Accountable care organizations and HPV vaccine uptake: a multilevel analysis.

Objectives: To examine associations between accountable care organization (ACO) membership and human papillomavirus (HPV) vaccination and to evaluate variation in HPV vaccination across ACO providers.

Study Design: Retrospective cohort study.

Methods: We analyzed the records of commercially insured children and adolescents aged 11 to 14 years using Connecticut's All-Payer Claims Database from January 2012 to December 2017.

Clinical outcomes in borderline and locally advanced pancreatic cancer with the addition of low-dose-rate brachytherapy to standard of care therapy.

Purpose: Surgical resection remains the only curative therapy for pancreatic cancer. Unfortunately, many patients have borderline or unresectable disease at diagnosis due to proximity of major abdominal vessels. Neoadjuvant chemotherapy and radiation are used to down-stage, however, there is a risk that there will be a positive/close surgical margin.

Understanding the Burden of 30-Day Readmission in Patients With Both Primary and Secondary Diagnoses of Heart Failure: Causes, Timing, and Impact of Co-Morbidities.

Although efforts to reduce 30-day readmission rates have mainly focused on patients with heart failure (HF) as a primary diagnosis at index hospitalization, patients with HF as a secondary diagnosis remain common, costly, and understudied. This study aimed to determine the incidence, etiology, and patterns of 30-day readmissions after discharge for HF as a primary and secondary diagnosis and investigate the impact of co-morbidities on HF readmission. The National Readmission Database from 2014 to 2016 was used to identify HF patients with a linked 30-day readmission.

Predictors of 30-Day Readmission in Patients Hospitalized With Heart Failure as a Primary Versus Secondary Diagnosis.

Short-term rehospitalizations are common, costly, and detrimental to patients with heart failure (HF). Current research and policy have focused primarily on 30-day readmissions for patients with HF as a primary diagnosis at index hospitalization, whereas a much larger population of patients are admitted with HF as a secondary diagnosis. This study aims to compare patients initially hospitalized for HF as either a primary or a secondary diagnosis, and to identify the most important factors in predicting 30-day readmission.

A Survey on Cone-beam Computed Tomography Usage Among Endodontists in the United States.

Introduction: The aim of the study was to investigate the accessibility and frequency of cone-beam computed tomography (CBCT) usage and to assess the economic and logistical factors involved with its usage among active American Association of Endodontists (AAE) members, utilizing a web-based survey.

Methods: A survey of 19 questions was sent to 3,071 AAE members addressing participant access to, along with financial and logistical aspects of CBCT imaging. Descriptive analysis was performed and Fisher exact test utilized to test associations between groups (P < .

Documented Penicillin Allergies on Antibiotic Selection at Pediatric Emergency Department Visits.

Background: Penicillin or amoxicillin are the recommended treatments for the most common pediatric bacterial illnesses. Allergies to penicillin are commonly reported among children but rarely true. We evaluated the impact of reported penicillin allergies on broad-spectrum antibiotic use overall and for the treatment of common respiratory infections among treat-and-release pediatric emergency department (ED) visits.

Parent-reported penicillin allergies in children: A qualitative study.

Background: Penicillin allergies are commonly reported in children. Most reported penicillin allergies are false, resulting in the unnecessary selection of alternative antibiotic treatments that promote antibiotic resistance. While formal allergy testing is encouraged to establish a diagnosis of penicillin allergy, children are rarely referred for allergy testing, and study of parents' experiences and perceptions of their child's reported penicillin allergy is limited.

Pursuing sources of heterogeneity in modeling clustered population.

Researchers often have to deal with heterogeneous population with mixed regression relationships, increasingly so in the era of data explosion. In such problems, when there are many candidate predictors, it is not only of interest to identify the predictors that are associated with the outcome, but also to distinguish the true sources of heterogeneity, that is, to identify the predictors that have different effects among the clusters and thus are the true contributors to the formation of the clusters. We clarify the concepts of the source of heterogeneity that account for potential scale differences of the clusters and propose a regularized finite mixture effects regression to achieve heterogeneity pursuit and feature selection simultaneously.

Reductions in Race and Ethnic Disparities in Hospital Readmissions Following Total Joint Arthroplasty from 2005 to 2015.

Background: Racial and ethnic disparities in hospital readmissions following total joint arthroplasty present opportunities for reducing cost and improving health equity. Despite efforts to reduce readmissions following total joint arthroplasty in the general population, no studies have documented the impact of these efforts on racial and ethnic disparities in total joint arthroplasty readmissions. The purpose of this study was to determine whether comprehensive efforts to reduce hospital readmissions following total joint arthroplasty have impacted racial and ethnic disparities in readmission rates during the period from 2005 to 2015.

Age Differences in Racial/Ethnic Disparities in Preventable Hospitalizations for Heart Failure in Connecticut, 2009-2015: A Population-Based Longitudinal Study.

Objective: Preventable hospitalizations for heart failure result in a large proportion of hospitalizations. The primary objective of this study was to describe longitudinal trends in the association of race/ethnicity with preventable hospitalizations for heart failure in Connecticut and differences in disparities by age.

Methods: We analyzed data on hospitalizations in all civilian acute-care hospitals in Connecticut during a 7-year period, 2009 through 2015.

Imputing race and ethnic information in administrative health data.

Objective: To improve on existing methods to infer race/ethnicity in health care data through an analysis of birth records from Connecticut.

Data Source: A total of 162 467 Connecticut birth records from 2009 to 2013.

Study Design: We developed a logistic model to predict race/ethnicity using data from US Census and patient-level information.

Defining Endodontic Residents' Clinical Experiences: A National Survey.

Endodontic residency programs across the U.S. vary in the exposure they provide to residents in procedures, protocols, and equipment.

Interventions to Improve Management of Chronic Conditions Among Racial and Ethnic Minorities.

Digital and mhealth interventions can be effective in improving health outcomes among minority patients with diabetes, congestive heart failure, and chronic respiratory diseases. A number of electronic and digital approaches to individual and population-level interventions involving telephones, internet and web-based resources, and mobile platforms have been deployed to improve chronic disease outcomes. This paper summarizes the evidence supporting the efficacy of various behavioral and digital interventions targeting intermediate outcomes and hospitalizations with particular emphasis on studies examining the effects of these interventions on racial and ethnic minority population.

Using mHealth technologies to improve the identification of behavioral health problems in urban primary care settings.

Introduction: Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population.

Methods: In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n = 146) using an electronic tablet-based screening tool.

Racial and Ethnic Disparities in Preventable Hospitalizations for Chronic Disease: Prevalence and Risk Factors.

Background: Hospitalizations due to ambulatory care sensitive conditions (ACSCs) result in high morbidity and economic burden on the American healthcare system. Admissions due to chronic ACSCs, in particular, cost the American healthcare system over 30 billion dollars annually.

Objectives And Methods: This paper presents the current research on racial and ethnic disparities in the burden of hospitalizations due to chronic ACSCs.

A Review of Statistical Disclosure Control Techniques Employed by Web-Based Data Query Systems.

We systematically reviewed the statistical disclosure control techniques employed for releasing aggregate data in Web-based data query systems listed in the National Association for Public Health Statistics and Information Systems (NAPHSIS). Each Web-based data query system was examined to see whether (1) it employed any type of cell suppression, (2) it used secondary cell suppression, and (3) suppressed cell counts could be calculated. No more than 30 minutes was spent on each system.

Variation in patient-provider communication by patient's race and ethnicity, provider type, and continuity in and site of care: An analysis of data from the Connecticut Health Care Survey.

Objectives: The purpose of this study is to examine the quality of patient-reported communication with their health care providers using data from a large, statewide survey of patients. We examine the relationship between patient's race and ethnicity, type of health care provider, site of and continuity in care, and the quality of patient-provider communication.

Methods: We analyze data from the Connecticut Health Care Survey, a representative telephone survey of 4608 Connecticut residents conducted between June 2012 and February 2013.

Racial and Ethnic Disparities in Hospital Readmissions After Delivery.

Objective: To examine 30-day readmission rates after vaginal and cesarean delivery by race-ethnicity and insurance status.

Methods: We analyzed hospital discharge data contained in a statewide database maintained by the Connecticut Department of Public Health. Discharge data for patients admitted for vaginal delivery without complication (n=167,857) and cesarean delivery without complication (n=75,552) from 2005 to 2012 were analyzed using marginal logistic models for clustered data with generalized estimating equations.