Research Briefs

Since 1967, Penn's Leonard Davis Institute of Health Economics (LDI) has been the leading university institute dedicated to data-driven, policy-focused research that improves our nation’s health and health care. LDI’s Research Briefs provide a succinct summary of key findings and policy implications of new studies conducted by LDI’s Senior Fellows. They are produced by LDI’s policy team.





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Now showing 1 - 10 of 69
  • Publication
    Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial
    (2016-01-15) Asch, David A; Troxel, Andrea B; Stewart, Walter F; Sequist, Thomas D; Jones, James B; Hirsch, AnneMarie G; Hoffer, Karen; Zhu, Jingsan; Wang, Wenli; Hodolfski, Amanda; Frasch, Antoinette B; Weiner, Mark G; Finnerty, Darra D; Volpp, Kevin G; Rosenthal, Meredith B; Gangemi, Kelsey
    Can financial incentives be used to reduce cholesterol levels in high-risk patients? This randomized trial says modest reductions can be achieved only by targeting incentives to both patients and physicians, not to one or the other.
  • Publication
    ACA-Mandated Elimination of Cost Sharing for Preventive Screening has had Limited Early Impact
    (2015-12-21) Polsky, Daniel; Zhu, Jingsan; Mehta, Shivan; Lewis, James; Volpp, Kevin G; Kolstad, Jonathan T; Loewenstein, George
    Did the Affordable Care Act’s elimination of cost sharing for preventive services increase rates of colonoscopy and mammography screening? Early results say no.
  • Publication
    Comparison of the Value of Nursing Work Environments in Hospitals Across Different Levels of Patient Risk
    (2016-01-20) Silber, Jeffrey H; Rosenbaum, Paul R; McHugh, Matthew D; Ludwig, Justin M; Even-Shoshan, Orit; Smith, Herbert L; Nikman, Bijan A; Fleisher, Lee A; Kelz, Rachel R; Aiken, Linda H
    Hospitals with better nurse working environments provide better value (lower mortality with similar costs) especially for higher-risk surgical patients.
  • Publication
    Effect of Nudges to Clinicians, Patients, or Both to Increase Statin Prescribing: A Cluster Randomized Clinical Trial
    (2022-12-06) Tachibana, Chris
    Nudges — which present information or set choices to achieve desired behavior — increased guideline based statin prescribing over usual care. Clinician nudges alone had a small effect, patient nudges alone had no effect, and combined clinician and patient nudges had the greatest effect, increasing prescribing by 7.2 percentage points. The interventions employed a common electronic health record (EHR) system, making them generalizable and scalable.
  • Publication
    Duty Hour Reform and the Outcomes of Patients Treated by New Surgeons
    (2020-12-10) Kelz, Rachel R.; Niknam, Bijan A.; Sellers, Morgan M.; Sharpe, James E.; Rosenbaum, Paul R.; Hill, Alexander S.; Zhou, Hong; Hochman, Lauren L.; Bilimoria, Karl Y.; Itani, Kamal; Romano, Patrick S.; Silber, Jeffrey H.
    Despite concerns that duty hour reform might adversely affect the performance of new surgeons, this national study found no impact on patient outcomes, including 30-day mortality rates, failure-to-rescue, length of stay, and use of intensive care units. These findings should allay fears that reduced work hours during residency would produce surgeons less prepared for practice than their more experienced colleagues.
  • Publication
    Chronic Hospital Nurse Understaffing Meets COVID-19
    (2020-08-18) Lasater, Karen B.; Aiken, Linda H.; Sloane, Douglas M.; French, Rachel; Martin, Brendan; Reneau, Kyrani; Alexander, Maryann; McHugh, Matthew D.
    A study of hospitals in New York and Illinois at the start of the COVID-19 pandemic found that most did not meet benchmark patient-to-nurse staffing ratios for medical-surgical or intensive care units. New York City hospitals had especially low staffing ratios. Understaffed hospitals were associated with less job satisfaction among nurses, unfavorable grades for patient safety and quality of care, and hesitance by nurses and patients to recommend their hospitals.
  • Publication
    A National Comparison of Operative Outcomes of New and Experienced Surgeons
    (2019-10-25) Kelz, Rachel R.; Sellers, Morgan M.; Niknam, Bijan A.; Sharpe, James E.; Rosenbaum, Paul R.; Hill, Alexander S.; Zhou, Hong; Hochman, Lauren L.; Bilimoria, Karl Y.; Itani, Kamal; Romano, Patrick S.; Silber, Jeffrey S.
  • Publication
    Are There Enough Experienced Physicians to Treat Patients Hospitalized With COVID?
    (2020-11-16) Ryskina, Kira L.
    In this national study of 438,895 physicians, 45% provided care to hospitalized patients and 7% provided critical care. At the high estimate of patients requiring hospitalization at the projected peak of the pandemic, 18 states and Washington, DC would have patient to physician ratios greater than 15:1 (a level associated with poor outcomes among hospitalized patients). There was considerable geographic variation in the availability of physicians: 41% of hospital service areas did not have a physician with critical care experience.
  • Publication
    Affirmative Action Bans and Health Risk Behaviors
    (2019-07-19) Venkataramani, Atheendar S.; Cook, Erin; O'Brien, Rourke L.; Kawachi, Ichiro; Jena, Anupam B.; Tsai, Alexander C.
    College affirmative action bans were associated with higher rates of smoking and drinking in underrepresented minority 11th and 12th graders, and these students continued to smoke at higher rates into young adulthood. Policymakers should consider unintended public health consequences of proposals, such as affirmative action bans, that may limit socioeconomic opportunities.
  • Publication
    Health Inequity in the United States: A Primer
    (2020-01-06) Escarce, José
    By any measure, the United States has a level of health inequity rarely seen among developed nations. The roots of this inequity are deep and complex, and are a function of differences in income, education, race and segregation, and place. In this primer, we provide an overview of these distinctly American problems, and discuss programs and policies that might promote greater health equity in the population.