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Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy 2016 University of Windsor

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants ...


Depression Treatment Decreases Healthcare Expenditures Among Working Age Patients With Comorbid Conditions And Type 2 Diabetes Mellitus Along With Newly-Diagnosed Depression, Rituparna Bhattacharya, Chan Shen, Amy B. Wachholtz, Nilanjana Dwibedi, Usha Sambamthoori 2016 Humana, Inc.

Depression Treatment Decreases Healthcare Expenditures Among Working Age Patients With Comorbid Conditions And Type 2 Diabetes Mellitus Along With Newly-Diagnosed Depression, Rituparna Bhattacharya, Chan Shen, Amy B. Wachholtz, Nilanjana Dwibedi, Usha Sambamthoori

Amy B. Wachholtz

BACKGROUND: There are many studies in the literature on the association between depression treatment and health expenditures. However, there is a knowledge gap in examining this relationship taking into account coexisting chronic conditions among patients with diabetes. We aim to analyze the association between depression treatment and healthcare expenditures among adults with Type 2 Diabetes Mellitus (T2DM) and newly-diagnosed depression, with consideration of coexisting chronic physical conditions.

METHODS: We used multi-state Medicaid data (2000-2008) and adopted a retrospective longitudinal cohort design. Medical conditions were identified using diagnosis codes (ICD-9-CM and CPT systems). Healthcare expenditures were aggregated for each month for ...


Barriers And Facilitators To Deaf Trauma Survivors’ Help-Seeking Behavior: Lessons For Behavioral Clinical Trials Research: A Master’S Thesis, Melissa L. Anderson 2016 University of Massachusetts Medical School

Barriers And Facilitators To Deaf Trauma Survivors’ Help-Seeking Behavior: Lessons For Behavioral Clinical Trials Research: A Master’S Thesis, Melissa L. Anderson

Melissa L. Anderson

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility in the design of study methodology. To inform such considerations, we conducted a secondary analysis of a mixed-methods study that explored 16 Deaf trauma survivors’ help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that can be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged are what we would expect of any research participant, Deaf or hearing – a need for communication access, empathy, respect, strict confidentiality ...


Understanding Health Care Costs In A Wisconsin Acute Leukemia Population, Patricia Steinert, Ron A. Cisler 2016 Medical College of Wisconsin

Understanding Health Care Costs In A Wisconsin Acute Leukemia Population, Patricia Steinert, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose

We investigated factors driving health care costs of patients with a diagnosis of acute myeloid and acute lymphoblastic leukemia.

Methods

Standard costs identified in insurance claims data obtained from the Wisconsin Health Information Organization were used in a sample of 837 acute leukemia patients from April 2009 to June 2011. The Andersen behavioral model of health care utilization guided selection of patient and community factors expected to influence health care costs. A generalized linear model fitting gamma-distributed data with log-link technique was used to analyze cost.

Results

Type of treatment received and disease severity represented significant cost drivers, and ...


Advancing Population Health: New Models And The Role Of Research. An Overview Of The 22nd Annual Health Care Systems Research Network Conference, Robert T. Greenlee, Lois E. Lamerato, Sarah M. Greene 2016 Marshfield Clinic Research Foundation

Advancing Population Health: New Models And The Role Of Research. An Overview Of The 22nd Annual Health Care Systems Research Network Conference, Robert T. Greenlee, Lois E. Lamerato, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN; formerly HMO Research Network) held its annual conference in Atlanta, Georgia, in April 2016. A consortium of research organizations affiliated with 20 large health care delivery systems, the HCSRN met for the 22nd consecutive year to report on scientific achievements, develop and share skills and best practices, and promote new research collaborations. The 2016 conference, with a theme of “Advancing Population Health: New Models and the Role of Research,” was co-hosted on behalf of HCSRN by Marshfield Clinic Research Foundation and Henry Ford Health System’s Public Health Sciences Department. The 350 ...


Sharing Experiences And Expertise: The Health Care Systems Research Network Workshop On Patient Engagement In Research, Sarah Madrid, Leah Tuzzio, Cheryl D. Stults, Leslie A. Wright, Gina Napolitano, Ellis Dillon, Heather Tabano, Sarah M. Greene 2016 Institute for Health Research, Kaiser Permanente Colorado

Sharing Experiences And Expertise: The Health Care Systems Research Network Workshop On Patient Engagement In Research, Sarah Madrid, Leah Tuzzio, Cheryl D. Stults, Leslie A. Wright, Gina Napolitano, Ellis Dillon, Heather Tabano, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network’s (HCSRN) Patient Engagement in Research Scientific Interest Group (PER SIG) held a half-day workshop for researchers attending HCSRN’s 22nd annual conference, April 16, 2016, in Atlanta, Georgia. The workshop blended didactic and interactive content to facilitate co-learning. Both researchers and patient partners developed the content, including three broad topics: engagement of patient partners in developing research studies, nurturing partnerships, and assessing the impact of patient engagement in research. Each module presented approaches relevant to the specific topic, including lessons from the literature and in-the-field experience. Patient partners reflected on their experience related ...


Introduction Of An Area Deprivation Index Measuring Patient Socio-Economic Status In An Integrated Health System: Implications For Population Health, Andrew J. Knighton, Lucy Savitz, Tom Belnap, Brad Stephenson, James VanDerslice 2016 Insitute for Healthcare Leadership, Intermountain Healthcare

Introduction Of An Area Deprivation Index Measuring Patient Socio-Economic Status In An Integrated Health System: Implications For Population Health, Andrew J. Knighton, Lucy Savitz, Tom Belnap, Brad Stephenson, James Vanderslice

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: Intermountain Healthcare is a fully integrated delivery system based in Salt Lake City, Utah. As a learning healthcare system with a mission of performance excellence, it became apparent that population health management and our efforts to move towards shared accountability would require additional patient-centric metrics in order to provide the right care to the right patients at the right time. Several European countries have adopted social deprivation indices in measuring the impact that social determinants can have on health. Such indices provide a geographic, area-based measure of how socioeconomically deprived residents of that area are on average. Intermountain’s ...


Framework For Deploying A Virtualized Computing Environment For Collaborative And Secure Data Analytics, Adrian Meyer, Laura Green, Ciearro Faulk, Stephen Galla, Anne-Marie Meyer 2016 UNC Lineberger Comprehensive Cancer Center

Framework For Deploying A Virtualized Computing Environment For Collaborative And Secure Data Analytics, Adrian Meyer, Laura Green, Ciearro Faulk, Stephen Galla, Anne-Marie Meyer

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: Large amounts of health data generated by a wide range of health care applications across a variety of systems have the potential to offer valuable insight into populations and health care systems, but robust and secure computing and analytic systems are required to leverage this information.

Framework: We discuss our experiences deploying a Secure Data Analysis Platform (SeDAP), and provide a framework to plan, build and deploy a virtual desktop infrastructure (VDI) to enable innovation, collaboration and operate within academic funding structures. It outlines 6 core components: Security, Ease of Access, Performance, Cost, Tools, and Training.

Conclusion: A platform ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

Tiffany A. Moore Simas

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

Jeroan J. Allison

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

Nancy Byatt

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


Profile Of Rural Residential Care Facilities: A Chartbook, Jennifer D. Lenardson, Eileen Griffin, Erika C. Ziller, Andrew F. Coburn 2016 University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center

Profile Of Rural Residential Care Facilities: A Chartbook, Jennifer D. Lenardson, Eileen Griffin, Erika C. Ziller, Andrew F. Coburn

Jennifer Lenardson

Section I examines differences in rural and urban RCF characteristics. Section II explores differences in the characteristics and functional status of RCF residents. Section III profiles the services provided by rural and urban RCFs and Section IV examines rural-urban differences in admission and discharge policies and how these might reflect options for aging-in-place in rural and urban RCFs. The final section discusses policy implications for providing residential care in rural areas as part of a broader continuum of LTSS services.


Profile Of Rural Residential Care Facilities: A Chartbook, Jennifer D. Lenardson, Eileen Griffin, Erika C. Ziller, Andrew F. Coburn 2016 University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center

Profile Of Rural Residential Care Facilities: A Chartbook, Jennifer D. Lenardson, Eileen Griffin, Erika C. Ziller, Andrew F. Coburn

Jennifer Lenardson

Section I examines differences in rural and urban RCF characteristics. Section II explores differences in the characteristics and functional status of RCF residents. Section III profiles the services provided by rural and urban RCFs and Section IV examines rural-urban differences in admission and discharge policies and how these might reflect options for aging-in-place in rural and urban RCFs. The final section discusses policy implications for providing residential care in rural areas as part of a broader continuum of LTSS services.


6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin 2016 University of Massachusettts Medical School

6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin

Leslie R. Harrold

Background/Purpose: The increase in total knee replacements (TKRs) between 1979 and 2006 is staggering. Debate is growing regarding the appropriate utilization of TKRs. We examined pain, function, quality of life (QOL), and satisfaction at 6-month post-surgery by pain and function at time of surgery. Methods: Data came from the nationally representative FORCE-TJR cohort of patients from 150 surgeons. Participants had primary, unilateral TKRs due to osteoarthritis between 2011 and 2014. Their knee pain (KOOS), physical functions (SF36), and QOL were measured at pre- and 6 months post-surgery. We classified patients as having high or low pre-operative pain (KOOS Pain ...


Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver 2016 East Tennessee State University

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N = 222 ...


Patient Satisfaction As A Reflection Of Quality Health Care And Outcomes, Ian C. Brown, Taylor M. Piatkowski 2016 James Madison University

Patient Satisfaction As A Reflection Of Quality Health Care And Outcomes, Ian C. Brown, Taylor M. Piatkowski

Physician Assistant Capstones

Background: In 2006 the Centers of Medicaid and Medicare Services mandated that acute care centers begin submitting HCAHPS survey data for financial reimbursement for Medicare patients. The national shift to a patient centered focus and the financial incentive to improve patient satisfaction scores has stimulated debate regarding the relationship between patient satisfaction and quality healthcare.

Clinical Question: Does improvement in patient satisfaction with their healthcare and its providers, as measured by the HCAHPS survey, improve healthcare quality and outcomes?

Design: Systematic literature review.

Methods: Searches were performed using PubMed and Scopus databases.The terms used for the PubMed search were ...


What Causes Care Coordination Problems? A Case For Microanalysis, Wayne Zachary, Russell Charles Maulitz, Drew A. Zachary 2016 Starship Health Technologies, LLC

What Causes Care Coordination Problems? A Case For Microanalysis, Wayne Zachary, Russell Charles Maulitz, Drew A. Zachary

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: Care coordination (CC) is an important fulcrum for pursuing a range of health care goals. Current research and policy analyses have focused on aggregated data rather than on understanding what happens within individual cases. At the case level, CC emerges as a complex network of communications among providers over time, crossing and recrossing many organizational boundaries. Micro-level analysis is needed to understand where and how CC fails, as well as to identify best practices and root causes of problems.

Coordination Process Diagramming: Coordination Process Diagramming (CPD) is a new framework for representing and analyzing CC arcs at the micro ...


Implementation And Reporting Of Causal Mediation Analysis In 2015: A Systematic Review In Epidemiological Studies, Shao-Hsien Liu, Christine M. Ulbricht, Stavroula A. Chrysanthopoulou, Kate L. Lapane 2016 University of Massachusetts Medical School

Implementation And Reporting Of Causal Mediation Analysis In 2015: A Systematic Review In Epidemiological Studies, Shao-Hsien Liu, Christine M. Ulbricht, Stavroula A. Chrysanthopoulou, Kate L. Lapane

Open Access Articles

BACKGROUND: Causal mediation analysis is often used to understand the impact of variables along the causal pathway of an occurrence relation. How well studies apply and report the elements of causal mediation analysis remains unknown.

METHODS: We systematically reviewed epidemiological studies published in 2015 that employed causal mediation analysis to estimate direct and indirect effects of observed associations between an exposure on an outcome. We identified potential epidemiological studies through conducting a citation search within Web of Science and a keyword search within PubMed. Two reviewers independently screened studies for eligibility. For eligible studies, one reviewer performed data extraction, and ...


Depression Treatment Decreases Healthcare Expenditures Among Working Age Patients With Comorbid Conditions And Type 2 Diabetes Mellitus Along With Newly-Diagnosed Depression, Rituparna Bhattacharya, Chan Shen, Amy B. Wachholtz, Nilanjana Dwibedi, Usha Sambamthoori 2016 Humana, Inc.

Depression Treatment Decreases Healthcare Expenditures Among Working Age Patients With Comorbid Conditions And Type 2 Diabetes Mellitus Along With Newly-Diagnosed Depression, Rituparna Bhattacharya, Chan Shen, Amy B. Wachholtz, Nilanjana Dwibedi, Usha Sambamthoori

Open Access Articles

BACKGROUND: There are many studies in the literature on the association between depression treatment and health expenditures. However, there is a knowledge gap in examining this relationship taking into account coexisting chronic conditions among patients with diabetes. We aim to analyze the association between depression treatment and healthcare expenditures among adults with Type 2 Diabetes Mellitus (T2DM) and newly-diagnosed depression, with consideration of coexisting chronic physical conditions.

METHODS: We used multi-state Medicaid data (2000-2008) and adopted a retrospective longitudinal cohort design. Medical conditions were identified using diagnosis codes (ICD-9-CM and CPT systems). Healthcare expenditures were aggregated for each month for ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

UMass Center for Clinical and Translational Science Supported Publications

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


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