A5054693994- Patient Satisfaction in Healthcare
- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Pharmaceutical Practices and Patient Outcomes
- Emergency and Acute Care Studies
- Global Health Workforce Issues
- Telemedicine and Telehealth Implementation
- Health Systems, Economic Evaluations, Quality of Life
- Patient Safety and Medication Errors
- Geriatric Care and Nursing Homes
- Patient-Provider Communication in Healthcare
- Medication Adherence and Compliance
- Hospital Admissions and Outcomes
- Healthcare Systems and Technology
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Blood Pressure and Hypertension Studies
- Heart Failure Treatment and Management
- Healthcare cost, quality, practices
- Atrial Fibrillation Management and Outcomes
- Trauma and Emergency Care Studies
- Health Literacy and Information Accessibility
- Palliative Care and End-of-Life Issues
- Diversity and Career in Medicine
- Venous Thromboembolism Diagnosis and Management
- Health disparities and outcomes
Iowa City VA Health Care System
2015-2025
University of Iowa
2016-2025
GGG (France)
2024
University of Iowa Health Care
2024
H. Henriksen (Norway)
2023
Veterans Health Administration
2002-2022
Health Services Research & Development
2005-2022
VA Puget Sound Health Care System
2019-2022
University of Washington
2020-2022
Society of General Internal Medicine
2022
OBJECTIVES: To evaluate the relationship between inappropriate prescribing, medication underuse, and total number of medications used by patients. DESIGN: Cross‐sectional study. SETTING: Veterans Affairs Medical Center. PARTICIPANTS: One hundred ninety‐six outpatients aged 65 older who were taking five or more medications. MEASUREMENTS: Inappropriate prescribing was assessed using a combination Beers drugs‐to‐avoid criteria (2003 update) subscales Medication Appropriateness Index that assess...
Previous studies of hospital readmission have focused on specific conditions or populations and generated complex prediction models.To identify predictors early in a diverse patient population derive validate simple model for identifying patients at high risk.Prospective observational cohort study.Participants encompassed 10,946 discharged home from general medicine services six academic medical centers were randomly divided into derivation (n = 7,287) validation 3,659) cohorts.We identified...
<h3>Context</h3>Total hip arthroplasty is a common surgical procedure but little known about longitudinal trends.<h3>Objective</h3>To examine demographics and outcomes of patients undergoing primary revision total arthroplasty.<h3>Design, Setting, Participants</h3>Observational cohort 1 453 493 Medicare Part A beneficiaries who underwent 348 596 arthroplasty. Participants were identified using International Classification Diseases, Ninth Revision, Clinical Modification codes for between 1991...
Chinese translation Background: Reducing length of stay (LOS) has been a priority for hospitals and health care systems. However, there is concern that this reduction may result in increased hospital readmissions. Objective: To determine trends LOS 30-day readmission rates all medical diagnoses combined 5 specific common the Veterans Health Administration. Design: Observational study from 1997 to 2010. Setting: All 129 acute Affairs United States. Patients: 4 124 907 admissions with...
Explicit measures of potentially inappropriate prescribing, such as the Beers criteria, have been associated with risk for adverse drug events (ADEs). However, no link has established actual prescribing using implicit measures.To determine whether an measure can predict ADE risk.Patients were veterans aged 65 years and older who seen in primary care clinics participated a randomized controlled trial pharmacist-physician collaborative intervention. Inappropriate was determined at baseline,...
Background. Relationships between day of the week admission to hospitals and hospital outcomes have been poorly studied. Intensive care units (ICUs) appear be uniquely suited examine such a question given unpredictability ICU admissions clinical instability their patient populations. Methods. This retrospective cohort study included 156,136 patients admitted 38 ICUs in 28 large Midwestern metropolitan area during 1991 1997. Demographic data were collected from patients’ medical records used...
Patients admitted to general medicine inpatient services are increasingly cared for by hospital-based physicians rather than their primary care providers (PCPs). This separation of hospital and ambulatory may result in important discontinuities after discharge. We sought determine whether communication between PCPs influences patient outcomes.
Purpose: The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of VHA scheme, we compared its categories 3 Office Management and Budget (OMB) 4 Rural-Urban Commuting Area (RUCA) geographical categories. Method: Using residence information for health care enrollees, urban-rural classifications under VHA, OMB, RUCA schemes; distributions rural enrollees across networks (Veterans...
Survey response rate is regarded as a key data-quality indicator, yet not necessarily predictive of nonresponse bias. Our study objective was to use high-response-rate survey assess bias across successive waves. This healthcare leaders utilized web-based, self-report format with an initial invitation and four nonrespondent follow-ups. Across five waves, comparisons were made for demographic facility characteristics, proportion items completed, distribution three question types: factual...
Many hospitals have undertaken initiatives to improve care during the end of life, recognizing that some individuals unique needs are often not met in acute inpatient settings. Studies surgical patients shown this population receive palliative at reduced rates comparison with medical patients.To determine differences use and hospice between an integrated health system.Veterans Health Administration (VHA) enrollment data administrative sets were used identify 191,280 VHA who died October 1,...
Health literacy is an important priority in health care delivery, but its effect on clinical outcomes remains incompletely elucidated. This observational cohort study examined the association of with medication knowledge, adherence, and adverse drug events among cognitively intact veterans older than 65 years old who were taking 5 or more medications enrolled a Veterans Administration primary clinic. was determined by Rapid Estimate Adult Literacy Medicine. Medication knowledge adherence...
Pharmacists may improve medication-related outcomes during transitions of care. The aim the Iowa Continuity Care Study was to determine if a pharmacist case manager (PCM) providing faxed discharge medication care plan from tertiary institution primary could appropriateness and reduce adverse events, rehospitalization emergency department visits.Design. Randomized, controlled trial 945 participants assigned enhanced, minimal usual groups conducted 2007 2012. Subjects. Participants with...
Unintentional discrepancies across care settings are a common form of medication error and can contribute to patient harm. Medication reconciliation reduce discrepancies; however, effective implementation in real-world is challenging.We conducted pragmatic quality improvement (QI) study at five US hospitals, two which included concurrent controls. The intervention consisted local best practices, utilising an evidence-based toolkit with 11 components. Trained QI mentors monthly site phone...
Abstract Background The COVID-19 pandemic encouraged telemedicine expansion. Research regarding follow-up healthcare utilization and primary care (PC) is lacking. Objective To evaluate whether differed across PC populations using telemedicine. Design Retrospective observational cohort study administrative data from veterans with minimally one visit before the (March 1, 2019–February 28, 2020) after in-person restrictions were lifted (October 2020–September 30, 2021). Participants All...
Context: Rural persons with human immunodeficiency virus (HIV) face many barriers to care, but little is known about rural-urban variation in HIV outcomes. Objective: To determine the association between rural residence and Design, Setting, Patients: Retrospective cohort study of mortality among initiating care Veterans Administration (VA) during 1998–2006, follow-up through 2008. was determined using Urban Commuting Area codes. We identified 8489 VA no evidence combination antiretroviral...
Unresolved medication discrepancies during hospitalization can contribute to adverse drug events, resulting in patient harm. Discrepancies be reduced by performing reconciliation; however, effective implementation of reconciliation has proven challenging. The goals the Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS) are operationalize best practices for inpatient reconciliation, test their effect on potentially harmful unintentional discrepancies, and understand...