We have proposed five projects that together address many of the shortcomings in our understanding of how to measure, study and improve efficiency in healthcare. Core B is responsible for data management and analytic support for the data on which the five projects rest. To understand the causes and consequences of differences in the efficiency of healthcare, it is crucial to have: (1) a comprehensive database with sufficient power to characterize detailed patterns of healthcare utilization at the regional, hospital, physician and network levels, (2) a broad array of additional measures drawn from diverse sources that can augment these data, (3) the analytic capacity and oversight to ensure the timely preparation of analytic datasets, and (4) appropriate access to these resources for other investigators. We plan first to maintain a comprehensive and secure database of administrative data including Medicare and Medicaid enrollment files, claims records, and supplementary files. Second, we hope to obtain and manage additional data files required for this P01 and to develop subproject-specific analytic files. We will obtain data from a variety of sources, including the American Board of Internal Medicine, the Minimum Data Set of nursing home care, and Michigan and Texas Blue Cross Blue Shield data. Third, we seek to maintain a computing infrastructure and procedures capable of managing a high volume of patient identifiable, confidential data while ensuring timely and appropriate access to authorized investigators. And finally, we plan to make the research files developed under this P01 available to the research community to the extent permissible under law.

Public Health Relevance

Medicare, Medicaid and private health plans are all moving toward payment systems intended to reward value: better care and lower costs. This Core is intended to acquire, maintain, and disseminate comprehensive data with innovative measures of cost and quality based on all three payers. These data will be used to study productivity gaps and opportunities to improve efficiency of healthcare.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Program Projects (P01)
Project #
5P01AG019783-12
Application #
8588855
Study Section
Special Emphasis Panel (ZAG1-ZIJ-1)
Project Start
Project End
Budget Start
2013-12-01
Budget End
2014-11-30
Support Year
12
Fiscal Year
2014
Total Cost
$395,054
Indirect Cost
$120,468
Name
Dartmouth College
Department
Type
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Bekelis, Kimon; Gottlieb, Dan; Labropoulos, Nicos et al. (2017) The impact of hybrid neurosurgeons on the outcomes of endovascular coiling for unruptured cerebral aneurysms. J Neurosurg 126:29-35
Nyweide, David J; Bynum, Julie P W (2017) Relationship Between Continuity of Ambulatory Care and Risk of Emergency Department Episodes Among Older Adults. Ann Emerg Med 69:407-415.e3
Chandra, Amitabh; Frakes, Michael; Malani, Anup (2017) Challenges To Reducing Discrimination And Health Inequity Through Existing Civil Rights Laws. Health Aff (Millwood) 36:1041-1047
Bekelis, Kimon; Skinner, Jonathan; Gottlieb, Daniel et al. (2017) De-adoption and exnovation in the use of carotid revascularization: retrospective cohort study. BMJ 359:j4695
Bekelis, Kimon; Gottlieb, Daniel J; Su, Yin et al. (2017) Comparison of clipping and coiling in elderly patients with unruptured cerebral aneurysms. J Neurosurg 126:811-818
Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A et al. (2017) Does Objective Quality of Physicians Correlate with Patient Satisfaction Measured by Hospital Compare Metrics in New York State? World Neurosurg 103:852-858.e1
Bekelis, Kimon; Missios, Symeon; Coy, Shannon et al. (2017) Association of Hospital Teaching Status with Neurosurgical Outcomes: An Instrumental Variable Analysis. World Neurosurg :
Norton, Edward C; Li, Jun; Das, Anup et al. (2017) Moneyball in Medicare. J Health Econ :
Regenbogen, Scott E; Cain-Nielsen, Anne H; Norton, Edward C et al. (2017) Costs and Consequences of Early Hospital Discharge After Major Inpatient Surgery in Older Adults. JAMA Surg 152:e170123
Missios, Symeon; Bekelis, Kimon (2017) Association of Hospitalization for Neurosurgical Operations in Magnet Hospitals With Mortality and Length of Stay. Neurosurgery :

Showing the most recent 10 out of 239 publications