Featured Publications
Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among Adults in the US, 1999 to 2018
Caraballo C, Ndumele CD, Roy B, Lu Y, Riley C, Herrin J, Krumholz HM. Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among Adults in the US, 1999 to 2018. JAMA Health Forum 2022, 3: e223856. PMID: 36306118, PMCID: PMC9617175, DOI: 10.1001/jamahealthforum.2022.3856.Peer-Reviewed Original ResearchConceptsTimely medical careSerial cross-sectional studyNational Health Interview SurveyCross-sectional studyHealth Interview SurveyMedical careLack of transportationEthnic disparitiesHispanics/LatinosWhite individualsEthnicity groupsInterview SurveyCost of careSelf-reported raceStudy cohortClinic hoursMAIN OUTCOMEMedical officesCarePrevalenceLatino individualsBlack individualsSignificant differencesSignificant increasePopulation groups
2024
Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance
Nash K, Weerahandi H, Yu H, Venkatesh A, Holaday L, Herrin J, Lin Z, Horwitz L, Ross J, Bernheim S. Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance. JAMA 2024, 331: 111-123. PMID: 38193960, PMCID: PMC10777266, DOI: 10.1001/jama.2023.24874.Peer-Reviewed Original ResearchConceptsBlack patientsPatient populationHospital characteristicsHospital-wide readmission measureDual-eligible patientsHospital patient populationCross-sectional studyMeasures of hospitalHealth care qualityPatient demographicsReadmission ratesClinical outcomesPatient raceEligible hospitalsReadmissionMAIN OUTCOMEReadmission measuresMedicare dataUS hospitalsHospitalCare qualityPatientsMedicaid ServicesOutcomesLower percentage
2022
Factors Associated With Disparities in Hospital Readmission Rates Among US Adults Dually Eligible for Medicare and Medicaid
Silvestri D, Goutos D, Lloren A, Zhou S, Zhou G, Farietta T, Charania S, Herrin J, Peltz A, Lin Z, Bernheim S. Factors Associated With Disparities in Hospital Readmission Rates Among US Adults Dually Eligible for Medicare and Medicaid. JAMA Health Forum 2022, 3: e214611. PMID: 35977231, PMCID: PMC8903116, DOI: 10.1001/jamahealthforum.2021.4611.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNon-DE patientsCommunity-level factorsHospital disparitiesHeart failureDE patientsReadmission ratesCohort studyUS hospitalsRisk-adjusted readmission ratesRetrospective cohort studyHospital readmission ratesLow-income older adultsHospital quality improvementEligible patientsHospital readmissionMedicaid eligibility policyCare transitionsMyocardial infarctionState Medicaid policiesWorse outcomesMedicare patientsMAIN OUTCOMEUS adultsPneumonia
2021
Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018
Mahajan S, Caraballo C, Lu Y, Valero-Elizondo J, Massey D, Annapureddy AR, Roy B, Riley C, Murugiah K, Onuma O, Nunez-Smith M, Forman HP, Nasir K, Herrin J, Krumholz HM. Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. JAMA 2021, 326: 637-648. PMID: 34402830, PMCID: PMC8371573, DOI: 10.1001/jama.2021.9907.Peer-Reviewed Original ResearchConceptsHealth care accessFair health statusSelf-reported health statusCare accessHealth statusWhite individualsEthnic differencesLatino/HispanicNational Health Interview Survey dataSerial cross-sectional studySelf-reported functional limitationsBlack individualsHealth Interview Survey dataLow incomeCross-sectional studyCross-sectional survey studyInterview Survey dataSelf-reported raceSelf-report measuresMAIN OUTCOMEUS adultsFunctional limitationsPercentage of peopleSignificant decreaseAdults
2020
Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study
Arora A, Spatz ES, Herrin J, Riley C, Roy B, Rula EY, Kell KP, Krumholz HM. Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study. BMJ Open 2020, 10: e035645. PMID: 32948545, PMCID: PMC7500307, DOI: 10.1136/bmjopen-2019-035645.Peer-Reviewed Original ResearchConceptsObservational cross-sectional studyCross-sectional studyHigh-poverty countiesMean wellRobert Wood Johnson Foundation County Health RankingsLow physical inactivityPrimary care physiciansCounty characteristicsPopulation health modelCounty Health RankingsPreventable hospital staysHospital stayCare physiciansHighest quartilePhysical inactivityHigh percentageMAIN OUTCOMELow prevalenceIndex scoreHeavy drinkersHealth RankingsPopulation-level measuresHealth modelBottom quintileTop quintileSurvival After Cancer Treatment at Top-Ranked US Cancer Hospitals vs Affiliates of Top-Ranked Cancer Hospitals
Boffa DJ, Mallin K, Herrin J, Resio B, Salazar MC, Palis B, Facktor M, McCabe R, Nelson H, Shulman LN. Survival After Cancer Treatment at Top-Ranked US Cancer Hospitals vs Affiliates of Top-Ranked Cancer Hospitals. JAMA Network Open 2020, 3: e203942. PMID: 32453382, PMCID: PMC7251445, DOI: 10.1001/jamanetworkopen.2020.3942.Peer-Reviewed Original ResearchConceptsLong-term survivalCancer HospitalSurgical treatmentShort-term survivalComplex cancer treatmentAffiliate hospitalsCancer treatmentCancer careAdjusted long-term survivalNational Cancer DatabaseAnnual surgical volumeComplex cancer careIndividuals 18 yearsComplex surgical proceduresPerioperative mortalityCohort studyAffiliated HospitalPooled analysisBladder cancerCancer DatabasePatient outcomesSurgical volumeSurgical proceduresMAIN OUTCOMESurvival advantage
2019
Association of Racial Bias With Burnout Among Resident Physicians
Dyrbye L, Herrin J, West CP, Wittlin NM, Dovidio JF, Hardeman R, Burke SE, Phelan S, Onyeador IN, Cunningham B, van Ryn M. Association of Racial Bias With Burnout Among Resident Physicians. JAMA Network Open 2019, 2: e197457. PMID: 31348503, PMCID: PMC6661712, DOI: 10.1001/jamanetworkopen.2019.7457.Peer-Reviewed Original ResearchConceptsSymptoms of burnoutResident physiciansFT scoreRacial disparitiesDose-response associationHealth careDirect patient interactionResident physician trainingCohort studyBlack patientsMultivariable analysisPhysician respondentsHigh prevalenceMAIN OUTCOMEWhite raceMedical careBurnout itemsSymptomsPhysiciansPatient interactionsMaslach Burnout InventoryPhysician trainingTime pointsCareScarce evidenceDifferential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery
Hoag JR, Resio BJ, Monsalve AF, Chiu AS, Brown LB, Herrin J, Blasberg JD, Kim AW, Boffa DJ. Differential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery. JAMA Network Open 2019, 2: e191912. PMID: 30977848, PMCID: PMC6481444, DOI: 10.1001/jamanetworkopen.2019.1912.Peer-Reviewed Original ResearchConceptsComplex cancer surgeryCancer surgeryCancer HospitalMedicare beneficiariesCancer NetworkRelative safetyStandardized mortality ratioComplex cancer careCross-sectional studyTop-ranked hospitalsMedicaid Services 100Hierarchical logistic regressionPerioperative mortalityAffiliated HospitalCancer careMortality ratioOdds ratioMAIN OUTCOMESurgeryHospitalReview filesDifferential safetyLogistic regressionMortalityMedicare providers
2018
Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians.
Dyrbye LN, Burke SE, Hardeman RR, Herrin J, Wittlin NM, Yeazel M, Dovidio JF, Cunningham B, White RO, Phelan SM, Satele DV, Shanafelt TD, van Ryn M. Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians. JAMA 2018, 320: 1114-1130. PMID: 30422299, PMCID: PMC6233627, DOI: 10.1001/jama.2018.12615.Peer-Reviewed Original ResearchConceptsCareer choice regretSymptoms of burnoutResident physiciansClinical specialtiesUS resident physiciansLevel of anxietyRelative riskProspective cohort studyHigher relative riskCohort studyMultivariable analysisFemale sexBaseline questionnaireMAIN OUTCOMEGeneral surgeryHigh riskLower riskUS Medical Licensing Examination Step 1 scoresMedical schoolsSymptomsInternal medicinePhysiciansDemographic characteristicsRisk of burnoutEmergency medicineAssociation of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older
Riley C, Roy B, Herrin J, Spatz ES, Arora A, Kell KP, Rula EY, Krumholz HM. Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older. JAMA Network Open 2018, 1: e182136. PMID: 30646154, PMCID: PMC6324481, DOI: 10.1001/jamanetworkopen.2018.2136.Peer-Reviewed Original ResearchConceptsMedicare FFS beneficiariesPeople 65 yearsHealth care spendingFFS beneficiariesCare spendingPopulation-based cross-sectional studyLower health care spendingHealth care system capacityCross-sectional studyHealth care systemPopulation levelPayment modelsCare payment modelsHighest quintileInverse associationStudy interventionMAIN OUTCOMEMedicare feeMedicare beneficiariesUS national studyOverall healthMedian household incomeBeing IndexCare systemDemographic characteristics
2016
Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions
Desai NR, Ross JS, Kwon JY, Herrin J, Dharmarajan K, Bernheim SM, Krumholz HM, Horwitz LI. Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions. JAMA 2016, 316: 2647-2656. PMID: 28027367, PMCID: PMC5599851, DOI: 10.1001/jama.2016.18533.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionReadmission ratesReadmissions Reduction ProgramHeart failurePenalty statusNontarget conditionsMedicare feeMean readmission rateThirty-day riskRetrospective cohort studyUnplanned readmission rateReduction programsHRRP announcementHRRP implementationPenalized hospitalsCohort studyService patientsMyocardial infarctionMAIN OUTCOMEExcess readmissionsMedicare beneficiariesService beneficiariesHospitalPatients
2013
Association between physicians’ experience after training and maternal obstetrical outcomes: cohort study
Epstein AJ, Srinivas SK, Nicholson S, Herrin J, Asch DA. Association between physicians’ experience after training and maternal obstetrical outcomes: cohort study. The BMJ 2013, 346: f1596. PMID: 23538919, PMCID: PMC3610558, DOI: 10.1136/bmj.f1596.Peer-Reviewed Original ResearchConceptsMaternal complication ratesMaternal complicationsComplication rateRetrospective cohort analysisAcute care hospitalsObstetrical outcomesCesarean deliveryCohort studyCare hospitalVaginal deliveryCesarean birthCompletion of residencyCohort analysisPhysician yearsMAIN OUTCOMEThird decadePost-residency practiceComplicationsObstetriciansMore yearsSecular trendsComposite measurePercentage pointsAssociationSecond decade