Healthcare Workforce

The mix and distribution of health care providers. LDI Senior Fellows study how to transform health care delivery through the optimal training, mix, and placement of health care professionals and allied health workers to deliver cost-effective care.

Physicians’ Participation In ACOs Is Lower In Places With Vulnerable Populations Than In More Affluent Communities

Research Brief
Aug. 8, 2016

Early evidence suggests that accountable care organizations (ACOs) - networks of doctors and hospitals whose members share responsibility for providing coordinated care to patients - improve health care quality and constrain costs. ACOs are increasingly common in the U.S., both for Medicare and commercially insured patients. However, there are concerns that ACOs may worsen existing disparities in health care quality if disadvantaged patients have less access to physicians who participate in them. Does physicians’ ACO participation relate to the sociodemographic characteristics of their patient population, and if so, why?

Racial Disparities in Geographic Access to Primary Care in Philadelphia

Research Brief
Aug. 8, 2016

Geographic access to primary care providers is usually considered a problem of rural areas, rather than of more densely populated urban ones. But the supply of primary care providers may be inadequate in certain neighborhoods even if the number of providers for the population is adequate for the city as a whole.The authors conducted a spatial analysis of census tracts in Philadelphia to assess the supply of primary care providers, quantify differences in supply that might contribute to disparities, and determine population characteristics associated with variations in geographic access. They calculated the ratio of adults-per-primary-care-provider in each tract using a five-minute travel time from the center of each census tract. They wanted to know if the overall number of providers in a city obscures significant differences across neighborhoods, and if so, whether low-access neighborhoods are more likely to be found in areas with large concentrations of racial and ethnic minorities.  

Chart of the Day: Medical Debtor Nation

Jul. 22, 2016

This chart on the educational debt level of medical school graduates was tucked away in supplementary material for an excellent article by Ari Friedman and colleagues in the Journal of General Internal Medicine on loan forgiveness programs:

Generic Medication Prescription Rates After Health System–Wide Redesign of Default Options Within the Electronic Health Record

May. 19, 2016

Mitesh Patel, Susan Day, Scott Halpern, William Hanson, Joseph Martinez, Steven Honeywell Jr, Kevin Volpp

In JAMA Internal Medicine, Mitesh Patel and colleagues, including Scott Halpern and Kevin Volpp, evaluate how changing electronic health record (EHR) defaults affects physician prescribing of generic drugs. For the study, the researchers utilized a systemic change to the University of Pennsylvania Health System’s EHR defaults. As part of this change, an opt-out checkbox labeled “dispense as written” was added to the prescription screen, and if left unchecked the generic-equivalent medication was prescribed. The authors find that generic prescribing rates increased significantly...

Gender of the Clinician, Child, and Guardian and the Association With Receipt of Routine Adolescent Vaccines

May. 17, 2016

Laura Johnson Faherty, Benjamin French, Alexander Fiks

In the Journal of Adolescent Health, Laura Johnson Faherty and colleagues, including Benjamin French and Alexander Fiks, investigate the relationship of the gender of the clinician, child and guardian to the child’s receipt of human papilloma virus (HPV) vaccine compared to tetanus, diphtheria, acellular pertussis (Tdap) and meningococcal dose 1 (MCV4) vaccines. Faherty and colleagues used electronic health record data from visits by adolescents to 27 primary care practices from 2009 to 2014 and stratified visits by type (preventive/acute). Adolescents were more likely to be...

Click Worthy: Stories Encourage Emergency Physicians to Learn More About Opioid Prescribing Guidelines

Research Brief
Zachary F. Meisel, MD
May. 5, 2016

New study finds that narrative vignettes outperform standard summaries in promoting engagement with opioid prescription guidelines among a national sample of emergency physicians. 

Built Environment Assessment: Multidisciplinary Perspectives

Apr. 19, 2016

Karen Glanz, Susan Handy, Kathryn Henderson, Sandy Slater, Erica Davis, Lisa Powell

In SSM Population Health, Karen Glanz and colleagues examine how different disciplinary perspectives can contribute to environmental context-based assessment related to obesity.  The authors also make recommendations for encouraging effective advances in built-environment assessment. A multidisciplinary team of experts convened in 2013 to discuss how their respective disciplines can collaborate to integrate environmental assessment to prevent obesity. There has been significant progress in collaboration across key disciplines that contribute to studies of built environments and...

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