Cost analysis of a coaching intervention to increase use of transradial percutaneous coronary intervention.

Background: The transradial approach (TRA) to cardiac catheterization is safer than the traditional transfemoral approach (TFA), with similar clinical effectiveness. However, adoption of TRA remains low, representing less than 50% of catheterization procedures in 2015. Peer coaching is one approach to facilitate implementation; however, the costs of this strategy for cardiac procedures such as TRA are unclear.

Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states.

Aims: To understand patients' and providers' perceptions of primary care delivered by nurse practitioners (NPs) in the Veterans Affairs Healthcare System.

Design: Qualitative exploratory study (in convergent mixed-methods design).

Methods: Semi-structured interviews in 2016 with primary care providers and patients from facilities in states with full and restricted practice authority for NPs.

Outcomes of primary care delivery by nurse practitioners: Utilization, cost, and quality of care.

Objective: To examine whether nurse practitioner (NP)-assigned patients exhibited differences in utilization, costs, and clinical outcomes compared to medical doctor (MD)-assigned patients.

Data Sources: Veterans Affairs (VA) administrative data capturing characteristics, outcomes, and provider assignments of 806 434 VA patients assigned to an MD primary care provider (PCP) who left VA practice between 2010 and 2012.

Study Design: We applied a difference-in-difference approach comparing outcomes between patients reassigned to MD and NP PCPs, respectively.

Accessing Care Through the Veterans Choice Program: The Veteran Experience.

Background: The Veterans Choice Program (VCP) was implemented to improve healthcare access by expanding healthcare options for Veterans Health Administration (VHA) enrollees.

Objectives: To understand Veterans' experience accessing VCP care.

Design: Qualitative content analysis.

Methods for Measuring Racial Differences in Hospitals Outcomes Attributable to Disparities in Use of High-Quality Hospital Care.

Objective: To compare two approaches to measuring racial/ethnic disparities in the use of high-quality hospitals.

Data Sources: Simulated data.

Study Design: Through simulations, we compared the "minority-serving" approach of assessing differences in risk-adjusted outcomes at minority-serving and non-minority-serving hospitals with a "fixed-effect" approach that estimated the reduction in adverse outcomes if the distribution of minority and white patients across hospitals was the same.

Trends in Timing of Dialysis Initiation within Versus Outside the Department of Veterans Affairs.

Background And Objectives: The secular trend toward dialysis initiation at progressively higher levels of eGFR is not well understood. This study compared temporal trends in eGFR at dialysis initiation within versus outside the Department of Veterans Affairs (VA)-the largest non-fee-for-service health system in the United States.

Design, Setting, Participants, & Measurements: The study used linked data from the US Renal Data System, VA, and Medicare to compare temporal trends in eGFR at dialysis initiation between 2000 and 2009 (n=971,543).

Weekend Discharges and Length of Stay Among Veterans Admitted for Chronic Obstructive Pulmonary Disease.

Background: Discharge rates are substantially lower on weekends, though the impact on hospital length of stay (LOS) is not fully understood.

Objectives: The primary objective was to examine the association of weekend discharges with hospital LOS. We also examined the association of weekend discharges with readmission, mortality, and postdischarge follow-up.