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.

Healthcare System Supports for Young Adult Patients with Pediatric Onset Chronic Conditions: A Qualitative Study

Jan. 11, 2015

Dava E. Szalda, Manuel E. Jimenez, Jeremiah E. Long, Amelia Ni, Judy A. Shea, Sophia Jan

In the Journal of Pediatric Nursing, Dava Szalda and colleagues examine how adult primary care teams can facilitate the transition and ongoing care of adults with pediatric onset chronic illness. Currently, over 90% of pediatric patients with chronic medical conditions are living into adulthood. For some pediatric onset chronic conditions there are more adults living with an illness than children. This qualitative study explores practice supports and barriers to care for this population, comparing them to other patients with chronic illness in order to identify facilitators that...

Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients

Dec. 10, 2014

Mitesh S. Patel, Kevin G. Volpp, Dylan S. Small, Alexander S. Hill, Orit Even-Shoshan, Lisa Rosenbaum, Richard N. Ross, Lisa Bellini, Jingsan Zhu, and Jeffrey H. Silber

In the Journal of the American Medical Association, Mitesh Patel, Kevin Volpp and colleagues evaluate patient outcomes associated with 2011 limits on resident work hours, and find no change in 30-day mortality rates or 30-day all-cause readmission rates. See the LDI blog post on this study.

Primary Care Shortages: More Than Just a Head Count

Nov. 21, 2014

A new LDI/INQRI Research Brief, written by Mark Pauly, PhD, Mary Naylor, RN, PhD, and me, reviews the evidence of an existing or looming primary care shortage in the wake of the ACA. Will the combined effects of an aging population, an increase in coverage and demand for care, and a decrease in the number of physicians going into primary care create widespread gaps in access? Who will treat the newly insured, and will this exacerbate existing workforce shortages?

Primary Care Shortages: More Than a Head Count

Issue Brief
Nov. 21, 2014

The existence of a primary care physician shortage, even prior to the ACA, is not universally accepted. A new report by the Institute on Medicine found “no credible evidence” that the nation faces a looming physician shortage in primary care specialties. There is greater consensus about a maldistribution of physicians, in terms of specialty, geography, and practice settings. 

Patient Handoffs: A High-Stakes Game of Telephone

Nov. 20, 2014

As a past, present, or future patient, you might hope that your health care providers are consistently and reliably involved in your care. Just like you, though, your providers need rest and time off. When they go off-duty, responsibility for you is transferred, or "handed off", to someone else.

Carrots and Sticks to Reduce Readmissions and Improve Home Health Care

Oct. 1, 2014

The Affordable Care Act has generated carrots and sticks for hospitals to reduce readmissions. With the goal of achieving the Triple Aim (improving quality of patient care, improving population health, and reducing overall cost of care), innovative care delivery models are being tested locally and nationally, including the roll-out of Accountable Care Organizations and bundled payment programs. These programs create incentives in terms of shared savings for health care systems that provide high quality, coordinated care.

Wage, Work Environment, and Staffing: Effects on Nurse Outcomes

Aug. 1, 2014

Matthew McHugh, Chenjuan Ma

In Policy, Politics, and Nursing Practice, Matthew McHugh and Penn Nursing colleague Chenjuan Ma look at the effects of wages on better nursing outcomes - less burnout, job dissatisfaction, and intention to leave the job. While prior studies have found links between work environment and staffing levels on nurse outcomes, they did not investigate the effects of wages. McHugh and Ma cross-analyze administrative data with a four-state survey. Logistic regression models, both with and without wage included, show that wage is associated with reported job dissatisfaction and intent to leave, but...