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University of Massachusetts Medical School

Public Affairs, Public Policy and Public Administration

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Articles 1 - 30 of 211

Full-Text Articles in Social and Behavioral Sciences

Simulation-Based Power And Sample Size Calculation For Designing Interrupted Time Series Analyses Of Count Outcomes In Evaluation Of Health Policy Interventions, Wei Liu, Shangyuan Ye, Bruce A. Barton, Melissa A. Fischer, Colleen Lawrence, Elizabeth J. Rahn, Maria I. Danila, Kenneth G. Saag, Paul A. Harris, Stephenie C. Lemon, Jeroan J. Allison, Bo Zhang Mar 2020

Simulation-Based Power And Sample Size Calculation For Designing Interrupted Time Series Analyses Of Count Outcomes In Evaluation Of Health Policy Interventions, Wei Liu, Shangyuan Ye, Bruce A. Barton, Melissa A. Fischer, Colleen Lawrence, Elizabeth J. Rahn, Maria I. Danila, Kenneth G. Saag, Paul A. Harris, Stephenie C. Lemon, Jeroan J. Allison, Bo Zhang

Population and Quantitative Health Sciences Publications

Objective: The purpose of this study was to present the design, model, and data analysis of an interrupted time series (ITS) model applied to evaluate the impact of health policy, systems, or environmental interventions using count outcomes. Simulation methods were used to conduct power and sample size calculations for these studies.

Methods: We proposed the models and analyses of ITS designs for count outcomes using the Strengthening Translational Research in Diverse Enrollment (STRIDE) study as an example. The models we used were observation-driven models, which bundle a lagged term on the conditional mean of the outcome for a time series ...


Utilization Of Acp Cpt Codes Among High-Need Medicare Beneficiaries In 2017: A Brief Report, Amanda J. Reich, Ginger Jin, Avni Gupta, Dae Kim, Stuart Lipstiz, Holly G. Prigerson, Jennifer Tjia, Keren Ladin, Scott D. Halpern, Zara Cooper, Joel S. Weissman Feb 2020

Utilization Of Acp Cpt Codes Among High-Need Medicare Beneficiaries In 2017: A Brief Report, Amanda J. Reich, Ginger Jin, Avni Gupta, Dae Kim, Stuart Lipstiz, Holly G. Prigerson, Jennifer Tjia, Keren Ladin, Scott D. Halpern, Zara Cooper, Joel S. Weissman

Open Access Articles

IMPORTANCE: Medicare beneficiaries with high medical needs can benefit from Advance Care Planning (ACP). Medicare reimburses clinical providers for ACP discussions, but it is unknown whether high-need beneficiaries are receiving this service.

OBJECTIVE: To compare rates of billed ACP discussions among a cohort of high-need Medicare beneficiaries with the non-high-needs Medicare population.

DESIGN: Retrospective analysis of Medicare Fee-for-Service (FFS) claims in 2017 comparing high-need beneficiaries (seriously ill, frail, ESRD, and disabled) with non-high need beneficiaries.

SETTING: Nationally representative FFS Medicare 20% sample.

PARTICIPANTS: Medicare beneficiaries were assigned to one of the following classifications: seriously ill (65+), frail (65+), seriously ill ...


Hypertension And Diabetes Treatment Affordability And Government Expenditures Following Changes In Patient Cost Sharing In The "Farmacia Popular" Program In Brazil: An Interrupted Time Series Study, Isabel Cristina Martins Emmerick, Monica Rodrigues Campos, Rondineli Mendes. Da Silva, Luisa Arueira Chaves, Andrea Damaso Bertoldi, Dennis Ross-Degnan, Vera Lucia Luiza Jan 2020

Hypertension And Diabetes Treatment Affordability And Government Expenditures Following Changes In Patient Cost Sharing In The "Farmacia Popular" Program In Brazil: An Interrupted Time Series Study, Isabel Cristina Martins Emmerick, Monica Rodrigues Campos, Rondineli Mendes. Da Silva, Luisa Arueira Chaves, Andrea Damaso Bertoldi, Dennis Ross-Degnan, Vera Lucia Luiza

Surgery Publications

BACKGROUND: Increasing medicines availability and affordability is a key goal of Brazilian health policies. "Farmacia Popular" (FP) Program is one of the government's key strategies to achieve this goal. Under FP, antihypertension (HTN) and antiglycemic (DM) medicines have been provided at subsidized prices in private retail settings since 2006, and free of charge since 2011. We aim to assess the impact of sequential changes in FP benefits on patient affordability and government expenditures for HTN and DM treatment under the FP, and examine their implications for public financing mechanisms and program sustainability.

METHODS: Longitudinal, retrospective study using interrupted time ...


The Smoking Gun: Can We Do For Gun Control What We Are Doing To Control The Vaping And E-Cigarettes Epidemic?, Robert J. Goldberg, Kate L. Lapane, Stephenie C. Lemon, Michael P. Hirsh Jan 2020

The Smoking Gun: Can We Do For Gun Control What We Are Doing To Control The Vaping And E-Cigarettes Epidemic?, Robert J. Goldberg, Kate L. Lapane, Stephenie C. Lemon, Michael P. Hirsh

Open Access Articles

An editorial by UMass Medical School public health experts calls for legislators and policymakers to take bold action on gun control, similar to the recent ban in Massachusetts on vaping products in response to lung illnesses in vaping device and e-cigarette users.


Accessibility And Iot / Smart And Connected Communities, John Rochford Dec 2019

Accessibility And Iot / Smart And Connected Communities, John Rochford

University of Massachusetts Medical School Publications

The Internet of things (IoT) has unlimited potential to empower the lives of everyone. IoT devices increasingly appear in homes and power smart and connected communities. Related user experience design efforts must involve and consider people with disabilities, including the world’s rapidly aging population of seniors. They must be able to use IoT device and app interfaces. While secure and private IoT device data collection and communication are important for everyone, people with disabilities have unique related needs. Many current resources and developing efforts that can benefit UX designers to address these needs exist.


Healthy Eating Policy Strategies In Community Health Improvement Plans: A Cross-Sectional Survey Of Us Local Health Departments, Meera Sreedhara, Karin V. Goins, Christine F. Frisard, Milagros C. Rosal, Stephenie C. Lemon Dec 2019

Healthy Eating Policy Strategies In Community Health Improvement Plans: A Cross-Sectional Survey Of Us Local Health Departments, Meera Sreedhara, Karin V. Goins, Christine F. Frisard, Milagros C. Rosal, Stephenie C. Lemon

UMass Worcester PRC Publications

CONTEXT: Policies (eg, regulations, taxes, and zoning ordinances) can increase opportunities for healthy eating. Community Health Improvement Plans (CHIP) may foster collaboration and local health department (LHD) engagement in policy decision making to improve local food environments. Limited research describes what policies supportive of healthy food environments are included in CHIPs nationally and relationships between LHD characteristics and participation in plans including such policies.

OBJECTIVES: To determine the proportion of US LHDs who participated in development of a CHIP containing healthy eating policy strategies and assess the association between LHD characteristics and inclusion of any healthy eating policy strategy in ...


Advancing The Implementation And Sustainment Of Medication Assisted Treatment For Opioid Use Disorders In Prisons And Jails, Warren J. Ferguson, Joan Johnston, Jennifer G. Clarke, Peter J. Koutoujian, Kathleen Maurer, Colleen Gallagher, Julie White, Dyana Nickl, Faye S. Taxman Dec 2019

Advancing The Implementation And Sustainment Of Medication Assisted Treatment For Opioid Use Disorders In Prisons And Jails, Warren J. Ferguson, Joan Johnston, Jennifer G. Clarke, Peter J. Koutoujian, Kathleen Maurer, Colleen Gallagher, Julie White, Dyana Nickl, Faye S. Taxman

Open Access Articles

BACKGROUND: Opioid use disorder (OUD) is among the most prevalent medical condition experienced by incarcerated persons, yet medication assisted therapy (MAT) is uncommon. Four jail and prison systems partnered with researchers to document their adoption of MAT for incarcerated individuals with opioid use disorders (OUD) using their established treatment protocols. Employing the EPIS (Exploration, Planning, Implementation, and Sustainment) framework, programs report on systematic efforts to expand screening, treatment and provide linkage to community-based care upon release.

RESULTS: All four systems were engaged with implementation of MAT at the outset of the study. Thus, findings focus more on uptake and penetration ...


Why Does The Adverse Effect Of Inappropriate Mri For Lbp Vary By Geographic Location? An Exploratory Analysis, Mujahed Shraim, Manuel Cifuentes, Joanna L. Willetts, Helen R. Marucci-Wellman, Glenn Pransky Nov 2019

Why Does The Adverse Effect Of Inappropriate Mri For Lbp Vary By Geographic Location? An Exploratory Analysis, Mujahed Shraim, Manuel Cifuentes, Joanna L. Willetts, Helen R. Marucci-Wellman, Glenn Pransky

Open Access Articles

BACKGROUND: Early magnetic resonance imaging (eMRI) for nonspecific low back pain (LBP) not adherent to clinical guidelines is linked with prolonged work disability. Although the prevalence of eMRI for occupational LBP varies substantially among states, it is unknown whether the risk of prolonged disability associated with eMRI varies according to individual and area-level characteristics. The aim was to explore whether the known risk of increased length of disability (LOD) associated with eMRI scanning not adherent to guidelines for occupational LBP varies according to patient and area-level characteristics, and the potential reasons for any observed variations.

METHODS: A retrospective cohort of ...


The Opioid Epidemic In Rural Northern New England: An Approach To Epidemiologic, Policy, And Legal Surveillance, Thomas J. Stopka, Erin Jacque, Patsy Kelso, Haley Guhn-Knight, Kerry Nolte, Randall Jr. Hoskinson, Amanda Jones, Joseph Harding, Aurora Drew, Anne Vandonsel, Peter D. Friedmann Nov 2019

The Opioid Epidemic In Rural Northern New England: An Approach To Epidemiologic, Policy, And Legal Surveillance, Thomas J. Stopka, Erin Jacque, Patsy Kelso, Haley Guhn-Knight, Kerry Nolte, Randall Jr. Hoskinson, Amanda Jones, Joseph Harding, Aurora Drew, Anne Vandonsel, Peter D. Friedmann

Open Access Articles

The opioid crisis presents substantial challenges to public health in New England's rural states, where access to pharmacotherapy for opioid use disorder (OUD), harm reduction, HIV and hepatitis C virus (HCV) services vary widely. We present an approach to characterizing the epidemiology, policy and resource environment for OUD and its consequences, with a focus on eleven rural counties in Massachusetts, New Hampshire and Vermont between 2014 and 2018. We developed health policy summaries and logic models to facilitate comparison of opioid epidemic-related polices across the three states that could influence the risk environment and access to services. We assessed ...


Integrating Personalized Care Planning Into Primary Care: A Multiple-Case Study Of Early Adopting Patient-Centered Medical Homes, Rendelle E. Bolton, Barbara G. Bokhour, Timothy P. Hogan, Tana M. Luger, Mollie Ruben, Gemmae M. Fix Oct 2019

Integrating Personalized Care Planning Into Primary Care: A Multiple-Case Study Of Early Adopting Patient-Centered Medical Homes, Rendelle E. Bolton, Barbara G. Bokhour, Timothy P. Hogan, Tana M. Luger, Mollie Ruben, Gemmae M. Fix

Population and Quantitative Health Sciences Publications

BACKGROUND: Personalized care planning is a patient-centered, whole-person approach to treatment planning. Personalized care plans improve patient outcomes and are now mandated for chronic care management reimbursement. Yet guidance on how to best implement personalized care planning in practice is limited.

OBJECTIVE: We examined the adoption of personalized care planning in patient-centered medical home (PCMH) clinics to identify processes and organizational characteristics that facilitated or hindered use in routine practice.

DESIGN: Qualitative multiple-case study design. We conducted site visits at PCMH clinics in four US Veterans Health Administration (VHA) medical centers. Data included 10 general clinic observations, 34 direct observations ...


Brazilian Generics Market Change After Farmacia Popular Program, Andrea Damaso Bertoldi, Luisa Arueira Chaves, Dennis Ross-Degnan, Vera Lucia Luiza, Isabel Cristina Martins Emmerick, Rondineli Mendes Da Silva, Monica Rodrigues. Campos Oct 2019

Brazilian Generics Market Change After Farmacia Popular Program, Andrea Damaso Bertoldi, Luisa Arueira Chaves, Dennis Ross-Degnan, Vera Lucia Luiza, Isabel Cristina Martins Emmerick, Rondineli Mendes Da Silva, Monica Rodrigues. Campos

Open Access Articles

OBJECTIVE: To evaluate trends in the use of generic and non-generic medicines to treat hypertension and diabetes under the Farmacia Popular Program (FP) and its impact on generic medicines sales volume and market share in the Brazilian pharmaceutical market.

METHODS: This longitudinal, retrospective study used interrupted time series design to analyze changes in monthly sales volume and proportion of medicines sales (market share) for oral antidiabetic and antihypertensive medicines for generic versus non-generic products. Analyses were conducted in a combined dataset that aggregate monthly sales volumes from the Farmacia Popular program and from the QuintilesIMS (IQVIA) national market sales data ...


A Novel Tool To Improve Shared Decision Making And Adherence In Multiple Sclerosis: Development And Preliminary Testing, Nananda Col, Enrique Alvarez, Vicky Springmann, Carolina Ionete, Idanis Berrios Morales, Andrew Solomon, Christen Kutz, Carolyn Griffin, Brenda Tierman, Terrie Livingston, Michelle Patel, Danny Van Leeuwen, Long Ngo, Lori Pbert Oct 2019

A Novel Tool To Improve Shared Decision Making And Adherence In Multiple Sclerosis: Development And Preliminary Testing, Nananda Col, Enrique Alvarez, Vicky Springmann, Carolina Ionete, Idanis Berrios Morales, Andrew Solomon, Christen Kutz, Carolyn Griffin, Brenda Tierman, Terrie Livingston, Michelle Patel, Danny Van Leeuwen, Long Ngo, Lori Pbert

Open Access Articles

Background. Most people with multiple sclerosis (MS) want to be involved in medical decision making about disease-modifying therapies (DMTs), but new approaches are needed to overcome barriers to participation.

Objectives. We sought to develop a shared decision-making (SDM) tool for MS DMTs, evaluate patient and provider responses to the tool, and address challenges encountered during development to guide a future trial.

Methods. We created a patient-centered design process informed by image theory to develop the MS-SUPPORT SDM tool. Development included semistructured interviews and alpha and beta testing with MS patients and providers. Beta testing assessed dissemination and clinical integration strategies ...


Anticoagulant Prescribing For Non-Valvular Atrial Fibrillation In The Veterans Health Administration, Adam J. Rose, Robert J. Goldberg, David D. Mcmanus, Alok Kapoor, Victoria Wang, Weisong Liu, Hong Yu Sep 2019

Anticoagulant Prescribing For Non-Valvular Atrial Fibrillation In The Veterans Health Administration, Adam J. Rose, Robert J. Goldberg, David D. Mcmanus, Alok Kapoor, Victoria Wang, Weisong Liu, Hong Yu

Open Access Articles

Background: Direct acting oral anticoagulants (DOACs) theoretically could contribute to addressing underuse of anticoagulation in non-valvular atrial fibrillation (NVAF). Few studies have examined this prospect, however. The potential of DOACs to address underuse of anticoagulation in NVAF could be magnified within a healthcare system that sharply limits patients' exposure to out-of-pocket copayments, such as the Veterans Health Administration (VA).

Methods and Results: We used a clinical data set of all patients with NVAF treated within VA from 2007 to 2016 (n=987 373). We examined how the proportion of patients receiving any anticoagulation, and which agent was prescribed, changed over ...


Experiences With The Veterans' Choice Program, Kevin T. Stroupe, Rachael Martinez, Timothy P. Hogan, Elisa J. Gordon, Beverly Gonzalez, Ibuola Kale, Chad Osteen, Elizabeth Tarlov, Frances M. Weaver, Denise M. Hynes, Bridget M. Smith Aug 2019

Experiences With The Veterans' Choice Program, Kevin T. Stroupe, Rachael Martinez, Timothy P. Hogan, Elisa J. Gordon, Beverly Gonzalez, Ibuola Kale, Chad Osteen, Elizabeth Tarlov, Frances M. Weaver, Denise M. Hynes, Bridget M. Smith

Population and Quantitative Health Sciences Publications

BACKGROUND: To address concerns about Veterans' access to care at US Department of Veterans Affairs (VA) healthcare facilities, the Veterans Access, Choice, and Accountability Act was enacted to facilitate Veterans' access to care in non-VA settings, resulting in the "Veterans Choice Program" (VCP).

OBJECTIVES: To assess the characteristics of Veterans who used or planned to use the VCP, reasons for using or planning to use the VCP, and experiences with the VCP.

DESIGN: Mixed-methods.

SUBJECTS: After sampling Veterans in the Midwest census region receiving care at VA healthcare facilities, we included 4521 Veterans in the analyses. Of these, 60 Veterans ...


Automated Text Messaging With Patients In Department Of Veterans Affairs Specialty Clinics: Cluster Randomized Trial, Vera Yakovchenko, Timothy P. Hogan, Thomas K. Houston, Lorilei Richardson, Jessica Lipschitz, Beth Ann Petrakis, Chris Gillespie, D. Keith Mcinnes Aug 2019

Automated Text Messaging With Patients In Department Of Veterans Affairs Specialty Clinics: Cluster Randomized Trial, Vera Yakovchenko, Timothy P. Hogan, Thomas K. Houston, Lorilei Richardson, Jessica Lipschitz, Beth Ann Petrakis, Chris Gillespie, D. Keith Mcinnes

Open Access Articles

BACKGROUND: Acceptability of mobile phone text messaging as a means of asynchronous communication between health care systems and patients is growing. The US Department of Veterans Affairs (VA) has adopted an automated texting system (aTS) for national rollout. The aTS allows providers to develop clinical texting protocols to promote patient self-management and allows clinical teams to monitor patient progress between in-person visits. Texting-supported hepatitis C virus (HCV) treatment has not been previously tested.

OBJECTIVE: Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), we developed an aTS HCV protocol and conducted a mixed methods, hybrid type 2 effectiveness implementation ...


Stepping Up Active Transportation In Community Health Improvement Plans: Findings From A National Probability Survey Of Local Health Departments, Meera Sreedhara, Karin V. Goins, Christine F. Frisard, Milagros C. Rosal, Stephenie C. Lemon Jul 2019

Stepping Up Active Transportation In Community Health Improvement Plans: Findings From A National Probability Survey Of Local Health Departments, Meera Sreedhara, Karin V. Goins, Christine F. Frisard, Milagros C. Rosal, Stephenie C. Lemon

UMass Worcester PRC Publications

BACKGROUND: Local health departments (LHDs) are increasingly involved in Community Health Improvement Plans (CHIPs), a collaborative planning process that represents an opportunity for prioritizing physical activity. We determined the proportion of LHDs reporting active transportation strategies in CHIPs and associations between LHD characteristics and such strategies.

METHODS: A national probability survey of US LHDs ( < 500,000 residents; 30.2% response rate) was conducted in 2017 (n = 162). LHDs reported the inclusion of 8 active transportation strategies in a CHIP. We calculated the proportion of LHDs reporting each strategy. Multivariate logistic regression models determined the associations between LHD characteristics and inclusion of strategies in a CHIP. Inverse probability weights were applied for each stratum.

RESULTS: 45.6% of US LHDs reported participating in a CHIP with > /=1 active transportation strategy. Proportions for specific strategies ranged from 22.3% (Safe Routes to School) to 4.1% (Transit-Oriented Development). Achieving national accreditation (odds ratio [OR] = 3.67; 95% confidence interval [CI], 1 ...


A Permethrin Metabolite Is Associated With Adaptive Immune Responses In Gulf War Illness, Utsav Joshi, Lawrence J. Stern, Laila Abdullah Jul 2019

A Permethrin Metabolite Is Associated With Adaptive Immune Responses In Gulf War Illness, Utsav Joshi, Lawrence J. Stern, Laila Abdullah

Open Access Articles

Gulf War Illness (GWI), affecting 30% of veterans from the 1991 Gulf War (GW), is a multi-symptom illness with features similar to those of patients with autoimmune diseases. The objective of the current work is to determine if exposure to GW-related pesticides, such as permethrin (PER), activates peripheral and central nervous system (CNS) adaptive immune responses. In the current study, we focused on a PER metabolite, 3-phenoxybenzoic acid (3-PBA), as this is a common metabolite previously shown to form adducts with endogenous proteins. We observed the presence of 3-PBA and 3-PBA modified lysine of protein peptides in the brain, blood ...


Opportunities For Employers To Support Physical Activity Through Policy, Elizabeth Ablah, Stephenie C. Lemon, Nicolaas P. Pronk, Janet R. Wojcik, Qaiser Mukhtar, Jessica Grossmeier, Keshia M. Pollack, Laurie P. Whitsel Jun 2019

Opportunities For Employers To Support Physical Activity Through Policy, Elizabeth Ablah, Stephenie C. Lemon, Nicolaas P. Pronk, Janet R. Wojcik, Qaiser Mukhtar, Jessica Grossmeier, Keshia M. Pollack, Laurie P. Whitsel

UMass Worcester PRC Publications

In an effort to improve health and business outcomes, workplaces are supplementing traditional physical activity programs focused on individual behavior change with policies designed to change workplace culture. However, confusion exists about how to define workplace policies. In practice, worksites implement programs, benefit designs, and environmental strategies and describe these as policies. The purpose of this essay is to provide a definition for worksite policy and discuss how policy approaches can support employers’ efforts to promote physical activity. We also describe worksite physical activity policies that employers can adopt and implement.


Best Practices For Member Outreach And Engagement: How Effective Acos Build Understanding And Respect, Jessica Carpenter, Jocelyn Gordon Jun 2019

Best Practices For Member Outreach And Engagement: How Effective Acos Build Understanding And Respect, Jessica Carpenter, Jocelyn Gordon

Commonwealth Medicine Publications

Targeted strategies and sustained efforts at member outreach and engagement are helping Accountable Care Organizations (ACOs) and their Community Partners (CPs) achieve their shared goals for delivering patient-centered care. The most successful organizations focus on activities designed to create a stronger connection with their members, building trust and a better understanding of individuals’ characteristics and care needs. Positive results of these efforts include successful person-centered care planning, improved compliance with care plans and prescriptions, and implementation of recommended lifestyle changes — changes that help support independent living, reduce medical costs and complications, and drive improvements in member satisfaction.


University Of Massachusetts Medical School Report To Minnesota Department Of Human Services Health And Incarceration Project, Katharine London, Jeremy Tourish Jun 2019

University Of Massachusetts Medical School Report To Minnesota Department Of Human Services Health And Incarceration Project, Katharine London, Jeremy Tourish

Commonwealth Medicine Publications

On behalf of the Minnesota Department of Health Services, Health Law & Policy experts from our Public and Private Health Solutions group completed a literature review of successful efforts to improve the health of previously incarcerated individuals. In addition, our experts conducted five focus groups to obtain recommendations from experienced professionals who work directly with previously incarcerated individuals regarding interventions likely to improve the health of this unique population.

This study came about at the direction of Minnesota Legislature. They were interested in developing a methodology for paying higher rates to health care providers who provide services to high cost and ...


Opioid Overdose Deaths And Potentially Inappropriate Opioid Prescribing Practices (Pip): A Spatial Epidemiological Study, Thomas J. Stopka, Harsha Amaravadi, Anna R. Kaplan, Rachel Hoh, Dana Bernson, Kenneth K.H. Chui, Thomas Land, Alexander Y. Walley, Marc R. Larochelle, Adam J. Rose Jun 2019

Opioid Overdose Deaths And Potentially Inappropriate Opioid Prescribing Practices (Pip): A Spatial Epidemiological Study, Thomas J. Stopka, Harsha Amaravadi, Anna R. Kaplan, Rachel Hoh, Dana Bernson, Kenneth K.H. Chui, Thomas Land, Alexander Y. Walley, Marc R. Larochelle, Adam J. Rose

Open Access Articles

INTRODUCTION: Opioid overdose deaths quintupled in Massachusetts between 2000 and 2016. Potentially inappropriate opioid prescribing practices (PIP) are associated with increases in overdoses. The purpose of this study was to conduct spatial epidemiological analyses of novel comprehensively linked data to identify overdose and PIP hotspots.

METHODS: Sixteen administrative datasets, including prescription monitoring, medical claims, vital statistics, and medical examiner data, covering >98% of Massachusetts residents between 2011-2015, were linked in 2017 to better investigate the opioid epidemic. PIP was defined by six measures: > /=100 morphine milligram equivalents (MMEs), co-prescription of benzodiazepines and opioids, cash purchases of opioid prescriptions, opioid prescriptions ...


How Do Patients With Mental Health Diagnoses Use Online Patient Portals? An Observational Analysis From The Veterans Health Administration, Bella Etingen, Timothy P. Hogan, Rachael N. Martinez, Stephanie L. Shimada, Kevin Stroupe, Kim Nazi, Samantha L. Connolly, Jessica Lipschitz, Frances M. Weaver, Bridget Smith May 2019

How Do Patients With Mental Health Diagnoses Use Online Patient Portals? An Observational Analysis From The Veterans Health Administration, Bella Etingen, Timothy P. Hogan, Rachael N. Martinez, Stephanie L. Shimada, Kevin Stroupe, Kim Nazi, Samantha L. Connolly, Jessica Lipschitz, Frances M. Weaver, Bridget Smith

Population and Quantitative Health Sciences Publications

Online patient portals may be effective for engaging patients with mental health conditions in their own health care. This retrospective database analysis reports patient portal use among Veterans with mental health diagnoses. Unadjusted and adjusted odds of portal feature use was calculated using logistic regressions. Having experienced military sexual trauma or having an anxiety disorder, post-traumatic stress disorder, or depression were associated with increased odds of portal use; bipolar, substance use, psychotic and adjustment disorders were associated with decreased odds. Future research should examine factors that influence portal use to understand diagnosis-level differences and improve engagement with such tools.


Improving Care Coordination For Veterans Within Va And Across Healthcare Systems, Kristina M. Cordasco, Denise M. Hynes, Kristin M. Mattocks, Lori A. Bastian, Hayden B. Bosworth, David Atkins May 2019

Improving Care Coordination For Veterans Within Va And Across Healthcare Systems, Kristina M. Cordasco, Denise M. Hynes, Kristin M. Mattocks, Lori A. Bastian, Hayden B. Bosworth, David Atkins

Population and Quantitative Health Sciences Publications

The VA faces a plethora of care coordination challenges. Many Veterans have multiple conditions and providers, and many get a portion of their care in the community, a number that will only grow as recent legislation expands options for private care. These challenges have spawned new VA initiatives for redesigning care to meet them, described in this supplement in an editorial by Hosenfeld and colleagues. The VA Health Services Research and Development (HSR&D) service, in partnership with VA’s Office of Primary Care, and Office of Community Care, sponsored a State of the Art (SOTA) conference with the goals of (a) summarizing what is known about care coordination relevant to Veterans’ care; (b) identifying care coordination approaches ready for wider dissemination and implementation within VA; and (c) identifying a research agenda and recommendations, as appropriate, for increasing VA’s ...


Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six, Robin E. Clark, Linda Weinreb, Julie M. Flahive, Robert W. Seifert May 2019

Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six, Robin E. Clark, Linda Weinreb, Julie M. Flahive, Robert W. Seifert

Commonwealth Medicine Publications

Homeless infants are known to have poor birth outcomes, but the longitudinal impact of homelessness on health, health care use, and health spending during the early years of life has received little attention. Linking Massachusetts emergency shelter enrollment records for the period 2008-15 with Medicaid claims, we compared 5,762 infants who experienced a homeless episode with a group of 5,553 infants matched on sex, race/ethnicity, location, and birth month. Infants born during a period of unstable housing resulting in homelessness had higher rates of low birthweight, respiratory problems, fever, and other common conditions; longer neonatal intensive care ...


Recommendations For The Evaluation Of Cross-System Care Coordination From The Va State-Of-The-Art Working Group On Va/Non-Va Care, Kristin M. Mattocks, Kristin Cunningham, A. Rani Elwy, Erin P. Finley, Clinton Greenstone, Michelle A. Mengeling, Steven D. Pizer, Megan E. Vanneman, Michael Weiner, Lori A. Bastian May 2019

Recommendations For The Evaluation Of Cross-System Care Coordination From The Va State-Of-The-Art Working Group On Va/Non-Va Care, Kristin M. Mattocks, Kristin Cunningham, A. Rani Elwy, Erin P. Finley, Clinton Greenstone, Michelle A. Mengeling, Steven D. Pizer, Megan E. Vanneman, Michael Weiner, Lori A. Bastian

Population and Quantitative Health Sciences Publications

In response to widespread concerns regarding Veterans' access to VA care, Congress enacted the Veterans Access, Choice and Accountability Act of 2014, which required VA to establish the Veterans Choice Program (VCP). Since the inception of VCP, more than two million Veterans have received care from community providers, representing approximately 25% of Veterans enrolled in VA care. However, expanded access to non-VA care has created challenges in care coordination between VA and community health systems. In March 2018, the VA Health Services Research and Development Service hosted a VA State of the Art conference (SOTA) focused on care coordination. The ...


Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer May 2019

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Population and Quantitative Health Sciences Publications

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among ...


Will Ending Certain Drug Rebates Lower List Prices And Patient Out-Of-Pocket Costs?, Mckenzie Taylor, Stephanie Tran Apr 2019

Will Ending Certain Drug Rebates Lower List Prices And Patient Out-Of-Pocket Costs?, Mckenzie Taylor, Stephanie Tran

Commonwealth Medicine Publications

Earlier this year, the Department of Health and Human Services (HHS) proposed changes to the current pricing and contracting system for federal health care programs, Medicare Part D and Medicaid.This proposal aligns with the Trump Administration’s blueprint for lowering drug prices which we have written about previously.


Smoke-Free Environment Policy In Vietnam: What Did People See And How Did They React When They Visited Various Public Places, Vinh H. Nguyen, D. A. Do, T. T.H. Do, T. M.A. Dao, B. G. Kim, T H. Phan, T. H. Doan, N. K. Luong, T. L. Nguyen, V. M. Hoang, T. Q. N. Pham, T. Q. Nguyen Mar 2019

Smoke-Free Environment Policy In Vietnam: What Did People See And How Did They React When They Visited Various Public Places, Vinh H. Nguyen, D. A. Do, T. T.H. Do, T. M.A. Dao, B. G. Kim, T H. Phan, T. H. Doan, N. K. Luong, T. L. Nguyen, V. M. Hoang, T. Q. N. Pham, T. Q. Nguyen

Open Access Articles

Introduction: Since Vietnam has signed WHO framework on tobacco control (FCTC) in 2003 and has issued tobacco control law in 2013, there has been little research concerning about what impacts smoke-free regulations have had on public compliance. The objective of this study was to assess public exposure to secondhand smoke and reaction toward smoke-free policy regulations in Vietnam and the associated factor.

Methods: Using the design of GATS (Global Adult Tobacco Survey), a nationally representative sample of 8,996 adults were approached for data collection. Logistic regression was used to examine the associated factor.

Results: The study revealed that the ...


The Expanding Role Of Pharmacists: A Positive Shift For Health Care, Ashley Chiara Mar 2019

The Expanding Role Of Pharmacists: A Positive Shift For Health Care, Ashley Chiara

Commonwealth Medicine Publications

When reflecting upon the impactful members of a patient’s healthcare team, much consideration is given to the patient’s nurses, primary care physician and specialists. However, with nearly nine in 10 Americans living within five miles of a community pharmacy, and four in five receiving prescription benefits through a pharmacy benefit manager (PBM), the role of the pharmacist in orchestrating a patient’s care on the front lines is often overlooked.


A National Study Of Veterans With Major Upper Limb Amputation: Survey Methods, Participants, And Summary Findings, Linda Resnik, Sarah Ekerholm, Matthew Borgia, Melissa A. Clark Mar 2019

A National Study Of Veterans With Major Upper Limb Amputation: Survey Methods, Participants, And Summary Findings, Linda Resnik, Sarah Ekerholm, Matthew Borgia, Melissa A. Clark

Open Access Articles

INTRODUCTION: A comprehensive study to assess quality and outcomes of care for Veterans with upper limb amputation is needed. This paper presents methods and summary findings from a national survey of Veterans with upper limb amputation.

METHODS: After completion of a pilot study to develop and refine methods, computer-assisted telephone interviews were conducted with 808 Veterans with upper limb amputation (response rate = 47.7%; cooperation rate = 63.3%).

RESULTS: Respondents were 776 unilateral and 32 bilateral amputees, 97.5% male, mean age 63.3 (sd 14.1). Prostheses were used by 60% unilateral and 91% bilateral, the majority used body ...