Financial Toxicity Order Set: Implementing a Simple Intervention to Better Connect Patients With Resources.

Purpose: Financial toxicity of cancer treatment is well described in the literature, including characterizations of its risk factors, manifestations, and consequences. There is, however, limited research on interventions, particularly those at the hospital level, to address the issue.

Methods: From March 1, 2019, to February 28, 2022, a multidisciplinary team conducted a three-cycle Plan-Do-Study-Act (PDSA) process to develop, test, and implement an electronic medical record (EMR) order set to directly refer patients to a hospital-based financial assistance program.

Risk factors for financial toxicity in patients with gynecologic cancer.

Background: The cost of cancer care is high and rising. Evidence of increased patient cost burden is prevalent in the medical literature and has been defined as "financial toxicity," the financial hardship and financial concerns experienced by patients because of a disease and its related treatments. With targeted therapies and growing out-of-pocket costs, patient financial toxicity is a growing concern among patients with gynecologic cancer.

Hospital strategies to engage physicians in quality improvement.

In the last decade, growing evidence that the quality of U.S. health care is uneven at best has prompted greater attention to quality improvement, especially in the nation's hospitals.

Massachusetts health reform: high costs and expanding expectations may weaken employer support.

Passage of health reform legislation in Massachusetts required significant bipartisan compromise and buy in among key stakeholders, including employers. However, findings from a recent follow-up study by the Center for Studying Health System Change (HSC) suggest two important developments may threaten employer support as the reform plays out. First, improved access to the non-group--or individual--insurance market, the availability of state-subsidized coverage, and the costs of increased employee take up of employer-sponsored coverage and rising premiums potentially weaken employers' motivation and ability to provide coverage.

A health plan work in progress: hospital-physician price and quality transparency.

Responding to large employers' interest in greater health care price and quality transparency, health plans are developing consumer tools to compare price and quality information across hospitals and physicians, but the tools' pervasiveness and usefulness are limited, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Many large employers view price and quality transparency as key to a broader consumerism strategy, where employees take more responsibility for medical costs, lifestyle choices and treatment decisions. Some health plans believe providing price and quality information to enrollees is a competitive advantage, while others are skeptical about the benefits and are proceeding cautiously to avoid potential unintended consequences.

Developing health system surge capacity: community efforts in jeopardy.

Since Sept. 11, 2001, communities have responded to the federal call to enhance health care surge capacity--the space, supplies, staffing and management structure to care for many injured or ill people during a terrorist attack, natural disaster or infectious disease pandemic. Communities with varied experience handling emergencies are building broad surge capacity, including transportation, communication, hospital care and handling mass fatalities, according to a new study by the Center for Studying Health System Change (HSC).

The role of nurses in hospital quality improvement.

As the nation's hospitals face increasing demands to participate in a wide range of quality improvement activities, the role and influence of nurses in these efforts is also increasing, according to a new study by the Center for Studying Health System Change (HSC). Hospital organizational cultures set the stage for quality improvement and nurses' roles in those activities. Hospitals with supportive leadership, a philosophy of quality as everyone's responsibility, individual accountability, physician and nurse champions, and effective feedback reportedly offer greater promise for successful staff engagement in improvement activities.

Dampness and mold in the home and depression: an examination of mold-related illness and perceived control of one's home as possible depression pathways.

Objectives: We evaluated a previously reported association between residence in a damp and moldy dwelling and the risk of depression and investigated whether depression was mediated by perception of control over one's home or mold-related physical illness.

Methods: We used survey data from 8 European cities. A dampness and mold score was created from resident- and inspector-reported data.

Physicians moving to mid-sized, single-specialty practices.

The proportion of physicians in solo and two-physician practices decreased significantly from 40.7 percent to 32.5 percent between 1996-97 and 2004-05, according to a national study from the Center for Studying Health System Change (HSC).

Massachusetts health reform: employers, lower-wage workers and universal coverage.

As Massachusetts' landmark effort to reach nearly universal health coverage unfolds, the state is now focusing on employers to take steps to increase coverage. All employers--except firms with fewer than 11 workers--face new requirements under the 2006 law, including establishing Section 125, or cafeteria, plans to allow workers to purchase insurance with pre-tax dollars and paying a $295 annual fee if they do not make a "fair and reasonable" contribution to the cost of workers' coverage. Through interviews with Massachusetts health care leaders (see Data Source), the Center for Studying Health System Change (HSC) examined how the law is likely to affect employer decisions to offer health insurance to workers and employee decisions to purchase coverage.

High-performance health plan networks: early experiences.

Health plans have introduced high-performance networks to encourage use of network providers--predominantly physician specialists--deemed high performing on efficiency and quality measures. Early adopters of these networks are large national employers, and, while other employers are interested, actual adoption has lagged, according to a study by the Center for Studying Health System Change (HSC). Enrollment in products using high-performance networks is limited, and objective evidence on the impact on service use, costs and quality is lacking.

Perceived safety of area of residence and exercise: a pan-European study.

The authors examined the association between perceived safety of neighborhood and likelihood of exercise among adult residents of eight European cities. Data were collected by a survey of neighborhood, housing, and health conducted by the World Health Organization in 2002 and 2003. Baseline category logistic regression models were fit to estimate the association between perceived safety and exercise, accounting for demographic and place-of-residence characteristics.