RESEARCH
Medical Care
Alsan M, Morden NE, Gottlieb JD, Zhou W , Skinner JS
Excessive antibiotic use in cold and flu season is costly and contributes to antibiotic resistance. The study objective was to develop an index of excessive antibiotic use in cold and flu season and determine its correlation with other indicators of prescribing quality.
Medical Care
Morden NE, Munson JC, Colla CH, Skinner JS, Bynum JPW, Zhou, W, Meara E
Prescription opioid use and overdose deaths are increasing in the United States. Among disabledMedicare beneficiaries under the age of 65, the rise in musculoskeletal conditions as qualifying diagnoses suggests that opioid analgesic use may be common and increasing, raising safety concerns.
Medical Care
Yasaitis LC, Bynum JP, Skinner JS
There is considerable regional variation in Medicare outpatient visit rates; such variations may be the consequence of patient health, race/ethnicity differences, patient preferences, or physician supply and beliefs about the efficacy of frequently scheduled visits. The objective of the study was to test associations between varying regional Medicare outpatient visit rates and beneficiaries' health, race/ethnicity, preferences, and physician practice norms and supply.
Medical Care
Bynum JP, Fisher ES, Song Y, Skinner JS, Chandra A
Improving the health of minority patients who have diabetes depends in part on improving quality and reducing disparities in ambulatory care. It has been difficult to measure these components at the level of actionable units.
Medical Care
Barnato AE, Herndon MB, Anthony DL, Gallagher, Skinner JS, Bynum, JPW, Fisher ES
We sought to test whether variations across regions in end-of-life (EOL) treatment intensity are associated with regional differences in patient preferences for EOL care.
Medical Care
Moen EL, Bynum JP, Austin AA, Skinner JS, Chakraborti G, O’Malley AJ
Implantable cardioverter defibrillator (ICD) therapy is used for primary prevention of death among people with heart failure, and new evidence in 2005 on its effectiveness changed practice guidelines in the United States. The objective of this study is to examine how the connectedness of physicians and hospitals, measured using network analysis, relates to guideline-consistent ICD implantation. We constructed physician and hospital networks for cardiovascular disease. Physicians were linked if they shared cardiovascular disease patients; these links were aggregated by hospital affiliation to construct a hospital network…
Medical Care
Alexander J. Mainor, JD, MPH, Nancy E. Morden, MD, MPH, Jeremy Smith, MPH, Stephanie Tomlin, MS, MPA, and Jonathan Skinner, PhD
Using an analysis of Medicare data before and after the switch, we illustrate potential pitfalls of these crosswalks. We test some available translations by measuring weekly frequencies of common conditions during the transition and reveal the discontinuity of measures temporally aligned with the adoption of ICD-10 (October 1, 2015, the first day of the fourth quarter of 2015). We then suggest addressing this problem by creating a public good for all researchers, using a web-based platform, “Dataverse” for sharing ICD-9 and comparable ICD-10 definitions, rate comparisons that quantify the discontinuity in diverse datasets (to allow adjustment for comparisons over time), and the programming code used to make the comparisons. Our exploration of inpatient diagnostic code discontinuity illustrates the problem and serves as a starting point for the envisioned shared resource that would include a broad range of datasets.
