optimizing health care delivery and outcomes richard a. hansen, phd gilliland professor and head...
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![Page 1: Optimizing Health Care Delivery and Outcomes Richard A. Hansen, PhD Gilliland Professor and Head Department of Health Outcomes Research and Policy](https://reader036.vdocuments.us/reader036/viewer/2022062423/56649ea85503460f94bab3b5/html5/thumbnails/1.jpg)
Optimizing Health Care Delivery and Outcomes
Richard A. Hansen, PhDGilliland Professor and Head
Department of Health Outcomes Research and Policy
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Health Spending and Outcomes
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State ranking on health system performance Heart disease mortality rates for age 40
Healthcare Quality and Outcomes
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Complex patientsComplex care
Complex systemsComplex treatments
Healthcare is Complex
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Complex Patients…
…or complex care?Maciejewski et al., JGIM 2014; Hansen et al., Annals of Pharmacotherapy (in press)
Grant s AHRQ 1R21HS019445-01 AHRQ 1R01HS023099-01
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Complex Care
Emergency Room Visits
Probability Number
of 1+ Visits of Visits
Odds Ratio (95%CI) IRR (95%CI)
Probability of
Hospital Admission
Odds Ratio (95% CI)
1 Condition (lagged) Reference Reference Reference
2 Conditions (lagged) 1.02 (0.80, 1.29) 0.98 (0.83, 1.15) 1.07 (0.88, 1.29)
3+ Conditions (lagged) 1.38 (0.99, 1.91) 0.86 (0.71, 1.04) 1.11 (0.84, 1.46)
1 Prescriber (lagged) Reference Reference Reference
2 Prescribers (lagged) 1.24 (0.99, 1.56) 1.15 (0.98, 1.35) 1.31 (1.09, 1.57)*
3 Prescribers (lagged) 1.58 (1.17, 2.13)* 1.18 (0.99, 1.41) 1.31 (1.01, 1.69) *
4+ Prescribers(lagged) 1.96 (1.39, 2.75)*** 1.38 (1.13, 1.70)* 1.47 (1.08, 2.01) *
Grant s AHRQ 1R21HS019445-01 AHRQ 1R01HS023099-01
Maciejewski et al., JGIM 2014; Hansen et al., Annals of Pharmacotherapy (in press)
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Complex systems
Drug-related risk of bleeding across 200 million patients represented in U.S. data repositories
Hansen et al., RSM (in press)Hansen et al., Drug Safety (2013)Fox et al., JBI (2013)
Grants: FNIH HANSE11OMOPNPC (No Number)
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Richard A. [email protected]
Current and Recent Funding
Funding Opportunities
Complex patients and conditions• AHRQ 1R21HS019445-01 (Duke)• AHRQ 1R01HS023099-01 (UNC)
Complex treatments and drug safety• FDA 1U01FD005272-01 (Auburn)• FNIH HANSE11OMOP (Auburn)• National Pharmaceutical Council
• NIH (R01 & R18 in review)• PCORI, AHRQ, CDC, FDA
Interdisciplinary collaboration is key…