Research Publications

California’s Senate Bill 277: Local Health Jurisdictions’ Experiences With the Elimination of Nonmedical Vaccine Exemptions

Dec. 6, 2018

Salini Mohanty, Alison M. Buttenheim, Caroline M. Joyce, Amanda C. Howa, Daniel Salmon, and Saad B. Omer

Abstract [from journal]

Objectives. To understand the experiences of local health jurisdictions with Senate Bill 277 (SB277), the California law that eliminated nonmedical vaccine exemptions for public- and private-school entry.

Methods. We...

Changes to Racial Disparities in Readmission Rates After Medicare’s Hospital Readmissions Reduction Program Within Safety-Net and Non-Safety-Net Hospitals

Research Brief
Dec. 6, 2018

After the Medicare Hospital Readmissions Reduction Program began enforcing financial penalties, disparities in readmissions between white and black patients widened at safety-net hospitals for conditions not targeted by the program. Disparities were stable for conditions targeted by the program. At non-safety-net hospitals, disparities were unchanged for both targeted and non-targeted conditions.

Intensive Care Unit Capacity Strain and Outcomes of Critical Illness in a Resource-Limited Setting: A 2-Hospital Study in South Africa

Dec. 5, 2018

George L. Anesi, Nicole B. Ga...

Abstract [from journal]

Objective: To measure the association of intensive care unit (ICU) capacity strain with processes of care and outcomes of critical illness in a resource-limited setting.

Methods: We performed a retrospective cohort study of 5332 patients referred to the ICUs at 2 public hospitals in South Africa using the country’s first published multicenter electronic critical care database. We assessed the
...

Closing the gaps in opioid use disorder research, policy and practice: conference proceedings

Dec. 1, 2018

Matthew A. Miclette, Jared A. Leff, Isabella Cuan, Jeffrey H. Samet, Brendan Saloner, Gary Mendell, Yuhua Bao, Michael A. Ashburn, Marcus A. Bachhuber, Bruce R. Schackman, Daniel E. Polsky, Zachary F. Meisel

Abstract [from journal]

Drug overdose deaths involving opioids have surged in recent years and the economic cost of the opioid epidemic is estimated to be over $500 billion annually. In the midst of calls for declaring a national emergency, health policy decision makers are considering the best ways to allocate resources to curb the epidemic. On June 9, 2017, 116 invited health researchers, clinicians, policymakers, health system leaders, and other...

Measuring Organizational Cultural Competence to Promote Diversity in Academic Healthcare Organizations

Jaya Aysola, MD, MPH
Nov. 28, 2018

Jaya Aysola, Diana Harris, Hairong Huo, Charmaine S. Wright,and Eve Higginbotham

ABSTRACT [FROM JOURNAL]

Purpose: To evaluate what drives respondent perceptions of health system organizational cultural competence.

Methods: We estimated associations between survey respondent (n=3506) demographic characteristics, length of employment, position, and place of work and their reported perceptions of institutional culture.

Results: In adjusted analyses, respondents self-identifying as non-Hispanic black versus non-Hispanic

...

The Prevalence, Risk Factors, and Outcomes of Medication Trade-offs in Kidney and Liver Transplant Recipients: A Pilot Study

Nov. 28, 2018

Marina Serper, Peter P. Reese, Rachel R. Patzer, Josh Levitsky, Michael S. Wolf

ABSTRACT [FROM JOURNAL]

High out‐of‐pocket medication costs negatively impact adherence in transplantation. We evaluated the association of “medication trade‐offs”—defined as choosing to spend money on other expenses over medications—with medication nonadherence and transplant outcomes. From 2011 to 2012, we performed a prospective study of 201 transplanted recipients (n = 103 liver, n = 98 kidney and) at two large US transplant centers. Structured interviews assessed socio‐demographics, medication adherence, and medication

...

Using a Decision Support Algorithm for Referrals to Post-Acute Care

Nov. 28, 2018

Kathryn H.Bowles, Sarah J.Ratcliffe, John H.Holmes, SueKeim, Sheryl Potashnik, Emilia Flores, Diane Humbrecht, Christina R.Whitehouse,...

ABSTRACT [FROM JOURNAL]

Objectives: Although hospital clinicians strive to effectively refer patients who require post-acute care (PAC), their discharge planning processes often vary greatly, and typically are not evidence-based.

Design: Quasi-experimental study employing pre-/postdesign. Aimed at improving patient-centered discharge processes, we examined the effects of the Discharge Referral Expert System for Care Transitions (DIRECT) algorithm that

...

Longitudinal Heterogeneity in Handgun-Carrying Behavior Among Urban American Youth: Intervention Priorities at Different Life Stages

Nov. 28, 2018

Beidi Dong, Sara F. Jacoby, Christopher N. Morrison, Douglas J. Wiebe

ABSTRACT [FROM JOURNAL]

Purpose: To determine longitudinal patterns of handgun-carrying behavior among urban American youth and identify modifiable risk factors associated with distinct carrying patterns that should be targeted at different life stages.

Methods: Using panel data from the National Longitudinal Survey of Youth 1997, we estimated longitudinal trajectories of handgun carrying among urban Americans, who carried a handgun at least once between 1997

...

Non-profit Hospital Community Benefit Spending Based on Local Sociodemographics

Nov. 28, 2018

ABSTRACT [FROM JOURNAL]

Non-profit hospitals are facing greater pressure to address the social determinants of health. Since 2012, with new requirements for greater transparency and community health needs assessments, non-profit tax exemption requirements are believed to incentivize investments in the community, particularly for vulnerable populations. We conducted a cross-sectional analysis of community benefit spending by private, acute care, non-profit hospitals from 2012–2014 to measure if hospitals have begun to address local community needs. We measured total community...

Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss

Nov. 19, 2018

Courtney A. Schreiber, Mitchell D. Creinin, Jessica Atrio, Sarita Sonalkar, Sarah J. Ratcliffe, and Kurt T. Barnhart

 

Abstract

BACKGROUND: Medical management of early pregnancy loss is an alternative to uterine aspiration, but standard medical treatment with misoprostol commonly results in treatment failure. We compared the efficacy and safety of pretreatment with mifepristone followed by treatment with misoprostol with the efficacy and safety of misoprostol use alone for the management of early pregnancy loss.

METHODS: We randomly assigned 300 women who had an anembryonic gestation or in whom embryonic or fetal death was confirmed to receive pretreatment with 200 mg of mifepristone,...

Cost Impact of The Transitional Care Model for Hospitalized Cognitively Impaired Older Adults

Research Brief
Nov. 19, 2018

Using advanced practice nurses to support high risk patients and their families to transition from hospital to home can reduce postacute care use and costs. A study comparing three evidence-based care management interventions for a population of hospitalized older adults with cognitive impairment found that the Transitional Care Model, which relies on advanced practice nurses to deliver services from hospital to home, was associated with lower postacute care costs when compared to two “hospital only” interventions.

To Retweet or Not to Retweet: Understanding What Features of Cardiovascular Tweets Influence Their Retransmission

Nov. 12, 2018

Qinghua Yang, Christopher Tufts, Lyle Ungar, Sharath Guntuku & Raina Merchant

ABSTRACT [FROM JOURNAL]

Twitter is one of the largest social networking sites (SNSs) in the world, yet little is known about what cardiovascular health related tweets go viral and what characteristics are associated with retransmission. The current study aims to identify a function of the observable characteristics of cardiovascular tweets, including characteristics of the source, content, and style that predict the retransmission of these tweets. We identified a random sample of 1,251 tweets associated with CVD originating from the United States between 2009 and 2015. Automated...

Does Nursing Home Compare Reflect Patient Safety In Nursing Homes?

Nov. 12, 2018

Daniel Brauner, Rachel M. Werner, Tetyana P. Shippee, John Cursio, Hari Sharma, and R. Tamara Konetzka

ABSTRACT [FROM JOURNAL]

The past several decades have seen significant policy efforts to improve the quality of care in nursing homes, but the patient safety movement has largely ignored this setting. In this study we compared nursing homes’ performance on several composite quality measures from Nursing Home Compare, the most prominent recent example of a national policy aimed at improving the quality of nursing home care, to their performance on measures of patient safety in nursing homes such as pressure sores, infections, falls, and medication errors. Although Nursing Home...

Online Ratings of the Patient Experience: Emergency Departments Versus Urgent Care Centers

Nov. 12, 2018

Anish K. Agarwal, Kevin Mahoney, Amy L. Lanza, Elissa V. Klinger,...

ABSTRACT [FROM JOURNAL]

Study Objective: Individuals increasingly use online rating platforms to rate and review hospitals. We seek to describe and compare publicly available online review content and ratings of emergency departments (EDs) and urgent care centers.

Methods: We analyzed Yelp reviews of EDs and urgent care centers to

...

Changes in Primary Care Access at Community Health Centers Between 2012/2013 and 2016

Nov. 12, 2018

Brendan Saloner, Adam S. Wilk, Douglas Wissoker, Molly Candon, Katherine Hempstead, Karin V. Rhodes,...

ABSTRACT [FROM JOURNAL]

Objective: To compare access at community health centers (CHCs) vs private offices (non‐CHCs) under the Affordable Care Act.

Data Source: Ten state primary care audit conducted in 2012/2013 and 2016.

Study Design: CHCs and non‐CHCs were called. We calculated difference in differences comparing CHCs vs non‐CHCs by caller insurance type.

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