Amber E Barnato
Datos Biográficos
| ID | 331987 |
|---|---|
| NOMBRE | Amber E Barnato |
| NOMBRES | Amber E |
| APELLIDO | Barnato |
| FIRMA | BARNATO A E |
| AFILIACIONES | University of Pittsburgh |
| ORCID | 0000-0003-1080-6270 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 16 |
| TOTAL DE CITAS | 2 |
| TOTAL COMO AUTOR | 16 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2005 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 1 |
Causal inference for intervention spillover in a stepped wedge cluster-randomized trial
Often motivated by concerns about contamination of control subjects, stepped wedge cluster-randomized trial designs assign interventions to distinct clusters (e.g., hospitals) and protect against confounding by randomizing the timing of intervention delivery. However, when trial units are embedded in professional networks that span clusters, such designs cannot prevent spillover. In this study, we use longitudinal cluster-randomized trial data an…
“I didn’t go into medicine just to be on the phone”
Guided by communication accommodation theory, we studied 27 physician reports of patient-physician advanced cancer communication during the COVID-19 pandemic. Advanced cancer communication requires recognizing patients' psychosocial states and collaboratively engaging patients empathetically to develop the shared understanding necessary to guide decision-making. However, physicians found their communication underaccommodated, stemming from person…
A Quality Improvement Initiative for Inpatient Advance Care Planning
This nationwide cohort study suggests that while the ACP quality initiative increased ACP billing, changes in clinical outcomes were inconsistent with the hypotheses. Further study is needed to address questions regarding confounding by unobserved measures of care quality
Power and racial differences in the communication experiences of Black and White patients living with advanced cancer and their care partners
Problematic Integration
We describe racially discordant oncology encounters involving EOL decision-making. Fifty-eight provider interviews were content analyzed using the tenets of problematic integration theory. We found EOL discussions between non-Black providers and their Black patients were often complex and anxiety-inducing. That anxiety consisted of (1) ontological uncertainty in which providers characterized the nature of Black patients as distrustful, especially…
Prudence in end-of-life decision making
Despite significant improvements in end-of-life care over several decades, belated hospice referrals and hospital staffing patterns make challenging end-of-life conversations between strangers unsurprising, especially when the interaction is time-sensitive. Understanding how physicians perform under these circumstances is relevant to patient quality and medical education. This study is a secondary analysis of transcripts from a simulation that pl…
What is in the palliative care 'syringe'? A systems perspective
The diffusion of palliative care has been rapid, yet uncertainty remains regarding palliative care's "active ingredients." The National Consensus Project Guidelines for Quality Palliative Care identified eight domains of palliative care. Despite these identified domains, when pressed to describe the specific maneuvers used in clinical encounters, palliative care providers acknowledge that "it's complex." The field of systems has been used to expl…
Identifying Strategies for Effective Telemedicine Use in Intensive Care Units
Telemedicine, the use of audiovisual technology to provide health care from a remote location, is increasingly used in intensive care units (ICUs). However, studies evaluating the impact of ICU telemedicine show mixed results, with some studies demonstrating improved patient outcomes, while others show limited benefit or even harm. Little is known about the mechanisms that influence variation in ICU telemedicine effectiveness, leaving providers w…
ICU Telemedicine and Critical Care Mortality
BACKGROUND: Intensive care unit (ICU) telemedicine is an increasingly common strategy for improving the outcome of critical care, but its overall impact is uncertain. OBJECTIVES: To determine the effectiveness of ICU telemedicine in a national sample of hospitals and quantify variation in effectiveness across hospitals. RESEARCH DESIGN: We performed a multicenter retrospective case-control study using 2001-2010 Medicare claims data linked to a na…
Association Between Anticipatory Grief and Problem Solving Among Family Caregivers of Persons With Cognitive Impairment
Higher anticipatory grief among family caregivers impaired problem solving, which could have negative consequences for their medical decision making responsibilities
Is Survival Better at Hospitals With Higher “End-of-Life” Treatment Intensity
BACKGROUND: Concern regarding wide variations in spending and intensive care unit use for patients at the end of life hinges on the assumption that such treatment offers little or no survival benefit. OBJECTIVE: To explore the relationship between hospital "end-of-life" (EOL) treatment intensity and postadmission survival. RESEARCH DESIGN: Retrospective cohort analysis of Pennsylvania Health Care Cost Containment Council discharge data April 2001…
Development and Validation of Hospital “End-of-Life” Treatment Intensity Measures
BACKGROUND: Health care utilization among decedents is increasingly used as a measure of health care efficiency, but decedent-based measures may be biased estimates of care received by "dying" patients. OBJECTIVE: To develop and validate new measures of hospital "end-of-life" treatment intensity. RESEARCH DESIGN: Retrospective cohort study using Pennsylvania Health Care Cost Containment Council (PHC4) discharge data (April 2001-March 2005) and Ce…
Organizational Determinants of Hospital End-of-Life Treatment Intensity
BACKGROUND: There is substantial hospital-level variation in end-of-life (EOL) treatment intensity. OBJECTIVE: To explore the association between organizational factors and EOL treatment intensity in Pennsylvania (PA) hospitals. RESEARCH DESIGN: Cross-sectional mixed-mode survey of Chief Nursing Officers of PA hospitals linked to hospital-level measures of EOL treatment intensity calculated from PA Health Care Cost Containment Council (PHC4) hosp…
End‐of‐life spending
Are Regional Variations in End-of-Life Care Intensity Explained by Patient Preferences
OBJECTIVE: We sought to test whether variations across regions in end-of-life (EOL) treatment intensity are associated with regional differences in patient preferences for EOL care. RESEARCH DESIGN: Dual-language (English/Spanish) survey conducted March to October 2005, either by mail or computer-assisted telephone questionnaire, among a probability sample of 3480 Medicare part A and/or B eligible beneficiaries in the 20% denominator file, age 65…
Hospital-Level Racial Disparities in Acute Myocardial Infarction Treatment and Outcomes
BACKGROUND: Previous studies have documented racial disparities in treatment of acute myocardial infarction (AMI) among Medicare beneficiaries. However, the extent to which unobserved differences between hospitals explains some of these differences is unknown. OBJECTIVE: The objective of this study was to determine whether the observed racial treatment disparities for AMI narrow when analyses account for differences in where blacks and whites are…
What is in the palliative care 'syringe'? A systems perspective
The diffusion of palliative care has been rapid, yet uncertainty remains regarding palliative care's "active ingredients." The National Consensus Project Guidelines for Quality Palliative Care identified eight domains of palliative care. Despite these identified domains, when pressed to describe the specific maneuvers used in clinical encounters, palliative care providers acknowledge that "it's complex." The field of systems has been used to expl…
Association Between Anticipatory Grief and Problem Solving Among Family Caregivers of Persons With Cognitive Impairment
Higher anticipatory grief among family caregivers impaired problem solving, which could have negative consequences for their medical decision making responsibilities
Hospital-Level Racial Disparities in Acute Myocardial Infarction Treatment and Outcomes
BACKGROUND: Previous studies have documented racial disparities in treatment of acute myocardial infarction (AMI) among Medicare beneficiaries. However, the extent to which unobserved differences between hospitals explains some of these differences is unknown. OBJECTIVE: The objective of this study was to determine whether the observed racial treatment disparities for AMI narrow when analyses account for differences in where blacks and whites are…
End‐of‐life spending
Are Regional Variations in End-of-Life Care Intensity Explained by Patient Preferences
OBJECTIVE: We sought to test whether variations across regions in end-of-life (EOL) treatment intensity are associated with regional differences in patient preferences for EOL care. RESEARCH DESIGN: Dual-language (English/Spanish) survey conducted March to October 2005, either by mail or computer-assisted telephone questionnaire, among a probability sample of 3480 Medicare part A and/or B eligible beneficiaries in the 20% denominator file, age 65…
Development and Validation of Hospital “End-of-Life” Treatment Intensity Measures
BACKGROUND: Health care utilization among decedents is increasingly used as a measure of health care efficiency, but decedent-based measures may be biased estimates of care received by "dying" patients. OBJECTIVE: To develop and validate new measures of hospital "end-of-life" treatment intensity. RESEARCH DESIGN: Retrospective cohort study using Pennsylvania Health Care Cost Containment Council (PHC4) discharge data (April 2001-March 2005) and Ce…
Organizational Determinants of Hospital End-of-Life Treatment Intensity
BACKGROUND: There is substantial hospital-level variation in end-of-life (EOL) treatment intensity. OBJECTIVE: To explore the association between organizational factors and EOL treatment intensity in Pennsylvania (PA) hospitals. RESEARCH DESIGN: Cross-sectional mixed-mode survey of Chief Nursing Officers of PA hospitals linked to hospital-level measures of EOL treatment intensity calculated from PA Health Care Cost Containment Council (PHC4) hosp…
Is Survival Better at Hospitals With Higher “End-of-Life” Treatment Intensity
BACKGROUND: Concern regarding wide variations in spending and intensive care unit use for patients at the end of life hinges on the assumption that such treatment offers little or no survival benefit. OBJECTIVE: To explore the relationship between hospital "end-of-life" (EOL) treatment intensity and postadmission survival. RESEARCH DESIGN: Retrospective cohort analysis of Pennsylvania Health Care Cost Containment Council discharge data April 2001…
Association Between Anticipatory Grief and Problem Solving Among Family Caregivers of Persons With Cognitive Impairment
Higher anticipatory grief among family caregivers impaired problem solving, which could have negative consequences for their medical decision making responsibilities
ICU Telemedicine and Critical Care Mortality
BACKGROUND: Intensive care unit (ICU) telemedicine is an increasingly common strategy for improving the outcome of critical care, but its overall impact is uncertain. OBJECTIVES: To determine the effectiveness of ICU telemedicine in a national sample of hospitals and quantify variation in effectiveness across hospitals. RESEARCH DESIGN: We performed a multicenter retrospective case-control study using 2001-2010 Medicare claims data linked to a na…
Identifying Strategies for Effective Telemedicine Use in Intensive Care Units
Telemedicine, the use of audiovisual technology to provide health care from a remote location, is increasingly used in intensive care units (ICUs). However, studies evaluating the impact of ICU telemedicine show mixed results, with some studies demonstrating improved patient outcomes, while others show limited benefit or even harm. Little is known about the mechanisms that influence variation in ICU telemedicine effectiveness, leaving providers w…
Prudence in end-of-life decision making
Despite significant improvements in end-of-life care over several decades, belated hospice referrals and hospital staffing patterns make challenging end-of-life conversations between strangers unsurprising, especially when the interaction is time-sensitive. Understanding how physicians perform under these circumstances is relevant to patient quality and medical education. This study is a secondary analysis of transcripts from a simulation that pl…
What is in the palliative care 'syringe'? A systems perspective
The diffusion of palliative care has been rapid, yet uncertainty remains regarding palliative care's "active ingredients." The National Consensus Project Guidelines for Quality Palliative Care identified eight domains of palliative care. Despite these identified domains, when pressed to describe the specific maneuvers used in clinical encounters, palliative care providers acknowledge that "it's complex." The field of systems has been used to expl…
Problematic Integration
We describe racially discordant oncology encounters involving EOL decision-making. Fifty-eight provider interviews were content analyzed using the tenets of problematic integration theory. We found EOL discussions between non-Black providers and their Black patients were often complex and anxiety-inducing. That anxiety consisted of (1) ontological uncertainty in which providers characterized the nature of Black patients as distrustful, especially…
A Quality Improvement Initiative for Inpatient Advance Care Planning
This nationwide cohort study suggests that while the ACP quality initiative increased ACP billing, changes in clinical outcomes were inconsistent with the hypotheses. Further study is needed to address questions regarding confounding by unobserved measures of care quality
Power and racial differences in the communication experiences of Black and White patients living with advanced cancer and their care partners
“I didn’t go into medicine just to be on the phone”
Guided by communication accommodation theory, we studied 27 physician reports of patient-physician advanced cancer communication during the COVID-19 pandemic. Advanced cancer communication requires recognizing patients' psychosocial states and collaboratively engaging patients empathetically to develop the shared understanding necessary to guide decision-making. However, physicians found their communication underaccommodated, stemming from person…
Causal inference for intervention spillover in a stepped wedge cluster-randomized trial
Often motivated by concerns about contamination of control subjects, stepped wedge cluster-randomized trial designs assign interventions to distinct clusters (e.g., hospitals) and protect against confounding by randomizing the timing of intervention delivery. However, when trial units are embedded in professional networks that span clusters, such designs cannot prevent spillover. In this study, we use longitudinal cluster-randomized trial data an…
Medicine (12 obras) · Palliative Care and End-of-Life Issues (12 obras) · Psychology (8 obras) · Nursing (6 obras) · Emergency Medicine (5 obras) · Emergency Medicine (5 obras) · Health care (5 obras) · Health Systems, Economic Evaluations, Quality of Life (4 obras) · Palliative care (4 obras) · Patient-Provider Communication in Healthcare (4 obras)