Scholars@Duke
Virginia Wang

Virginia Wang

Professor in Population Health Sciences
Population Health Sciences
virginia.wang@duke.edu
Campus Box 104023, Durham, NC 27710
215 Morris Street, Room 219, Durham, NC 27710

Scholarly Works - Journal articles

Pain Management Among Veterans on Hemodialysis Before and After Implementation of the Veteran Health Administration's Opioid Safety Initiative.

Journal article J Palliat Med · March 2026 BACKGROUND: Little is known about the impact of opioid safety initiatives (OSIs) on veterans with end-stage kidney disease on hemodialysis, a seriously ill population for whom balancing the benefits and harms of opioids can be challenging. OBJECTIVE: To as ... Full text Link to item Cite

Enhancing team communication to improve implementation of a supervised walking program for hospitalized veterans: Evidence from a multi-site trial in the Veterans Health Administration.

Journal article PM R · November 2025 INTRODUCTION: The timely translation of evidence-based programs into real-world clinical settings is a persistent challenge due to complexities related to organizational context and team function, particularly in inpatient settings. Strategies are needed t ... Full text Link to item Cite

Design and rationale of the SMaRRT-HD study: A pragmatic, randomized trial of symptom monitoring for individuals receiving maintenance hemodialysis.

Journal article Contemp Clin Trials · October 2025 Individuals with hemodialysis-dependent kidney failure often suffer from numerous symptoms that contribute to poor patient outcomes. The Symptom Monitoring in Renal Replacement Therapy-Hemodialysis (SMaRRT-HD) Study is a pragmatic randomized trial of monit ... Full text Link to item Cite

Psychological Resilience and Physical Function in Veterans With Chronic Kidney Disease: A Brief Report.

Journal article J Am Geriatr Soc · June 2025 BACKGROUND: Psychological resilience has been characterized as the ability to recover from stressful life events. Not well studied is whether self-reported measures of psychological resilience are associated with physical function recovery. Therefore, we e ... Full text Link to item Cite

Outcomes of Community-Acquired Acute Kidney Injury: A Cohort Study of US Veterans.

Journal article Med Care · February 1, 2025 BACKGROUND: Community-acquired acute kidney injury (CA-AKI) occurs outside of the hospital and is the most common form of AKI. CA-AKI is not well understood, which hinders efforts to prevent, identify, and manage CA-AKI. OBJECTIVE: Examine 30-day outcomes ... Full text Link to item Cite

Medicare Enrollment and Spending Among Patients Initiating Dialysis After the Affordable Care Act.

Journal article JAMA Health Forum · December 6, 2024 IMPORTANCE: Medicare finances health care for most US patients with end-stage kidney disease (ESKD), regardless of age. Medicare enrollment may have slowed for patients with incident ESKD who gained access to new private insurance options with the 2014 pas ... Full text Link to item Cite

The business case for hospital mobility programs in the veterans health care system: Results from multi-hospital implementation of the STRIDE program.

Journal article Health Serv Res · December 2024 OBJECTIVE: To conduct a business case analysis for Department of Veterans Affairs (VA) program STRIDE (ASsisTed EaRly MobIlization for hospitalizeD older VEterans), which was designed to address immobility for hospitalized older adults. DATA SOURCES AND ST ... Full text Link to item Cite

Implementation outcomes from a multi-site stepped wedge cluster randomized family caregiver skills training trial.

Journal article Health Serv Res · December 2024 OBJECTIVE: To assess whether a team collaboration strategy (CONNECT) improves implementation outcomes of a family caregiver skills training program (iHI-FIVES). DATA SOURCES AND STUDY SETTING: iHI-FIVES was delivered to caregivers at eight Veterans Affairs ... Full text Link to item Cite

A stepped wedge cluster randomized trial to evaluate the effectiveness of a multisite family caregiver skills training program.

Journal article Health Serv Res · December 2024 OBJECTIVE: To assess the effects of an evidence-based family caregiver training program (implementation of Helping Invested Families Improve Veteran Experiences Study [iHI-FIVES]) in the Veterans Affairs healthcare system on Veteran days not at home and fa ... Full text Link to item Cite

Site-initiated adaptations in the implementation of an evidence-based inpatient walking program.

Journal article J Am Geriatr Soc · October 2024 BACKGROUND: There is increasing recognition of the importance of maximizing program-setting fit in scaling and spreading effective programs. However, in the context of hospital-based mobility programs, there is limited information on how settings could con ... Full text Link to item Cite

Trajectories of Physical Resilience Among Older Veterans With Stage 4 CKD.

Journal article Am J Kidney Dis · August 2024 RATIONALE & OBJECTIVE: Although functional impairment is common among older adults with chronic kidney disease (CKD), functional reserve before an acute health event and physical resilience after the event have not been characterized in this population. Th ... Full text Link to item Cite

Cystatin C Use for CKD Detection in the Veterans Health Administration System: A Qualitative Study of Barriers and Facilitators.

Journal article Kidney Med · June 2024 RATIONALE & OBJECTIVE: The measurement of cystatin C has been recommended to enhance chronic kidney disease (CKD) detection and risk stratification in clinical practice. This study gathered insights into the perceptions and experiences of clinical staff re ... Full text Link to item Cite

Prescription and Dispensation of QT-Prolonging Medications in Individuals Receiving Hemodialysis.

Journal article JAMA Netw Open · April 1, 2024 IMPORTANCE: Individuals with dialysis-dependent kidney failure have numerous risk factors for medication-related adverse events, including receipt of care by multiple clinicians and initiation of some QT-prolonging medications with known risk of torsades d ... Full text Link to item Cite

Improving Health Equity in Living Donor Kidney Transplant: Application of an Implementation Science Framework.

Journal article Transplant Proc · 2024 BACKGROUND: Interventions to improve racial equity in access to living donor kidney transplants (LDKT) have focused primarily on patients, ignoring the contributions of clinicians, transplant centers, and health system factors. Obtaining access to LDKT is ... Full text Link to item Cite

"I've been doing this for years": the COVID-19 pandemic and family caregiver isolation and loneliness.

Journal article Front Aging · 2024 BACKGROUND: Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregiv ... Full text Link to item Cite

Racial Equity in Living Donor Kidney Transplant Centers, 2008-2018.

Journal article JAMA Netw Open · December 1, 2023 IMPORTANCE: It is unclear whether center-level factors are associated with racial equity in living donor kidney transplant (LDKT). OBJECTIVE: To evaluate center-level factors and racial equity in LDKT during an 11-year time period. DESIGN, SETTING, AND PAR ... Full text Link to item Cite

Residential Structural Racism and Prevalence of Chronic Health Conditions.

Journal article JAMA Netw Open · December 1, 2023 IMPORTANCE: Studies elucidating determinants of residential neighborhood-level health inequities are needed. OBJECTIVE: To quantify associations of structural racism indicators with neighborhood prevalence of chronic kidney disease (CKD), diabetes, and hyp ... Full text Link to item Cite

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.

Journal article Implement Sci Commun · October 12, 2023 BACKGROUND: Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient a ... Full text Open Access Link to item Cite

Epidemiology of Community-Acquired Acute Kidney Injury Among US Veterans.

Journal article Am J Kidney Dis · September 2023 RATIONALE & OBJECTIVE: Community-acquired acute kidney injury (CA-AKI) develops outside of the hospital and is the most common form of AKI globally. National estimates of CA-AKI in the United States are absent due to limited availability of laboratory data ... Full text Link to item Cite

Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers' diffusion of innovation theory.

Journal article Implement Sci Commun · June 19, 2023 BACKGROUND: Caregivers FIRST is an evidence-based program addressing gaps in caregivers' skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance pla ... Full text Open Access Link to item Cite

Costs Associated With Progression of Mildly Reduced Kidney Function Among Medicare Advantage Enrollees.

Journal article Kidney Med · June 2023 RATIONALE & OBJECTIVE: The prevalence of early chronic kidney disease (CKD) in older adults has increased in the past 2 decades, yet CKD disease progression, overall, is variable. It is unclear whether health care costs differ by progression trajectory. Th ... Full text Link to item Cite

Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial.

Journal article Ann Intern Med · June 2023 BACKGROUND: In trials, hospital walking programs have been shown to improve functional ability after discharge, but little evidence exists about their effectiveness under routine practice conditions. OBJECTIVE: To evaluate the effect of implementation of a ... Full text Link to item Cite

A Cluster Randomized Trial of a Family Health History Platform to Identify and Manage Patients at Increased Risk for Colorectal Cancer.

Journal article J Gen Intern Med · May 2023 BACKGROUND: Obtaining comprehensive family health history (FHH) to inform colorectal cancer (CRC) risk management in primary care settings is challenging. OBJECTIVE: To examine the effectiveness of a patient-facing FHH platform to identify and manage patie ... Full text Link to item Cite

Intensification of Implementation Strategies: Developing a Model of Foundational and Enhanced Implementation Approaches to Support National Adoption and Scale-up.

Journal article Gerontologist · March 21, 2023 Implementation strategies are activities to support integration of evidence-based programs (EBPs) into routine care. Comprised of 170+ facilities, the Veterans Affairs Healthcare System is conducive to evaluating feasibility and scalability of implementati ... Full text Link to item Cite

Have racial disparities in home dialysis utilization changed over time?

Journal article Am J Manag Care · March 2023 OBJECTIVES: The Medicare end-stage kidney disease (ESKD) prospective payment system (PPS) for maintenance dialysis, implemented in 2011, resulted in modestly increased access to both home-based peritoneal dialysis (PD) and home hemodialysis (HHD) treatment ... Full text Link to item Cite

Association of the Affordable Care Act on Access to and Outcomes After Kidney or Liver Transplant: A Transplant Registry Study.

Journal article Transplant Proc · 2023 BACKGROUND: To evaluate the effect of the Affordable Care Act (ACA) Medicaid expansion on payor mix among patients on the kidney and liver transplant waiting list as well as waiting list and post-transplant outcomes. DESIGN: Using the Scientific Registry o ... Full text Link to item Cite

Impact of the COVID-19 Pandemic on the Provision of Dialysis Service and Mortality in Veterans Receiving Maintenance Hemodialysis in the VA: An Interrupted Time-Series Analysis.

Journal article Am J Nephrol · 2023 INTRODUCTION: According to the US Renal Data System (USRDS), patients with end-stage kidney disease (ESKD) on maintenance dialysis had higher mortality during early COVID-19 pandemic. Less is known about the effect of the pandemic on the delivery of outpat ... Full text Link to item Cite

Reserve and resilience in CKD: concept introduction and baseline results from the Physical REsilience Prediction in Advanced REnal Disease (PREPARED) study.

Journal article BMC Nephrol · December 31, 2022 BACKGROUND: The purpose of this manuscript is to introduce reserve and resilience as novel concepts in chronic kidney disease (CKD) research and present baseline data from a unique prospective cohort study designed to characterize recovery from functional ... Full text Link to item Cite

Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study.

Journal article J Gen Intern Med · December 2022 BACKGROUND: Inpatient mobility programs can help older adults maintain function during hospitalization. Changing hospital practice can be complex and require engagement of various staff levels and disciplines; however, we know little about how interprofess ... Full text Link to item Cite

Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol.

Journal article BMC Nephrol · October 12, 2022 BACKGROUND: There are major gaps in the implementation of guideline-concordant care for persons with chronic kidney disease (CKD). The CKD Cascade of Care (C3) initiative seeks to improve CKD care by improving detection and treatment of CKD in primary care ... Full text Link to item Cite

Rates of Medicare Enrollment Among Dialysis Patients After Implementation of Medicare Payment Reform and the Affordable Care Act Marketplace.

Journal article JAMA Netw Open · September 1, 2022 IMPORTANCE: Medicare finances health care for most US patients with end-stage kidney disease (ESKD), regardless of age. The 2011 Medicare prospective payment system (PPS) for dialysis reduced reimbursement for hemodialysis, and the 2014 Patient Protection ... Full text Link to item Cite

Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness.

Journal article BMC Health Serv Res · July 29, 2022 BACKGROUND: Clinical interventions often need to be adapted from their original design when they are applied to new settings. There is a growing literature describing frameworks and approaches to deploying and documenting adaptations of evidence-based prac ... Full text Open Access Link to item Cite

Identifying Family and Unpaid Caregivers in Electronic Health Records: Descriptive Analysis.

Journal article JMIR Form Res · July 18, 2022 BACKGROUND: Most efforts to identify caregivers for research use passive approaches such as self-nomination. We describe an approach in which electronic health records (EHRs) can help identify, recruit, and increase diverse representations of family and ot ... Full text Open Access Link to item Cite

Implications of Cross-System Use Among US Veterans With Advanced Kidney Disease in the Era of the MISSION Act: A Qualitative Study of Health Care Records.

Journal article JAMA Intern Med · July 1, 2022 IMPORTANCE: Since 2014, when Congress passed the Veterans Access Choice and Accountability (Choice) Act (replaced in 2018 with the more comprehensive Maintaining Internal Systems and Strengthening Integrated Outside Networks [MISSION] Act), the Department ... Full text Link to item Cite

Unintended Consequences of COVID-19 Social Distancing Among Older Adults With Kidney Disease.

Journal article J Gerontol A Biol Sci Med Sci · April 1, 2022 BACKGROUND: While social distancing policies protect older adults with advanced chronic kidney disease (CKD) from exposure to COVID-19, reduced social interaction may also have unintended consequences. METHODS: To identify subgroups of patients at risk for ... Full text Link to item Cite

Market Consolidation and Innovation in US Dialysis.

Journal article Adv Chronic Kidney Dis · January 2022 While patients with end-stage kidney disease have benefited from innovations in clinical therapeutics and care delivery, these changes have been primarily incremental and have not fundamentally transformed care delivery. Dialysis markets are highly concent ... Full text Link to item Cite

Association of Social Risk Factors With Home Dialysis and Kidney Transplant Rates in Dialysis Facilities.

Journal article JAMA · December 14, 2021 This study examines rates of home dialysis and transplant at dialysis facilities that serve patients with high social risk to understand how they fare under the End-Stage Renal Disease Treatment Choices Model. ... Full text Link to item Cite

Walking All over COVID-19: The Rapid Development of STRIDE in Your Room, an Innovative Approach to Enhance a Hospital-Based Walking Program during the Pandemic.

Journal article Geriatrics (Basel) · November 10, 2021 Hospitalization is common among older adults. Prolonged time in bed during hospitalization can lead to deconditioning and functional impairments. Our team is currently working with Department of Veterans Affairs (VA) medical centers across the United State ... Full text Open Access Link to item Cite

Trends in Dialysis Industry Consolidation After Medicare Payment Reform, 2006-2016.

Journal article JAMA Health Forum · November 2021 IMPORTANCE: The dialysis industry is highly concentrated, with large dialysis organizations now providing dialysis for more than 85% of patients with kidney failure in the United States. In 2011, Medicare introduced a new Prospective Payment System (PPS) f ... Full text Open Access Link to item Cite

Trends in Regional Supply of Peritoneal Dialysis in an Era of Health Reform, 2006 to 2013.

Journal article Med Care Res Rev · June 2021 Peritoneal dialysis (PD), a home-based treatment for kidney failure, is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis. Yet <10% of patients receive PD. Access to this alternative treatment, vis-à-vis ... Full text Link to item Cite

Replicating an effective VA program to train and support family caregivers: a hybrid type III effectiveness-implementation design.

Journal article BMC Health Serv Res · May 6, 2021 BACKGROUND: Caring for a growing aging population using existing long-term care resources while simultaneously supporting and educating family caregivers, is a public health challenge. We describe the application of the Replicating Effective Programs (REP) ... Full text Open Access Link to item Cite

Annual wellness visits and care management before and after dialysis initiation.

Journal article BMC Nephrol · May 5, 2021 INTRODUCTION: Demands of dialysis regimens may pose challenges for primary care provider (PCP) engagement and timely preventive care. This is especially the case for patients initiating dialysis adjusting to new logistical challenges and management of symp ... Full text Link to item Cite

Source of Post-Transplant Care and Mortality among Kidney Transplant Recipients Dually Enrolled in VA and Medicare.

Journal article Clin J Am Soc Nephrol · March 8, 2021 BACKGROUND AND OBJECTIVES: Many kidney transplant recipients enrolled in the Veterans Health Administration are also enrolled in Medicare and eligible to receive both Veterans Health Administration and private sector care. Where these patients receive tran ... Full text Link to item Cite

Comparing Mortality of Peritoneal and Hemodialysis Patients in an Era of Medicare Payment Reform.

Journal article Med Care · February 1, 2021 BACKGROUND: Prior studies have shown peritoneal dialysis (PD) patients to have lower or equivalent mortality to patients who receive in-center hemodialysis (HD). Medicare's 2011 bundled dialysis prospective payment system encouraged expansion of home-based ... Full text Link to item Cite

Opioid Prescribing in the 2016 Medicare Fee-for-Service Population.

Journal article J Am Geriatr Soc · February 2021 BACKGROUND AND OBJECTIVES: Opioid use and misuse are prevalent and remain a national crisis. This study identified beneficiary characteristics associated with filling opioid prescriptions, variation in opioid dosing, and opioid use with average daily doses ... Full text Link to item Cite

Facility-Level Variation in Dialysis Use and Mortality Among Older Veterans With Incident Kidney Failure.

Journal article JAMA Netw Open · January 4, 2021 IMPORTANCE: Current guidelines lack consensus regarding the treatment of patients who may not benefit from dialysis; this lack of consensus may be associated with the substantial variation in dialysis use and outcomes across health care facilities. OBJECTI ... Full text Link to item Cite

Disparities in Chronic Kidney Disease Progression by Medicare Advantage Enrollees.

Journal article Am J Nephrol · 2021 INTRODUCTION: The prevalence of chronic kidney disease (CKD) in Medicare beneficiaries has quadrupled in the past 2 decades, but little is known about risk factors affecting the progression of CKD. This study aims to understand the progression in Medicare ... Full text Link to item Cite

Association of VA Payment Reform for Dialysis with Spending, Access to Care, and Outcomes for Veterans with ESKD.

Journal article Clin J Am Soc Nephrol · November 6, 2020 BACKGROUND AND OBJECTIVES: Because of the limited capacity of its own dialysis facilities, the Department of Veterans Affairs (VA) Veterans Health Administration routinely outsources dialysis care to community providers. Prior to 2011-when the VA implement ... Full text Link to item Cite

Fragmentation of care as a barrier to optimal ESKD management.

Journal article Semin Dial · November 2020 Caring for patients with end-stage kidney disease (ESKD) in the United States is challenging, due in part to the complex epidemiology of the disease's progression as well as the ways in which care is delivered. As CKD progresses toward ESKD, the number of ... Full text Link to item Cite

Implementation of a stepped wedge cluster randomized trial to evaluate a hospital mobility program.

Journal article Trials · October 16, 2020 BACKGROUND: Stepped wedge cluster randomized trials (SW-CRT) are increasingly used to evaluate new clinical programs, yet there is limited guidance on practical aspects of applying this design. We report our early experiences conducting a SW-CRT to examine ... Full text Open Access Link to item Cite

Supply and Distribution of Vascular Access Physicians in the United States: A Cross-Sectional Study.

Journal article Kidney360 · August 2020 BACKGROUND: Because functioning permanent vascular access (arteriovenous fistula [AVF] or arteriovenous graft [AVG]) is crucial for optimizing patient outcomes for those on hemodialysis, the supply of physicians placing vascular access is key. We investiga ... Full text Link to item Cite

Medicare Enrollment Among Patients With End-Stage Kidney Disease Receiving Dialysis in Outpatient Facilities Between 2005 and 2016.

Journal article JAMA · April 7, 2020 This study characterizes annual changes in enrollment of Medicare and non-Medicare patients treated at dialysis facilities before and after 2011 payment reforms and 2014 Affordable Care Act changes that influenced reimbursements. ... Full text Link to item Cite

Care continuity impacts medicare expenditures of older adults: Fact or fiction?

Journal article Healthc (Amst) · March 2020 BACKGROUND: Older adults with cardiometabolic conditions are typically seen by multiple providers. Management by multiple providers may compromise care continuity and increase health expenditures for older adults, which may partly explain the inverse assoc ... Full text Link to item Cite

Implementation of a group physical therapy program for Veterans with knee osteoarthritis.

Journal article BMC Musculoskelet Disord · February 3, 2020 BACKGROUND: A previous randomized clinical trial found that a Group Physical Therapy (PT) program for knee osteoarthritis yielded similar improvements in pain and function compared with traditional individual PT. Based on these findings the Group PT progra ... Full text Open Access Link to item Cite

Adaptation and Implementation of a Family Caregiver Skills Training Program: From Single Site RCT to Multisite Pragmatic Intervention.

Journal article J Nurs Scholarsh · January 2020 PURPOSE: We describe an approach to rapidly adapt and implement an education and skills improvement intervention to address the needs of family caregivers of functionally impaired veterans-Helping Invested Families Improve Veterans' Experience Study (HI-FI ... Full text Link to item Cite

Trends in Peritoneal Dialysis Use in the United States after Medicare Payment Reform.

Journal article Clin J Am Soc Nephrol · December 6, 2019 BACKGROUND AND OBJECTIVES: Peritoneal dialysis (PD) for ESKD is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis (HD), but has historically been underused. We assessed the effect of the 2011 Medicare pro ... Full text Link to item Cite

An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial.

Journal article Trials · October 7, 2019 BACKGROUND: Colorectal cancer is the fourth most commonly diagnosed cancer in the United States. Approximately 3-10% of the population has an increased risk for colorectal cancer due to family history and warrants more frequent or intensive screening. Yet, ... Full text Link to item Cite

Lab-based and diagnosis-based chronic kidney disease recognition and staging concordance.

Journal article BMC Nephrol · September 14, 2019 BACKGROUND: Chronic kidney disease (CKD) is often under-recognized and poorly documented via diagnoses, but the extent of under-recognition is not well understood among Medicare beneficiaries. The current study used claims-based diagnosis and lab data to e ... Full text Link to item Cite

Authors' Reply.

Journal article J Am Soc Nephrol · July 2019 Full text Link to item Cite

Survival among Veterans Obtaining Dialysis in VA and Non-VA Settings.

Journal article J Am Soc Nephrol · January 2019 BACKGROUND: Outcomes of veterans with ESRD may differ depending on where they receive dialysis and who finances this care, but little is known about variation in outcomes across different dialysis settings and financial arrangements. METHODS: We examined s ... Full text Link to item Cite

Implementing a Mandated Program Across a Regional Health Care System: A Rapid Qualitative Assessment to Evaluate Early Implementation Strategies.

Journal article Qual Manag Health Care · 2019 BACKGROUND: Rapid qualitative assessment was used to describe early strategies to implement an evidence-based walking program for hospitalized older adults, assiSTed eaRly mobIlity for hospitalizeD older vEterans (STRIDE), mandated by a regional Department ... Full text Link to item Cite

Medicare's New Prospective Payment System on Facility Provision of Peritoneal Dialysis.

Journal article Clin J Am Soc Nephrol · December 7, 2018 BACKGROUND AND OBJECTIVES: Peritoneal dialysis is a self-administered, home-based treatment for ESKD associated with equivalent mortality, higher quality of life, and lower costs compared with hemodialysis. In 2011, Medicare implemented a comprehensive pro ... Full text Link to item Cite

Comparative Assessment of Utilization and Hospital Outcomes of Veterans Receiving VA and Non-VA Outpatient Dialysis.

Journal article Health Serv Res · December 2018 OBJECTIVE: Growing demand for VA dialysis exceeds its supply and travel distances prohibit many Veterans from receiving dialysis in a VA facility, leading to increased use of dialysis from non-VA providers. This study compared utilization and hospitalizati ... Full text Link to item Cite

Early Mobility in the Hospital: Lessons Learned from the STRIDE Program.

Journal article Geriatrics (Basel) · December 2018 Immobility during hospitalization is widely recognized as a contributor to deconditioning, functional loss, and increased need for institutional post-acute care. Several studies have demonstrated that inpatient walking programs can mitigate some of these n ... Full text Open Access Link to item Cite

Working smarter not harder: Coupling implementation to de-implementation.

Journal article Healthc (Amst) · June 2018 In this paper, we discuss de-implementation as an implicit part of implementation and organizational change, and consider its underlying processes of unlearning to discontinue or deviate from ineffective practice and learning to applying newer, more effect ... Full text Link to item Cite

Supporting teams to optimize function and independence in Veterans: a multi-study program and mixed methods protocol.

Journal article Implement Sci · April 20, 2018 BACKGROUND: Successful implementation of new clinical programs depends on effectively establishing, reorganizing, or enhancing team structures and processes to coordinate the work of individuals who are interdependent in their tasks, manage relationships, ... Full text Open Access Link to item Cite

Prescriber continuity and medication availability in older adults with cardiometabolic conditions.

Journal article SAGE Open Med · 2018 BACKGROUND: Many older adults have multiple conditions and see multiple providers, which may impact their use of essential medications. OBJECTIVE: We examined whether the number of prescribers of these medications was associated with the availability of me ... Full text Open Access Link to item Cite

Minding the gap and overlap: a literature review of fragmentation of primary care for chronic dialysis patients.

Journal article BMC Nephrol · August 29, 2017 BACKGROUND: Care coordination is a challenge for patients with kidney disease, who often see multiple providers to manage their associated complex chronic conditions. Much of the focus has been on primary care physician (PCP) and nephrologist collaboration ... Full text Link to item Cite

Prescriber Continuity and Disease Control of Older Adults.

Journal article Med Care · April 2017 BACKGROUND: Medicare beneficiaries with multiple chronic conditions are typically seen by multiple providers, particularly specialists. Clinically appropriate referrals to multiple specialists may compromise the continuity of care for multiple chronic cond ... Full text Link to item Cite

Impacts of Geographic Distance on Peritoneal Dialysis Utilization: Refining Models of Treatment Selection.

Journal article Health Serv Res · February 2017 OBJECTIVE: To examine the relationship between distance to dialysis provider and patient selection of dialysis modality, informed by the absolute distance from a patient's home and relative distance of alternative modalities. DATA SOURCES: U.S. Renal Data ... Full text Link to item Cite

Appropriate baseline laboratory testing following ACEI or ARB initiation by Medicare FFS beneficiaries.

Journal article Pharmacoepidemiol Drug Saf · September 2016 BACKGROUND: Laboratory testing to identify contraindications and adverse drug reactions is important for safety of patients initiating angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). Rates and predictors of appropria ... Full text Link to item Cite

Do Veterans Health Administration Enrollees Generalize to Other Populations?

Journal article Med Care Res Rev · August 2016 The Veterans Health Administration (VHA) has historically served a disproportionately male patient population with lower income and greater rates of mental illness than non-VHA populations. The generalizability of research based on VHA enrollees is unknown ... Full text Link to item Cite

The Economic Burden of Chronic Kidney Disease and End-Stage Renal Disease.

Journal article Semin Nephrol · July 2016 The growing prevalence and progression of chronic kidney disease (CKD) raises concerns about our capacity to manage its economic burden to patients, caregivers, and society. The societal direct and indirect costs of CKD and end-stage renal disease are subs ... Full text Link to item Cite

Linkage of Laboratory Results to Medicare Fee-for-Service Claims.

Journal article Med Care · November 2015 BACKGROUND: Medicare is the single largest purchaser of laboratory testing in the United States, yet test results associated with Medicare laboratory claims have historically not been available. OBJECTIVE: The purpose of this study was to describe both the ... Full text Link to item Cite

Impact of automated reporting of estimated glomerular filtration rate in the veterans health administration.

Journal article Med Care · February 2015 BACKGROUND: Early detection and treatment of chronic kidney disease (CKD) is important for slowing progression to renal failure and preventing cardiovascular events, but CKD is often not recognized and patients are referred to nephrologists too late for ti ... Full text Link to item Cite

Inertia in health care organizations: A case study of peritoneal dialysis services.

Journal article Health Care Manage Rev · 2015 BACKGROUND: Change is difficult for health care organizations where adoption of new practices is notoriously slow. Inertial behavior may reflect organizations' rational, strategic nonresponse to its environment or latent, institutionalizing preservation of ... Full text Link to item Cite

Recognition of CKD after the introduction of automated reporting of estimated GFR in the Veterans Health Administration.

Journal article Clin J Am Soc Nephrol · January 2014 BACKGROUND AND OBJECTIVES: Early detection of CKD is important for slowing progression to renal failure and preventing cardiovascular events. Automated laboratory reporting of estimated GFR (eGFR) has been introduced in many health systems to improve CKD r ... Full text Link to item Cite

The continuity and quality of primary care.

Journal article Med Care Res Rev · October 2013 Patients who have access to different health care systems, such as Medicare-eligible veterans, may obtain services in either or both health systems. We examined whether quality of diabetes care was associated with care continuity or veterans' usual source ... Full text Link to item Cite

Potential bias in medication adherence studies of prevalent users.

Journal article Health Serv Res · August 2013 PURPOSE: We examined how the choice of historic medication use criteria for identifying prevalent users may bias estimated adherence changes associated with a medication copayment increase. METHODS: From pharmacy claims data in a retrospective cohort study ... Full text Link to item Cite

Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.

Journal article BMC Health Serv Res · January 18, 2013 BACKGROUND: Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcom ... Full text Link to item Cite

Implementation of automated reporting of estimated glomerular filtration rate among Veterans Affairs laboratories: a retrospective study.

Journal article BMC Med Inform Decis Mak · July 12, 2012 BACKGROUND: Automated reporting of estimated glomerular filtration rate (eGFR) is a recent advance in laboratory information technology (IT) that generates a measure of kidney function with chemistry laboratory results to aid early detection of chronic kid ... Full text Open Access Link to item Cite

Economic evaluation of telephone self-management interventions for blood pressure control.

Journal article Am Heart J · June 2012 BACKGROUND: Half of patients with hypertension have poor blood pressure (BP) control. Recent models for treating hypertension have integrated disease monitoring and telephone-based interventions delivered in patients' homes. This study evaluated the costs ... Full text Open Access Link to item Cite

Does medication adherence following a copayment increase differ by disease burden?

Journal article Health Serv Res · December 2011 OBJECTIVES: To compare changes in medication adherence between patients with high- or low-comorbidity burden after a copayment increase. METHODS: We conducted a retrospective observational study at four Veterans Affairs (VA) medical centers by comparing ve ... Full text Link to item Cite

Early evidence on the quality of care provided by special needs plans.

Journal article Med Care · October 2011 BACKGROUND: Medicare Advantage special needs plans (SNPs) have grown significantly over the past 7 years, but patient outcomes have only recently been publicly reported. METHODS: Reporting rates and scores on 4 publicly reported Healthcare Effectiveness Da ... Full text Link to item Cite

Longitudinal analysis of market factors associated with provision of peritoneal dialysis services.

Journal article Med Care Res Rev · October 2011 Despite the appeal of peritoneal dialysis (PD) among patients, payers, and providers, its use in the United States has been limited and declining. Prior research has found that patient factors explain little variation in PD utilization, and little is known ... Full text Link to item Cite

Home blood pressure management and improved blood pressure control: results from a randomized controlled trial.

Journal article Arch Intern Med · July 11, 2011 BACKGROUND: To determine which of 3 interventions was most effective in improving blood pressure (BP) control, we performed a 4-arm randomized trial with 18-month follow-up at the primary care clinics at a Veterans Affairs Medical Center. METHODS: Eligible ... Full text Open Access Link to item Cite

Geographic and temporal trends in peritoneal dialysis services in the United States between 1995 and 2003.

Journal article Am J Kidney Dis · June 2010 BACKGROUND: Peritoneal dialysis (PD) is the preferred dialysis modality for many patients with end-stage renal disease (ESRD) in the United States. However, in sharp contrast to the high rates of PD use in other industrialized countries, PD use in the Unit ... Full text Link to item Cite

Changes in the monitoring and oversight practices of not-for-profit hospital governing boards 1989-2005: evidence from three national surveys.

Journal article Med Care Res Rev · April 2009 Despite the legal and practical importance of monitoring and oversight of management by hospital governing boards, there is little empirical evidence of how hospital boards fulfill these roles and the extent to which these practices have changed over time. ... Full text Link to item Cite

An empirical taxonomy of hospital governing board roles.

Journal article Health Serv Res · August 2008 OBJECTIVE: To develop a taxonomy of governing board roles in U.S. hospitals. DATA SOURCES: 2005 AHA Hospital Governance Survey, 2004 AHA Annual Survey of Hospitals, and Area Resource File. STUDY DESIGN: A governing board taxonomy was developed using cluste ... Full text Link to item Cite

A taxonomy of hospital governing boards

Journal article Academy of Management 2007 Annual Meeting: Doing Well by Doing Good, AOM 2007 · December 1, 2007 The purpose of this study was to develop an empirical taxonomy of governing boards in U.S. community hospitals. The taxonomy was developed using a configurational perspective and with cluster analysis according to three main areas of board responsibility-m ... Cite

Developing practitioner leaders in a distance education doctoral program: challenges and opportunities.

Journal article J Health Adm Educ · 2007 The nation's first executive doctoral program in health leadership was launched at the University of North Carolina School of Public Health in August 2005. The program confers a DrPH in health administration. This paper describes the program goals, admissi ... Link to item Cite

Recruiting participants to cancer prevention clinical trials: lessons from successful community oncology networks.

Journal article Oncol Nurs Forum · September 1, 2006 PURPOSE/OBJECTIVES: To describe the organizational designs and task environments of community oncology networks with high accrual rates to cancer prevention clinical trials. DESIGN: Replicated case study design; structural contingency theory. SETTING: Loca ... Full text Link to item Cite

Use of deceptive tactics in physician practices: are there differences between international and US medical graduates?

Journal article Health Policy · March 2004 Concerns have been raised about the medical practices of international medical graduates (IMGs) in the United States. This study examined the differences between IMGs and US-trained medical graduates (USMGs) in their attitude toward and utilization of dece ... Full text Link to item Cite