A5040474455- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Medication Adherence and Compliance
- Mental Health Treatment and Access
- Food Security and Health in Diverse Populations
- Pharmaceutical Economics and Policy
- Health disparities and outcomes
- Global Health Care Issues
- Pharmaceutical studies and practices
- Bipolar Disorder and Treatment
- Asthma and respiratory diseases
- Schizophrenia research and treatment
- Pharmaceutical Practices and Patient Outcomes
- Homelessness and Social Issues
- Global Health Workforce Issues
- Geriatric Care and Nursing Homes
- Healthcare cost, quality, practices
- Smoking Behavior and Cessation
- Obesity, Physical Activity, Diet
- Respiratory and Cough-Related Research
- Psychosomatic Disorders and Their Treatments
- Electroconvulsive Therapy Studies
- Health Policy Implementation Science
- Global Cancer Incidence and Screening
Massachusetts General Hospital
2016-2025
Harvard University
2016-2025
Lemuel Shattuck Hospital
2019-2024
British Columbia Children's Hospital
2024
University of British Columbia
2024
National Bureau of Economic Research
2020-2023
Boston University
2022-2023
Brigham and Women's Hospital
2023
San Diego State University
2023
Cambridge Health Alliance
2023
Little information exists about the consequences of limits on prescription-drug benefits for Medicare beneficiaries.
Background: Differentiating between appropriate and inappropriate resource use represents a critical challenge in health services research. The New York University Emergency Department (NYU ED) visit severity algorithm attempts to classify visits the ED based on diagnosis, but it has not been formally validated. Objective: To assess validity of NYU algorithm. Research Design: A longitudinal study single integrated delivery system from January 1999 December 2001. Subjects: total 2,257,445...
The aim of this study was to evaluate the impact introducing health information technology (HIT) on physician-patient interactions during outpatient visits.
<h3>Importance</h3> There is limited information about health care use and costs in patients with functional neurological disorders (FNDs). <h3>Objective</h3> To assess US emergency department (ED) inpatient charges for FNDs. <h3>Design, Setting, Participants</h3> This economic evaluation used Healthcare Cost Utilization Project data to all-payer (1) adult (age, ≥18 years) hospitalizations (2008-2017), (2) pediatric 5-17 (2003, 2006, 2009, 2012, 2016), (3) ED evaluations...
Few previous studies have evaluated primary adherence (whether a new prescription is filled within 30 d) to controller medications in individuals with persistent asthma.To compare the major medication regimens for asthma.This was retrospective cohort study of enrollees from five large health plans. We used electronic medical data on patients all ages asthma who had experienced an asthma-related exacerbation prior 12 months. studied measures including proportion days covered and (first d).Our...
Background Patient reports of their adherence behaviors, concerns about statins, and perceptions atherosclerotic cardiovascular disease (ASCVD) risk could inform approaches for improving to statin therapy. We examined these factors associations with adherence. Methods conducted telephone interviews among a stratified random sample adults receiving statins within an integrated delivery system (N = 730, 81% response rate) in 2010. sampled equal numbers individuals three clinical categories:...
Consumer-directed health plans are with high deductibles that typically require patients to bear no out-of-pocket costs for preventive care, such as annual physicals or screening tests, in order ease financial barriers and encourage seek care. We surveyed people California who had a consumer-directed plan found fewer than one five understood their exempted office visits, medical screenings from deductible, meaning this care was free modest copayment. Roughly said they delayed avoided visit,...
To compare drug costs and adherence among Medicare beneficiaries with the standard Part D coverage gap versus supplemental in 2006.Pharmacy data from Advantage Prescription Drug (MAPD) plans.Parallel analyses comparing aged 65+ diabetes an integrated MAPD a no (n=28,780); network-model generic-only during (n=14,984).Drug spending was 3 percent (95 confidence interval [CI]: 1-4 percent) 4 (CI: 1-6 lower full or coverage, respectively. Out-of-pocket expenditures were 189 higher 185-193 to...
Rationale: Statins, or HMG-CoA reductase inhibitors, may aid in the treatment of asthma through their pleiotropic antiinflammatory effects.Objectives: To examine effect statin therapy on asthma-related exacerbations using a large population-based cohort.Methods: Statin users aged 31 years greater with were identified from Population-Based Effectiveness Asthma and Lung population, which includes data five health plans. exposure assessed over 24-month observation period. medication possession...
The Affordable Care Act (ACA) increased funding for Federally Qualified Health Centers (FQHCs). We defined FQHC service areas based on patient use and examined the characteristics of that gained access post-ACA. using total counts by ZIP code from Uniform Data System (UDS) compared this approach with existing methods. then codes included in Medically Underserved Areas/Populations (MUA/Ps) vs. MUA/P did not gain to FQHCs between 2011-15. UDS data Primary Service Areas or counties a higher...
Health systems are increasingly addressing health-related social needs. The Massachusetts Flexible Services program (Flex) is a 3-year pilot to address food insecurity and housing by connecting Medicaid accountable care organization (ACO) enrollees community resources.
Abstract Objective To provide a research agenda and recommendations to address inequities in access health care. Data Sources Study Setting The Agency for Healthcare Research Quality (AHRQ) organized Health Equity Summit July 2022 evaluate what equity care means the context of AHRQ's mission delivery implementation portfolio. findings are result this Summit, subsequent convenings experts on from academia, industry, government. Design Multi‐stakeholder input author consensus framework key...
Objective: Individuals with severe mental illness (SMI) have a shorter life expectancy compared to the general population, largely due cardiovascular disease (CVD). In this report from Fixed Dose Intervention Trial of New England Enhancing Survival in SMI Patients (FITNESS), we examined baseline CVD risk factors and their treatment patients second generation antipsychotic (SGA) use. Methods: FITNESS enrolled 204 participants SGA use, but without documented history or diabetes mellitus,...
Background: Telestroke may mitigate racial/ethnic and rural disparities in access to acute stroke expertise. Objective: examine the relationship between patient race/ethnicity presentation an emergency department (ED) with capabilities, including telestroke, whether this varied by rurality. Methods: Data maintained California Department of Health Care Access Information identified all statewide encounters 2021. ED capabilities were from 2021 National Inventory-USA database (e.g., telestroke...
The aim of the study was to assess US inpatient and emergency department (ED) charges for functional neurologic disorder (FND), investigate subtype variations, compare costs with research funding. We used 2009-2019 Healthcare Cost Utilization Project data adult pediatric inpatient/ED stays associated in 2019 inflation-adjusted dollars, ICD-10-defined FND (F.44.4-F44.7) vs comparators neuroinflammatory/demyelinating diseases, refractory epilepsy, anterior horn cell diseases. NIH funding...
Variance reduction is sometimes considered as a goal of clinical quality improvement. among physicians, hospitals, or health plans has been evaluated the proportion total variance (or intraclass correlation, ICC) in measure; low ICCs have interpreted to indicate potential for improvement at that level. However, absolute amount variation, expressed clinically meaningful units, less frequently reported. Moreover, changes components not studied improves.To examine primary care physician and...
<h3>Importance</h3> The Patient Protection and Affordable Care Act (ACA) includes subsidies that reduce patient cost sharing for low-income families. Limited information on the effects of among children is available to guide these efforts. <h3>Objective</h3> To examine associations between sharing, income, care seeking financial stress with asthma. <h3>Design, Setting, Participants</h3> A telephone survey in 2012 about experiences during prior year within an integrated health delivery...
The Affordable Care Act expanded Medicaid and increased federal funding for Community Health Centers (CHCs). To examine the role of coverage on care patterns those with available safety net care, we assessed differences in access to CHC patients continuous vs. gaps insurance last year. We used data adult respondents from 2014 Center Patient Survey (N = 1720) some period without 12 months. examined reported need any medical mental health prescription drugs, dental referrals outside months,...
High deductible–based health insurance plans require consumers to pay for care until reaching the deductible amount. However, information is limited on how well understand their benefits and they respond these costs. In telephone interviews, we found that had knowledge about deductibles yet frequently reported changing care-seeking behavior because of cost. Poor effects design, with some avoiding services were exempt from deductible. Consumers need more decision support differentiate when...
Little is known about drug cost communications of Medicare Part D beneficiaries with chronic conditions such as diabetes. The purpose this study to assess diabetes' levels communication physicians regarding prescription costs; the perceived importance these communications; switching due cost; and self-reported cost-related medication non-adherence. Data were obtained from a cross-sectional survey (58% response rate) 1,458 diabetes who entered coverage gap in 2006; adjusted percentages...