Nancy Kim, MD, PhD
About
Titles
Senior Medical Director, Care Signature; Associate Clinical Professor, General Internal Medicine
Biography
Dr. Kim is a Board-certified internist and hospitalist trained in health services research. She is the Senior Medical Director of Care Signature for the Yale-New Haven Health System. She has served in the past as the Associate Director of the Office of Student Research at the Yale School of Medicine and the Measure Lead for the CMS Episode of Care Payment Measures for Acute Myocardial Infarction, Heart Failure, Pneumonia, and primary elective hip/knee arthroplasty at Yale CORE.
In her role as the Senior Medical Director, she leads strategic clinical initiatives on end-of-life care, healthcare equity, and hospital and health system efficiency in Orthopedics, Physical Therapy and other services. Additionally, she evaluates the impact of Care Signature clinical pathways on processes of care and clinical outcomes in the hospital setting. With her extensive clinical experience, Dr. Kim has a unique “front line” perspective regarding the daily operations of a hospital. This clinical lens brings to her research an understanding of a hospital’s work environment, structure, and patient throughput which may otherwise be unobserved by traditional metrics.
Appointments
General Internal Medicine
Associate Clinical ProfessorPrimary
Other Departments & Organizations
Education & Training
- Non Degree Program
- Yale University School of Management, Executive Education (2023)
- PhD
- Yale University School of Medicine, Investigative Medicine (2008)
- Non Degree Program
- Yale University School of Medicine, Robert Wood Johnson Clinical Scholars Program (2004)
- Fellow
- Yale University School of Medicine (2004)
- Chief Resident
- Yale (2001)
- Resident
- Yale (2000)
- MD
- Temple University (1997)
- BA
- Yale University (1992)
Research
Publications
2015
An Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction
Kim N, Bernheim SM, Ott LS, Han L, Spivack SB, Xu X, Volpe M, Liu A, Krumholz HM. An Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction. Medical Care 2015, 53: 542-549. PMID: 25970575, DOI: 10.1097/mlr.0000000000000361.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionICD-9 codes 410Administrative Claims MeasurePatients 65 yearsDate of admissionClaims-based measuresIntraclass correlation coefficient scoreIntraclass correlation coefficientValue of careHigh-value careClinical variablesDischarge diagnosisMedicare patientsMedicare claimsClinical careAMI episodeAMI hospitalizationCare costsCode 410HospitalizationMedicaid ServicesHospitalClaims measuresCarePatients need safer hospitals, every day of the week
Dharmarajan K, Kim N, Krumholz HM. Patients need safer hospitals, every day of the week. The BMJ 2015, 350: h1826. PMID: 25877669, DOI: 10.1136/bmj.h1826.Peer-Reviewed Original ResearchUSE OF ADVANCED THERAPIES FOR ACUTE PULMONARY EMBOLISM AND RELATED OUTCOMES AMONG FEE-FOR-SERVICE MEDICARE BENEFICIARIES FROM 1999 TO 2010
Bikdeli B, Wang Y, Minges K, Desai N, Kim N, Desai M, Spertus J, Masoudi F, Nallamothu B, Goldhaber S, Krumholz H. USE OF ADVANCED THERAPIES FOR ACUTE PULMONARY EMBOLISM AND RELATED OUTCOMES AMONG FEE-FOR-SERVICE MEDICARE BENEFICIARIES FROM 1999 TO 2010. Journal Of The American College Of Cardiology 2015, 65: a2128. DOI: 10.1016/s0735-1097(15)62128-3.Peer-Reviewed Original ResearchIntravenous Fluids in Acute Decompensated Heart Failure
Bikdeli B, Strait KM, Dharmarajan K, Li SX, Mody P, Partovian C, Coca SG, Kim N, Horwitz LI, Testani JM, Krumholz HM. Intravenous Fluids in Acute Decompensated Heart Failure. JACC Heart Failure 2015, 3: 127-133. PMID: 25660836, PMCID: PMC4438991, DOI: 10.1016/j.jchf.2014.09.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleFluid TherapyHeart FailureHospital MortalityHospitalizationHumansInfusions, IntravenousIntensive Care UnitsIntubation, IntratrachealIsotonic SolutionsMaleMiddle AgedRenal Replacement TherapyRetrospective StudiesRinger's SolutionSaline Solution, HypertonicSodium Potassium Chloride Symporter InhibitorsUnited StatesYoung AdultConceptsAcute decompensated heart failureDecompensated heart failureHeart failureIntravenous fluidsRetrospective cohort studyCritical care admissionRenal replacement therapyDays of hospitalizationProportion of hospitalizationsHalf-normal salineWarrants further investigationOnly diureticsCare admissionHospital deathHospital outcomesCohort studyLoop diureticsPatient groupReplacement therapyWorse outcomesNormal salineInpatient careMedian volumePatientsHospitalization
2014
Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities
Ben-Josef G, Ott LS, Spivack SB, Wang C, Ross JS, Shah SJ, Curtis JP, Kim N, Krumholz HM, Bernheim SM. Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities. Circulation Cardiovascular Quality And Outcomes 2014, 7: 882-888. PMID: 25387777, DOI: 10.1161/circoutcomes.114.000927.Peer-Reviewed Original ResearchConceptsNon-PCI hospitalsCoronary artery bypass graft ratesPCI hospitalsAcute myocardial infarctionMyocardial infarctionPercutaneous coronary intervention capabilityAcute myocardial infarction admissionsLower revascularization ratesPrincipal discharge diagnosisTreatment of patientsMyocardial infarction admissionsHigh rateMyocardial infarction episodeGraft ratePCI capabilityPCI useIndex admissionRevascularization ratesClinical characteristicsPatient demographicsDays postadmissionDischarge diagnosisMedicare patientsCare proceduresMedicare feeTrends in Aortic Dissection Hospitalizations, Interventions, and Outcomes Among Medicare Beneficiaries in the United States, 2000–2011
Mody PS, Wang Y, Geirsson A, Kim N, Desai MM, Gupta A, Dodson JA, Krumholz HM. Trends in Aortic Dissection Hospitalizations, Interventions, and Outcomes Among Medicare Beneficiaries in the United States, 2000–2011. Circulation Cardiovascular Quality And Outcomes 2014, 7: 920-928. PMID: 25336626, PMCID: PMC4380171, DOI: 10.1161/circoutcomes.114.001140.Peer-Reviewed Original ResearchRelationship Between Universal Health Outcome Priorities and Willingness to Take Medication for Primary Prevention of Myocardial Infarction
Case SM, O'Leary J, Kim N, Tinetti ME, Fried TR. Relationship Between Universal Health Outcome Priorities and Willingness to Take Medication for Primary Prevention of Myocardial Infarction. Journal Of The American Geriatrics Society 2014, 62: 1753-1758. PMID: 25146885, PMCID: PMC4172520, DOI: 10.1111/jgs.12983.Peer-Reviewed Original ResearchConceptsMyocardial infarctionOutcome prioritiesPrimary preventionUniversal health outcomesFuture healthObservational cohort studyBurden of treatmentCommunity-dwelling adultsIndividual treatment decisionsSpecific clinical situationsNegative predictive valueQuality of lifeQuantity of lifeCohort studyTreatment decisionsMedicationsPredictive valueHealth outcomesClinical situationsSignificant associationOlder personsInfarctionMedication scenariosAdverse effectsPreventionTrends in left ventricular assist device use and outcomes among Medicare beneficiaries, 2004–2011
Lampropulos JF, Kim N, Wang Y, Desai MM, Barreto-Filho JA, Dodson JA, Dries DL, Mangi AA, Krumholz HM. Trends in left ventricular assist device use and outcomes among Medicare beneficiaries, 2004–2011. Open Heart 2014, 1: e000109. PMID: 25332817, PMCID: PMC4189322, DOI: 10.1136/openhrt-2014-000109.Peer-Reviewed Original ResearchDischarge dispositionLVAD implantationMortality rateRehospitalisation ratesIndex hospitalisationImplantation rateLeft ventricular assist device useVentricular assist device useMedicaid Services paymentsProportion of patientsLong-term outcomesPost-procedure lengthUse of LVADsDevice implantation ratesHospital daysHospitalisation costsHeartMate IILVAD useMedicare feeMedicare populationMedicare beneficiariesService beneficiariesHospitalisationDevice useStay“Phenotyping” Hospital Value of Care for Patients with Heart Failure
Xu X, Li S, Lin H, Normand S, Kim N, Ott LS, Lagu T, Duan M, Kroch EA, Krumholz HM. “Phenotyping” Hospital Value of Care for Patients with Heart Failure. Health Services Research 2014, 49: 2000-2016. PMID: 24974769, PMCID: PMC4254136, DOI: 10.1111/1475-6773.12197.Peer-Reviewed Original ResearchConceptsLower mortalityHeart failureHeart failure hospitalizationHospital mortality rateLonger hospital stayIntensive care unitDistinct joint trajectoriesValue of careFailure hospitalizationHospital stayCare unitClinical outcomesGroup of hospitalsHospital characteristicsHospital careHospital patternsSurgical proceduresMultinomial logistic regressionMortality rateHigh mortalityHospitalHospitalizationMortalityLogistic regressionHospital ValueHospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure
Kulkarni VT, Kim N, Dai Y, Dharmarajan K, Safavi KC, Bikdeli B, Lindenauer PK, Testani J, Dries DL, Krumholz HM. Hospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure. Circulation Heart Failure 2014, 7: 427-433. PMID: 24633829, PMCID: PMC4386575, DOI: 10.1161/circheartfailure.113.000698.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNoninvasive positive pressure ventilationDecompensated heart failureRisk-standardized mortality ratesPositive pressure ventilationHeart failureIntubation rateMortality ratePressure ventilationUse of NPPVHospital risk-standardized mortality ratesHigher intubation rateHospital practice patternsHospital-level outcomesCross-sectional studyHierarchical logistic regression modelsLogistic regression modelsNIPPV useHospital variationSuch hospitalizationsPractice patternsHospitalizationHospitalQuartileBottom quartile
News
News
- September 13, 2023
Department of Internal Medicine Voluntary Faculty Promotions (September 2023)
- May 04, 2023
Department of Internal Medicine Promotions
- March 22, 2016
Pulmonary embolism treatment widely used, despite uncertain benefit
- February 05, 2015
After hospital discharge, deadly heart risks can remain for up to a year