A5069088469- Healthcare Policy and Management
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac, Anesthesia and Surgical Outcomes
- Forgiveness and Related Behaviors
- Grief, Bereavement, and Mental Health
- Antibiotics Pharmacokinetics and Efficacy
- Primary Care and Health Outcomes
- Global Cancer Incidence and Screening
- Anesthesia and Pain Management
- Antibiotic Resistance in Bacteria
- Hip and Femur Fractures
- Healthcare cost, quality, practices
- Patient Satisfaction in Healthcare
- Bacterial Identification and Susceptibility Testing
- Antibiotic Use and Resistance
- Conflict Management and Negotiation
- Global Health Care Issues
- Antimicrobial Resistance in Staphylococcus
- Colorectal Cancer Screening and Detection
- Emotions and Moral Behavior
- Breast Cancer Treatment Studies
- Frailty in Older Adults
- Optimism, Hope, and Well-being
- Antifungal resistance and susceptibility
- Religion, Spirituality, and Psychology
University of Pittsburgh Medical Center
2021-2025
University of Pittsburgh
2021-2025
UPMC Health System
2021-2023
Hospital of the University of Pennsylvania
2014-2021
VA Pittsburgh Healthcare System
2021
Children's Hospital of Philadelphia
2012-2018
California State University, Fullerton
2018
UPMC Hillman Cancer Center
2014
University of Pennsylvania
2013-2014
Oklahoma Foundation for Medical Quality
2014
Hip fracture is a common, morbid, and costly event among older adults. Data are inconclusive as to whether epidural or spinal (regional) anesthesia improves outcomes after hip surgery.The authors examined retrospective cohort of patients undergoing surgery for in 126 hospitals New York 2007 2008. They tested the association record indicating receipt regional versus general with primary outcome inpatient mortality secondary pulmonary cardiovascular complications using hospital fixed-effects...
<h3>Importance</h3> Difference in breast cancer survival by race is a recognized problem among Medicare beneficiaries. <h3>Objective</h3> To determine if racial disparity primarily attributable to differences presentation characteristics at diagnosis or subsequent treatment. <h3>Design, Setting, and Patients</h3> Comparison of 7375 black women 65 years older diagnosed between 1991 2005 3 sets matched white control patients selected from 99 898 potential controls, using data for 16 US...
More than 300,000 hip fractures occur each year in the United States. Recent practice guidelines have advocated greater use of regional anesthesia for fracture surgery.To test association (ie, spinal or epidural) vs general with 30-day mortality and hospital length stay after fracture.We conducted a matched retrospective cohort study involving patients 50 years older who were undergoing surgery at acute care hospitals New York State between July 1, 2004, December 31, 2011. Our main analysis...
The literature suggests that hospitals with better nursing work environments provide quality of care. Less is known about value (cost vs quality).To test whether displayed than those worse and to determine patient risk groups associated the greatest value.A retrospective matched-cohort design, comparing outcomes cost patients at focal recognized nationally as having good nurse working nurse-to-bed ratios 1 or greater control group without such recognition less 1. This study included 25 752...
Differences in colon cancer survival by race are a recognized problem among Medicare beneficiaries.To determine to what extent the racial disparity is due presentation characteristics at diagnosis or subsequent treatment.Black patients with were matched 3 groups of white patients: "demographic characteristics" match controlling for age, sex, year, and Survey, Epidemiology, End Results (SEER) site; "presentation" demographic plus comorbid conditions tumor characteristics, including stage...
Among consecutive patients with multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia we found those treated ceftazidime-avibactam were more likely to develop resistance (defined as ≥4-fold increased MIC) than ceftolozane-tazobactam (40% vs 10%; P = .002). Ceftazidime-avibactam was associated new mutations in ampC and efflux regulatory pathways.
Develop an improved method for auditing hospital cost and quality.Medicare claims in general, gynecologic urologic surgery, orthopedics from Illinois, Texas, New York between 2004 2006.A template of 300 representative patients was constructed then used to match at hospitals that had a minimum 500 over 3-year study period.From each 217 we chose most resembling the using multivariate matching.The matching algorithm found close matches on procedures patient characteristics, far more balanced...
Abstract Background Necrotizing soft tissue infections (NSTIs) are life-threatening infections. The aim of this study is to evaluate the safety clindamycin plus vancomycin versus linezolid as empiric treatment NSTI. Methods Retrospective, single-center, quasi-experimental patients admitted from June 1, 2018 30, 2019 (pre-intervention) and May 2020 October 15, 2021 (post-intervention). Patients who received surgical management within 24 hours NSTI diagnosis at least one dose or were included....
Abstract Background Successful use of carbapenems in combination with cefazolin or oxacillin for treatment MSSA bacteraemia has been described; however, comparative data to standard approaches are lacking. Methods This was a multicentre, retrospective study adult patients &gt;48 h. Standard considered monotherapy cefazolin, nafcillin. Combination therapy defined as the addition ertapenem meropenem at least 24 The primary outcome duration time from administration an antibiotic vitro...
In the current research, we tested downstream effects of divine forgiveness (i.e., perceived by God) on interpersonal apology behavior through two counteracting pathways: an inhibiting pathway self-forgiveness, and a facilitating gratitude humility. Study 1 (N = 435), using recalled offenses, found that higher was positively associated with which in turn negatively behavior. 2 531), offenses experimental design, replicated our findings from whereby (vs. control) promoted greater However,...
Abstract Background Shorter antibiotic courses are non-inferior to longer for treatment of uncomplicated gram-negative bacteremia (GNB). This study evaluated the impact a pharmacist-driven stewardship effort use clinical decision support software (CDSS; ILÚM Insight, Infectious Diseases Connect, Inc.) plus an evidence-based algorithm on duration therapy (DOT) GNB in UPMC health system, USA. Methods retrospective cohort utilized CDSS alerts Enterobacterales adults from March August 2022...
In the current research, we tested downstream effects of divine forgiveness (i.e., perceived by God) on interpersonal apology behavior through two counteracting pathways: an inhibiting pathway self-forgiveness and a facilitating gratitude humility. Study 1 ( N = 435), using recalled offenses, found that higher was positively associated with self-forgiveness, which in turn negatively behavior. 2 531), offenses experimental design, replicated our findings from whereby (vs. control) promoted...
Neuman, Mark D.*; Silber, Jeffrey H.*†; Elkassabany, Nabil M.*; Ludwig, Justin M.†; Fleisher, Lee A.* Author Information
Objective: Characterize the distribution of healthcare utilization associated with pre-operative frailty in year following evaluation by a surgeon. Summary Background Data: Frailty is increased morbidity, mortality, and costs for surgical patients. However, total financial burden frail patients beyond index surgery inpatient stay remains unknown. Methods: Prospective cohort assembled from February 2016 to December 2020 within multi-hospital integrated delivery finance system (IDFS),...
Racial disparities in general surgical outcomes are known to exist but not well understood.To determine if black-white surgery mortality for Medicare patients attributable poorer health status among blacks on admission or differences the quality of care provided by admitting hospitals.Matched cohort study using Tapered Multivariate Matching.All black elderly (N=18,861) and white-matched controls within same 6 states 838 hospitals.Thirty-day (primary); others include in-hospital mortality,...
<h3>Importance</h3> Asthma is the most prevalent chronic illness among children, remaining a leading cause of pediatric hospitalizations and representing major financial burden to many health care systems. <h3>Objective</h3> To implement new auditing process examining whether differences in hospital practice style may be associated with potential resource savings or inefficiencies treating asthma admissions. <h3>Design, Setting, Participants</h3> A retrospective matched-cohort design study,...
Objective Develop an improved method for auditing hospital cost and quality tailored to a specific hospital's patient population. Data Sources/Setting Medicare claims in general, gynecologic urologic surgery, orthopedics from Illinois, New York, Texas between 2004 2006. Study Design A template of 300 representative patients single index was constructed used match at 43 hospitals that had minimum 500 over 3‐year study period. Collection/Extraction Methods From each we chose most resembling...
Using Pennsylvania Medicare claims from 1995 to 1996, the authors previously reported that anesthesia procedure length appears longer in blacks than whites. In a new study using different and larger data set, now examine whether body mass index (BMI), not available claims, explains this difference. The also relative contributions of surgical times.
Objective To develop a method to allow hospital compare its performance using entire patient population the outcomes of very similar patients treated elsewhere. Data Sources/Setting Medicare claims in orthopedics and common general, gynecologic, urologic surgery from Illinois, New York, Texas 2004 2006. Study Design Using two example “focal” hospitals, each hospital's were matched 10 selected 619 other hospitals. Collection/Extraction Methods All used at focal hospital, we found closest...
Objective: To characterize patterns of healthcare utilization before and after surgery determine any association with pre-operative frailty. Summary Background Data: Frail patients experience worse post-operative outcomes increased costs during the surgical encounter. Evidence is comparatively lacking for longer-term effects frailty on utilization. Methods: Retrospective, longitudinal cohort analysis adult undergoing elective procedure following assessment Risk Analysis Index (RAI) from...
BACKGROUND: Direct oral anticoagulants (DOACs) have become widely used for the prevention of stroke in nonvalvular atrial fibrillation (AF) and treatment venous thromboembolism (VTE). Warfarin, standard care prior to DOACs, requires monitoring dose adjustment ensure patients remain appropriately anticoagulated. DOACs do not require but are significantly more expensive. We sought examine real-world effectiveness costs warfarin with AF VTE. OBJECTIVE: To clinical economic outcomes. The...