Medicine and Health Sciences Commons^™

Issues With Variability In Electronic Health Record Data About Race And Ethnicity: Descriptive Analysis Of The National Covid Cohort Collaborative Data Enclave, Lily A. Cook Ma, David A. Dorr, Nicole G. Weiskopf, Nisha Mathews, Kelly L. Gonzales, Adam Wilcox, Charisse Madlock-Brown, N3c Consortium

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:The adverse impact of COVID-19 on marginalized and under-resourced communities of color has highlighted the need for accurate, comprehensive race and ethnicity data. However, a significant technical challenge related to integrating race and ethnicity data in large, consolidated databases is the lack of consistency in how data about race and ethnicity are collected and structured by health care organizations.

Objective:This study aims to evaluate and describe variations in how health care systems collect and report information about the race and ethnicity of their patients and to assess how well these data are integrated when aggregated into a large clinical database. …

Evaluation Of The Livewell Method: Final Report, Paula Carder, Serena Hasworth, Diana Cater

Institute on Aging Publications

The LiveWell Method uses a practice-based framework to improve the quality of life for people living and working in long-term care settings, including assisted living and memory care. It is designed to improve teamwork, communication, and morale by helping staff organize, track, measure, and improve daily operations. This evaluation is informed by the LiveWell Method’s “bottom-up and top enabled” approach, which engages and empowers direct care staff and administrators to create a more democratic and transparent workplace. In addition, the evaluation included questions to assess LiveWell’s core values, such as creating care innovations, nurturing dignity, creating community, and honoring elders, …

Health And Dental Care Expenditures In The United States From 1996 To 2016, Man Hung, Martin S. Lipsky, Ryan Moffat, Evelyn Lauren, Eric S. Hon, Jungweon Park, Gagandeep Gill, Julie Xu, Lourdes Peralta, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: As total health and dental care expenditures in the United States continue to rise, healthcare disparities for low to middle-income Americans creates an imperative to analyze existing expenditures. This study examined health and dental care expenditures in the United States from 1996 to 2016 and explored trends in spending across various population subgroups.

Methods: Using data collected by the Medical Expenditure Panel Survey, this study examined health and dental care expenditures in the United States from 1996 to 2016. Trends in spending were displayed graphically and spending across subgroups examined. All expenditures were adjusted for inflation or …

Association Of A Multisite Interprofessional Education Initiative With Quality Of Primary Care, Samuel T. Edwards, Elizabeth Hooker, Rebecca Brienza, Bridget O’Brien, Hyunjee Kim, Stuart Gilman, Nancy Harada, Lillian Gelberg, Sarah Shull, Meike Niederhausen, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance Studies have shown that interprofessional education (IPE) improves learner proficiencies, but few have measured the association of IPE with patient outcomes, such as clinical quality.

Objective To estimate the association of a multisite IPE initiative with quality of care.

Design, Setting, and Participants This study used difference-in-differences analysis of US Department of Veterans Affairs (VA) electronic health record data from July 1, 2008, to June 30, 2015. Patients cared for by resident clinicians in 5 VA academic primary care clinics that participated in the Centers of Excellence in Primary Care Education (CoEPCE), an initiative designed to promote IPE among …

Screening For Unhealthy Drug Use: Updated Evidence Report And Systematic Review For The Us Preventive Services Task Force, Carrie D. Patnode, Leslie A. Perdue, Megan Rushkin, Tracy Dana, Ian Blazina, Christina Bougatsos, Sara Grusing, Elizabeth A. O'Connor, Rongwei Fu, Roger Chou

OHSU-PSU School of Public Health Faculty Publications and Presentations

IMPORTANCE

Illicit drug use is among the most common causes of preventable morbidity and mortality in the US.

OBJECTIVE

To systematically review the literature on screening and interventions for drug use to inform the US Preventive Services Task Force.

DATA SOURCES MEDLINE, PubMed, PsycINFO, Embase, and Cochrane Central Register of Controlled Trials through September 18, 2018; literature surveillance through September 21, 2019. STUDY SELECTION Test accuracy studies to detect drug misuse and randomized clinical trials of screening and interventions to reduce drug use. DATA EXTRACTION AND SYNTHESIS Critical appraisal and data abstraction by 2 reviewers and random-effects meta-analyses. MAIN OUTCOMES …

Clinical Practice Variation Among Adult Infectious Disease Physicians In The Management Of Staphylococcus Aureus Bacteremia, Catherine Liu, Luke Strnad, Susan E. Beekmann, Philip M. Polgreen, Henry F. Chambers

OHSU-PSU School of Public Health Faculty Publications and Presentations

Infectious disease management of Staphylococcus aureus bacteremia (SAB) was surveyed through the Emerging Infections Network. While there were areas of consensus, we found substantial practice variation in diagnostic evaluation and management of adult patients with SAB. These findings highlight opportunities for further research and guidance to define best practices.

Role Of The Hospital In The 21st Century Opioid Overdose Epidemic: The Addiction Medicine Consult Service, Kelsey C. Priest, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: The aim of the study was to explore and describe the structure and design elements of addiction medicine consult (AMC) services within selected US hospitals. Methods: As part of a larger mixed methods study, 10 qualitative semi-structured telephone interviews were completed with board-certified addiction medicine physicians affiliated with the Addiction Medicine Foundation's Addiction Medicine Fellowship Programs at 9 US hospitals. Interviews were transcribed, coded, and analyzed using a directed content analysis. Results: Interviews completed with established AMC services in 9 hospitals probed AMC structure and design commonalities and differences across 4 domains: (1) availability and coverage, (2) team composition, …

Supporting Nursing Home Staff Through Person-Centered Care Practices, Diana White, Sarah Dys, Jaclyn Winfree, Serena Hasworth, Ozcan Tunalilar

Institute on Aging Publications

Policies and practices have increasingly focused on person-centered care (PCC) to improve quality of life for long-term care residents and staff. Adequate staffing has been a consistent barrier to implementing and sustaining PCC practices. The purpose of this paper is to explore the association between job satisfaction and PCC practices. This research was conducted in a stratified random sample of 33 Oregon nursing homes which were representative in terms of quality, profit/nonprofit ownership, and urban/rural location. Data were collected from 415 staff who completed the staff assessment of person-directed care, direct care worker job satisfaction scale, turnover intention, and organizational …

Impacts Of An Opioid Overdose Prevention Intervention Delivered Subsequent To Acute Care, Caleb J. Banta-Green, Phillip O. Coffin, Joseph O. Merrill, Jeanne M. Sears, Chris Dunn, Norbert D. Yanez, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons.

Methods Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting …

Shared Medical Appointments And Patient-Centered Experience: A Mixed-Methods Systematic Review, Kim H. Wadsworth, Trevor G. Archibald, Allison E. Payne, Anita K. Cleary, Byron L. Haney, Adam S. Hoverman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Shared medical appointments (SMAs), or group visits, are a healthcare delivery method with the potential to improve chronic disease management and preventive care. In this review, we sought to better understand opportunities, barriers, and limitations to SMAs based on patient experience in the primary care context.

Methods: An experienced biomedical librarian conducted literature searches of PubMed, Cochrane Library, PsycINFO, CINAHL, Web of Science, ClinicalTrials.gov, and SSRN for peer-reviewed publications published 1997 or after. We searched grey literature, nonempirical reports, social science publications, and citations from published systematic reviews. The search yielded 1359 papers, including qualitative, quantitative, …

Alternative Payment Models And Hospital Engagement In Health Information Exchange, Sunny C. Lin, John M. Hollingsworth, Julia Adler-Milstein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives:

To assess whether hospital participation in alternative payment models (APMs) is associated with greater engagement in health information exchange (HIE) along 4 dimensions: volume of patients for whom information is exchanged, diversity of information types, breadth of partner types, and depth of technical approach.

Study Design:

Pooled, cross-sectional analysis of data on US hospitals from 2014–2015.

Methods:

APM participation came from Leavitt Partners data, Medicare public use files, and the American Hospital Association (AHA) Annual Survey. We used Medicare data to measure HIE volume for 798 hospitals attesting to stage 2 Meaningful Use and the AHA Information Technology Supplement …

Use Of Quality Improvement Strategies Among Small To Medium-Size Us Primary Care Practices, Bijal A. Balasubramanian, Miguel Marino, Deborah J. Cohen, Rikki L. Ward, Alex Preston, Rachel Springer, Stephan R. Lindner, Samuel Edwards, John Mcconnell, Benjamin F. Crabtree, William L. Miller, Kurt C. Stange, Leif I. Solberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Improving primary care quality is a national priority, but little is known about the extent to which small to medium-size practices use quality improvement (QI) strategies to improve care. We examined variations in use of QI strategies among 1,181 small to medium-size primary care practices engaged in a national initiative spanning 12 US states to improve quality of care for heart health and assessed factors associated with those variations.

Concerning Trends In Allopathic Medical School Faculty Rank For Indigenous People: 2014–2016, Erik Brodt, Amanda Bruegl, Erin K. Thayer, M. Patrice Eiff, Kelly L. Gonzales, Carlos J. Crespo

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Trends in faculty rank according to racial and ethnic composition have not been reviewed in over a decade.

Objective: To study trends in faculty rank according to racial and ethnicity with a specific focus on Indigenous faculty, which has been understudied.

Methods: Data from the Association of American Medical Colleges’ Faculty Administrative Management Online User System was used to study trends in race/ethnicity faculty composition and rank between 2014 and 2016, which included information on 481,753 faculty members from 141 US allopathic medical schools.

Results: The majority of medical school faculty were White, 62.4% (n = 300,642). Asian …

Enriching Clinical Learning Environments Through Partnerships: Academic And Practice Partnerships To Strengthen Care For Older Adults In Residential And Assisted Living Settings, Juliana Cartwright, Diana L. White

Institute on Aging Publications

This report was prepared by Oregon Health & Science University (OHSU) School of Nursing and the Institute on Aging at Portland State University to describe an academic-community partnership using the Enriching Clinical Learning Environments through Partnerships (ECLEPs) model. This two-year project was conducted with 34 students in the RN-BSN program in eight assisted living (AL) communities and ElderPlace, a PACE program serving residents in assisted living and other residential settings. Quality improvement was the focus of the project. Features of the ECLEPs model include:

• An intentional partnership between academic and clinical organizations
• Relationship-based; shared decision making
• Long-term commitment between partners …

From Research-To-Practice: An Adaptation And Dissemination Of The Compass Program For Home Care Workers, Ryan Olson, Jennifer Hess, Kelsey N. Parker, Sharon V. Thompson, Anjali Rameshbabu, Kristy Luther Rhoten, Miguel Marino

OHSU-PSU School of Public Health Faculty Publications and Presentations

The COMmunity of Practice And Safety Support (COMPASS) program was developed to prevent injuries and advance the health and well-being of home care workers. The program integrates elements of peer-led social support groups with scripted team-based programs to help workers learn together, solve problems, set goals, make changes, and enrich their supportive professional network. After a successful pilot study and randomized controlled trial, COMPASS was adapted for the Oregon Home Care Commission’s training system for statewide dissemination. The adapted program included fewer total meetings (7 versus 13), an accelerated meeting schedule (every two weeks versus monthly), and a range of …

Medicare Accountable Care Organizations Are Not Associated With Reductions In The Use Of Low-Value Coronary Revascularization, John M. Hollingsworth, Brahmajee K. Nallamothu, Phyllis Yan, Sarah Ward, Sunny C. Lin, Carrie H. Colla, Valerie A. Lewis, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

BACKGROUND:
Because specialty care accounts for half of Medicare expenditures, improving its value is critical to the success of Medicare accountable care organizations (ACOs) in curbing spending growth. However, whether ACOs have reduced low-value specialty care without compromising use of high-value services remains unknown.

METHODS AND RESULTS:
Using national Medicare data, we identified 2 cohorts: beneficiaries for whom the value of coronary revascularization is lower (those with ischemic heart disease without angina, congestive heart failure, or recent admission for acute myocardial infarction) and beneficiaries for whom its value is higher (those with recent acute myocardial infarction admission). We then determined …

Healing Pathways: A Program For Women With Physical Disabilities And Depression, Dena Hassouneh, Thuan Nguyen, Zunqiu Chen, Elizabeth Mcneff

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective. The objective of this study was to test the efficacy of the Healing Pathways (HP) program in reducing clinically significantly depressive symptoms in women with physical disabilities (WPD). Healing Pathways is a peer-implemented group mental health treatment program targeting WPD who have clinically significant cooccurring depressive symptoms. Participants. Eighty women were randomized in this trial. Design. This study used a community-based participatory intervention research design. Using community-based recruiting methods, participants were recruited from Centers for Independent Living, local disability service organizations, via Craig's list as well as other community locations such as grocery stores and bus …