A5030722401- Healthcare Policy and Management
- Machine Learning in Healthcare
- Primary Care and Health Outcomes
- Dementia and Cognitive Impairment Research
- Emergency and Acute Care Studies
- Mental Health Treatment and Access
- Biomedical Text Mining and Ontologies
- Adolescent and Pediatric Healthcare
- Innovations in Medical Education
- Electronic Health Records Systems
- Healthcare professionals’ stress and burnout
- Bipolar Disorder and Treatment
- Intensive Care Unit Cognitive Disorders
- Child and Adolescent Health
- Digital Mental Health Interventions
- Schizophrenia research and treatment
- Geriatric Care and Nursing Homes
- Mental Health Research Topics
- Sepsis Diagnosis and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Medical Education and Admissions
- Electroconvulsive Therapy Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Child and Adolescent Psychosocial and Emotional Development
- Mental Health and Psychiatry
McLean Hospital
2018-2025
Harvard University
2020-2025
Brigham and Women's Hospital
2025
Massachusetts General Hospital
2017-2024
The Ohio State University
2017-2024
Gates Foundation
2024
Cambridge Health Alliance
2024
Center for Autism and Related Disorders
2023
University of California, Los Angeles
2022
Northwestern University
2021
Long-term acute care hospitals have emerged as a novel approach for the of patients recovering from severe illness, but extent and increases in their activity at national level are unknown.To examine temporal trends long-term hospital utilization after an episode critical illness among fee-for-service Medicare beneficiaries aged 65 years or older.Retrospective cohort study using Provider Analysis Review files 1997 to 2006. We included all hospitalizations involving admission intensive unit...
Klebsiella pneumoniae causes community- and healthcare-associated infections in children adults. Globally 2019, an estimated 1.27 million (95% Uncertainty Interval [UI]: 0.91-1.71) 4.95 UI: 3.62-6.57) deaths were attributed to associated with bacterial antimicrobial resistance (AMR), respectively. K. was the second leading pathogen AMR resistant bacteria. Furthermore, rise of both hospital-acquired is a concern for neonates infants who are at high risk invasive disease. There limited...
Lack of health insurance maybe an independent risk factor for mortality and differential treatment in critical illness.To determine whether uninsured critically ill patients had differences 30-day care service use compared with those private to if outcome variability could be attributed patient-level or hospital-level effects.Retrospective cohort study using Pennsylvania hospital discharge data detailed clinical adjustment, from fiscal years 2005 2006, consisting 167 general acute hospitals,...
For patients recovering from severe acute illness, admission to a long-term care hospital (LTAC) is an increasingly common alternative continued management in intensive unit (ICU).To examine the effectiveness of LTAC transfer with chronic critical illness.Retrospective cohort study United States hospitals 2002 2006.Medicare beneficiaries defined as mechanical ventilation and at least 14 days care.Survival, costs, readmissions. We used multivariate analyses instrumental variables account for...
To learn what graduating medical students considered the primary purposes of fourth year school, their approach to residency selection, and challenges they faced in meeting fourth-year goals.A 52-question Web-based survey was administered from 20 U.S. MD-granting schools spring 2014. Quantitative data were analyzed with one-way analysis variance, chi-square analysis, or paired t tests. Responses an open-ended question coded into themes confirmed.A total 1,367/2,884 (47.4%) responded....
Abstract Background/Objectives No data exist regarding the validity of International Classification Disease (ICD)‐10 dementia diagnoses against a clinician‐adjudicated reference standard within Medicare claims data. We examined accuracy claims‐based with respect to expert clinician adjudication using novel database individual‐level linkages between electronic health record (EHR) and claims. Design In this retrospective observational study, two neurologists psychiatrists performed...
The app evaluation framework of the American Psychiatric Association (APA) has emerged as an adaptable tool for those seeking to navigate ever-growing space mental health apps. authors describe a meeting convened in December 2019 refine APA framework. expert panel comprised 16 individuals across care fields, with representation from psychiatry, psychology, social work, nursing, clinical informatics, peer support specialists, and lived experience. This resulted update addition clearer...
This study examined the impact of state medical licensure exemptions and telehealth registries on college students' access to psychiatric care. The authors attempted contact 901 psychiatrists who advertised online Psychology Today by using a simulated patient, described as student attending in with exemption or registry. Contact was established 282 (31%) across 10 states. Of 143 contacted were accepting new patients, seven (5%) aware exemptions, 43 (30%) willing establish care students...
To evaluate the impact of COVID-19 pandemic on clinical outcomes, we used data from Electronic Health Records 128 patients receiving care at a First Episode Psychosis clinic.Rates admission or emergency room (ER) visits January 2020 to July were analysed using difference-in-difference regression. We same weeks in 2019 control for seasonality.We found 17 hospitalizations ER between 1 and 13 March (incidence rate: 71.4 events/1000 person-weeks) 6 14 20 June 18.5 an incidence rate ratio 0.26....
Medicare psychiatrists in 2013 and 2019, although increases the proportion of HSAs with PMHNPs may have helped some rural areas maintain access to psychiatric prescribers.A limitation is that this study excluded clinical nurse specialists psychologists who can prescribe states.We underestimated PMHNP participation due prevalence incident-to-billing under which care provided by billed a physician's National Provider Identifier number. 6Identification delivery models maximize availability...
Electronic health records (EHRs) with large sample sizes and rich information offer great potential for dementia research, but current methods of phenotyping cognitive status are not scalable.The aim this study was to evaluate whether natural language processing (NLP)-powered semiautomated annotation can improve the speed interrater reliability chart reviews status.In diagnostic study, we developed evaluated a NLP-powered tool (NAT) facilitate status. Clinical experts adjudicated 627...
Objectives: To determine whether insurance coverage and race are associated with long-term acute care hospital utilization in critically ill patients requiring mechanical ventilation. Design: Retrospective cohort study. Setting: Nonfederal Pennsylvania discharges from 2004 to 2006. Patients: Eligible were aged 18 yrs or older, of white black race, underwent ventilation an intensive unit during their stay. Interventions: None. Measurements Main Results: We used multivariable logistic...
Objective: Access to specialty mental health care may be poor because many psychiatrists do not accept insurance reimbursement, whereas patients rely on help pay for care. The objective of this study was examine the extent participation in private by licensed psychiatrists. Methods: Using 2013 Massachusetts licensing data and All-Payer Claims Database (APCD), authors performed a cross-sectional analysis Massachusetts. fraction who filed claims, number unique with claims per psychiatrist,...
Patients in the US are more likely to receive out-of-network behavioral health care, including treatment for mental or substance use disorders, than they other medical and surgical services out of network. To date, in-network trends prices ambulatory care have been seldom described. Here we compare levels growth insurer-negotiated (allowed amounts), patient cost sharing, psychotherapy network a large, commercially insured population during 2007–17. For both adult child psychotherapy, sharing...
Objective: Many parents struggle to find mental health care for their children, and many clinicians do not accept insurance payments. The authors aimed estimate the frequency cost of self-pay psychotherapy psychotropic medication management visits youths determine how service use varies by family income. Methods: A descriptive cross-sectional analysis was performed among ages 5–17 years in 2018–2020 Medical Expenditure Panel Survey. Specialist included those with psychiatrists,...
Since the COVID-19 pandemic, emergency department boarding of youth with mental health concerns has increased.
Using observational data and variation in hospital admissions across days of the week, we examined association between ED boarding time development delirium within 72 hours admission among patients aged 65+ years admitted to an inpatient neurology ward. We exploited a natural experiment created by potentially exogenous week because competition for floor beds. proportional hazard models adjusting socio-demographic clinical characteristics propensity score, onset 858 patients: 2/3 were stroke,...
In 2020 Medicare reintroduced Alzheimer's disease and related dementias (ADRD) Hierarchical Condition Categories (HCCs) to risk-adjust Advantage accountable care organization (ACO) payments. The potential for spending increases from this policy change are not well understood because the baseline accuracy of ADRD HCCs is uncertain. Using linked 2016–18 claims electronic health record data a large ACO, we evaluated claims-based against reference standard clinician-adjudicated disease. An...
Objective. To create an IPE course that improved knowledge related to HIV history, prevention, and therapy, in health professions students their interest confidence becoming interprofessional collaborative clinicians, specifically involved the care of people living with HIV. Methods. A motivational design framework was used incorporated whole-task complex scenarios, team-based application, experiential components. Multiple sources quantitative qualitative data, including AIDS Education...
A national emergency in child and adolescent mental health was declared the United States 2021 wake of COVID-19 pandemic. This Open Forum discusses potential solutions to better support by improving or expanding school-based services, psychiatry access programs, virtual new models care (e.g., integrated youth services hubs crisis stabilization units). The success such programs is dependent on stable funding, strong leadership accountability, robust well-trained workforces, systems...