A5081259110- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Chronic Disease Management Strategies
- Patient Satisfaction in Healthcare
- Global Health Care Issues
- Health Systems, Economic Evaluations, Quality of Life
- Telemedicine and Telehealth Implementation
- Global Health Workforce Issues
- COVID-19 and healthcare impacts
- Health disparities and outcomes
- Medication Adherence and Compliance
- Geriatric Care and Nursing Homes
- COVID-19 and Mental Health
- Mobile Health and mHealth Applications
- Healthcare professionals’ stress and burnout
- Bariatric Surgery and Outcomes
- Pharmaceutical Practices and Patient Outcomes
- Healthcare cost, quality, practices
- Emergency and Acute Care Studies
- Obesity, Physical Activity, Diet
- Employment and Welfare Studies
- Diversity and Career in Medicine
- Long-Term Effects of COVID-19
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Policy Implementation Science
University of Washington
2016-2025
VA Puget Sound Health Care System
2016-2025
Northwest University
2024-2025
ID-FISH Technology (United States)
2025
Health Services Research & Development
2014-2024
Center for Innovation
2014-2024
VA Center for Clinical Management Research
2024
VA Palo Alto Health Care System
2018-2024
Veterans Health Administration
2022-2024
United States Department of Veterans Affairs
2019-2024
In 2010, the Veterans Health Administration (VHA) began implementing patient-centered medical home (PCMH) model. The Patient Aligned Care Team (PACT) initiative aims to improve health outcomes through team-based care, improved access, and care management. To track progress evaluate at all VHA primary clinics, we developed validated a method assess PCMH implementation.To create an index that measures extent of implementation, describe variation in examine association between implementation...
Abstract Objective To examine whether nurse practitioner (NP)‐assigned patients exhibited differences in utilization, costs, and clinical outcomes compared to medical doctor (MD)‐assigned patients. Data Sources Veterans Affairs (VA) administrative data capturing characteristics, outcomes, provider assignments of 806 434 VA assigned an MD primary care (PCP) who left practice between 2010 2012. Study Design We applied a difference‐in‐difference approach comparing reassigned NP PCPs,...
The Veterans Health Administration (VHA) has historically served a disproportionately male patient population with lower income and greater rates of mental illness than non-VHA populations. generalizability research based on VHA enrollees is unknown because the overlap between populations never been empirically examined. This study used 2013 National Interview Survey data to examine extent which had similar demographic health characteristics as individuals Medicaid, Medicare, or private...
In 2010 the Veterans Health Administration (VHA) began a nationwide initiative called Patient Aligned Care Teams (PACT) that reorganized care at all VHA primary clinics in accordance with patient-centered medical home model. We analyzed data for fiscal years 2003–12 to assess how trends health use and costs changed after implementation of PACT. found PACT was associated modest increases visits decreases both hospitalizations ambulatory care–sensitive conditions outpatient mental specialists....
Abstract Purpose Interactive clinical video telemedicine (CVT) has the potential to benefit health care systems and patients by improving access, lowering costs, more efficiently distributing providers. However, there is a gap in current knowledge around demand for uses of CVT large integrated systems. Methods We conducted an observational study using Veterans Health Administration (VHA) administrative databases analyze trends utilization, types received, among 7.65 million veterans during...
Importance The association of COVID-19 infection with outpatient care utilization is unclear. Many studies reported population surveillance rather than comparing health use between COVID-19–infected and uninfected cohorts. Objective To compare across 6 categories (primary care, specialty surgery mental health, emergency diagnostic and/or other care) veterans or without infection. Design, Setting, Participants In a retrospective cohort study Veterans Affairs primary patients, were matched to...
Abstract Background Breast cancer screening (BCS) inequities are evident at national and local levels, many health systems want to address these inequities, but may lack data about contributing factors. The objective of this study was inform system interventions through an exploratory analysis potential multilevel contributors BCS using data. Methods authors conducted a cross‐sectional within large academic including 19,774 individuals who identified as Black ( n = 1445) or White 18,329)...
Little is known about the characteristics of individuals using urgent care centers or walk-in retail clinics, collectively called convenience clinics (CC), as places usual care. Using 2022 National Health Interview Survey data and logistic regression, we identified factors associated with adults CCs regularly. Among a place care, 7.5% reported receiving at CCs. Individuals who were younger, working, uninsured significantly more likely to report their source Understanding CC users critical...
Abstract Background As social need screening and intervention activities increase, the long-term objective of our work is to inform how implement health into healthcare settings. The purpose this study assess changes in needs over time between two support programs as part a integration effort primary care clinics within an integrated system Washington state. Methods We used stratified randomization assign 535 patients who self-reported on screener October 2022-January 2023 one programs:...
Objective To examine associations between clinics’ extent of patient‐centered medical home ( PCMH ) implementation and improvements in chronic illness care quality. Data Source from 808 Veterans Health Administration VHA primary clinics nationwide implementing the Patient Aligned Care Teams PACT initiative, begun 2010. Design Clinic‐level longitudinal observational study that received training resources to implement . Clinics varied they had components place by 2012. Collection Clinical...
Objective To examine the long‐term reliance on outpatient care at population (i.e., system) level among fee‐for‐service Medicare‐enrolled elderly veterans in Department of Veterans Affairs ( VA ) health system and Medicare from 2003 to 2014. Data Sources/Study Setting We analyzed a 5 percent random sample, stratified by facility, age, gender, race, enrolled primary panel using administrative data claims. Study Design performed repeated cross‐sectional analysis over 48 quarters. was defined...
Abstract Introduction Racial/ethnic disparities exist in the Veterans Health Administration (VHA), despite financial barriers to care being largely mitigated and Administration’s (VA) organizational commitment health equity. Accurately identifying minority veterans is critical monitoring progress toward equity as VHA treats an increasingly racially ethnically diverse veteran population. Although VHA’s completeness of race ethnicity data generally better than its public sector private...
Understanding how SARS-CoV-2 infection impacts long-term patient outcomes requires identification of comparable persons with and without infection. We report the design implementation a matching strategy employed by Department Veterans Affairs' (VA) COVID-19 Observational Research Collaboratory (CORC) to develop cohorts infected uninfected for purpose inferring potential causative adverse effects in Veteran population.In retrospective cohort study, we identified VA health care system...
Many previous studies estimating the relationship between body mass index (BMI) and mortality impose assumptions regarding functional form for BMI result in conflicting findings. This study investigated a flexible data driven modelling approach to determine nonlinear asymmetric used examine obesity. was then compared against other commonly regression models. from National Health Interview Survey, 1997 2000. Respondents were linked Death Index with follow-up through 2005. We estimated 5-year...
In the United States, more than 25 million people have diabetes. Medication adherence is known to be important for disease control. However, factors that consistently predict medication are unclear and literature lacks patient perspectives on how health care systems affect oral hypoglycemic agents (OHAs). This study explored facilitators barriers OHA by obtaining of Veterans Affairs (VA) patients with prescriptions.A total 45 participated in 12 focus groups a wide range issues might...
Abstract Background Experts recommend that treatment for substance use disorder (SUD) be integrated into primary care. The Digital Therapeutics Opioids and Other SUD (DIGITS) Trial tests strategies implementing reSET® reSET-O®, which are prescription digital therapeutics opioid disorder, respectively, include the community reinforcement approach, contingency management, fluency training to reinforce concept mastery. This purpose of this trial is test whether two implementation improve...