Female doctor with child

Encounters From Device Complications Among Children With Medical Complexity

Encounters From Device Complications Among Children With Medical Complexity

Children with medical complexity (CMC) are commonly assisted by medical devices to support essential body functions, although complications may lead to preventable emergency department (ED) and hospital use. HIP Investigator, Dr. Ryan Coller et al. identified predictors of device-complicated ED visits and hospitalizations. The team of authors found that device-complicated ED visits and hospitalizations comprised a substantial proportion of total hospital and ED use. Developing interventions to prevent device complications may be a promising strategy to reduce overall CMC use.

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Doctor standing with laptop

Telehealth with remote blood pressure monitoring for postpartum hypertension

Telehealth with remote blood pressure monitoring for postpartum hypertension

Postpartum hypertension is a leading indication for hospital readmissions within the first 6 weeks after delivery. Authors including HIP Investigator, Dr. Heather Johnson investigate feasibility of telehealth with remote blood pressure monitoring for management of hypertension in postpartum women at risk of severe hypertension after hospital discharge.

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Female child and doctor

Making Time to Coordinate Care for Children With Medical Complexity

Making Time to Coordinate Care for Children With Medical Complexity

Care coordination has become the focus of the rapidly expanding field of complex care. Supporting the personnel and infrastructure to successfully coordinate care for CMC is a major sustainability challenge facing complex-care programs today. HIP Investigator, Dr. Ryan Coller et al. report on time spent in nonbillable care coordination activities for 208 CMC over their program’s first 2 years.

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Doctor and overweight patient

Blood Pressure Control and Other Quality of Care Metrics for Patients with Obesity and Diabetes

Blood Pressure Control and Other Quality of Care Metrics for Patients with Obesity and Diabetes

There are no population-level estimates in the United States for achievement of blood pressure goals in patients with diabetes and hypertension by obesity weight class. A team of authors, including HIP Investigator, Dr. Maureen Smith examined the relationship between the extent of obesity and the achievement of guideline-recommended blood pressure goals and other quality of care metrics among patients with diabetes.

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Diabetic child self manage

The relationship of Type 1 diabetes self-management barriers to child and parent quality of life: a US cross-sectional study

The relationship of Type 1 diabetes self-management barriers to child and parent quality of life: a US cross-sectional study

Type 1 diabetes can reduce health‐related quality of life (QOL) for children, adolescents and their parents. Families of children and adolescents with Type 1 diabetes experience self-management challenges that negatively impact diabetes control. A team of authors, including HIP Investigator Dr. Elizabeth Cox, assessed whether self-management challenges are also associated with quality of life (QOL) for children and adolescents with Type 1 diabetes and their parents.

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Eye exam

Factors influencing patient adherence with diabetic eye screening in rural communities: A qualitative study

Factors influencing patient adherence with diabetic eye screening in rural communities: A qualitative study

Diabetic retinopathy remains the leading cause of blindness among working-age U.S. adults largely due to low screening rates. Rural populations face particularly greater challenges to screening because they are older, poorer, less insured, and less likely to receive guideline-concordant care than those in urban areas. Current patient education efforts may not fully address multiple barriers to screening faced by rural patients. HIP Investigator, Dr. Yao Liu et al. sought to characterize contextual factors affecting rural patient adherence with diabetic eye screening guidelines.

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Senior woman waiting for treatment in hospital

Increasing SBP variability is associated with an increased risk of developing incident diabetic foot ulcers.

Increasing SBP variability is associated with an increased risk of developing incident diabetic foot ulcers.

Excessive SBP variability may offer a potential new target for mitigating end-organ damage associated with microvascular and macrovascular disease, such as diabetic foot ulcers. Targeting SBP variability in addition to the absolute value, may help reduce the high risk of vascular complications faced by patients with diabetes. The goal of this study by HIP Investigator, Dr. Meghan Brennan et al. is to determine whether the risk of incident diabetic foot ulceration increases as SBP variability increases.

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Veteran Engagement

Development of a veteran engagement toolkit for researchers.

Development of a veteran engagement toolkit for researchers.

Engaging patients in the planning, implementation and dissemination of research can increase the credibility and relevance of results and lead to higher quality, more patient-centered care. Veterans have unique experiences and healthcare needs, making their input on research related to their care particularly important. However, existing veteran engagement resources primarily focus on veterans who receive care through the Veterans Health Administration (VA). This excludes those veterans - the majority - who do not use the VA for healthcare.

To address the gap Dr. Nasia Safdar, Nicole Brys, and Dr. Jeff Whittle developed a veteran engagement toolkit that was informed by the work of both VA and non-VA researchers across the USA.

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young boy patient

Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial.

Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial.

Complex care programs seek to influence key health outcomes for children with medical complexity (CMC), and investment in program infrastructure is often justified by anticipating savings from lower health care use. HIP Investigator, Dr. Ryan Coller et al. sought to examine the effect of a caregiver coaching intervention, Plans for Action and Care Transitions (PACT), on hospital use among children with medical complexity (CMC) within a complex care medical home. Among CMC within a complex care program, a health coaching intervention designed to identify, prevent, and manage patient-specific crises and postdischarge transitions appears to lower hospitalizations and charges.

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Doctors working around table

Optimal treatment assignment to maximize expected outcome with multiple treatments.

Optimal treatment assignment to maximize expected outcome with multiple treatments.

When there is substantial heterogeneity of treatment effectiveness, it is crucial to identify individualized treatment assignment rules for comparative treatment selection. HIP Investigator, Dr. Menggang Yu et al. propose an outcome weighted learning method that extends estimating individualized treatment rules to multi‐treatment case by using a vector hinge loss as a target function. Consistency of the resulting estimator is shown in the article.

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