?COREC Thereisextensiveunexplainedgeographicandorganizationalvariationinhealthcareutilizationandoutcomes acrosstheUnitedStates.Manyhealthpolicyexpertsviewthereductionofunwarrantedvariationtobe essentialinimprovinghealthcarequalityandreducingcosts.Previously,individualheterogeneityofclinicians, hospitals,andhealthsystemshasbeenstudiedasapossibledeterminantofsuchvariation.However, substantialvariationisleftunexplained.Wehypothesizethatthebestwaytomakefurtherinroadsisinthe contextofcliniciannetworksandthatthearrayofprofessionalrelationshipsbetweencliniciansacrosstheU.S. isthemechanismforthediffusionanddisseminationofbest-practice(highvalue,lowcost)andworst-practice (ineffectiveandexpensive)care.Unfortunately,ithasprovenchallengingtomeasureprofessionalnetworks amongU.S.providers.TheMethodsCorewillmeetthischallengeby(i)measuringrelationshipsfrompatient- clinicianencountersinMedicareclaimsdatausingmethodsthatmakegreateruseoftheinformationcontained inthemthanpreviously,(ii)computingnetworkmeasuresandstatisticalmodelsinvolvingthemfortheentire U.S.socialnetwork,and(iii)usingadvancedcomputingtoimplementcomputationsontheentirenetworkin feasibletime.Advancesinstatisticalmethodsformodelinghierarchicallystructureddataandcausally- defendablecomparativeeffectivenessresearchwillalsobemade.Thesemethodologicalinnovationssupport andenhancethefiveprojects,providingthemthebasistodelvedeeperintotheirvariouslinesofenquirythan wouldbepossibleotherwise.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Program Projects (P01)
Project #
2P01AG019783-16
Application #
9490974
Study Section
Special Emphasis Panel (ZAG1)
Project Start
2001-09-15
Project End
2023-02-28
Budget Start
2017-12-01
Budget End
2018-11-30
Support Year
16
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Dartmouth College
Department
Type
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A (2018) Outcomes of Elective Cerebral Aneurysm Treatment Performed by Attending Neurosurgeons after Night Work. Neurosurgery 82:329-334
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