Publications (51) View all
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Article: Commentary: Measuring What Matters Most.
Milbank Quarterly 03/2013; 91(1):201-204. · 5.62 Impact Factor -
Article: Ethnic differences in potentially preventable hospitalizations among Asian Americans, Native Hawaiians, and other Pacific Islanders: implications for reducing health care disparities.
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ABSTRACT: A serious challenge to eliminating US health disparities stems from the inability to reliably measure outcomes, particularly for numerically small populations. Our study aimed to produce reliable estimates of health care quality among Native Hawaiian (NH), Other Pacific Islander (PI), and Asian American (AA) subgroups. Prevention Quality Indicators (PQIs) from the Agency for Healthcare Research and Quality were used to calculate 3 PQI composites and 8 individual chronic condition indicators. Data sources were the Healthcare Cost and Utilization Project State Inpatient Databases and the Hawaii Health Survey. Risk-adjusted PQI rates for adults were computed for 2005 through 2007. Relative rates for 2007 were calculated for each racial/ethnic group and compared to Whites. Statistical significance was based on P < .05 from a two-sided t test. The combined AANHPI group had higher overall and chronic PQI composite rates than Whites in 2007. When disaggregated into discrete racial/ethnic subgroups, Chinese and Japanese had lower rates than Whites for all 3 composites, whereas NH and Other PI subgroups typically had the worst health outcomes. Trends in PQI rates from 2005 through 2007 showed persistent gaps between groups, especially across chronic PQIs. Despite recent efforts to reduce racial/ethnic health care disparities, significant gaps remain in potentially preventable hospitalization rates. Practical tools that measure inequities across diverse, numerically small populations may suggest ways to optimally funnel limited resources toward improving racial/ethnic differences in health outcomes.Ethnicity & disease 01/2013; 23(1):6-11. · 0.90 Impact Factor -
Article: Racial disparities in the frequency of patient safety events: results from the National Medicare Patient Safety Monitoring System.
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ABSTRACT: Although there is extensive evidence of racial disparities in processes and outcomes of medical care, there has been limited investigation of disparities in patient safety. To determine whether there are racial disparities in the frequency of adverse events studied in the Medicare Patient Safety Monitoring System. Abstraction of 102,623 randomly selected charts from hospital discharges of non-Hispanic white and black Medicare patients between January 1, 2004 and December 31, 2007 to assess frequency of patient safety events in 4 domains: general (pressure ulcers and falls), selected nosocomial infections, selected procedure-related adverse events, and adverse drug events due to anticoagulants and hypoglycemic agents. Racial disparities in risk of patient safety events, and differences in adverse event rates among hospital groups stratified by percentage of black patients. Blacks had higher adjusted risk than whites of suffering one of the measured nosocomial infections (1.34; 95% confidence interval, 1.17-1.55; P < 0.001) and one of the measured adverse drug events (1.29; 95% confidence interval, 1.19-1.40; P < 0.001). After adjustment for patient and hospital factors, patients in hospitals with the highest percentages of black patients were at increased risk of experiencing one of the measured nosocomial infections (1.9% vs. 1.5%; P < 0.001) and adverse drug events (8.7% vs. 7.8%; P < 0.01). Hospitalized blacks are at higher risk than whites of experiencing certain patient safety events. In addition, hospitals serving high percentages of black patients have higher risk-adjusted rates of selected patient safety events.Medical care 05/2011; 49(5):504-10. · 3.24 Impact Factor -
Article: How innovative treatment models and data use are improving diabetes care among older African American adults.
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ABSTRACT: By 2030, the number of older adults within the United States will have doubled to approximately 71.5 million. Included in this population estimate is the relative growth in the number of older adults of racial and ethnic minority descent. Research has indicated that these individuals, specifically African Americans, have a higher incidence of diabetes than whites, as well as a higher rate of hospitalization compared to whites. This is also true for the older African American. Unfortunately, those with the greatest need for diabetes-related care are least likely to access that care. Moreover, in spite of the indication of need, it is extremely difficult to fully identify strategies that would be optimal for these older minority populations. This paper addresses strategies and techniques to fill gaps in knowledge by detailing efforts, such as the use of health information technologies and multilevel diabetes education teams, to improve the health outcomes of older adult African Americans who have diabetes.Population Health Management 02/2011; 14(3):143-55. · 1.02 Impact Factor -
Article: Potentially preventable hospitalizations - United States, 2004-2007.
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ABSTRACT: When patients seek prompt attention from primary care providers for acute illnesses (e.g., pneumonia) or worsening of chronic conditions (e.g., diabetes), hospitalization often can be avoided. Hospitalizations that better primary care could have prevented are termed "potentially preventable hospitalizations." Although not all such hospitalizations can be avoided, rates of potentially preventable hospitalizations vary; communities with poorer access to coordinated primary care tend to have higher rates of potentially preventable hospitalizations.MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries / CDC 01/2011; 60 Suppl:80-3.
