Author Interviews, COVID -19 Coronavirus, Education / 18.09.2020

MedicalResearch.com Interview with: Thomas M. Selden Director of the Division of Research and Modeling Center for Financing, Access, and Cost Trends Agency for Healthcare Research and Quality Rockville, Maryland MedicalResearch.com: What is the background for this study? Response: Across the United States, school districts are facing decisions about whether and how to reopen elementary and secondary schools. We conducted this study to provide evidence on the risk of severe COVID-19 among adults who are connected to schools in some way – as teachers or other school workers or as household members of school-age children or school employees. The Agency for Healthcare Research and Quality (AHRQ) collects the data we used in this study as part of its longstanding Medical Expenditure Panel Survey (MEPS), which is the nation’s most complete source of data on the cost and use of health care and health insurance coverage. (more…)
Author Interviews, COVID -19 Coronavirus / 08.05.2020

MedicalResearch.com Interview with: Anirban Basu, Ph.D. Stergachis Family Endowed Director and Professor The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute University of Washington, Seattle MedicalResearch.com: What is the background for this study? What are the main findings? Response: The infection fatality ratio (IFR) of Covid19 infections is a key parameter to model the future burden of this pandemic. Case fatality rates at any point in time provide a biased estimate of IFR because of the undercounting in both the reported number of covid deaths (numerator) and the reported number of Covid19 cases (denominator). Instead, this study looked at the temporality or time trend of the CFRs within specific counties in the US (where data were deemed to be mature) to understand the underlying IFRs that these trends allude to. It estimates county-specific IFR to range from 0.5% to 3.6%, with a population average for the US at 1.3% (95% CCI: 0.6% - 2.1%). (more…)
Author Interviews, Health Care Systems, University of Pittsburgh / 10.12.2019

MedicalResearch.com Interview with: Hayley Drew Germack PhD Assistant Professor of Acute and Tertiary Care University of Pittsburgh School of Nursing MedicalResearch.com: What is the background for this study? Response: The rate of rural hospital closures has been increasing over the last ten years. Rural hospitals close for a number of reasons including poor hospital economic health tied to uncompensated care and community factors, like a local aging population. Rural hospital and unit closures have been tied to decreased access to emergency and specialty care for patients including decreased access to obstetric-gynecological services and increase travel time for appointments. A recent paper also found a 6% increase in mortality in conditions needing emergent attention after rural hospital closures. We examined the impact of hospital closures in rural counties on the counties’ supply of physicians. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Race/Ethnic Diversity / 05.08.2019

MedicalResearch.com Interview with: Muhammad Ali Chaudhary, MD Research Scientist Center for Surgery and Public Health Department of Surgery Brigham and Women’s Hospital Harvard Medical School Harvard T. H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Many studies have documented disparities in cardiovascular care for minorities, specifically African Americans compared to white patients. Coronary artery bypass grafting (CABG) is a common procedure in the United States, and the outcomes and post-surgical care for African Americans tend to be worse. We examined whether patients insured through TRICARE — a universal insurance and equal-access integrated healthcare system that covers more than 9 million active-duty members, veterans and their families — experienced these disparities. We found no racial disparities in quality-of-care outcomes, providing insights about the potential impacts of universal insurance and an equal-access health care system. The study included 8,183 TRICARE patients, aged 18-64, who had undergone CABG. The study took its data from TRICARE health care claims from the Military Health System Data Repository for the years of 2006 to 2014. (more…)
Author Interviews, Electronic Records / 02.07.2019

MedicalResearch.com Interview with: Ming Tai-Seale, PhD, MPH Professor Department of Family Medicine and Public Health University of California San Diego School of Medicine MedicalResearch.com: What is the background for this study? Response: The electronic health record (EHR) potentially creates a 24/7 work environment for physicians. Its impact on physicians’ wellness has become a challenge for most health care delivery organizations. Understanding the relationships between physicians’ well-being and “desktop medicine”1 work in the EHR and work environment is critical if burnout is to be addressed more effectively. (more…)
Author Interviews, Education, Outcomes & Safety / 08.05.2019

MedicalResearch.com Interview with: Veronica Toffolutti PhD Postdoctoral researcher working with Professor David Stuckler Department of Sociology Bocconi University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Openness has been linked with better patient safety and better understanding of patients’ care goals. In addition, more open environments appear to be linked with positively ranked quality of teamwork, which in turns lead to better health care. Yet if the expected benefits are to be achieved, it is necessary to show that greater openness actually corresponds to improvements in performance or lower mortality rates. To the best of our knowledge our is the first study to show an association between hospital mortality and openness and more precisely one point increase in the standardized openness score leads to a decrease of 6.48% in the hospital mortality rates. With the term openness we refer to an environment in which communication among patients, staff members and managers is open and transparent. (more…)
Author Interviews, Health Care Systems, Outcomes & Safety, University of Pennsylvania / 01.04.2019

MedicalResearch.com Interview with: Kira L. Ryskina MD MS Assistant Professor Of Medicine Division of General Internal Medicine Perelman School of Medicine, University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Post-acute care in skilled nursing facilities (SNF or sometimes called subacute rehab) is a very common discharge destination after a hospital stay. Patients discharged to these facilities represent more clinically complex and high-need patients than patients discharged home. We wanted to understand how soon after discharge from the hospital to a skilled nursing facility are patients seen by a physician. We found that first visits by a physician or advanced practitioner (a nurse practitioner or physician assistant) for initial medical assessment occurred within four days of SNF admission in 71.5 percent of the stays. However, there was considerable variation in days to first visit at the regional, facility, and patient levels. One in five initial physician visits occurred more than 4 days after admission to skilled nursing facilities. In 10.4 percent of stays there was no physician or advanced practitioner visit. Much of the variability in visit timing had to do with SNF characteristics and geography compared to patient clinical or demographic characteristics. Patients who did not receive a physician visit had nearly double the rates of readmissions or deaths compared to patients who were seen. (more…)
Author Interviews, Cost of Health Care, University of Pittsburgh / 08.01.2019

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of our study was to answer a research question of high policy relevance: to what extent are rising drug costs due to inflation in the prices of existing products versus the market entry of new, more expensive drugs. We found that rising prices of brand-name drugs are largely driven by manufacturers increasing prices of medications that are already in the market rather than to the entry of new products. In contrast, increases in costs of specialty and generic drugs were driven by the entry of new drugs. (more…)