Research Publications

A Mixed Methods Evaluation of Early Childhood Abuse Prevention Within Evidence-Based Home Visiting Programs

Jun. 13, 2018

Meredith Matone, Katherine Kellom, Heather Griffis, William Quarshie, Jennifer Faerber, Peter Gierlach, Jennifer Whittaker, David M. Rubin...

ABSTRACT [FROM JOURNAL]

Objectives: In this large scale, mixed methods evaluation, we determined the impact and context of early childhood home visiting on rates of child abuse-related injury. 

Methods: Entropy-balanced and propensity score matched retrospective cohort analysis comparing children of Pennsylvania Nurse–Family Partnership (NFP), Parents As Teachers (PAT), and Early Head Start (EHS) enrollees and children of Pennsylvania Medicaid eligible women from 2008 to 2014. Abuse-related injury episodes were identified in medical...

Loss-Framed Financial Incentives and Personalized Goal-Setting to Increase Physical Activity among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Trial

Jun. 13, 2018

Neel P. Chokshi, Srinath AdusumalliDylan S. Small, Alexander Morris, Jordyn Feingold, ...

ABSTRACT [FROM JOURNAL] 

Background: Regular physical activity reduces the risk of cardiovascular events, but most ischemic heart disease (IHD) patients do not obtain enough.

Methods and Results: ACTIVE REWARD (A Clinical Trial Investigating Effects of a Randomized Evaluation of Wearable Activity Trackers with Financial Rewards) was a 24‐week home‐based, remotely monitored, randomized trial with a 16‐week intervention (8‐week ramp‐up incentive phase and 8

...

Comparison Of Hospitals Participating In Medicare’s Voluntary And Mandatory Orthopedic Bundle Programs

Jun. 6, 2018

Abstract [from journal]

We analyzed data from Medicare and the American Hospital Association Annual Survey to compare characteristics and baseline performance among hospitals in Medicare’s voluntary (Bundled Payments for Care Improvement initiative, or BPCI) and mandatory (Comprehensive Care for Joint Replacement Model, or CJR) joint replacement bundled payment programs. BPCI hospitals had higher mean patient volume and were larger and more teaching intensive than were CJR hospitals, but the two groups had similar risk exposure and baseline episode quality and cost. BPCI hospitals...

Internet and Social Media Access Among Youth Experiencing Homelessness: Mixed-Methods Study

Jun. 6, 2018

Lauren A. Houdek VonHoltz, Rosemary Frasso, Jesse M. Golinkoff, Alicia J. Lozano, Alexandra Hanlon, Nadia Dowshen

ABSTRACT [from journal]

Background: Youth experiencing homelessness are at a risk for a variety of adverse outcomes. Given the widespread use of the internet and social media, these new technologies may be used to address their needs and for outreach purposes. However, little is known about how this group uses these resources.

Objective: This study investigated how homeless adolescents use these technologies for general and health-related purposes, whether the scope of their use changes with housing status, and...

Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation

Jun. 6, 2018

Charlene A. Wong, Sajal Kulhari, Ellen J. McGeoch, Arthur T. Jones, Janet Weiner, Daniel Polsky, ...

Abstract [from journal]

Background: The design of the Affordable Care Act’s (ACA) health insurance marketplaces influences complex health plan choices.

Objective: To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison.

Design: In November–December 2016, we examined the

...

Geographic Variation in Postpartum Prescription Opioid Use: Opportunities to Improve Maternal Safety

Jun. 6, 2018

Nora V. Becker, Karen J.Gibbins, Jeanmarie Perrone, Brandon C. Maughan

Abstract [from journal]

Background: Obstetric delivery is among the most common in-hospital procedures experienced by reproductive-age women, yet there is little literature on patterns of postpartum opioid prescriptions after such episodes.

Methods: We used claims data from 871,195 vaginal deliveries to 768,455 privately-insured women with an in-hospital delivery between June 2001 and July 2013 to examine the state- and census division-level proportions of women who

...

Effect of Social Comparison Feedback on Laboratory Test Ordering for Hospitalized Patients: A Randomized Controlled Trial

May. 31, 2018

Kira Ryskina, C. Jessica Dine, Yevgeniy Gitelman, Damien Leri, Mitesh Patel, Gregory Kurtzman, Lisa Y. Lin, ...

Abstract [from journal]

Background: Social comparison feedback is an increasingly popular strategy that uses performance report cards to modify physician behavior. Our objective was to test the effect of such feedback on the ordering of routine laboratory tests for hospitalized patients, a practice considered overused.

Methods: This was a single-blinded randomized controlled trial. Between January and June 2016, physicians on six general medicine teams at the Hospital of the University of

...

Family Food Purchases of High- and Low-Calorie Foods in Full-Service Supermarkets and Other Food Retailers by Black Women in an Urban US Setting

May. 31, 2018

Benjamin W. Chrisinger, Katherine Isselmann DiSantis, Amy E. HillierShiriki K. Kumanyika

Abstract [from journal]

Public health interventions to increase supermarket access assume that shopping in supermarkets is associated with healthier food purchases compared to other store types. To test this assumption, we compared purchasing patterns by store-type for certain higher-calorie, less healthy foods (HCF) and lower-calorie, healthier foods (LCF) in a sample of 35 black women household shoppers in Philadelphia, PA. Data analyzed were from 450 food shopping receipts collected by these shoppers over four-week periods in 2012. We compared the

...

A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation

Research Brief
May. 25, 2018

In a trial examining five approaches to smoking cessation among over 6,000 U.S. employees, financial incentives combined with free cessation aids were more effective at getting employees to stop smoking than free cessation aids alone. Specifically, the most effective intervention (free cessation aids plus $600 in redeemable funds) helped 2.9% of participants stop smoking through six months after their target quit date; this rate jumped to 12.7% among participants who actively engaged in the trial and were more motivated to quit. For employees with access to usual care (information and a free motivational text messaging service), offering free cessation aids or electronic cigarettes (e-cigarettes) did not help them quit smoking.

Trends in P2Y12 Receptor Inhibitor Use and Adherence After Percutaneous Coronary Intervention, 2008-2016

Research Brief
May. 25, 2018

Post-angioplasty, patient adherence to recommended antiplatelet therapy decreased when newer, more expensive drugs were introduced. From 2008-2016, as the use of newer agents increased, the proportion of patients not filling any antiplatelet prescription within 30 days of discharge increased from 6.4% to 19.1%. In the subsequent 12 months, the newer drugs were associated with higher patient costs and lower adherence to recommended therapy.

Conditional Admission, Religious Exemption Type, and Nonmedical Vaccine Exemptions in California Before and After a State Policy Change

May. 25, 2018

Alison M. Buttenheim, Malia Jones, Caitlin Mckown, Daniel Salmon, Saad B. Omerd

Abstract [from journal]

Recent measles and pertussis outbreaks in the US have focused national attention on state laws governing exemptions from mandatory vaccines for school entry. After several years of increases in nonmedical exemptions in California, the state assembly passed Assembly Bill 2109 in 2012, making

...

The Future of Medicaid: State Legislator Views on Policy Waivers

Research Brief
May. 23, 2018

A survey of state legislators revealed clear partisan differences in Medicaid reform priorities and policy preferences that states are pursuing in Section 1115 waiver applications. While there was some agreement across parties on broad goals for the Medicaid program, such as reducing health care spending and increasing affordability of health care, there was little consensus on specific policy changes needed to meet these goals.

The Effect of Workforce Assignment on Performance: Evidence from Home Health Care

Research Brief
May. 22, 2018

In this study of more than 43,000 home health episodes following a hospitalization, handoffs between skilled nursing providers—a marker of discontinuity of care—substantially increased hospital readmissions, and were more detrimental for sicker patients. The estimates imply that a single handoff increases the likelihood of 30-day hospital readmission by 16% and that one in four hospitalizations during home health care could be avoided if handoffs were eliminated.

Trends in hospital-SNF relationships in the care of Medicare beneficiaries

May. 17, 2018

Joshua M. Liao, R. Tamara Konetzka, Rachel M. Werner

Abstract [from journal]

Improving the value of post-acute care at skilled nursing facilities (SNFs) has become a Medicare policy priority. Anecdotally, hospitals have responded by formally acquiring or pursuing tighter informal connections with SNFs. We evaluated the trend in connections between US acute care hospitals and Medicare-certified SNFs between 2000 and 2013 using vertical integration and two novel network-based measures (number of SNF partners, and...

Understanding Pediatric Caretakers’ Views On Obtaining Medical Care for Low‐Acuity Illness

May. 17, 2018

Whitney V. Cabey, Judy A. Shea, Shreya Kangovi, Danielle Kennedy, Chiamaka Onwuzulike, Joel Fein
 

Abstract [from journal]

Background: A significant proportion of low acuity emergency department (ED) visits are by patients under 18 years of age. Results from prior interventions designed to reduce low acuity pediatric ED use have been mixed or poorly sustained, perhaps because they were not informed by patient and caretakers’ perspectives. The objective of this study was to explore caretaker decision‐making processes, values and priorities when deciding to seek care.

Methods

...

Pages