Information Gains versus Hassle Costs: How Do Prescription Drug Monitoring Programs Reduce Opioid Prescribing?
Abstract: In the U.S., opioid overdoses, abuse and diversion have increased dramatically over the last two decades creating an unprecedented public health crisis. Interventions targeted at physician prescribing may play an important role in reducing opioid abuse. In this project, we will study the consequences of one of the most widely adopted physician interventions– Prescription Drug Monitoring Programs (PDMPs).
Housing Affordability and Health Outcomes: a Longitudinal Study of Community Dwelling Older Adults in the U.S. from 2006-2016
Abstract: As U.S. healthcare shifts toward value-based payment, health systems and policy makers are starting to consider housing affordability as an important social determinant of health. However, little is known about the association of housing affordability with health outcomes among older adults. Several pathways may link housing affordability to health consequences among older people. First, housing affordability may act as a competing demand that diverts resources from one’s health and self-care, leading to higher healthcare utilization.
Does access to gynecologic oncologists or medical oncologists affect outcomes for advanced gynecologic cancers? Impact of provider specialty on survival outcomes, health care utilization, and spending.
Abstract: The aim of the proposed pilot study is to examine the impact of provider specialty on health care utilization and spending for women with advanced gynecologic cancers. Currently, women with advanced gynecologic cancer may receive chemotherapy from one of two specialty providers, gynecologic oncologists or medical oncologists, due to geographic-based availability of providers, health insurer network coverage, or other patient, provider, and systems factors.
Opioid Initiation and Conversion to Persistent Use Related to Childbirth among Low-Income Young Philadelphia Mothers
Abstract: Opioid use among women of child-bearing age has increased dramatically in recent years, becoming one of the leading causes of death among young adults in the United States. Long term opioid use often begins with treatment for a painful injury or condition, including childbirth. Identifying vulnerable populations at highest risk for conversion to persistent opioid use following prescription at childbirth is one strategy for targeted intervention at the clinician and patient levels.
Dialysis facility joint ventures: do resource utilization and health outcomes vary by ownership status of dialysis facilities?
Abstract: Dialysis facility joint ventures (JVs) allow a nephrologist or group of nephrologists to partner with a dialysis company to share in the management, profits, and losses of an outpatient dialysis facility. Proponents of JVs argue that these arrangements align the interests of nephrologists and dialysis companies to drive improved clinical outcomes and increased patient satisfaction. Others have cautioned that JVs create financial conflicts of interest for participating nephrologists that may inappropriately influence decisions about patient care.
Abstract: Many physicians receive payments and other in-kind compensation from companies that produce products they can prescribe, inject, or recommend.
Trends in Durable Ventricular Assist Device Implantation Rates with the Affordable Care Act and Medicaid Expansion
Abstract: The Affordable Care Act (ACA) lead to one of the largest expansion of health insurance coverage in non-elderly adults, particularly in those eligible for Medicaid. There is evidence that the ACA has led to increases in healthcare utilization and access. However, the impact on health outcomes for patients is still unclear. There are only two treatment options for patients with end-stage heart failure that can prolong life and improve quality of life long term, heart transplantation and ventricular assist device (VAD) implantation.
Abstract: The opioid crisis is devastating American communities. The emergency department (ED) provides life-saving care to patients who overdose and offers opportunities to engage patients in long-term treatment for opioid use disorder (OUD). Early initiation of medication-assisted treatment (MAT) and referral to community treatment resources from the ED are evidence-based strategies for preventing opioid overdose death. However, it is presumed that few patients who are treated for opioid-related illness in the ED successfully transition to ambulatory treatment.
Evaluating Nursing Home Compare 5-Star Ratings as an Indicator of Skilled Nursing Facility Quality for Veterans
Principal Investigator: Kirstin Manges, PhD
Abstract: The deportation of undocumented immigrants has increased since the 2016 presidential election. The increased rate of immigration enforcement might discourage undocumented patients from receiving healthcare. My hypothesis is that there has been a decrease in primary care utilization and an increase in inpatient utilization amongst undocumented immigrants since the 2016 election.
Examining Outcomes associated with Delivering Medication-Assisted Treatment for Opioid Addiction through a Mobile Medication Unit
Abstract: This application proposes to examine the impact of a mobile treatment unit for opioid-dependent individuals compared with fixed sites. Despite the critical role mobile medication-assisted treatment (MAT) units could play in combatting the opioid epidemic, there is remarkably little research examining who is treated in these units and the outcome of these individuals compared with those treated in brick-and-mortar facilities.
Abstract: Issuers participating in the Health Insurance Exchange (the exchange) have always been concerned about adverse selection. The community rating on the exchange combined with lack of information on the insurees’ health, risk preference, and propensity to use healthcare services makes the on-exchange plans vulnerable to adverse selection. Severe adverse selection will force insures to leave the market, undermining the affordability of insurance plans, eventually hurting consumers’ welfare.
Do Simple Structural Home Repairs Improve the Health of Low-Income Philadelphians and Their Neighborhoods? An Evaluation of Philadelphia’s Basic Systems Repair Program
Background: The places where people live, work, and play can be significant sources of poor health and persistent health disparities. Housing is one such place.
Leveraging National Databases to Understand Access to Medication-Assisted Treatment for Opiate Abuse under Medicaid
Abstract: Fatalities from opiate overdose among young and middle-aged adults have risen to epidemic levels. This proposal will measure the impact of Medicaid, and specifically Medicaid expansions through the Affordable Care Act (ACA), on mitigating this public health threat. We propose to examine the association between ACA expansion and changes in prescriptions for medication-assisted treatment (MAT), as measured by prescriptions for methadone, buprenorphine, and naltrexone.
Abstract: CPHI is proposing a multidisciplinary “Safe Injection Facility (SIF) Evaluation Working Group” composed of faculty, fellows, and relevant stakeholders from the city and the drug-using community. SIFs are legally sanctioned locations that provide people who use drugs with a clean, safe, non-judgmental space to use with medical oversight and oftentimes access to social services. Limited data from other countries shows improvements in both individual and community health.