A5090713082- Healthcare Systems and Reforms
- Global Health Care Issues
- Global Maternal and Child Health
- HIV/AIDS Research and Interventions
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Adolescent Sexual and Reproductive Health
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- HIV/AIDS Impact and Responses
- Child Nutrition and Water Access
- HIV-related health complications and treatments
- Pharmaceutical Economics and Policy
- Viral Infections and Outbreaks Research
- Parasites and Host Interactions
- Global Health Workforce Issues
- Tuberculosis Research and Epidemiology
- Transplantation: Methods and Outcomes
- Urinary Tract Infections Management
- Mechanical Circulatory Support Devices
- Cardiac pacing and defibrillation studies
- Video Surveillance and Tracking Methods
- Health disparities and outcomes
- Malaria Research and Control
- Healthcare cost, quality, practices
University of Washington
2021-2025
Institute for Health Metrics and Evaluation
2020-2025
Seattle University
2025
Massachusetts General Hospital
2024
Stanford University
2024
Swiss Tropical and Public Health Institute
2020-2022
University of Basel
2020-2022
International Rescue Committee
2016-2017
Johns Hopkins University
2015
Elizabeth Glaser Pediatric AIDS Foundation
2014
Importance Understanding the drivers of health care spending across US counties is important for developing policies and assessing allocation services. Objective To estimate amount cross-county variation explained by (1) population age, (2) condition prevalence, (3) service utilization, (4) price intensity. Design, Setting, Participants In this cross-sectional study, data 4 key per capita were extracted 3110 counties, 148 conditions, 38 age-sex groups, payers, 7 types 2019. Service...
Importance Understanding health conditions with the most spending and variation across locations over time is important for identifying trends, highlighting inequalities, developing strategies lowering spending. Objective To estimate US care each of 3110 counties, 4 payers (Medicare, Medicaid, private insurance, out-of-pocket payments), according to 148 conditions, 38 age/sex groups, 7 types from 2010 2019. Design, Setting, Participants Observational analysis using more than 40 billion...
Sustainable Development Goal (SDG) 3 aims to "ensure healthy lives and promote well-being for all at ages". While a substantial effort has been made quantify progress towards SDG3, less research focused on tracking spending this goal. We used estimates measure in financing the priority areas of examine association between outcomes financing, identify where resource gains are most needed achieve SDG3 indicators which data available.We estimated domestic health spending, disaggregated by...
Measuring health care spending by race and ethnicity is important for understanding patterns in utilization treatment.
Many low-income countries are in the process of scaling up health insurance with goal achieving universal coverage. However, little is known about usage and financial sustainability mandatory insurance. This study analyzes 26 million claims submitted to Tanzanian National Health Insurance Fund (NHIF), which covers two public servants for whom mandatory, understand patterns, cost drivers, sustainability. We find that 2016, half policyholders used a service within single year, an average...
BackgroundEstimates of government spending and development assistance for tuberculosis exist, but less is known about out-of-pocket prepaid private spending. We aimed to provide comprehensive estimates total on in low-income middle-income countries 2000–17.MethodsWe extracted data spending, unit costs, health-care use from the WHO global database, Global Fund proposals reports, National Health Accounts, WHO-Choosing Interventions that are Cost-Effective project Institute Metrics Evaluation...
Abstract Background As more countries progress towards malaria elimination, a better understanding of the most critical health system features for enabling and supporting control elimination is needed. Methods All available systems data relevant were collated from 23 online repositories. Principal component analysis was used to create domain specific performance measures. Multiple regression model selection approaches identify key predictors in 2000–2016 period among 105 countries....
Little is known about health care spending variation across the US for recent years. To estimate by state and payer, we combined data from government’s State Health Expenditure Accounts, which have estimates through 2014, with other primary on spending. In 2019 state-specific per person ranged $7,250 to $14,500. After adjustment inflation, annualized growth each 1.0 percent in Washington, D.C., 4.2 South Dakota between 2013 2019. The factors that explained most states were incomes (25.3...
The Lesotho Ministry of Health issued guidelines on active case finding (ACF) for tuberculosis (TB) and isoniazid preventive therapy (IPT) in April 2011. ACF has been recommended maternal child health (MCH) settings globally, however, the feasibility implementing IPT within MCH countries with high concurrent HIV TB epidemics is unknown.The study evaluated implementation 2 facilities Lesotho. This descriptive prospective analyzed data collected during routine services. Categorical continuous...
New tools, including light-emitting diode (LED) fluorescence microscopy and the molecular assay Xpert MTB/RIF, offer increased sensitivity for tuberculosis (TB) in persons with HIV but come higher costs. Using operational data from rural Malawi, we explored potential cost-effectiveness of on-demand screening TB low-income countries Sub-Saharan Africa.Costs were empirically collected 4 clinics 1 hospital using a microcosting approach, through direct interview observation national program...
Objective: Evaluate the clinical utility of patient-collected dried blood spots (DBS) in measuring HIV-1 viral load (VL) for monitoring antiretroviral therapy (ART) compared to provider-collected DBS and plasma. Design: In a randomized trial community-based delivery ART South Africa, we assessed performance of: specimens plasma, participant-collected vs. staff-collected specimens, measure VL. Methods: The bioMérieux NucliSENS EasyQ v2.0 assay was used VL measurement. From October 2017...
This study examines the relationship between pharmacy closures and anticonvulsant prescription fills number of days supplied.
Community-based delivery and monitoring of antiretroviral therapy (ART) for HIV has the potential to increase viral suppression individual- population-level health benefits. However, cost-effectiveness budget impact are needed public policy. We used a mathematical model transmission in KwaZulu-Natal, South Africa, estimate population prevalence, incidence, mortality, disability-adjusted life-years (DALYs) from 2020 2060 two scenarios: 1) standard clinic-based care 2) five-yearly home testing...
Objectives Current guidelines for the control of soil-transmitted helminths (STH) recommend deworming children and other high-risk groups, primarily using school-based (SBD) programmes. However, targeting individuals all ages through community-wide mass drug administration (cMDA) may interrupt STH transmission in some settings. We compared costs cMDA to SBD inform decision-making about future updates policy. Design conducted activity-based microcosting 2 years Benin, India Malawi within an...
Abstract Antiretroviral therapy (ART) is needed across the lifetime to maintain viral suppression for people living with HIV. In South Africa, obstacles reliable access ART persist and are magnified in rural areas, where HIV services also typically costlier deliver. A recent pilot randomized study (the Deliver Health Study) found that home-delivered refills, provided at a low user fee, effectively overcame logistical barriers improved clinical outcomes Africa. present costing using payer...
Background: The 2021 Price Transparency Final Rule required hospitals to publicly disclose commercial prices for all medical services. Using data made available by this legislation, we investigated variation in inpatient percutaneous coronary intervention (PCI). Hypothesis: We hypothesized that there would be substantial differences between and within associated with factors such as market competitiveness rather than patient outcomes. Methods: PCI hospitalization (MS-DRG 247-251) were...
Antiretroviral therapy (ART) is needed across the lifetime to maintain viral suppression for people living with HIV. In South Africa, obstacles reliable access ART persist and are magnified in rural areas, where HIV services also typically costlier deliver. A recent pilot randomized study (the Deliver Health Study) found that home-delivered refills, provided at a low user fee, effectively overcame logistical barriers improved clinical outcomes Africa. present costing using provider...
Purpose: In 2015, Community Event-Based Surveillance (CEBS) was implemented in Sierra Leone to provide an early warning system for Ebola virus disease (EVD), using a pre-established network of Health Workers (CHWs) generate alerts "trigger events" indicative EVD. We analysed the demographic breakdown sex and age-specific reporting trends within CEBS system. Methods & Materials: Alerts generated by from February 27, 2015-June 30, 2016 were described type trigger event (sick, death, unsafe...
To estimate health care systems' value in treating major illnesses for each US state and identify system characteristics associated with value.Annual condition-specific death incidence estimates from the Global Burden Disease 2019 Study annual spending per person National Health Expenditure Accounts.Using non-linear meta-stochastic frontier analysis, mortality ratios 136 treatable were regressed separately on capita key covariates such as age, obesity, smoking, educational attainment. State-...
Objective To present a costing study integrated within the DeWorm3 multi-country field trial of community-wide mass drug administration (cMDA) for elimination soil-transmitted helminths. Design Tailored data collection instruments covering resource use, expenditure and operational details were developed each site. These populated alongside activities by on-site staff. Data quality control validation processes established. Programmed routines used to clean, standardise analyse derive costs...
Abstract Introduction Community-based delivery and monitoring of antiretroviral therapy (ART) for HIV has the potential to increase viral suppression individual- population-level health benefits. However, cost-effectiveness budget impact are needed public policy. Methods Findings We used a mathematical model transmission in KwaZulu-Natal, South Africa, estimate population prevalence, incidence, mortality, disability-adjusted life-years (DALYs) from 2020 2060 two scenarios: 1) standard...
ObjectiveTo assess whether the change in death swabbing policy SierraLeon has begun to affect community reporting, we analyzedtrends reporting before and after change.IntroductionStemming from 2014-6 Ebola virus disease (EVD) outbreak,community event based surveillance (CEBS) was implemented inSierra Leone using health workers generate alerts fortrigger events suggestive of EVD transmission. Through September30, 2015 (last month active transmission), majority (86%)of reflected deaths; this...