Publications

Integrating Social Needs Into Health Care: A Twenty-Year Case Study Of Adaptation And Diffusion

Feb. 14, 2018

Rebecca D. Onie, Risa Lavizzo-Mourey, Thomas H. Lee, James S. Marks, and Rocco J. Perla

In Health Affairs, Rebecca Onie and colleagues, including Risa Lavizzo-Mourey, conduct a twenty-year qualitative case study of Health Leads, an organization that partners with health care institutions and communities to address patients’ basic resource needs, and its funders. The case study demonstrates the successful stages of diffusion, defined as the process by which an innovation is communicated over time within a social system, leading to increased exposure and adoption. The authors segmented the process for Health Leads into five distinct phases:

  1. Testing and
  2. ...

The Use of Individual Provider Performance Reports by US Hospitals

Feb. 13, 2018

In the Journal of Hospital Medicine, Joshua Rolnick and Kira Ryskina analyze trends in how hospitals use the electronic health record to track and provide feedback on provider performance. The authors use data from a nationally representative survey of US hospitals from 2013 to 2015 to identify hospitals that have used electronic data to create individual provider performance profiles (IPPs). They model how the odds of IPP use differ as a function of hospital characteristics, including ownership (non-profit, for-profit, or government), geographic region, teaching versus...

Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis

Feb. 12, 2018

Ashish P. Thakrar, Alexandra D Forrest, Mitchell G. Maltenfort, and Christopher B. Forrest

In Health Affairs, Christopher Forrest and colleagues analyze mortality trends in the United States and 19 comparator nations for children ages 0-19 from 1961 to 2010. Membership in the Organisation for Economic Cooperation and Development (OECD) was used as a proxy for countries with similar levels of economic development and political structure as the United States.

The authors observed a decline in child mortality in all 20 countries over the 50-year period. Despite this achievement, reductions in mortality rates were not evenly distributed across nations; childhood...

Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs

Feb. 1, 2018

Jessica G. Smith, Jeannette A. Rogowski, Kathryn M. Schoenauer, ...

In the Journal of Perinatal and Neonatal Nursing, Jessica Smith and colleagues, including Jeannette Rogowski and Eileen Lake, investigate how infants in drug withdrawal compare with nondrug withdrawal infants to inform proper nurse assignments based on infant acuity and parental needs. Though not commonly recognized, a troubling aspect of the opioid epidemic is increased drug use among pregnant women, which has led to an increase in infants who are...

Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs

Feb. 1, 2018

R. Tamara Konetzka, Meghan M. Skira and Rachel M. Werner

In the American Journal of Health Economics, Rachel Werner and colleagues analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented pay-for-performance (P4P) programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, the authors examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in...

Evaluating the association between the built environment and primary care access for new Medicaid enrollees in an urban environment using Walk and Transit Scores

Jan. 24, 2018

Krisda H. Chaiyachati, Jeffrey K. Hom, Rebecca A. Hubbard, Charlene Wong, and ...

In Preventive Medicine Reports, Krisda Chaiyachati and colleagues, including Jeffrey Hom and David Grande, describe the association between the quality of an individual’s built environment, as reflected by Walk Score™ (a measure of walkability to neighborhood resources) and Transit Score™ (a measure of transit access), with having a usual source of care among low-income adults in Philadelphia. They ascertained usual source of care (other than a hospital or emergency department) with the question: “Is there a particular doctor's office, clinic, health center, or other place that...

Relationship Between State-Level Google Online Search Volume and Cancer Incidence in the United States: Retrospective Study

Jan. 18, 2018

Charles A Phillips,  Allison Barz Leahy, Yimei Li,  Marilyn M Schapira, L Charles Bailey, ...

Do online searches reflect the underlying epidemiology of cancer in a region, and is search frequency affected by cancer-related public events and celerity news? In the Journal of Medical Internet Research, Charles Phillips and colleagues, including Marilyn Schapira and Raina Merchant, examine the association of Google search activity with the incidence of six common cancers over time in the United States. The authors used 2004-2013 data from the Centers for Disease Control and Prevention (CDC) and Google Trends (GT), an application that can track the relative search frequency of...

Patient satisfaction with hospital care and nurses in England: an observational study

Jan. 11, 2018

Linda H. Aiken, Douglas M. Sloane, Jane Ball, Luk Bruyneel, Anne Marie Rafferty, Peter Griffiths

In BMJ Open, Linda Aiken and colleagues examine how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels, and hospital work environments in National Health Service (NHS) hospitals in England. The authors use national survey data from over 66,000 hospital patients and nearly 3,000 inpatient nurses for their analysis.

The authors find that patients have a high level of trust and confidence in RNs, but only 60 percent of patients indicated that there were enough RNs to care for them. The importance of adequate RN...

Association of high cost sharing and targeted therapy initiation among elderly Medicare patients with metastatic renal cell carcinoma

Dec. 12, 2017

Pengxiang (Alex) Li, Yu-Ning Wong, Jordan Jahnke, Amy R. Pettit, and Jalpa A. Doshi

In Cancer Medicine, Pengxiang (Alex) Li and colleagues, including Jalpa Doshi, explore whether high out-of-pocket costs limit access to oral therapies for Medicare patients newly diagnosed with metastatic renal cell carcinoma. Using 2011–2013 Medicare claims, the investigators identified 1,721 patients newly diagnosed with metastases in the liver, lung, or bone. They compared low-income Medicare Part D beneficiaries (who had low out-of-pocket costs due to...

Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents

Dec. 6, 2017

Linda Fleisher, Danielle Erkoboni, Katherine Halkyard, Emily Sykes, Marisol S. Norris, Lorrie Walker, and ...

In the International Journal of Environmental Research and Public Health, Linda Fleisher and colleagues, including Danielle Erkoboni and Flaura Winston, identify gaps in parental knowledge about and perceived challenges in the use of appropriate child restraints in motor vehicles. They also explore the acceptability of using a mobile app to guide car seat installation. Injuries to passengers in motor vehicle crashes remain a leading cause of child mortality. As such, the delivery of information about proper child restrain systems (CRS) use...

Using Wearable Devices and Smartphones to Track Physical Activity: Initial Activation, Sustained Use, and Step Counts Across Sociodemographic Characteristics in a National Sample

Dec. 3, 2017

Mitesh S. Patel, Luca Foschini, Gregory W. Kurtzman, Jingsan Zhu, Wenli Wang, Charles A.L. Rareshide, Susan M. Zbikowski

In Annals of Internal Medicine, Mitesh Patel and colleagues describe rates of initial use of activity trackers, sustained use after 6 months, and step counts across different sociodemographic characteristics from a wellness program offered across the United States. Many large employers are using data collected from wearable devices and smartphones in workplace wellness programs; however, the characteristics of persons who use these devices are poorly understood.

Mean daily step count and sociodemographic characteristics between 2014 and 2015 were obtained from Humana for...

The Short- and Long-Term Effects of Smoking Cessation on Alcohol Consumption

Dec. 1, 2017

In the International Journal of Health Economics and Management, Benjamin Ukert examines short- and long-term effects of quitting smoking on alcohol consumption. Most interventions have focused on reducing either cigarette or alcohol consumption to address the severe health and economic consequences of both risky behaviors, while ignoring how they interact.

To estimate the relationship between smoking and alcohol consumption, the author utilizes data from the Lung Health Study (LHS), a randomized smoking...

What Every Graduating Resident Needs to Know About Quality Improvement and Patient Safety: A Content Analysis of 26 Sets of ACGME Milestones

Nov. 29, 2017

Meghan Lane-Fall, Joshua J. Davis, Justin Clapp, Jennifer S. Myers, Lee Ann Riesenberg

In the Journal of the Association of American Medical Colleges, Meghan Lane-Fall and colleagues analyze milestones – competency-based outcomes assessing graduate medical trainees – across 26 specialties to identify common expectations related to quality improvement (QI) and patient safety (PS). The purpose of this work is to move toward a consensus around what every medical trainee needs to know in QI and PS, irrespective of specialty.

The authors performed a content analysis of 612 published milestones from the Accreditation Council for Graduate Medical Education (ACGME)....

An Ethical Duty to Protect One’s Own Information Privacy?

Nov. 8, 2017

Anita L. Allen

In the Alabama Law Review, Anita Allen explores if individuals have a moral or ethical obligation to protect their own information privacy. Safeguarding others’ privacy is widely understood to be a responsibility of government, business, and individuals. But is anyone ethically required — not just prudentially advised — to protect his or her own privacy? If so, how might a requirement to protect one’s own privacy influence everyday choices, public policy, or the law?

Allen tests the idea of an ethical mandate to protect one’s own privacy, while identifying the practical and...

Protecting One’s Own Privacy in a Big Data Economy

Nov. 8, 2017

Anita L. Allen

In the Harvard Law Review Forum, Anita Allen reflects on preserving one’s own privacy in a Big Data economy. Big Data is the vast quantities of information amenable to large-scale collection, storage, and analysis that is used by companies and researchers to reveal otherwise unascertained patterns, links, behaviors, and practical knowledge. Individuals invisibly contribute to Big Data whenever they live digital lifestyles or otherwise participate in the digital economy.

In her paper, Allen comments first on whether the notion that individuals have a moral obligation to...

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