Our aim is to determine if automated insulin delivery (AID) systems provide good value compared with standard insulin delivery. We will support the external validation of a computer simulation model (Swedish National Diabetes Register T1D model) which will then be…
Youth with autism spectrum disorder often have complex medical needs. Disruptions of healthcare during the transition from pediatric to adult healthcare may put youth with autism spectrum disorder at higher risk of medical emergencies and high medical costs. To understand…
Practitioners expected the Affordable Care Act (ACA) to increase availability of health services and access to treatment for Americans with substance use disorders (SUDs). Yet research has not examined the associations among ACA enrollment mechanisms, deductibles, and the use of…
The decreased trend in patients seeking care for acute stroke, acute MI, and acute surgical presentations during the COVID-19 pandemic is concerning for potential long-term morbidity, mortality, rehabilitation costs, and preventable downstream health care utilization. We aim to assess the…
The Mental Health Research Network (MHRN) is a consortium of 13 health system research centers, embedded in large and diverse healthcare systems, dedicated to improving patient mental health through research, practice, and policy; with expertise in mental health research as…
Overall goal is to define and refine the current epidemiology, clinical characteristics, and treatment practices in respiratory failure in late and moderately preterm infants. Specific aims are to determine that incidence and epidemiology of respiratory failure in neonates born 32-36…
Amid a growing geriatric population and rise in frailty-related morbidity, fall prevention represents an opportunity to improve patient outcomes and reduce health care costs. Traditional lectures on geriatric content have had limited impact on physician behaviors; however, use of multimodal…
RATIONALE: In October 2012, the initial phase of the Hospital Readmission Reduction Program (HRRP) imposed financial penalties on hospitals with higher than expected risk-adjusted 30-day readmission rates for Medicare beneficiaries with congestive heart failure, myocardial infarction, and pneumonia. We hypothesized…
Predictive analytics in health care has generated increasing enthusiasm recently, as reflected in a rapidly growing body of predictive models reported in literature and in real-time embedded models using electronic health record data. However, estimating the benefit of applying any…
Rates of surgery for nonmalignant colorectal polyps are increasing in the United States despite evidence that most polyps can be managed endoscopically. We aimed to determine nationally representative estimates and to identify predictors of in-hospital mortality and morbidity after surgery…
Our prior study examined the impact of one aspect of Medicare Part D, the removal of limits on the number of reimbursable prescriptions per month (drug caps) on racial differences in chronic disease treatment among dual Medicare and Medicaid enrollees…
This study explores the enduring impact of screening, brief intervention, and referral to treatment (SBIRT) delivered in pediatric primary care, on young adults. We will examine substance use, mental health and medical outcomes, and health services utilization and cost over…
People with type 2 diabetes vary greatly in their use of high-cost health care resources. We examined the association of anxiety with high-cost use after accounting for depression and medical comorbidity. Using electronic health record data, we assessed past anxiety…
Many cervical cancer screening strategies are now recommended in the United States, but the benefits, harms, and costs of each option are unclear. To estimate the cost-effectiveness of 12 cervical cancer screening strategies. The cross-sectional portion of this study enrolled…
BACKGROUND: Medical malpractice data can be leveraged to understand specialty-specific risk.METHODS: Malpractice claims were examined from the Comparative Benchmarking System (2007-2016), a national database containing > 30% of claims data in the United States. Claims were identified with either internal…
Current World Health Organization guidelines for conducting anti-malarial drug efficacy clinical trials recommend genotyping Plasmodium falciparum genes msp1 and msp2 to distinguish recrudescence from reinfection. A more recently developed potential alternative to this method is a molecular genotyping assay based…
The tax penalty for noncompliance with the Affordable Care Act's individual mandate is to be eliminated starting in 2019. We investigated the potential impact of this change on enrollees' decisions to purchase insurance and on individual-market premiums. In a survey…
Objective This study was aimed to compare health care costs and utilization at birth through 1 year, between preterm and term infants, by week of gestation. Methods A cross-sectional study of infants born at ≥ 23 weeks of gestational age (GA) at Kaiser…
We examined the impact of the Affordable Care Act-mandated elimination of tobacco cessation pharmacotherapy (TCP) copayments on patient use of TCP, overall and by income. Electronic health record data captured any and combination (eg, nicotine gum plus patch) TCP use…
A relatively small proportion of patients with complex needs represent a major source of cost and utilization. The fundamental principle that distinguishes complex needs patients from other high-cost patients with well-defined medical issues is that "complex needs" is a highly…
The clinical and financial impact of diabetes-related interventions and policies may not be quantifiable without the use of simulation models that reflect the long-term course of disease and its complications. Models of diabetes complications are used by healthcare delivery systems…
Although the prognosis of ambulatory heart failure (HF) has improved dramatically there have been few advances in the management of acute HF (AHF). Despite regional differences in patient characteristics, background therapy, and event rates, AHF clinical trial enrollment has transitioned…
Recent international phase III clinical trials of novel therapies for hospitalized heart failure (HHF) have failed to improve the unacceptably high postdischarge event rate. These large studies have demonstrated notable geographic and site-specific variation in patient profiles and enrollment. Possible…
Hospitalization for heart failure (HF) is a clinical entity associated with high postdischarge morbidity and mortality, yet few therapies are available to improve outcomes in patients with this condition. In the past decade, large phase III studies of HF treatments…
Hospitalization for worsening chronic heart failure results in high post-discharge mortality, morbidity, and cost. However, thorough characterization, soon after discharge of patients with early post-discharge events has not been previously performed. The objectives of this study were to describe the…
BACKGROUND: Colorectal cancer (CRC) screening rates are low in many areas and cost-effective interventions to promote CRC screening are needed. Recently in a randomized controlled trial, a mailed educational reminder increased CRC screening rates by 16.2% among U.S. Veterans. The…
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