A5032442638- Emergency and Acute Care Studies
- Homelessness and Social Issues
- Healthcare Policy and Management
- Food Security and Health in Diverse Populations
- Geriatric Care and Nursing Homes
- Primary Care and Health Outcomes
- Health disparities and outcomes
- Trauma and Emergency Care Studies
- Patient Satisfaction in Healthcare
- Opioid Use Disorder Treatment
- COVID-19 and healthcare impacts
- Chronic Disease Management Strategies
- Substance Abuse Treatment and Outcomes
- Housing, Finance, and Neoliberalism
- Infection Control and Ventilation
- Disaster Response and Management
- Emergency Medicine Education and Research
- Family and Disability Support Research
- Case Reports on Hematomas
- Cardiac Arrest and Resuscitation
- Viral Infections and Outbreaks Research
- Health Systems, Economic Evaluations, Quality of Life
- Palliative Care and End-of-Life Issues
- Global Health Care Issues
- Obesity and Health Practices
University of California, San Francisco
2015-2024
Stony Brook University Hospital
2024
San Francisco General Hospital
2024
Lee University
2016-2022
UCSF Benioff Children's Hospital
2021
University of Rochester
2021
Mathematica Policy Research
2020
University of San Francisco
2019
Bellevue Hospital Center
2003-2014
New York University
2005-2013
IntroductionThis study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.MethodsAs part of a mixed-methods multisite study, the authors conducted semistructured interviews with subset adult patients caregivers pediatric who had completed Center for Medicare Medicaid Innovation Accountable Health Communities tool between July 2018 February 2019. Interviews, in English or Spanish, asked about reactions screening,...
Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates and caregiver acceptability of screening. was a cross-sectional survey 969 adult patients caregivers pediatric recruited from 6 primary care clinics 4 emergency departments across 9 states. Survey items included the Center for Medicare Medicaid Innovation Accountable Health Communities' screening tool questions appropriateness comfort...
ACADEMIC EMERGENCY MEDICINE 2011; 18:e64–e69 © 2011 by the Society for Academic Emergency Medicine Abstract Frequent use of emergency department (ED) services is often perceived to be a potentially preventable misuse resources. The underlying assumption that similar and more appropriate care can delivered outside EDs at lower cost. To reduce costs incentivize services, there have been efforts design interventions transition health utilization frequent users from other settings such as...
<h3>Importance</h3>Reduction in emergency department (ED) use is frequently viewed as a potential source for cost savings. One consideration has been to deny payment if the patient's diagnosis upon ED discharge appears reflect “nonemergency” condition. This approach does not incorporate other clinical factors such chief complaint that may inform necessity care.<h3>Objective</h3>To determine whether presenting and correspond sufficiently support of basis policies discouraging use.<h3>Design,...
Urban legend has often characterized frequent emergency department (ED) patients as mentally ill substance users who are a costly drain on the health care system and contribute to ED overcrowding because of unnecessary visits for conditions that could be treated more efficiently elsewhere. This study Medicaid in New York City shows behavioral responsible small share by users, use accounts portion these patients’ total costs. Frequent have substantial burden disease, they high rates primary...
This cross-sectional study examines prevalence of fit test failure 2 types N95 mask (dome-shaped and duckbill) during extended use or reuse among health care workers over days in April 2020 the UCSF emergency department.
The median age of single homeless adults is approximately 50 years. Older have poor social support and experience a high prevalence chronic disease, depression, substance use disorders. Access to mobile phones the internet could help lower barriers support, services, medical care; however, little known about access these by older adults.
<h3>Importance</h3> There has been recent media attention on the risk of excess mortality among homeless individuals during COVID-19 pandemic, yet data these deaths are limited. <h3>Objectives</h3> To quantify and describe people experiencing homelessness in San Francisco pandemic to compare characteristics with those prior years. <h3>Design, Setting, Participants</h3> A cross-sectional study tracking from 2016 2021 Francisco, California. All deceased who were at time death whose processed...
Precision medicine is data-driven health care tailored to individual patients based on their unique attributes, including biologic profiles, disease expressions, local environments, and socioeconomic conditions. Emergency (EM) has been peripheral the precision discourse, lacking both a unified definition of clear research agenda. We convened national consensus conference build shared mental model develop agenda for EM.
A small percentage of high-risk patients accounts for a large proportion Medicaid spending in the United States, which has become an urgent policy issue. Our objective was to pilot novel patient-centered intervention with frequent hospital admissions determine its potential improve care and reduce costs. Community hospital-based management coordination pre-post analysis health utilization. We enrolled fee-for-service aged 18-64 who were admitted urban public identified as being at high risk...
To examine whether randomization to permanent supportive housing (PSH) versus usual care reduces the use of acute health and other services among chronically homeless high users county-funded services.Between 2015 2019, we assessed service from Santa Clara County, CA, administrative claims data for all care, jail shelter, mortality.We conducted a randomized controlled trial multiple systems. We compared postrandomization outcomes systems using multivariate regression analysis.We extracted...
Prescription opioids play a significant role in the ongoing opioid crisis. Guidelines and physician education have had mixed success curbing prescriptions, highlighting need for other tools that can change prescriber behavior, including nudges based behavioral economics.To determine whether to what extent changes default settings electronic medical record (EMR) are associated with prescriptions patients discharged from emergency departments (EDs).This quality improvement study randomly...
<h3>Importance</h3> Some jurisdictions used hotels to provide emergency noncongregate shelter and support services reduce the risk of COVID-19 infection among people experiencing homelessness (PEH). A subset these shelter-in-place (SIP) hotel guests were high users acute health services, association placement with their service use remains unknown. <h3>Objective</h3> To evaluate SIP placements a PEH prior use. <h3>Design, Setting, Participants</h3> This study matched retrospective cohort...
The median age of single homeless adults is over 50, yet little known about their emergency department (ED) use. We describe use and factors associated with ED in a sample 50 older.We recruited 350 participants who were or older Oakland, California. interviewed residential history the prior 6 months, health status, health-related behaviors, services assessed cognition mobility. Our primary outcome was number visits months based on medical record review. used negative binomial regression to...
Frequent emergency department (ED) users often have complex behavioral health and social needs. However, policy makers focus on this population's medical system use without examining its of services systems. To illuminate the wide-ranging needs frequent ED users, we compared medical, mental health, substance use, among nonelderly nonfrequent, frequent, superfrequent in San Francisco County, California. We linked administrative data for fiscal years 2013–15 beneficiaries county's Medicaid...
Previous research suggests that some substance users have multiple crisis detoxification visits and never access rehabilitation care. This care-seeking pattern leads to poorer outcomes higher costs. The authors aimed identify predictors of repeat by analyzing state-level data routinely collected at the time substances use services admission. Repeat clients were more likely be homeless, city-dwelling fee-for-service Medicaid recipients. less than those with one admission enter within 3 days....
Many frequent emergency department (ED) users do not sustain high use over time, which makes it difficult to create targeted interventions address their health needs. We performed a retrospective analysis of nonelderly adult ED in California measure the persistence period 2005-15, describe characteristics persistent and nonpersistent users, identify predictors use. Of 2005, 30.5 percent remained 2006. A small but nontrivial population (16.5 percent, 5.7 1.9 percent) exhibited for three, six,...
Importance The COVID-19 pandemic resulted in a widespread acute shortage of N95 respirators, prompting the Centers for Disease Control and Prevention to develop guidelines extended use limited reuse N95s health care workers (HCWs). While HCWs followed these conserve N95s, evidence from clinical settings regarding safety is limited. Objective To measure incidence fit test failure during compare between types. Design, Setting, Participants This prospective cohort study, conducted April 2,...
To develop and validate rates of potentially preventable emergency department (ED) visits as indicators community health.Agency for Healthcare Research Quality, Cost Utilization Project 2008-2010 State Inpatient Databases Emergency Department Databases.Empirical analyses structured panel reviews.Panels 14-17 clinicians end users evaluated a set ED Prevention Quality Indicators (PQIs) using Modified Delphi process. Empirical included assessing variation in PQI across counties sensitivity...