Publications

Modeling Lottery Incentives for Daily Adherence

Dylan S. Small, PhD
Apr. 11, 2019

Colman H. Humphrey, Dylan S. Small, Shane T. Jensen, Kevin G. Volpp, David A. Asch...

ABSTRACT [FROM JOURNAL]

Many health issues require adherence to recommended daily activities, such as taking medication to manage a chronic condition, walking a certain distance to promote weight loss, or measuring weights to assess fluid balance in heart failure. The cost of nonadherence can be high, with respect to both individual health outcomes and the healthcare system. Incentivizing adherence to daily activities can promote better health in patients and populations and potentially provide long-term cost savings...

Rationale and Design of EMPOWER, a Pragmatic Randomized Trial of Automated Hovering in Patients With Congestive Heart Failure

Shivan J. Mehta, MD, MBA
Apr. 11, 2019

Shivan J. MehtaKevin G. Volpp, David A. Asch, Lee R. Goldberg, ...

ABSTRACT [FROM JOURNAL]

Background: Congestive heart failure is a major cause of morbidity, mortality, and cost. Disease management programs have shown promise but lack firm evidence of effectiveness and scalability. We describe the motivation, design,...

Unemployment Claims in Philadelphia One Year After Implementation of the Sweetened Beverage Tax

Apr. 11, 2019

Hannah G. Lawman, Sara N. Bleich, Jiali Yan, Michael T. LeVasseur, Nandita Mitra, Christina A. Roberto

ABSTRACT [FROM JOURNAL]

Objectives: Possible adverse economic impacts of sweetened drink taxes are a key concern for numerous stakeholders. This study examined changes in unemployment benefit claims filings in Philadelphia compared to its neighboring counties two years prior to and 14 months post implementation of a 1.5 cents per ounce excise tax on sugar- and artificially-sweetened beverages.

Methods: Data were obtained from the Pennsylvania Department of Labor. Interrupted time series

...

Effects of Public Reporting Legislation of Nurse Staffing: A Trend Analysis

Apr. 3, 2019

Pamela B. de Cordova, Jeannette Rogowski, Kathryn A. Riman...

ABSTRACT [FROM JOURNAL]

Public reporting is a tactic that hospitals and other health care facilities use to provide data such as outcomes to clinicians, patients, and payers. Although inadequate registered nurse (RN) staffing has been linked to poor patient outcomes, only eight states in the United States publicly report staffing ratios—five mandated by legislation and the other three electively. We examine nurse staffing trends after the New Jersey (NJ) legislature and governor enacted P.L.1971, c.136 (C.26:2 H-13) on January 24, 2005, mandating that all health care facilities...

Racial Segregation and Inequality in the Neonatal Intensive Care Unit for Very Low-Birth-Weight and Very Preterm Infants

Apr. 3, 2019

Jeffrey D. Horbar, Erika M. Edwards, Lucy T. Greenberg, Jochen Profit, David Draper, Daniel Helkey, Scott A. Lorch, Henry C. Lee, Ciaran S. Phibbs, J...

ABSTRACT [FROM JOURNAL]

Importance: Racial and ethnic minorities receive lower-quality health care than white non-Hispanic individuals in the United States. Where minority infants receive care and the role that may play in the quality of care received is unclear.

Objective: To determine the extent of segregation and inequality of care of very low-birth-weight and very preterm infants across neonatal intensive care units (NICUs) in the United States.

Design, Setting, and Participants: This cohort study of 743 NICUs in...

Patient-Centered Preference Assessment to Improve Satisfaction With Care Among Patients With Localized Prostate Cancer: A Randomized Controlled Trial

Mar. 20, 2019

Ravishankar Jayadevappa, Sumedha Chhatre, Joseph J. Gallo, Marsha Wittink, Knashawn H. Morales, David I. Lee, Thomas J. Guzzo, Neha Vapiwala, Yu-Ning Wong, Diane K. Newman, Keith Van Arsdalen, S. Bruce...

Abstract [from journal]

Purpose: To study the effectiveness of the Patient Preferences for Prostate Cancer Care (PreProCare) intervention in improving the primary outcome of satisfaction with care and secondary outcomes of satisfaction with decision, decision regret, and treatment choice among patients with localized prostate cancer.
 
Methods: In this multicenter randomized controlled study, we randomly assigned patients with localized prostate cancer to the PreProCare intervention or
...

Access to Primary and Dental Care Among Adults Newly Enrolled in Medicaid

Mar. 18, 2019

ABSTRACT [FROM JOURNAL]

Objectives: Adequate access to primary and dental care is essential for population health, and some state Medicaid programs have expanded insurance coverage for both. However, there are few data on new Medicaid enrollees’ ability to access services. We examined the relationship between provider supply and enrollees’ identification of usual sources of care.

Study Design: Between November 2015 and February 2016, we surveyed low-income adults newly insured through Medicaid in Philadelphia, Pennsylvania, to determine if...

Patient Safety Outcomes Under Flexible and Standard Resident Duty-Hour Rules

Mar. 18, 2019

Jeffrey H. Silber, Lisa M. Bellini, Judy A. Shea, Sanjay V. Desai, David F. Dinges, Mathias Basner, Orit Even-Shoshan, Alexander S. Hill, ...

ABSTRACT [FROM JOURNAL]

Background: Concern persists that extended shifts in medical residency programs may adversely affect patient safety.

Methods: We conducted a cluster-randomized noninferiority trial in 63 internal-medicine residency programs during the 2015–2016 academic year. Programs underwent randomization to a group with standard duty hours, as adopted by the Accreditation Council for Graduate Medical Education (ACGME) in July 2011, or to a group with more flexible duty-hour rules that did not specify limits on shift length or...

Repeat Laboratory Testing in the Pediatric Emergency Department: How Often and How Important?

Mar. 18, 2019

Evan Fieldston, Oludolapo Fakeye, David Friedman

 

ABSTRACT [FROM JOURNAL]

Background: Little is known about repeat testing for patients admitted to children's hospitals from the emergency department (ED).

Objective: The objective of this study was to describe the trend of repeat laboratory testing from a children's hospital ED.

Methods: Laboratory studies were analyzed for July 2002 to June 2010 for complete blood counts (CBCs; 7 years), basic metabolic panels (BMPs; 2.5 years), and coagulation studies (7 years) ordered and reordered in the ED within 8 hours for...

Parent Perceptions on Transfers to Pediatric Emergency Departments and the Role of Telemedicine

Mar. 18, 2019

Cynthia Mollen, Mira Henien, Lisa Jacobs, Sage Myers

ABSTRACT [FROM JOURNAL]

Objective: Real-time audiovisual consultation (telemedicine) has been proven feasible and is a promising alternative to interfacility transfer. We sought to describe caregiver perceptions of the decision to transfer his or her child to a pediatric emergency department and the potential use of telemedicine as an alternative to transfer.

Methods: Semistructured interviews of caregivers of patients transferred to a pediatric emergency department. Purposive sampling was used to recruit caregivers of patients who were...

Differential Payment to Research Participants in the Same Study: An Ethical Analysis

Mar. 13, 2019

ABSTRACT [FROM JOURNAL]

Recognising that offers of payment to research participants can serve various purposes—reimbursement, compensation and incentive—helps uncover differences between participants, which can justify differential payment of participants within the same study. Participants with different study-related expenses will need different amounts of reimbursement to be restored to their preparticipation financial baseline. Differential compensation can be acceptable when some research participants commit more time or assume greater burdens than others, or if inter-site...

The Roles Of Assisters And Automated Decision Support Tools In Consumers’ Marketplace Choices: Room For Improvement

Mar. 12, 2019

Charlene A. Wong, Eric Ellsworth, Farrah Madanay, Dave Chandrasekaran, Megan Moore, Daniel Polsky, Peter A. Ubel

ABSTRACT [FROM JOURNAL]

Assisters provide in-person and phone-based support to help consumers narrow their plan options on the Affordable Care Act’s health insurance Marketplaces. We elicited the perspectives of a national sample of thirty-two assisters from ten states on consumer plan selection and available Marketplace decision support tools (for example, total cost estimators and provider network look-up tools). Assisters identified several shortcomings that limited their use of decision support tools, such as nonspecific cost estimates and inaccurate provider network data....

Use of the Palliative Performance Scale to Estimate Survival among Home Hospice Heart Failure Patients

Mar. 12, 2019

Ruth M. Masterson Creber, David Russell, Frances Dooley, Lizeyka Jordan, Dawon Baik, Parag Goyal, Scott Hummel, Ellen K. Hummel, Kathryn H. Bowles
 

ABSTRACT [FROM JOURNAL]

Background: Estimating survival is challenging in the terminal phase of advanced heart failure. Patients, families and healthcare organizations would benefit from more reliable prognostic tools. The Palliative Performance Scale Version 2 (PPSv2) has been widely used to estimate survival in patients with cancer, but rarely used in patients with heart failure.

Methods: We performed a retrospective analysis of 1,114 patients with a primary

...

Linking Women Experiencing Incarceration to Community-Based HIV Pre-Exposure Prophylaxis Care: Protocol of a Pilot Trial

Anne M. Teitelman, PhD, CRNP
Mar. 12, 2019

Susan E. Ramsey, Evan G. Ames, Lauren Brinkley-Rubinstein, Anne M. Teitelman, Jennifer Clarke and Clair Kaplan

ABSTRACT [FROM JOURNAL]

Background: Women experiencing incarceration (WEI) engage in high rates of sex- and drug-related behavior that places them at risk for HIV. Pre-exposure prophylaxis (PrEP) is an efficacious means of reducing HIV acquisition. There is a general lack of knowledge regarding PrEP among women at elevated risk, and only a small percentage of at-risk women are currently engaged in PrEP care. The period of incarceration represents an opportunity to

...

What Predicts Health Care Transitions for Older Adults Following Introduction of LTSS?

Mar. 11, 2019

Karen B. Hirschman, Mark P. Toles, Alexandra L. Hanlon, Liming Huang, Mary D. Naylor

ABSTRACT [FROM JOURNAL]

Objective: To determine predictors of health care transitions (i.e., acute care service use, transfers from lower to higher intensity services) among older adults new to long-term services and supports [LTSS]. 

Method: 470 new LTSS recipients followed for 24 months. Multivariable Poisson regression modeling within a generalized estimating equation framework. 

Results: Being male, having multiple chronic conditions, lower self-reported physical health ratings and lower quality of life ratings...

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