2024
Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study. Journal Of Palliative Medicine 2024 PMID: 39515377, DOI: 10.1089/jpm.2024.0182.Peer-Reviewed Original ResearchSpecialist palliative careVeterans Affairs Medical CenterEnd of lifeCare qualityInpatient hospiceEnd of life outcomesUse of hospiceInpatient hospice careMedical CenterMultilevel logistic regressionFamilies of patientsAffairs Medical CenterHospice carePalliative careRetrospective cohort studyAdvanced heart failureBlack adultsHospiceCohort studyFacility rateLogistic regressionStudy outcomesObservational studyCareHeart failureFactors Associated With Influenza Vaccination in a National Veteran Cohort
Chen A, Farmer M, Han L, Runels T, Bade B, Crothers K, Bastian L, Bazan I, Bean-Mayberry B, Brandt C, Akgün K. Factors Associated With Influenza Vaccination in a National Veteran Cohort. AJPM Focus 2024, 4: 100290. PMID: 39611140, PMCID: PMC11602634, DOI: 10.1016/j.focus.2024.100290.Peer-Reviewed Original ResearchOdds of vaccinationInfluenza vaccineFemale veteransAmerican Indian/Alaskan Native raceFactors associated with influenza vaccinationReceipt of influenza vaccinationDocumenting influenza vaccinationReduced oddsRetrospective cohort studyElectronic health record dataMale veteransHealth record dataAmbulatory care utilizationInfluenza seasonRuralMale sexWhite male veteransWhite veteransAssociated with raceCohort studyBlack veteransBlack raceEthnic groupsRacial disparitiesInfluenzaImpact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders – A retrospective cohort study
Han L, Goulet J, Skanderson M, Redd D, Brandt C, Zeng-Treitler Q. Impact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders – A retrospective cohort study. Journal Of Pain 2024, 26: 104695. PMID: 39384145, DOI: 10.1016/j.jpain.2024.104695.Peer-Reviewed Original ResearchIntegrative health approachesHealth approachOpioid prescriptionsMusculoskeletal disordersAdministration electronic health recordComplementary health approachesPrimary care visitsElectronic health recordsPharmacy dispensing recordsCIH approachesCare visitsDispensed opioid prescriptionsHealth recordsRetrospective cohort studyDispensing recordsPatient's painAnalytic sampleIndex diagnosisExposure groupCohort studyVeteransOpioid initiationQuasi-experimental investigationCIHPrescriptionVariation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers
Zhan Y, Han L, Abel E, Akgun K, Redeker N, Feder S. Variation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers. Journal Of Pain And Symptom Management 2024, 67: e551-e552. DOI: 10.1016/j.jpainsymman.2024.02.339.Peer-Reviewed Original ResearchSpecialist palliative careVA Medical CenterDepartment of Veterans AffairsPalliative careVeterans AffairsRandom intercept multilevel logistic regressionPalliative care deliveryDelivery characteristicsMedical CenterMultilevel logistic regressionCare deliveryICD-9/10 codesAdvanced heart failureRetrospective cohort studyHealth careModifiable factorsCareTeam staffingCohort studyHeart failureLogistic regressionImplementation effortsIdentified factorsICD-9/10Study findingsVariation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Variation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs. Journal Of Pain And Symptom Management 2024, 68: 22-31.e1. PMID: 38561132, PMCID: PMC11168897, DOI: 10.1016/j.jpainsymman.2024.03.022.Peer-Reviewed Original ResearchOutpatient specialist palliative careSpecialist palliative careVeterans Affairs Medical CenterPalliative careSpecialist palliative care consultationRandom intercept multilevel logistic regressionDepartment of Veterans AffairsMultilevel logistic regressionAffairs Medical CenterClinical practice guidelinesICD-9/10 codesAdvanced heart failureRetrospective cohort studyVeterans AffairsOutpatient palliativeOutpatient deliveryPractice guidelinesCohort studyLogistic regressionCardiology involvementDelivery characteristicsAssociated factorsMedical CenterIdentified factorsICD-9/10
2023
Racial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates
Bernstein E, DeRycke E, Han L, Farmer M, Bastian L, Bean-Mayberry B, Bade B, Brandt C, Crothers K, Skanderson M, Ruser C, Spelman J, Bazan I, Justice A, Rentsch C, Akgün K. Racial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates. AJPM Focus 2023, 2: 100094. PMID: 37362395, PMCID: PMC10038675, DOI: 10.1016/j.focus.2023.100094.Peer-Reviewed Original ResearchRace/ethnicity groupsFirst vaccinationFirst COVID-19 vaccinationVeterans AffairsWhite veteransCharlson Comorbidity IndexRetrospective cohort studyPrimary care visitsEthnicity groupsCOVID-19 vaccinationLarge healthcare systemEquitable vaccine distributionAsian Americans/Pacific IslandersRace/ethnicityUnvaccinated patientsComorbidity indexInfluenza vaccinationSelf-reported categoriesBlack groupCare visitsCohort studyHazard ratioPrimary outcomeWhite patientsBlack patients
2022
Post-9/11 deployment history and the incidence of breast cancer among women veterans
Gaffey A, Han L, Ramsey C, Skanderson M, Dziura J, Driscoll M, Burg M, Brandt C, Bastian L, Haskell S. Post-9/11 deployment history and the incidence of breast cancer among women veterans. Annals Of Epidemiology 2022, 77: 98-102. PMID: 36470323, DOI: 10.1016/j.annepidem.2022.11.010.Peer-Reviewed Original ResearchConceptsOEF/OIF deploymentBreast cancerWomen veteransHealthcare utilizationHormone replacement therapy useRetrospective cohort studyVeterans Affairs (VA) careHealthy soldier effectOEF/OIFCohort studyTherapy useBC incidenceHormonal contraceptivesLifestyle factorsPrimary careBC diagnosisLower incidenceOperations Enduring Freedom/Iraqi FreedomWomenIncidenceGreater likelihoodIraqi FreedomVeteransCancerCareMental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings
Dobscha SK, Luther SL, Kerns RD, Finch DK, Goulet JL, Brandt CA, Skanderson M, Bathulapalli H, Fodeh SJ, Hahm B, Bouayad L, Lee A, Han L. Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings. Journal Of Pain 2022, 24: 273-281. PMID: 36167230, PMCID: PMC9898089, DOI: 10.1016/j.jpain.2022.08.009.Peer-Reviewed Original ResearchConceptsPain care qualityQuality pain careMental health conditionsPrimary care cliniciansVeterans Health AdministrationPain carePCQ scoresHealth conditionsCare cliniciansUse disordersCare qualitySevere musculoskeletal painRetrospective cohort studyPrimary care visitsGeneral medical carePrimary care settingElectronic health record dataFinal adjusted modelMental health diagnosesEquation Poisson modelsHealth record dataBipolar disorder diagnosisSubstance use disordersAlcohol use disorderPost-traumatic stress disorder
2020
Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes
Cohen AB, Han L, OʼLeary JR, Fried TR. Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes. Journal Of The American Geriatrics Society 2020, 69: 342-348. PMID: 33170957, PMCID: PMC7902349, DOI: 10.1111/jgs.16900.Peer-Reviewed Original ResearchConceptsDays of lifeHospital deathHigh-intensity treatmentMechanical ventilationTube placementHome residentsCardiopulmonary resuscitationNursing homesIntensive care unit admissionMinimum Data Set assessmentsCare unit admissionRetrospective cohort studyNursing home residentsHigh-intensity endMore nursing homesUnit admissionICU admissionCohort studySecondary outcomesPrimary outcomeHospital transferLife hospitalizationsSevere dementiaLife careDementia severity