The mission of the Center for Health Care Research and
Policy is to: (1) improve the health of the public by conducting
research that examines access to health care, increases the quality of
health care services, and informs health policy and practice; and (2)
lead educational programs that promote these goals.
, Progress Report Summary (2011)
|HIE Across Unaffiliated Systems Perceived as Cost-Saving but May be Inhibited by Financial Incentives and Market Competition. |
Research conducted by Center faculty and Senior Scholars reported the early adoption and perceived benefits of health information exchange (HIE) across unaffiliated health care systems in the November 2013 issue of the American Journal of Managed Care. Over 9000 MetroHealth patients had data obtained from other hospitals and clinical practice sites during the first 7 months of HIE availability through Epic’s Care Everywhere HIE system. As compared to patients for whom HIE was not requested, patients with HIE were older and had more medical conditions. By insurance type, commercially insured patients were least likely to have HIE requested. In a related survey, MetroHealth physicians reported that requesting outside clinical information was highly acceptable to patients and resulted in less redundant testing, reduced hospitalizations, and improved efficiency. “Lower HIE use among commercially insured patients reinforces concerns raised by others that financial incentives and market competition may be inhibiting widespread use” said Center Director Randall Cebul, senior author on the report. “This may slow the demonstration of HIE’s benefits to patients and other payers for health care.”
|Remembering Elizabeth McKinley|
It is my sad duty to share that Elizabeth “Lissa” McKinley, M.D.,M.P.H., founding dean of the Emily Blackwell Society and a treasured member of our school community, died Saturday after a long and courageous battle with cancer. She is survived by her husband, Robert “Chip” Gilkeson, M.D., a professor of radiology at Case Western Reserve, son, Will, and daughter Katie, as well as legions of physicians whom she taught to listen, hear, and heal. More.
|Love Named Fellow of the American Statistical Association|
Thomas Love, Director of the Center`s Biostatistics & Evaluation Unit, and Professor of Medicine, Epidemiology & Biostatistics at CWRU has been named a fellow of the American Statistical Association (ASA), the nation’s preeminent professional statistical society, announced ASA President Marie Davidian.
“I congratulate Thomas on being honored as a new ASA Fellow,” said Davidian. “His accomplishments have contributed greatly to the advancement of statistical science and have rightfully earned him the respect and admiration of his ASA peers.”
Love was honored for exemplary service and significant leadership in the statistical community, for notable contributions to statistical education, and for extensive collaborative efforts in clinical and health services research. He will be honored for his achievements at a ceremony August 6 at the annual Joint Statistical Meetings in Montréal, Québec, Canada.
|Bariatric Surgery Does Not Reduce Total Health Care Costs Over Time|
With colleagues at Johns Hopkins University, Center faculty member Shari Bolen, MD, MPH recently published an article in JAMA-Surgery that evaluated costs after bariatric surgery using insurance claims data from 7 different states in the U.S. (first article). As compared with obese individuals who did not undergo surgery, costs were not different for individuals undergoing bariatric surgery after 6 years of follow-up. According to Dr. Bolen, “while bariatric surgery may not reduce health care costs in the short-term, we still do not know the longer term effects, say after 15 to 20 years, when cost savings might accrue as a result of better control of diabetes and other cardiovascular diseases, as we have shown in the past (second article). In my opinion, we should continue to focus on lifestyle management of obesity, saving bariatric surgery for those individuals with severe obesity that affects their quality of life or for those with poorly controlled co-morbid illnesses.”
|Corlett Presented on the Likely Effects of Medicaid Expansion in Ohio, February 22nd. |
Center Senior Scholar and former Ohio Medicaid Director John R. Corlett, Vice President, Government Relations and Community Affairs for The MetroHealth System, will present the results of an important new study that has found that Ohio would net $1.4 billion over the next decade if Ohio were to expand Medicaid as allowed under the Affordable Care Act. Governor John Kasich revealed his administration’s Medicaid proposals with his proposed budget on February 5, 2013. Get HPIO (Health Policy Institute of Ohio) study here.
|Third Edition of Rating Scales in Mental Health Published by Johns Hopkins University Press.|
Center Senior Scholar Martha Sajatovic, MD, Willard Brown Chair in Neurological Outcomes Research and Professor of Psychiatry and of Neurology at University Hospitals, recently published the third edition of her book, co-authored with Luis Ramirez, MD, on rating scales in mental health. The book builds upon Dr. Sajatovic’s long-standing interest and expertise in neuropsychiatric health outcomes. As reviewed for Amazon.com, “this highly regarded compendium describes and analyzes 116 scales in 20 categories, including anxiety, bipolar disorder, depression, eating disorders, geriatrics, psychosis, sexual disorders, substance abuse, and suicide risk.” To see the review on Amazon, click here.
|MetroHealth Part of $5 Million National Effort to Study 800,000 Children Nationwide|
Under the direction of Center faculty member Dr. David Kaelber, The MetroHealth System is one of five systems chosen to participate in a national study that would use electronic health records (EHR) and other electronic data to study pediatric diseases in 800,000 children. The $5 million study is funded by the Health Resources and Services Administration in collaboration with the Eunice Kennedy Shriver National Institute of Child Health & Human Development. Projects include a study to examine the long-term side effects of pharmaceutical treatments in children, such as antipsychotic drugs and off-label asthma medications, and the prevalence and management of pediatric high blood pressure.
“This is a big step forward in our ability to study disease and improve the health of children nationally. Some diseases are relatively rare and some medications are used infrequently, so we need a large population of children to study,” said Kaelber. “Our electronic health records provide us opportunities to study these challenges in ways that we never dreamed of even 10 years ago.” Other investigators involved in this grant are from the American Academy of Pediatrics, Boston University and the Children’s Hospital of Philadelphia.
|Center Faculty Win International Award for Best Paper in Health Economics, 2012. Explains why small companies overpay for health insurance. |
When small companies think about why they spend so much on health insurance coverage for employees, their thoughts might include pre-existing conditions and bad lifestyle choices. But a recent study by faculty in the Center for Health Care Research and Policy identifies another cause of high premiums – and the results are receiving international acclaim. Read more.
|Better Health’s New England Journal of Medicine Manuscript Recognized as High Impact Publication by the American Medical Informatics Association|
During the Year in Review session at the AMIA Symposium, on Tuesday October 25, 2011 in Washington, D.C., “Electronic health records and the quality of diabetes care” was recognized among 2011’s high impact publications in two categories: Computerized Clinical Decision Support and Practice of Informatics http://faculty.washington.edu/dmasys/YearInReview/2011index.html
|Observational Study Suggests that ARBs may be a better choice than ACE-inhibitors in Certain Elderly Heart Failure Patients|
A team of researchers, including Center faculty member Thomas E. Love, Ph.D., reported important differences in the ways in which various heart failure drugs appear to work, depending on whether the patient has systolic or diastolic heart failure. A Reuters Health report on the study, which suggests that angiotensin receptor blockers (ARBs) may have an edge in some elderly heart failure patients over ACE-inhibitors, may be found at http://www.thedoctorschannel.com/go/reuters/4765.html