Publications

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Policy Note
In 1975, a cap of $250,000 was adopted by California on noneconomic losses in malpractice cases. It was imposed in a time of perceived crisis, when state legislators and others believed rising malpractice premiums and risk of lawsuit would encourage physicians to retire from practicing medicine and would raise overall medical costs through defensive medicine.
Policy Note
In 1975, a cap of $250,000 was adopted by California on noneconomic losses in malpractice cases. It was imposed in a time of perceived crisis, when state legislators and others believed rising malpractice premiums and risk of lawsuit would encourage physicians to retire from practicing medicine and would raise overall medical costs through defensive medicine.
Policy Research Report
California has promoted value-based care in its public hospitals under a Section 1115 Medicaid Waiver called Public Hospital Redesign and Incentives in Medi-Cal (PRIME), a waiver overseen by California’s Department of Health Care Services (DHCS). PRIME required public hospitals to significantly transform their outpatient care delivery to receive payment for improved performance.
Policy Research Report
California has promoted value-based care in its public hospitals under a Section 1115 Medicaid Waiver called Public Hospital Redesign and Incentives in Medi-Cal (PRIME), a waiver overseen by California’s Department of Health Care Services (DHCS). PRIME required public hospitals to significantly transform their outpatient care delivery to receive payment for improved performance.
Journal Article
There has been little research on the relationship between education and health care utilization, especially for racial/ethnic minorities. This study aimed to examine the association between education and hospitalizations, investigate the mechanisms, and disaggregate the relationship by gender, race/ethnicity, and age groups. A retrospective cohort analyst was conducted using data from the 1992–2016 U.S. Health and Retirement Study.
Journal Article
There has been little research on the relationship between education and health care utilization, especially for racial/ethnic minorities. This study aimed to examine the association between education and hospitalizations, investigate the mechanisms, and disaggregate the relationship by gender, race/ethnicity, and age groups. A retrospective cohort analyst was conducted using data from the 1992–2016 U.S. Health and Retirement Study.
Journal Article
The authors examined how estimates of the association between nurse staffing and patient length of stay (LOS) change with data aggregation over varying time periods and settings, and statistical controls for unobserved heterogeneity. They used longitudinal secondary data from October 2002 to September 2006 for 215 intensive care units and 438 general acute care units at 143 facilities in the Veterans Affairs (VA) health care system.
Journal Article
The authors examined how estimates of the association between nurse staffing and patient length of stay (LOS) change with data aggregation over varying time periods and settings, and statistical controls for unobserved heterogeneity. They used longitudinal secondary data from October 2002 to September 2006 for 215 intensive care units and 438 general acute care units at 143 facilities in the Veterans Affairs (VA) health care system.
Research Report
California has promoted value-based care in its public hospitals under a Section 1115 Medicaid Waiver called Public Hospital Redesign and Incentives in Medi-Cal (PRIME), a waiver overseen by California’s Department of Health Care Services (DHCS). PRIME required 54 public hospitals to significantly transform their outpatient care delivery, receiving payment for improved performance.
Research Report
California has promoted value-based care in its public hospitals under a Section 1115 Medicaid Waiver called Public Hospital Redesign and Incentives in Medi-Cal (PRIME), a waiver overseen by California’s Department of Health Care Services (DHCS). PRIME required 54 public hospitals to significantly transform their outpatient care delivery, receiving payment for improved performance.
Journal Article
The California Delivery System Reform Incentive Payment Program (DSRIP) provided incentive payments to Designated Public Hospitals (DPHs) to improve quality of care. Authors assessed the program's impact on reductions in sepsis mortality, central line-associated bloodstream infections (CLABSIs), venous thromboembolisms (VTEs), and hospital-acquired pressure ulcers (HAPUs).
Journal Article
The California Delivery System Reform Incentive Payment Program (DSRIP) provided incentive payments to Designated Public Hospitals (DPHs) to improve quality of care. Authors assessed the program's impact on reductions in sepsis mortality, central line-associated bloodstream infections (CLABSIs), venous thromboembolisms (VTEs), and hospital-acquired pressure ulcers (HAPUs).
Journal Article
Using multi-state discharge data, to identify predictors of frequent emergency department (ED) use among the homeless patients seen in emergent care, and to compare frequent versus less frequent homeless ED users for their risk of serious health services utilization outcomes.
Journal Article
Using multi-state discharge data, to identify predictors of frequent emergency department (ED) use among the homeless patients seen in emergent care, and to compare frequent versus less frequent homeless ED users for their risk of serious health services utilization outcomes.
Journal Article
​The association of nursing staffing with patient outcomes has primarily been studied by comparing high to low staffed hospitals, raising concern other factors may account for observed differences. Authors examine the association of inpatient mortality with patients’ cumulative exposure to shifts with low registered nurse (RN) staffing, low nursing support staffing and high patient turnover. Authors used cumulative counts of exposure to shifts with low staffing and high patient turnover as time-varying covariates in survival analysis of data from a three-campus US academic medical center for 2007–2012.
Journal Article
​The association of nursing staffing with patient outcomes has primarily been studied by comparing high to low staffed hospitals, raising concern other factors may account for observed differences. Authors examine the association of inpatient mortality with patients’ cumulative exposure to shifts with low registered nurse (RN) staffing, low nursing support staffing and high patient turnover. Authors used cumulative counts of exposure to shifts with low staffing and high patient turnover as time-varying covariates in survival analysis of data from a three-campus US academic medical center for 2007–2012.
Journal Article
High-cost patients are a frequent focus of improvement projects based on primary care and other settings. Efforts to characterize high-cost, high-need patients are needed to inform care planning, but such efforts often rely on a priori assumptions, masking underlying complexities of a heterogenous population. In this study, authors define recognizable subgroups of patients among high-cost adults based on clinical conditions, and describe their survival and future spending.
Journal Article
High-cost patients are a frequent focus of improvement projects based on primary care and other settings. Efforts to characterize high-cost, high-need patients are needed to inform care planning, but such efforts often rely on a priori assumptions, masking underlying complexities of a heterogenous population. In this study, authors define recognizable subgroups of patients among high-cost adults based on clinical conditions, and describe their survival and future spending.
Journal Article
Congressional and Veterans Affairs (VA) leaders have recommended the VA become more of a purchaser than a provider of health care. Fee-for-service Medicare provides an example of how purchased care differs from the VA's directly provided care. Using established indicators of overly intensive end-of-life care, authors compared the quality of care provided through the two systems to veterans dying of cancer in fiscal years 2010–14.
Journal Article
Congressional and Veterans Affairs (VA) leaders have recommended the VA become more of a purchaser than a provider of health care. Fee-for-service Medicare provides an example of how purchased care differs from the VA's directly provided care. Using established indicators of overly intensive end-of-life care, authors compared the quality of care provided through the two systems to veterans dying of cancer in fiscal years 2010–14.