optimizing health care delivery and outcomes richard a. hansen, phd gilliland professor and head...
TRANSCRIPT
Optimizing Health Care Delivery and Outcomes
Richard A. Hansen, PhDGilliland Professor and Head
Department of Health Outcomes Research and Policy
Health Spending and Outcomes
State ranking on health system performance Heart disease mortality rates for age 40
Healthcare Quality and Outcomes
Complex patientsComplex care
Complex systemsComplex treatments
Healthcare is Complex
Complex Patients…
…or complex care?Maciejewski et al., JGIM 2014; Hansen et al., Annals of Pharmacotherapy (in press)
Grant s AHRQ 1R21HS019445-01 AHRQ 1R01HS023099-01
Complex Care
Emergency Room Visits
Probability Number
of 1+ Visits of Visits
Odds Ratio (95%CI) IRR (95%CI)
Probability of
Hospital Admission
Odds Ratio (95% CI)
1 Condition (lagged) Reference Reference Reference
2 Conditions (lagged) 1.02 (0.80, 1.29) 0.98 (0.83, 1.15) 1.07 (0.88, 1.29)
3+ Conditions (lagged) 1.38 (0.99, 1.91) 0.86 (0.71, 1.04) 1.11 (0.84, 1.46)
1 Prescriber (lagged) Reference Reference Reference
2 Prescribers (lagged) 1.24 (0.99, 1.56) 1.15 (0.98, 1.35) 1.31 (1.09, 1.57)*
3 Prescribers (lagged) 1.58 (1.17, 2.13)* 1.18 (0.99, 1.41) 1.31 (1.01, 1.69) *
4+ Prescribers(lagged) 1.96 (1.39, 2.75)*** 1.38 (1.13, 1.70)* 1.47 (1.08, 2.01) *
Grant s AHRQ 1R21HS019445-01 AHRQ 1R01HS023099-01
Maciejewski et al., JGIM 2014; Hansen et al., Annals of Pharmacotherapy (in press)
Complex systems
Drug-related risk of bleeding across 200 million patients represented in U.S. data repositories
Hansen et al., RSM (in press)Hansen et al., Drug Safety (2013)Fox et al., JBI (2013)
Grants: FNIH HANSE11OMOPNPC (No Number)
Richard A. [email protected]
Current and Recent Funding
Funding Opportunities
Complex patients and conditions• AHRQ 1R21HS019445-01 (Duke)• AHRQ 1R01HS023099-01 (UNC)
Complex treatments and drug safety• FDA 1U01FD005272-01 (Auburn)• FNIH HANSE11OMOP (Auburn)• National Pharmaceutical Council
• NIH (R01 & R18 in review)• PCORI, AHRQ, CDC, FDA
Interdisciplinary collaboration is key…