose We reviewed large-budget, National Institutes of Health (NIH)-supported randomized controlled trials (RCTs) with behavioral interventions to assess (1) publication rates, (2) trial registration, (3) use of objective measures, (4) significant behavior and physiological change, and (5) effect sizes. Methods We identified large-budget grants (>$500,000/year) funded by NIH (National Heart Lung and Blood Institute (NHLBI) or National Institute of Diabetes & Digestive and Kidney Diseases (NIDDK)) for cardiovascular disease (dates January 1, 1980 to December 31, 2012). Among 106 grants that potentially met inclusion criteria, 20 studies were not published and 48 publications were excluded, leaving 38 publications for analysis. ClinicalTrials.gov abstracts were used to determine whether outcome measures had been pre-specified. Results Three fourths of trials were registered in ClinicalTrials.gov and all published pre-specified outcomes. Twenty-six trials reported a behavioral outcome with 81 % reporting significant improvements for the target behavior. Thirty-two trials reported a physiological outcome. All were objectively measured, and 81 % reported significant benefit. Seventeen trials reported morbidity outcomes, and seven reported a significant benefit. Nine trials assessed mortality, and all were null for this outcome. Conclusions Behavioral trials complied with trial registration standards. Most reported a physiological benefit, but few documented morbidity or mortality benefits. C1 [Irvin, Veronica L.] Oregon State Univ, Sch Social & Behav Hlth Sci, Coll Publ Hlth & Human Sci, 457 Waldo Hall, Corvallis, OR 97331 USA. [Kaplan, Robert M.] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. RP Irvin, VL (reprint author), Oregon State Univ, Sch Social & Behav Hlth Sci, Coll Publ Hlth & Human Sci, 457 Waldo Hall, Corvallis, OR 97331 USA. EM Veronica.irvin@oregonstate.edu FU Intramural NIH HHS [ZIA CL060082-01] NR 72 TC 1 Z9 1 U1 2 U2 7 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0883-6612 EI 1532-4796 J9 ANN BEHAV MED JI Ann. Behav. Med. PD FEB PY 2016 VL 50 IS 1 BP 130 EP 146 DI 10.1007/s12160-015-9739-7 PG 17 WC Psychology, Multidisciplinary SC Psychology GA DI6VU UT WOS:000373639100013 PM 26507906 ER PT J AU Robinson, KA Chou, R Berkman, ND Newberry, SJ Fu, RW Hartling, L Dryden, D Butler, M Foisy, M Anderson, J Motu'apuaka, M Relevo, R Guise, JM Chang, S AF Robinson, Karen A. Chou, Roger Berkman, Nancy D. Newberry, Sydne J. Fu, Rongwei Hartling, Lisa Dryden, Donna Butler, Mary Foisy, Michelle Anderson, Johanna Motu'apuaka, Makalapua Relevo, Rose Guise, Jeanne-Marie Chang, Stephanie TI Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Review DE Systematic reviews; Methods guidance AB Objectives: As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. We developed guidance on the integration of systematic reviews into new reviews. Methods: A workgroup of methodologists from Evidence-based Practice Centers developed consensus-based recommendations. Discussions were informed by a literature scan and by interviews with organizations that conduct systematic reviews. Results: Twelve recommendations were developed addressing selecting reviews, assessing risk of bias, qualitative and quantitative synthesis, and summarizing and assessing body of evidence. Conclusions: We provide preliminary guidance for an efficient and unbiased approach to integrating existing systematic reviews with primary studies in a new review. (C) 2016 Elsevier Inc. All rights reserved. C1 [Robinson, Karen A.] Johns Hopkins Univ, 1830 E Monument St,Suite 8068, Baltimore, MD 21287 USA. [Chou, Roger] Oregon Hlth & Sci Univ, Pacific Northwest Evidence Based Practice Ctr, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. [Berkman, Nancy D.] Univ N Carolina, Cecil G Sheps Ctr Hlth Serv Res, CB 7590 725,Martin Luther King Jr Blvd, Chapel Hill, NC 27599 USA. [Newberry, Sydne J.] RAND Corp, Southern Calif Evidence Based Practice Ctr, 1776 Main St,POB 2138, Santa Monica, CA 90407 USA. [Fu, Rongwei; Anderson, Johanna; Motu'apuaka, Makalapua; Relevo, Rose; Guise, Jeanne-Marie] Portland VA Res Fdn, 3710 SW,US Vet Hosp Rd,Mail Code R&D71, Portland, OR 97239 USA. [Hartling, Lisa; Dryden, Donna; Foisy, Michelle] Edmonton Clin Hlth Acad, Alberta Res Ctr Hlth Evidence, Room 4-496A,th Floor,11405-87 Ave, Edmonton, AB T6G 1C9, Canada. [Butler, Mary] Univ Minnesota, Sch Publ Hlth, D351 Mayo MMC 197,420 Delaware St SE, Minneapolis, MN 55455 USA. [Chang, Stephanie] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. RP Robinson, KA (reprint author), Johns Hopkins Univ, 1830 E Monument St,Suite 8068, Baltimore, MD 21287 USA. EM krobin@jhmi.edu OI Robinson, Karen/0000-0003-1021-7820 FU Agency for Healthcare Research and Quality (AHRQ), Rockville, MD FX This article is based on a project conducted by a working group with the Evidence-based Practice Center (EPC) Program supported by the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD. NR 18 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 EI 1878-5921 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD FEB PY 2016 VL 70 BP 38 EP 44 DI 10.1016/j.jclinepi.2015.05.035 PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA DE5NE UT WOS:000370676900005 PM 26261004 ER PT J AU Lipton, BJ Decker, SL AF Lipton, Brandy J. Decker, Sandra L. TI The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE United States; Public insurance; Insurance expansion; Medicaid; Low-income adults; Vision care; Visual acuity ID QUALITY-OF-LIFE; EYE CARE; INSURANCE-COVERAGE; UNITED-STATES; VISUAL IMPAIRMENT; OREGON EXPERIMENT; IMPACT; PEOPLE AB Background: Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. Research objective: This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. Methodology: We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. Findings: Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. Conclusion: Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. (C) 2015 Elsevier Ltd. All rights reserved. C1 [Lipton, Brandy J.; Decker, Sandra L.] Natl Ctr Hlth Stat, 3311 Toledo Rd, Hyattsville, MD 20782 USA. [Lipton, Brandy J.] Social & Sci Syst Inc, 5600 Fishers Lane,Mail Stop 07W41A, Rockville, MD 20857 USA. [Lipton, Brandy J.; Decker, Sandra L.] Agcy Healthcare Res & Qual, 5600 Fishers Lane,Mail Stop 07W41A, Rockville, MD 20857 USA. RP Lipton, BJ (reprint author), Social & Sci Syst Inc, 5600 Fishers Lane,Mail Stop 07W41A, Rockville, MD 20857 USA.; Lipton, BJ (reprint author), Agcy Healthcare Res & Qual, 5600 Fishers Lane,Mail Stop 07W41A, Rockville, MD 20857 USA. EM Brandy.lipton@ahrq.hhs.gov; Sandra.decker@ahrq.hhs.gov NR 35 TC 2 Z9 2 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD FEB PY 2016 VL 150 BP 258 EP 267 DI 10.1016/j.socscimed.2015.10.055 PG 10 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA DE0HB UT WOS:000370304600030 PM 26607098 ER PT J AU Yang, HY Chen, HJ Marsteller, JA Liang, L Shi, LY Wang, YF AF Yang, Hsing-Yu Chen, Hsin-Jen Marsteller, Jill A. Liang, Lan Shi, Leiyu Wang, Youfa TI Patient-health care professional gender or race/ethnicity concordance and its association with weight-related advice in the United States SO PATIENT EDUCATION AND COUNSELING LA English DT Article DE Obesity; Overweight; Health disparity; Concordance; Health care professional ID LIFE-STYLE ADVICE; PHYSICIAN GENDER; RACE-CONCORDANCE; GENERAL-PRACTICE; OBESE-PATIENTS; SERVICES; COMMUNICATION; OVERWEIGHT; VISITS AB Objective: Examine association between adult patients' and health care providers' (HCPs) gender or race/ethnicity concordance and patients' reported receiving weight-related advice from HCP's in USA. Methods: Using Medical Expenditure Panel Survey (MEPS) 2004-2007 data, studied prevalence of weight-related advice (on exercise and diet) given to patients and its association with patients/HCPs concordance in gender (n = 9,686) and race/ethnicity (n = 8,825). Results: Overall, 46% of patients received HCP advice on diet and 49% on exercise. Overweight females seeing female HCPs were more likely to receive exercise advice than those seeing male HCPs (OR = 1.44 [95% CI: 1.10-1.89]). Race/ethnicity concordance was associated with lower odds of advice-receiving in certain populations (OR = 0.80 [0.67-0.97] for exercise and OR = 0.42 [0.19-0.91] for diet among white patients, OR = 0.47 [0.23-0.98] for exercise among Hispanic overweight patients). Conclusions: Patient/HCP gender or race/ethnicity concordance was not positively associated with HCPs providing weight-related advice. Patients with female HCPs or with racial/ethnic discordant HCPs (especially black or Asian HCPs) were more likely to receive advice. (C) 2015 Elsevier Ireland Ltd. All rights reserved. C1 [Yang, Hsing-Yu] Mackay Med Coll, Dept Nursing, Taipei, Taiwan. [Yang, Hsing-Yu; Chen, Hsin-Jen; Wang, Youfa] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Johns Hopkins Global Ctr Childhood Obes, Baltimore, MD USA. [Chen, Hsin-Jen] Natl Yang Ming Univ, Inst Publ Hlth, Taipei 112, Taiwan. [Chen, Hsin-Jen] Natl Yang Ming Univ, Dept Publ Hlth, Taipei 112, Taiwan. [Marsteller, Jill A.; Shi, Leiyu] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA. [Liang, Lan] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Wang, Youfa] SUNY Buffalo, Sch Publ Hlth & Hlth Profess, Dept Epidemiol & Environm Hlth, 270 Farber Hall, Buffalo, NY 14214 USA. RP Wang, YF (reprint author), SUNY Buffalo, Sch Publ Hlth & Hlth Profess, Dept Epidemiol & Environm Hlth, 270 Farber Hall, Buffalo, NY 14214 USA. EM youfawan@buffalo.edu OI Chen, Hsin-Jen/0000-0003-4876-634X FU National Institute of Diabetes and Digestive and Kidney Diseases [R01DK81335-01A1, R01DK081335-02] FX The study was supported in part by research grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK81335-01A1, R01DK081335-02). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and the Agency for Healthcare Research and Quality. This is related to part of Dr. Hsing-Yu Yang's doctoral dissertation research at Johns Hopkins University under Dr. Youfa Wang's guidance. We thank Drs. Hong Xue, Larry Cheskin and Yea-Jen Hsu for their assistance in improving the study. NR 32 TC 0 Z9 0 U1 3 U2 5 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD FEB PY 2016 VL 99 IS 2 BP 271 EP 278 DI 10.1016/j.pec.2015.08.030 PG 8 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA DE7GU UT WOS:000370804700013 PM 26349935 ER PT J AU Leroy, L Johnson, K Miller, T AF Leroy, Lisa Johnson, Karin Miller, Therese TI Team-Based Delivery of Clinical Preventive Services: What Does it Look Like? SO INTERNATIONAL JOURNAL OF QUALITATIVE METHODS LA English DT Meeting Abstract C1 [Leroy, Lisa] Abt Associates Inc, Cambridge, MA USA. [Johnson, Karin] MacColl Inst Healthcare Improvement, Seattle, WA USA. [Miller, Therese] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1609-4069 J9 INT J QUAL METH JI Int. J. Qual. Meth. PD JAN-DEC PY 2016 VL 15 IS 1 PG 1 WC Social Sciences, Interdisciplinary SC Social Sciences - Other Topics GA EE9BW UT WOS:000389921700443 ER PT B AU Ballard, DJ da Graca, B Fleming, NS Fullerton, CT AF Ballard, David J. da Graca, Briget Fleming, Neil S. Fullerton, Cliff T. BA Mayzell, G BF Mayzell, G TI The Value Proposition for Prevention and Screening SO POPULATION HEALTH: AN IMPLEMENTATION GUIDE TO IMPROVE OUTCOMES AND LOWER COSTS LA English DT Article; Book Chapter ID ACCOUNTABLE CARE ORGANIZATIONS; CORONARY-HEART-DISEASE; POPULATION HEALTH; MYOCARDIAL-INFARCTION; BENEFIT-ANALYSIS; PUBLIC-HEALTH; UNITED-STATES; SERVICES; INTEGRATION; MANAGEMENT C1 [Ballard, David J.; da Graca, Briget; Fullerton, Cliff T.] Baylor Scott & White Hlth, Dallas, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Heart Hosp Baylor Plano, Plano, TX 75093 USA. [Ballard, David J.] BHCS, Melbourne, Vic, Australia. [Ballard, David J.] AHRQ, Natl Advisory Council, Washington, DC USA. [Ballard, David J.] UNC, Sch Publ Hlth Fdn Board, Chapel Hill, NC 27515 USA. [Ballard, David J.] Lawrenceville Sch, Board Trustees, Lawrenceville, NJ USA. [Ballard, David J.] Texas Hosp Assoc, Austin, TX USA. [Fleming, Neil S.] Baylor Scott & White Hlth, Off Chief Qual Officer, Ctr Clin Effectiveness, Quantitat Sci, Dallas, TX USA. [Fleming, Neil S.] Baylor Univ, Hankamer Sch Business, Robbins Inst Hlth Policy & Leadership, Hlth Serv Res, Waco, TX 76798 USA. [Fleming, Neil S.] Baylor Hlth Care Syst STEEEP Global Inst, Ft Worth, TX USA. [Fleming, Neil S.] BHCS, Healthcare Res, Melbourne, Vic, Australia. [Fullerton, Cliff T.] Baylor Scott & White Qual Alliance, Melbourne, Vic, Australia. [Fullerton, Cliff T.] Garland North Garland, Family Med Ctr, Garland, TX USA. [Fullerton, Cliff T.] HealthTexas Provider Network HTPN, Dallas, TX USA. [Fullerton, Cliff T.] Texas Acad Family Phys Fdn, San Antonio, TX USA. [Fullerton, Cliff T.] Dallas Ft Worth Business Grp Hlth Diabet Comm, Dallas, TX USA. [Fullerton, Cliff T.] Texas Med Assoc Qual Council & Management Serv Or, Austin, TX USA. RP Ballard, DJ (reprint author), Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA.; Ballard, DJ (reprint author), Univ Virginia, Sch Med, Charlottesville, VA 22903 USA.; Ballard, DJ (reprint author), Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA.; Ballard, DJ (reprint author), Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA.; Ballard, DJ (reprint author), Heart Hosp Baylor Plano, Plano, TX 75093 USA.; Ballard, DJ (reprint author), UNC, Sch Publ Hlth Fdn Board, Chapel Hill, NC 27515 USA. NR 69 TC 0 Z9 0 U1 0 U2 0 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4987-0556-1; 978-1-4987-0555-4 PY 2016 BP 75 EP 95 PG 21 WC Health Policy & Services SC Health Care Sciences & Services GA BF9EN UT WOS:000385496900007 ER PT J AU Ricciardi, R Moy, E Wilson, NJ AF Ricciardi, Richard Moy, Ernest Wilson, Nancy J. TI Finding the True North Lessons From the National Healthcare Quality and Disparities Report SO JOURNAL OF NURSING CARE QUALITY LA English DT Editorial Material C1 [Ricciardi, Richard] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. [Moy, Ernest] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, 540 Gaither Rd, Rockville, MD 20850 USA. [Wilson, Nancy J.] Agcy Healthcare Res & Qual, Natl Qual Strategy, 540 Gaither Rd, Rockville, MD 20850 USA. RP Ricciardi, R (reprint author), Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. EM Richard.Ricciardi@ahrq.hhs.gov NR 14 TC 0 Z9 0 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1057-3631 EI 1550-5065 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JAN-MAR PY 2016 VL 31 IS 1 BP 9 EP 12 DI 10.1097/NCQ.0000000000000164 PG 4 WC Nursing SC Nursing GA DP1JG UT WOS:000378245700004 PM 26599416 ER PT J AU Berliner, E AF Berliner, Elise TI Multisociety Letter to the Agency for Healthcare Research and Quality: Serious Methodological Flaws Plague Technology Assessment on Pain Management Injection Therapies for Low Back Pain SO PAIN MEDICINE LA English DT Letter ID EPIDURAL STEROID INJECTIONS; LUMBAR RADICULAR PAIN; DOUBLE-BLIND; DISC HERNIATION; TRANSFORAMINAL INJECTION; CLINICAL-FEATURES; CORTICOSTEROID INJECTIONS; SACROILIAC JOINT; SCIATICA; PREVALENCE C1 [Berliner, Elise] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Technol Assessment Program, 540 Gaither Rd, Rockville, MD 20850 USA. RP Berliner, E (reprint author), Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Technol Assessment Program, 540 Gaither Rd, Rockville, MD 20850 USA. NR 35 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1526-2375 EI 1526-4637 J9 PAIN MED JI Pain Med. PD JAN PY 2016 VL 17 IS 1 BP 10 EP 15 DI 10.1111/pme.12934 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA DI8DD UT WOS:000373730500004 PM 26400156 ER PT J AU Wittie, M Ngo-Metzger, Q Lebrun-Harris, L Shi, LY Nair, S AF Wittie, Michael Ngo-Metzger, Quyen Lebrun-Harris, Lydie Shi, Leiyu Nair, Suma TI Enabling Quality: Electronic Health Record Adoption and Meaningful Use Readiness in Federally Funded Health Centers SO JOURNAL FOR HEALTHCARE QUALITY LA English DT Article DE community health centers; electronic health record; health disparities; health information technology; primary care ID INFORMATION-TECHNOLOGY; NATIONAL-SURVEY; CARE; PHYSICIANS; AMERICA; ACCESS AB The Health Resources and Services Administration has supported the adoption of electronic health records (EHRs) by federally funded health centers for over a decade; however, little is known about health centers' current EHR adoption rates, progress toward Meaningful Use, and factors related to adoption. We analyzed cross-sectional data from all 1,128 health centers in 2011, which served over 20 million patients during that year. As of 2011, 80% of health centers reported using an EHR, and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic composition, physician staffing, or health center funding; however, there were small variations in adoption by total patient cost and percent of revenue from grants. Findings revealed no evidence of a digital divide among health centers, indicating that health centers are implementing EHRs, in keeping with their mission to reduce health disparities. C1 [Wittie, Michael] US Dept Hlth & Human Serv, Hlth Informat Technol Branch, Off Qual & Data, Bur Primary Hlth Care,Hlth Resources & Serv Adm, Atlanta, GA 30303 USA. [Wittie, Michael] Hlth Informat Technol, Atlanta, GA 30302 USA. [Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Atlanta, GA USA. [Ngo-Metzger, Quyen] HRSA, Bur Primary Hlth Care, Data Branch, Atlanta, GA USA. [Ngo-Metzger, Quyen] Univ Calif Irvine, Irvine, CA USA. [Lebrun-Harris, Lydie] US Dept Hlth & Human Serv, Off Qual & Data, Bur Primary Hlth Care, HRSA, Atlanta, GA USA. [Lebrun-Harris, Lydie] HRSA, Off Res & Evaluat, Off Planning Anal & Evaluat, Atlanta, GA USA. [Shi, Leiyu] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Hlth Policy & Hlth Serv Res, Baltimore, MD USA. [Nair, Suma] Hlth Resources & Serv Adm, Bur Primary Hlth Care, Off Qual & Data, Atlanta, GA USA. RP Wittie, M (reprint author), US Dept Hlth & Human Serv, Hlth Informat Technol Branch, Off Qual & Data, Bur Primary Hlth Care,Hlth Resources & Serv Adm, Atlanta, GA 30303 USA.; Wittie, M (reprint author), Hlth Informat Technol, Atlanta, GA 30302 USA. EM michael.wittie@hhs.gov NR 30 TC 2 Z9 2 U1 1 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1062-2551 EI 1945-1474 J9 J HEALTHC QUAL JI J. Healthc. Qual. PD JAN-FEB PY 2016 VL 38 IS 1 BP 42 EP 51 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DH4XK UT WOS:000372788700007 PM 24612263 ER PT J AU Gooptu, A Moriya, AS Simon, KI Sommers, BD AF Gooptu, Angshuman Moriya, Asako S. Simon, Kosali I. Sommers, Benjamin D. TI Medicaid Expansion Did Not Result In Significant Employment Changes Or Job Reductions In 2014 SO HEALTH AFFAIRS LA English DT Article ID AFFORDABLE CARE ACT; HEALTH-INSURANCE; COVERAGE; IMPACT AB Medicaid expansion undertaken through the Affordable Care Act (ACA) is already producing major changes in insurance coverage and access to care, but its potential impacts on the labor market are also important policy considerations. Economic theory suggests that receipt of Medicaid might benefit workers who would no longer be tied to specific jobs to receive health insurance (known as job lock), giving them more flexibility in their choice of employment, or might encourage low-income workers to reduce their hours or stop working if they no longer need employment-based insurance. Evidence on labor changes after previous Medicaid expansions is mixed. To view the impact of the ACA on current labor market participation, we analyzed labor-market participation among adults with incomes below 138 percent of the federal poverty level, comparing Medicaid expansion and nonexpansion states and Medicaid-eligible and -ineligible groups, for the pre-ACA period (2005-13) and the first fifteen months of the expansion (January 2014-March 2015). Medicaid expansion did not result in significant changes in employment, job switching, or full-versus part-time status. While we cannot exclude the possibility of small changes in these outcomes, our findings rule out the large change found in one influential pre-ACA study; furthermore, they suggest that the Medicaid expansion has had limited impact on labor-market outcomes thus far. C1 [Gooptu, Angshuman; Simon, Kosali I.] Indiana Univ, Sch Publ & Environm Affairs, Bloomington, IN 47405 USA. [Moriya, Asako S.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Simon, Kosali I.] NBER, Cambridge, MA 02138 USA. [Sommers, Benjamin D.] Harvard Univ, TH Chan Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA. [Sommers, Benjamin D.] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA. RP Moriya, AS (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. EM Asako.Moriya@ahrq.hhs.gov FU Agency for Healthcare Research and Quality (AHRQ) [K02HS021291]; Department of Labor Scholars Program FX Benjamin D. Sommers was supported by a research grant from the Agency for Healthcare Research and Quality (AHRQ) (Grant No. K02HS021291). The authors thank Robert Kaestner, Bowen Garrett, Thomas Selden, Joel Cohen, and Steve Cohen; and seminar participants at Columbia University, Purdue University, Vanderbilt University, and AHRQ for helpful comments. The authors also thank the Department of Labor Scholars Program for funding the related earlier research. Sommers currently serves part time as an adviser to the Department of Health and Human Services (HHS), but this article was written in his capacity as a Harvard University employee. The views expressed in this article are those of the authors and do not represent the views of HHS or the AHRQ. NR 14 TC 4 Z9 4 U1 1 U2 6 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JAN PY 2016 VL 35 IS 1 BP 111 EP 118 DI 10.1377/hlthaff.2015.0747 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DD1PV UT WOS:000369694700015 PM 26733708 ER PT J AU Moriya, AS Selden, TM Simon, KI AF Moriya, Asako S. Selden, Thomas M. Simon, Kosali I. TI Little Change Seen In Part-Time Employment As A Result Of The Affordable Care Act SO HEALTH AFFAIRS LA English DT Article ID PUBLIC-HEALTH INSURANCE C1 [Moriya, Asako S.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Selden, Thomas M.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Div Res & Modeling, Rockville, MD USA. [Simon, Kosali I.] Indiana Univ, Sch Publ & Environm Affairs, Bloomington, IN 47405 USA. [Simon, Kosali I.] NBER, Cambridge, MA 02138 USA. RP Moriya, AS (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. EM Asako.Moriya@ahrq.hhs.gov NR 11 TC 4 Z9 4 U1 1 U2 3 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JAN PY 2016 VL 35 IS 1 BP 119 EP 123 DI 10.1377/hlthaff.2015.0949 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DD1PV UT WOS:000369694700016 PM 26733709 ER PT J AU Weiss, BD Brega, AG LeBlanc, WG Mabachi, NM Barnard, J Albright, K Cifuentes, M Brach, C West, DR AF Weiss, Barry D. Brega, Angela G. LeBlanc, William G. Mabachi, Natabhona M. Barnard, Juliana Albright, Karen Cifuentes, Maribel Brach, Cindy West, David R. TI Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit SO JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE LA English DT Article DE Education of Patients; Health Literacy; Medical Errors; Polypharmacy ID ELDERLY-PATIENTS; RECONCILIATION; BAG AB Background: Although routine medication reviews in primary care practice are recommended to identify drug therapy problems, it is often difficult to get patients to bring all their medications to office visits. The objective of this study was to determine whether the medication review tool in the Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit can help to improve medication reviews in primary care practices. Methods: The toolkit's "Brown Bag Medication Review" was implemented in a rural private practice in Missouri and an urban teaching practice in California. Practices recorded outcomes of medication reviews with 45 patients before toolkit implementation and then changed their medication review processes based on guidance in the toolkit. Six months later we conducted interviews with practice staff to identify changes made as a result of implementing the tool, and practices recorded outcomes of medication reviews with 41 additional patients. Data analyses compared differences in whether all medications were brought to visits, the number of medications reviewed, drug therapy problems identified, and changes in medication regimens before and after implementation. Results: Interviews revealed that practices made the changes recommended in the toolkit to encourage patients to bring medications to office visits. Evaluation before and after implementation revealed a 3-fold increase in the percentage of patients who brought all their prescription medications and a 6-fold increase in the number of prescription medications brought to office visits. The percentage of reviews in which drug therapy problems were identified doubled, as did the percentage of medication regimens revised. Conclusions: Use of the Health Literacy Universal Precautions Toolkit can help to identify drug therapy problems. C1 [Weiss, Barry D.] Univ Arizona, Dept Family & Community Med, Tucson, AZ 85724 USA. [Brega, Angela G.; Albright, Karen] Colorado Sch Publ Hlth, Dept Community & Behav Hlth, Aurora, CO USA. [Brega, Angela G.; LeBlanc, William G.; Cifuentes, Maribel; West, David R.] Univ Colorado, Dept Family Med, Aurora, CO USA. [Mabachi, Natabhona M.] Amer Acad Family Phys, Kansas City, KS USA. [Barnard, Juliana; Albright, Karen; West, David R.] Univ Colorado, Colorado Hlth Outcomes Program, Aurora, CO USA. [Brach, Cindy] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. RP Weiss, BD (reprint author), Univ Arizona, Dept Family & Community Med, 1450 N Cherry Ave, Tucson, AZ 85724 USA. EM bdweiss@u.arizona.edu FU Agency for Healthcare Research and Quality [HHSA290200710008] FX Support for this work was provided by a contract from the Agency for Healthcare Research and Quality (HHSA290200710008 to DRW). NR 12 TC 1 Z9 2 U1 1 U2 7 PU AMER BOARD FAMILY MEDICINE PI LEXINGTON PA 2228 YOUNG DR, LEXINGTON, KY 40505 USA SN 1557-2625 EI 1558-7118 J9 J AM BOARD FAM MED JI J. Am. Board Fam. Med. PD JAN-FEB PY 2016 VL 29 IS 1 BP 18 EP 23 DI 10.3122/jabfm.2016.01.150163 PG 6 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DA9ZW UT WOS:000368169400005 PM 26769873 ER PT J AU Strobino, DM Ahmed, S Mistry, K Wasserman, E Hossain, MB Minkovitz, C AF Strobino, Donna M. Ahmed, Saifuddin Mistry, Kamila Wasserman, Ellen Hossain, Mian B. Minkovitz, Cynthia TI Maternal Depressive Symptoms and Attained Size Among Children in the First 2 Years of Life SO ACADEMIC PEDIATRICS LA English DT Article DE depressive symptoms; growth; maternal; young children ID FAILURE-TO-THRIVE; POSTNATAL DEPRESSION; NUTRITIONAL-STATUS; BIRTH COHORT; GROWTH; PREVALENCE; OUTCOMES; HEALTH; IMPACT; METAANALYSIS AB OBJECTIVE: To evaluate the relation of maternal depressive symptoms with attained size and whether it is stronger for young children in low-income families. METHODS: Secondary analysis was performed of longitudinal data from enrollment and parents surveys from the Healthy Steps for Young Children National Evaluation among 4745 children who made at least one visit to a Healthy Steps site. Length and weight data from medical records were converted to z scores and percentiles for length for age and weight for length at 6, 12, and 24 months using 2000 Centers for Disease Control and Prevention growth standards. Analyses evaluated the relation of maternal depressive symptoms at 2 to 4 months using a modified 14-item Center for Epidemiologic Depression Scale with attained size and child, maternal, and family characteristics. Regression models estimated the relation of symptoms with z scores and logistic regression the relation for short stature (below 10th percentile for length for age), adjusted for covariates. RESULTS: Maternal depressive symptoms were associated with z scores for length for age at 6, 12, and 24 months and short stature at 6 and 24 months for children in low/middle-income families. The z scores at 24 months remained significantly lower for children in low/middle-income families whose mothers reported depressive symptoms, after adjustment for covariates. The odds of short stature were significantly increased at 6 months in the total sample and among low/middle-income families for children whose mothers reported symptoms. Other measures of attained size were not associated with depressive symptoms. CONCLUSIONS: The link between maternal symptoms and young children's risk of short stature reinforces recommendations for increased screening for postpartum depressive symptoms and for clinicians to review growth charts, with parents for impaired/unfavorable patterns. C1 [Strobino, Donna M.; Ahmed, Saifuddin; Minkovitz, Cynthia] Johns Hopkins Bloomberg Sch Publ Hlth, Populat Family & Reprod Hlth, Baltimore, MD 21205 USA. [Wasserman, Ellen] Johns Hopkins Childrens Ctr, Dept Pediat, Baltimore, MD USA. [Hossain, Mian B.] Morgan State Univ, Dept Publ Hlth Anal, Baltimore, MD 21239 USA. [Mistry, Kamila] Agcy Hlth Care Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD USA. RP Strobino, DM (reprint author), Johns Hopkins Bloomberg Sch Publ Hlth, Populat Family & Reprod Hlth, 615 N Wolfe St,E4650, Baltimore, MD 21205 USA. EM dstrobi1@jhu.edu FU Research Program, MCHB, HRSA [R40MC03602-01-0]; Commonwealth Fund for the Healthy Steps Evaluation FX Funded in part by grant R40MC03602-01-0 (Donna Strobino, principal investigator), Research Program, MCHB, HRSA, and the Commonwealth Fund for the Healthy Steps Evaluation (Bernard Guyer, principal investigator). The funders had no involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. NR 39 TC 0 Z9 0 U1 2 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD JAN-FEB PY 2016 VL 16 IS 1 BP 75 EP 81 PG 7 WC Pediatrics SC Pediatrics GA DA4GN UT WOS:000367758300011 PM 26498256 ER PT J AU Moy, E Coffey, RM Moore, BJ Barrett, ML Hall, KK AF Moy, Ernest Coffey, Rosanna M. Moore, Brian J. Barrett, Marguerite L. Hall, Kendall K. TI Length of stay in EDs: variation across classifications of clinical condition and patient discharge disposition SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID EMERGENCY-DEPARTMENT VISITS; ADMISSIONS; OCCUPANCY; OUTCOMES; CARE AB Study objective: Duration of a stay in an emergency department (ED) is considered a measure of quality, but current measures average lengths of stay across all conditions. Previous research on ED length of stay has been limited to a single condition or a few hospitals. We use a census of one state's data to measure length of ED stays by patients' conditions and dispositions and explore differences between means and medians as quality metrics. Methods: The data source was the Healthcare Cost and Utilization Project 2011 State Emergency Department Databases and State Inpatient Databases for Florida. Florida is unique in collecting ED length of stay for both released and admitted patients. Clinical Classifications Software was used to group visits based on first-listed International Classification of Disease, Ninth Edition, Clinical Modification, diagnoses. Results: For the 10 most common diagnoses, patients with relatively minor injuries typically required the shortest mean stay (3 hours or less); conditions resulting in admission or transfer tended to be more serious, resulting in longer stays. Patients requiring the longest stays, by disposition, had discharge diagnoses of nonspecific chest pain (mean 7.4 hours among discharged patients), urinary tract infections (4.8 hours among admissions), and schizophrenia (9.6 hours among transfers) among the top 10 diagnoses. Conclusion: Emergency department length of stay as a measure of ED quality should take into account the considerable variation by condition and disposition of the patient. Emergency department length of stay measurement could be improved in the United States by standardizing its definition; distinguishing visits involving treatment, observation, and boarding; and incorporating more distributional information. (C) 2015 Elsevier Inc. All rights reserved. C1 [Moy, Ernest] Ctr Qual Improvement & Patient Safety, Agcy Healthcare Res & Qual, Rockville, MD USA. [Coffey, Rosanna M.] Truven Hlth Analyt, Bethesda, MD USA. [Moore, Brian J.] Truven Hlth Analyt, Ann Arbor, MI 48108 USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Hall, Kendall K.] MedStar Hlth, Washington, DC USA. RP Moore, BJ (reprint author), Truven Hlth Analyt, 777 E Eisenhower Pkwy, Ann Arbor, MI 48108 USA. EM brian.moore@truvenhealth.com FU Agency for Healthcare Research and Quality [HHSA-290-2013-00002-C] FX This study was funded by the Agency for Healthcare Research and Quality under a contract to Truven Health Analytics to develop and support the Healthcare Cost and Utilization Project (contract no. HHSA-290-2013-00002-C). The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality or the US Department of Health and Human Services. NR 27 TC 1 Z9 1 U1 3 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0735-6757 EI 1532-8171 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD JAN PY 2016 VL 34 IS 1 BP 83 EP 87 DI 10.1016/j.ajem.2015.09.031 PG 5 WC Emergency Medicine SC Emergency Medicine GA CY1IH UT WOS:000366159400017 PM 26603268 ER PT J AU Fan, T Feaginsfletcher, H AF Fan, Tina Feaginsfletcher, Heather TI Screening for Iron Deficiency Anemia in Young Children SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Feaginsfletcher, Heather] Uniformed Serv Univ Hlth Sci, Gen Prevent Med Resident, Bethesda, MD 20814 USA. RP Fan, T (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD DEC 15 PY 2015 VL 92 IS 12 BP 1103 EP 1104 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DB9XU UT WOS:000368871800008 PM 26760597 ER PT J AU Furukawa, MF King, J Patel, V AF Furukawa, Michael F. King, Jennifer Patel, Vaishali TI Physician Attitudes on Ease of Use of EHR Functionalities Related to Meaningful Use SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID ELECTRONIC HEALTH RECORD; PRIMARY-CARE; INFORMATION-TECHNOLOGY; SATISFACTION; IMPLEMENTATION; SYSTEMS; PROVIDERS; BENEFITS; SAFETY; COMMON AB Objectives: To assess physician attitudes on ease of use of electronic health record (EHR) functionalities related to "Meaningful Use" (MU) and whether perceived ease of use was associated with EHR characteristics, including meeting MU criteria, technical assistance from EHR vendors or regional extension centers, and the amount of clinical staff training. Study Design: A cross sectional analysis of the 2011 Physician Workflow study, nationally representative of US office-based physicians. Methods: Cross-sectional data were used to examine physician attitudes on ease of use of 14 EHR functionalities related to MU, among physicians with any EHR system. Results: For 11 of the 14 EHR functions examined, physicians with EHRs that met MU criteria were significantly more likely than physicians that also utilized EHR systems to report that EHR functions were easy to use. For 8 of the functions examined, physicians receiving technical assistance from a vendor or regional extension center were significantly more likely to report that the EHR function was easy to use. Conclusions: Our study of a nationally representative survey of office-based physicians found that physicians' adoption and perceived ease of use of EHR functionalities related to MU was generally high. C1 [Furukawa, Michael F.] Agcy Healthcare Res & Qual, 5600 Fishers Ln, Rockville, MD 20857 USA. [King, Jennifer] Aledade, Bethesda, MD USA. [Patel, Vaishali] Off Natl Coordinator Hlth Informat Technol, Washington, DC USA. RP Furukawa, MF (reprint author), Agcy Healthcare Res & Qual, 5600 Fishers Ln, Rockville, MD 20857 USA. EM Michael.Furukawa@ahrq.hhs.gov NR 36 TC 0 Z9 0 U1 1 U2 3 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD DEC PY 2015 VL 21 IS 12 BP E684 EP + PG 12 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA DC7GQ UT WOS:000369388100009 PM 26760432 ER PT J AU Kronick, R Casalino, LP Bindman, AB AF Kronick, Richard Casalino, Lawrence P. Bindman, Andrew B. TI Apple Pickers or Federal Judges: Strong versus Weak Incentives in Physician Payment SO HEALTH SERVICES RESEARCH LA English DT Editorial Material ID HEALTH-CARE; PERFORMANCE; MEDICARE; RISKS C1 [Kronick, Richard] Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20815 USA. [Casalino, Lawrence P.] Weill Cornell Med Coll, Dept Healthcare Policy & Res, New York, NY USA. [Bindman, Andrew B.] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. [Bindman, Andrew B.] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Bindman, Andrew B.] Univ Calif San Francisco, PRL Inst Hlth Policy Studies, San Francisco, CA 94143 USA. RP Kronick, R (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20815 USA. EM richard.kronick@ahrq.hhs.gov FU Agency for HealthCare Research and Quality FX This project is funded by the Agency for HealthCare Research and Quality. NR 17 TC 2 Z9 2 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 2015 VL 50 SU 2 BP 2049 EP 2056 DI 10.1111/1475-6773.12424 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA DB7VW UT WOS:000368725900001 PM 26769059 ER PT J AU Cherney, AR Marin, JR Brown, J Anise, A Krosnick, S Henriksen, K Lewis, RJ Mills, AM AF Cherney, Alan R. Marin, Jennifer R. Brown, Jeremy Anise, Ayodola Krosnick, Steven Henriksen, Kerm Lewis, Roger J. Mills, Angela M. TI Funding Research in Emergency Diagnostic Imaging: Summary of a Panel Discussion at the 2015 Academic Emergency Medicine Consensus Conference SO ACADEMIC EMERGENCY MEDICINE LA English DT Article; Proceedings Paper CT Academic-Emergency-Medicine (AEM) Consensus Conference CY MAY 12, 2015 CL San Diego, CA SP Acad Emergency Med ID HEALTH-CARE RESEARCH; AGENCY AB As part of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," a panel of representatives from the National Institute of Health's Office of Emergency Care Research, the National Institute of Biomedical Imaging and Bioengineering, the Agency for Healthcare Research and Quality, and the Patient-Centered Outcomes Research Institute was assembled to discuss future opportunities for funding research in this particular area of interest. Representatives from these agencies and organizations discussed their missions and priorities and how they distribute funding. They also addressed questions on mechanisms for new and established researchers to secure future funding. (C) 2015 by the Society for Academic Emergency Medicine C1 [Cherney, Alan R.] Lehigh Valley Hlth Network, Dept Emergency Med, Allentown, PA USA. [Marin, Jennifer R.] Univ Pittsburgh, Sch Med, Dept Pediat, Pittsburgh, PA 15261 USA. [Marin, Jennifer R.] Univ Pittsburgh, Sch Med, Dept Emergency Med, Pittsburgh, PA USA. [Brown, Jeremy] Natl Inst Hlth Off Emergency Care Res, Bethesda, MD USA. [Anise, Ayodola] Patient Ctr Outcomes Res Inst, Addressing Dispar Program, Washington, DC USA. [Krosnick, Steven] Natl Inst Biomed Imaging & Bioengn, Bethesda, MD USA. [Henriksen, Kerm] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Human Factors Advisor Patient Safety, Rockville, MD USA. [Lewis, Roger J.] Harbor UCLA Med Ctr, Dept Emergency Med, Torrance, CA 90509 USA. [Mills, Angela M.] Univ Penn, Dept Emergency Med, Perelman Sch Med, Philadelphia, PA 19104 USA. RP Mills, AM (reprint author), Univ Penn, Dept Emergency Med, Perelman Sch Med, Philadelphia, PA 19104 USA. EM millsa@uphs.upenn.edu FU Agency for Healthcare Research and Quality [R13HS023498-01]; Agency for Healthcare Research and Quality (AHRQ) [1R13HS023498-01]; National Institute of Biomedical Imaging and Bioengineering [1 R13 EB 019813-01] FX Dr. Marin was supported by the Agency for Healthcare Research and Quality (R13HS023498-01); receives support as teaching faculty for 3rd Rock Ultrasound, LLC; and has served as a consultant for Venaxis, Inc.; Funding for this conference was made possible (in part) by grant number 1R13HS023498-01 from the Agency for Healthcare Research and Quality (AHRQ) and grant number 1 R13 EB 019813-01 from the National Institute of Biomedical Imaging and Bioengineering. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. NR 12 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1069-6563 EI 1553-2712 J9 ACAD EMERG MED JI Acad. Emerg. Med. PD DEC PY 2015 VL 22 IS 12 SI SI BP 1400 EP 1405 DI 10.1111/acem.12825 PG 6 WC Emergency Medicine SC Emergency Medicine GA DA5FP UT WOS:000367828900006 PM 26567519 ER PT J AU Lipton, BJ Decker, SL AF Lipton, Brandy J. Decker, Sandra L. TI The effect of health insurance coverage on medical care utilization and health outcomes: Evidence from Medicaid adult vision benefits SO JOURNAL OF HEALTH ECONOMICS LA English DT Article DE Health insurance; Medicaid expansions; Vision care ID QUALITY-OF-LIFE; VISUAL IMPAIRMENT; UNITED-STATES; REFRACTIVE ERROR; IMPACT; CHILDREN; AVAILABILITY; ELIGIBILITY; EXPANSIONS; PREVALENCE AB Increasing the proportion of adults that have regular, comprehensive eye exams and reducing visual impairment due to uncorrected refractive error and other common eye health problems are federal health objectives. We examine the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. Using a difference-in-difference-in-difference approach, we find that Medicaid beneficiaries with vision coverage are 4.4 percentage points (p <0.01) more likely to have seen an eye doctor in the past year, 5.3 percentage points (p <0.01) less likely to report needing but not purchasing eyeglasses or contacts due to cost, 2.0 percentage points (p <0.05) less likely to report difficulty seeing with usual vision correction, and 1.2 percentage points (p <0.01) less likely to have a functional limitation due to vision. (C) 2015 Elsevier B.V. All rights reserved. C1 [Lipton, Brandy J.; Decker, Sandra L.] Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Lipton, BJ (reprint author), Social & Sci Syst Inc, Agcy Healthcare Res & Qual, 5600 Fishers Lane,07W41A, Rockville, MD 20857 USA. EM Brandy.lipton@ahrq.hhs.gov NR 49 TC 1 Z9 1 U1 2 U2 10 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-6296 EI 1879-1646 J9 J HEALTH ECON JI J. Health Econ. PD DEC PY 2015 VL 44 BP 320 EP 332 DI 10.1016/j.jhealeco.2015.10.006 PG 13 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA CZ9HI UT WOS:000367408200023 PM 26588999 ER PT J AU Jacobs, PD Banthin, JS Trachtman, S AF Jacobs, Paul D. Banthin, Jessica S. Trachtman, Samuel TI Insurer Competition In Federally Run Marketplaces Is Associated With Lower Premiums SO HEALTH AFFAIRS LA English DT Article AB Federal subsidies for health insurance premiums sold through the Marketplaces are tied to the cost of the benchmark plan, the second-lowest-cost silver plan. According to economic theory, the presence of more competitors should lead to lower premiums, implying smaller federal outlays for premium subsidies. The long-term impact of the Affordable Care Act on government spending will depend on the cost of these premium subsidies over time, with insurer participation and the level of competition likely to influence those costs. We studied insurer participation and premiums during the first two years of the Marketplaces. We found that the addition of a single insurer in a county was associated with a 1.2 percent lower premium for the average silver plan and a 3.5 percent lower premium for the benchmark plan in the federally run Marketplaces. We found that the effect of insurer entry was muted after two or three additional entrants. These findings suggest that increased insurer participation in the federally run Marketplaces reduces federal payments for premium subsidies. C1 [Jacobs, Paul D.] Agcy Healthcare Res & Qual, Div Res & Modeling, Rockville, MD 20857 USA. [Banthin, Jessica S.; Trachtman, Samuel] Congress Budget Off, Hlth Retirement & Long Term Anal Div, Washington, DC USA. RP Jacobs, PD (reprint author), Agcy Healthcare Res & Qual, Div Res & Modeling, Rockville, MD 20857 USA. EM Paul.Jacobs@ahrq.hhs.gov NR 17 TC 1 Z9 1 U1 2 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD DEC PY 2015 VL 34 IS 12 BP 2027 EP 2035 DI 10.1377/hlthaff.2015.0548 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CY9KB UT WOS:000366724700004 PM 26643622 ER PT J AU Vistnes, J Selden, TM Zawacki, A AF Vistnes, Jessica Selden, Thomas M. Zawacki, Alice TI Several Factors Responsible For The Recent Slowdown In Premium Growth In Employer-Sponsored Insurance SO HEALTH AFFAIRS LA English DT Article ID HEALTH SPENDING GROWTH; ECONOMY AB Containing growth in health care spending is important to the long-term fiscal health of the United States. Researchers have been seeking to identify which factors behind the recent spending slowdown might continue to have an impact after the economy has fully recovered from the Great Recession (2007-09). We extended this inquiry by decomposing trends in the growth of private-sector employer-sponsored insurance premiums. Using data for 2001-13 from the Medical Expenditure Panel Survey-Insurance Component and a combination of cell-and regression-based decomposition methods, we found that the slowdown in premium growth that preceded the recession reflected declining growth rates in per policyholder premiums. For 2009-11, however, the dominant contributors to the slowdown were factors underlying declining employee enrollment: a sharp downturn in employment in 2009, followed by eroding offer and eligibility rates. Growth in per policyholder premiums slowed in 2012 and 2013 compared to the preceding few years. Like other researchers, we found that a substantial portion of premium growth remained unexplained. However, it is likely driven, in part, by growth in the underlying cost of medical care. C1 [Vistnes, Jessica] AHRQ, Rockville, MD 20857 USA. [Selden, Thomas M.] AHRQ, Div Res & Modeling, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Zawacki, Alice] Census Bur, Washington, DC USA. RP Vistnes, J (reprint author), AHRQ, Rockville, MD 20857 USA. EM Jessica.Vistnes@ahrq.hhs.gov NR 22 TC 0 Z9 0 U1 0 U2 0 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD DEC PY 2015 VL 34 IS 12 BP 2036 EP 2043 DI 10.1377/hlthaff.2015.0436 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CY9KB UT WOS:000366724700005 PM 26643623 ER PT J AU Hellinger, FJ AF Hellinger, Fred J. TI In Four ACA Expansion States, The Percentage Of Uninsured Hospitalizations For People With HIV Declined, 2012-14 SO HEALTH AFFAIRS LA English DT Article ID PNEUMOCYSTIS-CARINII-PNEUMONIA; ANTIRETROVIRAL THERAPY; HEALTH-INSURANCE; MORTALITY; CARE; MEDICAID; AIDS; EXPERIENCE; INFECTION; SURVIVAL AB This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. I used data from the State Inpatient Databases of the Healthcare Cost and Utilization Project for all hospitalizations of patients with HIV from 2012 through the first six months of 2014 in four states that expanded their Medicaid programs and two states that did not. I found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent. I also found that hospitalized patients with HIV who did not have insurance were 40 percent more likely to die during their hospital stays than comparable patients with insurance. C1 [Hellinger, Fred J.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20857 USA. RP Hellinger, FJ (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20857 USA. EM fred.hellinger@ahrq.hhs.gov NR 38 TC 0 Z9 0 U1 5 U2 8 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD DEC PY 2015 VL 34 IS 12 BP 2061 EP 2068 DI 10.1377/hlthaff.2015.0718 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CY9KB UT WOS:000366724700008 PM 26643626 ER PT J AU Selden, TM Karaca, Z Keenan, P White, C Kronick, R AF Selden, Thomas M. Karaca, Zeynal Keenan, Patricia White, Chapin Kronick, Richard TI DATAWATCH The Growing Difference Between Public And Private Payment Rates For Inpatient Hospital Care SO HEALTH AFFAIRS LA English DT Article ID EXPENDITURE PANEL SURVEY; INFORMATION-RESOURCE; COST-SHIFT; CONSOLIDATION AB The difference between private and public (Medicare and Medicaid) payment rates for inpatient hospital stays widened between 1996 and 2012. Medical Expenditure Panel Survey data reveal that standardized private insurer payment rates in 2012 were approximately 75 percent greater than Medicare's-a sharp increase from the differential of approximately 10 percent in the period 1996-2001. C1 [Selden, Thomas M.] AHRQ, Div Res & Modeling, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. [Karaca, Zeynal] AHRQ, Div Markets & Econ Res, Ctr Delivery Org & Markets, Rockville, MD USA. [Keenan, Patricia; Kronick, Richard] AHRQ, Rockville, MD USA. [White, Chapin] RAND Corp, Arlington, VA USA. RP Selden, TM (reprint author), AHRQ, Div Res & Modeling, Ctr Financing Access & Cost Trends, Rockville, MD 20857 USA. EM Thomas.Selden@ahrq.hhs.gov NR 23 TC 3 Z9 3 U1 1 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD DEC PY 2015 VL 34 IS 12 BP 2147 EP 2150 DI 10.1377/hlthaff.2015.0706 PG 4 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CY9KB UT WOS:000366724700018 PM 26643636 ER PT J AU Hartling, L Guise, JM Kato, E Anderson, J Belinson, S Berliner, E Dryden, DM Featherstone, R Mitchell, MD Motu'apuaka, M Noorani, H Paynter, R Robinson, KA Schoelles, K Umscheid, CA Whitlock, E AF Hartling, Lisa Guise, Jeanne-Marie Kato, Elisabeth Anderson, Johanna Belinson, Suzanne Berliner, Elise Dryden, Donna M. Featherstone, Robin Mitchell, Matthew D. Motu'apuaka, Makalapua Noorani, Hussein Paynter, Robin Robinson, Karen A. Schoelles, Karen Umscheid, Craig A. Whitlock, Evelyn TI A taxonomy of rapid reviews links report types and methods to specific decision-making contexts SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Review DE Systematic reviews; Rapid reviews; Methodology; Interviews; Stakeholders; Automation ID SYSTEMATIC REVIEWS; PRODUCTS; MAKERS AB Objectives: Describe characteristics of rapid reviews and examine the impact of methodological variations on their reliability and validity. Study Design and Setting: We conducted a literature review and interviews with organizations that produce rapid reviews or related products to identify methods, guidance, empiric evidence, and current practices. Results: We identified 36 rapid products from 20 organizations (production time, 5 minutes to 8 months). Methods differed from systematic reviews at all stages. As time frames increased, methods became more rigorous; however, restrictions on database searching, inclusion criteria, data extracted, and independent dual review remained. We categorized rapid products based on extent of synthesis. "Inventories" list what evidence is available. "Rapid responses" present best available evidence with no formal synthesis. "Rapid reviews" synthesize the quality of and findings from the evidence. "Automated approaches" generate meta-analyses in response to user-defined queries. Rapid products rely on a close relationship with end users and support specific decisions in an identified time frame. Limited empiric evidence exists comparing rapid and systematic reviews. Conclusions: Rapid products have tremendous methodological variation; categorization based on time frame or type of synthesis reveals patterns. The similarity across rapid products lies in the close relationship with the end user to meet time-sensitive decision-making needs. (C) 2015 Elsevier Inc. All rights reserved. C1 [Hartling, Lisa; Dryden, Donna M.; Featherstone, Robin] Univ Alberta, Dept Pediat, Edmonton, AB, Canada. [Guise, Jeanne-Marie; Anderson, Johanna; Motu'apuaka, Makalapua; Paynter, Robin] Portland VA Res Fdn, Sci Resource Ctr, AHRQ Effect Hlth Care Program, Portland VA Med Ctr, Portland, OR USA. [Kato, Elisabeth; Berliner, Elise] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD USA. [Belinson, Suzanne; Noorani, Hussein] Blue Cross Blue Shield Assoc, Off Clin Affairs, Chicago, IL USA. [Mitchell, Matthew D.; Schoelles, Karen; Umscheid, Craig A.] Univ Penn, ECRI Inst, Penn Med AHRQ EPC, Philadelphia, PA 19104 USA. [Mitchell, Matthew D.; Schoelles, Karen; Umscheid, Craig A.] Univ Penn, Ctr Evidence Based Practice, Philadelphia, PA 19104 USA. [Mitchell, Matthew D.; Schoelles, Karen; Umscheid, Craig A.] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. [Robinson, Karen A.] Johns Hopkins Univ, Dept Med, Baltimore, MD USA. [Whitlock, Evelyn] Kaiser Permanente Res Affiliates, Portland, OR USA. RP Hartling, L (reprint author), 4-472 ECHA,11405-87 Ave, Edmonton, AB T6G IC9, Canada. EM hartling@ualberta.ca RI Featherstone, Robin/J-5165-2014; OI Featherstone, Robin/0000-0003-2517-2258; Paynter, Robin/0000-0002-6969-4261 FU Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland [290-2012-00013-I, 290-2012-00010-I, 290-2012-00011-I, 290-2012-00015-I, 290-2012-00007-I, 290201200004C] FX This manuscript is based on a project conducted by a working group with the Evidence-based Practice Center Program supported by the Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland through contracts to the following Evidence-based Practice Centers: University of Alberta (290-2012-00013-I), Blue Cross Blue Shield (290-2012-00010-I), ECRI- Penn (290-2012-00011-I), Kaiser (290-2012-00015-I), The Johns Hopkins University (290-2012-00007-I), and the Scientific Resource Center for the EPC Program (290201200004C). The findings and conclusions in this manuscript are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. No statement in this manuscript should be construed as an official position of AHRQ or of the US Department of Health and Human Services. NR 21 TC 5 Z9 5 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 EI 1878-5921 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2015 VL 68 IS 12 BP 1451 EP 1462 DI 10.1016/j.jclinepi.2015.05.036 PG 12 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CY6TR UT WOS:000366542200010 PM 26278023 ER PT J AU Guy, GP Yabroff, KR Ekwueme, DU Virgo, KS Han, XS Banegas, MP Soni, A Zheng, ZY Chawla, N Geiger, AM AF Guy, Gery P., Jr. Yabroff, K. Robin Ekwueme, Donatus U. Virgo, Katherine S. Han, Xuesong Banegas, Matthew P. Soni, Anita Zheng, Zhiyuan Chawla, Neetu Geiger, Ann M. TI Healthcare Expenditure Burden Among Non-elderly Cancer Survivors, 2008-2012 SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID 2ND PRIMARY CANCERS; BREAST-CANCER; UNITED-STATES; NATIONAL-SURVEY; MEDICAL-CARE; COST; THERAPY; ADULTS; ONCOLOGISTS; MAMMOGRAPHY AB Introduction: There is increasing concern regarding the financial burden of cancer on patients and their families. This study presents nationally representative estimates of annual out-of-pocket (OOP) burden among non-elderly cancer survivors and assesses the association between high OOP burden and access to care and preventive service utilization. Methods: Using the 2008-2012 Medical Expenditure Panel Survey, 4,271 cancer survivors and 96,780 individuals without a history of cancer were identified, all aged 18-64 years. High annual OOP burden was defined as spending >20% of annual family income on OOP healthcare costs. Associations between high OOP burden and access to care were evaluated with multivariable logistic regression. Analyses were conducted in 2015. Results: Compared with individuals without a cancer history, cancer survivors were more likely to report a high OOP burden (4.3% vs 3.4%, p=0.009) in adjusted analyses. High OOP burden was more common among cancer survivors who were poor (18.4%), with either public insurance (7.9%) or uninsured (5.7%), and not working (10.2%). Among cancer survivors, high OOP burden was associated with being unable to obtain necessary medical care (19.2% vs 12.5%, p=0.002), delaying necessary medical care (21.6% vs 13.8%, p=0.002), and lower breast cancer screening rates among age-appropriate women (63.2% vs 75.9%, p=0.02). Conclusions: High OOP burden is more common among adults with a cancer history than those without a cancer history. High OOP burden was associated with being unable to obtain necessary medical care, delaying necessary medical care, and lower breast cancer screening rates among women. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine. C1 [Guy, Gery P., Jr.; Ekwueme, Donatus U.] CDC, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. [Yabroff, K. Robin; Geiger, Ann M.] NCI, Healthcare Delivery Res Program, Div Canc Control & Populat Sci, Rockville, MD USA. [Virgo, Katherine S.] Emory Univ, Dept Hlth Policy & Management, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. [Han, Xuesong; Zheng, Zhiyuan] Amer Canc Soc, Surveillance & Hlth Serv Res Program, Atlanta, GA 30329 USA. [Banegas, Matthew P.] Kaiser Permanente Northwest, Ctr Hlth Res, Portland, OR USA. [Soni, Anita] Ctr Financing Access & Cost Trends, Agcy Healthcare Res & Qual, Rockville, MD USA. [Chawla, Neetu] Kaiser Permanente No Calif, Div Res, Oakland, CA USA. RP Guy, GP (reprint author), CDC, Div Canc Prevent & Control, 4770 Buford Highway NE,MS K-76, Atlanta, GA 30341 USA. EM irm2@cdc.gov FU Centers for Disease Control and Prevention, Division of Cancer Prevention and Control FX Publication of this article was supported by the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control. NR 36 TC 6 Z9 6 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD DEC PY 2015 VL 49 IS 6 SU 5 BP S489 EP S497 DI 10.1016/j.amepre.2015.09.002 PG 9 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA CW5UH UT WOS:000365061600005 PM 26590644 ER PT J AU Andrews, RM Moy, E AF Andrews, Roxanne M. Moy, Ernest TI RACIAL DIFFERENCES IN HOSPITAL MORTALITY FOR MEDICAL AND SURGICAL ADMISSIONS: VARIATIONS BY PATIENT AND HOSPITAL CHARACTERISTICS SO ETHNICITY & DISEASE LA English DT Article DE Race; Hospital Care; Hospital Mortality ID HEALTH-CARE-SYSTEM; ETHNIC DISPARITIES; VETERANS; OUTCOMES; SURGERY; VOLUME AB Objective: To determine if there are disparities between White and Black inpatient mortality rates for specific medical and surgical conditions and whether disparities vary by patient and hospital subgroups. Design, Setting, Participants: All-payer discharge records in the 2009 Healthcare Cost and Utilization Project, State Inpatient Databases (SID) for 36 states that comprised about 80% of the Black and White populations in the United States were used to create a random, stratified sample of about 1,900 community hospitals (a 40% sample of US hospitals). All discharges in the hospitals were included and weighted for national estimates. Main Outcome Measures: Inpatient Quality Indicators, developed by the Agency for Healthcare Research and Quality, were used to measure risk-adjusted hospital mortality for six medical conditions and four surgeries. National estimates compared non-Hispanic Whites to Blacks by patient and hospital characteristics. Results: Blacks had lower mortality for all medical conditions compared to Whites. However, they had higher mortality rates for two surgical procedures (coronary artery bypass graft and craniotomy) and lower mortality for one surgery (abdominal aortic anuerysm repair). These patterns held for most, though not all, patient and hospital subgroups for medical conditions, but disparities typically varied by subgroup for surgeries. Conclusions: Policymakers and researchers may use these findings in targeting interventions, designing quality reporting programs and designing studies on why the disparities exist and how to reduce them. C1 [Andrews, Roxanne M.; Moy, Ernest] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Moy, E (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM ernest.moy@ahrq.hhs.gov FU AHRQ FX We thank the statewide data organizations participating in the HCUP whose data were used in this study (listed at www.hcup-us.ahrq.gov/partners.jsp). This study was supported by the AHRQ. The authors are responsible for the contents of the article. No statement in this article should be construed as an official position of AHRQ or the United States Department of Health and Human Services. The authors would like to acknowledge the contribution of Marguerite Barrett, MS (M.L. Barrett, Inc.) for managing file preparation and statistical programming support. NR 31 TC 2 Z9 2 U1 0 U2 0 PU INT SOC HYPERTENSION BLACKS-ISHIB PI ATLANTA PA 100 AUBURN AVE NE STE 401, ATLANTA, GA 30303-2527 USA SN 1049-510X EI 1945-0826 J9 ETHNIC DIS JI Ethn. Dis. PD WIN PY 2015 VL 25 IS 1 BP 90 EP 97 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA CU7KV UT WOS:000363717600016 PM 25812258 ER PT J AU Manski, RJ Vargas, CM Brown, E Carper, KV Macek, MD Cohen, LA AF Manski, Richard J. Vargas, Clemencia M. Brown, Erwin Carper, Kelly V. Macek, Mark D. Cohen, Leonard A. TI Dental procedures among children age birth to 20, United States, 1999 and 2009 SO JOURNAL OF PUBLIC HEALTH DENTISTRY LA English DT Article DE children; dental care; dental insurance; health care surveys; poverty; United States; MEPS; dental procedures ID CARE; VISITS AB ObjectiveTo describe dental procedures received by US children and adolescents by poverty status and dental insurance coverage. MethodsData for this analysis came from the 1999 and 2009 Medical Expenditure Panel Surveys. The primary outcome variable represented the types of dental procedures that were received during dental visits in the preceding year. Descriptive variables included dental insurance and poverty status. Analysis was restricted to children from birth to 20 years. ResultsOverall, diagnostic (41.2 percent) and preventive (35.8 percent) procedures accounted for most of the procedures received by children from birth to 20 years of age, while restorative procedures accounted for just 5 percent. Children from low-income families received a higher proportion of restorative procedures than children in higher-income families. The proportion of diagnostic and preventive services was lower among uninsured children than among publicly insured children. Orthodontic services, on the other hand, represented a greater percentage of these procedures among uninsured children than among publicly insured children. DiscussionThe vast majority of procedures received by children from birth to 20 years were diagnostic and preventive. Most children with at least one dental visit received a diagnostic or preventive service. Between 1999 and 2009, the proportion of all services received accounted for by diagnostic or preventive services increased. However, the proportion in which each type of procedure was received by children who made at least one visit who received did not change. C1 [Manski, Richard J.; Macek, Mark D.; Cohen, Leonard A.] Univ Maryland, Sch Dent, Dent Publ Hlth, Baltimore, MD 21201 USA. [Vargas, Clemencia M.] Univ Maryland, Sch Dent, Orthodont & Pediat Dent, Baltimore, MD 21201 USA. [Brown, Erwin] Agcy Healthcare Res & Qual, Div Survey Operat, Rockville, MD USA. [Carper, Kelly V.] Agcy Healthcare Res & Qual, Div Stat Res & Methods, Rockville, MD USA. RP Manski, RJ (reprint author), Univ Maryland, Sch Dent, Dent Publ Hlth, 650 W Baltimore St, Baltimore, MD 21201 USA. EM rmanski@umaryland.edu NR 22 TC 2 Z9 2 U1 0 U2 23 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-4006 EI 1752-7325 J9 J PUBLIC HEALTH DENT JI J. Public Health Dent. PD WIN PY 2015 VL 75 IS 1 BP 10 EP 16 DI 10.1111/jphd.12065 PG 7 WC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health SC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health GA CD2KE UT WOS:000350905900002 PM 24964135 ER PT J AU Lee, KC Payne, CB AF Lee, Karen C. Payne, Chelsea B. TI Screening for Speech and Language Delay and Disorders in Children Five Years and Younger SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Lee, Karen C.] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Payne, Chelsea B.] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Lee, KC (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 2 U2 4 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD NOV 15 PY 2015 VL 92 IS 10 BP 923 EP 924 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA DB5RW UT WOS:000368572300008 PM 26554286 ER PT J AU Groessl, EJ Kaplan, RM Castro, CM Espeland, MA Pahor, M AF Groessl, E. J. Kaplan, R. M. Castro, C. M. Espeland, M. A. Pahor, M. TI COST-EFFECTIVENESS OF THE LIFE-M PHYSICAL ACTIVITY INTERVENTION FOR OLDER ADULTS SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Groessl, E. J.] Univ Calif San Diego, VA San Diego, La Jolla, CA 92093 USA. [Kaplan, R. M.] AHRQ, Rockville, MD USA. [Castro, C. M.] Stanford Univ, Stanford, CA 94305 USA. [Espeland, M. A.] Wake Forest Univ, Winston Salem, NC 27109 USA. [Pahor, M.] Univ Florida, Gainesville, FL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0016-9013 EI 1758-5341 J9 GERONTOLOGIST JI Gerontologist PD NOV PY 2015 VL 55 SU 2 BP 561 EP 561 PG 1 WC Gerontology SC Geriatrics & Gerontology GA DJ5BV UT WOS:000374222702658 ER PT J AU Abdus, S Mistry, KB Selden, TM AF Abdus, Salam Mistry, Kamila B. Selden, Thomas M. TI Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID HEALTH-CARE; PREVENTIVE SERVICES; WOMEN; QUALITY; ACCESS; ADULTS AB Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. C1 [Abdus, Salam] Social & Sci Syst, Silver Spring, MD USA. [Mistry, Kamila B.; Selden, Thomas M.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Selden, TM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM thomas.selden@ahrq.hhs.gov NR 27 TC 4 Z9 4 U1 0 U2 6 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 EI 1541-0048 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD NOV PY 2015 VL 105 SU 5 BP S668 EP S675 DI 10.2105/AJPH.2015.302892 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA DB2KL UT WOS:000368337000009 PM 26447920 ER PT J AU Heslin, KC Gable, A Dobalian, A AF Heslin, Kevin C. Gable, Alicia Dobalian, Aram TI Special Services for Women in Substance Use Disorders Treatment: How Does the Department of Veterans Affairs Compare with Other Providers? SO WOMENS HEALTH ISSUES LA English DT Article ID HEALTH-CARE-DELIVERY; ABUSE TREATMENT; MENTAL-HEALTH; INNOVATION; RETENTION; ADOPTION; PATIENT AB Background: Gender is an important consideration in the treatment of substance use disorders (SUD). Although the number of women seeking care through the Department of Veterans Affairs (VA) has increased dramatically, little is known about the capacity of the VA to meet the needs of women with SUD. We examined the prevalence of programs and key services for women in VA facilities in a survey of 14,311 SUD treatment facilities. Methods: Using data from the 2012 National Survey of Substance Abuse Treatment Services, we calculated the percent of VA facilities offering special programs or groups exclusively for women, compared with facilities under other types of ownership. For each ownership type, we also calculated the mean number of ancillary services offered that are critical for many women in SUD treatment, including child care, domestic violence counseling, and transportation assistance. Multivariable models were used to adjust for differences in other facility characteristics. Findings: Approximately 31% of facilities had special programs exclusively for women. The VA had the lowest prevalence of programs for women, at 19.1%; however, the VA offered an average of 5 key services for women, which was significantly higher than the averages for other federal (n = 2), local (n = 4), and private for-profit (n = 2) facilities. Results were generally robust to multivariable adjustments. Conclusions: The VA should consider developing more SUD programs and groups exclusively for women, while maintaining ancillary services at their relatively abundant level. Gender-specific programs and groups could serve as points of referral to ancillary services for women veterans. Published by Elsevier Inc. on behalf of the Jacobs Institute of Women's Health. C1 [Heslin, Kevin C.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. [Gable, Alicia; Dobalian, Aram] Vet Emergency Management Evaluat Ctr, North Hills, CA USA. RP Heslin, KC (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM kevin.heslin@ahrq.hhs.gov FU Office of Public Health, Veterans Health Administration, Department of Veterans Affairs FX This research was conducted while Kevin Heslin was a research health scientist at the Veterans Health Administration. We acknowledge the support of this research by the Office of Public Health, Veterans Health Administration, Department of Veterans Affairs. The funder played no role in the design or conduct of the study, the collection, management, analysis, or interpretation of the data, or the preparation, review, or approval of the manuscript. NR 28 TC 0 Z9 0 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1049-3867 EI 1878-4321 J9 WOMEN HEALTH ISS JI Womens Health Iss. PD NOV-DEC PY 2015 VL 25 IS 6 BP 666 EP 672 DI 10.1016/j.whi.2015.07.005 PG 7 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA DB1DH UT WOS:000368247700012 PM 26329259 ER PT J AU Pezzin, LE Pollak, RA Schone, BS AF Pezzin, Liliana E. Pollak, Robert A. Schone, Barbara S. TI Bargaining Power, Parental Caregiving, and Intergenerational Coresidence SO JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES LA English DT Article DE Aging; Caregiving; Family bargaining; Intergenerational coresidence ID INTER VIVOS TRANSFERS; LIVING ARRANGEMENTS; ELDERLY PARENTS; UNITED-STATES; ADULT SIBLINGS; HOUSEHOLD; CARE; CHILDREN; LIFE; AGE AB To examine the effect of changes in parent-child coresidence on caregiving decisions of non-resident siblings over a 5-year period while controlling for characteristics of the elderly parent and adult children in the family network. We use difference-in-difference models applied to Health and Retirement Study-Assets and Health Dynamics of the Elderly data to test the hypothesis that the formation of a joint household between a parent and one of her children raises the bargaining power of non-resident siblings, who then reduce their care to the parent. Similarly, the dissolution of a parent-child household is expected to increase the bargaining power of the child who no longer coresides with the parent relative to her siblings. We find that children whose parent and sibling begin coresiding during the study period are less likely to provide care and provide fewer hours of care than children whose parents never coresided with a child. Adult children whose parent cease coresiding with a sibling, on the other hand, have a higher likelihood of providing care and provide significantly more hours of care relative to children whose parents either coresided with a sibling in both time periods or never coresided with a child. Meeting the needs of the growing elderly population while maintaining them in the community is a particular focus of long-term care policy. To the extent that shared living is an important component of such care, the observed sensitivity of non-resident children's caregiving efforts has implications for the well-being of both disabled parents and their coresiding adult children. C1 [Pezzin, Liliana E.] Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA. [Pezzin, Liliana E.] Med Coll Wisconsin, Hlth Policy Inst, Milwaukee, WI 53226 USA. [Pollak, Robert A.] Washington Univ, Olin Business Sch, Dept Econ, St Louis, MO USA. [Schone, Barbara S.] Georgetown Univ, Agcy Healthcare Res & Qual, Washington, DC USA. RP Pezzin, LE (reprint author), Med Coll Wisconsin, Dept Med, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA. EM lpezzin@mcw.edu FU National Institute on Aging [NIA R01 AG025475] FX This work was supported by the National Institute on Aging grant NIA R01 AG025475. NR 53 TC 1 Z9 1 U1 4 U2 8 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1079-5014 EI 1758-5368 J9 J GERONTOL B-PSYCHOL JI J. Gerontol. Ser. B-Psychol. Sci. Soc. Sci. PD NOV PY 2015 VL 70 IS 6 BP 969 EP 980 DI 10.1093/geronb/gbu079 PG 12 WC Geriatrics & Gerontology; Gerontology; Psychology; Psychology, Multidisciplinary SC Geriatrics & Gerontology; Psychology GA CW1VF UT WOS:000364779200017 PM 24994851 ER PT J AU Berkman, ND Lohr, KN Ansari, MT Balk, EM Kane, R McDonagh, M Morton, SC Viswanathan, M Bass, EB Butler, M Gartlehner, G Hartling, L McPheeters, M Morgan, LC Reston, J Sista, P Whitlock, E Chang, S AF Berkman, Nancy D. Lohr, Kathleen N. Ansari, Mohammed T. Balk, Ethan M. Kane, Robert McDonagh, Marian Morton, Sally C. Viswanathan, Meera Bass, Eric B. Butler, Mary Gartlehner, Gerald Hartling, Lisa McPheeters, Melissa Morgan, Laura C. Reston, James Sista, Priyanka Whitlock, Evelyn Chang, Stephanie TI Grading the strength of a body of evidence when assessing health care interventions: an EPC update SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE Evidence-based practice; Methods; Strength of evidence; Systematic reviews; Clinical practice guidelines; Health care delivery; Health policy; Minimally important differences; Optimal information size ID PUBLICATION BIAS; SYSTEMATIC REVIEWS; MEGA-TRIALS; BINARY OUTCOMES; FINDINGS TABLES; QUALITY; METAANALYSIS; PROGRAM; AHRQ; RECOMMENDATIONS AB Objectives: To revise 2010 guidance on grading the strength of evidence (SOB) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions in systematic reviews produced by the Evidence-based Practice Center (EPC) program, established by the US Agency for Healthcare Research and Quality (AHRQ). Study Design and Setting: A cross-EPC working group reviewed authoritative systems for grading SOE [primarily the approach from the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group] and conducted extensive discussions with GRADE and other experts. Results: Updated guidance continues to be conceptually similar to GRADE. Reviewers are to evaluate SOE separately for each major treatment comparison for each major outcome. We added reporting bias as a required domain and retained study limitations (risk of bias), consistency, directness, and precision (and three optional domains). Additional guidance covers scoring consistency, precision, and reporting bias, grading bodies of evidence with randomized controlled trials and observational studies, evaluating single study bodies of evidence, using studies with high risk of bias, and presenting findings with greater clarity and transparency. SOB is graded high, moderate, low, or insufficient, reflecting reviewers' confidence in the findings for a specific treatment comparison and outcome. Conclusion: No single approach for grading SOE suits all reviews, but a more consistent and transparent approach to reporting summary information will make reviews more useful to the broad range of audiences that AHRQ's work aims to reach. EPC working groups will consider ongoing challenges and modify guidance as needed, on issues such as combining trials and observational studies in bodies of evidence, weighting domains, and combining qualitative and quantitative syntheses. (C) 2015 Elsevier Inc. All rights reserved. C1 [Berkman, Nancy D.; Lohr, Kathleen N.; Viswanathan, Meera; Gartlehner, Gerald; Morgan, Laura C.] RTI Int Res Triangle Inst, Div Social Policy Hlth & Econ Res, Res Triangle Pk, NC 27709 USA. [Ansari, Mohammed T.] Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON K1H 8L6, Canada. [Balk, Ethan M.] Brown Univ, Sch Publ Hlth, Ctr Evidence Based Med, Providence, RI 02912 USA. [Kane, Robert; Butler, Mary] Univ Minnesota, Sch Publ Hlth, Minneapolis, MN 55455 USA. [McDonagh, Marian] Oregon Hlth & Sci Univ, Pacific Northwest Evidence Based Practice Ctr, Portland, OR 97239 USA. [Morton, Sally C.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. [Bass, Eric B.] Johns Hopkins Univ, Dept Med, Baltimore, MD 21205 USA. [Bass, Eric B.] Johns Hopkins Univ, Dept Hlth Policy & Management, Baltimore, MD 21205 USA. [Gartlehner, Gerald] Danube Univ, Dept Clin Epidemiol & Evidence Based Med, A-3500 Krems, Austria. [Hartling, Lisa] Univ Alberta, Dept Pediat, Edmonton, AB T6G 1C9, Canada. [McPheeters, Melissa] Vanderbilt Univ, Med Ctr, Dept Hlth Policy, Nashville, TN 37203 USA. [Reston, James] ECRI Inst Headquarters, Evidence Based Practice Ctr, Plymouth Meeting, PA 19462 USA. [Reston, James] ECRI Inst Headquarters, Hlth Technol Assessment Grp, Plymouth Meeting, PA 19462 USA. [Sista, Priyanka] Univ N Carolina, Sch Med, Chapel Hill, NC 27599 USA. [Whitlock, Evelyn] Kaiser Permanente, Ctr Hlth Res, Portland, OR 97227 USA. [Chang, Stephanie] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD 20850 USA. RP Berkman, ND (reprint author), RTI Int Res Triangle Inst, Div Social Policy Hlth & Econ Res, POB 12194,3040 Cornwallis Rd, Res Triangle Pk, NC 27709 USA. EM berkman@rti.org OI Gartlehner, Gerald/0000-0001-5531-3678 FU US Agency for Healthcare Research and Quality (AHRQ) [HHSA-290-2007-10056-I-EPC3, 5] FX This article was supported by a contract award from the US Agency for Healthcare Research and Quality (AHRQ; Contract No. HHSA-290-2007-10056-I-EPC3, Task Order #5) to RTI International (the RTI-University of North Carolina Evidence-based Practice Center). The findings and conclusions expressed here are those of the authors and do not necessarily represent the views of AHRQ or the U.S. Department of Health and Human Services. NR 60 TC 16 Z9 16 U1 3 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 EI 1878-5921 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD NOV PY 2015 VL 68 IS 11 BP 1312 EP 1324 DI 10.1016/j.jclinepi.2014.11.023 PG 13 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CV9NC UT WOS:000364612900008 PM 25721570 ER PT J AU Upadhya, KK Burke, AE Marcell, AV Misty, K Cheng, TL AF Upadhya, Krishna K. Burke, Anne E. Marcell, Arik V. Misty, Kamila Cheng, Tina L. TI Contraceptive service needs of women with young children presenting for pediatric care SO CONTRACEPTION LA English DT Article DE Contraception; Family planning; Preconception health; Pediatrics; Health services ID LOW-INCOME WOMEN; UNITED-STATES; UNINTENDED PREGNANCY; SOCIAL DISPARITIES; ACCESS AB Objectives: The primary objective of this study is to characterize the need for contraceptive services and contraceptive method use among women with young children presenting to child health clinics. A secondary objective is to characterize the factors, including access to care and health needs, that exist in this population and to evaluate their association with contraceptive method use. Study design: This is a cross-sectional study of women with children under age 36 months presenting to four child health practices in the Baltimore, Maryland, area. Participating women completed a survey to assess desire for pregnancy, contraceptive method use and related characteristics. Results: A total of 238 participants (82%) were in need of contraceptive services (fertile and not desiring pregnancy). Overall, 59 (25%) of women in need were not using a contraceptive method (unmet need) and 79 (33%) were using a highly effective method (implant or intrauterine device). Factors associated with lower odds of unmet need for contraceptive services included attendance at a routine postpartum visit and visiting a healthcare provider to discuss contraception after pregnancy. Approximately half of index pregnancies were unintended and this was the only health factor associated with greater odds of using of a highly effective contraceptive method. Conclusions: Most women presenting with young children for pediatric care indicated that they were not currently trying to become pregnant and reported current methods of pregnancy prevention that ranged from none to highly effective. Women who had not sought postpregnancy contraceptive care were more likely to have unmet need for contraceptive services. (C) 2015 Elsevier Inc. All rights reserved. C1 [Upadhya, Krishna K.; Marcell, Arik V.; Misty, Kamila; Cheng, Tina L.] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21287 USA. [Upadhya, Krishna K.; Burke, Anne E.; Marcell, Arik V.; Cheng, Tina L.] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Populat Family & Reprod Hlth, Baltimore, MD 21287 USA. [Burke, Anne E.] Johns Hopkins Univ, Sch Med, Dept Gynecol & Obstet, Baltimore, MD 21224 USA. [Misty, Kamila] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD 20850 USA. RP Upadhya, KK (reprint author), Johns Hopkins Sch Med, 200 N Wolfe St,Room 2060, Baltimore, MD 21287 USA. EM kupadhy2@jhmi.edu; aburke@jhmi.edu; amarcel2@jhmi.edu; kmistry2@jhmi.edu; tcheng2@jhmi.edu OI Upadhya, Krishna/0000-0003-2188-9630 FU Johns Hopkins Health Care; Aetna Foundation; Abell Foundation; Straus Foundation; Zanvyl and Isabelle Krieger Fund; Maternal and Child Health Bureau; National Institute on Minority Health and Health Disparities [P20 MD000198]; Centro Sol: Johns Hopkins Center for Salud/(Health) and Opportunity for Latinos; US Department of Health and Human Services; Agency for Healthcare Research and Quality FX We would like to acknowledge funding support for this project from Johns Hopkins Health Care; Aetna, Abell and Straus Foundations; and The Zanvyl and Isabelle Krieger Fund. This publication was also supported by the Maternal and Child Health Bureau (T.L.C.), DC-Baltimore Research Center on Child Health Disparities P20 MD000198 from the National Institute on Minority Health and Health Disparities and Centro Sol: Johns Hopkins Center for Salud/(Health) and Opportunity for Latinos (T.L.C.). The content is solely the responsibility of the authors and do not necessarily represent the US Department of Health and Human Services or its component, the Agency for Healthcare Research and Quality or the funding agencies. NR 25 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0010-7824 EI 1879-0518 J9 CONTRACEPTION JI Contraception PD NOV PY 2015 VL 92 IS 5 BP 508 EP 512 DI 10.1016/j.contraception.2015.07.004 PG 5 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA CV4YY UT WOS:000364273600014 PM 26197265 ER PT J AU Mukamel, DB Ladd, H Li, Y Temkin-Greener, H Ngo-Metzger, Q AF Mukamel, Dana B. Ladd, Heather Li, Yue Temkin-Greener, Helena Ngo-Metzger, Quyen TI Have Racial Disparities in Ambulatory Care Sensitive Admissions Abated Over Time? SO MEDICAL CARE LA English DT Article DE disparities; quality of care; ambulatory care sensitive conditions ID MEDICAID MANAGED CARE; POTENTIALLY PREVENTABLE HOSPITALIZATIONS; RACE; CAROLINA; ADULTS; REFORM; MATTER; RATES AB Background:Racial disparities in access to care and access to high-quality care have been persistent over many decades. They have been documented in all areas of health care, including ambulatory care. Policy initiatives have been implemented to address disparities and close the gaps in care that minorities face. Less is known about the effectiveness of these polices.Objectives:To evaluate whether disparities in quality of ambulatory care have abated during the decade of 2000 by answering 2 questions: (1) were there differences in ambulatory care sensitive hospital admissions rates by race?; (2) have these differences been declining over time?Research Design:Multivariable linear regressions with fixed county effects and robust SEs of longitudinal panel data.Subjects:A total of 4,032,322 discharges in 172 counties in 6 states during 2003-2009.Measures:Prevention Quality Indicators (PQIs) developed by the Agency for Healthcare Research and Quality, by county, and race calculated from the Healthcare Cost and Utilization Project dataset.Results:In 2003 the overall PQI admission rates were higher for African Americans (around 16.5/1000) than for whites (around 15/1000). By 2009, the overall and the chronic PQI admission rates declined significantly (P<0.01) for whites. They either did not decline or increased for African Americans. Acute PQI rates declined significantly for whites and remained stable for African Americans.Conclusions:Policies addressing persisting racial disparities in quality of ambulatory care for African Americans should focus on the chronic PQIs. In addition, efforts should be made to improve data quality for race and ethnicity information on hospital discharge data to enable informed policy evaluation and planning. C1 [Mukamel, Dana B.; Ladd, Heather] Univ Calif Irvine, Dept Med, Irvine, CA 92697 USA. [Li, Yue; Temkin-Greener, Helena] Univ Rochester, Sch Med, Dept Publ Hlth Sci, Rochester, NY USA. [Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Mukamel, DB (reprint author), Univ Calif Irvine, Dept Med, 100 Theory,Suite 100, Irvine, CA 92697 USA. EM dmukamel@uci.edu FU NIH/NIMHD [R01 MD007662] FX Supported by NIH/NIMHD Grant # R01 MD007662. NR 32 TC 1 Z9 1 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD NOV PY 2015 VL 53 IS 11 BP 931 EP 939 DI 10.1097/MLR.0000000000000426 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CU2TL UT WOS:000363376400004 PM 26421373 ER PT J AU Shrestha, S Foxman, B Berus, J van Panhuis, WG Steiner, C Viboud, C Rohani, P AF Shrestha, Sourya Foxman, Betsy Berus, Joshua van Panhuis, Willem G. Steiner, Claudia Viboud, Cecile Rohani, Pejman TI The role of influenza in the epidemiology of pneumonia SO SCIENTIFIC REPORTS LA English DT Article ID HONG-KONG INFLUENZA; PNEUMOCOCCAL PNEUMONIA; BACTERIAL PNEUMONIA; STREPTOCOCCUS-PNEUMONIAE; STAPHYLOCOCCUS-AUREUS; LETHAL SYNERGISM; UNITED-STATES; MOUSE MODEL; VIRUS; INFECTION AB Interactions arising from sequential viral and bacterial infections play important roles in the epidemiological outcome of many respiratory pathogens. Influenza virus has been implicated in the pathogenesis of several respiratory bacterial pathogens commonly associated with pneumonia. Though clinical evidence supporting this interaction is unambiguous, its population-level effects-magnitude, epidemiological impact and variation during pandemic and seasonal outbreaks-remain unclear. To address these unknowns, we used longitudinal influenza and pneumonia incidence data, at different spatial resolutions and across different epidemiological periods, to infer the nature, timing and the intensity of influenza-pneumonia interaction. We used a mechanistic transmission model within a likelihood-based inference framework to carry out formal hypothesis testing. Irrespective of the source of data examined, we found that influenza infection increases the risk of pneumonia by similar to 100-fold. We found no support for enhanced transmission or severity impact of the interaction. For model-validation, we challenged our fitted model to make out-of-sample pneumonia predictions during pandemic and non-pandemic periods. The consistency in our inference tests carried out on several distinct datasets, and the predictive skill of our model increase confidence in our overall conclusion that influenza infection substantially enhances the risk of pneumonia, though only for a short period. C1 [Shrestha, Sourya] Univ Michigan, Dept Ecol & Evolutionary Biol, Ann Arbor, MI 48109 USA. [Shrestha, Sourya] Univ Michigan, Ctr Study Complex Syst, Ann Arbor, MI 48109 USA. [Shrestha, Sourya] Johns Hopkins Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 22105 USA. [Foxman, Betsy] Univ Michigan, Dept Epidemiol, Ann Arbor, MI 48109 USA. [Berus, Joshua] Univ Michigan, Undergrad Res Opportun Program, Ann Arbor, MI 48109 USA. [van Panhuis, Willem G.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15261 USA. [Steiner, Claudia] US Dept HHS, Healthcare Cost & Utilizat Project, Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Viboud, Cecile] NIH, Div Int Epidemiol & Populat Studies, Bethesda, MD 20892 USA. [Rohani, Pejman] Univ Georgia, Odum Sch Ecol, Athens, GA 30602 USA. [Rohani, Pejman] Univ Georgia, Sch Vet Med, Dept Infect Dis, Athens, GA 30602 USA. [Rohani, Pejman] NCI, Fogarty Int Ctr, Bethesda, MD 20892 USA. RP Shrestha, S (reprint author), Univ Michigan, Dept Ecol & Evolutionary Biol, Ann Arbor, MI 48109 USA. EM sourya@jhu.edu FU Research and Policy in Infectious Disease Dynamics program of the Science and Technology Directorate; Department of Homeland Security; Fogarty International Center; National Institutes of Health; MIDAS, National Institute of General Medical Sciences [U54-GM111274]; Pfizer Inc. FX We would like to thank the Illinois Department of Public Health for voluntarily participating in the HCUP. We would also like to thank Marc Lipsitch for helpful suggestions. PR received support from the Research and Policy in Infectious Disease Dynamics program of the Science and Technology Directorate, Department of Homeland Security, the Fogarty International Center, National Institutes of Health and by MIDAS, National Institute of General Medical Sciences U54-GM111274. PR and BF were also supported by an investigator-initiated grant from Pfizer Inc. NR 57 TC 2 Z9 2 U1 1 U2 8 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 2045-2322 J9 SCI REP-UK JI Sci Rep PD OCT 21 PY 2015 VL 5 AR 15314 DI 10.1038/srep15314 PG 13 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA CU1MI UT WOS:000363285600001 PM 26486591 ER PT J AU Cros, J Ballard, T AF Cros, Jennifer Ballard, Timothy TI Screening for Thyroid Dysfunction SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Cros, Jennifer] US Prevent Serv Task Force Program, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Ballard, Timothy] Uniformed Serv Univ Hlth Sci, Gen Prevent Med Residency, Bethesda, MD 20814 USA. RP Cros, J (reprint author), US Prevent Serv Task Force Program, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 2 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD OCT 15 PY 2015 VL 92 IS 8 BP 717 EP 718 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA CT7MN UT WOS:000362998900007 PM 26554412 ER PT J AU Brega, AG Freedman, MAG LeBlanc, WG Barnard, J Mabachi, NM Cifuentes, M Albright, K Weiss, BD Brach, C West, DR AF Brega, Angela G. Freedman, Megan A. G. LeBlanc, William G. Barnard, Juliana Mabachi, Natabhona M. Cifuentes, Maribel Albright, Karen Weiss, Barry D. Brach, Cindy West, David R. TI Using the Health Literacy Universal Precautions Toolkit to Improve the Quality of Patient Materials SO JOURNAL OF HEALTH COMMUNICATION LA English DT Article ID CANCER INFORMATION; READABILITY; PRINT AB Patient materials are often written above the reading level of most adults. Tool 11 of the Health Literacy Universal Precautions Toolkit ("Design Easy-to-Read Material") provides guidance on ensuring that written patient materials are easy to understand. As part of a pragmatic demonstration of the Toolkit, we examined how four primary care practices implemented Tool 11 and whether written materials improved as a result. We conducted interviews to learn about practices' implementation activities and assessed the readability, understandability, and actionability of patient education materials collected during pre- and postimplementation site visits. Interview data indicated that practices followed many action steps recommended in Tool 11, including training staff, assessing readability, and developing or revising materials, typically focusing on brief documents such as patient letters and information sheets. Many of the revised and newly developed documents had reading levels appropriate for most patients andin the case of revised documentsbetter readability than the original materials. In contrast, the readability, understandability, and actionability of lengthier patient education materials were poor and did not improve over the 6-month implementation period. Findings guided revisions to Tool 11 and highlighted the importance of engaging multiple stakeholders in improving the quality of patient materials. C1 [Brega, Angela G.; Freedman, Megan A. G.; Albright, Karen] Colorado Sch Publ Hlth, Dept Community & Behav Hlth, Aurora, CO 80045 USA. [Brega, Angela G.; LeBlanc, William G.; Cifuentes, Maribel; West, David R.] Univ Colorado, Dept Family Med, Aurora, CO USA. [Barnard, Juliana; Albright, Karen; West, David R.] Univ Colorado, Adult & Child Ctr Hlth Outcomes Res & Delivery Sc, Aurora, CO USA. [Mabachi, Natabhona M.] Amer Acad Family Phys, Kansas City, KS USA. [Mabachi, Natabhona M.] Univ Kansas, Med Ctr, Dept Family Med, Kansas City, KS 66103 USA. [Weiss, Barry D.] Univ Arizona, Dept Family & Community Med, Tucson, AZ USA. [Brach, Cindy] Agcy Healthcare Res & Qual, Ctr Delivery Org & Mkt, Rockville, MD USA. RP Brega, AG (reprint author), Colorado Sch Publ Hlth, Dept Community & Behav Hlth, 13055 East 17th Ave,Mail Stop F800, Aurora, CO 80045 USA. EM angela.brega@ucdenver.edu FU Agency for Healthcare Research and Quality [HHSA290200710008] FX Support for this work was provided by a contract from the Agency for Healthcare Research and Quality (HHSA290200710008, David R. West). NR 30 TC 1 Z9 1 U1 2 U2 11 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 530 WALNUT STREET, STE 850, PHILADELPHIA, PA 19106 USA SN 1081-0730 EI 1087-0415 J9 J HEALTH COMMUN JI J. Health Commun. PD OCT 9 PY 2015 VL 20 SU 2 SI SI BP 69 EP 76 DI 10.1080/10810730.2015.1081997 PG 8 WC Communication; Information Science & Library Science SC Communication; Information Science & Library Science GA CU7BL UT WOS:000363690000009 PM 26513033 ER PT J AU Steiner, CA Maggard-Gibbons, M Raetzman, SO Barrett, ML Sacks, GD Owens, PL AF Steiner, Claudia A. Maggard-Gibbons, Melinda Raetzman, Susan Oehme Barrett, Marguerite L. Sacks, Greg D. Owens, Pamela L. TI Return to Acute Care Following Ambulatory Surgery SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 [Steiner, Claudia A.; Owens, Pamela L.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. [Maggard-Gibbons, Melinda] RAND Corp, Santa Monica, CA USA. [Raetzman, Susan Oehme] Truven Hlth Analyt, Bethesda, MD USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Sacks, Greg D.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. RP Steiner, CA (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM claudia.steiner@ahrq.hhs.gov NR 6 TC 0 Z9 0 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 6 PY 2015 VL 314 IS 13 BP 1397 EP 1399 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA CT2PH UT WOS:000362644700019 PM 26441186 ER PT J AU Burns, KM Encinosa, WE Pearson, GD Kaltman, JR AF Burns, Kristin M. Encinosa, William E. Pearson, Gail D. Kaltman, Jonathan R. TI Electrocardiogram in Preparticipation Athletic Evaluations among Insured Youths SO JOURNAL OF PEDIATRICS LA English DT Article ID SUDDEN CARDIAC DEATH; AMERICAN-HEART-ASSOCIATION; COLLEGE-OF-CARDIOLOGY; CARDIOVASCULAR-ABNORMALITIES; SCIENTIFIC STATEMENT; PREVENTION; RECOMMENDATIONS; STRATEGIES; REDUCE; COST AB Objective To retrospectively characterize electrocardiogram (ECG) use among preparticipation history and examinations (PPEs). Study design Using the 2005 to 2010 MarketScan insurance database, we identified subjects aged 5-21 years with either a PPE with an ECG or a PPE alone, excluding those with known cardiac diagnoses. We described cardiology referrals and subspecialty testing within 180 days and cardiac diagnoses within 1 year of the PPE, and the costs of testing in each group. Results From 2005-2009, 503 304 PPEs occurred in 419 456 subjects, of which 8621 (2%) included an ECG. ECG use increased from 12-20 per 1000 PPEs from 2005-2009. Females, lower socioeconomic status, and rural settings were associated with fewer ECGs. Thirteen percent of PPEs with ECG and 0.5% of PPEs alone led to a cardiology referral. After PPEs with ECG, cardiac disease was identified in 18% (2% sports-limiting); after PPEs alone, cardiac disease was identified in 0.5% (0.03% sports-limiting). The PPE had a sensitivity of 44% and a specificity of 98.6% of identifying cardiac disease. The total reimbursement cost of PPEs plus testing was $ 80 396 464 ($ 160 per PPE). Conclusions These real-world data demonstrate that community providers selectively use the ECG as part of the PPE with a high rate of identification of cardiac disease. Mass ECG screening would need to be more efficient at identifying disease than this selective approach. C1 [Burns, Kristin M.; Pearson, Gail D.; Kaltman, Jonathan R.] NHLBI, NIH, Bethesda, MD 20892 USA. [Encinosa, William E.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. RP Burns, KM (reprint author), NHLBI, Div Cardiovasc Sci, Heart Dev & Struct Dis Branch, NIH, 6701 Rockledge Dr,Room 8220, Bethesda, MD 20892 USA. EM kristin.burns@nih.gov FU Intramural NIH HHS [Z99 HL999999] NR 27 TC 1 Z9 1 U1 0 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-3476 EI 1097-6833 J9 J PEDIATR-US JI J. Pediatr. PD OCT PY 2015 VL 167 IS 4 BP 804 EP + DI 10.1016/j.jpeds.2015.06.011 PG 7 WC Pediatrics SC Pediatrics GA CU5BE UT WOS:000363545800007 PM 26148663 ER PT J AU Carls, GS Henke, RM Karaca, Z Marder, WD Wong, HS AF Carls, Ginger Smith Henke, Rachel Mosher Karaca, Zeynal Marder, William D. Wong, Herbert S. TI The Relationship between Local Economic Conditions and Acute Myocardial Infarction Hospital Utilization by Adults and Seniors in the United States, 1995-2011 SO HEALTH SERVICES RESEARCH LA English DT Article DE Acute myocardial infarction; economic cycles; hospital utilization; determinants of health; Medicare ID AMERICAN-HEART-ASSOCIATION; BUSINESS-CYCLE; SCIENTIFIC STATEMENT; HEALTH BEHAVIORS; CARE; DECOMPOSITION; RECESSIONS; MORTALITY; DISEASE; FILTER AB Objective. To assess the association between aggregate unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 19952011. Data Sources/Study Setting. Community hospital discharge data from states collected for the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) and economic data from the Bureau of Labor Statistics, 1995-2011. Study Design. Quarterly time series study of unemployment and aggregate hospital discharges in local areas using fixed effects to control for differences between local areas. Data Collection/Extraction Methods. Secondary data on inpatient stays and unemployment rates aggregated to micropolitan and metropolitan areas. Principal Findings. For both adults and seniors, a 1 percentage point increase in the contemporaneous unemployment rate was associated with a statistically significant 0.80 percent (adults) to 0.96 percent (seniors) decline in AMI hospitalization during the first half of the study but was unrelated to the economic cycle in the second half of the study period. Conclusions. The study found evidence that the aggregate relationship between health and the economy may be shifting for cardiovascular events, paralleling recent research that has shown a similar shift for some types of mortality (Ruhm 2013), self-reported health, and inpatient use among seniors (McInerney and Mellor 2012). C1 [Henke, Rachel Mosher; Marder, William D.] Truven Hlth Analyt, Cambridge, MA 02140 USA. [Karaca, Zeynal; Wong, Herbert S.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Henke, RM (reprint author), Truven Hlth Analyt, 150 Cambridge Pk Dr, Cambridge, MA 02140 USA. EM rachel.henke@truvenhealth.com OI Marder, William/0000-0002-7198-6933 FU AHRQ [HHSA-290-2013-00002-C] FX Joint Acknowledgment/Disclosure Statement: Funding for this manuscript was provided by AHRQ (Contract Number: HHSA-290-2013-00002-C). The study design and development of the manuscript was a joint effort with Truven Health Analytics and AHRQ staff. Minya Sheng provided programming support and Brian Moore provided research support. The authors would like to acknowledge the HCUP Partner organizations for contributing data to the HCUP State Inpatient Databases (SID) used in this study. A full list of HCUP Data Partners can be found at http://www.hcup-us.ahrq.gov/hcupdatapartners.jsp. NR 35 TC 0 Z9 0 U1 1 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 2015 VL 50 IS 5 BP 1688 EP 1709 DI 10.1111/1475-6773.12298 PG 22 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CT8JX UT WOS:000363063300016 PM 25772510 ER PT J AU Vo, NM Trocki, R AF Vo, Nghia M. Trocki, Rebecca TI Virtual and Peer Reviews of Grant Applications at the Agency for Healthcare Research and Quality SO SOUTHERN MEDICAL JOURNAL LA English DT Article DE development; evaluation; health services research; medical education-faculty development; peer review; virtual review ID SCIENCE; SYSTEM AB Objectives This study documents the first six unplanned virtual review (VR) sessions conducted during the 2012 hurricane season at the Agency for Healthcare Research and Quality and their effects on review outcomes. It also compares these VR sessions with five face-to-face (FF) sessions. Methods In the first part of this study, six VR sessions are analyzed in terms of feasibility, reproducibility, and reviewers' responses to a questionnaire about VR. In the second part, the VR sessions are compared with five other FF meetings in terms of costs and duration per discussed application. Results Despite their technical novelty, all of the VR sessions have been successfully conducted to the satisfaction of reviewers and agency organizers. Special emphasis panel reviewers are more receptive to the new technology than study section reviewers: 75% versus 42%, respectively (P < 0.05). Although the duration per discussed application is comparable to FF, the cost per reviewer is much lower for VR sessions than FF sessions. Conclusions VR has successfully been used in six review sessions with a maximum of 34 discussed applications per session, special emphasis panel reviewers are more receptive to VR than SS reviewers, VR is a duplicable and low-cost method of review, and practitioners and scientists are urged to serve as reviewers because doing so may assist them in receiving funding. C1 [Vo, Nghia M.; Trocki, Rebecca] Agcy Healthcare Res & Qual, Off Extramural Res & Prior Populat, Div Sci Review, Rockville, MD 20850 USA. RP Vo, NM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd,Room 2017, Rockville, MD 20850 USA. EM Nghia.vo@ahrq.hhs.gov NR 8 TC 0 Z9 0 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0038-4348 EI 1541-8243 J9 SOUTH MED J JI South.Med.J. PD OCT PY 2015 VL 108 IS 10 BP 622 EP 626 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA CS7MU UT WOS:000362268500010 PM 26437196 ER PT J AU Abdus, S Zuvekas, SH AF Abdus, Salam Zuvekas, Samuel H. TI Racial/Ethnic Differences in the Relationship between Obesity and Depression Treatment SO JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH LA English DT Article ID SELF-REPORTED WEIGHT; MAJOR DEPRESSION; UNITED-STATES; ETHNIC-DIFFERENCES; NATIONAL-HEALTH; US ADULTS; DISPARITIES; POPULATION; ASSOCIATION; OVERWEIGHT AB Using data from the 2004 to 2008 Medical Expenditure Panel Survey (MEPS), this study examined the relationship between obesity and the treatment of depression across racial/ethnic subgroups, controlling for depressive symptoms, self-rated mental health, health status, and socioeconomic characteristics. The association between obesity and depression-related medication was significant for white women but not for black or Hispanic women. Similarly, the association between obesity and depression-related ambulatory visits was significant for white women but not for black or Hispanic women. The results for men were, in general, mixed and inconsistent. The significant racial/ethnic differences found in the relationship between obesity and depression treatment among women suggest that social and cultural factors might play important roles in depression treatment among women. C1 [Abdus, Salam] Social & Sci Syst, Rockville, MD 20850 USA. [Zuvekas, Samuel H.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Abdus, S (reprint author), Social & Sci Syst, 540 Gaither Rd, Rockville, MD 20850 USA. EM salam.abdus@ahrq.hhs.gov; samuel.zuvekas@ahrq.hhs.gov NR 32 TC 0 Z9 0 U1 2 U2 5 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1094-3412 EI 1556-3308 J9 J BEHAV HEALTH SER R JI J. Behav. Health Serv. Res. PD OCT PY 2015 VL 42 IS 4 BP 486 EP 503 DI 10.1007/s11414-014-9391-1 PG 18 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CS0OC UT WOS:000361759900006 PM 24464180 ER PT J AU McNellis, RJ Lewis, P AF McNellis, Robert J. Lewis, Paul, III TI Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [McNellis, Robert J.] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Lewis, Paul, III] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP McNellis, RJ (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 3 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD SEP 15 PY 2015 VL 92 IS 6 BP 509 EP 510 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA CR6AA UT WOS:000361424300014 PM 26371735 ER PT J AU Smith, MW Friedman, B Karaca, Z Wong, HS AF Smith, Mark W. Friedman, Bernard Karaca, Zeynal Wong, Herbert S. TI Predicting inpatient hospital payments in the United States: a retrospective analysis SO BMC HEALTH SERVICES RESEARCH LA English DT Article AB Background: The Affordable Care Act (ACA) has increased rates of public and private health insurance in the United States. Increasing coverage could raise hospital revenue and reduce the need to shift costs to insured patients. The consequences of ACA on hospital revenues could be examined if payments were known for most hospitals in the United States. Actual payment data are considered confidential, however, and only charges are widely available. Payment-to-charge ratios (PCRs), which convert hospital charges to an estimated payment, have been estimated for hospitals in 10 states. Here we evaluated whether PCRs can be predicted for hospitals in states that do not provide detailed financial data. Methods: We predicted PCRs for 5 payer categories for over 1,000 community hospitals in 10 states as a function of state, market, hospital, and patient characteristics. Data sources included the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases, HCUP Hospital Market Structure file, Medicare Provider of Service file, and state information from several sources. We performed out-of-sample prediction to determine the magnitude of prediction errors by payer category. Results: Many individual, hospital, and state factors were significant predictors of PCRs. Root mean squared error of prediction ranged from 32 to over 100 % of the mean and varied considerably by which states were included or predicted. The cost-to-charge ratio (CCR) was highly correlated with PCRs for Medicare, Medicaid, and private insurance but not for self-pay or other insurance categories. Conclusions: Inpatient payments can be estimated with modest accuracy for community hospital stays funded by Medicare, Medicaid, and private insurance. They improve upon CCRs by allowing separate estimation by payer type. PCRs are currently the only approach to estimating fee-for-service payments for privately insured stays, which represent a sizable proportion of stays for individuals under age 65. Additional research is needed to improve the predictive accuracy of the models for all payers. C1 [Smith, Mark W.] Truven Hlth Analyt, Bethesda, MD 20814 USA. [Friedman, Bernard; Karaca, Zeynal; Wong, Herbert S.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Smith, MW (reprint author), Truven Hlth Analyt, 7700 Old Georgetown Rd,Suite 650, Bethesda, MD 20814 USA. EM mark.w.smith@truvenhealth.com FU Agency for Healthcare Research and Quality FX The analysis included data from the following HCUP Partner organizations: California Office of Statewide Health Planning & Development, Florida Agency for Health Care Administration, Massachusetts Division of Health Care Finance and Policy, Nevada Department of Health and Human Services, New Jersey Department of Health, Virginia Health Information, West Virginia Healthcare Authority, Wisconsin Department of Health Services, and two additional Northern states for which permission to identify was not obtained. This work was funded by Agency for Healthcare Research and Quality. The authors thank Yu Sun for programming support, Arpit Misra for helpful comments, and Linda Lee for editorial assistance. The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. NR 14 TC 2 Z9 2 U1 2 U2 7 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD SEP 10 PY 2015 VL 15 AR 372 DI 10.1186/s12913-015-1040-8 PG 12 WC Health Care Sciences & Services SC Health Care Sciences & Services GA CR4GV UT WOS:000361290900001 PM 26358055 ER PT J AU Kremers, HM Larson, DR Crowson, CS Kremers, WK Washington, RE Steiner, CA Jiranek, WA Berry, DJ AF Kremers, Hilal Maradit Larson, Dirk R. Crowson, Cynthia S. Kremers, Walter K. Washington, Raynard E. Steiner, Claudia A. Jiranek, William A. Berry, Daniel J. TI Prevalence of Total Hip and Knee Replacement in the United States SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME LA English DT Article ID ROCHESTER EPIDEMIOLOGY PROJECT; MEDICAL-RECORDS-LINKAGE; LONG-TERM MORTALITY; REVISION TOTAL HIP; ARTHROPLASTY REGISTER; POPULATION; OSTEOARTHRITIS; DISEASE; BURDEN; SYSTEM AB Background: Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown. Our objective was to estimate the prevalence of total hip and total knee replacement in the United States. Methods: Prevalence was estimated using the counting method by combining historical incidence data from the National Hospital Discharge Survey and the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 1969 to 2010 with general population census and mortality counts. We accounted for relative differences in mortality rates between those who have had total hip or knee replacement and the general population. Results: The 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83% and 1.52%, respectively. Prevalence was higher among women than among men and increased with age, reaching 5.26% for total hip replacement and 10.38% for total knee replacement at eighty years. These estimates corresponded to 2.5 million individuals (1.4 million women and 1.1 million men) with total hip replacement and 4.7 million individuals (3.0 million women and 1.7 million men) with total knee replacement in 2010. Secular trends indicated a substantial rise in prevalence over time and a shift to younger ages. Conclusions: Around 7 million Americans are living with a hip or knee replacement, and consequently, in most cases, are mobile, despite advanced arthritis. These numbers underscore the substantial public health impact of total hip and knee arthroplasties. C1 [Kremers, Hilal Maradit; Larson, Dirk R.; Crowson, Cynthia S.; Kremers, Walter K.] Mayo Clin, Dept Hlth Sci Res, Rochester, MN 55905 USA. [Kremers, Hilal Maradit; Berry, Daniel J.] Mayo Clin, Dept Orthoped Surg, Rochester, MN 55905 USA. [Crowson, Cynthia S.] Mayo Clin, Div Rheumatol, Rochester, MN 55905 USA. [Washington, Raynard E.; Steiner, Claudia A.] AHRQ, CDOM, HCUP, Rockville, MD 20850 USA. [Jiranek, William A.] Virginia Commonwealth Univ, Med Ctr, Dept Orthoped Surg, Richmond, VA 23235 USA. RP Kremers, HM (reprint author), Mayo Clin, Dept Hlth Sci Res, 200 First St SW, Rochester, MN 55905 USA. EM maradit@mayo.edu FU National Institute on Aging of the National Institutes of Health [R01AG034676] FX No external funds were used for the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript. This study was, in part, made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under award number R01AG034676. NR 30 TC 21 Z9 21 U1 3 U2 5 PU JOURNAL BONE JOINT SURGERY INC PI NEEDHAM PA 20 PICKERING ST, NEEDHAM, MA 02192 USA SN 0021-9355 EI 1535-1386 J9 J BONE JOINT SURG AM JI J. Bone Joint Surg.-Am. Vol. PD SEP 2 PY 2015 VL 97A IS 17 BP 1386 EP 1397 DI 10.2106/JBJS.N.01141 PG 12 WC Orthopedics; Surgery SC Orthopedics; Surgery GA CY4SH UT WOS:000366398000006 ER PT J AU Ricciardi, R AF Ricciardi, Richard TI I'm in an NP State of Mind: A Tribute to Dr. Henry K. Silver on the 50th Anniversary of the Nurse Practitioner Profession SO JOURNAL OF PEDIATRIC HEALTH CARE LA English DT Editorial Material C1 [Ricciardi, Richard] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Ricciardi, R (reprint author), 504 Saddle Ridge Ln, Rockville, MD 20850 USA. EM richard.ricciardi@ahrq.hhs.gov NR 3 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0891-5245 EI 1532-656X J9 J PEDIATR HEALTH CAR JI J. Pediatr. Health Care PD SEP-OCT PY 2015 VL 29 IS 5 BP 397 EP 399 DI 10.1016/j.pedhc.2015.06.009 PG 3 WC Health Policy & Services; Nursing; Pediatrics SC Health Care Sciences & Services; Nursing; Pediatrics GA CV0SV UT WOS:000363964300002 PM 26302689 ER PT J AU Davidoff, AJ Hill, SC Bernard, D Yabroff, KR AF Davidoff, Amy J. Hill, Steven C. Bernard, Didem Yabroff, K. Robin TI The Affordable Care Act and Expanded Insurance Eligibility Among Nonelderly Adult Cancer Survivors SO JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE LA English DT Article ID HEALTH-CARE; PATIENT PROTECTION; ACCESS; POLICY; INFORMATION; DISPARITIES; LEGISLATION; REFORM; IMPACT AB Background: Cancer survivors may face barriers to accessing health insurance and experience financial hardship because of medical expenditures. We examined potential improvements in access to insurance for cancer survivors through adult Medicaid expansions and premium tax credits in the new insurance marketplaces under the Affordable Care Act (ACA). Methods: Eligibility for Medicaid and premium tax credits was simulated for cancer survivors age 18 to 64 years in the 2008 to 2010 Medical Expenditure Panel Survey using a detailed deterministic model. Financial hardship was determined as: 1) delays or unmet need for medical, prescription, or dental care because of cost or insurance issues and/or 2) family out-of-pocket medical spending that was 20% or more of gross income. Descriptive analyses were stratified by whether the state of residence chose to expand Medicaid by January 2015. All statistical tests were two-sided. Results: Overall, 14.7% of 9.44 million cancer survivors were uninsured, with 18% reporting financial hardship. Under the ACA, 19% overall, 30% of the uninsured, and 39% of those reporting financial hardship would be Medicaid eligible. An additional 10% would be eligible for premium tax credits, with the remainder able to participate in the Marketplace without tax credits. However, 21% of uninsured cancer survivors in states not expanding Medicaid would be ineligible for assistance with coverage. Conclusions: Under the ACA, many of the uninsured and a larger proportion of survivors facing financial hardship will be eligible for Medicaid or premium tax credits in the Marketplaces. ACA implementation will dramatically enhance insurance availability and is likely to reduce financial hardship for vulnerable cancer survivors. C1 [Davidoff, Amy J.] Yale Univ, Sch Publ Hlth, New Haven, CT 06520 USA. [Hill, Steven C.; Bernard, Didem] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Yabroff, K. Robin] Natl Canc Inst, Div Canc Control & Populat Sci, Hlth Serv & Econ Branch, Bethesda, MD USA. RP Davidoff, AJ (reprint author), Yale Univ, Sch Publ Hlth, POB 208034,60 Coll St, New Haven, CT 06520 USA. EM amy.davidoff@yale.edu NR 36 TC 6 Z9 6 U1 1 U2 3 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0027-8874 EI 1460-2105 J9 JNCI-J NATL CANCER I JI JNCI-J. Natl. Cancer Inst. PD SEP PY 2015 VL 107 IS 9 AR djv181 DI 10.1093/jnci/djv181 PG 8 WC Oncology SC Oncology GA CU0KA UT WOS:000363203800011 ER PT J AU Cassel, CK Kronick, R AF Cassel, Christine K. Kronick, Richard TI Learning From the Past to Measure the Future SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material C1 [Cassel, Christine K.] Natl Qual Forum, Washington, DC 20005 USA. [Kronick, Richard] Agcy Healthcare Res & Qual, US Dept Hlth & Human Serv, Washington, DC USA. RP Cassel, CK (reprint author), Natl Qual Forum, 1030 15th St NW,Ste 800, Washington, DC 20005 USA. EM cassel@qualityforum.org NR 7 TC 1 Z9 1 U1 1 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD SEP 1 PY 2015 VL 314 IS 9 BP 875 EP 876 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA CQ1WX UT WOS:000360392100011 PM 26325553 ER PT J AU Curry, SJ McNellis, RJ AF Curry, Susan J. McNellis, Robert J. TI Behavioral Counseling in Primary Care Perspectives in Enhancing the Evidence Base SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Editorial Material C1 [Curry, Susan J.] Univ Iowa, Coll Publ Hlth, Iowa City, IA 52242 USA. [McNellis, Robert J.] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD USA. RP Curry, SJ (reprint author), Univ Iowa, 100 CPHB,S153A,145 North Riverside Dr, Iowa City, IA 52242 USA. EM sue-curry@uiowa.edu NR 12 TC 2 Z9 2 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD SEP PY 2015 VL 49 IS 3 SU 2 BP S125 EP S128 DI 10.1016/j.amepre.2015.06.004 PG 4 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA CP4UM UT WOS:000359878100001 PM 26296546 ER PT J AU Kurth, AE Miller, TL Woo, M Davidson, KW AF Kurth, Ann E. Miller, Therese L. Woo, Meghan Davidson, Karina W. TI Understanding Research Gaps and Priorities for Improving Behavioral Counseling Interventions Lessons Learned From the US Preventive Services Task Force SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID ALCOHOL-CONSUMPTION; ADOLESCENTS; TAXONOMY AB Behavioral counseling interventions can address significant causes of preventable morbidity and mortality. However, despite a growing evidence base for behavioral counseling interventions, there remain significant research gaps that limit translating the evidence into clinical practice. Using U.S. Preventive Services Task Force (USPSTF) examples, we address how researchers and funders can move the research portfolio forward to achieve better application of behavioral counseling interventions to address substantial health burdens in the U.S. This paper describes the types of gaps that the USPSTF encounters across its behavioral counseling intervention topics and provides suggestions for opportunities to address these gaps to enhance the evidence base for primary care based behavioral counseling recommendations. To accomplish this, we draw from both the USPSTF experience and issues identified by researchers and clinicians during the USPSTF-sponsored Behavioral Counseling Intervention Forum. We also discuss the dilemma posed by having "insufficient" evidence with which to make a behavioral counseling intervention related recommendation, and describe two case examples (screening for alcohol misuse in adolescence and screening for child maltreatment), detailing the research gaps that remain. Recommendations are outlined for researchers, funders, and practice implementers to improve behavioral counseling intervention research and application. (C) 2015 American Journal of Preventive Medicine. C1 [Kurth, Ann E.] NYU, Coll Nursing, Global & Global Inst Publ Hlth, New York, NY 10010 USA. [Miller, Therese L.] USDHHS, Agcy Healthcare Res & Qual, Rockville, MD USA. [Woo, Meghan] ABT Associates Inc, Cambridge, MA 02138 USA. [Davidson, Karina W.] Columbia Univ, Dept Med, New York, NY USA. RP Kurth, AE (reprint author), NYU, 433 First Ave,Room 640, New York, NY 10010 USA. EM ak160@nyu.edu FU Agency for Healthcare Research and Quality (AHRQ); AHRQ [HHSA290-2010-00004i, TO 4] FX Publication of this article was supported by the Agency for Healthcare Research and Quality (AHRQ).; Administrative and logistical support for this paper was provided by AHRQ through contract HHSA290-2010-00004i, TO 4. NR 22 TC 1 Z9 1 U1 2 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD SEP PY 2015 VL 49 IS 3 SU 2 BP S158 EP S165 DI 10.1016/j.amepre.2015.06.007 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA CP4UM UT WOS:000359878100005 PM 26296550 ER PT J AU McNellis, RJ Ory, MG Lin, JS O'Connor, EA AF McNellis, Robert J. Ory, Marcia G. Lin, Jennifer S. O'Connor, Elizabeth A. TI Standards of Evidence for Behavioral Counseling Recommendations SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID SERVICES TASK-FORCE; SEXUALLY-TRANSMITTED INFECTIONS; PRIMARY-CARE; INTERVENTIONS; TRANSLATION; STATEMENT AB Behavioral counseling interventions to promote healthy behaviors can significantly reduce leading causes of disease and death. Recommendations for delivery of these interventions in primary care have been and continue to be an important part of the U.S. Preventive Services Task Force's portfolio of clinical preventive services recommendations. However, primary and secondary research on the effectiveness of behavioral counseling interventions can be more complex than recommendations for screening or use of preventive medications. The nature of behavior change and interventions to promote it can lead to unique challenges. This paper summarizes and expands upon an extensive discussion held at the U.S. Preventive Services Task Force's Expert Forum on behavioral counseling interventions held in November 2013. The paper describes the foundational challenges for using behavioral outcomes as evidence to support a Task Force recommendation. The paper discusses research design and reporting characteristics needed by behavioral counseling intervention researchers in order for their research to contribute to the evidentiary basis of a Task Force recommendation. Finally, the paper identifies critical issues that need to be considered by the Task Force and other stakeholders to maintain confidence and credibility in the standards of evidence for behavioral counseling recommendations. (C) 2015 American Journal of Preventive Medicine. C1 [McNellis, Robert J.] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD 20850 USA. [Ory, Marcia G.] Texas A&M Hlth Sci Ctr, Sch Publ Hlth, College Stn, TX USA. [Lin, Jennifer S.; O'Connor, Elizabeth A.] Kaiser Permanente Res Affiliates Evidence Based P, Ctr Hlth Res, Portland, OR USA. RP McNellis, RJ (reprint author), Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. EM robert.mcnellis@ahrq.hhs.gov FU Agency for Healthcare Research and Quality (AHRQ); AHRQ [HHSA290-2010-00004i, TO 4] FX Publication of this article was supported by the Agency for Healthcare Research and Quality (AHRQ).; Administrative and logistical support for this paper was provided by AHRQ through contract HHSA290-2010-00004i, TO 4. NR 13 TC 3 Z9 3 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD SEP PY 2015 VL 49 IS 3 SU 2 BP S150 EP S157 DI 10.1016/j.amepre.2015.06.002 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA CP4UM UT WOS:000359878100004 PM 26296549 ER PT J AU Murray, DM Kaplan, RM Ngo-Metzger, Q Portnoy, B Olkkola, S Stredrick, D Kuczmarski, RJ Goldstein, AB Perl, HI O'Connell, ME AF Murray, David M. Kaplan, Robert M. Ngo-Metzger, Quyen Portnoy, Barry Olkkola, Susanne Stredrick, Denise Kuczmarski, Robert J. Goldstein, Amy B. Perl, Harold I. O'Connell, Mary E. TI Enhancing Coordination Among the US Preventive Services Task Force, Agency for Healthcare Research and Quality, and National Institutes of Health SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID RANDOMIZED-TRIALS; TRANSLATION; COMMUNITY; PROGRAM AB This paper focuses on the relationships among the U.S. Preventive Services Task Force (USPSTF); Agency for Healthcare Research and Quality (AHRQ); and NIH. After a brief description of the Task Force, AHRQ, NIH, and an example of how they interact, we describe the steps that have been taken recently by NIH to enhance their coordination. We also discuss several challenges that remain and consider potential remedies that NIH, AHRQ, and investigators can take to provide the USPSTF with the data it needs to make recommendations, particularly those pertaining to behavioral interventions. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine. C1 [Murray, David M.; Portnoy, Barry; Olkkola, Susanne; Stredrick, Denise] NIH, Off Dis Prevent, Div Program Coordinat Planning & Strateg Initiat, Off Director, Bethesda, MD 20892 USA. [Kaplan, Robert M.; Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, Rockville, MD USA. [Kuczmarski, Robert J.] NIDDK, Div Digest Dis & Nutr, NIH, Bethesda, MD 20892 USA. [Goldstein, Amy B.] NIMH, Div Serv & Intervent Res, NIH, Bethesda, MD 20892 USA. [Perl, Harold I.] NIDA, Prevent Res Branch, Div Epidemiol Serv & Prevent Res, NIH, Bethesda, MD 20892 USA. [O'Connell, Mary E.] NCI, Behav Res Program, Div Canc Control & Populat Sci, NIH, Bethesda, MD 20892 USA. RP Murray, DM (reprint author), NIH, Off Dis Prevent, Div Program Coordinat Planning & Strateg Initiat, Off Director, 6100 Execut Blvd,Suite 2B03, Bethesda, MD 20892 USA. EM david.murray2@nih.gov FU Agency for Healthcare Research and Quality (AHRQ); AHRQ [HHSA290-2010-00004i, TO 4] FX Publication of this article was supported by the Agency for Healthcare Research and Quality (AHRQ).; Administrative and logistical support for this paper was provided by AHRQ through contract HHSA290-2010-00004i, TO 4. NR 16 TC 4 Z9 4 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD SEP PY 2015 VL 49 IS 3 SU 2 BP S166 EP S173 DI 10.1016/j.amepre.2015.04.024 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA CP4UM UT WOS:000359878100006 PM 26296551 ER PT J AU Lipton, BJ Decker, SL AF Lipton, Brandy J. Decker, Sandra L. TI Association between diagnosed diabetes and trouble seeing, National Health Interview Survey, 2011-13 SO JOURNAL OF DIABETES LA English DT Letter DE complications of diabetes; diabetes mellitus; visual impairment ID VISUAL IMPAIRMENT; UNITED-STATES; PREVALENCE C1 [Lipton, Brandy J.] Social & Sci Syst, Sliver Spring, MD USA. [Decker, Sandra L.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Lipton, BJ (reprint author), Social & Sci Syst, 540 Gaither Rd,Suite 2000, Rockville, MD 20850 USA. EM brandy.lipton@ahrq.hhs.gov NR 7 TC 0 Z9 0 U1 2 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1753-0393 EI 1753-0407 J9 J DIABETES JI J. Diabetes PD SEP PY 2015 VL 7 IS 5 BP 743 EP 746 DI 10.1111/1753-0407.12311 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA CO6WV UT WOS:000359298900020 PM 25990867 ER PT J AU Bixenstine, PJ Cheng, TNL Cheng, DN Connor, KA Mistry, KB AF Bixenstine, Paul J. Cheng, Tina L. Cheng, Diana Connor, Katherine A. Mistry, Kamila B. TI Association Between Preconception Counseling and Folic Acid Supplementation Before Pregnancy and Reasons for Non-Use SO MATERNAL AND CHILD HEALTH JOURNAL LA English DT Article DE Folic acid; Preconception counseling; Preconception care; PRAMS; Women's health ID NEURAL-TUBE DEFECTS; ASSESSMENT MONITORING-SYSTEM; UNITED-STATES; HEALTH; WOMEN; CARE; FORTIFICATION; PREVENTION; IMPACT AB To examine the relationship between folic acid preconception counseling (PCC) and folic acid use and reasons for non-use among women with a recent live birth. We analyzed Maryland Pregnancy Risk Assessment Monitoring System (PRAMS) survey responses from 2009 to 2011 (n = 4,426, response rate = 67 %). Multivariable weighted logistic regression models were used to explore associations between folic acid PCC receipt and folic acid use and reasons for non-use. Approximately 30 % of women reported daily folic acid use the month before pregnancy, with lower rates among those who were < 30, non-white, or unmarried; received WIC during pregnancy; had suffered a stressful event prepregnancy; smoked prepregnancy; had a previous live birth; or had an unintended pregnancy (all p < 0.05). The most common reasons for folic acid non-use were "not planning pregnancy" (61 %) and "didn't think needed to take" (41 %). Folic acid PCC receipt was reported by 27 % of women and was associated with three times the odds of folic acid use (adjusted odds ratio [aOR] 3.15, 95 % CI 2.47-4.03) and half the odds of reporting "didn't think needed to take" (aOR 0.47, 95 % CI 0.28-0.78) as a reason for non-use. Less than one-third of recent Maryland mothers reported using folic acid daily before pregnancy and only 27 % reported receiving folic acid PCC. However, folic acid PCC was associated with increased folic acid use and decreased reporting that women did not think they needed to take folic acid. Our data support initiatives to promote provision of folic acid PCC to all women of childbearing age. C1 [Bixenstine, Paul J.; Cheng, Tina L.; Mistry, Kamila B.] Johns Hopkins Univ, Sch Med, Dept Pediat, Div Gen Pediat & Adolescent Med, Baltimore, MD 21205 USA. [Cheng, Diana] MCH Bur, Maryland Dept Hlth & Mental Hyg, Surveillance & Qual Initiat, Baltimore, MD 21201 USA. [Connor, Katherine A.] Herman & Walter Samuelson Childrens Hosp Sinai, Baltimore, MD 21215 USA. [Mistry, Kamila B.] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD 20850 USA. RP Bixenstine, PJ (reprint author), Johns Hopkins Univ, Sch Med, Dept Pediat, Div Gen Pediat & Adolescent Med, Baltimore, MD 21205 USA. EM pbixens1@jhmi.edu; tcheng2@jhmi.edu; diana.cheng@maryland.gov; connor.katherine@gmail.com; kmistry2@jhmi.edu FU DC Baltimore Research Center on Child Health Disparities from National Institute on Minority Health and Health Disparities [P20 MD000198]; Centro SOL: Johns Hopkins Center for Salud (Health) and Opportunity for Latinos FX Tina Cheng, MD, MPH, acknowledges support from the DC Baltimore Research Center on Child Health Disparities P20 MD000198 from the National Institute on Minority Health and Health Disparities and from Centro SOL: Johns Hopkins Center for Salud (Health) and Opportunity for Latinos (TLC). The other authors have no known specific financial interests, relationships or affiliations relevant to the subject of this manuscript. The views expressed in this article are those of the authors and do not necessarily represent the views of the US Department of Health and Human Services, the Agency for Healthcare Research and Quality, or the views of the funding agencies aforementioned. The authors would also like to acknowledge Cara Buchanan, Lynette Forrest, Frances Harris, and Krishna Upadhya, MD, for their indispensable contributions to this manuscript. NR 41 TC 3 Z9 3 U1 2 U2 11 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1092-7875 EI 1573-6628 J9 MATERN CHILD HLTH J JI Matern. Child Health J. PD SEP PY 2015 VL 19 IS 9 BP 1974 EP 1984 DI 10.1007/s10995-015-1705-2 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA CN9CY UT WOS:000358745200010 PM 25663654 ER PT J AU Mabry-Hernandez, I Lewis, P AF Mabry-Hernandez, Iris Lewis, Paul, III TI Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Mabry-Hernandez, Iris] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Lewis, Paul, III] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Mabry-Hernandez, I (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD AUG 15 PY 2015 VL 92 IS 4 BP 301 EP 302 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA CP5VF UT WOS:000359952400006 PM 26280235 ER PT J AU Weinberger, DM Warren, JL Steiner, CA Charu, V Viboud, C Pitzer, VE AF Weinberger, Daniel M. Warren, Joshua L. Steiner, Claudia A. Charu, Vivek Viboud, Cecile Pitzer, Virginia E. TI Reduced-Dose Schedule of Prophylaxis Based on Local Data Provides Near-Optimal Protection Against Respiratory Syncytial Virus SO CLINICAL INFECTIOUS DISEASES LA English DT Article DE RSV; respiratory syncytial virus; prophylaxis; palivizumab; spatial variation ID UNITED-STATES; NATIONAL-SURVEILLANCE; COST-EFFECTIVENESS; PALIVIZUMAB; CHILDREN; INFANTS; RISK; HOSPITALIZATION; INFECTION; SEASON AB Background. Respiratory syncytial virus (RSV) is a major cause of respiratory infections among young children and can lead to severe disease among some infants. Infants at high risk for severe RSV infection receive monthly injections of a prophylactic monoclonal antibody during the RSV season based on national guidelines. We considered whether a reduced-dose schedule tailored to the local RSV season in the continental United States would provide adequate protection. Methods. Hospitalization data for 1942 counties across 38 states from 1997 to 2009 were obtained from the State Inpatient Databases (Agency for Healthcare Research and Quality). We assessed the timing of RSV epidemics at the county and state levels using a 2-stage hierarchical Bayesian change point model. We used a simple summation approach to estimate the fraction of RSV cases that occur during the window of protection provided by initiating RSV prophylaxis during different weeks of the year. Results. The timing of RSV epidemic onset varied significantly at the local level. Nevertheless, the national recommendations for initiation of prophylaxis provided near-optimal coverage of the RSV season in most of the continental United States. Reducing from 5 to 4 monthly doses (with a later initiation) provides near-optimal coverage (<5% decrease in coverage) in most settings. Earlier optimal dates for initiating 4 doses of prophylaxis were associated with being farther south and east, higher population density, and having a higher percentage of the population that was black or Hispanic. Conclusions. A 4-dose schedule of prophylactic injections timed with local RSV epidemics could provide C1 [Weinberger, Daniel M.; Pitzer, Virginia E.] Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA. [Warren, Joshua L.] Yale Univ, Sch Publ Hlth, Dept Biostat, New Haven, CT 06520 USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Healthcare Cost & Utilizat Project, Ctr Delivery Org & Markets, Rockville, MD USA. [Charu, Vivek; Viboud, Cecile] NIH, Div Int Epidemiol & Populat Studies, Fogarty Int Ctr, Bethesda, MD 20892 USA. RP Weinberger, DM (reprint author), Yale Univ, Dept Epidemiol Microbial Dis, POB 208034, New Haven, CT 06520 USA. EM daniel.weinberger@yale.edu OI Pitzer, Virginia/0000-0003-1015-2289; Weinberger, Daniel/0000-0003-1178-8086 FU Bill & Melinda Gates Foundation; Pfizer; Division of International Epidemiology and Population Studies; Fogarty International Center, National Institutes of Health (NIH); RAPIDD program of the Science and Technology Directorate, Department of Homeland Security; [UL1TR000142] FX C. V. was supported by the Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health (NIH). V. E. P. was supported by the Bill & Melinda Gates Foundation and the RAPIDD program of the Science and Technology Directorate, Department of Homeland Security, and the Fogarty International Center, NIH. D. M. W. is a Pepper Scholar with support from the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (grant number P30AG021342 NIH/National Institute on Aging), and acknowledges support from UL1TR000142 as well as support from the Bill & Melinda Gates Foundation and Pfizer. NR 23 TC 5 Z9 5 U1 1 U2 5 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 EI 1537-6591 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG 15 PY 2015 VL 61 IS 4 BP 506 EP 514 DI 10.1093/cid/civ331 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA CO7MT UT WOS:000359344200005 PM 25904370 ER PT J AU Kaplan, RM Irvin, VL AF Kaplan, Robert M. Irvin, Veronica L. TI Likelihood of Null Effects of Large NHLBI Clinical Trials Has Increased over Time SO PLOS ONE LA English DT Article ID DRUG-DEVELOPMENT; PIPELINE; CLINICALTRIALS.GOV; PUBLICATION AB Background We explore whether the number of null results in large National Heart Lung, and Blood Institute (NHLBI) funded trials has increased over time. Methods We identified all large NHLBI supported RCTs between 1970 and 2012 evaluating drugs or dietary supplements for the treatment or prevention of cardiovascular disease. Trials were included if direct costs >$500,000/year, participants were adult humans, and the primary outcome was cardiovascular risk, disease or death. The 55 trials meeting these criteria were coded for whether they were published prior to or after the year 2000, whether they registered in clinicaltrials.gov prior to publication, used active or placebo comparator, and whether or not the trial had industry co-sponsorship. We tabulated whether the study reported a positive, negative, or null result on the primary outcome variable and for total mortality. Results 17 of 30 studies (57%) published prior to 2000 showed a significant benefit of intervention on the primary outcome in comparison to only 2 among the 25 (8%) trials published after 2000 (chi(2)=12.2, df= 1, p=0.0005). There has been no change in the proportion of trials that compared treatment to placebo versus active comparator. Industry co-sponsorship was unrelated to the probability of reporting a significant benefit. Pre-registration in clinical trials.gov was strongly associated with the trend toward null findings. Conclusions The number NHLBI trials reporting positive results declined after the year 2000. Prospective declaration of outcomes in RCTs, and the adoption of transparent reporting standards, as required by clinicaltrials. gov, may have contributed to the trend toward null findings. C1 [Kaplan, Robert M.] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD 20852 USA. [Irvin, Veronica L.] Oregon State Univ, Corvallis, OR 97331 USA. RP Kaplan, RM (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD 20852 USA. EM Robert.Kaplan@ahrq.hhs.gov FU NIH intramural program FX The work was completed while both authors were employees of the National Institutes of Health. The work was supported by the NIH intramural program. NR 12 TC 23 Z9 24 U1 4 U2 7 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD AUG 5 PY 2015 VL 10 IS 8 AR e0132382 DI 10.1371/journal.pone.0132382 PG 12 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA CO3MH UT WOS:000359061400022 PM 26244868 ER PT J AU Hudson, JL Abdus, S AF Hudson, Julie L. Abdus, Salam TI Coverage And Care Consequences For Families In Which Children Have Mixed Eligibility For Public Insurance SO HEALTH AFFAIRS LA English DT Article ID HEALTH-INSURANCE; MEDICAID AB Public health insurance for low-income children in the United States is primarily available through Medicaid and the Children's Health Insurance Program (CHIP). Mixed eligibility occurs when there is a mix of either "Medicaid-and CHIP-eligible" children or a mix of "eligible (for public insurance) and ineligible (for public insurance)" children in the family. We used data from the Medical Expenditure Panel Survey (MEPS) Household Component for 2001-12 to examine insurance coverage, access to care, and health care use for eligible children in families with mixed-eligible siblings compared to those in families where all siblings were eligible for one program. We found that mixed eligibility has a significant dampening effect for eligible children in families with a mix of eligible and ineligible siblings. These children were more likely to be uninsured and less likely to have a usual source of care, less likely to have any preventive dental or well-child visits during the year, and less likely to fully adhere to recommended preventive dental and well-child visits than eligible children with all-Medicaid-or all-CHIP-eligible siblings. We found no significant impact for eligible children living in Medicaid-CHIP-mixed families. C1 [Hudson, Julie L.] Agcy Healthcare Res & Qual, Div Modeling & Simulat Ctr Financing Access & Cos, Rockville, MD 20850 USA. [Abdus, Salam] Social & Sci Syst, Rockville, MD USA. RP Hudson, JL (reprint author), Agcy Healthcare Res & Qual, Div Modeling & Simulat Ctr Financing Access & Cos, Rockville, MD 20850 USA. EM jhudson@ahrq.gov NR 13 TC 2 Z9 2 U1 1 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD AUG PY 2015 VL 34 IS 8 BP 1340 EP 1348 DI 10.1377/hlthaff.2015.0128 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CR2FH UT WOS:000361141000014 PM 26240248 ER PT J AU Fingar, KR Smith, MW Davies, S McDonald, KM Stocks, C Raven, MC AF Fingar, Kathryn R. Smith, Mark W. Davies, Sheryl McDonald, Kathryn M. Stocks, Carol Raven, Maria C. TI Medicaid Dental Coverage Alone May Not Lower Rates Of Dental Emergency Department Visits SO HEALTH AFFAIRS LA English DT Article ID DENTISTS; OFFICES; ACCESS AB Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers. C1 [Fingar, Kathryn R.] Truven Hlth Analyt, Sacramento, CA 95833 USA. [Smith, Mark W.] Truven Hlth Analyt, Fed Govt Div, Sacramento, CA USA. [Davies, Sheryl; McDonald, Kathryn M.] Stanford Univ, Ctr Hlth Policy, Stanford, CA 94305 USA. [Davies, Sheryl; McDonald, Kathryn M.] Stanford Univ, Ctr Primary Care & Outcomes Res, Stanford, CA 94305 USA. [Stocks, Carol] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Raven, Maria C.] Univ Calif San Francisco, Emergency Med, San Francisco, CA 94143 USA. RP Fingar, KR (reprint author), Truven Hlth Analyt, Sacramento, CA 95833 USA. EM katie.fingar@truvenhealth.com FU Agency for Healthcare Research and Quality (AHRQ) [HHSA290201200003I]; AHRQ [K12HS021700] FX Funding was provided by the Agency for Healthcare Research and Quality (AHRQ) (Contract No. HHSA290201200003I). Maria Raven was supported by AHRQ under Award No. K12HS021700. The findings and conclusions in this article are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ or the Department of Health and Human Services. The authors acknowledge the following team members and federal agency staff members for their participation in the development and testing of conceptual models, indicators, and supporting materials: at AHRQ, Pam Owens and Carol Stocks; at Stanford University, Kit Delgado, Lauren Riendeau, Eric Schmidt, Ellen Schultz, Karey Shuhendler, and Ewen Wang; at Truven Health Analytics, Marguerite Barrett, Rosanna Coffey, Bob Houchens, and Audrey Weiss. In addition, the authors thank the members of the various internal expert, stakeholder, and validation panels that participated in this work for their review of the materials. Finally, the authors acknowledge Nils Nordstrand of Truven Health Analytics for analyzing the study data. The analysis files used to develop and test the emergency department Prevention Quality Indicator software included records from the 2008-10 State Emergency Department Databases (SEDD) and State Inpatient Databases (SID). The authors acknowledge the Healthcare Cost and Utilization Project (HCUP) partner organizations that participated in the HCUP 2008-10 SEDD and SID (see http://www.hcup-us.ahrq.gov/partners.jsp). NR 41 TC 2 Z9 2 U1 1 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD AUG PY 2015 VL 34 IS 8 BP 1349 EP 1357 DI 10.1377/hlthaff.2015.0223 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CR2FH UT WOS:000361141000015 PM 26240249 ER PT J AU Andrews, RM AF Andrews, Roxanne M. TI Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements SO HEALTH SERVICES RESEARCH LA English DT Article DE Administrative data; hospital; race; ethnicity; clinical data ID PATIENT SAFETY INDICATORS; ELECTRONIC HEALTH RECORDS; INPATIENT MORTALITY; DATA INFRASTRUCTURE; ADMINISTRATIVE DATA; RISK ADJUSTMENT; CLAIMS DATA; CARE; ACCURACY; SERVICES AB ObjectivesTo provide an overview of statewide hospital discharge databases (HDD), including their uses in health services research and limitations, and to describe Agency for Healthcare Research and Quality (AHRQ) Enhanced State Data grants to address clinical and race-ethnicity data limitations. Principal FindingsAlmost all states have statewide HDD collected by public or private data organizations. Statewide HDD, based on the hospital claim with state variations, contain useful core variables and require minimal collection burden. AHRQ's Healthcare Cost and Utilization Project builds uniform state and national research files using statewide HDD. States, hospitals, and researchers use statewide HDD for many purposes. Illustrating researchers' use, during 2012-2014, HSR published 26 HDD-based articles on health policy, access, quality, clinical aspects of care, race-ethnicity and insurance impacts, economics, financing, and research methods. HDD have limitations affecting their use. Five AHRQ grants focused on enhancing clinical data and three grants aimed at improving race-ethnicity data. ConclusionICD-10 implementation will significantly affect the HDD. The AHRQ grants, information technology advances, payment policy changes, and the need for outpatient information may stimulate other statewide HDD changes. To remain a mainstay of health services research, statewide HDD need to keep pace with changing user needs while minimizing collection burdens. C1 Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. RP Andrews, RM (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM roxanne.andrews@comcast.net NR 87 TC 2 Z9 2 U1 6 U2 8 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD AUG PY 2015 VL 50 SU 1 BP 1273 EP 1299 DI 10.1111/1475-6773.12343 PG 27 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CN7KN UT WOS:000358613400002 PM 26150118 ER PT J AU DesRoches, CM Wong, HS Rich, EC Majumdar, SR AF DesRoches, Catherine M. Wong, Herbert S. Rich, Eugene C. Majumdar, Sumit R. TI Making the Case for a New National Data Collection Effort on Physicians and Their Practices SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material DE survey research; health policy; physician workforce C1 [DesRoches, Catherine M.; Rich, Eugene C.] Mathemat Policy Res, Cambridge, MA 02139 USA. [Wong, Herbert S.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Majumdar, Sumit R.] Univ Alberta, Dept Med, Edmonton, AB, Canada. RP DesRoches, CM (reprint author), Mathemat Policy Res, 955 Massachusetts Ave,Suite 801, Cambridge, MA 02139 USA. EM cdesroches@mathematic-mpr.com NR 6 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2015 VL 30 SU 3 BP 553 EP 554 DI 10.1007/s11606-015-3386-3 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA CN4FK UT WOS:000358385700001 ER PT J AU Fan, TN Rossi, C AF Fan, Tina Rossi, Carlo TI Screening for Cognitive Impairment in Older Adults SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, New York, NY 10010 USA. [Rossi, Carlo] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Fan, TN (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, New York, NY 10010 USA. NR 2 TC 1 Z9 1 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUL 15 PY 2015 VL 92 IS 2 BP 125 EP 126 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA CN4KN UT WOS:000358399100005 PM 26176371 ER PT J AU Ricciardi, R AF Ricciardi, Richard TI AHRQ Focuses on Ambulatory Patient Safety SO JOURNAL OF NURSING CARE QUALITY LA English DT Editorial Material ID CARE C1 [Ricciardi, Richard] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. RP Ricciardi, R (reprint author), Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. EM Richard.Ricciardi@ahrq.hhs.gov NR 10 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1057-3631 EI 1550-5065 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JUL-SEP PY 2015 VL 30 IS 3 BP 193 EP 196 DI 10.1097/NCQ.0000000000000124 PG 4 WC Nursing SC Nursing GA DD0NE UT WOS:000369615900003 PM 25893714 ER PT J AU Jacobs, PD Buntin, MB AF Jacobs, Paul D. Buntin, Melinda B. TI Determinants of Medicare Plan Choices: Are Beneficiaries More Influenced by Premiums or Benefits? SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID PRICE SENSITIVITY; HEALTH; COMPETITION; ENROLLMENT; RETIREES; PROGRAM AB Objectives: To evaluate the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. Study Design: We matched respondents in the 2008 Medicare Current Beneficiary Survey to the Medicare Advantage (MA) plans available to them using the Bid Pricing Tool and previously unavailable data on beneficiaries' plan choices. Methods: We estimated a 2-stage nested logit model of Medicare plan choice decision making, including the decision to choose traditional fee-for-service (FFS) Medicare or an MA plan, and for those choosing MA, which specific plan they chose. Results: Beneficiaries living in areas with higher average monthly rebates available from MA plans were more likely to choose MA rather than FFS. When choosing MA plans, beneficiaries are roughly 2 to 3 times more responsive to dollars spent to reduce cost sharing than reductions in their premium. We calculated an elasticity of plan choice with respect to the monthly MA premium of -0.20. Beneficiaries with lower incomes are more sensitive to plan premiums and cost sharing than higher-income beneficiaries. Conclusions: MA plans appear to have a limited incentive to aggressively price their products, and seem to compete primarily over reduced beneficiary cost sharing. Given the limitations of the current plan choice environment, policies designed to encourage the selection of lower-cost plans may require increasing premium differences between plans and providing the tools to enable beneficiaries to easily assess those differences. C1 [Jacobs, Paul D.] Congress Budget Off, Washington, DC USA. [Buntin, Melinda B.] Vanderbilt Univ, Sch Med, Dept Hlth Policy, Nashville, TN 37212 USA. RP Jacobs, PD (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM paul.jacobs@ahrq.hhs.gov NR 16 TC 0 Z9 0 U1 2 U2 4 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD JUL PY 2015 VL 21 IS 7 BP 498 EP U72 PG 13 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA CN8CC UT WOS:000358664000006 PM 26247740 ER PT J AU Irvin, VL Breen, N Meissner, HI Liu, BM Kaplan, RM AF Irvin, Veronica L. Breen, Nancy Meissner, Helen I. Liu, Benmei Kaplan, Robert M. TI Non-normal Screening Mammography Results, Lumpectomies, and Breast Cancer Reported by California Women, 2001-2009 SO WOMENS HEALTH ISSUES LA English DT Article ID SERVICES TASK-FORCE; FAMILY-HISTORY; UNITED-STATES; SELF-REPORT; POPULATION; RECALL; BIOPSY; BIAS; RECOMMENDATION; DISPARITIES AB Background: Although screening mammography may contribute to decreases in breast cancer mortality in a population, it may also increase the risk of false positives, anxiety, and unnecessary and costly medical procedures in individuals. We report trends in self-reported non-normal screening mammography results, lumpectomies, and breast cancer in a representative sample of California women. Methods: Data were obtained from the 2001, 2005, and 2009 cross-sectional California Health Interview Surveys (CHIS) and weighted to the California population. CHIS employed a multistage sampling design to administer telephone surveys in 6 languages. Our study sample was restricted to women 40 years and older who reported a screening mammogram in the past 2 years. Sample sizes were 13,974 in 2001, 12,069 in 2005, and 15,552 in 2009. Women reporting non-normal results were asked whether they had an operation to remove the lump and, if so, whether the lump was confirmed as malignant. Findings: Between 2001 and 2009, the percent of California women who reported having been diagnosed with breast cancer was relatively stable. For each of the three age groups studied, the percentage of non-normal mammography results increased and the percentages of lumpectomies decreased and, for every woman reporting a diagnosis of breast cancer, three women reported a lumpectomy that turned out not to be cancer. This ratio was greater for younger women and less for older women. Conclusions: Despite relatively constant rates of breast cancer diagnosis from 2001 to 2009, the percentage of non-normal mammography results increased and lumpectomies declined. Published by Elsevier Inc. C1 [Irvin, Veronica L.] Oregon State Univ, Coll Publ Hlth Human Sci, Sch Social & Behav Hlth Sci, Hlth Promot & Hlth Behav, Corvallis, OR 97331 USA. [Breen, Nancy] NCI, NIH, Hlth Syst & Intervent Res Branch, Healthcare Delivery Res Program, Rockville, MD USA. [Meissner, Helen I.] NIH, Tobacco Regulatory Sci Program, Off Dis Prevent, Rockville, MD USA. [Liu, Benmei] NCI, NIH, Div Canc Control & Populat Sci, Rockville, MD USA. [Kaplan, Robert M.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Irvin, VL (reprint author), Oregon State Univ, Coll Publ Hlth Human Sci, Sch Social & Behav Hlth Sci, 457 Waldo Hall, Corvallis, OR 97331 USA. EM veronica.irvin@oregonstate.edu OI Irvin, Veronica/0000-0001-6337-9108 FU Intramural Research Program of the Clinical Center, Department of Rehabilitation Medicine; Division of Cancer Control and Population Sciences at the National Cancer Institute; National Institutes of Health FX This research was supported in part by the Intramural Research Program of the Clinical Center, Department of Rehabilitation Medicine; and the Division of Cancer Control and Population Sciences at the National Cancer Institute, which are all part of the National Institutes of Health. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the National Institutes of Health or the United States government. NR 54 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1049-3867 EI 1878-4321 J9 WOMEN HEALTH ISS JI Womens Health Iss. PD JUL-AUG PY 2015 VL 25 IS 4 BP 331 EP 340 DI 10.1016/j.whi.2015.03.003 PG 10 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA CN7HK UT WOS:000358604800004 PM 26070253 ER PT J AU Gooch, B Goodman, J Gracia, JN Griffin, SO Grummer-Strawn, L Hirschman, J Hyman, F Iafolla, T Kohn, W Lester, AM Makrides, NS Manski, R Osorio, AM Silverman, B Sinks, T AF Gooch, Barbara Goodman, Jesse Gracia, J. Nadine Griffin, Susan O. Grummer-Strawn, Laurence Hirschman, Jay Hyman, Frederick Iafolla, Timothy Kohn, William Lester, Arlene M. Makrides, Nicholas S. Manski, Richard Osorio, Ana Maria Silverman, Benson Sinks, Thomas CA US Dept Hlth Human Serv Federal Pa TI US Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries SO PUBLIC HEALTH REPORTS LA English DT Article ID UNITED-STATES; ENAMEL FLUOROSIS; INFANT FORMULA; CHILDRENS INTELLIGENCE; RISK-FACTORS; ORAL-HEALTH; OSTEOSARCOMA; COMMUNITY; IMPACT; NEEDS C1 [Gooch, Barbara; Griffin, Susan O.; Kohn, William] US Dept HHS, Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Oral Hlth, Washington, DC USA. [Goodman, Jesse] US Dept HHS, Sci & Publ Hlth, US FDA, Washington, DC USA. [Gracia, J. Nadine] US Dept HHS, Off Assistant Secretary Hlth, Washington, DC USA. [Grummer-Strawn, Laurence] US Dept HHS, Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Nutr Phys Act & Obes,Maternal & Child Nutr Br, Washington, DC USA. [Hirschman, Jay] Food & Nutr Serv, USDA, Off Res & Anal, Washington, DC USA. [Hyman, Frederick] US Dept HHS, US FDA, Ctr Drug Evaluat & Res, Div Dermatol & Dent Prod, Washington, DC USA. [Iafolla, Timothy] Natl Inst Dent & Craniofacial Res, US Dept HHS, NIH, Off Sci & Policy Anal, Washington, DC USA. [Lester, Arlene M.; Makrides, Nicholas S.] US PHS, Washington, DC USA. [Lester, Arlene M.] US Dept HHS, Off Secretary, Washington, DC USA. [Makrides, Nicholas S.] US Dept Justice, Fed Bur Prisons, Washington, DC USA. [Manski, Richard] US Dept HHS, Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Washington, DC USA. [Osorio, Ana Maria] US PHS, US Dept HHS, Off Assistant Secretary Hlth, Washington, DC USA. [Silverman, Benson] US Dept HHS, US FDA, Ctr Food Safety & Appl Nutr, Washington, DC USA. [Sinks, Thomas] US Dept HHS, Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Agcy Tox Subst & Dis Registry, Washington, DC USA. RP Gooch, B (reprint author), Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Oral Hlth, 4770 Buford Hwy NE,MS F-80, Atlanta, GA 30341 USA. EM bgooch@cdc.gov NR 90 TC 0 Z9 0 U1 5 U2 17 PU ASSOC SCHOOLS PUBLIC HEALTH PI WASHINGTON PA 1900 M ST NW, STE 710, WASHINGTON, DC 20036 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD JUL-AUG PY 2015 VL 130 IS 4 BP 318 EP 331 PG 14 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA CM5DN UT WOS:000357707100008 ER PT J AU Chenoweth, CE Hines, SC Hall, KK Saran, R Kalbfleisch, JD Spencer, T Frank, KM Carlson, D Deane, J Roys, E Scholz, N Parrotte, C Messana, JM AF Chenoweth, Carol E. Hines, Stephen C. Hall, Kendall K. Saran, Rajiv Kalbfleisch, John D. Spencer, Teri Frank, Kelly M. Carlson, Diane Deane, Jan Roys, Erik Scholz, Natalie Parrotte, Casey Messana, Joseph M. TI Variation in Infection Prevention Practices in Dialysis Facilities: Results From the National Opportunity to Improve Infection Control in ESRD (End-Stage Renal Disease) Project SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID BLOOD-STREAM INFECTIONS; HEMODIALYSIS AB OBJECTIVE. To observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. SETTING AND PARTICIPANTS. Thirty-four hemodialysis facilities were randomly selected from among 772 facilities in 4 end-stage renal disease participating networks. Facility selection was stratified on dialysis organization affiliation, size, socioeconomic status, and urban/rural status. MEASUREMENTS. Trained infection control evaluators used an infection control worksheet to observe 73 distinct infection control practices at the hemodialysis facilities, from October 1, 2011, through January 31, 2012. RESULTS. There was considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68% (range, 45%-92%) across all facilities. Overall adherence to expected hand hygiene practice was 72% (range, 10%-100%). Compliance to hand hygiene before and after procedures was high; however, during procedures hand hygiene compliance averaged 58%. Use of chlorhexidine as the specific agent for exit site care was 19% overall but varied from 0% to 35% by facility type. The 8 checklists varied in the frequency of perfect performance from 0% for meeting every item on the checklist for disinfection practices to 22% on the arteriovenous access practices at initiation. CONCLUSIONS. Our findings suggest that there are many areas for improvement in hand hygiene and other infection prevention practices in end-stage renal disease. These NOTICE project findings will help inform the development of a larger quality improvement initiative at dialysis facilities. C1 [Chenoweth, Carol E.; Saran, Rajiv; Kalbfleisch, John D.; Roys, Erik; Scholz, Natalie; Parrotte, Casey; Messana, Joseph M.] Univ Michigan, Ann Arbor, MI 48109 USA. [Hines, Stephen C.] Hlth Res & Educ Trust, Chicago, IL USA. [Hall, Kendall K.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Spencer, Teri] TB Spencer Consulting, Fallbrook, CA USA. [Frank, Kelly M.] Ctr Medicaid Serv, Waterloo, IA USA. [Frank, Kelly M.] Ctr Medicare Serv, Waterloo, IA USA. [Carlson, Diane; Deane, Jan] Renal Network Upper Midwest, St Paul, MN USA. RP Chenoweth, CE (reprint author), Univ Michigan, Med Ctr, Taubman Ctr 3119, 1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA. EM cchenow@umich.edu FU Agency for Healthcare Research and Quality; Health Research Educational Trust [HHSA290200600022I] FX The Agency for Healthcare Research and Quality and the Health Research Educational Trust (contract HHSA290200600022I, "Improving Infection Control Practices in End-Stage Renal Disease [ESRD] Facilities"). NR 17 TC 1 Z9 1 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD JUL PY 2015 VL 36 IS 7 BP 802 EP 806 DI 10.1017/ice.2015.55 PG 5 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA CK8UE UT WOS:000356513400007 PM 25773538 ER PT J AU Yehia, BR Stephens-Shields, AJ Fleishman, JA Berry, SA Agwu, AL Metlay, JP Moore, RD Mathews, WC Nijhawan, A Rutstein, R Gaur, AH Gebo, KA AF Yehia, Baligh R. Stephens-Shields, Alisa J. Fleishman, John A. Berry, Stephen A. Agwu, Allison L. Metlay, Joshua P. Moore, Richard D. Mathews, W. Christopher Nijhawan, Ank Rutstein, Richard Gaur, Aditya H. Gebo, Kelly A. CA HIV Res Network TI The HIV Care Continuum: Changes over Time in Retention in Care and Viral Suppressionqs SO PLOS ONE LA English DT Article ID ANTIRETROVIRAL THERAPY; SELF-MANAGEMENT; CHRONIC DISEASE; UNITED-STATES; BEHAVIORAL-MODEL; OUTCOMES; PREVENTION; ADHERENCE; CASCADE; CLINICS AB Background The HIV care continuum (diagnosis, linkage to care, retention in care, receipt of antiretroviral therapy (ART), viral suppression) has been used to identify opportunities for improving the delivery of HIV care. Continuum steps are typically calculated in a conditional manner, with the number of persons completing the prior step serving as the base population for the next step. This approach may underestimate the prevalence of viral suppression by excluding patients who are suppressed but do not meet standard definitions of retention in care. Understanding how retention in care and viral suppression interact and change over time may improve our ability to intervene on these steps in the continuum. Methods We followed 17,140 patients at 11 U.S. HIV clinics between 2010-2012. For each calendar year, patients were classified into one of five categories: (1) retained/suppressed, (2) retained/not-suppressed, (3) not-retained/suppressed, (4) not-retained/not-suppressed, and (5) lost to follow-up (for calendar years 2011 and 2012 only). Retained individuals were those completing >= 2 HIV medical visits separated by >= 90 days in the year. Persons not retained completed >= 1 HIV medical visit during the year, but did not meet the retention definition. Persons lost to follow-up had no HIV medical visits in the year. HIV viral suppression was defined as HIV-1 RNA <= 200 copies/mL at the last measure in the year. Multinomial logistic regression was used to determine the probability of patients' transitioning between retention/suppression categories from 2010 to 2011 and 2010 to 2012, adjusting for age, sex, race/ethnicity, HIV risk factor, insurance status, CD4 count, and use of ART. Results Overall, 65.8% of patients were retained/suppressed, 17.4% retained/not-suppressed, 10.0% not-retained/suppressed, and 6.8% not-retained/not-suppressed in 2010. 59.5% of patients maintained the same status in 2011 (kappa=0.458) and 53.3% maintained the same status in 2012 (kappa=0.437). Conclusions Not counting patients not-retained/suppressed as virally suppressed, as is commonly done in the HIV care continuum, underestimated the proportion suppressed by 13%. Applying the care continuum in a longitudinal manner will enhance its utility. C1 [Yehia, Baligh R.] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA. [Yehia, Baligh R.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Yehia, Baligh R.; Stephens-Shields, Alisa J.] Univ Penn, Perelman Sch Med, Ctr Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Berry, Stephen A.; Agwu, Allison L.; Moore, Richard D.; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. [Metlay, Joshua P.] Massachusetts Gen Hosp, Div Gen Med, Boston, MA 02114 USA. [Mathews, W. Christopher] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. [Nijhawan, Ank] Univ Texas SW Med Ctr Dallas, Dept Med, Dallas, TX 75390 USA. [Rutstein, Richard] Childrens Hosp Philadelphia, Div Gen Pediat, Philadelphia, PA 19104 USA. [Gaur, Aditya H.] St Jude Childrens Res Hosp, Dept Infect Dis, Memphis, TN USA. RP Yehia, BR (reprint author), Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA. EM byehia@upenn.edu FU Agency for Healthcare Research and Quality [HHSA290201100007C]; National Institutes of Health [K23-MH097647, K23-AI084854] FX This work was supported by the Agency for Healthcare Research and Quality [HHSA290201100007C] and the National Institutes of Health [K23-MH097647 to BRY; K23-AI084854 to SAB]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 30 TC 8 Z9 8 U1 1 U2 4 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD JUN 18 PY 2015 VL 10 IS 6 AR e0129376 DI 10.1371/journal.pone.0129376 PG 10 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA CK9NT UT WOS:000356567500046 PM 26086089 ER PT J AU Fan, TN Rossi, C AF Fan, Tina Rossi, Carlo TI Primary Care Behavioral Interventions to Reduce Illicit Drug and Nonmedical Pharmaceutical Use in Children SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Washington, DC 20010 USA. [Rossi, Carlo] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Fan, TN (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Washington, DC 20010 USA. NR 2 TC 0 Z9 0 U1 0 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUN 15 PY 2015 VL 91 IS 12 BP 865 EP 866 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA CK6ER UT WOS:000356321800006 PM 26131946 ER PT J AU Leshem, E Tate, JE Steiner, CA Curns, AT Lopman, BA Parashar, UD AF Leshem, Eyal Tate, Jacqueline E. Steiner, Claudia A. Curns, Aaron T. Lopman, Ben A. Parashar, Umesh D. TI Acute Gastroenteritis Hospitalizations Among US Children Following Implementation of the Rotavirus Vaccine SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID HEALTH-CARE UTILIZATION; UNITED-STATES; DIARRHEA C1 [Leshem, Eyal; Tate, Jacqueline E.; Curns, Aaron T.; Lopman, Ben A.; Parashar, Umesh D.] US Ctr Dis Control & Prevent, Div Viral Dis, Atlanta, GA 30333 USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Healthcare Cost & Utilizat Project, Rockville, MD USA. RP Leshem, E (reprint author), US Ctr Dis Control & Prevent, Div Viral Dis, 1600 Clifton Rd NE,Mail Stop A-34, Atlanta, GA 30333 USA. EM eleshem@cdc.gov OI Leshem, Eyal/0000-0003-1267-6131 NR 6 TC 11 Z9 11 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 9 PY 2015 VL 313 IS 22 BP 2282 EP 2284 DI 10.1001/jama.2015.5571 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA CK1VH UT WOS:000355995300024 PM 26057291 ER PT J AU Ricci, KA Griffin, AR Heslin, KC Kranke, D Dobalian, A AF Ricci, Karen A. Griffin, Anne R. Heslin, Kevin C. Kranke, Derrick Dobalian, Aram TI Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making SO PREHOSPITAL AND DISASTER MEDICINE LA English DT Article DE disasters; hospital evacuation; organizational culture; organizational decision making ID PUBLIC-HEALTH; DISASTERS; LESSONS; SANDY; CARE AB Problem: Hospital-evacuation decisions are rarely straightforward in protracted advance-warning events. Previous work provides little insight into the decision-making process around evacuation. This study was conducted to identify factors that most heavily influenced the decisions to evacuate the US Department of Veterans Affairs (VA) New York Harbor Healthcare System's (NYHHS; New York USA) Manhattan Campus before Hurricane Irene in 2011 and before Superstorm Sandy in 2012. Methods: Semi-structured interviews with 11 senior leaders were conducted on the processes and factors that influenced the evacuation decisions prior to each event. Results: The most influential factor in the decision to evacuate the Manhattan Campus before Hurricane Irene was New York City's (NYC's) hospital-evacuation mandate. As a federal facility, the Manhattan VA medical center (VAMC) was exempt from the city's order, but decision makers felt compelled to comply. In the case of Superstorm Sandy, corporate memory of a similar 1992 storm that crippled the Manhattan facility drove the decision to evacuate before the storm hit. Conclusions: Results suggest that hospital-evacuation decisions are confounded by political considerations and are influenced by past disaster experience. Greater shared situational awareness among at-risk hospitals, along with a more coordinated approach to evacuation decision making, could reduce pressure on hospitals to make these high-stakes decisions. Systematic mechanisms for collecting, documenting, and sharing lessons learned from past disasters are sorely needed at the institutional, local, and national levels. Ricci KA, Griffin AR, Heslin KC, Kranke D, Dobalian A. Evacuate or shelter-in-place? The role of corporate memory and political environment in hospital-evacuation decision making. C1 [Ricci, Karen A.; Griffin, Anne R.; Kranke, Derrick; Dobalian, Aram] US Dept Vet Affairs, Vet Emergency Management Evaluat Ctr VEMEC, North Hills, CA USA. [Ricci, Karen A.] RAND Corp, Santa Monica, CA USA. [Heslin, Kevin C.] US Dept HHS, Ctr Delivery Org & Markets CDOM, Agcy Healthcare Res & Qual, Rockville, MD USA. [Dobalian, Aram] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA USA. [Dobalian, Aram] Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. RP Dobalian, A (reprint author), Vet Emergency Management Evaluat Ctr VEMEC, 16111 Plummer St,MS 152, North Hills, CA 91343 USA. EM Aram.Dobalian@va.gov NR 27 TC 2 Z9 2 U1 7 U2 10 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 1049-023X EI 1945-1938 J9 PREHOSPITAL DISASTER JI Prehospital Disaster Med. PD JUN PY 2015 VL 30 IS 3 BP 233 EP 238 DI 10.1017/S1049023X15000229 PG 6 WC Emergency Medicine SC Emergency Medicine GA CN4OP UT WOS:000358410000004 PM 25783663 ER PT J AU Borden, WB Chiang, YP Kronick, R AF Borden, William B. Chiang, Yen-Pin Kronick, Richard TI Bringing Patient-Centered Outcomes Research to Life SO VALUE IN HEALTH LA English DT Editorial Material DE dissemination; health care delivery; implementation; patient-centered outcomes research ID SERIOUS CARDIOVASCULAR EVENTS; ADULTS; YOUNG AB A substantial gap exists between medical evidence that is known and medical evidence that is put into practice. Although the Agency for Healthcare Research and Quality (AHRQ) has a long history of developing the content of evidence, the agency now pivots to close that gap by focusing on evidence dissemination and implementation. Achieving better health outcomes requires both the generation of new patient-centered outcomes research (PCOR) knowledge and the appropriate and timely implementation of that knowledge into practice. The Affordable Care Act provided funds to support both types of PCOR efforts, with AHRQ building on years of experience to advance research dissemination and implementation. This article describes the work the AHRQ has done, is doing, and will do in the future. To communicate PCOR evidence findings, AHRQ is currently synthesizing research findings into convincing collections of evidence that can be best taken up by clinicians, patients and caregivers, and policymakers. The future direction for AHRQ is to improve the context for evidence and practice improvement, thereby creating an environment receptive to PCOR. Toward this goal, AHRQ is actively engaging partners, such as professional societies and insurers, to make evidence central to decision making. In addition, AHRQ recently launched two programs that seek to both understand and encourage the use of evidence in clinical practice. Throughout these efforts, AHRQ will continually assess needs and adapt initiatives to ensure that PCOR translates into improved patient-centered health outcomes. C1 [Borden, William B.] George Washington Univ, Washington, DC 20037 USA. [Chiang, Yen-Pin] Patient Centered Outcomes Res Inst, Washington, DC USA. [Kronick, Richard] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Borden, WB (reprint author), George Washington Univ, 2150 Penn Ave,NW Suite 10-409, Washington, DC 20037 USA. EM wborden@mfa.gwu.edu NR 10 TC 1 Z9 1 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD JUN PY 2015 VL 18 IS 4 BP 355 EP 357 DI 10.1016/j.jval.2015.01.010 PG 3 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA CK6SQ UT WOS:000356358600001 PM 26091588 ER PT J AU Spector, WD Limcangco, R Mutter, RL Pines, JM Owens, P AF Spector, William D. Limcangco, Rhona Mutter, Ryan L. Pines, Jesse M. Owens, Pamela TI Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID EMERGENCY-DEPARTMENT; CARE; PHYSICIANS; RATES AB Introduction: Inpatient hospital costs represent nearly a third of heath care spending. The proportion of inpatients visits that originate in the emergency department (ED) has been growing, approaching half of all inpatient admissions. Injury is the most common reason for adult ED visits, representing nearly one-quarter of all ED visits. Objective: The objective was to explore the association of clinical and nonclinical factors with the decision to admit ED patients with injury. Research design and participants: This is a retrospective cohort study of injury-related ED encounters by adults in select states in 2009. We limited the study to ED visits of persons with moderately severe injuries. We used logistic regression to calculate the marginal effects, estimating 4 equations to account for different risk patterns for older and younger adults, and types of injuries. Regression models controlled for comorbidities, injury characteristics, demographic characteristics, and state fixed effects. Results: Injury location, type, and mechanism and comorbidities had large effects on hospitalization rates as expected. We found higher inpatient admission rates by level of trauma center designation and hospital size, but findings differed by age and type of injury. For younger adults, patients with private insurance and patients who traveled more than 30 miles were more likely to be admitted. Conclusions: There is great variation in inpatient admission decisions for moderately injured patients in the ED. Decisions appear to be dominated by clinical factors such as injury characteristics and comorbidities; however, nonclinical factors, such as type of insurance, hospital size, and trauma center designation, also play an important role. Published by Elsevier Inc. C1 [Spector, William D.; Owens, Pamela] US Dept Hlth & Human Serv, Agcy Healthcare Res & Qual, Rockville, MD USA. [Limcangco, Rhona] Social & Sci Syst Inc, Silver Spring, MD USA. [Mutter, Ryan L.] US Dept Hlth & Human Serv, Substance Abuse & Mental Hlth Adm, Rockville, MD USA. [Pines, Jesse M.] George Washington Univ, Dept Emergency Med, Washington, DC USA. [Pines, Jesse M.] George Washington Univ, Dept Hlth Policy, Washington, DC USA. RP Spector, WD (reprint author), 540 Gaither Rd, Rockville, MD 20850 USA. EM William.Spector@ahrq.hhs.gov NR 19 TC 0 Z9 0 U1 1 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0735-6757 EI 1532-8171 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD JUN PY 2015 VL 33 IS 6 BP 764 EP 769 DI 10.1016/j.ajem.2015.02.045 PG 6 WC Emergency Medicine SC Emergency Medicine GA CL0AS UT WOS:000356601400005 PM 25865158 ER PT J AU Antwi, YA Moriya, AS Simon, K Sommers, BD AF Antwi, Yaa Akosa Moriya, Asako S. Simon, Kosali Sommers, Benjamin D. TI Changes in Emergency Department Use Among Young Adults After the Patient Protection and Affordable Care Act's Dependent Coverage Provision SO ANNALS OF EMERGENCY MEDICINE LA English DT Article ID HEALTH-INSURANCE COVERAGE; REFORM; MASSACHUSETTS; ACCESS; MANDATE; VISITS; IMPACT; COST AB Study objective: Since September 2010, the Patient Protection and Affordable Care Act has allowed young adults to remain as dependents on their parents' private health plans until age 26 years. This insurance expansion could improve the efficiency of medical care delivery by reducing unnecessary emergency department (ED) use. We evaluated the effect of this provision on ED use among young adults. Methods: We used a nationally representative ED visit database of more than 17 million visits from 2007 to 2011. Our analysis compared young adults aged 19 to 25 years (the age group targeted by the law) with slightly older adults aged 27 to 29 years (control group), before and after the implementation of the law. Results: The quarterly ED-visit rate decreased by 1.6 per 1,000 population (95% confidence interval 1.2 to 2.1) among targeted young adults after the implementation of the provision, relative to a comparison group. The decrease was concentrated among women, weekday visits, non urgent conditions, and conditions that can be treated in other settings. We found no effect among weekend visits or visits due to injuries or urgent conditions. The provision also changed the health insurance composition of ED visits; the fraction of privately insured young adults increased, whereas the fraction of those insured through Medicaid and those uninsured decreased. Conclusion: The Patient Protection and Affordable Care Act dependent coverage expansion was associated with a statistically significant yet modest decrease in ED use, concentrated in the types of ED visits that were likely to be responsive to changes to insurance status. In response to the law, young adults appeared to have altered their visit pattern to reflect a more efficient use of medical care. C1 [Antwi, Yaa Akosa] Indiana Univ Purdue Univ, Dept Econ, Indianapolis, IN 46202 USA. [Moriya, Asako S.; Simon, Kosali] Indiana Univ, Sch Publ & Environm Affairs, Bloomington, IN 47405 USA. [Moriya, Asako S.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Simon, Kosali] NBER, Boston, MA USA. [Sommers, Benjamin D.] Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA. [Sommers, Benjamin D.] Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA. RP Moriya, AS (reprint author), Indiana Univ, Sch Publ & Environm Affairs, Bloomington, IN 47405 USA. EM asako.moriya@ahrq.hhs.gov NR 28 TC 12 Z9 12 U1 3 U2 17 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD JUN PY 2015 VL 65 IS 6 BP 664 EP 672 DI 10.1016/j.annemergmed.2015.01.010 PG 9 WC Emergency Medicine SC Emergency Medicine GA CJ8YB UT WOS:000355788300010 ER PT J AU Hsiao, CJ AF Hsiao, Chun-Ju TI The Role of HIT in Care Coordination in the United States Reply SO MEDICAL CARE LA English DT Letter ID INFORMATION-TECHNOLOGY C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Hsiao, CJ (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. NR 5 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD JUN PY 2015 VL 53 IS 6 BP 558 EP 559 PG 3 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CI4NI UT WOS:000354726500015 PM 25961658 ER PT J AU Sarpong, EM Miller, GE AF Sarpong, Eric M. Miller, G. Edward TI Narrow- and Broad-Spectrum Antibiotic Use among US Children SO HEALTH SERVICES RESEARCH LA English DT Article DE Children; antibiotics; narrow- and broad-spectrum; multinomial choice model ID ACUTE OTITIS-MEDIA; ANTIMICROBIAL AGENTS; UNITED-STATES; JUDICIOUS USE; ACUTE SINUSITIS; VISIT RATES; TRENDS; PRINCIPLES; INFECTIONS; BRONCHITIS AB ObjectivesTo provide updated estimates of narrow- and broad-spectrum antibiotic use among U.S. children. Data SourcesLinked nationally representative data from the 2004-2010 Medical Expenditure Panel Survey Household Component and the 2000 Decennial Census. Study DesignRelationships between individual-, family-, and community-level characteristics and the use of antibiotics overall and in the treatment of respiratory tract infections (RTIs) are examined using multinomial choice models. Principal FindingsMore than one quarter (27.3 percent) of children used at least one antibiotic each year with 12.8 percent using broad-spectrum and 18.5 percent using narrow-spectrum antibiotics. Among children with use, more than two-thirds (68.6 percent) used antibiotics to treat RTIs. Multivariate models revealed many differences across groups in antibiotic use, overall and in the treatment of RTIs. Differential use was associated with a broad range of factors related to need (e.g., age, health status), resources (e.g., insurance status, parental income, and education), race-ethnicity, and Census region. ConclusionsDespite encouraging reports regarding the declining use of antibiotics, large differences in use associated with resources, race-ethnicity, and Census regions suggest a need for further improvement in the judicious and appropriate prescribing of antibiotics for U.S. children. C1 [Sarpong, Eric M.; Miller, G. Edward] Agcy Healthcare Res & Qual, Div Modeling & Simulat, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. RP Sarpong, EM (reprint author), Agcy Healthcare Res & Qual, Div Modeling & Simulat, Ctr Financing Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20850 USA. EM eric.sarpong@ahrq.hhs.gov NR 31 TC 6 Z9 6 U1 0 U2 4 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD JUN PY 2015 VL 50 IS 3 BP 830 EP 846 DI 10.1111/1475-6773.12260 PG 17 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CI6OA UT WOS:000354878300012 PM 25424240 ER PT J AU Duong, VH Baer, MR Hendrick, F Weiss, SR Sato, M Zeidan, AM Gore, SD Davidoff, AJ AF Duong, Vu H. Baer, Maria R. Hendrick, Franklin Weiss, Sheila R. Sato, Masayo Zeidan, Amer M. Gore, Steven D. Davidoff, Amy J. TI Variations in erythropoiesis-stimulating agent administration intransfusion-dependent myelodysplastic syndromes impact response SO LEUKEMIA RESEARCH LA English DT Article DE Myelodysplastic syndromes; Erythropoiesis stimulating agents; Anemia; Comparative effectiveness ID DARBEPOETIN-ALPHA; PHASE-II; PLUS ERYTHROPOIETIN; ERYTHROID RESPONSE; GFM EXPERIENCE; GROWTH-FACTORS; G-CSF; ANEMIA; EFFICACY; TRIAL AB Introduction: Erythropoiesis-stimulating agents (ESAs) reduce red blood cell (RBC) transfusions in approximately 40% of patients with myelodysplastic syndrome (MDS) in clinical trials. We studied the association of timing of ESA initiation, agent (epoetin alfa, darbepoetin) and number of weeks of ESA use with response in MDS patients in routine practice. Methods: Patients diagnosed with MDS from 2001 to 2005 were identified in the Surveillance Epidemiology and End Results-Medicare linked database. The study cohort consisted of patients with new-onset transfusion dependence (TD). All patients received an ESA at least once during the study period, which began the week that criteria for TD were met and continued until transfusion independence (TI). Kaplan-Meier statistics and Cox Proportional Hazard models were used to assess relationships between time to ESA initiation, agent and number of weeks of ESA use and TI attainment. Results: Of 610 TD patients treated with ESAs, 210 (34.4%) achieved TI. Median time from ESA initiation to TI was 13 weeks. Shorter time from TD to ESA initiation and use of darbepoetin were associated with higher probability of achieving TI. The probability of achieving TI decreased beyond 8 weeks of treatment, and was very low beyond 16 weeks (8-15 weeks: HR = 0.64, 16-31 weeks: HR = 0.25, 32+ weeks HR = 0.10). Conclusions: In this observational, population-based study, variations in ESA administration impacted response in transfusion-dependent MDS patients, with higher response rates with early administration and use of darbepoetin, and low response likelihood in non-responders beyond 16 weeks of therapy. (C) 2015 Elsevier Ltd. All rights reserved. C1 [Duong, Vu H.; Baer, Maria R.] Univ Maryland Marlene, Baltimore, MD USA. [Duong, Vu H.; Baer, Maria R.] Univ Maryland, Stewart Greenebaum Canc Ctr, Sch Med, Baltimore, MD 21201 USA. [Duong, Vu H.; Baer, Maria R.] Univ Maryland, Dept Med, Sch Med, Baltimore, MD 21201 USA. [Hendrick, Franklin; Weiss, Sheila R.; Sato, Masayo] Univ Maryland, Sch Pharm, Pharmaceut Hlth Serv Res Dept, Baltimore, MD 21201 USA. [Zeidan, Amer M.; Gore, Steven D.] Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD USA. [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Duong, VH (reprint author), Univ Maryland, Greenebaum Canc Ctr, 22 S Greene St,S9D04B, Baltimore, MD 21201 USA. EM vduong@umm.edu OI Davidoff, Amy/0000-0001-8141-9249 FU NIH/NCI [RC1 CA145831-01] FX Funding was provided by NIH/NCI RC1 CA145831-01 (Davidoff, PI). NR 26 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0145-2126 J9 LEUKEMIA RES JI Leuk. Res. PD JUN PY 2015 VL 39 IS 6 BP 586 EP 591 DI 10.1016/j.leukres.2015.03.013 PG 6 WC Oncology; Hematology SC Oncology; Hematology GA CI5EP UT WOS:000354776600007 PM 25869077 ER PT J AU Henke, RM Karaca, Z Lin, H Wier, LM Marder, W Wong, HS AF Henke, Rachel Mosher Karaca, Zeynal Lin, Hollis Wier, Lauren M. Marder, William Wong, Herbert S. TI Patient Factors Contributing to Variation in Same-Hospital Readmission Rate SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Article DE hospital readmission; same-hospital readmission; patient factors; bundled payments; Medicare ID RISK AB The Centers for Medicare & Medicaid Services Hospital Readmission Reduction Program and the Centers for Medicare & Medicaid Innovations Bundled Payments for Care Improvement Initiative hold hospitals accountable for readmissions that occur at other hospitals. A few studies have described the extent to which hospital readmissions occur at the original place of treatment (i.e., same-hospital readmissions). This study uses data from 16 states to describe variation in same-hospital readmissions by patient characteristics across multiple conditions. We found that the majority of 30-day readmissions occur at the same hospital, although rates varied considerably by condition. A significant number of hospitals had very low rates of same-hospital readmissions, meaning that the majority of their readmissions went to other hospitals. Future research should examine why some hospitals are able to retain patients for a same-hospital readmission and others are not. C1 [Henke, Rachel Mosher; Lin, Hollis; Wier, Lauren M.; Marder, William] Truven Hlth Analyt, Cambridge, MA 02140 USA. Truven Hlth Analyt, Santa Barbara, CA USA. [Karaca, Zeynal; Wong, Herbert S.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Henke, RM (reprint author), Truven Hlth Analyt, 150 Cambridge Pk Dr, Cambridge, MA 02140 USA. EM rachel.henke@truvenhealth.com OI Marder, William/0000-0002-7198-6933 FU Agency for Healthcare Research and Quality [HHSA-290-2013-00002-C] FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by the Agency for Healthcare Research and Quality (Contract Number: HHSA-290-2013-00002-C). NR 8 TC 2 Z9 2 U1 1 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 EI 1552-6801 J9 MED CARE RES REV JI Med. Care Res. Rev. PD JUN PY 2015 VL 72 IS 3 BP 338 EP 358 DI 10.1177/1077558715577478 PG 21 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CH6AO UT WOS:000354117900006 PM 25824244 ER PT J AU Moore, JE Titler, MG Low, LK Dalton, VK Sampselle, CM AF Moore, Jennifer E. Titler, Marita G. Low, Lisa Kane Dalton, Vanessa K. Sampselle, Carolyn M. TI Transforming Patient-Centered Care: Development of the Evidence Informed Decision Making through Engagement Model SO WOMENS HEALTH ISSUES LA English DT Article ID HEALTH-CARE; ELECTIVE INDUCTION; CLINICAL-PRACTICE; LABOR; ACTIVATION; OUTCOMES; SATISFACTION; PREFERENCES; PERCEPTIONS; EXPERIENCES AB Background: In response to the passage of the Affordable Care Act in the United States, clinicians and researchers are critically evaluating methods to engage patients in implementing evidence-based care to improve health outcomes. However, most models on implementation only target clinicians or health systems as the adopters of evidence. Patients are largely ignored in these models. A new implementation model that captures the complex but important role of patients in the uptake of evidence may be a critical missing link. Discussion: Through a process of theory evaluation and development, we explore patient-centered concepts (patient activation and shared decision making) within an implementation model by mapping qualitative data from an elective induction of labor study to assess the model's ability to capture these key concepts. The process demonstrated that a new, patient-centered model for implementation is needed. In response, the Evidence Informed Decision Making through Engagement Model is presented. We conclude that, by fully integrating women into an implementation model, outcomes that are important to both the clinician and patient will improve. Conclusions: In the interest of providing evidence-based care to women during pregnancy and childbirth, it is essential that care is patient centered. The inclusion of concepts discussed in this article has the potential to extend beyond maternity care and influence other clinical areas. Utilizing the newly developed Evidence Informed Decision Making through Engagement Model provides a framework for utilizing evidence and translating it into practice while acknowledging the important role that women have in the process. Published by Elsevier Inc. C1 [Moore, Jennifer E.] Agcy Healthcare Res & Qual, Off Womens Hlth & Gender Res, US Dept HHS, Off Extramural Res Educ & Prior Populat, Rockville, MD 20850 USA. [Titler, Marita G.; Low, Lisa Kane; Sampselle, Carolyn M.] Univ Michigan, Sch Nursing, Dept Hlth Behav & Biol Sci, Ann Arbor, MI 48109 USA. [Dalton, Vanessa K.] Univ Michigan, Sch Med, Obstet & Gynecol, Ann Arbor, MI USA. [Sampselle, Carolyn M.] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA. RP Moore, JE (reprint author), Agcy Healthcare Res & Qual, Off Womens Hlth & Gender Res, US Dept HHS, Off Extramural Res Educ & Prior Populat, 540 Gaither Rd, Rockville, MD 20850 USA. EM Moore.JenniferElaine@gmail.com FU National Institutes of Health Individual National Research Service Award [F31NR012855]; Blue Cross Blue Shield Foundation of Michigan [1808.SAP] FX This project was funded by the National Institutes of Health Individual National Research Service Award, Grant #F31NR012855 (PI: Moore), and the Blue Cross Blue Shield Foundation of Michigan, Grant #1808.SAP (PI: Moore). NR 49 TC 3 Z9 3 U1 3 U2 10 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1049-3867 EI 1878-4321 J9 WOMEN HEALTH ISS JI Womens Health Iss. PD MAY-JUN PY 2015 VL 25 IS 3 BP 276 EP 282 DI 10.1016/j.whi.2015.02.002 PG 7 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA CN7HG UT WOS:000358604400013 PM 25864022 ER PT J AU Hudson, JL Hill, SC Selden, TM AF Hudson, Julie L. Hill, Steven C. Selden, Thomas M. TI If Rollbacks Go Forward, Up To 14 Million Children Could Become Ineligible For Public Or Subsidized Coverage By 2019 SO HEALTH AFFAIRS LA English DT Article ID HEALTH REFORM; MEDICAID; ELIGIBILITY; INSURANCE; BACK AB In spring 2015 Congress passed legislation to extend funding for the Children's Health Insurance Program (CHIP) through the end of fiscal year 2017. This two-year extension pushes to 2017 the question of whether CHIP funding will end, allowing states to end their separate state CHIP programs. Also, when the Affordable Care Act's maintenance-of-effort requirements expire after 2019, states will be allowed to roll back Medicaid-and CHIP-eligibility thresholds to minimum levels allowed by federal law. This study investigated the potential health insurance options available to low-income children if these events happen. If all states roll back coverage to federal statutory minimums, then, among children in families with incomes up to 400 percent of the federal poverty guidelines, the share ineligible for public coverage or subsidized Marketplace coverage would increase from 22 percent in 2014 (12.5 million children) to 46 percent after 2019 (26.5 million children). While not all states are likely to reduce eligibility to federal statutory minimums, these estimates highlight the fact that many children who do lose public eligibility will not become eligible for subsidized Marketplace coverage. C1 [Hudson, Julie L.; Hill, Steven C.; Selden, Thomas M.] AHRQ, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD 20850 USA. RP Hudson, JL (reprint author), AHRQ, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD 20850 USA. EM Julie.Hudson@ahrq.hhs.gov NR 13 TC 5 Z9 5 U1 0 U2 0 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD MAY PY 2015 VL 34 IS 5 BP 864 EP 870 DI 10.1377/hlthaff.2015.0004 PG 7 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CM2KL UT WOS:000357508600020 PM 25926593 ER PT J AU Cutler, E Henke, RE Marder, WD Karaca, Z Wong, H AF Cutler, E. Henke, R. E. Marder, W. D. Karaca, Z. Wong, H. TI HOSPITAL COST AND QUALITY TRENDS BEFORE AND AFTER ACO ADOPTION SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Cutler, E.; Henke, R. E.; Marder, W. D.] Truven Hlth Analyt, Cambridge, MA USA. [Karaca, Z.; Wong, H.] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2015 VL 18 IS 3 MA PHS178 BP A277 EP A277 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA CI1IZ UT WOS:000354498504289 ER PT J AU Du, D McKean, S Kelman, JA Laschinger, J Johnson, C Warnock, R Worrall, CM Sedrakyan, A Liu, X Encinosa, W MaCurdy, TE Izurieta, HS AF Du, D. McKean, S. Kelman, J. A. Laschinger, J. Johnson, C. Warnock, R. Worrall, C. M. Sedrakyan, A. Liu, X. Encinosa, W. MaCurdy, T. E. Izurieta, H. S. TI COMPARE EARLY MORTALITY AFTER AORTIC VALVE REPLACEMENT WITH MECHANICAL PROSTHETIC VS BIOPROSTHETIC VALVES AMONG MEDICARE BENEFICIARIES SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Du, D.; Laschinger, J.; Izurieta, H. S.] US FDA, Silver Spring, MD USA. [McKean, S.; Johnson, C.; Warnock, R.] Acumen LLC, Burlingame, CA USA. [Kelman, J. A.; Liu, X.] CMS, Washington, DC USA. [Worrall, C. M.] CMS, Baltimore, MD USA. [MaCurdy, T. E.] Weill Cornell Med Coll, New York, NY USA. [Encinosa, W.] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2015 VL 18 IS 3 MA PCV22 BP A133 EP A133 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA CI1IZ UT WOS:000354498502116 ER PT J AU Kato, EU Hartling, L Guise, JM AF Kato, E. U. Hartling, L. Guise, J. M. TI METHODS AND CONTEXT FOR THE PRODUCTION OF RAPID REVIEWS SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Kato, E. U.] AHRQ, Rockville, MD USA. [Hartling, L.] Univ Alberta, Edmonton, AB, Canada. [Guise, J. M.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2015 VL 18 IS 3 MA PRM150 BP A36 EP A36 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA CI1IZ UT WOS:000354498500190 ER PT J AU Shi, LY Lebrun-Harris, LA Chen, LR Parasuraman, SR Zhu, JS Ngo-Metzger, Q Sripipatana, A AF Shi, Leiyu Lebrun-Harris, Lydie A. Chen, Li-Ru Parasuraman, Sarika Rane Zhu, Jinsheng Ngo-Metzger, Quyen Sripipatana, Alek TI Preventive Counseling Services during Primary Care Visits: A Comparison of Health Centers versus Other Physician Offices SO JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED LA English DT Article DE Disparities; preventive care; safety-net providers; health centers ID UNITED-STATES; DISPARITIES; INSURANCE; ACCESS; WOMEN AB We compared preventive counseling services provided by health centers versus other physician offices. Cross-sectional data came from the 2008 National Ambulatory Medical Care Survey, including 25,177 patient visits in physician offices and 3,345 patient visits in health centers. Despite serving disproportionately more vulnerable patients, health centers provided comparable rates of preventive counseling services, compared with other physician offices: health education (39% vs. 36%), disease management (34% vs. 41%), asthma education (21% vs. 13%), tobacco education (19% for both), and weight reduction education (6% vs. 9%) (p>.05 for all). Adjusted analyses showed no association between health care setting and preventive counseling. C1 [Shi, Leiyu; Parasuraman, Sarika Rane; Zhu, Jinsheng] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Ctr Primary Care Policy, Baltimore, MD USA. [Lebrun-Harris, Lydie A.] US Dept Hlth & Human Serv, Hlth Resources & Serv Adm, Off Planning Anal & Evaluat, Rockville, MD USA. [Chen, Li-Ru] Da Yeh Univ, Coll Management, Dacun Changhua, Taiwan. [Ngo-Metzger, Quyen] Ctr Primary Care Prevent & Clin Partnerships, US Dept Hlth & Human Serv, Agcy Healthcare Res & Qual, Rockville, MD USA. Bur Primary Hlth Care, Hlth Resources & Serv Adm, US Dept Hlth & Human Serv, Rockville, MD USA. RP Shi, LY (reprint author), Johns Hopkins Primary Care Policy Ctr, Baltimore, MD 21205 USA. EM lshi@jhsph.edu NR 34 TC 1 Z9 1 U1 1 U2 5 PU JOHNS HOPKINS UNIV PRESS PI BALTIMORE PA JOURNALS PUBLISHING DIVISION, 2715 NORTH CHARLES ST, BALTIMORE, MD 21218-4363 USA SN 1049-2089 EI 1548-6869 J9 J HEALTH CARE POOR U JI J. Health Care Poor Underserved PD MAY PY 2015 VL 26 IS 2 BP 519 EP 535 PG 17 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CI2OQ UT WOS:000354587300019 PM 25913348 ER PT J AU Carman, KL Mallery, C Maurer, M Wang, G Garfinkel, S Yang, MS Gilmore, D Windham, A Ginsburg, M Sofaer, S Gold, M Pathak-Sen, E Davies, T Siegel, J Mangrum, R Fernandez, J Richmond, J Fishkin, J Chao, AS AF Carman, Kristin L. Mallery, Coretta Maurer, Maureen Wang, Grace Garfinkel, Steve Yang, Manshu Gilmore, Dierdre Windham, Amy Ginsburg, Marjorie Sofaer, Shoshanna Gold, Marthe Pathak-Sen, Ela Davies, Todd Siegel, Joanna Mangrum, Rikki Fernandez, Jessica Richmond, Jennifer Fishkin, James Chao, Alice Siu TI Effectiveness of public deliberation methods for gathering input on issues in healthcare: Results from a randomized trial SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE Public deliberation; Public engagement; Citizens' jury; Public opinion; Evidence-based medicine; Comparative effectiveness research; United States ID DECISION-MAKING; PARTICIPATION; ENGAGEMENT; POLICY; CONSUMERS; PATIENT; CONTEXT; CITIZEN AB Public deliberation elicits informed perspectives on complex issues that are values-laden and lack technical solutions. This Deliberative Methods Demonstration examined the effectiveness of public deliberation for obtaining informed public input regarding the role of medical evidence in U.S. healthcare. We conducted a 5-arm randomized controlled trial, assigning participants to one of four deliberative methods or to a reading materials only (RMO) control group. The four deliberative methods reflected important differences in implementation, including length of the deliberative process and mode of interaction. The project convened 76 groups between August and November 2012 in four U.S. locations: Chicago, IL; Sacramento, CA; Silver Spring, MD; and Durham, NC, capturing a sociodemographically diverse sample with specific attention to ensuring inclusion of Hispanic, African-American, and elderly participants. Of 1774 people recruited, 75% participated: 961 took part in a deliberative method and 377 participants comprised the RMO control group. To assess effectiveness of the deliberative methods overall and of individual methods, we evaluated whether mean pre-post changes on a knowledge and attitude survey were statistically different from the RMO control using ANCOVA. In addition, we calculated mean scores capturing participant views of the impact and value of deliberation. Participating in deliberation increased participants' knowledge of evidence and comparative effectiveness research and shifted participants' attitudes regarding the role of evidence in decision-making. When comparing each deliberative method to the RMO control group, all four deliberative methods resulted in statistically significant change on at least one knowledge or attitude measure. These findings were underscored by self-reports that the experience affected participants' opinions. Public deliberation offers unique potential for those seeking informed input on complex, values-laden topics affecting broad public constituencies. (C) 2015 Elsevier Ltd. All rights reserved. C1 [Carman, Kristin L.; Mallery, Coretta; Maurer, Maureen; Wang, Grace; Garfinkel, Steve; Yang, Manshu; Gilmore, Dierdre; Windham, Amy; Sofaer, Shoshanna; Mangrum, Rikki; Fernandez, Jessica; Richmond, Jennifer] Amer Inst Res, Washington, DC 20007 USA. [Ginsburg, Marjorie] Ctr Healthcare Decis, Sacramento, CA 95825 USA. [Gold, Marthe] CUNY, Grad Ctr, City Coll New York, New York, NY 10016 USA. [Pathak-Sen, Ela] Nishana Enterprises Ltd, Commot, Painswick GL6 6RT, England. [Davies, Todd] Stanford Univ, CSLI, Ctr Study Language & Informat, Stanford, CA 94305 USA. [Siegel, Joanna] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD 20850 USA. [Fishkin, James; Chao, Alice Siu] Stanford Univ, Dept Commun, Ctr Deliberat Democracy, Stanford, CA 94305 USA. RP Carman, KL (reprint author), Amer Inst Res, Hlth & Social Dev, 1000 Thomas Jefferson St NW, Washington, DC 20007 USA. EM KCarman@air.org RI Davies, Todd/K-5053-2015 OI Davies, Todd/0000-0001-9082-4887 FU Agency for Healthcare Research and Quality [290-2010-00005CAHRQ] FX We gratefully acknowledge our project team and anonymous reviewers for their contributions to this article. We are most indebted to our participants, who taught each other and us so much. This study was support by the Agency for Healthcare Research and Quality (Contract No. 290-2010-00005CAHRQ). NR 42 TC 7 Z9 7 U1 2 U2 8 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD MAY PY 2015 VL 133 SI SI BP 11 EP 20 DI 10.1016/j.socscimed.2015.03.024 PG 10 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA CI2LT UT WOS:000354579800003 PM 25828260 ER PT J AU Heisey-Grove, D Wall, HK Helwig, A Wright, JS AF Heisey-Grove, Dawn Wall, Hilary K. Helwig, Amy Wright, Janet S. TI Using Electronic Clinical Quality Measure Reporting for Public Health Surveillance SO MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT LA English DT Article C1 [Heisey-Grove, Dawn] CDC, Off Planning Evaluat & Anal, Off Natl Coordinator Hlth Informat Technol, Atlanta, GA 30333 USA. [Wall, Hilary K.; Wright, Janet S.] CDC, Div Heart Dis & Stroke Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. [Helwig, Amy] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Heisey-Grove, D (reprint author), CDC, Off Planning Evaluat & Anal, Off Natl Coordinator Hlth Informat Technol, Atlanta, GA 30333 USA. EM Dawn.Heisey-Grove@hhs.gov NR 6 TC 2 Z9 2 U1 0 U2 1 PU CENTERS DISEASE CONTROL PI ATLANTA PA 1600 CLIFTON RD, ATLANTA, GA 30333 USA SN 0149-2195 EI 1545-861X J9 MMWR-MORBID MORTAL W JI MMWR-Morb. Mortal. Wkly. Rep. PD MAY 1 PY 2015 VL 64 IS 16 BP 439 EP 442 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA CH3GV UT WOS:000353918400003 PM 25928469 ER PT J AU Kaplan, RM Howard, VJ Safford, MM Howard, G AF Kaplan, Robert M. Howard, Virginia J. Safford, Monika M. Howard, George TI Educational attainment and longevity: results from the REGARDS US national cohort study of blacks and whites SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE Educational attainment; Life expectancy; All-cause mortality; Prospective cohort ID HEALTHY LIFE EXPECTANCY; ADULT MORTALITY; UNITED-STATES; RISK-FACTORS; AGE; COUNTRIES; INEQUALITIES; GRADIENT; GENDER; INCOME AB Background: Educational attainment may be an important determinant of life expectancy. However, few studies have prospectively evaluated the relationship between educational attainment and life expectancy using adjustments for other social, behavioral, and biological factors. Method: The data were from the REasons for Geographic and Racial Differences in Stroke study that enrolled 30,239 black and white adults (>= 45 years) between 2003 and 2007. Demographic and cardiovascular risk information was collected and participants were followed for health outcomes. Educational attainment was categorized as less than high school education, high school graduate, some college, or college graduate. Proportional hazards analysis was used to characterize survival by level of education. Results: Educational attainment and follow-up data were available on 29,657(98%) of the participants. Over 6.3 years of follow-up, 3673 participants died. There was a monotonically increasing risk of death with lower levels of educational attainment. The same monotonic relationship held with adjustments for age, race, sex, cardiovascular risk factors, and health behaviors. The unadjusted hazard ratio for those without a high school education in comparison with college graduates was 2.89 (95% CI =2.64-3.18). Although adjustment for income, health behaviors, and cardiovascular risk factors attenuated the relationship, the same consistent pattern was observed after adjustment. The relationship between educational attainment and longevity was similar for black and white participants. The monotonic relationship between educational attainment and longevity was observed for all age groups, except for those aged 85 years or more. Conclusions: Educational attainment is a significant predictor of longevity. Other factors including age, race, income, health behaviors, and cardiovascular risk factors only partially explain the relationship. Published by Elsevier Inc. C1 [Kaplan, Robert M.] NIH, Off Behav & Social Sci Res, Bethesda, MD 20892 USA. [Howard, Virginia J.] Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA. [Safford, Monika M.] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA. [Howard, George] Univ Alabama Birmingham, Dept Biostat, Birmingham, AL 35294 USA. RP Kaplan, RM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM rmkaplan@ucla.edu FU National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH) [U01 NS041588]; American Reinvestment and Recovery Act supplement; Department of Health and Human Services FX This research was supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Department of Health and Human Services, and also an American Reinvestment and Recovery Act supplement. The content is solely the responsibility of the authors and does not necessarily represent the official views and positions of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. NR 25 TC 2 Z9 3 U1 3 U2 15 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1047-2797 EI 1873-2585 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD MAY PY 2015 VL 25 IS 5 BP 323 EP 328 DI 10.1016/j.annepidem.2015.01.017 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA CG5XI UT WOS:000353368800003 PM 25791026 ER PT J AU McAlearney, AS Hefner, JL Robbins, J Harrison, MI Garman, A AF McAlearney, Ann Scheck Hefner, Jennifer L. Robbins, Julie Harrison, Michael I. Garman, Andrew TI Preventing Central Line-Associated Bloodstream Infections: A Qualitative Study of Management Practices SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID INTENSIVE-CARE UNITS; HEALTH-CARE; HOSPITALS; CONTEXT; PROGRAM AB OBJECTIVE. To identify factors that may explain hospital-level differences in outcomes of programs to prevent central line-associated bloodstream infections. DESIGN. Extensive qualitative case study comparing higher-and lower-performing hospitals on the basis of reduction in the rate of central line-associated bloodstream infections. In-depth interviews were transcribed verbatim and analyzed to determine whether emergent themes differentiated higher-from lower-performing hospitals. SETTING. Eight US hospitals that had participated in the federally funded On the CUSP-Stop BSI initiative. PARTICIPANTS. One hundred ninety-four interviewees including administrative leaders, clinical leaders, professional staff, and frontline physicians and nurses. RESULTS. A main theme that differentiated higher-from lower-performing hospitals was a distinctive framing of the goal of "getting to zero" infections. Although all sites reported this goal, at the higher-performing sites the goal was explicitly stated, widely embraced, and aggressively pursued; in contrast, at the lower-performing hospitals the goal was more of an aspiration and not embraced as part of the strategy to prevent infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition. We present these strategies for prevention of healthcare-associated infection as a management "bundle" with corresponding suggestions for implementation. CONCLUSIONS. Some of the variance associated with CLABSI prevention program outcomes may relate to specific management practices. Adding a management practice bundle may provide critical guidance to physicians, clinical managers, and hospital leaders as they work to prevent healthcare-associated infections. C1 [McAlearney, Ann Scheck; Hefner, Jennifer L.; Robbins, Julie] Ohio State Univ, Dept Family Med, Coll Med, Columbus, OH 43201 USA. [McAlearney, Ann Scheck] Ohio State Univ, Div Hlth Serv Management & Policy, Coll Publ Hlth, Columbus, OH 43210 USA. [Harrison, Michael I.] Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD USA. [Garman, Andrew] Rush Univ, Dept Hlth Syst Management, Chicago, IL 60612 USA. [Garman, Andrew] Natl Ctr Healthcare Leadership, Chicago, IL USA. RP McAlearney, AS (reprint author), Ohio State Univ, Dept Family Med, Coll Med, 2231 Noth High St,273 Northwood & High, Columbus, OH 43201 USA. EM Ann.McAlearney@osumc.edu RI Hefner, Jennifer/P-5962-2014 OI Hefner, Jennifer/0000-0001-8083-8038 FU AHRQ [HHSA290200600022] FX AHRQ (contract #HHSA290200600022). NR 24 TC 4 Z9 4 U1 3 U2 15 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD MAY PY 2015 VL 36 IS 5 BP 557 EP 563 DI 10.1017/ice.2015.27 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA CG1MP UT WOS:000353037100008 ER PT J AU Kaplan, R Morgan, G AF Kaplan, Robert Morgan, Glen TI PROVIDERS ADVICE CONCERNING SMOKING CESSATION: EVIDENCE FROM THE MEDICAL EXPENDITURES PANEL SURVEY SO ANNALS OF BEHAVIORAL MEDICINE LA English DT Meeting Abstract C1 [Kaplan, Robert] AHRQ, Rockville, MD 20850 USA. [Morgan, Glen] NCI, Rockville, MD USA. EM rmkaplan@ucla.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0883-6612 EI 1532-4796 J9 ANN BEHAV MED JI Ann. Behav. Med. PD APR PY 2015 VL 49 SU 1 MA B133 BP S124 EP S124 PG 1 WC Psychology, Multidisciplinary SC Psychology GA DA5EH UT WOS:000367825001486 ER PT J AU Hellinger, FJ AF Hellinger, Fred Joseph TI Measuring the Cost Effectiveness of HIV Prevention Interventions in the US: Pitfalls and Problems SO APPLIED HEALTH ECONOMICS AND HEALTH POLICY LA English DT Editorial Material ID ACTIVE ANTIRETROVIRAL THERAPY; UNITED-STATES; PREEXPOSURE PROPHYLAXIS; ERA; OUTCOMES; IMPACT C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Hellinger, FJ (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. EM fred.hellinger@ahrq.hhs.gov NR 19 TC 0 Z9 0 U1 0 U2 1 PU SPRINGER INTERNATIONAL PUBLISHING AG PI CHAM PA GEWERBESTRASSE 11, CHAM, CH-6330, SWITZERLAND SN 1175-5652 EI 1179-1896 J9 APPL HEALTH ECON HEA JI Appl. Health Econ. Health Policy PD APR PY 2015 VL 13 IS 2 BP 129 EP 133 DI 10.1007/s40258-015-0158-5 PG 5 WC Health Policy & Services SC Health Care Sciences & Services GA CQ2YN UT WOS:000360468600003 PM 25724918 ER PT J AU Selden, TM Dubay, L Miller, GE Vistnes, J Buettgens, M Kenney, GM AF Selden, Thomas M. Dubay, Lisa Miller, G. Edward Vistnes, Jessica Buettgens, Matthew Kenney, Genevieve M. TI Many Families May Face Sharply Higher Costs If Public Health Insurance For Their Children Is Rolled Back SO HEALTH AFFAIRS LA English DT Article ID COVERAGE AB Millions of US children could lose access to public health care coverage if Congress does not renew federal funding for the Children's Health Insurance Program (CHIP), which is set to expire September 30, 2015-the end of the federal fiscal year. Additional cuts in public coverage for children in families with incomes above 133 percent of the federal poverty level are possible if the Affordable Care Act's "maintenance of effort" provisions regarding Medicaid and CHIP are allowed to expire as scheduled in 2019. The potential for a significant rollback of public coverage for children raises important policy questions regarding alternative pathways to affordable and high-quality coverage for low-income children. For many children at risk of losing eligibility for public coverage, the primary alternative pathway to coverage would be through their parents' employer-sponsored insurance, yet relatively little is known about the cost and quality of that coverage. Our estimates, based on data from the Insurance Component of the 2012 and 2013 Medical Expenditure Panel Surveys, show that many families would face sharply higher costs of covering their children. In many cases, the only employer-sponsored coverage available would be a high-deductible plan. C1 [Selden, Thomas M.] AHRQ, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD 20850 USA. [Dubay, Lisa] Urban Inst, Ctr Hlth Policy, Washington, DC 20037 USA. [Miller, G. Edward] AHRQ, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD USA. [Vistnes, Jessica] AHRQ, Ctr Financing Access & Cost Trends, Div Social & Econ Res, Rockville, MD USA. [Buettgens, Matthew] Urban Inst, Washington, DC 20037 USA. [Kenney, Genevieve M.] Urban Inst, Ctr Hlth Policy, Washington, DC 20037 USA. RP Selden, TM (reprint author), AHRQ, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD 20850 USA. EM Thomas.Selden@ahrq.hhs.gov FU National Institute for Health Care Reform; Urban Institute FX Lisa Dubay, Matthew Buettgens, and Genevieve Kenney received Funding From the National Institute for Health Care Reform and the Urban Institute. The authors are grateful for the helpful suggestions of Joel Cohen, Steven Cohen, Steven Hill, Julie Hudson, and Steve Machlin. Any remaining errors are the authors' own. The research reported in this article was conducted while Ed Miller and Jessica Vistnes were also Special Sworn Status researchers at the US Census Bureau's Suitland, Maryland, Census Research Data Center. The views expressed in this article are those of the authors, and no official endorsement by the Department of Health and Human Services or the Agency for Healthcare Research and Quality is intended or should be inferred. Nor do the views expressed in this article necessarily indicate concurrence by the Urban Institute or the Census Bureau. The results presented in this article have been screened to ensure that no confidential information has been revealed. [Published online March 25, 2015.] NR 20 TC 7 Z9 7 U1 0 U2 1 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD APR PY 2015 VL 34 IS 4 BP 697 EP 706 DI 10.1377/hlthaff.2015.0003 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CI5JX UT WOS:000354792900021 PM 25809641 ER PT J AU Schackman, BR Fleishman, JA Su, AE Berkowitz, BK Moore, RD Walensky, RP Becker, JE Voss, C Paltiel, AD Weinstein, MC Freedberg, KA Gebo, KA Losina, E AF Schackman, Bruce R. Fleishman, John A. Su, Amanda E. Berkowitz, Bethany K. Moore, Richard D. Walensky, Rochelle P. Becker, Jessica E. Voss, Cindy Paltiel, A. David Weinstein, Milton C. Freedberg, Kenneth A. Gebo, Kelly A. Losina, Elena TI The Lifetime Medical Cost Savings From Preventing HIV in the United States SO MEDICAL CARE LA English DT Article DE HIV; AIDS; health care cost; prevention; computer modeling ID ACTIVE ANTIRETROVIRAL THERAPY; HEALTH-SERVICES UTILIZATION; INFECTED PATIENTS; CARE; ERA; OUTPATIENT; HIV/AIDS; DISEASE; ADULTS; AIDS AB Objective: Enhanced HIV prevention interventions, such as pre-exposure prophylaxis for high-risk individuals, require substantial investments. We sought to estimate the medical cost saved by averting 1 HIV infection in the United States. Methods: We estimated lifetime medical costs in persons with and without HIV to determine the cost saved by preventing 1 HIV infection. We used a computer simulation model of HIV disease and treatment (CEPAC) to project CD4 cell count, antiretroviral treatment status, and mortality after HIV infection. Annual medical cost estimates for HIV-infected persons, adjusted for age, sex, race/ethnicity, and transmission risk group, were from the HIV Research Network (range, $1854-$4545/mo) and for HIV-uninfected persons were from the Medical Expenditure Panel Survey (range, $73$628/mo). Results are reported as lifetime medical costs from the US health system perspective discounted at 3% (2012 USD). Results: The estimated discounted lifetime cost for persons who become HIV infected at age 35 is $326,500 (60% for antiretroviral medications, 15% for other medications, 25% nondrug costs). For individuals who remain uninfected but at high risk for infection, the discounted lifetime cost estimate is $96,700. The medical cost saved by avoiding 1 HIV infection is $229,800. The cost saved would reach $338,400 if all HIV-infected individuals presented early and remained in care. Cost savings are higher taking into account secondary infections avoided and lower if HIV infections are temporarily delayed rather than permanently avoided. Conclusions: The economic value of HIV prevention in the United States is substantial given the high cost of HIV disease treatment. C1 [Schackman, Bruce R.] Weill Cornell Med Coll, Dept Healthcare Policy & Res, New York, NY 10064 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Su, Amanda E.; Berkowitz, Bethany K.; Walensky, Rochelle P.; Becker, Jessica E.; Freedberg, Kenneth A.; Losina, Elena] Massachusetts Gen Hosp, Div Gen Internal Med, Boston, MA 02114 USA. [Su, Amanda E.; Berkowitz, Bethany K.; Walensky, Rochelle P.; Becker, Jessica E.; Freedberg, Kenneth A.; Losina, Elena] Massachusetts Gen Hosp, Med Practice Evaluat Ctr, Boston, MA 02114 USA. [Moore, Richard D.; Voss, Cindy; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. [Walensky, Rochelle P.; Freedberg, Kenneth A.] Massachusetts Gen Hosp, Div Infect Dis, Boston, MA 02114 USA. [Walensky, Rochelle P.; Freedberg, Kenneth A.; Losina, Elena] Harvard Univ, Ctr AIDS Res, Cambridge, MA 02138 USA. [Walensky, Rochelle P.] Brigham & Womens Hosp, Div Infect Dis, Boston, MA 02115 USA. [Paltiel, A. David] Yale Univ, Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA. [Weinstein, Milton C.; Freedberg, Kenneth A.] Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA. [Freedberg, Kenneth A.] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA. [Losina, Elena] Brigham & Womens Hosp, Dept Orthoped Surg, Boston, MA 02115 USA. [Losina, Elena] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA USA. RP Schackman, BR (reprint author), Weill Cornell Med Coll, Dept Healthcare Policy & Res, Healthcare Policy & Res, 425 East 61st St Suite 301, New York, NY 10064 USA. EM brs2006@med.cornell.edu FU Agency for Healthcare Research and Quality, Rockville, Maryland; Health Resources and Services Administration, Rockville, Maryland FX HIVRN Sponsoring Agencies: Agency for Healthcare Research and Quality, Rockville, Maryland (Fred Hellinger, PhD, John Fleishman, PhD, Irene Fraser, PhD); Health Resources and Services Administration, Rockville, Maryland (Robert Mills, PhD, Faye Malitz, MS). NR 50 TC 12 Z9 12 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD APR PY 2015 VL 53 IS 4 BP 293 EP 301 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CG3EE UT WOS:000353160100004 PM 25710311 ER PT J AU Pylypchuk, Y Sarpong, EM AF Pylypchuk, Yuriy Sarpong, Eric M. TI Nurse Practitioners and Their Effects on Visits to Primary Care Physicians SO B E JOURNAL OF ECONOMIC ANALYSIS & POLICY LA English DT Article DE nurse practitioners; endogeneity; supply of physicians ID HEALTH; ASSISTANTS; SPECIALTY; RESOURCE; OUTCOMES; MODELS; LEMONS; IMPACT; TIME AB The demand for primary care services is expected to increase at a time of persistent shortages of primary care physicians (PCPs) in the United States. A proposed solution is to expand the role of other allied health professions. This study examines the causal effects of visits to nurse practitioners (NPs) on the demand for services from PCPs. We employ a system of simultaneous equations and dynamic panel estimators to control for endogeneity of visits to NPs. Results indicate that patients who visited an NP are significantly less likely to visit PCPs and to receive prescribed medication, medical check-up, and diagnosis from PCPs. Findings were robust to other specification and passed a falsification test. The results suggest that the use of NPs could serve as a potential option to address shortages in supply of primary care services. C1 [Pylypchuk, Yuriy] Social & Sci Syst, Rockville, MD 20852 USA. [Pylypchuk, Yuriy] Georgetown Univ, McCourt Sch Publ Policy, Washington, DC USA. [Sarpong, Eric M.] AHRQ, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Pylypchuk, Y (reprint author), Social & Sci Syst, Rockville, MD 20852 USA. EM ypylypch@ahrq.gov; eric.sarpong@ahrq.hhs.gov NR 35 TC 0 Z9 0 U1 2 U2 4 PU WALTER DE GRUYTER GMBH PI BERLIN PA GENTHINER STRASSE 13, D-10785 BERLIN, GERMANY SN 1935-1682 J9 BE J ECON ANAL POLI JI B E J. Econ. Anal. Policy PD APR PY 2015 VL 15 IS 2 BP 837 EP 864 DI 10.1515/bejeap-2014-0018 PG 28 WC Economics SC Business & Economics GA CE9FG UT WOS:000352148800014 ER PT J AU Crowell, TA Berry, SA Fleishman, JA LaRue, RW Korthuis, PT Nijhawan, AE Moore, RD Gebo, KA AF Crowell, Trevor A. Berry, Stephen A. Fleishman, John A. LaRue, Richard W. Korthuis, Philip T. Nijhawan, Ank E. Moore, Richard D. Gebo, Kelly A. CA HIV Res Network TI Impact of Hepatitis Coinfection on Healthcare Utilization Among Persons Living With HIV SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV; hepatitis B virus; hepatitis C virus; mental health; healthcare utilization; hospitalization ID C VIRUS-INFECTION; ACTIVE ANTIRETROVIRAL THERAPY; UNITED-STATES; HEPATOCELLULAR-CARCINOMA; HOSPITALIZATION RATES; MULTICENTER COHORT; VIRAL-HEPATITIS; NATURAL-HISTORY; HCV INFECTION; MORTALITY AB Hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection are increasingly important sources of morbidity among HIV-infected persons. We determined associations between hepatitis coinfection and healthcare utilization among HIV-infected adults at 4 US sites during 2006-2011. Outpatient HIV visits did not differ by hepatitis serostatus and decreased over time. Mental health visits were more common among HIV/HCV coinfected persons than among HIV monoinfected persons [incidence rate ratio (IRR): 1.27, 95% confidence interval (CI): 1.08 to 1.50]. Hospitalization rates were higher among all hepatitis-infected groups than among HIV monoinfected (HIV/HBV: IRR: 1.23, 95% CI: 1.05 to 1.44; HIV/HCV: IRR: 1.22, 95% CI: 1.10 to 1.36; HIV/HBV/HCV: IRR: 1.31, 95% CI: 1.02 to 1.68). These findings may inform the design of clinical services and allocation of resources. C1 [Crowell, Trevor A.; Berry, Stephen A.; LaRue, Richard W.; Moore, Richard D.; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Med, Div Infect Dis, Baltimore, MD 21205 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Korthuis, Philip T.] Oregon Hlth & Sci Univ, Dept Med, Div Gen Internal Med & Geriatr, Portland, OR 97201 USA. [Nijhawan, Ank E.] Univ Texas SW Med Ctr Dallas, Dept Internal Med, Div Infect Dis, Dallas, TX 75390 USA. RP Crowell, TA (reprint author), Walter Reed Army Inst Res, US Mil HIV Res Program, 6720-A Rockledge Dr,Suite 400, Bethesda, MD 20817 USA. EM tcrowell@hivresearch.org FU Agency for Healthcare Research and Quality [HHSA290201100007C]; Health Resources and Services Administration [HHSH250201200008C]; National Institute of Allergy and Infectious Diseases [K23 AI084854]; National Center for Advancing Translational Sciences [KL2TR001103]; Tibotec FX Supported by the Agency for Healthcare Research and Quality (HHSA290201100007C), the Health Resources and Services Administration (HHSH250201200008C), the National Institute of Allergy and Infectious Diseases (K23 AI084854), and the National Center for Advancing Translational Sciences (KL2TR001103).; K.A.G. has been a consultant to Tibotec and BMS and received research funding from Tibotec. The remaining authors have no conflicts of interest to disclose. NR 37 TC 2 Z9 2 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1525-4135 EI 1077-9450 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD APR 1 PY 2015 VL 68 IS 4 BP 425 EP 431 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA CE1RC UT WOS:000351588600014 PM 25559601 ER PT J AU Mabry-Hernandez, I Chu, KS AF Mabry-Hernandez, Iris Chu, Kasi TI Screening for Oral Cancer SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Mabry-Hernandez, Iris] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Chu, Kasi] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Mabry-Hernandez, I (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD MAR 15 PY 2015 VL 91 IS 6 BP 387 EP 388 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA CD8GO UT WOS:000351333400011 PM 25822557 ER PT J AU Davidoff, AJ Miller, GE Sarpong, EM Yang, E Brandt, N Fick, DM AF Davidoff, Amy J. Miller, G. Edward Sarpong, Eric M. Yang, Eunice Brandt, Nicole Fick, Donna M. TI Prevalence of Potentially Inappropriate Medication Use in Older Adults Using the 2012 Beers Criteria SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE inappropriate; Beers criteria; older adults; medication; MEPS ID NURSING-HOME RESIDENTS; EXPLICIT CRITERIA; HEALTH-CARE; SUPPORT; PANEL AB ObjectivesTo use the most recently available population-based data to estimate potentially inappropriate medication (PIM) prevalence under the 2012 update of the Beers list of PIMs and to provide a benchmark from which to measure future changes. DesignRetrospective cohort study using nationally representative data. Setting2006-2010 Medical Expenditure Panel Survey (MEPS). ParticipantsCommunity-dwelling sample of U.S. older adults (N=18,475). MeasurementsThe updated Beers criteria were operationalized, generating a broad PIM definition that incorporated form, route, or dose restrictions where clearly specified and a qualified definition that applied specific exceptions where mentioned in the rationale associated with each drug category. Bivariate analyses described PIM prevalence, comparing the two operational definitions, and examined time trends. ResultsOf older adults with prescription medications, 42.6% had at least one medication fill that met the broad definition, with nonsteroidal anti-inflammatory drugs (NSAIDs) having the highest prevalence (10.9%). The rate declined from 45.5% in 2006-2007 to 40.8% in 2009-2010. The categories with the largest absolute decline were NSAIDs, selected sulfonylureas, and estrogens. PIM prevalence was 30.9% using the qualified definition. ConclusionDespite the overall high use of PIMs, there has been a decline observed in recent years. Future studies should test the effect of educational and clinical interventions on changes in PIM use and outcomes. The current study results can aid in targeting these interventions. C1 [Davidoff, Amy J.] Yale Univ, Sch Publ Hlth, New Haven, CT 06520 USA. [Miller, G. Edward; Sarpong, Eric M.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Yang, Eunice] Univ N Carolina, Sch Publ Hlth, Chapel Hill, NC USA. [Brandt, Nicole] Univ Maryland Baltimore, Sch Pharm, Geriatr Pharmacotherapy Pharm Practice & Sci, Baltimore, MD USA. [Fick, Donna M.] Penn State Univ, Coll Nursing, Dept Psychiat, University Pk, PA 16802 USA. [Fick, Donna M.] Penn State Univ, Coll Med, University Pk, PA 16802 USA. RP Davidoff, AJ (reprint author), Yale Univ, Sch Publ Hlth, POB 208034,60 Coll St, New Haven, CT 06520 USA. EM amy.davidoff@yale.edu FU National Institute of Nursing [R01 NR011042] FX Drs. Davidoff, Miller, Sarpong and Brandt and Ms. Yang received no external financial support for the research and/or authorship of this article. Dr. Fick receives partial support for her time from National Institute of Nursing Research Grant R01 NR011042. NR 25 TC 13 Z9 13 U1 1 U2 6 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 EI 1532-5415 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD MAR PY 2015 VL 63 IS 3 BP 486 EP 500 DI 10.1111/jgs.13320 PG 15 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA CE3PO UT WOS:000351740400009 PM 25752646 ER PT J AU Odejide, OO Cronin, AM Davidoff, AJ LaCasce, AS Abel, GA AF Odejide, Oreofe O. Cronin, Angel M. Davidoff, Amy J. LaCasce, Ann S. Abel, Gregory A. TI Limited stage diffuse large B-cell lymphoma: comparative eff ectiveness of treatment strategies in a large cohort of elderly patients SO LEUKEMIA & LYMPHOMA LA English DT Article DE Diff use large B-cell lymphoma; rituximab; comparative eff ectiveness; elderly ID NON-HODGKINS-LYMPHOMA; LOCALIZED AGGRESSIVE LYMPHOMA; CHEMOTHERAPY PLUS RITUXIMAB; DETUDE-DES-LYMPHOMES; COMORBIDITY INDEX; CHOP CHEMOTHERAPY; BRITISH-COLUMBIA; ONCOLOGY-GROUP; RADIOTHERAPY; OUTCOMES AB Optimal treatment for limited stage diffuse large B-cell lymphoma (DLBCL) in the elderly is controversial. Using the Surveillance, Epidemiology and End Results-Medicare database, we compared overall survival (OS), time to second-line therapy (surrogate for recurrence) and adverse events in elderly patients diagnosed with stage I or II DLBCL in 1999-2009, who received either abbreviated rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (RCHOP) plus radiation or 6-8 cycles of RCHOP alone. Of 874 patients, 359 received abbreviated RCHOP with radiation, and 515 received a full course of RCHOP. In propensity score-adjusted analyses, OS was similar in both groups (hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.76, 1.38). Abbreviated RCHOP with radiation was associated with lower risk of second-line therapy (HR 0.71, 95% CI 0.53, 0.94) and lower odds of febrile neutropenia (odds ratio [OR] 0.27, 95% CI 0.15, 0.50). While the two treatments resulted in similar survival, our data suggest that abbreviated RCHOP with radiation may be better tolerated than a full course of RCHOP. C1 [Odejide, Oreofe O.; Cronin, Angel M.; Abel, Gregory A.] Dana Farber Canc Inst, Div Populat Sci, Boston, MA 02215 USA. [Odejide, Oreofe O.; LaCasce, Ann S.] Dana Farber Canc Inst, Ctr Lymphoma, Boston, MA 02215 USA. [Abel, Gregory A.] Dana Farber Canc Inst, Ctr Leukemia, Dept Med Oncol, Boston, MA 02215 USA. [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Abel, GA (reprint author), Dana Farber Canc Inst, 450 Brookline Ave, Boston, MA 02215 USA. EM Gregory_abel@dfci.harvard.edu FU American Society of Hematology Clinical Research Training Institute; Lymphoma Research Foundation Postdoctoral Fellow Award FX The authors thank Philippe Armand for assistance with access to the DF/Lymphoma CRIS database. This research was supported by the American Society of Hematology Clinical Research Training Institute (O.O.O) and a Lymphoma Research Foundation Postdoctoral Fellow Award (O.O.O). NR 33 TC 11 Z9 11 U1 0 U2 2 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1042-8194 EI 1029-2403 J9 LEUKEMIA LYMPHOMA JI Leuk. Lymphoma PD MAR PY 2015 VL 56 IS 3 BP 716 EP 724 DI 10.3109/10428194.2014.930853 PG 9 WC Oncology; Hematology SC Oncology; Hematology GA CD5RC UT WOS:000351144500027 PM 24913508 ER PT J AU Li, CY Li, CH Forsythe, L Lerro, C Soni, A AF Li, Chunyu Li, Chenghui Forsythe, Laura Lerro, Catherine Soni, Anita TI Mental health services utilization and expenditures associated with cancer survivorship in the United States SO JOURNAL OF CANCER SURVIVORSHIP LA English DT Article DE Cancer; Mental health; Utilization; Expenditures; Prescription drug ID PSYCHOLOGICAL DISTRESS; PSYCHOSOCIAL INTERVENTIONS; POPULATION; CARE; DEPRESSION; TRENDS; EMPLOYMENT; ADJUSTMENT; MORTALITY; PATTERNS AB The aim of this study is to assess mental health services utilization and expenditures associated with cancer history using a nationally representative sample in the US. We used data from the 2008-2011 Medical Expenditure Panel Survey and multivariate regression models to assess mental health services use and expenditures among cancer survivors compared to individuals without a cancer history, stratified by age (18-64 and a parts per thousand yen65 years) and time since diagnosis (a parts per thousand currency sign1 vs. > 1 year). Among adults aged 18-64, compared with individuals without a cancer history, cancer survivors were more likely to screen positive for current psychological distress and depression regardless of time since diagnosis; survivors diagnosed > 1 year ago were more likely to use mental health prescription drugs; those diagnosed within 1 year reported significantly lower annual per capita mental health drug expenditure and out-of-pocket mental health expenditure, while those diagnosed > 1 year presented significantly higher annual per capita mental health expenditure. No significant differences in mental health expenditures were found among adults aged 65 or older. Mental health problems presented higher health and economic burden among younger and longer-term survivors than individuals without a cancer history. This study provides data for monitoring the impact of initiatives to enhance coverage and access for mental health services at the national level. Early detection and appropriate treatment of mental health problems may help improve quality of cancer survivorship. C1 [Li, Chunyu] Ctr Dis Control & Prevent, Div Canc Prevent & Control, Atlanta, GA 30341 USA. [Li, Chenghui] Univ Arkansas Med Sci, Coll Pharm, Div Pharmaceut Evaluat & Policy, Little Rock, AR 72205 USA. [Forsythe, Laura] PCORI, Res Integrat & Evaluat Program, Washington, DC USA. [Lerro, Catherine] Amer Canc Soc, Hlth Serv Res Program, Intramural Res Dept, Natl Home Off, Atlanta, GA 30329 USA. [Soni, Anita] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Li, CY (reprint author), Ctr Dis Control & Prevent, Div Canc Prevent & Control, 4770 Buford Highway NE,MS F-76, Atlanta, GA 30341 USA. EM cli11@cdc.gov FU Intramural CDC HHS [CC999999] NR 39 TC 2 Z9 2 U1 0 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1932-2259 EI 1932-2267 J9 J CANCER SURVIV JI J. Cancer Surviv.-Res. Pract. PD MAR PY 2015 VL 9 IS 1 BP 50 EP 58 DI 10.1007/s11764-014-0392-0 PG 9 WC Oncology; Social Sciences, Biomedical SC Oncology; Biomedical Social Sciences GA CC4ZB UT WOS:000350364400006 PM 25108481 ER PT J AU Agwu, AL Lee, L Fleishman, JA Voss, C Yehia, BR Althoff, KN Rutstein, R Mathews, WC Nijhawan, A Moore, RD Gaur, AH Gebo, KA AF Agwu, Allison L. Lee, Lana Fleishman, John A. Voss, Cindy Yehia, Baligh R. Althoff, Keri N. Rutstein, Richard Mathews, W. Christopher Nijhawan, Ank Moore, Richard D. Gaur, Aditya H. Gebo, Kelly A. TI Aging and Loss to Follow-up Among Youth Living With Human Immunodeficiency Virus in the HIV Research Network SO JOURNAL OF ADOLESCENT HEALTH LA English DT Article DE Adolescents; Youth; Young adults; Loss to follow-up; Attrition; Care; HIV Research Network ID ANTIRETROVIRAL THERAPY; UNITED-STATES; YOUNG-ADULTS; HEALTH-CARE; TRANSITION; ADOLESCENTS; INFECTION; RETENTION; STRATEGIES; OUTCOMES AB Purpose: In the United States, 21 years is a critical age of legal and social transition, with changes insocial programs such as public insurance coverage. Human immunodeficiency virus (HIV)-infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday. Methods: All HIV-infected 21-year-olds engaged in care (2002-2011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years. Results: Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8%) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95% confidence interval [CI], 1.42-5.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95% CI, 1.67-4.42), and antiretroviral therapy prescription (AOR,.50; 95% CI,.41-.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds. Conclusions: Although 19.8% of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients. (C) 2015 Society for Adolescent Health and Medicine. All rights reserved. C1 [Agwu, Allison L.] Johns Hopkins Sch Med, Dept Pediat, Div Pediat Infect Dis, Baltimore, MD USA. [Agwu, Allison L.; Voss, Cindy; Gebo, Kelly A.] Johns Hopkins Sch Med, Dept Med, Div Infect Dis, Baltimore, MD USA. [Lee, Lana] Johns Hopkins Sch Med, Dept Pediat, Div Gen Pediat & Adolescent Med, Baltimore, MD USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Yehia, Baligh R.] Univ Penn, Perelman Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. [Althoff, Keri N.] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. [Rutstein, Richard] Childrens Hosp Philadelphia, Div Gen Pediat, Philadelphia, PA 19104 USA. [Mathews, W. Christopher] Univ Calif San Diego, Med Ctr, Dept Clin Med, San Diego, CA 92103 USA. [Nijhawan, Ank] UT Southwestern Med Ctr, Dept Internal Med, Dallas, TX USA. [Moore, Richard D.] Johns Hopkins Sch Med, Dept Med, Div Gen Internal Med, Baltimore, MD USA. [Gaur, Aditya H.] St Jude Childrens Res Hosp, Dept Infect Dis, Memphis, TN 38105 USA. RP Agwu, AL (reprint author), Johns Hopkins Med Inst, Dept Pediat, Div Pediat Infect Dis, 200 N Wolfe St,Room 3145, Baltimore, MD 21287 USA. EM ageorg10@jhmi.edu RI Mathews, William/E-4451-2010 OI Mathews, William/0000-0002-2352-0725 FU Agency for Healthcare Research and Quality [290-11-00007c]; Johns Hopkins Center for AIDS Research [P30 AI094189] FX The HIV Research Network is supported by the Agency for Healthcare Research and Quality (290-11-00007c) and the Johns Hopkins Center for AIDS Research (P30 AI094189). NR 35 TC 11 Z9 12 U1 1 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1054-139X EI 1879-1972 J9 J ADOLESCENT HEALTH JI J. Adolesc. Health PD MAR PY 2015 VL 56 IS 3 BP 345 EP 351 DI 10.1016/j.jadohealth.2014.11.009 PG 7 WC Psychology, Developmental; Public, Environmental & Occupational Health; Pediatrics SC Psychology; Public, Environmental & Occupational Health; Pediatrics GA CC2AR UT WOS:000350147500014 PM 25703322 ER PT J AU Correa, A Bardenheier, B Elixhauser, A Geiss, LS Gregg, E AF Correa, Adolfo Bardenheier, Barbara Elixhauser, Anne Geiss, Linda S. Gregg, Edward TI Trends in Prevalence of Diabetes Among Delivery Hospitalizations, United States, 1993-2009 SO MATERNAL AND CHILD HEALTH JOURNAL LA English DT Article DE Diabetes; Pregnancy; Prevalence; Surveillance ID RECOMMENDATIONS; PREGNANCY; MELLITUS; OBESITY; RATES; RISK AB To describe recent trends in prevalence of pre-existing diabetes mellitus (PDM) (i.e., type 1 or type 2 diabetes) and gestational diabetes mellitus (GDM) among delivery hospitalizations in the United States. Data on delivery hospitalizations from 1993 through 2009 were obtained from the Health Care Cost and Utilization Project (HCUP) Nationwide Inpatient Sample. Diagnosis-Related Group codes were used to identify deliveries and diagnosis codes on presence of diabetes. Rates of hospitalizations with diabetes were calculated per 100 deliveries by type of diabetes, hospital geographic region, patient's age, degree of urbanicity of patient's residence, categorized median household income for patient's ZIP Code, expected primary payer, and type of delivery. From 1993 to 2009, age-standardized prevalence of diabetes per 100 deliveries increased from 0.62 to 0.90 for PDM (trend p < 0.001) and from 3.09 to 5.57 for GDM (trend p < 0.001). In 2009, correlates of PDM at delivery included older age [40-44 vs. 15-24: odds ratio 6.45 (95 % CI 5.27-7.88)], Medicaid/Medicare versus private payment sources [1.77 (95 % CI 1.59-1.98)], patient's ZIP Code with a median household income in bottom quartile versus other quartiles [1.54 (95 % CI 1.41, 1.69)], and C-section versus vaginal delivery [3.36 (95 % CI 3.10-3.64)]. Correlates of GDM at delivery were similar. Among U.S. delivery hospitalizations, the prevalence of diabetes is increasing. In 2009, the prevalence of diabetes was higher among women in older age groups, living in ZIP codes with lower household incomes, or with public insurance. C1 [Correa, Adolfo] Univ Mississippi, Med Ctr, Dept Med, Jackson, MS 39213 USA. [Correa, Adolfo] Univ Mississippi, Med Ctr, Dept Pediat, Jackson, MS 39213 USA. [Bardenheier, Barbara; Geiss, Linda S.; Gregg, Edward] Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. [Elixhauser, Anne] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Correa, A (reprint author), Univ Mississippi, Med Ctr, Dept Med, 350 Woodrow Wilson Dr,Suite 701, Jackson, MS 39213 USA. EM acorrea@umc.edu FU Intramural CDC HHS [CC999999] NR 25 TC 10 Z9 10 U1 1 U2 5 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1092-7875 EI 1573-6628 J9 MATERN CHILD HLTH J JI Matern. Child Health J. PD MAR PY 2015 VL 19 IS 3 BP 635 EP 642 DI 10.1007/s10995-014-1553-5 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA CB6VC UT WOS:000349763800024 PM 24996952 ER PT J AU Mabry-Hernandez, I Chu, K AF Mabry-Hernandez, Iris Chu, Kasi TI Screening for Primary Hypertension in Children and Adolescents SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Mabry-Hernandez, Iris] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Chu, Kasi] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Mabry-Hernandez, I (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD FEB 15 PY 2015 VL 91 IS 4 BP 257 EP 258 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA CC0GY UT WOS:000350015000007 PM 25955627 ER PT J AU Moy, E Barrett, M Coffey, R Hines, AL Newman-Toker, DE AF Moy, Ernest Barrett, Marguerite Coffey, Rosanna Hines, Anika L. Newman-Toker, David E. TI Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics SO DIAGNOSIS LA English DT Article DE acute myocardial infarction; chest pain; diagnostic error; emergency department; health disparities; missed diagnosis ID ACUTE CARDIAC ISCHEMIA; CHEST-PAIN; ERRORS; RISK; MULTICENTER; INTERVENTIONS; MANAGEMENT; MEDICINE; DISEASE; TRIAGE AB Background: An estimated 1.2 million people in the US have an acute myocardial infarction (AMI) each year. An estimated 7% of AMI hospitalizations result in death. Most patients experiencing acute coronary symptoms, such as unstable angina, visit an emergency department (ED). Some patients hospitalized with AMI after a treat-and-release ED visit likely represent missed opportunities for correct diagnosis and treatment. The purpose of the present study is to estimate the frequency of missed AMI or its precursors in the ED by examining use of EDs prior to hospitalization for AMI. Methods: We estimated the rate of probable missed diagnoses in EDs in the week before hospitalization for AMI and examined associated factors. We used Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases for 2007 to evaluate missed diagnoses in 111,973 admitted patients aged 18 years and older. Results: We identified missed diagnoses in the ED for 993 of 112,000 patients (0.9% of all AMI admissions). These patients had visited an ED with chest pain or cardiac conditions, were released, and were subsequently admitted for AMI within 7 days. Higher odds of having missed diagnoses were associated with being younger and of Black race. Hospital teaching status, availability of cardiac catheterization, high ED admission rates, high inpatient occupancy rates, and urban location were associated with lower odds of missed diagnoses. Conclusions: Administrative data provide robust information that may help EDs identify populations at risk of experiencing a missed diagnosis, address disparities, and reduce diagnostic errors. C1 [Coffey, Rosanna; Hines, Anika L.] Truven Hlth Analyt, Bethesda, MD 20814 USA. [Hines, Anika L.] ML Barrett Inc, Bethesda, MD 20814 USA. [Moy, Ernest] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD 20850 USA. [Barrett, Marguerite] ML Barrett Inc, Del Mar, CA 92014 USA. [Newman-Toker, David E.] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD 21287 USA. RP Hines, AL (reprint author), Truven Hlth Analyt, 7700 Old Georgetown Rd,Suite 650, Bethesda, MD 20814 USA. EM anika.hines@truvenhealth.com NR 47 TC 3 Z9 3 U1 1 U2 1 PU WALTER DE GRUYTER GMBH PI BERLIN PA GENTHINER STRASSE 13, D-10785 BERLIN, GERMANY SN 2194-8011 EI 2194-802X J9 DIAGNOSIS JI Diagnosis PD FEB PY 2015 VL 2 IS 1 BP 29 EP 40 DI 10.1515/dx-2014-0053 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA CL9FA UT WOS:000357280000005 ER PT J AU Hill, SC AF Hill, Steven C. TI Medicaid Expansion In Opt-Out States Would Produce Consumer Savings And Less Financial Burden Than Exchange Coverage SO HEALTH AFFAIRS LA English DT Article ID CIGARETTE-SMOKING; UNITED-STATES; HEALTH-CARE; ADULTS AB In the twenty-three states that have decided against expanding Medicaid under the Affordable Care Act, uninsured adults who would have been eligible for Medicaid and have incomes at or above the federal poverty guidelines are generally eligible for Marketplace (insurance exchange) premium tax credits and plans with generous benefits. This study compared estimated out-of-pocket spending for care and premiums, as well as the financial burdens they impose, for the families of these adults under two simulation scenarios: obtaining coverage through a silver plan with subsidized cost sharing and enrolling in expanded Medicaid. Compared with Marketplace coverage, Medicaid would more than halve average annual out-of-pocket spending ($938 versus $1,948), while dramatically reducing the percentage of adults in families with out-of-pocket expenses exceeding 10 percent or 20 percent of income (6.0 percent versus 17.1 percent and 0.9 percent versus 3.7 percent, respectively). Larger reductions would be seen for families with smokers, who under Medicaid would no longer be subject to Marketplace tobacco user surcharges. Medicaid expansion may offer a greater opportunity than access to Marketplace insurance to promote the financial well-being of previously uninsured low-income adults. C1 Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. RP Hill, SC (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. EM steven.hill@ahrq.hhs.gov NR 23 TC 2 Z9 2 U1 1 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD FEB PY 2015 VL 34 IS 2 BP 340 EP 349 DI 10.1377/hlthaff.2014.1058 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CE3HA UT WOS:000351716100022 PM 25631764 ER PT J AU Kindermann, DR Mutter, RL Houchens, RL Barrett, ML Pines, JM AF Kindermann, Dana R. Mutter, Ryan L. Houchens, Robert L. Barrett, Marguerite L. Pines, Jesse M. TI Emergency Department Transfers and Transfer Relationships in United States Hospitals SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; TRAUMA CARE; PATIENT-TRANSFERS; INJURED PATIENTS; LEVEL-I; REGIONALIZATION; OUTCOMES; IMPLEMENTATION; INSURANCE; MORTALITY AB ObjectivesThe objective was to describe transfers out of hospital-based emergency departments (EDs) in the United States and to identify different characteristics of sending and receiving hospitals, travel distance during transfer, disposition on arrival to the second hospital, and median number of transfer partners among sending hospitals. MethodsEmergency department records were linked at transferring hospitals to ED and inpatient records at receiving hospitals in nine U.S. states using the 2010 Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases and State Inpatient Databases, the American Hospital Association Annual Survey, and the Trauma Information Exchange Program. Using the Clinical Classification Software (CCS) to categorize conditions, the 50 disease categories with the highest transfer rates were studied, and these were then placed into nine clinical groups. Records were included where both sending and receiving records were available; these data were tabulated to describe ED transfer patterns, hospital-to-hospital distances, final patient disposition, and number of transfer partners. ResultsA total of 97,021 ED transfer encounters were included in the analysis from the 50 highest transfer rate disease categories. Among these, transfer rates ranged from 1% to 13%. Circulatory conditions made up about half of all transfers. Receiving hospitals were more likely to be nonprofit, teaching, trauma, and urban and have more beds with greater specialty coverage and more advanced diagnostic and therapeutic resources. The median transfer distance was 23 miles, with 25% traveling more than 40 to 50 miles. About 8% of transferred encounters were discharged from the second ED, but that varied from 0.6% to 53% across the 50 conditions. Sending hospitals had a median of seven transfer partners across all conditions and between one and four per clinical group. ConclusionsAmong high-transfer conditions in U.S. EDs, patients are often transferred great distances, more commonly to large teaching hospitals with greater resources. The large number of transfer partners indicates a possible lack of stable transfer relationships between U.S. hospitals. (C) 2015 by the Society for Academic Emergency Medicine C1 [Kindermann, Dana R.] Permanente Med Grp Inc, Dept Emergency Med, Oakland, CA 94612 USA. [Mutter, Ryan L.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Houchens, Robert L.] Truven Hlth Analyt, Santa Barbara, CA USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Pines, Jesse M.] George Washington Univ, Dept Emergency Med, Washington, DC USA. [Pines, Jesse M.] George Washington Univ, Dept Hlth Policy, Washington, DC USA. RP Kindermann, DR (reprint author), Permanente Med Grp Inc, Dept Emergency Med, Oakland, CA 94612 USA. EM danakindermann@gmail.com FU Agency for Healthcare Research and Quality [HHSA-290-2013-00002-C] FX This study was funded by the Agency for Healthcare Research and Quality under a contract to Truven Health Analytics to develop and support the Healthcare Cost and Utilization Project (Contract No. HHSA-290-2013-00002-C). NR 20 TC 0 Z9 0 U1 1 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1069-6563 EI 1553-2712 J9 ACAD EMERG MED JI Acad. Emerg. Med. PD FEB PY 2015 VL 22 IS 2 BP 157 EP 165 DI 10.1111/acem.12586 PG 9 WC Emergency Medicine SC Emergency Medicine GA CC1LI UT WOS:000350101800004 PM 25640281 ER PT J AU Kindermann, DR Mutter, RL Houchens, RL Barrett, ML Pines, JM AF Kindermann, Dana R. Mutter, Ryan L. Houchens, Robert L. Barrett, Marguerite L. Pines, Jesse M. TI The Transfer Instability Index: A Novel Metric of Emergency Department Transfer Relationships SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID DIVERSITY; CARE AB ObjectivesIn this study, the objective was to characterize emergency department (ED) transfer relationships and study the factors that predict the stability of those relationships. A metric is derived for ED transfer relationships that may be useful in assessing emergency care regionalization and as a resource for future emergency medicine research. MethodsEmergency department records at transferring hospitals were linked to ED and inpatient records at receiving hospitals in nine U.S. states using the 2010 Healthcare Cost and Utilization Project State Emergency Department Databases and State Inpatient Databases, the American Hospital Association Annual Survey, and the Trauma Information Exchange Program. Using the Clinical Classification Software to categorize conditions, high transfer rate conditions were placed into nine clinical groups. The authors created a new measure, the transfer instability index, which estimates the effective number of transfer partners for each sending ED: this is designed to measure the stability of outgoing transfer relationships, where higher values of the index indicate less stable relationships. The index provides a measure of how many hospitals a transferring hospital sends its patients to (weighted by how often each transfer partner is used). Regression was used to analyze factors associated with higher values of the index. ResultsSending hospitals had a median of 3.5 effective transfer partners across all conditions. The calculated transfer instability indices varied from 1 to 2.4 across disease categories. In general, higher index values were associated with treating a higher proportion of publicly insured patients: 10 and 12% increases in the Medicare and Medicaid share of ED encounters, respectively, were associated with 10 and 14% increases in the effective number of transfer partners. This public insurance effect held while studying all conditions together as well as within individual disease categories, such as cardiac, neurologic, and traumatic conditions. ConclusionsUnited States EDs that transfer patients to other hospitals often have multiple transfer partners. The stability of the transfer relationship, assessed by the transfer instability index, differs by condition. Less stable transfer relationships (i.e., hospitals with greater numbers of transfer partners) were more common in EDs with higher proportions of publicly insured patients. (C) 2015 by the Society for Academic Emergency Medicine C1 [Kindermann, Dana R.] Permanente Med Grp Inc, Dept Emergency Med, Oakland, CA 94612 USA. [Mutter, Ryan L.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Houchens, Robert L.] Truven Hlth Analyt, Santa Barbara, CA USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Pines, Jesse M.] George Washington Univ, Dept Emergency Med, Washington, DC USA. [Pines, Jesse M.] George Washington Univ, Dept Hlth Policy, Washington, DC USA. RP Kindermann, DR (reprint author), Permanente Med Grp Inc, Dept Emergency Med, Oakland, CA 94612 USA. EM danakindermann@gmail.com FU Agency for Healthcare Research and Quality [HHSA-290-2013-00002-C] FX This study was funded by the Agency for Healthcare Research and Quality under a contract to Truven Health Analytics to develop and support the Healthcare Cost and Utilization Project (Contract No. HHSA-290-2013-00002-C). NR 9 TC 2 Z9 2 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1069-6563 EI 1553-2712 J9 ACAD EMERG MED JI Acad. Emerg. Med. PD FEB PY 2015 VL 22 IS 2 BP 166 EP 171 DI 10.1111/acem.12589 PG 6 WC Emergency Medicine SC Emergency Medicine GA CC1LI UT WOS:000350101800005 PM 25640740 ER PT J AU Galarraga, JE Mutter, R Pines, JM AF Galarraga, Jessica E. Mutter, Ryan Pines, Jesse M. TI Costs Associated with Ambulatory Care Sensitive Conditions Across Hospital-based Settings SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID EMERGENCY-DEPARTMENT VISITS; ACADEMIC HEALTH CENTERS; COMORBIDITY INDEX; ADMISSION RATES; RETAIL CLINICS; PERFORMANCE; CLAIMS; COULD AB ObjectivesAmbulatory care sensitive conditions (ACSCs) are acute care diagnoses that could potentially be prevented through improved primary care. This study investigated how payments and charges for these ACSC visits differ by three hospital-based settings (outpatient, emergency department [ED], and inpatient) and examined differences in payments and charges by their physician and facility components. MethodsThis was a secondary analysis of data (2005 through 2010) from the Medical Expenditure Panel Survey. Multiple linear regression models were used to assess differences in the mean-adjusted payments and charges for ACSC visits by clinical setting and further divided payments and charges into physician and facility components. ResultsOf all ACSC visits from 2005 through 2010, 41% were outpatient visits, 36% were ED visits, and 23% were hospital admissions. After adjusting for patient demographics and comorbid conditions, charges for an inpatient ACSC visit were four times higher ($11,414 vs. $2,563) and payments were five times higher ($4,325 vs. $859) when compared to an ED visit. By comparison, charges for an ACSC ED visit were two times higher ($2,563 vs. $1,084) and payments 2.5 times higher ($859 vs. $341) relative to an ACSC visit managed in an outpatient hospital-based clinic. Across all clinical settings, hospital facility fees account for 77% to 94% of the charge differences and 81% to 93% of the payment differences. ConclusionsFor hospital-based ACSC visits, inpatient hospitalizations are by far the most expensive. Finding ways to expand outpatient resources and improve the health management of the chronically ill may avoid conditions that lead to more expensive hospital-based encounters. Across all hospital-based settings, facility fees are the major contributor of expense. (C) 2015 by the Society for Academic Emergency Medicine C1 [Galarraga, Jessica E.; Pines, Jesse M.] George Washington Univ, Dept Emergency Med, Washington, DC 20052 USA. [Pines, Jesse M.] George Washington Univ, Dept Hlth Policy, Washington, DC USA. [Mutter, Ryan] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Galarraga, JE (reprint author), George Washington Univ, Dept Emergency Med, Washington, DC 20052 USA. EM jgala84@gwu.edu NR 47 TC 5 Z9 5 U1 2 U2 6 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1069-6563 EI 1553-2712 J9 ACAD EMERG MED JI Acad. Emerg. Med. PD FEB PY 2015 VL 22 IS 2 BP 172 EP 181 DI 10.1111/acem.12579 PG 10 WC Emergency Medicine SC Emergency Medicine GA CC1LI UT WOS:000350101800006 PM 25639774 ER PT J AU Wang, G Gold, M Siegel, J Sofaer, S Yang, MS Mallery, C Carman, KL AF Wang, Grace Gold, Marthe Siegel, Joanna Sofaer, Shoshanna Yang, Manshu Mallery, Coretta Carman, Kristin L. TI Deliberation: Obtaining Informed Input from a Diverse Public SO JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED LA English DT Article DE Deliberation; public policy; public opinion; race; ethnicity; education ID HEALTH-CARE; PATIENT PERCEPTIONS; SYSTEM; BIAS AB Objectives. Health care decision makers require public input to incorporate diverse values into programs and policies. Deliberation, one method for obtaining input, seeks to apply inclusive principles wherein diverse groups provide perspectives to inform decisions. We evaluate whether participants of different racial, ethnic, and educational backgrounds show differences in the effect of deliberation and the value placed on deliberation participation. Methods. We surveyed 907 participants before and after deliberation. Regression models examined associations between demographics and change in knowledge and attitudes, and perceived impact. Results. Changes in knowledge about using medical evidence in decision-making were not associated with race, ethnicity, or education. Changes in attitudes were not associated with these characteristics with one exception. African American, Hispanic, and participants with lower educational attainment reported more perceived impact. Conclusion. Similar results across demographic groups suggest deliberation's promise for obtaining input from a diverse public to inform health programs and policies. C1 [Wang, Grace; Yang, Manshu; Mallery, Coretta; Carman, Kristin L.] Amer Inst Res, Hlth & Social Dev Program, Washington, DC USA. [Gold, Marthe] CUNY City Coll, Sophie Davis Sch Biomed Educ, New York, NY USA. [Siegel, Joanna] AHRQ, Rockville, MD USA. [Sofaer, Shoshanna] CUNY Bernard M Baruch Coll, Sch Publ Affairs, New York, NY 10010 USA. RP Wang, G (reprint author), 2800 Campus Dr,Suite 200, San Mateo, CA 94403 USA. EM gwang@air.org NR 31 TC 1 Z9 1 U1 0 U2 1 PU JOHNS HOPKINS UNIV PRESS PI BALTIMORE PA JOURNALS PUBLISHING DIVISION, 2715 NORTH CHARLES ST, BALTIMORE, MD 21218-4363 USA SN 1049-2089 EI 1548-6869 J9 J HEALTH CARE POOR U JI J. Health Care Poor Underserved PD FEB PY 2015 VL 26 IS 1 BP 223 EP 242 PG 20 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CC7BO UT WOS:000350522900020 PM 25702739 ER PT J AU Spittel, ML Riley, WT Kaplan, RM AF Spittel, Michael L. Riley, William T. Kaplan, Robert M. TI Educational attainment and life expectancy: A perspective from the NIH Office of Behavioral and Social Sciences Research SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE NIH; BSSR; Education and health; Program ID ADULT MORTALITY; UNITED-STATES; GRADIENT; HEALTH; RACE AB The NIH Office of Behavioral and Social Sciences Research (OBSSR) furthers the mission of the NIH by stimulating behavioral and social sciences research throughout NIH and integrating these areas of research more fully into the NIH health research enterprise, thereby improving our understanding, treatment, and prevention of disease. OBSSR accomplishes this mission through several strategic priorities: (1) supporting the next generation of basic behavioral and social sciences research, (2) facilitating interdisciplinary research, (3) promoting a multi-level systems perspective of health and behavior, and (4) encouraging a problem-focused perspective on population health. Published by Elsevier Ltd. C1 [Spittel, Michael L.; Riley, William T.] NIH, Off Behav & Social Sci Res, US Dept HHS, Bethesda, MD 20892 USA. [Kaplan, Robert M.] US Dept HHS, Agcy Healthcare Res & Qual, Washington, DC USA. RP Spittel, ML (reprint author), NIH, Off Behav & Social Sci Res, US Dept HHS, Bethesda, MD 20892 USA. EM Michael.Spittel@nih.gov NR 13 TC 1 Z9 1 U1 1 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD FEB PY 2015 VL 127 SI SI BP 203 EP 205 DI 10.1016/j.socscimed.2014.11.017 PG 3 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA CC1AZ UT WOS:000350074800024 PM 25511259 ER PT J AU Hsiao, CJ King, J Hing, E Simon, AE AF Hsiao, Chun-Ju King, Jennifer Hing, Esther Simon, Alan E. TI The Role of Health Information Technology in Care Coordination in the United States SO MEDICAL CARE LA English DT Article DE care coordination; health information technology; electronic health record; NAMCS; NEHRS ID EXCHANGE; CHALLENGES; PROGRESS; RECORDS; OFFICE AB Objectives: Examine the extent to which office-based physicians in the United States receive patient health information necessary to coordinate care across settings and determine whether receipt of information needed to coordinate care is associated with use of health information technology (HIT) (defined by presence or absence of electronic health record system and electronic sharing of information). Research Design: Cross-sectional study using the 2012 National Electronic Health Records Survey (65% weighted response rate). Subjects: Office-based physicians. Measures: Use of HIT and 3 types of patient health information needed to coordinate care. Results: In 2012, 64% of physicians routinely received the results of a patient's consultation with a provider outside of their practice, whereas 46% routinely received a patient's history and reason for a referred consultation from a provider outside of their practice. About 54% of physicians reported routinely receiving a patient's hospital discharge information. In adjusted analysis, significant differences in receiving necessary information were observed by use of HIT. Compared with those not using HIT, a lower percentage of physicians who used an electronic health record system and shared patient health information electronically failed to receive the results of outside consultations or patient's history and reason for a referred consultation. No significant differences were observed for the receipt of hospital discharge information by use of HIT. Among physicians routinely receiving information needed for care coordination, at least 54% of them did not receive the information electronically. Conclusions: Although a higher percentage of physicians using HIT received patient information necessary for care coordination than those who did not use HIT, more than one third did not routinely receive the needed patient information at all. C1 [Hsiao, Chun-Ju] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [King, Jennifer] Off Natl Coordinator Hlth Informat Technol, Washington, DC USA. [Hsiao, Chun-Ju; Hing, Esther; Simon, Alan E.] Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Hsiao, CJ (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd,Room 3331, Rockville, MD 20850 USA. EM janey.hsiao@ahrq.hhs.gov NR 27 TC 5 Z9 5 U1 0 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD FEB PY 2015 VL 53 IS 2 BP 184 EP 190 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA CB6ZG UT WOS:000349775000013 PM 25464164 ER PT J AU Kaplan, RM Sun, QK Ries, AL AF Kaplan, Robert M. Sun, Qiankun Ries, Andrew L. TI Quality of Well-being Outcomes in the National Emphysema Treatment Trial SO CHEST LA English DT Article ID VOLUME-REDUCTION SURGERY; OBSTRUCTIVE PULMONARY-DISEASE; OF-LIFE; LUNG-VOLUME; COST-EFFECTIVENESS; MAJOR DEPRESSION; RANDOMIZED-TRIAL; CYSTIC-FIBROSIS; SCALE; TRANSPLANTATION AB BACKGROUND: Surgical and medical treatments for emphysema may affect both quality and quantity of life. The purpose of this article is to report outcomes from the National Emphysema Treatment Trial ( NETT) using an index that combines quality and quantity of life. METHODS: This was a prospective randomized clinical trial. Following pulmonary rehabilitation, 1,218 patients with severe emphysema were randomly assigned to maximal medical therapy or to lung volume reduction surgery (LVRS). A generic quality-of-life measure, known as the Quality of Well-being Scale (QWB), was administered at baseline and again at 6, 12, 24, 36, 48, 60, and 72 months following treatment assignment. RESULTS: At baseline, QWB scores were comparable for the Medical and LVRS groups. For both groups, scores significantly improved following the rehabilitation program. The QWB scores before death for patients in the LVRS group improved up to the year 2 visit, whereas scores for the Medical group dropped significantly following the baseline visit. Imputing zeros ( 0) for death, QWB scores decreased significantly for both groups. With or without scoring death as 0, the LVRS group achieved better outcomes, and the significant differences were maintained until the sixth year. Over 6 years of follow-up, LVRS produced an average of 0.30 quality-adjusted life years (QALYs), or the equivalent of about 3.6 months of well life. CONCLUSIONS: Compared with maximal medical therapy alone, patients undergoing maximal medical therapy plus LVRS experienced improved health-related quality of life and gained more QALYs. C1 [Kaplan, Robert M.; Sun, Qiankun] NIH, Bethesda, MD 20892 USA. [Ries, Andrew L.] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. [Ries, Andrew L.] Univ Calif San Diego, Dept Family & Prevent Med, San Diego, CA 92103 USA. RP Kaplan, RM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM robert.kaplan@ahrq.hhs.gov FU National Heart, Lung, and Blood Institute [N01HR76101, N01HR76102, N01HR76103, N01HR76104, N01HR76105, N01HR76106, N01HR76107, N01HR76108, N01HR76109, N01HR76110, N01HR76111, N01HR76112, N01HR76113, N01HR76114, N01HR76115, N01HR76116, N01HR76118, N01-HR76119]; Center for Medicare and Medicaid Services; Agency for Healthcare Research and Quality FX This study was supported by contracts with the National Heart, Lung, and Blood Institute [Grants N01HR76101, N01HR76102, N01HR76103, N01HR76104, N01HR76105, N01HR76106, N01HR76107, N01HR76108, N01HR76109, N01HR76110, N01HR76111, N01HR76112, N01HR76113, N01HR76114, N01HR76115, N01HR76116, N01HR76118, and N01-HR76119], the Center for Medicare and Medicaid Services (formerly the Health Care Financing Administration), and the Agency for Healthcare Research and Quality. NR 30 TC 1 Z9 1 U1 0 U2 4 PU AMER COLL CHEST PHYSICIANS PI GLENVIEW PA 2595 PATRIOT BLVD, GLENVIEW, IL 60026 USA SN 0012-3692 J9 CHEST JI Chest PD FEB PY 2015 VL 147 IS 2 BP 377 EP 387 DI 10.1378/chest.14-0528 PG 11 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA CB1YF UT WOS:000349423200018 PM 25340383 ER PT J AU Smith, MW Stocks, C Santora, PB AF Smith, Mark W. Stocks, Carol Santora, Patricia B. TI Hospital Readmission Rates and Emergency Department Visits for Mental Health and Substance Abuse Conditions SO COMMUNITY MENTAL HEALTH JOURNAL LA English DT Article DE Alcohol-related disorders; Drug-related disorders; Mental disorders; Anxiety disorders; Emergency service; Hospital readmissions ID CONTROLLED-TRIAL; FREQUENT USERS; CARE; PROGRAM; TRENDS AB Community hospital stays in 12 states during 2008-2009 were analyzed to determine predictors of 12-month hospital readmission and emergency department (EDs) revisits among persons with a mental health or substance abuse diagnosis. Probabilities of hospital readmission and of ED revisits were modeled as functions of patient demographics, insurance type, number of prior-year hospital stays, diagnoses and other characteristics of the initial stay, and hospital characteristics. Alcohol or drug dependence, dementias, psychotic disorders, autism, impulse control disorders, and personality disorders were most strongly associated with future inpatient admission or ED revisits within 12 months of initial encounter. Insurance type, including uninsured status, were highly significant (p < .01) predictors of both readmission and ED revisits. C1 [Smith, Mark W.] Truven Hlth Analyt, Bethesda, MD 21244 USA. [Stocks, Carol] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Santora, Patricia B.] Substance Abuse & Mental Hlth Serv Adm, Ctr Substance Abuse Treatment, Rockville, MD USA. RP Smith, MW (reprint author), Truven Hlth Analyt, Bethesda, MD 21244 USA. EM mark.w.smith@truvenhealth.com FU PHS HHS [HHSA-290-2006-00009-C] NR 26 TC 14 Z9 14 U1 2 U2 12 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0010-3853 EI 1573-2789 J9 COMMUNITY MENT HLT J JI Community Ment. Health J. PD FEB PY 2015 VL 51 IS 2 BP 190 EP 197 DI 10.1007/s10597-014-9784-x PG 8 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA AZ3HC UT WOS:000348117000011 PM 25563483 ER PT J AU Guy, GP Machlin, SR Ekwueme, DU Yabroff, KR AF Guy, Gery P., Jr. Machlin, Steven R. Ekwueme, Donatus U. Yabroff, K. Robin TI Prevalence and Costs of Skin Cancer Treatment in the US, 2002-2006 and 2007-2011 SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID METAANALYSIS; MELANOMA AB Background: Skin cancer, the most common cancer in the U.S., is a major public health problem. The incidence of nonmelanoma and melanoma skin cancer is increasing; however, little is known about the economic burden of treatment. Purpose: To examine trends in the treated prevalence and treatment costs of nonmelanoma and melanoma skin cancers. Methods: This study used data on adults from the 2002-2011 Medical Expenditure Panel Survey full-year consolidated files and information from corresponding medical conditions and medical event files to estimate the treated prevalence and treatment cost of nonmelanoma skin cancer, melanoma skin cancer, and all other cancer sites. Analyses were conducted in January 2014. Results: The average annual number of adults treated for skin cancer increased from 3.4 million in 2002-2006 to 4.9 million in 2007-2011 (p<0.001). During this period, the average annual total cost for skin cancer increased from $3.6 billion to $8.1 billion (p=-0.001), representing an increase of 126.2%, while the average annual total cost for all other cancers increased by 25.1%. During 2007-2011, nearly 5 million adults were treated for skin cancer annually, with average treatment costs of $8.1 billion each year. Conclusions: These findings demonstrate that the health and economic burden of skin cancer treatment is substantial and increasing. Such findings highlight the importance of skin cancer prevention efforts, which may result in future savings to the healthcare system. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine C1 [Guy, Gery P., Jr.; Ekwueme, Donatus U.] CDC, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. [Machlin, Steven R.] NCI, Ctr Financing Access & Cost Trends, Agcy Healthcare Res & Qual, Rockville, MD USA. [Yabroff, K. Robin] NCI, Div Canc Control & Populat Sci, Rockville, MD USA. RP Guy, GP (reprint author), CDC, Div Canc Prevent & Control, 4770 Buford Highway NE,MS F-76, Atlanta, GA 30341 USA. EM irm2@cdc.gov OI Yabroff, K. Robin/0000-0003-0644-5572 FU Social & Scientific Systems, Inc. FX We would like to thank Zhengyi Fang of Social & Scientific Systems, Inc. for programming support. NR 12 TC 56 Z9 57 U1 4 U2 15 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD FEB PY 2015 VL 48 IS 2 BP 183 EP 187 DI 10.1016/j.amepre.2014.08.036 PG 5 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA AZ2YY UT WOS:000348096300010 PM 25442229 ER PT J AU Kaplan, RM Smith, WB AF Kaplan, Robert M. Smith, Wendy B. BE Jeste, DV Palmer, BW TI What Is Well-Being? SO POSITIVE PSYCHIATRY: A CLINICAL HANDBOOK LA English DT Article; Book Chapter ID QUALITY-OF-LIFE; HEALTH; TECHNOLOGY; PREVALENCE; PREVENTION; VALIDITY; OUTCOMES; INDEXES; DISEASE; SF-36 C1 [Kaplan, Robert M.] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD 20852 USA. [Smith, Wendy B.] NIH, Res Dev & Outreach, Off Behav & Social Sci Res, Off Director, Bethesda, MD 20892 USA. RP Kaplan, RM (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD 20852 USA. NR 29 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209 USA BN 978-1-58562-495-9 PY 2015 BP 111 EP 125 D2 10.1176/appi.books.9781615370818 PG 15 WC Psychiatry SC Psychiatry GA BF6IU UT WOS:000383142600007 ER PT J AU Holman, RC Hennessy, T Singleton, RJ Seeman, SM Redd, JT Steiner, CA Bartholomew, ML Bruce, MG AF Holman, R. C. Hennessy, T. Singleton, R. J. Seeman, S. M. Redd, J. T. Steiner, C. A. Bartholomew, M. L. Bruce, M. G. TI Infectious Disease Hospitalizations among Alaska Native Infants, Alaska, USA. SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract CT 20th IEA World Congress of Epidemiology (WCE) CY AUG 17-21, 2014 CL Anchorage, AK SP Int Epidemiol Assoc C1 [Holman, R. C.; Seeman, S. M.] CDC, Atlanta, GA USA. [Hennessy, T.; Bruce, M. G.] CDC Arctic Invest Program, Anchorage, AK USA. [Singleton, R. J.] ANTHC, Anchorage, AK USA. [Redd, J. T.] IHS, Santa Fe, NM USA. [Steiner, C. A.] AHRQ, Rockville, MD USA. [Bartholomew, M. L.] IHS, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 EI 1464-3685 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PY 2015 VL 44 SU 1 MA 1881 BP 99 EP 99 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA DM9BV UT WOS:000376659900229 ER PT J AU Foote, EM Singleton, RJ Holman, RC Seeman, SM Steiner, CA Bartholomew, M Hennessy, TW AF Foote, Eric M. Singleton, Rosalyn J. Holman, Robert C. Seeman, Sara M. Steiner, Claudia A. Bartholomew, Michael Hennessy, Thomas W. TI Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population SO INTERNATIONAL JOURNAL OF CIRCUMPOLAR HEALTH LA English DT Article DE pneumonia; epidemiology; American Indian; respiratory; Alaska Native ID INVASIVE PNEUMOCOCCAL DISEASE; WOOD-BURNING STOVES; INFLUENZA-A H1N1; VACCINATION COVERAGE; VIRUS-INFECTION; RISK-FACTORS; US CHILDREN; ALASKA; PNEUMONIA; BRONCHIOLITIS AB Background. The lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998-2008, yet remained 1.6 times higher than the general US child population in 2006-2008. Purpose. Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. Methods. A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009-2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998-1999 rates prior to pneumococcal conjugate vaccine introduction. Results. The average annual LRTI-associated hospitalization rate declined from 1998-1999 to 2009-2011 in AI/AN (35%, p <0.01) and the general US child population (19%, SE: 4.5%, p <0.01). The 2009-2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6-14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant ( <1 year) pneumonia -associated and 2009-2010 H1N1 influenza associated hospitalizations. Conclusions. Although the LRTI-associated hospitalization rate declined, the 2009-2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children. C1 [Foote, Eric M.] Univ Washington, Sch Med, Dept Pediat, Seattle, WA 98195 USA. [Singleton, Rosalyn J.] Alaska Native Tribal Hlth Consortium, Div Community Hlth Serv, Anchorage, AK USA. [Singleton, Rosalyn J.; Holman, Robert C.; Hennessy, Thomas W.] Ctr Dis Control & Prevent CDC, Arctic Invest Program, NCEZID, Anchorage, AK 99508 USA. [Seeman, Sara M.] CDC, Div High Consequence Pathogens & Pathol, NCEZID, Atlanta, GA 30333 USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Healthcare Cost & Utilizat Project, Ctr Delivery Org & Markets, Rockville, MD USA. [Bartholomew, Michael] Indian Hlth Serv, Div Epidemiol & Dis Prevent, Rockville, MD USA. RP Singleton, RJ (reprint author), Ctr Dis Control & Prevent CDC, NCEZID, 4055 Tudor Ctr Dr, Anchorage, AK 99508 USA. EM Ris2@cdc.gov NR 53 TC 4 Z9 4 U1 1 U2 4 PU CO-ACTION PUBLISHING PI JARFALLA PA RIPVAGEN 7, JARFALLA, SE-175 64, SWEDEN SN 1239-9736 EI 2242-3982 J9 INT J CIRCUMPOL HEAL JI Int. J. Circumpolar Health PY 2015 VL 74 AR 29256 DI 10.3402/ijch.v74.29256 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA DC9ZC UT WOS:000369579100001 PM 26547082 ER PT J AU Dor, A Encinosa, WE Carey, K AF Dor, Avi Encinosa, William E. Carey, Kathleen TI Medicare's Hospital Compare Quality Reports Appear To Have Slowed Price Increases For Two Major Procedures SO HEALTH AFFAIRS LA English DT Article ID MORTALITY; IMPACT AB Previous research has found that Hospital Compare, Medicare's public reporting initiative, has had little impact on patient outcomes. However, little is known about the initiative's impact on hospital prices, which may be significant because private insurers are generally well positioned to respond to quality information when negotiating prices with hospitals. We estimated difference-in-differences models of the effects of Hospital Compare quality reporting on transaction prices for two major cardiac procedures, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). States that had mandated their own public reporting systems before the implementation of Hospital Compare formed the control group. We found that prices for these procedures continued to increase overall after the initiation of Hospital Compare quality scores, but the rate of increase was significantly lower in states with no quality reporting metrics of their own before Hospital Compare, when compared to the control states (annual rates of increase of 4.4 percent versus 8.7 percent for PCI, and 3.9 percent versus 10.6 percent for CABG, adjusted for overall inflation). This finding implies that Hospital Compare provided leverage to purchasers in moderating price increases, while adding competitive pressures on hospitals. Providing accurate quality information on both hospitals and health plans could benefit consumers. C1 [Dor, Avi] George Washington Univ, Milken Inst Sch Publ Hlth, Hlth Policy & Econ, Washington, DC 20052 USA. [Dor, Avi] Natl Bur Econ Res Cambridge, Cambridge, MA USA. [Encinosa, William E.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Carey, Kathleen] Boston Univ, Sch Publ Hlth, Boston, MA USA. RP Dor, A (reprint author), George Washington Univ, Milken Inst Sch Publ Hlth, Hlth Policy & Econ, Washington, DC 20052 USA. EM avidor@gwu.edu FU Agency for Healthcare Quality and Research (AHRQ) [R01 HS023610-01]; National Cancer Institute of the National Institutes of Health (NIH) [R01CA129766] FX The authors thank the editors and three anonymous reviewers for helpful comments. Avi Dor and Kathleen Carey acknowledge support from the Agency for Healthcare Quality and Research (AHRQ; Grant No. R01 HS023610-01). Dor acknowledges additional support from the National Cancer Institute of the National Institutes of Health (NIH; Grant No. R01CA129766). The views expressed in this article are those of the authors, and no official endorsement by AHRQ, NIH, or the Department of Health and Human Services is intended or should be inferred. NR 30 TC 2 Z9 2 U1 1 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JAN PY 2015 VL 34 IS 1 BP 71 EP 77 DI 10.1377/hlthaff.2014.0263 PG 7 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA CE3GZ UT WOS:000351716000011 PM 25561646 ER PT J AU Weinberger, DM Klugman, KP Steiner, CA Simonsen, L Viboud, C AF Weinberger, Daniel M. Klugman, Keith P. Steiner, Claudia A. Simonsen, Lone Viboud, Cecile TI Association between Respiratory Syncytial Virus Activity and Pneumococcal Disease in Infants: A Time Series Analysis of US Hospitalization Data SO PLOS MEDICINE LA English DT Article ID STREPTOCOCCUS-PNEUMONIAE; CONJUGATE VACCINE; BACTERIAL-INFECTION; UNITED-STATES; INFLUENZA; CHILDREN; IMPACT; YOUNGER; SEASON; RISK AB Background: The importance of bacterial infections following respiratory syncytial virus (RSV) remains unclear. We evaluated whether variations in RSV epidemic timing and magnitude are associated with variations in pneumococcal disease epidemics and whether changes in pneumococcal disease following the introduction of seven-valent pneumococcal conjugate vaccine (PCV7) were associated with changes in the rate of hospitalizations coded as RSV. Methods and Findings: We used data from the State Inpatient Databases (Agency for Healthcare Research and Quality), including >700,000 RSV hospitalizations and > 16,000 pneumococcal pneumonia hospitalizations in 36 states (1992/1993-2008/2009). Harmonic regression was used to estimate the timing of the average seasonal peak of RSV, pneumococcal pneumonia, and pneumococcal septicemia. We then estimated the association between the incidence of pneumococcal disease in children and the activity of RSV and influenza (where there is a well-established association) using Poisson regression models that controlled for shared seasonal variations. Finally, we estimated changes in the rate of hospitalizations coded as RSV following the introduction of PCV7. RSV and pneumococcal pneumonia shared a distinctive spatiotemporal pattern (correlation of peak timing: p = 0.70, 95% CI: 0.45, 0.84). RSV was associated with a significant increase in the incidence of pneumococcal pneumonia in children aged <1 y (attributable percent [AP]: 20.3%, 95% CI: 17.4%, 25.1%) and among children aged 1-2 y (AP: 10.1%, 95% CI: 7.6%, 13.9%). Influenza was also associated with an increase in pneumococcal pneumonia among children aged 1-2 y (AP: 3.2%, 95% CI: 1.7%, 4.7%). Finally, we observed a significant decline in RSV-coded hospitalizations in children aged,1 y following PCV7 introduction (-18.0%, 95% CI: -22.6%, -13.1%, for 2004/2005-2008/2009 versus 1997/1998-1999/2000). This study used aggregated hospitalization data, and studies with individual-level, laboratory-confirmed data could help to confirm these findings. Conclusions: These analyses provide evidence for an interaction between RSV and pneumococcal pneumonia. Future work should evaluate whether treatment for secondary bacterial infections could be considered for pneumonia cases even if a child tests positive for RSV. Please see later in the article for the Editors' Summary. C1 [Weinberger, Daniel M.] Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA. [Weinberger, Daniel M.; Simonsen, Lone; Viboud, Cecile] NIH, Div Int Epidemiol & Populat Studies, Fogarty Int Ctr, Bethesda, MD 20892 USA. [Klugman, Keith P.] Emory Univ, Dept Global Hlth, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Healthcare Cost & Utilizat Project, Rockville, MD USA. [Simonsen, Lone] George Washington Univ, Dept Global Hlth, Washington, DC USA. RP Weinberger, DM (reprint author), Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA. EM Daniel.weinberger@yale.edu OI Simonsen, Lone/0000-0003-1535-8526; Weinberger, Daniel/0000-0003-1178-8086 FU Division of International Epidemiology and Population Studies, Fogarty International Center, US National Institutes of Health; Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine [P30AG021342 NIH/NIA]; Yale Center for Clinical Investigation [UL1 TR000142]; Bill & Melinda Gates Foundation; RAPIDD (Research and Policy for Infectious Disease Dynamics) program of the Science and Technology Directorate; Department of Homeland Security; Fogarty International Center FX DMW and CV were supported by the Division of International Epidemiology and Population Studies, Fogarty International Center, US National Institutes of Health. DMW is supported by the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (#P30AG021342 NIH/NIA), the Yale Center for Clinical Investigation (UL1 TR000142), and the Bill & Melinda Gates Foundation. LS acknowledges support from the RAPIDD (Research and Policy for Infectious Disease Dynamics) program of the Science and Technology Directorate, Department of Homeland Security, and the Fogarty International Center. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 44 TC 22 Z9 23 U1 0 U2 3 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1549-1676 J9 PLOS MED JI PLos Med. PD JAN PY 2015 VL 12 IS 1 AR e1001776 DI 10.1371/journal.pmed.1001776 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA CE3GX UT WOS:000351715800002 PM 25562317 ER PT J AU Baldziki, M Ball, P Brown, J Chan, HC Cheetham, TC Conn, T Daniel, GW Hendrickson, M Hilbrich, L Johnson, A Miller, SB Moore, T Motheral, B Priddy, SA Raebel, MA Randhawa, G Surratt, P Walraven, C White, TJ Zheng, Y Bruns, K Carden, MJ Dragovich, C Eichelberger, B Rosato, E Sega, T AF Baldziki, Mike Ball, Phil Brown, Jeff Chan, Hungching Cheetham, T. Craig Conn, Thomas Daniel, Gregory W. Hendrickson, Mark Hilbrich, Lutz Johnson, Ayanna Miller, Steven B. Moore, Tom Motheral, Brenda Priddy, Sarah A. Raebel, Marsha A. Randhawa, Gurvaneet Surratt, Penny Walraven, Cheryl White, T. Jeff Zheng, Yi Bruns, Kevin Carden, Mary Jo Dragovich, Charlie Eichelberger, Bernadette Rosato, Edith Sega, Todd CA AMCP Task Force Biosimilar TI Utilizing Data Consortia to Monitor Safety and Effectiveness of Biosimilars and Their Innovator Products SO JOURNAL OF MANAGED CARE PHARMACY LA English DT Article AB BACKGROUND: The Biologics Price Competition and Innovation Act, introduced as part of the Affordable Care Act, directed the FDA to create an approval pathway for biologic products shown to be biosimilar or interchangeable with an FDA-approved innovator drug. These biosimilars will not be chemically identical to the reference agent. Investigational studies conducted with biosimilar agents will likely provide limited real-world evidence of their effectiveness and safety. How do we best monitor effectiveness and safety of biosimilar products once approved by the FDA and used more extensively by patients? OBJECTIVE: To determine the feasibility of developing a distributed research network that will use health insurance plan and health delivery system data to detect biosimilar safety and effectiveness signals early and be able to answer important managed care pharmacy questions from both the government and managed care organizations. METHODS: Twenty-one members of the AMCP Task Force on Biosimilar Collective Intelligence Systems met November 12, 2013, to discuss issues involved in designing this consortium and to explore next steps. RESULTS: The task force concluded that a managed care biosimilars research consortium would be of significant value. Task force members agreed that it is best to use a distributed research network structurally similar to existing DARTNet, HMO Research Network, and Mini-Sentinel consortia. However, for some surveillance projects that it undertakes, the task force recognizes it may need supplemental data from managed care and other sources (i.e., a "hybrid" structure model). CONCLUSIONS: The task force believes that AMCP is well positioned to lead the biosimilar-monitoring effort and that the next step to developing a biosimilar-innovator collective intelligence system is to convene an advisory council to address organizational governance. Copyright (C) 2015, Academy of Managed Care Pharmacy. All rights reserved. C1 [Baldziki, Mike] Armada, Ind Relat & Advocacy, Rockville, MD USA. [Ball, Phil] Actavis Inc, Biol Alliance Management & Govt Affairs, Parsippany, NJ USA. [Brown, Jeff] Harvard Univ, Therapeut Res & Infect Dis Epidemiol, Harvard Pilgrim Hlth Care Inst, Sch Med,Dept Populat Med, Cambridge, MA 02138 USA. [Chan, Hungching] OptumInsights, Med Informat, Eden Prairie, MN USA. [Cheetham, T. Craig] Kaiser Permanente, Pharm Analyt Serv, Denver, CO USA. [Conn, Thomas] Armada, Costa Mes, CA USA. [Daniel, Gregory W.] Brookings Engelberg Ctr Hlth Care Reform, Econ Studies & Managing, Lawrence, KS USA. [Hendrickson, Mark] Gener Pharmaceut Assoc, Sci & Regulatory Affairs, Istanbul, Turkey. [Hilbrich, Lutz] Boehringer Ingelheim GmbH & Co KG, Integrated Program Management Biosimilars, Ingelheim, Germany. [Johnson, Ayanna] Natl Consumers League, Hlth Policy, New York, NY USA. [Miller, Steven B.] Express Scripts Inc, St Louis, MO USA. [Miller, Steven B.] Express Scripts Inc, Med, St Louis, MO USA. [Moore, Tom] Amgen Inc, US Value & Access, Thousand Oaks, CA USA. [Motheral, Brenda] Artemetrx, Brentwood, TN USA. [Priddy, Sarah A.] Humana Comprehens Hlth Insights, Res, Louisville, KY USA. [Raebel, Marsha A.] Kaiser Permanente, Colorado Inst Hlth Res, Denver, CO USA. [Randhawa, Gurvaneet] Agcy Healthcare Res & Qual, Clin Genom & Personalized Med, COE, Rockville, MD USA. [Surratt, Penny] Humana, Channel Strategies Specialty Prod, Louisville, KY USA. [Walraven, Cheryl] Aetna, FDA Mini Sentinel Project, Hartford, CT USA. [White, T. Jeff] Wellpoint, Drug Evaluat & Clin Analyt, Clin Pharm Policy, Indianapolis, IN USA. [Zheng, Yi] Aetna, Hartford, CT USA. [Bruns, Kevin] Acad Managed Care Pharm, Commun, Alexandria, VA 22314 USA. [Carden, Mary Jo] Acad Managed Care Pharm, Regulatory Affairs, Alexandria, VA 22314 USA. [Dragovich, Charlie] Acad Managed Care Pharm, Business Dev, Alexandria, VA 22314 USA. [Eichelberger, Bernadette; Sega, Todd] Acad Managed Care Pharm, Pharm Affairs, Alexandria, VA 22314 USA. [Rosato, Edith] Acad Managed Care Pharm, IOM, Alexandria, VA 22314 USA. RP Eichelberger, B (reprint author), Acad Managed Care Pharm, Pharm Affairs, 100 N Pitt St,Ste 400, Alexandria, VA 22314 USA. EM beichelberger@amcp.org FU Actavis, Inc.; Amgen; Armada; Boehringer-Ingelheim; Specialty Pharmacy Association of America FX The AMCP Task Force on Biosimilar Collective Intelligence Systems and the development of this proceedings document were supported by Actavis, Inc., Amgen, Armada, Boehringer-Ingelheim, and the Specialty Pharmacy Association of America. NR 21 TC 3 Z9 3 U1 0 U2 1 PU ACAD MANAGED CARE PHARMACY PI ALEXANDRIA PA 100 N PITT ST, 400, ALEXANDRIA, VA 22314-3134 USA SN 1083-4087 J9 J MANAGE CARE PHARM JI J. Manag. Care Pharm. PD JAN PY 2015 VL 21 IS 1 BP 23 EP 34 PG 12 WC Health Care Sciences & Services; Pharmacology & Pharmacy SC Health Care Sciences & Services; Pharmacology & Pharmacy GA CC8KP UT WOS:000350617900003 ER PT J AU Brady, PJ Battles, JB Ricciardi, R AF Brady, P. Jeffrey Battles, James B. Ricciardi, Richard TI Teamwork What Health Care Has Learned From the Military SO JOURNAL OF NURSING CARE QUALITY LA English DT Editorial Material C1 [Brady, P. Jeffrey; Battles, James B.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD 20850 USA. [Ricciardi, Richard] Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD 20850 USA. RP Brady, PJ (reprint author), Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, 540 Gaither Rd,Ste 2000, Rockville, MD 20850 USA. EM jeff.brady@ahrq.hhs.gov NR 11 TC 0 Z9 0 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1057-3631 EI 1550-5065 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JAN-MAR PY 2015 VL 30 IS 1 BP 3 EP 6 DI 10.1097/NCQ.0000000000000094 PG 4 WC Nursing SC Nursing GA CB3SR UT WOS:000349549300002 PM 25415426 ER PT J AU Pitzer, VE Viboud, C Alonso, WJ Wilcox, T Metcalf, CJ Steiner, CA Haynes, AK Grenfell, BT AF Pitzer, Virginia E. Viboud, Cecile Alonso, Wladimir J. Wilcox, Tanya Metcalf, C. Jessica Steiner, Claudia A. Haynes, Amber K. Grenfell, Bryan T. TI Environmental Drivers of the Spatiotemporal Dynamics of Respiratory Syncytial Virus in the United States SO PLOS PATHOGENS LA English DT Article ID YOUNG-CHILDREN; NATIONAL-SURVEILLANCE; MEASLES EPIDEMICS; GROUP-B; GROUP-A; TRANSMISSION DYNAMICS; SPATIAL HIERARCHIES; INFECTIOUS-DISEASES; TRACT INFECTIONS; KILIFI DISTRICT AB Epidemics of respiratory syncytial virus (RSV) are known to occur in wintertime in temperate countries including the United States, but there is a limited understanding of the importance of climatic drivers in determining the seasonality of RSV. In the United States, RSV activity is highly spatially structured, with seasonal peaks beginning in Florida in November through December and ending in the upper Midwest in February-March, and prolonged disease activity in the southeastern US. Using data on both age-specific hospitalizations and laboratory reports of RSV in the US, and employing a combination of statistical and mechanistic epidemic modeling, we examined the association between environmental variables and state-specific measures of RSV seasonality. Temperature, vapor pressure, precipitation, and potential evapotranspiration (PET) were significantly associated with the timing of RSV activity across states in univariate exploratory analyses. The amplitude and timing of seasonality in the transmission rate was significantly correlated with seasonal fluctuations in PET, and negatively correlated with mean vapor pressure, minimum temperature, and precipitation. States with low mean vapor pressure and the largest seasonal variation in PET tended to experience biennial patterns of RSV activity, with alternating years of "early-big" and "ate-small" epidemics. Our model for the transmission dynamics of RSV was able to replicate these biennial transitions at higher amplitudes of seasonality in the transmission rate. This successfully connects environmental drivers to the epidemic dynamics of RSV; however, it does not fully explain why RSV activity begins in Florida, one of the warmest states, when RSV is a winter-seasonal pathogen. Understanding and predicting the seasonality of RSV is essential in determining the optimal timing of immunoprophylaxis. C1 [Pitzer, Virginia E.] Yale Univ, Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA. [Pitzer, Virginia E.; Viboud, Cecile; Alonso, Wladimir J.; Wilcox, Tanya; Grenfell, Bryan T.] NIH, Fogarty Int Ctr, Bethesda, MD 20892 USA. [Metcalf, C. Jessica] Univ Oxford, Dept Zool, Oxford, England. [Metcalf, C. Jessica; Grenfell, Bryan T.] Princeton Univ, Dept Ecol & Evolutionary Biol, Princeton, NJ 08544 USA. [Steiner, Claudia A.] US Dept HHS, Healthcare Cost & Utilizat Project, Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD USA. [Haynes, Amber K.] Ctr Dis Control & Prevent, Epidemiol Branch, Div Viral Dis, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA. RP Pitzer, VE (reprint author), Yale Univ, Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA. EM virginia.pitzer@yale.edu OI Pitzer, Virginia/0000-0003-1015-2289 FU Bill & Melinda Gates Foundation (Vaccine Modeling Initiative); Research and Policy for Infectious Disease Dynamics (RAPIDD) program of the Science & Technology Directorate, Department of Homeland Security; Fogarty International Center, National Institutes of Health FX This work was supported by the Bill & Melinda Gates Foundation (Vaccine Modeling Initiative; https://vaccinemodeling.org/) and the Research and Policy for Infectious Disease Dynamics (RAPIDD) program of the Science & Technology Directorate, Department of Homeland Security, and the Fogarty International Center, National Institutes of Health (http://www.fic.nih.gov/about/staff/pages/epidemiology-population.aspx) (VEP, CJM, and BTG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 71 TC 14 Z9 14 U1 0 U2 9 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1553-7366 EI 1553-7374 J9 PLOS PATHOG JI PLoS Pathog. PD JAN PY 2015 VL 11 IS 1 AR e1004591 DI 10.1371/journal.ppat.1004591 PG 14 WC Microbiology; Parasitology; Virology SC Microbiology; Parasitology; Virology GA CA7OF UT WOS:000349106100023 PM 25569275 ER PT J AU van Weel, C Turnbull, D Whitehead, E Bazemore, A Goodyear-Smith, F Jackson, C Lam, CLK van der Linden, BA Meyers, D van den Muijsenbergh, M Phillips, R Ramirez-Aranda, JM Tamblyn, R van Weel-Baumgarten, E AF van Weel, Chris Turnbull, Deborah Whitehead, Emma Bazemore, Andrew Goodyear-Smith, Felicity Jackson, Claire Lam, Cindy L. K. van der Linden, Barbara A. Meyers, David van den Muijsenbergh, Maria Phillips, Robert Ramirez-Aranda, Jose M. Tamblyn, Robyn van Weel-Baumgarten, Evalyn TI INTERNATIONAL COLLABORATION IN INNOVATING HEALTH SYSTEMS SO ANNALS OF FAMILY MEDICINE LA English DT Editorial Material C1 [van Weel, Chris; Turnbull, Deborah; Whitehead, Emma; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evalyn] Radboud Univ Nijmegen, NL-6525 ED Nijmegen, Netherlands. [van Weel, Chris] Auralian Natl Univ, Canberra, ACT, Australia. [Turnbull, Deborah] Univ Adelaide, Adelaide, SA 5005, Australia. [Bazemore, Andrew] Robert Graham Ctr, Washington, DC USA. [Goodyear-Smith, Felicity] Univ Auckland, Auckland 1, New Zealand. [Jackson, Claire] Univ Queensland, Brisbane, Qld 4072, Australia. [Lam, Cindy L. K.] Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China. [van der Linden, Barbara A.] ZonMw, Utrecht, Netherlands. [Meyers, David] AHRQ, Rockville, MD USA. [Phillips, Robert] ABFM, Lexington, KY USA. [Ramirez-Aranda, Jose M.] Autonomous Univ Nuevo Leon, San Nicolas De Los Garza, NL, Mexico. [Tamblyn, Robyn] McGill Univ, CIHR, Montreal, PQ H3A 2T5, Canada. RP van Weel, C (reprint author), Radboud Univ Nijmegen, NL-6525 ED Nijmegen, Netherlands. RI Muijsenbergh, M.E.T.C./L-4534-2015; jackson, claire /A-1986-2011; van Weel, Chris/D-4375-2009; Tamblyn, Robyn/L-6010-2016; Weel-Baumgarten, E.M./L-4746-2015; OI jackson, claire /0000-0003-1177-1380; van Weel, Chris/0000-0003-3653-4701; Ramirez-Aranda, Jose Manuel/0000-0001-7364-6847 NR 0 TC 3 Z9 3 U1 0 U2 5 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672 USA SN 1544-1709 EI 1544-1717 J9 ANN FAM MED JI Ann. Fam. Med. PD JAN-FEB PY 2015 VL 13 IS 1 BP 86 EP 87 DI 10.1370/afm.1751 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AZ0JJ UT WOS:000347931600018 PM 25583898 ER PT J AU Torio, CM Encinosa, W Berdahl, T McCormick, MC Simpson, LA AF Torio, Celeste Marie Encinosa, William Berdahl, Terceira McCormick, Marie C. Simpson, Lisa A. TI Annual Report on Health Care for Children and Youth in the United States: National Estimates of Cost, Utilization and Expenditures for Children With Mental Health Conditions SO ACADEMIC PEDIATRICS LA English DT Article DE children; health care utilization; mental health; national estimates; trends in hospitalization ID DELIBERATE SELF-HARM; GREAT RECESSION; ECONOMIC-CRISIS; COMORBIDITY-SURVEY; PSYCHIATRIC INPATIENT; ADOLESCENT-SUPPLEMENT; SUICIDAL-BEHAVIOR; YOUNG-PEOPLE; UNMET NEED; TRENDS AB OBJECTIVE: To examine national trends in hospital utilization, costs, and expenditures for children with mental health conditions. METHODS: The analyses of children aged 1 to 17 are based on AHRQ's 2006 and 2011 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS) databases, and on AHRQ's pooled 2006 to 2011 Medical Expenditure Panel Survey (MEPS). All estimates are nationally representative, and standard errors account for the complex survey designs. RESULTS: Although overall all-cause children's hospitalizations did not increase between 2006 and 2011, hospitalizations for all listed mental health conditions increased by nearly 50% among children aged 10 to 14 years, and by 21% for emergency department (ED) visits. Behavioral disorders experienced a shift in underlying patterns between 2006 and 2011: inpatient stays for alcohol-related disorders declined by 44%, but ED visits increased by 34% for substance-related disorders and by 71% for impulse control disorders. Inpatient visits for suicide, suicidal ideation, and self-injury increased by 104% for children ages 1 to 17 years, and by 151% for children ages 10 to 14 years during this period. A total of $11.6 billion was spent on hospital visits for mental health during this period. Medicaid covered half of the inpatient visits, but with 50% to 30% longer length of stays in 2006 and 2011, respectively, than private payers. Medicaid's overall share of the ED visits increased from 45% in 2006 to 53% in 2011. CONCLUSIONS: These alarming trends highlight the renewed need for research on mental health care for children. This study also provides a baseline for evaluating the impact of the Affordable Care Act and the mental health parity legislation on mental health utilization and expenditures for children. C1 [Torio, Celeste Marie; Encinosa, William; Berdahl, Terceira] Agcy Healthcare Res & Qual, Dept Hlth & Human Serv, Rockville, MD 20850 USA. [McCormick, Marie C.] Harvard Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA 02115 USA. [Simpson, Lisa A.] Acad Hlth, Washington, DC USA. RP Torio, CM (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Dept Hlth & Human Serv, 540 Gaither Rd, Rockville, MD 20850 USA. EM celeste.torio@ahrq.hhs.gov NR 80 TC 13 Z9 13 U1 4 U2 23 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD JAN-FEB PY 2015 VL 15 IS 1 BP 19 EP 35 DI 10.1016/j.acap.2014.07.007 PG 17 WC Pediatrics SC Pediatrics GA AY0BJ UT WOS:000347262600005 PM 25444653 ER PT J AU McMullen, CK Safford, MM Bosworth, HB Phansalkar, S Leong, A Fagan, MB Trontell, A Rumptz, M Vandermeer, ML Brinkman, WB Burkholder, R Frank, L Hommel, K Mathews, R Hornbrook, MC Seid, M Fordis, M Lambertt, B McElwee, N Singh, JA AF McMullen, Carmit K. Safford, Monika M. Bosworth, Hayden B. Phansalkar, Shobha Leong, Amye Fagan, Maureen B. Trontell, Anne Rumptz, Maureen Vandermeer, Meredith L. Brinkman, William B. Burkholder, Rebecca Frank, Lori Hommel, Kevin Mathews, Robin Hornbrook, Mark C. Seid, Michael Fordis, Michael Lambertt, Bruce McElwee, Newell Singh, Jasvinder A. CA CERTs PCMM Workshop Working Grp TI Patient-centered priorities for improving medication management and adherence SO PATIENT EDUCATION AND COUNSELING LA English DT Article DE Patient-centered research; Adherence; Chronic disease; Medication management; Stakeholder engagement ID OF-THE-LITERATURE; CARE; METAANALYSIS; INTERVENTIONS; STATEMENT; OUTCOMES; COST; RISK AB Objective: The Centers for Education and Research on Therapeutics convened a workshop to examine the scientific evidence on medication adherence interventions from the patient-centered perspective and to explore the potential of patient-centered medication management to improve chronic disease treatment. Methods: Patients, providers, researchers, and other stakeholders (N = 28) identified and prioritized ideas for future research and practice. We analyzed stakeholder voting on priorities and reviewed themes in workshop discussions. Results: Ten priority areas emerged. Three areas were highly rated by all stakeholder groups: creating tools and systems to facilitate and evaluate patient-centered medication management plans; developing training on patient-centered prescribing for providers; and increasing patients' knowledge about medication management. However, priorities differed across stakeholder groups. Notably, patients prioritized using peer support to improve medication management while researchers did not. Conclusion: Engaging multiple stakeholders in setting a patient-centered research agenda and broadening the scope of adherence interventions to include other aspects of medication management resulted in priorities outside the traditional scope of adherence research. Practice Implications: Workshop participants recognized the potential benefits of patient-centered medication management but also identified many challenges to implementation that require additional research and innovation. (C) 2014 Elsevier Ireland Ltd. All rights reserved. C1 [McMullen, Carmit K.; Rumptz, Maureen; Vandermeer, Meredith L.; Hornbrook, Mark C.] Kaiser Permanente Northwest, Ctr Hlth Res, Portland, OR 97227 USA. [Safford, Monika M.; Singh, Jasvinder A.] Univ Alabama Birmingham, Dept Med, Div Prevent Med, Birmingham, AL 35294 USA. [Bosworth, Hayden B.; Mathews, Robin] Duke Univ, Durham, NC USA. [Phansalkar, Shobha] Partners Healthcare Syst Inc, Wellesley, MA USA. [Phansalkar, Shobha] Brigham & Womens Hosp, Boston, MA 02115 USA. [Phansalkar, Shobha; Fagan, Maureen B.] Harvard Univ, Sch Med, Boston, MA USA. [Leong, Amye] Healthy Motivat, Santa Barbara, CA USA. [Fagan, Maureen B.] Brigham & Womens Hosp, Ctr Patients & Families, Boston, MA 02115 USA. [Trontell, Anne] Agcy Hlth Care Res & Qual, Rockville, MD USA. [Brinkman, William B.; Hommel, Kevin; Seid, Michael] Cincinnati Childrens Hosp & Med Ctr, Cincinnati, OH USA. [Burkholder, Rebecca] Natl Consumers League, Washington, DC USA. [Frank, Lori] Patient Ctr Outcomes Res Inst, Washington, DC USA. [Fordis, Michael] Baylor Coll Med, Houston, TX 77030 USA. [Lambertt, Bruce] Northwestern Univ, Ctr Commun & Hlth, Chicago, IL 60611 USA. [McElwee, Newell] Merck & Co Inc, New York, NY USA. [Singh, Jasvinder A.] Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP McMullen, CK (reprint author), Kaiser Permanente Northwest, Ctr Hlth Res, 3800N Interstate Ave, Portland, OR 97227 USA. EM Carmit.McMullen@kpchr.org FU Agency for Healthcare Research and Quality [U19HS021107] FX This project was supported by grant number U19HS021107 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. We extend special acknowledgments to the late Jessie Gruman, who, as president and founder of the Center for Advancing Health provided a strong, articulate voice at the workshop. Her contributions as a patient representative brought focus and urgency to the issue of patient-centered medication management; she will be missed. NR 38 TC 4 Z9 4 U1 0 U2 5 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD JAN PY 2015 VL 98 IS 1 BP 102 EP 110 DI 10.1016/j.pec.2014.09.015 PG 9 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA AX5FO UT WOS:000346952400014 PM 25448313 ER PT J AU Habbema, JDF Wilt, TJ Etzioni, R Nelson, HD Schechter, CB Lawrence, WF Melnikow, J Kuntz, KM Owens, DK Feuer, EJ AF Habbema, J. Dik F. Wilt, Timothy J. Etzioni, Ruth Nelson, Heidi D. Schechter, Clyde B. Lawrence, William F. Melnikow, Joy Kuntz, Karen M. Owens, Douglas K. Feuer, Eric J. TI Models in the Development of Clinical Practice Guidelines SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID SERVICES TASK-FORCE; COLORECTAL-CANCER; RECOMMENDATION STATEMENT; BREAST-CANCER; UNITED-STATES; MORTALITY AB Clinical practice guidelines should be based on the best scientific evidence derived from systematic reviews of primary research. However, these studies often do not provide evidence needed by guideline development groups to evaluate the tradeoffs between benefits and harms. In this article, the authors identify 4 areas where models can bridge the gaps between published evidence and the information needed for guideline development applying new or updated information on disease risk, diagnostic test properties, and treatment efficacy; exploring a more complete array of alternative intervention strategies; assessing benefits and harms over a lifetime horizon; and projecting outcomes for the conditions for which the guideline is intended. The use of modeling as an approach to bridge these gaps (provided that the models are high-quality and adequately validated) is considered. Colorectal and breast cancer screening are used as examples to show the utility of models for these purposes. The authors propose that a modeling study is most useful when strong primary evidence is available to inform the model but critical gaps remain between the evidence and the questions that the guideline group must address. In these cases, model results have a place alongside the findings of systematic reviews to inform health care practice and policy. C1 Erasmus MC Univ Med Ctr, NL-3015 CN Rotterdam, Netherlands. Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Albert Einstein Coll Med, New York, NY USA. Agcy Healthcare Res & Qual, Rockville, MD USA. UC Davis Med Ctr, Sacramento, CA USA. Stanford Univ, Stanford, CA 94305 USA. NCI, Bethesda, MD 20892 USA. RP Habbema, JDF (reprint author), Erasmus MC Univ Med Ctr, Dept Publ Hlth, Wytemaweg 80, NL-3015 CN Rotterdam, Netherlands. EM j.d.f.habbema@erasmusmc.nl FU U.S. Department of Veterans Affairs; Agency for Healthcare Research and Quality; American College of Physicians; National Kidney Foundation; Kidney Diseases International; National Institutes of Health; National Cancer Institute; California Health Benefits Review Program FX Dr. Wilt is supported by grants from the U.S. Department of Veterans Affairs and the Agency for Healthcare Research and Quality and contracts to conduct evidence synthesis from the American College of Physicians, the National Kidney Foundation, and Kidney Diseases International. Dr. Nelson is supported by the Agency for Healthcare Research and Quality and the National Institutes of Health. Dr. Schechter is supported by grants from the National Cancer Institute to develop and apply models of breast cancer epidemiology. Dr. Melnikow receives extramural support from the California Health Benefits Review Program and the National Institutes of Health. Dr. Owens is supported by the U.S. Department of Veterans Affairs. NR 37 TC 14 Z9 14 U1 1 U2 6 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 EI 1539-3704 J9 ANN INTERN MED JI Ann. Intern. Med. PD DEC 2 PY 2014 VL 161 IS 11 BP 812 EP U105 DI 10.7326/M14-0845 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA AX9UJ UT WOS:000347247200010 PM 25437409 ER PT J AU Simeone, RM Oster, ME Cassell, CH Armour, BS Gray, DT Honein, MA AF Simeone, Regina M. Oster, Matthew E. Cassell, Cynthia H. Armour, Brian S. Gray, Darryl T. Honein, Margaret A. TI Pediatric Inpatient Hospital Resource Use for Congenital Heart Defects SO BIRTH DEFECTS RESEARCH PART A-CLINICAL AND MOLECULAR TERATOLOGY LA English DT Article DE heart defects; congenital; healthcare resource use; hospital costs; Kids' Inpatient Database ID UNITED-STATES; DISEASE; PREVALENCE; INFANTS; QUALITY; TRENDS; COSTS; CARE AB Background: Congenital heart defects (CHDs) occur in approximately 8 per 1000 live births. Improvements in detection and treatment have increased survival. Few national estimates of the healthcare costs for infants, children and adolescents with CHDs are available. Methods: We estimated hospital costs for hospitalizations using pediatric (0-20 years) hospital discharge data from the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) for hospitalizations with CHD diagnoses. Estimates were up-weighted to be nationally representative. Mean costs were compared by demographic factors and presence of critical CHDs (CCHDs). Results: Up-weighting of the KID generated an estimated 4,461,615 pediatric hospitalizations nationwide, excluding normal newborn births. The 163,980 (3.7%) pediatric hospitalizations with CHDs accounted for approximately $5.6 billion in hospital costs, representing 15.1% of costs for all pediatric hospitalizations in 2009. Approximately 17% of CHD hospitalizations had a CCHD, but it varied by age: approximately 14% of hospitalizations of infants, 30% of hospitalizations of patients aged 1 to 10 years, and 25% of hospitalizations of patients aged 11 to 20 years. Mean costs of CHD hospitalizations were higher in infancy ($36,601) than at older ages and were higher for hospitalizations with a CCHD diagnosis ($52,899). Hospitalizations with CCHDs accounted for 26.7% of all costs for CHD hospitalizations, with hypoplastic left heart syndrome, coarctation of the aorta, and tetralogy of Fallot having the highest total costs. Conclusion: Hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with CCHD diagnoses accounted for 27% of CHD hospital costs. Birth Defects Research (Part A) 100:934-943, 2014. (c) 2014 Wiley Periodicals, Inc. C1 [Simeone, Regina M.; Oster, Matthew E.; Cassell, Cynthia H.; Armour, Brian S.; Honein, Margaret A.] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. [Simeone, Regina M.] Oak Ridge Inst Sci & Educ, Oak Ridge, TN USA. [Oster, Matthew E.] Childrens Healthcare Atlanta, Sibley Heart Ctr, Atlanta, GA USA. [Gray, Darryl T.] Agcy Healthcare Res & Qual, Ctr Qual Improvement, Rockville, MD USA. RP Simeone, RM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, 1600 Clifton Rd,MS E-86, Atlanta, GA 30333 USA. EM rsimeone@cdc.gov FU Research Participation Program at the Centers for Disease Control and Prevention FX Regina M. Simeone was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education (ORISE) through an interagency agreement between the U.S. Department of Energy and the Centers for Disease Control and Prevention. NR 27 TC 11 Z9 11 U1 1 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1542-0752 EI 1542-0760 J9 BIRTH DEFECTS RES A JI Birth Defects Res. Part A-Clin. Mol. Teratol. PD DEC PY 2014 VL 100 IS 12 BP 934 EP 943 DI 10.1002/bdra.23262 PG 10 WC Developmental Biology; Toxicology SC Developmental Biology; Toxicology GA AX4RB UT WOS:000346918000004 PM 24975483 ER PT J AU Hines, AL Andrews, RM Moy, E Barrett, ML Coffey, RM AF Hines, Anika L. Andrews, Roxanne M. Moy, Ernest Barrett, Marguerite L. Coffey, Rosanna M. TI Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors SO INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH LA English DT Article DE health status disparities; language; inpatients; quality indicators; Whites; Blacks; Asians; Hispanics ID SEVERE PERINEAL TRAUMA; HEALTH-CARE-SYSTEM; LENGTH-OF-STAY; HOSPITAL MORTALITY; ASIAN-AMERICANS; UNITED-STATES; PROFICIENCY; VETERANS; SERVICES; CONCORDANCE AB Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients. Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes. C1 [Hines, Anika L.; Coffey, Rosanna M.] Truven Hlth Analyt, Bethesda, MD 20814 USA. [Andrews, Roxanne M.; Moy, Ernest] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA 92014 USA. RP Hines, AL (reprint author), Truven Hlth Analyt, 7700 Old Georgetown Rd,Suite 650, Bethesda, MD 20814 USA. EM anika.hines@truvenhealth.com; roxanne.andrews@ahrq.hhs.gov; ernest.moy@ahrq.hhs.gov; barrettm@earthlink.com; rosanna.coffey@truvenhealth.com FU Healthcare Cost and Utilization Project [HHSA-290-2013-00002-C] FX This study was funded by the Agency for Healthcare Research and Quality under a contract to Truven Health Analytics to develop and support the Healthcare Cost and Utilization Project (Contract No. HHSA-290-2013-00002-C). This article does not represent the policy of either the Agency for Healthcare Research and Quality or the US Department of Health and Human Services (HHS). The views expressed herein are those of the authors and no official endorsement by AHRQ or HHS is intended or should be inferred. NR 40 TC 4 Z9 4 U1 0 U2 4 PU MDPI AG PI BASEL PA POSTFACH, CH-4005 BASEL, SWITZERLAND SN 1660-4601 J9 INT J ENV RES PUB HE JI Int. J. Environ. Res. Public Health PD DEC PY 2014 VL 11 IS 12 BP 13017 EP 13034 DI 10.3390/ijerph111213017 PG 18 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA AX2TJ UT WOS:000346797100058 PM 25514153 ER PT J AU Reiter, KL Jiang, HJ Wang, J AF Reiter, Kristin L. Jiang, H. Joanna Wang, Jia TI Facing the Recession: How Did Safety-Net Hospitals Fare Financially Compared with Their Peers SO HEALTH SERVICES RESEARCH LA English DT Article DE Hospital safety-net; financial performance; recession ID HEALTH; CARE; PROFITABILITY; PROVIDERS; THREATEN; PROFIT; MARKET; REFORM; 1990S AB ObjectiveTo examine the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals. Data Sources/Study SettingAgency for Healthcare Research and Quality Hospital Cost and Utilization Project State Inpatient Databases, Medicare Cost Reports, American Hospital Association Annual Survey, InterStudy, and Area Health Resource File. Study DesignRetrospective, longitudinal panel of hospitals, 2007-2011. Safety-net hospitals were identified using percentage of patients who were Medicaid or uninsured. Generalized estimating equations were used to estimate average effects of the recession on hospital operating and total margins, revenues and expenses in each year, 2008-2011, comparing safety-net with non-safety-net hospitals. Data Collection/Extraction Methods1,453 urban, nonfederal, general acute hospitals in 32 states with complete data. Principal FindingsSafety-net hospitals, as identified in 2007, had lower operating and total margins. The gap in operating margin between safety-net and non-safety-net hospitals was sustained throughout the recession; however, total margin was more negatively affected for non-safety-net hospitals in 2008. Higher percentages of Medicaid and uninsured patients were associated with lower revenue in private hospitals in all years, and lower revenue and expenses in public hospitals in 2011. ConclusionsSafety-net hospitals may not be disproportionately vulnerable to macro-economic fluctuations, but their significantly lower margins leave less financial cushion to weather sustained financial pressure. C1 [Reiter, Kristin L.] Univ N Carolina, Chapel Hill, NC 27599 USA. [Jiang, H. Joanna] Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD USA. [Wang, Jia] Data & Analyt Solut Inc, Rockville, MD USA. RP Reiter, KL (reprint author), Univ N Carolina, 1104H McGavran Greenberg Hall,Campus Box 7411, Chapel Hill, NC 27599 USA. EM reiter@email.unc.edu FU Agency for Healthcare Research and Quality FX This study was funded by the Agency for Healthcare Research and Quality through intramural research. The views expressed herein are those of the authors. No official endorsement by any agency of the federal government, the University of North Carolina at Chapel Hill, or Data and Analytic Solutions, Inc. is intended or should be inferred. NR 37 TC 6 Z9 6 U1 2 U2 12 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 2014 VL 49 IS 6 BP 1747 EP 1766 DI 10.1111/1475-6773.12230 PG 20 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AU0XT UT WOS:000345346300004 PM 25220012 ER PT J AU Fan, T Do, T AF Fan, Tina Do, Tai TI Primary Care Interventions to Prevent Tobacco Use in Children and Adolescents SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Do, Tai] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Fan, T (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD NOV 15 PY 2014 VL 90 IS 10 BP 723 EP 724 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AU3ZD UT WOS:000345548100007 PM 25403037 ER PT J AU Maeda, JLK Henke, RM Marder, WD Karaca, Z Friedman, BS Wong, HS AF Maeda, Jared Lane K. Henke, Rachel Mosher Marder, William D. Karaca, Zeynal Friedman, Bernard S. Wong, Herbert S. TI Variation in Hospital Inpatient Prices Across Small Geographic Areas SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID MARKET CONCENTRATION; MEDICARE; SURGERY; COSTS AB Objectives To examine whether market competition may influence the difference in the inpatient price per discharge between public (Medicare) and private payers across small geographic areas. Study Design Retrospective multivariate analysis. Methods Data came from the 2006 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs) in 162 counties from 6 states where an HCUP price-to-charge ratio (PCR) was available. The SIDs were linked with the Area Resource File, American Hospital Association Annual Survey Database, and US Census Bureau data files. Hospital inpatient prices were estimated by applying the HCUP PCR to total hospital charges. Payer-specific price comparisons were made for all discharges, an acute condition (acute myocardial infarction), and an elective condition (knee arthroplasty). Ordinary least squares models were used to examine the effect of market competition on the inpatient price per discharge by payer. Results Greater geographic variation was found in the inpatient price per discharge among private than public payers for most hospital services. Hospitals in more concentrated markets were associated with a higher price per discharge among knee arthroplasty discharges for both payers. Conclusions Hospitals charged significantly higher prices to private than public payers. Because the payment policies from Medicare ultimately affect private payers, public policy efforts that take into consideration market-based approaches or payment reform may help to reduce price variations. C1 [Henke, Rachel Mosher; Marder, William D.] Analyt Consulting & Res Serv, Truven Hlth Analyt, Cambridge, MA USA. [Karaca, Zeynal; Friedman, Bernard S.; Wong, Herbert S.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Maeda, Jared Lane K.] Kaiser Permanente, Midatlantic Permanente Res Inst, Rockville, MD 20852 USA. RP Maeda, JLK (reprint author), Kaiser Permanente, Midatlantic Permanente Res Inst, 2101 E Jefferson St,3 West, Rockville, MD 20852 USA. EM jared.maeda@gmail.com OI Marder, William/0000-0002-7198-6933 FU Agency for Healthcare Research and Quality (AHRQ) [HHSA-290-2006-00009-C]; Truven Health Analytics FX This study was sponsored by the Agency for Healthcare Research and Quality (AHRQ) under contract number HHSA-290-2006-00009-C with Truven Health Analytics. The views expressed herein are those of the authors. No official endorsement by any agency of the federal government or of a state government is intended or should be inferred. NR 24 TC 1 Z9 1 U1 0 U2 2 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD NOV PY 2014 VL 20 IS 11 BP 907 EP + PG 14 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA CD3SM UT WOS:000351001000011 PM 25495111 ER PT J AU Chaney, KJ Gustafson, DH Chaney, KJ AF Chaney, K. J. Gustafson, D. H. Chaney, K. J. TI AGING IN PLACE: UNDERSTANDING THE ROLE OF TECHNOLOGY AND DESIGNING BETTER SYSTEMS SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Chaney, K. J.; Chaney, K. J.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Gustafson, D. H.] Univ Wisconsin, Madison, WI USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0016-9013 EI 1758-5341 J9 GERONTOLOGIST JI Gerontologist PD NOV PY 2014 VL 54 SU 2 BP 126 EP 126 PG 1 WC Gerontology SC Geriatrics & Gerontology GA AW5TU UT WOS:000346337501301 ER PT J AU Du, DY McKean, S Kelman, JA Laschinger, J Johnson, C Warnock, R Worrall, CM Sedrakyan, A Encinosa, W MaCurdy, TE Izurieta, HS AF Du, Dongyi (Tony) McKean, Stephen Kelman, Jeffrey A. Laschinger, John Johnson, Chris Warnock, Rob Worrall, Chris M. Sedrakyan, Art Encinosa, William MaCurdy, Thomas E. Izurieta, Hector S. TI Early Mortality After Aortic Valve Replacement With Mechanical Prosthetic vs Bioprosthetic Valves Among Medicare Beneficiaries A Population-Based Cohort Study SO JAMA INTERNAL MEDICINE LA English DT Article ID PROPENSITY SCORE; HEART-VALVE; SOCIETY; DISEASE; SURGERY AB IMPORTANCE Early mortality for patients who undergo aortic valve replacement (AVR) may differ between mechanical and biological prosthetic (hereinafter referred to as bioprosthetic) valves. Clinical trials may have difficulty addressing this issue owing to limited sample sizes and low mortality rates. OBJECTIVE To compare early mortality after AVR between the recipients of mechanical and bioprosthetic aortic valves. DESIGN, SETTING, AND PARTICIPANTS A retrospective analysis of patients 65 years or older in the Medicare databases who underwent AVR from July 1, 2006, through December 31, 2011. In the mixed-effects models adjusting for physician and hospital random effects, we estimated odds ratios (OR) of early mortality to compare mechanical vs bioprosthetic valves. EXPOSURES Mechanical or bioprosthetic aortic valve replacement. MAIN OUTCOMES AND MEASURES Early mortalitywas measured as death on the date of surgery, death within 1 to 30 or 31 to 365 days after the date of surgery, death within 30 days after the date of hospital discharge, and operative mortality (death within 30 days after surgery or at discharge, whichever is longer). RESULTS Of the 66 453 Medicare beneficiaries who met inclusion criteria, 19 190 (28.88%) received a mechanical valve and 47 263 (71.12%) received a bioprosthetic valve. The risk for death on the date of surgery was 60% higher for recipients of mechanical valves than recipients of bioprosthetic valves (OR, 1.61 [95% CI, 1.27-2.04; P <.001]; risk ratio [RR], 1.60). The risk difference decreased to 16% during the 30 days after the date of surgery (OR, 1.18 [95% CI, 1.09-1.28; P < .001]; RR, 1.16). We found no differences within 31 to 365 days after the date of surgery and within the 30 days after discharge. The risk for operative mortality was 19% higher for recipients of mechanical compared with bioprosthetic valves (OR, 1.21 [95% CI, 1.13-1.30; P < .001]; RR, 1.19). The number needed to treat with mechanical valves to observe 1 additional death on the surgery date was 290; to observe 1 additional death within 30 days of surgery, 121. Consistent findings were observed in subgroup analyses of patients who underwent concurrent AVR and coronary artery bypass graft, but not in the subgroup undergoing isolated AVR. CONCLUSIONS AND RELEVANCE In this cohort analysis of Medicare beneficiaries, use of mechanical aortic valves was associated with a higher risk for death on the date of surgery and within the 30 days after surgery compared with bioprosthetic aortic valves among patients who underwent concurrent AVR and coronary artery bypass graft but not isolated AVR. C1 [Du, Dongyi (Tony); Izurieta, Hector S.] US FDA, Off Biostat & Epidemiol, Ctr Biol Evaluat & Res, Rockville, MD 20857 USA. [Du, Dongyi (Tony)] US FDA, Off Surveillance & Biometr, Ctr Devices & Radiol Hlth, Silver Spring, MD USA. [McKean, Stephen; Warnock, Rob; MaCurdy, Thomas E.] Acumen LLC, Burlingame, CA USA. [Kelman, Jeffrey A.; Worrall, Chris M.] Ctr Medicare & Medicaid Serv, Washington, DC USA. [Laschinger, John] US FDA, Off Device Evaluat, Ctr Devices & Radiol Hlth, Silver Spring, MD USA. [Sedrakyan, Art] Weill Cornell Med Coll, Patient Ctr Comparat Effectiveness Program, New York, NY USA. [Sedrakyan, Art] Weill Cornell Med Coll, MDEpiNet Sci & Infrastruct Ctr, New York, NY USA. [Encinosa, William] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [MaCurdy, Thomas E.] Stanford Univ, Dept Econ, Stanford, CA 94305 USA. RP Du, DY (reprint author), Ctr Devices & Radiol Hlth Food & Drug Adm, Off Surveillance & Biometr, 10903 New Hampshire Ave, Silver Spring, MD 20993 USA. EM dongyi.du@fda.hhs.gov FU SafeRx Project, Centers for Medicare & Medicaid Services; SafeRx Project, US Food and Drug Administration FX This study was performed as part of the SafeRx Project, a joint initiative of the Centers for Medicare & Medicaid Services and the US Food and Drug Administration. NR 37 TC 7 Z9 7 U1 1 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 2168-6106 EI 2168-6114 J9 JAMA INTERN MED JI JAMA Intern. Med. PD NOV PY 2014 VL 174 IS 11 BP 1788 EP 1795 DI 10.1001/jamainternmed.2014.4300 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA AU9KA UT WOS:000345909900018 PM 25221895 ER PT J AU Mutter, R Stocks, C AF Mutter, Ryan Stocks, Carol TI Using Healthcare Cost and Utilization Project (HCUP) Data for Emergency Medicine Research SO ANNALS OF EMERGENCY MEDICINE LA English DT Editorial Material ID UNITED-STATES; FALL 2009; IMPACT; HOSPITALS; ADULTS; RATES; STAYS C1 [Mutter, Ryan] Subst Abuse & Mental Hlth Serv Adm, Ctr Behav Hlth Stat & Qual, Rockville, MD 20857 USA. [Stocks, Carol] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. RP Mutter, R (reprint author), Subst Abuse & Mental Hlth Serv Adm, Ctr Behav Hlth Stat & Qual, Rockville, MD 20857 USA. EM ryan.mutter@samhsa.hhs.gov NR 22 TC 2 Z9 2 U1 1 U2 4 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD NOV PY 2014 VL 64 IS 5 BP 458 EP 460 DI 10.1016/j.annemergmed.2014.09.014 PG 3 WC Emergency Medicine SC Emergency Medicine GA AS7LX UT WOS:000344438600006 PM 25669700 ER PT J AU Kaplan, RM Sun, QK Naunheim, KS Ries, AL AF Kaplan, Robert M. Sun, Qiankun Naunheim, Keith S. Ries, Andrew L. TI Long-Term Follow-Up of High-Risk Patients in the National Emphysema Treatment Trial SO ANNALS OF THORACIC SURGERY LA English DT Article ID VOLUME-REDUCTION SURGERY; WELL-BEING SCALE; RANDOMIZED-TRIAL; QUALITY AB Background. The National Emphysema Treatment Trial (NETT) was a randomized clinical trial designed to compare lung volume reduction surgery (LVRS) with maximal medical care for patients with severe emphysema. The trial was halted early for a subgroup of patients with severe lung disease. We report longer term follow-up for this high-risk subgroup. Methods. In a randomized clinical trial, patients with moderate to severe emphysema were assigned to LVRS plus maximal medical care or to maximal medical care alone and followed prospectively for vital status over 15 years. We focus on 140 high-risk patients. Quality of life data were available through 6 years of follow-up and were assessed using the University of California, San Diego Shortness of Breath Questionnaire and the Self-Administered Quality of Well-Being Scale. Results. Through the first 3 years of follow-up, surgical patients in the high-risk subgroup had a significantly higher probability of death. However, the mortality curves crossed and there was a trend favoring surgical treatment through the remainder of the follow-up. The log-rank test suggested that the 2 groups were not significantly different (p = 0.95) in survival. Quality of life data suggested an advantage of LVRS through the first 5 years of follow-up (p < 0.01). The combined quality-adjusted survival model favored the medical group for the first few years of follow-up and favored the LVRS group after 4 years. Conclusions. The NETT was stopped early for high-risk patients with severe lung disease. Longer term follow-up suggests that surgical patients in this high-risk subgroup ultimately achieved comparable outcomes. The high risk of death within 30 days of the surgery may discourage use of the procedure for high-risk patients despite the potential for better long-term outcomes. (C) 2014 by The Society of Thoracic Surgeons C1 NIH, Dept Rehabil Med, Ctr Clin, Bethesda, MD 20892 USA. St Louis Univ, Sch Med, Dept Surg, St Louis, MO USA. Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Family & Prevent Med, San Diego, CA 92103 USA. RP Kaplan, RM (reprint author), Off Director, Agcy Healthcare Res & Qual, 240 Gaither Rd, Rockville, MD 20850 USA. EM rmkaplan@ucla.edu FU National Heart, Lung, and Blood Institute [N01HR76101, N01HR76102, N01HR76104, N01HR76105, N01HR76106, N01HR76107, N01HR76108, N01HR76109, N01HR76110, N01HR76111, N01HR76112, N01HR76113, N01HR76114, N01HR76115, N01HR76116, N01HR76118, N01HR76119]; Center for Medicare and Medicaid Services (formerly the Health Care Financing Administration); Agency for Healthcare Research and Quality FX Supported by contracts with the National Heart, Lung, and Blood Institute (N01HR76101, N01HR76102, N01HR76103, N01HR76104, N01HR76105, N01HR76106, N01HR76107, N01HR76108, N01HR76109, N01HR76110, N01HR76111, N01HR76112, N01HR76113, N01HR76114, N01HR76115, N01HR76116, N01HR76118, and N01HR76119), the Center for Medicare and Medicaid Services (formerly the Health Care Financing Administration), and the Agency for Healthcare Research and Quality. ClinicalTrials.gov Identifier: NCT00000606. NR 10 TC 4 Z9 5 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 EI 1552-6259 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD NOV PY 2014 VL 98 IS 5 BP 1782 EP 1789 DI 10.1016/j.athoracsur.2014.06.031 PG 8 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA AT2EZ UT WOS:000344746600064 PM 25201722 ER PT J AU Guise, JM Chang, C Viswanathan, M Glick, S Treadwell, J Umscheid, CA Whitlock, E Fu, R Berliner, E Poynter, R Anderson, J Motu'apuaka, P Trikalinos, T AF Guise, Jeanne-Marie Chang, Christine Viswanathan, Meera Glick, Susan Treadwell, Jonathan Umscheid, Craig A. Whitlock, Evelyn Fu, Rongwei Berliner, Elise Poynter, Robin Anderson, Johanna Motu'apuaka, Pua Trikalinos, Tom TI Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Review DE Evidence-based medicine; Complex interventions; Multicomponent interventions; Systematic reviews; Evidence synthesis methods; Reporting guideline; Complexity ID PUBLIC-HEALTH; METAANALYSIS; CHALLENGES; MANAGEMENT; TRIALS AB Objectives: The purpose of this Agency for Healthcare Research and Quality Evidence-based Practice Center methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. Study Design and Setting: We performed a literature scan and conducted semistructured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions (CMCIs) or organizational leaders Who implement CMCIs in health care. Results: Challenges identified include lack of consistent terminology for such interventions (eg, complex, multicomponent, multidimensional, multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from holistic to individual component analytic approaches; and incomplete and inconsistent reporting of elements critical to understanding the success and impact of multicomponent interventions, such as methods used for implementation the context in which interventions are implemented. Conclusion: We provide a framework for the spectrum of conceptual and analytic approaches to synthesizing studies of multicomponent interventions and an initial list of critical reporting elements for such studies. This information is intended to help systematic reviewers understand the options and tradeoffs available for such reviews. (C) 2014 Elsevier Inc. All rights reserved. C1 [Guise, Jeanne-Marie; Fu, Rongwei; Poynter, Robin; Anderson, Johanna; Motu'apuaka, Pua] Portland VA Res Fdn, Sci Resource Ctr, AHRQ Effect Hlth Care Program, Portland, OR 97239 USA. [Chang, Christine; Berliner, Elise] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Viswanathan, Meera] RTI UNC Evidencebased Practice Ctr, Res Triangle Pk, NC 27709 USA. [Glick, Susan] Blue Cross Blue Shield Evidencebased Practice Ctr, Chicago, IL 60601 USA. [Treadwell, Jonathan; Umscheid, Craig A.] ECRI Penn Evidencebased Practice Ctr, Plymouth Meeting, PA 19462 USA. [Whitlock, Evelyn] Kaiser Evidence Based Practice Ctr, Portland, OR 97227 USA. [Trikalinos, Tom] Brown Univ, Brown Evidence Based Practice Ctr, Providence, RI 02912 USA. RP Guise, JM (reprint author), Portland VA Res Fdn, Sci Resource Ctr, AHRQ Effect Hlth Care Program, 3710 SW US Vet Hosp Rd,Mailcode R&D71, Portland, OR 97239 USA. EM guisej@ohsu.edu OI Glick, Susan/0000-0002-9672-6273; Paynter, Robin/0000-0002-6969-4261 FU Agency for Healthcare Research and Quality [HHSA290201200010i, HHSA290201200012i, HHSA290201200011i, HHSA290201200015i, HHSA290201200008i, HHSA290201200004C]; U.S. Department of Health and Human Services FX This project was funded under contract numbers HHSA290201200010i, HHSA290201200012i, HHSA290201200011i, HHSA290201200015i, HHSA290201200008i, and HHSA290201200004C from the Agency for Healthcare Research and Quality and U.S. Department of Health and Human Services. NR 33 TC 7 Z9 7 U1 1 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 EI 1878-5921 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD NOV PY 2014 VL 67 IS 11 BP 1181 EP 1191 DI 10.1016/j.jclinepi.2014.06.010 PG 11 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AT5JK UT WOS:000344979400002 PM 25438663 ER PT J AU Viswanathan, M Carey, TS Belinson, SE Berliner, E Chang, SM Graham, E Guise, JM Ip, S Maglione, MA McCrory, DC McPheeters, M Newberry, SJ Sista, P White, CM AF Viswanathan, Meera Carey, Timothy S. Belinson, Suzanne E. Berliner, Elise Chang, Stephanie M. Graham, Elaine Guise, Jeanne-Marie Ip, Stanley Maglione, Margaret A. McCrory, Douglas C. McPheeters, Melissa Newberry, Sydne J. Sista, Priyanka White, C. Michael TI A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE Nonfinancial conflicts of interest; Systematic review methods; Comparative effectiveness; Evidence-based practice; Bias; Identification and management of conflicts of interest ID FINANCIAL CONFLICTS; METAANALYSES AB Objectives: Groups such as the Institute of Medicine emphasize the importance of attention to financial conflicts of interest. Little guidance exists, however, on managing the risk of bias for systematic reviews from nonfinancial conflicts of interest. We sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. Study Design and Setting: Workgroup members built on existing guidance from international and domestic institutions on managing conflicts of interest. We then developed practical guidance in the form of an instrument for each potential source of conflict. Results: We modified the Institute of Medicine's definition of conflict of interest to arrive at a definition specific to nonfinancial conflicts. We propose questions for funders and systematic review principal investigators to evaluate the risk of nonfinancial conflicts of interest. Once risks have been identified, options for managing conflicts include disclosure followed by no change in the systematic review team or activities, inclusion on the team along with other members with differing viewpoints to ensure diverse perspectives, exclusion from certain activities, and exclusion from the project entirely. Conclusion: The feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated. (C) 2014 Elsevier Inc. All rights reserved. C1 [Viswanathan, Meera; Sista, Priyanka] RTI Int, Social Stat & Environm Sci, Res Triangle Pk, NC 27709 USA. [Carey, Timothy S.] Univ N Carolina, Cecil G Sheps Ctr Hlth Serv Res, Chapel Hill, NC 27599 USA. [Belinson, Suzanne E.] Blue Cross Blue Shield Assoc, Chicago, IL 60601 USA. [Berliner, Elise; Chang, Stephanie M.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Graham, Elaine; Guise, Jeanne-Marie] Oregon Hlth & Sci Univ, Portland, OR 97239 USA. [Maglione, Margaret A.; Newberry, Sydne J.] RAND Corp, Santa Monica, CA 90407 USA. [McCrory, Douglas C.] Duke Univ, Dept Med, Durham, NC 27710 USA. [McPheeters, Melissa] Vanderbilt Univ, Med Ctr, Nashville, TN 37203 USA. [White, C. Michael] Univ Connecticut, Sch Pharm, Storrs, CT 06269 USA. RP Viswanathan, M (reprint author), RTI Int, Social Stat & Environm Sci, 3040 Cornwallis Rd, Res Triangle Pk, NC 27709 USA. EM viswanathan@rti.org OI McCrory, Douglas/0000-0003-2093-0611 FU Agency for Healthcare Research and Quality [290200710056I] FX This effort was funded by the Agency for Healthcare Research and Quality through contract number 290200710056I. NR 19 TC 3 Z9 3 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 EI 1878-5921 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD NOV PY 2014 VL 67 IS 11 BP 1229 EP 1238 DI 10.1016/j.jclinepi.2014.02.023 PG 10 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AT5JK UT WOS:000344979400007 PM 25022723 ER PT J AU Weidmer, BA Cleary, PD Keller, S Evensen, C Hurtado, MP Kosiak, B Gallagher, PM Levine, R Hays, RD AF Weidmer, Beverly A. Cleary, Paul D. Keller, San Evensen, Christian Hurtado, Margarita P. Kosiak, Beth Gallagher, Patricia M. Levine, Roger Hays, Ron D. TI Development and Evaluation of the CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey for In-Center Hemodialysis Patients SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE CAHPS In-Center Hemodialysis (ICH) Survey; hemodialysis; patient experiences of care; end-stage renal disease (ESRD); patient satisfaction; quality of care; patient-centered care ID CHRONIC KIDNEY-DISEASE; HOSPITAL SURVEY; QUALITY; DESIGN; PLANS; NEEDS; RISK; LIFE AB Background: The US Centers for Medicare & Medicaid Services assess patient experiences of care as part of the end-stage renal disease prospective payment system and Quality Incentive Program. This article describes the development and evaluation of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) In-Center Hemodialysis Survey. Study Design: We conducted formative research to generate survey questions and performed statistical analyses to evaluate the survey's measurement properties. Setting & Participants: Formative research included focus groups, cognitive interviews, and field testing the survey with dialysis patients. Measurements & Outcomes: We assessed internal consistency reliability (Cronbach alpha) and center-level reliability for 3 multi-item scales. We evaluated construct validity using correlations of the scales with global ratings of the kidney doctor, staff, and dialysis center. Results: Response rate was 46% (1,454 completed surveys). Analyses support 3 multi-item scales: Nephrologists' Communication and Caring (7 items, alpha = 0.89), Quality of Dialysis Center Care and Operations (22 items, alpha = 0.93), and Providing Information to Patients (11 items, alpha = 0.75). The communication scale was correlated the most strongly with the global rating of the "kidney doctor" (r = 0.78). The Dialysis Center Care and Operations scale was correlated most strongly with global ratings of staff (r = 0.75) and the center (r = 0.69). Providing Information to Patients was correlated most strongly with the global rating of the staff (r = 0.41). Limitations: A relatively small number of patients completed the survey in Spanish. Conclusions: This study provides support for the reliability and validity of the CAHPS In-Center Hemodialysis Survey for assessing patient experiences of care at dialysis facilities. The survey can be used to compare care provided at different facilities. (C) 2014 by the National Kidney Foundation, Inc. C1 [Weidmer, Beverly A.] RAND Corp, Santa Monica, CA USA. [Cleary, Paul D.] Yale Univ, Sch Publ Hlth, New Haven, CT USA. [Keller, San; Evensen, Christian] Amer Inst Res, Chapel Hill, NC USA. [Hurtado, Margarita P.] Amer Inst Res, Silver Spring, MA USA. [Kosiak, Beth] Agcy Healthcare Res & Qual, Rockville, MD USA. [Gallagher, Patricia M.] Univ Massachusetts, Boston, MA 02125 USA. [Levine, Roger] Amer Inst Res, San Mateo, CA USA. [Hays, Ron D.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Weidmer, BA (reprint author), RAND, 1776 Main St, Santa Monica, CA 90407 USA. EM beverly_weidmer@rand.org FU Agency for Healthcare Research and Quality [U18 HS09204, U18 HS016980]; CMS [U18 HS09204, U18 HS016980]; National Institute on Aging [P30-AG021684]; National Institute on Minority Health and Health Disparities [P20MD000182] FX Support: Preparation of the manuscript was supported through cooperative agreements from the Agency for Healthcare Research and Quality (U18 HS09204 and U18 HS016980) and CMS. Dr Hays also was supported in part by grants from the National Institute on Aging (P30-AG021684) and National Institute on Minority Health and Health Disparities (P20MD000182). NR 29 TC 8 Z9 8 U1 1 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0272-6386 EI 1523-6838 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD NOV PY 2014 VL 64 IS 5 BP 753 EP 760 DI 10.1053/j.ajkd.2014.04.021 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA AS4IM UT WOS:000344237900016 PM 24998035 ER PT J AU Martsolf, GR Auerbach, D Benevent, R Stocks, C Jiang, HJ Pearson, ML Ehrlich, ED Gibson, TB AF Martsolf, Grant R. Auerbach, David Benevent, Richele Stocks, Carol Jiang, H. Joanna Pearson, Marjorie L. Ehrlich, Emily D. Gibson, Teresa B. TI Examining the Value of Inpatient Nurse Staffing An Assessment of Quality and Patient Care Costs SO MEDICAL CARE LA English DT Article DE nursing; nurse staffing; patient care costs; adverse events; quality; length of stay ID HEALTH-CARE; HOSPITALS; READMISSIONS; ASSOCIATION; SAFETY; IMPACT; UNITS; FALLS; STAY AB Background: Inpatient quality deficits have important implications for the health and well-being of patients. They also have important financial implications for payers and hospitals by leading to longer lengths of stay and higher intensity of treatment. Many of these costly quality deficits are particularly sensitive to nursing care. Objective: To assess the effect of nurse staffing on quality of care and inpatient care costs. Design: Longitudinal analysis using hospital nurse staffing data and the Healthcare Cost and Utilization Project State Inpatient Databases from 2008 through 2011. Subjects: Hospital discharges from California, Nevada, and Maryland (n = 18,474,860). Methods: A longitudinal, hospital-fixed effect model was estimated to assess the effect of nurse staffing levels and skill mix on patient care costs, length of stay, and adverse events, adjusting for patient clinical and demographic characteristics. Results: Increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, but did not lead to increases in patient care costs. Changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs. Conclusions: The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix can lead to improved quality and reduced length of stay at no additional cost. C1 [Martsolf, Grant R.] RAND Corp, Pittsburgh, PA USA. [Auerbach, David] RAND Corp, Boston, MA USA. [Benevent, Richele] Truven Hlth Analyt, Santa Barbara, CA USA. [Stocks, Carol; Jiang, H. Joanna] AHRQ, CDOM, Rockville, MD USA. [Pearson, Marjorie L.] RAND Corp, Santa Monica, CA USA. [Ehrlich, Emily D.; Gibson, Teresa B.] Truven Hlth Analyt, Ann Arbor, MI 48108 USA. RP Gibson, TB (reprint author), Truven Hlth Analyt, 777 E Eisenhower Pkwy, Ann Arbor, MI 48108 USA. EM tbgibson1@gmail.com FU Agency for Healthcare Research and Quality (AHRQ) [HHSA-290-2006-00009-C] FX Supported by the Agency for Healthcare Research and Quality (AHRQ) (Contract HHSA-290-2006-00009-C) through intramural research. The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ, or the US Department of Health and Human Services. NR 44 TC 8 Z9 8 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD NOV PY 2014 VL 52 IS 11 BP 982 EP 988 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AR9XL UT WOS:000343930300008 PM 25304017 ER PT J AU Berliner, E AF Berliner, Elise TI Adopting Medical Technology SO MEDICAL DECISION MAKING LA English DT Editorial Material ID BREAST-CANCER; THERAPY C1 [Berliner, Elise] Agcy Healthcare Res & Qual, Rockville, MD 20852 USA. [Berliner, Elise] US Dept HHS, AHRQ, Washington, DC USA. RP Berliner, E (reprint author), Agcy Healthcare Res & Qual, Technol Assessment Program, 540 Gaither Rd, Rockville, MD 20852 USA. EM elise.berliner@ahrq.hhs.gov NR 12 TC 0 Z9 0 U1 0 U2 0 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0272-989X EI 1552-681X J9 MED DECIS MAKING JI Med. Decis. Mak. PD NOV PY 2014 VL 34 IS 8 BP 948 EP 950 DI 10.1177/0272989X14546378 PG 3 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA AS1TN UT WOS:000344064400003 PM 25224365 ER PT J AU Fan, TN Do, T AF Fan, Tina Do, Tai TI Screening for Glaucoma SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Do, Tai] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Fan, T (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 3 TC 0 Z9 0 U1 0 U2 3 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD OCT 15 PY 2014 VL 90 IS 8 BP 569 EP 570 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AR6EK UT WOS:000343676000009 PM 25369645 ER PT J AU Maeda, JLK Henke, RM Marder, WD Karaca, Z Friedman, BS Wong, HS AF Maeda, Jared Lane K. Henke, Rachel Mosher Marder, William D. Karaca, Zeynal Friedman, Bernard S. Wong, Herbert S. TI Association between the unemployment rate and inpatient cost per discharge by payer in the United States, 2005-2010 SO BMC HEALTH SERVICES RESEARCH LA English DT Article ID GEOGRAPHIC-VARIATION; HEALTH-CARE; RECESSIONS; GROWTH; ECONOMETRICS; EFFICIENCY AB Background: Several reports have linked the 2007-2009 Great Recession in the United States with a slowdown in health care spending and decreased utilization. However, little is known regarding how the recent economic downturn affected hospital costs per inpatient stay for different segments of the population. The purpose of this study was to examine the association between changes in the unemployment rate and inpatient cost per discharge for Medicare and commercial discharges. Methods: We used retrospective data at the Core Based Statistical Area (CBSA)-level from 46 states that contributed to the Healthcare Cost and Utilization Project State Inpatient Databases from 2005 to 2010. Unemployment data was derived from the American Community Survey. An instrumental variable two-stage least squares approach with fixed- or random-effects was used to examine the association between unemployment rate and inpatient cost per discharge by payer because of potential endogeneity. Results: The marginal effect of unemployment was associated with an increase in inpatient cost per discharge for both payers. A one percentage point increase in the unemployment rate was associated with a $37 increase for commercial discharges and a $49 increase for Medicare discharges. Conclusions: We find evidence that the inpatient cost per discharge is countercyclical across different segments of the population. The underlying mechanisms by which unemployment affects hospital resource use however, might differ between payer groups. C1 [Maeda, Jared Lane K.] Kaiser Permanente, Mid Atlantic Permanente Res Inst, Rockville, MD 20852 USA. [Henke, Rachel Mosher; Marder, William D.] Truven Hlth Analyt, Cambridge, MA 02140 USA. [Karaca, Zeynal; Friedman, Bernard S.; Wong, Herbert S.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. RP Maeda, JLK (reprint author), Kaiser Permanente, Mid Atlantic Permanente Res Inst, 2101 East Jefferson St, Rockville, MD 20852 USA. EM jared.maeda@gmail.com OI Marder, William/0000-0002-7198-6933 FU Agency for Healthcare Research and Quality [HHSA-290-2006-00009-C]; Truven Health Analytics FX Disclosures: This study was sponsored by the Agency for Healthcare Research and Quality under contract number HHSA-290-2006-00009-C with Truven Health Analytics. NR 24 TC 1 Z9 1 U1 1 U2 8 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD OCT 13 PY 2014 VL 14 AR 378 DI 10.1186/1472-6963-14-378 PG 8 WC Health Care Sciences & Services SC Health Care Sciences & Services GA AR0JU UT WOS:000343259000001 PM 25311258 ER PT J AU Battles, JB Cleeman, JI Kahn, KL Weinberg, DA AF Battles, James B. Cleeman, James I. Kahn, Katherine L. Weinberg, Daniel A. TI Introduction: From science to implementation: The Agency for Healthcare Research and Quality's program to prevent healthcare-associated infections-results and lessons learned SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Editorial Material C1 [Battles, James B.; Cleeman, James I.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Kahn, Katherine L.] RAND Corp, Santa Monica, CA USA. [Kahn, Katherine L.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Weinberg, Daniel A.] IMPAQ Int LLC, Columbia, MD USA. RP Weinberg, DA (reprint author), 10420 Little Patuxent Pkwy,Ste 300, Columbia, MD 21044 USA. EM dweinberg@impaqint.com NR 17 TC 1 Z9 1 U1 1 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-6553 EI 1527-3296 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD OCT PY 2014 VL 42 IS 10 SU S BP S189 EP S190 DI 10.1016/j.ajic.2014.07.006 PG 2 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA CO8YN UT WOS:000359458200001 PM 25239708 ER PT J AU Fakih, MG Krein, SL Edson, B Watson, SR Battles, JB Saint, S AF Fakih, Mohamad G. Krein, Sarah L. Edson, Barbara Watson, Sam R. Battles, James B. Saint, Sanjay TI Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Article DE Urinary catheter; Collaboration; Infection; Safety; Quality improvement ID ASYMPTOMATIC BACTERIURIA; HOSPITALIZED-PATIENTS; EMERGENCY-DEPARTMENT; IMPROVEMENT PROJECT; FOLEY CATHETERS; COMPLICATIONS; RISK; GUIDELINES; CHAMPION; OVERUSE AB Preventing catheter-associated urinary tract infection (CAUTI) remains a significant challenge for US hospitals. The "On the CUSP: Stop CAUTI" initiative represents the single largest national effort (involving >950 hospitals) to mitigate urinary catheter risk. The program brings together key organizations to assist state hospital associations and hospitals by providing education and coaching support, addressing both the technical aspects of preventing CAUTI and CAUTI-specific socio-adaptive challenges. At the local level, engaging health care workers, from physicians and nurses to other ancillary services, is critical. This includes (1) making the importance of addressing CAUTI stakeholder specific, (2) ensuring support from leaders of essential disciplines, (3) underscoring the importance of the collaborative nature of CAUTI prevention, and (4) identifying champions within the organization to lead and be accountable for the work. Sustainability is ensured by integrating the process into the health care worker's daily routine activities. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. C1 [Fakih, Mohamad G.] St John Hosp & Med Ctr, Detroit, MI USA. [Fakih, Mohamad G.] Wayne State Univ, Sch Med, Detroit, MI USA. [Krein, Sarah L.; Saint, Sanjay] VA Ann Arbor Healthcare Syst, Ann Arbor, MI USA. [Krein, Sarah L.] Univ Michigan, Sch Med, Ann Arbor, MI USA. [Edson, Barbara] Hlth Res & Educ Trust, Chicago, IL USA. [Watson, Sam R.] Michigan Hlth & Hosp Assoc, Lansing, MI USA. [Battles, James B.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Fakih, MG (reprint author), St John Hosp & Med Ctr, Infect Prevent & Control, 19251 Mack Ave,Ste 190, Grosse Pointe Woods, MI 48236 USA. EM Mohamad.Fakih@stjohn.org FU Agency for Healthcare Research and Quality [HHSA290201000025I/HHSA29032001T]; Agency for Healthcare Research and Quality (AHRQ) FX This project was supported by a contract from the Agency for Healthcare Research and Quality HHSA290201000025I/HHSA29032001T.; Publication of this article was supported by the Agency for Healthcare Research and Quality (AHRQ). NR 46 TC 8 Z9 8 U1 1 U2 7 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-6553 EI 1527-3296 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD OCT PY 2014 VL 42 IS 10 SU S BP S223 EP S229 DI 10.1016/j.ajic.2014.03.355 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA CO8YN UT WOS:000359458200007 PM 25239714 ER PT J AU Laiteerapong, N Kirby, J Gao, Y Yu, TC Sharma, R Nocon, R Lee, SM Chin, MH Nathan, AG Ngo-Metzger, Q Huang, ES AF Laiteerapong, Neda Kirby, James Gao, Yue Yu, Tzy-Chyi Sharma, Ravi Nocon, Robert Lee, Sang Mee Chin, Marshall H. Nathan, Aviva G. Ngo-Metzger, Quyen Huang, Elbert S. TI Health Care Utilization and Receipt of Preventive Care for Patients Seen at Federally Funded Health Centers Compared to Other Sites of Primary Care SO HEALTH SERVICES RESEARCH LA English DT Article DE Safety net; preventive care; utilization ID PROPENSITY SCORE; EMERGENCY-DEPARTMENT; SAFETY-NET; PHYSICIANS OFFICES; MEDICAID PATIENTS; SERVICES; QUALITY; HOSPITALIZATIONS; PERFORMANCE; POPULATION AB Objective. To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. Data Sources. A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004-2008). Study Design. HC patients were defined as those with >= 50 percent of outpatient visits at HCs in the first panel year. Outcomes included utilization and preventive care receipt from the second panel year. We used negative binomial and logistic regression models with propensity score adjustment for confounding differences between HC and non-HC patients. Principal Findings. Compared to non-HC patients, HC patients had fewer office visits (adjusted incidence rate ratio [aIRR], 0.63) and hospitalizations (aIRR, 0.43) (both p < .001). HC patients were more likely to receive breast cancer screening than non-HC patients (adjusted odds ratio [aOR] 2.78, p < .01). In subgroup analyses, uninsured HC patients had fewer outpatient and emergency room visits and were more likely to receive dietary advice and breast cancer screening compared to non-HC patients. Conclusions. Health centers add value to the health care system by providing socially and medically disadvantaged patients with care that results in lower utilization and maintained or improved preventive care. C1 [Laiteerapong, Neda] Univ Chicago, Chicago, IL 60637 USA. [Kirby, James; Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, Rockville, MD USA. [Gao, Yue; Nocon, Robert; Lee, Sang Mee; Chin, Marshall H.; Nathan, Aviva G.; Huang, Elbert S.] Univ Chicago, Dept Med, Chicago, IL 60637 USA. [Gao, Yue; Nocon, Robert; Lee, Sang Mee; Chin, Marshall H.; Nathan, Aviva G.; Huang, Elbert S.] Univ Chicago, Gen Internal Med Sect, Chicago, IL 60637 USA. [Yu, Tzy-Chyi] Univ Chicago, NORC, Parsippany, NJ USA. [Sharma, Ravi] US Dept HHS, Bur Primary Hlth Care Hlth Resources & Serv Adm, Rockville, MD USA. RP Laiteerapong, N (reprint author), Univ Chicago, 5841 S Maryland Ave,MC 2007, Chicago, IL 60637 USA. EM nlaiteer@medicine.bsd.uchicago.edu FU Health Resources and Services Administration's Bureau of Primary Health Care; NIDDK [K23 DK097283, K24 DK071933]; John A. Hartford Foundation Center of Excellence Award (American Federation for Aging Research) FX Joint Acknowledgment/Disclosure Statement: Dr. Laiteerapong had full access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the analysis. Dr. Laiteerapong led the study concept and design, analysis and interpretation of data, and preparation of the manuscript. Dr. Kirby, Ms. Gao, Dr. Yu, Dr. Lee, and Dr. Huang participated in the study concept and design, analysis and interpretation of data, and preparation of manuscript. Ms. Gao participated in the analysis and interpretation of data and preparation of the manuscript. Drs. Sharma and Ngo-Metzger participated in the study concept and design, analysis and interpretation of data, and preparation of the manuscript. Mr. Nocon and Dr. Chin participated in the study concept and design and preparation of the manuscript. Ms. Nathan participated in the analysis and interpretation of data and the preparation of manuscript. Funding for this project was sponsored by the Health Resources and Services Administration's Bureau of Primary Health Care. The sponsor (BPHC) was involved in the design and conduct of the study, analysis and interpretation of the data, and review and approval of the manuscript. The sponsor was not involved in the collection or management of data. Dr. Laiteerapong is supported by NIDDK K23 DK097283 and a John A. Hartford Foundation Center of Excellence Award (American Federation for Aging Research). Dr. Chin is supported by NIDDK K24 DK071933. Dr. Laiteerapong, Ms. Gao, Mr. Nocon, Ms. Nathan, Dr. Chin, and Dr. Huang are members of the NIDDK Chicago Center for Diabetes Translation Research at the University of Chicago (P30 DK092949). This manuscript was presented in abstract form to the Society of General Internal Medicine (SGIM) 36th Annual Meeting, Denver, Colorado, April 2013. The authors thank Elizabeth A. Stuart, PhD, Department of Mental Health and Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, for providing consultation on the use of propensity score methods with survey data. Dr. Stuart received compensation for her work. NR 38 TC 5 Z9 5 U1 3 U2 4 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 2014 VL 49 IS 5 BP 1498 EP 1518 DI 10.1111/1475-6773.12178 PG 21 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AQ7OA UT WOS:000343006400006 PM 24779670 ER PT J AU McNamara, P Damberg, CL AF McNamara, Peggy Damberg, Cheryl L. TI Supplemental Issue: Informing the Next Generation of Public Reporting for Consumers Foreword SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Editorial Material C1 [McNamara, Peggy] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Damberg, Cheryl L.] RAND Corp, Santa Monica, CA USA. RP Damberg, CL (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM peggy.mcnamara@ahrq.hhs.gov NR 0 TC 0 Z9 0 U1 0 U2 0 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 EI 1552-6801 J9 MED CARE RES REV JI Med. Care Res. Rev. PD OCT PY 2014 VL 71 IS 5 SU S BP 3S EP 4S DI 10.1177/1077558714535981 PG 2 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AQ5KF UT WOS:000342846400001 PM 25340210 ER PT J AU Hussey, PS Luft, HS McNamara, P AF Hussey, Peter S. Luft, Harold S. McNamara, Peggy TI Public Reporting of Provider Performance at a Crossroads in the United States: Summary of Current Barriers and Recommendations on How to Move Forward Introduction SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Editorial Material DE consumer engagement in quality; public reporting; report cards; transparency; health care decision making ID REPORT CARDS; QUALITY AB Twenty-seven years after the first public release by the U.S. government of data on the quality of hospital care, public reporting for consumers has expanded substantially. Despite the growth in public reporting activities, there is limited evidence of their use by consumers in ways that significantly affect health care delivery. Support for public reporting continues, in part, because of the face value of transparency. The limited impact of reporting efforts is plausibly due to flaws in the content, design, and implementation of existing public reports rather than inherent limitations of reporting. Substantial work is still needed for public reports to achieve their potential for engaging and informing consumers. We present a vision statement and 10 recommendations to achieve this potential. C1 [Hussey, Peter S.] RAND Corp, Boston, MA 02116 USA. [Luft, Harold S.] Palo Alto Med Fdn, Palo Alto, CA USA. [McNamara, Peggy] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Hussey, PS (reprint author), RAND Corp, 20 Pk Plaza,Suite 920, Boston, MA 02116 USA. EM hussey@rand.org NR 21 TC 10 Z9 10 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 EI 1552-6801 J9 MED CARE RES REV JI Med. Care Res. Rev. PD OCT PY 2014 VL 71 IS 5 SU S BP 5S EP 16S DI 10.1177/1077558714535980 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AQ5KF UT WOS:000342846400002 PM 24871273 ER PT J AU Damberg, CL McNamara, P AF Damberg, Cheryl L. McNamara, Peggy TI Postscript: Research Agenda to Guide the Next Generation of Public Reports for Consumers SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Editorial Material DE consumer engagement in quality; public reporting; report cards; transparency; health care decision making ID HEALTH-CARE; PERFORMANCE DATA; INFORMATION; PHYSICIAN; WANT AB There is significant interest in building the next generation of public reporting tools that will more effectively engage consumers and better enable them to make use of comparative performance information when selecting a provider. Demand for public reporting tools that make health care cost and quality information transparent is fueled by a variety of market forces underway. A host of public reporting efforts and studies have identified a number of challenges, highlighting that we still do not understand how best to design public reports to meet the needs of the consumer. We identify five areas for additional research that, if addressed, could foster better design and delivery of quality and cost information to consumers. C1 [Damberg, Cheryl L.] RAND Corp, Santa Monica, CA 90407 USA. [McNamara, Peggy] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Damberg, CL (reprint author), RAND Corp, 1776 Main St, Santa Monica, CA 90407 USA. EM damberg@rand.org NR 27 TC 3 Z9 3 U1 1 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 EI 1552-6801 J9 MED CARE RES REV JI Med. Care Res. Rev. PD OCT PY 2014 VL 71 IS 5 SU S BP 97S EP 107S DI 10.1177/1077558714535982 PG 11 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AQ5KF UT WOS:000342846400007 PM 24860123 ER PT J AU Broussard, CS Frey, MT Hernandez-Diaz, S Greene, MF Chambers, CD Sahin, L Sharp, BAC Honein, MA AF Broussard, Cheryl S. Frey, Meghan T. Hernandez-Diaz, Sonia Greene, Michael F. Chambers, Christina D. Sahin, Leyla Sharp, Beth A. Collins Honein, Margaret A. TI Developing a Systematic Approach to Safer Medication Use during Pregnancy: Summary of a Centers for Disease Control and Prevention-Convened Meeting SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Meeting Abstract C1 [Broussard, Cheryl S.; Frey, Meghan T.; Honein, Margaret A.] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA USA. [Frey, Meghan T.] Oak Ridge Inst Sci & Educ, Oak Ridge, TN USA. [Hernandez-Diaz, Sonia] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. [Greene, Michael F.] Harvard Univ, Sch Med, Dept Obstet Gynecol & Reprod Biol, Boston, MA 02115 USA. [Greene, Michael F.] Massachusetts Gen Hosp, Boston, MA 02114 USA. [Chambers, Christina D.] Univ Calif San Francisco, Dept Pediat, La Jolla, CA USA. [Chambers, Christina D.] Univ Calif San Francisco, Dept Family & Prevent Med, La Jolla, CA USA. [Sahin, Leyla] US FDA, Ctr Drug Evaluat & Res, Silver Spring, MD USA. [Sharp, Beth A. Collins] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1053-8569 EI 1099-1557 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD OCT PY 2014 VL 23 SU 1 SI SI MA 594 BP 315 EP 315 PG 1 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA AQ4JZ UT WOS:000342763600590 ER PT J AU Encinosa, W Meyerhoefer, C Zuvekas, S Du, DY AF Encinosa, William Meyerhoefer, Chad Zuvekas, Samuel Du, Dongyi TI The Impact of Direct-to-Consumer Advertising on Health Insurance Markets SO GENEVA PAPERS ON RISK AND INSURANCE-ISSUES AND PRACTICE LA English DT Article DE health insurance; direct-to-consumer advertising; pharmaceuticals; prices ID PRESCRIPTION DRUGS; PRICE; INFORMATION; ANTIDEPRESSANTS; PERFORMANCE; ECONOMICS; QUANTITY AB Direct-to-consumer advertising (DTCA) for drugs has increased from US$200 million in 1997 to US$4 billion in 2011. While studies show that DTCA impacts the patient-physician relationship, little is known of the effect of DTCA on health insurance markets. We test whether DTCA raises the costs in these markets or makes the markets more efficient in drug pricing. Across 212 markets, we examine the impact of DTCA on insurers' negotiated prices for 166 drugs. Controlling for unobserved pharmacy and pharmacy benefit manager attributes, as well as manufacturer advertising market selection effects, we find that an increase in a manufacturer's DTCA spending lowers insurer prices and reduces insurance market price dispersion. These competitive effects intensify as DTCA competition increases between drug manufacturers. C1 [Encinosa, William] Georgetown Univ, McCourt Sch Publ Policy, Washington, DC 20057 USA. [Meyerhoefer, Chad] Lehigh Univ, Bethlehem, PA 18015 USA. [Meyerhoefer, Chad] NBER, Cambridge, MA 02138 USA. [Encinosa, William; Zuvekas, Samuel] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Du, Dongyi] Food & Drug Adm, Ctr Devices & Radiol Hlth, Silver Spring, MD 20993 USA. RP Encinosa, W (reprint author), Georgetown Univ, McCourt Sch Publ Policy, 37th St NW & O St NW,Old North 100, Washington, DC 20057 USA. EM william.encinosa@ahrq.hhs.gov; chm308@lehigh.edu; samuel.zuvekas@ahrq.hhs.gov; dongyi.du@fda.hhs.gov NR 51 TC 0 Z9 0 U1 3 U2 14 PU PALGRAVE MACMILLAN LTD PI BASINGSTOKE PA BRUNEL RD BLDG, HOUNDMILLS, BASINGSTOKE RG21 6XS, HANTS, ENGLAND SN 1018-5895 EI 1468-0440 J9 GENEVA PAP R I-ISS P JI Geneva Pap. Risk Insur.-Issues Pract. PD OCT PY 2014 VL 39 IS 4 BP 749 EP 767 DI 10.1057/gpp.2014.33 PG 19 WC Business, Finance SC Business & Economics GA AQ3ZI UT WOS:000342731600009 ER PT J AU Bakullari, A Metersky, ML Wang, Y Eldridge, N Eckenrode, S Pandolfi, MM Jaser, L Galusha, D Moy, E AF Bakullari, Anila Metersky, Mark L. Wang, Yun Eldridge, Noel Eckenrode, Sheila Pandolfi, Michelle M. Jaser, Lisa Galusha, Deron Moy, Ernest TI Racial and Ethnic Disparities in Healthcare-Associated Infections in the United States, 2009-2011 SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID CLOSTRIDIUM-DIFFICILE INFECTION; PATIENT-SAFETY; US HOSPITALS; EVENTS AB BACKGROUND. Little is known about racial and ethnic disparities in the occurrence of healthcare-associated infections (HAIs) in hospitalized patients. OBJECTIVE. To determine whether racial/ethnic disparities exist in the rate of occurrence of HAIs captured in the Medicare Patient Safety Monitoring System (MPSMS). METHODS. Chart-abstracted MPSMS data from randomly selected all-payer hospital discharges of adult patients (18 years old or above) between January 1, 2009, and December 31, 2011, for 3 common medical conditions: acute cardiovascular disease (composed of acute myocardial infarction and heart failure), pneumonia, and major surgery for 6 HAT measures (hospital-acquired antibiotic-associated Clostridium difficile, central line associated bloodstream infections, postoperative pneumonia, catheter-associated urinary tract infections, hospital-acquired methicillin-resistant Staphylococcus aureus, and ventilator-associated pneumonia). RESULTS. The study sample included 79,019 patients who had valid racial/ethnic information divided into 6 racial/ethnic groups white non-Hispanic (n = 62,533), black non-Hispanic (n = 9,693), Hispanic (n = 4,681), Asian (n = 1,225), Native Hawaiian/Pacific Islander (n = 94), and other (n = 793) who were at risk for at least 1 HAT. The occurrence rate for HAIs was 1.1% for non-Hispanic white patients, 1.3% for non-Hispanic black patients, 1.5% for Hispanic patients, 1.8% for Asian patients, 1.7% for Native Hawaiian/Pacific Islander patients, and 0.70% for other patients. Compared with white patients, the age/gender/comorbidity-adjusted odds ratios of occurrence of HAIs were 1.1 (95% confidence interval [CI], 0.99-1.23), 1.3 (95% CI, 1.15-1.53), 1.4 (95% CI, 1.07-1.75), and 0.7 (95% CI, 0.40 1.12) for black, Hispanic, Asian, and a combined group of Native Hawaiian/Pacific Islander and other patients, respectively. CONCLUSIONS. Among patients hospitalized with acute cardiovascular disease, pneumonia, and major surgery, Asian and Hispanic patients. C1 [Bakullari, Anila; Metersky, Mark L.; Eckenrode, Sheila; Pandolfi, Michelle M.; Jaser, Lisa; Galusha, Deron] Qualidigm, Wethersfield, CT 06109 USA. [Metersky, Mark L.] Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, Farmington, CT USA. [Wang, Yun] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Eldridge, Noel; Moy, Ernest] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. [Jaser, Lisa] Griffin Hosp Pharm, Derby, CT USA. [Galusha, Deron] Yale Univ, Sch Med, Dept Internal Med, Gen Internal Med Sect, New Haven, CT 06510 USA. RP Bakullari, A (reprint author), Qualidigm, 1290 Silas Deane Highway,Suite 4A, Wethersfield, CT 06109 USA. EM abakullari@qualidigm.org FU Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland [HHSA290201200003C] FX This work was supported by the Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland (contract HHSA290201200003C). Qualidigm was the contractor. The content does not necessarily represent the official views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government. The authors assume full responsibility for the accuracy and completeness of the ideas. NR 23 TC 5 Z9 5 U1 1 U2 6 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD OCT PY 2014 VL 35 SU 3 BP S10 EP S16 DI 10.1086/677827 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA AP2XP UT WOS:000341939700003 PM 25222888 ER PT J AU Battles, JB Cleeman, JI Kahn, KL Weinberg, DA AF Battles, James B. Cleeman, James I. Kahn, Katherine L. Weinberg, Daniel A. TI Introduction to "Preventing Healthcare-Associated Infections: Results and Lessons Learned from AHRQ's HAI Program" SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Editorial Material C1 [Battles, James B.; Cleeman, James I.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Kahn, Katherine L.] RAND Corp, Santa Monica, CA USA. [Weinberg, Daniel A.] IMPAQ Int LLC, Columbia, MD USA. RP Weinberg, DA (reprint author), 10420 Little Patuxent Pkwy,Suite 300, Columbia, MD 21044 USA. EM dweinberg@impaqint.com NR 19 TC 1 Z9 1 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD OCT PY 2014 VL 35 SU 3 BP S1 EP S2 DI 10.1086/677817 PG 2 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA AP2XP UT WOS:000341939700001 PM 25222887 ER PT J AU Eckenrode, S Bakullari, A Metersky, ML Wang, Y Pandolfi, MM Galusha, D Jaser, L Eldridge, N AF Eckenrode, Sheila Bakullari, Anila Metersky, Mark L. Wang, Yun Pandolfi, Michelle M. Galusha, Deron Jaser, Lisa Eldridge, Noel TI The Association between Age, Sex, and Hospital-Acquired Infection Rates: Results from the 2009-2011 National Medicare Patient Safety Monitoring System SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID INTENSIVE-CARE-UNIT; BLOOD-STREAM; RISK-FACTORS; EPIDEMIOLOGY; PNEUMONIA AB OBJECTIVE. To define the relationships between age, sex and hospital-acquired infection (HAI) rates in a national cohort of hospitalized patients. METHODS. Analysis of chart-abstracted Medicare Patient Safety Monitoring System data from randomly selected medical records of patients hospitalized between January 1, 2009, and December 31, 2011, for acute cardiovascular disease, pneumonia, or major surgery associated with 1 of 6 HAIs. Patients were stratified into 6 groups. We then analyzed the association of age, sex, and 2 outcomes; the rate of occurrence of HAI for patients who were at risk and the rate of patients having at least 1 HAI. RESULTS. Among 85,461 patients, all groups except younger female surgical patients had higher catheter-associated urinary tract infection (CAUTI) rates than male patients. After adjustment for comorbidities, there was no overall evidence of higher HAI rates among elderly patients. In patients with acute cardiovascular disease, women had higher rates of HAIs. Among patients with pneumonia, there was no significant difference in the rate of HAIs among most age and sex groups. Among surgical patients, all age and sex groups had a significantly higher adjusted rate of developing at least 1 HAI except females 65 years of age or older. Similar results were seen for the outcome of the occurrence rate of HAIs. CONCLUSIONS. There was not an overall increased risk of HAIs among older patients hospitalized for acute cardiovascular disease, pneumonia, and major surgery after adjustment for comorbidities. The relationship between sex and the rate of HAIs varied depending C1 [Eckenrode, Sheila; Bakullari, Anila; Metersky, Mark L.; Pandolfi, Michelle M.; Galusha, Deron] Qualidigm, Wethersfield, CT 06109 USA. [Metersky, Mark L.] Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, Farmington, CT USA. [Wang, Yun] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Galusha, Deron] Yale Univ, Sch Med, Dept Internal Med, Gen Internal Med Sect, New Haven, CT 06510 USA. [Jaser, Lisa] Griffin Hosp, Derby, CT USA. [Eldridge, Noel] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. RP Eckenrode, S (reprint author), Qualidigm, 1290 Silas Deane Highway,Suite 4A, Wethersfield, CT 06109 USA. EM seckenrode@qualidigm.org FU Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland [HHSA290201200003C] FX This work was supported by the Agency for Healthcare Research and Quality (contract HHSA290201200003C), US Department of Health and Human Services, Rockville, Maryland. Qualidigm was the contractor. The content does not necessarily represent the official views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. The authors assume full responsibility for the accuracy and completeness of the ideas. The views expressed in the article represent the authors and not their respective institutional affiliations. NR 18 TC 3 Z9 4 U1 3 U2 20 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD OCT PY 2014 VL 35 SU 3 BP S3 EP S9 DI 10.1086/677831 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA AP2XP UT WOS:000341939700002 PM 25222895 ER PT J AU Furuno, JP Corner, AC Johnson, JK Rosenberg, JH Moore, SL MacKenzie, TD Hall, KK Hirshon, JM AF Furuno, Jon P. Corner, Angela C. Johnson, J. Kristie Rosenberg, Joseph H. Moore, Susan L. MacKenzie, Thomas D. Hall, Kendall K. Hirshon, Jon Mark TI Using Antibiograms to Improve Antibiotic Prescribing in Skilled Nursing Facilities SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID LONG-TERM-CARE; RANDOMIZED CONTROLLED-TRIAL; EDUCATIONAL INTERVENTION; INFECTION-CONTROL; HOME RESIDENTS; RESISTANCE AB BACKGROUND. Antibiograms have effectively improved antibiotic prescribing in acute-care settings; however, their effectiveness in skilled nursing facilities (SNFs) is currently unknown. OBJECTIVE. To develop SNF-specific antibiograms and identify opportunities to improve antibiotic prescribing. DESIGN AND SETTING. Cross-Sectional and pretest-posttest study among residents of 3 Maryland SNFs. METHODS. Antibiograms were created using clinical culture data from a 6-month period in each SNF. We also used admission clinical culture data from the acute care facility primarily associated with each SNF for transferred residents. We manually collected all data from medical charts, and antibiograms were created using WHONET software. We then used a pretest-posttest study to evaluate the effectiveness of an antibiogram on changing antibiotic prescribing practices in a single SNF. Appropriate empirical antibiotic therapy was defined as an empirical antibiotic choice that sufficiently covered the infecting organism, considering antibiotic susceptibilities. RESULTS. We reviewed 839 patient charts from SNF and acute care facilities. During the initial assessment period, 85% of initial antibiotic use in the SNFs was empirical, and thus only 15% of initial antibiotics were based on culture results. Fluoroquinolones were the most frequently used empirical antibiotics, accounting for 54.5% of initial prescribing instances. Among patients with available culture data, only 35% of empirical antibiotic prescribing was determined to be appropriate. In the single SNF in which we evaluated antibiogram effectiveness, prevalence of appropriate antibiotic prescribing increased from 32% to 45% after antibiogram implementation; however, this was not statistically significant (P =.32). CONCLUSIONS. Implementation of antibiograms may be effective in improving empirical antibiotic prescribing in SNFs. C1 [Furuno, Jon P.] OHSU, Dept Pharm Practice, Coll Pharm, OSU, Portland, OR 97239 USA. [Corner, Angela C.; Johnson, J. Kristie; Rosenberg, Joseph H.; Hirshon, Jon Mark] Univ Maryland, Sch Med, Dept Epidemiol & Publ Hlth, Baltimore, MD 21201 USA. [Corner, Angela C.; Hirshon, Jon Mark] Univ Maryland, Sch Med, Natl Study Ctr Trauma & EMS, Baltimore, MD 21201 USA. [Johnson, J. Kristie] Univ Maryland, Sch Med, Dept Pathol, Baltimore, MD 21201 USA. [Moore, Susan L.; MacKenzie, Thomas D.] Denver Hlth & Hosp Author, Dept Patient Safety & Qual, Denver, CO USA. [Moore, Susan L.; MacKenzie, Thomas D.] Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. [Hall, Kendall K.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Hirshon, Jon Mark] Univ Maryland, Sch Med, Dept Emergency Med, Baltimore, MD 21201 USA. RP Furuno, JP (reprint author), OHSU, Dept Pharm Practice, Coll Pharm, OSU, 3303 SW Bond Ave,Mail Code CH12C, Portland, OR 97239 USA. EM furuno@ohsu.edu OI Hirshon, Jon Mark/0000-0002-5247-529X FU Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services [HHSA290200600020I] FX This project was supported under contract number HHSA290200600020I, ACTION Task Order 9, "Using Nursing Home Antibiograms to Improve Antibiotic Prescribing and Delivery," from the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services. The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the US Department of Health and Human Services. NR 19 TC 5 Z9 5 U1 0 U2 4 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD OCT PY 2014 VL 35 SU 3 BP S56 EP S61 DI 10.1086/677818 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA AP2XP UT WOS:000341939700009 PM 25222899 ER PT J AU Jacobs, JH Viboud, C Tchetgen, ET Schwartz, J Steiner, C Simonsen, L Lipsitch, M AF Jacobs, Jessica Hartman Viboud, Cecile Tchetgen, Eric Tchetgen Schwartz, Joel Steiner, Claudia Simonsen, Lone Lipsitch, Marc TI The Association of Meningococcal Disease with Influenza in the United States, 1989-2009 SO PLOS ONE LA English DT Article ID RESPIRATORY SYNCYTIAL VIRUS; A VIRUS; NEISSERIA-MENINGITIDIS; EPIDEMIC INFLUENZA; INFECTIONS; ENGLAND; MODELS; WALES; BOOTSTRAP; SCHOOL AB Importance and Objective: Prior influenza infection is a risk factor for invasive meningococcal disease. Quantifying the fraction of meningococcal disease attributable to influenza could improve understanding of viral-bacterial interaction and indicate additional health benefits to influenza immunization. Design, Setting and Participants: A time series analysis of the association of influenza and meningococcal disease using hospitalizations in 9 states from 1989-2009 included in the State Inpatient Databases from the Agency for Healthcare Research and Quality and the proportion of positive influenza tests by subtype reported to the Centers for Disease Control. The model accounts for the autocorrelation of meningococcal disease and influenza between weeks, temporal trends, co-circulating respiratory syncytial virus, and seasonality. The influenza-subtype-attributable fraction was estimated using the model coefficients. We analyzed the synchrony of seasonal peaks in hospitalizations for influenza, respiratory syncytial virus, and meningococcal disease. Results and Conclusions: In 19 of 20 seasons, influenza peaked <= 2 weeks before meningococcal disease, and peaks were highly correlated in time (rho = 0.95; P<.001). H3N2 and H1N1 peaks were highly synchronized with meningococcal disease while pandemic H1N1, B, and respiratory syncytial virus were not. Over 20 years, 12.8% (95% CI, 9.1-15.0) of meningococcal disease can be attributable to influenza in the preceding weeks with H3N2 accounting for 5.2% (95% CI, 3.0-6.5), H1N1 4.3% (95% CI, 2.6-5.6), B 3.0% (95% CI, 0.8-4.9) and pH1N1 0.2% (95% CI, 0-0.4). During the height of influenza season, weekly attributable fractions reach 59%. While vaccination against meningococcal disease is the most important prevention strategy, influenza vaccination could provide further protection, particularly in young children where the meningococcal disease vaccine is not recommended or protective against the most common serogroup. C1 [Jacobs, Jessica Hartman; Tchetgen, Eric Tchetgen; Schwartz, Joel; Lipsitch, Marc] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Ctr Communicable Dis Dynam, Boston, MA 02115 USA. [Viboud, Cecile; Simonsen, Lone] NIH, Div Int Epidemiol & Populat Studies, Fogarty Int Ctr, Bethesda, MD 20892 USA. [Tchetgen, Eric Tchetgen] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Schwartz, Joel] Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA. [Steiner, Claudia] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Simonsen, Lone] George Washington Univ, Sch Publ Hlth & Hlth Serv, Dept Global Hlth, Washington, DC USA. [Lipsitch, Marc] Harvard Univ, Sch Publ Hlth, Dept Immunol & Infect Dis, Boston, MA 02115 USA. RP Lipsitch, M (reprint author), Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Ctr Communicable Dis Dynam, Boston, MA 02115 USA. EM mlipsitc@hsph.harvard.edu OI Simonsen, Lone/0000-0003-1535-8526 FU National Institute Of General Medical Sciences [U54GM088558] FX The project described was supported by the National Institute Of General Medical Sciences [Award Number U54GM088558]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute Of General Medical Sciences, the National Institutes of Health, or the Agency for Healthcare Research and Quality. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 46 TC 4 Z9 4 U1 0 U2 1 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD SEP 29 PY 2014 VL 9 IS 9 AR e107486 DI 10.1371/journal.pone.0107486 PG 8 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA AU6XR UT WOS:000345745400023 PM 25265409 ER PT J AU Parekh, AK Kronick, R Tavenner, M AF Parekh, Anand K. Kronick, Richard Tavenner, Marilyn TI Optimizing Health for Persons With Multiple Chronic Conditions SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID CARE C1 [Parekh, Anand K.] US Dept HHS, Off Assistant Secretary Hlth, Washington, DC 20201 USA. [Kronick, Richard] US Dept HHS, Agcy Healthcare Res & Qual, Washington, DC 20201 USA. [Tavenner, Marilyn] US Dept HHS, Ctr Medicare & Medicaid Serv, Washington, DC 20201 USA. RP Parekh, AK (reprint author), US Dept HHS, Off Assistant Secretary Hlth, 200 Independence Ave SW, Washington, DC 20201 USA. EM anand.parekh@hhs.gov NR 7 TC 22 Z9 22 U1 0 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD SEP 24 PY 2014 VL 312 IS 12 BP 1199 EP 1200 DI 10.1001/jama.2014.10181 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA AP3QA UT WOS:000341990600016 PM 25133982 ER PT J AU Mabry-Hernandez, I Blackmer, S AF Mabry-Hernandez, Iris Blackmer, Shannon TI Screening for Hepatitis C Virus Infection in Adults SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Mabry-Hernandez, Iris] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Blackmer, Shannon] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Mabry-Hernandez, I (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD SEP 15 PY 2014 VL 90 IS 6 BP 405 EP 406 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AP3FK UT WOS:000341960800006 PM 25251234 ER PT J AU Kaplan, RM Riley, WT Mabry, PL AF Kaplan, Robert M. Riley, William T. Mabry, Patricia L. TI News from the NIH: leveraging big data in the behavioral sciences SO TRANSLATIONAL BEHAVIORAL MEDICINE LA English DT News Item C1 [Kaplan, Robert M.] Agcy Healthcare Res & Qual, Off Director, Rockville, MD 20850 USA. [Riley, William T.] NIH, Off Behav & Social Sci Res, Bethesda, MD 20892 USA. [Mabry, Patricia L.] NIH, Off Dis Prevent, Bethesda, MD 20892 USA. RP Kaplan, RM (reprint author), Agcy Healthcare Res & Qual, Off Director, 540 Gaither Rd,Suite 2000, Rockville, MD 20850 USA. EM Robert.Kaplan@ahrq.hhs.gov NR 8 TC 4 Z9 4 U1 1 U2 5 PU SPRINGER INTERNATIONAL PUBLISHING AG PI CHAM PA GEWERBESTRASSE 11, CHAM, CH-6330, SWITZERLAND SN 1869-6716 EI 1613-9860 J9 TRANSL BEHAV MED JI Transl. Behav. Med. PD SEP PY 2014 VL 4 IS 3 BP 229 EP 231 DI 10.1007/s13142-014-0267-y PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA CL2PO UT WOS:000356786700001 PM 25264461 ER PT J AU Joseph, S Sow, M Furukawa, MF Posnack, S Chaffee, MA AF Joseph, Seth Sow, Max Furukawa, Michael F. Posnack, Steven Chaffee, Mary Ann TI HITECH Spurs EHR Vendor Competition and Innovation, Resulting in Increased Adoption SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID ELECTRONIC HEALTH RECORDS; PROGRAM; SYSTEM; CARE AB The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted to increase electronic health record (EHR) adoption by providers and hospitals. Experts expressed skepticism about whether the program would indeed hasten adoption and could be implemented in time for the initial reporting period. Could EHR vendors meet the certification requirements, and could the industry innovate to meet small-practice needs? This study, in addition to documenting increased provider adoption, provides the first evidence of increased competitiveness and innovation in the EHR industry spurred by HITECH. For example, the number of EHR vendors certified for e-prescribing with Surescripts increased from 96 to 229 over the program's first 3 years. We also find that prescribers in small practices increasingly adopted lower-cost, Web-based e-prescribing and EHR applications at significantly higher rates (15%-35%) than did large practices (3%-4%), which generally have more human and capital resources to make significant investments. These findings suggest that EHR vendors were highly responsive to HITECH requirements and have been adapting their strategies to meet nuanced market needs, providing reason to be optimistic about the Programs' future. C1 [Joseph, Seth; Sow, Max; Chaffee, Mary Ann] Surescripts, Arlington, VA 22202 USA. [Furukawa, Michael F.] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. [Furukawa, Michael F.; Posnack, Steven] US Dept HHS, Off Natl Coordinator Hlth Informat Technol, Washington, DC 20201 USA. RP Chaffee, MA (reprint author), Surescripts, 2800 Crystal Dr, Arlington, VA 22202 USA. EM Maryann.chaffee@sure-scripts.com NR 17 TC 5 Z9 5 U1 1 U2 5 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD SEP PY 2014 VL 20 IS 9 BP 734 EP 740 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA CD3QC UT WOS:000350993300012 PM 25365748 ER PT J AU Adler-Milstein, J DesRoches, CM Furukawa, MF Worzala, C Charles, D Kralovec, P Stalley, S Jha, AK AF Adler-Milstein, Julia DesRoches, Catherine M. Furukawa, Michael F. Worzala, Chantal Charles, Dustin Kralovec, Peter Stalley, Samantha Jha, Ashish K. TI More Than Half of US Hospitals Have At Least A Basic EHR, But Stage 2 Criteria Remain Challenging For Most SO HEALTH AFFAIRS LA English DT Article ID HEALTH INFORMATION-TECHNOLOGY; CARE AB The national effort to promote the adoption and meaningful use of electronic health records (EHRs) is well under way. However, 2014 marks an important transition: For many hospitals, penalties will be assessed in fiscal year 2015 for failing to meet federal meaningful-use criteria by the end of fiscal year 2014. We used recent data from the American Hospital Association Annual Survey of Hospitals-IT Supplement to assess progress and challenges. EHR adoption among US hospitals continues to rise steeply: 59 percent now have at least a basic EHR. Small and rural hospitals continue to lag behind their better resourced counterparts. Most hospitals are able to meet many of the stage 2 meaningful-use criteria, but only 5.8 percent of hospitals are able to meet them all. Several criteria, including sharing care summaries with other providers and providing patients with online access to their data, will require attention from EHR vendors to ensure that the necessary functions are available and additional effort from many hospitals to make certain that these functionalities are used. Policy makers may want to consider new targeted strategies to ensure that all hospitals move toward meaningful use of EHRs. C1 [Adler-Milstein, Julia] Univ Michigan, Sch Informat, Ann Arbor, MI 48109 USA. [Adler-Milstein, Julia] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA. [DesRoches, Catherine M.] Mathemat Policy Res Cambridge, Cambridge, MA USA. [Furukawa, Michael F.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Furukawa, Michael F.] Dept Hlth & Human Serv, Off Natl Coordinator Hlth Informat Technol ONC, Off Econ Anal Evaluat & Modeling, Bethesda, MD 20892 USA. [Worzala, Chantal] Amer Hosp Assoc Washington, Washington, DC USA. [Kralovec, Peter] Hlth Forum, Chicago, IL USA. [Jha, Ashish K.] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. RP Adler-Milstein, J (reprint author), Univ Michigan, Sch Informat, Ann Arbor, MI 48109 USA. EM cdesroches@mathematica-mpr.com FU Robert Wood Johnson Foundation FX The views expressed in this article are those of the authors and do not necessarily reflect those of the Department of Health and Human Services. Funding for this research was provided by the Robert Wood Johnson Foundation. [Published online August 7, 2014.] NR 17 TC 45 Z9 45 U1 1 U2 7 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD SEP PY 2014 VL 33 IS 9 BP 1664 EP 1671 DI 10.1377/hlthaff.2014.0453 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AR2GK UT WOS:000343401600022 PM 25104826 ER PT J AU Furukawa, MF King, J Patel, V Hsiao, CJ Adler-Milstein, J Jha, AK AF Furukawa, Michael F. King, Jennifer Patel, Vaishali Hsiao, Chun-Ju Adler-Milstein, Julia Jha, Ashish K. TI Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings SO HEALTH AFFAIRS LA English DT Article ID MEANINGFUL USE; TECHNOLOGY; CARE; PHYSICIANS; ATTITUDES; RECORDS; DOCTORS AB The United States is making substantial investments to accelerate the adoption and use of interoperable electronic health record (EHR) systems. Using data from the 2009-13 Electronic Health Records Survey, we found that EHR adoption continues to grow: In 2013, 78 percent of office-based physicians had adopted some type of EHR, and 48 percent had the capabilities required for a basic EHR system. However, we also found persistent gaps in EHR adoption, with physicians in solo practices and non-primary care specialties lagging behind others. Physicians' electronic health information exchange with other providers was limited, with only 14 percent sharing data with providers outside their organization. Finally, we found that 30 percent of physicians routinely used capabilities for secure messaging with patients, and 24 percent routinely provided patients with the ability to view online, download, or transmit their health record. These findings suggest that although EHR adoption continues to grow, policies to support health information exchange and patient engagement will require ongoing attention. C1 [Furukawa, Michael F.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. [Furukawa, Michael F.] Dept Hlth & Human Serv, Off Econ Anal Evaluat & Modeling, Off Natl Coordinator Hlth Informat Technol ONC, Bethesda, MD 20892 USA. [King, Jennifer] ONC, Off Econ Anal Evaluat & Modeling, Res & Evaluat Branch, Washington, DC 20201 USA. [Patel, Vaishali] ONC, Off Planning Evaluat & Anal, Washington, DC 20201 USA. [Hsiao, Chun-Ju] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Adler-Milstein, Julia] Univ Michigan, Sch Informat, Ann Arbor, MI 48109 USA. [Adler-Milstein, Julia] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA. [Jha, Ashish K.] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. RP Furukawa, MF (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. EM michael.furukawa@ahrq.hhs.gov NR 24 TC 49 Z9 50 U1 2 U2 20 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD SEP PY 2014 VL 33 IS 9 BP 1672 EP 1679 DI 10.1377/hlthaff.2014.0445 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AR2GK UT WOS:000343401600023 PM 25104827 ER PT J AU Mehal, JM Holman, RC Steiner, CA Bartholomew, ML Singleton, RJ AF Mehal, Jason M. Holman, Robert C. Steiner, Claudia A. Bartholomew, Michael L. Singleton, Rosalyn J. TI Epidemiology of Asthma Hospitalizations Among American Indian and Alaska Native People and the General United States Population SO CHEST LA English DT Article ID RESPIRATORY-TRACT; CHILDHOOD ASTHMA; RURAL ALASKA; RISK-FACTORS; HEALTH-CARE; CHILDREN; PREVALENCE; TRENDS; BRONCHIOLITIS; INFECTIONS AB BACKGROUND: Asthma, a common chronic disease among adults and children in the United States, results in nearly one-half million hospitalizations annually. There has been no evaluation of asthma hospitalizations for American Indian and Alaska Native (AI/AN) people since a previous study using data for 1988-2002. In this study, we describe the epidemiology and trends for asthma hospitalizations among AI/AN people and the general US population for 2003-2011. METHODS: Hospital discharge records with a first-listed diagnosis of asthma for 2003-2011 were examined for AI/AN people, using Indian Health Service (IHS) data, and for the general US population, using the Nationwide Inpatient Sample. Average annual crude and age-adjusted hospitalization rates were calculated. RESULTS: The average annual asthma hospitalization rates for AI/AN people and the general US population decreased from 2003-2005 to 2009-2011 (32% and 11% [SE, 3%], respectively). The average annual age-adjusted rate for 2009-2011 was lower for AI/AN people (7.6 per 10,000 population) compared with the general US population (13.2 per 10,000; 95% CI, 12.8-13.6). Age-specific AI/AN rates were highest among infants and children 1 to 4 years of age. IHS regional rates declined in all regions except Alaska. CONCLUSIONS: Asthma hospitalization rates are decreasing for AI/AN people and the general US population despite increasing prevalence rates. AI/AN people experienced a substantially lower age-adjusted asthma hospitalization rate compared with the general US population. Although the rates for AI/AN infants and children 1 to 4 years of age have declined substantially, they remain higher compared with other age groups. Improved disease management and awareness should help to further decrease asthma hospitalizations, particularly among young children. C1 [Mehal, Jason M.; Holman, Robert C.] Ctr Dis Control & Prevent CDC, Div High Consequence Pathogens & Pathol, NCEZID, DHHS, Atlanta, GA 30333 USA. [Steiner, Claudia A.] Ctr Delivery Organizat & Markets, Agcy Healthcare Res & Qual, DHHS, Healthcare Cost & Utilizat Project, Rockville, MD USA. [Bartholomew, Michael L.] DHHS, Indian Hlth Serv, Rockville, MD USA. [Singleton, Rosalyn J.] Alaska Native Tribal Hlth Consortium, Anchorage, AK USA. [Singleton, Rosalyn J.] CDC, Arct Investigat Program, Div Preparedness & Emerging Infect, NCEZID,DHHS, Anchorage, AK USA. RP Mehal, JM (reprint author), Ctr Dis Control & Prevent, 1600 Clift Rd NE,MS A-30, Atlanta, GA 30333 USA. EM jmehal@cdc.gov NR 40 TC 3 Z9 3 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI GLENVIEW PA 2595 PATRIOT BLVD, GLENVIEW, IL 60026 USA SN 0012-3692 J9 CHEST JI Chest PD SEP PY 2014 VL 146 IS 3 BP 624 EP 632 DI 10.1378/chest.14-0183 PG 9 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA AP9UM UT WOS:000342425800041 PM 24810971 ER PT J AU Shoemaker, SJ Wolf, MS Brach, C AF Shoemaker, Sarah J. Wolf, Michael S. Brach, Cindy TI Development of the Patient Education Materials Assessment Tool (PEMAT): A new measure of understandability and actionability for print and audiovisual patient information SO PATIENT EDUCATION AND COUNSELING LA English DT Article DE Health literacy; Assessment; Measurement; Instrument development; Patient education; Educational materials; Audiovisual materials; Plain language; Clear communication; Readability ID HEALTH LITERACY DEMANDS; AGREEMENT; OUTCOMES; COMPREHENSION AB Objective: To develop a reliable and valid instrument to assess the understandability and actionability of print and audiovisual materials. Methods: We compiled items from existing instruments/guides that the expert panel assessed for face/content validity. We completed four rounds of reliability testing, and produced evidence of construct validity with consumers and readability assessments. Results: The experts deemed the PEMAT items face/content valid. Four rounds of reliability testing and refinement were conducted using raters untrained on the PEMAT. Agreement improved across rounds. The final PEMAT showed moderate agreement per Kappa (Average K=0.57) and strong agreement per Gwet's AC1 (Average = 0.74). Internal consistency was strong (alpha = 0.71; Average Item-Total Correlation = 0.62). For,construct validation with consumers (n = 47), we found significant differences between actionable and poorly-actionable materials in comprehension scores (76% vs. 63%, p < 0.05) and ratings (8.9 vs. 7.7,p < 0.05). For understandability, there was a significant difference for only one of two topics on consumer numeric scores. For actionability, there were significant positive correlations between PEMAT scores and consumer-testing results, but no relationship for understandability. There were, however, strong, negative correlations between grade-level and both consumer-testing results and PEMAT scores. Conclusions: The PEMAT demonstrated strong internal consistency, reliability, and evidence of construct validity. Practice implications: The PEMAT. can help professionals judge the quality of materials (available at: http://www.ahrq.gov/pemat). (C) 2014 Elsevier Ireland Ltd. All rights reserved. C1 [Shoemaker, Sarah J.] ABT Associates Inc, Hlth Policy, Cambridge, MA 02138 USA. [Wolf, Michael S.] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. [Brach, Cindy] AHRQ, Rockville, MD USA. RP Shoemaker, SJ (reprint author), ABT Associates Inc, Wheeler St, Cambridge, MA 02138 USA. EM sarah_shoemaker@abtassoc.com FU Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services [HHSA290200900012I]; AHRQ [HHSA290200900012I] FX The information upon which this publication is based was performed under Contract #HHSA290200900012I, TO 4 "Improving EHRs Patient Education Materials" funded by the Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The author assumes full responsibility for the accuracy and completeness of the ideas presented. Financial support for this study was provided by AHRQ under contract #HHSA290200900012I, TO 4. NR 37 TC 28 Z9 28 U1 6 U2 19 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD SEP PY 2014 VL 96 IS 3 BP 395 EP 403 DI 10.1016/j.pec.2014.05.027 PG 9 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA AP7QF UT WOS:000342271100020 PM 24973195 ER PT J AU Bailey, LC Mistry, KB Tinoco, A Earls, M Rollins, MC Hanley, K Christensen, KI Jones, M Woods, D AF Bailey, L. Charles Mistry, Kamila B. Tinoco, Aldo Earls, Marian Rollins, Marjorie C. Hanley, Kendra Christensen, Ken I. Jones, Meredith Woods, Donna TI Addressing Electronic Clinical Information in the Construction of Quality Measures SO ACADEMIC PEDIATRICS LA English DT Article DE CHIPRA; electronic health records; e-measurement; PQMP; quality measurement ID HEALTH RECORDS; CARE; TECHNOLOGY; EXTRACTION; PERFORMANCE; OUTCOMES; CHILD AB Electronic health records (EHR) and registries play a central role in health care and provide access to detailed clinical information at the individual, institutional, and population level. Use of these data for clinical quality/performance improvement and cost management has been a. focus of policy initiatives over the past decade. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA)-mandated Pediatric Quality Measurement Program supports development and testing of quality measures for children on the basis of electronic clinical information, including de novo measures and respecification of existing measures designed for other data sources. Drawing on the experience of Centers of Excellence, we review both structural and pragmatic considerations in e-measurement. The presence of primary observations in EHR-derived data make it possible to measure outcomes in ways that are difficult with administrative data alone. However, relevant information may be located in narrative text, making it difficult to interpret. EHR systems are collecting more discrete data, but the structure, semantics, and adoption of data elements vary across vendors and sites. EHR systems also differ in ability to incorporate pediatric concepts such as variable dosing and growth percentiles. This variability complicates quality measurement, as do limitations in established measure formats, such as the Quality Data Model, to e-measurement. Addressing these challenges will require investment by vendors, researchers, and clinicians alike in developing better pediatric content for standard terminologies and data models, encouraging wider adoption of technical standards that support reliable quality measurement, better harmonizing data collection with clinical work flow in EHRs, and better understanding the behavior and potential of e-measures. C1 [Bailey, L. Charles] Univ Penn, Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA. [Bailey, L. Charles] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. [Mistry, Kamila B.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Tinoco, Aldo] Natl Comm Qual Assurance, Washington, DC USA. [Earls, Marian] Community Care North Carolina, Greensboro, NC USA. [Rollins, Marjorie C.; Hanley, Kendra; Christensen, Ken I.; Jones, Meredith] Amer Med Assoc, Chicago, IL 60610 USA. [Woods, Donna] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. RP Bailey, LC (reprint author), Childrens Hosp Philadelphia, Div Oncol, CTRB 10407,34th St & Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM baileyc@email.chop.edu FU Pediatric Quality Measurement Program Center of Excellence, Agency for Healthcare Research and Quality; National Collaborative for Innovation in Quality Measurement; Pediatric Measurement Center of Excellence FX The authors are supported by Pediatric Quality Measurement Program Center of Excellence grants from the Agency for Healthcare Research and Quality to the Children's Hospital of Philadelphia (C.B.), the National Collaborative for Innovation in Quality Measurement (A.T.), and the Pediatric Measurement Center of Excellence (M.R., K.H., K.C., M.J, D.W.). NR 41 TC 2 Z9 2 U1 1 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD SEP-OCT PY 2014 VL 14 IS 5 SU S BP S82 EP S89 PG 8 WC Pediatrics SC Pediatrics GA AP2KE UT WOS:000341900300018 PM 25169464 ER PT J AU Dougherty, D Mistry, KB Lindly, O Desoto, M LLanos, K Chesley, F AF Dougherty, Denise Mistry, Kamila B. Lindly, Olivia Desoto, Maushami LLanos, Karen Chesley, Francis TI Systematic Evidence-Based Quality Measurement Life-Cycle Approach to Measure Retirement in CHIPRA SO ACADEMIC PEDIATRICS LA English DT Article DE AHRQ; CHIPRA; CMS; quality measures ID HEALTH-CARE QUALITY; CHILDREN AB OBJECTIVE: In 2009, Centers for Medicare and Medicaid Services (CMS) publicly released an initial child core set (CCS) of health care quality measures for voluntary reporting by state Medicaid and Children's Health Insurance Program (CHIP) programs. CMS is responsible for implementing the reporting program and for updating the CCS annually. We assessed selected CCS measures for potential retirement. METHODS: We identified a 23-member external advisory group to provide relevant expertise. We worked with the group to identify 4 major criteria with multiple subcomponents for assessing the measures. We provided information corresponding to each criterion and subcriterion, using a variety of sources such as the 2009 Medicaid Analytic eXtract (MAX), state-level Medicaid and CHIP data submitted to the CMS, and summaries of published literature on clinical and quality improvement effectiveness related to the CCS topics. Using this information, the group: 1) used a modified Delphi process to score the measures in 2 anonymous scoring rounds (on a scale of 1 to 9 in each round); 2) voted on whether each measure should be retired; and 3) provided narrative explanations of their choices (which formed the basis of our qualitative findings). Recommendations were reviewed by CMS before promulgation to state programs. RESULTS: The Subcommittee of the National Advisory Council on Healthcare Research and Quality (SNAC) recommended that the 4 major criteria be importance, scientific acceptability, feasibility, and usability. The SNAC recommended 3 measures for retirement: access to primary care; testing for strep before recommending antibiotics for pharyngitis; and annual HbA1c testing of children with diabetes. Explanations for suggesting retirement of the measures included: views that the well-visit measures were a better measure of access than the primary care measure; a likely ceiling effect (pharyngitis); and the paucity of clinical evidence and low prevalence (both for HbA1c). CMS recommended that state Medicaid and CHIP programs retire 2 of the recommended measures from the CCS, but retained the access to primary care measure. CONCLUSIONS: Periodic reassessment of the value of health care quality measures can reduce reporting burden and allow measure users to focus on measures with higher likelihood of leading to improvements in quality of care and child health outcomes. C1 [Dougherty, Denise; Lindly, Olivia] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Mistry, Kamila B.; Desoto, Maushami; Chesley, Francis] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD USA. [LLanos, Karen] Ctr Medicare & Medicaid Serv, Ctr Medicaid, Baltimore, MD USA. [LLanos, Karen] Ctr Medicare & Medicaid Serv, CHIP Serv, Baltimore, MD USA. RP Dougherty, D (reprint author), Agcy Healthcare Res & Qual, Child Hlth & Qual Improvement, 540 Gaither Rd, Rockville, MD 20850 USA. EM Denise.dougherty@ahrq.hhs.gov NR 25 TC 4 Z9 4 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD SEP-OCT PY 2014 VL 14 IS 5 SU S BP S97 EP S103 PG 7 WC Pediatrics SC Pediatrics GA AP2KE UT WOS:000341900300020 PM 25169466 ER PT J AU Dougherty, D Mistry, KB LLanos, K Lillie-Blanton, M Chesley, F AF Dougherty, Denise Mistry, Kamila B. LLanos, Karen Lillie-Blanton, Marsha Chesley, Francis TI An AHRQ and CMS Perspective on the Pediatric Quality Measures Program SO ACADEMIC PEDIATRICS LA English DT Editorial Material ID HEALTH-CARE C1 [Dougherty, Denise; Mistry, Kamila B.; Chesley, Francis] US Dept Hlth & Human Serv, Off Extramural Res Educ & Prior Populat, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [LLanos, Karen; Lillie-Blanton, Marsha] Ctr Medicare Serv, Ctr Medicaid & CHIP Serv, Baltimore, MD USA. [LLanos, Karen; Lillie-Blanton, Marsha] Ctr Medicaid Serv, Ctr Medicaid & CHIP Serv, Baltimore, MD USA. RP Dougherty, D (reprint author), US Dept Hlth & Human Serv, Off Extramural Res Educ & Prior Populat, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. EM Kamila.Mistry@ahrq.hhs.gov NR 9 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD SEP-OCT PY 2014 VL 14 IS 5 SU S BP S17 EP S18 PG 2 WC Pediatrics SC Pediatrics GA AP2KE UT WOS:000341900300008 PM 25169452 ER PT J AU Kuhlthau, KA Mistry, KB Forrest, CB Dougherty, D AF Kuhlthau, Karen A. Mistry, Kamila B. Forrest, Christopher B. Dougherty, Denise TI Advancing the Science of Measurement in Pediatric Quality of Care SO ACADEMIC PEDIATRICS LA English DT Editorial Material ID IMPROVEMENT C1 [Kuhlthau, Karen A.] Massachusetts Gen Hosp, Dept Pediat, Boston, MA 02114 USA. [Kuhlthau, Karen A.] Harvard Univ, Sch Med, Boston, MA 02115 USA. [Mistry, Kamila B.; Dougherty, Denise] Agcy Healthcare Res & Qual, Rockville, MD USA. [Forrest, Christopher B.] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA. RP Kuhlthau, KA (reprint author), Massachusetts Gen Hosp, Dept Pediat, 100 Cambridge St,15th Floor, Boston, MA 02114 USA. EM kkuhlthau@mgh.harvard.edu FU AHRQ HHS [U18HS20408] NR 28 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD SEP-OCT PY 2014 VL 14 IS 5 SU S BP S1 EP S3 PG 3 WC Pediatrics SC Pediatrics GA AP2KE UT WOS:000341900300001 PM 25169448 ER PT J AU Mistry, KB Chesley, F LLanos, K Dougherty, D AF Mistry, Kamila B. Chesley, Francis LLanos, Karen Dougherty, Denise TI Advancing Children's Health Care and Outcomes Through the Pediatric Quality Measures Program SO ACADEMIC PEDIATRICS LA English DT Article DE children; quality ID IMPROVE AB In 2009 Congress passed the Children's Health Insurance Program Reauthorization Act (CHIPRA), which presented an unprecedented opportunity to measure and improve health care quality and outcomes for children. The Agency for Healthcare Research and Quality, in partnership with the Centers for Medicare & Medicaid Services, has worked to fulfill a number of quality measurement provisions under CHIPRA, including establishing the Pediatric Quality Measures Program (PQMP). The PQMP was charged with establishing a publicly available portfolio of new and enhanced evidence-based pediatric quality measures for use by Medicaid/Children's Health Insurance Program and other public and private programs and to also provide opportunities to improve and strengthen the Child Core Set of quality measures. This article focuses on the PQMP and provides an overview of the program's goals and related activities, lessons learned, and future opportunities. C1 [Mistry, Kamila B.; Chesley, Francis; Dougherty, Denise] Agcy Healthcare Res & Qual, Childrens Hlth Insurance Program Reauthorizat Act, Pediat Qual Measures Program, Off Extramural Res Educ & Prior Populat, Rockville, MD 20850 USA. [LLanos, Karen] Ctr Medicare Serv, Ctr Medicaid & CHIP Serv, Baltimore, MD USA. [LLanos, Karen] Ctr Medicaid Serv, Ctr Medicaid & CHIP Serv, Baltimore, MD USA. RP Mistry, KB (reprint author), Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, 540 Gaither Rd, Rockville, MD 20850 USA. EM Kamila.Mistry@ahrq.hhs.gov FU CMS FX The PQMP is funded by CMS. NR 26 TC 9 Z9 9 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD SEP-OCT PY 2014 VL 14 IS 5 SU S BP S19 EP S26 DI 10.1016/j.acap.2014.06.025 PG 8 WC Pediatrics SC Pediatrics GA AP2KE UT WOS:000341900300009 PM 25169453 ER PT J AU Hackbarth, AD Munier, WB Eldridge, N Jordan, J Richards, C Brennan, NJ Wagner, D McGann, P AF Hackbarth, Andrew D. Munier, William B. Eldridge, Noel Jordan, Jack Richards, Chesley Brennan, Niall J. Wagner, Dennis McGann, Paul TI An Overview of Measurement Activities in the Partnership for Patients SO JOURNAL OF PATIENT SAFETY LA English DT Article DE partnership for patients; measurement; adverse events ID ADVERSE EVENTS; SAFETY; TRENDS; CARE AB The Partnership for Patients, launched in April 2011, is a national quality improvement initiative from the Department of Health and Human Services that has set ambitious goals for U. S. providers to improve patient safety and care transitions. This paper outlines the initiative's measurement strategy, describing four measurement-related objectives: (1) to track national progress toward the program goals that U. S. hospitals reduce preventable adverse events by 40% and readmissions by 20%; (2) to support local quality improvement measurement in participating hospitals by providing the appropriate tools, training, and programmatic structure; (3) to obtain feedback on hospital and contractor progress, in close to real time, so the project can be effectively managed; and (4) to evaluate the program's impact on adverse event and readmission rates. C1 [Hackbarth, Andrew D.; Jordan, Jack; Brennan, Niall J.; Wagner, Dennis; McGann, Paul] Ctr Medicare & Medicaid Serv, Baltimore, MD USA. [Munier, William B.; Eldridge, Noel] Agcy Healthcare Res & Qual, Rockville, MD USA. [Richards, Chesley] Ctr Dis Control & Prevent, Atlanta, GA USA. RP Hackbarth, AD (reprint author), Ctr Medicare & Medicaid Serv, 200 Independence Ave SW, Washington, DC 20201 USA. EM andrew.hackbarth@cms.hhs.gov NR 13 TC 2 Z9 2 U1 1 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1549-8417 EI 1549-8425 J9 J PATIENT SAF JI J. Patient Saf. PD SEP PY 2014 VL 10 IS 3 BP 125 EP 132 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AP7AW UT WOS:000342230900002 PM 25119788 ER PT J AU Broussard, CS Frey, MT Hernandez-Diaz, S Greene, MF Chambers, CD Sahin, L Sharp, BAC Honein, MA AF Broussard, Cheryl S. Frey, Meghan T. Hernandez-Diaz, Sonia Greene, Michael F. Chambers, Christina D. Sahin, Leyla Sharp, Beth A. Collins Honein, Margaret A. TI Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention-convened meeting SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article DE Centers for Disease Control and Prevention; expert review; medications; pregnancy; teratogens ID RECOMMENDATIONS; WOMEN; LACTATION; INFECTION; FETAL; BIRTH; RISK; CDC AB To address information gaps that limit informed clinical decisions on medication use in pregnancy, the Centers for Disease Control and Prevention (CDC) solicited expert input on a draft prototype outlining a systematic approach to evaluating the quality and strength of existing evidence for associated risks. The draft prototype outlined a process for the systematic review of available evidence and deliberations by a panel of experts to inform clinical decision making for managing health conditions in pregnancy. At an expert meeting convened by the CDC in January 2013, participants divided into working groups discussed decision points within the prototype. This report summarizes their discussions of best practices for formulating an expert review process, developing evidence summaries and treatment guidance, and disseminating information. There is clear recognition of current knowledge gaps and a strong collaboration of federal partners, academic experts, and professional organizations willing to work together toward safer medication use during pregnancy. C1 [Broussard, Cheryl S.; Frey, Meghan T.; Honein, Margaret A.] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. [Frey, Meghan T.] Oak Ridge Inst Sci & Educ, Oak Ridge, TN USA. [Hernandez-Diaz, Sonia] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. [Greene, Michael F.] Harvard Univ, Sch Med, Dept Obstet Gynecol & Reprod Biol, Boston, MA 02115 USA. [Greene, Michael F.] Massachusetts Gen Hosp, Boston, MA 02114 USA. [Chambers, Christina D.] Univ Calif San Diego, Dept Pediat, La Jolla, CA 92093 USA. [Chambers, Christina D.] Univ Calif San Diego, Dept Family & Prevent Med, La Jolla, CA 92093 USA. [Sahin, Leyla] US FDA, Ctr Drug Evaluat & Res, Off New Drugs, Maternal Hlth Team,Pediat & Maternal Hlth Staff, Silver Spring, MD USA. [Sharp, Beth A. Collins] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Broussard, CS (reprint author), Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. FU Centers for Disease Control and Prevention (CDC) FX This work was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention (CDC) administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the CDC (M.T.F.). NR 35 TC 11 Z9 11 U1 0 U2 4 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9378 EI 1097-6868 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD SEP PY 2014 VL 211 IS 3 BP 208 EP U667 DI 10.1016/j.ajog.2014.05.040 PG 8 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA AO4HO UT WOS:000341297900007 PM 24881821 ER PT J AU Robinson, MN Tansil, KA Elder, RW Soler, RE Labre, MP Mercer, SL Eroglu, D Baur, C Lyon-Daniel, K Fridinger, F Sokler, LA Green, LW Miller, T Dearing, JW Evans, WD Snyder, LB Viswanath, KK Beistle, DM Chervin, DD Bernhardt, JM Rimer, BK AF Robinson, Maren N. Tansil, Kristin A. Elder, Randy W. Soler, Robin E. Labre, Magdala P. Mercer, Shawna L. Eroglu, Dogan Baur, Cynthia Lyon-Daniel, Katherine Fridinger, Fred Sokler, Lynn A. Green, Lawrence W. Miller, Therese Dearing, James W. Evans, William D. Snyder, Leslie B. Viswanath, K. Kasisomayajula Beistle, Diane M. Chervin, Doryn D. Bernhardt, Jay M. Rimer, Barbara K. CA Community Prevent Serv Task Force TI Mass Media Health Communication Campaigns Combined with Health-Related Product Distribution A Community Guide Systematic Review SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Review ID BICYCLE HELMET USE; HIV-PREVENTION; CONTROLLED-TRIAL; INTERVENTION; QUITLINE; BEHAVIOR; ADOLESCENTS; PROMOTION; SERVICES; EXPOSURE AB Context: Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury. Evidence acquisition: Using methods previously developed for the Community Guide, a systematic review (search period, January 1980-December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products. Evidence synthesis: Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns. Conclusions: Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics. (Am J Prey Med 2014;47(3):360-371) Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine C1 [Robinson, Maren N.; Tansil, Kristin A.; Elder, Randy W.; Soler, Robin E.; Labre, Magdala P.; Mercer, Shawna L.] CDC, Community Guide Branch, Div Epidemiol Anal & Lib Serv, Ctr Surveillance Epidemiol & Lab Serv, Atlanta, GA 30333 USA. [Eroglu, Dogan; Baur, Cynthia; Lyon-Daniel, Katherine; Fridinger, Fred; Sokler, Lynn A.] CDC, Off Assoc Director Commun, Off Director, Atlanta, GA 30333 USA. [Beistle, Diane M.] CDC, Off Smoking & Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. [Green, Lawrence W.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Miller, Therese] Agcy Healthcare Res & Qual, Rockville, MD USA. [Dearing, James W.] Michigan State Univ, E Lansing, MI 48824 USA. [Evans, William D.] George Washington Univ, St Louis, MO USA. [Snyder, Leslie B.] Univ Connecticut, Storrs Mansfield, CT USA. [Chervin, Doryn D.] Harvard Univ, Sch Publ Hlth, Cambridge, MA 02138 USA. [Chervin, Doryn D.] SciMetrika, Durham, NC USA. [Rimer, Barbara K.] Univ N Carolina, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA. [Bernhardt, Jay M.] Univ Florida, Gainesville, FL USA. RP Elder, RW (reprint author), Guide Community Prevent Serv, 1600 Clifton Rd,Mailstop E-69, Atlanta, GA 30333 USA. EM relder1@cdc.gov OI Bernhardt, Jay/0000-0002-2045-4005 NR 58 TC 10 Z9 11 U1 3 U2 34 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 EI 1873-2607 J9 AM J PREV MED JI Am. J. Prev. Med. PD SEP PY 2014 VL 47 IS 3 BP 360 EP 371 DI 10.1016/j.amepre.2014.05.034 PG 12 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA AN6WH UT WOS:000340738600015 PM 25145620 ER PT J AU Haines, CF Fleishman, JA Yehia, BR Berry, SA Moore, RD Bamford, LP Gebo, KA AF Haines, Charles F. Fleishman, John A. Yehia, Baligh R. Berry, Stephen A. Moore, Richard D. Bamford, Laura P. Gebo, Kelly A. CA HIV Res Network TI Increase in CD4 Count Among New Enrollees in HIV Care in the Modern Antiretroviral Therapy Era SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV; CD4 count; presentation to care; linkage to care; HIV screening ID HEALTH-SERVICES UTILIZATION; UNITED-STATES; HIV-1-INFECTED PATIENTS; COST-EFFECTIVENESS; CELL COUNT; INFECTION; TRENDS; PREVENTION; GENDER; ADULTS AB Background: Earlier HIV diagnosis and engagement in care improve outcomes and is cost effective, as a result, in 2006, the Centers for Disease Control and Prevention (CDC) revised the HIV-screening guidelines. We sought to determine whether the CD4 count (CD4) at presentation, a surrogate for time to presentation, increased during the study period. Our a priori hypothesis was that the CD4 at presentation increased during the study period, particularly after the CDC guideline revision. Methods: We performed a retrospective cohort study and analyzed data from the HIV Research Network, a consortium of 18 US clinics caring for HIV-infected patients. HIV-infected adults (>= 18 years old) newly presenting for care between 2003 and 2011 were included in this study. Multivariable linear regression examined associations with CD4 at enrollment. Calendar year was modeled as a linear spline with a change in slope at 2008, allowing determination of the mean change in CD4 per year during 20032007 and 2008-2011. Results: Over 13,543 newly presenting subjects enrolled from 2003 to 2011. Median CD4 at enrollment rose from 285 to 317 cells per cubic millimeter between 2003-2007 and 2008-2011 (P > 0.001). After adjusting for age, race/ethnicity, gender, HIV risk factor, and clinic site, the mean increase in the CD4 count at presentation per year was 13.3 cells per cubic millimeter per year (95% confidence interval 6.4 to 20.1 cells per cubic millimeter per year) greater during 2008-2011 than during 2003-2007. Conclusions: We demonstrate a small, but statistically significant, increase in CD4 at presentation after the CDC guideline revision. More efforts are needed to decrease time to presentation to HIV care. C1 [Haines, Charles F.; Berry, Stephen A.; Moore, Richard D.; Gebo, Kelly A.] Johns Hopkins Med, Div Infect Dis, Dept Med, Baltimore, MD 21287 USA. [Fleishman, John A.] AHRQ, Rockville, MD USA. [Fleishman, John A.; Yehia, Baligh R.; Bamford, Laura P.] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA. [Bamford, Laura P.] Jonathan Lax Treatment Ctr, Philadelphia, PA USA. RP Haines, CF (reprint author), Johns Hopkins Med, Div Infect Dis, Dept Med, 1830 E Monument St,Room 435, Baltimore, MD 21287 USA. EM chaines6@jhmi.edu FU Agency for Healthcare Research and Quality, Rockville, MD; Health Resources and Services Administration, Rockville, MD; Tibotec; Janssen Pharmaceuticals; National Institutes of Health [5KL2-RR025006, K23-AI084854, K23-MH097647-01A1, R01-DA11602, K24-DA00432, R01-AA16893, RO1 AG026250] FX Sponsoring Agencies: Agency for Healthcare Research and Quality, Rockville, MD (Fred Hellinger, PhD, John Fleishman, PhD, Irene Fraser, PhD); Health Resources and Services Administration, Rockville, MD (Robert Mills, PhD, Faye Malitz, MS). Data Coordinating Center: Johns Hopkins University (Richard Moore, MD, Jeanne Keruly, CRNP, Kelly Gebo, MD, Cindy Voss, MA, Nikki Balding, MS).; K.A.G. reported having served as a consultant, having served on a scientific advisory board, and having received research funding from Tibotec. L. P. B. reported receiving research funding from Janssen Pharmaceuticals. No other disclosures were reported. C. F. H., S. A. B., B. R. Y., R. D. M., and K. A. G. are supported by the National Institutes of Health (5KL2-RR025006, K23-AI084854, K23-MH097647-01A1, R01-DA11602, K24-DA00432, R01-AA16893, RO1 AG026250). Data collection and the HIVRN data coordinating center are supported by the Agency for Healthcare Research and Quality (HHSA290201100007C). NR 29 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1525-4135 EI 1077-9450 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD SEP 1 PY 2014 VL 67 IS 1 BP 84 EP 90 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA AN6SP UT WOS:000340727600013 PM 24872131 ER PT J AU Yehia, BR Fleishman, JA Agwu, AL Metlay, JP Berry, SA Gebo, KA AF Yehia, Baligh R. Fleishman, John A. Agwu, Allison L. Metlay, Joshua P. Berry, Stephen A. Gebo, Kelly A. CA HIV Res Network TI Health Insurance Coverage for Persons in HIV Care, 2006-2012 SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV; insurance; Medicare; Medicaid; Ryan White; Affordable Care Act ID UNITED-STATES; ANTIRETROVIRAL THERAPY; VIRAL SUPPRESSION; INFECTED PATIENTS; DISPARITIES; SERVICES; MORTALITY; CLINICS; DECLINE; ADULTS AB We examined trends in health insurance coverage among 36,999 HIV-infected adults in care at 11 US HIV clinics between 2006 and 2012. Aggregate health insurance coverage was stable during this time. The proportions of patient-years with private, Medicaid, Medicare, and no insurance during this period were 15.9%, 35.7%, 20.1%, and 28.4%, respectively. Medicaid coverage was more prevalent among women than men, blacks, and Hispanics than whites, and individuals with injection drug use risk compared with other transmission risk factors. Hispanics and younger age groups were more likely to be uninsured than other racial/ethnic and older age groups, respectively. C1 [Yehia, Baligh R.] Univ Penn, Perelman Sch Med, Dept Med, Philadelphia, PA 19104 USA. [Yehia, Baligh R.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Agwu, Allison L.; Berry, Stephen A.; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. [Metlay, Joshua P.] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA. RP Yehia, BR (reprint author), Univ Penn, Perelman Sch Med, 1021 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM byehia@upenn.edu FU Agency for Healthcare Research and Quality [HHSA290201100007C]; Health Resources and Services Administration [HHSH250201200008C]; National Institutes of Health [K23-MH097647]; Gilead Sciences; Tibotec FX Supported by the Agency for Healthcare Research and Quality (HHSA290201100007C), the Health Resources and Services Administration (HHSH250201200008C), and the National Institutes of Health (K23-MH097647 to B.R.Y.).; BRY received grants to his institution from Gilead Sciences. KAG received grants to her institution from Tibotec, and provided consultancy to Tibotec and Bristol-Myers Squibb. The remaining authors have no conflicts of interest to disclose. NR 29 TC 12 Z9 12 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 EI 1077-9450 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD SEP 1 PY 2014 VL 67 IS 1 BP 102 EP 106 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA AN6SP UT WOS:000340727600015 PM 24977377 ER PT J AU Fan, TN Pham, A AF Fan, Tina Anh Pham TI Primary Care Interventions to Prevent Child Maltreatment SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Anh Pham] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Fan, TN (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD AUG 15 PY 2014 VL 90 IS 4 BP 255 EP 256 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AN3VL UT WOS:000340516700010 PM 25251000 ER PT J AU Smith, SR AF Smith, Scott R. TI Preface to the AHRQ Supplement SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Smith, SR (reprint author), Agcy Healthcare Res & Qual, John M Eisenberg Bldg,540 Gaither Rd, Rockville, MD 20850 USA. EM Scott.Smith@ahrq.hhs.gov NR 2 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2014 VL 29 SU 3 BP S712 EP S713 DI 10.1007/s11606-014-2922-x PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA AU1XU UT WOS:000345411700002 PM 25029982 ER PT J AU Kaplan, RM Herrmann, AK Morrison, JT DeFina, LF Morrow, JR AF Kaplan, Robert M. Herrmann, Alison K. Morrison, James T. DeFina, Laura F. Morrow, James R., Jr. TI Costs Associated With Women's Physical Activity Musculoskeletal Injuries: The Women's Injury Study SO JOURNAL OF PHYSICAL ACTIVITY & HEALTH LA English DT Article DE expenses; medical costs; MVPA; risk ID EXERCISE; RISKS; WIN AB Background: Despite benefits of physical activity (PA), exercise is also associated with risks. Musculoskeletal injury (MSI) risk increases with exercise frequency/intensity. MSI is associated with costs including medical care and time lost from work. Purpose: To evaluate the economic costs associated with PA-related MSIs in community-dwelling women. Method: Participants included 909 women in the Women's Injury Study reporting PA behaviors and MSI incidence weekly via the Internet for up to 3 years (mean follow-up 1.89 years). Participants provided consent to obtain health records. Costs were estimated by medical records and self-reports of medical care. Components included physician visits, medical facility contacts, medication costs, and missed work. Results: Of 909 participants, 243 reported 323 episodes of expenditure or contact with the health care system associated with PA. Total costs of episodes ranged from $0-$18,934. Modal cost was $0 (mean = $433 +/- $1670). Costs were positively skewed with nearly all participants reporting no or very low costs. Conclusions: About 1 in 4 community-dwelling women who are physically active experienced a PA-related MSI. The majority of injuries were minor, and large expenses associated with MSI were rare. The long-term health benefits and costs savings resulting from PA likely outweigh the minor costs associated with MSI from a physically-active lifestyle. C1 [Kaplan, Robert M.; Herrmann, Alison K.; Morrison, James T.] Univ Calif Los Angeles, Dept Hlth Serv, UCLA Fielding Sch Publ Hlth, Los Angeles, CA USA. [DeFina, Laura F.; Morrow, James R., Jr.] Cooper Inst, Dept Clin Res, Dallas, TX USA. [Morrow, James R., Jr.] Univ N Texas, Dept Kinesiol Hlth Promot & Recreat, Denton, TX 76203 USA. RP Kaplan, RM (reprint author), Agcy Hlth Care Res & Qual, Rockville, MD 20850 USA. EM Jim.Morrow@unt.edu FU NIAMS NIH HHS [R01 AR052459] NR 16 TC 2 Z9 2 U1 1 U2 1 PU HUMAN KINETICS PUBL INC PI CHAMPAIGN PA 1607 N MARKET ST, PO BOX 5076, CHAMPAIGN, IL 61820-2200 USA SN 1543-3080 EI 1543-5474 J9 J PHYS ACT HEALTH JI J. Phys. Act. Health PD AUG PY 2014 VL 11 IS 6 BP 1149 EP 1155 DI 10.1123/jpah.2012-0459 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AT3LL UT WOS:000344836300012 PM 24187018 ER PT J AU Trudnak, T Kelley, D Zerzan, J Griffith, K Jiang, HJ Fairbrother, GL AF Trudnak, Tara Kelley, David Zerzan, Judy Griffith, Katherine Jiang, H. Joanna Fairbrother, Gerry L. TI Medicaid Admissions And Readmissions: Understanding The Prevalence, Payment, And Most Common Diagnoses SO HEALTH AFFAIRS LA English DT Article ID RISK; REHOSPITALIZATIONS; DISORDERS; PROGRAM; RATES AB Reducing hospital readmissions is a way to improve care and reduce avoidable costs. However, there have been few studies of readmissions in the Medicaid population. We sought to characterize acute care hospital admissions and thirty-day readmissions in the Medicaid population through a retrospective analysis in nineteen states. We found that Medicaid readmissions were both prevalent (9.4 percent of all admissions) and costly ($77 million per state) and that they represented 12.5 percent of Medicaid payments for all hospitalizations. Five diagnostic groups appeared to drive Medicaid readmissions, accounting for 57 percent of readmissions and 49 percent of hospital payments for readmissions. The most prevalent diagnostic categories were mental and behavioral disorders and diagnoses related to pregnancy, childbirth, and their complications, which together accounted for 31.2 percent of readmissions. This analysis, conducted through the Medicaid Medical Directors Learning Network, allows Medicaid medical directors to better understand the nature and prevalence of hospital use in the Medicaid population and provides a baseline for measuring improvement. C1 [Trudnak, Tara; Griffith, Katherine; Fairbrother, Gerry L.] AcademyHealth, Washington, DC USA. [Kelley, David] Penn Dept Publ Welf, Harrisburg, PA USA. [Zerzan, Judy] Colorado Dept Hlth Care Policy & Financing, Client & Clin Care Off, Denver, CO USA. [Jiang, H. Joanna] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. RP Trudnak, T (reprint author), Altarum Inst, Alexandria, VA 22314 USA. EM tara.trudnak@altarum.org FU Agency for Healthcare Research and Quality (AHRQ) [HHSA 29020090015C] FX This project was funded by the Agency for Healthcare Research and Quality (AHRQ) (Contract No. HHSA 29020090015C). The opinions expressed in this article are those of the authors and do not reflect the official position of AHRQ or the Department of Health and Human Services. The authors acknowledge the leadership of the Medicaid Medical Directors Learning Network (MMDLN) in launching collaborative studies for the benefit of Medicaid beneficiaries. The authors especially acknowledge the efforts of the MMDLN working group that spearheaded efforts in this project and of the states that participated and their analysts who completed state-level analyses. In addition, the authors thank Marjorie Shofer, the MMDLN project officer, for her contributions. NR 21 TC 14 Z9 14 U1 1 U2 6 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD AUG PY 2014 VL 33 IS 8 BP 1337 EP 1344 DI 10.1377/hlthaff.2013.0632 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AN3FV UT WOS:000340471700006 PM 25092834 ER PT J AU Abdus, S Hudson, J Hill, SC Selden, TM AF Abdus, Salam Hudson, Julie Hill, Steven C. Selden, Thomas M. TI Children's Health Insurance Program Premiums Adversely Affect Enrollment, Especially Among Lower-Income Children SO HEALTH AFFAIRS LA English DT Article ID SCHIP PREMIUMS; COVERAGE; ELIGIBILITY; CHIP AB Both Medicaid and the Children's Health Insurance Program (CHIP), which are run by the states and funded by federal and state dollars, offer health insurance coverage for low-income children. Thirty-three states charged premiums for children at some income ranges in CHIP or Medicaid in 2013. Using data from the 1999-2010 Medical Expenditure Panel Surveys, we show that the relationship between premiums and coverage varies considerably by income level and by parental access to employer-sponsored insurance. Among children with family incomes above 150 percent of the federal poverty level, a $10 increase in monthly premiums is associated with a 1.6-percentage-point reduction in Medicaid or CHIP coverage. In this income range, the increase in uninsurance may be higher among those children whose parents lack an offer of employer-sponsored insurance than among those whose parents have such an offer. Among children with family incomes of 101-150 percent of poverty, a $10 increase in monthly premiums is associated with a 6.7-percentage-point reduction in Medicaid or CHIP coverage and a 3.3-percentage-point increase in uninsurance. In this income range, the increase in uninsurance is even larger among children whose parents lack offers of employer coverage. C1 [Abdus, Salam] Social & Sci Syst, Rockville, MD 20852 USA. [Hudson, Julie; Hill, Steven C.; Selden, Thomas M.] AHRQ, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD USA. RP Abdus, S (reprint author), Social & Sci Syst, Rockville, MD 20852 USA. EM salam.abdus@ahrq.hhs.gov NR 23 TC 3 Z9 3 U1 0 U2 3 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD AUG PY 2014 VL 33 IS 8 BP 1353 EP 1360 DI 10.1377/hlthaff.2014.0182 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AN3FV UT WOS:000340471700008 PM 25092836 ER PT J AU Lebrun-Harris, LA Tomoyasu, N Ngo-Metzger, Q AF Lebrun-Harris, Lydie A. Tomoyasu, Naomi Ngo-Metzger, Quyen TI Substance Use, Risk of Dependence, Counseling and Treatment among Adult Health Center Patients SO JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED LA English DT Article DE Health centers; primary care; substance use; counseling; treatment ID SERIOUS MENTAL-ILLNESS; PSYCHOLOGICAL DISTRESS; GENERAL-POPULATION; SCREENING SCALES; NATIONAL-SURVEY; TRENDS; ABUSE; PROVISION; SERVICES; K6 AB Health centers provide primary care to 20 million underserved patients. We examined the prevalence of substance use and risk of dependence among health center patients, and identified factors associated with desire for counseling/treatment and discussions about substance use with a doctor. National data on 3,949 adults came from the 2009 Health Center Patient Survey. Forty percent of patients reported past-year binge drinking, 14% of patients had used any drug in the past three months, and 13% of these recent users were at high risk of dependence. Eighty-four percent of patients who desired substance use counseling or treatment reported receiving it. Several factors were associated with patients discussing substance use with their doctors (e.g., younger age, being male, severe mental illness, current smoking). Patients most likely to desire substance use counseling or treatment were male, unmarried, insured, current smokers, and indicated mental health problems. C1 [Lebrun-Harris, Lydie A.] US Dept Hlth & Human Serv DHHS, Hlth Resources & Serv Adm HRSA, Off Planning Anal & Evaluat, Rockville, MD USA. [Tomoyasu, Naomi] DHHS, Ctr Medicare Serv, Baltimore, MD USA. [Tomoyasu, Naomi] DHHS, Ctr Medicaid Serv CMS, Ctr Medicare & Medicaid Innovat, Baltimore, MD USA. [Ngo-Metzger, Quyen] DHHS, Agcy Healthcare Res & Qual, Washington, DC USA. [Ngo-Metzger, Quyen] Ctr Primary Care Prevent & Clin Partnerships, Rockville, MD USA. RP Lebrun-Harris, LA (reprint author), US Dept HHS, Hlth Resources & Serv Adm, Off Planning Anal & Evaluat, Off Res & Evaluat, 5600 Fishers Lane,10-29, Rockville, MD 20857 USA. EM Ilebrun-harris@hrsa.gov NR 29 TC 1 Z9 1 U1 0 U2 4 PU JOHNS HOPKINS UNIV PRESS PI BALTIMORE PA JOURNALS PUBLISHING DIVISION, 2715 NORTH CHARLES ST, BALTIMORE, MD 21218-4363 USA SN 1049-2089 EI 1548-6869 J9 J HEALTH CARE POOR U JI J. Health Care Poor Underserved PD AUG PY 2014 VL 25 IS 3 BP 1217 EP 1230 PG 14 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AN0XC UT WOS:000340306300020 PM 25130235 ER PT J AU Sarpong, EM AF Sarpong, Eric M. TI The Impact of Obesity on Medication Use and Expenditures among Nonelderly Adults with Asthma SO JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED LA English DT Article DE Asthma; obesity; nonelderly adults; medication use; expenditures ID BODY-MASS INDEX; UNITED-STATES; 2-PART MODELS; HEALTH-CARE; SEVERITY; OVERWEIGHT; BURDEN AB Obesity contributes substantially to health resource use and costs. This study examines the impact of obesity on medication use and expenditures among nonelderly adults with asthma using the Medical Expenditure Panel Survey. Obese classes II/III individuals were more likely to have current asthma, seek treatment for asthma, use more medications, and have higher medication and health care expenditures compared with normal weight individuals. Multivariate results indicate that if obese classes II/III were normal weight the probability of asthma treatment would decrease by 8.0 percentage points. Conditional on any asthma treatment, if obese classes II/III were normal weight the mean number of total prescribed medications would decrease by 19.42 fills, and expected expenditures on total prescribed medications and health care would decrease by $1,738.68 and $3,682.58, respectively. These results suggest that, all else equal, reduction in body weight may help reduce health resource use and expenditures for nonelderly adults with asthma. C1 [Sarpong, Eric M.] US Dept HHS, Ctr Financing Access & Cost Trends, Agcy Healthcare Res & Qual, Rockville, MD USA. RP Sarpong, EM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM eric.sarpong@ahrq.hhs.gov NR 44 TC 1 Z9 1 U1 1 U2 2 PU JOHNS HOPKINS UNIV PRESS PI BALTIMORE PA JOURNALS PUBLISHING DIVISION, 2715 NORTH CHARLES ST, BALTIMORE, MD 21218-4363 USA SN 1049-2089 EI 1548-6869 J9 J HEALTH CARE POOR U JI J. Health Care Poor Underserved PD AUG PY 2014 VL 25 IS 3 BP 1245 EP 1261 PG 17 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AN0XC UT WOS:000340306300022 PM 25130237 ER PT J AU Traxler, RM Callinan, LS Holman, RC Steiner, C Guerra, MA AF Traxler, Rita M. Callinan, Laura S. Holman, Robert C. Steiner, Claudia Guerra, Marta A. TI Leptospirosis-Associated Hospitalizations, United States, 1998-2009 SO EMERGING INFECTIOUS DISEASES LA English DT Article ID REEMERGING LEPTOSPIROSIS; CLINICAL PRESENTATION; RISK-FACTORS; PUERTO-RICO; HAWAII; EMERGENCE AB A small percentage of persons with leptospirosis, a re-emerging zoonosis, experience severe complications that require hospitalization. The number of leptospirosis cases in the United States is unknown. Thus, to estimate the hospitalization rate for this disease, we analyzed US hospital discharge records for 1998-2009 for the total US population by using the Nationwide Inpatient Sample. During that time, the aver-age annual rate of leptospirosis-associated hospitalizations was 0.6 hospitalizations/1,000,000 population. Leptospirosis-associated hospitalization rates were higher for persons >20 years of age and for male patients. For leptospirosis-associated hospitalizations, the average age of patients at admission was lower, the average length of stay for patients was longer, and hospital charges were higher than those for nonleptospirosis infectious disease associated hospitalizations. Educating clinicians on the signs and symptoms of leptospirosis may result in earlier diagnosis and treatment and, thereby, reduced disease severity and hospitalization costs. C1 [Traxler, Rita M.; Callinan, Laura S.; Holman, Robert C.; Guerra, Marta A.] Ctr Dis Control & Prevent, Atlanta, GA 30329 USA. [Steiner, Claudia] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Traxler, RM (reprint author), Ctr Dis Control & Prevent, 1600 Clifton Rd NE,Mailstop A30, Atlanta, GA 30329 USA. EM rtraxler@cdc.gov NR 35 TC 5 Z9 5 U1 0 U2 6 PU CENTERS DISEASE CONTROL PI ATLANTA PA 1600 CLIFTON RD, ATLANTA, GA 30333 USA SN 1080-6040 EI 1080-6059 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD AUG PY 2014 VL 20 IS 8 BP 1273 EP 1279 DI 10.3201/eid2008.130450 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA AM4ZF UT WOS:000339864000001 PM 25076111 ER PT J AU Zuckerman, IH Davidoff, AJ Erten, MZ Stuart, B Shaffer, T Dougherty, JS Yong, C AF Zuckerman, Ilene H. Davidoff, Amy J. Erten, Mujde Z. Stuart, Bruce Shaffer, Thomas Dougherty, J. Samantha Yong, Candice TI Use of and spending on supportive care medications among Medicare beneficiaries with cancer SO SUPPORTIVE CARE IN CANCER LA English DT Article DE Cancer; Medicare; Part D; Supportive care ID BREAST-CANCER; LUNG-CANCER; STAGE; UNDERTREATMENT; PRESCRIPTION; PREVALENCE; INSURANCE; COVERAGE; THERAPY; PATIENT AB The study objective was to provide population-based estimates of supportive care medication (SCM) use among Medicare beneficiaries with cancer and determine factors related to SCM receipt. This retrospective cohort study of community-based Medicare beneficiaries used the Medicare Current Beneficiary Survey (1997-2007). Dependent variables comprised use and spending on SCMs for three medication classes: opioids, antidepressants/sedative/hypnotics (ASH), and antiemetics. Independent variables of interest were supplemental insurance coverage, cancer site, and treatment. Multivariate models determined factors affecting receipt of, and spending on, SCMs. We also compared SCM use and spending among beneficiaries with and without cancer in order to understand what portion of SCM use and spending could be attributed to cancer as opposed to other comorbid conditions. A total of 1,836 Medicare beneficiaries with cancer and 9,898 beneficiaries without cancer were eligible for the study. Beneficiaries with cancer were more likely to receive opioids, ASH, and antiemetics compared to non-cancer beneficiaries. Adjusted annual payments for antiemetics were on average $637 higher in with cancer versus without cancer (p < 0.01), while ASH payments were $184 lower (p < 0.01). Opioid spending was similar among cancer and non-cancer users. Relative to colon cancer, beneficiaries with prostate cancer were least likely to receive any of the three SCM classes. Receipt of antineoplastic treatment increased the probability of use of all three classes of SCMs. Insurance coverage did not influence the use of or spending on opioids or antiemetics, but was associated with both outcomes for ASH. The use of all three SCM classes was significantly lower during years before Part D implementation of the new Medicare Part D prescription drug benefit and was higher after implementation of Part D. This study provides population-based information on SCM use among Medicare beneficiaries with cancer. Cancer site and treatment modality were important predictors of SCM use. C1 [Zuckerman, Ilene H.; Davidoff, Amy J.; Stuart, Bruce; Shaffer, Thomas; Dougherty, J. Samantha; Yong, Candice] Univ Maryland, Sch Pharm, Peter Lamy Ctr Drug Therapy & Aging, Pharmaceut Hlth Serv Res Dept, Baltimore, MD 21201 USA. [Zuckerman, Ilene H.] IMPAQ Int LLC, Columbia, MD 21044 USA. [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Erten, Mujde Z.] Univ Vermont, Dept Surg, Coll Med, Burlington, VT 05405 USA. [Dougherty, J. Samantha] Pharmaceut Res & Manufacturers Amer, Washington, DC USA. RP Zuckerman, IH (reprint author), IMPAQ Int LLC, 10420 Little Patuxent Pkwy,Suite 300, Columbia, MD 21044 USA. EM izuckerman@impaqint.com FU American Cancer Society [RSGI-10-109-01-CPHPS]; Supplemental Medical and Drug Insurance and Cancer Related Spending FX Funding sources American Cancer Society RSGI-10-109-01-CPHPS and Supplemental Medical and Drug Insurance and Cancer Related Spending are gratefully acknowledged by the authors. NR 31 TC 0 Z9 0 U1 2 U2 5 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0941-4355 EI 1433-7339 J9 SUPPORT CARE CANCER JI Support. Care Cancer PD AUG PY 2014 VL 22 IS 8 BP 2185 EP 2195 DI 10.1007/s00520-014-2187-2 PG 11 WC Oncology; Health Care Sciences & Services; Rehabilitation SC Oncology; Health Care Sciences & Services; Rehabilitation GA AL7TT UT WOS:000339339300022 PM 24659243 ER PT J AU Yehia, BR Herati, RS Fleishman, JA Gallant, JE Agwu, AL Berry, SA Korthuis, PT Moore, RD Metlay, JP Gebo, KA AF Yehia, Baligh R. Herati, Ramin S. Fleishman, John A. Gallant, Joel E. Agwu, Allison L. Berry, Stephen A. Korthuis, P. Todd Moore, Richard D. Metlay, Joshua P. Gebo, Kelly A. CA HIV Res Network TI Hepatitis C Virus Testing in Adults Living with HIV: A Need for Improved Screening Efforts SO PLOS ONE LA English DT Article ID INJECTION-DRUG USERS; INFECTIOUS-DISEASES SOCIETY; PRIMARY-CARE; MEDICINE ASSOCIATION; FREQUENT ATTENDERS; POSITIVE PATIENTS; HEALTH-CARE; INTERVENTION; GUIDELINES; RECOMMENDATIONS AB Objectives: Guidelines recommend hepatitis C virus (HCV) screening for all people living with HIV (PLWH). Understanding HCV testing practices may improve compliance with guidelines and can help identify areas for future intervention. Methods: We evaluated HCV screening and unnecessary repeat HCV testing in 8,590 PLWH initiating care at 12 U.S. HIV clinics between 2006 and 2010, with follow-up through 2011. Multivariable logistic regression examined the association between patient factors and the outcomes: HCV screening (>= 1 HCV antibody tests during the study period) and unnecessary repeat HCV testing (>= 1 HCV antibody tests in patients with a prior positive test result). Results: Overall, 82% of patients were screened for HCV, 18% of those screened were HCV antibody-positive, and 40% of HCV antibody-positive patients had unnecessary repeat HCV testing. The likelihood of being screened for HCV increased as the number of outpatient visits rose (adjusted odds ratio 1.02, 95% confidence interval 1.01-1.03). Compared to men who have sex with men (MSM), patients with injection drug use (IDU) were less likely to be screened for HCV (0.63, 0.52-0.78); while individuals with Medicaid were more likely to be screened than those with private insurance (1.30, 1.04-1.62). Patients with heterosexual (1.78, 1.20-2.65) and IDU (1.58, 1.06-2.34) risk compared to MSM, and those with higher numbers of outpatient (1.03, 1.01-1.04) and inpatient (1.09, 1.01-1.19) visits were at greatest risk of unnecessary HCV testing. Conclusions: Additional efforts to improve compliance with HCV testing guidelines are needed. Leveraging health information technology may increase HCV screening and reduce unnecessary testing. C1 [Yehia, Baligh R.; Herati, Ramin S.] Univ Penn, Perelman Sch Med, Dept Med, Philadelphia, PA 19104 USA. [Yehia, Baligh R.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Gallant, Joel E.] Southwest Care Ctr, Santa Fe, NM USA. [Agwu, Allison L.; Berry, Stephen A.; Moore, Richard D.; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. [Korthuis, P. Todd] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA. [Metlay, Joshua P.] Massachusetts Gen Hosp, Div Gen Med, Boston, MA 02114 USA. RP Yehia, BR (reprint author), Univ Penn, Perelman Sch Med, Dept Med, Philadelphia, PA 19104 USA. EM byehia@upenn.edu OI Sedaghat Herati, Ramin/0000-0001-7713-2587 FU Agency for Healthcare Research and Quality [HHSA290201100007C]; National Institutes of Health [K23-MH097647-01A1, K23AI084854] FX This work was supported by the Agency for Healthcare Research and Quality, www.ahrq.gov, [HHSA290201100007C] and the National Institutes of Health, www.nih.gov, [K23-MH097647-01A1 to BRY, K23AI084854 to SAB]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 42 TC 2 Z9 2 U1 0 U2 1 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD JUL 17 PY 2014 VL 9 IS 7 AR e102766 DI 10.1371/journal.pone.0102766 PG 8 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA AL8VR UT WOS:000339418300089 PM 25032989 ER PT J AU Quyen, NM Fan, T AF Quyen Ngo-Metzger Fan, Tina TI Screening for Lung Cancer SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Quyen Ngo-Metzger; Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. RP Quyen, NM (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 3 TC 0 Z9 0 U1 0 U2 2 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUL 15 PY 2014 VL 90 IS 2 BP 117 EP 118 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AL7IE UT WOS:000339306600007 ER PT J AU Jones, EB Furukawa, MF AF Jones, Emily B. Furukawa, Michael F. TI Adoption And Use Of Electronic Health Records Among Federally Qualified Health Centers Grew Substantially During 2010-12 SO HEALTH AFFAIRS LA English DT Article ID INFORMATION-TECHNOLOGY; MEANINGFUL USE; SYSTEMS; DISPARITIES AB Federally qualified health centers play an important role in providing health care to underserved populations. Recent substantial federal investments in health information technology have enabled health centers to expand their use of electronic health record (EHR) systems, but factors associated with adoption are not clear. We examined 2010-12 administrative data from the Health Resources and Services Administration's Uniform Data System for more than 1,100 health centers. We found that in 2012 nine out of ten health centers had adopted a EHR system, and half had adopted EHRs with basic capabilities. Seven in ten health centers reported that their providers were receiving meaningful-use incentive payments from the Centers for Medicare and Medicaid Services (CMS). Only one-third of health centers had EHR systems that could meet CMS's stage 1 meaningful-use core requirements. Health centers that met the stage 1 requirements had more than twice the odds of receiving quality recognition, compared with centers with less than basic EHRs. Policy initiatives should focus assistance on EHR capabilities with slower uptake; connect providers with technical assistance to support implementation; and leverage the connection between meaningful use and quality recognition programs. C1 [Jones, Emily B.] Dept Hlth & Human Serv, Off Natl Coordinator Hlth Informat Technol ONC, Washington, DC USA. [Furukawa, Michael F.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. EM Emily.Jones@hhs.gov NR 31 TC 11 Z9 12 U1 0 U2 2 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JUL PY 2014 VL 33 IS 7 BP 1254 EP 1261 DI 10.1377/hlthaff.2013.1274 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AN3FC UT WOS:000340469700021 PM 25006154 ER PT J AU Cole, B Dickerson, JA Graber, ML Fantz, CR Laposata, M Henriksen, K Astion, ML Epner, P AF Cole, Bonnie Dickerson, Jane A. Graber, Mark L. Fantz, Corinne. R. Laposata, Michael Henriksen, Kerm Astion, Michael L. Epner, Paul TI A prospective tool for risk assessment of sendout testing SO CLINICA CHIMICA ACTA LA English DT Article DE Errors; Laboratory risk; Risk assessment tool; Referral laboratory; Reference laboratory; Sendout ID LABORATORY MEDICINE; ERRORS AB Objective: Errors associated with laboratory testing can cause significant patient harm. Sendout testing refers to tests sent by a primary lab to a reference lab when testing is unavailable at the primary lab. Sendout testing is particularly high risk for patient harm, due to many factors including increased hand-offs, manual processes, and complexity associated with rare; low-volume tests. No published prospective tools exist for sendout risk assessment. Methods: A novel prospective tool was developed to assess risk of diagnostic errors involving laboratory sendout testing. This tool was successfully piloted at nine sites. Results: Marked diversity was noted among survey respondents, particularly in the sections on quality metrics and utilization management. Of note, most sites had committees who managed rules for test ordering, but few places reported enforcing these rules. Only one site claimed to routinely measure the frequency clinicians failed to retrieve test results. An evaluation of the-tool indicated that it was both useful and easy to use. Conclusions: This tool could be used by other laboratories to identity the areas of highest risk to patients, which in turn may guide them in focusing their quality improvement efforts and resources. (C) 2014 Elsevier B.V. All rights reserved. C1 [Cole, Bonnie; Dickerson, Jane A.; Astion, Michael L.] Seattle Childrens Hosp, Dept Labs, Seattle, WA 98145 USA. [Cole, Bonnie] Univ Washington, Dept Pathol, Seattle, WA 98195 USA. [Dickerson, Jane A.; Astion, Michael L.] Univ Washington, Dept Lab Med, Seattle, WA 98195 USA. [Graber, Mark L.] RTI Int, Chapel Hill, NC USA. [Graber, Mark L.] SUNY Stony Brook, Sch Med, Stony Brook, NY USA. [Fantz, Corinne. R.] Emory Univ, Dept Pathol & Lab Med, Atlanta, GA 30322 USA. [Laposata, Michael] Vanderbilt Univ, Dept Pathol Microbiol & Immunol, Nashville, IN USA. [Henriksen, Kerm] Agcy Healthcare Res & Qual, Rockville, MD USA. [Henriksen, Kerm] Paul Epner LLC, Evanston, IL USA. RP Cole, B (reprint author), Seattle Childrens Hosp, M-S OC8-720, Seattle, WA 98145 USA. EM bonnie.cole2@seattlechildrens.org FU Agency for Healthcare Research and Quality [HHSA29032001T] FX This study was funded by the Agency for Healthcare Research and Quality, ACTION II Task Order #1 to RTI International, contract no. HHSA29032001T. NR 12 TC 2 Z9 2 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0009-8981 EI 1873-3492 J9 CLIN CHIM ACTA JI Clin. Chim. Acta PD JUL 1 PY 2014 VL 434 BP 1 EP 5 PG 5 WC Medical Laboratory Technology SC Medical Laboratory Technology GA AJ6DS UT WOS:000337780500001 PM 24685573 ER PT J AU Kronick, R AF Kronick, Richard TI Patient Safety: The Agency for Healthcare Research and Quality's Ongoing Commitment SO JOURNAL OF NURSING CARE QUALITY LA English DT Editorial Material C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Kronick, R (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Director@ahrq.hhs.gov NR 13 TC 3 Z9 4 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1057-3631 EI 1550-5065 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JUL-SEP PY 2014 VL 29 IS 3 BP 195 EP 199 DI 10.1097/NCQ.0000000000000065 PG 5 WC Nursing SC Nursing GA AI9VS UT WOS:000337290600004 PM 24853980 ER PT J AU Lee, KC Pham, A AF Lee, Karen C. Anh Pham TI Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Lee, Karen C.] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Anh Pham] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Lee, KC (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 1 Z9 1 U1 1 U2 3 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUN 15 PY 2014 VL 89 IS 12 BP 971 EP 972 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AJ3HK UT WOS:000337556900005 PM 25162164 ER PT J AU Ekwueme, DU Yabroff, KR Guy, GP Banegas, MP de Moor, JS Li, CY Han, XS Zheng, ZY Soni, A Davidoff, A Rechis, R Virgo, KS AF Ekwueme, Donatus U. Yabroff, K. Robin Guy, Gery P., Jr. Banegas, Matthew P. de Moor, Janet S. Li, Chunyu Han, Xuesong Zheng, Zhiyuan Soni, Anita Davidoff, Amy Rechis, Ruth Virgo, Katherine S. TI Medical Costs and Productivity Losses of Cancer Survivors - United States, 2008-2011 SO MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT LA English DT Article ID CARE C1 [Ekwueme, Donatus U.; Guy, Gery P., Jr.; Li, Chunyu] CDC, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. [Yabroff, K. Robin; Banegas, Matthew P.; de Moor, Janet S.] NCI, Bethesda, MD 20892 USA. [Han, Xuesong; Zheng, Zhiyuan] Amer Canc Soc, Atlanta, GA 30329 USA. [Soni, Anita; Davidoff, Amy] Agcy Healthcare Res & Qual, Rockville, MD USA. [Rechis, Ruth] Livestrong Fdn, Austin, TX USA. [Virgo, Katherine S.] Emory Univ, Atlanta, GA 30322 USA. RP Ekwueme, DU (reprint author), CDC, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. EM dce3@cdc.gov NR 10 TC 20 Z9 20 U1 0 U2 9 PU CENTER DISEASE CONTROL & PREVENTION PI ATLANTA PA MAILSTOP E-90, ATLANTA, GA 30333 USA SN 0149-2195 EI 1545-861X J9 MMWR-MORBID MORTAL W JI MMWR-Morb. Mortal. Wkly. Rep. PD JUN 13 PY 2014 VL 63 IS 23 BP 505 EP 510 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AJ4KN UT WOS:000337645300001 PM 24918485 ER PT J AU Manski, RJ Cohen, LA Brown, E Carper, KV Vargas, C Macek, MD AF Manski, Richard J. Cohen, Leonard A. Brown, Erwin Carper, Kelly V. Vargas, Clemencia Macek, Mark D. TI Dental service mix among older adults aged 65 and over, United States, 1999 and 2009 SO JOURNAL OF PUBLIC HEALTH DENTISTRY LA English DT Article DE older adult; dental care; dental insurance; health-care surveys; poverty; United States ID CARE; FUTURE AB ObjectivesThe oral health of older Americans will assume increasing importance because of their increasing numbers and the evolving connections between oral health and general health. To establish a baseline and provide data for oral health workforce models, this report describes the types of dental procedures received by US adults 65years and older in 2009 and looks at trends since 1999. MethodsData for this analysis came from the 1999 and 2009 Medical Expenditure Panel Survey. The primary outcome variable represented the types of dental procedures that were received during a dental visit in the preceding year. Descriptive variables included dental insurance and poverty status. Analysis was restricted to adults aged 65 and over. ResultsIn 2009, diagnostic and preventive procedures accounted for almost three-quarters of all services. Compared with services received by those with private insurance, there were significantly fewer diagnostic and endodontic procedures among those with public coverage. Between 1999 and 2009, the proportion of preventive services significantly increased, whereas the proportion of restorative and endodontic services significantly decreased. Also, the likelihood of receiving preventive procedures increased, whereas the probability of receiving restorative or endodontic services decreased. ConclusionsFindings point to a shift in the mix of dental services received by older adults during the two periods. The predominance of diagnostic and preventive procedures has important access and workforce implications. An expanded role for dental hygienists in helping to meet the oral health needs of older adults is possible given a hygienist's current scope of practice. C1 [Manski, Richard J.; Cohen, Leonard A.; Vargas, Clemencia; Macek, Mark D.] Univ Maryland, Sch Dent, Baltimore, MD 21201 USA. [Brown, Erwin] Agcy Healthcare Res & Qual, Div Survey Operat, Rockville, MD USA. [Carper, Kelly V.] Agcy Healthcare Res & Qual, Div Stat Res & Methods, Rockville, MD USA. RP Manski, RJ (reprint author), Univ Maryland, Sch Dent, Baltimore, MD 21201 USA. EM rmanski@umaryland.edu NR 17 TC 4 Z9 4 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-4006 EI 1752-7325 J9 J PUBLIC HEALTH DENT JI J. Public Health Dent. PD SUM PY 2014 VL 74 IS 3 BP 219 EP 226 DI 10.1111/jphd.12049 PG 8 WC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health SC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health GA AP5TG UT WOS:000342141000007 PM 24428804 ER PT J AU Sorkin, DH Mavandadi, S Rook, KS Biegler, KA Kilgore, D Dow, E Ngo-Metzger, Q AF Sorkin, Dara H. Mavandadi, Shahrzad Rook, Karen S. Biegler, Kelly A. Kilgore, David Dow, Emily Ngo-Metzger, Quyen TI Dyadic Collaboration in Shared Health Behavior Change: The Effects of a Randomized Trial to Test a Lifestyle Intervention for High-Risk Latinas SO HEALTH PSYCHOLOGY LA English DT Article DE dyadic behavioral lifestyle intervention; social support and social control; type 2 diabetes control and prevention; weight loss; Hispanic; Latina ID DIABETES PREVENTION PROGRAM; WEIGHT-LOSS INTERVENTION; MEXICAN-AMERICAN WOMEN; SOCIAL SUPPORT; PHYSICAL-ACTIVITY; CHRONIC ILLNESS; PSYCHOLOGICAL DISTRESS; GLYCEMIC LOAD; US ADULTS; FAMILY AB Objective: This study sought to evaluate the feasibility of a pilot, dyad-based lifestyle intervention, the Unidas por la Vida program, for improving weight loss and dietary intake among high-risk Mexican American mothers who have Type 2 diabetes and their overweight/obese adult daughters. Method: Mother-daughter dyads (N = 89) were recruited from two federally qualified health centers and randomly assigned to either the Unidas intervention or to the control condition. The 16-week Unidas intervention consisted of the following: (a) four group meetings, (b) eight home visits, and (c) booster telephone calls by a lifestyle community coach. The control condition consisted of educational materials mailed to participants' homes. Participants completed surveys at T1 (baseline) and T2 (16 weeks) that assessed various demographic, social network involvement, and dietary variables. Results: Unidas participants lost significantly more weight at T2 (p < .003) compared with the control participants. Furthermore, intervention participants also were more likely to be eating foods with lower glycemic load (p < .001) and less saturated fat (p = .004) at T2. Unidas participants also reported a significant increase in health-related social support and social control (persuasion control only) and a decrease in undermining. Conclusions: The Unidas program promoted weight loss and improved dietary intake, as well as changes in diet-related involvement of participants' social networks. The results from this study demonstrate that interventions that draw upon multiple people who share a health-risk have the potential to foster significant changes in lifestyle behaviors and in social network members' health-related involvement. Future research that builds on these findings is needed to elucidate the specific dyadic and social network processes that may drive health behavior change. C1 [Sorkin, Dara H.; Biegler, Kelly A.] Univ Calif Irvine, Div Gen Internal Med, Irvine, CA USA. [Sorkin, Dara H.; Biegler, Kelly A.] Univ Calif Irvine, Primary Care & Hlth Policy Res Inst, Irvine, CA USA. [Mavandadi, Shahrzad] Univ Penn, Perelman Sch Med, Philadelphia VA Med Center;, Mental Illness Res Educ & Clin Ctr,Dept Psychiat, Philadelphia, PA 19104 USA. [Rook, Karen S.] Univ Calif Irvine, Dept Psychol & Social Behav, Irvine, CA USA. [Kilgore, David; Dow, Emily] Univ Calif Irvine, Div Family Med, Irvine, CA USA. [Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, Ctr Primary Care Prevent & Clin Partnership, US Prevent Serv Task Force Program, US Dept Hlth & Human Serv, Rockville, MD USA. RP Sorkin, DH (reprint author), UCI Hlth Policy Res Inst, Suite 110, Irvine, CA 92617 USA. EM dsorkin@uci.edu FU National Center for Research Resources; National Center for Advancing Translational Sciences, National Institutes of Health [UL1 TR000153, R34DK083500, K01DK078939] FX We thank Carolina Vilchis and Grada Christensen for their contributions. We would also like to thank Karen McGlinn, Executive Director, Share Our Selves Medical Clinic, for her unwavering support. The project described was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grants UL1 TR000153, R34DK083500, and K01DK078939. The views expressed in this publication are solely the opinions of the authors and do not necessarily reflect the official policies of U.S. Department of Veterans Affairs, Department of Health and Human Services, the National Institutes of Health, or the Agency for Healthcare Research and Quality, nor does mention of the department or agency names imply endorsement by the U.S. government. NR 58 TC 14 Z9 14 U1 3 U2 24 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0278-6133 EI 1930-7810 J9 HEALTH PSYCHOL JI Health Psychol. PD JUN PY 2014 VL 33 IS 6 SI SI BP 566 EP 575 DI 10.1037/hea0000063 PG 10 WC Psychology, Clinical; Psychology SC Psychology GA AK5CQ UT WOS:000338442300008 PM 24884910 ER PT J AU Davidoff, AJ Gardner, LD Zuckerman, IH Hendrick, F Ke, XH Edelman, MJ AF Davidoff, Amy J. Gardner, Lisa D. Zuckerman, Ilene H. Hendrick, Franklin Ke, Xuehua Edelman, Martin J. TI Validation of Disability Status, a Claims-based Measure of Functional Status for Cancer Treatment and Outcomes Studies SO MEDICAL CARE LA English DT Article DE comorbidity; Medicare; outcomes research; casual inference; research methodology ID INSTRUMENTAL VARIABLE METHODS; QUALITY-OF-LIFE; MYELODYSPLASTIC SYNDROMES; BREAST-CANCER; PROPENSITY SCORE; LUNG-CANCER; ELDERLY-PATIENTS; COLON-CANCER; COMORBIDITY; CHEMOTHERAPY AB Background:In prior research, we developed a claims-based prediction model for poor patient disability status (DS), a proxy measure for performance status, commonly used by oncologists to summarize patient functional status and assess ability of a patient to tolerate aggressive treatment. In this study, we implemented and validated the DS measure in 4 cohorts of cancer patients: early and advanced non-small cell lung cancers (NSCLC), stage IV estrogen receptor-negative (ER-) breast cancer, and myelodysplastic syndromes (MDS).Data and Methods:SEER-Medicare data (1999-2007) for the 4 cohorts of cancer patients. Bivariate and multivariate logistic regression tested the association of the DS measure with designated cancer-directed treatments: early NSCLC (surgery), advanced NSCLC (chemotherapy), stage IV ER- breast cancer (chemotherapy), and MDS (erythropoiesis-stimulating agents). Treatment model fit was compared across model iterations.Results:In both unadjusted and adjusted results, predicted poor DS was strongly associated with a lower likelihood of cancer treatment receipt in all 4 cohorts [early NSCLC (N=20,280), advanced NSCLC (N=31,341), stage IV ER- breast cancer (N=1519), and MDS (N=6058)] independent of other patient, contextual, and disease characteristics, as well as the Charlson Comorbidity Index. Inclusion of the DS measure into models already controlling for other variables did not significantly improve model fit across the cohorts.Conclusions:The DS measure is a significant independent predictor of cancer-directed treatment. Small changes in model fit associated with both DS and the Charlson Comorbidity Index suggest that unobserved factors continue to play a role in determining cancer treatments. C1 [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Gardner, Lisa D.] Sch Med, Columbia, MD USA. [Zuckerman, Ilene H.] IMPAQ Int LLC, Columbia, MD USA. [Hendrick, Franklin; Ke, Xuehua] Univ Maryland, Sch Pharm, Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. [Edelman, Martin J.] Univ New Mexico, Sch Med, Albuquerque, NM 87131 USA. RP Hendrick, F (reprint author), Univ Maryland, Sch Pharm, Pharmaceut Hlth Serv Res, 220 Arch St,12th Floor, Baltimore, MD 21201 USA. EM fhend001@umaryland.edu FU NIH/NCI [R21 CA137283, RC1 CA145831] FX This research was initiated while A.J.D. was employed by the University of Maryland Baltimore, with funding through NIH/NCI R21 CA137283 (A.J.D., principal investigator) and NIH/NCI RC1 CA145831 (A.J.D., principal investigator). A.J.D., F. H., and X. K. also received support through NIH/NCI RC1 CA145831. The opinions expressed in this article are the author's own and do not reflect the view of the Agency for Healthcare Research and Quality, the Department of Health and Human Services, or the United States government. NR 43 TC 9 Z9 9 U1 3 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD JUN PY 2014 VL 52 IS 6 BP 500 EP 510 DI 10.1097/MLR.0000000000000122 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ5LK UT WOS:000337723900007 PM 24638118 ER PT J AU Moore, JE Low, LK Titler, MG Dalton, VK Sampselle, CM AF Moore, Jennifer E. Low, Lisa Kane Titler, Marita G. Dalton, Vanessa K. Sampselle, Carolyn M. TI Moving Toward Patient-Centered Care: Women's Decisions, Perceptions, and Experiences of the Induction of Labor Process SO BIRTH-ISSUES IN PERINATAL CARE LA English DT Article DE implementation science; induction of labor; informed shared decision making; patient-centered outcomes research ID ELECTIVE INDUCTION; NULLIPAROUS WOMEN; CESAREAN-SECTION; DELIVERY; OUTCOMES; MODE AB BackgroundPatient preferences and clinician practices are possible causative factors to explain the increase in induction of labor, but scientific studies that demonstrate this link are limited. The purpose of this study is to identify factors that influence inductions from the perspective of women. MethodsA qualitative investigation using grounded theory methodology was conducted. Women were interviewed preinduction and postinduction. Analysis of the interviews was conducted using constant comparison to identify codes, categories, and themes. Through this process the complex intersection between women, their clinician, and the application of evidence-based care in clinical practice was explored. ResultsFive major themes from the preinduction interview were identified; safety of baby, women's trust in their clinician, relief of discomfort and/or anxiety, diminish potential or actual risk, and lack of informed decision making. Five major themes were identified from the postinduction interview; lack of informed decision making, induction as part of a checklist, women's trust in their clinician, happy with induction, and opportunities to improve the experience. ConclusionsLack of informed decision making was cited as a barrier to optimal care. This study has important implications for patient-centered research and clinical care, requiring the inclusion of women and the salient concepts of care that they identify. C1 [Moore, Jennifer E.] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. [Low, Lisa Kane; Titler, Marita G.; Sampselle, Carolyn M.] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA. [Dalton, Vanessa K.] Univ Michigan, Sch Med, Ann Arbor, MI USA. RP Moore, JE (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. FU National Institutes of Health Individual National Research Service Award [F31NR012855]; Blue Cross Blue Shield Foundation of Michigan Dissertation Grant [1808.SAP] FX National Institutes of Health Individual National Research Service Award, Grant #F31NR012855 (PI: Moore), and the Blue Cross Blue Shield Foundation of Michigan Dissertation Grant, Grant #1808.SAP (PI: Moore). NR 31 TC 9 Z9 9 U1 4 U2 10 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0730-7659 EI 1523-536X J9 BIRTH-ISS PERINAT C JI Birth-Issue Perinat. Care PD JUN PY 2014 VL 41 IS 2 BP 138 EP 146 DI 10.1111/birt.12080 PG 9 WC Nursing; Obstetrics & Gynecology; Pediatrics SC Nursing; Obstetrics & Gynecology; Pediatrics GA AI9XF UT WOS:000337298500003 PM 24702312 ER PT J AU Moyer, VA AF Moyer, Virginia A. CA US Preventive Serv Task Force TI Prevention of Dental Caries in Children From Birth Through Age 5 Years: US Preventive Services Task Force Recommendation Statement SO PEDIATRICS LA English DT Article DE dentistry/oral health; preventive medicine ID RANDOMIZED CONTROLLED-TRIAL; FLUORIDE VARNISH; ORAL-HEALTH; ABORIGINAL CHILDREN; CARE; PEDIATRICIANS; SUPPLEMENTS; FLUOROSIS; DENTITION; EFFICACY AB DESCRIPTION: Update of the 2004 US Preventive Services Task Force (USPSTF) recommendation on prevention of dental caries in preschoolaged children. METHODS: The USPSTF reviewed the evidence on prevention of dental caries by primary care clinicians in children 5 years and younger, focusing on screening for caries, assessment of risk for future caries, and the effectiveness of various interventions that have possible benefits in preventing caries. POPULATION: This recommendation applies to children age 5 years and younger. RECOMMENDATION: The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride. (B recommendation) The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by primary care clinicians in children from birth to age 5 years. C1 [Moyer, Virginia A.; US Preventive Serv Task Force] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Moyer, VA (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM coordinator@uspstf.net FU US Preventive Services Task Force FX The US Preventive Services Task Force is an independent, voluntary body. The US Congress mandates that the Agency for Healthcare Research and Quality support the operations of the US Preventive Services Task Force. NR 41 TC 20 Z9 20 U1 1 U2 9 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 EI 1098-4275 J9 PEDIATRICS JI Pediatrics PD JUN PY 2014 VL 133 IS 6 BP 1102 EP 1111 DI 10.1542/peds.2014-0483 PG 10 WC Pediatrics SC Pediatrics GA AI8MY UT WOS:000337172600061 PM 24799546 ER PT J AU McNellis, R Barnes, KR AF McNellis, Robert Barnes, Kirsten R. TI Vitamin D and Calcium Supplementation to Prevent Fractures in Adults SO AMERICAN FAMILY PHYSICIAN LA English DT Article ID SERVICES TASK-FORCE C1 [McNellis, Robert] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Barnes, Kirsten R.] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP McNellis, R (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 6 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JUN 1 PY 2014 VL 89 IS 11 BP 897 EP 898 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AI7KN UT WOS:000337069500015 PM 25077396 ER PT J AU Camp, KM Parisi, MA Acosta, PB Berry, GT Bilder, DA Blau, N Bodamer, OA Brosco, JP Brown, CS Burlina, AB Burton, BK Chang, CS Coates, PM Cunningham, AC Dobrowolski, SF Ferguson, JH Franklin, TD Frazier, DM Grange, DK Greene, CL Groft, SC Harding, CO Howell, RR Huntington, KL Hyatt-Knorr, HD Jevaji, IP Levy, HL Lichter-Konecki, U Lindegren, ML Lloyd-Puryear, MA Matalon, K MacDonald, A McPheeters, ML Mitchell, JJ Mofidi, S Moseley, KD Mueller, CM Mulberg, AE Nerurkar, LS Ogata, BN Pariser, AR Prasad, S Pridjian, G Rasmussen, SA Reddy, UM Rohr, FJ Singh, RH Sirrs, SM Stremer, SE Tagle, DA Thompson, SM Urv, TK Utz, JR van Spronsen, F Vockley, J Waisbren, SE Weglicki, LS White, DA Whitley, CB Wilfond, BS Yannicelli, S Young, JM AF Camp, Kathryn M. Parisi, Melissa A. Acosta, Phyllis B. Berry, Gerard. T. Bilder, Deborah A. Blau, Nenad Bodamer, Olaf A. Brosco, Jeffrey P. Brown, Christine S. Burlina, Alberto B. Burton, Barbara K. Chang, Christine S. Coates, Paul M. Cunningham, Amy C. Dobrowolski, Steven F. Ferguson, John H. Franklin, Thomas D. Frazier, Dianne M. Grange, Dorothy K. Greene, Carol L. Groft, Stephen C. Harding, Cary O. Howell, R. Rodney Huntington, Kathleen L. Hyatt-Knorr, Henrietta D. Jevaji, Indira P. Levy, Harvey L. Lichter-Konecki, Uta Lindegren, Mary Lou Lloyd-Puryear, Michele A. Matalon, Kimberlee MacDonald, Anita McPheeters, Melissa L. Mitchell, John J. Mofidi, Shideh Moseley, Kathryn D. Mueller, Christine M. Mulberg, Andrew E. Nerurkar, Lata S. Ogata, Beth N. Pariser, Anne R. Prasad, Suyash Pridjian, Gabriella Rasmussen, Sonja A. Reddy, Uma M. Rohr, Frances J. Singh, Rani H. Sirrs, Sandra M. Stremer, Stephanie E. Tagle, Danilo A. Thompson, Susan M. Urv, Tiina K. Utz, Jeanine R. van Spronsen, Francjan Vockley, Jerry Waisbren, Susan E. Weglicki, Linda S. White, Desiree A. Whitley, Chester B. Wilfond, Benjamin S. Yannicelli, Steven Young, Justin M. TI Phenylketonuria Scientific Review Conference: State of the science and future research needs SO MOLECULAR GENETICS AND METABOLISM LA English DT Article DE Phenylketonuria; Sapropterin; Hyperphenylalaninemia; Maternal PIN; Large neutral amino acids; Glycomacropeptide ID PHENYLALANINE-HYDROXYLASE DEFICIENCY; NEUTRAL AMINO-ACIDS; DIHYDROPTERIDINE REDUCTASE DEFICIENCY; CONTINUOUSLY TREATED PHENYLKETONURIA; TETRAHYDROBIOPTERIN LOADING TEST; GENOTYPE-PHENOTYPE CORRELATIONS; THERAPEUTIC LIVER REPOPULATION; MATERNAL BLOOD PHENYLALANINE; ENZYME REPLACEMENT THERAPY; TANDEM MASS-SPECTROMETRY AB New developments in the treatment and management of phenylketonuria (PKU) as well as advances in molecular testing have emerged since the National Institutes of Health 2000 PKU Consensus Statement was released. An NIH State-of-the-Science Conference was convened in 2012 to address new findings, particularly the use of the medication sapropterin to treat some individuals with PKU, and to develop a research agenda. Prior to the 2012 conference, five working groups of experts and public members met over a 1-year period. The working groups addressed the following: long-term outcomes and management across the lifespan; PKU and pregnancy; diet control and management; pharmacologic interventions; and molecular testing, new technologies, and epidemiologic considerations. In a parallel and independent activity, an Evidence-based Practice Center supported by the Agency for Healthcare Research and Quality conducted a systematic review of adjuvant treatments for PKU; its conclusions were presented at the conference. The conference included the findings of the working groups, panel discussions from industry and international perspectives, and presentations on topics such as emerging treatments for PKU, transitioning to adult care, and the U.S. Food and Drug Administration regulatory perspective. Over 85 experts participated in the conference through information gathering and/or as presenters during the conference, and they reached several important conclusions. The most serious neurological impairments in PKU are preventable with current dietary treatment approaches. However, a variety of more subtle physical, cognitive, and behavioral consequences of even well-controlled PKU are now recognized. The best outcomes in maternal PKU occur when blood phenylalanine (Phe) concentrations are maintained between 120 and 360 Rtnol/L before and during pregnancy. The dietary management treatment goal for individuals with PKU is a blood Phe concentration between 120 and 360 [tmol/L. The use of genotype information in the newborn period may yield valuable insights about the severity of the condition for infants diagnosed before maximal Phe levels are achieved. While emerging and established genotype-phenotype correlations may transform our understanding of PKU, establishing correlations with intellectual outcomes is more challenging. Regarding the use of sapropterin in PKU, there are significant gaps in predicting response to treatment; at least half of those with PKU will have either minimal or no response. A coordinated approach to PKU treatment improves long-term outcomes for those with PKU and facilitates the conduct of research to improve diagnosis and treatment. New drugs that are safe, efficacious, and impact a larger proportion of individuals with PKU are needed. However, it is imperative that treatment guidelines and the decision processes for determining access to treatments be tied to a solid evidence base with rigorous standards for robust and consistent data collection. The process that preceded the PKU State-of-the-Science Conference, the conference itself, and the identification of a research agenda have facilitated the development of clinical practice guidelines by professional organizations and serve as a model for other inborn errors of metabolism. C1 [Camp, Kathryn M.; Coates, Paul M.; Lloyd-Puryear, Michele A.] NIH, Off Dietary Supplements, Bethesda, MD 20982 USA. [Parisi, Melissa A.; Reddy, Uma M.; Urv, Tiina K.] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, NIH, Bethesda, MD 20892 USA. [Acosta, Phyllis B.; Singh, Rani H.] Emory Univ, Atlanta, GA 30033 USA. [Berry, Gerard. T.; Levy, Harvey L.; Waisbren, Susan E.] Harvard Univ, Boston Childrens Hosp, Sch Med, Boston, MA 02115 USA. [Bilder, Deborah A.] Univ Utah, Dept Psychiat, Salt Lake City, UT 84108 USA. [Blau, Nenad] Univ Childrens Hosp, Heidelberg, Germany. [Blau, Nenad] Univ Childrens Hosp, Zurich, Switzerland. [Bodamer, Olaf A.; Howell, R. Rodney] Univ Miami, Miller Sch Med, Miami, FL 33136 USA. [Brosco, Jeffrey P.] Univ Miami, Mailman Ctr Child Dev, Miami, FL 33101 USA. [Brown, Christine S.; Franklin, Thomas D.] Natl PKU Alliance, Encinitas, CA USA. [Burlina, Alberto B.] Univ Hosp, I-35128 Padua, Italy. [Burton, Barbara K.] Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL 60611 USA. [Chang, Christine S.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Cunningham, Amy C.; Pridjian, Gabriella] Tulane Univ, Sch Med, Hayward Genet Ctr, New Orleans, LA 70112 USA. [Dobrowolski, Steven F.; Vockley, Jerry] Univ Pittsburgh, Pittsburgh, PA 15224 USA. [Ferguson, John H.; Groft, Stephen C.; Hyatt-Knorr, Henrietta D.; Nerurkar, Lata S.] NIH, Off Rare Dis Res, Natl Ctr Adv Translat Sci, Bethesda, MD 20982 USA. [Frazier, Dianne M.] Univ N Carolina, Chapel Hill, NC 27599 USA. [Grange, Dorothy K.] Washington Univ, St Louis Childrens Hosp, Sch Med, St Louis, MO 63110 USA. [Greene, Carol L.] Univ Maryland, Sch Med, Baltimore, MD 21201 USA. [Harding, Cary O.; Huntington, Kathleen L.] Oregon Hlth & Sci Univ, Portland, OR 97239 USA. [Jevaji, Indira P.] NIH, Off Res Womens Hlth, Bethesda, MD 20817 USA. [Lichter-Konecki, Uta] George Washington Univ, Childrens Natl Med Ctr, Washington, DC 20010 USA. [Lindegren, Mary Lou] Vanderbilt Univ, Sch Med, Nashville, TN 37203 USA. [Matalon, Kimberlee] Univ Houston, Houston, TX 77204 USA. [MacDonald, Anita] Birmingham Childrens Hosp, Birmingham B4 6NH, W Midlands, England. [McPheeters, Melissa L.] Inst Med & Publ Hlth, Vanderbilt Evidence Based Practice Ctr, Nashville, TN 37203 USA. [Mitchell, John J.] McGill Univ, Ctr Hlth, Montreal, PQ H3H 1P3, Canada. [Mofidi, Shideh] Maria Fareri Childrens Hosp, Westchester Med Ctr, Valhalla, NY 10595 USA. [Moseley, Kathryn D.] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA. [Mueller, Christine M.] US FDA, Off Orphan Prod Dev, Silver Spring, MD 20993 USA. [Mulberg, Andrew E.; Pariser, Anne R.] US FDA, Ctr Drug Evaluat & Res, Silver Spring, MD 20993 USA. [Ogata, Beth N.] Univ Washington, Seattle, WA 98195 USA. [Prasad, Suyash] BioMarin Pharmaceut Inc, San Rafael, CA 94901 USA. [Rasmussen, Sonja A.] Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. [Rohr, Frances J.] Boston Childrens Hosp, Boston, MA 02115 USA. [Sirrs, Sandra M.] Univ British Columbia, Vancouver Gen Hosp, Vancouver, BC V5Z 1M9, Canada. [Burlina, Alberto B.] PKU & Allied Disorders Wisconsin, Madison, WI 53705 USA. [Tagle, Danilo A.] NIH, Natl Ctr Adv Translat Sci, Bethesda, MD 20892 USA. [Thompson, Susan M.] Childrens Hosp Westrnead, Sydney, NSW 2145, Australia. [Utz, Jeanine R.; Whitley, Chester B.] Univ Minnesota, Minneapolis, MN 55455 USA. [van Spronsen, Francjan] Univ Groningen, Univ Med Ctr Groningen, Beatrix Childrens Hosp, NL-9700 AB Groningen, Netherlands. [Weglicki, Linda S.] NINR, NIH, Bethesda, MD 20892 USA. [White, Desiree A.] Washington Univ, Dept Psychol, St Louis, MO 63130 USA. [Wilfond, Benjamin S.] Univ Washington, Seattle Childrens Res Inst, Sch Med, Seattle, WA 98101 USA. [Yannicelli, Steven] Nutricia North Amer, Rockville, MD 20850 USA. [Young, Justin M.] Young Face Facial Plast & Reconstruct Surg, Cumming, GA 30041 USA. RP Camp, KM (reprint author), 6100 Execut Blvd, Rockville, MD 20892 USA. EM campkm@od.nih.gov; parisima@mail.nih.gov; pja1933@gmail.com; gerard.berry@childrens.harvard.edu; deborah.bilder@hsc.utah.edu; nenad.blau@med.uni-heidelberg.de; obodamer@med.miami.edu; jbrosco@med.miami.edu; christine.brown@npkua.org; alberto.burlina@unipd.it; bburton@luriechildrens.org; christine.chang@ahrq.hhs.gov; coatesp@od.nih.gov; acunnin@tulane.edu; dobrowolskis@upmc.edu; jferg@helix.nih.gov; tom.franklin@npkua.org; dianne_frazier@med.unc.edu; grange_d@kids.wustl.edu; cgreene@peds.umaryland.edu; stephen.groft@nih.gov; hardingc@ohsu.edu; rhowell@miami.edu; huntingt@ohsu.edu; henrietta.hyatt-knorr@nih.gov; indira.jevaji@cms.hhs.gov; harvey.levy@childrens.harvard.edu; ulichter@cnmc.org; marylou.lindegren@vanderbilt.edu; lloydpuryearma@od.nih.gov; kmatalon@uh.edu; anita.macdonald@bch.nhs.uk; melissa.mcpheeters@vanderbilt.edu; john.mitchell@muhc.mcgill.ca; shideh_mofidi@nymc.edu; kmoseley@usc.edu; christine.mueller@nih.gov; andrew.mulberg@fda.hhs.gov; lnerurkar@gmail.com; bogata@uw.edu; anne.pariser@fda.hhs.gov; sprasad@bmrn.com; pridjian@tulane.edu; skr9@cdc.gov; reddyu@mail.nih.gov; frances.rohr@childrens.harvard.edu; rsingh@emory.edu; sandra.sirrs@vch.ca; sstremer@yahoo.com; danilo.tagle@nih.gov; sue.thompson@health.nsw.gov.au; urvtiin@mail.nih.gov; jutz1@fairview.org; f.j.van.spronsen@umcg.nl; vockleyg@upmc.edu; susan.waisbren@childrens.harvard.edu; weglickils@mail.nih.gov; dawhite@wustl.edu; whitley@umn.edu; benjamin.wilfond@seattlechildrens.org; steven.yannicelli@nutricia.com; jmichaelyoung@yahoo.com OI Berry, Gerard/0000-0001-5299-3313; Vockley, Jerry/0000-0002-8180-6457 NR 336 TC 43 Z9 43 U1 5 U2 73 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1096-7192 EI 1096-7206 J9 MOL GENET METAB JI Mol. Genet. Metab. PD JUN PY 2014 VL 112 IS 2 BP 87 EP 122 DI 10.1016/j.ymgme.2014.02.013 PG 36 WC Endocrinology & Metabolism; Genetics & Heredity; Medicine, Research & Experimental SC Endocrinology & Metabolism; Genetics & Heredity; Research & Experimental Medicine GA AI7KF UT WOS:000337067900002 PM 24667081 ER PT J AU Wasserman, M Renfrew, MR Green, AR Lopez, L Tan-McGrory, A Brach, C Betancourt, JR AF Wasserman, Melanie Renfrew, Megan R. Green, Alexander R. Lopez, Lenny Tan-McGrory, Aswita Brach, Cindy Betancourt, Joseph R. TI Identifying and Preventing Medical Errors in Patients With Limited English Proficiency: Key Findings and Tools for the Field SO JOURNAL FOR HEALTHCARE QUALITY LA English DT Article DE patient safety; performance improvement; quality improvement; research-qualitative AB Since the 1999 Institute of Medicine (IOM) report To Err is Human, progress has been made in patient safety, but few efforts have focused on safety in patients with limited English proficiency (LEP). This article describes the development, content, and testing of two new evidence-based Agency for Healthcare Research and Quality (AHRQ) tools for LEP patient safety. In the content development phase, a comprehensive mixed-methods approach was used to identify common causes of errors for LEP patients, high-risk scenarios, and evidence-based strategies to address them. Based on our findings, Improving Patient Safety Systems for Limited English Proficient Patients: A Guide for Hospitals contains recommendations to improve detection and prevention of medical errors across diverse populations, and TeamSTEPPS Enhancing Safety for Patients with Limited English Proficiency Module trains staff to improve safety through team communication and incorporating interpreters in the care process. The Hospital Guide was validated with leaders in quality and safety at diverse hospitals, and the TeamSTEPPS LEP module was field-tested in varied settings within three hospitals. Both tools were found to be implementable, acceptable to their audiences, and conducive to learning. Further research on the impact of the combined use of the guide and module would shed light on their value as a multifaceted intervention. C1 [Wasserman, Melanie] Abt Associates Inc, Cambridge, MA 02138 USA. [Renfrew, Megan R.] Massachusetts Gen Hosp Phys Org, Charlestown, MA USA. [Renfrew, Megan R.; Green, Alexander R.; Lopez, Lenny; Tan-McGrory, Aswita] Dispar Solut Ctr, Baltimore, MD USA. [Green, Alexander R.; Lopez, Lenny] Massachusetts Gen Hosp, Mongan Inst Hlth Policy, Boston, MA 02114 USA. [Green, Alexander R.] Harvard Univ, Sch Med, Cross Cultural Care Comm, Cambridge, MA 02138 USA. [Lopez, Lenny] Brigham & Womens Hosp, Boston, MA 02115 USA. [Lopez, Lenny] Harvard Univ, Sch Med, Cambridge, MA 02138 USA. [Brach, Cindy] Agcy Healthcare Res & Qual, New York, NY USA. [Betancourt, Joseph R.] Massachusetts Gen Hosp, Dispar Solut Ctr, Boston, MA 02114 USA. [Betancourt, Joseph R.] Massachusetts Gen Hosp, Boston, MA 02114 USA. RP Wasserman, M (reprint author), Abt Associates Inc, Cambridge, MA 02138 USA. EM melanie_wasserman@abtassoc.com FU Intramural AHRQ HHS [HS999999] NR 16 TC 3 Z9 3 U1 2 U2 6 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1062-2551 EI 1945-1474 J9 J HEALTHC QUAL JI J. Healthc. Qual. PD MAY-JUN PY 2014 VL 36 IS 3 BP 5 EP 16 DI 10.1111/jhq.12065 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AZ8FK UT WOS:000348450200001 PM 24629098 ER PT J AU Erten, MZ Stuart, B Davidoff, AJ AF Erten, M. Z. Stuart, B. Davidoff, A. J. TI EFFECTS OF NEWLY DIAGNOSED CANCER ON MEDICATION MANAGEMENT OF PREVALENT DIABETES SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Erten, M. Z.] Univ Vermont, Coll Med, Burlington, VT USA. [Stuart, B.] Univ Maryland, Sch Pharm, Baltimore, MD 21201 USA. [Davidoff, A. J.] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2014 VL 17 IS 3 MA PCN165 BP A96 EP A97 PG 2 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AO1OG UT WOS:000341082000525 ER PT J AU Karaca, Z Wong, H Stensland, J AF Karaca, Z. Wong, H. Stensland, J. TI DO MEDICARE ADVANTAGE ENROLLEES VISIT HIGH-COST HOSPITALS? SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Karaca, Z.; Wong, H.] AHRQ, Rockville, MD USA. [Stensland, J.] Medicare Payment Advisory Commiss, Washington, DC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2014 VL 17 IS 3 MA PHP70 BP A21 EP A21 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AO1OG UT WOS:000341082000115 ER PT J AU Karaca, Z Wong, H AF Karaca, Z. Wong, H. TI THE ROLE OF PATIENT-PHYSICIAN COMMUNICATION ON HEALTH CARE COSTS SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Karaca, Z.; Wong, H.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2014 VL 17 IS 3 MA PHP69 BP A21 EP A21 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AO1OG UT WOS:000341082000114 ER PT J AU Marder, W Lenhart, GM Karaca, Z Wier, LM Wong, H AF Marder, W. Lenhart, G. M. Karaca, Z. Wier, L. M. Wong, H. TI THE EFFECT OF MASSACHUSETTS HEALTH CARE REFORM ON HOSPITAL INPATIENT USE SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Marder, W.; Lenhart, G. M.; Wier, L. M.] Truven Hlth Analyt, Cambridge, MA USA. [Karaca, Z.; Wong, H.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2014 VL 17 IS 3 MA PHP66 BP A21 EP A21 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AO1OG UT WOS:000341082000111 ER PT J AU Pickens, G Carls, G Eibner, C Jiang, HJ Karaca, Z Weiss, A Wong, H AF Pickens, G. Carls, G. Eibner, C. Jiang, H. J. Karaca, Z. Weiss, A. Wong, H. TI PROJECTING THE USE OF INPATIENT AND EMERGENCY DEPARTMENT SERVICES AFTER THE AFFORDABLE CARE ACT MEDICAID EXPANSION SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Pickens, G.; Weiss, A.] Truven Hlth Analyt, Cambridge, MA USA. [Carls, G.] Truven Hlth Analyt, Ann Arbor, MI USA. [Eibner, C.] RAND Corp, Arlington, VA USA. [Jiang, H. J.; Karaca, Z.; Wong, H.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2014 VL 17 IS 3 MA AH1 BP A1 EP A1 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AO1OG UT WOS:000341082000005 ER PT J AU Smith, M Karaca, Z Wong, H AF Smith, M. Karaca, Z. Wong, H. TI PREDICTING PRICE-TO-CHARGE RATIOS FOR COMMUNITY HOSPITALS IN THE UNITED STATES SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Smith, M.] Truven Hlth Analyt, Bethesda, MD USA. [Karaca, Z.; Wong, H.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2014 VL 17 IS 3 MA PHP145 BP A34 EP A34 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AO1OG UT WOS:000341082000187 ER PT J AU Weiss, A Carls, G Jiang, HJ Karaca, Z Pickens, G Wong, H AF Weiss, A. Carls, G. Jiang, H. J. Karaca, Z. Pickens, G. Wong, H. TI ESTABLISHING BENCHMARKS TO UNDERSTAND HOSPITAL UTILIZATION FOLLOWING MEDICAID EXPANSION UNDER THE AFFORDABLE CARE ACT SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Weiss, A.; Pickens, G.] Truven Hlth Analyt, Cambridge, MA USA. [Carls, G.] Truven Hlth Analyt, Ann Arbor, MI USA. [Jiang, H. J.; Karaca, Z.; Wong, H.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD MAY PY 2014 VL 17 IS 3 MA AH2 BP A1 EP A1 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AO1OG UT WOS:000341082000002 ER PT J AU Bernard, DM Johansson, P Fang, ZY AF Bernard, Didem Minbay Johansson, Patrik Fang, Zhengyi TI Out-of-Pocket Healthcare Expenditure Burdens Among Nonelderly Adults With Hypertension SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID UNITED-STATES; PERSISTENCE; ADHERENCE; INSURANCE; THERAPY; COSTS AB Objectives To examine the prevalence of high out-of-pocket burdens and self-perceived financial barriers to care among patients receiving hypertension treatment. Study Population Persons 18 to 64 years receiving treatment for hypertension from a nationally representative sample of the US population from the 2007 to 2009 Medical Expenditure Panel Survey. Main Outcome Measures The proportion of persons living in families with high a out-of-pocket burden associated with medical spending relative to income, defining high healthcare burden as spending on healthcare greater than 20% of income and high total burden as spending on healthcare and insurance premiums greater than 20% of income. Results The prevalence of high total burdens was significantly greater for persons receiving treatment for hypertension (13.1%) compared with other chronically ill (10.5%) and well patients (5.3%). Among hypertension patients with high total burdens, 15.7% said they were unable to get care and 13.6% said they delayed care due to financial reasons. Self-perceived financial barriers were highest among the uninsured and those with public coverage: 35.2% among the uninsured and 23.9% among those with public coverage said they were unable to get care due to financial reasons. Conclusions High burdens may deter patients from getting needed care. Our findings have 2 distinct policy implications. First, raising awareness among providers regarding the prevalence of high out-of-pocket burdens and financial barriers to care may encourage physicians to discuss healthcare coverage and associated costs with their patients, To the extent that patients' perceptions about their ability to pay are incorrect, physicians can help patients overcome barriers to treatment. Second, health plans could reduce patient cost sharing on drugs for which there is a strong body of evidence documenting cost-saving treatment such as antihypertensive medication. Addressing financial barriers to care may improve treatment adherence among patients with hypertension. C1 [Bernard, Didem Minbay] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. [Johansson, Patrik] Univ Nebraska Med Ctr, Coll Publ Hlth, Omaha, NE USA. [Fang, Zhengyi] Social & Sci Syst, Silver Spring, MD USA. RP Bernard, DM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Didem.Bernard@ahrq.hhs.gov NR 33 TC 7 Z9 7 U1 0 U2 2 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD MAY PY 2014 VL 20 IS 5 BP 406 EP 413 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA AL5AV UT WOS:000339146800011 PM 25181569 ER PT J AU McGuire, TG Newhouse, JP Normand, SL Shi, J Zuvekas, S AF McGuire, Thomas G. Newhouse, Joseph P. Normand, Sharon-Lise Shi, Julie Zuvekas, Samuel TI Assessing incentives for service-level selection in private health insurance exchanges SO JOURNAL OF HEALTH ECONOMICS LA English DT Article DE Health insurance; Exchanges; Adverse selection ID RISK ADJUSTMENT; MENTAL-HEALTH; ADVERSE SELECTION; MANAGED CARE; MARKETS; MEDICARE; PLANS; PROGRAM; PAYMENT AB Even with open enrollment and mandated purchase, incentives created by adverse selection may undermine the efficiency of service offerings by plans in the new health insurance Exchanges created by the Affordable Care Act. Using data on persons likely to participate in Exchanges drawn from five waves of the Medical Expenditure Panel Survey, we measure plan incentives in two ways. First, we construct predictive ratios, improving on current methods by taking into account the role of premiums in financing plans. Second, relying on an explicit model of plan profit maximization, we measure incentives based on the predictability and predictiveness of various medical diagnoses. Among the chronic diseases studied, plans have the greatest incentive to skimp on care for cancer, and mental health and substance abuse. (C) 2014 Elsevier B.V. All rights reserved. C1 [McGuire, Thomas G.; Newhouse, Joseph P.; Normand, Sharon-Lise; Shi, Julie] Harvard Univ, Dept Hlth Care Policy, Sch Med, Cambridge, MA 02138 USA. [McGuire, Thomas G.; Newhouse, Joseph P.] NBER, Cambridge, MA 02138 USA. [Newhouse, Joseph P.; Normand, Sharon-Lise] Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Cambridge, MA 02138 USA. [Newhouse, Joseph P.] Harvard Univ, Kennedy Sch, Cambridge, MA 02138 USA. [Zuvekas, Samuel] Agcy Healthcare Res & Qual, Rockville, MD USA. RP McGuire, TG (reprint author), Harvard Univ, Dept Hlth Care Policy, Sch Med, Cambridge, MA 02138 USA. EM mcguire@hcp.med.harvard.edu FU National Institute of Mental Health [R01 MH094290]; National Institute of Aging [P01 AG032952] FX Research for this paper was supported by the National Institute of Mental Health (R01 MH094290) and the National Institute of Aging (P01 AG032952). This paper represents the views of the authors and no official endorsement by the Agency for Healthcare Research and Quality or the Department of Health and Human Services is intended or should be inferred. NR 43 TC 11 Z9 11 U1 1 U2 7 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-6296 EI 1879-1646 J9 J HEALTH ECON JI J. Health Econ. PD MAY PY 2014 VL 35 BP 47 EP 63 DI 10.1016/j.jhealeco.2014.01.009 PG 17 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA AJ7IK UT WOS:000337870200005 PM 24603443 ER PT J AU Bayliss, EA Bonds, DE Boyd, CM Davis, MM Finke, B Fox, MH Glasgow, RE Goodman, RA Heurtin-Roberts, S Lachenmayr, S Lind, C Madigan, EA Meyers, DS Mintz, S Nilsen, WJ Okun, S Ruiz, S Salive, ME Stange, KC AF Bayliss, Elizabeth A. Bonds, Denise E. Boyd, Cynthia M. Davis, Melinda M. Finke, Bruce Fox, Michael H. Glasgow, Russell E. Goodman, Richard A. Heurtin-Roberts, Suzanne Lachenmayr, Sue Lind, Cristin Madigan, Elizabeth A. Meyers, David S. Mintz, Suzanne Nilsen, Wendy J. Okun, Sally Ruiz, Sarah Salive, Marcel E. Stange, Kurt C. TI Understanding the Context of Health for Persons With Multiple Chronic Conditions: Moving From What Is the Matter to What Matters SO ANNALS OF FAMILY MEDICINE LA English DT Article DE multiple chronic conditions; chronic illness; health services research ID QUALITY-OF-LIFE; RANDOMIZED CONTROLLED-TRIALS; TEAM SCIENCE; PRIMARY-CARE; EXTERNAL VALIDITY; BIOPSYCHOSOCIAL MODEL; COMPLEXITY SCIENCE; PATIENT-CARE; NEED; MULTIMORBIDITY AB PURPOSE An isolated focus on 1 disease at a time is insufficient to generate the scientific evidence needed to improve the health of persons living with more than 1 chronic condition. This article explores how to bring context into research efforts to improve the health of persons living with multiple chronic conditions (MCC). METHODS Forty-five experts, including persons with MCC, family and friend caregivers, researchers, policy makers, funders, and clinicians met to critically consider 4 aspects of incorporating context into research on MCC: key contextual factors, needed research, essential research methods for understanding important contextual factors, and necessary partnerships for catalyzing collaborative action in conducting and applying research. RESULTS Key contextual factors involve complementary perspectives across multiple levels: public policy, community, health care systems, family, and person, as well as the cellular and molecular levels where most research currently is focused. Needed research involves moving from a disease focus toward a person-driven, goal-directed research agenda. Relevant research methods are participatory, flexible, multilevel, quantitative and qualitative, conducive to longitudinal dynamic measurement from diverse data sources, sufficiently detailed to consider what works for whom in which situation, and generative of ongoing communities of learning, living and practice. Important partnerships for collaborative action include cooperation among members of the research enterprise, health care providers, community-based support, persons with MCC and their family and friend caregivers, policy makers, and payers, including government, public health, philanthropic organizations, and the business community. CONCLUSION Consistent attention to contextual factors is needed to enhance health research for persons with MCC. Rigorous, integrated, participatory, multimethod approaches to generate new knowledge and diverse partnerships can be used to increase the relevance of research to make health care more sustainable, safe, equitable and effective, to reduce suffering, and to improve quality of life. C1 [Bayliss, Elizabeth A.] Kaiser Permanente, Denver, CO USA. [Bonds, Denise E.] NHLBI, Bethesda, MD 20892 USA. [Boyd, Cynthia M.] Johns Hopkins Univ, Sch Med, Baltimore, MD USA. [Boyd, Cynthia M.] Bloomberg Sch Publ Hlth, Baltimore, MD USA. [Davis, Melinda M.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Finke, Bruce] Indian Hlth Serv, Nashville, TN USA. [Fox, Michael H.; Goodman, Richard A.] Ctr Dis Control & Prevent, Atlanta, GA USA. [Glasgow, Russell E.; Heurtin-Roberts, Suzanne] NCI, NIH, Bethesda, MD 20892 USA. [Glasgow, Russell E.] Univ Colorado, Sch Med, Denver, CO USA. [Goodman, Richard A.] Dept Hlth & Human Serv, Off Assistant Secretary Hlth, Atlanta, GA USA. [Lachenmayr, Sue; Ruiz, Sarah] Natl Council Aging, Washington, DC USA. [Lind, Cristin] Karolinska Inst, Stockholm, Sweden. [Meyers, David S.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Nilsen, Wendy J.] NIH, Off Behav & Social Sci Res, Bethesda, MD 20892 USA. [Okun, Sally] PatientsLikeMe, Cambridge, MA USA. [Ruiz, Sarah] Univ Chicago, Chicago, IL 60637 USA. [Salive, Marcel E.] NIA, Bethesda, MD USA. RP Stange, KC (reprint author), Case Western Reserve Univ, 11000 Cedar Ave,Suite 402, Cleveland, OH 44106 USA. EM kcs@case.edu RI Ruiz, Sarah/B-3456-2017 OI Ruiz, Sarah/0000-0002-6428-2321 FU Clinical Research Professorship from the American Cancer Society; National Cancer Society FX Dr Stange's time is supported in part by a Clinical Research Professorship from the American Cancer Society and by the National Cancer Society through the Intergovernmental Personnel Act. NR 99 TC 36 Z9 36 U1 7 U2 45 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672 USA SN 1544-1709 EI 1544-1717 J9 ANN FAM MED JI Ann. Fam. Med. PD MAY-JUN PY 2014 VL 12 IS 3 BP 260 EP 269 DI 10.1370/afm.1643 PG 10 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AI3YM UT WOS:000336801800011 PM 24821898 ER PT J AU Baumblatt, JAG Wiedeman, C Dunn, JR Schaffner, W Paulozzi, LJ Jones, TF AF Baumblatt, Jane A. Gwira Wiedeman, Caleb Dunn, John R. Schaffner, William Paulozzi, Leonard J. Jones, Timothy F. TI High-Risk Use by Patients Prescribed Opioids for Pain and Its Role in Overdose Deaths SO JAMA INTERNAL MEDICINE LA English DT Article ID PRESCRIPTION DRUG OVERDOSES; UNITED-STATES; ABUSE; ANALGESICS; DIVERSION; MORTALITY; EPIDEMIC AB IMPORTANCE From January 1, 2003, through December 31, 2010, drug overdose deaths in Tennessee increased from 422 to 1059 per year. More of these deaths involved prescription opioids than heroin and cocaine combined. OBJECTIVE To assess the contribution of certain opioid-prescribing patterns to the risk of overdose death. DESIGN, SETTING, AND PARTICIPANTS We performed a matched case-control study that analyzed opioid prescription data from the Tennessee Controlled Substances Monitoring Program (TNCSMP) from January 1, 2007, through December 31, 2011, to identify risk factors associated with opioid-related overdose deaths from January 1, 2009, through December 31, 2010. Case patients were ascertained from death certificate data. Age-and sex-matched controls were randomly selected from among live patients in the TNCSMP. MAIN OUTCOMES AND MEASURES We defined a high-risk number of prescribers or pharmacies as 4 or more per year and high-risk dosage as a daily mean of more than 100 morphine milligram equivalents (MMEs) per year. The main outcome was opioid-related overdose death. RESULTS From January 1, 2007, through December 31, 2011, one-third of the population of Tennessee filled an opioid prescription each year, and opioid prescription rates increased from 108.3 to 142.5 per 100 population per year. Among all patients in Tennessee prescribed opioids during 2011, 7.6% used more than 4 prescribers, 2.5% used more than 4 pharmacies, and 2.8% had a mean daily dosage greater than 100 MMEs. Increased risk of opioid-related overdose death was associated with 4 or more prescribers (adjusted odds ratio [aOR], 6.5; 95% CI, 5.1-8.5), 4 or more pharmacies (aOR, 6.0; 95% CI, 4.4-8.3), and more than 100 MMEs (aOR, 11.2; 95% CI, 8.3-15.1). Persons with 1 or more risk factor accounted for 55% of all overdose deaths. CONCLUSIONS AND RELEVANCE High-risk use of prescription opioids is frequent and increasing in Tennessee and is associated with increased overdose mortality. Use of prescription drug-monitoring program data to direct risk-reduction measures to the types of patients overrepresented among overdose deaths might reduce mortality associated with opioid abuse. C1 [Baumblatt, Jane A. Gwira] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Tennessee Dept Hlth, Nashville, TN USA. [Wiedeman, Caleb; Dunn, John R.; Schaffner, William; Jones, Timothy F.] Tennessee Dept Hlth, Nashville, TN USA. [Dunn, John R.; Schaffner, William] Vanderbilt Univ, Sch Med, Dept Prevent Med & Med, Nashville, TN 37212 USA. [Paulozzi, Leonard J.] Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA USA. RP Baumblatt, JAG (reprint author), Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, 540 Gaither Rd, Rockville, MD 20850 USA. NR 31 TC 44 Z9 44 U1 4 U2 12 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 2168-6106 EI 2168-6114 J9 JAMA INTERN MED JI JAMA Intern. Med. PD MAY PY 2014 VL 174 IS 5 BP 796 EP 801 DI 10.1001/jamainternmed.2013.12711 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA AI4NS UT WOS:000336842700028 ER PT J AU Cabana, MD Cheng, TL Bauer, AJ Bogue, CW Chien, AT Dean, JM Scheindlin, B Kelle, A Coyne-Beasley, T DiMeglio, L DeGraw, CA Dougherty, D Freed, GL Guttmacher, AE Minkovitz, C Shalowitz, M Cull, W AF Cabana, Michael D. Cheng, Tina L. Bauer, Andrew J. Bogue, Clifford W. Chien, Alyna T. Dean, J. Michael Scheindlin, Ben Kelle, Angela Coyne-Beasley, Tamera DiMeglio, Linda DeGraw, Christopher A. Dougherty, Denise Freed, Gary L. Guttmacher, Alan E. Minkovitz, Cynthia Shalowitz, Madeleine Cull, William CA Comm Pediat Res TI Promoting Education, Mentorship, and Support for Pediatric Research SO PEDIATRICS LA English DT Article DE pediatric education; training; workforce; epidemiology; health services research; community-based participatory research; translational research; basic science research; postgraduate training ID CLINICAL-RESEARCH; TRANSLATIONAL RESEARCH; PHYSICIAN-SCIENTISTS; CAREER-DEVELOPMENT; HEALTH; PROGRAM; CHALLENGES; PERSPECTIVES; INSTITUTES; MEDICINE AB Pediatricians play a key role in advancing child health research to best attain and improve the physical, mental, and social health and well-being of all infants, children, adolescents, and young adults. Child health presents unique issues that require investigators who specialize in pediatric research. In addition, the scope of the pediatric research enterprise is transdisciplinary and includes the full spectrum of basic science, translational, community-based, health services, and child health policy research. Although most pediatricians do not directly engage in research, knowledge of research methodologies and approaches promotes critical evaluation of scientific literature, the practice of evidence-based medicine, and advocacy for evidence-based child health policy. This statement includes specific recommendations to promote further research education and support at all levels of pediatric training, from premedical to continuing medical education, as well as recommendations to increase support and mentorship for research activities. Pediatric research is crucial to the American Academy of Pediatrics' goal of improving the health of all children. The American Academy of Pediatrics continues to promote and encourage efforts to facilitate the creation of new knowledge and ways to reduce barriers experienced by trainees, practitioners, and academic faculty pursuing research. C1 [DeGraw, Christopher A.] Maternal & Child Hlth Bur, Rockville, MD USA. [Dougherty, Denise] Agcy Healthcare Res & Qual, Rockville, MD USA. [Guttmacher, Alan E.] NICHHD, Rockville, MD USA. OI Kelle, Angela/0000-0002-5222-0916; DiMeglio, Linda/0000-0002-8033-6078 NR 50 TC 3 Z9 3 U1 1 U2 4 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 EI 1098-4275 J9 PEDIATRICS JI Pediatrics PD MAY PY 2014 VL 133 IS 5 BP 943 EP 949 DI 10.1542/peds.2014-0448 PG 7 WC Pediatrics SC Pediatrics GA AG2HK UT WOS:000335236800026 ER PT J AU Kindermann, DR Mutter, RL Cartright-Smith, L Rosenbaum, S Pines, JM AF Kindermann, Dana R. Mutter, Ryan L. Cartright-Smith, Lara Rosenbaum, Sara Pines, Jesse M. TI Admit or Transfer? The Role of Insurance in High-Transfer-Rate Medical Conditions in the Emergency Department SO ANNALS OF EMERGENCY MEDICINE LA English DT Article ID I TRAUMA CENTER; LEVEL-I; MYOCARDIAL-INFARCTION; ADMINISTRATIVE DATA; INJURED PATIENTS; CARE; CENTERS; BENEFIT; COVERAGE; CRISIS AB Study objective: We study the association of payer status with odds of transfer compared with admission from the emergency department (ED) for multiple diagnoses with a high percentage of transfers. Methods: This was a retrospective study of adult ED encounters using the Healthcare Cost and Utilization Project 2010 Nationwide Emergency Department Sample. We used the Clinical Classification Software to identify disease categories with 5% or more encounters resulting in transfer (27 categories; 3.7 million encounters based on survey weights). We sorted encounters by condition into 12 groups according to expected medical or surgical specialist needs. We used logistic regression to assess the role of payer status on odds of transfer compared with admission and report adjusted odds ratios (ORs). Results: Among high-transfer conditions in 2010, uninsured patients had double the odds of transfer compared with privately insured patients (OR 2.12; 95% confidence interval [Cl] 1.72 to 2.62). Medicaid patients were also more likely to be transferred (OR 1.2; 95% Cl 1.04 to 1.38). Uninsured patients had higher odds of transfer in all specialist categories (significant in 9 of 12). The categories with the highest odds of transfer for the uninsured included nephrology (OR 2.44; 95% Cl 1.07 to 5.55), psychiatry (OR 2.26; 95% Cl 1.65 to 3.25), and hematology-oncology (OR 2.21; 95% Cl 1.50 to 3.25); the highest for Medicaid were general surgery (OR 1.61; 95% Cl 1.09 to 1.83), hematology-oncology (OR 1.55; 95% Cl 1.05 to 2.30), and vascular surgery (OR 1.55; 95% Cl 1.02 to 2.28). Conclusion: Insurance status appears to play a role in ED disposition (transfer versus admission) for many high-transfer conditions. C1 [Kindermann, Dana R.] George Washington Univ Hosp, Dept Emergency Med, Washington, DC 20037 USA. [Mutter, Ryan L.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Cartright-Smith, Lara; Rosenbaum, Sara] George Washington Univ, Sch Publ Hlth & Hlth Serv, Dept Hlth Policy, Washington, DC USA. [Pines, Jesse M.] George Washington Univ, Dept Hlth Policy, Washington, DC USA. [Pines, Jesse M.] George Washington Univ, Dept Emergency Med, Washington, DC USA. RP Kindermann, DR (reprint author), George Washington Univ Hosp, Dept Emergency Med, Washington, DC 20037 USA. EM danakindermann@gmail.com NR 37 TC 8 Z9 8 U1 2 U2 4 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD MAY PY 2014 VL 63 IS 5 BP 561 EP 571 DI 10.1016/j.annemergmed.2013.11.019 PG 11 WC Emergency Medicine SC Emergency Medicine GA AH2EI UT WOS:000335933900009 PM 24342815 ER PT J AU Mutter, R Clancy, C AF Mutter, Ryan Clancy, Carolyn TI Investing in Emergency Medicine to Improve Health Care for All Americans: The Role of the Agency for Healthcare Research and Quality SO ANNALS OF EMERGENCY MEDICINE LA English DT Editorial Material ID INTENSIVE-CARE; UNITED-STATES; HOSPITAL-CARE; TRAUMA; SERVICES; OUTCOMES; DISEASE; ERRORS; COLLABORATION; DEPARTMENTS C1 [Mutter, Ryan; Clancy, Carolyn] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Mutter, R (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. EM iyan.mutter@ahrq.hhs.gov NR 40 TC 1 Z9 1 U1 0 U2 2 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD MAY PY 2014 VL 63 IS 5 BP 580 EP 583 DI 10.1016/j.annemergmed.2013.06.021 PG 4 WC Emergency Medicine SC Emergency Medicine GA AH2EI UT WOS:000335933900011 PM 23870860 ER PT J AU Baumblatt, JAG Dunn, JR Schaffner, W Moncayo, AC Stull-Lane, A Jones, TF AF Baumblatt, Jane A. Gwira Dunn, John R. Schaffner, William Moncayo, Abelardo C. Stull-Lane, Annica Jones, Timothy F. TI An Outbreak of Bed Bug Infestation in an Office Building SO JOURNAL OF ENVIRONMENTAL HEALTH LA English DT Article ID BITES AB Since 2000, resurgence in bed bugs has occurred in the U.S. Reports of infestations of homes, hospitals, hotels, and offices have been described. On September 1, 2011, complaints of itching and bites among workers in an office were reported to the Tennessee Department of Health. A retrospective cohort study and environmental assessments were performed in response to the complaints. Canines certified to detect live bed bugs were used to inspect the office and arthropod samples were collected. Of 76 office workers, 61 (80%) were interviewed; 39 (64%) met the case definition. Pruritic maculopapular lesions were consistent with arthropod bites. One collected arthropod sample was identified as a bed bug by three entomologists. Exposures associated with symptoms included working in a cubicle in which a canine identified bed bugs (risk ratio [RR]: 1.8; 95% confidence interval [CI]: 1.3-3.6), and self-reported seasonal allergies (RR: 1.6, 95% CI: 1.0-2.4). Bed bugs represent a reemerging and challenging environmental problem with clinical, psychological, and financial impacts. C1 [Baumblatt, Jane A. Gwira] Ctr Dis Control & Prevent, Tennessee Dept Hlth, Hyattsville, MD USA. [Dunn, John R.; Schaffner, William; Jones, Timothy F.] Vanderbilt Univ, Sch Med, Tennessee Dept Hlth, Nashville, TN USA. [Moncayo, Abelardo C.; Stull-Lane, Annica] Tennessee Dept Hlth, Nashville, TN USA. RP Baumblatt, JAG (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Jane.Baumblatt@ahrq.hhs.gov NR 9 TC 2 Z9 2 U1 0 U2 9 PU NATL ENVIRON HEALTH ASSOC PI DENVER PA 720 S COLORADO BLVD SUITE 970, SOUTH TOWER, DENVER, CO 80246 USA SN 0022-0892 J9 J ENVIRON HEALTH JI J. Environ. Health PD APR PY 2014 VL 76 IS 8 BP 16 EP 18 PG 3 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA AO7NS UT WOS:000341540500003 PM 24749221 ER PT J AU Hill, SC Abdus, S Hudson, JL Selden, TM AF Hill, Steven C. Abdus, Salam Hudson, Julie L. Selden, Thomas M. TI Adults In The Income Range For The Affordable Care Act's Medicaid Expansion Are Healthier Than Pre-ACA Enrollees SO HEALTH AFFAIRS LA English DT Article ID VALIDITY; SCALES AB The Affordable Care Act (ACA) has dramatically increased the number of low-income nonelderly adults eligible for Medicaid. Starting in 2014, states can elect to cover individuals and families with modified adjusted gross incomes below a threshold of 133 percent of federal poverty guidelines, with a 5 percent income disregard. We used simulation methods and data from the Medical Expenditure Panel Survey to compare nondisabled adults enrolled in Medicaid prior to the ACA with two other groups: adults who were eligible for Medicaid but not enrolled in it, and adults who were in the income range for the ACA's Medicaid expansion and thus newly eligible for coverage. Although differences in health across the groups were not large, both the newly eligible and those eligible before the ACA but not enrolled were healthier on several measures than pre-ACA enrollees. Twenty-five states have opted not to use the ACA to expand Medicaid eligibility. If these states reverse their decisions, their Medicaid programs might not enroll a population that is sicker than their pre-ACA enrollees. By expanding Medicaid eligibility, states could provide coverage to millions of healthier adults as well as to millions who have chronic conditions and who need care. C1 [Hill, Steven C.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends CFACT, Rockville, MD 20850 USA. [Abdus, Salam] Social & Sci Syst, Rockville, MD USA. [Hudson, Julie L.] CFACT, Rockville, MD USA. [Selden, Thomas M.] CFACT, Div Modeling & Simulat, Rockville, MD USA. RP Hill, SC (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends CFACT, Rockville, MD 20850 USA. EM Steven.Hill@ahrq.hhs.gov NR 17 TC 12 Z9 12 U1 1 U2 5 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD APR PY 2014 VL 33 IS 4 BP 691 EP 699 DI 10.1377/hlthaff.2013.0743 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AI2CN UT WOS:000336664600024 PM 24670269 ER PT J AU Crowell, TA Gebo, KA Balagopal, A Fleishman, JA Agwu, AL Berry, SA AF Crowell, Trevor A. Gebo, Kelly A. Balagopal, Ashwin Fleishman, John A. Agwu, Allison L. Berry, Stephen A. CA HIV Res Network TI Impact of Hepatitis Coinfection on Hospitalization Rates and Causes in a Multicenter Cohort of Persons Living With HIV SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV; hepatitis B; hepatitis C; hospitalizations; health care utilization ID C VIRUS-INFECTION; HUMAN-IMMUNODEFICIENCY-VIRUS; HEPATOCELLULAR-CARCINOMA; LIVER-CIRRHOSIS; HCV INFECTION; HAART ERA; B-VIRUS; CARE; INDIVIDUALS; PREVALENCE AB Background:Chronic viral hepatitis is a potentially important determinant of health care utilization among persons living with HIV. We describe hospitalization rates and reasons for hospitalization among persons living with HIV stratified by coinfection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV).Methods:Laboratory, demographic, and hospitalization data were obtained for all patients receiving longitudinal HIV care during 2010 at 9 geographically diverse sites. Hepatitis serostatus was assessed by hepatitis B surface antigen and/or hepatitis C antibody. ICD-9 codes were used to assign hospitalizations into diagnostic categories. Negative binomial regression was used to assess factors associated with all-cause and diagnostic category-specific hospitalizations.Results:A total of 2793 hospitalizations were observed among 12,819 patients. Of these patients, 49.3% had HIV monoinfection, 4.1% HIV/HBV, 15.4% HIV/HCV, 2.5% HIV/HBV/HCV, and 28.7% unknown hepatitis serostatus. Compared with HIV monoinfection, the risk of all-cause hospitalization was increased with HIV/HBV [adjusted incidence rate ratio 1.55 (1.17 to 2.06)], HIV/HCV [1.45 (1.21 to 1.74)], and HIV/HBV/HCV [1.52 (1.04 to 2.22)]. Risk of hospitalization for non-AIDS-defining infection was also higher among patients with HIV/HBV [2.07 (1.38 to 3.11)], HIV/HCV [1.81 (1.36 to 2.40)], and HIV/HBV/HCV [1.96 (1.11 to 3.46)]. HIV/HBV was associated with hospitalization for gastrointestinal/liver disease [2.55 (1.30 to 5.01)]. HIV/HCV was associated with hospitalization for psychiatric illness [1.89 (1.11 to 3.26)].Conclusions:HBV and HCV coinfection are associated with increased risk of all-cause hospitalization and hospitalization for non-AIDS-defining infections, as compared with HIV monoinfection. Policy-makers and third-party payers should be aware of the heightened risk of hospitalization associated with coinfection when allocating health care resources and considering models of health care delivery. C1 [Crowell, Trevor A.; Gebo, Kelly A.; Balagopal, Ashwin; Agwu, Allison L.; Berry, Stephen A.] Johns Hopkins Univ, Dept Med, Baltimore, MD 21287 USA. [Agwu, Allison L.] Johns Hopkins Univ, Dept Pediat, Baltimore, MD 21287 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Crowell, TA (reprint author), Johns Hopkins Univ, Sch Med, Div Infect Dis & HIV Med, 1830 East Monument St,Room 457, Baltimore, MD 21287 USA. EM trevor.crowell@jhmi.edu OI Crowell, Trevor/0000-0001-5947-265X FU Agency for Healthcare Research and Quality [HHSA290201100007C]; Health Resources and Services Administration [HHHSH250201200008C]; National Institute of Allergy and Infectious Diseases [K23 AI084854]; National Institute on Drug Abuse [R01 DA016078] FX Supported by the Agency for Healthcare Research and Quality (HHSA290201100007C), the Health Resources and Services Administration (HHHSH250201200008C), the National Institute of Allergy and Infectious Diseases (K23 AI084854), and the National Institute on Drug Abuse (R01 DA016078). NR 40 TC 11 Z9 11 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 EI 1077-9450 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD APR 1 PY 2014 VL 65 IS 4 BP 429 EP 437 DI 10.1097/QAI.0000000000000059 PG 9 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA AD3PU UT WOS:000333159000015 PM 24256631 ER PT J AU Leotsakos, A Zheng, H Croteau, R Loeb, JM Sherman, H Hoffman, C Morganstein, L O'Leary, D Bruneau, C Lee, P Duguid, M Thomeczek, C Van der Schrieck-De Loos, E Munier, B AF Leotsakos, Agnes Zheng, Hao Croteau, Rick Loeb, Jerod M. Sherman, Heather Hoffman, Carolyn Morganstein, Louise O'Leary, Dennis Bruneau, Charles Lee, Peter Duguid, Margaret Thomeczek, Christian Van der Schrieck-De Loos, Erica Munier, Bill TI Standardization in patient safety: the WHO High 5s project SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE patient safety; standard operating protocol; standardization; evaluation; medication safety; surgical safety AB Despite its success in other industries, process standardization in health care has been slow to gain traction or to demonstrate a positive impact on the safety of care. The High 5s project is a global patient safety initiative of the World Health Organization (WHO) to facilitate the development, implementation and evaluation of Standard Operating Protocols (SOPs) within a global learning community to achieve measurable, significant and sustainable reductions in challenging patient safety problems. The project seeks to answer two questions: (i) Is it feasible to implement standardized health care processes in individual hospitals, among multiple hospitals within individual countries and across country boundaries? (ii) If so, what is the impact of standardization on the safety problems that the project is targeting? The two key areas in which the High 5s project is innovative are its use of process standardization both in hospitals within a country and in multiple participating countries, and its carefully designed multi-pronged approach to evaluation. Three SOPsucorrect surgery, medication reconciliation, concentrated injectable medicinesuhave been developed and are being implemented and evaluated in multiple hospitals in seven participating countries. Nearly 5 years into the implementation, it is clear that this is just the beginning of what can be seen as an exercise in behavior management, asking whether health care workers can adapt their behaviors and environments to standardize care processes in widely varying hospital settings. C1 [Leotsakos, Agnes; Zheng, Hao] WHO, PSP, CH-1211 Geneva, Switzerland. [Croteau, Rick; Loeb, Jerod M.; O'Leary, Dennis] Int Joint Commiss, Oak Brook, IL USA. [Sherman, Heather] Int Joint Commiss, Oak Brook Terrace, IL USA. [Hoffman, Carolyn] Alberta Hlth Serv, Qual & Healthcare Improvement, Edmonton, AB, Canada. [Morganstein, Louise] Tavistock & Portman NHS Fdn Trust, NHS, London, England. [Bruneau, Charles] French Natl Author Hlth HAS, Paris, France. [Lee, Peter] Minist Hlth, Singapore, Singapore. [Duguid, Margaret] Australian Commiss Safety & Qual Hlth Care, Sydney, NSW, Australia. [Thomeczek, Christian] Agcy Qual Med, Berlin, Germany. [Van der Schrieck-De Loos, Erica] CBO Dutch Inst Healthcare Improvement, Utrecht, Netherlands. [Munier, Bill] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. RP Leotsakos, A (reprint author), WHO, PSP, HIS, Ave Appia 20, CH-1211 Geneva, Switzerland. EM leotsakosa@who.int FU US Agency for Healthcare Research and Quality [HHSA290-2012-00006C] FX This work is being supported by the US Agency for Healthcare Research and Quality (grant/contract number HHSA290-2012-00006C). NR 40 TC 15 Z9 15 U1 1 U2 12 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1353-4505 EI 1464-3677 J9 INT J QUAL HEALTH C JI Int. J. Qual. Health Care PD APR PY 2014 VL 26 IS 2 BP 109 EP 116 DI 10.1093/intqhc/mzu010 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AF4MR UT WOS:000334687500001 PM 24713313 ER PT J AU Barocas, DA Alvarez, J Koyama, T Anderson, CB Gray, DT Fowke, JH You, CC Chang, SS Cookson, MS Smith, JA Penson, DF AF Barocas, Daniel A. Alvarez, JoAnn Koyama, Tatsuki Anderson, Christopher B. Gray, Darryl T. Fowke, Jay H. You, Chaochen Chang, Sam S. Cookson, Michael S. Smith, Joseph A., Jr. Penson, David F. TI Racial Variation in the Quality of Surgical Care for Bladder Cancer SO CANCER LA English DT Article DE health disparities; quality of care; bladder cancer; surgery ID IN-HOSPITAL MORTALITY; RADICAL CYSTECTOMY; OPERATIVE MORTALITY; OF-CARE; SURGEON VOLUME; OUTCOMES; IMPACT; STAGE; DISPARITIES; INDICATORS AB BACKGROUNDDifferences in quality of care may contribute to racial variation in outcomes of bladder cancer (BCa). Quality indicators in patients undergoing surgery for BCa include the use of high-volume surgeons and high-volume hospitals, and, when clinically indicated, receipt of pelvic lymphadenectomy, receipt of continent urinary diversion, and undergoing radical cystectomy instead of partial cystectomy. The authors compared these quality indicators as well as adverse perioperative outcomes in black patients and white patients with BCa. METHODSThe Healthcare Cost and Utilization Project State Inpatient Databases for New York, Florida, and Maryland (1996-2009) were used, because they consistently included race, surgeon, and hospital identifiers. Quality indicators were compared across racial groups using regression models adjusting for age, sex, Elixhauser comorbidity sum, insurance, state, and year of surgery, accounting for clustering within hospital. RESULTSBlack patients were treated more often by lower volume surgeons and hospitals, they had significantly lower receipt of pelvic lymphadenectomy and continent diversion, and they experienced higher rates of adverse outcomes compared with white patients. These associations remained significant for black patients who received treatment from surgeons and at hospitals in the top volume decile. CONCLUSIONSBlack patients with BCa had lower use of experienced providers and institutions for BCa surgery. In addition, the quality of care for black patients was lower than that for whites even if they received treatment in a high-volume setting. This gap in quality of care requires further investigation. Cancer 2014;120:1018-1025. (c) 2013 American Cancer Society. An all-payer administrative data set from 3 states is used to measure racial variation in the quality of surgical care among patients undergoing bladder removal for bladder cancer. The results indicate that black patients experience a lower quality of care compared with white patients, even when they are treated by high-volume surgeons at high-volume hospitals. C1 [Barocas, Daniel A.; Anderson, Christopher B.; Fowke, Jay H.; You, Chaochen; Chang, Sam S.; Cookson, Michael S.; Smith, Joseph A., Jr.; Penson, David F.] Vanderbilt Univ, Dept Urol Surg, Nashville, TN 37232 USA. [Barocas, Daniel A.; Penson, David F.] Vanderbilt Univ, Ctr Surg Qual & Outcomes Res, Nashville, TN 37232 USA. [Alvarez, JoAnn; Koyama, Tatsuki] Vanderbilt Univ, Sch Med, Dept Biostat, Nashville, TN 37232 USA. [Gray, Darryl T.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Fowke, Jay H.] Vanderbilt Univ, Div Epidemiol, Nashville, TN 37232 USA. [Penson, David F.] Tennessee Valley Vet Adm Geriatr Res, Educ & Clin Ctr, Nashville, TN USA. RP Barocas, DA (reprint author), Vanderbilt Univ, Med Ctr, A-1302 Med Ctr North, Nashville, TN 37232 USA. EM dan.barocas@vanderbilt.edu FU American Cancer Society Internal Review grant [58-0009-51]; National Center for Research Resources/National Institutes of Health through Vanderbilt Clinical and Translational Science Award [UL1TR000445] FX This study was supported American Cancer Society Internal Review grant 58-0009-51, administered by the Vanderbilt Ingram Cancer Center, and by the National Center for Research Resources/National Institutes of Health through Vanderbilt Clinical and Translational Science Award UL1TR000445. NR 29 TC 10 Z9 10 U1 2 U2 12 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0008-543X EI 1097-0142 J9 CANCER-AM CANCER SOC JI Cancer PD APR 1 PY 2014 VL 120 IS 7 BP 1018 EP 1025 DI 10.1002/cncr.28520 PG 8 WC Oncology SC Oncology GA AD0IB UT WOS:000332916600023 PM 24339051 ER PT J AU Buckley, DI Ansari, MT Butler, M Soh, C Chang, CS AF Buckley, David I. Ansari, Mohammed T. Butler, Mary Soh, Clara Chang, Christine S. TI The refinement of topics for systematic reviews: lessons and recommendations from the Effective Health Care Program SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE Systematic review; Evidence-based practice; Stakeholder engagement; Methods; Decision making; Patient-centered care; Research design ID AHRQ AB Objectives: The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program conducts systematic reviews of health-care topics nominated by stakeholders. Topics undergo refinement to ensure relevant questions of appropriate scope and useful reviews. Input from key informants, experts, and a literature scan informs changes in the nominated topic. AHRQ convened a work group to assess approaches and develop recommendations for topic refinement. Study Design and Setting: Work group members experienced in topic refinement generated a list of questions and guiding principles relevant to the refinement process. They discussed each issue and reached agreement on recommendations. Results: Topics should address important health-care questions or dilemmas, consider stakeholder priorities and values, reflect the state of the science, and be consistent with systematic review research methods. Guiding principles of topic refinement are fidelity to the nomination, relevance, research feasibility, responsiveness to stakeholder inputs, reduced investigator bias, transparency, and suitable scope. Suggestions for stakeholder engagement, synthesis of input, and reporting are discussed. Refinement decisions require judgment and balancing guiding principles. Variability in topics precludes a prescriptive approach. Conclusion: Accurate, rigorous, and useful systematic reviews require well-refined topics. These guiding principles and methodological recommendations may help investigators refine topics for reviews. (C) 2014 Elsevier Inc. All rights reserved. C1 [Buckley, David I.] Oregon Hlth & Sci Univ, Portland, OR 97239 USA. [Ansari, Mohammed T.] Ottawa Hosp, Methods Ctr, Clin Epidemiol Program, Ottawa, ON K1H 8L6, Canada. [Butler, Mary] Univ Minnesota, Sch Publ Hlth, Div Hlth Policy & Management, Minneapolis, MN 55455 USA. [Soh, Clara] Evidence Based Practice Ctr, Kaiser Permanente Ctr Hlth Res, Portland, OR 97227 USA. [Chang, Christine S.] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD 20850 USA. RP Buckley, DI (reprint author), Oregon Hlth & Sci Univ, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. FU Agency for Healthcare Research and Quality, US Department of Health and Human Services [HHSA 290-2007-10057-I] FX This project was funded under Contract No. HHSA 290-2007-10057-I from the Agency for Healthcare Research and Quality, US Department of Health and Human Services. The authors of this article are responsible for its content, including any clinical treatment recommendations. No statement in this article should be construed as an official position of AHRQ or of the US Department of Health and Human Services. NR 13 TC 0 Z9 0 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 EI 1878-5921 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD APR PY 2014 VL 67 IS 4 BP 425 EP 432 DI 10.1016/j.jclinepi.2013.10.023 PG 8 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AE8MQ UT WOS:000334256400010 PM 24581296 ER PT J AU Streiff, MB Brady, PJ Grant, AM Grosse, SD Wong, B Popovic, T AF Streiff, Michael B. Brady, P. Jeffrey Grant, Althea M. Grosse, Scott D. Wong, Betty Popovic, Tanja TI CDC Grand Rounds: Preventing Hospital-Associated Venous Thromboembolism SO MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT LA English DT Article ID POSTTHROMBOTIC SYNDROME; THROMBOSIS; VTE; GUIDELINES; EVENTS; RISK; CARE C1 [Streiff, Michael B.] Johns Hopkins Med Inst, Anticoagulat Management Serv, Baltimore, MD USA. [Brady, P. Jeffrey] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Grant, Althea M.; Grosse, Scott D.] CDC, Div Blood Disorders, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. [Wong, Betty; Popovic, Tanja] CDC, Off Director, Atlanta, GA 30333 USA. RP Grosse, SD (reprint author), CDC, Div Blood Disorders, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. EM sgrosse@cdc.gov NR 23 TC 6 Z9 7 U1 0 U2 3 PU CENTER DISEASE CONTROL & PREVENTION PI ATLANTA PA MAILSTOP E-90, ATLANTA, GA 30333 USA SN 0149-2195 EI 1545-861X J9 MMWR-MORBID MORTAL W JI MMWR-Morb. Mortal. Wkly. Rep. PD MAR 7 PY 2014 VL 63 IS 9 BP 190 EP 193 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AC3GJ UT WOS:000332404000003 PM 24598595 ER PT J AU Grembowski, D Schaefer, J Johnson, KE Fischer, H Moore, SL Tai-Seale, M Ricciardi, R Fraser, JR Miller, D LeRoy, L AF Grembowski, David Schaefer, Judith Johnson, Karin E. Fischer, Henry Moore, Susan L. Tai-Seale, Ming Ricciardi, Richard Fraser, James R. Miller, Donald LeRoy, Lisa CA AHRQ MCC Res Network TI A Conceptual Model of the Role of Complexity in the Care of Patients With Multiple Chronic Conditions SO MEDICAL CARE LA English DT Editorial Material DE chronic disease; theoretical models; healthcare delivery ID QUALITY-OF-LIFE; HEALTH-CARE; OLDER-ADULTS; MULTIMORBIDITY; OUTCOMES; ORGANIZATION; NEEDS; LAW AB Background: Effective healthcare for people with multiple chronic conditions (MCC) is a US priority, but the inherent complexity makes both research and delivery of care particularly challenging. As part of AHRQ Multiple Chronic Conditions Research Network (MCCRN) efforts, the Network developed a conceptual model to guide research in this area. Objective: To synthesize methodological and topical issues relevant to MCC patient care into a framework that can improve the delivery of care and advance future research about caring for patients with MCC. Methods: The Network synthesized essential constructs for MCC research identified from roundtable discussion, input from expert advisors, and previously published models. Results: The AHRQ MCCRN conceptual model defines complexity as the gap between patient needs and healthcare services, taking into account both the multiple considerations that affect the needs of MCC patients, as well as the contextual factors that influence service delivery. The model reframes processes and outcomes to include not only clinical care quality and experience, but also patient health, well being, and quality of life. The single-condition paradigm for treating needs one-by-one falls apart and highlights the need for care systems to address dynamic patient needs. Conclusions: Defining complexity in terms of the misalignment between patient needs and services offers new insights in how to research and develop solutions to patient care needs. C1 [Grembowski, David] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [Schaefer, Judith; Johnson, Karin E.; Fraser, James R.] Grp Hlth Res Inst, MacColl Ctr Healthcare Innovat, Seattle, WA 98101 USA. [Fischer, Henry; Moore, Susan L.] Denver Hlth & Hosp Author, Denver, CO USA. [Tai-Seale, Ming] Palo Alto Med Fdn Res Inst, Palo Alto, CA USA. [Ricciardi, Richard] Ctr Primary Care Prevent & Clin Partnerships, Agcy Healthcare Res & Qual, Rockville, MD USA. [Miller, Donald] Edith Nourse Rogers Mem Vet Hosp, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. [LeRoy, Lisa] Abt Associates Inc, Cambridge, MA USA. RP Johnson, KE (reprint author), Grp Hlth Res Inst, MacColl Ctr Healthcare Innovat, 1730 Minor Ave,Suite 1600, Seattle, WA 98101 USA. EM johnson.ke@ghc.org FU AHRQ HHS [R21 HS019501, R21 HS017657] NR 45 TC 24 Z9 25 U1 1 U2 13 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD MAR PY 2014 VL 52 IS 3 SU 2 BP S7 EP S14 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ8BA UT WOS:000337926100003 PM 24561762 ER PT J AU LeRoy, L Bayliss, E Domino, M Miller, BF Rust, G Gerteis, J Miller, T AF LeRoy, Lisa Bayliss, Elizabeth Domino, Marisa Miller, Benjamin F. Rust, George Gerteis, Jessie Miller, Therese CA AHRQ MCC Res Network TI The Agency for Healthcare Research and Quality Multiple Chronic Conditions Research Network Overview of Research Contributions and Future Priorities SO MEDICAL CARE LA English DT Editorial Material ID DISEASE; COMORBIDITY; DEPRESSION; ADULTS; MULTIMORBIDITY; EXPENDITURES; POPULATION; MORTALITY; PATTERNS; OBESITY AB Background: By 2030, 171 million Americans are expected to have more than one chronic condition. The cohort of individuals with multiple chronic conditions (MCC) is growing and two thirds of healthcare costs for the US population are currently spent on the 20% of people who have MCC. Objectives: Recognizing the need for increased investment in MCC programs and research, Health and Human Services (HHS) developed the HHS Strategic Framework on MCC. The Agency for Healthcare Research and Quality (AHRQ) contributed to the goals of the framework by funding the MCC Research Network, comprising 45 diverse grants and representing one of the largest federal investment in MCC studies to date. Results: The initial body of research emerging from the AHRQ MCC Research Network included: comanagement of commonly co-occurring conditions (including by caregivers); care for patients with low-prevalence combinations of MCC; the effect of MCC patients on provider performance metrics; guidelines for preventive services; medication management in individuals with MCC; as well as MCC-specific methodological and analytical techniques. Conclusions: The authors describe a subset of research contributions made in each topic area and make 3 recommendations for future MCC research: (1) include person-centered and person-driven measures and outcomes, (2) consider the person in the context of their relationships and community, and (3) include mental healthcare as an essential part of overall healthcare. C1 [LeRoy, Lisa; Gerteis, Jessie] Abt Associates Inc, Cambridge, MA 02138 USA. [Bayliss, Elizabeth] Kaiser Permanente Colorado, Denver, CO USA. [Domino, Marisa] Univ N Carolina, Dept Hlth Policy & Management, Chapel Hill, NC USA. [Miller, Benjamin F.] Univ Colorado, Denver Sch Med, Aurora, CO USA. [Rust, George] Morehouse Sch Med, Ellenwood, GA USA. [Miller, Therese] Agcy Healthcare Res & Qual, Rockville, MD USA. RP LeRoy, L (reprint author), Abt Associates Inc, 55 Wheeler St, Cambridge, MA 02138 USA. EM lisa_leroy@abtassoc.com FU AHRQ HHS [K18 HS022444] NR 36 TC 17 Z9 17 U1 4 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD MAR PY 2014 VL 52 IS 3 SU 2 BP S15 EP S22 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ8BA UT WOS:000337926100004 PM 24561753 ER PT J AU Parekh, AK Meyers, DS AF Parekh, Anand K. Meyers, David S. TI Foreword SO MEDICAL CARE LA English DT Editorial Material C1 [Parekh, Anand K.] US Dept HHS, Off Assistant Secretary Hlth, Washington, DC 20201 USA. [Meyers, David S.] AHRQ, Ctr Primary Care Prevent & Clin Partnerships, Rockville, MD 20850 USA. RP Meyers, DS (reprint author), AHRQ, Ctr Primary Care Prevent & Clin Partnerships, 540 Gaither Rd, Rockville, MD 20850 USA. EM david.meyers@ahrq.hhs.gov NR 8 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD MAR PY 2014 VL 52 IS 3 SU 2 BP S1 EP S2 PG 2 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ8BA UT WOS:000337926100001 PM 24561747 ER PT J AU Tinetti, ME Basu, J AF Tinetti, Mary E. Basu, Jayasree TI Research on Multiple Chronic Conditions Where We Are and Where We Need to Go SO MEDICAL CARE LA English DT Editorial Material ID CARE C1 [Tinetti, Mary E.] Yale Univ, Sch Med, Dept Med Internal Med Geriatr, New Haven, CT 06520 USA. [Tinetti, Mary E.] Yale Univ, Sch Publ Hlth, New Haven, CT 06520 USA. [Basu, Jayasree] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Tinetti, ME (reprint author), Yale Univ, Sch Med, Dept Med Internal Med Geriatr, POB 208025,333 Cedar St, New Haven, CT 06520 USA. EM mary.tinetti@yale.edu NR 22 TC 19 Z9 19 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD MAR PY 2014 VL 52 IS 3 SU 2 BP S3 EP S6 PG 4 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ8BA UT WOS:000337926100002 PM 24561755 ER PT J AU Manski, RJ Macek, MD Brown, E Carper, KV Cohen, LA Vargas, C AF Manski, Richard J. Macek, Mark D. Brown, Erwin Carper, Kelly V. Cohen, Leonard A. Vargas, Clemencia TI Dental service mix among working-age adults in the United States, 1999 and 2009 SO JOURNAL OF PUBLIC HEALTH DENTISTRY LA English DT Article DE adult; dental care; dental insurance; health-care surveys; poverty; United States ID ORAL-HEALTH; CARE; FUTURE; COSTS AB Objective In the United States, health-care costs are increasing while state and federal budgets contract. In order to establish a baseline and provide data for alternative oral health workforce models, this report describes the types of dental procedures received by US working-age adults in 2009 and looks at trends since 1999. Methods Data for this analysis came from the 1999 and 2009 Medical Expenditure Panel Surveys. The primary outcome variable represented the types of dental procedures undergone during a dental visit in the preceding year. Descriptive variables included dental insurance coverage and income. Analysis was restricted to adults aged 21-64 years. Results In 2009, diagnostic and preventive procedures accounted for >75 percent of all dental services received by working-age adults. Those with public insurance and those who were uninsured, as well as those with lower income, were less likely to receive these services than their peers. Between 1999 and 2009, small but statistically significant increases in the proportion of preventive and diagnostic procedures received occurred in the nation. The likelihood that a preventive service would be received during a visit also increased during this period, while the probability that a restorative procedure would be undergone went down. Conclusions Preventive-type procedures represented the vast majority of dental services received by working-age adults in 2009. Between 1999 and 2009, receipt of preventive-type procedures generally increased while receipt of surgical-type procedures decreased. These findings emphasize the health-promoting role of the dental team and provide a baseline for the measurement of future trends. C1 [Manski, Richard J.; Macek, Mark D.; Cohen, Leonard A.; Vargas, Clemencia] Univ Maryland Sch Dent, Baltimore, MD 21201 USA. [Brown, Erwin] Agcy Healthcare Res & Qual, Div Survey Operat, Rockville, MD USA. [Carper, Kelly V.] Agcy Healthcare Res & Qual, Div Stat Res & Methods, Rockville, MD USA. RP Manski, RJ (reprint author), Univ Maryland Sch Dent, Baltimore, MD 21201 USA. EM rmanski@umaryland.edu NR 19 TC 6 Z9 6 U1 0 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-4006 EI 1752-7325 J9 J PUBLIC HEALTH DENT JI J. Public Health Dent. PD SPR PY 2014 VL 74 IS 2 BP 102 EP 109 DI 10.1111/jphd.12032 PG 8 WC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health SC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health GA AJ3JT UT WOS:000337563200003 PM 24032402 ER PT J AU Yehia, BR French, B Fleishman, JA Metlay, JP Berry, SA Korthuis, PT Agwu, AL Gebo, KA AF Yehia, Baligh R. French, Benjamin Fleishman, John A. Metlay, Joshua P. Berry, Stephen A. Korthuis, P. Todd Agwu, Allison L. Gebo, Kelly A. CA HIV Res Network TI Retention in Care Is More Strongly Associated With Viral Suppression in HIV-Infected Patients With Lower Versus Higher CD4 Counts SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV disease severity; viral suppression; engagement in care; retention in care; retention measures; CD4 count ID ACTIVE ANTIRETROVIRAL THERAPY; MEDICAL-CARE; ADHERENCE; COHORT; PREDICTORS; PREVENTION; SURVIVAL; OUTCOMES; FAILURE; CLINICS AB Background: Retention in care is important for all HIV-infected patients, but may be more important for people with advanced HIV disease. We evaluated whether the association between retention in care and viral suppression differed by HIV disease severity. Methods: A repeated cross-sectional analysis (2006-2011) involving 35,433 adults at 18 US HIV clinics. Multivariable logistic regression models examined associations between retention measures [Health Resources and Services Administration (HRSA) retention measure, 6-month gap, and 3-month visit constancy] and viral suppression (HIV-1 RNA <= 400 copies/mL) for HIV disease severity groups defined by CD4 counts: <= 200, 201-350, 351-500, and >500 cells per cubic millimeter. Results: Overall, patients met the HRSA measure in 84% of person-years, did not have a 6-month gap in 76%, and had visits in all 4 quarters in 37%; patients achieved viral suppression in 72% of person-years. The association between retention in care and viral suppression differed by disease severity, and was strongest for patients with lower CD4 counts: <= 200 [adjusted odds ratio (AOR) = 2.33, 95% confidence interval (CI): 2.16 to 2.51], 201-350 (AOR = 1.96, CI: 1.81 to 2.12), 351-500 (AOR = 1.65, CI: 1.53 to 1.78), and >500 cells per cubic millimeter (AOR = 1.22, CI: 1.14 to 1.30) using the HRSA retention measure as a representative example. Conclusions: This is one of the first studies to report the impact of HIV disease severity on retention in care and viral suppression, demonstrating that retention in care is more strongly associated with viral suppression in patients with lower CD4 counts. These results have important implications for improving the health of patients with advanced HIV disease and for test and treat approaches to HIV prevention. C1 [Yehia, Baligh R.] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA. [Yehia, Baligh R.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Yehia, Baligh R.] Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Philadelphia, PA USA. [French, Benjamin] Univ Penn, Perelman Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Metlay, Joshua P.] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA. [Berry, Stephen A.; Agwu, Allison L.; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. [Korthuis, P. Todd] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA. RP Yehia, BR (reprint author), Univ Penn, Dept Med, Perelman Sch Med, 1021 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM byehia@upenn.edu FU Agency for Healthcare Research and Quality [HHSA290201100007C]; National Institutes of Health [K23-MH097647] FX Supported by the Agency for Healthcare Research and Quality (HHSA290201100007C) and the National Institutes of Health (K23-MH097647 to B.R.Y.). NR 34 TC 21 Z9 21 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 EI 1077-9450 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD MAR 1 PY 2014 VL 65 IS 3 BP 333 EP 339 DI 10.1097/QAI.0000000000000023 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA AH0DL UT WOS:000335789200023 PM 24129370 ER PT J AU Olsho, LEW Spector, WD Williams, CS Rhodes, W Fink, RV Limcangco, R Hurd, D AF Olsho, Lauren E. W. Spector, William D. Williams, Christianna S. Rhodes, William Fink, Rebecca V. Limcangco, Rhona Hurd, Donna TI Evaluation of AHRQ's On-Time Pressure Ulcer Prevention Program A Facilitator-assisted Clinical Decision Support Intervention for Nursing Homes SO MEDICAL CARE LA English DT Article DE quality improvement; pressure ulcers; interrupted time series; clinical decision support ID RISK-ADJUSTMENT MODEL; MINIMUM DATA SET; PRIMARY-CARE; QUALITY; SUSTAINABILITY; DOCUMENTATION; PREVALENCE; RESIDENTS; COST AB Background: Pressure ulcers present serious health and economic consequences for nursing home residents. The Agency for Healthcare Research & Quality, in partnership with the New York State Department of Health, implemented the pressure ulcer module of On-Time Quality Improvement for Long Term Care (On-Time), a clinical decision support intervention to reduce pressure ulcer incidence rates. Objective: To evaluate the effectiveness of the On-Time program in reducing the rate of in-house-acquired pressure ulcers among nursing home residents. Research Design and Subjects: We employed an interrupted time-series design to identify impacts of 4 core On-Time program components on resident pressure ulcer incidence in 12 New York State nursing homes implementing the intervention (n=3463 residents). The sample was purposively selected to include nursing homes with high baseline prevalence and incidence of pressure ulcers and high motivation to reduce pressure ulcers. Differential timing and sequencing of 4 core On-Time components across intervention nursing homes and units enabled estimation of separate impacts for each component. Inclusion of a nonequivalent comparison group of 13 nursing homes not implementing On-Time (n=2698 residents) accounts for potential mean-reversion bias. Impacts were estimated via a random-effects Poisson model including resident-level and facility-level covariates. Results: We find a large and statistically significant reduction in pressure ulcer incidence associated with the joint implementation of 4 core On-Time components (incidence rate ratio=0.409; P=0.035). Impacts vary with implementation of specific component combinations. Conclusions: On-Time implementation is associated with sizable reductions in pressure ulcer incidence. C1 [Olsho, Lauren E. W.; Williams, Christianna S.; Rhodes, William; Fink, Rebecca V.; Hurd, Donna] ABT Associates Inc, US Hlth Div, Cambridge, MA 02138 USA. [Spector, William D.] US Dept HHS, Agcy Healthcare Res & Qual, Washington, DC USA. [Limcangco, Rhona] Social & Sci Syst Inc, Rockville, MD USA. RP Olsho, LEW (reprint author), ABT Associates Inc, 55 Wheeler St, Cambridge, MA 02138 USA. EM lauren_olsho@abtassoc.com FU Agency for Healthcare Research & Quality (AHRQ), Department of Health & Human Services (DHHS) [HHSA290200600011i] FX Supported by the Agency for Healthcare Research & Quality (AHRQ), Department of Health & Human Services (DHHS), under contract #HHSA290200600011i. NR 33 TC 7 Z9 7 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD MAR PY 2014 VL 52 IS 3 BP 258 EP 266 DI 10.1097/MLR.0000000000000080 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AG3NW UT WOS:000335327400012 PM 24374408 ER PT J AU Singleton, RJ Holman, RC Person, MK Steiner, CA Redd, JT Hennessy, TW Groom, A Holve, S Seward, JF AF Singleton, Rosalyn J. Holman, Robert C. Person, Marissa K. Steiner, Claudia A. Redd, John T. Hennessy, Thomas W. Groom, Amy Holve, Stephen Seward, Jane F. TI Impact of Varicella Vaccination on Varicella-related Hospitalizations Among American Indian/ Alaska Native People SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE American Indian; Alaska Native; varicella; children; hospitalization ID UNITED-STATES; CHILDREN; INFANTS; US; IMPLEMENTATION; POPULATION; PROGRAM; DECLINE; EPIDEMIOLOGY; INFECTION AB Background: Routine childhood varicella vaccination, implemented in 1995, has resulted in significant declines in varicella-related hospitalizations in the United States. Varicella hospitalization rates among the American Indian (AI) and Alaska Native (AN) population have not been previously documented. Methods: We selected varicella-related hospitalizations, based on a published definition, from the Indian Health Service inpatient database for AI/ANs in the Alaska, Southwest and Northern Plains regions (1995-2010) and from the Nationwide Inpatient Sample for the general US population (2007-2010). We analyzed average annual hospitalization rates prevaccine (1995-1998) and postvaccine (2007-2010) for the AI/AN population, and postvaccine for the general US population. Results: From 1995-1998 to 2007-2010, the average annual varicella-related hospitalization rate for AI/ANs in the 3 regions decreased 95% (0.66-0.03/10,000 persons); the postvaccine rate appears lower than the general US rate (0.06, 95% confidence interval: 0.05-0.06). The rate declined in all AI/AN pediatric age groups. Infants experienced the highest prevaccine (14.07) and postvaccine (0.83) hospitalization rates. Adults experienced low rates in both periods. Varicella vaccination rates in 19- to 35-month-old AI/AN children during fiscal years 2008-2010 were 88.1-91.0%. Conclusions: Widespread use of varicella vaccine in AI/AN children was accompanied by substantial declines in varicella-related hospitalizations consistent with high varicella vaccine effectiveness in preventing severe varicella outcomes. C1 [Singleton, Rosalyn J.] Alaska Native Tribal Hlth Consortium, Anchorage, AK USA. [Holman, Robert C.; Person, Marissa K.] Ctr Dis Control & Prevent CDC, Div High Consequence Pathogens & Pathol, NCEZID, USDHHS, Atlanta, GA USA. [Steiner, Claudia A.] USDHHS, Healthcare Cost & Utilizat Project, Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD USA. [Redd, John T.] USDHHS, IHS, Santa Fe, NM USA. [Hennessy, Thomas W.] USDHHS, Arctic Invest Program, NCEZID, CDC, Anchorage, AK USA. [Groom, Amy] USA USDHHS, Immunizat Serv Div, CDC, Atlanta, GA USA. [Holve, Stephen] USDHHS, Tuba City Reg Hlth Care, IHS, Tuba City, AZ USA. [Seward, Jane F.] CDC, Div Viral Dis, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30333 USA. RP Singleton, RJ (reprint author), AIP CDC, 4055 Tudor Ctr Dr, Anchorage, AK 99508 USA. EM ris2@cdc.gov NR 31 TC 3 Z9 4 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0891-3668 EI 1532-0987 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD MAR PY 2014 VL 33 IS 3 BP 276 EP 279 DI 10.1097/INF.0000000000000100 PG 4 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA AB3OB UT WOS:000331699000016 PM 24136373 ER PT J AU Ricciardi, R AF Ricciardi, Richard TI Response to: Development of integrated mental health care: Critical workforce competencies SO NURSING OUTLOOK LA English DT Letter C1 Agcy Healthcare Res & Qual, Ctr Primary Care Prevent & Clin Partnerships, Rockville, MD 20850 USA. RP Ricciardi, R (reprint author), Agcy Healthcare Res & Qual, Ctr Primary Care Prevent & Clin Partnerships, Rockville, MD 20850 USA. EM Richard.Ricciardi@ahrq.hhs.gov NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0029-6554 EI 1528-3968 J9 NURS OUTLOOK JI Nurs. Outlook PD MAR-APR PY 2014 VL 62 IS 2 BP 76 EP 76 DI 10.1016/j.outlook.2013.12.009 PG 1 WC Nursing SC Nursing GA AD9FZ UT WOS:000333571500003 PM 24630676 ER PT J AU Dougherty, D Chen, XH Gray, DT Simon, AE AF Dougherty, Denise Chen, Xiuhua Gray, Darryl T. Simon, Alan E. TI Child and Adolescent Health Care Quality and Disparities: Are We Making Progress? SO ACADEMIC PEDIATRICS LA English DT Article DE asthma; Children's Health Insurance Program (CHIP); disparities; Hispanic; Medicaid; patient centeredness; preventive services; quality; trends ID UNITED-STATES; INSURANCE DISPARITIES; US CHILDREN; IMPROVEMENT; ACCESS; MORTALITY AB OBJECTIVE: Children and adolescents are known to experience poor health care quality; some groups of children have poorer health care than others. We sought to examine trends over time in health care quality and disparities by race, Hispanic ethnicity, income, insurance, gender, rurality, and special health care needs. METHODS: Source data were extracted from the 2011 National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR) database, which contains aggregated data from many government and private sources for the years 2000 through 2009. The NHQR and NHDR approaches to calculating disparities and trends in quality and disparities were used. Within each quality measure with available data, results for demographic subgroups of children characterized by race/ethnicity, income, insurance, residence, special health care need, and gender were compared to those of a reference group to determine whether disparities existed and whether disparities had changed over time. RESULTS: Of 68 measures with data for calculating potential disparities, 50 showed disparities in quality for at least 1 comparison subgroup in the most recent year of data available, while 18 measures showed no such disparities. Of the 50 measures with current disparities, 39 measures had sufficient data to calculate trends. Among the 137 comparisons made within these 39 measures, there was no change in disparities over time for 126 comparisons, 3 comparisons worsened, and 8 comparisons improved. CONCLUSIONS: There was some progress in health care quality and reducing disparities in children's health care quality from 2000 to 2009; opportunities for targeting improvement strategies remain. C1 [Dougherty, Denise; Gray, Darryl T.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Chen, Xiuhua] Social & Sci Syst Inc, Silver Spring, MD USA. [Simon, Alan E.] Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Dougherty, D (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM denise.dougherty@ahrq.hhs.gov FU AHRQ [HHSA290200900010C] FX We gratefully acknowledge the work of the many federal and nonfederal entities that provide the data on which the NHQR and the NHDR are based. AHRQ's NHQR/NHDR production team and AHRQ's contract HHSA290200900010C with Social & Scientific Systems Inc. (SSS) supported performance of the analyses on which this study was based. We also acknowledge thoughtful reviewer comments provided by Dr Ernest Moy of AHRQ and Dr Janet Pagan-Sutton of SSS. NR 48 TC 7 Z9 7 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD MAR-APR PY 2014 VL 14 IS 2 BP 137 EP 148 PG 12 WC Pediatrics SC Pediatrics GA AD3MF UT WOS:000333142500006 PM 24602576 ER PT J AU Basu, J Mobley, LR Thumula, V AF Basu, Jayasree Mobley, Lee R. Thumula, Vennela TI The Small Area Predictors of Ambulatory Care Sensitive Hospitalizations: A Comparison of Changes over Time SO SOCIAL WORK IN PUBLIC HEALTH LA English DT Article DE Preventable hospitalizations; small area analysis; ambulatory care sensitive conditions; quality of primary care; changes over time ID AVOIDABLE HOSPITALIZATIONS; SOCIOECONOMIC-STATUS; PREVENTABLE HOSPITALIZATIONS; CHILDREN; RATES; INSURANCE; ILLNESS; ACCESS; IMPACT; URBAN AB The hospital admission for ambulatory care sensitive conditions (ACSCs) is a validated indicator of impeded access to good primary and preventive care services. The authors examine the predictors of ACSC admissions in small geographic areas in two cross-sections spanning an 11-year time interval (1995-2005). Using hospital discharge data from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality for Arizona, California, Massachusetts, Maryland, New Jersey, and New York for the years 1995 and 2005, the study includes a multivariate cross-sectional design, using compositional factors describing the hospitalized populations and the contextual factors, all aggregated at the primary care service area level. The study uses ordinary least squares regressions with and without state fixed effects, adjusting for heteroscedasticity. Data is pooled over 2 years to assess the statistically significant changes in associations over time. ACSC admission rates were inversely related to the availability of local primary care physicians, and managed care was associated with declines in ACSC admissions for the elderly. Minorities, aged elderly, and percent under federal poverty level were found to be associated with higher ACSC rates. The comparative analysis for 2 years highlights significant declines in the association with ACSC rates of several factors including percent minorities and rurality. The two policy-driven factors, primary care physician capacity and Medicare-managed care penetration, were not found significantly more effective over time. Using small area analysis, the study indicates that improvements in socioeconomic conditions and geographic access may have helped improve the quality of primary care received by the elderly over the last decade, particularly among some minority groups. C1 [Basu, Jayasree] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Mobley, Lee R.] RTI Int, Res Triangle Pk, NC USA. [Thumula, Vennela] Univ Mississippi, Dept Pharm Adm, Oxford, MS USA. RP Basu, J (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Jayasree.basu@ahrq.hhs.gov RI Dalla Zuanna, Teresa/G-3133-2015 NR 33 TC 2 Z9 2 U1 3 U2 11 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1937-1918 EI 1937-190X J9 SOC WORK PUBLIC HLTH JI Soc. Work Public Health PD FEB 23 PY 2014 VL 29 IS 2 BP 176 EP 188 DI 10.1080/19371918.2013.776316 PG 13 WC Public, Environmental & Occupational Health; Social Work SC Public, Environmental & Occupational Health; Social Work GA 290RL UT WOS:000329775900009 PM 24405202 ER PT J AU Owens, PL Barrett, ML Raetzman, S Maggard-Gibbons, M Steiner, CA AF Owens, Pamela L. Barrett, Marguerite L. Raetzman, Susan Maggard-Gibbons, Melinda Steiner, Claudia A. TI Surgical Site Infections Following Ambulatory Surgery Procedures SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID WOUND INFECTIONS; HAND SURGERY; SAME-DAY; IDENTIFICATION; CARE; COMPLICATIONS; RISK AB IMPORTANCE Surgical site infections can result in substantial morbidity following inpatient surgery. Little is known about serious infections following ambulatory surgery. OBJECTIVE To determine the incidence of clinically significant surgical site infections (CS-SSIs) following low-to moderate-risk ambulatory surgery in patients with low risk for surgical complications. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of ambulatory surgical procedures complicated by CS-SSIs that require a postsurgical acute care visit (defined as subsequent hospitalization or ambulatory surgical visit for infection) using the 2010 Healthcare Cost and Utilization Project State Ambulatory Surgery and State Inpatient Databases for 8 geographically dispersed states (California, Florida, Georgia, Hawaii, Missouri, Nebraska, New York, and Tennessee) representing one-third of the US population. Index cases included 284 098 ambulatory surgical procedures (general surgery, orthopedic, neurosurgical, gynecologic, and urologic) in adult patients with low surgical risk (defined as not seen in past 30 days in acute care, length of stay less than 2 days, no other surgery on the same day, and discharged home and no infection coded on the same day). MAIN OUTCOMES AND MEASURES Rates of 14- and 30-day postsurgical acute care visits for CS-SSIs following ambulatory surgery. RESULTS Postsurgical acute care visits for CS-SSIs occurred in 3.09 (95% CI, 2.89-3.30) per 1000 ambulatory surgical procedures at 14 days and 4.84 (95% CI, 4.59-5.10) per 1000 at 30 days. Two-thirds (63.7%) of all visits for CS-SSI occurred within 14 days of the surgery; of those visits, 93.2%(95% CI, 91.3%-94.7%) involved treatment in the inpatient setting. All-cause inpatient or outpatient postsurgical visits, including those for CS-SSIs, following ambulatory surgery occurred in 19.99 (95% CI, 19.48-20.51) per 1000 ambulatory surgical procedures at 14 days and 33.62 (95% CI, 32.96-34.29) per 1000 at 30 days. CONCLUSIONS AND RELEVANCE Among patients in 8 states undergoing ambulatory surgery, rates of postsurgical visits for CS-SSIs were low relative to all causes; however, they may represent a substantial number of adverse outcomes in aggregate. Thus, these serious infections merit quality improvement efforts to minimize their occurrence. C1 [Owens, Pamela L.; Steiner, Claudia A.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. [Barrett, Marguerite L.] ML Barrett Inc, Del Mar, CA USA. [Raetzman, Susan] Truven Hlth Analyt, Bethesda, MD USA. [Maggard-Gibbons, Melinda] RAND Corp, Los Angeles, CA USA. [Maggard-Gibbons, Melinda] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. RP Steiner, CA (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM claudia.steiner@ahrq.hhs.gov FU Agency for Healthcare Research and Quality (AHRQ) [HHSA-290-2013-00002-C] FX This study was funded by the Agency for Healthcare Research and Quality (AHRQ) under a contract to Truven Health Analytics to develop and support the Healthcare Cost and Utilization Project (HCUP) (contract HHSA-290-2013-00002-C). NR 36 TC 22 Z9 22 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 19 PY 2014 VL 311 IS 7 BP 709 EP 716 DI 10.1001/jama.2014.4 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA AA8ZO UT WOS:000331383700023 PM 24549551 ER PT J AU Fan, T Smallman, DP AF Fan, Tina Smallman, Darlene P. TI Screening for Chronic Kidney Disease SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Fan, Tina] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Smallman, Darlene P.] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. RP Fan, T (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X EI 1532-0650 J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD FEB 15 PY 2014 VL 89 IS 4 BP 293 EP 294 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AB0VK UT WOS:000331510000007 PM 24695451 ER PT J AU Vora, NM Holman, RC Mehal, JM Steiner, CA Blanton, J Sejvar, J AF Vora, Neil M. Holman, Robert C. Mehal, Jason M. Steiner, Claudia A. Blanton, Jesse Sejvar, James TI Burden of encephalitis-associated hospitalizations in the United States, 1998-2010 SO NEUROLOGY LA English DT Article ID INFECTIOUS-DISEASES; VIRUS; RECIPIENTS; CHALLENGE; OUTBREAK; TRENDS AB Objective:To estimate the burden of encephalitis-associated hospitalizations in the United States for 1998-2010.Methods:Using the Nationwide Inpatient Sample, a nationally representative database of hospitalizations, estimated numbers and rates of encephalitis-associated hospitalizations for 1998-2010 were calculated. Etiology and outcome of encephalitis-associated hospitalizations were examined, as well as accompanying diagnoses listed along with encephalitis on the discharge records. Total hospital charges (in 2010 US dollars) were assessed.Results:An estimated 263,352 (standard error: 3,017) encephalitis-associated hospitalizations occurred in the United States during 1998-2010, which corresponds to an average of 20,258 (standard error: 232) encephalitis-associated hospitalizations per year. A fatal outcome occurred in 5.8% (95% confidence interval [CI]: 5.6%-6.0%) of all encephalitis-associated hospitalizations and in 10.1% (95% CI: 9.2%-11.2%) and 17.1% (95% CI: 14.6%-20.0%) of encephalitis-associated hospitalizations in which a code for HIV or a tissue or organ transplant was listed, respectively. The proportion of encephalitis-associated hospitalizations in which an etiology for encephalitis was specified was 50.3% (95% CI: 49.6%-51.0%) and that for which the etiology was unspecified was 49.7% (95% CI: 49.0%-50.4%). Total charges for encephalitis-associated hospitalizations in 2010 were an estimated $2.0 billion.Conclusions:Encephalitis remains a major public health concern in the United States. Among the large number of encephalitis-associated hospitalizations for which an etiology is not reported may be novel infectious and noninfectious forms of encephalitis. Associated conditions such as HIV or transplantation increase the risk of a fatal outcome from an encephalitis-associated hospitalization and should be monitored. C1 [Vora, Neil M.] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA 30333 USA. [Vora, Neil M.; Holman, Robert C.; Mehal, Jason M.; Blanton, Jesse; Sejvar, James] Ctr Dis Control & Prevent, Div High Consequence Pathogens & Pathol, Atlanta, GA USA. [Steiner, Claudia A.] US Dept HHS, Healthcare Cost & Utilizat Project, Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD USA. RP Vora, NM (reprint author), Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA 30333 USA. EM wii8@cdc.gov NR 35 TC 39 Z9 39 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 EI 1526-632X J9 NEUROLOGY JI Neurology PD FEB 4 PY 2014 VL 82 IS 5 BP 443 EP 451 DI 10.1212/WNL.0000000000000086 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA AH9WA UT WOS:000336494600016 PM 24384647 ER PT J AU Battles, JB Farr, SL Weinberg, DA AF Battles, James B. Farr, Stacy L. Weinberg, Daniel A. TI From Research to Nationwide Implementation The Impact of AHRQ's HAI Prevention Program SO MEDICAL CARE LA English DT Article DE healthcare-associated infections (HAIs); infection prevention; quality improvement; federal agency ID ICU AB Introduction: The Agency for Healthcare Research and Quality (AHRQ's) Patient Safety Program is responsive to AHRQ's mission of quality improvement in healthcare. As part of this program, AHRQ has invested in projects to prevent healthcare-associated infections (HAIs), and funding has increased significantly over the last decade. AHRQ-funded projects have focused on generating new knowledge and promoting the nationwide implementation of proven HAI prevention measures in diverse healthcare settings. Objectives: To provide insight to AHRQ's HAI prevention strategies by: first, discussing the context and structure of AHRQ's HAI research portfolio and funding decisions; secondly, describing the process of prevention practice implementation and lessons learned; and third, explaining the outcomes and national impact of the AHRQ program. Results and Conclusions: In the early 2000s, AHRQ identified HAIs as an important and preventable public health threat and built their HAI-prevention portfolio based on National Action Plan priorities, available resources, advice from experts, and the state of science. This paper describes major contributions that have emerged from AHRQ-funded HAI projects. The projects examined, many of which focus on implementation of HAI prevention practices, yield useful lessons learned for future implementation and research endeavors and show significant impact of AHRQ's program in reducing HAIs. C1 [Battles, James B.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety CQulPS, Rockville, MD 20850 USA. [Farr, Stacy L.; Weinberg, Daniel A.] IMPAQ Int LLC, Columbia, MD USA. RP Battles, JB (reprint author), Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety CQulPS, 500 Gaither Rd, Rockville, MD 20850 USA. EM james.battles@ahrq.hhs.gov NR 35 TC 2 Z9 2 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD FEB PY 2014 VL 52 IS 2 SU 1 BP S91 EP S96 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ8AD UT WOS:000337923400013 PM 24430273 ER PT J AU Jeeva, RR Wright, D AF Jeeva, Rita Rani Wright, Donald TI Healthcare-associated Infections A National Patient Safety Problem and the Coordinated Response SO MEDICAL CARE LA English DT Article DE Healthcare-associated infections (HAIs); infection prevention; quality improvement C1 [Jeeva, Rita Rani; Wright, Donald] US Dept HHS, Off Assistant Secretary Hlth, Off Dis Prevent & Hlth Promot, Rockville, MD 20850 USA. RP Jeeva, RR (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, 540 Gaither Rd, Rockville, MD 20850 USA. EM Rani.Jeeva@ahrq.hhs.gov NR 26 TC 7 Z9 7 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD FEB PY 2014 VL 52 IS 2 SU 1 BP S4 EP S8 PG 5 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ8AD UT WOS:000337923400002 PM 24430265 ER PT J AU Kahn, KL Battles, JB AF Kahn, Katherine L. Battles, James B. TI Taking National Action to Prevent and Eliminate Healthcare-associated Infections Introduction SO MEDICAL CARE LA English DT Editorial Material AB Background: The widespread prevalence and enormous cost of healthcare-associated infections (HAIs) constitute a major public health problem and patient safety concern. Objectives: In 2009, IMPAQ International and the RAND Corporation initiated an independent, outside evaluation of Health and Human Services' HAI prevention efforts as guided and driven by the Action Plan. The 3-year evaluation, whose findings are presented in this special issue, was intended to assess the outcomes of the US Department of Health and Human Services' (HHS's) past efforts, and also to provide ongoing, formative feedback to Action Plan leadership to guide their efforts. Research Design: This special issue presents results from the evaluation of the Action Plan, along with related articles intended to examine the issue of HAIs from many angles. Results: To address the national epidemic of HAIs, in 2009 HHS released the HHS National Action Plan to Prevent Healthcare-associated Infections, which was updated and expanded in 2012. The Action Plan established national goals for HAI prevention and identified key actions needed to reduce, prevent, and eventually eliminate the burden posed by HAIs. Conclusions: Broad lessons learned from the Action Plan evaluation document changes in structures, processes, and outcomes pertinent to eradicating HAIs, and identify lessons that are applicable to other large federal implementation efforts. C1 [Kahn, Katherine L.] RAND Corp, Santa Monica, CA 90407 USA. [Kahn, Katherine L.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Battles, James B.] AHRQ, Ctr Qual Improvement & Patient Safety CQuIPS, Rockville, MD USA. RP Kahn, KL (reprint author), RAND Corp, 1776 Main St, Santa Monica, CA 90407 USA. EM kahn@rand.org FU PHS HHS [HHSA290200710071T] NR 14 TC 1 Z9 1 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD FEB PY 2014 VL 52 IS 2 SU 1 BP S1 EP S3 PG 3 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ8AD UT WOS:000337923400001 PM 24430261 ER PT J AU Le Cook, B Zuvekas, SH Carson, N Wayne, GF Vesper, A McGuire, TG AF Le Cook, Benjamin Zuvekas, Samuel H. Carson, Nicholas Wayne, Geoffrey Ferris Vesper, Andrew McGuire, Thomas G. TI Assessing Racial/Ethnic Disparities in Treatment across Episodes of Mental Health Care SO HEALTH SERVICES RESEARCH LA English DT Article ID MEDICARE MANAGED CARE; UNITED-STATES; ETHNIC DISPARITIES; DEPRESSION TREATMENT; RACIAL DISPARITIES; AFRICAN-AMERICANS; NATIONAL-SURVEY; FOLLOW-UP; SERVICES; DEMAND C1 [Le Cook, Benjamin; Carson, Nicholas] Harvard Univ, Sch Med, Ctr Multicultural Mental Hlth Res, Dept Psychiat, Somerville, MA 02143 USA. [Zuvekas, Samuel H.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Wayne, Geoffrey Ferris] Ctr Multicultural Mental Hlth Res, Somerville, MA USA. [Vesper, Andrew] Harvard Univ, Dept Stat, Harvard Grad Sch Arts & Sci, Cambridge, MA 02138 USA. [McGuire, Thomas G.] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. RP Le Cook, B (reprint author), Harvard Univ, Sch Med, Ctr Multicultural Mental Hlth Res, Dept Psychiat, 120 Beacon St,4th Floor, Somerville, MA 02143 USA. EM bcook@charesearch.org FU National Institutes of Health NIMH [R01 MH09 1042] FX The project was supported by the National Institutes of Health NIMH grant R01 MH09 1042. NR 77 TC 3 Z9 3 U1 2 U2 9 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2014 VL 49 IS 1 BP 206 EP 229 PG 24 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA AA3LU UT WOS:000330994800012 ER PT J AU Brach, C Dreyer, BP Schillinger, D AF Brach, Cindy Dreyer, Benard P. Schillinger, Dean TI Physicians' Roles in Creating Health Literate Organizations: A Call to Action SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 [Brach, Cindy] Agcy Healthcare Res & Qual, Rockville, MD USA. [Dreyer, Benard P.] NYU, Dept Pediat, Bellevue Hosp, New York, NY 10016 USA. [Schillinger, Dean] Univ Calif San Francisco, Div Gen Internal Med, Dept Med, San Francisco, CA 94143 USA. RP Schillinger, D (reprint author), Univ Calif San Francisco, Div Gen Internal Med, Dept Med, UCSF Box 1364, San Francisco, CA 94143 USA. EM dschillinger@medsfgh.ucsf.edcu OI Dreyer, Benard/0000-0001-5299-5634 NR 5 TC 8 Z9 8 U1 0 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD FEB PY 2014 VL 29 IS 2 BP 273 EP 275 DI 10.1007/s11606-013-2619-6 PG 3 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA AA2WS UT WOS:000330955500005 PM 24113805 ER PT J AU Wang, Y Eldridge, N Metersky, ML Verzier, NR Meehan, TP Pandolfi, MM Foody, JM Ho, SY Galusha, D Kliman, RE Sonnenfeld, N Krumholz, HM Battles, J AF Wang, Yun Eldridge, Noel Metersky, Mark L. Verzier, Nancy R. Meehan, Thomas P. Pandolfi, Michelle M. Foody, JoAnne M. Ho, Shih-Yieh Galusha, Deron Kliman, Rebecca E. Sonnenfeld, Nancy Krumholz, Harlan M. Battles, James TI National Trends in Patient Safety for Four Common Conditions, 2005-2011 SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; MEDICARE BENEFICIARIES; MONITORING-SYSTEM; AMERICAN-COLLEGE; MORTALITY-RATES; HEALTH-CARE; OUTCOMES; QUALITY; ERRORS; INTERVENTION AB BackgroundChanges in adverse-event rates among Medicare patients with common medical conditions and conditions requiring surgery remain largely unknown. MethodsWe used Medicare Patient Safety Monitoring System data abstracted from medical records on 21 adverse events in patients hospitalized in the United States between 2005 and 2011 for acute myocardial infarction, congestive heart failure, pneumonia, or conditions requiring surgery. We estimated trends in the rate of occurrence of adverse events for which patients were at risk, the proportion of patients with one or more adverse events, and the number of adverse events per 1000 hospitalizations. ResultsThe study included 61,523 patients hospitalized for acute myocardial infarction (19%), congestive heart failure (25%), pneumonia (30%), and conditions requiring surgery (27%). From 2005 through 2011, among patients with acute myocardial infarction, the rate of occurrence of adverse events declined from 5.0% to 3.7% (difference, 1.3 percentage points; 95% confidence interval [CI], 0.7 to 1.9), the proportion of patients with one or more adverse events declined from 26.0% to 19.4% (difference, 6.6 percentage points; 95% CI, 3.3 to 10.2), and the number of adverse events per 1000 hospitalizations declined from 401.9 to 262.2 (difference, 139.7; 95% CI, 90.6 to 189.0). Among patients with congestive heart failure, the rate of occurrence of adverse events declined from 3.7% to 2.7% (difference, 1.0 percentage points; 95% CI, 0.5 to 1.4), the proportion of patients with one or more adverse events declined from 17.5% to 14.2% (difference, 3.3 percentage points; 95% CI, 1.0 to 5.5), and the number of adverse events per 1000 hospitalizations declined from 235.2 to 166.9 (difference, 68.3; 95% CI, 39.9 to 96.7). Patients with pneumonia and those with conditions requiring surgery had no significant declines in adverse-event rates. ConclusionsFrom 2005 through 2011, adverse-event rates declined substantially among patients hospitalized for acute myocardial infarction or congestive heart failure but not among those hospitalized for pneumonia or conditions requiring surgery. C1 [Metersky, Mark L.] Univ Connecticut, Sch Med, Div Pulm & Crit Care Med, Farmington, CT USA. [Wang, Yun; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Krumholz, Harlan M.] Yale Univ, Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. [Meehan, Thomas P.; Galusha, Deron; Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Gen Internal Med Sect, New Haven, CT 06510 USA. [Wang, Yun] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Foody, JoAnne M.] Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA. [Foody, JoAnne M.] Harvard Univ, Sch Med, Boston, MA USA. [Eldridge, Noel; Battles, James] Agcy Healthcare Res & Qual, Dept Hlth & Human Serv, Rockville, MD 20850 USA. [Kliman, Rebecca E.; Sonnenfeld, Nancy] Ctr Medicare Serv, Dept Hlth & Human Serv, Baltimore, MD USA. [Kliman, Rebecca E.; Sonnenfeld, Nancy] Ctr Medicaid Serv, Dept Hlth & Human Serv, Baltimore, MD USA. RP Wang, Y (reprint author), Harvard Univ, Sch Publ Hlth, Dept Biostat, SPH2,Rm 437F,655 Huntington Ave, Boston, MA 02115 USA. EM yunwang@hsph.harvard.edu; noel.eldridge@ahrq.hhs.gov FU Agency for Healthcare Research and Quality FX Funded by the Agency for Healthcare Research and Quality and others. NR 39 TC 57 Z9 58 U1 1 U2 8 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 EI 1533-4406 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JAN 23 PY 2014 VL 370 IS 4 BP 341 EP 351 DI 10.1056/NEJMsa1300991 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 294HP UT WOS:000330036200009 PM 24450892 ER PT J AU Weinberger, DM Grant, LR Steiner, CA Weatherholtz, R Santosham, M Viboud, C O'Brien, KL AF Weinberger, Daniel M. Grant, Lindsay R. Steiner, Claudia A. Weatherholtz, Robert Santosham, Mathuram Viboud, Cecile O'Brien, Katherine L. TI Seasonal Drivers of Pneumococcal Disease Incidence: Impact of Bacterial Carriage and Viral Activity SO CLINICAL INFECTIOUS DISEASES LA English DT Article DE pneumococcal; co-infections; RSV; seasonality; pneumonia ID RESPIRATORY-SYNCYTIAL-VIRUS; CONJUGATE VACCINE USE; STREPTOCOCCUS-PNEUMONIAE; NASOPHARYNGEAL CARRIAGE; UNITED-STATES; CHILDREN; POPULATION; INFLUENZA; HOSPITALIZATIONS; COLONIZATION AB Background. Winter-seasonal epidemics of pneumococcal disease provide an opportunity to understand the drivers of incidence. We sought to determine whether seasonality of invasive pneumococcal disease is caused by increased nasopharyngeal transmission of the bacteria or increased susceptibility to invasive infections driven by co-circulating winter respiratory viruses. Methods. We analyzed pneumococcal carriage and invasive disease data collected from children <7 years old in the Navajo/White Mountain Apache populations between 1996 and 2012. Regression models were used to quantify seasonal variations in carriage prevalence, carriage density, and disease incidence. We also fit a multivariate model to determine the contribution of carriage prevalence and RSV activity to pneumococcal disease incidence while controlling for shared seasonal factors. Results. The seasonal patterns of invasive pneumococcal disease epidemics varied significantly by clinical presentation: bacteremic pneumococcal pneumonia incidence peaked in late winter, whereas invasive nonpneumonia pneumococcal incidence peaked in autumn. Pneumococcal carriage prevalence and density also varied seasonally, with peak prevalence occurring in late autumn. In a multivariate model, RSV activity was associated with significant increases in bacteremic pneumonia cases (attributable percentage, 15.5%; 95% confidence interval [CI], 1.8%-26.1%) but was not associated with invasive nonpneumonia infections (8.0%; 95% CI, -4.8% to 19.3%). In contrast, seasonal variations in carriage prevalence were associated with significant increases in invasive nonpneumonia infections (31.4%; 95% CI, 8.8%-51.4%) but not with bacteremic pneumonia. Conclusions. The seasonality of invasive pneumococcal pneumonia could be due to increased susceptibility to invasive infection triggered by viral pathogens, whereas seasonality of other invasive pneumococcal infections might be primarily driven by increased nasopharyngeal transmission of the bacteria. C1 [Weinberger, Daniel M.] Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA. [Weinberger, Daniel M.; Viboud, Cecile] NIH, Div Int Epidemiol & Populat Studies, Fogarty Int Ctr, Bethesda, MD 20892 USA. [Grant, Lindsay R.; Weatherholtz, Robert; Santosham, Mathuram; O'Brien, Katherine L.] Ctr Amer Indian Hlth, Baltimore, MD USA. [O'Brien, Katherine L.] Johns Hopkins Bloomberg Sch Publ Hlth, Int Vaccine Access Ctr, Baltimore, MD USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Weinberger, DM (reprint author), Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, POB 208034, New Haven, CT 06520 USA. EM daniel.weinberger@yale.edu OI Weinberger, Daniel/0000-0003-1178-8086 FU Multinational Influenza Seasonal Mortality Study; Office of Global Health Affairs' International Influenza Unit in the Office of the Secretary of the Department of Health and Human Services FX This work is supported by the Multinational Influenza Seasonal Mortality Study, with funding from the Office of Global Health Affairs' International Influenza Unit in the Office of the Secretary of the Department of Health and Human Services. NR 31 TC 27 Z9 29 U1 1 U2 10 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 EI 1537-6591 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JAN 15 PY 2014 VL 58 IS 2 BP 188 EP 194 DI 10.1093/cid/cit721 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 281WI UT WOS:000329131300009 PM 24190895 ER PT J AU Randhawa, GS AF Randhawa, Gurvaneet S. TI Building electronic data infrastructure for comparative effectiveness research: accomplishments, lessons learned and future steps SO JOURNAL OF COMPARATIVE EFFECTIVENESS RESEARCH LA English DT Article DE American Recovery Reinvestment Act; clinical informatics; comparative effectiveness research; data infrastructure; distributed research; learning health system; quality improvement; registry; sustainability ID HEALTH SYSTEM; CLINICAL-DATA; FRAMEWORK AB There are large gaps in our knowledge on the potential impact of diagnostics and therapeutics on outcomes of patients treated in the real world. Comparative effectiveness research aims to fill these gaps to maximize effectiveness of these interventions. Health information technology has the potential to dramatically improve the practice of medicine and of research. This is an overview of about US$100 million of American Recovery and Reinvestment Act investment in 12 projects managed by the Agency for Healthcare Research and Quality to build an electronic clinical data infrastructure that connects research with healthcare delivery. The achievements and lessons learned from these projects provided a foundation for the National Patient-Centered Clinical Research Network (PCORnet)and will help to guide future infrastructure development needed to build an efficient, scalable and sustainable learning health system. C1 Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD 20850 USA. RP Randhawa, GS (reprint author), Agcy Healthcare Res & Qual, Ctr Evidence & Practice Improvement, Rockville, MD 20850 USA. EM Gurvaneet.Randhawa@ahrq.hhs.gov NR 20 TC 2 Z9 2 U1 1 U2 5 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 2042-6305 EI 2042-6313 J9 J COMP EFFECT RES JI J. Comp. Eff. Res. PY 2014 VL 3 IS 6 BP 567 EP 572 DI 10.2217/cer.14.73 PG 6 WC Health Care Sciences & Services SC Health Care Sciences & Services GA AW4PI UT WOS:000346262700004 PM 25494561 ER PT J AU Gliklich, RE Leavy, MB Karl, J Campion, DM Levy, D Berliner, E AF Gliklich, Richard E. Leavy, Michelle B. Karl, Jannette Campion, Daniel M. Levy, Daniel Berliner, Elise TI A framework for creating standardized outcome measures for patient registries SO JOURNAL OF COMPARATIVE EFFECTIVENESS RESEARCH LA English DT Article DE comparative effectiveness research; conceptual model; outcome measure; outcome measurement; patient outcomes; patient registry AB Aim: Our objectives were to create a conceptual framework for development of standard outcome measures and to design and pilot test a tool for displaying outcome measures. Materials & methods: Information on outcome measures used in registries was gathered through stakeholder discussions, which informed the development of the outcome measurement framework and the related tool. Results: The outcome measurement framework is a conceptual model for how information relevant to evaluating patient outcomes may be defined and collected in a standard way for a broad range of health areas. The related tool facilitates collecting, displaying and searching for information on outcome measures. Conclusion: The model developed through this process offers a framework that can be used to define outcome measures in a standard way across medical conditions. C1 [Gliklich, Richard E.] Harvard Univ, Sch Med, Massachusetts Eye & Ear Infirm, Boston, MA 02114 USA. [Leavy, Michelle B.; Karl, Jannette] Quintiles, Cambridge, MA 02139 USA. [Campion, Daniel M.] Quintiles, Rockville, MD 20852 USA. [Levy, Daniel] Amazing Charts, Boston, MA 02199 USA. [Berliner, Elise] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Leavy, MB (reprint author), Quintiles, 201 Broadway, Cambridge, MA 02139 USA. EM michelle.leavy@quintiles.com FU Agency for Healthcare Research and Quality under Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program [HHSA29020050035I TO7] FX The project described in this article was funded by the Agency for Healthcare Research and Quality under the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program (contract number HHSA29020050035I TO7). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. NR 17 TC 0 Z9 0 U1 0 U2 3 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 2042-6305 EI 2042-6313 J9 J COMP EFFECT RES JI J. Comp. Eff. Res. PY 2014 VL 3 IS 5 BP 473 EP 480 DI 10.2217/CER.14.38 PG 8 WC Health Care Sciences & Services SC Health Care Sciences & Services GA AS6QI UT WOS:000344387200006 PM 25350799 ER PT J AU Gray, DT AF Gray, D. T. TI PROCESS/OUTCOME MEASURES OF ADULT VENOUS THROMBOEMBOLUS (VTE) & PULMONARY EMBOLUS (PE) PROPHYLAXIS SO CARDIOLOGY LA English DT Meeting Abstract C1 [Gray, D. T.] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0008-6312 EI 1421-9751 J9 CARDIOLOGY JI Cardiology PY 2014 VL 128 SU 1 MA 062 BP 77 EP 77 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA AP2VI UT WOS:000341933400063 ER PT B AU Bishop, EM AF Bishop, Elizabeth M. BE Hamilton, HE Chou, WYS TI Donation solicitation in interaction Telephone requests for human tissue donations SO ROUTLEDGE HANDBOOK OF LANGUAGE AND HEALTH COMMUNICATION SE Routledge Handbooks in Applied Linguistics LA English DT Article; Book Chapter ID TALK-IN-INTERACTION; ORGAN DONATION; PROCUREMENT; FAMILIES; PARENTS; POLICY; TRANSPLANTATION; DECISION; CONSENT; CALLS C1 AHRQ, Rockville, MD 20850 USA. RP Bishop, EM (reprint author), AHRQ, Rockville, MD 20850 USA. NR 60 TC 0 Z9 0 U1 0 U2 0 PU ROUTLEDGE PI ABINGDON PA 2 PARK SQ, MILTON PARK, ABINGDON OX14 4RN, OXFORD, ENGLAND BN 978-1-315-85697-1; 978-0-415-67043-2 J9 ROUT HANDB APPL PY 2014 BP 642 EP 656 PG 15 WC Health Policy & Services; Linguistics SC Health Care Sciences & Services; Linguistics GA BB1JD UT WOS:000341147600041 ER PT S AU Dorsey, R Graham, G Glied, S Meyers, D Clancy, C Koh, H AF Dorsey, Rashida Graham, Garth Glied, Sherry Meyers, David Clancy, Carolyn Koh, Howard BE Fielding, JE TI Implementing Health Reform: Improved Data Collection and the Monitoring of Health Disparities SO ANNUAL REVIEW OF PUBLIC HEALTH, VOL 35 SE Annual Review of Public Health LA English DT Review; Book Chapter DE data standards; Affordable Care Act; demographic data; population-based surveys ID LIMITED ENGLISH PROFICIENCY; PRIMARY LANGUAGE; UNITED-STATES; GENDER-DIFFERENCES; INTELLECTUAL DISABILITIES; MEASUREMENT ISSUES; SEX DIFFERENTIALS; DATA STANDARDS; PUBLIC-HEALTH; MEDICAL-CARE AB The relative lack of standards for collecting data on population subgroups has not only limited our understanding of health disparities, but also impaired our ability to develop policies to eliminate them. This article provides background about past challenges to collecting data by race/ethnicity, primary language, sex, and disability status. It then discusses how passage of the Affordable Care Act has provided new opportunities to improve data-collection standards for the demographic variables of interest and, as such, a better understanding of the characteristics of populations served by the U. S. Department of Health and Human Services (HHS). The new standards have been formally adopted by the Secretary of HHS for application in all HHS-sponsored population health surveys involving self-reporting. The new data-collection standards will not only promote the uniform collection and utilization of demographic data, but also help the country shape future programs and policies to advance public health and to reduce disparities. C1 [Dorsey, Rashida] US Dept HHS, Off Minor Hlth, Rockville, MD 20852 USA. [Graham, Garth] Univ Florida, Dept Med, Gainesville, FL 32611 USA. [Glied, Sherry] NYU, Robert F Wagner Grad Sch Publ Serv, New York, NY 10012 USA. [Meyers, David] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Clancy, Carolyn] US Dept Vet Affairs, Off Qual Safety & Value, Washington, DC 20420 USA. [Koh, Howard] US Dept HHS, Off Assistant Secretary Hlth, Washington, DC 20201 USA. RP Dorsey, R (reprint author), US Dept HHS, Off Minor Hlth, Rockville, MD 20852 USA. EM Rashida.Dorsey@hhs.gov; Garth.Graham@medicine.ufl.edu; sherry.glied@nyu.edu; David.Meyers@ahrq.hhs.gov; Carolyn.Clancy@va.gov; Howard.Koh@hhs.gov NR 101 TC 3 Z9 3 U1 3 U2 13 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0897 USA SN 0163-7525 BN 978-0-8243-2735-4 J9 ANNU REV PUBL HEALTH JI Annu. Rev. Public Health PY 2014 VL 35 BP 123 EP 138 DI 10.1146/annurev-publhealth-032013-182423 PG 16 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA BA4SB UT WOS:000336207500009 PM 24365094 ER PT J AU Ricciardi, R AF Ricciardi, Richard TI Untitled SO JOURNAL OF PEDIATRIC HEALTH CARE LA English DT Letter C1 Agcy Healthcare Res & Qual, Rockville, MD USA. RP Ricciardi, R (reprint author), Agcy Healthcare Res & Qual, Rockville, MD USA. EM nursepractitioner@comcast.net NR 2 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0891-5245 EI 1532-656X J9 J PEDIATR HEALTH CAR JI J. Pediatr. Health Care PD JAN-FEB PY 2014 VL 28 IS 1 BP 4 EP 4 DI 10.1016/j.pedhc.2013.07.014 PG 1 WC Health Policy & Services; Nursing; Pediatrics SC Health Care Sciences & Services; Nursing; Pediatrics GA 290UK UT WOS:000329783600004 PM 24330920 ER PT J AU Erten, MZ Davidoff, AJ Zuckerman, IH Shaffer, T Dougherty, JS Ke, XH Stuart, B AF Erten, Mujde Z. Davidoff, Amy J. Zuckerman, Ilene H. Shaffer, Thomas Dougherty, J. Samantha Ke, Xuehua Stuart, Bruce TI The Effect of Supplemental Medical and Prescription Drug Coverage on Health Care Spending for Medicare Beneficiaries with Cancer SO VALUE IN HEALTH LA English DT Article DE cancer; cost-sharing; Medicare; supplemental insurance ID ADVERSE SELECTION; INSURANCE; MARKET; RISK; REFORMS; ACCESS; COST AB Objectives: To examine whether patients with newly diagnosed cancer respond differently to supplemental coverage than the general Medicare population. Methods: A cohort of newly diagnosed cancer patients (n = 1,799) from the 1997-2007 Medicare Current Beneficiary Survey and a noncancer cohort (n = 9,726) were identified and matched by panel year. Two-year total medical care spending was estimated by using generalized linear models with gamma distribution and log link including endogeneity-corrected models. Interactions between cancer and type of insurance allowed testing for differential effects of a cancer diagnosis. Results: The cancer cohort spent an adjusted $15,605 more over 2 years than did the noncancer comparison group. Relative to those without supplemental coverage, beneficiaries with employer-sponsored insurance, other private with prescription drug coverage, and public coverage had significantly higher total spending ($3,510, $2,823, and $4,065, respectively, for main models). For beneficiaries with cancer, supplemental insurance effects were similar in magnitude yet negative, suggesting little net effect of supplemental insurance for cancer patients. The endogeneity-corrected models produced implausibly large main effects of supplemental insurance, but the Cancer x Insurance interactions were similar in both models. Conclusions: Medicare beneficiaries with cancer are less responsive to the presence and type of supplemental insurance than are beneficiaries without cancer. Proposed restrictions on the availability of supplemental insurance intended to reduce Medicare spending would be unlikely to limit expenditures by beneficiaries with cancer, but would shift the financial burden to those beneficiaries. Policymakers should consider welfare effects associated with coverage restrictions. C1 [Erten, Mujde Z.] Univ Vermont, Coll Med, Dept Surg, Burlington, VT 05405 USA. [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Zuckerman, Ilene H.; Shaffer, Thomas; Stuart, Bruce] Univ Maryland, Sch Pharm, Peter Lamy Ctr Drug Therapy & Aging, Baltimore, MD 21201 USA. [Zuckerman, Ilene H.; Shaffer, Thomas; Ke, Xuehua; Stuart, Bruce] Univ Maryland, Sch Med, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. [Dougherty, J. Samantha] PhRMA, Washington, DC USA. RP Erten, MZ (reprint author), Univ Vermont, Coll Med, Dept Surg, Courtyard Given S354,89 Beaumont Ave, Burlington, VT 05405 USA. EM mujde.erten@med.uvm.edu FU American Cancer Society [RSGI-1 0-1 09-0 1-CPHPS] FX Support for this research was provided through a grant from the American Cancer Society (RSGI-1 0-1 09-0 1-CPHPS). The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of PhRMA. This article was prepared while Amy J. Davidoff was employed at the University of Maryland School of Pharmacy. The opinions expressed in this article are the authors' own and do not reflect the view of the Agency for Healthcare Research and Quality, the Department of Health and Human Services, or the United States government. NR 27 TC 1 Z9 1 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 EI 1524-4733 J9 VALUE HEALTH JI Value Health PD JAN PY 2014 VL 17 IS 1 BP 15 EP 21 DI 10.1016/j.jval.2013.11.003 PG 7 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 291RS UT WOS:000329847500004 PM 24438713 ER PT J AU Moy, E Freeman, W AF Moy, Ernest Freeman, William TI Federal Investments to Eliminate Racial/Ethnic Health-Care Disparities SO PUBLIC HEALTH REPORTS LA English DT Article ID RACE AB Health care is an important lever for moderating the effects of social determinants on health. We present a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. Improving access to health care and enhancing patient-provider interaction are critical pathways for reducing disparities. Increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication. Federal policy makers should continue interest in workforce diversity to optimize the health of all Americans. C1 [Moy, Ernest; Freeman, William] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Moy, E (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM ernest.moy@ahrq.hhs.gov NR 26 TC 3 Z9 3 U1 1 U2 3 PU ASSOC SCHOOLS PUBLIC HEALTH PI WASHINGTON PA 1900 M ST NW, STE 710, WASHINGTON, DC 20036 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD JAN-FEB PY 2014 VL 129 SU 2 BP 62 EP 70 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 288BN UT WOS:000329587100012 PM 24385667 ER PT J AU Berenholtz, SM Lubomski, LH Weeks, K Goeschel, CA Marsteller, JA Pham, JC Sawyer, MD Thompson, DA Winters, BD Cosgrove, SE Yang, T Louis, TA Lucas, BM George, CT Watson, SR Albert-Lesher, MI St Andre, JR Combes, JR Bohr, D Hines, SC Battles, JB Pronovost, PJ AF Berenholtz, Sean M. Lubomski, Lisa H. Weeks, Kristina Goeschel, Christine A. Marsteller, Jill A. Pham, Julius C. Sawyer, Melinda D. Thompson, David A. Winters, Bradford D. Cosgrove, Sara E. Yang, Ting Louis, Thomas A. Lucas, Barbara Meyer George, Christine T. Watson, Sam R. Albert-Lesher, Mariana I. St Andre, Justin R. Combes, John R. Bohr, Deborah Hines, Stephen C. Battles, James B. Pronovost, Peter J. CA CUSP Stop BSI Program TI Eliminating Central Line-Associated Bloodstream Infections: A National Patient Safety Imperative SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID INTENSIVE-CARE UNITS; QUALITY IMPROVEMENT; STATEWIDE; PROGRAM; IMPACT; ICU AB Background.Several studies demonstrating that central line--associated bloodstream infections (CLABSIs) are preventable prompted a national initiative to reduce the incidence of these infections.Methods.We conducted a collaborative cohort study to evaluate the impact of the national On the CUSP: Stop BSI program on CLABSI rates among participating adult intensive care units (ICUs). The program goal was to achieve a unit-level mean CLABSI rate of less than 1 case per 1,000 catheter-days using standardized definitions from the National Healthcare Safety Network. Multilevel Poisson regression modeling compared infection rates before, during, and up to 18 months after the intervention was implemented.Results.A total of 1,071 ICUs from 44 states, the District of Columbia, and Puerto Rico, reporting 27,153 ICU-months and 4,454,324 catheter-days of data, were included in the analysis. The overall mean CLABSI rate significantly decreased from 1.96 cases per 1,000 catheter-days at baseline to 1.15 at 16--18 months after implementation. CLABSI rates decreased during all observation periods compared with baseline, with adjusted incidence rate ratios steadily decreasing to 0.57 (95% confidence intervals, 0.50--0.65) at 16--18 months after implementation.Conclusion.Coincident with the implementation of the national On the CUSP: Stop BSI program was a significant and sustained decrease in CLABSIs among a large and diverse cohort of ICUs, demonstrating an overall 43% decrease and suggesting the majority of ICUs in the United States can achieve additional reductions in CLABSI rates. C1 [Berenholtz, Sean M.; Lubomski, Lisa H.; Weeks, Kristina; Goeschel, Christine A.; Pham, Julius C.; Thompson, David A.; Winters, Bradford D.; Yang, Ting; Pronovost, Peter J.] Johns Hopkins Univ, Johns Hopkins Armstrong Inst Patient Safety & Qua, Sch Med, Baltimore, MD 21202 USA. [Berenholtz, Sean M.; Lubomski, Lisa H.; Weeks, Kristina; Goeschel, Christine A.; Pham, Julius C.; Thompson, David A.; Winters, Bradford D.; Yang, Ting; Pronovost, Peter J.] Johns Hopkins Univ, Dept Anesthesiol & Crit Care Med, Sch Med, Baltimore, MD 21202 USA. [Berenholtz, Sean M.; Marsteller, Jill A.; Pronovost, Peter J.] Johns Hopkins Univ, Dept Surg, Sch Med, Baltimore, MD 21202 USA. [Berenholtz, Sean M.; Goeschel, Christine A.; Marsteller, Jill A.; Pronovost, Peter J.] Johns Hopkins Univ, Dept Hlth Policy & Management, Bloomberg Sch Publ Hlth, Baltimore, MD 21202 USA. [Pham, Julius C.] Johns Hopkins Univ, Dept Emergency Med, Sch Med, Baltimore, MD 21202 USA. [Sawyer, Melinda D.; Cosgrove, Sara E.] Johns Hopkins Univ, Dept Med, Sch Med, Baltimore, MD 21202 USA. [Louis, Thomas A.] Johns Hopkins Univ, Dept Biostat, Bloomberg Sch Publ Hlth, Baltimore, MD 21202 USA. [Lucas, Barbara Meyer; George, Christine T.; Watson, Sam R.] Michigan Hlth & Hosp Assoc, Keystone Ctr Patient Safety & Qual, Lansing, MI USA. [Albert-Lesher, Mariana I.; St Andre, Justin R.; Combes, John R.; Bohr, Deborah; Hines, Stephen C.] Hlth Res & Educ Trust, Bethesda, MD USA. [Battles, James B.] Agcy Healthcare Res & Qual, Bethesda, MD USA. RP Berenholtz, SM (reprint author), Johns Hopkins Univ, Armstrong Inst Patent Safety & Qual, 750 East Pratt St,15th Floor, Baltimore, MD 21202 USA. EM sberenho@jhmi.edu FU Health Research and Education Trust from the Agency for Healthcare Research and Quality [HHSA2902006000222] FX This research was supported by a subcontract with the Health Research and Education Trust from the Agency for Healthcare Research and Quality (HHSA2902006000222) and from private philanthropy. NR 20 TC 34 Z9 35 U1 3 U2 11 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X EI 1559-6834 J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD JAN 1 PY 2014 VL 35 IS 1 BP 56 EP 62 DI 10.1086/674384 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 272KZ UT WOS:000328460800010 PM 24334799 ER PT J AU Spector, WD AF Spector, William D. TI Response to Letter to the Editor Regarding the Paper "Potentially Avoidable Hospitalization for Elderly Long-stay Residents in Nursing Homes" SO MEDICAL CARE LA English DT Letter C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Spector, WD (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. NR 0 TC 0 Z9 0 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD JAN PY 2014 VL 52 IS 1 BP 93 EP 94 DI 10.1097/MLR.0b013e3182a98371 PG 2 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 275UG UT WOS:000328702600016 PM 24309672 ER PT J AU Meyerhoefer, CD Zuvekas, SH Manski, R AF Meyerhoefer, Chad D. Zuvekas, Samuel H. Manski, Richard TI THE DEMAND FOR PREVENTIVE AND RESTORATIVE DENTAL SERVICES SO HEALTH ECONOMICS LA English DT Article DE health care demand; dental services; price elasticity ID INSURANCE-COVERAGE; ORAL-HEALTH; CARE; IMPACT; CHILDREN; MODELS; ACCESS; TOO AB Chronic tooth decay is the most common chronic condition in the United States among children ages 5-17 and also affects a large percentage of adults. Oral health conditions are preventable, but less than half of the US population uses dental services annually. We seek to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. Using data from the 2001-2006 Medical Expenditure Panel Survey and an American Dental Association survey of dental procedure prices, we jointly estimate the probability of using preventive and both basic and major restorative services through a correlated random effects specification that controls for endogeneity. We found that dental coverage increased the probability of preventive care use by 19% and the use of restorative services 11% to 16%. Both conditional and unconditional on dental coverage, the use of dental services was not sensitive to out-of-pocket costs. We conclude that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants. Copyright (c) 2013 John Wiley & Sons, Ltd. C1 [Meyerhoefer, Chad D.] Lehigh Univ, Dept Econ, Bethlehem, PA 18015 USA. [Meyerhoefer, Chad D.] Natl Bur Econ Res, Cambridge, MA 02138 USA. [Zuvekas, Samuel H.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. [Manski, Richard] Univ Maryland, Sch Dent, Agcy Healthcare Res & Qual, Baltimore, MD 21201 USA. RP Zuvekas, SH (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20850 USA. EM samuel.zuvekas@ahrq.hhs.gov NR 31 TC 12 Z9 12 U1 3 U2 15 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1057-9230 EI 1099-1050 J9 HEALTH ECON JI Health Econ. PD JAN PY 2014 VL 23 IS 1 BP 14 EP 32 DI 10.1002/hec.2899 PG 19 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 270BT UT WOS:000328293300002 PM 23349123 ER PT B AU Allison, JT Ballard, DJ AF Allison, Joel T. Ballard, David J. BE Ballard, DJ TI Governance SO ACHIEVING STEEEP HEALTH CARE LA English DT Article; Book Chapter C1 [Allison, Joel T.; Ballard, David J.] BHCS, Dallas, TX USA. [Allison, Joel T.] Amer Coll Healthcare Execut, Chicago, IL USA. [Allison, Joel T.] Healthcare Leadership Council, Chicago, IL USA. [Allison, Joel T.] Joint Commiss Board Commissioners, Dallas, TX USA. [Allison, Joel T.] United Surg Partners Int Board, Addison, TX USA. [Allison, Joel T.] Texas Assoc Voluntary Hosp, Dallas, TX USA. [Allison, Joel T.] Healthcare Coalit Texas, Dallas, TX USA. [Allison, Joel T.] Dallas Citizens Council, Dallas, TX USA. [Allison, Joel T.] Dallas Educ Fdn, Dallas, TX USA. [Allison, Joel T.] Denison Forum Truth & Culture, Dallas, TX USA. [Ballard, David J.] BHCS Inst Hlth Care Res & Improvement, Dallas, TX USA. [Ballard, David J.] BHCS STEEEP Safe Timely Effect Efficient Equitabl, Dallas, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Mayo Sect Hlth Serv Evaluat, Rochester, MN USA. [Ballard, David J.] Kerr L White Inst Hlth Serv Res, Decatur, GA USA. [Ballard, David J.] Int Soc Qual Hlth Care, Melbourne, Vic, Australia. [Ballard, David J.] AHRQ, Hlth Care Qual & Effectiveness Res Study Sect, Rockville, MD USA. [Ballard, David J.] Univ N Carolina, Chapel Hill, NC 27515 USA. RP Allison, JT (reprint author), BHCS, Dallas, TX USA. NR 12 TC 0 Z9 0 U1 0 U2 0 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4665-6538-8; 978-1-4665-6537-1 PY 2014 BP 1 EP 10 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BE6PM UT WOS:000374503500004 ER PT B AU Allison, JT Ballard, DJ AF Allison, Joel T. Ballard, David J. BE Ballard, DJ TI Leadership SO ACHIEVING STEEEP HEALTH CARE LA English DT Article; Book Chapter C1 [Allison, Joel T.; Ballard, David J.] BHCS, Dallas, TX USA. [Allison, Joel T.] Amer Coll Healthcare Execut, New York, NY USA. [Allison, Joel T.] Healthcare Leadership Council, Washington, DC USA. [Allison, Joel T.] Joint Commiss Board Commissioners, Dallas, TX USA. [Allison, Joel T.] United Surg Partners Int Board, Addison, TX USA. [Allison, Joel T.] Texas Assoc Voluntary Hosp, Dallas, TX USA. [Ballard, David J.] Healthcare Coalit Texas, Dallas, TX USA. [Ballard, David J.] Dallas Citizens Council, Dallas, TX USA. [Ballard, David J.] Dallas Educ Fdn, Dallas, TX USA. [Ballard, David J.] Denison Forum Truth & Culture, Dallas, TX USA. [Ballard, David J.] BHCS Inst Hlth Care Res & Improvement, Dallas, TX USA. [Ballard, David J.] BHCS STEEEP Safe Timely Effect Efficient Equitabl, Dallas, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Mayo Sect Hlth Serv Evaluat, Rochester, MN USA. [Ballard, David J.] Kerr L White Inst Hlth Serv Res, Decatur, GA USA. [Ballard, David J.] Int Soc Qual Hlth Care, Rockville, MD USA. [Ballard, David J.] AHRQ, Hlth Care Qual & Effectiveness Res Study Sect, Rockville, MD USA. [Ballard, David J.] Univ N Carolina, Chapel Hill, NC 27515 USA. RP Allison, JT (reprint author), BHCS, Dallas, TX USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4665-6538-8; 978-1-4665-6537-1 PY 2014 BP 11 EP 13 PG 3 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BE6PM UT WOS:000374503500005 ER PT B AU Ballard, DJ AF Ballard, David J. BE Ballard, DJ TI Achieving STEEEP Health Care Preface SO ACHIEVING STEEEP HEALTH CARE LA English DT Editorial Material; Book Chapter ID MEDICARE BENEFICIARIES; QUALITY; RECOMMENDATIONS; HYPERTENSION; MANAGEMENT; COMMUNITY; PROGRAM; SYSTEM C1 [Ballard, David J.] BHCS, Dallas, TX USA. [Ballard, David J.] BHCS Inst Hlth Care Res & Improvement, Dallas, TX USA. [Ballard, David J.] BHCS STEEEP Safe Timely Effect Efficient Equitabl, Dallas, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Mayo Sect Hlth Serv Evaluat, Rochester, MN USA. [Ballard, David J.] Kerr L White Inst Hlth Serv Res, Decatur, GA USA. [Ballard, David J.] Int Soc Qual Hlth Care, Dublin, Ireland. [Ballard, David J.] AHRQ, Hlth Care Qual & Effectiveness Res study Sect, Rockville, MD USA. [Ballard, David J.] Univ N Carolina, Chapel Hill, NC 27515 USA. RP Ballard, DJ (reprint author), AHRQ, Ctr Educ & Res Therapeut Steering Comm, Rockville, MD USA. NR 32 TC 0 Z9 0 U1 1 U2 1 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4665-6538-8; 978-1-4665-6537-1 PY 2014 BP XV EP XX PG 6 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BE6PM UT WOS:000374503500002 ER PT B AU Ballard, DJ Convery, P Brock, G AF Ballard, David J. Convery, Paul Brock, Gary BE Ballard, DJ TI Organizational Structures SO ACHIEVING STEEEP HEALTH CARE LA English DT Article; Book Chapter ID HEALTH-CARE-SYSTEM C1 [Ballard, David J.; Convery, Paul; Brock, Gary] BHCS, Dallas, TX USA. [Ballard, David J.] BHCS Inst Hlth Care Res & Improvement, Ft Worth, TX USA. [Ballard, David J.] BHCS STEEEP Safe Timely Effect Efficient Equitabl, Ft Worth, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Mayo Sect Hlth Serv Evaluat, Rochester, MN USA. [Ballard, David J.] Kerr L White Inst Hlth Serv Res, Decatur, GA USA. [Ballard, David J.] Int Soc Qual Hlth Care, Rockville, MD USA. [Ballard, David J.] AHRQ, Hlth Care Qual & Effectiveness Res Study Sect, Rockville, MD USA. [Ballard, David J.] Univ N Carolina, Chapel Hill, NC 27515 USA. [Convery, Paul] SSM Hlth Care, St Louis, MO USA. [Convery, Paul] St Louis Med Grp, St Louis, MO USA. [Convery, Paul] Southwest Med Ctr, St Louis, MO USA. [Convery, Paul] Natl Qual Forum, Provider Council, Dallas, TX USA. [Convery, Paul] Natl Qual Forum, Leadership Network, Dallas, TX USA. [Convery, Paul] Inst Clin Qual & Value, Dallas, TX USA. [Convery, Paul] Ft Worth Hosp Council, Educ & Res Fdn Board Dallas, Dallas, TX USA. RP Ballard, DJ (reprint author), AHRQ, Ctr Educ & Res Therapeut Steering Comm, Rockville, MD 20857 USA. NR 8 TC 0 Z9 0 U1 1 U2 1 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4665-6538-8; 978-1-4665-6537-1 PY 2014 BP 15 EP 20 PG 6 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BE6PM UT WOS:000374503500006 ER PT B AU Ballard, DJ Fleming, NS AF Ballard, David J. Fleming, Neil S. BE Ballard, DJ TI Achieving STEEEP Health Care Introduction SO ACHIEVING STEEEP HEALTH CARE LA English DT Editorial Material; Book Chapter C1 [Ballard, David J.] BHCS, Dallas, TX USA. [Ballard, David J.] BHCS Inst Hlth Care Res & Improvement, Dallas, TX USA. [Ballard, David J.] BHCS STEEEP Safe Timely Effect Efficient Equitabl, Dallas, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Mayo Sect Hlth Serv Evaluat, Rochester, MN USA. [Ballard, David J.] Kerr L White Inst Hlth Serv Res, Rockville, MD USA. [Ballard, David J.] Int Soc Qual Hlth Care, Rockville, MD USA. [Ballard, David J.] AHRQ, Hlth Care Qual & Effectiveness Res Study Sect, Rockville, MD USA. [Ballard, David J.] Univ N Carolina, Chapel Hill, NC 27515 USA. [Fleming, Neil S.] BHCS STEEEP Global Inst, Dallas, TX USA. [Fleming, Neil S.] Ctr Dis Control, Natl Ctr Hlth Stat, Atlanta, GA 30333 USA. RP Ballard, DJ (reprint author), AHRQ, Ctr Educ & Res Therapeut Steering Comm, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4665-6538-8; 978-1-4665-6537-1 PY 2014 BP XXIII EP XXIX PG 7 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BE6PM UT WOS:000374503500003 ER PT B AU Savelsbergh, F Green, RT Ballard, DJ AF Savelsbergh, Fred Green, Robert T. Ballard, David J. BE Ballard, DJ TI Financial Leadership SO ACHIEVING STEEEP HEALTH CARE LA English DT Article; Book Chapter ID CARE; QUALITY; COSTS C1 [Savelsbergh, Fred; Ballard, David J.] Baylor Hlth Care Syst, Dallas, TX USA. [Green, Robert T.] Baylor Hlth Care Syst, Strateg Financial Serv, Dallas, TX USA. [Green, Robert T.] Centegra Hlth Syst, Mchenry, IL USA. [Ballard, David J.] BHCS Inst Hlth Care Res & Improvement, Dallas, TX USA. [Ballard, David J.] BHCS STEEEP Safe Timely Effect Efficient Equitabl, Dallas, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Mayo Sect Hlth Serv Evaluat, Rochester, MN USA. [Ballard, David J.] Kerr L White Inst Hlth Serv Res, Augusta, GA USA. [Ballard, David J.] Int Soc Qual Hlth Care, Dallas, TX USA. [Ballard, David J.] AHRQ, Hlth Care Qual & Effectiveness Res Study Sect, Dallas, TX USA. [Ballard, David J.] Univ N Carolina, Chapel Hill, NC 27515 USA. RP Savelsbergh, F (reprint author), Baylor Hlth Care Syst, Dallas, TX USA. NR 11 TC 0 Z9 0 U1 0 U2 0 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4665-6538-8; 978-1-4665-6537-1 PY 2014 BP 27 EP 31 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BE6PM UT WOS:000374503500008 ER PT B AU Fleming, NS Ballard, DJ AF Fleming, Neil S. Ballard, David J. BE Ballard, DJ TI Achieving STEEEP Health Care Conclusion SO ACHIEVING STEEEP HEALTH CARE LA English DT Editorial Material; Book Chapter C1 [Fleming, Neil S.] BHCS STEEEP Global Inst, Dallas, TX 75206 USA. [Fleming, Neil S.] BHCS, Dallas, TX USA. [Fleming, Neil S.] Ctr Dis Control, Natl Ctr Hlth Stat, Atlanta, GA 30333 USA. [Ballard, David J.] BHCS, Dallas, TX USA. [Ballard, David J.] BHCS Inst Hlth Care Res & Improvement, Dallas, TX USA. [Ballard, David J.] Global Inst, BHCS STEEEP Safe Timely Effect Efficient Equitabl, Dallas, TX USA. [Ballard, David J.] Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. [Ballard, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22903 USA. [Ballard, David J.] Emory Univ, Sch Med, Med, Atlanta, GA 30322 USA. [Ballard, David J.] Emory Univ, Rollins Sch Publ Hlth, Epidemiol, Atlanta, GA 30322 USA. [Ballard, David J.] Mayo Sect Hlth Serv Evaluat, Rochester, MN USA. [Ballard, David J.] Kerr L White Inst Hlth Serv Res, Augusta, GA USA. [Ballard, David J.] Int Soc Qual Hlth Care, Melbourne, Vic, Australia. [Ballard, David J.] Agcy Healthcare Res & Qual, Hlth Care Qual & Effectiveness Res Study Sect, Rockville, MD USA. RP Fleming, NS (reprint author), BHCS STEEEP Global Inst, Dallas, TX 75206 USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU CRC PRESS-TAYLOR & FRANCIS GROUP PI BOCA RATON PA 6000 BROKEN SOUND PARKWAY NW, STE 300, BOCA RATON, FL 33487-2742 USA BN 978-1-4665-6538-8; 978-1-4665-6537-1 PY 2014 BP 237 EP 242 PG 6 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BE6PM UT WOS:000374503500032 ER PT J AU Lawrence, WF AF Lawrence, William F. TI Comparative Effectiveness Research in Practice and Policy for Radiation Oncology SO SEMINARS IN RADIATION ONCOLOGY LA English DT Article ID SHARED DECISION-MAKING; LOCALIZED PROSTATE-CANCER; HEALTH-CARE PROGRAM; QUALITY; INTERVENTIONS; FRAMEWORK; AHRQ; AIDS AB Interest in comparative effectiveness research (CER) has increased dramatically over the past decade, yet perceptions about what comprises CER varies. CER has several attributes relevant to practice and policy: (1) The goal of CER is to inform decisions about health care. (2) Literature synthesis is used in addition to primary research. (3) CER evaluates not only overall outcomes for the population but also evaluates subgroups that may have heterogeneous outcomes. (4) Research places an emphasis on outcomes in the "real-world" settings. (5) Outcomes studied should be relevant to patients. In radiation oncology, where many of the traditional clinical trials are comparative in nature, the line between CER and "traditional" research may be blurred, but an increased emphasis on CER can help to bridge the research enterprise and clinical practice, helping to inform decision making at the patient, clinician, and policy levels. Published by Elsevier Inc. C1 [Lawrence, William F.] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD 20850 USA. RP Lawrence, WF (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM William.lawrence@ahrq.hhs.gov NR 32 TC 1 Z9 1 U1 1 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1053-4296 EI 1532-9461 J9 SEMIN RADIAT ONCOL JI Semin. Radiat. Oncol. PD JAN PY 2014 VL 24 IS 1 BP 54 EP 60 DI 10.1016/j.semradonc.2013.09.001 PG 7 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 268PI UT WOS:000328182600008 PM 24314343 ER PT J AU McGuire, TG Glazer, J Newhouse, JP Normand, SL Shi, JL Sinaiko, AD Zuvekas, SH AF McGuire, Thomas G. Glazer, Jacob Newhouse, Joseph P. Normand, Sharon-Lise Shi, Julie Sinaiko, Anna D. Zuvekas, Samuel H. TI Integrating risk adjustment and enrollee premiums in health plan payment SO JOURNAL OF HEALTH ECONOMICS LA English DT Article DE Risk adjustment; Premiums; Health insurance; Exchanges; Medicare ID MEDICARE ADVANTAGE; CARE; CHOICE; INSURANCE; QUALITY; MODEL AB In two important health policy contexts - private plans in Medicare and the new state-run "Exchanges" created as part of the Affordable Care Act (ACA) - plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). (C) 2013 Elsevier B.V. All rights reserved. C1 [McGuire, Thomas G.; Newhouse, Joseph P.; Normand, Sharon-Lise] Harvard Univ, Sch Med, Dept Hlth Care Policy, Cambridge, MA 02138 USA. [McGuire, Thomas G.; Newhouse, Joseph P.] NBER, Cambridge, MA 02138 USA. [Newhouse, Joseph P.; Sinaiko, Anna D.] Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Cambridge, MA 02138 USA. [Newhouse, Joseph P.] Harvard Univ, Kennedy Sch, Cambridge, MA 02138 USA. [Glazer, Jacob; Shi, Julie] Boston Univ, Dept Econ, Boston, MA 02215 USA. [Zuvekas, Samuel H.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Glazer, Jacob] Tel Aviv Univ, Fac Management, IL-69978 Tel Aviv, Israel. RP McGuire, TG (reprint author), Harvard Univ, Sch Med, Dept Hlth Care Policy, Cambridge, MA 02138 USA. EM mcguire@hcp.med.harvard.edu FU National Institute of Aging [P01 AG032952]; National Institute of Mental Health [R01 MH094290] FX Research for this paper was supported by the National Institute of Aging (P01 AG032952) and the National Institute of Mental Health (R01 MH094290). This paper represents the views of the authors and no official endorsement by the Agency for Healthcare Research and Quality or the Department of Health and Human Services is intended or should be inferred. We are grateful to Helen Levy and other participants at the "Science of Medicare" meeting at the University of Southern California, January 25-26, 2012. We are also grateful to Sebastian Bauhoff, Randy Ellis, Laura Hatfield and Sara Machado for comments on an earlier draft. NR 31 TC 11 Z9 11 U1 3 U2 18 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-6296 EI 1879-1646 J9 J HEALTH ECON JI J. Health Econ. PD DEC PY 2013 VL 32 IS 6 BP 1263 EP 1277 DI 10.1016/j.jhealeco.2013.05.002 PG 15 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 283VM UT WOS:000329275100023 PM 24308878 ER PT J AU Barry, MJ Andriole, GL Culkin, DJ Fox, SH Jones, KM Carlyle, MH Wilt, TJ AF Barry, Michael J. Andriole, Gerald L. Culkin, Daniel J. Fox, Steven H. Jones, Karen M. Carlyle, Maureen H. Wilt, Timothy J. TI Ascertaining cause of death among men in the Prostate Cancer Intervention Versus Observation Trial SO CLINICAL TRIALS LA English DT Article ID COMPARING RADICAL PROSTATECTOMY; FOLLOW-UP; MORTALITY AB Background The Prostate Cancer Intervention Versus Observation Trial (PIVOT) randomized 731 men with localized prostate cancer to radical prostatectomy or observation. Purpose We describe the methods and results for cause-of-death assignments in PIVOT, and compare them to alternative strategies for ascertaining prostate cancer-specific mortality, as well as to the methods and results in the similar Scandinavian Prostate Cancer Group Study 4 (SPCG-4) trial. Methods Three PIVOT Endpoints Committee members, blinded to randomized treatment assignments, reviewed medical records and death certificates when available to assign a cause of death using a primary and a secondary adjudication question. Initial disagreements were resolved through discussion. The level of initial agreement among committee members was examined, as well as guesses at randomized treatment assignments for a convenience sample of cases. Final cause of death determinations were compared to death certificates. Results Complete agreement on cause of death by all three committee members before any discussion was achieved in 200/354 (56%) cases on the primary and 209/354 (59%) cases on the secondary. However, complete agreement on the primary rose to 306/354 (86%) when definite' and probably' categories were collapsed, as planned a priori. The three committee members' proportions of correct guesses of randomized treatment assignment were 82/121 (68%), 113/148 (76%), and 99/134 (74%). Using the committee's final adjudications as a gold standard, death certificates had suboptimal sensitivities, specificities, or predictive values depending on how they were used to determine cause of death. Limitations There was no separate gold standard' by which to judge the accuracy of the final endpoints committee adjudications, and useful death certificates could not be obtained on about a third of PIVOT participants who died. Conclusions The low level of initial agreement on cause of death among endpoint committee members and the potential for biased determinations due to partial unblinding to treatment assignment raise methodologic concerns about using prostate cancer mortality as an endpoint in clinical trials like PIVOT. C1 [Barry, Michael J.] Massachusetts Gen Hosp, Div Gen Med, Boston, MA 02114 USA. [Andriole, Gerald L.] Washington Univ, Sch Med, Div Urol Surg, St Louis, MO 63110 USA. [Culkin, Daniel J.] Univ Oklahoma, Hlth Sci Ctr, Dept Urol, Oklahoma City, OK USA. [Fox, Steven H.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Jones, Karen M.] Cooperat Studies Coordinating Ctr, Dept Vet Affairs Med Ctr, Perry Point, MD USA. [Carlyle, Maureen H.; Wilt, Timothy J.] Minneapolis VA Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. RP Barry, MJ (reprint author), Massachusetts Gen Hosp, Div Gen Med, 50 Staniford St,9th Floor, Boston, MA 02114 USA. EM mbarry@partners.org FU Department of Veterans Affairs Cooperative Studies Program [CSP-407]; Agency for Healthcare Research and Quality FX This work was supported by the Department of Veterans Affairs Cooperative Studies Program (CSP-407), with participation from the National Cancer Institute (Protocol number NCI-T94-0131O), and the Agency for Healthcare Research and Quality. Supplemental funding specifically for the analyses in this article was provided by the Agency for Healthcare Research and Quality. NR 15 TC 8 Z9 8 U1 0 U2 2 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1740-7745 EI 1740-7753 J9 CLIN TRIALS JI Clin. Trials PD DEC PY 2013 VL 10 IS 6 BP 907 EP 914 DI 10.1177/1740774513498008 PG 8 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 275LB UT WOS:000328676700009 PM 23988464 ER PT J AU Ross, MA Hockenberry, JM Mutter, R Barrett, M Wheatley, M Pitts, SR AF Ross, Michael A. Hockenberry, Jason M. Mutter, Ryan Barrett, Marguerite Wheatley, Matthew Pitts, Stephen R. TI Protocol-Driven Emergency Department Observation Units Offer Savings, Shorter Stays, And Reduced Admissions SO HEALTH AFFAIRS LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; DIAGNOSTIC PROTOCOL; INPATIENT; TRENDS; CARE AB Many patients who seek emergency department (ED) treatment are not well enough for immediate discharge but are not clearly sick enough to warrant full inpatient admission. These patients are increasingly treated as outpatients using observation services. Hospitals employ four basic approaches to observation services, which can be categorized by the presence or absence of a dedicated observation unit and of defined protocols. To understand which approach might have the greatest impact, we compared 2010 data from three sources: a case study of observation units in Atlanta, Georgia; statewide discharge data for Georgia; and national survey and discharge data. Compared to patients receiving observation services elsewhere in the hospital, patients cared for in "type 1" observation units-dedicated units with defined protocols-have a 23-38 percent shorter length-of-stay, a 17-44 percent lower probability of subsequent inpatient admission, and $950 million in potential national cost savings each year. Furthermore, we estimate that 11.7 percent of short-stay inpatients nationwide could be treated in a type 1 unit, with possible savings of $5.5-$8.5 billion annually. Policy makers should have hospitals report the setting in which observation services are provided and consider payment incentives for care in a type 1 unit. C1 [Ross, Michael A.; Wheatley, Matthew] Emory Univ, Sch Med, Atlanta, GA 30322 USA. [Ross, Michael A.] Grady Mem Hosp, Atlanta, GA USA. [Ross, Michael A.] Emory Univ Hosp, Atlanta, GA USA. [Ross, Michael A.] Emory Univ Hosp, Clin Decis Unit, Atlanta, GA USA. [Hockenberry, Jason M.] Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. [Hockenberry, Jason M.] Vet Affairs Hlth Serv Res, Minneapolis, MN USA. [Hockenberry, Jason M.] Natl Bur Econ Res, Cambridge, MA 02138 USA. [Mutter, Ryan] Agcy Healthcare Res & Qual, Rockville, MD USA. [Barrett, Marguerite] Healthcare Cost & Utilizat Project Truven Hlth An, Santa Barbara, CA USA. [Wheatley, Matthew] Grady Mem Hosp, Clin Decis Unit, Atlanta, GA USA. [Pitts, Stephen R.] Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA USA. [Pitts, Stephen R.] Grady Mem Hosp, Emergency Dept, Atlanta, GA USA. RP Ross, MA (reprint author), Emory Univ, Sch Med, Atlanta, GA 30322 USA. EM maross@emory.edu NR 26 TC 34 Z9 34 U1 1 U2 6 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD DEC PY 2013 VL 32 IS 12 BP 2149 EP 2156 DI 10.1377/hlthaff.2013.0662 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 275QC UT WOS:000328690900014 PM 24301399 ER PT J AU Lomotan, EA Dougherty, D AF Lomotan, Edwin A. Dougherty, Denise TI Pediatric Health Care Quality Measures: Considerations for Pharmacotherapy SO PEDIATRIC DRUGS LA English DT Article ID RANDOMIZED CONTROLLED-TRIALS; INFORMATION-TECHNOLOGY; FOSTER-CARE; CHILDREN; MEDICINES; YOUTH; JOURNALS; TRENDS; NEED; GAP AB Measuring the quality use of medicines can be conceptualized as a mechanism for understanding appropriate use, underuse, overuse, or misuse. For pediatric pharmacotherapy, measuring the quality use of medicines requires awareness of the differences in health care between children and adults and the differences in the quality and quantity of science that supports evidence-based practice in pediatric health care compared with adult health care. Here we use the Pediatric Quality Measures Program that arose from the Children's Health Insurance Program Reauthorization Act in the United States to illustrate the challenges in developing quality measures of pediatric pharmacotherapy. The challenges are primarily twofold: (i) weak evidence base for the specific pharmacotherapy in children and (ii) limited data to calculate the measure. A weak evidence base must often be weighed against the importance of the topic if the quality measure is intended to address a known quality of care or public health problem. Limited data because of insufficient amount or inappropriate type will affect implementation of the measure and its eventual usefulness. Methods to meet these challenges often depend on the priorities of and the tools available to end users. Health information technology is emerging as a tool to improve quality measurement but presents additional challenges. C1 [Lomotan, Edwin A.; Dougherty, Denise] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. [Lomotan, Edwin A.] US Hlth Resources & Serv Adm, Rockville, MD 20857 USA. RP Lomotan, EA (reprint author), US Hlth Resources & Serv Adm, 5600 Fishers Lane, Rockville, MD 20857 USA. EM ELomotan@hrsa.gov NR 47 TC 0 Z9 0 U1 0 U2 0 PU ADIS INT LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1174-5878 EI 1179-2019 J9 PEDIATR DRUGS JI Pediatr. Drugs PD DEC PY 2013 VL 15 IS 6 BP 441 EP 447 DI 10.1007/s40272-013-0042-4 PG 7 WC Pediatrics; Pharmacology & Pharmacy SC Pediatrics; Pharmacology & Pharmacy GA 269RA UT WOS:000328258400003 PM 23918049 ER PT J AU Hellinger, FJ AF Hellinger, Fred J. TI Assessing the Cost Effectiveness of Pre-Exposure Prophylaxis for HIV Prevention in the US SO PHARMACOECONOMICS LA English DT Article ID UNITED-STATES; ANTIRETROVIRAL THERAPY; INFECTION; MEN; SEX; TRANSMISSION; MODELS; IMPACT; INDIVIDUALS; PERSISTENCE AB About 50,000 people are infected with HIV in the US each year and this number has remained virtually the same for the past decade. Yet, in the last few years, evidence from several multinational randomized clinical trials has shown that the provision of antiretroviral drug to uninfected persons (i.e. pre-exposure prophylaxis) reduces the incidence of HIV by about 50 %. However, evidence from cost-effectiveness studies conducted in the US yield widely varying estimates of the cost per quality-adjusted life-year (QALY) gained, and this variation reflects the substantial uncertainty surrounding the determinants of HIV transmission (e.g. adherence rates to prophylactic medications, the average number of sexual partners, the number and types of sexual acts, the viral load of infected partners, and the proportion of contacts where condoms are used), as well as different approaches to translating a reduction in HIV cases into an estimate of the increase in the number of QALYs. C1 Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. RP Hellinger, FJ (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM fred.hellinger@ahrq.hhs.gov NR 63 TC 7 Z9 7 U1 1 U2 10 PU ADIS INT LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1170-7690 EI 1179-2027 J9 PHARMACOECONOMICS JI Pharmacoeconomics PD DEC PY 2013 VL 31 IS 12 BP 1091 EP 1104 DI 10.1007/s40273-013-0111-0 PG 14 WC Economics; Health Care Sciences & Services; Health Policy & Services; Pharmacology & Pharmacy SC Business & Economics; Health Care Sciences & Services; Pharmacology & Pharmacy GA 269CM UT WOS:000328218100002 PM 24271858 ER PT J AU Ghali, WA Pincus, HA Southern, DA Brien, SE Romano, PS Burnand, B Droler, SE Sundararajan, V Moskal, L Forster, AJ Gurevich, Y Quan, H Colin, C Munier, WB Harrison, J Spaeth-Rublee, B Kostanjsek, N Ustun, TB AF Ghali, William A. Pincus, Harold A. Southern, Danielle A. Brien, Susan E. Romano, Patrick S. Burnand, Bernard Droesler, Saskia E. Sundararajan, Vijaya Moskal, Lori Forster, Alan J. Gurevich, Yana Quan, Hude Colin, Cyrille Munier, William B. Harrison, James Spaeth-Rublee, Brigitta Kostanjsek, Nenad Ustun, T. Bedirhan TI ICD-11 for quality and safety: overview of the who quality and safety topic advisory group SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE ICD-11; quality; safety; patient safety ID PATIENT SAFETY; COUNTRIES; RATES AB This paper outlines the approach that the WHO's Family of International Classifications (WHO-FIC) network is undertaking to create ICD-11. We also outline the more focused work of the Quality and Safety Topic Advisory Group, whose activities include the following: (i) cataloguing existing ICD-9 and ICD-10 quality and safety indicators; (ii) reviewing ICD morbidity coding rules for main condition, diagnosis timing, numbers of diagnosis fields and diagnosis clustering; (iii) substantial restructuring of the healthcare related injury concepts coded in the ICD-10 chapters 19/20, (iv) mapping of ICD-11 quality and safety concepts to the information model of the WHO's International Classification for Patient Safety and the AHRQ Common Formats; (v) the review of vertical chapter content in all chapters of the ICD-11 beta version and (vi) downstream field testing of ICD-11 prior to its official 2015 release. The transition from ICD-10 to ICD-11 promises to produce an enhanced classification that will have better potential to capture important concepts relevant to measuring health system safety and quality-an important use case for the classification. C1 [Ghali, William A.; Southern, Danielle A.; Quan, Hude] Univ Calgary, Dept Community Hlth Sci, Inst Publ Hlth, Calgary, AB, Canada. [Ghali, William A.] Univ Calgary, Fac Med, Calgary, AB, Canada. [Pincus, Harold A.; Spaeth-Rublee, Brigitta] Columbia Univ, Dept Psychiat, New York State Psychiat Inst, New York, NY USA. [Pincus, Harold A.] Columbia Univ, Irving Inst Clin & Translat Res, New York Presbyterian Hosp, New York, NY USA. [Pincus, Harold A.] RAND Corp, Pittsburgh, PA USA. [Brien, Susan E.] Hlth Council Canada, Toronto, ON, Canada. [Romano, Patrick S.] Univ Calif Davis, Sch Med, Dept Gen Internal Med, Sacramento, CA USA. [Romano, Patrick S.] Univ Calif Davis, Sch Med, Dept Gen Pediat, Sacramento, CA USA. [Burnand, Bernard] Univ Lausanne Hosp, Inst Social & Prevent Med IUMSP, Lausanne, Switzerland. [Droesler, Saskia E.] Niederrhein Univ Appl Sci, Fac Hlth Care, Krefeld, Germany. [Sundararajan, Vijaya] Univ Melbourne, Dept Med, St Vincents Hosp, Melbourne, Vic 3010, Australia. [Sundararajan, Vijaya] Monash Univ, Dept Med, Southern Clin Sch, Clayton, Vic 3800, Australia. [Moskal, Lori; Gurevich, Yana] Canadian Inst Hlth Informat, Toronto, ON, Canada. [Forster, Alan J.] Univ Ottawa, Dept Med, Ottawa, ON, Canada. [Colin, Cyrille] Hosp Civils Lyon, Dept Med Informat, Hlth Evaluat & Clin Res, Lyon, France. [Munier, William B.] AHRQ, Rockville, MD USA. [Harrison, James] Flinders Univ S Australia, Adelaide, SA, Australia. [Kostanjsek, Nenad; Ustun, T. Bedirhan] WHO, CH-1211 Geneva, Switzerland. RP Ghali, WA (reprint author), Univ Calgary, Dept Med & Community Hlth Sci, 3rd Floor TRW,3280 Hosp Dr NW, Calgary, AB T2N 4Z6, Canada. EM wghali@ucalgary.ca RI Romano, Patrick/N-4225-2014; Harrison, James/B-8958-2009; OI Romano, Patrick/0000-0001-6749-3979; Harrison, James/0000-0001-9893-8491; Southern, Danielle/0000-0002-0006-0033; Sundararajan, Vijaya/0000-0001-9387-1865 FU Canadian Patient Safety Institute (CPSI); Canadian Institute for Health Information (CIHI); Agency for Healthcare Research and Quality (AHRQ); Alberta Innovates Health Solutions (AI-HS) FX This project is supported over the course of five meetings by the Canadian Patient Safety Institute (CPSI), Canadian Institute for Health Information (CIHI) and an Agency for Healthcare Research and Quality (AHRQ) large meeting grant. Dr Ghali is funded as an Alberta Innovates Health Solutions (AI-HS) senior health scholar. NR 25 TC 8 Z9 9 U1 1 U2 13 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1353-4505 EI 1464-3677 J9 INT J QUAL HEALTH C JI Int. J. Qual. Health Care PD DEC PY 2013 VL 25 IS 6 BP 621 EP 625 DI 10.1093/intqhc/mzt074 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 263FG UT WOS:000327791600001 PM 24154846 ER PT J AU Stuart, B Davidoff, A Erten, M Gottlieb, SS Dai, ML Shaffer, T Zuckerman, IH Simoni-Wastila, L Bryant-Comstock, L Shenolikar, R AF Stuart, Bruce Davidoff, Amy Erten, Mujde Gottlieb, Stephen S. Dai, Mingliang Shaffer, Thomas Zuckerman, Ilene H. Simoni-Wastila, Linda Bryant-Comstock, Lynda Shenolikar, Rahul TI How Medicare Part D Benefit Phases Affect Adherence with Evidence-Based Medications Following Acute Myocardial Infarction SO HEALTH SERVICES RESEARCH LA English DT Article DE Medicare Part D; benefit design; AMI; evidence-based drugs ID D PRESCRIPTION BENEFIT; COVERAGE AB ObjectiveAssess impact of Medicare Part D benefit phases on adherence with evidence-based medications after hospitalization for an acute myocardial infarction. Data SourceRandom 5 percent sample of Medicare beneficiaries. Study DesignDifference-in-difference analysis of drug adherence by AMI patients stratified by low-income subsidy (LIS) status and benefit phase. Data Collection/Extraction MethodsSubjects were identified with an AMI diagnosis in Medicare Part A files between April 2006 and December 2007 and followed until December 2008 or death (N=8,900). Adherence was measured as percent of days covered (PDC) per month with four drug classes used in AMI treatment: angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs), beta-blockers, statins, and clopidogrel. Monthly exposure to Part D benefit phases was calculated from flags on each Part D claim. Principal FindingsFor non-LIS enrollees, transitioning from the initial coverage phase into the Part D coverage gap was associated with statistically significant reductions in mean PDC for all four drug classes: statins (-7.8 percent), clopidogrel (-7.0 percent), beta-blockers (-5.9 percent), and ACE inhibitor/ARBs (-5.1 percent). There were no significant changes in adherence associated with transitioning from the gap to the catastrophic coverage phase. ConclusionsAs the Part D doughnut hole is gradually filled in by 2020, Medicare Part D enrollees with critical diseases such as AMI who rely heavily on brand name drugs are likely to exhibit modest increases in adherence. Those reliant on generic drugs are less likely to be affected. C1 [Stuart, Bruce] Univ Maryland, Peter Lamy Ctr Drug Therapy & Aging, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. [Davidoff, Amy] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Erten, Mujde] Univ Vermont, Coll Med, Ctr Clin & Translat Sci, Dept Surg Fac,Global Hlth Econ Unit, Burlington, VT USA. [Gottlieb, Stephen S.] Univ Maryland, Dept Med, Baltimore, MD 21201 USA. [Dai, Mingliang] Univ Maryland, Baltimore, MD 21201 USA. [Zuckerman, Ilene H.; Simoni-Wastila, Linda] Univ Maryland, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. [Bryant-Comstock, Lynda] GlaxoSmithKline Inc, Govt Relat, HHS Team, Healthcare Reform Strateg Planning, Durham, NC USA. [Shenolikar, Rahul] GlaxoSmithKline Inc, US Hlth Outcomes, Comparat Effectiveness Res & Hlth Policy Res, Durham, NC USA. RP Stuart, B (reprint author), Univ Maryland, Peter Lamy Ctr Drug Therapy & Aging, Dept Pharmaceut Hlth Serv Res, 220 Arch St Room 01-212, Baltimore, MD 21201 USA. EM bstuart@rx.umaryland.edu FU GlaxoSmithKline; GSK FX The research presented in this article was sponsored by a grant from GlaxoSmithKline. Each author has made substantive intellectual contributions to the study. Bruce Stuart, Amy Davidoff, Mujde Erten, Stephen Gottlieb, Mingliang Dai, Thomas Shaffer, Ilene Zuckerman, and Linda Simoni-Wastila received grant funds from GSK to conduct research for this project. Lynda Bryant-Comstock and Rahul Shenolikar are employees of GSK. NR 17 TC 9 Z9 9 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 2013 VL 48 IS 6 BP 1960 EP 1977 DI 10.1111/1475-6773.12073 PN 1 PG 18 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 257NT UT WOS:000327392300010 PM 23742013 ER PT J AU Sarpong, EM Miller, GE AF Sarpong, Eric M. Miller, G. Edward TI Racial and Ethnic Differences in Childhood Asthma Treatment in the United States SO HEALTH SERVICES RESEARCH LA English DT Article DE Children; race-ethnicity; insurance status; asthma controller medications; decomposition ID BLINDER-OAXACA DECOMPOSITION; HEALTH-CARE UTILIZATION; FOLLOW-UP; MANAGEMENT-PRACTICES; REGRESSION MODELS; MEDICATION USE; NEW-YORK; CHILDREN; DISPARITIES; PREVALENCE AB ObjectiveTo examine racial-ethnic differences in asthma controller medication use among insured U.S. children. Data SourcesLinked nationally representative data from the Medical Expenditure Panel Survey (2005-2008), the 2000 Decennial Census, and the National Health Interview Survey (2004-2007). Study DesignThe study quantifies the portion of racial-ethnic differences in children's controller use that are attributable to differences in need, enabling and predisposing characteristics. Principal FindingsNon-Hispanic black and Hispanic children were less likely to use controllers than non-Hispanic white children. Blinder-Oaxaca decomposition results indicated that observable characteristics explain less than 40 percent of the overall differential in controller use between non-Hispanic whites and non-Hispanic blacks. In contrast, observable characteristics explain more than two-thirds (71.3 percent) of the overall non-Hispanic white-Hispanic differential in controller use. For non-Hispanic blacks, a majority of the explained differential in controller use were attributed to enabling characteristics. For Hispanics, a significant portion of the explained differential in controller use was attributed to predisposing characteristics. In addition, a larger portion of the differential in controller use was explained by observable characteristics for publicly insured non-Hispanic black and Hispanic children. ConclusionsThe large observed differences in controller use highlight the continuing challenges of ensuring that all U.S. children have access to quality asthma care. C1 [Sarpong, Eric M.; Miller, G. Edward] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD 20850 USA. RP Sarpong, EM (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, 540 Gaither Rd, Rockville, MD 20850 USA. EM ESarpong@AHRQ.gov NR 64 TC 2 Z9 2 U1 0 U2 9 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 EI 1475-6773 J9 HEALTH SERV RES JI Health Serv. Res. PD DEC PY 2013 VL 48 IS 6 BP 2014 EP 2036 DI 10.1111/1475-6773.12077 PN 1 PG 23 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 257NT UT WOS:000327392300013 PM 23800044 ER PT J AU Moy, E Mau, MK Raetzman, S Barrett, M Miyamura, JB Chaves, KH Andrews, R AF Moy, Ernest Mau, Marjorie K. Raetzman, Susan Barrett, Marguerite Miyamura, Jill B. Chaves, Karen H. Andrews, Roxanne TI ETHNIC DIFFERENCES IN POTENTIALLY PREVENTABLE HOSPITALIZATIONS AMONG ASIAN AMERICANS, NATIVE HAWAIIANS, AND OTHER PACIFIC ISLANDERS: IMPLICATIONS FOR REDUCING HEALTH CARE DISPARITIES SO ETHNICITY & DISEASE LA English DT Article DE Quality of Health Care; Health Care Disparities; Minority Health AB Objectives: A serious challenge to eliminating US health disparities stems from the inability to reliably measure outcomes, particularly for numerically small populations. Our study aimed to produce reliable estimates of health care quality among Native Hawaiian (NH), Other Pacific Islander (PI), and Asian American (M) subgroups. Design: Prevention Quality Indicators (PQIs) from the Agency for Healthcare Research and Quality were used to calculate 3 POI composites and 8 individual chronic condition indicators. Data sources were the Healthcare Cost and Utilization Project State Inpatient Databases and the Hawaii Health-Survey. Main Outcome Measures: Risk-adjusted PQI rates for adults were computed for 2005 through 2007. Relative rates for 2007 were calculated for each racial/ethnic group and compared to Whites. Statistical significance was based on P<.05 from a two-sided t test. Results: The combined AANHPI group had higher overall and chronic POI composite rates than Whites in 2007. When disaggregated into discrete racial/ethnic subgroups, Chinese and Japanese had lower rates than Whites for all 3 composites, whereas NH and Other PI subgroups typically had the worst health outcomes. Trends in PQI rates from 2005 through 2007 showed persistent gaps between groups, especially across chronic PQIs. Conclusions: Despite recent efforts to reduce racial/ethnic health care disparities, significant gaps remain in potentially preventable hospitalization rates. Practical tools that measure inequities across diverse, numerically small populations may suggest ways to optimally funnel limited resources toward improving racial/ethnic differences in health outcomes. (Ethn Dis. 2013;23[1]:6-11) C1 [Moy, Ernest; Chaves, Karen H.; Andrews, Roxanne] Univ Hawaii, Ctr Qual Improvement & Patient Safety, Agcy Healthcare Res & Qual, Honolulu, HI 96822 USA. [Mau, Marjorie K.] Univ Hawaii, Dept Native Hawaiian Hlth, John A Burns Sch Med, Honolulu, HI 96822 USA. [Raetzman, Susan] Truven Hlth Analyt, Washington, DC 20008 USA. [Barrett, Marguerite] ML Barrett Inc, Stuart, FL USA. [Miyamura, Jill B.] Hawaii Hlth Informat Corp, Honolulu, HI USA. RP Raetzman, S (reprint author), Truven Hlth Analyt, 4301 Connecticut Ave NW,Suite 330, Washington, DC 20008 USA. EM susan.raetzman@truvenhealth.com RI Dalla Zuanna, Teresa/G-3133-2015 FU Agency for Healthcare Research and Quality (AHRQ) FX The authors thank Elizabeth Stranges, MS, for assistance with a review of the literature, and Kay Baker, PhD, of the Hawaii State Department of Health for assistance in providing population estimates. This study was funded by the Agency for Healthcare Research and Quality (AHRQ) under a contract to Truven Health Analytics for developing and supporting the Healthcare Cost and Utilization Project (HCUP). The views expressed in this article are those of the authors and do not necessarily reflect those of AHRQ or the US Department of Health and Human Services. NR 20 TC 8 Z9 8 U1 1 U2 113 PU INT SOC HYPERTENSION BLACKS-ISHIB PI ATLANTA PA 100 AUBURN AVE NE STE 401, ATLANTA, GA 30303-2527 USA SN 1049-510X J9 ETHNIC DIS JI Ethn. Dis. PD WIN PY 2013 VL 23 IS 1 BP 6 EP 11 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 069VH UT WOS:000313464700002 PM 23495615 ER PT J AU Moy, E Chang, E Barrett, M AF Moy, Ernest Chang, Eva Barrett, Marguerite TI Potentially Preventable Hospitalizations - United States, 2001-2009 SO MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT LA English DT Article C1 [Moy, Ernest] Agcy Healthcare Res & Qual, Rockville, MD USA. [Chang, Eva] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA. [Barrett, Marguerite] ML Barrett Inc, Del Mar, CA USA. RP Moy, E (reprint author), Agcy Healthcare Res & Qual, Rockville, MD USA. EM moy@ahrq.hhs.gov RI Dalla Zuanna, Teresa/G-3133-2015 NR 10 TC 13 Z9 13 U1 0 U2 1 PU CENTERS DISEASE CONTROL PI ATLANTA PA 1600 CLIFTON RD, ATLANTA, GA 30333 USA SN 0149-2195 EI 1545-861X J9 MMWR-MORBID MORTAL W JI MMWR-Morb. Mortal. Wkly. Rep. PD NOV 22 PY 2013 VL 62 IS 3 SU S BP 139 EP 143 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA V40KA UT WOS:000209476300023 PM 24264504 ER PT J AU Lebrun-Harris, LA Shi, LY Zhu, JS Burke, MT Sripipatana, A Ngo-Metzger, Q AF Lebrun-Harris, Lydie A. Shi, Leiyu Zhu, Jinsheng Burke, Matthew T. Sripipatana, Alek Ngo-Metzger, Quyen TI Effects of Patient-Centered Medical Home Attributes on Patients' Perceptions of Quality in Federally Supported Health Centers SO ANNALS OF FAMILY MEDICINE LA English DT Article DE primary care; patient-centered care; health care quality assessment; vulnerable populations ID PRIMARY-CARE; MORTALITY; OUTCOMES; RATINGS; SAFETY AB PURPOSE We sought to assess patients' ratings of patient-centered medical home (PCMH) attributes and overall quality of care within federally supported health centers. METHODS Data were collected through the 2009 Health Center Patient Survey (n = 4,562), which consisted of in-person interviews and included a nationally representative sample of patients seen in health centers. Quality measures included patients' perceptions of overall quality of services, perceptions of quality of clinician advice/ treatment, and likelihood of referring friends and relatives to the health center. PCMH attributes included (1) access to care getting to health center, (2) access to care during visit, (3) patient-centered communication with health care clinicians, (4) patient-centered communication with support staff, (5) self-management support for chronic conditions, (6) self-management support for behavioral risks, and (7) comprehensive preventive care. Bivariate analysis and logistic regressions were used to examine associations between patients' perceptions of PCMH attributes and patient-reported quality of care. RESULTS Eighty-four percent of patients reported excellent/ very good overall quality of services, 81% reported excellent/ very good quality of clinician care, and 84% were very likely to refer friends and relatives. Higher patient ratings on the access to care and patient-centered communication attributes were associated with higher odds of patient-reported high quality of care on the 3 outcome measures. CONCLUSIONS More than 80% of patients perceived high quality of care in health centers. PCMH attributes related to access to care and communication were associated with greater likelihood of patients reporting high-quality care. C1 [Lebrun-Harris, Lydie A.] US Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USA. [Shi, Leiyu; Zhu, Jinsheng] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA. [Shi, Leiyu; Zhu, Jinsheng] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Primary Care Policy Ctr, Baltimore, MD USA. [Burke, Matthew T.] Franklin Sq Hosp, Dept Family Med, Baltimore, MD USA. [Sripipatana, Alek] US Dept Hlth & Human Serv, Off Qual & Data, Bur Primary Hlth Care Hlth Resources & Serv, Rockville, MD 20857 USA. [Ngo-Metzger, Quyen] US Dept Hlth & Human Serv, US Prevent Serv Task Force, Ctr Primary Care Prevent & Clin Partnerships, Agcy Healthcare Res & Qual, Rockville, MD 20857 USA. RP Lebrun-Harris, LA (reprint author), US Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, 5600 Fishers Lane 10-29, Rockville, MD 20857 USA. EM llebrun-harris@hrsa.gov FU Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) [HHSH250200646022I] FX The authors acknowledge the financial support for this study by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) (contract No. HHSH250200646022I). NR 38 TC 5 Z9 5 U1 2 U2 3 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672 USA SN 1544-1709 EI 1544-1717 J9 ANN FAM MED JI Ann. Fam. Med. PD NOV-DEC PY 2013 VL 11 IS 6 BP 508 EP 516 DI 10.1370/afm.1544 PG 9 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AI3XU UT WOS:000336799800003 PM 24218374 ER PT J AU Garfinkel, S Frentzel, E Evensen, C Keller, S Yost, KJ Sangl, J Arora, NK AF Garfinkel, Steven Frentzel, Elizabeth Evensen, Christian Keller, San Yost, Kathleen J. Sangl, Judith Arora, Neeraj K. TI Developing CAHPS for cancer care prototype: Progress and next steps. SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Meeting Abstract CT ASCO's Quality Care Symposium CY NOV 01-02, 2013 CL San Diego, CA SP ASCO C1 Amer Inst Res, Chapel Hill, NC USA. Mayo Clin, Rochester, MN USA. Agcy Healthcare Res & Qual, Rockville, MD USA. NCI, NIH, Bethesda, MD 20892 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X EI 1527-7755 J9 J CLIN ONCOL JI J. Clin. Oncol. PD NOV 1 PY 2013 VL 31 IS 31 SU S MA 134 PG 1 WC Oncology SC Oncology GA AG6YR UT WOS:000335565500131 ER PT J AU Zeidan, AM Gore, SD McNally, DL Baer, MR Hendrick, F Mahmoud, D Davidoff, AJ AF Zeidan, Amer M. Gore, Steven D. McNally, Diane L. Baer, Maria R. Hendrick, Franklin Mahmoud, Dalia Davidoff, Amy J. TI Lenalidomide Performance in the Real World Patterns of Use and Effectiveness in a Medicare Population With Myelodysplastic Syndromes SO CANCER LA English DT Article DE myelodysplastic syndromes; lenalidomide; 5q deletion; Medicare population ID 5Q DELETION; EFFICACY; PHASE-2; RISK AB BACKGROUNDLenalidomide is approved for the treatment of anemia with transfusion dependence (TD) in patients with lower-risk myelodysplastic syndrome (MDS) with 5q deletion (del5q-MDS), but its real-life use and effect on transfusion needs are unclear. In the current study, the authors examined its use in the Medicare population. METHODSPatients with MDS who were enrolled in Medicare Parts A, B, and D were identified using International Classification of Diseases 9-Clinical Modification (ICD-9) codes from 100% Medicare claims from 2006 through 2008. Patients were followed until the end of the study or death. Claims were used to determine time to initiation of lenalidomide, daily dose, duration, and other MDS therapies. Transfusion status was defined each week based on transfusion use in rolling 8-week period: TD, required transfusions during 2 weeks, separated by 3 weeks; transfusion user (TU), 1 transfusion; and transfusion independence (TI), no transfusions. RESULTSA total of 753 of 23,855 patients (3.2%) received lenalidomide, including 31% of 470 patients with del5q-MDS. At the time of lenalidomide initiation, 33% of patients were TD, 31% were TU, and 36% were TI. The median time to lenalidomide initiation was shorter for patients with del5q-MDS than for other lower-risk patients (8 weeks vs 20 weeks; P<.01). The percentage of patients with del5q-MDS receiving lenalidomide increased over time. Lenalidomide initiation was found to be negatively associated with older age and baseline diabetes, stroke, and renal disease. During the observation period, 44% of TU/TD patients (53% of the patients with del5q-MDS) achieved reductions in transfusion use; among TD patients receiving 3 cycles, 77% reduced their transfusion use and 40% achieved TI. CONCLUSIONSTo the authors' knowledge, the current study is the first report of lenalidomide use in a large Medicare-enrolled population with MDS. Reductions in transfusion rates were overall consistent with data from clinical trials. Response rates were higher when 3 lenalidomide cycles were received. Cancer 2013;119:3870-3878. (c) 2013 American Cancer Society. C1 [Zeidan, Amer M.; Gore, Steven D.] Johns Hopkins Univ Hosp, Dept Oncol, Baltimore, MD 21287 USA. [McNally, Diane L.; Hendrick, Franklin] Univ Maryland, Sch Pharm, Baltimore, MD 21201 USA. [Baer, Maria R.] Univ Maryland, Greenebaum Canc Ctr, Baltimore, MD 21201 USA. [Mahmoud, Dalia] Celgene Corp, Summit, NJ USA. [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Zeidan, AM (reprint author), Johns Hopkins Univ Hosp, Dept Oncol, CRB1,Room 186, Baltimore, MD 21287 USA. EM azeidan1@jhmi.edu FU Celgene; National Institutes of Health/National Cancer Institute [RC1 CA145831] FX Funding was provided by Celgene. Dr. Gore, Ms. McNally, Dr. Baer, Mr. Hendrick, and Dr. Davidoff received partial funding from National Institutes of Health/National Cancer Institute grant RC1 CA145831 (Dr. Davidoff, Principal Investigator). NR 17 TC 11 Z9 11 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0008-543X EI 1097-0142 J9 CANCER-AM CANCER SOC JI Cancer PD NOV 1 PY 2013 VL 119 IS 21 BP 3870 EP 3878 DI 10.1002/cncr.28298 PG 9 WC Oncology SC Oncology GA 295BN UT WOS:000330091700021 PM 23922173 ER PT J AU Spector, WD Limcangco, R Mutter, R Owens, P AF Spector, W. D. Limcangco, R. Mutter, R. Owens, P. TI FACTORS AFFECTING THE DECISION TO HOSPITALIZE ADULTS PRESENTING IN THE ER WITH INJURIES: A COMPARISON OF ELDERLY AND NONELDERLY SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Spector, W. D.; Mutter, R.; Owens, P.] AHRQ, Rockville, MD USA. [Limcangco, R.] Social & Sci Syst Inc, Silver Spring, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0016-9013 EI 1758-5341 J9 GERONTOLOGIST JI Gerontologist PD NOV PY 2013 VL 53 SU 1 BP 369 EP 369 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 258EN UT WOS:000327442104333 ER PT J AU Basu, J Friedman, B AF Basu, Jayasree Friedman, Bernard TI Adverse Events for Hospitalized Medicare Patients: Is There a Difference between HMO and FFS Enrollees? SO SOCIAL WORK IN PUBLIC HEALTH LA English DT Article DE Adverse events; Medicare HMO; fee-for-service; hospitalized patients ID ICD-9-CM ADMINISTRATIVE DATA; CLINICAL COMORBIDITY INDEX; CARE; SEVERITY; INJURIES; SURGERY; ILLNESS; SAFETY; CHOICE AB The study examines the likelihood of adverse outcomes associated with selected hospital safety events for two groups of Medicare patients: those enrolled in health maintenance organizations (HMOs) versus those enrolled in fee-for-service (FFS) insurance plans. The authors hypothesize that HMO patients may receive different qualities of hospital services and/or physician services relative to FFS patients. Based on the Healthcare Cost and Utilization Project State Inpatient Database, the authors include discharge data on all hospitalized elderly Medicare patients in Florida in 2002 and use multivariate logistic regression models with adjustments for hospital-level clusters. The findings demonstrate that, after adjusting for hospital quality, Medicare HMO patients were at higher risk of adverse outcomes than Medicare FFS patients for iatrogenic pneumothorax, accidental puncture or laceration, and postoperative respiratory failure. C1 [Basu, Jayasree; Friedman, Bernard] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Basu, J (reprint author), Agcy Healthcare Res & Qual, Ctr Primary Care Prevent & Clin Partnerships, 540 Gaither Rd, Rockville, MD 20850 USA. EM Jayasree.basu@ahrq.hhs.gov NR 26 TC 0 Z9 0 U1 0 U2 0 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1937-1918 EI 1937-190X J9 SOC WORK PUBLIC HLTH JI Soc. Work Public Health PD NOV 1 PY 2013 VL 28 IS 7 BP 639 EP 651 DI 10.1080/19371918.2011.592089 PG 13 WC Public, Environmental & Occupational Health; Social Work SC Public, Environmental & Occupational Health; Social Work GA 268QS UT WOS:000328186200001 PM 24074128 ER PT J AU Devers, KJ Foster, L Brach, C AF Devers, Kelly J. Foster, Leslie Brach, Cindy TI Nine States' Use of Collaboratives to Improve Children's Health Care Quality in Medicaid and CHIP SO ACADEMIC PEDIATRICS LA English DT Article DE collaborative; Medicaid/CHIP; patient-centered medical home; primary care; quality improvement ID SERVICES RESEARCH AB We examine quality improvement (QI) collaboratives underway in 9 states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program. A total of 147 diverse, child-serving practices were participating in the collaboratives. We conducted 256 semistructured interviews with key stakeholders from March to August 2012-2 years into the 5-year demonstration projects and analyzed states' grant applications, operating plans, and progress reports. The collaboratives have multiple complex aims. In addition to developing patient-centered medical home (PCMH) capability, some states use collaboratives to familiarize practices with CMS's Initial Core Set of Children's Health Care Quality Measures, practice-level quality measurement, and improving QI knowledge and skills. The duration of the collaboratives is longer than other well-known collaborative models. Collaboratives also vary in their methods for targeting areas for improvement and strategies for motivating practice recruitment and engagement. States also vary with respect to the other strategies they use to support QI and PCMH development. All states supplement the collaboratives with practice facilitation; the majority utilized practice-level parent engagement, but only 4 used work-force augmentation (ie, providing care coordinators and QI specialists). Practice staff highly valued aspects of the collaboratives and supplemental strategies, including the opportunity to work with experts and other child-serving practices; states' efforts to provide stipends and align demonstration efforts with other professional requirements or programs; receipt of relevant, customized QI materials; opportunities to learn how care coordinators or QI specialists might work in their practice without the risk of hiring them; and satisfaction from learning more about quality measures, QI concepts and techniques, critical medical home components, and how to identify PCMH capacity and performance gaps. However, practice staff also reported a variety of challenges, including difficulty learning from other practices that have very different preexisting QI and PCMH capacity and patient populations, or that are working on different topic areas and measures; a sometimes overwhelming amount of materials and ideas covered during in-person meetings; difficulty keeping up with Webinars, calls, and Web sites/blogs; and trouble motivating and sharing information with other practice staff not attending collaborative activities. As the demonstration projects continue, states and the national evaluation team will learn more about how best to use collaboratives and complementary strategies to support child-serving practices in QI and PCMH development. States will also search for ways to sustain and spread these activities after the demonstration ends, if they prove effective. C1 [Devers, Kelly J.] Urban Inst, Ctr Hlth Policy, Washington, DC 20037 USA. [Foster, Leslie] Math Policy Res Inc, Oakland, CA USA. [Brach, Cindy] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Devers, KJ (reprint author), 2100 M St NW, Washington, DC 20037 USA. EM kdevers@urban.org FU Agency for Healthcare Quality and Research (AHRQ) [HHSA29020090002191]; Urban Institute (UI); AcademyHealth FX The national evaluation of the CHIPRA Quality Demonstration Grant Program is supported by a contract (HHSA29020090002191) from the Agency for Healthcare Quality and Research (AHRQ) to Mathematica Policy Research (MPR) and its partners, the Urban Institute (UI) and AcademyHealth. Special thanks are due to Karen Llanos at CMS, Henry Ireys at MPR, Rachel Burton and Rebecca Peters at UT, and Stacy Farr (formerly) at AHRQ for their careful review and many helpful comments. We particularly appreciate the help received from demonstration staff and providers in the 9 states featured in this article and the time they spent answering many questions during our site visits and reviewing an early draft. The observations contained in this article represent the views of the authors and do not necessarily reflect the opinions or perspectives of any state or federal agency, Mathematica Policy Research, or the Urban Institute. NR 29 TC 7 Z9 7 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD NOV-DEC PY 2013 VL 13 IS 6 SU S BP S95 EP S102 PG 8 WC Pediatrics SC Pediatrics GA 261TY UT WOS:000327688700018 PM 24268093 ER PT J AU McCormick, MC Co, JPT Dougherty, D AF McCormick, Marie C. Co, John Patrick T. Dougherty, Denise TI Quality Improvement in Pediatric Health Care: Introduction to the Supplement SO ACADEMIC PEDIATRICS LA English DT Editorial Material C1 [Dougherty, Denise] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [McCormick, Marie C.] Harvard Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA 02115 USA. [Co, John Patrick T.] MassGen Hosp Children, Dept Pediat, MGH Ctr Child & Adolescent Hlth Res Policy, Boston, MA USA. RP Dougherty, D (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM denise.dougherty@ahrq.hhs.gov NR 19 TC 4 Z9 4 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 EI 1876-2867 J9 ACAD PEDIATR JI Acad. Pediatr. PD NOV-DEC PY 2013 VL 13 IS 6 SU S BP S1 EP S4 PG 4 WC Pediatrics SC Pediatrics GA 261TY UT WOS:000327688700001 PM 24268076 ER PT J AU Abdus, S Selden, TM AF Abdus, Salam Selden, Thomas M. TI Preventive Services for Adults How have Differences Across Subgroups Changed Over the Past Decade? SO MEDICAL CARE LA English DT Article DE preventive services; disparities; adult ID HEALTH-CARE SERVICES; UNITED-STATES; RACIAL/ETHNIC DISPARITIES; MAMMOGRAPHY; WOMEN; ACCESS; TRENDS AB Background:A large literature documents cross-sectional differences in adult preventive services across population subgroups. Less is known, however, about how these differences have changed over time.Objectives:This study tracks changes over time in the distribution of preventive services use across groups defined by poverty status, race/ethnicity, insurance coverage, Census region, and urbanicity.Methods:Data from the 1996-2008 Medical Expenditure Panel Survey are used to examine 5 preventive services: general checkups, blood pressure screening, blood cholesterol screening, Pap smears, and mammograms. Multivariate logistic regression models of preventive services use are used to compute adjusted utilization for each subgroup of adults aged 19-64 in 1996/1998, 2002/2003, and 2007/2008. We then examine the extent to which percentage point gaps in utilization rates across subgroups have changed between 1996/1998 and 2007/2008.Results:Our analysis of utilization rates across subgroups and over time identified only rare cases in which subgroup differences narrowed or widened between 1996/1998 and 2007/2008. Rather, differences across subgroups tended to persist over time. Some of the largest (adjusted) gaps are between adults with and without coverage, and only for blood cholesterol screening do we observe significant narrowing of the gap between the uninsured and the privately insured. Regional differences persisted or widened over the study period.Conclusions:On the eve of health reform implementation, a key challenge facing the Affordable Care Act will be to address persistent differences in preventive services use within the US population. C1 [Abdus, Salam] Social & Sci Syst, Rockville, MD 20850 USA. [Selden, Thomas M.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Div Modeling & Simulat, Rockville, MD USA. RP Abdus, S (reprint author), Social & Sci Syst, 540 Gaither Rd, Rockville, MD 20850 USA. EM salam.abdus@ahrq.hhs.gov NR 42 TC 5 Z9 5 U1 0 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD NOV PY 2013 VL 51 IS 11 BP 999 EP 1007 DI 10.1097/MLR.0b013e3182a97bc0 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 239NZ UT WOS:000326033800008 PM 24036996 ER PT J AU Lori, JR Munro, ML Rominski, S Williams, G Dahn, BT Boyd, CJ Moore, JE Gwenegale, W AF Lori, Jody R. Munro, Michelle L. Rominski, Sarah Williams, Garfee Dahn, Bernice T. Boyd, Carol J. Moore, Jennifer E. Gwenegale, Walter TI Maternity waiting homes and traditional midwives in rural Liberia SO INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS LA English DT Article DE Liberia; Maternal mortality; Maternity waiting homes; Midwifery ID HEALTH AB Objective: Maternity waiting homes (MWHs) can reduce maternal morbidity and mortality by increasing access to skilled birth attendants (SBAs). The present analysis was conducted to determine whether MWHs increase the use of SBAs at rural primary health clinics in Liberia; to determine whether traditional midwives (TMs) are able to work with SBAs as a team and to describe the perceptions of TMs as they engage with SBAs; and to determine whether MWHs decrease maternal and child morbidity and mortality. Methods: The present analysis was conducted halfway through a large cohort study in which 5 Liberian communities received the intervention (establishment of an MWH) and 5 Liberian communities did not (control group). Focus groups were conducted to examine the views of TMs on their integration into health teams. Results: Communities with MWHs experienced a significant increase in team births from baseline to post-intervention (10.8% versus 95.2%, P < 0.001), with greater TM engagement. Lower rates of maternal and perinatal death were reported from communities with MWHs. Conclusion: The reduction in morbidity and mortality indicates that the establishment of MWHs is an effective strategy to increase the use of SBAs, improve the collaboration between SBAs and TMs, and improve maternal and neonatal health. (C) 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. C1 [Lori, Jody R.] Univ Michigan, Sch Nursing, Div Hlth Promot & Risk Reduct, Ann Arbor, MI 48109 USA. [Munro, Michelle L.; Boyd, Carol J.] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA. [Rominski, Sarah] Univ Michigan, Sch Med, Global REACH, Ann Arbor, MI USA. [Williams, Garfee] Phebe Hosp, Sch Nursing, Suakoko, Liberia. [Williams, Garfee; Dahn, Bernice T.; Gwenegale, Walter] Liberia Minist Hlth & Social Welf, Monrovia, Liberia. [Moore, Jennifer E.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Lori, JR (reprint author), Univ Michigan, Sch Nursing, Div Hlth Promot & Risk Reduct, 400 N Ingalls,Room 3352, Ann Arbor, MI 48109 USA. EM jrlori@umich.edu RI Mashamba-Thompson, Tivani /B-6087-2014 FU US Agency for International Development [USAID-M-OOA-GH-HSR-10-40]; Fogarty International Center at the National Institutes of Health [1 K01 TW00 8763-01A1]; National Institutes of Health, National Institutes for Nursing Research [F31NR01 2852, F31NR01 2855] FX The present study and the development of this article were supported in part by a research grant from the US Agency for International Development, Grant USAID-M-OOA-GH-HSR-10-40 (J.R.L. and CJ.B., co-principal investigators) and 1 K01 TW00 8763-01A1 from the Fogarty International Center at the National Institutes of Health (J.R.L., principal investigator). Support to M.LM. and J.E.M. was provided by the National Institutes of Health, National Institutes for Nursing Research grant numbers F31NR01 2852 and F31NR01 2855, respectively. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the US Department of Health and Human Services or the Agency for Healthcare Research and Quality. NR 19 TC 9 Z9 9 U1 0 U2 12 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0020-7292 EI 1879-3479 J9 INT J GYNECOL OBSTET JI Int. J. Gynecol. Obstet. PD NOV PY 2013 VL 123 IS 2 BP 114 EP 118 DI 10.1016/j.ijgo.2013.05.024 PG 5 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 239ES UT WOS:000326006000007 PM 23992657 ER PT J AU Cohen, SB Rohde, F Yu, W AF Cohen, Steven B. Rohde, Fred Yu, William TI Building Wave Response Rates in a Longitudinal Survey: Essential for Nonsampling Error Reduction or Last In-First Out? SO FIELD METHODS LA English DT Article DE reluctant respondents; attrition; adaptive survey designs; MEPS ID HEALTH SURVEYS; DESIGN; NONRESPONSE; UTILITY; COSTS; BIAS AB In national health care surveys, significant amounts of resources are allocated to obtaining the participation of households that constitute the last 5-10% of the overall survey response rate. This study examines the implications of a reduction in targeted first-round response rates in the Medical Expenditure Panel Survey (MEPS), a national health care survey designed to produce estimates of health care utilization, expenditures, and insurance coverage. The potential impact of this modification on annual and overall longitudinal survey response rates, survey estimates, and costs is determined and compared with an alternative approach that subsamples these difficult to field cases. Study findings revealed nonuniform results when evaluating the capacity of these alternative design strategies to achieve precision targets while simultaneously satisfying data collection budget constraints for a variety of medical care expenditure estimates. Based on these results, it was determined that additional experimentation was necessary prior to implementing design modifications. C1 [Cohen, Steven B.; Rohde, Fred; Yu, William] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. RP Cohen, SB (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, 540 Gaither Rd John M Eisenberg Bldg, Rockville, MD 20850 USA. EM scohen@ahrq.gov NR 33 TC 0 Z9 0 U1 0 U2 2 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1525-822X EI 1552-3969 J9 FIELD METHOD JI Field Methods PD NOV PY 2013 VL 25 IS 4 BP 361 EP 387 DI 10.1177/1525822X13507863 PG 27 WC Anthropology; Social Sciences, Interdisciplinary SC Anthropology; Social Sciences - Other Topics GA 236MN UT WOS:000325801400003 ER PT J AU Encinosa, WE Bae, J AF Encinosa, William E. Bae, Jaeyong TI Will Meaningful Use Electronic Medical Records Reduce Hospital Costs? SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article AB Background: More than one-third of the Centers for Medicare & Medicaid Services core meaningful use (MU) requirements deal with medication management. Objectives: To examine what impact the 5 core medication MU criteria have on hospital-acquired adverse drug events (ADEs) and their costs in 2010, as a baseline for the start of MU implementation in 2011. Data Sources: 2010 Florida State Inpatient Database (Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality), American Hospital Association (AHA) Healthcare IT Database Supplement to the AHA 2010 Annual Survey of Hospitals, and Hospital Compare. Methods: We developed one of the first quality indicators to track in-hospital ADEs in administrative data. Controlling for nonresponse selection bias, we used multivariate logit regression analysis to examine the impact of the 5 MU medication elements on the probability of an ADE and on its costs. Results: A hospital-acquired ADE was noted in 1.7% of hospitalizations. Odds of an ADE were 63% less in hospitals that adopted all 5 core medication MU elements (10% of hospitals in 2010) compared with hospitals that adopted no core elements. This effect was found even among low-performing hospitals with below-average Hospital Compare quality. Estimated hospital cost savings per averted ADE were $4790. If all hospitals in Florida had adopted all 5 functions, 55,700 ADEs would have been averted and $267 million per year would have been saved. Conclusions: Adoption of core medication MU elements will cut ADE rates, with cost savings that recoup 22% of information technology costs. C1 [Encinosa, William E.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Encinosa, William E.] Georgetown Univ, Rockville, MD USA. [Bae, Jaeyong] Emory Univ, Atlanta, GA 30322 USA. RP Encinosa, WE (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM william.encinosa@ahrq.hhs.gov FU Agency for Healthcare Research and Quality FX This study was funded by the Agency for Healthcare Research and Quality. NR 16 TC 1 Z9 1 U1 0 U2 1 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD NOV PY 2013 VL 19 SI SI BP ESP19 EP ESP25 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA V44PC UT WOS:000209759900004 PM 24511884 ER PT J AU Harris, AD Pineles, L Belton, B Johnson, JK Shardell, M Loeb, M Newhouse, R Dembry, L Braun, B Perencevich, EN Hall, KK Morgan, DJ AF Harris, Anthony D. Pineles, Lisa Belton, Beverly Johnson, J. Kristie Shardell, Michelle Loeb, Mark Newhouse, Robin Dembry, Louise Braun, Barbara Perencevich, Eli N. Hall, Kendall K. Morgan, Daniel J. CA Benefits Universal Glove Gown BUGG TI Universal Glove and Gown Use and Acquisition of Antibiotic-Resistant Bacteria in the ICU A Randomized Trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID CARE-ASSOCIATED INFECTIONS; STAPHYLOCOCCUS-AUREUS; METHICILLIN-RESISTANT; INTENSIVE-CARE; CONTACT PRECAUTIONS; UNITED-STATES; TRANSMISSION; ENTEROCOCCUS; HOSPITALS; IMPACT AB IMPORTANCE Antibiotic-resistant bacteria are associated with increased patient morbidity and mortality. It is unknown whether wearing gloves and gowns for all patient contact in the intensive care unit (ICU) decreases acquisition of antibiotic-resistant bacteria. OBJECTIVE To assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) compared with usual care. DESIGN, SETTING, AND PARTICIPANTS Cluster-randomized trial in 20 medical and surgical ICUs in 20 US hospitals from January 4, 2012, to October 4, 2012. INTERVENTIONS In the intervention ICUs, all health care workers were required to wear gloves and gowns for all patient contact and when entering any patient room. MAIN OUTCOMES AND MEASURES The primary outcome was acquisition of MRSA or VRE based on surveillance cultures collected on admission and discharge from the ICU. Secondary outcomes included individual VRE acquisition, MRSA acquisition, frequency of health care worker visits, hand hygiene compliance, health care-associated infections, and adverse events. RESULTS From the 26 180 patients included, 92 241 swabs were collected for the primary outcome. Intervention ICUs had a decrease in the primary outcome of MRSA or VRE from 21.35 acquisitions per 1000 patient-days (95% CI, 17.57 to 25.94) in the baseline period to 16.91 acquisitions per 1000 patient-days (95% CI, 14.09 to 20.28) in the study period, whereas control ICUs had a decrease in MRSA or VRE from 19.02 acquisitions per 1000 patient-days (95% CI, 14.20 to 25.49) in the baseline period to 16.29 acquisitions per 1000 patient-days (95% CI, 13.48 to 19.68) in the study period, a difference in changes that was not statistically significant (difference, -1.71 acquisitions per 1000 person-days, 95% CI, -6.15 to 2.73; P = .57). For key secondary outcomes, there was no difference in VRE acquisition with the intervention (difference, 0.89 acquisitions per 1000 person-days; 95% CI, -4.27 to 6.04, P = .70), whereas for MRSA, there were fewer acquisitions with the intervention (difference, -2.98 acquisitions per 1000 person-days; 95% CI, -5.58 to -0.38; P = .046). Universal glove and gown use also decreased health care worker room entry (4.28 vs 5.24 entries per hour, difference, -0.96; 95% CI, -1.71 to -0.21, P = .02), increased room-exit hand hygiene compliance (78.3% vs 62.9%, difference, 15.4%; 95% CI, 8.99% to 21.8%; P = .02) and had no statistically significant effect on rates of adverse events (58.7 events per 1000 patient days vs 74.4 events per 1000 patient days; difference, -15.7; 95% CI, -40.7 to 9.2, P = .24). CONCLUSIONS AND RELEVANCE The use of gloves and gowns for all patient contact compared with usual care among patients in medical and surgical ICUs did not result in a difference in the primary outcome of acquisition of MRSA or VRE. Although there was a lower risk of MRSA acquisition alone and no difference in adverse events, these secondary outcomes require replication before reaching definitive conclusions. C1 [Harris, Anthony D.; Pineles, Lisa; Johnson, J. Kristie; Shardell, Michelle; Morgan, Daniel J.] Univ Maryland, Sch Med, Baltimore, MD 21201 USA. [Belton, Beverly; Dembry, Louise] Yale New Haven Hlth Syst Ctr Healthcare Solut, New Haven, CT USA. [Loeb, Mark] McMaster Univ, Hamilton, ON, Canada. [Newhouse, Robin] Univ Maryland, Sch Nursing, Baltimore, MD 21201 USA. [Braun, Barbara] Joint Commiss, Oak Brook Terrace, IL USA. [Perencevich, Eli N.] Univ Iowa Hlth Care, Iowa City, IA USA. [Hall, Kendall K.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Morgan, Daniel J.] VA Maryland Hlth Care Syst, Baltimore, MD USA. RP Harris, AD (reprint author), Univ Maryland, Sch Med, 10 S Pine St,MSTF 330, Baltimore, MD 21201 USA. EM aharris@epi.umaryland.edu RI Jacob, Jesse/A-8836-2009; OI Lissauer, Matthew/0000-0002-6008-9778; Warren, David/0000-0001-8679-8241 FU Agency for Healthcare Research and Quality (AHRQ) [HHSA290200600015]; National Institutes of Health [5K25AG034216-03, 5K24AI079040-05]; AHRQ [1K08HS18111-01] FX This study was supported by grants HHSA290200600015 from the Agency for Healthcare Research and Quality (AHRQ), 5K25AG034216-03 (Dr Shardell) and 5K24AI079040-05 (Dr Harris) from the National Institutes of Health, and 1K08HS18111-01 (Dr Morgan) from the AHRQ. NR 41 TC 74 Z9 76 U1 3 U2 19 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 16 PY 2013 VL 310 IS 15 BP 1571 EP 1580 DI 10.1001/jama.2013.277815 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 234EP UT WOS:000325624800020 PM 24097234 ER PT J AU Gliklich, RE Levy, D Campion, DM Leavy, M Karl, J Berliner, E Khurana, L Hossfeld, W AF Gliklich, Richard E. Levy, Daniel Campion, Daniel M. Leavy, Michelle Karl, Jannette Berliner, Elise Khurana, Laura Hossfeld, Willet TI Registry of Patient Registries (RoPR): Advancing Registries for Comparative Effectiveness Research SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Meeting Abstract C1 [Gliklich, Richard E.; Levy, Daniel; Campion, Daniel M.; Leavy, Michelle; Karl, Jannette; Khurana, Laura; Hossfeld, Willet] A Quintiles Co, Outcome, Cambridge, MA USA. [Berliner, Elise] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1053-8569 EI 1099-1557 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD OCT PY 2013 VL 22 SU 1 SI SI MA 257 BP 124 EP 124 PG 1 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA AF7EJ UT WOS:000334876100238 ER PT J AU Gliklich, R Dreyer, N Hernandez-Diaz, S Cragan, J Tassinari, M Covington, D Ephross, S Chambers, C Berliner, E Leavy, M Khurana, L AF Gliklich, Richard Dreyer, Nancy Hernandez-Diaz, Sonia Cragan, Janet Tassinari, Melissa Covington, Deborah Ephross, Sara Chambers, Christina Berliner, Elise Leavy, Michelle Khurana, Laura TI Best Practices for Pregnancy Registries SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Meeting Abstract C1 [Gliklich, Richard; Dreyer, Nancy; Leavy, Michelle; Khurana, Laura] Outcome, Cambridge, MA USA. [Hernandez-Diaz, Sonia] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. [Cragan, Janet] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev DIsabil, Atlanta, GA USA. [Tassinari, Melissa] US FDA, Ctr Drug Evaluat & Res, Silver Spring, MD USA. [Covington, Deborah] PPD, Wilmington, NC USA. [Ephross, Sara] GlaxoSmithKline, Res Triangle Pk, NC USA. [Chambers, Christina] Univ Calif San Diego, La Jolla, CA 92093 USA. [Berliner, Elise] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1053-8569 EI 1099-1557 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD OCT PY 2013 VL 22 SU 1 SI SI MA 310 BP 150 EP 150 PG 1 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA AF7EJ UT WOS:000334876100289 ER PT J AU Kirby, JB Kaneda, T AF Kirby, James B. Kaneda, Toshiko TI 'Double Jeopardy' Measure Suggests Blacks And Hispanics Face More Severe Disparities Than Previously Indicated SO HEALTH AFFAIRS LA English DT Article ID SELF-RATED HEALTH; INSURANCE; MORTALITY; INEQUALITY; GENDER; LIFE; CARE; RACE AB Eliminating disparities in health and health care is a long-standing objective of the US government. Racial and ethnic differences in insurance coverage pose a major obstacle to achieving this objective. With important coverage provisions of the Affordable Care Act beginning to take effect, we propose a new way of conceptualizing and quantifying the racial and ethnic disadvantages of uninsurance over the course of a lifetime. Using a life expectancy approach, we estimate the number of years whites, blacks, and Hispanics can expect to live in insurance "double jeopardy": being uninsured while also in lesser health and, therefore, at higher risk of needing medical care. Our measures indicate that compared to whites, Hispanics and blacks are more likely not only to be uninsured at any point throughout most of their lives, but also to spend more years uninsured and spend more of these uninsured years at high risk of needing medical care. These life expectancy measures-designed for ease of use by policy makers, researchers, and the general public-have the potential to reframe the discussion of disparities and monitor progress toward their elimination. C1 [Kirby, James B.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Kaneda, Toshiko] Populat Reference Bur, Int Programs, Washington, DC USA. RP Kirby, JB (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. EM jkirby@ahrq.gov NR 40 TC 5 Z9 5 U1 3 U2 8 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD OCT PY 2013 VL 32 IS 10 BP 1766 EP 1772 DI 10.1377/hlthaff.2013.0434 PG 7 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 250GG UT WOS:000326837900012 PM 24101067 ER PT J AU Qasim, M Andrews, RM AF Qasim, Mehwish Andrews, Roxanne M. TI Despite Overall Improvement In Surgical Outcomes Since 2000, Income-Related Disparities Persist SO HEALTH AFFAIRS LA English DT Article ID PATIENT-SAFETY; SOCIOECONOMIC-STATUS; OPERATIVE MORTALITY; QUALITY IMPROVEMENT; HOSPITAL VOLUME; NATIONAL TRENDS; UNITED-STATES; SURGERY; COMPLICATIONS; ASSOCIATION AB Despite improvements in health care, disparities in care still exist and are widening for some health measures. This study examined postsurgical outcomes for patients from low-income areas as compared to outcomes for those from high-income areas in the United States from 2000 to 2009. We found that postsurgical outcomes improved in general, with significant decreases in nine of twelve mortality and patient safety measures and an increase in one measure. Patients from low-income areas had worse surgical outcomes than those from high-income areas for nine of twelve measures in both 2000 and 2009. The disparities in outcomes between low-and high-income groups did not change significantly for nine of the twelve measures. For the three measures that did change significantly, in only two of the cases was the change favorable for patients from low-income areas. These findings have implications for efforts to improve surgical outcomes and health policy and indicate the need for research on the cause of continued disparities in postsurgical outcomes. C1 [Qasim, Mehwish] Univ Iowa, Dept Hlth Management & Policy, Iowa City, IA 52242 USA. [Andrews, Roxanne M.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Qasim, M (reprint author), Univ Iowa, Dept Hlth Management & Policy, Iowa City, IA 52242 USA. EM mehwish-qasim@uiowa.edu FU Agency for Healthcare Research and Quality FX Financial support for this study was provided by the Agency for Healthcare Research and Quality, which employed the authors during the time period of the study. The authors thank the statewide data organizations that participate in the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project: Arizona Department of Health Services; Arkansas Department of Health; California Office of Statewide Health Planning and Development; Colorado Hospital Association; Connecticut Hospital Association; Florida Agency for Health Care Administration; Georgia Hospital Association; Hawaii Health Information Corporation; Illinois Department of Public Health; Indiana Hospital Association; Iowa Hospital Association; Kansas Hospital Association; Kentucky Cabinet for Health and Family Services; Louisiana Department of Health and Hospitals; Maine Health Data Organization; Maryland Health Services Cost Review Commission; Massachusetts Division of Health Care Finance and Policy; Michigan Health and Hospital Association; Minnesota Hospital Association; Missouri Hospital Industry Data Institute; Nebraska Hospital Association; Nevada Department of Health and Human Services; New Hampshire Department of Health and Human Services; New Jersey Department of Health and Senior Services; New Mexico Health Policy Commission; New York State Department of Health; North Carolina Department of Health and Human Services; Ohio Hospital Association; Oklahoma State Department of Health; Oregon Association of Hospitals and Health Systems; Pennsylvania Health Care Cost Containment Council; Rhode Island Department of Health; South Carolina State Budget and Control Board; South Dakota Association of Healthcare Organizations; Tennessee Hospital Association; Texas Department of State Health Services; Utah Department of Health; Vermont Association of Hospitals and Health Systems; Virginia Health Information; Washington State Department of Health; West Virginia Health Care Authority; Wisconsin Department of Health Services; and Wyoming Hospital Association. The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality or the US Department of Health and Human Services. NR 40 TC 4 Z9 4 U1 0 U2 2 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD OCT PY 2013 VL 32 IS 10 BP 1773 EP 1780 DI 10.1377/hlthaff.2013.0194 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 250GG UT WOS:000326837900013 PM 24101068 ER PT J AU Lowe, S Ross, M Wheatley, M Hockenberry, J Mutter, R AF Lowe, S. Ross, M. Wheatley, M. Hockenberry, J. Mutter, R. TI The Impact of a Protocol-Driven Emergency Department Observation Unit on Prolonged Inpatient Observation Stays SO ANNALS OF EMERGENCY MEDICINE LA English DT Meeting Abstract CT Research Forum of the American-College-of-Emergency-Physicians (ACEP) CY OCT 14-15, 2013 CL Seattle, WA SP Amer Coll Emergency Phys C1 Emory Univ, Atlanta, GA 30322 USA. Rollins Sch Publ Hlth, Atlanta, GA USA. Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD OCT PY 2013 VL 62 IS 4 SU S BP S59 EP S60 PG 2 WC Emergency Medicine SC Emergency Medicine GA 232PO UT WOS:000325506500156 ER PT J AU Henriksen, K Brady, J AF Henriksen, Kerm Brady, Jeff TI The pursuit of better diagnostic performance: a human factors perspective SO BMJ QUALITY & SAFETY LA English DT Editorial Material DE Diagnostic errors; Human factors; Information technology; Checklists; Simulation ID BLOOD-STREAM INFECTIONS; ERRORS; CARE; SAFETY; MEDICINE; SYSTEMS AB Despite the relatively slow start in treating diagnostic error as an amenable research topic at the beginning of the patient safety movement, interest has steadily increased over the past few years in the form of solicitations for research, regularly scheduled conferences, an expanding literature and even a new professional society. Yet improving diagnostic performance increasingly is recognised as a multifaceted challenge. With the aid of a human factors perspective, this paper addresses a few of these challenges, including questions that focus on who owns the problem, treating cognitive and system shortcomings as separate issues, why knowledge in the head is not enough, and what we are learning from health information technology (IT) and the use of checklists. To encourage empirical testing of interventions that aim to improve diagnostic performance, a systems engineering approach making use of rapid-cycle prototyping and simulation is proposed. To gain a fuller understanding of the complexity of the sociotechnical space where diagnostic work is performed, a final note calls for the formation of substantive partnerships with those in disciplines beyond the clinical domain. C1 [Henriksen, Kerm; Brady, Jeff] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Henriksen, K (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Kerm.Henriksen@ahrq.hhs.gov NR 45 TC 1 Z9 1 U1 1 U2 9 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 2044-5415 EI 2044-5423 J9 BMJ QUAL SAF JI BMJ Qual. Saf. PD OCT PY 2013 VL 22 SU 2 BP ii1 EP ii5 DI 10.1136/bmjqs-2013-001827 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 222NC UT WOS:000324736900001 PM 23704082 ER PT J AU Levit, KR Friedman, B Wong, HS AF Levit, Katharine R. Friedman, Bernard Wong, Herbert S. TI Estimating Inpatient Hospital Prices from State Administrative Data and Hospital Financial Reports SO HEALTH SERVICES RESEARCH LA English DT Article DE Inpatient hospital prices; revenue; Medicare; Medicaid; private insurance ID MEDICARE; COSTS AB ObjectiveTo develop a tool for estimating hospital-specific inpatient prices for major payers. Data SourcesAHRQ Healthcare Cost and Utilization Project State Inpatient Databases and complete hospital financial reporting of revenues mandated in 10 states for 2006. Study DesignHospital discharge records and hospital financial information were merged to estimate revenue per stay by payer. Estimated prices were validated against other data sources. Principal FindingsHospital prices can be reasonably estimated for 10 geographically diverse states. All-payer price-to-charge ratios, an intermediate step in estimating prices, compare favorably to cost-to-charge ratios. Estimated prices also compare well with Medicare, MarketScan private insurance, and the Medical Expenditure Panel Survey prices for major payers, given limitations of each dataset. ConclusionsPublic reporting of prices is a consumer resource in making decisions about health care treatment; for self-pay patients, they can provide leverage in negotiating discounts off of charges. Researchers can also use prices to increase understanding of the level and causes of price differentials among geographic areas. Prices by payer expand investigational tools available to study the interaction of inpatient hospital price setting among public and private payersan important asset as the payer mix changes with the implementation of the Affordable Care Act. C1 [Levit, Katharine R.] Truven Hlth Analyt, Bethesda, MD 20814 USA. [Friedman, Bernard; Wong, Herbert S.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Levit, KR (reprint author), Truven Hlth Analyt, 7700 Old Georgetown Rd,Suite 650, Bethesda, MD 20814 USA. EM Katharine.levit@truvenhealth.com FU Truven Health Analytics; Agency for Healthcare Research and Quality FX The authors would like to acknowledge the data organizations that contributed data to HCUP that were used in this study: California Office of Statewide Health Planning and Development; Florida Agency for Health Care Administration; Massachusetts Division of Health Care Finance and Policy; Nevada Department of Health and Human Services; New Jersey Department of Health and Senior Services; Virginia Health Information; Washington State Department of Health; West Virginia Health Care Authority; and Wisconsin Department of Health Services. We also acknowledge the work of the Truven Health Analytics staff: Jayne Johann for obtaining the state financial information from states; Yu Sun for computer programming; and Linda Lee for editorial review. This study was supported by the Agency for Healthcare Research and Quality. The views expressed herein are those of the authors. No official endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality, or the data organizations that provided data used in this study is intended or should be inferred. NR 11 TC 10 Z9 10 U1 1 U2 7 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 2013 VL 48 IS 5 BP 1779 EP 1797 DI 10.1111/1475-6773.12065 PG 19 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 225YF UT WOS:000325000400015 PM 23662642 ER PT J AU Pezzin, LE Pollak, RA Schone, BS AF Pezzin, Liliana E. Pollak, Robert A. Schone, Barbara S. TI Complex Families and Late-Life Outcomes Among Elderly Persons: Disability, Institutionalization, and Longevity SO JOURNAL OF MARRIAGE AND FAMILY LA English DT Article DE aging; disability; divorce; families in middle and later life; intergenerational relations; stepfamilies ID SOCIAL RELATIONSHIPS; MARITAL TRANSITIONS; MENTAL-HEALTH; COURSE PERSPECTIVE; SUPPORT; MARRIAGE; REMARRIAGE; DIVORCE; PARENTS; FATHERS AB The authors examined the effects of marital status and family structure on disability, institutionalization, and longevity for a nationally representative sample of elderly persons using Gompertz duration models applied to longitudinal data from 3 cohorts of the Health and Retirement Study (N=11,481). They found that parents with only stepchildren have worse outcomes than parents with only biological children. Elderly mothers with only stepchildren become disabled and institutionalized sooner, and elderly men with only stepchildren have shorter longevity relative to their counterparts with only biological children. The effect of membership in a blended family differs by gender. Relative to those with only biological children, women in blended families have greater longevity and become disabled later, whereas men in blended families have reduced longevity. The findings indicate that changing marital patterns and increased complexity in family life have adverse effects on late-life health outcomes. C1 [Pezzin, Liliana E.] Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA. [Pezzin, Liliana E.] Med Coll Wisconsin, Hlth Policy Inst, Milwaukee, WI 53226 USA. [Pollak, Robert A.] Washington Univ, Dept Econ, St Louis, MO 63130 USA. [Pollak, Robert A.] Washington Univ, Olin Business Sch, St Louis, MO 63130 USA. [Schone, Barbara S.] Agcy Healthcare Res & Qual, Washington, DC 20057 USA. [Schone, Barbara S.] Georgetown Univ, Washington, DC 20057 USA. RP Pezzin, LE (reprint author), Med Coll Wisconsin, Dept Med, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA. EM lpezzin@mcw.edu FU NIA NIH HHS [R01 AG025475] NR 52 TC 4 Z9 4 U1 2 U2 34 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-2445 J9 J MARRIAGE FAM JI J. Marriage Fam. PD OCT PY 2013 VL 75 IS 5 BP 1084 EP 1097 DI 10.1111/jomf.12062 PG 14 WC Family Studies; Sociology SC Family Studies; Sociology GA 210JZ UT WOS:000323829900003 PM 24031097 ER PT J AU Yost, KJ Frentzel, E Egginton, JS Cowans, T Evensen, C Frost, MH Beebe, T Arora, NK Sangl, J Garfinkel, S AF Yost, Kathleen J. Frentzel, Elizabeth Egginton, Jason S. Cowans, Tamika Evensen, Christian Frost, Marlene H. Beebe, Timothy Arora, Neeraj K. Sangl, Judith Garfinkel, Steven TI Measuring cancer care quality: the impact of patient and stakeholder input on survey design SO QUALITY OF LIFE RESEARCH LA English DT Meeting Abstract C1 [Yost, Kathleen J.; Egginton, Jason S.; Frost, Marlene H.; Beebe, Timothy] Mayo Clin, Rochester, MN USA. [Frentzel, Elizabeth; Cowans, Tamika; Evensen, Christian; Arora, Neeraj K.; Garfinkel, Steven] Amer Inst Res, Chapel Hill, NC USA. [Sangl, Judith] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0962-9343 EI 1573-2649 J9 QUAL LIFE RES JI Qual. Life Res. PD OCT PY 2013 VL 22 SU 1 MA 205.1 PG 2 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA V38QX UT WOS:000209359000069 ER PT J AU Ngo-Metzger, Q Ward, JW Valdiserri, RO AF Ngo-Metzger, Quyen Ward, John W. Valdiserri, Ronald O. TI Expanded Hepatitis C Virus Screening Recommendations Promote Opportunities for Care and Cure SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material ID UNITED-STATES; PERSONS BORN; INFECTION C1 [Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Ward, John W.] Ctr Dis Control & Prevent, Atlanta, GA USA. [Valdiserri, Ronald O.] US Dept HHS, Washington, DC 20201 USA. RP Ngo-Metzger, Q (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. NR 8 TC 12 Z9 12 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 EI 1539-3704 J9 ANN INTERN MED JI Ann. Intern. Med. PD SEP 3 PY 2013 VL 159 IS 5 BP 364 EP + DI 10.7326/0003-4819-159-5-201309030-00675 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 215YA UT WOS:000324245900010 PM 23797155 ER PT J AU Charland, KM Buckeridge, DL Hoen, AG Berry, JG Elixhauser, A Melton, F Brownstein, JS AF Charland, Katia M. Buckeridge, David L. Hoen, Anne G. Berry, Jay G. Elixhauser, Anne Melton, Forrest Brownstein, John S. TI Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza-related hospitalizations in the United States SO INFLUENZA AND OTHER RESPIRATORY VIRUSES LA English DT Article DE Diet; exercise; influenza; influenza-like illness; obesity ID RESPIRATORY-TRACT INFECTION; RISK-FACTORS; ACQUIRED PNEUMONIA; DISEASE BURDEN; CHILDREN; HEALTH; VACCINATION; SYSTEM; COHORT; CARE AB Background Findings from studies examining the association between obesity and acute respiratory infection are inconsistent. Few studies have assessed the relationship between obesity-related behavioral factors, such as diet and exercise, and risk of acute respiratory infection. Objective To determine whether community prevalence of obesity, low fruit/vegetable consumption, and physical inactivity are associated with influenza-related hospitalization rates. Methods Using data from 274 US counties, from 2002 to 2008, we regressed county influenza-related hospitalization rates on county prevalence of obesity (BMI >= 30), low fruit/vegetable consumption (< 5 servings/day), and physical inactivity (< 30 minutes/month recreational exercise), while adjusting for community-level confounders such as insurance coverage and the number of primary care physicians per 100 000 population. Results A 5% increase in obesity prevalence was associated with a 12% increase in influenza-related hospitalization rates [ adjusted rate ratio (ARR) 1.12, 95% confidence interval (CI) 1.07, 1.17]. Similarly, a 5% increase in the prevalence of low fruit /vegetable consumption and physical inactivity was associated with an increase of 12% (ARR 1.12, 95% CI 1.08, 1.17) and 11% (ARR 1.11, 95% CI 1.07, 1.16), respectively. When all three variables were included in the same model, a 5% increase in prevalence of obesity, low fruit /vegetable consumption, and physical inactivity was associated with 6%, 8%, and 7% increases in influenza-related hospitalization rates, respectively. Conclusions Communities with a greater prevalence of obesity were more likely to have high influenza-related hospitalization rates. Similarly, less physically active populations, with lower fruit /vegetable consumption, tended to have higher influenzarelated hospitalization rates, even after accounting for obesity. C1 [Charland, Katia M.; Brownstein, John S.] Childrens Hosp, Childrens Hosp Informat Program, Boston, MA 02115 USA. [Charland, Katia M.; Berry, Jay G.; Brownstein, John S.] Harvard Univ, Sch Med, Dept Med, Div Gen Pediat,Childrens Hosp Boston, Boston, MA USA. [Charland, Katia M.; Buckeridge, David L.] McGill Univ, Surveillance Lab, McGill Clin & Hlth Informat, Montreal, PQ, Canada. [Charland, Katia M.; Buckeridge, David L.; Brownstein, John S.] McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada. [Buckeridge, David L.] Agence Sante & Serv Sociaux Montreal, Direct Sante Publ, Montreal, PQ, Canada. [Hoen, Anne G.] Dartmouth Coll, Geisel Sch Med, Dept Community & Family Med, Lebanon, NH 03756 USA. [Elixhauser, Anne] Agcy Healthcare Res & Qual, Rockville, MD USA. [Melton, Forrest] Calif State Univ, Div Sci & Environm Policy, Seaside, CA USA. [Melton, Forrest] NASA Ames Res Ctr, Sunnyvale, CA USA. RP Charland, KM (reprint author), 1140 Pine Ave West, Montreal, PQ H3A 1A3, Canada. EM katia.charland@mcgill.ca FU National Aeronautics and Space Administration [Feasibility-08-0024] FX The authors are grateful to Rick Jordan for technical help and Chris Delaney for fruitful discussions. Hospitalization data were contributed by the following HCUP State Inpatient Database: California Office of Statewide Health Planning and Development, Colorado Hospital Association, Florida Agency for Health Care Administration, Illinois Department of Public Health, Kansas Hospital Association, Maryland Health Services Cost Review Commission, Massachusetts Division of Health Care Finance and Policy, Minnesota Hospital Association, New Jersey Department of Health, New York State Department of Health, Ohio Hospital Association, Oregon Health Policy and Research, Oregon Association of Hospitals and Health Systems, South Carolina State Budget & Control Board, South Dakota Association of Healthcare Organizations, Texas Department of State Health Services, Utah Department of Health, Vermont Association of Hospitals and Health Systems, Washington State Department of Health, and Wisconsin Department of Health Services. This work was supported by the National Aeronautics and Space Administration grant number Feasibility-08-0024. NR 62 TC 8 Z9 8 U1 0 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1750-2640 EI 1750-2659 J9 INFLUENZA OTHER RESP JI Influenza Other Respir. Viruses PD SEP PY 2013 VL 7 IS 5 BP 718 EP 728 DI 10.1111/irv.12019 PG 11 WC Infectious Diseases; Virology SC Infectious Diseases; Virology GA 268HZ UT WOS:000328162300007 PM 23136926 ER PT J AU Charu, V Simonsen, L Lustig, R Steiner, C Viboud, C AF Charu, Vivek Simonsen, Lone Lustig, Roger Steiner, Claudia Viboud, Cecile TI Mortality burden of the 2009-10 influenza pandemic in the United States: improving the timeliness of influenza severity estimates using inpatient mortality records SO INFLUENZA AND OTHER RESPIRATORY VIRUSES LA English DT Article DE Age patterns; influenza; influenza-related mortality; pandemic influenza; years of life lost ID RESPIRATORY SYNCYTIAL VIRUS; SEASONAL INFLUENZA; LIFE LOST; A H1N1; HOSPITALIZATIONS; IMPACT; EPIDEMIOLOGY; DISEASE AB Background Delays in the release of national vital statistics hinder timely assessment of influenza severity, especially during pandemics. Inpatient mortality records could provide timelier estimates of influenza-associated mortality. Methods We compiled weekly age-specific deaths for various causes from US State Inpatient Databases (1990-2010) and national vital statistics (1990-2009). We calculated influenza-attributable excess deaths by season based on Poisson regression models driven by indicators of respiratory virus activity, seasonality, and temporal trends. Results Extrapolations of excess mortality from inpatient data fell within 11% and 17% of vital statistics estimates for pandemic and seasonal influenza, respectively, with high year-to-year correlation (Spearman's rho=087-090, P<0001, n=19). We attribute 14800 excess respiratory and cardiac deaths (95% CI: 10000-19650) to pandemic influenza activity during April 2009-April 2010, 79% of which occurred in people under 65years. Conclusions Modeling inpatient mortality records provides useful estimates of influenza severity in advance of national vital statistics release, capturing both the magnitude and the age distribution of pandemic and epidemic deaths. We provide the first age- and cause-specific estimates of the 2009 pandemic mortality burden using traditional excess mortality' methods, confirming the unusual burden of this virus in young populations. Our inpatient-based approach could help monitor mortality trends in other infectious diseases. C1 [Charu, Vivek; Simonsen, Lone; Viboud, Cecile] NIH, Fogarty Int Ctr, Bethesda, MD 20892 USA. [Charu, Vivek] Johns Hopkins Univ, Sch Med, Baltimore, MD USA. [Simonsen, Lone] George Washington Univ, Sch Publ Hlth & Hlth Serv, Dept Global Hlth, Washington, DC USA. [Lustig, Roger] Sage Analyt, Bethesda, MD USA. [Steiner, Claudia] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Charu, V (reprint author), NIH, Fogarty Int Ctr, Bldg 10, Bethesda, MD 20892 USA. EM charuvn@mail.nih.gov; viboudc@mail.nih.gov OI Simonsen, Lone/0000-0003-1535-8526 FU in-house Influenza Research Program of the Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health; International Influenza Unit, Office of Global Affairs, Department of Health and Human Services; RAPIDD program of the Science and Technology Directorate, Department of Homeland Security FX We thank Richard Jordan at the Agency for Healthcare Quality and Research (AHRQ) for his help in data extraction. This research was conducted in the context of the Multinational Influenza Seasonal Mortality Study (MISMS), an ongoing international collaborative effort to understand influenza epidemiological and evolutionary patterns, led by the Fogarty International Center, National Institutes of Health (http://www.origem.info/misms/index.php). This work was supported by the in-house Influenza Research Program of the Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, which is funded by the International Influenza Unit, Office of Global Affairs, Department of Health and Human Services. L.S. acknowledges support from the RAPIDD program of the Science and Technology Directorate, Department of Homeland Security. Part of the information contained in this manuscript was presented at the International Conference on Emerging Infectious Diseases (Atlanta, GA USA; March 2012). The authors do not have commercial or other associations that might pose a conflict of interest. NR 24 TC 7 Z9 7 U1 0 U2 5 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1750-2640 EI 1750-2659 J9 INFLUENZA OTHER RESP JI Influenza Other Respir. Viruses PD SEP PY 2013 VL 7 IS 5 BP 863 EP 871 DI 10.1111/irv.12096 PG 9 WC Infectious Diseases; Virology SC Infectious Diseases; Virology GA 268IE UT WOS:000328162800016 PM 23419002 ER PT J AU Clancy, CM AF Clancy, Carolyn M. TI Acute Care Quality Improves While Barriers to Access Remain: AHRQ's 2012 Healthcare Quality and Disparities Reports SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Editorial Material C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Clancy, CM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Carolyn.Clancy@ahrq.hhs.gov NR 3 TC 1 Z9 1 U1 1 U2 3 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1062-8606 J9 AM J MED QUAL JI Am. J. Med. Qual. PD SEP PY 2013 VL 28 IS 5 BP 443 EP 445 DI 10.1177/1062860613495148 PG 3 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 222NL UT WOS:000324737800011 PM 23880776 ER PT J AU Utter, GH Cox, GL Owens, PL Romano, PS AF Utter, Garth H. Cox, Ginger L. Owens, Pamela L. Romano, Patrick S. TI Challenges and Opportunities with ICD-10-CM/PCS: Implications for Surgical Research Involving Administrative Data SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Review C1 [Utter, Garth H.] Univ Calif Davis, Med Ctr, Dept Surg, Sacramento, CA 95817 USA. [Romano, Patrick S.] Univ Calif Davis, Med Ctr, Dept Internal Med, Sacramento, CA 95817 USA. [Utter, Garth H.; Cox, Ginger L.; Romano, Patrick S.] Univ Calif Davis, Med Ctr, Ctr Healthcare Policy & Res, Sacramento, CA 95817 USA. [Owens, Pamela L.] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. RP Utter, GH (reprint author), Univ Calif Davis, Med Ctr, Dept Surg, 2315 Stockton Blvd,Rm 4206 MH, Sacramento, CA 95817 USA. EM garth.utter@ucdmc.ucdavis.edu RI Romano, Patrick/N-4225-2014; OI Romano, Patrick/0000-0001-6749-3979; Utter, Garth/0000-0001-7747-3429 FU Agency for Healthcare Research and Quality [HHSA290201200001C] FX This article was supported by contract #HHSA290201200001C from the Agency for Healthcare Research and Quality. The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality or the US Department of Health and Human Services. NR 13 TC 3 Z9 4 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD SEP PY 2013 VL 217 IS 3 BP 516 EP 526 DI 10.1016/j.jamcollsurg.2013.04.029 PG 11 WC Surgery SC Surgery GA 213GK UT WOS:000324043300017 PM 23891069 ER PT J AU Yabroff, KR Short, PF Machlin, S Dowling, E Rozjabek, H Li, CY McNeel, T Ekwueme, DU Virgo, KS AF Yabroff, K. Robin Short, Pamela F. Machlin, Steven Dowling, Emily Rozjabek, Heather Li, Chunyu McNeel, Timothy Ekwueme, Donatus U. Virgo, Katherine S. TI Access to Preventive Health Care for Cancer Survivors SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID 2ND PRIMARY CANCERS; UNITED-STATES; MEDICAL-CARE; BREAST; MAINTENANCE AB Background: Access to health care, particularly effective primary and secondary preventive care, is critical for cancer survivors, in order to minimize the adverse sequelae of cancer and its treatment. Purpose: The goal of the study was to evaluate the association between cancer survivorship and access to primary and preventive health care. Methods: Cancer survivors (n=4960) and individuals without a cancer history (n=64,431) aged >= 18 years, from the 2008-2010 Medical Expenditure Panel Survey (MEPS), were evaluated. Multiple measures of access and preventive services use were compared. The association between cancer survivorship and access and preventive services was evaluated with multivariate logistic regression models, stratified by age group (18-64 years and >= 65 years), controlling for the effects of age, gender, race/ethnicity, education, marital status, and comorbidities. Data were analyzed in 2013. Results: Cancer survivors aged >= 65 years had equivalent or greater access and preventive services use than individuals without a cancer history, in adjusted analyses. However, among those aged 18-64 years with private health insurance, cancer survivors were more likely than other individuals to have a usual source of care and to use preventive services, whereas uninsured or publicly insured cancer survivors were generally less likely to have a usual source of care and to use preventive services than were uninsured or publicly insured adults without a cancer history. Conclusions: Although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine C1 [Yabroff, K. Robin; Rozjabek, Heather] NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. [Machlin, Steven] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [McNeel, Timothy] Informat Management Serv Inc, Calverton, MD USA. [Short, Pamela F.] Penn State Univ, Ctr Hlth Care & Policy Res, University Pk, PA 16802 USA. [Dowling, Emily] Massachusetts Gen Hosp, Inst Technol Assessment, Boston, MA 02114 USA. [Li, Chunyu; Ekwueme, Donatus U.] CDC, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. [Virgo, Katherine S.] Intramural Res Dept, Hlth Serv Res Program, Amer Canc Soc, Natl Home Off, Atlanta, GA USA. RP Yabroff, KR (reprint author), NCI, Hlth Serv & Econ Branch, 9609 Med Ctr Dr,3E436, Rockville, MD 20850 USA. EM yabroffr@mail.nih.gov NR 28 TC 10 Z9 10 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD SEP PY 2013 VL 45 IS 3 BP 304 EP 312 DI 10.1016/j.amepre.2013.04.021 PG 9 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 202CU UT WOS:000323191900008 ER PT J AU Yehia, BR Fleishman, JA Moore, RD Gebo, KA AF Yehia, Baligh R. Fleishman, John A. Moore, Richard D. Gebo, Kelly A. TI Retention in Care and Health Outcomes of Transgender Persons Living With HIV SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID UNITED-STATES C1 [Yehia, Baligh R.] Univ Penn, Perelman Sch Med, Dept Med, Philadelphia, PA 19104 USA. [Yehia, Baligh R.] Philadelphia Vet Affairs Ctr Hlth Equity Res & Pr, Philadelphia, PA USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Moore, Richard D.; Gebo, Kelly A.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. RP Yehia, BR (reprint author), Univ Penn, Perelman Sch Med, 1309 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM byehia@upenn.edu FU NIAAA NIH HHS [R01 AA016893, R01-AA16893]; NIDA NIH HHS [K24-DA00432, R01 DA011602, K24 DA000432, R01-DA11602]; NIMH NIH HHS [K23-MH097647-01A1, K23 MH097647]; PHS HHS [HHSA290201100007C] NR 8 TC 12 Z9 12 U1 0 U2 7 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD SEP 1 PY 2013 VL 57 IS 5 BP 774 EP U2 DI 10.1093/cid/cit363 PG 3 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 199DJ UT WOS:000322974400028 PM 23723203 ER PT J AU Gagnier, JJ Morgenstern, H Altman, DG Berlin, J Chang, S McCulloch, P Sun, X Moher, D AF Gagnier, Joel J. Morgenstern, Hal Altman, Doug G. Berlin, Jesse Chang, Stephanie McCulloch, Peter Sun, Xin Moher, David CA Ann Arbor Clinical Heterogeneity C TI Consensus-based recommendations for investigating clinical heterogeneity in systematic reviews SO BMC MEDICAL RESEARCH METHODOLOGY LA English DT Review ID INDIVIDUAL PATIENT DATA; UPDATED METHOD GUIDELINES; META-REGRESSION; KNOWLEDGE TRANSLATION; RANDOMIZED-TRIALS; HEALTH-CARE; COCHRANE COLLABORATION; LINE RISK; METAANALYSIS; EVENTS AB Background: Critics of systematic reviews have argued that these studies often fail to inform clinical decision making because their results are far too general, that the data are sparse, such that findings cannot be applied to individual patients or for other decision making. While there is some consensus on methods for investigating statistical and methodological heterogeneity, little attention has been paid to clinical aspects of heterogeneity. Clinical heterogeneity, true effect heterogeneity, can be defined as variability among studies in the participants, the types or timing of outcome measurements, and the intervention characteristics. The objective of this project was to develop recommendations for investigating clinical heterogeneity in systematic reviews. Methods: We used a modified Delphi technique with three phases: (1) pre-meeting item generation; (2) face-to-face consensus meeting in the form of a modified Delphi process; and (3) post-meeting feedback. We identified and invited potential participants with expertise in systematic review methodology, systematic review reporting, or statistical aspects of meta-analyses, or those who published papers on clinical heterogeneity. Results: Between April and June of 2011, we conducted phone calls with participants. In June 2011 we held the face-to-face focus group meeting in Ann Arbor, Michigan. First, we agreed upon a definition of clinical heterogeneity: Variations in the treatment effect that are due to differences in clinically related characteristics. Next, we discussed and generated recommendations in the following 12 categories related to investigating clinical heterogeneity: the systematic review team, planning investigations, rationale for choice of variables, types of clinical variables, the role of statistical heterogeneity, the use of plotting and visual aids, dealing with outlier studies, the number of investigations or variables, the role of the best evidence synthesis, types of statistical methods, the interpretation of findings, and reporting. Conclusions: Clinical heterogeneity is common in systematic reviews. Our recommendations can help guide systematic reviewers in conducting valid and reliable investigations of clinical heterogeneity. Findings of these investigations may allow for increased applicability of findings of systematic reviews to the management of individual patients. C1 [Gagnier, Joel J.] Univ Michigan, Dept Orthopaed Surg, MedSport, Ann Arbor, MI 48106 USA. [Gagnier, Joel J.; Morgenstern, Hal] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA. [Altman, Doug G.] Univ Oxford, Ctr Stat Med, Oxford, England. [Berlin, Jesse] Johnson & Johnson Pharmaceut, Res & Dev, Philadelphia, PA USA. [Chang, Stephanie] Agcy Healthcare Res & Qual, Rockville, MD USA. [McCulloch, Peter] Univ Oxford, Ctr Evidence Based Med, Oxford, England. [Sun, Xin] Oregon Hlth & Sci Univ, Kaiser Permanente Ctr Hlth Res & Oregon, Evidence Based Practice Ctr, Portland, OR USA. [Moher, David] Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada. [Moher, David] Univ Ottawa, Dept Epidemiol, Ottawa, ON, Canada. RP Gagnier, JJ (reprint author), Univ Michigan, Dept Orthopaed Surg, MedSport, 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48106 USA. EM jgagnier@umich.edu OI Moher , David /0000-0003-2434-4206 FU National Library of Medicine [R21LM010832-02] FX This research was supported by a grant from the National Library of Medicine: Grant # R21LM010832-02. We would also like to acknowledge two research assistants on this project: Laura Chess and Patrick Kellam. See Additional file 1 for a complete list of the Ann Arbor Clinical Heterogeneity Consensus Group. NR 69 TC 15 Z9 15 U1 1 U2 9 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-2288 J9 BMC MED RES METHODOL JI BMC Med. Res. Methodol. PD AUG 30 PY 2013 VL 13 AR 106 DI 10.1186/1471-2288-13-106 PG 11 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 216YM UT WOS:000324322800001 PM 24004523 ER PT J AU Berry, SA Fleishman, JA Yehia, BR Korthuis, PT Agwu, AL Moore, RD Gebo, KA AF Berry, Stephen A. Fleishman, John A. Yehia, Baligh R. Korthuis, P. Todd Agwu, Allison L. Moore, Richard D. Gebo, Kelly A. CA HIV Res Network TI Thirty-day hospital readmission rate among adults living with HIV SO AIDS LA English DT Article DE AIDS-defining illness; healthcare utilization; HIV; outpatient hospital follow-up; readmission ID ACTIVE ANTIRETROVIRAL THERAPY; FOLLOW-UP; INFECTED PATIENTS; CONTROLLED-TRIAL; HEART-FAILURE; CELL COUNT; COHORT; RISK; CARE; DISEASE AB Objective:Thirty-day hospital readmission rate is receiving increasing attention as a quality-of-care indicator. The objective of this study was to determine readmission rates and to identify factors associated with readmission among persons living with HIV.Design:Prospective multicenter observational cohort.Setting:Nine US HIV clinics affiliated through the HIV Research Network.Participants:Patients engaged in HIV care during 2005-2010.Main outcome measure(s):Readmission rate was defined as the proportion of hospitalizations followed by a readmission within 30 days. Factors in multivariate analyses included diagnostic categories, patient demographic and clinical characteristics, and having an outpatient follow-up visit.Results:Among 11651 total index hospitalizations, the 30-day readmission rate was 19.3%. AIDS-defining illnesses (ADIs, 9.6% of index hospitalizations) and non-AIDS-defining infections (26.4% of index hospitalizations) had readmission rates of 26.2 and 16.6%, respectively. Factors independently associated with readmission included lower CD4(+) cell count [adjusted odds ratio 1.80 (1.53-2.11) for CD4(+) cell count <50 vs. 351cells/l], longer length of stay [1.77 (1.53-2.04) for 9 days vs. 1-3 days], and several diagnostic categories including ADI. Having an outpatient follow-up clinic visit was not associated with lower readmission risk [adjusted hazard ratio 0.98 (0.88-1.08)].Conclusion:The 19.3% readmission rate exceeds the 13.3% rate reported for the general population of 18-64-year-olds. HIV providers may use the 19.3% rate as a basis of comparison. Policymakers may consider the impact of HIV when estimating expected readmissions for a hospital or region. Preventing or recovering from severe immune dysfunction may be the most important factor to reducing readmissions. C1 [Berry, Stephen A.; Agwu, Allison L.; Moore, Richard D.; Gebo, Kelly A.] Johns Hopkins Univ, Baltimore, MD USA. [Fleishman, John A.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Yehia, Baligh R.] Univ Penn, Philadelphia, PA 19104 USA. [Korthuis, P. Todd] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. RP Berry, SA (reprint author), Johns Hopkins Sch Med, Div Infect Dis, 1503 E Jefferson St,Off 115, Baltimore, MD 21287 USA. EM sberry8@jhmi.edu FU Agency for Healthcare Research and Quality [HHSA290201100007C]; Health Resources and Services Administration [HHSH250201200008C]; National Institutes of Health [K23 AI084854, K23 MH097647, K23 AI084549]; Agency for Healthcare Research and Quality, Rockville, Maryland; Health Resources and Services Administration, Rockville, Maryland FX This work was supported by the Agency for Healthcare Research and Quality (HHSA290201100007C to R. D. M. and K. A. G.); the Health Resources and Services Administration (HHSH250201200008C to K. A. G.); and the National Institutes of Health (K23 AI084854 to SAB, K23 MH097647 to B.R.Y., and K23 AI084549 to A.L.A.).; Agency for Healthcare Research and Quality, Rockville, Maryland (Fred Hellinger, PhD, John Fleishman, PhD, Irene Fraser, PhD); Health Resources and Services Administration, Rockville, Maryland (Robert Mills, PhD, Faye Malitz, MS). NR 35 TC 6 Z9 6 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 EI 1473-5571 J9 AIDS JI Aids PD AUG 24 PY 2013 VL 27 IS 13 BP 2059 EP 2068 DI 10.1097/QAD.0b013e3283623d5f PG 10 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 248MG UT WOS:000326703500006 PM 23612008 ER PT J AU Spector, WD Limcangco, R Williams, C Rhodes, W Hurd, D AF Spector, William D. Limcangco, Rhona Williams, Christianna Rhodes, William Hurd, Donna TI Potentially Avoidable Hospitalizations for Elderly Long-stay Residents in Nursing Homes SO MEDICAL CARE LA English DT Article DE avoidable hospitalizations; nursing home; quality; transfers; elderly; risk factors; proportional hazard model ID COMPETING RISK; REDUCE HOSPITALIZATIONS; ALZHEIMERS-DISEASE; PRESSURE ULCERS; OWNERSHIP TYPE; OLDER-ADULTS; TERM-CARE; PNEUMONIA; PREDICTORS; FACILITY AB Background: Hospitalizations of long-stay nursing home (NH) residents are common. The high estimates of potentially avoidable hospitalizations in NHs suggest that efforts to reduce avoidable hospitalizations may be effective in lowering health care expenditures as well as improving the quality of care for NH residents. Objective: To determine the relationship between clinical risk factors, facility characteristics and State policy variables, and both avoidable and unavoidable hospitalizations. Method: Hospitalization risk is estimated using competing risks proportional hazards regressions. Three hospitalization measures were constructed: (1) ambulatory care-sensitive conditions (ACSCs); (2) additional NH-sensitive avoidable conditions (ANHACs); and (3) nursing home unavoidable conditions (NHUCs). In all models, we include clinical risk factors, facility characteristics, and State policy variables that may influence the decision to hospitalize. Subjects: The population of interest is a cohort of long-stay NH residents. Data are from the Nursing Home Stay file, a sample of residents in 10% of certified NHs in the United States (2006-2008). Results: Three fifths of hospitalizations were potentially avoidable and the majority was for infections, injuries, and congestive heart failure. Clinical risk factors include renal disease, diabetes, and a high number of medications among others. Staffing, quality, and reimbursement affect avoidable, but not unavoidable hospitalizations. Conclusions: A NH-sensitive measure of avoidable hospitalizations identifies both clinical facility and policy risk factors, emphasizing the potential for both reimbursement and clinical strategies to reduce hospitalizations from NHs. C1 [Spector, William D.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Limcangco, Rhona] Social & Sci Syst Inc, Silver Spring, MD USA. [Williams, Christianna] Abt Associates Inc, Durham, NC USA. [Rhodes, William; Hurd, Donna] ABT Associates Inc, Cambridge, MA 02138 USA. RP Spector, WD (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. EM William.Spector@ahrq.hhs.gov NR 45 TC 24 Z9 24 U1 3 U2 14 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD AUG PY 2013 VL 51 IS 8 BP 673 EP 681 DI 10.1097/MLR.0b013e3182984bff PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 202OX UT WOS:000323228500008 PM 23703648 ER PT J AU Schneeweiss, S Seeger, JD Jackson, JW Smith, SR AF Schneeweiss, Sebastian Seeger, John D. Jackson, John W. Smith, Scott R. TI Methods for Comparative Effectiveness Research/Patient-Centered Outcomes Research: From Efficacy to Effectiveness SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Editorial Material C1 [Schneeweiss, Sebastian; Seeger, John D.; Jackson, John W.] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02120 USA. [Smith, Scott R.] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Boston, MA USA. RP Schneeweiss, S (reprint author), Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Pharmacoepidemiol & Pharmacoecon, 1 Brigham Circle,Suite 3030, Boston, MA 02120 USA. EM Schneeweiss@post.harvard.edu RI Schneeweiss, Sebastian/C-2125-2013 NR 20 TC 4 Z9 5 U1 1 U2 10 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD AUG PY 2013 VL 66 IS 8 SU 1 BP S1 EP S4 DI 10.1016/j.jclinepi.2013.05.012 PG 4 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 188QA UT WOS:000322207400001 PM 23849143 ER PT J AU Padden, DL Connors, RA Posey, SM Ricciardi, R Agazio, JG AF Padden, Diane L. Connors, Rebecca A. Posey, Sheena M. Ricciardi, Richard Agazio, Janice G. TI Factors Influencing a Health Promoting Lifestyle in Spouses of Active Duty Military SO HEALTH CARE FOR WOMEN INTERNATIONAL LA English DT Article ID CORONARY-HEART-DISEASE; LOW-INCOME OVERWEIGHT; PERCEIVED STRESS; PHYSICAL-ACTIVITY; SOCIAL SUPPORT; RISK-FACTOR; PSYCHOLOGICAL DISTRESS; DEPLOYMENT SEPARATION; OBESE MOTHERS; PILOT PROGRAM AB The purpose of this study was to understand the factors influencing the health promoting behaviors (HPBs) of military spouses. Pender's Health Promotion Model provided the theoretical framework guiding this study. One hundred twelve female spouses were surveyed regarding their perceived health status, perceived stress, self-efficacy, social support, and participation in HPBs. Perceived health status, self-efficacy, social support, and HPBs were positively related, whereas perceived stress was negatively related. Hierarchical multiple regression analysis showed perceived stress and social support to be predictive of an overall health promoting lifestyle (HPLPII), with the full model explaining 49.7% of the variance. C1 [Padden, Diane L.; Connors, Rebecca A.; Posey, Sheena M.] Uniformed Serv Univ Hlth Sci, Grad Sch Nursing, Bethesda, MD 20814 USA. [Ricciardi, Richard] Agcy Healthcare Res & Qual, Ctr Primary Care Prevent & Clin Partnerships, Rockville, MD USA. [Agazio, Janice G.] Catholic Univ Amer, Sch Nursing, Washington, DC 20064 USA. RP Padden, DL (reprint author), Uniformed Serv Univ Hlth Sci, Grad Sch Nursing, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA. EM dpadden@usuhs.mil NR 56 TC 1 Z9 1 U1 1 U2 8 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0739-9332 J9 HEALTH CARE WOMEN IN JI Health Care Women Int. PD AUG 1 PY 2013 VL 34 IS 8 BP 674 EP 693 DI 10.1080/07399332.2012.736572 PG 20 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA 182HG UT WOS:000321731700004 PM 23531168 ER PT J AU Clancy, CM AF Clancy, Carolyn M. TI Children's electronic health records: has the tipping point arrived? SO JOURNAL OF COMPARATIVE EFFECTIVENESS RESEARCH LA English DT Editorial Material ID INFORMATION-TECHNOLOGY C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Clancy, CM (reprint author), Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. EM cclancy@ahrq.gov NR 7 TC 0 Z9 0 U1 0 U2 0 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 2042-6305 EI 2042-6313 J9 J COMP EFFECT RES JI J. Comp. Eff. Res. PD JUL PY 2013 VL 2 IS 4 BP 359 EP 361 DI 10.2217/CER.13.44 PG 3 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 301JH UT WOS:000330528100004 PM 24236674 ER PT J AU Clancy, CM AF Clancy, Carolyn M. TI Evidence-Based Toolkit Helps Organizations Reduce Patient Falls SO JOURNAL OF NURSING CARE QUALITY LA English DT Editorial Material C1 Agcy Hlth Care Res & Qual, Rockville, MD 20850 USA. RP Clancy, CM (reprint author), Agcy Hlth Care Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM carolyn.clancy@ahrq.hhs.gov NR 7 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1057-3631 EI 1550-5065 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JUL-SEP PY 2013 VL 28 IS 3 BP 195 EP 197 DI 10.1097/NCQ.0b013e318294a9d1 PG 3 WC Nursing SC Nursing GA 300MN UT WOS:000330468100001 PM 23715018 ER PT J AU Luoto, J Maglione, MA Johnsen, B Chang, C Higgs, ES Perry, T Shekelle, PG AF Luoto, Jill Maglione, Margaret A. Johnsen, Breanne Chang, Christine Higgs, Elizabeth S. Perry, Tanja Shekelle, Paul G. TI A Comparison of Frameworks Evaluating Evidence for Global Health Interventions SO PLOS MEDICINE LA English DT Editorial Material ID RADICAL-RETHINKING; ABHIJIT BANERJEE; POOR-ECONOMICS; QUALITY; RECOMMENDATIONS; METAANALYSIS; STRENGTH; POVERTY; TRIALS; GRADE C1 [Luoto, Jill; Maglione, Margaret A.; Johnsen, Breanne; Perry, Tanja; Shekelle, Paul G.] Rand Hlth, Southern Calif Evidence Based Practice Ctr, Santa Monica, CA USA. [Chang, Christine] Agcy Healthcare Res & Qual, Rockville, MD USA. [Higgs, Elizabeth S.] NIAID, NIH, Bethesda, MD 20892 USA. [Shekelle, Paul G.] West Los Angeles VA Med Ctr, Los Angeles, CA USA. RP Luoto, J (reprint author), Rand Hlth, Southern Calif Evidence Based Practice Ctr, Santa Monica, CA USA. EM jluoto@rand.org FU PHS HHS [HHSA290200710062I] NR 31 TC 5 Z9 5 U1 1 U2 3 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1549-1676 J9 PLOS MED JI PLos Med. PD JUL PY 2013 VL 10 IS 7 AR e1001469 DI 10.1371/journal.pmed.1001469 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 193VY UT WOS:000322590800001 PM 23874159 ER PT J AU Clancy, CM Sharp, BAC AF Clancy, Carolyn M. Sharp, Beth A. Collins TI Women's Health During Health Care Transformation SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material ID VETERANS C1 [Clancy, Carolyn M.; Sharp, Beth A. Collins] US Dept HHS, AHRQ, Rockville, MD 20850 USA. [Clancy, Carolyn M.] George Washington Univ, Sch Med, Washington, DC USA. RP Clancy, CM (reprint author), US Dept HHS, AHRQ, 540 Gaither Rd, Rockville, MD 20850 USA. EM Carolyn.clancy@ahrq.hhs.gov NR 9 TC 2 Z9 2 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUL PY 2013 VL 28 SU 2 BP S500 EP S503 DI 10.1007/s11606-013-2473-6 PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 184RL UT WOS:000321910900004 PM 23807056 ER PT J AU Chambers, DA Mullican, CA Stirratt, M AF Chambers, David A. Mullican, Charlotte A. Stirratt, Michael TI Health information technology and mental health services research: a path forward SO GENERAL HOSPITAL PSYCHIATRY LA English DT Editorial Material C1 [Chambers, David A.] NIMH, Div Serv & Intervent Res, NIH, Bethesda, MD 20892 USA. [Mullican, Charlotte A.] Agcy Healthcare Res & Qual, Ctr Primary Care Prevent & Clin Partnerships, Rockville, MD USA. [Stirratt, Michael] NIMH, Div AIDS Res, NIH, Bethesda, MD 20892 USA. RP Chambers, DA (reprint author), NIMH, Div Serv & Intervent Res, NIH, Bethesda, MD 20892 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0163-8343 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD JUL-AUG PY 2013 VL 35 IS 4 BP 329 EP 331 DI 10.1016/j.genhosppsych.2013.03.006 PG 3 WC Psychiatry SC Psychiatry GA 173UU UT WOS:000321107600001 PM 23582190 ER PT J AU Mustafa, RA Santesso, N Brozek, J Akl, EA Walter, SD Norman, G Kulasegaram, M Christensen, R Guyatt, GH Falck-Ytter, Y Chang, S Murad, MH Vist, GE Lasserson, T Gartlehner, G Shukla, V Sun, X Whittington, C Post, PN Lang, E Thaler, K Kunnamo, I Alenius, H Meerpohl, JJ Alba, AC Nevis, IF Gentles, S Ethier, MC Carrasco-Labra, A Khatib, R Nesrallah, G Kroft, J Selk, A Brignardello-Petersen, R Schunemann, HJ AF Mustafa, Reem A. Santesso, Nancy Brozek, Jan Akl, Elie A. Walter, Stephen D. Norman, Geoff Kulasegaram, Mahan Christensen, Robin Guyatt, Gordon H. Falck-Ytter, Yngve Chang, Stephanie Murad, Mohammad Hassan Vist, Gunn E. Lasserson, Toby Gartlehner, Gerald Shukla, Vijay Sun, Xin Whittington, Craig Post, Piet N. Lang, Eddy Thaler, Kylie Kunnamo, Ilkka Alenius, Heidi Meerpohl, Joerg J. Alba, Ana C. Nevis, Immaculate F. Gentles, Stephen Ethier, Marie-Chantal Carrasco-Labra, Alonso Khatib, Rasha Nesrallah, Gihad Kroft, Jamie Selk, Amanda Brignardello-Petersen, Romina Schuenemann, Holger J. TI The GRADE approach is reproducible in assessing the quality of evidence of quantitative evidence syntheses SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE GRADE; Inter-rater reliability; Levels of evidence; Evidence-based medicine; Reproducibility; Validation studies ID GUIDELINES; RECOMMENDATIONS; STRENGTH AB Objective: We evaluated the inter-rater reliability (IRR) of assessing the quality of evidence (QoE) using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Study Design and Setting: On completing two training exercises, participants worked independently as individual raters to assess the QoE of 16 outcomes. After recording their initial impression using a global rating, raters graded the QoE following the GRADE approach. Subsequently, randomly paired raters submitted a consensus rating. Results: The IRR without using the GRADE approach for two individual raters was 0.31 (95% confidence interval [95% CI] = 0.21-0.42) among Health Research Methodology students (n = 10) and 0.27 (95% CI = 0.19-0.37) among the GRADE working group members (n = 15). The corresponding IRR of the GRADE approach in assessing the QoE was significantly higher, that is, 0.66 (95% CI = 0.56-0.75) and 0.72 (95% CI = 0.61-0.79), respectively. The IRR further increased for three (0.80 [95% CI = 0.73-0.86] and 0.74 [95% CI = 0.65-0.81]) or four raters (0.84 [95% CI = 0.78-0.89] and 0.79 [95% CI = 0.71-0.85]). The IRR did not improve when QoE was assessed through a consensus rating. Conclusion: Our findings suggest that trained individuals using the GRADE approach improves reliability in comparison to intuitive judgments about the QoE and that two individual raters can reliably assess the QoE using the GRADE system. (c) 2013 Elsevier Inc. All rights reserved. C1 [Mustafa, Reem A.; Santesso, Nancy; Brozek, Jan; Akl, Elie A.; Walter, Stephen D.; Norman, Geoff; Kulasegaram, Mahan; Guyatt, Gordon H.; Alba, Ana C.; Nevis, Immaculate F.; Gentles, Stephen; Ethier, Marie-Chantal; Carrasco-Labra, Alonso; Khatib, Rasha; Nesrallah, Gihad; Brignardello-Petersen, Romina; Schuenemann, Holger J.] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4K1, Canada. [Brozek, Jan; Guyatt, Gordon H.; Schuenemann, Holger J.] McMaster Univ, Dept Med, Hamilton, ON L8S 4K1, Canada. [Akl, Elie A.] SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA. [Christensen, Robin] Copenhagen Univ Hosp, Musculoskeletal Stat Unit, Parker Inst, Frederiksberg, Denmark. [Falck-Ytter, Yngve] Case Western Reserve Univ, Louis Stokes Cleveland VA Med Ctr, Cleveland, OH 44106 USA. [Chang, Stephanie] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Murad, Mohammad Hassan] Mayo Clin, Knowledge & Evaluat Res Unit, Rochester, MN USA. [Vist, Gunn E.] Norwegian Knowledge Ctr Hlth Serv, N-0130 Oslo, Norway. [Lasserson, Toby] Cochrane Editorial Unit, London, England. [Gartlehner, Gerald] RTI Int, Durham, NC USA. [Shukla, Vijay] CADTH, Ottawa, ON K1S 5S8, Canada. [Sun, Xin] Kaiser Permanente Northwest, Ctr Hlth Res, Portland, OR 97227 USA. [Whittington, Craig] Natl Collaborating Ctr Mental Hlth, Ctr Outcomes Res & Effectiveness, Res Dept Clin Educ & Hlth Psychol, London, England. [Post, Piet N.] Post Voor Zorg, Delft, Netherlands. [Lang, Eddy] Univ Calgary, Dept Emergency Med, Calgary, AB 2NT 2T9, Canada. [Thaler, Kylie] Danube Univ Krems, Austrian Cochrane Branch, Dept Evidence Based Med & Clin Epidemiol, Krems, Austria. [Kunnamo, Ilkka; Alenius, Heidi] Duodecim Med Publicat Ltd, EBM Guidelines, Helsinki, Finland. [Meerpohl, Joerg J.] Univ Med Ctr Freiburg, Inst Med Biometry & Med Informat, German Cochrane Ctr, Freiburg, Germany. [Alba, Ana C.] Toronto Gen Hosp, Univ Hlth Network, Toronto, ON M5G 2C4, Canada. [Ethier, Marie-Chantal] Hosp Sick Children, Toronto, ON M5G 1X8, Canada. [Carrasco-Labra, Alonso; Brignardello-Petersen, Romina] Univ Chile, Evidence Based Dent Unit, Fac Dent, Santiago, Chile. [Khatib, Rasha] Populat Hlth Res Inst, Hamilton, ON L8L 2X2, Canada. [Nesrallah, Gihad] Humber River Reg Hosp, Toronto, ON M5B 1Z2, Canada. [Kroft, Jamie] Sunnybrook Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada. [Selk, Amanda] Womens Coll Hosp, Toronto, ON M5S 1B2, Canada. RP Schunemann, HJ (reprint author), McMaster Univ, Dept Clin Epidemiol & Biostat, HSC Room 2C15,1280 Main St,West, Hamilton, ON L8S 4K1, Canada. EM schuneh@mcmaster.ca RI Meerpohl, Joerg/J-4224-2013; Whittington, Craig/B-1380-2008; Kulasegaram, Kulamakan/H-6663-2016; Selk, Amanda/C-1441-2016; OI Meerpohl, Joerg/0000-0002-1333-5403; Whittington, Craig/0000-0002-1950-0334; Mustafa, Reem/0000-0002-2091-0875; Gartlehner, Gerald/0000-0001-5531-3678; Murad, Mohammad Hassan/0000-0001-5502-5975; Lang, Eddy/0000-0003-0850-4337 NR 21 TC 37 Z9 38 U1 0 U2 16 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD JUL PY 2013 VL 66 IS 7 BP 736 EP 742 DI 10.1016/j.jclinepi.2013.02.004 PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 164RI UT WOS:000320426800008 PM 23623694 ER PT J AU Shrestha, S Foxman, B Weinberger, DM Steiner, C Viboud, C Rohani, P AF Shrestha, Sourya Foxman, Betsy Weinberger, Daniel M. Steiner, Claudia Viboud, Cecile Rohani, Pejman TI Identifying the Interaction Between Influenza and Pneumococcal Pneumonia Using Incidence Data SO SCIENCE TRANSLATIONAL MEDICINE LA English DT Article ID TIME-SERIES ANALYSIS; HONG KONG INFLUENZA; STREPTOCOCCUS-PNEUMONIAE; PANDEMIC INFLUENZA; BACTERIAL PNEUMONIA; RESPIRATORY VIRUSES; UNITED-STATES; A H1N1; DISEASE; ASSOCIATION AB The association between influenza virus and the bacterium Streptococcus pneumoniae (pneumococcus) has been proposed as a polymicrobial system, whereby transmission and pathogenicity of one pathogen (the bacterium) are affected by interactions with the other (the virus). However, studies focusing on different scales of resolution have painted an inconsistent picture: Individual-scale animal experiments have unequivocally demonstrated an association, whereas epidemiological support in human populations is, at best, inconclusive. We integrate weekly incidence reports and a mechanistic transmission model within a likelihood-based inference framework to characterize the nature, timing, and magnitude of this interaction. We find support for a strong but short-lived interaction, with influenza infection increasing susceptibility to pneumococcal pneumonia similar to 100-fold. We infer modest population-level impacts arising from strong processes at the level of an individual, thereby resolving the dichotomy in seemingly inconsistent observations across scales. An accurate characterization of the influenza-pneumococcal interaction can form a basis for more effective clinical care and public health measures for pneumococcal pneumonia. C1 [Shrestha, Sourya; Rohani, Pejman] Univ Michigan, Dept Ecol & Evolutionary Biol, Ann Arbor, MI 48109 USA. [Shrestha, Sourya; Rohani, Pejman] Univ Michigan, Ctr Study Complex Syst, Ann Arbor, MI 48109 USA. [Foxman, Betsy] Univ Michigan, Dept Epidemiol, Ann Arbor, MI 48109 USA. [Weinberger, Daniel M.; Viboud, Cecile] NIH, Div Int Epidemiol & Populat Studies, Bethesda, MD 20892 USA. [Weinberger, Daniel M.] Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA. [Steiner, Claudia] US Dept HHS, Healthcare Cost & Utilizat Project, Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Rohani, Pejman] NIH, Fogarty Int Ctr, Bethesda, MD 20892 USA. RP Shrestha, S (reprint author), Univ Michigan, Dept Ecol & Evolutionary Biol, Ann Arbor, MI 48109 USA. EM sourya@umich.edu RI Foxman, Betsy/E-1836-2015; OI Shrestha, Sourya/0000-0002-6106-6834; Foxman, Betsy/0000-0001-6682-238X; Weinberger, Daniel/0000-0003-1178-8086 FU Vaccine Modeling Initiative of the Bill & Melinda Gates Foundation; Research and Policy in Infectious Disease Dynamics program of the Science and Technology Directorate, Department of Homeland Security, the Fogarty International Center, NIH FX Funding: S.S. and P. R. were supported by the Vaccine Modeling Initiative of the Bill & Melinda Gates Foundation. P. R. also received support from the Research and Policy in Infectious Disease Dynamics program of the Science and Technology Directorate, Department of Homeland Security, the Fogarty International Center, NIH. NR 62 TC 28 Z9 30 U1 2 U2 16 PU AMER ASSOC ADVANCEMENT SCIENCE PI WASHINGTON PA 1200 NEW YORK AVE, NW, WASHINGTON, DC 20005 USA SN 1946-6234 J9 SCI TRANSL MED JI Sci. Transl. Med. PD JUN 26 PY 2013 VL 5 IS 191 AR 191ra84 DI 10.1126/scitranslmed.3005982 PG 9 WC Cell Biology; Medicine, Research & Experimental SC Cell Biology; Research & Experimental Medicine GA 171KX UT WOS:000320928000005 PM 23803706 ER PT J AU Liu, YH Chen, HJ Liang, L Wang, YF AF Liu, Yinghui Chen, Hsin-jen Liang, Lan Wang, Youfa TI Parent-Child Resemblance in Weight Status and Its Correlates in the United States SO PLOS ONE LA English DT Article ID BODY-MASS INDEX; SELF-REPORTED WEIGHT; LIFE-STYLE FACTORS; FAMILIAL RESEMBLANCE; CATEGORICAL-DATA; QUEBEC FAMILY; HEALTH-SURVEY; OBESITY; OVERWEIGHT; ADIPOSITY AB Background: Few studies have examined parent-child resemblance in body weight status using nationally representative data for the US. Design: We analyzed Body Mass Index (BMI), weight status, and related correlates for 4,846 boys, 4,725 girls, and their parents based on US nationally representative data from the 2006 and 2007 Medical Expenditure Panel Survey (MEPS). Pearson partial correlation coefficients, percent agreement, weighted kappa coefficients, and binary and multinomial logistic regression were used to examine parent-child resemblance, adjusted for complex sampling design. Results: Pearson partial correlation coefficients between parent and child's BMI measures were 0.15 for father-son pairs, 0.17 for father-daughter pairs, 0.20 for mother-son pairs, and 0.23 for mother-daughter pairs. The weighted kappa coefficients between BMI quintiles of parent and child ranged from -0.02 to 0.25. Odds ratio analyses found children were 2.1 (95% confidence interval (CI): 1.6, 2.8) times more likely to be obese if only their father was obese, 1.9 (95% CI: 1.5, 2.4) times more likely if only their mother was obese, and 3.2 (95% CI: 2.5, 4.2) times more likely if both parents were obese. Conclusions: Parent-child resemblance in BMI appears weak and may vary across parent-child dyad types in the US population. However, parental obesity status is associated with children's obesity status. Use of different measures of parent-child resemblance in body weight status can lead to different conclusions. C1 [Liu, Yinghui; Chen, Hsin-jen; Wang, Youfa] Johns Hopkins Bloomberg Sch Publ Hlth, Johns Hopkins Global Ctr Childhood Obes, Baltimore, MD USA. [Liu, Yinghui; Chen, Hsin-jen; Wang, Youfa] Johns Hopkins Bloomberg Sch Publ Hlth, Ctr Human Nutr, Dept Int Hlth, Baltimore, MD USA. [Liang, Lan] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Wang, YF (reprint author), Johns Hopkins Bloomberg Sch Publ Hlth, Johns Hopkins Global Ctr Childhood Obes, Baltimore, MD USA. EM ywang@jhsph.edu OI Chen, Hsin-Jen/0000-0003-4876-634X FU NIH/NICHD [1R03HD058077-01A1, R03HD058077-01A1S1, 1R01HD064685-01A1] FX The study was supported by research grants from the NIH/NICHD (1R03HD058077-01A1, R03HD058077-01A1S1; 1R01HD064685-01A1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 39 TC 1 Z9 1 U1 6 U2 13 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD JUN 10 PY 2013 VL 8 IS 6 AR e65361 DI 10.1371/journal.pone.0065361 PG 12 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 164VY UT WOS:000320440500033 PM 23762352 ER PT J AU Conway, PH Mostashari, F Clancy, C AF Conway, Patrick H. Mostashari, Farzad Clancy, Carolyn TI The Future of Quality Measurement for Improvement and Accountability SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material C1 [Conway, Patrick H.; Mostashari, Farzad; Clancy, Carolyn] Dept Hlth & Human Serv, Washington, DC USA. [Conway, Patrick H.] Ctr Medicare & Medicaid Serv, Baltimore, MD 21244 USA. [Mostashari, Farzad] Off Natl Coordinator Hlth Informat Technol, Washington, DC USA. [Clancy, Carolyn] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Conway, PH (reprint author), Ctr Medicare & Medicaid Serv, 7500 Secur Blvd,Mailstop S3-02-01, Baltimore, MD 21244 USA. EM patrick.conway@cms.hhs.gov NR 5 TC 39 Z9 39 U1 1 U2 6 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 5 PY 2013 VL 309 IS 21 BP 2215 EP 2216 DI 10.1001/jama.2013.4929 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 156YC UT WOS:000319859200022 PM 23736730 ER PT J AU Laiteerapong, N Kirby, J Gao, Y Yu, TC Sharma, R Lee, SM Chin, M Nathan, AG Ngo-Metzger, Q Huang, ES AF Laiteerapong, Neda Kirby, James Gao, Yue Yu, Tzy-Chyi Sharma, Ravi Lee, Sang Mee Chin, Marshall Nathan, Aviva G. Ngo-Metzger, Quyen Huang, Elbert S. TI HEALTH CENTERS CARE FOR A SICKER POPULATION WITH FEWER CLINIC VISITS AND FEWER HOSPITALIZATIONS SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 36th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 24-27, 2013 CL Denver, CO SP Soc Gen Internal Med C1 [Laiteerapong, Neda; Gao, Yue; Lee, Sang Mee; Chin, Marshall; Nathan, Aviva G.; Huang, Elbert S.] Univ Chicago, Chicago, IL 60637 USA. [Kirby, James; Ngo-Metzger, Quyen] Agcy Healthcare Res & Qual, Rockville, MD USA. [Yu, Tzy-Chyi] NORC, Bethesda, MD USA. [Sharma, Ravi] Bur Primary Hlth Care, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUN PY 2013 VL 28 SU 1 BP S84 EP S84 PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA AB6ZP UT WOS:000331939300200 ER PT J AU Clancy, CM Margolis, PA Miller, M AF Clancy, Carolyn M. Margolis, Peter A. Miller, Marlene TI Collaborative Networks for Both Improvement and Research SO PEDIATRICS LA English DT Article DE Learning Networks; Rapid Learning Networks; Learning Healthcare System; quality improvement ID CONTINUING MEDICAL-EDUCATION; HEALTH-CARE QUALITY; PHYSICIAN; STRATEGIES; CHILDRENS; OUTCOMES AB Moving significant therapeutic discoveries beyond early biomedical translation or T1 science and into practice involves: (1) T2 science, identifying "the right treatment for the right patient in the right way at the right time" (eg, patient-centered outcomes research) and tools to implement this knowledge (eg, guidelines, registries); and (2) T3 studies addressing how to achieve health care delivery change. Collaborative improvement networks can serve as large-scale, health system laboratories to engage clinicians, researchers, patients, and parents in testing approaches to translate research into practice. Improvement networks are of particular importance for pediatric T2 and T3 research, as evidence to establish safety and efficacy of therapeutic interventions in children is often lacking. Networks for improvement and research are also consistent with the Institute of Medicine's Learning Healthcare Systems model in which learning networks provide a system for improving care and outcomes and generate new knowledge in near real-time. Creation of total population registries in collaborative network sites provides large, representative study samples with high-quality data that can be used to generate evidence and to inform clinical decision-making. Networks use collaboration, data, and quality-improvement methods to standardize practice. Therefore, variation in outcomes due to unreliable and unnecessary care delivery is reduced, increasing statistical power, and allowing a consistent baseline from which to test new strategies. In addition, collaborative networks for improvement and research offer the opportunity to not only make improvements but also to study improvements to determine which interventions and combination of strategies work best in what settings. C1 [Clancy, Carolyn M.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Margolis, Peter A.] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA. [Miller, Marlene] Childrens Hosp Assoc, Alexandria, VA USA. [Miller, Marlene] Johns Hopkins Childrens Ctr, Baltimore, MD USA. RP Clancy, CM (reprint author), AHRQ, John M Eisenberg Bldg,540 Gaither Rd, Rockville, MD 20850 USA. EM carolyn.clancy@ahrq.hhs.gov FU American Board of Pediatrics Foundation; Children's Hospital Association; James M. Anderson Center for Health Systems Excellence at Cincinnati Children's Hospital Medical Center; pediatric Center for Education and Research on Therapeutics; Agency for Healthcare Research and Quality [U19HS021114] FX The conference on which the articles in this supplement were based was funded by the American Board of Pediatrics Foundation, the National Association of Children's Hospitals and Related Institutions (now the Children's Hospital Association), the James M. Anderson Center for Health Systems Excellence at Cincinnati Children's Hospital Medical Center, and the pediatric Center for Education and Research on Therapeutics, supported by cooperative agreement number U19HS021114 from the Agency for Healthcare Research and Quality. NR 25 TC 7 Z9 7 U1 0 U2 16 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 EI 1098-4275 J9 PEDIATRICS JI Pediatrics PD JUN PY 2013 VL 131 SU 4 BP S210 EP S214 DI 10.1542/peds.2012-3786H PG 5 WC Pediatrics SC Pediatrics GA 181NR UT WOS:000321674900005 PM 23729762 ER PT J AU Timbie, JW Ringel, JS Fox, S Pillemer, F Waxman, DA Moore, M Hansen, CK Knebel, AR Ricciardi, R Kellermann, AL AF Timbie, Justin W. Ringel, Jeanne S. Fox, Steven Pillemer, Francesca Waxman, Daniel A. Moore, Melinda Hansen, Cynthia K. Knebel, Ann R. Ricciardi, Richard Kellermann, Arthur L. TI Systematic Review of Strategies to Manage and Allocate Scarce Resources During Mass Casualty Events SO ANNALS OF EMERGENCY MEDICINE LA English DT Review ID CONSTRAINED TRIAGE METHOD; HEALTH-CARE; DISASTER RESPONSE; ANTHRAX BIOTERRORISM; EMERGENCY RESPONSE; HURRICANE KATRINA; MEDICAL RESPONSE; TRAUMA WORKLOAD; SURGE-CAPACITY; COMPUTER-MODEL AB Study objective: Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs. Methods: Our literature search included MEDLINE, Scopus, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Database of Systematic Reviews, from 1990 through late 2011. We also searched the gray literature, using the New York Academy of Medicine's Grey Literature Report and key Web sites. We included both English- and foreign-language articles. We included studies that evaluated strategies used in actual mass casualty events or tested through drills, exercises, or computer simulations. We excluded studies that lacked a comparison group or did not report quantitative outcomes. Data extraction, quality assessment, and strength of evidence ratings were conducted by a single researcher and reviewed by a second; discrepancies were reconciled by the 2 reviewers. Because of heterogeneity in outcome measures, we qualitatively synthesized findings within categories of strategies. Results: From 5,716 potentially relevant citations, 74 studies met inclusion criteria. Strategies included reducing demand for health care services (18 studies), optimizing use of existing resources (50), augmenting existing resources (5), implementing crisis standards of care (5), and multiple categories (4). The evidence was sufficient to form conclusions on 2 strategies, although the strength of evidence was rated as low. First, as a strategy to reduce demand for health care services, points of dispensing can be used to efficiently distribute biological countermeasures after a bioterrorism attack or influenza pandemic, and their organization influences speed of distribution. Second, as a strategy to optimize use of existing resources, commonly used field triage systems do not perform consistently during actual mass casualty events. The number of high-quality studies addressing other strategies was insufficient to support conclusions about their effectiveness because of differences in study context, comparison groups, and outcome measures. Our literature search may have missed key resource management and allocation strategies because of their extreme heterogeneity. lnterrater reliability was not assessed for quality assessments or strength of evidence ratings. Publication bias is likely, given the large number of studies reporting positive findings. Conclusion: The current evidence base is inadequate to inform providers and policymakers about the most effective strategies for managing or allocating scarce resources during mass casualty events. Consensus on methodological standards that encompass a range of study designs is needed to guide future research and strengthen the evidence base. Evidentiary standards should be developed to promote consensus interpretations of the evidence supporting individual strategies. C1 [Timbie, Justin W.; Ringel, Jeanne S.; Fox, Steven; Pillemer, Francesca; Waxman, Daniel A.; Moore, Melinda; Kellermann, Arthur L.] RAND Corp, Santa Monica, CA USA. [Hansen, Cynthia K.] US Dept HHS, Off Assistant Secretary Preparedness & Response, Bethesda, MD USA. [Knebel, Ann R.] NINR, NIH, Bethesda, MD 20892 USA. [Ricciardi, Richard] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Timbie, JW (reprint author), RAND Corp, Santa Monica, CA USA. EM jtimbie@rand.org FU Southern California Evidence-based Practice Center from the Agency for Healthcare Research and Quality [290-2007-10062-I]; US Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response (ASPR) FX By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. This study was conducted by the Southern California Evidence-based Practice Center under contract 290-2007-10062-I from the Agency for Healthcare Research and Quality, with funding support from the US Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response (ASPR). Representatives of ASPR developed the research questions and contributed to the final article. NR 95 TC 17 Z9 17 U1 4 U2 40 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD JUN PY 2013 VL 61 IS 6 BP 677 EP 689 DI 10.1016/j.annemergmed.2013.02.005 PG 13 WC Emergency Medicine SC Emergency Medicine GA 161OZ UT WOS:000320204500016 PM 23522610 ER PT J AU Davidoff, AJ Weiss, SR Baer, MR Ke, XH Hendrick, F Zeidan, A Gore, SD AF Davidoff, Amy J. Weiss, Sheila R. Baer, Maria R. Ke, Xuehua Hendrick, Franklin Zeidan, Amer Gore, Steven D. TI Patterns of erythropoiesis-stimulating agent use among Medicare beneficiaries with myelodysplastic syndromes and consistency with clinical guidelines SO LEUKEMIA RESEARCH LA English DT Article DE Erythropoiesis-stimulating agent; Myelodysplastic syndrome; Guideline adherence; Supportive care; Medicare ID CHEMOTHERAPY-INDUCED ANEMIA; QUALITY-OF-LIFE; UNITED-STATES; CANCER-PATIENTS; PHYSICIAN CHARACTERISTICS; DARBEPOETIN ALPHA; HEMOGLOBIN LEVELS; EPOETIN; SURVIVAL; EFFICACY AB Erythropoiesis-stimulating agents (ESA) are used commonly to reduce symptomatic anemia in patients with myelodysplastic syndromes (MDS). We assessed population-based patterns of ESA use relative to treatment guidelines using data from the Surveillance, Epidemiology, and End Results (SEER) registries, with linked Medicare claims providing detailed treatment data from 2001 through 2005. The study found widespread use (62%) of ESA in Medicare beneficiaries with MDS. Similar ESA use rates regardless of risk status, low frequency (45%) of serum erythropoietin determination prior to ESA initiation, and high prevalence (60.4%) of short-duration ESA episodes suggest clinically important discrepancies between actual practice and guideline-recommended therapy. Published by Elsevier Ltd. C1 [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. [Weiss, Sheila R.; Ke, Xuehua; Hendrick, Franklin] Univ Maryland, Sch Pharm, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. [Weiss, Sheila R.; Baer, Maria R.] Univ Maryland, Marlene & Stewart Greenebaum Canc Ctr, Baltimore, MD 21201 USA. [Baer, Maria R.] Univ Maryland, Sch Med, Dept Med, Baltimore, MD 21201 USA. [Zeidan, Amer; Gore, Steven D.] Sidney Kimmel Comprehens Canc Ctr Johns Hopkins, Dept Oncol, Baltimore, MD USA. RP Davidoff, AJ (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20850 USA. EM amy.davidoff@ahrq.hhs.gov FU NIH [1RC1CA145831-01, 2K24CA111717-06A1]; GlaxoSmithKline; Novartis; Celgene FX Funding from NIH 1RC1CA145831-01 (ARRA Challenge Grant), (AJD, PI) and 2K24CA111717-06A1 (SDG, PI). The funder had no input into the design, analysis, results, or dissemination of this research.; S.D.G. and A.J.D. owned Celgene stock until 12/2011. A.J.D. received additional funding from GlaxoSmithKline, Novartis, and Celgene until 8/2012. M.R.B. receives research funding from Novartis and Celgene. Other authors have no relevant conflict of interests to disclose. NR 36 TC 11 Z9 11 U1 0 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0145-2126 J9 LEUKEMIA RES JI Leuk. Res. PD JUN PY 2013 VL 37 IS 6 BP 675 EP 680 DI 10.1016/j.leukres.2013.02.021 PG 6 WC Oncology; Hematology SC Oncology; Hematology GA 143YG UT WOS:000318904600015 PM 23523473 ER PT J AU Henke, RM Maeda, JL Marder, WD Friedman, BS Wong, HS AF Henke, Rachel Mosher Maeda, Jared Lane Marder, William D. Friedman, Barry S. Wong, Herbert S. TI Medicare and Commercial Inpatient Resource Use: Impact of Hospital Competition SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article AB Objectives: To examine the influence of hospital competition on small-area inpatient resource use by payer. Methods: We measured hospital competition and inpatient resource use using data from the 2008 Healthcare Cost and Utilization Project State Inpatient Databases. Generalized linear models adjusted for patient, population, and market characteristics were used to assess the relationship between inpatient resource use and hospital competition. Results: Hospital competition had a similar influence on inpatient resource intensity for Medicare and privately insured patients. Hospitals in more competitive markets had significantly lower costs per discharge for both Medicare and privately insured patients. Hospital competition was not significantly associated with length of stay per discharge for either payer. Conclusion: Findings suggest that policies or incentives that promote or encourage competition in less competitive markets may reduce variation in resource use for both Medicare and private payers. C1 [Henke, Rachel Mosher; Maeda, Jared Lane; Marder, William D.] Truven Hlth Analyt, Cambridge, MA USA. [Friedman, Barry S.; Wong, Herbert S.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Henke, RM (reprint author), Truven Hlth Analyt, Res, 150 CambridgePk Dr, Cambridge, MA 02140 USA. EM rachel.henke@truvenhealth.com FU Agency for Healthcare Research and Quality [HHSA290200600009C] FX Agency for Healthcare Research and Quality contract HHSA290200600009C. NR 28 TC 3 Z9 3 U1 0 U2 0 PU MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC PI PLAINSBORO PA 666 PLAINSBORO RD, STE 300, PLAINSBORO, NJ 08536 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD JUN PY 2013 VL 19 IS 6 BP E238 EP E248 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA V44PA UT WOS:000209759700005 PM 23844753 ER PT J AU Gore, S Davidoff, AJ Hendrick, F Duong, V Stuart, BC Baer, MR Shenolikar, R Zeidan, A AF Gore, Steven Davidoff, Amy J. Hendrick, Franklin Vu Duong Stuart, Bruce C. Baer, Maria R. Shenolikar, Rahul Zeidan, Amer TI Effect of availability of oral iron chelation therapy (ICT) on initiation, duration, and dose adequacy in patients with myelodysplastic syndromes (MDS) and transfusional iron overload (TIO). SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Meeting Abstract CT Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) CY MAY 31-JUN 04, 2013 CL Chicago, IL SP Amer Soc Clin Oncol C1 Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD USA. Agcy Healthcare Res & Qual, Rockville, MD USA. Univ Maryland, Sch Pharm, Baltimore, MD 21201 USA. Univ Maryland, Marlene & Stewart Greenebaum Canc Ctr, Baltimore, MD 21201 USA. GlaxoSmithKline, Res Triangle Pk, NC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 2318 MILL ROAD, STE 800, ALEXANDRIA, VA 22314 USA SN 0732-183X EI 1527-7755 J9 J CLIN ONCOL JI J. Clin. Oncol. PD MAY 20 PY 2013 VL 31 IS 15 SU S MA e17584 PG 1 WC Oncology SC Oncology GA AG4VY UT WOS:000335419604453 ER PT J AU Pesis-Katz, I Phelps, CE Temkin-Greener, H Spector, WD Veazie, P Mukamel, DB AF Pesis-Katz, Irena Phelps, Charles E. Temkin-Greener, Helena Spector, William D. Veazie, Peter Mukamel, Dana B. TI Making Difficult Decisions: The Role of Quality of Care in Choosing a Nursing Home SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID COMPARE REPORT CARD; PUBLICATION; MARKET; OWNERSHIP; PLACEMENT; IMPACT; INFORMATION; COMPETITION; SERVICES AB Objectives. We investigated how quality of care affects choosing a nursing home. Methods. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. Results. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. Conclusions. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers. C1 [Pesis-Katz, Irena] Univ Rochester, Sch Nursing, Rochester, NY 14642 USA. [Phelps, Charles E.; Temkin-Greener, Helena; Veazie, Peter] Univ Rochester, Dept Publ Hlth Sci, Rochester, NY 14642 USA. [Spector, William D.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Mukamel, Dana B.] Univ Calif Irvine, Dept Med, Irvine, CA 92717 USA. [Mukamel, Dana B.] Univ Calif Irvine, Hlth Policy Res Inst, Irvine, CA USA. RP Pesis-Katz, I (reprint author), Univ Rochester, Med Ctr, Sch Nursing, 601 Elmwood Ave,Box SON, Rochester, NY 14642 USA. EM Irena_Pesis-Katz@URMC.Rochester.edu RI Pesis-Katz, Irena/E-2684-2013 FU National Institute on Aging [AG027420] FX Dana Mukamel gratefully acknowledges support from the National Institute on Aging (grant AG027420). NR 41 TC 7 Z9 8 U1 1 U2 10 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 EI 1541-0048 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAY PY 2013 VL 103 IS 5 BP E31 EP E37 DI 10.2105/AJPH.2013.301243 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AA2UJ UT WOS:000330949300013 PM 23488519 ER PT J AU Cohen, SB Cohen, JW AF Cohen, Steven B. Cohen, Joel W. TI The Capacity of the Medical Expenditure Panel Survey to Inform the Affordable Care Act SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article DE MEPS; Affordable Care Act; health insurance ID HEALTH-INSURANCE; COVERAGE; ACCESS AB The Affordable Care Act (ACA) was enacted with major provisions to expand health insurance coverage, control health care costs, and improve the health care delivery system. Essential data resources will be required for effective program planning, administration, and management, in addition to facilitating evaluations of program performance. The Medical Expenditure Panel Survey (MEPS) is one of the core data resources that has been used to inform several provisions of the ACA. This paper provides a summary of the capacity of the MEPS to inform program planning, implementation, and evaluations of program performance for several components of the ACA. C1 [Cohen, Steven B.; Cohen, Joel W.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Cohen, SB (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, 540 Gaither Rd,John M Eisenberg Bldg, Rockville, MD 20850 USA. EM steven.cohen@ahrq.hhs.gov FU Agency for Healthcare Research and Quality FX The author(s) received the following financial support for the research, authorship, and/or publication of this article: The authors received support from the Agency for Healthcare Research and Quality as part of their core responsibilities. NR 15 TC 2 Z9 2 U1 0 U2 2 PU BLUE CROSS BLUE SHIELD ASSOC PI ROCHESTER PA 150 EAST MAIN ST, ROCHESTER, NY 14647 USA SN 0046-9580 EI 1945-7243 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD MAY PY 2013 VL 50 IS 2 BP 124 EP 134 DI 10.1177/0046958013513678 PG 11 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 298OR UT WOS:000330334400004 PM 24574130 ER PT J AU Bardenheier, BH Elixhauser, A Imperatore, G Devlin, HM Kuklina, EV Geiss, LS Correa, A AF Bardenheier, Barbara H. Elixhauser, Anne Imperatore, Giuseppina Devlin, Heather M. Kuklina, Elena V. Geiss, Linda S. Correa, Adolfo TI Variation in Prevalence of Gestational Diabetes Mellitus Among Hospital Discharges for Obstetric Delivery Across 23 States in the United States SO DIABETES CARE LA English DT Article ID NEW-YORK-CITY; RACIAL/ETHNIC DISPARITIES; MATERNAL MORBIDITY; PREGNANT-WOMEN; OBESE WOMEN; TRENDS; POPULATION; RISK AB OBJECTIVE-To examine variability in diagnosed gestational diabetes mellitus (GDM) prevalence at delivery by race/ethnicity and state. RESEARCH DESIGN AND METHODS-We used data from the Healthcare Cost and Utilization Project State Inpatient Databases for 23 states of the United States with available race/ethnicity data for 2008 to examine age-adjusted and race-adjusted rates of GDM by state. We used multilevel analysis to examine factors that explain the variability in GDM between states. RESULTS-Age-adjusted and race-adjusted GDM rates (per 100 deliveries) varied widely between states, ranging from 3.47 in Utah to 7.15 in Rhode Island. Eighty-six percent of the variability in GDM between states was explained as follows: 14.7% by age; 11.8% by race/ethnicity; 5.9% by insurance; and 2.9% by interaction between race/ethnicity and insurance at the individual level; 17.6% by hospital level factors; 27.4% by the proportion of obese women in the state; 4.3% by the proportion of Hispanic women aged 15-44 years in the state; and 1.5% by the proportion of white non-Hispanic women aged 15-44 years in the state. CONCLUSIONS-Our results suggest that GDM rates differ by state, with this variation attributable to differences in obesity at the population level (or "at the state level"), age, race/ethnicity, hospital, and insurance. C1 [Bardenheier, Barbara H.; Imperatore, Giuseppina; Devlin, Heather M.; Geiss, Linda S.] Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. [Elixhauser, Anne] Agcy Healthcare Res & Qual, Rockville, MD USA. [Correa, Adolfo] Univ Mississippi, Med Ctr, Dept Med, Jackson, MS 39216 USA. [Kuklina, Elena V.] Ctr Dis Control & Prevent, Div Heart Dis & Stroke Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. RP Bardenheier, BH (reprint author), Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. EM bfb7@cdc.gov NR 30 TC 25 Z9 25 U1 1 U2 7 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD MAY PY 2013 VL 36 IS 5 BP 1209 EP 1214 DI 10.2337/dc12-0901 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 155WW UT WOS:000319782100024 PM 23248195 ER PT J AU Clancy, CM Chesley, F Dougherty, D AF Clancy, Carolyn M. Chesley, Francis Dougherty, Denise TI Health Care for Children and Youth in the United States: 13 Years of Evidence SO ACADEMIC PEDIATRICS LA English DT Editorial Material ID VITAL-STATISTICS; QUALITY; EXPENDITURES; ACCESS; COVERAGE; PATTERNS; TRENDS; FOCUS C1 [Clancy, Carolyn M.] Agcy Healthcare Res & Qual, Off Director, Rockville, MD 20850 USA. [Chesley, Francis; Dougherty, Denise] Agcy Healthcare Res & Qual, Off Extramural Res Educ & Prior Populat, Rockville, MD 20850 USA. [Clancy, Carolyn M.] Dept Hlth & Human Serv, Rockville, MD USA. RP Dougherty, D (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM denise.dougherty@ahrq.hhs.gov NR 31 TC 2 Z9 2 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 J9 ACAD PEDIATR JI Acad. Pediatr. PD MAY-JUN PY 2013 VL 13 IS 3 BP 181 EP 183 PG 3 WC Pediatrics SC Pediatrics GA 148MW UT WOS:000319249700001 PM 23680336 ER PT J AU Berdahl, TA Friedman, BS McCormick, MC Simpson, L AF Berdahl, Terceira A. Friedman, Bernard S. McCormick, Marie C. Simpson, Lisa TI Annual Report on Health Care for Children and Youth in the United States: Trends in Racial/Ethnic, Income, and Insurance Disparities Over Time, 2002-2009 SO ACADEMIC PEDIATRICS LA English DT Article DE children's health; children's health care; community income; disparities; HCUP; health care access; health care trends; income; insurance; MEPS; race/ethnicity; utilization ID TAKE-UP; PUBLIC INSURANCE; CROWD-OUT; QUALITY; ACCESS; EXPENDITURES; COVERAGE; CALIFORNIA; PATTERNS; IMPACT AB OBJECTIVE: To examine trends in children's health access, utilization, and expenditures over time (2002-2009) by race/ethnicity, income, and insurance status/expected payer. METHODS: Data include a nationally representative random sample of children in the United States in 2002-2009 from the Medical Expenditure Panel Survey (MEPS) and a nationwide sample of pediatric hospitalizations in 2005 and 2009 from the Healthcare Cost and Utilization Project (HCUP). RESULTS: The percentage of children with private insurance coverage declined from 65.3% in 2002 to 60.6% in 2009. At the same time, the percentage of publicly insured children increased from 27.0% in 2002 to 33.1% in 2009. Fewer children reported being uninsured in 2009 (6.3%) compared to 2002 (7.7%). The most significant progress was for Hispanic children, for whom the percentage of uninsured dropped from 15.0% in 2002 to 10.3% in 2009. The uninsured were consistently the least likely to have access to a usual source of care, and this disparity remained unchanged in 2009. Non-Hispanic whites were most likely to report a usual source of care in both 2002 and 2009. The percentage of children with a doctor visit improved for whites and Hispanics (2009 vs 2002). In contrast, black children saw no improvement during this time period. Between 2002 and 2009, children's average total health care expenditures increased from $1294 to $1914. Average total expenditures nearly doubled between 2002 and 2009 for white children with private health insurance. Among infants, hospitalizations for pneumonia decreased in absolute number (41,000 to 34,000) and as a share of discharges (0.8% to 0.7%). Fluid and electrolyte disorders also decreased over time. Influenza appeared only in 2009 in the list of top 15 diagnoses with 11,000 hospitalization cases. For children aged 1 to 17, asthma hospitalization increased in absolute number (from 119,000 to 134,000) and share of discharges (6.6% to 7.6%). Skin infections appeared in the top 15 categories in 2009, with 57,000 cases (3.3% of total). CONCLUSIONS: Despite significant improvement in insurance coverage, disparities by race/ethnicity and income persist in access to and use of care. Hispanic children experienced progress in a number of measures, while black children did not. Because racial/ethnic and socioeconomic disparities are often reported as single cross-sectional studies, our approach is innovative and improves on prior studies by examining population trends during the time period 2002-2009. Our study sheds light on children's disparities during the most recent economic crisis. C1 [Berdahl, Terceira A.; Friedman, Bernard S.] Agcy Healthcare Res & Qual, Dept Hlth & Human Serv, Rockville, MD 20850 USA. [McCormick, Marie C.] Harvard Univ, Sch Publ Hlth, Dept Soc Human Dev & Hlth, Boston, MA 02115 USA. [Simpson, Lisa] Acad Hlth, Washington, DC USA. RP Berdahl, TA (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM terceira.berdahl@ahrq.hhs.gov OI McCormmick, Marie/0000-0002-3938-1707 NR 35 TC 26 Z9 26 U1 1 U2 17 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1876-2859 J9 ACAD PEDIATR JI Acad. Pediatr. PD MAY-JUN PY 2013 VL 13 IS 3 BP 191 EP 203 DI 10.1016/j.acap.2013.02.003 PG 13 WC Pediatrics SC Pediatrics GA 148MW UT WOS:000319249700004 PM 23680339 ER PT J AU Gliklich, RE Levy, D Campion, DM Leavy, MB Karl, J Berliner, E Taylor, T Hossfeld, W Khurana, LL Thompson, D AF Gliklich, R. E. Levy, D. Campion, D. M. Leavy, M. B. Karl, J. Berliner, E. Taylor, T. Hossfeld, W. Khurana, L. L. Thompson, D. TI REGISTRY OF PATIENT REGISTRIES (ROPR): PURPOSE, DESIGN AND EARLY EXPERIENCE SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Gliklich, R. E.; Levy, D.; Campion, D. M.; Leavy, M. B.; Karl, J.; Taylor, T.; Hossfeld, W.; Khurana, L. L.] Quintiles Outcome, Cambridge, MA USA. [Berliner, E.] AHRQ, Rockville, MD USA. [Thompson, D.] Quintiles, Medford, MA USA. NR 0 TC 0 Z9 0 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A265 EP A265 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916402329 ER PT J AU Gliklich, RE Karl, J Leavy, MB Campion, DM Levy, D Berliner, E Khurana, LL Taylor, T Hossfeld, W Thompson, D AF Gliklich, R. E. Karl, J. Leavy, M. B. Campion, D. M. Levy, D. Berliner, E. Khurana, L. L. Taylor, T. Hossfeld, W. Thompson, D. TI CHALLENGES IN DEVELOPING AN OUTCOME MEASURES FRAMEWORK FOR PATIENT REGISTRIES SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Gliklich, R. E.; Karl, J.; Leavy, M. B.; Campion, D. M.; Levy, D.; Khurana, L. L.; Taylor, T.; Hossfeld, W.] Quintiles Outcome, Cambridge, MA USA. [Berliner, E.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A265 EP A265 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916402331 ER PT J AU Maeda, JL Henke, RM Marder, WD Friedman, BS Wong, H AF Maeda, J. L. Henke, R. M. Marder, W. D. Friedman, B. S. Wong, H. TI FACTORS INFLUENCING THE VARIATION IN HOSPITAL INPATIENT PRICES BETWEEN PUBLIC AND PRIVATE PAYERS SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Maeda, J. L.] Kaiser Permanente, Rockville, MD USA. [Henke, R. M.; Marder, W. D.] Truven Hlth Analyt, Cambridge, MA USA. [Friedman, B. S.; Wong, H.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A208 EP A208 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916402033 ER PT J AU Maeda, JL Henke, RM Ehrlich, E Marder, WD Friedman, BS Wong, H AF Maeda, J. L. Henke, R. M. Ehrlich, E. Marder, W. D. Friedman, B. S. Wong, H. TI IMPACT OF PRIMARY CARE AVAILABILITY ON HOSPITAL INPATIENT USE BY INSURANCE STATUS SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Maeda, J. L.] Kaiser Permanente, Rockville, MD USA. [Henke, R. M.; Marder, W. D.] Truven Hlth Analyt, Cambridge, MA USA. [Ehrlich, E.] Truven Hlth Analyt, Ann Arbor, MI USA. [Friedman, B. S.; Wong, H.] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A200 EP A200 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916401535 ER PT J AU Shoemaker, JS Davidoff, A Stuart, B Zuckerman, IH Onukwugha, E Powers, CA AF Shoemaker, J. S. Davidoff, A. Stuart, B. Zuckerman, I. H. Onukwugha, E. Powers, C. A. TI THE ROLE OF HEALTH SHOCKS IN LATE PART D ENROLLMENT SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Shoemaker, J. S.] PhRMA, Washington, DC USA. [Davidoff, A.] AHRQ, Rockville, MD USA. [Stuart, B.; Zuckerman, I. H.; Onukwugha, E.] Univ Maryland, Sch Pharm, Baltimore, MD 21201 USA. [Powers, C. A.] Ctr Medicare Serv, Baltimore, MD USA. [Powers, C. A.] Ctr Medicaid Serv, Baltimore, MD USA. NR 0 TC 0 Z9 0 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A262 EP A262 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916402314 ER PT J AU Wong, H Karaca, Z AF Wong, H. Karaca, Z. TI DID MEDICAL LITIGATION AGAINST PHYSICIANS INCREASE INPATIENT HOSPITAL COST? SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Wong, H.; Karaca, Z.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A257 EP A258 PG 2 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916402291 ER PT J AU Wong, H Karaca, Z AF Wong, H. Karaca, Z. TI DETERMINANTS OF PHYSICIAN PRACTICE STYLES SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Wong, H.; Karaca, Z.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A257 EP A257 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916402290 ER PT J AU Wong, H Karaca, Z AF Wong, H. Karaca, Z. TI RACIAL DISPARITY IN HOSPITAL INPATIENT COST: HOMELESS VERSUS NON-HOMELESS PATIENTS SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Wong, H.; Karaca, Z.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD MAY PY 2013 VL 16 IS 3 BP A256 EP A256 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 144CE UT WOS:000318916402285 ER PT J AU Zimring, C Denham, ME Jacob, JT Cowan, DZ Do, E Hall, K Kamerow, D Kasali, A Steinberg, JP AF Zimring, Craig Denham, Megan E. Jacob, Jesse T. Cowan, David Z. Do, Ellen Hall, Kendall Kamerow, Douglas Kasali, Altug Steinberg, James P. TI Evidence-Based Design of Healthcare Facilities: Opportunities for Research and Practice in Infection Prevention SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Editorial Material ID SAFETY; HOSPITALS C1 [Zimring, Craig; Denham, Megan E.; Kasali, Altug] Georgia Inst Technol, Sch Architecture, SimTigrate Design Lab, Atlanta, GA 30332 USA. [Jacob, Jesse T.; Steinberg, James P.] Emory Univ, Sch Med, Div Infect Dis, Dept Med, Atlanta, GA 30308 USA. [Cowan, David Z.] Georgia Inst Technol, Hlth Syst Inst, Atlanta, GA 30332 USA. [Do, Ellen] Georgia Inst Technol, Sch Ind Design, Atlanta, GA 30332 USA. [Hall, Kendall] Agcy Healthcare Res & Qual, Rockville, MD USA. [Kamerow, Douglas] RTI Int, Washington, DC USA. RP Steinberg, JP (reprint author), Emory Univ, Sch Med, Div Infect Dis, 550 Peachtree St NE,Room 5-4403, Atlanta, GA 30308 USA. EM jstei02@emory.edu RI Jacob, Jesse/A-8836-2009 NR 17 TC 6 Z9 6 U1 1 U2 12 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD MAY PY 2013 VL 34 IS 5 SI SI BP 514 EP 516 DI 10.1086/670220 PG 3 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 123XC UT WOS:000317424200011 PM 23571369 ER PT J AU McNellis, RJ Genevro, JL Meyers, DS AF McNellis, Robert J. Genevro, Janice L. Meyers, David S. TI Lessons Learned From the Study of Primary Care Transformation SO ANNALS OF FAMILY MEDICINE LA English DT Article DE patient-centered medical home; primary care; change, organizational; practice-based research; certification; change management ID MEDICAL HOME C1 [McNellis, Robert J.; Genevro, Janice L.; Meyers, David S.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP McNellis, RJ (reprint author), Agcy Healthcare Res & Qual, Ctr Primary Care Prevent & Clin Partnerships, 540 Gaither Rd, Rockville, MD 20850 USA. EM robert.mcnellis@ahrq.hhs.gov NR 12 TC 20 Z9 22 U1 1 U2 5 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672 USA SN 1544-1709 EI 1544-1717 J9 ANN FAM MED JI Ann. Fam. Med. PD MAY-JUN PY 2013 VL 11 SU 1 BP S1 EP S5 DI 10.1370/afm.1548 PG 5 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA AI3XE UT WOS:000336798200001 PM 23690378 ER PT J AU Zeidan, A Davidoff, A Hendrick, F Duong, V Stuart, B Baer, M Gore, S AF Zeidan, A. Davidoff, A. Hendrick, F. Duong, V. Stuart, B. Baer, M. Gore, S. TI Effect of availability of oral iron chelation therapy on initiation, duration, and dose adequacy in patients with myelodysplastic syndromes SO LEUKEMIA RESEARCH LA English DT Meeting Abstract C1 [Zeidan, A.; Gore, S.] Johns Hopkins Univ, Dept Oncol, Baltimore, MD USA. [Davidoff, A.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Hendrick, F.; Stuart, B.] Univ Maryland, Sch Pharm, Baltimore, MD 21201 USA. [Duong, V.; Baer, M.] Univ Maryland, Sch Med, Baltimore, MD 21201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0145-2126 EI 1873-5835 J9 LEUKEMIA RES JI Leuk. Res. PD MAY PY 2013 VL 37 SU 1 MA P-181 BP S105 EP S105 PG 1 WC Oncology; Hematology SC Oncology; Hematology GA V40RR UT WOS:000209496200228 ER PT J AU Machlin, SR Soni, A AF Machlin, Steven R. Soni, Anita TI Health Care Expenditures for Adults With Multiple Treated Chronic Conditions: Estimates From the Medical Expenditure Panel Survey, 2009 SO PREVENTING CHRONIC DISEASE LA English DT Article ID UNITED-STATES AB The objective of this article is to illustrate the usefulness of Medical Expenditure Panel Survey (MEPS) data for examining variations in medical expenditures for people with multiple chronic conditions (MCC). We analyzed 2009 MEPS data to produce estimates of treated prevalence for MCC and associated medical expenditures for adults in the US civilian noninstitutionalized population (sample = 24,870). We also identified the most common dyad and triad combinations of treated conditions. Approximately one-quarter of civilian US adults were treated for MCCs in 2009; 18.3% were treated for 2 to 3 conditions and 7% were treated for 4 or more conditions. The proportion of adults treated for MCC increased with age. White non-Hispanic adults were most likely and Hispanic and Asian adults were least likely to be treated for MCC. Health care expenditures increased as the number of chronic conditions treated increased. Regardless of age or sex, hypertension and hyperlipidemia was the most common dyad among adults treated for MCC; diabetes in conjunction with these 2 conditions was a common triad. MEPS has the capacity to produce national estimates of health care expenditures associated with MCC. MEPS data in conjunction with data from other US Department of Health and Human Services sources provide information that can inform policies addressing the complex issue of MCC. C1 [Machlin, Steven R.; Soni, Anita] AHRQ, CFACT, Rockville, MD 20850 USA. RP Soni, A (reprint author), AHRQ, CFACT, 540 Gaither Rd, Rockville, MD 20850 USA. EM anita.soni@ahrq.hhs.gov NR 11 TC 3 Z9 3 U1 0 U2 4 PU CENTERS DISEASE CONTROL PI ATLANTA PA 1600 CLIFTON RD, ATLANTA, GA 30333 USA SN 1545-1151 J9 PREV CHRONIC DIS JI Prev. Chronic Dis. PD APR PY 2013 VL 10 AR UNSP 120172 DI 10.5888/pcd10.120172 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 285JS UT WOS:000329390700017 ER PT J AU Steiner, CA Friedman, B AF Steiner, Claudia A. Friedman, Bernard TI Hospital Utilization, Costs, and Mortality for Adults With Multiple Chronic Conditions, Nationwide Inpatient Sample, 2009 SO PREVENTING CHRONIC DISEASE LA English DT Article AB Objective Our objective was to provide a national estimate across all payers of the distribution and cost of selected chronic conditions for hospitalized adults in 2009, stratified by demographic characteristics. Analysis We analyzed the Nationwide Inpatient Sample (NIS), the largest all-payer inpatient database in the United States. Use, cost, and mortality estimates across payer, age, sex, and race/ethnicity are produced for grouped or multiple chronic conditions (MCC). The 5 most common dyads and triads were determined. Results In 2009, there were approximately 28 million adult discharges from US hospitals other than those related to pregnancy and maternity; 39% had 2 to 3 MCC, and 33% had 4 or more. A higher number of MCC was associated with higher mortality, use of services, and average cost. The percentages of Medicaid, privately insured patients, and ethnic/racial groups with 4 or more MCC were highly sensitive to age. Summary This descriptive analysis of multipayer inpatient data provides a robust national view of the substantial use and costs among adults hospitalized with MCC. C1 [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Healthcare Cost & Utilizat Project, Rockville, MD 20850 USA. [Friedman, Bernard] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Steiner, CA (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Healthcare Cost & Utilizat Project, 540 Gaither Rd, Rockville, MD 20850 USA. EM Claudia.Steiner@ahrq.hhs.gov FU Agency for Healthcare Research and Quality FX The authors were supported wholly by the Agency for Healthcare Research and Quality during the conduct of this work. The views are those of the authors. No official endorsement by any agency of the federal or state governments is intended or should be inferred. NR 8 TC 8 Z9 8 U1 0 U2 2 PU CENTERS DISEASE CONTROL PI ATLANTA PA 1600 CLIFTON RD, ATLANTA, GA 30333 USA SN 1545-1151 J9 PREV CHRONIC DIS JI Prev. Chronic Dis. PD APR PY 2013 VL 10 AR UNSP 120292 DI 10.5888/pcd10.120292 PG 19 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 285JS UT WOS:000329390700016 ER PT J AU Zandberg, DP Huang, TY Ke, XH Baer, MR Gore, SD Smith, SW Davidoff, AJ AF Zandberg, Dan P. Huang, Ting-Ying Ke, Xuehua Baer, Maria R. Gore, Steven D. Smith, Sheila Weiss Davidoff, Amy J. TI Treatment and outcomes for chronic myelomonocytic leukemia compared to myelodysplastic syndromes in older adults SO HAEMATOLOGICA LA English DT Article ID UNITED-STATES; PROGNOSTIC-FACTORS; RISK; DIAGNOSIS; CARE AB Prior studies have investigated patients' characteristics, treatments, and outcomes for older adults with myelodysplastic syndromes, but most failed to distinguish chronic myelomonocytic leukemia. Recognizing potentially important differences between the diseases, we undertook a population-based comparison of baseline characteristics, treatments, and outcomes between older adults with chronic myelomonocytic leukemia and myelodysplastic syndromes. The patients' data were obtained from Surveillance Epidemiology and End Results registry data from 2001-2005, linked to Medicare claims. Baseline characteristics, treatment (red blood cell transfusions, hematopoietic growth factors, hypomethylating agents, chemotherapy or transplantation), progression to acute myeloid leukemia, and overall survival were compared using bivariate techniques. Multivariate logistic regression estimated differences in treatments received. Cox proportional hazard models estimated the effects of chronic myelomonocytic leukemia relative to myelodysplastic syndromes on progression-free survival. A larger proportion of patients with chronic myelomonocytic leukemia (n=792), compared to patients with myelodysplastic syndromes (n=7,385), failed to receive any treatment (25% versus 15%; P<0.0001), or only received red blood cell transfusions (19.8% versus 16.7%; P=0.037). A larger percentage of patients with chronic myelomonocytic leukemia progressed to acute myeloid leukemia (42.6% versus 15.5%, respectively; P<0.0001), with shorter time to progression. Chronic myelomonocytic leukemia patients had a shorter median survival (13.3 versus 23.3 months; P<0.0001) and lower 3-year survival rate (19% versus 36%; P<0.0001). Adjusted estimates, controlling for baseline characteristics and selected treatments, indicate that chronic myelomonocytic leukemia was associated with an increased risk of progression to acute myeloid leukemia or death (HR 2.22; P<0.0001), compared to myelodysplastic syndromes. In conclusion, chronic myelomonocytic leukemia is less frequently treated in older adults and is associated with worse outcomes, even after controlling for the patients' baseline characteristics and selected treatments. Our data suggest the need for continued evaluation of the biological differences between these diseases and clinical trials targeting chronic myelomonocytic leukemia. C1 [Zandberg, Dan P.; Baer, Maria R.; Smith, Sheila Weiss] Univ Maryland, Sch Med, Dept Med, Div Hematol Oncol, Baltimore, MD 21201 USA. [Zandberg, Dan P.; Baer, Maria R.; Smith, Sheila Weiss] Univ Maryland, Marlene & Stewart Greenebaum Canc Ctr, Baltimore, MD 21201 USA. [Huang, Ting-Ying; Ke, Xuehua; Smith, Sheila Weiss] Univ Maryland, Sch Pharm, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. [Gore, Steven D.] Johns Hopkins Univ, Dept Oncol, Baltimore, MD USA. [Gore, Steven D.] Johns Hopkins, Sidney Kimmel Comprehens Canc Ctr, Div Hematol Malignancies, Baltimore, MD USA. [Davidoff, Amy J.] US Dept Hlth & Human Serv, Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Zandberg, DP (reprint author), Univ Maryland, Sch Med, Dept Med, Div Hematol Oncol, Baltimore, MD 21201 USA. EM dzandberg@umm.edu FU NIH [1RC1CA145831-01, 2K24CA111717-06A1] FX This work was supported by NIH 1RC1CA145831-01(ARRA Challenge Grant) (Davidoff, PI) and 2K24CA111717-06A1 (Gore, PI). NR 20 TC 0 Z9 1 U1 0 U2 3 PU FERRATA STORTI FOUNDATION PI PAVIA PA VIA GIUSEPPE BELLI 4, 27100 PAVIA, ITALY SN 0390-6078 J9 HAEMATOLOGICA JI Haematologica PD APR PY 2013 VL 98 IS 4 BP 584 EP 590 DI 10.3324/haematol.2012.062547 PG 7 WC Hematology SC Hematology GA 157LN UT WOS:000319897700025 PM 23144192 ER PT J AU Lee, SYD Weiner, BJ Harrison, MI Belden, CM AF Lee, Shoou-Yih Daniel Weiner, Bryan J. Harrison, Michael I. Belden, C. Michael TI Organizational Transformation: A Systematic Review of Empirical Research in Health Care and Other Industries SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Review DE transformational change; organizations; systematic review; health care ID STRATEGIC CHANGE; RADICAL CHANGE; PUNCTUATED EQUILIBRIUM; EXECUTIVE SUCCESSION; REVOLUTIONARY CHANGE; STRUCTURAL-CHANGE; CORPORATE CHANGE; REORIENTATION; HOSPITALS; CONSEQUENCES AB Health care organization leaders and policy makers seeking ways to reform the delivery of health care have become increasingly interested in transformational change. To foster understanding of how organizational transformation occurs and to stimulate further research, we report findings from a systematic review of empirical research on transformational change in the health care and non-health care literature, with a focus on the antecedents, processes (or paths), and outcomes of transformational change. Fifty-six studies, of which 13 were in health care, met our selection criteria. With one exception, all were published since 1990, indicating the recent upsurge of interest in this area. Limited differences were found between health care and non-health care studies. Available research documents the multiplicity of factors affecting change and the complexity of their interactions, but less information is available about the processes of transformational change than about its antecedents and consequences. Research and practice implications are discussed. C1 [Lee, Shoou-Yih Daniel] Univ Michigan, Ann Arbor, MI 48109 USA. [Weiner, Bryan J.; Belden, C. Michael] Univ N Carolina, Chapel Hill, NC USA. [Harrison, Michael I.] Agcy Healthcare Res & Qual, Washington, DC USA. RP Lee, SYD (reprint author), Univ Michigan, 1420 Washington Hts, Ann Arbor, MI 48109 USA. EM sylee@umich.edu FU RWJF Investigator Awards in Health Policy Research [63906] FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The first two authors, Lee and Weiner, received funding from the RWJF Investigator Awards in Health Policy Research (Grant # 63906) for their effort in the study. NR 93 TC 8 Z9 8 U1 3 U2 38 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 J9 MED CARE RES REV JI Med. Care Res. Rev. PD APR PY 2013 VL 70 IS 2 BP 115 EP 142 DI 10.1177/1077558712458539 PG 28 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 138QK UT WOS:000318523300001 PM 22955697 ER PT J AU Pines, JM Mutter, RL Zocchi, MS AF Pines, Jesse M. Mutter, Ryan L. Zocchi, Mark S. TI Variation in Emergency Department Admission Rates Across the United States SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Article DE variation; local practice; emergency; emergency department; admission ID PHYSICIANS; POLICY; CARE AB There were more than 19 million hospitalizations in 2008 from hospital-based emergency departments (EDs), representing nearly 50% of all U. S. admissions. Factors related to variation in hospital-level ED admission rates are unknown. Generalized linear models were used to assess patient-, hospital-, and community-level factors associated with ED admission rates across a sample of U. S. hospitals using Healthcare Cost and Utilization Project data. In 1,376 EDs, the mean ED admission rate, when defined as direct admissions and also transfers from one ED to another hospital, was 17.5% and varied from 9.8% to 25.8% at the 10th and 90th percentiles. Higher proportions of Medicare and uninsured patients, more inpatient beds, lower ED volumes, for-profit ownership, trauma center status, and higher hospital occupancy rates were associated with higher ED admission rates. Also, hospitals in counties with fewer primary care physicians per capita and higher county-level ED admission rates had higher ED admission rates. C1 [Pines, Jesse M.; Zocchi, Mark S.] George Washington Univ, Washington, DC 20037 USA. [Mutter, Ryan L.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Zocchi, MS (reprint author), George Washington Univ, Dept Hlth Policy, 2121 K ST NW, Washington, DC 20037 USA. EM mzocchi@gwu.edu NR 20 TC 39 Z9 39 U1 0 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 J9 MED CARE RES REV JI Med. Care Res. Rev. PD APR PY 2013 VL 70 IS 2 BP 218 EP 231 DI 10.1177/1077558712470565 PG 14 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 138QK UT WOS:000318523300006 PM 23295438 ER PT J AU Hempel, S Newberry, S Wang, Z Booth, M Shanman, R Johnsen, B Shier, V Saliba, D Spector, WD Ganz, DA AF Hempel, Susanne Newberry, Sydne Wang, Zhen Booth, Marika Shanman, Roberta Johnsen, Breanne Shier, Victoria Saliba, Debra Spector, William D. Ganz, David A. TI Hospital Fall Prevention: A Systematic Review of Implementation, Components, Adherence, and Effectiveness SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE fall prevention; implementation; hospital; systematic review ID QUALITY IMPROVEMENT; PATIENT SAFETY; CARE HOSPITALS; INTERVENTIONS; METAANALYSIS; INPATIENTS; WORK AB Objectives To systematically document the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. Design Systematic review. Studies were identified through existing reviews, searching five electronic databases, screening reference lists, and contacting topic experts for studies published through August 2011. Setting U.S. acute care hospitals. Participants Studies reporting in-hospital falls for intervention groups and concurrent (e.g., controlled trials) or historic comparators (e.g., beforeafter studies). Intervention Fall prevention interventions. Measurements Incidence rate ratios (IRR, ratio of fall rate postintervention or treatment group to the fall rate preintervention or control group) and ratings of study details. Results Fifty-nine studies met inclusion criteria. Implementation strategies were sparsely documented (17% not at all) and included staff education, establishing committees, seeking leadership support, and occasionally continuous quality improvement techniques. Most interventions (81%) included multiple components (e.g., risk assessments (often not validated), visual risk alerts, patient education, care rounds, bed-exit alarms, and postfall evaluations). Fifty-four percent did not report on fall prevention measures applied in the comparison group, and 39% neither reported fidelity data nor described adherence strategies such as regular audits and feedback to ensure completion of care processes. Only 45% of concurrent and 15% of historic control studies reported sufficient data to compare fall rates. The pooled postintervention incidence rate ratio (IRR) was 0.77 (95% confidence interval=0.521.12, P=.17; eight studies; I2: 94%). Meta-regressions showed no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. Conclusion Promising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls. C1 [Hempel, Susanne; Newberry, Sydne; Wang, Zhen; Booth, Marika; Shanman, Roberta; Johnsen, Breanne; Shier, Victoria; Saliba, Debra; Ganz, David A.] RAND Corp, Santa Monica, CA 90407 USA. [Saliba, Debra; Ganz, David A.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Saliba, Debra] Univ Calif Los Angeles, JH Borun Ctr, Los Angeles, CA USA. [Spector, William D.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Ganz, David A.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Hempel, S (reprint author), RAND Corp, Southern Calif Evidence Based Practice Ctr, 1776 Main St, Santa Monica, CA 90407 USA. EM susanne_hempel@rand.org RI Wang, Zhen/D-5991-2013 OI Wang, Zhen/0000-0002-9368-6149 FU AHRQ [HHSA290201000017I]; U.S. Department of Veterans Affairs, Veterans Health Administration, Veterans Affairs Health Services Research and Development (HSR&D) Service through the VA Greater Los Angeles HSR&D Center of Excellence [VA CD2 08-012-1] FX The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. This project was funded under Contract HHSA290201000017I TO #1 from the AHRQ. Additional support was provided through the U.S. Department of Veterans Affairs, Veterans Health Administration, Veterans Affairs Health Services Research and Development (HSR&D) Service through the VA Greater Los Angeles HSR&D Center of Excellence (Project VA CD2 08-012-1 and a locally initiated project). NR 29 TC 30 Z9 30 U1 2 U2 25 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2013 VL 61 IS 4 BP 483 EP 494 DI 10.1111/jgs.12169 PG 12 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 130IN UT WOS:000317907600001 PM 23527904 ER PT J AU Davidoff, AJ Zuckerman, IH Pandya, N Hendrick, F Ke, XH Hurria, A Lichtman, SM Hussain, A Weiner, JP Edelman, MJ AF Davidoff, Amy J. Zuckerman, Ilene H. Pandya, Naimish Hendrick, Franklin Ke, Xuehua Hurria, Arti Lichtman, Stuart M. Hussain, Arif Weiner, Jonathan P. Edelman, Martin J. TI A novel approach to improve health status measurement in observational claims-based studies of cancer treatment and outcomes SO JOURNAL OF GERIATRIC ONCOLOGY LA English DT Article DE Medicare; Cancer; Health status; Observational study; Treatment selection bias; Functional status ID COOPERATIVE-ONCOLOGY-GROUP; III COLON-CANCER; GERIATRIC ASSESSMENT; PERFORMANCE STATUS; UNITED-STATES; LUNG-CANCER; CHEMOTHERAPY; POPULATION; MEDICARE; SURVIVAL AB Objectives: To develop and provide initial validation for a multivariate, claims-based prediction model for disability status (DS), a proxy measure of performance status (PS), among older adults. The model was designed to augment information on health status at the point of cancer diagnosis in studies using insurance claims to examine cancer treatment and outcomes. Materials and Methods: We used data from the 2001-2005 Medicare Current Beneficiary Survey (MCBS), with observations randomly split into estimation and validation subsamples. We developed an algorithm linking self-reported functional status measures to a DS scale, a proxy for the Eastern Cooperative Oncology Group (ECOG) PS scale. The DS measure was dichotomized to focus on good [ECOG 0-2] versus poor [ECOG 3-4] PS. We identified potential claims-based predictors, and estimated multivariate logistic regression models, with poor DS as the dependent measure, using a stepwise approach to select the optimal model. Construct validity was tested by determining whether the predicted DS measure generated by the model was a significant predictor of survival within a validation sample from the MCBS. Results and Conclusion: One-tenth of the beneficiaries met the definition for poor DS. The base model yielded high sensitivity (0.79) and specificity (0.92); positive predictive value=48.3% and negative predictive value=97.8%, c-statistic=0.92 and good model calibration. Adjusted poor claims-based DS was associated with an increased hazard of death (HR=3.53, 95% CI 3.18, 3.92). The ability to assess DS should improve covariate control and reduce indication bias in observational studies of cancer treatment and outcomes based on insurance claims. (C) 2013 Elsevier Ltd. All rights reserved. C1 [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Zuckerman, Ilene H.; Hendrick, Franklin; Ke, Xuehua] Univ Maryland, Sch Pharm, Baltimore, MD 21201 USA. [Pandya, Naimish; Hussain, Arif; Edelman, Martin J.] Univ Maryland, Greenebaum Canc Ctr, Baltimore, MD 21201 USA. [Hurria, Arti] City Hope Natl Med Ctr, Duarte, CA 91010 USA. [Lichtman, Stuart M.] Mem Sloan Kettering Canc Ctr, Commack, NY 11725 USA. [Weiner, Jonathan P.] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA. RP Hendrick, F (reprint author), Univ Maryland, Sch Pharm, 220 Arch St,12th Floor, Baltimore, MD 21201 USA. EM amy.davidoff@ahrq.hhs.gov; izuckerm@rx.umaryland.edu; npandya@umm.edu; fhend001@umaryland.edu; xke001@umaryland.edu; ahurria@coh.org; lichtmas@mskcc.org; ahussain@som.umaryland.edu; jweiner@jhsph.edu; medelman@umm.edu FU NCI NIH HHS [R21 CA137283] NR 33 TC 22 Z9 22 U1 3 U2 7 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1879-4068 J9 J GERIATR ONCOL JI J. Geriatr. Oncol. PD APR PY 2013 VL 4 IS 2 BP 157 EP 165 DI 10.1016/j.jgo.2012.12.005 PG 9 WC Oncology; Geriatrics & Gerontology SC Oncology; Geriatrics & Gerontology GA 118KI UT WOS:000317024000009 PM 23795223 ER PT J AU Pylypchuk, Y Sarpong, EM AF Pylypchuk, Yuriy Sarpong, Eric M. TI Comparison of Health Care Utilization: United States versus Canada SO HEALTH SERVICES RESEARCH LA English DT Article DE Health care services; universal coverage; Canada; United States ID ACCESS; ADULTS AB Objective To compare health care utilization between Canadian and U.S. residents. Data Sources Nationally representative 2007 surveys from the Medical Expenditure Panel Survey for the United States and the Canadian Community Health Survey for Canada. Study Design We use descriptive and multivariate methods to examine differences in health care utilization rates for visits to medical providers, nurses, chiropractors, specialists, dentists, and overnight hospital stays, usual source of care, Pap smear tests, and mammograms. Principal Findings The poor and less educated were more likely to utilize health care in Canada than in the United States. The differences were especially pronounced for having a usual source of care and for visits to providers, specialists, and dentists. Health care use for residents with high incomes and higher levels of education were not markedly different between the two countries and often higher for U.S residents. Foreign-born residents were more likely to use health care in Canada than in the United States. The descriptive results were confirmed in multivariate regressions. Conclusions Given the magnitude of our results, the health insurance structure in Canada might have played an important role in improving access to care for subpopulations examined in this study. C1 [Pylypchuk, Yuriy] Social & Sci Syst, Rockville, MD 20850 USA. [Pylypchuk, Yuriy] Georgetown Publ Policy Inst, Rockville, MD 20850 USA. [Sarpong, Eric M.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Pylypchuk, Y (reprint author), Social & Sci Syst, 540 Gaither Rd, Rockville, MD 20850 USA. EM yuriy.ypylypch@ahrq.gov OI SARPONG, ERIC/0000-0002-3674-8112 NR 14 TC 3 Z9 3 U1 0 U2 27 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD APR PY 2013 VL 48 IS 2 BP 560 EP 581 DI 10.1111/j.1475-6773.2012.01466.x PN 1 PG 22 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 106CW UT WOS:000316120200012 PM 23003340 ER PT J AU Braithwaite, S Friedman, B Mutter, R Handrigan, M AF Braithwaite, Sabina Friedman, Bernard Mutter, Ryan Handrigan, Michael TI Microsimulation of Financial Impact of Demand Surge on Hospitals: The H1N1 Influenza Pandemic of Fall 2009 SO HEALTH SERVICES RESEARCH LA English DT Article DE Microsimulation; H1N1; hospital preparedness; hospital finance ID UNITED-STATES; CAPACITY AB Objective Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009. The goal was to estimate net income and losses (nationally, and by hospital type) of a response of filling unused hospital bed capacity proportionately and postponing elective admissions (a passive supply response). Methods Epidemiologic assumptions were combined with assumptions from other literature (e.g., staff absenteeism, profitability by payer class), Census data on age groups by region, and baseline hospital utilization data. Hospital discharge records were available from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS). Hospital bed capacity and staffing were measured with the American Hospital Association's (AHA) Annual Survey. Results Nationwide, in a scenario of relatively severe epidemiologic assumptions, we estimated aggregate net income of $119million for about 1 million additional influenza-related admissions, and a net loss of $37million for 52,000 postponed elective admissions. Implications Aggregate and distributional results did not suggest that a policy of promising additional financial compensation to hospitals in anticipation of the surge in flu cases was necessary. The analysis identified needs for better information of several types to improve simulations of hospital behavior and impacts during demand surges. C1 [Friedman, Bernard; Mutter, Ryan] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. [Braithwaite, Sabina] Univ Kansas, Dept Prevent Med & Publ Hlth, Wichita Sedgwick Cty EMS Syst Dept Emergency Med, Wichita, KS USA. [Handrigan, Michael] US Dept HHS, Ctr Medicare Serv, Arlington, VA USA. [Handrigan, Michael] US Dept HHS, Ctr Medicaid Serv, Arlington, VA USA. RP Friedman, B (reprint author), US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. EM econobarry@gmail.com NR 25 TC 3 Z9 3 U1 1 U2 14 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD APR PY 2013 VL 48 IS 2 BP 735 EP 752 DI 10.1111/1475-6773.12041 PN 2 PG 18 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 106CZ UT WOS:000316120600005 PM 23398540 ER PT J AU Miller, GE Selden, TM AF Miller, G. Edward Selden, Thomas M. TI Tax Subsidies for Employer-Sponsored Health Insurance: Updated Microsimulation Estimates and Sensitivity to Alternative Incidence Assumptions SO HEALTH SERVICES RESEARCH LA English DT Article DE Microsimulation; health insurance; tax subsidy ID COVERAGE; COSTS; EXCLUSION; WORKERS; REFORM; PLAN AB Objective To estimate 2012 tax expenditures for employer-sponsored insurance (ESI) in the United States and to explore the sensitivity of estimates to assumptions regarding the incidence of employer premium contributions. Data Sources Nationally representative Medical Expenditure Panel Survey data from the 20052007 Household Component (MEPS-HC) and the 20092010 Insurance Component (MEPS IC). Study Design We use MEPS HC workers to construct synthetic workforces for MEPS IC establishments, applying the workers' marginal tax rates to the establishments' insurance premiums to compute the tax subsidy, in aggregate and by establishment characteristics. Simulation enables us to examine the sensitivity of ESI tax subsidy estimates to a range of scenarios for the within-firm incidence of employer premium contributions when workers have heterogeneous health risks and make heterogeneous plan choices. Principal Findings We simulate the total ESI tax subsidy for all active, civilian U.S. workers to be $257.4billion in 2012. In the private sector, the subsidy disproportionately flows to workers in large establishments and establishments with predominantly high wage or full-time workforces. The estimates are remarkably robust to alternative incidence assumptions. Conclusions The aggregate value of the ESI tax subsidy and its distribution across firms can be reliably estimated using simplified incidence assumptions. C1 [Miller, G. Edward; Selden, Thomas M.] Agcy Healthcare Res & Qual, Div Modeling & Simulat, Ctr Financing Access & Cost Trends, Rockville, MD 20782 USA. RP Miller, GE (reprint author), Agcy Healthcare Res & Qual, Div Modeling & Simulat, Ctr Financing Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20782 USA. EM emiller@ahrq.gov NR 36 TC 0 Z9 0 U1 2 U2 7 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD APR PY 2013 VL 48 IS 2 BP 866 EP 883 DI 10.1111/1475-6773.12037 PN 2 PG 18 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 106CZ UT WOS:000316120600012 PM 23398400 ER PT J AU Mutter, RL Greene, WH Spector, W Rosko, MD Mukamel, DB AF Mutter, Ryan L. Greene, William H. Spector, William Rosko, Michael D. Mukamel, Dana B. TI Investigating the impact of endogeneity on inefficiency estimates in the application of stochastic frontier analysis to nursing homes SO JOURNAL OF PRODUCTIVITY ANALYSIS LA English DT Article DE Stochastic frontier analysis; Endogeneity; Efficiency; Quality; Nursing homes ID HOSPITAL INEFFICIENCY; QUALITY; CARE; EFFICIENCY; COST AB This paper examines the impact of an endogenous cost function variable on the inefficiency estimates generated by stochastic frontier analysis (SFA). The specific variable of interest in this application is endogenous quality in nursing homes. We simulate a dataset based on the characteristics of for-profit nursing homes in California, which we use to assess the impact on SFA-generated inefficiency estimates of an endogenous regressor under a variety of scenarios, including variations in the strength and direction of the endogeneity and whether the correlation is with the random noise or the inefficiency residual component of the error term. We compare each of these cases when quality is included and excluded from the cost equation. We provide evidence of the impact of endogeneity on inefficiency estimates yielded by SFA under these various scenarios and when the endogenous regressor is included and excluded from the model. C1 [Mutter, Ryan L.; Spector, William] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. [Greene, William H.] NYU, Stern Sch Business, New York, NY 10012 USA. [Rosko, Michael D.] Widener Univ, Sch Business Adm, Chester, PA 19013 USA. [Mukamel, Dana B.] Univ Calif Irvine, Hlth Policy Res Inst, Dept Med, Irvine, CA 92697 USA. RP Mutter, RL (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM Ryan.Mutter@ahrq.hhs.gov; wgreene@stern.nyu.edu; William.Spector@ahrq.hhs.gov; mdrosko@widener.edu; dmukamel@uci.edu NR 19 TC 9 Z9 9 U1 1 U2 20 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0895-562X J9 J PROD ANAL JI J. Prod. Anal. PD APR PY 2013 VL 39 IS 2 BP 101 EP 110 DI 10.1007/s11123-012-0277-z PG 10 WC Business; Economics; Social Sciences, Mathematical Methods SC Business & Economics; Mathematical Methods In Social Sciences GA 098VZ UT WOS:000315578500001 ER PT J AU Mark, TL Lawrence, W Coffey, RM Kenney, T Chu, BC Mohler, ER Steiner, C AF Mark, Tami L. Lawrence, William Coffey, Rosanna M. Kenney, Timothy Chu, Bong Chul Mohler, Emile R., III Steiner, Claudia TI The value of linking hospital discharge and mortality data for comparative effectiveness research SO JOURNAL OF COMPARATIVE EFFECTIVENESS RESEARCH LA English DT Article DE abdominal aortic aneurysm; comparative effectiveness; linked data; observational data analysis ID ABDOMINAL-AORTIC-ANEURYSM; RANDOMIZED CONTROLLED-TRIAL; OPEN REPAIR; ENDOVASCULAR REPAIR; OUTCOMES AB Background: Linkage of US state hospital discharge records to state death certificate records offers the possibility of tracking long-term mortality outcomes across large, diverse patient populations, which may be useful for comparative effective analyses. Aim: To demonstrate the value of linking state community hospital discharge data to vital statistics death files for research by conducting a comparative effectiveness analysis. Methods: Linked Patient Discharge Data and Vital Statistics Death Files from the California Office of Statewide Health Planning and Development were used to compare survival rates for patients with an elective repair for abdominal aortic aneurysm who received open aneurysm repair (OAR) versus endovascular aneurysm repair (EVAR). The sample consisted of 13,652 hospitalized patients who underwent an OAR or EVAR for abdominal aortic aneurysm between 1 July 2000 and 31 January 2006. Patients were matched using propensity scores (8966 patients in the matched sample). In-hospital, 30-day, 1-year and 5-year mortality rates were compared between the OAR and EVAR populations, before and after propensity score matching. Results: We found a few data anomalies (92 out of 13,652), primarily in patients' sex and date of death. The analysis revealed that in the matched cohort, in-hospital and 30-day postdischarge mortality rates were significantly lower following EVAR than OAR; however, consistent with previous clinical trials, differences in the 1-and 5-year rates were not statistically significant. Conclusion: The study demonstrates that linked US state discharge and mortality data can be a valuable resource for comparative effectiveness analyses. In particular, this approach may be useful when generally available data sets such as Medicare claims data limit the generalizability of findings. Policy-makers and others should consider greater investments in these data. C1 [Mark, Tami L.; Coffey, Rosanna M.; Chu, Bong Chul] Truven Hlth Analyt, Washington, DC 20008 USA. [Lawrence, William; Steiner, Claudia] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Kenney, Timothy] Kenney IS Consulting Inc, Ojai, CA 93023 USA. [Mohler, Emile R., III] Translat Res Ctr, Philadelphia, PA 19104 USA. [Mohler, Emile R., III] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. RP Mark, TL (reprint author), Truven Hlth Analyt, 4301 Connecticut Ave NW,Suite 330, Washington, DC 20008 USA. EM tami.mark@truvenhealth.com NR 21 TC 4 Z9 4 U1 0 U2 0 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 2042-6305 EI 2042-6313 J9 J COMP EFFECT RES JI J. Comp. Eff. Res. PD MAR PY 2013 VL 2 IS 2 BP 175 EP 184 DI 10.2217/CER.13.4 PG 10 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 299CN UT WOS:000330372700015 PM 24236559 ER PT J AU Abdus, S Selden, TM AF Abdus, Salam Selden, Thomas M. TI Adherence With Recommended Well-Child Visits Has Grown, But Large Gaps Persist Among Various Socioeconomic Groups SO HEALTH AFFAIRS LA English DT Article ID LOW-INCOME CHILDREN; EXPENDITURE PANEL SURVEY; PREVENTIVE CARE; HEALTH-CARE; MEDICAID; GUIDELINES; COVERAGE; ACCESS AB A goal of federal policy is to improve preventive health care for children. However, little is known about how adherence to recommendations by the American Academy of Pediatrics for well-child visits has changed over time. Using the 1996-2008 Medical Expenditure Panel Surveys, we examined trends in adherence and whether differences across population subgroups narrowed or widened over time. We found that the ratio of actual to recommended well-child visits rose from 46.3 percent during the 1996-98 time period to 58.9 percent during the 2007-08 time period. Although this increase in adherence is important, improvement occurred unevenly. We observed large differences in adherence at the start of the study period across income, race or ethnicity, parent education, region, insurance coverage, and having a usual source of care. None of these differences had narrowed significantly by the end of the study period. Indeed, differences widened across parent education, between those with and without insurance coverage, by usual source of care, and between the Northeast and the Midwest and West regions. Our results highlight the importance of provisions in the Affordable Care Act to expand coverage, strengthen incentives for preventive services, and improve the measurement of preventive services. C1 [Abdus, Salam] Social & Sci Syst, Silver Spring, MD USA. [Selden, Thomas M.] Agcy Healthcare Res & Qual, Div Modeling & Simulat, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Abdus, S (reprint author), Social & Sci Syst, Silver Spring, MD USA. EM Thomas.Selden@ahrq.hhs.gov NR 22 TC 16 Z9 16 U1 0 U2 6 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD MAR PY 2013 VL 32 IS 3 BP 508 EP 515 DI 10.1377/hlthaff.2012.0691 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 111YK UT WOS:000316557900009 PM 23459729 ER PT J AU Clancy, CM Moy, E AF Clancy, Carolyn M. Moy, Ernest TI Commentary: Measuring What Matters Most SO MILBANK QUARTERLY LA English DT Editorial Material C1 [Clancy, Carolyn M.; Moy, Ernest] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Clancy, CM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Carolyn.clancy@ahrq.hhs.gov NR 3 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0887-378X J9 MILBANK Q JI Milbank Q. PD MAR PY 2013 VL 91 IS 1 BP 201 EP 204 DI 10.1111/milq.12008 PG 4 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 108IT UT WOS:000316286900009 PM 23488717 ER PT J AU Jiang, HJ Friedman, B Jiang, SY AF Jiang, H. Joanna Friedman, Bernard Jiang, Shenyi TI Hospital cost and quality performance in relation to market forces: an examination of US community hospitals in the "post-managed care era" SO INTERNATIONAL JOURNAL OF HEALTH CARE FINANCE & ECONOMICS LA English DT Article DE Managed care; Hospital cost; Mortality rates; Hospital competition ID PRICE-COMPETITION; HMO PENETRATION; MORTALITY; CALIFORNIA; INFLATION; MODELS; STATES; END AB Managed care substantially transformed the U.S. healthcare sector in the last two decades of the twentieth century, injecting price competition among hospitals for the first time in history. However, total HMO enrollment has declined since 2000. This study addresses whether managed care and hospital competition continued to show positive effects on hospital cost and quality performance in the "post-managed care era." Using data for 1,521 urban hospitals drawn from the Healthcare Cost and Utilization Project, we examined hospital cost per stay and mortality rate in relation to HMO penetration and hospital competition between 2001 and 2005, controlling for patient, hospital, and other market characteristics. Regression analyses were employed to examine both cross-sectional and longitudinal variation in hospital performance. We found that in markets with high HMO penetration, increase in hospital competition over time was associated with decrease in mortality but no change in cost. In markets without high HMO penetration, increase in hospital competition was associated with increase in cost but no change in mortality. Overall, hospitals in high HMO penetration markets consistently showed lower average costs, and hospitals in markets with high hospital competition consistently showed lower mortality rates. Hospitals in markets with high HMO penetration also showed lower mortality rates in 2005 with no such difference found in 2001. Our findings suggest that while managed care may have lost its strength in slowing hospital cost growth, differences in average hospital cost associated with different levels of HMO penetration across markets still persist. Furthermore, these health plans appear to put quality of care on a higher priority than before. C1 [Jiang, H. Joanna; Friedman, Bernard] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD 20850 USA. [Jiang, Shenyi] Renmin Univ China, Hanqing Adv Inst Econ & Finance, Beijing 100872, Peoples R China. RP Jiang, HJ (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM joanna.jiang@ahrq.gov NR 36 TC 4 Z9 4 U1 2 U2 18 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1389-6563 J9 INT J HEALTH CARE FI JI Int. J. Health Care Financ. Econ. PD MAR PY 2013 VL 13 IS 1 BP 53 EP 71 DI 10.1007/s10754-013-9122-9 PG 19 WC Business, Finance; Economics; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 088MG UT WOS:000314838100003 PM 23355253 ER PT J AU Rubinson, L Mutter, R Viboud, C Hupert, N Uyeki, T Creanga, A Finelli, L Iwashyna, TJ Carr, B Merchant, R Katikineni, D Vaughn, F Clancy, C Lurie, N AF Rubinson, Lewis Mutter, Ryan Viboud, Cecile Hupert, Nathaniel Uyeki, Timothy Creanga, Andreea Finelli, Lyn Iwashyna, Theodore J. Carr, Brendan Merchant, Raina Katikineni, Devi Vaughn, Frances Clancy, Carolyn Lurie, Nicole TI Impact of the Fall 2009 Influenza A(H1N1)pdm09 Pandemic on US Hospitals SO MEDICAL CARE LA English DT Article DE pandemic influenza; hospital surge capacity; emergency department ID A H1N1 VIRUS; ACUTE MYOCARDIAL-INFARCTION; UNITED-STATES; INFECTION; BURDEN AB Background: Understanding how hospitals functioned during the 2009 influenza A(H1N1)pdm09 pandemic may improve future public health emergency response, but information about its impact on US hospitals remains largely unknown. Research Design: We matched hospital and emergency department (ED) discharge data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project with community-level influenza-like illness activity during each hospital's pandemic period in fall 2009 compared with a corresponding calendar baseline period. We compared inpatient mortality for sentinel conditions at high-surge versus nonsurge hospitals. Results: US hospitals experienced a doubling of pneumonia and influenza ED visits during fall 2009 compared with prior years, along with an 18% increase in overall ED visits. Although no significant increase in total inpatient admissions occurred overall, approximately 10% of all study hospitals experienced high surge, associated with higher acute myocardial infarction and stroke case fatality rates. These hospitals had similar characteristics to other US hospitals except that they had higher mortality for acute cardiac illnesses before the pandemic. After adjusting for 2008 case fatality rates, the association between high-surge hospitals and increased mortality for acute myocardial infarction and stroke patients persisted. Conclusions: The fall 2009 pandemic period substantially impacted US hospitals, mostly through increased ED visits. For a small proportion of hospitals that experienced a high surge in inpatient admissions, increased mortality from selected clinical conditions was associated with both prepandemic outcomes and surge, highlighting the linkage between daily hospital operations and disaster preparedness. C1 [Rubinson, Lewis; Vaughn, Frances; Lurie, Nicole] US Dept HHS, Off Assistant Secretary Preparedness & Response, Washington, DC 20201 USA. [Mutter, Ryan; Clancy, Carolyn] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Viboud, Cecile] NIH, Fogarty Int Ctr, Bethesda, MD 20892 USA. [Hupert, Nathaniel] Weill Cornell Med Ctr, New York, NY USA. [Uyeki, Timothy; Finelli, Lyn] Ctr Dis Control & Prevent, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA. [Creanga, Andreea] Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. [Iwashyna, Theodore J.] Univ Michigan Hlth Syst, Dept Internal Med, Ann Arbor, MI USA. [Carr, Brendan; Merchant, Raina] Univ Penn, Perelman Sch Med, Dept Emergency Med, Philadelphia, PA 19104 USA. [Katikineni, Devi] Social & Sci Syst Inc, Silver Spring, MD USA. RP Mutter, R (reprint author), Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, 540 Gaither Rd, Rockville, MD 20850 USA. EM Ryan.Mutter@ahrq.hhs.gov OI Iwashyna, Theodore/0000-0002-4226-9310 NR 23 TC 7 Z9 7 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD MAR PY 2013 VL 51 IS 3 BP 259 EP 265 DI 10.1097/MLR.0b013e31827da8ea PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 090NE UT WOS:000314985100009 PM 23295577 ER PT J AU Pyrgos, V Seitz, AE Steiner, CA Prevots, DR Williamson, PR AF Pyrgos, Vasilios Seitz, Amy E. Steiner, Claudia A. Prevots, D. Rebecca Williamson, Peter R. TI Epidemiology of Cryptococcal Meningitis in the US: 1997-2009 SO PLOS ONE LA English DT Article ID CLINICAL-PRACTICE GUIDELINES; INFECTIOUS-DISEASES SOCIETY; NEOFORMANS INFECTION; ACTIVE SURVEILLANCE; EMERGING PATHOGEN; UNITED-STATES; UPDATE; HOSPITALIZATIONS; HYDROCEPHALUS; DEFICIENCY AB Cryptococcal meningitis (CM) causes significant morbidity and mortality globally; however, recent national trends have not been described. Incidence and trends for CM-associated hospitalizations in 18 states were estimated using the Agency for Healthcare and Research Quality (AHRQ) State Inpatient Databases (SID) datasets for 1997 through 2009. We identified 30,840 hospitalizations coded for CM, of which 21.6% were among HIV-uninfected patients. CM in-hospital mortality was significant (12.4% for women and 10.8% for men) with a total of 3,440 deaths over the study period. Co-morbidities of CM coded at increased frequency in HIV-uninfected CM hospitalized populations included hydrocephalus and acute/chronic renal failure as well as possible predispositions including transplantation, combined T and B cell defects, Cushing's syndrome, liver disease and hypogammaglobulinemia. Median hospitalization costs were significant for CM and higher for HIV-uninfected patients (16,803.01 vs. 15,708.07; p<0.0001). Cryptococcal meningitis remains a disease with significant morbidity and mortality in the U.S. and the relative burden among persons without HIV infection is increasing. C1 [Pyrgos, Vasilios; Seitz, Amy E.; Prevots, D. Rebecca; Williamson, Peter R.] NIAID, Lab Clin Infect Dis, NIH, Bethesda, MD 20892 USA. [Steiner, Claudia A.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Healthcare Cost & Utilizat Project, Rockville, MD USA. [Williamson, Peter R.] Univ Chicago, Dept Med, Chicago Coll Med, Infect Dis Sect, Chicago, IL 60637 USA. RP Williamson, PR (reprint author), NIAID, Lab Clin Infect Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA. EM williamsonpr@mail.nih.gov FU Intramural Research Program of the National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) FX This research was supported by the Intramural Research Program of the National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional outside funding was obtained. NR 41 TC 44 Z9 47 U1 1 U2 7 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD FEB 15 PY 2013 VL 8 IS 2 AR e56269 DI 10.1371/journal.pone.0056269 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 099EQ UT WOS:000315603700039 PM 23457543 ER PT J AU Sharkey, S Hudak, S Horn, SD Barrett, R Spector, W Limcangco, R AF Sharkey, Siobhan Hudak, Sandra Horn, Susan D. Barrett, Ryan Spector, William Limcangco, Rhona TI Exploratory Study of Nursing Home Factors Associated with Successful Implementation of Clinical Decision Support Tools for Pressure Ulcer Prevention SO ADVANCES IN SKIN & WOUND CARE LA English DT Article DE Nursing home quality improvement; pressure ulcer prevention; health information technology tools for clinical decision making ID QUALITY; CARE; DOCUMENTATION AB OBJECTIVES: To determine those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. DESIGN: Observational study with quantitative analysis of nursing home characteristics, team participation levels, and implementation milestones collected as part of a QI program. SETTING: Fourteen nursing homes in Washington, District of Columbia, participating in the On-Time Pressure Ulcer Prevention program. MAIN OUTCOME MEASURES: The nursing home level of implementation was measured by counting the number of implementation milestones achieved after at least 9 months of implementation effort. MAIN RESULTS: After at least 9 months of implementation effort, 36% of the nursing homes achieved level III, a high level of implementation, of the On-Time QI-HIT program. Factors significantly associated with high implementation were high level of involvement from the administrator or director of nursing, high level of nurse manager participation, presence of in-house dietitian, high level of participation of staff educator and QI personnel, presence of an internal champion, and team's openness to redesign. One factor that was identified as a barrier to high level of implementation was higher numbers of health inspection deficiencies per bed. CONCLUSION: The learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home. C1 [Sharkey, Siobhan; Hudak, Sandra] Hlth Management Strategies, Austin, TX 78749 USA. [Horn, Susan D.; Barrett, Ryan] Inst Clin Outcomes Res, Salt Lake City, UT USA. [Spector, William] US Dept HHS, Agcy Healthcare Res & Qual, Rockville, MD USA. [Limcangco, Rhona] Social & Sci Syst Inc, Rockville, MD USA. RP Sharkey, S (reprint author), Hlth Management Strategies, Austin, TX 78749 USA. FU Agency for Healthcare Research and Quality, US Department of Health Human Services [HHSA290-2005-0020]; Delmarva Foundation FX This work was supported by the Agency for Healthcare Research and Quality, US Department of Health & Human Services, contract HHSA290-2005-0020. Additional funding was provided by Delmarva Foundation. NR 13 TC 9 Z9 9 U1 0 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1527-7941 J9 ADV SKIN WOUND CARE JI Adv. Skin Wound Care PD FEB PY 2013 VL 26 IS 2 BP 83 EP 92 DI 10.1097/01.ASW.0000426718.59326.bb PG 10 WC Dermatology; Nursing; Surgery SC Dermatology; Nursing; Surgery GA 094TN UT WOS:000315286800008 PM 23337649 ER PT J AU Koh, HK Brach, C Harris, LM Parchman, ML AF Koh, Howard K. Brach, Cindy Harris, Linda M. Parchman, Michael L. TI A Proposed 'Health Literate Care Model' Would Constitute A Systems Approach To Improving Patients' Engagement In Care SO HEALTH AFFAIRS LA English DT Article ID CHRONIC ILLNESS CARE; RANDOMIZED-TRIAL AB Improving health outcomes relies on patients' full engagement in prevention, decision-making, and self-management activities. Health literacy, or people's ability to obtain, process, communicate, and understand basic health information and services, is essential to those actions. Yet relatively few Americans are proficient in understanding and acting on available health information. We propose a Health Literate Care Model that would weave health literacy strategies into the widely adopted Care Model (formerly known as the Chronic Care Model). Our model calls for first approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them, and then subsequently confirming and ensuring patients' understanding. For health care organizations adopting our model, health literacy would then become an organizational value infused into all aspects of planning and operations, including self-management support, delivery system design, shared decision-making support, clinical information systems to track and plan patient care, and helping patients access community resources. We also propose a measurement framework to track the impact of the new Health Literate Care Model on patient outcomes and quality of care. C1 [Koh, Howard K.; Harris, Linda M.] US Dept HHS, Washington, DC 20201 USA. [Brach, Cindy] Agcy Healthcare Res & Qual, Rockville, MD USA. [Parchman, Michael L.] MacColl Ctr Healthcare Innovat, Grp Hlth Res Inst, Seattle, WA USA. RP Koh, HK (reprint author), US Dept HHS, Washington, DC 20201 USA. EM linda.harris@hhs.gov OI Parchman, Michael/0000-0001-7129-2889 FU Intramural AHRQ HHS [HS999999] NR 43 TC 51 Z9 53 U1 1 U2 23 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD FEB PY 2013 VL 32 IS 2 BP 357 EP 367 DI 10.1377/hlthaff.2012.1205 PG 11 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 093QQ UT WOS:000315206900021 PM 23381529 ER PT J AU Fleurence, R Selby, JV Odom-Walker, K Hunt, G Meltzer, D Slutsky, JR Yancy, C AF Fleurence, Rachael Selby, Joe V. Odom-Walker, Kara Hunt, Gail Meltzer, David Slutsky, Jean R. Yancy, Clyde TI How The Patient-Centered Outcomes Research Institute Is Engaging Patients And Others In Shaping Its Research Agenda SO HEALTH AFFAIRS LA English DT Article ID CRITERIA AB Clinical research has been driven traditionally by investigators, from generating research questions and outcomes through analysis and release of study results. Building on the work of others, the Patient-Centered Outcomes Research Institute (PCORI) is tapping into its broad-based stakeholder community-especially patients, caregivers, and their clinicians-to generate topics for research, help the institute prioritize those topics, select topics for funding, and ensure patients' involvement in the design of research projects. This article describes PCORI's approach, which is emblematic of the organization's mandate under the Affordable Care Act to seek meaningful ways to integrate the patient's voice into the research process, and describes how it is being used in selection of research that PCORI will fund. We also describe challenges facing our approach, including a lack of common language and training on the part of patients and resistance on the part of researchers to questions that are not researcher generated. Faced with the reality that PCORI will not be able to fund all research questions posed to it, there will also be difficult decisions to make when selecting those that have the highest priority for funding. C1 [Fleurence, Rachael] PCORI, Patient Ctr Outcomes Res Methods Program, Washington, DC USA. [Selby, Joe V.; Odom-Walker, Kara] PCORI, Washington, DC USA. [Hunt, Gail] Natl Alliance Caregiving, Bethesda, MD USA. [Meltzer, David] Univ Chicago, Ctr Hlth & Social Sci, Chicago, IL 60637 USA. [Meltzer, David] Univ Chicago, Sect Hosp Med, Chicago, IL 60637 USA. [Meltzer, David] Univ Chicago, Comm Clin & Translat Sci, Chicago, IL 60637 USA. [Meltzer, David] Univ Chicago, MD PhD Program Med & Social Sci, Chicago, IL 60637 USA. [Meltzer, David] Univ Chicago, Dept Med, Chicago, IL 60637 USA. [Meltzer, David] Univ Chicago, Dept Econ, Chicago, IL 60637 USA. [Meltzer, David] Univ Chicago, Grad Sch Publ Policy Studies, Chicago, IL 60637 USA. [Slutsky, Jean R.] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD USA. [Yancy, Clyde] Northwestern Univ, Div Cardiol, Chicago, IL 60611 USA. [Yancy, Clyde] Northwestern Univ, Chicago, IL 60611 USA. RP Fleurence, R (reprint author), PCORI, Patient Ctr Outcomes Res Methods Program, Washington, DC USA. EM rfleurence@pcori.org RI Meltzer, David/C-2926-2009 OI Meltzer, David/0000-0003-2790-7393 NR 18 TC 57 Z9 58 U1 0 U2 14 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD FEB PY 2013 VL 32 IS 2 BP 393 EP 400 DI 10.1377/hlthaff.2012.1176 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 093QQ UT WOS:000315206900025 PM 23381533 ER PT J AU Mukamel, DB Li, Y Weimer, DL Spector, WD Bailey, L Harrington, C AF Mukamel, Dana B. Li, Yue Weimer, David L. Spector, William D. Bailey, Lauren Harrington, Charlene TI What Factors Contribute to Successful Appeals of Nursing Homes' Deficiencies in the Informal Dispute Resolution Process? SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article DE Nursing homes; quality; deficiencies; regulation; appeal ID QUALITY AB Objectives: To determine what factors contribute to successful appeals of nursing home deficiencies in the Informal Dispute Resolution (IDR) process. Design: We merged Centers for Medicare and Medicaid Services' data about IDRs with Online Survey, Certification, and Reporting data about nursing home characteristics. We performed multivariate statistical analyses to predict successful appeals as a function of characteristics of the deficiency being appealed, the survey that triggered the deficiency, characteristics of the nursing home, and the state. Setting: All nursing homes nationally in the period 2005-2008. Measurements: Successful appeals were defined as those in which the deficiency was removed or its severity or scope reduced. Independent variables included the Centers for Medicare and Medicaid Services' measures of severity and scope of deficiency, abuse and neglect, substandard care, total number of deficiencies in the survey, whether the IDR was triggered by a survey or complaint, facility ownership and reputation, and state stringency of regulation. Results: Twenty-six percent of submitted IDRs were successful in 2005-2008. Success was more likely for less severe deficiencies, when deficiencies were triggered by a survey rather than a complaint, and when fewer deficiencies were included in the appeal. Facility ownership and state stringency of regulation were not significantly associated with the IDR success. Discussion: Overall, 2.6% of deficiencies issued were overturned through the IDR process. Further study is required to determine the appropriateness of these overturned cases and the opportunities they offer to improve the survey process. Copyright (C) 2013 - American Medical Directors Association, Inc. C1 [Mukamel, Dana B.; Bailey, Lauren] Univ Calif Irvine, Hlth Policy Res Inst, Dept Med, Irvine, CA 92697 USA. [Li, Yue] Univ Rochester, Med Ctr, Dept Publ Hlth Sci, Rochester, NY 14642 USA. [Weimer, David L.] Univ Wisconsin, Dept Polit Sci, LaFollette Sch Publ Affairs, Madison, WI USA. [Spector, William D.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Harrington, Charlene] Univ Calif San Francisco, Dept Social & Behav Sci, San Francisco, CA USA. RP Mukamel, DB (reprint author), Univ Calif Irvine, Hlth Policy Res Inst, Dept Med, 100 Theory Suite 110, Irvine, CA 92697 USA. EM dmukamel@uci.edu FU National Institutes of Aging [AG027420] FX This work was funded by the National Institutes of Aging Grant AG027420. NR 15 TC 0 Z9 0 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD FEB PY 2013 VL 14 IS 2 BP 101 EP 104 DI 10.1016/j.jamda.2012.09.015 PG 4 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 088EV UT WOS:000314817500006 PM 23141210 ER PT J AU Chang, SM AF Chang, Stephanie M. TI Should meta-analyses trump observational studies? SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Editorial Material ID MORTALITY C1 Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Chang, SM (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM stephanie.chang@ahrq.hhs.gov NR 3 TC 4 Z9 4 U1 0 U2 4 PU AMER SOC NUTRITION-ASN PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD FEB PY 2013 VL 97 IS 2 BP 237 EP 238 DI 10.3945/ajcn.112.055111 PG 2 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 075JI UT WOS:000313880900003 PM 23255570 ER PT J AU Guyatt, G Oxman, AD Sultan, S Brozek, J Glasziou, P Alonso-Coello, P Atkins, D Kunz, R Montori, V Jaeschke, R Rind, D Dahm, P Akl, EA Meerpohl, J Vist, G Berliner, E Norris, S Falck-Ytter, Y Schunemann, HJ AF Guyatt, Gordon Oxman, Andrew D. Sultan, Shahnaz Brozek, Jan Glasziou, Paul Alonso-Coello, Pablo Atkins, David Kunz, Regina Montori, Victor Jaeschke, Roman Rind, David Dahm, Philipp Akl, Elie A. Meerpohl, Joerg Vist, Gunn Berliner, Elise Norris, Susan Falck-Ytter, Yngve Schuenemann, Holger J. TI GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE GRADE; Quality of evidence; Confidence in estimates; Guideline methodology; Systematic review methodology; Values and preferences ID QUALITY; METAANALYSIS AB GRADE requires guideline developers to make an overall rating of confidence in estimates of effect (quality of evidence high, moderate, low, or very low) for each important or critical outcome. GRADE suggests, for each outcome, the initial separate consideration of five domains of reasons for rating down the confidence in effect estimates, thereby allowing systematic review authors and guideline developers to arrive at an outcome-specific rating of confidence. Although this rating system represents discrete steps on an ordinal scale, it is helpful to view confidence in estimates as a continuum, and the final rating of confidence may differ from that suggested by separate consideration of each domain. An overall rating of confidence in estimates of effect is only relevant in settings when recommendations are being made. In general, it is based on the critical outcome that provides the lowest confidence. (C) 2013 Elsevier Inc. All rights reserved. C1 [Guyatt, Gordon] McMaster Univ, Dept Clin Epidemiol & Biostat, CLAR Res Grp, Hamilton, ON L8N 3Z5, Canada. [Guyatt, Gordon; Schuenemann, Holger J.] McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada. [Oxman, Andrew D.; Vist, Gunn] Norwegian Knowledge Ctr Hlth Serv, N-0130 Oslo, Norway. [Sultan, Shahnaz] Univ Florida, Dept Med, Div Gastroenterol Hepatol & Nutr, Gainesville, FL USA. [Brozek, Jan] Univ Oxford, Oxford, England. [Glasziou, Paul] CIBERESP IIB St Pau, Iberoamer Cochrane Ctr, Barcelona 08041, Spain. [Alonso-Coello, Pablo] Dept Vet Affairs, Off Res & Dev, QUERI Program, Washington, DC USA. [Atkins, David] Univ Basel Hosp, Acad Swiss Insurance Med Asim, CH-4031 Basel, Switzerland. [Kunz, Regina] Univ Basel Hosp, Basel Inst Clin Epidemiol, CH-4031 Basel, Switzerland. [Kunz, Regina] Mayo Clin, Knowledge & Evaluat Res Unit, Rochester, MN USA. [Guyatt, Gordon; Montori, Victor] McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada. [Jaeschke, Roman] Harvard Univ, Sch Med, UpToDate, Boston, MA USA. [Rind, David] Univ Florida, Dept Urol, Gainesville, FL USA. [Dahm, Philipp] SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA. [Akl, Elie A.] Univ Med Ctr Freiburg, Inst Med Biometry & Med Informat, German Cochrane Ctr, D-79104 Freiburg, Germany. [Meerpohl, Joerg] Univ Med Ctr Freiburg, Dept Pediat & Adolescent Med, Div Pediat Hematol & Oncol, D-79106 Freiburg, Germany. [Meerpohl, Joerg] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Technol Assessment Program, Rockville, MD 20850 USA. [Berliner, Elise] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97239 USA. [Norris, Susan; Falck-Ytter, Yngve] Case Western Reserve Univ, Case & VA Med Ctr, Div Gastroenterol, Cleveland, OH 44106 USA. RP Guyatt, G (reprint author), McMaster Univ, Dept Clin Epidemiol & Biostat, CLAR Res Grp, Room 2C12,1200 Main St W, Hamilton, ON L8N 3Z5, Canada. EM guyatt@mcmaster.ca RI Meerpohl, Joerg/J-4224-2013; Glasziou, Paul/A-7832-2008; OI Meerpohl, Joerg/0000-0002-1333-5403; Glasziou, Paul/0000-0001-7564-073X; Montori, Victor/0000-0003-0595-2898 NR 13 TC 113 Z9 118 U1 1 U2 10 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD FEB PY 2013 VL 66 IS 2 BP 151 EP 157 DI 10.1016/j.jclinepi.2012.01.006 PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 068PK UT WOS:000313378500006 PM 22542023 ER PT J AU Schildhaus, S Stocks, C Santora, PB Smith, MW AF Schildhaus, Sam Stocks, Carol Santora, Patricia B. Smith, Mark W. TI Community hospital admission from the emergency department by persons with substance use disorders SO JOURNAL OF SUBSTANCE ABUSE TREATMENT LA English DT Article DE Substance-related disorders; Alcohol-related disorders; Drug-related disorders emergency service, Hospital; Insurance, Health ID CARE AB Persons with a substance use disorder (SUD) are less likely to be insured and may have limited access to appropriate care, thereby increasing their reliance on emergency departments (EDs). We investigated whether health conditions and insurance status are significant predictors of admission to a community hospital directly from an ED visit with an SUD diagnosis. We analyzed the 2008 Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project. Lack of health insurance was disproportionately likely in ED visits that carried an SUD diagnosis, whether alcohol- or drug-related. Using regression analysis, most SUD and non-SUD diagnostic categories and many procedure categories were significantly related to subsequent hospital admission. Controlling for clinical characteristics, SUD-related ED visits covered by public or private insurance had substantially higher odds of leading to hospital admission than did uninsured visits. Policies that broaden insurance coverage may improve access to inpatient care for persons with SUDS. (C) 2013 Elsevier Inc. All rights reserved. C1 [Schildhaus, Sam; Smith, Mark W.] Thomson Reuters, Washington, DC 20008 USA. [Stocks, Carol] US Dept HHS, AHRQ, Ctr Delivery Org & Markets, Rockville, MD USA. [Santora, Patricia B.] US Dept HHS, SAMHSA, Ctr Subst Abuse Treatment, Rockville, MD USA. [Smith, Mark W.] Stanford Univ, Ctr Primary Care & Outcomes Res, Stanford, CA 94305 USA. RP Smith, MW (reprint author), Thomson Reuters, 4301 Connecticut Ave NW,Ste 330, Washington, DC 20008 USA. EM mark.w.smith@thomsonreuters.com RI Smith, Mark/G-1522-2012; OI Smith, Mark/0000-0002-4582-9088; Stocks, Carol/0000-0003-3440-3193 NR 8 TC 0 Z9 0 U1 0 U2 6 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0740-5472 J9 J SUBST ABUSE TREAT JI J. Subst. Abus. Treat. PD FEB PY 2013 VL 44 IS 2 BP 201 EP 207 DI 10.1016/j.jsat.2012.05.003 PG 7 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 056HO UT WOS:000312479200007 PM 22672807 ER PT J AU Hall, KK Kamerow, DB AF Hall, Kendall K. Kamerow, Douglas B. TI Understanding the Role of Facility Design in the Acquisition and Prevention of Healthcare-Associated Infections SO HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL LA English DT Editorial Material DE Built environment; design process; evidence-based design; healthcare-associated infections; hospital ID HOSPITAL SURFACES C1 [Hall, Kendall K.] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Kamerow, Douglas B.] RTI Int, Hlth Serv & Policy Res, Washington, DC USA. RP Hall, KK (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM Ken-dall.Hall@ahrq.hhs.gov NR 14 TC 2 Z9 2 U1 1 U2 3 PU VENDOME GROUP LLC PI NEW YORK PA 6 EAST 32 ST, 8 FLOOR, NEW YORK, NY 10016 USA SN 1937-5867 EI 2167-5112 J9 HERD-HEALTH ENV RES JI Herd-Health Env. Res. Des. J. PY 2013 VL 7 SU S SI SI BP 13 EP 17 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AN9MP UT WOS:000340931300003 ER PT J AU Zimring, C Jacob, JT Denham, ME Kamerow, DB Hall, KK Cowan, DZ Kasali, A Lenfestey, NF Do, E Steinberg, JP AF Zimring, Craig Jacob, Jesse T. Denham, Megan E. Kamerow, Douglas B. Hall, Kendall K. Cowan, David Z. Kasali, Altug Lenfestey, Nancy F. Do, Ellen Steinberg, James P. TI The Role of Facility Design in Preventing the Transmission of Healthcare-Associated Infections: Background and Conceptual Framework SO HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL LA English DT Article DE Built environment; design; healthcare-associated infection; hospital AB OBJECTIVE: To describe the conceptual framework and methodology used to conduct a comprehensive literature review of current evidence evaluating the role of the built environment in the transmission of healthcare-associated infections. BACKGROUND: A multidisciplinary approach to evaluating a vast and diverse dataset requires a conceptual framework to create a common understanding for interpretation. This common understanding is accomplished through the application of a "chain of transmission" model, depicting temporal and physical paths of pathogens that cause healthcare-associated infections. The chain of transmission interventions model argues that infection can potentially be reduced by interrupting any of several links in the chain. TOPICAL HEADINGS: The key pathogens impacted by the built environment are identified. The chain of transmission and the conceptual framework are described. Opportunities for intervention through the built environment are presented, which in turn guide the subsequent methodology used to conduct the systematic literature review. CONCLUSIONS: The chain of transmission interventions model is a multidisciplinary conceptualization of the interaction between pathogens and the built environment, and this model facilitated a systematic literature review of a very large amount of data. C1 [Zimring, Craig; Denham, Megan E.; Kasali, Altug] Georgia Inst Technol, SimTigrate Design Lab, Coll Architecture, Atlanta, GA 30332 USA. [Jacob, Jesse T.; Steinberg, James P.] Emory Univ, Sch Med, Div Infect Dis, Atlanta, GA USA. [Kamerow, Douglas B.] RTI Int, Hlth Serv & Policy Res, Washington, DC USA. [Hall, Kendall K.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Cowan, David Z.] Georgia Inst Technol, Hlth Syst Inst, Atlanta, GA 30332 USA. [Lenfestey, Nancy F.] RTI Int, Res Triangle Pk, NC USA. [Do, Ellen] Georgia Inst Technol, Sch Ind Design, Sch Interact Comp, Atlanta, GA 30332 USA. RP Zimring, C (reprint author), Georgia Inst Technol, 828 West Peachtree St NW,Suite 334, Atlanta, GA 30332 USA. EM craig.zimring@coa.gatech.edu RI Jacob, Jesse/A-8836-2009 NR 8 TC 8 Z9 8 U1 1 U2 6 PU VENDOME GROUP LLC PI NEW YORK PA 6 EAST 32 ST, 8 FLOOR, NEW YORK, NY 10016 USA SN 1937-5867 EI 2167-5112 J9 HERD-HEALTH ENV RES JI Herd-Health Env. Res. Des. J. PY 2013 VL 7 SU S SI SI BP 18 EP 30 PG 13 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AN9MP UT WOS:000340931300004 ER PT J AU Lenfestey, NF Denham, ME Hall, KK Kamerow, DB AF Lenfestey, Nancy F. Denham, Megan E. Hall, Kendall K. Kamerow, Douglas B. TI Expert Opinions on the Role of Facility Design in the Acquisition and Prevention of Healthcare-Associated Infections SO HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL LA English DT Article DE Built environment; design process; evidence-based design; healthcare-associated infections; hospital AB OBJECTIVE: To assess expert knowledge, perceptions, and experience on the role of the built environment in the acquisition and transmission of healthcare-associated infections (HAIs), facility design decision-making considerations, and strategies for intervention through facility design and technologies. BACKGROUND: Healthcare-associated infections pose a serious and costly threat to public health in the United States. A growing evidence base suggests that the built environment can play a role in interrupting the chain of infection. METHODS: Semi-structured individual interviews and triads were conducted with 26 experts in hospital administration, architecture, interior design, infection control, and air and water quality. A grounded theory approach was used for interview coding and interpretation. RESULTS: Participants characterized the shift in thinking about the relationship between the built environment and HAI transmission as a "progression," as accountability for infection prevention has expanded beyond clinicians. Organizational leaders aim to make informed design decisions, but this can be challenging due to the paucity of efficacy and return on investment data. Emerging interventions include copper impregnated materials, seamless flooring, and chilled beams. CONCLUSIONS: No single intervention is entirely effective in mitigating HAI risk; multiple interventions are needed. In addition to the built environment, human behavior must be considered, as noncompliance can render even the best designs ineffective. Increased multidisciplinary collaboration is needed to improve the application of evidence and experience in healthcare facility design. In the absence of conclusive evidence regarding interventions aimed at reducing HAI transmission, a combination of research data and practical experience should be used to inform design decisions. C1 [Lenfestey, Nancy F.] RTI Int, Res Triangle Pk, NC USA. [Denham, Megan E.] Georgia Inst Technol, SimTigrate Design Lab, Coll Architecture, Atlanta, GA 30332 USA. [Hall, Kendall K.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Kamerow, Douglas B.] RTI Int, Hlth Serv & Policy Res, Washington, DC USA. RP Denham, ME (reprint author), Georgia Inst Technol, SimTigrate Design Lab, Coll Architecture, 828 West Peachtree St NW,Suite 334, Atlanta, GA 30332 USA. EM megan.denham@coa.gatech.edu NR 12 TC 5 Z9 5 U1 1 U2 3 PU VENDOME GROUP LLC PI NEW YORK PA 6 EAST 32 ST, 8 FLOOR, NEW YORK, NY 10016 USA SN 1937-5867 EI 2167-5112 J9 HERD-HEALTH ENV RES JI Herd-Health Env. Res. Des. J. PY 2013 VL 7 SU S SI SI BP 31 EP 45 PG 15 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AN9MP UT WOS:000340931300005 ER PT J AU Steinberg, JP Denham, ME Zimring, C Kasali, A Hall, KK Jacob, JT AF Steinberg, James P. Denham, Megan E. Zimring, Craig Kasali, Altug Hall, Kendall K. Jacob, Jesse T. TI The Role of the Hospital Environment in the Prevention of Healthcare-Associated Infections by Contact Transmission SO HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL LA English DT Article DE Built environment; design; hand washing; healthcare-association infection; hospital; infection control ID HYDROGEN-PEROXIDE VAPOR; VANCOMYCIN-RESISTANT ENTEROCOCCUS; HAND HYGIENE COMPLIANCE; PRIOR ROOM OCCUPANTS; CLOSTRIDIUM-DIFFICILE; STAPHYLOCOCCUS-AUREUS; NOSOCOMIAL INFECTIONS; CROSS-TRANSMISSION; UV-LIGHT; DECONTAMINATION AB OBJECTIVE: This article describes the role of the hospital environment in the spread of pathogens by direct and indirect contact. In addition, the prevention of transmission through interventions involving the built environment is discussed. BACKGROUND: The hospital environment can become contaminated with pathogenic microorganisms, some of which can persist for long periods of time. Although contamination is common, the contribution of the hospital environment to the development of healthcare-associated infections remains unclear. In part spurred by the development of newer technologies to enhance environmental cleaning or to prevent contamination, research into the role of the environment in causing healthcare-associated infections has accelerated. TOPICAL HEADINGS: A review of the recent literature finds an increasing body of evidence implicating contaminated surfaces in patient care areas in the transmission of pathogens and the development of infections. Single-patient rooms and optimally placed alcohol hand rub dispensers and other design features can mitigate infection risk. Enhanced environmental cleaning including touchless technologies and self-cleaning surfaces can reduce environmental contamination and may prevent infections. CONCLUSIONS: The hospital environment contributes to transmission of pathogens in hospitals and to the development of healthcare-associated infections. Newer technologies to prevent environmental contamination or to enhance cleaning are promising although additional studies with the endpoints of reduction of infections are needed before the role of these technologies is known. C1 [Steinberg, James P.; Jacob, Jesse T.] Emory Univ, Sch Med, Div Infect Dis, Atlanta, GA 30308 USA. [Denham, Megan E.; Zimring, Craig; Kasali, Altug] Georgia Inst Technol, Coll Architecture, SimTigrate Design Lab, Atlanta, GA 30332 USA. [Hall, Kendall K.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. RP Steinberg, JP (reprint author), Emory Univ, Sch Med, Div Infect Dis, 550 Peachtree St NE,Rm 5-4403, Atlanta, GA 30308 USA. EM jstei02@emory.edu RI Jacob, Jesse/A-8836-2009 NR 59 TC 5 Z9 5 U1 2 U2 10 PU VENDOME GROUP LLC PI NEW YORK PA 6 EAST 32 ST, 8 FLOOR, NEW YORK, NY 10016 USA SN 1937-5867 EI 2167-5112 J9 HERD-HEALTH ENV RES JI Herd-Health Env. Res. Des. J. PY 2013 VL 7 SU S SI SI BP 46 EP 73 PG 28 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AN9MP UT WOS:000340931300006 ER PT J AU Zimring, C Denham, ME Jacob, JT Kamerow, DB Lenfestey, N Hall, KK Kasali, A Cowan, DZ Steinberg, JP AF Zimring, Craig Denham, Megan E. Jacob, Jesse T. Kamerow, Douglas B. Lenfestey, Nancy Hall, Kendall K. Kasali, Altug Cowan, David Z. Steinberg, James P. TI The Role of Facility Design in Preventing Healthcare-Associated Infection: Interventions, Conclusions, and Research Needs SO HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL LA English DT Article DE Built environment; evidence-based design; healthcare-association infection; hospital; infection control AB OBJECTIVE: To summarize the findings and provide recommendations based on the multidisciplinary literature review and industry scan, focusing on the links between the built environment and healthcare-associated infections. To propose a research agenda in order to increase informed design decisions and advance the evidence base. BACKGROUND: The HAI-Design project explores the research linking a range of design interventions to healthcare-associated infection. The multidisciplinary team evaluated over 3,800 articles and conducted interviews with a range of stakeholders including CEOs, architects, designers, physicians and other healthcare experts, the results of which are featured in this special Supplement as topical papers. TOPICAL HEADINGS: The four topical papers describing the role of the built environment in the acquisition of healthcare-associated infections are summarized. The evidence evaluating the strategies for intervention through the built environment is analyzed, and a research agenda is proposed. CONCLUSIONS: While the evidence base supporting the efficacy of strategies and technologies continues to grow, there are currently few data that demonstrate a reduction in infection rates. The need for multidisciplinary collaboration and increased efforts to standardize the evaluation of environmental studies are essential to overcome the many challenges and improve the reliability of data C1 [Zimring, Craig; Denham, Megan E.; Kasali, Altug] Georgia Inst Technol, Coll Architecture, SimTigrate Design Lab, Atlanta, GA 30332 USA. [Jacob, Jesse T.; Steinberg, James P.] Emory Univ, Sch Med, Div Infect Dis, Atlanta, GA USA. [Kamerow, Douglas B.] RTI Int, Hlth Serv & Policy Res, Washington, DC USA. [Lenfestey, Nancy] RTI Int, Res Triangle Pk, NC USA. [Hall, Kendall K.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Cowan, David Z.] Georgia Inst Technol, Hlth Syst Inst, Atlanta, GA 30332 USA. RP Zimring, C (reprint author), Georgia Inst Technol, 828 West Peachtree St NW,Suite 334, Atlanta, GA 30332 USA. EM craig.zimring@coa.gatech.edu RI Jacob, Jesse/A-8836-2009 NR 10 TC 5 Z9 5 U1 2 U2 4 PU VENDOME GROUP LLC PI NEW YORK PA 6 EAST 32 ST, 8 FLOOR, NEW YORK, NY 10016 USA SN 1937-5867 EI 2167-5112 J9 HERD-HEALTH ENV RES JI Herd-Health Env. Res. Des. J. PY 2013 VL 7 SU S SI SI BP 127 EP 139 PG 13 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA AN9MP UT WOS:000340931300009 ER PT J AU Holman, RC Hennessy, TW Haberling, DL Callinan, LS Singleton, RJ Redd, JT Steiner, CA Bruce, MG AF Holman, Robert C. Hennessy, Thomas W. Haberling, Dana L. Callinan, Laura S. Singleton, Rosalyn J. Redd, John T. Steiner, Claudia A. Bruce, Michael G. TI Increasing trend in the rate of infectious disease hospitalisations among Alaska Native people SO INTERNATIONAL JOURNAL OF CIRCUMPOLAR HEALTH LA English DT Article DE Alaska Native; infectious disease; hospitalisations; Alaska; lower respiratory tract infection ID SYNCYTIAL VIRUS-DISEASE; RESPIRATORY-TRACT; GENERAL-POPULATION; CHILDREN YOUNGER; UNITED-STATES; AMERICAN; INFANTS; RISK; WATER; AGE AB Objectives. To examine the epidemiology of infectious disease (ID) hospitalisations among Alaska Native (AN) people. Methods. Hospitalisations with a first-listed ID diagnosis for American Indians and ANs residing in Alaska during 2001-2009 were selected from the Indian Health Service direct and contract health service inpatient data. ID hospitalisations to describe the general US population were selected from the Nationwide Inpatient Sample. Annual and average annual (2007-2009) hospitalization rates were calculated. Results. During 2007-2009, IDs accounted for 20% of hospitalisations among AN people. The 2007-2009 average annual age-adjusted ID hospitalisation rate (2126/100,000 persons) was higher than that for the general US population (1679/100,000; 95% CI 1639-1720). The ID hospitalisation rate for AN people increased from 2001 to 2009 (17%, p<0.001). Although the rate during 2001-2009 declined for AN infants (<1 year of age; p=0.03), they had the highest 2007-2009 average annual rate (15106/100,000), which was 3 times the rate for general US infants (5215/100,000; 95% CI 4783-5647). The annual rates for the age groups 1-4, 5-19, 40-49, 50-59 and 70-79 years increased (p<0.05). The highest 2007-2009 age-adjusted average annual ID hospitalisation rates were in the Yukon-Kuskokwim (YK) (3492/100,000) and Kotzebue (3433/ 100,000) regions; infant rates were 30422/100,000 and 26698/100,000 in these regions, respectively. During 2007-2009, lower respiratory tract infections accounted for 39% of all ID hospitalisations and approximately 50% of ID hospitalisations in YK, Kotzebue and Norton Sound, and 74% of infant ID hospitalisations. Conclusions. The ID hospitalisation rate increased for AN people overall. The rate for AN people remained higher than that for the general US population, particularly in infants and in the YK and Kotzebue regions. Prevention measures to reduce ID morbidity among AN people should be increased in high-risk regions and for diseases with high hospitalisation rates. C1 [Holman, Robert C.; Haberling, Dana L.; Callinan, Laura S.] USDHHS, Ctr Dis Control & Prevent CDC, NCEZID, Div High Consequence Pathogens & Pathol, Atlanta, GA USA. [Hennessy, Thomas W.; Singleton, Rosalyn J.; Bruce, Michael G.] USDHHS, CDC, NCEZID, Arctic Invest Program, Anchorage, AK USA. [Singleton, Rosalyn J.] Alaska Native Tribal Hlth Consortium, Anchorage, AK USA. [Redd, John T.] USDHHS, Indian Hlth Serv, Santa Fe, NM USA. [Steiner, Claudia A.] Ctr Delivery Org & Markets, Agcy Healthcare Res & Qual, Healthcare Cost & Utilizat Project, Rockville, MD USA. RP Holman, RC (reprint author), Ctr Dis Control, Natl Ctr Emerging & Zoonot Infect Dis, Div High Consequence Pathogens & Pathol, Mailstop A-30, Atlanta, GA 30333 USA. EM RHolman@cdc.gov NR 32 TC 3 Z9 3 U1 1 U2 3 PU CO-ACTION PUBLISHING PI JARFALLA PA RIPVAGEN 7, JARFALLA, SE-175 64, SWEDEN SN 1239-9736 EI 2242-3982 J9 INT J CIRCUMPOL HEAL JI Int. J. Circumpolar Health PY 2013 VL 72 SU 1 BP 624 EP 632 AR 20994 DI 10.3402/ijch.v72i0.20994 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 235LZ UT WOS:000325721900221 ER PT J AU Tsai, J Grant, AM Soucie, JM Helwig, A Yusuf, HR Boulet, SL Reyes, NL Atrash, HK AF Tsai, James Grant, Althea M. Soucie, J. Michael Helwig, Amy Yusuf, Hussain R. Boulet, Sheree L. Reyes, Nimia L. Atrash, Hani K. TI Clustering Patterns of Comorbidities Associated with In-Hospital Death in Hospitalizations of US Adults with Venous Thromboembolism SO INTERNATIONAL JOURNAL OF MEDICAL SCIENCES LA English DT Article DE Comorbidity; Clustering pattern; Elixhauser comorbidity index; Venous thromboembolism; Hospitalization; Death; Mortality ID QUALITY-OF-CARE; RISK-FACTORS; ADMINISTRATIVE DATA; PULMONARY-EMBOLISM; DISEASE; CANCER; PROPHYLAXIS; PREVENTION; GUIDELINES; DIAGNOSIS AB Background: Venous thromboembolism (VTE) is a significant source of mortality, morbidity, disability, and impaired health-related quality of life in the world. Objective: We aimed to evaluate the clustering patterns and associations of 29 comorbidities with in-hospital death among adult hospitalizations with a diagnosis of VTE in the United States by analyzing data from the 2009 Nationwide Inpatient Sample. Methods: This cross-sectional study included 153,124 adult hospitalizations with a diagnosis of VTE. Adjusted rate ratios and 95% confidence intervals (CI) for in-hospital death were generated by using multivariable log-linear regression models to measure independent associations between comorbidities and in-hospital death. Results: We estimated that 44,200 in-hospital deaths occurred in 2009 among 773,273 US adult hospitalizations with a diagnosis of VTE. Subgroups of hospitalizations with comorbidities of "congestive heart failure," "chronic pulmonary disease," " coagulopathy," "liver disease," "lymphoma," " fluid and electrolyte disorders," "metastatic cancer," "peripheral vascular disorders," " pulmonary circulation disorders," "renal failure," "solid tumor without metastasis," or "weight loss" were positively and independently associated with 1.07 (95% CI: 1.02-1.12) to 2.06 (95% CI: 1.97-2.16) times increased likelihoods of in-hospital death, when compared to those without the corresponding comorbidities. The clustering patterns of these comorbidities by 4 disease categories (i.e., "cancer," "cardiovascular/respiratory/blood," "gastrointestinal/urologic," and "nutritional/bodyweight") were associated with 2.74 to 10.28 times increased likelihoods of in-hospital death, as compared to hospitalizations without any of these comorbidities. The overall increase in the cumulative number of comorbidities corresponded to significantly elevated risks (P-trend<0.01) for in-hospital death among hospitalizations with a diagnosis of VTE. Conclusion: The presence of multiple comorbidities is ubiquitous among hospitalizations of adults with VTE and among in-hospital deaths with VTE in the United States. The findings of our study further suggest that, among hospitalizations of adults with VTE, the presence of certain comorbidities or clustering of these comorbidities significantly elevates the risk of in-hospital death. C1 [Tsai, James; Grant, Althea M.; Soucie, J. Michael; Yusuf, Hussain R.; Reyes, Nimia L.; Atrash, Hani K.] Ctr Dis Control & Prevent, Div Blood Disorders, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA. [Helwig, Amy] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. [Boulet, Sheree L.] Ctr Dis Control & Prevent, Div Reprod Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. RP Tsai, J (reprint author), Ctr Dis Control & Prevent, Div Blood Disorders, Natl Ctr Birth Defects & Dev Disabil, 1600 Clifton Rd,Mail Stop E-64, Atlanta, GA 30333 USA. EM jxt9@cdc.gov NR 56 TC 3 Z9 3 U1 1 U2 1 PU IVYSPRING INT PUBL PI LAKE HAVEN PA PO BOX 4546, LAKE HAVEN, NSW 2263, AUSTRALIA SN 1449-1907 J9 INT J MED SCI JI Int. J. Med. Sci. PY 2013 VL 10 IS 10 BP 1352 EP 1360 DI 10.7150/ijms.6714 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 218DC UT WOS:000324411800013 PM 23983596 ER PT J AU Johnson, ES Bartman, BA Briesacher, BA Fleming, NS Gerhard, T Kornegay, CJ Nourjah, P Sauer, B Schumock, GT Sedrakyan, A Sturmer, T West, SL Schneeweiss, S AF Johnson, Eric S. Bartman, Barbara A. Briesacher, Becky A. Fleming, Neil S. Gerhard, Tobias Kornegay, Cynthia J. Nourjah, Parivash Sauer, Brian Schumock, Glen T. Sedrakyan, Art Stuermer, Til West, Suzanne L. Schneeweiss, Sebastian TI The incident user design in comparative effectiveness research SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Review DE inception cohort; incident interventions; study design; comparative effectiveness; pharmacoepidemiology ID POSTMENOPAUSAL HORMONE-THERAPY; CORONARY-HEART-DISEASE; DRUG UTILIZATION; RISK; EPIDEMIOLOGY; TRIALS AB Comparative effectiveness research includes cohort studies and registries of interventions. When investigators design such studies, how important is it to follow patients from the day they initiated treatment with the study interventions? Our article considers this question and related issues to start a dialogue on the value of the incident user design in comparative effectiveness research. By incident user design, we mean a study that sets the cohort's inception date according to patients' new use of an intervention. In contrast, most epidemiologic studies enroll patients who were currently or recently using an intervention when follow-up began. We take the incident user design as a reasonable default strategy because it reduces biases that can impact non-randomized studies, especially when investigators use healthcare databases. We review case studies where investigators have explored the consequences of designing a cohort study by restricting to incident users, but most of the discussion has been informed by expert opinion, not by systematic evidence. Published 2012. This article is a U.S. Government work and is in the public domain in the USA. C1 [Johnson, Eric S.] Kaiser Permanente, Ctr Hlth Res, Portland, OR USA. [Bartman, Barbara A.; Nourjah, Parivash] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD USA. [Briesacher, Becky A.] Univ Massachusetts, Sch Med, Div Geriatr Med, Worcester, MA USA. [Fleming, Neil S.] Baylor Hlth Care Syst, Ctr Hlth Care Res, Dallas, TX USA. [Gerhard, Tobias] Rutgers State Univ, Inst Hlth Hlth Care Policy & Aging Res, New Brunswick, NJ 08903 USA. [Kornegay, Cynthia J.] US FDA, Off Surveillance & Epidemiol, Silver Spring, MD USA. [Sauer, Brian] Salt Lake City Hlth Care Syst, Salt Lake City IDEAS Ctr Vet Affairs, Salt Lake City, UT USA. [Schumock, Glen T.] Univ Illinois, Sch Pharm, Dept Pharm Practice, Chicago, IL USA. [Sedrakyan, Art] Weill Cornell Med Coll, Div Outcomes & Effectiveness Res, New York, NY USA. [Stuermer, Til] Univ N Carolina, Dept Epidemiol, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA. [West, Suzanne L.] Res Triangle Inst Int, Hlth Social & Econ Res, Res Triangle Pk, NC USA. [Schneeweiss, Sebastian] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02115 USA. RP Johnson, ES (reprint author), Kaiser Permanente, Ctr Hlth Res, Portland, OR USA. EM Eric.S.Johnson@kpchr.org RI Schneeweiss, Sebastian/C-2125-2013 FU Agency for Healthcare Research and Quality, US Department of Health and Human Services FX This project was funded by the Agency for Healthcare Research and Quality, US Department of Health and Human Services, as part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program. The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the US Department of Health and Human Services. NR 30 TC 40 Z9 40 U1 2 U2 14 PU WILEY PERIODICALS, INC PI SAN FRANCISCO PA ONE MONTGOMERY ST, SUITE 1200, SAN FRANCISCO, CA 94104 USA SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD JAN PY 2013 VL 22 IS 1 BP 1 EP 6 DI 10.1002/pds.3334 PG 6 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 088FE UT WOS:000314818400001 PM 23023988 ER PT J AU Stuart, B Shoemaker, JS Dai, ML Davidoff, AJ AF Stuart, Bruce Shoemaker, J. Samantha Dai, Mingliang Davidoff, Amy J. TI Regions With Higher Medicare Part D Spending Show Better Drug Adherence, But Not Lower Medicare Costs For Two Diseases SO HEALTH AFFAIRS LA English DT Article ID GEOGRAPHIC-VARIATION; CARE; BENEFICIARIES; QUALITY AB A quarter-century of research on geographic variation in Medicare costs has failed to find any positive association between high spending and better health outcomes. We conducted this study using a 5 percent random sample of Medicare beneficiaries with diabetes or heart failure in 2006 and 2007 to see whether there was any correlation between geographic variation in Part D spending and good medication-taking behavior-and, if so, whether that correlation resulted in reduced Medicare Parts A and B spending on diabetes and heart failure treatments. We found that beneficiaries residing in areas characterized by higher adjusted drug spending had significantly more "therapy days"-days with recommended medications on hand-than did beneficiaries in lower-spending areas. However, we did not find that this factor translated into short-term savings in Medicare treatment costs for these two diseases. This result might not be surprising, since returns from medication adherence can take years to manifest. At the same time, discovering which regional factors are responsible for differences in drug spending and medication practices should be a high priority. If the observed differences are related to poor physician communication or lack of good care coordination, then appropriately designed policy tools-including accountable care organizations, medical homes, and provider quality reporting initiatives-might help address them. C1 [Stuart, Bruce] Univ Maryland, Sch Pharm, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. [Shoemaker, J. Samantha] Pharmaceut Res & Manufacturers Amer, Policy & Res, Washington, DC USA. [Davidoff, Amy J.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Stuart, B (reprint author), Univ Maryland, Sch Pharm, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA. EM mingdail@umbc.edu FU Commonwealth Fund FX The results were presented at the AcademyHealth Annual Research Meeting, Seattle, Washington, June 1114, 2011. The authors acknowledge Shinobu Suzuki for contributing to this research. This study was supported by a grant from the Commonwealth Fund. The funder had no role in the study design, data collection, analysis, or preparation of the manuscript. All authors contributed to the study design, data interpretation, and writing of the manuscript. This article was prepared while Samantha Shoemaker was a doctoral student at and Amy Davidoff was employed at the University of Maryland School of Pharmacy. The views and opinions expressed in this article are the authors' own and do not necessarily reflect the views of Pharmaceutical Research and Manufacturers of America, the Agency for Healthcare Research and Quality, the Department of Health and Human Services, or the US government. The authors report no conflicts of interest regarding the contents of this article. NR 17 TC 0 Z9 0 U1 1 U2 5 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JAN PY 2013 VL 32 IS 1 BP 120 EP 126 DI 10.1377/hlthaff.2011.0727 PG 7 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 077KH UT WOS:000314026100016 PM 23297279 ER PT J AU Taylor, EF Machta, RM Meyers, DS Genevro, J Peikes, DN AF Taylor, Erin Fries Machta, Rachel M. Meyers, David S. Genevro, Janice Peikes, Deborah N. TI Enhancing the Primary Care Team to Provide Redesigned Care: The Roles of Practice Facilitators and Care Managers SO ANNALS OF FAMILY MEDICINE LA English DT Article DE care coordination; practice facilitation; primary care; patient-centered care; quality improvement AB Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating their quality improvement activities and help build capacity for those activities-reflecting a systems-level approach to improving quality, safety, and implementation of evidence-based practices. Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care. Ann Fam Med 2013;11:80-83. doi:10.1370/afm.1462. C1 [Taylor, Erin Fries; Machta, Rachel M.; Peikes, Deborah N.] Math Policy Res, Washington, DC 20002 USA. [Meyers, David S.; Genevro, Janice] US Dept HHS, Ctr Primary Care Prevent & Clin Partnerships, Agcy Hlth Care Res & Qual, Rockville, MD USA. RP Taylor, EF (reprint author), Math Policy Res, 1100 1st St NE,12th Floor, Washington, DC 20002 USA. EM etaylor@mathematica-mpr.com NR 10 TC 43 Z9 44 U1 1 U2 11 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672 USA SN 1544-1709 J9 ANN FAM MED JI Ann. Fam. Med. PD JAN-FEB PY 2013 VL 11 IS 1 BP 80 EP 83 DI 10.1370/afm.1462 PG 4 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 074VE UT WOS:000313841600015 PM 23319510 ER PT J AU Koh, HK Baur, C Brach, C Harris, LM Rowden, JN AF Koh, Howard K. Baur, Cynthia Brach, Cindy Harris, Linda M. Rowden, Jessica N. TI Toward a Systems Approach to Health Literacy Research SO JOURNAL OF HEALTH COMMUNICATION LA English DT Editorial Material ID CARE; COMMUNICATION; TRIAL C1 [Koh, Howard K.] US Dept HHS, Off Assistant Secretary Hlth, Washington, DC 20201 USA. [Baur, Cynthia] Ctr Dis Control & Prevent, Off Associate Director Commun, Atlanta, GA USA. [Brach, Cindy] Agcy Healthcare Res & Qual, Rockville, MD USA. [Rowden, Jessica N.] US Dept HHS, Web Commun Hlth Commun & eHlth Div, Off Dis Prevent & Hlth Promot, Off Assistant Secretary Hlth, Rockville, MD 20852 USA. RP Rowden, JN (reprint author), US Dept HHS, Web Commun Hlth Commun & eHlth Div, Off Dis Prevent & Hlth Promot, Off Assistant Secretary Hlth, 1101 Wootton Pkwy, Rockville, MD 20852 USA. EM jessica.rowden@hhs.gov FU Intramural AHRQ HHS [HS999999] NR 21 TC 3 Z9 3 U1 0 U2 18 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1081-0730 J9 J HEALTH COMMUN JI J. Health Commun. PD JAN 1 PY 2013 VL 18 IS 1 BP 1 EP 5 DI 10.1080/10810730.2013.759029 PG 5 WC Communication; Information Science & Library Science SC Communication; Information Science & Library Science GA 069DR UT WOS:000313416000001 PM 23305507 ER PT J AU Noel, PH Lanham, HJ Palmer, RF Leykum, LK Parchman, ML AF Noel, Polly Hitchcock Lanham, Holly J. Palmer, Ray F. Leykum, Luci K. Parchman, Michael L. TI The importance of relational coordination and reciprocal learning for chronic illness care within primary care teams SO HEALTH CARE MANAGEMENT REVIEW LA English DT Article DE Chronic Care Model; diabetes; primary care; reciprocal learning; relational coordination ID CHRONIC DISEASES; MODEL; ORGANIZATIONS; SENSEMAKING; MODERATOR; SETTINGS; MEDIATOR; RISK; TIME AB Background: Recent research from a complexity theory perspective suggests that implementation of complex models of care, such as the Chronic Care Model (CCM), requires strong relationships and learning capacities among primary care teams. Purposes: Our primary aim was to assess the extent to which practice member perceptions of relational coordination and reciprocal learning were associated with the presence of CCM elements in community-based primary care practices. Methodology/Approach: We used baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM and improve risk factor control for patients with Type 2 diabetes in small primary care practices. Practice members (i.e., physicians, nonphysician providers, and staff) completed baseline assessments, which included the Relational Coordination Scale, Reciprocal Learning Scale, and the Assessment of Chronic Illness Care (ACIC) survey, along with items assessing individual and clinic characteristics. To assess the association between Relational Coordination, Reciprocal Learning, and ACIC, we used a series of hierarchical linear regression models accounting for clustering of individual practice members within clinics and controlling for individual- and practice-level characteristics and tested for mediation effects. Findings: A total of 283 practice members from 39 clinics completed baseline measures. Relational Coordination scores were significantly and positively associated with ACIC scores (Model 1). When Reciprocal Learning was added, Relational Coordination remained a significant yet notably attenuated predictor of ACIC (Model 2). The mediation effect was significant (z = 9.3, p < .01); 24% of the association between Relational Coordination and ACIC scores was explained by Reciprocal Learning. Of the individual- and practice-level covariates included in Model 3, only the presence of an electronic medical record was significant; Relational Coordination and Reciprocal Learning remained significant independent predictors of ACIC. Practice Implications: Efforts to implement complex models of care should incorporate strategies to strengthen relational coordination and reciprocal learning among team members. C1 [Noel, Polly Hitchcock; Lanham, Holly J.; Leykum, Luci K.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Noel, Polly Hitchcock; Lanham, Holly J.; Palmer, Ray F.; Leykum, Luci K.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX USA. [Parchman, Michael L.] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Noel, PH (reprint author), S Texas Vet Hlth Care Syst, San Antonio, TX USA. EM noelp@uthscsa.edu OI Parchman, Michael/0000-0001-7129-2889 FU NIDDK NIH HHS [R18 DK075692, R18 DK 075692, R18 DK075692-05] NR 39 TC 16 Z9 16 U1 0 U2 26 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0361-6274 J9 HEALTH CARE MANAGE R JI Health Care Manage. Rev. PD JAN-MAR PY 2013 VL 38 IS 1 BP 20 EP 28 DI 10.1097/HMR.0b013e3182497262 PG 9 WC Health Policy & Services SC Health Care Sciences & Services GA 050QZ UT WOS:000312070400003 PM 22310483 ER PT J AU Clancy, CM AF Clancy, Carolyn M. TI New Hospital Readmission Policy Links Financial and Quality Incentives SO JOURNAL OF NURSING CARE QUALITY LA English DT Editorial Material ID PROGRAM C1 Agcy Hlth Care Res & Qual, Rockville, MD 20850 USA. RP Clancy, CM (reprint author), Agcy Hlth Care Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM carolyn.clancy@ahrq.hhs.gov NR 12 TC 3 Z9 3 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1057-3631 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD JAN-MAR PY 2013 VL 28 IS 1 BP 1 EP 4 DI 10.1097/NCQ.0b013e3182725d82 PG 4 WC Nursing SC Nursing GA 050QI UT WOS:000312068700001 PM 23023188 ER PT J AU McHugh, M Van Dyke, KJ Howell, E Adams, F Moss, D Yonek, J AF McHugh, Megan Van Dyke, Kevin J. Howell, Embry Adams, Fiona Moss, Dina Yonek, Julie TI Changes in Patient Flow Among Five Hospitals Participating in a Learning Collaborative SO JOURNAL FOR HEALTHCARE QUALITY LA English DT Article DE emergency department; patient flow; quality improvement AB This was an evaluation of the efforts of five hospitals that participated in a collaborative aimed at improving patient flow and reducing emergency department (ED) crowding. Interviews with hospital implementation team members were conducted at two separate times, and multivariate linear regression models and bivariate logistic models were constructed to assess changes in ED length of stay (LOS) and left without being seen (LWBS). By the end of the collaborative, four of the five hospitals had at least one fully implemented improvement strategy. Those hospitals experienced modest improvements in patient flow: a hospital that implemented front-end improvements and devoted additional resources to fast track had a 51-min reduction in ED LOS, another that implemented only front-end improvements had a 9-min reduction in LOS, a third hospital that improved communication between the ED and inpatient units to facilitate admissions decreased LWBS from 0.6% to 0.4%, and a fourth hospital reduced LOS by 59 min for mid-acuity patients by establishing a new care process for them. Results suggest that relatively small changes may lead to improvements in measures of patient flow that are modest, at best. C1 [McHugh, Megan] Northwestern Univ, Inst Healthcare Studies, Feinberg Sch Med, Evanston, IL 60208 USA. [McHugh, Megan] Northwestern Univ, Dept Emergency Med, Feinberg Sch Med, Evanston, IL 60208 USA. [Van Dyke, Kevin J.] Natl Assoc Publ Hosp & Hlth Syst, Washington, DC USA. [Howell, Embry; Adams, Fiona] Urban Inst, Washington, DC 20037 USA. [Moss, Dina] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, ACTION Accelerating Change & Transformat Organiza, Rockville, MD USA. [Yonek, Julie] Northwestern Univ, Feinberg Sch Medicine, Ctr Healthcare Equ, Inst Healthcare Studies, Evanston, IL 60208 USA. RP McHugh, M (reprint author), Northwestern Univ, Inst Healthcare Studies, Feinberg Sch Med, Evanston, IL 60208 USA. EM megan-mchugh@northwestern.edu FU Agency for Healthcare Research and Quality (AHRQ) FX This study was funded by the Agency for Healthcare Research and Quality (AHRQ). The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ. The authors would like to acknowledge Michael Harrison (Senior Social Scientist, AHRQ) for helpful comments on a draft of this manuscript. NR 28 TC 1 Z9 1 U1 1 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1062-2551 EI 1945-1474 J9 J HEALTHC QUAL JI J. Healthc. Qual. PD JAN-FEB PY 2013 VL 35 IS 1 BP 21 EP 29 DI 10.1111/j.1945-1474.2011.00163.x PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V36OR UT WOS:000209221500003 PM 22092988 ER PT J AU Kemper, AR Kus, CA Ostrander, RJ Comeau, AM Boyle, CA Dougherty, D Mann, MY Botkin, JR Green, NS AF Kemper, Alex R. Kus, Christopher A. Ostrander, Robert J. Comeau, Anne Marie Boyle, Coleen A. Dougherty, Denise Mann, Marie Y. Botkin, Jeffrey R. Green, Nancy S. CA US Secretary Hlth Human Serv TI A framework for key considerations regarding point-of-care screening of newborns SO GENETICS IN MEDICINE LA English DT Review DE health policy; neonatal screening; point-of-care systems; public systems ID EARLY HEARING DETECTION; INTERVENTION PROGRAMS; FOLLOW-UP AB Newborn screening is performed under public health authority, with analysis carried out primarily by public health laboratories or other centralized laboratories. Increasingly, opportunities to improve infant health will arise from including screening tests that are completed at the birth centers instead of in centralized laboratories, constituting a significant shift for newborn screening. This report summarizes a framework developed by the US Secretary of Health and Human Services Advisory Committee on Heritable Disorders in Newborns and Children based on a series of meetings held during 2011 and 2012. These meetings were for the purpose of evaluating whether conditions identifiable through point-of-care screening should be added to the recommended universal screening panel, and to identify key considerations for birth hospitals, public health agencies, and clinicians when point-of-care newborn screening is implemented. Genet Med 2012: 14(12): 951-954 C1 [Kemper, Alex R.] Duke Univ, Dept Pediat, Durham, NC 27706 USA. [Kus, Christopher A.] New York State Dept Hlth, Albany, NY USA. [Ostrander, Robert J.] Valley View Family Practice Associates, Rushville, NY USA. [Comeau, Anne Marie] Univ Massachusetts, Sch Med, New England Newborn Screening Program, Worcester, MA USA. [Comeau, Anne Marie] Univ Massachusetts, Sch Med, Dept Pediat, Worcester, MA USA. [Boyle, Coleen A.] Ctr Dis Control & Prevent, Atlanta, GA USA. [Dougherty, Denise] Agcy Healthcare Res & Qual, Rockville, MD USA. [Mann, Marie Y.] US Hlth Resources & Serv Adm, Rockville, MD 20857 USA. [Botkin, Jeffrey R.] Univ Utah, Dept Pediat, Salt Lake City, UT USA. [Green, Nancy S.] Columbia Univ, Dept Pediat, Med Ctr, New York, NY 10027 USA. RP Kemper, AR (reprint author), Duke Univ, Dept Pediat, Durham, NC 27706 USA. EM alex.kemper@duke.edu OI Green, Nancy/0000-0002-9877-1561 FU Secretary of Health and Human Services Advisory Committee on Heritable Disorders in Newborns and Children FX The preparation of this report was supported by the logistics contract supporting the Secretary of Health and Human Services Advisory Committee on Heritable Disorders in Newborns and Children. The views expressed herein are solely those of the authors and do not necessarily reflect the views of the Secretary of the US Department of Health and Human Services or of the individual members of the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children. NR 9 TC 5 Z9 5 U1 0 U2 6 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1098-3600 J9 GENET MED JI Genet. Med. PD DEC PY 2012 VL 14 IS 12 BP 951 EP 954 DI 10.1038/gim.2012.89 PG 4 WC Genetics & Heredity SC Genetics & Heredity GA 049OD UT WOS:000311991800001 PM 22899090 ER PT J AU Yabroff, KR Dowling, E Rodriguez, J Ekwueme, DU Meissner, H Soni, A Lerro, C Willis, G Forsythe, LP Borowski, L Virgo, KS AF Yabroff, K. Robin Dowling, Emily Rodriguez, Juan Ekwueme, Donatus U. Meissner, Helen Soni, Anita Lerro, Catherine Willis, Gordon Forsythe, Laura P. Borowski, Laurel Virgo, Katherine S. TI The Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement SO JOURNAL OF CANCER SURVIVORSHIP-RESEARCH AND PRACTICE LA English DT Article DE Cost of illness; Health care expenditures; Burden of illness; Neoplasms; SEER-Medicare; NHIS; MEPS ID HEALTH-CARE COSTS; UNITED-STATES; BREAST-CANCER; LESS-THAN-65 YEARS; ECONOMIC BURDEN; POPULATION; TIME; AGE AB Introduction The prevalence of cancer survivorship in the USA is expected to increase in the future because the US population is increasing in size and is aging and because survival following diagnosis is improving for many types of cancer. Medical care costs associated with cancer are also projected to increase dramatically. However, currently available data for estimating medical care costs and other important aspects of the burden of cancer, including time spent receiving medical care, productivity loss due to morbidity for patients and their families, and financial hardship, are limited, particularly in the population under the age of 65. Methods We describe selected publicly available data sources for estimating the burden of cancer in the USA and a new collaborative effort to improve the quality of these data: the nationally representative Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement. Conclusions Data from this effort can be used to address key gaps in cancer survivorship research related to medical care costs, employment patterns, financial hardship, and other aspects of the burden of illness for cancer survivors and their families. Implications for cancer survivors Research using the MEPS Experiences with Cancer Survivorship Supplement can inform efforts by health care policy makers, healthcare systems, providers, and employers to improve the cancer survivorship experience in the USA. C1 [Yabroff, K. Robin] NCI, Hlth Serv & Econ Branch, Appl Res Program, Bethesda, MD 20892 USA. [Yabroff, K. Robin; Dowling, Emily; Willis, Gordon; Forsythe, Laura P.; Borowski, Laurel] NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. [Dowling, Emily] Massachusetts Gen Hosp, Inst Technol Assessment, Boston, MA 02114 USA. [Rodriguez, Juan; Ekwueme, Donatus U.] Ctr Dis Control & Prevent, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. [Soni, Anita] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Lerro, Catherine; Virgo, Katherine S.] Amer Canc Soc, Hlth Serv, Res Program, Intramural Res Dept,Natl Home Off, Atlanta, GA 30329 USA. RP Yabroff, KR (reprint author), NCI, Hlth Serv & Econ Branch, Appl Res Program, Execut Plaza N,Room 4005,6130 Execut Blvd,MSC 734, Bethesda, MD 20892 USA. EM yabroffr@mail.nih.gov OI Yabroff, K. Robin/0000-0003-0644-5572 FU NCI; CDC; National Institutes of Health Office of Behavioral and Social Sciences Research; ACS; AHRQ; Westat FX The authors wish to thank Cathy Bradley, Pamela Farley Short, Patricia Ganz, and Michael Feuerstein for comments on an early version of the MEPS Experiences with Cancer questionnaire; Martha Stapleton and Stephanie Beauvais of Westat for their detailed cognitive testing report describing responses in cancer survivors to the MEPS Experiences with Cancer questionnaire; and Stephanie Nutt and Ruth Rechis of LIVESTRONG, Neetu Chawla of the NCI for comments on an earlier version of the manuscript, and Timothy McNeel of IMS, Inc for programming assistance with the 2009 MEPS. Funding for the MEPS Experiences with Cancer Supplement was provided by the NCI, the CDC, the National Institutes of Health Office of Behavioral and Social Sciences Research, and the ACS and supported by the AHRQ and Westat. NR 40 TC 15 Z9 16 U1 0 U2 6 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1932-2259 J9 J CANCER SURVIV JI J. Cancer Surviv.-Res. Pract. PD DEC PY 2012 VL 6 IS 4 BP 407 EP 419 DI 10.1007/s11764-012-0221-2 PG 13 WC Oncology; Social Sciences, Biomedical SC Oncology; Biomedical Social Sciences GA 043HX UT WOS:000311534600007 PM 23011572 ER PT J AU Hill, SC Zuvekas, SH Zodet, MW AF Hill, Steven C. Zuvekas, Samuel H. Zodet, Marc W. TI Validity of Reported Medicare Part D Enrollment in the Medical Expenditure Panel Survey SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Article DE Medicare; prescription drug coverage; validity; measurement error ID PRESCRIPTION DRUG BENEFIT; PLAN; BENEFICIARIES; IMPACT AB The authors validate reported Part D coverage in the Medical Expenditure Panel Survey (MEPS) and assess the impact of misreporting on descriptive and behavioral analyses. MEPS participants with Medicare coverage during 2006 to 2007 were matched to Medicare administrative data. A summary measure of Part D coverage based on several questions has substantial validity (kappa = .70) and an agreement rate of 85.1%. Some beneficiaries confused Part D and private drug coverage, leading to both under- and overreported Part D coverage. Accuracy varies little by sociodemographic group. Standard regression models of the determinants of Part D enrollment were estimated with both MEPS-based and administrative data-based measures of Part D enrollment. In this analysis, the signs of the marginal effects were the same, the magnitudes were similar, and mostly the same variables had statistically significant effects in both regressions. Thus, behavioral analyses are largely unaffected by misreporting. C1 [Hill, Steven C.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD 20850 USA. RP Hill, SC (reprint author), Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, 540 Gaither Rd, Rockville, MD 20850 USA. EM steven.hill@ahrq.hhs.gov NR 22 TC 3 Z9 3 U1 1 U2 6 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 J9 MED CARE RES REV JI Med. Care Res. Rev. PD DEC PY 2012 VL 69 IS 6 BP 737 EP 750 DI 10.1177/1077558712457595 PG 14 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 032QI UT WOS:000310733600007 PM 22930311 ER PT J AU Croswell, J Luger, S AF Croswell, Jennifer Luger, Shelly TI Screening for and Management of Obesity in Adults SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material ID SERVICES TASK-FORCE C1 [Croswell, Jennifer] Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. [Luger, Shelly] Mt Marty Coll, Yankton, SD USA. [Luger, Shelly] Univ Kansas, Sch Nursing, Lawrence, KS 66045 USA. RP Croswell, J (reprint author), Agcy Healthcare Res & Qual, US Prevent Serv Task Force Program, Rockville, MD 20850 USA. NR 2 TC 0 Z9 0 U1 0 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD NOV 15 PY 2012 VL 86 IS 10 BP 947 EP 948 PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 038RT UT WOS:000311192500010 PM 23157148 ER PT J AU Cleary, PD Crofton, C Hays, RD Horner, R AF Cleary, Paul D. Crofton, Christine Hays, Ron D. Horner, Ronnie TI Advances from the Consumer Assessment of Healthcare Providers and Systems (CAHPS(R)) Project Introduction SO MEDICAL CARE LA English DT Editorial Material C1 [Cleary, Paul D.] Yale Univ, Sch Publ Hlth, New Haven, CT 06520 USA. [Crofton, Christine] Agcy Healthcare Res & Qual, Rockville, MD USA. [Hays, Ron D.] Univ Calif Los Angeles, Dept Med, RAND Corp, Santa Monica, CA USA. [Horner, Ronnie] Univ Cincinnati, Cincinnati, OH USA. RP Cleary, PD (reprint author), Yale Univ, Sch Publ Hlth, 60 Coll St,POB 208034, New Haven, CT 06520 USA. EM paul.cleary@yale.edu RI Hays, Ronald/D-5629-2013 NR 0 TC 2 Z9 2 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD NOV PY 2012 VL 50 IS 11 SU 3 BP S1 EP S1 DI 10.1097/MLR.0b013e31826ec0cb PG 1 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 080IU UT WOS:000314235900001 PM 23064270 ER PT J AU Mukamel, DB Weimer, D Harrington, C Spector, WD Bailey, L Li, Y AF Mukamel, D. B. Weimer, D. Harrington, C. Spector, W. D. Bailey, L. Li, Y. TI NURSING HOMES' SUCCESS IN USING THE INFORMAL DISPUTE RESOLUTION FOR APPEALING DEFICIENCIES SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Mukamel, D. B.; Bailey, L.] Univ Calif Irvine, Irvine, CA USA. [Weimer, D.] Univ Madison Wisconsin, Madison, WI USA. [Harrington, C.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Spector, W. D.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Li, Y.] Univ Rochester, Rochester, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD NOV PY 2012 VL 52 SU 1 BP 234 EP 234 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 061ZG UT WOS:000312888202217 ER PT J AU Potter, D AF Potter, D. TI PUBLIC REPORTING AND RESIDENTIAL CARE/ASSISTED LIVING: CHARTING A NEW FRONTIER? SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Potter, D.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD NOV PY 2012 VL 52 SU 1 BP 260 EP 260 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 061ZG UT WOS:000312888202346 ER PT J AU Castle, N Sangl, J AF Castle, N. Sangl, J. TI SATISFACTION OF DISCHARGED NURSING HOME RESIDENTS SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Castle, N.] Univ Pittsburgh, Pittsburgh, PA USA. [Sangl, J.] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD NOV PY 2012 VL 52 SU 1 BP 489 EP 490 PG 2 WC Gerontology SC Geriatrics & Gerontology GA 061ZG UT WOS:000312888203593 ER PT J AU Olsho, LE Spector, WD Williams, C Rhodes, W Fink, RV Limcangco, R Hurd, DT AF Olsho, L. E. Spector, W. D. Williams, C. Rhodes, W. Fink, R. V. Limcangco, R. Hurd, D. T. TI EVALUATION OF AHRQ'S ON-TIME PRESSURE ULCER PREVENTION PROGRAM SO GERONTOLOGIST LA English DT Meeting Abstract C1 [Olsho, L. E.; Williams, C.; Rhodes, W.; Fink, R. V.; Hurd, D. T.] ABT Associates Inc, US Hlth Div, Cambridge, MA 02138 USA. [Spector, W. D.; Limcangco, R.] Agcy Healthcare Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 3 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD NOV PY 2012 VL 52 SU 1 BP 490 EP 490 PG 1 WC Gerontology SC Geriatrics & Gerontology GA 061ZG UT WOS:000312888203595 ER PT J AU Gliklich, R Levy, D Campion, DM Leavy, MB Karl, J Berliner, E Khurana, L Hossfeld, W AF Gliklich, R. Levy, D. Campion, D. M. Leavy, M. B. Karl, J. Berliner, E. Khurana, L. Hossfeld, W. TI CHALLENGES IN DEVELOPING A NEW SYSTEM FOR REGISTRATION OF PATIENT REGISTRIES SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Gliklich, R.; Levy, D.; Campion, D. M.; Leavy, M. B.; Karl, J.; Khurana, L.; Hossfeld, W.] Outcome, Cambridge, MA USA. [Berliner, E.] AHRQ, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-3015 J9 VALUE HEALTH JI Value Health PD NOV PY 2012 VL 15 IS 7 BP A319 EP A319 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 055JF UT WOS:000312411100229 ER PT J AU Jonas, DE Mansfield, AJ Curtis, P Gilmore, JH Watson, LC Brode, S Tyutyulkova, S Crotty, K Viswanathan, M Tant, E Gordon, C Slaughter-Mason, S Shetiman, B AF Jonas, Daniel E. Mansfield, Alyssa J. Curtis, Pam Gilmore, John H. Watson, Lea C. Brode, Shannon Tyutyulkova, Sonia Crotty, Karen Viswanathan, Meera Tant, Elizabeth Gordon, Cathy Slaughter-Mason, Samantha Shetiman, Brian TI Identifying Priorities for Patient-Centered Outcomes Research for Serious Mental Illness SO PSYCHIATRIC SERVICES LA English DT Article ID CARE; SCHIZOPHRENIA; DEFINITIONS; DIFFUSION; PATTERNS; PARITY AB Objective: The purpose of this project was to engage a diverse group of stakeholders (N=38) to help establish priorities to guide patient-centered outcomes research (PCOR) in serious mental illness. Methods: Three meetings, two Web-based and one on site, were held to generate and prioritize an initial list of topics. Topics were then sorted and organized into common themes. Results: About 140 topics were identified and sorted into 21 main themes, ranked by priority. Three of the top four themes focused on how research was conducted, particularly the need to develop consensus measurement and outcomes definitions; improving infrastructure for research, longitudinal studies, and new data sets and investigators; and developing PCOR methodology. Stakeholders also identified a need to focus on service delivery, treatment settings, and structure of the delivery of care. Conclusions: Engagement by a broad group of stakeholders in a transparent process resulted in the identification of priority areas for PCOR. Stakeholders clearly indicated a need to fundamentally change how research on serious mental illness is conducted and a critical need for the development of methodology and infrastructure. Most current PCOR has been focused on relatively short-term outcomes, but real world, long-term studies providing guidance for treatment over the lifetime of a serious mental illness are needed. (Psychiatric Services 63:1125-1130, 2012; doi: 10.1176/appi.ps.201100369) C1 [Jonas, Daniel E.] Univ N Carolina, Dept Med, Chapel Hill, NC 27599 USA. [Gilmore, John H.; Watson, Lea C.; Shetiman, Brian] Univ N Carolina, Dept Psychiat, Chapel Hill, NC 27599 USA. [Jonas, Daniel E.] Univ N Carolina, Cecil G Sheps Ctr Health Serv Res, Chapel Hill, NC 27599 USA. [Gilmore, John H.; Brode, Shannon] Univ N Carolina, UNC Ctr Excellence Community Mental Hlth, Chapel Hill, NC 27599 USA. [Mansfield, Alyssa J.] Vet Hlth Adm, Natl Ctr fin PTSD, Pacific Islands Div, Honolulu, HI USA. [Curtis, Pam; Gordon, Cathy; Slaughter-Mason, Samantha] Oregon Hlth & Sci Univ, Oregon Evidence Based Practice Ctr, Sci Resource Ctr, Portland, OR USA. [Tyutyulkova, Sonia] Agcy Healthcare Res & Qual, Rockville, MD USA. [Crotty, Karen] Hayes Inc, Lansdale, PA USA. [Mansfield, Alyssa J.; Crotty, Karen; Viswanathan, Meera; Tant, Elizabeth] Res Triangle Inst Int, Res Triangle Pk, NC USA. RP Jonas, DE (reprint author), Univ N Carolina, Dept Med, 5039 Old Clin Bldg,CB 7110, Chapel Hill, NC 27599 USA. EM daniel_jonas@med.unc.edu FU Agency for Healthcare Research and Duality [290 2007 10056 I] FX This project was supported by American Recovery and Reinvestment Act contract 290 2007 10056 I from the Agency for Healthcare Research and Duality. The authors thank Carol Woodell, B.S.P.H., Lynn Rosenberg, M.S.W., Loraine Monroe, and Laura Small, B.A. They acknowledge the participation of the following stakeholders ill the Issues Exploration Forum: Jeffrey A. Buck, Ph.D., Chris Collins, Kurt Colisilis, M.D., M.B.A., Steven Crystal, PhD., Timothy Cuerdon, Ph.D., King Davis, Ph.D., M.S.W., Lisa Dixon, M.D., M.P.H., Kenneth Duckworth, Laura J. Fochtmann, M.D., Daniel Galper, Pit. D., Tobias Cerium!, Ph.D., Howard H. Goldman, Carrie Gray, M.B.A., Rachel G. Guerrero, M.S.W., L.C.S.W., Kevin Hennessy, Ph.D., Michael F. Hogan, Ph.D., Gayle Jordan-Randolph, M.D., Jeff King, Ph.D., Thomas Laughren, M.D., Hunter McQuistion, M.D., Don Mordecai, M.D., Eve Moscicki, Sc.D., M.P.H., Katherine Nordal, Ph.D., Ruth Peron, PhD., Harold Pincus, M.D., Rlioncla Robinson Beale, M.D., Agnes Rupp, Ph.D., Ron Schraiber, M.A., Steven Sharktein, M.D., David Site no, Ph.D., Jennifer Skewn, Ph.D., Pluscedia Williams, Sharon Yates, Alexander Young, M.D., M.S.H.S., Judy Zerzan, M.D., M.P.H. NR 33 TC 7 Z9 7 U1 1 U2 9 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD NOV PY 2012 VL 63 IS 11 BP 1125 EP 1130 DI 10.1176/appi.ps.201100369 PG 6 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 049KF UT WOS:000311981200011 PM 23117509 ER PT J AU Petterson, SM Liaw, WR Phillips, RL Rabin, DL Meyers, DS Bazemore, AW AF Petterson, Stephen M. Liaw, Winston R. Phillips, Robert L., Jr. Rabin, David L. Meyers, David S. Bazemore, Andrew W. TI Projecting US Primary Care Physician Workforce Needs: 2010-2025 SO ANNALS OF FAMILY MEDICINE LA English DT Article DE health policy research; primary care issues; insurance; Affordable Care Act; workforce; physician shortage ID UNITED-STATES AB PURPOSE We sought to project the number of primary care physicians required to meet US health care utilization needs through 2025 after passage of the Affordable Care Act. METHODS In this projection of workforce needs, we used the Medical Expenditure Panel Survey to calculate the use of office-based primary care in 2008. We used US Census Bureau projections to account for demographic changes and the American Medical Association's Masterfile to calculate the number of primary care physicians and determine the number of visits per physician. The main outcomes were the projected number of primary care visits through 2025 and the number of primary care physicians needed to conduct those visits. RESULTS Driven by population growth and aging, the total number of office visits to primary care physicians is projected to increase from 462 million in 2008 to 565 million in 2025. After incorporating insurance expansion, the United States will require nearly 52,000 additional primary care physicians by 2025. Population growth will be the largest driver, accounting for 33,000 additional physicians, while 10,000 additional physicians will be needed to accommodate population aging. Insurance expansion will require more than 8,000 additional physicians, a 3% increase in the current workforce. CONCLUSIONS Population growth will be the greatest driver of expected increases in primary care utilization. Aging and insurance expansion will also contribute to utilization, but to a smaller extent. C1 [Petterson, Stephen M.; Phillips, Robert L., Jr.; Bazemore, Andrew W.] Robert Graham Ctr, Washington, DC USA. [Liaw, Winston R.] Virginia Commonwealth Univ, Dept Family Med, Richmond, VA USA. [Rabin, David L.] Georgetown Univ, Dept Family Med, Washington, DC USA. [Meyers, David S.] Agcy Healthcare Res & Qual, Washington, DC USA. RP Liaw, WR (reprint author), 3650 Joseph Siewick Dr 400, Fairfax, VA 22033 USA. EM winstonrliaw@gmail.com FU Agency for Healthcare Research and Quality [HHSP233200900359P, AHR1256] FX This research was funded in part by the Agency for Healthcare Research and Quality through contract number HHSP233200900359P, reference number AHR1256. NR 21 TC 164 Z9 165 U1 2 U2 23 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672 USA SN 1544-1709 J9 ANN FAM MED JI Ann. Fam. Med. PD NOV-DEC PY 2012 VL 10 IS 6 BP 503 EP 509 DI 10.1370/afm.1431 PG 7 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 043XU UT WOS:000311584800004 PM 23149526 ER PT J AU Treadwell, JR Uhl, S Tipton, K Shamliyan, T Viswanathan, M Berkman, ND Sun, X Coleman, CI Elshaug, AG Singh, S Wang, SY Ramakrishnan, R AF Treadwell, Jonathan R. Uhl, Stacey Tipton, Kelley Shamliyan, Tatyana Viswanathan, Meera Berkman, Nancy D. Sun, Xin Coleman, Craig I. Elshaug, Adam G. Singh, Sonal Wang, Shi-Yi Ramakrishnan, Rema TI Assessing equivalence and noninferiority SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE Systematic reviews; Equivalence; Noninferiority; Methodology; Risk of bias; Strength of evidence ID TRIALS AB Objective: For systematic reviews, no guidance exists for what review methods support valid conclusions of equivalence (EQ) and non-inferiority (NI). To provide such guidance, we convened a workgroup of 13 experienced systematic reviewers from seven evidence-based practice centers (EPCs) and the Agency for Healthcare Research and Quality (AHRQ). Study Design and Setting: The Lead EPC first performed two methods projects intended to assist the workgroup in clarifying the context, prioritizing the issues, targeting the scope, and summarizing the state of the art. Results: Based on expert opinion, we devised guidance in four areas: 1) Unique risk of bias issues for trials self-identifying as EQ NI trials; 2) Setting the reviewer's minimum important difference; 3) Analytic foundations for concluding EQ or NI; and 4) Language considerations when concluding EQ or NI. Conclusion: This article summarizes the main recommendations, and the full guidance chapter appears on the AHRQ Web site. (C) 2012 Elsevier Inc. All rights reserved. C1 [Treadwell, Jonathan R.; Uhl, Stacey; Tipton, Kelley] ECRI Inst, Evidence Based Practice Ctr, Plymouth Meeting, PA USA. [Shamliyan, Tatyana; Wang, Shi-Yi; Ramakrishnan, Rema] Univ Minnesota, Div Hlth Policy & Management, Evidence Based Practice Ctr, Minneapolis, MN 55455 USA. [Viswanathan, Meera; Berkman, Nancy D.] RTI Int, RTI UNC Evidence Based Practice Ctr, Res Triangle Pk, NC 27709 USA. [Sun, Xin] Oregon Hlth & Sci Univ, Evidence Based Practice Ctr, Portland, OR 97227 USA. [Sun, Xin] Kaiser Permanente Ctr Hlth Res, Portland, OR 97227 USA. [Coleman, Craig I.] Univ Connecticut, Sch Pharm, UCONN Hartford Hosp Evidence Based Practice Ctr, Hartford, CT 06102 USA. [Elshaug, Adam G.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Elshaug, Adam G.] Univ Adelaide, Dept Publ Hlth, Adelaide, SA, Australia. [Singh, Sonal] Johns Hopkins Univ, Dept Med, Evidence Based Practice Ctr, Baltimore, MD 21287 USA. RP Treadwell, JR (reprint author), ECRI Inst, Evidence Based Practice Ctr, 5200 Butler Pike, Plymouth Meeting, PA USA. EM jtreadwell@ecri.org RI Singh, Sonal/A-4614-2008; Elshaug, Adam/A-5714-2008; OI Singh, Sonal/0000-0003-0912-941X; Elshaug, Adam/0000-0002-4939-5379 NR 21 TC 10 Z9 10 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD NOV PY 2012 VL 65 IS 11 BP 1144 EP 1149 DI 10.1016/j.jclinepi.2012.05.001 PG 6 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 017DY UT WOS:000309571500003 PM 22732455 ER PT J AU Li, Y Spector, WD Glance, LG Mukamel, DB AF Li, Yue Spector, William D. Glance, Laurent G. Mukamel, Dana B. TI State "Technical Assistance Programs" for Nursing Home Quality Improvement: Variations and Potential Implications SO JOURNAL OF AGING & SOCIAL POLICY LA English DT Article DE long-term care; nursing home; quality improvement; state regulations; technical assistance program ID ENFORCEMENT; PERFORMANCE; MEDICARE; PAY AB To improve nursing home quality, many states have developed "technical assistance programs" that provide on-site consultation and training for nursing facility staff. We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. As of 2010, 17 states had developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. In conclusion, state technical assistance programs for nursing homes vary in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives. C1 [Li, Yue] Univ Rochester, Med Ctr, Div Hlth Policy & Outcomes Res, Dept Publ Hlth Sci, Rochester, NY 14642 USA. [Spector, William D.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Glance, Laurent G.] Univ Rochester, Med Ctr, Dept Anesthesiol, Rochester, NY 14642 USA. [Glance, Laurent G.] Univ Rochester, Med Ctr, Dept Publ Hlth Sci, Rochester, NY 14642 USA. [Mukamel, Dana B.] Univ Calif Irvine, Dept Med, Irvine, CA 92717 USA. [Mukamel, Dana B.] Univ Calif Irvine, Hlth Policy Res Inst, Irvine, CA USA. RP Li, Y (reprint author), Univ Rochester, Med Ctr, Div Hlth Policy & Outcomes Res, Dept Publ Hlth Sci, 265 Crittenden Blvd,CU 420644, Rochester, NY 14642 USA. EM yue_li@urmc.rochester.edu FU NIA NIH HHS [R01AG032264, R01 AG032264] NR 37 TC 1 Z9 1 U1 0 U2 2 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 0895-9420 EI 1545-0821 J9 J AGING SOC POLICY JI J. Aging Soc. Policy PD OCT 1 PY 2012 VL 24 IS 4 BP 349 EP 367 DI 10.1080/08959420.2012.735157 PG 19 WC Gerontology SC Geriatrics & Gerontology GA 093SK UT WOS:000315212000001 PM 23216345 ER PT J AU Zodet, MW Stevans, JM AF Zodet, Marc W. Stevans, Joel M. TI THE 2008 PREVALENCE OF CHIROPRACTIC USE IN THE US ADULT POPULATION SO JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS LA English DT Article DE Chiropractic; Prevalence; Utilization; Cross-Sectional Studies ID UNITED-STATES; ALTERNATIVE MEDICINE; HEALTH-CARE; INSURANCE-COVERAGE; COMPLEMENTARY; SERVICES; TRENDS AB Objective: The purpose of this study was to produce prevalence estimates and identify determinants of variability in chiropractic use in the US adult population. Methods: The Medical Expenditure Panel Survey was used to estimate prevalence for the adult population and subpopulations according to several sociodemographic, geographic, and health characteristics. Multivariable logistic regression model was used to explore the effects of the independent predictors on chiropractic use. Results: The 2008 chiropractic prevalence of use was estimated to be 5.2% (95% confidence interval, 4.7-5.6). The adjusted odds of using chiropractic services were approximately 46% less for Asians, 63% less for Hispanics, and 73% less for blacks compared with whites; 21% less for men than women; and 68% higher for those with arthritis compared with those without. Persons from high-income families have greater odds of using chiropractic services compared with those from middle-income (42%) and low-income (67%) families. There was a significant interaction between Census region and urban-rural location. The results showed the prevalence of chiropractic use to be highest in small metro areas in the Midwest (10.5%) and Northeast (10.4%) as well as micropolitan/noncore areas in the West (10.8%) and Midwest (10.1%). Conclusions: This study validates previous findings showing the prevalence of use is higher for whites, women, and persons with higher family income or reported arthritis. The results of this study also indicate that chiropractic use varies across the urban-rural landscape depending on the region of the country, suggesting that the effect of geographic location may be more complex than previously reported. (J Manipulative Physiol Ther 2012;35:580-588) C1 [Zodet, Marc W.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. [Stevans, Joel M.] Univ Pittsburgh, Dept Phys Therapy, Pittsburgh, PA USA. RP Stevans, JM (reprint author), 6035 Forbes Tower, Pittsburgh, PA 15260 USA. EM Jms363@pitt.edu OI Stevans, Joel/0000-0001-8642-9446 FU NIH [T32 HD 049307] FX Dr Joel Stevans is funded by a NIH Training Grant (T32 HD 049307) and consults with Landmark Healthcare, Inc. NR 24 TC 9 Z9 9 U1 1 U2 2 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0161-4754 J9 J MANIP PHYSIOL THER JI J. Manip. Physiol. Ther. PD OCT PY 2012 VL 35 IS 8 BP 580 EP 588 DI 10.1016/j.jmpt.2012.10.001 PG 9 WC Health Care Sciences & Services; Integrative & Complementary Medicine; Rehabilitation SC Health Care Sciences & Services; Integrative & Complementary Medicine; Rehabilitation GA 049SF UT WOS:000312003000001 PM 23158463 ER PT J AU Stevans, JM Zodet, MW AF Stevans, Joel M. Zodet, Marc W. TI CLINICAL, DEMOGRAPHIC, AND GEOGRAPHIC DETERMINANTS OF VARIATION IN CHIROPRACTIC EPISODES OF CARE FOR ADULTS USING THE 2005-2008 MEDICAL EXPENDITURE PANEL SURVEY SO JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS LA English DT Article DE Chiropractic; Episode of Care; Costs and Cost Analysis; Health Expenditures; Cost Sharing ID UNITED-STATES; ALTERNATIVE MEDICINE; INSURANCE-COVERAGE; HEALTH-CARE; COMPLEMENTARY; SERVICES AB Objective: The primary aim of this study was to report nationally representative estimates of the visit utilization, per visit expenditures, and total expenditures for chiropractic episodes of care in the US adult population. The secondary aim was to identify clinical, demographic, geographic, and payment factors associated with variation in the levels of utilization and expenditures. Methods: Data from the 2005-2008 Medical Expenditure Panel Survey were used to construct complete episodes of chiropractic care (n = 1639) for the civilian, noninstitutionalized adult population. Bivariate descriptive statistics were calculated for visit utilization, per visit expenditures, and total expenditures per episode of care by several clinical, demographic, geographic, and payment variables. Multivariable regression models were used to evaluate the effects of the independent variables on each of the 3 dependent variables. Results: The unadjusted mean number of visits per episode was 5.8 (95% confidence interval [CI], 5.3-6.4] and varied significantly by race/ethnicity, perceived mental health, urban-rural location, and source of payment. The mean total expenditures per visit per episode were estimated to be $69 (95% CI, $65-$73). There was variation associated with the census region, urban-rural location, and source of payment variables. Total expenditures for an episode of care were estimated to be $424 (95% CI, $371-$477] with variation according to urban-rural location and source of payment. During 29% of the episodes all expenditures were paid with out-of-pocket funds. Conclusions: Variation in the utilization and expenditures during chiropractic episodes of care is primarily associated with payment source and geographic factors. (J Manipulative Physiol Ther 2012;35:589-599) C1 [Stevans, Joel M.] Univ Pittsburgh, Dept Phys Therapy, Pittsburgh, PA USA. [Zodet, Marc W.] Agcy Healthcare Res & Qual, Ctr Financing Access & Cost Trends, Rockville, MD USA. RP Stevans, JM (reprint author), 6035 Forbes Tower, Pittsburgh, PA 15260 USA. EM Jms363@pitt.edu OI Stevans, Joel/0000-0001-8642-9446 FU NIH [T32 HD 049307] FX Dr Joel Stevans is funded by a NIH Training Grant (T32 HD 049307). Dr Joel Stevans consults with Landmark Healthcare, Inc. NR 21 TC 8 Z9 8 U1 1 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0161-4754 J9 J MANIP PHYSIOL THER JI J. Manip. Physiol. Ther. PD OCT PY 2012 VL 35 IS 8 BP 589 EP 599 DI 10.1016/j.jmpt.2012.09.009 PG 11 WC Health Care Sciences & Services; Integrative & Complementary Medicine; Rehabilitation SC Health Care Sciences & Services; Integrative & Complementary Medicine; Rehabilitation GA 049SF UT WOS:000312003000002 PM 23158464 ER PT J AU Callahan, LF Hawk, V Broucksou, KA Hackney, B MacDonald, D Prizer, LP Jonas, BL Bauer, TK Rudd, RE Brach, C Dewalt, D AF Callahan, Leigh F. Hawk, Victoria Broucksou, Kimberly A. Hackney, Betsy MacDonald, Deb Prizer, Lindsay Penny Jonas, Beth L. Bauer, Thomas K. Rudd, Rima E. Brach, Cindy Dewalt, Darren TI Developing a Health Literacy Universal Precautions Toolkit for Rheumatology. SO ARTHRITIS AND RHEUMATISM LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-College-of-Rheumatology (ACR) and Association-of-Rheumatology-Health-Professionals (ARHP) CY NOV 09-14, 2012 CL Washington, DC SP Amer Coll Rheumatol (ACR), Assoc Rheumatol Hlth Profess (ARHP) C1 [Callahan, Leigh F.; Hawk, Victoria; Broucksou, Kimberly A.; Hackney, Betsy; MacDonald, Deb; Prizer, Lindsay Penny; Jonas, Beth L.; Dewalt, Darren] Univ N Carolina, Chapel Hill, NC USA. [Rudd, Rima E.] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. [Brach, Cindy] Agcy Hlth Care Res & Qual, Rockville, MD USA. NR 0 TC 0 Z9 0 U1 0 U2 4 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0004-3591 J9 ARTHRITIS RHEUM-US JI Arthritis Rheum. PD OCT PY 2012 VL 64 IS 10 SU S MA 1572 BP S672 EP S672 PG 1 WC Rheumatology SC Rheumatology GA 019OD UT WOS:000309748303293 ER PT J AU El-Kassar, N Flomerfelt, FA Choudhury, B Hugar, LA Chua, KS Kapoor, V Lucas, PJ Gress, RE AF El-Kassar, Nahed Flomerfelt, Francis A. Choudhury, Baishakhi Hugar, Lee A. Chua, Kevin S. Kapoor, Veena Lucas, Philip J. Gress, Ronald E. TI High levels of IL-7 cause dysregulation of thymocyte development SO INTERNATIONAL IMMUNOLOGY LA English DT Article DE CD127; IL-7; IL-7R; Notch-1; thymus ID COMMON LYMPHOID PROGENITORS; CELL LINEAGE COMMITMENT; MOUSE BONE-MARROW; T-CELL; IN-VIVO; NOTCH LIGANDS; FATE DECISION; THYMIC-B; DIFFERENTIATION; EXPRESSION AB IL-7 signaling is required for thymocyte development and its loss has a severe deleterious effect on thymus function. Thymocytestromal cell interactions and other mechanisms tightly regulate IL-7 expression. We show that disruption of that regulation by over-expression of IL-7 inhibits T-cell development and promotes extensive B-cell lymphopoiesis in the thymus. Our data reveal that high levels of IL-7 negate Notch-1 function in thymocytes found in IL-7 transgenic mice and in co-culture with OP9-DL1 cells. While high levels of IL-7R are present on thymocytes, increased suppressor of cytokine signaling-1 expression blunts IL-7 downstream signaling, resulting in hypo-phosphorylation of proteins in the PI3K-Akt pathway. Consequently, GSK3 remains active and inhibits Notch-1 signaling as observed by decreased Hes-1 and Deltex expression in thymic progenitors. This is the first demonstration that high levels of IL-7 antagonize Notch-1 signaling and suggest that IL-7 may affect T- versus B-lineage choice in the thymus. C1 [El-Kassar, Nahed; Flomerfelt, Francis A.; Choudhury, Baishakhi; Hugar, Lee A.; Chua, Kevin S.; Kapoor, Veena; Lucas, Philip J.; Gress, Ronald E.] NCI, Expt Immunol & Transplantat Branch, CRC, Bethesda, MD 20892 USA. RP El-Kassar, N (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM nahed.elkassar@ahrq.hhs.gov FU National Cancer Institute at the National Institutes of Health (Bethesda, MD USA) FX The Intramural Research Program of the National Cancer Institute at the National Institutes of Health (Bethesda, MD USA) provided funding for these studies that were performed solely at the NCI. NR 41 TC 4 Z9 5 U1 1 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0953-8178 J9 INT IMMUNOL JI Int. Immunol. PD OCT PY 2012 VL 24 IS 10 BP 661 EP + DI 10.1093/intimm/dxs067 PG 11 WC Immunology SC Immunology GA 015QG UT WOS:000309460400001 PM 22899673 ER PT J AU Mukamel, DB Weimer, DL Harrington, C Spector, WD Ladd, H Li, Y AF Mukamel, Dana B. Weimer, David L. Harrington, Charlene Spector, William D. Ladd, Heather Li, Yue TI The Effect of State Regulatory Stringency on Nursing Home Quality SO HEALTH SERVICES RESEARCH LA English DT Article DE Nursing homes; quality of care; regulation; cost-effectiveness; comparative effectiveness ID OF-CARE; STAFFING LEVELS; MEDICAID REIMBURSEMENT; RISK-ADJUSTMENT; STANDARDS; IMPACT; ENFORCEMENT; FACILITIES; BOUNDARIES; ECONOMICS AB Objective To test the hypothesis that more stringent quality regulations contribute to better quality nursing home care and to assess their cost-effectiveness. Data Sources/Setting Primary and secondary data from all states and U.S. nursing homes between 2005 and 2006. Study Design We estimated seven models, regressing quality measures on the Harrington Regulation Stringency Index and control variables. To account for endogeneity between regulation and quality, we used instrumental variables techniques. Quality was measured by staffing hours by type per case-mix adjusted day, hotel expenditures, and risk-adjusted decline in activities of daily living, high-risk pressure sores, and urinary incontinence. Data Collection All states' licensing and certification offices were surveyed to obtain data about deficiencies. Secondary data included the Minimum Data Set, Medicare Cost Reports, and the Economic Freedom Index. Principal Findings Regulatory stringency was significantly associated with better quality for four of the seven measures studied. The cost-effectiveness for the activities-of-daily-living measure was estimated at about 72,000 in 2011/ Quality Adjusted Life Year. Conclusions Quality regulations lead to better quality in nursing homes along some dimensions, but not all. Our estimates of cost-effectiveness suggest that increased regulatory stringency is in the ballpark of other acceptable cost-effective practices. C1 [Mukamel, Dana B.; Ladd, Heather] Univ Calif Irvine, Hlth Policy Res Inst, Irvine, CA 92697 USA. [Weimer, David L.] Univ Wisconsin, LaFollette Sch Publ Affairs, Madison, WI USA. [Harrington, Charlene] Univ Calif San Francisco, Dept Social & Behav Sci, San Francisco, CA USA. [Spector, William D.] Agcy Healthcare Res & Qual, Rockville, MD USA. [Li, Yue] Univ Rochester, Med Ctr, Dept Community & Prevent Med, Div Hlth Policy & Outcomes Res, Rochester, NY 14642 USA. RP Mukamel, DB (reprint author), Univ Calif Irvine, Hlth Policy Res Inst, 100 Acad,Suite 110, Irvine, CA 92697 USA. EM dmuka-mel@uci.edu FU National Institutes on Aging, Grant Title "Nursing Homes Quality and Variations in State Regulations" [AG027420] FX The authors gratefully acknowledge funding from the National Institutes on Aging, Grant Title "Nursing Homes Quality and Variations in State Regulations" and grant AG027420. NR 56 TC 15 Z9 15 U1 0 U2 13 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 2012 VL 47 IS 5 BP 1791 EP 1813 DI 10.1111/j.1475-6773.2012.01459.x PG 23 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 008PR UT WOS:000308969500004 PM 22946859 ER PT J AU Maeda, JLK Raetzman, SO Friedman, BS AF Maeda, Jared Lane K. Raetzman, Susan O. Friedman, Bernard S. TI What Hospital Inpatient Services Contributed the Most to the 2001-2006 Growth in the Cost per Case? SO HEALTH SERVICES RESEARCH LA English DT Article ID HEALTH-CARE; DRIVERS; STATE AB Objective To demonstrate a refined cost-estimation method that converts detailed charges for inpatient stays into costs at the department level to enable analyses that can unravel the sources of rapid growth in inpatient costs. Data Sources Healthcare Cost and Utilization Project State Inpatient Databases and Medicare Cost Reports for all community, nonrehabilitation hospitals in nine states that reported detailed charges in 2001 and 2006 (n = 10,280,416 discharges). Study Design We examined the cost per discharge across all discharges and five subgroups (medical, surgical, congestive heart failure, septicemia, and osteoarthritis). Data Collection/Extraction Methods We created cost-to-charge ratios (CCRs) for 13 cost-center or department-level buckets using the Medicare Cost Reports. We mapped service-code-level charges to a CCR with an internally developed crosswalk to estimate costs at the service-code level. Principal Findings Supplies and devices were leading contributors (24.2 percent) to the increase in mean cost per discharge across all discharges. Intensive care unit and room and board (semiprivate) charges also substantially contributed (17.6 percent and 11.3 percent, respectively). Imaging and other advanced technological services were not major contributors (4.9 percent). Conclusions Payers and policy makers may want to explore hospital stay costs that are rapidly rising to better understand their increases and effectiveness. C1 [Maeda, Jared Lane K.; Raetzman, Susan O.] Truven Hlth Analyt, Analyt Consulting Serv, Washington, DC USA. [Friedman, Bernard S.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Maeda, Jared Lane K.; Raetzman, Susan O.] Truven Hlth Analyt, Res Serv, Washington, DC USA. RP Maeda, JLK (reprint author), Truven Hlth Analyt, Analyt Consulting Serv, 4301 Connecticut Ave NW,Suite 330, Washington, DC USA. EM jared.maeda@truvenhealth.com FU Agency for Healthcare Research and Quality [HHSA-290-2006-00009-C] FX This study was sponsored by the Agency for Healthcare Research and Quality under contract number HHSA-290-2006-00009-C. NR 25 TC 18 Z9 19 U1 0 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 2012 VL 47 IS 5 BP 1814 EP 1835 DI 10.1111/j.1475-6773.2012.01460.x PG 22 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 008PR UT WOS:000308969500005 PM 22946883 ER PT J AU Spector, WD Mutter, R Owens, P Limcangco, R AF Spector, William D. Mutter, Ryan Owens, Pamela Limcangco, Rhona TI Thirty-Day, All-cause Readmissions for Elderly Patients Who Have an Injury-related Inpatient Stay SO MEDICAL CARE LA English DT Article DE hospital readmission; injury; readmission rate ID NURSING-HOME RESIDENTS; HIP FRACTURE; HOSPITAL READMISSION; CONTROLLED-TRIAL; CARDIAC-SURGERY; HEART-FAILURE; CARE; DISCHARGE; RATES; REHOSPITALIZATION AB Background: Policymakers are exploring ways to reduce readmission rates. Much attention has been given to readmissions for conditions such as heart failure, acute myocardial infarction, and pneumonia, but little attention has been given to readmissions of patients with injury-related index admissions. Methods: This analysis is a retrospective cohort study of elderly persons who are admitted to a community hospital for a principal diagnosis of injury. We use 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases from 11 States. With logistic regression we identify factors associated with a 30-day, all-cause inpatient readmission. Factors include: patient characteristics, injury characteristics, clinical experiences during the hospital stay, and hospital characteristics. Results: About 1 in 7 elderly patients with an injury-related admission were readmitted in 30 days (13.7%). We found that severe injuries had higher predicted readmission rates. Patients receiving transfusions, experiencing a Patient Safety Indicator event, and with infections had higher readmission rates. Patients discharged to nursing homes or home health care had higher readmission rates compared with patients discharged to the community. Conclusions: This study expands evidence for the influence of injury characteristics on readmission rates. It also provides evidence about hospital experiences that affect readmissions. These findings suggest that a focus on preventing complications during the hospital stay may help reduce hospital-specific readmissions for patients with injury-related conditions. It also suggests that a strategy to reduce readmission rates should not only focus on hospitals but also nursing homes and home health care. C1 [Spector, William D.; Mutter, Ryan; Owens, Pamela] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. [Limcangco, Rhona] Social & Sci Syst Inc, Silver Spring, MD USA. RP Spector, WD (reprint author), Agcy Healthcare Res & Qual, 540 Gaither Rd, Rockville, MD 20850 USA. EM William.Spector@ahrq.hhs.gov NR 46 TC 11 Z9 11 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD OCT PY 2012 VL 50 IS 10 BP 863 EP 869 DI 10.1097/MLR.0b013e31825f2840 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 009XM UT WOS:000309058700007 PM 22929994 ER PT J AU Coffey, RM Misra, A Barrett, M Andrews, RM Mutter, R Moy, E AF Coffey, Rosanna M. Misra, Arpit Barrett, Marguerite Andrews, Roxanne M. Mutter, Ryan Moy, Ernest TI Congestive Heart Failure: Who Is Likely to Be Readmitted? SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Article DE congestive heart failure; readmissions; all payers; Medicaid; Medicare; against medical advice; cost of index admission ID READMISSION RATES; HOSPITALIZATION; COST AB Readmission for congestive heart failure (CHF) is the most common reason for readmission among Medicare fee-for-service patients. Yet CHF readmissions are not just a Medicare problem. This study examined who is likely to be readmitted for CHF, using all-payer hospital discharges from 14 of the states participating in the Healthcare Cost and Utilization Project. Patients with the strongest positive association with readmission were discharged against medical advice, covered by Medicaid, and had more severe loss of function and certain comorbidities such as drug abuse, renal failure, or psychoses. Weak negative relationship between readmission and cost of index admission provides some evidence that hospitals with higher readmission rates do not systematically use fewer resources in treating patients in initial encounters. High readmission rate for Medicaid patients suggests that state and federal governments should target Medicaid populations and drug abuse treatment for better care coordination to reduce readmissions and health care costs. C1 [Coffey, Rosanna M.; Misra, Arpit] Thomson Reuters Inc, Washington, DC 20008 USA. [Barrett, Marguerite] ML Barrett Inc, Del Mar, CA USA. [Andrews, Roxanne M.; Mutter, Ryan; Moy, Ernest] Agcy Healthcare Res & Qual, Rockville, MD USA. RP Coffey, RM (reprint author), Thomson Reuters Inc, 4301 Connecticut Ave,Suite 330, Washington, DC 20008 USA. EM rosanna.coffey@thomsonreuters.com FU Agency for Healthcare Research and Quality FX The author(s) disclosed receipt of the following financial support for research, authorship, and/or publication of this article:; This work was funded by Agency for Healthcare Research and Quality. NR 21 TC 14 Z9 14 U1 0 U2 9 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 J9 MED CARE RES REV JI Med. Care Res. Rev. PD OCT PY 2012 VL 69 IS 5 BP 602 EP 616 DI 10.1177/1077558712448467 PG 15 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 000UB UT WOS:000308413200006 PM 22653415 ER PT J AU Barocas, DA Gray, DT Fowke, JH Mercaldo, ND Blume, JD Chang, SS Cookson, MS Smith, JA Penson, DF AF Barocas, Daniel A. Gray, Darryl T. Fowke, Jay H. Mercaldo, Nathaniel D. Blume, Jeffrey D. Chang, Sam S. Cookson, Michael S. Smith, Joseph A., Jr. Penson, David F. TI Racial Variation in the Quality of Surgical Care for Prostate Cancer SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; prostatectomy; healthcare disparities; minority health ID RADICAL PROSTATECTOMY; MEDICARE RECIPIENTS; UNITED-STATES; FREE SURVIVAL; WHITE MEN; MORTALITY; TRENDS; CALIFORNIA; DISPARITY AB Purpose: Difference in the quality of care may contribute to the less optimal prostate cancer treatment outcomes among black men compared with white men. We determined whether a racial quality of care gap exists in surgical care for prostate cancer, as evidenced by racial variation in the use of high volume surgeons and facilities, and in the quality of certain outcome measures of care. Materials and Methods: We performed cross-sectional and cohort analyses of administrative data from the Healthcare Cost and Utilization Project all-payer State Inpatient Databases, encompassing all nonfederal hospitals in Florida, Maryland and New York State from 1996 to 2007. Included in analysis were men 18 years old or older with a diagnosis of prostate cancer who underwent radical prostatectomy. We compared the use of surgeons and/or hospitals in the top quartile of annual volume for this procedure, inpatient blood transfusion, complications, mortality and length of stay between black and white patients. Results: Of 105,972 patients 81,112 (76.5%) were white, 14,006 (13.2%) were black, 6,999 (6.6%) were Hispanic and 3,855 (3.6%) were all other. In mixed effects multivariate models, black men had markedly lower use of high volume hospitals (OR 0.73, 95% CI 0.70-0.76) and surgeons (OR 0.67, 95% CI 0.64-0.70) compared to white men. Black men also had higher odds of blood transfusion (OR 1.08, 95% CI 1.01-1.14), longer length of stay (OR 1.07, 95% CI 1.06-1.07) and inpatient mortality (OR 1.73, 95% CI 1.02-2.92). Conclusions: Using an all-payer data set, we identified concerning potential quality of care gaps between black and white men undergoing radical prostatectomy for prostate cancer. C1 [Barocas, Daniel A.; Fowke, Jay H.; Chang, Sam S.; Cookson, Michael S.; Smith, Joseph A., Jr.; Penson, David F.] Vanderbilt Univ, Med Ctr, Dept Urol Surg, Nashville, TN 37203 USA. [Mercaldo, Nathaniel D.; Blume, Jeffrey D.] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN 37203 USA. [Barocas, Daniel A.; Penson, David F.] Vanderbilt Univ, Med Ctr, Ctr Surg Qual & Outcomes Res, Nashville, TN 37203 USA. [Fowke, Jay H.] Vanderbilt Univ, Med Ctr, Div Epidemiol, Nashville, TN 37203 USA. [Penson, David F.] Tennessee Valley Vet Adm Geriatr Res Educ & Clin, Nashville, TN USA. [Gray, Darryl T.] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD USA. RP Barocas, DA (reprint author), Vanderbilt Univ, Med Ctr, Dept Urol Surg, 2525 W End Ave,Suite 600, Nashville, TN 37203 USA. EM dan.barocas@vanderbilt.edu FU National Institute of Environmental Health Sciences [K12 ES15855]; National Center for Research Resources/National Institutes of Health via Vanderbilt CTSA Grant [UL1 RR024975] FX Supported by National Institute of Environmental Health Sciences K12 ES15855 and the National Center for Research Resources/National Institutes of Health via the Vanderbilt CTSA Grant UL1 RR024975. NR 30 TC 14 Z9 14 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD OCT PY 2012 VL 188 IS 4 BP 1279 EP 1285 DI 10.1016/j.juro.2012.06.037 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 005IZ UT WOS:000308745400082 PM 22902011 ER PT J AU Panepinto, JA Owens, PL Mosso, AL Steiner, CA Brousseau, DC AF Panepinto, J. A. Owens, P. L. Mosso, A. L. Steiner, C. A. Brousseau, D. C. TI Concentration of hospital care for acute sickle cell disease-related visits SO PEDIATRIC BLOOD & CANCER LA English DT Article DE access to care; continuity of care; minority health; utilization ID COMMON OUTCOMES; UNITED-STATES; MEDICAL HOME; ODDS RATIOS; RISK; TRANSITION; EMERGENCY; QUALITY; COHORT; MODEL AB Background Sickle cell disease (SCD) is characterized by frequent disease-related events that require acute care. It is unknown to what extent patients utilize multiple hospitals for acute care. We examined the continuity pattern of acute care visits to the hospital or emergency department. We hypothesized that among patients with multiple SCD related acute care visits, children experience more concentrated hospital care than adults and privately insured patients experience more concentrated hospital care than publicly insured patients. Procedure We conducted a retrospective cohort study using data from the 2005 and 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. Subjects included patients with SCD =1 year of age. The primary outcome was proportion of patients with multiple acute care visits to a single hospital. Results A total of 13,533 patients made =2 acute SCD-related visits. Of the 5,030 children, 77.3% went to the same hospital for all visits. In contrast, of the 8,503 adults, only 51.3% visited the same hospital. Adolescents were more likely than adults to go to one hospital [adjusted relative risk (ARR) 1.40, confidence interval (CI) 1.351.45]. Those with public insurance and the uninsured had a decreased probability of using one hospital (ARR 0.96, CI 0.940.99, and ARR 0.83, CI 0.790.88, respectively). Conclusions Adults and patients with public insurance or no insurance are more likely to use multiple hospitals for acute care. By receiving acute care at multiple hospitals, patients with SCD experience dispersed and fragmented care potentially leading to decreased care quality. Pediatr Blood Cancer 2012;59:685689. (c) 2011 Wiley Periodicals, Inc. C1 [Panepinto, J. A.; Brousseau, D. C.] Dept Pediat, Rockville, MD USA. [Panepinto, J. A.] Sect Hematol Oncol Bone Marrow Transplantat, Rockville, MD USA. [Brousseau, D. C.] Med Coll Wisconsin, Rockville, MD USA. [Panepinto, J. A.; Brousseau, D. C.] Childrens Hosp Wisconsin, Childrens Res Inst, Healthcare Cost & Utilizat Project, Rockville, MD USA. [Owens, P. L.; Steiner, C. A.] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Owens, P. L.] Washington Univ, Sch Med, Dept Internal Med, Div Infect Dis, St Louis, MO 63110 USA. [Mosso, A. L.] Social & Sci Syst Inc, Silver Spring, MD USA. RP Panepinto, JA (reprint author), MFRC, 8701 Watertown Plank Rd,Suite 3050, Milwaukee, WI 53226 USA. EM jpanepin@mcw.edu FU National Institutes of Health [K23 HL80092]; Agency for Healthcare Research and Quality [K08 HS015482-01A1] FX Grant sponsor: National Institutes of Health; Grant number: K23 HL80092; Grant sponsor: Agency for Healthcare Research and Quality; Grant number: K08 HS015482-01A1. NR 33 TC 6 Z9 6 U1 1 U2 6 PU WILEY PERIODICALS, INC PI SAN FRANCISCO PA ONE MONTGOMERY ST, SUITE 1200, SAN FRANCISCO, CA 94104 USA SN 1545-5009 J9 PEDIATR BLOOD CANCER JI Pediatr. Blood Cancer PD OCT PY 2012 VL 59 IS 4 BP 685 EP 689 DI 10.1002/pbc.24028 PG 5 WC Oncology; Hematology; Pediatrics SC Oncology; Hematology; Pediatrics GA 986ZN UT WOS:000307386300018 PM 22180290 ER PT J AU Chang, SM Carey, TS Kato, EU Guise, JM Sanders, GD AF Chang, Stephanie M. Carey, Timothy S. Kato, Elisabeth Uphoff Guise, Jeanne-Marie Sanders, Gillian D. TI Identifying Research Needs for Improving Health Care SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID CUMULATIVE METAANALYSES; SYSTEMATIC REVIEWS; PROGRAM; AHRQ; TIME; TRIALS AB Insights from systematic reviews can help new studies better meet the priorities and needs of patients and communities. However, systematic reviews unfortunately have not yet achieved this position to direct and guide new research studies. The Agency for Healthcare Research and Quality's Evidence-based Practice Center Program uses systematic reviews to identify gaps in current evidence and has developed a systematic process of prioritizing these gaps with stakeholder input into clearly defined "future research needs." Eight Evidence-based Practice Centers began to apply this effort in 2010 to various clinical and policy topics. Gaps that prevented systematic reviewers from answering central questions of the review may include insufficient studies on sub-populations, insufficient studies with appropriate comparators, lack of appropriate outcomes measured, and methods problems. Stakeholder panels, consisting of advocacy groups, patients, researchers, clinicians, funders, and policymakers, help refine the gaps through multiple conference calls and prioritization exercises. Each report highlights a focused set of 4 to 15 high-priority needs with an accompanying description of possible considerations for study design. Identification of high-priority research needs could potentially speed the development and implementation of high-priority, stakeholder-engaged research. C1 [Chang, Stephanie M.] Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD 20850 USA. Univ N Carolina, Chapel Hill, NC USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Duke Univ, Durham, NC USA. RP Chang, SM (reprint author), Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, 540 Gaither Rd, Rockville, MD 20850 USA. FU AHRQ, U.S. Department of Health and Human Services [290-2007-10056-1, 290-2007-10057-1, 290-2007-10066-1] FX This project was funded in part under contracts 290-2007-10056-1, 290-2007-10057-1, and 290-2007-10066-1 from the AHRQ, U.S. Department of Health and Human Services. NR 25 TC 15 Z9 15 U1 1 U2 5 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 EI 1539-3704 J9 ANN INTERN MED JI Ann. Intern. Med. PD SEP 18 PY 2012 VL 157 IS 6 BP 439 EP U106 DI 10.7326/0003-4819-157-6-201209180-00515 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 007UB UT WOS:000308912800018 PM 22847017 ER PT J AU Clancy, C Brach, C Abrams, M AF Clancy, Carolyn Brach, Cindy Abrams, Melinda TI Assessing Patient Experiences of Providers' Cultural Competence and Health Literacy Practices: CAHPS (R) Item Sets FOREWORD SO MEDICAL CARE LA English DT Editorial Material C1 [Clancy, Carolyn; Brach, Cindy; Abrams, Melinda] Agcy Healthcare Res & Qual, Rockville, MD 20850 USA. RP Brach, C (reprint author), Agcy Healthcare Res & Qual, MPP, 540 Gaither Rd, Rockville, MD 20850 USA. EM cindy.brach@ahrg.hhs.gov NR 8 TC 1 Z9 1 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD SEP PY 2012 VL 50 IS 9 SU 2 BP S1 EP S2 DI 10.1097/MLR.0b013e3182641e7f PG 2 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 080IO UT WOS:000314235300001 PM 22895224 ER PT J AU Weidmer, BA Brach, C Hays, RD AF Weidmer, Beverly A. Brach, Cindy Hays, Ron D. TI Development and Evaluation of CAHPS (R) Survey Items Assessing How Well Healthcare Providers Address Health Literacy SO MEDICAL CARE LA English DT Article DE health literacy; CAHPS; patient survey; communication ID CONSUMER ASSESSMENT; PLANS AB Background: The complexity of health information often exceeds patients' skills to understand and use it. Objective: To develop survey items assessing how well healthcare providers communicate health information. Methods: Domains and items for the Consumer Assessment of Healthcare Providers and Systems (CAHPS)(R) Item Set for Addressing Health Literacy were identified through an environmental scan and input from stakeholders. The draft item set was translated into Spanish and pretested in both English and Spanish. The revised item set was field tested with a randomly selected sample of adult patients from 2 sites using mail and telephonic data collection. Item-scale correlations, confirmatory factor analysis, and internal consistency reliability estimates were estimated to assess how well the survey items performed and identify composite measures. Finally, we regressed the CAHPS global rating of the provider item on the CAHPS core communication composite and the new health literacy composites. Results: A total of 601 completed surveys were obtained (52% response rate). Two composite measures were identified: (1) Communication to Improve Health Literacy (16 items); and (2) How Well Providers Communicate About Medicines (6 items). These 2 composites were significantly uniquely associated with the global rating of the provider (communication to improve health literacy: P < 0.001, b = 0.28; and communication about medicines composite: P = 0.02, b = 0.04). The 2 composites and the CAHPS core communication composite accounted for 51% of the variance in the global rating of the provider. A 5-item subset of the Communication to Improve Health Literacy composite accounted for 90% of the variance of the original 16-item composite. Conclusions: This study provides support for reliability and validity of the CAHPS Item Set for Addressing Health Literacy. These items can serve to assess whether healthcare providers have communicated effectively with their patients and as a tool for quality improvement. C1 [Weidmer, Beverly A.] RAND Corp, Santa Monica, CA 90407 USA. [Brach, Cindy] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Hays, Ron D.] Univ Calif Los Angeles, Dept Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90024 USA. RP Weidmer, BA (reprint author), RAND Corp, 1776 Main St,POB 2138, Santa Monica, CA 90407 USA. EM beverly_weidmer@rand.org RI Hays, Ronald/D-5629-2013 FU Agency for Healthcare Research and Quality [HHSP233200600332P]; AHRQ [U18 HS016980]; NIA [P30AG021684]; NIMHD [2P20MD000182] FX Supported by a contract from the Agency for Healthcare Research and Quality (HHSP233200600332P). R.D.H. was also supported in part by grants from AHRQ (U18 HS016980), NIA (P30AG021684), and the NIMHD (2P20MD000182). NR 26 TC 6 Z9 6 U1 4 U2 13 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD SEP PY 2012 VL 50 IS 9 SU 2 BP S3 EP S11 DI 10.1097/MLR.0b013e3182652482 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 080IO UT WOS:000314235300002 PM 22895227 ER PT J AU Weidmer, BA Brach, C Slaughter, ME Hays, RD AF Weidmer, Beverly A. Brach, Cindy Slaughter, Mary E. Hays, Ron D. TI Development of Items to Assess Patients' Health Literacy Experiences at Hospitals for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey SO MEDICAL CARE LA English DT Article DE health literacy; HCAHPS; patient survey; hospital survey; patient-provider communication ID PSYCHOMETRIC PROPERTIES; EDUCATION MATERIALS; CORE SURVEY; POPULATIONS; DISCHARGE; DESIGN; PLANS AB Background: The complexity of health information frequently exceeds patients' skills to understand and use it. Improvement in hospital communication has the potential to improve the quality of care. Objective: To develop a set of items to supplement the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey (HCAHPS) to assess how well hospitals communicate health information to inpatients. Methods: We conducted an environmental scan and obtained input from stakeholders to identify domains and survey items, and cognitively tested the item set in English and Spanish. We administered the items to a random sample of adult hospital patients using mail and telephone data collection. We estimate item-scale correlations for hypothesized multi-item composites, internal consistency reliability for composites, correlations among composites, and regressed global rating of the hospital and a would you recommend the hospital items on HCAHPS existing core and the new composites to evaluate the unique contribution of each to these "bottomline" measures. Results: A total of 1013 surveys were obtained (55% response rate). With some exceptions, correlations between items and scales were consistent with the hypothesized item clusters. Three composites were identified: (1) communication about tests; (2) communication about how to care for self and medicines; and (3) communication about forms. Conclusions: This study provides support for the measurement properties of the HCAHPS Item Set for Addressing Health Literacy. It can serve as both a measure of whether healthcare providers in a hospital setting have communicated effectively with their patients and as a tool for quality improvement. C1 [Weidmer, Beverly A.] RAND Corp, Santa Monica, CA 90407 USA. [Brach, Cindy] Agcy Healthcare Res & Qual, Ctr Delivery Org & Markets, Rockville, MD USA. [Slaughter, Mary E.] RAND Corp, Pittsburgh, PA USA. [Hays, Ron D.] Univ Calif Los Angeles, Dept Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90024 USA. RP Weidmer, BA (reprint author), RAND Corp, 1776 Main St,POB 2138, Santa Monica, CA 90407 USA. EM beverly_weidmer@rand.org RI Hays, Ronald/D-5629-2013 FU Agency for Healthcare Research and Quality [HHSP233200600332P]; AHRQ [U18 HS016980]; NIA [P30AG021684]; NIMHD [2P20MD000182] FX Supported by a contract from the Agency for Healthcare Research and Quality (HHSP233200600332P). R.D.H. was also supported in part by grants from AHRQ (U18 HS016980), NIA (P30AG021684), and the NIMHD (2P20MD000182). NR 39 TC 6 Z9 6 U1 3 U2 16 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD SEP PY 2012 VL 50 IS 9 SU 2 BP S12 EP S21 DI 10.1097/MLR.0b013e31826524a0 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 080IO UT WOS:000314235300003 PM 22895225 ER PT J AU Friedman, B Jiang, HJ Steiner, CA Bott, J AF Friedman, Bernard Jiang, H. Joanna Steiner, Claudia A. Bott, John TI Likelihood of Hospital Readmission after First Discharge: Medicare Advantage vs. Fee-for-Service Patients SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID QUALITY; CARE AB This study tests whether the likelihood of hospital readmission within 30 days of discharge is different for enrollees in Medicare Advantage plans versus the standard fee-for-service program. A key requirement is to control for self-selection into Advantage plans. The study uses statewide inpatient databases maintained by the Agency for Healthcare Research and Quality for five states in 2006. The type of Medicare coverage is known, along with an encrypted patient identifier. We identify eligible first discharges and the first readmission within 30 days. We use selected area characteristics as instrumental variables fir enrollment in Advantage plans and apply a bivariate probit analysis. Descriptively, there is a slightly lower likelihood of readmission for Advantage plan enrollees. However, the Advantage plan patients are younger and less severely ill. After risk adjustment and control for self:selection, the enrollees in Advantage plans have a substantially higher likelihood of readmission. Recognizing caveats and limitations, the study supports informing Medicare beneficiaries about the rates of readmission for Advantage plans in their area. Analytical methods to adjust for self: selection into particular plans or plan types should be considered when possible. C1 [Friedman, Bernard; Jiang, H. Joanna; Steiner, Claudia A.; Bott, John] AHRQ, Rockville, MD 20850 USA. RP Friedman, B (reprint author), AHRQ, 540 Gaither Rd, Rockville, MD 20850 USA. EM bernard.friedman@ahrq.hhs.gov FU Agency for Healthcare Research and Quality FX The authors were supported wholly by the Agency for Healthcare Research and Quality during the conduct of this research. The views are those of the authors. No official endorsement by any agency of the federal or state governments is intended or should be inferred NR 20 TC 2 Z9 2 U1 0 U2 8 PU BLUE CROSS BLUE SHIELD ASSOC PI ROCHESTER PA 150 EAST MAIN ST, ROCHESTER, NY 14647 USA SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD FAL PY 2012 VL 49 IS 3 BP 202 EP 213 DI 10.5034/inquiryjrnl_49.03.01 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 037TY UT WOS:000311130600004 PM 23230702 ER EF