Mentor: Ethan A. Halm, MD, MPH and Linda Calvillo-King, MD, MPH
Department: Division of General Internal Medicine, Dept. of Internal Medicine
Room number: CS8-528
Mail Code: 8889
Phone number: x8-2841
E-mail: ethan.halm@utsouthwestern.edu
Project title: Systematic review of the impact of social factors on mortality
and hospital readmission in patients with heart failure, myocardial infarction
and pneumonia
Human subjects IRB approved project number (where applicable): not applicable
Animal subjects IRB approved project number (where applicable):
Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)
Patient-based
Brief Description of Project:
Death or readmission after hospitalization for congestive heart failure, acute myocardial infarction or community-acquired pneumonia is an increasing focus for physicians, hospitals, payors, regulatory bodies and policymakers, as these outcomes have been proposed as publically reported measures of quality of care. In order to fairly compare physician and hospital performance on these clinical outcomes measures, appropriate accounting of differences in patient risk are needed. To date, most risk adjustment models proposed by the payors and policymakers predominantly focus on clinical variables easily ascertained by administrative billing data or crude sociodemographic factors such as age and gender. Inadequate adjustment for social factors know to influence the risk of death or readmission after a major cardiopulmonary hospitalization would be expected to result in poor performance reports for safety net hospitals which care for a disproportionate number of disadvantaged, high risk populations.
This project will perform a systematic review to examine to impact of all of full spectrum of social factors on risk of death or readmission within 30 days of discharge among patients with heart failure, myocardial infarction, and community-acquired pneumonia. We will also assess the methodological quality of the literature in this field. The project will involved structured review of published articles and inter-rater agreement comparisons using best practices for conducting evidence-based systematic reviews.
Previous Research Activities or Publications with Housestaff:
Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care: A systematic review and methodologic critique of the literature. Ann Intern Med 2002; 137:511-520.
Korn L, Reichert S, Simon T, Halm EA. Improving physicians' knowledge of the costs of common medications and willingness to consider costs when prescribing. J Gen Intern Med 2003; 18:31-37.
Press MJ, Chassin MR, Wang J, Tuhrim S, Halm EA. Predicting medical and surgical complications of carotid endarterectomy: Comparing the risk indices. Arch Intern Med 2006; 166:914-20.
Wisnivesky JP, Sampson H, Berns S, Kattan M, Halm EA. Lack of association between indoor allergen sensitization and asthma morbidity in inner-city adults. J Allergy Clin Immun 2007; 120:113-20.
Berns SH, Halm EA, Sampson HA, Sicherer SH, Busse PJ, Wisnivesky JP. Food
allergy as a risk factor for asthma morbidity in adults. J Asthma 2007, 44:377-81.