Publications by authors named "Rosalie Malsberger"
Objective: The study was done to evaluate levels of missing and invalid values in the Michigan (MI) National Emergency Medical Services Information System (NEMSIS) (MI-EMSIS) and explore possible causes to inform improvement in data reporting and prehospital care quality.
Methods: We used a mixed-methods approach to study trends in data reporting. The proportion of missing or invalid values for 18 key reported variables in the MI-EMSIS (2010-2015) dataset was assessed overall, then stratified by EMS agency, software platform, and Medical Control Authorities (MCA)-regional EMS oversight entities in MI.
The Association Between Hospital Occupancy and Mortality Among Medicare Patients.
Jt Comm J Qual Patient Saf
September 2020
Background: Hospital crowding is a major challenge facing US health care systems, but few studies have evaluated the association between inpatient occupancy and patient mortality. The objective of this study was to determine how increasing hospital occupancy is associated with the likelihood of inpatient and 30-day out-of-hospital mortality using a novel measure of inpatient occupancy.
Methods: The researchers conducted a retrospective, observational study using secondary data from the California Office of Statewide Health Planning and Development, including nonfederal, acute care facilities from 1998 to 2012.
An estimated 16 million workers use workers' compensation (WC) insurance annually in California. Many recent policy changes might have affected access to care for injured workers. For this study, the authors assess the various dimensions of access to care in the evolving policy environment to ensure that injured workers have adequate access to needed medical care and the opportunity to achieve better health outcomes.
View Article and Find Full Text PDFBackground: Crowding is a major challenge faced by EDs and is associated with poor outcomes.
Objectives: Determine the effect of high ED occupancy on disposition decisions, return ED visits, and hospitalizations.
Methods: We conducted a retrospective analysis of electronic health records of patients evaluated at an adult, urban, and academic ED over 20 months between the years 2012 and 2014.
Article Synopsis
- The study investigates how the frequency and regularity of primary care visits affect health outcomes for Medicare beneficiaries at federally qualified health centers between 2010 and 2014.
- Results show that beneficiaries with less regular primary care visits experienced more emergency department visits, hospitalizations, and higher Medicare costs than those with more regular visits.
- The findings suggest that temporal patterns of primary care visits significantly influence health outcomes, indicating that regularity of visits is an important factor to consider in healthcare delivery strategies.
Objectives: We examined differences in patient outcomes associated with 3 patient-centered medical home (PCMH) recognition programs-National Committee for Quality Assurance (NCQA) Level 3, The Joint Commission (TJC), and Accreditation Association for Ambulatory Health Care (AAAHC)-among Medicare beneficiaries receiving care at federally qualified health centers (FQHCs).
Study Design: We used data from CMS' FQHC Advanced Primary Care Practice Demonstration, in which participating FQHCs received assistance to achieve NCQA Level 3 PCMH recognition. We assessed the impact of the 3 recognition programs on utilization, quality, and Medicare expenditures using a sample of 1108 demonstration and comparison FQHCs.
Few studies have evaluated the relationship between high hospital occupancy and hospital-acquired complications. We evaluated the association between inpatient occupancy and hospital-acquired Clostridium difficile infection (CDI) using a novel measure of hospital occupancy. We analyzed administrative data from California hospitals from 2008-2012 for Medicare recipients aged 65 years with a discharge diagnosis of acute myocardial infarction, heart failure, or pneumonia.
View Article and Find Full Text PDFObjective: To understand how youth PTSD symptoms and externalizing problems emerge and change over time for youth with different profiles of victimization, including polyvictimization.
Method: We conducted a latent class analysis (LCA) to identify empirically derived victimization profiles in a sample of 2,776 youth who participated in an evaluation study. We then conducted growth curve analyses to determine whether these victimization profiles predicted change in the course of PTSD symptoms and externalizing problems over a 1-year time period for youth engaged in a variety of community-based services.
Article Synopsis
- Previous studies had conflicting results on whether patients receiving care from federally qualified health centers (FQHCs) used healthcare differently than those who did not.
- The study compared Medicare beneficiaries who primarily visited FQHCs with a large group of beneficiaries who received care elsewhere, analyzing their healthcare utilization patterns in 2013.
- The findings indicated that FQHC users had fewer visits to primary care or specialists but more emergency department visits, with hospitalization rates remaining similar between the two groups.
Background: From 2011 through 2014, the Federally Qualified Health Center Advanced Primary Care Practice Demonstration provided care management fees and technical assistance to a nationwide sample of 503 federally qualified health centers to help them achieve the highest (level 3) medical-home recognition by the National Committee for Quality Assurance, a designation that requires the implementation of processes to improve access, continuity, and coordination.
Methods: We examined the achievement of medical-home recognition and used Medicare claims and beneficiary surveys to measure utilization of services, quality of care, patients' experiences, and Medicare expenditures in demonstration sites versus comparison sites. Using difference-in-differences analyses, we compared changes in outcomes in the two groups of sites during a 3-year period.
Article Synopsis
- Patient-centered medical home (PCMH) models in federally qualified health centers (FQHCs) can enhance access to care, improve health outcomes, and reduce costs for Medicare beneficiaries.
- A study analyzed 804 FQHCs and over 231,000 Medicare beneficiaries, finding that most FQHCs had varying levels of PCMH capabilities, which correlated with increased outpatient visits but also more specialist and emergency department visits.
- Advanced PCMH sites resulted in higher overall Medicare spending but no increase in hospital admissions, highlighting the need for balancing accessibility with cost considerations in primary care.
The goal of this study is to better understand the characteristics of men who act as primary caregivers of maltreated children. We examined differences between male primary caregivers (fathers) for youth involved in the child welfare system and female primary caregivers (mothers). We conducted secondary data analyses of the National Survey of Child and Adolescent Well-Being-II baseline data.
View Article and Find Full Text PDFImportance: Access to specialists such as dermatologists is often limited for Medicaid enrollees. Teledermatology has been promoted as a potential solution; however, its effect on access to care at the population level has rarely been assessed.
Objectives: To evaluate the effect of teledermatology on the number of Medicaid enrollees who received dermatology care and to describe which patients were most likely to be referred to teledermatology.
Men are increasingly the heads of single parent households, yet are often excluded from child welfare research and practice. To better serve all families in the child welfare system, it is necessary to understand the impact of primary caregiving men on children's wellbeing. In this study we investigated the longitudinal effects of primary caregiving fathers' mental health and substance use on child mental health, and examined possible differences by child age and gender.
View Article and Find Full Text PDFAvailability and usability of behavioral health organization encounter data in MAX 2009.
Medicare Medicaid Res Rev
September 2015
Objective: To assess the availability, completeness, and quality of the Behavioral Health Organization (BHO) encounter data in MAX 2009.
Data Source: The Medicaid Analytic Extract (MAX) 2009.
Methods: We compared metrics of reporting completeness and quality for BHOs to similar metrics for six states that primarily cover MH and SA services on a FFS basis.