Scholars@Duke
Donald H. Taylor Jr.

Donald H. Taylor Jr.

Professor in the Sanford School of Public Policy
Sanford School of Public Policy
don.taylor@duke.edu
110 Rubenstein Hall, Box 90312, Durham, NC 27708-0312
110 Rubenstein Hall, Box 90312, Durham, NC 27708

Scholarly Works - Journal articles

Strategies to expand the distribution of nursing talent in the United States.

Journal article Nursing outlook · January 2024 This panel paper is the third installment in a six-part Nursing Outlook special edition based on the 2022 Emory Business Case for Nursing Summit. The 2022 summit was led by Emory School of Nursing in partnership with Emory School of Business. It convened n ... Full text Cite

Health Care Use and Spending Among Need-Based Subgroups of Medicare Beneficiaries With Full Medicaid Benefits.

Journal article JAMA Health Forum · May 5, 2023 IMPORTANCE: Beneficiaries dual eligible for Medicare and Medicaid account for a disproportionate share of expenditures due to their complex care needs. Lack of coordination between payment programs creates misaligned incentives, resulting in higher costs, ... Full text Link to item Cite

Access to COVID-19 testing by individuals with housing insecurity during the early days of the COVID-19 pandemic in the United States: a scoping review.

Journal article Front Public Health · 2023 INTRODUCTION: The COVID-19 pandemic focused attention on healthcare disparities and inequities faced by individuals within marginalized and structurally disadvantaged groups in the United States. These individuals bore the heaviest burden across this pande ... Full text Open Access Link to item Cite

Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions.

Journal article North Carolina medical journal · November 2022 BACKGROUND Transitional care and medical respite programs provide assistance to people experiencing homelessness as they move from acute care into community settings. These programs can address issues that may fall outside the reach of traditional m ... Full text Cite

The Cost-Effectiveness of Palliative Care: Insights from the PAL-HF Trial.

Journal article J Card Fail · June 2021 BACKGROUND: In a randomized control trial, Palliative Care in Heart Failure (PAL-HF) improved heart failure-related quality of life, though cost-effectiveness remains unknown. The aim of this study was to evaluate the cost-effectiveness of the PAL-HF trial ... Full text Link to item Cite

Selection Bias in Observational Studies of Palliative Care: Lessons Learned.

Journal article J Pain Symptom Manage · May 2021 CONTEXT: Palliative care (PC) programs are typically evaluated using observational data, raising concerns about selection bias. OBJECTIVES: To quantify selection bias because of observed and unobserved characteristics in a PC demonstration program. METHODS ... Full text Link to item Cite

Associations of Patient Characteristics and Care Setting with Complexity of Specialty Palliative Care Visits.

Journal article J Palliat Med · January 2021 Background: Information routinely collected during a palliative care consultation request may help predict the level of complexity of that patient encounter. Objectives: We examined whether patient and consultation characteristics, as captured in consultat ... Full text Link to item Cite

Trends and Factors Associated with Place of Death for Individuals with Dementia in the United States.

Journal article J Am Geriatr Soc · February 2020 OBJECTIVES: To assess trends and factors associated with place of death among individuals with Alzheimer's disease-related dementias (ADRD). DESIGN: Cross-sectional analysis. SETTING: Centers for Disease Control and Prevention Wide-ranging OnLine Data for ... Full text Link to item Cite

Use of Hospital Referral Regions in Evaluating End-of-Life Care.

Journal article J Palliat Med · January 2020 Background: Hospital referral regions (HRRs) are often used to characterize inpatient referral patterns, but it is unknown how well these geographic regions are aligned with variation in Medicare-financed hospice care, which is largely provided at home. Ob ... Full text Link to item Cite

Paying for Palliative Care in Medicare: Evidence From the Four Seasons/Duke CMMI Demonstration.

Journal article J Pain Symptom Manage · October 2019 CONTEXT: Palliative care improves patient and family outcomes and may reduce the cost of care, but this service is underutilized among Medicare beneficiaries. OBJECTIVES: To describe enrollment patterns and outcomes associated with the Center for Medicare ... Full text Link to item Cite

Medicare Shared Savings ACOs and Hospice Care for Ischemic Stroke Patients.

Journal article J Am Geriatr Soc · July 2019 OBJECTIVES: Palliative care services have the potential to improve the quality of end-of-life care and reduce cost. Services such as the Medicare hospice benefit, however, are often underutilized among stroke patients with a poor prognosis. We tested the h ... Full text Link to item Cite

Hospice Use Among Patients with Heart Failure.

Journal article Card Fail Rev · May 2019 Despite its many benefits, hospice care is underused for patients with heart failure. This paper discusses the factors contributing to this underuse and offers recommendations to optimise use for patients with heart failure and proposes metrics to optimise ... Full text Link to item Cite

Death of outrage over talking about dying.

Journal article BMJ Support Palliat Care · March 2019 OBJECTIVES: We examined public reaction to the proposed Center for Medicare and Medicaid Services rule reimbursing physicians for advanced care planning (ACP) discussions with patients. METHODS: Public comments made on regulations.gov were reviewed for rel ... Full text Link to item Cite

Patient, Caregiver, and Taxpayer Knowledge of Palliative Care and Views on a Model of Community-Based Palliative Care.

Journal article Journal of pain and symptom management · December 2018 ContextPalliative care (PC) model delivered by two large hospices and PC providers.ObjectivesTo understand study participants' knowledge of PC and acceptability of a new community-based PC model.MethodsSemistructured interview wi ... Full text Cite

Predicting Length of Hospice Stay: An Application of Quantile Regression.

Journal article J Palliat Med · August 2018 BACKGROUND: Use of the Medicare hospice benefit has been associated with high-quality care at the end of life, and hospice length of use in particular has been used as a proxy for appropriate timing of hospice enrollment. Quantile regression has been under ... Full text Link to item Cite

Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?

Journal article J Palliat Med · May 2018 BACKGROUND: On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the l ... Full text Link to item Cite

Advance care planning in Medicare: an early look at the impact of new reimbursement on billing and clinical practice.

Journal article BMJ supportive & palliative care · March 2018 ObjectiveIn this study, we examined the US Medicare programme's (government-funded social insurance for the elderly or disabled) new reimbursement for advance care planning (ACP) that began on 1 January 2016. This single-centre study addressed whe ... Full text Cite

Do Live Discharge Rates Increase as Hospices Approach Their Medicare Aggregate Payment Caps?

Journal article Journal of pain and symptom management · March 2018 ContextThe rate of live discharge from hospice and the proportion of hospices exceeding their aggregate caps have both increased for the last 15 years, becoming a source of federal scrutiny. The cap restricts aggregate payments hospices receive fr ... Full text Cite

Hospital-Based Palliative Care with Medicare Claims: Evidence From Colorado.

Journal article Am J Hosp Palliat Care · January 2018 BACKGROUND: The prevalence of hospital-based palliative care has been largely anecdotal as an increasing service being provided and there is a need to understand what trends can be analyzed with Medicare data. OBJECTIVE: To compare 2 methods of identifying ... Full text Link to item Cite

Improving the match between patients’ needs & end-of-life care by increasing patient choice in medicare

Journal article Behavioral Science and Policy · January 1, 2018 One way to achieve health equity—ensuring everyone has fair and just opportunities to be as healthy as possible—in the United States would be to reallocate Medicare spending from low-value medical care (expensive treatments that do little good) toward high ... Full text Cite

Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project.

Journal article J Palliat Med · November 2017 BACKGROUND: Although limited, the evidence base for Community-Based Palliative Care (CBPC) has shown that it improves patient health outcomes, increases satisfaction, and decreases cost. Minimal data exist comparing points of entry into palliative care and ... Full text Link to item Cite

Standardization and Scaling of a Community-Based Palliative Care Model.

Journal article J Palliat Med · November 2017 BACKGROUND: Although limited, the descriptions of Community-Based Palliative Care (CBPC) demonstrates variability in team structures, eligibility, and standardization across care settings. OBJECTIVE: In 2014, Four Seasons Compassion for Life, a nonprofit h ... Full text Link to item Cite

Delivery of Community-Based Palliative Care: Findings from a Time and Motion Study.

Journal article J Palliat Med · October 2017 BACKGROUND: Use of palliative care has increased substantially as the population ages and as evidence for its benefits grows. However, there is limited information regarding which care activities are necessary for delivering high-quality, interdisciplinary ... Full text Link to item Cite

One Size Does Not Fit All: Disease Profiles of Serious Illness Patients Receiving Specialty Palliative Care.

Journal article J Pain Symptom Manage · October 2017 INTRODUCTION: Understanding the symptom profiles of seriously ill patients who receive palliative care, especially noncancer diagnoses where the data are sparse and are critical to better targeting our resources to the needs of patients. METHODS: We perfor ... Full text Link to item Cite

Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial.

Journal article J Am Coll Cardiol · July 18, 2017 BACKGROUND: Advanced heart failure (HF) is characterized by high morbidity and mortality. Conventional therapy may not sufficiently reduce patient suffering and maximize quality of life. OBJECTIVES: The authors investigated whether an interdisciplinary pal ... Full text Link to item Cite

Palliative Care in Heart Failure The PAL-HF Randomized, Controlled Clinical Trial

Journal article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · July 18, 2017 Link to item Cite

A Positive Association Between Hospice Profit Margin And The Rate At Which Patients Are Discharged Before Death.

Journal article Health affairs (Project Hope) · July 2017 Hospice care is designed to support patients and families through the final phase of illness and death. Yet for more than a decade, hospices have steadily increased the rate at which they discharge patients before death-a practice known as "live discharge. ... Full text Cite

Comparing the Palliative Care Needs of Those With Cancer to Those With Common Non-Cancer Serious Illness.

Journal article J Pain Symptom Manage · June 2017 BACKGROUND: Historically, palliative care has been focused on those with cancer. Although these ties persist, palliative care is rapidly integrating into the care of patients with common, non-cancer serious illnesses. Despite this, the bulk of literature i ... Full text Link to item Cite

North Carolina Medicaid Reform: A Bipartisan Path Forward

Journal article Duke Law School Public Law & Legal Theory Series · April 25, 2017 Cite

The Case for Medicaid Expansion in North Carolina.

Journal article North Carolina medical journal · January 2017 North Carolina's refusal to expand its Medicaid program has left many thousands of North Carolinians without health insurance and has imposed unnecessary costs on all of the state's residents through higher premiums in the state's health insurance marketpl ... Full text Cite

Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress.

Journal article Psychooncology · June 2016 BACKGROUND: Cancer patients may experience financial distress as a side effect of their care. Little is known about which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. METHODS: We conducted ... Full text Link to item Cite

Adherence to Measuring What Matters Measures Using Point-of-Care Data Collection Across Diverse Clinical Settings.

Journal article J Pain Symptom Manage · March 2016 CONTEXT: Measuring What Matters (MWM) for palliative care has prioritized data collection efforts for evaluating quality in clinical practice. How these measures can be implemented across diverse clinical settings using point-of-care data collection on qua ... Full text Link to item Cite

What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients.

Journal article Journal of managed care & specialty pharmacy · February 2016 BackgroundU.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near fut ... Full text Cite

Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial.

Journal article JAMA Intern Med · May 2015 IMPORTANCE: For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy fo ... Full text Link to item Cite

The palliative care in heart failure trial: rationale and design.

Journal article Am Heart J · November 2014 BACKGROUND: The progressive nature of heart failure (HF) coupled with high mortality and poor quality of life mandates greater attention to palliative care as a routine component of advanced HF management. Limited evidence exists from randomized, controlle ... Full text Link to item Cite

There is a mismatch between the medicare benefit package and the preferences of patients with cancer and their caregivers.

Journal article J Clin Oncol · October 1, 2014 PURPOSE: To identify insured services that are most important to Medicare beneficiaries with cancer and their family caregivers when coverage is limited. METHODS: A total of 440 participants (patients, n = 246; caregivers, n = 194) were enrolled onto the C ... Full text Link to item Cite

A decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care.

Journal article BMC Health Serv Res · July 19, 2014 BACKGROUND: Concerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experiences serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prio ... Full text Link to item Cite

Quality measures for palliative care in patients with cancer: a systematic review.

Journal article J Oncol Pract · July 2014 PURPOSE: Quality assessment is a critical component of determining the value of medical services, including palliative care. Characterization of the current portfolio of measures that assess the quality of palliative care delivered in oncology is necessary ... Full text Link to item Cite

Physician and Patient and Caregiver Health Attitudes and Their Effect on Medicare Resource Allocation for Patients With Advanced Cancer.

Journal article JAMA Otolaryngol Head Neck Surg · June 2014 IMPORTANCE: Physicians must participate in end-of-life discussions, but they understand poorly their patients' end-of-life values and preferences. A better understanding of these preferences and the effect of baseline attitudes will improve end-of-life dis ... Full text Link to item Cite

HEALTH CARE SPENDING PATTERNS IN HIGH RESOURCE PATIENTS

Journal article VALUE IN HEALTH · May 1, 2014 Link to item Cite

Self-reported financial burden and satisfaction with care among patients with cancer.

Journal article Oncologist · April 2014 BACKGROUND: Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction. METHODS: This was an observational, cross-secti ... Full text Link to item Cite

Financial Distress, Use of Cost-Coping Strategies, and Adherence to Prescription Medication Among Patients With Cancer.

Journal article J Oncol Pract · November 2013 The authors found that cost-related medication nonadherence was prevalent among patients with cancer who sought financial assistance. ... Full text Link to item Cite

Targeted investment improves access to hospice and palliative care.

Journal article J Pain Symptom Manage · November 2013 CONTEXT: Availability of hospice and palliative care is increasing, despite lack of a clear national strategy for developing and evaluating their penetration into and impact on the target population. OBJECTIVES: To determine whether targeted investment (i. ... Full text Link to item Cite

The effect of palliative care on patient functioning.

Journal article J Palliat Med · October 2013 BACKGROUND: Palliative care is increasingly viewed as a care option that should not only be offered to patients very near the end of life. An important question is whether increased use of palliative care soon after a patient's referral will improve patien ... Full text Link to item Cite

Medicare as insurance innovator: the case of hospice.

Journal article The American journal of hospice & palliative care · September 2013 The stylized fact is that while private insurance has tended to innovate on the benefit design side of the insurance contract, Medicare has lead innovation on the payment side. Traditional or Fee-For-Service Medicare has produced many innovations in the pa ... Full text Cite

Physician allocation of Medicare resources for patients with advanced cancer.

Journal article J Palliat Med · August 2013 BACKGROUND: Little is known about what patients and physicians value in end-of-life care, or how these groups would craft a health plan for those with advanced cancer. OBJECTIVE: The study objective was to assess how otolaryngology, head and neck surgery ( ... Full text Link to item Cite

The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience.

Journal article Oncologist · 2013 PURPOSE: Cancer patients carry rising burdens of health care-related out-of-pocket expenses, and a growing number of patients are considered "underinsured." Our objective was to describe experiences of insured cancer patients requesting copayment assistanc ... Full text Link to item Cite

Copayment assistance and adherence to prescription medication among patients with cancer.

Journal article Journal of Clinical Oncology · December 1, 2012 57 Background: The relationship between prescription medication adherence and copay assistance is understudied and directly impacts quality of care. Methods: We conducted a cross-sectional survey study assessing patient-reported ... Full text Cite

Palliative care needs of patients with cancer living in the community.

Journal article J Oncol Pract · November 2011 PURPOSE: With improved effectiveness of early detection and treatment, many patients with cancer are now living with advanced disease and associated symptoms. As cancer becomes a chronic illness, adequate attention to patients' symptoms and psychosocial ne ... Full text Link to item Cite

Death service ratio: a measure of hospice utilization and cost impact.

Journal article Journal of pain and symptom management · June 2011 Full text Cite

Impact of out-of-pocket expenses on cancer care

Journal article JOURNAL OF CLINICAL ONCOLOGY · May 20, 2011 Link to item Cite

Impact of out-of-pocket expenses on cancer care.

Journal article Journal of clinical oncology : official journal of the American Society of Clinical Oncology · May 2011 6006 Background: How do out-of-pocket expenses for cancer care (OOPE) impact patient-reported lifestyle, quality, and satisfaction with cancer care?We recruited patients at Duke University Medical Center and from a national pool of applicants to the Health ... Cite

Palliative care and the search for value in health reform.

Journal article North Carolina medical journal · May 2011 Improving value in health care is of paramount importance, and doing so will require focus on both the costs and benefits of care. Palliative care addresses symptoms of disease regardless of prognosis, helps patients clarify their goals of care, and is key ... Full text Cite

Lower extremity physical performance, self-reported mobility difficulty, and use of compensatory strategies for mobility by elderly women.

Journal article Arch Phys Med Rehabil · February 2011 OBJECTIVE: To describe the relationship between lower extremity physical performance, self-reported mobility difficulty, and self-reported use of compensatory strategies (CSs) for mobility inside the home. DESIGN: Cross-sectional exploratory study. SETTING ... Full text Link to item Cite

Genetic testing for Alzheimer's and long-term care insurance.

Journal article Health Aff (Millwood) · 2010 Featured Publication A genetic marker known as apolipoprotein E provides a clear signal of a person's risk of developing Alzheimer's disease and thus that person's future need for long-term care. People who find that they have the variant of the trait that increases Alzheimer' ... Full text Link to item Cite

Health reform. Or not?

Journal article North Carolina medical journal · January 2010 Full text Cite

Is a home-care network necessary to access the Medicare hospice benefit?

Journal article J Palliat Med · August 2009 OBJECTIVE: To test whether the presence of an informal or formal care network in the home leads to different hospice utilization patterns near death. To examine how the informal care relationship affects hospice use patterns. DATA SOURCES: Medicare Current ... Full text Link to item Cite

The effect of hospice on Medicare and informal care costs: the U.S. Experience.

Journal article Journal of pain and symptom management · July 2009 The effect of hospice on third-party payer costs has long been of great interest in the United States and other nations. The choice of hospice could also influence the costs experienced by patients and family members as compared with when Medicare benefici ... Full text Cite

The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited.

Journal article J Alzheimers Dis · 2009 Our study estimates the sensitivity and specificity of Medicare claims to identify clinically-diagnosed dementia, and documents how errors in dementia assessment affect dementia cost estimates. We compared Medicare claims from 1993-2005 to clinical dementi ... Full text Link to item Cite

Identifying trajectories of depressive symptoms for women caring for their husbands with dementia.

Journal article J Am Geriatr Soc · February 2008 OBJECTIVES: To use an innovative statistical method, Latent Class Trajectory Analysis (LCTA), to identify and describe subgroups (called trajectories) of caregiver depressive symptoms in a national sample of wives providing informal care for their husbands ... Full text Link to item Cite

Identification of dementia: agreement among national survey data, medicare claims, and death certificates.

Journal article Health Serv Res · February 2008 OBJECTIVE: To estimate the proportion of seniors with dementia from three independent data sources and their agreement. DATA SOURCES: The longitudinal Asset and Health Dynamics among the Oldest Old (AHEAD) study (n=7,974), Medicare claims, and death certif ... Full text Link to item Cite

The effect of spousal caregiving and bereavement on depressive symptoms.

Journal article Aging Ment Health · January 2008 The objective of the study was to determine whether spousal caregiving and bereavement increases caregiver depressive symptoms. We followed 1,967 community-dwelling elderly couples from the 1993 Health and Retirement Study (HRS) until 2002 (five bi-annual ... Full text Link to item Cite

Trajectories of caregiving time provided by wives to their husbands with dementia.

Journal article Alzheimer Dis Assoc Disord · 2008 Spouses are often the first providers of informal care when their partners develop dementia. We used The National Longitudinal Caregiver Study (NLCS, 4 annual surveys, 1999 to 2002) and identified 3 distinct longitudinal patterns (trajectory classes) of to ... Full text Link to item Cite

Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000.

Journal article Am J Hosp Palliat Care · 2008 The aim of this study is to identify the prevalence and correlates of individuals discharged alive from hospice in the Medicare program to determine whether the current hospice benefit matches the needs of dying patients. Using a nationally representative ... Full text Link to item Cite

What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program?

Journal article Soc Sci Med · October 2007 Featured Publication Hospices have been expected to reduce health expenditures since their addition to the US Medicare benefit package in the early-1980s, but the literature on their ability to do so is mixed. The contradictory findings noted in previous studies may be due to ... Full text Link to item Cite

Designating places and populations as medically underserved: a proposal for a new approach.

Journal article Journal of health care for the poor and underserved · August 2007 This article describes the development of a theory-based, data-driven replacement for the Health Professional Shortage Area (HPSA) and Medically Underserved Area (MUA) designation systems. Data describing utilization of primary medical care and the distrib ... Full text Cite

Trajectories of caregiving time provided by wives to their husband’s with dementia

Journal article Forthcoming in Alzheimer’s Disease and Associated Disorders · 2007 Cite

Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000

Journal article Forthcoming in American Journal of Hospice and Palliative Medicine · 2007 Cite

The effect of spousal caregiving and bereavement on depressive symptoms

Journal article Forthcoming in Journal of Hospice and Palliative Medicine · 2007 Cite

The accidental system: private and public actions to provide long term care.

Journal article Forthcoming in N.C. Insight · 2007 Cite

Access to health care services for the disabled elderly.

Journal article Health Serv Res · June 2006 OBJECTIVE: To determine whether difficulty walking and the strategies persons use to compensate for this deficit influenced downstream Medicare expenditures. DATA SOURCE: Secondary data analysis of Medicare claims data (1999-2000) for age-eligible Medicare ... Full text Link to item Cite

Lower extremity physical performance and use of compensatory strategies for mobility.

Journal article J Am Geriatr Soc · February 2006 OBJECTIVES: To compare measured lower extremity physical performance in the clinic with the methods used to carry out mobility tasks at home and to identify key factors influencing day-to-day task performance. DESIGN: Cross-sectional analysis of the Women' ... Full text Link to item Cite

Designating Places and Populations as Medically Underserved: A Proposal for a New Approach

Journal article Journal of Health Care for the Poor and Underserved · 2006 Cite

Heavy alcohol use and marital dissolution in the USA.

Journal article Social science & medicine (1982) · December 2005 Using the first five waves of the US Health and Retirement Study, a nationally representative survey of middle-aged persons in the USA conducted between 1992 and 2000, we assessed the association between alcohol consumption and separation and divorce (comb ... Full text Cite

Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study.

Journal article Am J Public Health · September 2005 OBJECTIVES: Obese Americans, who receive more care for chronic diseases, may receive fewer preventive services. We evaluated the association between body mass index (BMI) and receipt of screening mammography and Papanicolaou tests among middle-aged women a ... Full text Link to item Cite

The impact of own and spouse's urinary incontinence on depressive symptoms.

Journal article Soc Sci Med · June 2005 This study investigated the impact of own and spouse's urinary incontinence on depressive symptoms. Attention was paid to the possibility that gender and caregiving might be important factors in understanding significant effects. We used negative binomial ... Full text Link to item Cite

Do seniors understand their risk of moving to a nursing home?

Journal article Health Serv Res · June 2005 OBJECTIVE: To determine whether seniors understand their risk of moving to a nursing home. Data Sources. We used longitudinal data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) database. AHEAD is a nationally representative survey (n=8,20 ... Full text Link to item Cite

Alzheimer's disease and the family caregiver: the cost and who pays?

Journal article North Carolina medical journal · January 2005 Full text Cite

Equal division of estates and the exchange motive.

Journal article Journal of aging & social policy · January 2005 Although the bequest motive is one of the most important theoretical extensions of the life-cycle hypothesis, few empirical studies have measured determinants of unequal estate division. We estimated whether several proxies that are consistent with exchang ... Full text Cite

Comorbid illness affects hospital costs related to hip arthroplasty: quantification of health status and implications for fair reimbursement and surgeon comparisons.

Journal article The Journal of arthroplasty · September 2004 Optimized resource allocation, reimbursement negotiations, and provider comparisons hinge on an understanding of the drivers of healthcare costs. Indices of comorbid illness may be useful for stratifying patients based on cost. Total hospital cost was anal ... Cite

Marked increase in Alzheimer's disease identified in medicare claims records between 1991 and 1999.

Journal article J Gerontol A Biol Sci Med Sci · July 2004 Featured Publication BACKGROUND: Epidemiologic evidence suggests that African Americans have higher rates of Alzheimer's disease (AD) than do whites. Examining longitudinal trends in the number of persons who are identified as having AD in administrative databases may provide ... Full text Link to item Cite

Outcomes of states' scholarship, loan repayment, and related programs for physicians.

Journal article Medical care · June 2004 ContextMany states attempt to entice young generalist physicians into rural and medically underserved areas with financial support-for-service programs-scholarships, service-option loans, loan repayment, direct financial incentives, and resident s ... Full text Cite

The effect of smoking on years of healthy life (YHL) lost among middle-aged and older Americans.

Journal article Health Serv Res · June 2004 OBJECTIVE: To estimate the effects of smoking on quality of life over time, using the Years of Healthy Life (YHL) construct. DATA SOURCES/STUDY SETTING: The Health and Retirement Study (HRS) survey (N=12,652) of persons 50 to 60 years old and the Asset and ... Full text Link to item Cite

Do the near-elderly value mortality risks differently?

Journal article Review of Economics and Statistics · February 1, 2004 Wage hedonic models are estimated with the Health and Retirement Study to measure the risk-wage tradeoffs (value of statistical lives) for older workers. The analysis explicitly allows for multiple employment states, including retirement, using a multinomi ... Full text Cite

Do the Near-Elderly Value Mortality Risks Differently from Younger Persons?

Journal article The Review of Economics and Statistics · 2004 Cite

Effects of risk and time preference and expected longevity on demand for medical tests

Journal article Journal of Risk and Uncertainty · January 1, 2004 Despite their conceptual importance, the effects of time preference, expected longevity, uncertainty, and risk aversion on behavior have not been analyzed empirically. We use data from the Health and Retirement Study (HRS) to assess the role of risk and ti ... Full text Cite

Number of children associated with obesity in middle-aged women and men: results from the health and retirement study.

Journal article J Womens Health (Larchmt) · 2004 OBJECTIVE: To study associations between number of children and obesity in middle-aged women and men. METHODS: In the Health and Retirement Study, a national survey of households, we tested the association between increasing number of children and obesity ... Full text Link to item Cite

The effect of equipment usage and residual task difficulty on use of personal assistance, days in bed, and nursing home placement.

Journal article J Am Geriatr Soc · January 2004 Featured Publication OBJECTIVES: To determine whether residual difficulty in functioning in spite of equipment use is linked with increased use of personal assistance. DESIGN: Longitudinal. Two waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) database were u ... Full text Link to item Cite

Racial differences in influenza vaccination among older Americans 1996-2000: longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey

Journal article BMC public health · December 16, 2003 BACKGROUND: Influenza is a common and serious public health problem among the elderly. The influenza vaccine is safe and effective. METHODS: The purpose of the study was to determine whether frequencies of receipt vary by race, age group, gender, and time ... Cite

Racial differences in influenza vaccination among older Americans 1996-2000: longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey.

Journal article BMC Public Health · December 16, 2003 BACKGROUND: Influenza is a common and serious public health problem among the elderly. The influenza vaccine is safe and effective. METHODS: The purpose of the study was to determine whether frequencies of receipt vary by race, age group, gender, and time ... Full text Link to item Cite

Caution in the use of the apolipoprotein E e4 allele as a predictor of healthcare costs.

Journal article Expert review of pharmacoeconomics & outcomes research · October 2003 Healthcare payers of all types are interested in accurately predicting future costs. The e4 allele of the gene coding for apolipoprotein E on chromosome 19 (e4 allele) is a potentially attractive genetic marker. This could be used to set insurance premiums ... Full text Cite

Does higher hospital cost imply higher quality of care?

Journal article Review of Economics and Statistics · February 1, 2003 This study investigates whether higher input use per stay in the hospital (treatment intensity) and longer length of stay improve outcomes of care. We allow for endogeneity of intensity and length of stay by estimating a quasi-maximum-likelihood discrete f ... Full text Open Access Cite

Does assistive technology substitute for personal assistance among the disabled elderly?

Journal article Am J Public Health · February 2003 OBJECTIVES: This study examined whether use of equipment (technological assistance) to cope with disability was associated with use of fewer hours of help from another person (personal assistance). METHODS: In a cross-sectional study of 2368 community dwel ... Full text Link to item Cite

Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment.

Journal article BMC Public Health · January 6, 2003 BACKGROUND: Uncontrolled hypertension (HT) is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objective ... Full text Link to item Cite

Does Higher Hospital Cost Imply Higher Quality of Care?

Journal article Review of Economics and Statistics · 2003 Cite

Does High Hospital Cost Imply Higher Quality of Care?

Journal article Review of Economics & Statistics · 2003 Cite

Is the APOE-4 Genotype Associated with Higher Hospital Costs?

Journal article American Journal of Geriatric Psychiatry · 2003 Cite

Is the APOE-4 Genotype Associated with Higher Hospital Costs?

Journal article American Journal of Geriatric Psychiatry · 2003 Cite

Caution should be used before using the APOE e4 as a predictor of health care costs.

Journal article Expert Review of Pharmacoeconomics and Outcomes Research · 2003 Cite

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

Journal article Ann Fam Med · 2003 BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This coho ... Full text Link to item Cite

Is the APOE epsilon4 genotype associated with higher hospital costs among elderly patients?

Journal article Am J Geriatr Psychiatry · 2003 OBJECTIVE: The apolipoprotein epsilon4 (APOE epsilon4) genotype is associated with a number of adverse health outcomes. The authors assessed whether the epsilon4 genotype was associated with higher hospital costs on the basis of data from 1,999 white or bl ... Link to item Cite

Health insurance and mammography: would a Medicare buy-in take us to universal screening?

Journal article Health services research · December 2002 ObjectiveTo determine whether health insurance expansions via a Medicare buy-in might plausibly increase mammography screening rates among women aged 50-64.Data sourcesTwo waves of the Health and Retirement Study (HRS) (1994, 1996).St ... Full text Cite

Information, addiction, and 'bad choices': Lessons from a century of cigarettes

Journal article Economics Letters · October 1, 2002 This study describes government interventions during the 1900s and their effects on cigarette consumption within a rational addiction framework. With annual data for the 20th century, impacts of specific antismoking information events disappear. U.S. per c ... Full text Cite

The accuracy of medicare claims data in identifying Alzheimer's disease.

Journal article J Clin Epidemiol · September 2002 We linked Medicare claims data to information on 417 patients with a clinical diagnosis of Alzheimer's disease in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) to determine what proportion of them were identified as having Alzheime ... Full text Link to item Cite

Benefits of smoking cessation for longevity. (vol 92, pg 990, 2002)

Journal article AMERICAN JOURNAL OF PUBLIC HEALTH · September 1, 2002 Link to item Cite

Effect of Alzheimer disease on the cost of treating other diseases.

Journal article Alzheimer disease and associated disorders · July 2002 The authors' objective is to determine the effect of diagnosed Alzheimer disease (AD) on cost to Medicare of treating other diseases. Using the 1994 National Long-Term Care Survey merged with Medicare claims and death data, the authors assessed the relativ ... Full text Cite

Apolipoprotein E epsilon4 and risk of mortality in African American and white older community residents.

Journal article Gerontologist · June 2002 PURPOSE: The goal of this study was to determine whether the epsilon4 allele of apolipoprotein E is predictive of mortality in a community-based sample. DESIGN AND METHODS: Of the stratified random household sample of 4,162 participants age 65 years and ol ... Full text Link to item Cite

Benefits of smoking cessation for longevity.

Journal article Am J Public Health · June 2002 OBJECTIVES: This study determined the life extension obtained from stopping smoking at various ages. METHODS: We estimated the relation between smoking and mortality among 877,243 respondents to the Cancer Prevention Study II. These estimates were applied ... Full text Link to item Cite

What price for-profit hospitals?

Journal article CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · May 2002 Cite

The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: results from the HRS and AHEAD. Health and Retirement Study. Asset and Health Dynamics Among the Oldest Old.

Journal article J Am Geriatr Soc · April 2002 OBJECTIVES: To analyze the effect of smoking, smoking cessation, and other modifiable risk factors on mobility in middle-aged and older Americans. DESIGN: Panel study; secondary data analysis. SETTING: United States (national sample). PARTICIPANTS: The Hea ... Full text Link to item Cite

A longitudinal study of the effects of tobacco smoking and other modifiable risk factors on ill health in middle-aged and old Americans: results from the Health and Retirement Study and Asset and Health Dynamics among the Oldest Old survey.

Journal article Prev Med · March 2002 BACKGROUND: While the effects of smoking and other modifiable risk factors on mortality and specific diseases are well established, their effects on ill health more generally are less known. Using two national, longitudinal surveys, the objective of this s ... Full text Link to item Cite

Do smokers respond to health shocks?

Journal article Review of Economics and Statistics · November 1, 2001 This paper reports the first effort to use data to evaluate how new information, acquired through exogenous health shocks, affects people's longevity expectations. We find that smokers react differently to health shocks than do those who quit smoking or ne ... Full text Open Access Cite

The effect of middle- and old-age body mass index on short-term mortality in older people.

Journal article J Am Geriatr Soc · October 2001 OBJECTIVES: To determine the effect of body mass index (BMI) at old age and at age 50 on short-term survival among persons age 65 and older. DESIGN: Cross-sectional, using the 4,791 respondents to the community interview of the 1994 National Long Term Care ... Full text Link to item Cite

The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons.

Journal article The journals of gerontology. Series B, Psychological sciences and social sciences · September 2001 ObjectivesOur primary objectives were (a) to determine the relative impact of Alzheimer's disease and related dementias (ADRD), disability, and common comorbid health conditions on the cost of caring for community-dwelling elderly person and (b) t ... Full text Cite

What we know is not enough.

Journal article Contemporary longterm care · July 2001 Cite

Alzheimer's Disease Cost: What We Know is Not Enough

Journal article Contemporary Long Term Care · 2001 Cite

The Relative Effect of Body Mass Index at Age 50 and Old Age on Mortality Among the Elderly

Journal article The Journal of the American Geriatrics Society · 2001 Cite

Longevity expectations and death: Can people predict their own demise?

Journal article American Economic Review · January 1, 2001 Full text Open Access Cite

Hospital ownership and cost and quality of care: is there a dime's worth of difference?

Journal article Journal of health economics · January 2001 Nonprofit organizations may predominate when output quality is difficult to monitor. Hospital care has this characteristic. This study compared program cost and quality of care for Medicare patients hospitalized following onset of four common conditions by ... Full text Cite

State scholarship, loan forgiveness, and related programs: the unheralded safety net.

Journal article JAMA · October 2000 ContextIn the mid-1980s, states expanded their initiatives of scholarships, loan repayment programs, and similar incentives to recruit primary care practitioners into underserved areas. With no national coordination or mandate to publicize these e ... Full text Cite

How much do persons with Alzheimer's disease cost Medicare?

Journal article Journal of the American Geriatrics Society · June 2000 BackgroundMedicare claims are increasingly being used to identify persons with chronic diseases such as Alzheimer's disease (AD) for the purpose of determining the cost to Medicare of caring for such persons. Past work has been limited by the use ... Full text Cite

Medical training debt and service commitments: the rural consequences.

Journal article The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · January 2000 This study assesses how student loan debt and scholarships, loan repayment and related programs with service requirements influence the incomes young physicians seek and attain, influence whether they choose to work in rural practice settings and affect th ... Full text Cite

Private and public choices in end-of-life care.

Journal article JAMA · December 1999 Full text Cite

Formation of trusts and spend down to Medicaid.

Journal article The journals of gerontology. Series B, Psychological sciences and social sciences · July 1999 ObjectiveTo identify the proportion of community-dwelling elderly persons (70+) who could affect their eligibility for Medicaid financing of a nursing home stay through the use of a trust and to quantify the prevalence and predictors of trusts. Full text Cite

Costs and outcomes of hip fracture and stroke, 1984 to 1994.

Journal article American journal of public health · June 1999 ObjectivesThis study quantified changes in Medicare payments and outcomes for hip fracture and stroke from 1984 to 1994.MethodsWe studied National Long Term Care Survey respondents who were hospitalized for hip fracture (n = 887) or strok ... Full text Cite

Retention of young general practitioners entering the NHS from 1991-1992.

Journal article The British journal of general practice : the journal of the Royal College of General Practitioners · April 1999 BackgroundThe supply of general practitioners (GPs) in the National Health Service (NHS) is dynamic and there are fears that there will be an inadequate number of doctors to meet the needs of the NHS. There are particular concerns about changes in ... Cite

Do targeted efforts for the rural underserved help kill comprehensive reform?

Journal article The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · January 1999 There has been a shift during the past 60 years from a broad notion of the entire nation as underserved to a more focused effort to identify particular areas (often rural) thought to be underserved. This approach was formalized with the advent of the war o ... Full text Cite

Cost and Outcomes of Stroke and Hip Fracture: Rising Costs but Better Outcomes?

Journal article American Journal of Public Health · 1999 Cite

Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?

Journal article BMJ (Clinical research ed.) · January 1999 ObjectivesTo determine the number and geographical distribution of general practitioners in the NHS who qualified medically in South Asia and to project their numbers as they retire.DesignRetrospective analysis of yearly data and projecti ... Full text Cite

Effects of admission to a teaching hospital on the cost and quality of care for Medicare beneficiaries.

Journal article The New England journal of medicine · January 1999 Background and methodsWe studied the effects of admission to a teaching hospital on the cost and quality of care for patients covered by Medicare (age, 65 years old or older). We used data from the National Long Term Care Survey and merged them wi ... Full text Cite

The natural life of policy indices: geographical problem areas in the U.S. and U.K.

Journal article Social science & medicine (1982) · September 1998 In spite of many fundamental differences between the health systems in the U.S. and U.K., each has pursued a policy of identifying geographical small-areas believed to have inadequate primary care physicians given local health care needs. The magnitude of ... Full text Cite

General practitioner turnover and migration in England 1990-94.

Journal article The British journal of general practice : the journal of the Royal College of General Practitioners · March 1998 BackgroundIn tandem with fears about a GP workforce crisis, increasing attention is being focused on the supply and distribution of primary care services: on general practitioners in particular. Differential turnover and migration across health au ... Cite

Partnership changes in English general practice from 1990 to 1994.

Journal article Journal of public health medicine · September 1997 BackgroundThe objective of this study was to quantify the rate of partnership change among general practitioners (GPs) in the National Health Service (NHS) in England from 1990 to 1994.MethodsTime series data on English GPs were analysed ... Full text Cite

Recruitment, retention, and time commitment change of general practitioners in England and Wales, 1990-4: a retrospective study.

Journal article BMJ (Clinical research ed.) · June 1997 ObjectivesTo describe the recruitment and retention of general practitioners and changes in their time commitment from 1 October 1990 to 1 October 1994.DesignRetrospective analysis of yearly data.SettingEngland and Wales.Subj ... Full text Cite

Partnership Changes in General Practice, 1990-1994

Journal article Journal of Public Health Medicine · 1997 Cite

Review of My Own Country

Journal article The Journal of Health Care for the Poor and Underserved · 1995 Cite

Using Logistic Regression to make County‐level Estimates of the Medically Uninsured in North Carolina

Journal article Review of Policy Research · January 1, 1995 Often, policy analysts are asked to produce data for which there are no universally accepted methods. Policymakers and legislators are continually searching for accurate estimates of the magnitude of the problem with which to inform their debate, but often ... Full text Cite

Increasing Obstetrical Care Access to the Rural Poor

Journal article Journal of Health Care for the Poor and Underserved · 1994 Cite

Helping nurse-midwives provide obstetrical care in rural North Carolina.

Journal article American journal of public health · June 1993 Full text Cite

Helping Nurse-Midwives Provide Obstetrical Care

Journal article American Journal of Public Health · 1993 Cite

Increasing obstetrical care access to the rural poor.

Journal article Journal of health care for the poor and underserved · January 1993 Rising malpractice insurance rates have led to a decrease in the number of physicians who provide rural obstetrical care. North Carolina has responded with the Rural Obstetrical Care Incentive (ROCI) Program, which provides up to $6,500 per year to physici ... Full text Cite

One state's response to the malpractice insurance crisis: North Carolina's Rural Obstetrical Care Incentive Program.

Journal article Public health reports (Washington, D.C. : 1974) · September 1992 In the period 1985-89, there was a severe drop in obstetrical services in rural areas of North Carolina, partly because of rising malpractice insurance rates. The State government responded with the Rural Obstetrical Care Incentive (ROCI) Program that prov ... Cite