Yong-Fang Kuo
Biographic Data
| ID | 109248 |
|---|---|
| NAME | Yong-Fang Kuo |
| GIVEN NAMES | Yong-Fang |
| FAMILY NAME | Kuo |
| SIGNATURE | KUO Y |
| AFFILIATIONS | The University of Texas Medical Branch at Galveston |
| ORCID | 0000-0003-1927-0927 |
| VERIFIED | Yes |
| TOTAL WORKS | 21 |
| TOTAL CITATIONS | 34 |
| AUTHOR COUNT | 21 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2006 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Breast and colorectal cancer screening and staging diagnosis among people with and without HIV
Background: Older people with HIV (PWH) are increasingly developing cancers commonly seen among people without HIV (PWOH). Few studies have simultaneously evaluated both cancer screening utilization and stage at diagnosis. We compared breast and colorectal cancer screening utilization and staging at diagnosis between PWH and PWOH.Methods: Using 2010–2019 SEER-Medicare linkage data, we identified adults aged ≥51 years with breast or colorectal can…
Defining and Measuring Delays in Postacute Care: Toward a Standardized Definition of Rehabilitation Access
BACKGROUND: Studying delays in postacute care (PAC) rehabilitation using Medicare data is challenging due to the absence of a standardized definition of PAC access timeframes across rehabilitation provider types. METHODS: We used 100% Medicare claims data for beneficiaries aged 66 and older discharged to PAC with one of 8 common medical conditions. PAC initiation was examined for inpatient rehabilitation facilities (IRFs), skilled nursing facilit…
Epidemiology and risk factors for ovarian cancer incidence in the USA: A multilevel analysis
Background: Ovarian cancer (OC) has the worst prognosis and highest death rate of all gynaecological cancers in the USA. We examined the independent effects of individual-, neighbourhood-, and state-level factors on ovarian cancer incidence using a multilevel analytical framework. Methods: In this retrospective cohort study, we analysed de-identified data from the All of Us research database, identifying women ≥18 years without prior ovarian canc…
Clinical Factors and Social Determinants of Health Predict Elder Mistreatment at Two Years Among Older Adults: A Preliminary Prediction Model
Low rates of screening for elder mistreatment preclude early detection and harm reduction. No validated tools currently exist to identify elder mistreatment with high sensitivity. We developed, internally validated, and tested a preliminary prediction model to improve elder mistreatment screening of older adults. This retrospective observational study used 20% national Medicare Fee-for-Service claims data for the logistic regression and machine l…
The Prevalence of Cognitive Impairment and Dementia in Incarcerated Older Adults
Future studies of cognitive impairment in prisons and jails can inform health care planning and resource allocation, such as expansion of access to palliative care, advance care planning, and targeted cognitive screening in older age groups
Disparities in Late-Stage Breast and Colorectal Cancer Diagnosis Among Hispanic, Non-Hispanic White, and Non-Hispanic Black Patients: A Retrospective Cohort Study of Texas Medicare Beneficiaries
Human Papillomavirus Vaccinations During the Covid-19 Pandemic in Middle Schools in the Rio Grande Valley of Texas
This quasi-experimental study (a community-based, physician-led human papillomavirus [HPV] education campaign and school-based vaccination program) followed 6481 students at eight Pharr–San Juan–Alamo Independent School District (Rio Grande Valley, Texas) middle schools between August 2016 and March 2021. We describe the successes and challenges experienced during the COVID-19 pandemic. HPV vaccine initiation and completion rates increased 1.29-f…
Exploring the Impact of ACA on Rural‐Urban Disparity in Oral Health Services Among US Noninstitutionalized Adults
PURPOSE: To explore the effect of the Affordable Care Act (ACA) on rural disparities in oral health services utilization based on disability status. METHODS: Comparing the 2011-2013 with the 2014-2016 Medical Expenditure Panel Survey, the study estimated the impacts of ACA on the likelihood of having preventive checkup and utilization of dental treatments in adults older than 18. FINDINGS: The sample consists of 216,184 noninstitutionalized adult…
How to Identify Team-based Primary Care in the United States Using Medicare Data
BACKGROUND: Studying team-based primary care using 100% national outpatient Medicare data is not feasible, due to limitations in the availability of this dataset to researchers. METHODS: We assessed whether analyses using different sets of Medicare data can produce results similar to those from analyses using 100% data from an entire state, in identifying primary care teams through social network analysis. First, we used data from 100% Medicare b…
Impact of Self-Care and Mobility on One or More Post-Acute Care Transitions
Objective: To investigate the association between functional status and post-acute care (PAC) transition(s). Methods: Secondary analysis of 2013-2014 Medicare data for individuals aged ≥66 years with stroke, lower extremity joint replacements, and hip/femur fracture discharged to one of three PAC settings (inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies). Functional scores were co-calibrated into a 0-100 …
Use of Medicare Data to Identify Team-based Primary Care: Is it Possible
BACKGROUND: It is unclear whether Medicare data can be used to identify type and degree of collaboration between primary care providers (PCPs) [medical doctors (MDs), nurse practitioners, and physician assistants] in a team care model. METHODS: We surveyed 63 primary care practices in Texas and linked the survey results to 2015 100% Medicare data. We identified PCP dyads of 2 providers in Medicare data and compared the results to those from our s…
Roles of Health Care Providers and Patients in Initiation of Unnecessary Papanicolaou Testing After Total Hysterectomy
Objectives. To assess Papanicolaou (Pap) testing use among US adult women with a history of a total hysterectomy for a benign condition and the roles of health care providers and patients in the initiation of screening Pap tests. Methods. We used 2000 to 2013 data from the National Health Interview Survey on women aged 20 years or older who had undergone a hysterectomy (n = 11 616) to estimate unnecessary Pap test use. Results. The percentage of …
Comparison of Comorbidity Scores in Predicting Surgical Outcomes
The CMS-HCC had superior performance in predicting surgical outcomes. Prescription-based scores, alone or in addition to diagnosis-based scores, were not better than any diagnosis-based scoring system
Potentially Preventable Hospitalizations in Medicare Patients With Diabetes: A Comparison of Primary Care Provided by Nurse Practitioners Versus Physicians
BACKGROUND: Few comparisons exist of the quality of primary care provided by nurse practitioners (NPs) versus physicians. METHODS: Patients with a diagnosis of diabetes in 2007-2010 (n=345,819) who received all primary care from NPs or from generalist physicians in a given year were selected from a national sample of Medicare beneficiaries. We compared the rate of potentially preventable hospitalizations among patients who received primary care f…
Potential Overuse of Screening Mammography and Its Association With Access to Primary Care
BACKGROUND: Cancer screening in individuals with limited life expectancy increases the risk of diagnosis and treatment of cancer that otherwise would not have become clinically apparent. OBJECTIVE: To estimate screening mammography use in women with limited life expectancy, its geographic variation, and association with access to primary care and mammographic resources. METHODS: We assessed screening mammography use in 2008-2009 in 106,737 women …
Reducing Bias in the Assessment of Treatment Effectiveness: Androgen Deprivation Therapy for Prostate Cancer
BACKGROUND: Indication bias is the major challenge in assessing treatment effectiveness in observational studies. We explored the potential advantages of using an instrumental variable approach in the context of primary androgen deprivation therapy (ADT) for prostate cancer. METHODS: We identified 31,930 men in the linked Surveillance, Epidemiology, and End Results-Medicare database with a diagnosis of prostate cancer who were not treated definit…
Association of Care by Hospitalists on Discharge Destination and 30-day Outcomes After Acute Ischemic Stroke
OBJECTIVES: The use of hospitalists is increasing. Hospitalists have been associated with reductions in length of stay and associated costs while not negatively impacting outcomes. We examine care for stroke patients because it requires complex care in the hospital and has high post discharge complications. We assessed the association of care provided by a hospitalist with length of stay, discharge destination, 30-day mortality, 30-day readmissio…
Multiple Measurement of Serum Lipids in the Elderly
BACKGROUND: Although there is considerable interest in underutilization of lipid testing, little is known about the prevalence and factors associated with overtesting of serum lipids. METHODS: We assessed the number of different days in which outpatient lipid testing was performed in a 5% national sample of patients with parts A and B Medicare in 2006. Covariates included patient characteristics (age, race, prior diagnosis of lipid disorder, and …
Neighbourhood ethnic composition and diet among Mexican-Americans
Objectives We explore the association between a neighbourhood’s ethnic composition and the foods and nutrients consumed by Mexican-Americans. Design Cross-sectional survey of a large national sample, from the Third National Health and Nutrition Examination Survey (1988–94), was linked to the 1990 Census. The outcomes were food frequencies and serum levels of micronutrients. The variable of interest was percentage of Mexican-Americans at the censu…
Mortality of Foreign-Born and US-Born Hispanic Adults at Younger Ages: A Reexamination of Recent Patterns
Objectives. We sought to determine whether mortality rates among immigrant and US-born Hispanic young adults were higher or lower compared with non-Hispanic Whites. We also sought to identify which causes of death accounted for the differences in mortality rates between groups. Measures. We used Texas and California vital registration data from 1999 to 2001 linked to 2000 census denominators. We calculated cause-specific, indirectly standardized …
Ascertainment of Hispanic Ethnicity on California Death Certificates: Implications for the Explanation of the Hispanic Mortality Advantage
Objectives. We determined the size and correlates of underascertainment of Hispanic ethnicity on California death certificates. Methods. We used 1999 to 2000 vital registration data. We compared Hispanic ethnicity reported on the death certificate to Hispanic ethnicity derived from birthplace for the foreign-born and an algorithm that used first and last name and percentage of Hispanics in the county of residence for the US-born. We validated dea…
Ascertainment of Hispanic Ethnicity on California Death Certificates: Implications for the Explanation of the Hispanic Mortality Advantage
Objectives. We determined the size and correlates of underascertainment of Hispanic ethnicity on California death certificates. Methods. We used 1999 to 2000 vital registration data. We compared Hispanic ethnicity reported on the death certificate to Hispanic ethnicity derived from birthplace for the foreign-born and an algorithm that used first and last name and percentage of Hispanics in the county of residence for the US-born. We validated dea…
Mortality of Foreign-Born and US-Born Hispanic Adults at Younger Ages: A Reexamination of Recent Patterns
Objectives. We sought to determine whether mortality rates among immigrant and US-born Hispanic young adults were higher or lower compared with non-Hispanic Whites. We also sought to identify which causes of death accounted for the differences in mortality rates between groups. Measures. We used Texas and California vital registration data from 1999 to 2001 linked to 2000 census denominators. We calculated cause-specific, indirectly standardized …
The Prevalence of Cognitive Impairment and Dementia in Incarcerated Older Adults
Future studies of cognitive impairment in prisons and jails can inform health care planning and resource allocation, such as expansion of access to palliative care, advance care planning, and targeted cognitive screening in older age groups
Ascertainment of Hispanic Ethnicity on California Death Certificates: Implications for the Explanation of the Hispanic Mortality Advantage
Objectives. We determined the size and correlates of underascertainment of Hispanic ethnicity on California death certificates. Methods. We used 1999 to 2000 vital registration data. We compared Hispanic ethnicity reported on the death certificate to Hispanic ethnicity derived from birthplace for the foreign-born and an algorithm that used first and last name and percentage of Hispanics in the county of residence for the US-born. We validated dea…
Mortality of Foreign-Born and US-Born Hispanic Adults at Younger Ages: A Reexamination of Recent Patterns
Objectives. We sought to determine whether mortality rates among immigrant and US-born Hispanic young adults were higher or lower compared with non-Hispanic Whites. We also sought to identify which causes of death accounted for the differences in mortality rates between groups. Measures. We used Texas and California vital registration data from 1999 to 2001 linked to 2000 census denominators. We calculated cause-specific, indirectly standardized …
Neighbourhood ethnic composition and diet among Mexican-Americans
Objectives We explore the association between a neighbourhood’s ethnic composition and the foods and nutrients consumed by Mexican-Americans. Design Cross-sectional survey of a large national sample, from the Third National Health and Nutrition Examination Survey (1988–94), was linked to the 1990 Census. The outcomes were food frequencies and serum levels of micronutrients. The variable of interest was percentage of Mexican-Americans at the censu…
Association of Care by Hospitalists on Discharge Destination and 30-day Outcomes After Acute Ischemic Stroke
OBJECTIVES: The use of hospitalists is increasing. Hospitalists have been associated with reductions in length of stay and associated costs while not negatively impacting outcomes. We examine care for stroke patients because it requires complex care in the hospital and has high post discharge complications. We assessed the association of care provided by a hospitalist with length of stay, discharge destination, 30-day mortality, 30-day readmissio…
Multiple Measurement of Serum Lipids in the Elderly
BACKGROUND: Although there is considerable interest in underutilization of lipid testing, little is known about the prevalence and factors associated with overtesting of serum lipids. METHODS: We assessed the number of different days in which outpatient lipid testing was performed in a 5% national sample of patients with parts A and B Medicare in 2006. Covariates included patient characteristics (age, race, prior diagnosis of lipid disorder, and …
Reducing Bias in the Assessment of Treatment Effectiveness: Androgen Deprivation Therapy for Prostate Cancer
BACKGROUND: Indication bias is the major challenge in assessing treatment effectiveness in observational studies. We explored the potential advantages of using an instrumental variable approach in the context of primary androgen deprivation therapy (ADT) for prostate cancer. METHODS: We identified 31,930 men in the linked Surveillance, Epidemiology, and End Results-Medicare database with a diagnosis of prostate cancer who were not treated definit…
Potential Overuse of Screening Mammography and Its Association With Access to Primary Care
BACKGROUND: Cancer screening in individuals with limited life expectancy increases the risk of diagnosis and treatment of cancer that otherwise would not have become clinically apparent. OBJECTIVE: To estimate screening mammography use in women with limited life expectancy, its geographic variation, and association with access to primary care and mammographic resources. METHODS: We assessed screening mammography use in 2008-2009 in 106,737 women …
Potentially Preventable Hospitalizations in Medicare Patients With Diabetes: A Comparison of Primary Care Provided by Nurse Practitioners Versus Physicians
BACKGROUND: Few comparisons exist of the quality of primary care provided by nurse practitioners (NPs) versus physicians. METHODS: Patients with a diagnosis of diabetes in 2007-2010 (n=345,819) who received all primary care from NPs or from generalist physicians in a given year were selected from a national sample of Medicare beneficiaries. We compared the rate of potentially preventable hospitalizations among patients who received primary care f…
Roles of Health Care Providers and Patients in Initiation of Unnecessary Papanicolaou Testing After Total Hysterectomy
Objectives. To assess Papanicolaou (Pap) testing use among US adult women with a history of a total hysterectomy for a benign condition and the roles of health care providers and patients in the initiation of screening Pap tests. Methods. We used 2000 to 2013 data from the National Health Interview Survey on women aged 20 years or older who had undergone a hysterectomy (n = 11 616) to estimate unnecessary Pap test use. Results. The percentage of …
Comparison of Comorbidity Scores in Predicting Surgical Outcomes
The CMS-HCC had superior performance in predicting surgical outcomes. Prescription-based scores, alone or in addition to diagnosis-based scores, were not better than any diagnosis-based scoring system
Use of Medicare Data to Identify Team-based Primary Care: Is it Possible
BACKGROUND: It is unclear whether Medicare data can be used to identify type and degree of collaboration between primary care providers (PCPs) [medical doctors (MDs), nurse practitioners, and physician assistants] in a team care model. METHODS: We surveyed 63 primary care practices in Texas and linked the survey results to 2015 100% Medicare data. We identified PCP dyads of 2 providers in Medicare data and compared the results to those from our s…
Impact of Self-Care and Mobility on One or More Post-Acute Care Transitions
Objective: To investigate the association between functional status and post-acute care (PAC) transition(s). Methods: Secondary analysis of 2013-2014 Medicare data for individuals aged ≥66 years with stroke, lower extremity joint replacements, and hip/femur fracture discharged to one of three PAC settings (inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies). Functional scores were co-calibrated into a 0-100 …
Exploring the Impact of ACA on Rural‐Urban Disparity in Oral Health Services Among US Noninstitutionalized Adults
PURPOSE: To explore the effect of the Affordable Care Act (ACA) on rural disparities in oral health services utilization based on disability status. METHODS: Comparing the 2011-2013 with the 2014-2016 Medical Expenditure Panel Survey, the study estimated the impacts of ACA on the likelihood of having preventive checkup and utilization of dental treatments in adults older than 18. FINDINGS: The sample consists of 216,184 noninstitutionalized adult…
How to Identify Team-based Primary Care in the United States Using Medicare Data
BACKGROUND: Studying team-based primary care using 100% national outpatient Medicare data is not feasible, due to limitations in the availability of this dataset to researchers. METHODS: We assessed whether analyses using different sets of Medicare data can produce results similar to those from analyses using 100% data from an entire state, in identifying primary care teams through social network analysis. First, we used data from 100% Medicare b…
Disparities in Late-Stage Breast and Colorectal Cancer Diagnosis Among Hispanic, Non-Hispanic White, and Non-Hispanic Black Patients: A Retrospective Cohort Study of Texas Medicare Beneficiaries
Human Papillomavirus Vaccinations During the Covid-19 Pandemic in Middle Schools in the Rio Grande Valley of Texas
This quasi-experimental study (a community-based, physician-led human papillomavirus [HPV] education campaign and school-based vaccination program) followed 6481 students at eight Pharr–San Juan–Alamo Independent School District (Rio Grande Valley, Texas) middle schools between August 2016 and March 2021. We describe the successes and challenges experienced during the COVID-19 pandemic. HPV vaccine initiation and completion rates increased 1.29-f…
The Prevalence of Cognitive Impairment and Dementia in Incarcerated Older Adults
Future studies of cognitive impairment in prisons and jails can inform health care planning and resource allocation, such as expansion of access to palliative care, advance care planning, and targeted cognitive screening in older age groups
Epidemiology and risk factors for ovarian cancer incidence in the USA: A multilevel analysis
Background: Ovarian cancer (OC) has the worst prognosis and highest death rate of all gynaecological cancers in the USA. We examined the independent effects of individual-, neighbourhood-, and state-level factors on ovarian cancer incidence using a multilevel analytical framework. Methods: In this retrospective cohort study, we analysed de-identified data from the All of Us research database, identifying women ≥18 years without prior ovarian canc…
Clinical Factors and Social Determinants of Health Predict Elder Mistreatment at Two Years Among Older Adults: A Preliminary Prediction Model
Low rates of screening for elder mistreatment preclude early detection and harm reduction. No validated tools currently exist to identify elder mistreatment with high sensitivity. We developed, internally validated, and tested a preliminary prediction model to improve elder mistreatment screening of older adults. This retrospective observational study used 20% national Medicare Fee-for-Service claims data for the logistic regression and machine l…
Breast and colorectal cancer screening and staging diagnosis among people with and without HIV
Background: Older people with HIV (PWH) are increasingly developing cancers commonly seen among people without HIV (PWOH). Few studies have simultaneously evaluated both cancer screening utilization and stage at diagnosis. We compared breast and colorectal cancer screening utilization and staging at diagnosis between PWH and PWOH.Methods: Using 2010–2019 SEER-Medicare linkage data, we identified adults aged ≥51 years with breast or colorectal can…
Defining and Measuring Delays in Postacute Care: Toward a Standardized Definition of Rehabilitation Access
BACKGROUND: Studying delays in postacute care (PAC) rehabilitation using Medicare data is challenging due to the absence of a standardized definition of PAC access timeframes across rehabilitation provider types. METHODS: We used 100% Medicare claims data for beneficiaries aged 66 and older discharged to PAC with one of 8 common medical conditions. PAC initiation was examined for inpatient rehabilitation facilities (IRFs), skilled nursing facilit…
Medicine (15 works) · Family medicine (8 works) · Environmental health (7 works) · Gerontology (7 works) · Demography (6 works) · Internal Medicine (6 works) · MEDLINE (6 works) · Population (6 works) · Health care (5 works) · Internal Medicine (5 works)