Research Briefs
Since 1967, Penn’s Leonard Davis Institute of 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. For more information, please contact Janet Weiner (weinerja@mail.med.upenn.edu).
Briefs from 2020
Duty Hour Reform and the Outcomes of Patients Treated by New Surgeons, Rachel R. Kelz, Bijan A. Niknam, Morgan M. Sellers, James E. Sharpe, Paul R. Rosenbaum, Alexander S. Hill, Hong Zhou, Lauren L. Hochman, Karl Y. Bilimoria, Kamal Itani, Patrick S. Romano, and Jeffrey H. Silber
Are There Enough Experienced Physicians to Treat Patients Hospitalized With COVID?, Kira L. Ryskina
Chronic Hospital Nurse Understaffing Meets COVID-19, Karen B. Lasater, Linda H. Aiken, Douglas M. Sloane, Rachel French, Brendan Martin, Kyrani Reneau, Maryann Alexander, and Matthew D. McHugh
Health Inequity in the United States: A Primer, José Escarce
Briefs from 2019
Household Monthly Alcohol Purchases After Washington's Privatization of Liquor, Sarah Beth L. Barnett, Norma B Coe, Jeffrey R. Harris, and Anirban Basu
Physician Consolidation and the Spread of Accountable Care Organizations, Genevieve P. Kanter, Daniel E. Polsky, and Rachel M. Werner
A National Comparison of Operative Outcomes of New and Experienced Surgeons, Rachel R. Kelz, Morgan M. Sellers, Bijan A. Niknam, James E. Sharpe, Paul R. Rosenbaum, Alexander S. Hill, Hong Zhou, Lauren L. Hochman, Karl Y. Bilimoria, Kamal Itani, Patrick S. Romano, and Jeffrey S. Silber
A National Comparison of Operative Outcomes of New and Experienced Surgeons, Rachel R. Kelz, Morgan M. Sellers, Mijan A. Niknam, James E. Sharpe, Paul R. Rosenbaum, Alexander S. Hill, Hong Zhou, Lauren L. Hochman, Karl Y. Bilimoria, Kamal Itani, Patrick S. Romano, and Jeffrey H. Silber
Evaluating A State Opioid Prescribing Limit and Electronic Medical Record Alert, Margaret Lowenstein, Erik Hossain, Wei Yang, Jeanmarie Perrone, Mark D. Neuman, Michael Ashburn, and M. Kit Delgado
Affirmative Action Bans and Health Risk Behaviors, Atheendar S. Venkataramani, Erin Cook, Rourke L. O'Brien, Ichiro Kawachi, Anupam B. Jena, and Alexander C. Tsai
Lower Health Care Use Among Elderly Patients Residing with Another Adult, Caroline Carlin and Guy David
Contributors to Post-Injury Mental Health In Urban Black Men With Serious Injuries, Therese S. Richmond, Douglas J. Wiebe, Patrick M. Reilly, John Rich, Justine Shults, and Nancy Kassam-Adams
Outcomes Associated With Good Hospital Work Environments for Nurses, Eileen T. Lake, Jordan Sanders, Kathryn A. Riman, Kathryn M. Schoenauer, and Yong Chen
Impact of Sweetened Beverage Tax on Chain Retailers in Philadelphia, Christina A. Roberto, Hannah G. Lawman, Michael T. LeVasseur, Nandita Mitra, Ana Peterhans, Bradley Herring, and Sara N. Bleich
Five-Year Cost of Dementia: Medicare, Lindsay White, Paul Fishman, Anirban Basu, Paul K. Crane, Eric B. Larson, and Norma B. Coe
The Effect of Predictive Analytics-Driven Interventions on Healthcare Utilization, Guy David, Aaron Smith-McLallen, and Benjamin Ukert
Assessing First Visits By Physicians To Medicare Patients Discharged To Skilled Nursing Facilities, Kira L. Ryskina, Yihao Yuan, Shelly Teng, and Robert Burke
U.S. Emergency Room Department Encounters for Firearm Injuries, 2009-2014, Edouard Coupet, Yanlan Huang, and M. Kit Delgado
Patient Outcomes After Hospital Discharge to Home with Home Health Care vs to a Skilled Nursing Facility, Rachel Werner, Norma B. Coe, Mingyu Qi, and R. Tamara Konetzka
Consumers' Responses to Surprise Medical Bills in Elective Situations, Benjamin Chartock, Christopher Garmon, and Sarah Schutz
Briefs from 2018
Changes to Racial Disparities in Readmission Rates After Medicare’s Hospital Readmissions Reduction Program Within Safety-Net and Non-Safety-Net Hospitals, Krisda Chaiyachati, Mingyu Qi, and Rachel Werner
Cost Impact of The Transitional Care Model for Hospitalized Cognitively Impaired Older Adults, Mark V. Pauly, Karen B. Hirschman, Alexandra L. Hanlon, Liming Huang, Kathryn H. Bowles, Christine Bradway, Kathleen McCauley, and Mary D. Naylor
Nurses' and Patients' Appraisals Show Patient Safety in Hospitals Remains a Concern, Linda H. Aiken, Douglas M. Sloane, Hilary Barnes, Jeannie P. Cimiotti, Olga F. Jarrín, and Matthew D. McHugh
A Comprehensive Measure of the Costs of Caring For a Parent: Differences According to Functional Status, Norma B. Coe, Meghan M. Skira, and Eric B. Larson
National Variation in Opioid Prescribing and Risk of Prolonged Use for Opioid-Naive Patients Treated in the Emergency Department for Ankle Sprains, M. Kit Delgado, Yanlan Huang, Zachary Meisel, Sean Hennessey, Michael Yokell, Daniel Polsky, and Jeanmarie Perrone
Trends in P2Y12 Receptor Inhibitor Use and Adherence After Percutaneous Coronary Intervention, 2008-2016, Elias J. Dayoub, Matthew Seigerman, Sony Tuteja, Taisei Kobayashi, Daniel Kolansky, Jay Giri, and Peter Groeneveld
A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation, Scott D. Halpern, Michael O. Harhay, Kathryn Saulsgiver, Christine Brophy, Andrea B. Troxel, and Kevin G. Volpp
The Future of Medicaid: State Legislator Views on Policy Waivers, Jane M. Zhu, Manik Chhabra, and David Grande
The Effect of Workforce Assignment on Performance: Evidence from Home Health Care, Guy David and Kunhee Lucy Kim
Lower Postsurgical Mortality for Individuals with Dementia with Better-Educated Hospital Workforce, Elizabeth M. White, Jessica G. Smith, Rebecca L Trotta, and Matthew D McHugh
Prior Authorization Requirements for Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors Across US Private and Public Payers, Jalpa A. Doshi, John Puckett, Michael S. Parmacek, and Daniel J. Rader
State Firearm Laws and Interstate Firearm Deaths From Homicide and Suicide in the United States: A Cross-Sectional Analysis of Data by County, Elinore J. Kaufman, Christopher N. Morrison, Charles C. Branas, and Douglas J. Wiebe
The Effect of Integration of Hospitals and Post-Acute Care Providers on Medicare Payment and Patient Outcomes, R Tamara Konetzka, Elizabeth A. Stuart, and Rachel M Werner
Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments: A Clinical Trial, Krisda H. Chaiyachati, Rebecca A. Hubbard, Alyssa Yeager, Brian Mugo, Stephanie Lopez, Elizabeth Asch, Catherine Shi, Judy A. Shea, Roy Rosin, and David Grande
Association between Electronic Medical Record Implementation of Default Opioid Prescription Quantities and Prescribing Behavior in Two Emergency Departments, M. Kit Delgado, Frances S. Shofer, Mitesh S. Patel, Scott Halpern, Christopher Edwards, Zachary F. Meisel, and Jeanmarie Perrone
Association of Patient Out-of-Pocket Costs With Prescription Abandonment and Delay in Fills of Novel Oral Anticancer Agents, Jalpa A. Doshi, Pengxiang Li, Amy R. Pettit, and Katrina A. Armstrong
Briefs from 2017
Physicians and Advanced Practitioners Specializing in Nursing Home Care, 2012-2015, Kira L. Ryskina, Daniel Polsky, and Rachel M Werner
Declining Medicaid Fees and Primary Care Availability for New Medicaid Patients, Molly Candon, Stephen Zuckerman, Douglas Wissoker, Brendan Saloner, Genevieve M. Kenney, Karin Rhodes, and Daniel Polsky
Networks in ACA Marketplaces are Narrower for Mental Health Care Than for Primary Care, Jane M. Zhu, Yuehan Zhang, and Daniel Polsky
Community Health Worker Support For Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial, Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A. Smith, and Judith A. Long
Structural, Nursing, and Physician Characteristics and 30-Day Mortality for Patients Undergoing Cardiac Surgery in Pennsylania, Meghan Lane-Fall, Tara Ramaswamy, Sydney E. S Brown, Xu He, Jacob Gutsche, Lee A. Fleisher, and Neuman Mark
Relation Between Narrow Networks and Providers of Cancer Care, Laura Yasaitis, Justin E. Bekelman, and Daniel Polsky
Hospital Readmission and Social Risk Factors Identified from Physician Notes, Amol Navathe, Feiran Zhong, Victor J. Lei, Frank Y. Chang, Margarita Sordo, Maxim Topaz, Shamkant B. Navathe, Roberto A. Rocha, and Li Zhou
Effect of a Price Transparency Intervention in the Electronic Health Record on Clinician Ordering of Inpatient Laboratory Tests, Mina S. Sedrak, Jennifer S. Myers, Dylan Small, Irving Nachamkin, Justin B. Ziemba, Dana Murray, Gregory W. Kurtzman, Jingsan Zhu, Wenli Wang, Deborah Mincarelli, Daniel Danoski, Brian P. Wells, Jeffrey S. Berns, Patrick J. Brennan, C. William Hanson, Jessica Dine, and Mitesh S. Patel
Evaluating the Impact of the Laborist Model of Obstetric Care on Maternal and Neonatal Outcomes, Sindhu K. Srinivas, Dylan Small, Michelle Macheras, Jesse Yenchih Hsu, Donna Caldwell, and Scott Lorch
Pediatric and Adult Physician Networks in Affordable Care Act Marketplace Plans, Charlene A. Wong, Kristin Kan, Zuleyha Cidav, Robert Nathenson, and Daniel Polsky
Cost of Joint Replacement Using Bundled Payment Models, Amol Navathe, Andrea B. Troxel, Joshua M. Liao, Nan Nan, Jingsan Zhu, Wenjun Zhong, and Ezekiel J. Emanuel
Briefs from 2016
Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial, Said A. Ibrahim, Marissa Blum, Gwo-Chin Lee, Pekka Mooar, Elina Medvedeva, Aliya Collier, and Diane Richardson
Recurrent Violent Injury: Magnitude, Risk Factors and Opportunities For Intervention From a Statewide Analysis, Elinore Kaufman, Kristin Rising, Douglas Wiebe, David Ebler, Marie Crandall, and M. Kit Delgado
Marketplace Plans With Narrow Physician Networks Feature Lower Monthly Premiums Than Plans With Larger Networks, Daniel Polsky, Zuleyha Cidav, and Ashley Swanson
Racial Disparities in Geographic Access to Primary Care in Philadelphia, Elizabeth J. Brown, Daniel Polsky, Corentin M. Barbu, Jane Seymour, and David Grande
Physicians’ Participation in ACOs is Lower in Places With Vulnerable Populations Than in More Affluent Communities, Laura C. Yasaitis, William Pajerowski, Daniel Polsky, and Rachel M Werner
Effects of Autism Spectrum Disorder Insurance Mandates on the Treated Prevalence of Autism Spectrum Disorder, David S. Mandell, Colleen L. Barry, Steven C. Marcus, Ming Xie, Kathleen Shea, Katherine Mullan, and Andrew J Epstein
Primary Care Appointment Availability for Medicaid Patients: Comparing Traditional and Premium Assistance Plans, Simon Basseyn, Brendan Saloner, Genevieve M. Kenney, Douglas Wissoker, Daniel Polsky, and Karin V. Rhodes
Impact of Medicare Advantage Prescription Drug Plan Star Ratings on Enrollment Before and After Implementation of Quality-Related Bonus Payments in 2012, Pengxiang Li and Jalpa A. Doshi
Click Worthy: Stories Encourage Emergency Physicians to Learn More About Opioid Prescribing Guidelines, Zachary Meisel, Joshua P. Metlay, Lauren Sinnenberg, Austin S. Kilaru, Anne V Grossestreuer, Frances K. Barg, Frances S. Shofer, Karin V. Rhodes, and Jeanmarie Perrone
Detecting Potential Overbilling in Medicare Reimbursement via Hours Worked, Hanming Fang and Qing Gong
For Third Enrollment Period, Marketplaces Expand Decision Support Tools to Assist Consumers, Charlene A. Wong, Daniel Polsky, Arthur T Jones, Janet Weiner, Robert Town, and Tom Baker
High Cost Sharing and Specialty Drug Initiation Under Medicare Part D: A Case Study in Patients With Newly Diagnosed Chronic Myeloid Leukemia, Jalpa A. Doshi, Pengxiang Li, Hairong Huo, Amy R. Pettit, Rishab Kumar, Brendan M. Weiss, and Scott F. Huntington
Transparency and Negotiated Prices: The Value of Information in Hospital-Supplier Bargaining, Matthew Grennan and Ashley Swanson
Changes in Consumer Demand Following Public Reporting of Summary Quality Ratings: An Evaluation in Nursing Homes, Rachel M. Werner, R Tamara Konetzka, and Daniel Polsky
Adjuvant Chemotherapy Use and Health Care Costs After Introduction of Genomic Testing in Breast Cancer, Andrew J Epstein, Yu-Ning Wong, Nandita Mitra, Anil Vachani, Sakhena Hin, Lin Yang, Aaron Smith-McLallen, Katrina Armstrong, and Peter W. Groeneveld
Comparison of the Value of Nursing Work Environments in Hospitals Across Different Levels of Patient Risk, Jeffrey H. Silber, Paul R. Rosenbaum, Matthew D McHugh, Justin M. Ludwig, Herbert L. Smith, Bijan A. Nikman, Orit Even-Shoshan, Lee A. Fleisher, Rachel R. Kelz, and Linda H. Aiken
Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial, David A. Asch, Andrea B. Troxel, Walter F. Stewart, Thomas D. Sequist, James B. Jones, AnneMarie G. Hirsch, Karen Hoffer, Jingsan Zhu, Wenli Wang, Amanda Hodolfski, Antoinette B. Frasch, Mark G. Weiner, Darra D. Finnerty, Meredith B. Rosenthal, Kelsey Gangemi, and Kevin G. Volpp
Briefs from 2015
ACA-Mandated Elimination of Cost Sharing for Preventive Screening has had Limited Early Impact, Shivan Mehta, Daniel Polsky, Jingsan Zhu, James Lewis, Jonathan T. Kolstad, George Loewenstein, and Kevin G. Volpp
Increasing the Value of Health Care: The Role of Nurses, Richard C. Lindrooth, Olga Yakusheva, Julie A Fairman, Mary D. Naylor, and Mark V. Pauly
Nursing in a Transformed Health Care System: New Roles, New Rules, Erin Fraher, Joanne Spetz, and Mary D. Naylor
Briefs from 2014
Primary Care Shortages: More Than a Head Count, Mark V. Pauly, Mary D. Naylor, and Janet Weiner