2020
The How Matters
Lee YSH, King MD, Anderson D, Cleary PD, Nembhard IM. The How Matters. Medical Care 2020, 58: 643-650. PMID: 32520838, DOI: 10.1097/mlr.0000000000001342.Peer-Reviewed Original ResearchConceptsPatient healthPrimary care providersQualified health centersDisease managementChronic disease managementPCP participationPatient characteristicsCare teamHealth centersHigher oddsPCP communicationCare providersPatient health managementPatientsHypertensionPractice sitesDisease controlDiabetesElectronic recordsLongitudinal studyMultilevel regression modelsTeam membersRegression modelsHealthPCP
2015
Accelerating Improvement and Narrowing Gaps: Trends in Patients' Experiences with Hospital Care Reflected in HCAHPS Public Reporting
Elliott MN, Cohea CW, Lehrman WG, Goldstein EH, Cleary PD, Giordano LA, Beckett MK, Zaslavsky AM. Accelerating Improvement and Narrowing Gaps: Trends in Patients' Experiences with Hospital Care Reflected in HCAHPS Public Reporting. Health Services Research 2015, 50: 1850-1867. PMID: 25854292, PMCID: PMC4693845, DOI: 10.1111/1475-6773.12305.Peer-Reviewed Original ResearchConceptsHospital care experiencesAdult inpatientsHospital characteristicsPublic reportingLinear mixed-effects regression modelsMixed effects regression modelsPatient characteristicsHCAHPS measuresHospital careHospital typePatient experienceHCAHPS scoresHospitalMeaningful improvementsCare experiencesPatient mixLarge hospitalsU.S. hospitalsPercent decreaseInpatientsNational probability sampleGreater improvementProbability sampleNarrowing GapsRegression models
2014
Are Comparisons of Patient Experiences Across Hospitals Fair? A Study in Veterans Health Administration Hospitals
Cleary PD, Meterko M, Wright SM, Zaslavsky AM. Are Comparisons of Patient Experiences Across Hospitals Fair? A Study in Veterans Health Administration Hospitals. Medical Care 2014, 52: 619-625. PMID: 24926709, PMCID: PMC4682878, DOI: 10.1097/mlr.0000000000000144.Peer-Reviewed Original ResearchMeSH KeywordsAgedAttitude of Health PersonnelConfounding Factors, EpidemiologicContinuity of Patient CareFemaleHealth Services AccessibilityHealth Services ResearchHospitals, VeteransHumansMaleMiddle AgedMyocardial InfarctionPatient SatisfactionQuality of Health CareResidence CharacteristicsSocioeconomic FactorsSurveys and QuestionnairesUnited StatesConceptsAcute myocardial infarctionPatients' clinical characteristicsClinical characteristicsPatient characteristicsPatient experienceInitial acute myocardial infarctionPatient-reported health statusVeterans Health Administration hospitalsVeterans Affairs Medical CenterVA administrative dataPatient experience surveysPatient care experiencesComplex patientsMyocardial infarctionPatient surveyMedical recordsAdministration HospitalClinical dataHospital careMedical CenterClinical informationHOSPITAL scoreInpatient experienceHealth statusHospital
2010
Mortality among Patients with Acute Myocardial Infarction: The Influences of Patient‐Centered Care and Evidence‐Based Medicine
Meterko M, Wright S, Lin H, Lowy E, Cleary PD. Mortality among Patients with Acute Myocardial Infarction: The Influences of Patient‐Centered Care and Evidence‐Based Medicine. Health Services Research 2010, 45: 1188-1204. PMID: 20662947, PMCID: PMC2965500, DOI: 10.1111/j.1475-6773.2010.01138.x.Peer-Reviewed Original ResearchMeSH KeywordsAgedAttitude to HealthEvidence-Based MedicineFemaleHealth Care SurveysHospitals, VeteransHumansLength of StayMaleMarkov ChainsMonte Carlo MethodMultivariate AnalysisMyocardial InfarctionOutcome Assessment, Health CarePatient-Centered CarePeer Review, Health CareProportional Hazards ModelsQuality of Health CareSurveys and QuestionnairesSurvival RateUnited StatesConceptsAcute myocardial infarctionPatient-centered careMyocardial infarctionInitial acute myocardial infarctionPatient health-related behaviorsVeterans Affairs Medical CenterBetter patient-centered carePatients' sociodemographic characteristicsPatient's clinical conditionRecent prospective studiesInfluence of patientImportant clinical benefitsProportional hazards modelEvidence-based treatmentsHealth-related behaviorsEvidence-based medicinePatient-physician relationshipPicker questionnaireCardiac symptomsPatient characteristicsAMI patientsClinical benefitProspective studyAMI careClinical conditions
2008
Case‐Mix Adjustment of Consumer Reports about Managed Behavioral Health Care and Health Plans
Eselius LL, Cleary PD, Zaslavsky AM, Huskamp HA, Busch SH. Case‐Mix Adjustment of Consumer Reports about Managed Behavioral Health Care and Health Plans. Health Services Research 2008, 43: 2014-2032. PMID: 18783456, PMCID: PMC2613989, DOI: 10.1111/j.1475-6773.2008.00894.x.Peer-Reviewed Original ResearchConceptsCase-mix adjustmentBehavioral health careHealth statusHealth plansPatient reportsSelf-reported general health statusSelf-reported mental health statusAlcohol/drug treatmentGeneral health statusHealth careHealth Outcomes SurveyBehavioral health plansMental health statusCase-mix adjustment modelExperience of careHealth care experiencesRace/ethnicityPatient characteristicsDrug treatmentOutcome SurveyCare experiencesPoor healthPlan rankingsReport scoresGood healthMedical Clinic Characteristics and Access to Behavioral Health Services for Persons With HIV
Ohl ME, Landon BE, Cleary PD, LeMaster J. Medical Clinic Characteristics and Access to Behavioral Health Services for Persons With HIV. Psychiatric Services 2008, 59: 400-407. PMID: 18378839, DOI: 10.1176/ps.2008.59.4.400.Peer-Reviewed Original ResearchConceptsSite case managementSubstance abuse careBehavioral health servicesCase managementClinic characteristicsSpecialist careHealth servicesMental health specialist careMental healthLikelihood of careSubstance useHIV specialty clinicsServices Utilization StudyActive substance useMental health specialistsSubgroup of personsMental health careHIV CostPatient characteristicsPrimary outcomeSpecialty clinicHealth specialistsHIVUtilization studiesClinicThe quality of care received by HIV patients without a primary provider
Ding L, Landon B, Wilson I, Hirschhorn L, Marsden P, Cleary P. The quality of care received by HIV patients without a primary provider. AIDS Care 2008, 20: 35-42. PMID: 18278613, DOI: 10.1080/09540120701439295.Peer-Reviewed Original ResearchConceptsPrimary HIV care providerHIV care providersCare providersQuality of careHIV patientsNurse practitionersUnmet needPhysician assistantsPrimary providersActive antiretroviral therapyServices Utilization StudyTerms of patientCare quality measuresNon-significant trendHIV expertiseHIV providersAntiretroviral therapyHIV CostPatient characteristicsHIV infectionIllness severityPatientsDrug usersUtilization studiesMedical care
2005
Quality of HIV care provided by nurse practitioners, physician assistants, and physicians.
Wilson IB, Landon BE, Hirschhorn LR, McInnes K, Ding L, Marsden PV, Cleary PD. Quality of HIV care provided by nurse practitioners, physician assistants, and physicians. Annals Of Internal Medicine 2005, 143: 729-36. PMID: 16287794, DOI: 10.7326/0003-4819-143-10-200511150-00010.Peer-Reviewed Original ResearchConceptsInfectious disease specialistsNurse practitionersHIV expertsQuality of carePhysician assistantsHIV careDisease specialistsHIV care sitesProtein derivative testingMedical record reviewPrimary care providersHigh-quality careCross-sectional analysisHIV expertisePatient characteristicsRecord reviewCare measuresPapanicolaou smearsComplex clinical processesMedical recordsAdjusted ratesCare sitesCare providersHIVCareCase‐Mix Adjustment of the CAHPS® Hospital Survey
O'Malley AJ, Zaslavsky AM, Elliott MN, Zaborski L, Cleary PD. Case‐Mix Adjustment of the CAHPS® Hospital Survey. Health Services Research 2005, 40: 2162-2181. PMID: 16316443, PMCID: PMC1361241, DOI: 10.1111/j.1475-6773.2005.00470.x.Peer-Reviewed Original ResearchConceptsGeneral health statusCase-mix adjustmentCirculatory disordersHospital SurveyMedical servicesCase-mix variablesNon-Hispanic blacksPatient characteristicsHospital survey dataPatient ratingsHospital ratingMedical conditionsCirculatory problemsHealth statusHealthcare providersHospitalHospital qualityCAHPS Hospital SurveyHospital servicesConsumer AssessmentSurgeryImpact of adjustmentDisordersAgeScoresAdjusting Pediatric Consumer Assessment of Health Plans Study (CAHPS) Scores to Ensure Fair Comparison of Health Plan Performances.
Kim M, Zaslavsky AM, Cleary PD. Adjusting Pediatric Consumer Assessment of Health Plans Study (CAHPS) Scores to Ensure Fair Comparison of Health Plan Performances. Medical Care 2005, 43: 44-52. PMID: 15626933.Peer-Reviewed Original ResearchConceptsPrivate health insuranceCasemix modelChild health statusCAHPS surveyPatient characteristicsHealth plansHealth Plans Study (CAHPS) surveyHealth insurancePlan ratingsHealth plan performanceHealth statusCAHPS scoresPlan differencesConsumer AssessmentCommercial plansParents' agePlan performanceAdjustment variablesMedicaidSeparate modelsSubstantial impactStudy surveyMedicaid beneficiariesMedicaid plansSuch models
2002
HIV Patients’ Experiences With Inpatient and Outpatient Care
Wilson IB, Ding L, Hays RD, Shapiro MF, Bozzette SA, Cleary PD. HIV Patients’ Experiences With Inpatient and Outpatient Care. Medical Care 2002, 40: 1149-1160. PMID: 12458298, DOI: 10.1097/00005650-200212000-00003.Peer-Reviewed Original ResearchConceptsOutpatient careCare experiencesPatient characteristicsInpatient stayGlobal ratingPatient experienceBetter provider-patient communicationOnly patient characteristicServices Utilization StudyProblem rateSpecific patient subgroupsProcess of careProvider-patient communicationSite of carePatient care experiencesQuality improvement effortsCohort studyHIV CostOutpatient visitsPatient subgroupsEmergency roomMultivariable modelInpatientsUtilization studiesHIVThe influence of patient characteristics on ratings of managed behavioral health care
Cleary P, Carlson M, Shaul J, Eisen S. The influence of patient characteristics on ratings of managed behavioral health care. The Journal Of Behavioral Health Services & Research 2002, 29: 481-489. PMID: 12404942, DOI: 10.1007/bf02287354.Peer-Reviewed Original ResearchConceptsBehavioral health carePatient characteristicsHealth careCare ratingsHealth care ratingsHealth care useCost of careRatings of patientsHealthy patientsCare usePatient ratingsPatientsEnrollee characteristicsHealth plansPlan ratingsCareInsurance coverageLess educationCommercial plansFrequent usersPublic plans
2001
Adjusting for Patient Characteristics When Analyzing Reports From Patients About Hospital Care
Hargraves J, Wilson I, Zaslavsky A, James C, Walker J, Rogers G, Cleary P. Adjusting for Patient Characteristics When Analyzing Reports From Patients About Hospital Care. Medical Care 2001, 39: 635-641. PMID: 11404646, DOI: 10.1097/00005650-200106000-00011.Peer-Reviewed Original ResearchConceptsPatient characteristicsHospital careHealth statusPatient-reported problemsCoordination of careTypes of patientsSample of patientsQuality improvement effortsInvolvement of familyPatient genderPatient preferencesHospital differencesPatientsHospital staffPhysical careConsistent associationHospitalHospital rankingsCareTelephone surveyImportant predictorEducation levelEmotional supportReportPresent data
2000
Information and its impact on satisfaction among surgical patients
Krupat E, Fancey M, Cleary P. Information and its impact on satisfaction among surgical patients. Social Science & Medicine 2000, 51: 1817-1825. PMID: 11128269, DOI: 10.1016/s0277-9536(00)00113-1.Peer-Reviewed Original ResearchConceptsSurgical patientsPatient characteristicsGlobal evaluationPatient evaluationHome recoveryHospital careSurgical informationPatientsVariety of providersEvaluation of qualityLarge-scale studiesCareMultiple regression analysisRegression analysisSensory informationInvolvementGeneral informationMedicationsHospitalEvaluationControl
1997
Treatment and Outcomes of Acute Myocardial Infarction Among Patients of Cardiologists and Generalist Physicians
Ayanian J, Guadagnoli E, McNeil B, Cleary P. Treatment and Outcomes of Acute Myocardial Infarction Among Patients of Cardiologists and Generalist Physicians. JAMA Internal Medicine 1997, 157: 2570-2576. PMID: 9531225, DOI: 10.1001/archinte.1997.00440430048006.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionGeneralist physiciansBypass surgeryPatient characteristicsCoronary angiographyCoronary angioplastyBeta-adrenergic blocking agentsPatients of cardiologistsCongestive heart failureCardiologists' patientsHeart failureThrombolytic therapyHospital characteristicsConsulting cardiologistBlocking agentMedicare beneficiariesPatientsBetter outcomesEffective drugsInfarctionHospitalCardiologistsPhysiciansMortality
1995
Satisfaction with ambulatory care of persons with AIDS
Stone V, Weissman J, Cleary P. Satisfaction with ambulatory care of persons with AIDS. Journal Of General Internal Medicine 1995, 10: 239-245. PMID: 7616331, DOI: 10.1007/bf02599878.Peer-Reviewed Original ResearchConceptsSelf-perceived health statusHealth maintenance organizationAmbulatory careLower self-perceived health statusHealth statusStaff-model health maintenance organizationPublic hospital HIV clinicMedical record reviewPatient-rated qualityPrimary outcome measureSeverity of illnessInjection drug usersMultiple logistic regressionPrimary care relationshipsSite of careAcademic group practiceAmbulatory care qualityHIV clinicPatient characteristicsBlack patientsRecord reviewAIDS patientsActive patientsPatient surveyPhysician care
1993
The Importance of Co-existent Disease in the Occurrence of Postoperative Complications and One-Year Recovery in Patients Undergoing Total Hip Replacement
Greenfield S, Apolone G, McNeil B, Cleary P. The Importance of Co-existent Disease in the Occurrence of Postoperative Complications and One-Year Recovery in Patients Undergoing Total Hip Replacement. Medical Care 1993, 31: 141-154. PMID: 8433577, DOI: 10.1097/00005650-199302000-00005.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAdultAgedCohort StudiesComorbidityDemographyFemaleHealth StatusHip ProsthesisHumansLogistic ModelsMaleMiddle AgedOdds RatioOutcome Assessment, Health CarePostoperative ComplicationsPrognosisQuality of LifeSeverity of Illness IndexSurveys and QuestionnairesUnited StatesConceptsCo-existent diseaseTotal hip replacementPostoperative complicationsHip replacementFunctional outcomeMedical recordsTotal hip replacement patientsFunctional outcome 1 yearHealth-related qualityTime of surgeryPost-operative complicationsSeverity of illnessOutcomes 1 yearHip replacement patientsPatients' medical recordsSignificant predictorsEffectiveness of careOne-year recoveryMedical record informationHospital complicationsICED scoreComorbid diseasesComplication rateHospital dischargePatient characteristics
1992
The Relationship Between Reported Problems and Patient Summary Evaluations of Hospital Care
Cleary P, Edgman-Levitan S, McMullen W, Delbanco T. The Relationship Between Reported Problems and Patient Summary Evaluations of Hospital Care. The Joint Commission Journal On Quality And Patient Safety 1992, 18: 53-59. PMID: 1574321, DOI: 10.1016/s0097-5990(16)30507-3.Peer-Reviewed Original ResearchConceptsHealth statusAspects of hospitalizationPatients' overall evaluationPatient characteristicsSurgical patientsPatient evaluationGeneral HospitalHospital careNationwide telephone surveyTelephone surveyCareStrongest predictorReported problemsOverall evaluationAssociationStatusHospitalizationPatientsHospitalEvaluation
1991
Variations in Length of Stay and Outcomes for Six Medical and Surgical Conditions in Massachusetts and California
Cleary P, Greenfield S, Mulley A, Pauker S, Schroeder S, Wexler L, McNeil B. Variations in Length of Stay and Outcomes for Six Medical and Surgical Conditions in Massachusetts and California. JAMA 1991, 266: 73-79. PMID: 2046132, DOI: 10.1001/jama.1991.03470010077034.Peer-Reviewed Original ResearchMeSH KeywordsAdultCaliforniaCholecystectomyComorbidityConsumer BehaviorCoronary Artery BypassFemaleHip ProsthesisHospitals, TeachingHumansLength of StayMaleMassachusettsMyocardial InfarctionOutcome and Process Assessment, Health CareProstatectomySurgical Procedures, OperativeSurveys and QuestionnairesConceptsLength of stayAcute myocardial infarctionHospital dischargeTotal hip replacementMyocardial infarctionFunctional statusPatient satisfactionMedical recordsHospital careCoronary artery bypass graft surgeryHip replacementArtery bypass graft surgeryInterinstitutional differencesBypass graft surgeryProbability of readmissionPatients' medical recordsAvailable outcome dataCase-mix differencesFollow-up questionnaireHospital complicationsGraft surgeryPatient characteristicsTransurethral prostatectomyWorse outcomesSurgical conditions