Through a combination of coursework, mentored research, clinical and research seminars, and input from advisors, I am proposing a plan for career development that will enable me to develop skills in patient- oriented clinical research, including advanced statistical analysis and quantitative, qualitative, and mixed research methods, allowing me to gain independence as an investigator, as well as expand my clinical geriatrics knowledge base. My long-term career goals are to improve health and health care for older adults, conducting clinically-relevant research that informs health policy, and to become a successful independent investigator in aging-related research. Measurement of quality and performance has become increasingly important in American healthcare. In July 2007, CMS began publicly reporting outcomes for two common, costly medical conditions: hospital- specific risk-standardized mortality rates (RSMRs) for acute myocardial infarction (AMI) and heart failure (HF). I am proposing a program of inquiry that will employ a mixed methods approach, pairing quantitative and qualitative methods, to be carried out in two phases. In Phase I, using a quasi-experimental design with pneumonia as a comparison group, we will examine whether public reporting of hospital-specific AMI or HF RSMRs is associated with a) lower mortality rates, b) an attempt to """"""""game"""""""" the measures by hospitals, and c) lower mortality rates among certain hospital types. In Phase II, we will characterize how hospital leaders and Medicare beneficiaries and hospital leaders perceive and use publicly-reported outcome measures, as well as explore their responses to findings generated in the Phase I studies. The results from both phases of the project will increase our understanding of the role and effectiveness of public reporting as a strategy for improving health care outcomes among older adults. These projects will serve as a foundation for future independent research focused on improving hospital quality of care for older adults. This application meets the Beeson Career Development Award's objective of expanding clinically-relevant research on aging in the area of clinical management and systems of care for older adults. The studies proposed within this award application will guide policy, inform health care improvement efforts for older adults, clarify the effect of publicly-reporting outcome measures, and address unsettled questions in the field.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Clinical Investigator Award (CIA) (K08)
Project #
Application #
Study Section
Special Emphasis Panel (ZAG1-ZIJ-4 (M1))
Program Officer
Haaga, John G
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Yale University
Internal Medicine/Medicine
Schools of Medicine
New Haven
United States
Zip Code
Ho, Vivian; Ross, Joseph S; Steiner, Claudia A et al. (2017) A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia. Med Care Res Rev 74:687-704
Low, Jeffrey; Ross, Joseph S; Ritchie, Jessica D et al. (2017) Comparison of two independent systematic reviews of trials of recombinant human bone morphogenetic protein-2 (rhBMP-2): the Yale Open Data Access Medtronic Project. Syst Rev 6:28
Horwitz, Leora I; Bernheim, Susannah M; Ross, Joseph S et al. (2017) Hospital Characteristics Associated With Risk-standardized Readmission Rates. Med Care 55:528-534
Ranasinghe, Isuru; Parzynski, Craig S; Searfoss, Rana et al. (2016) Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits. Gastroenterology 150:103-13
Downing, Nicholas S; Shah, Nilay D; Neiman, Joseph H et al. (2016) Participation of the elderly, women, and minorities in pivotal trials supporting 2011-2013 U.S. Food and Drug Administration approvals. Trials 17:199
Kronish, Ian M; Ross, Joseph S; Zhao, Hong et al. (2016) Impact of Hospitalization for Acute Myocardial Infarction on Adherence to Statins Among Older Adults. Circ Cardiovasc Qual Outcomes 9:364-71
Spatz, Erica S; Lipska, Kasia J; Dai, Ying et al. (2016) Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations: Rationale, Methods, and Early Results. Med Care 54:528-37
Chen, Ruijun; Desai, Nihar R; Ross, Joseph S et al. (2016) Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers. BMJ 352:i637
Barbour, Virginia; Burch, Druin; Godlee, Fiona et al. (2016) Characterisation of trials where marketing purposes have been influential in study design: a descriptive study. Trials 17:31
Nuti, Sudhakar V; Qin, Li; Rumsfeld, John S et al. (2016) Association of Admission to Veterans Affairs Hospitals vs Non-Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia. JAMA 315:582-92

Showing the most recent 10 out of 136 publications