Alan M Zaslavsky
Datos Biográficos
| ID | 1405916 |
|---|---|
| NOMBRE | Alan M Zaslavsky |
| NOMBRES | Alan M |
| APELLIDO | Zaslavsky |
| FIRMA | ZASLAVSKY A M |
| AFILIACIONES | Harvard University |
| ORCID | 0000-0003-1072-6043 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 72 |
| TOTAL DE CITAS | 71 |
| TOTAL COMO AUTOR | 72 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1993 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 5 |
Patterns and predictors of the transition between minimally adequate treatment and effective treatment coverage for mental disorders
BACKGROUND: The quality of mental disorder treatment varies widely, with many patients not receiving treatments based on evidence-based guidelines. We examine data from the World Mental Health (WMH) surveys to investigate prevalence and correlates of receiving effective treatment coverage (ETC) among patients receiving minimally adequate treatment (MAT) in the 12 months before interview. METHODS: Data come from 25 WMH surveys carried out in 21 co…
Age of onset and cumulative risk of mental disorders
BACKGROUND: Information on the frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad, cross-national estimates of this information from coordinated general population surveys were last updated in 2007. We aimed to provide updated and improved estimates of age-of-onset distributions, lifetime prevalence, and morbid risk. METHODS: In this cross-national analysis, we analyse…
Study on Covid-19 Home Monitoring—A Control Group Is Essential
In this issue of JAMA Health Forum, Misra-Hebert and colleagues 1 report on their evaluation of a program of home quarantine with remote monitoring for adults who received COVID-19 diagnoses
The Debut of Jama Health Forum as a Peer-Reviewed Journal
Exploring Potential Causal Inference Through Natural Experiments
Viewpoint “Natural Experiments” in Health Care Research Dhruv Khullar, MD, MPP; Anupam B. Jena, MD, PhD
Methodological Approaches to Understanding Causes of Health Disparities
Understanding health disparity causes is an important first step toward developing policies or interventions to eliminate disparities, but their nature makes identifying and addressing their causes challenging. Potential causal factors are often correlated, making it difficult to distinguish their effects. These factors may exist at different organizational levels (e.g., individual, family, neighborhood), each of which needs to be appropriately c…
Association of Federal Mental Health Parity Legislation With Health Care Use and Spending Among High Utilizers of Services
BACKGROUND: Decades-long efforts to require parity between behavioral and physical health insurance coverage culminated in the comprehensive federal Mental Health Parity and Addiction Equity Act. OBJECTIVES: To determine the association between federal parity and changes in mental health care utilization and spending, particularly among high utilizers. RESEARCH DESIGN: Difference-in-differences analyses compared changes before and after exposure …
Validating Reports of Chronic Conditions in the Medicare CAHPS Survey
BACKGROUND: The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey includes items about chronic conditions, health history, and self-rated health. Questions remain about the concordance between patient reports and administrative sources on questions related to health history. OBJECTIVE: To validate CAHPS measures of chronic conditions against claims-based measures from the Medicare Chronic Conditions Warehouse (CCW). …
WHO World Mental Health Surveys International College Student Project
Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources.The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, S…
The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys
Trauma and PTSD in the WHO World Mental Health Surveys
Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained r…
Sexual Assault Victimization and Mental Health Treatment, Suicide Attempts, and Career Outcomes Among Women in the US Army
Objectives. To examine associations of administratively recorded sexual assault victimization during military service with subsequent mental health and negative career outcomes among US Army women controlling for nonrandom victimization exposure. Methods. We used data from the Army Study to Assess Risk and Resilience in Servicemembers to apply propensity score methods to match all 4238 female Regular Army soldiers with administratively recorded s…
Mental disorders among college students in the World Health Organization World Mental Health Surveys
Background Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Method The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students ( n = 1572) and non-students…
Developing and Evaluating Composite Measures of Cancer Care Quality
The empirical-factor domains grouped measures variously by cancer type and care modality. The evidence did not support any single approach for generating cancer care composite measures. Weak associations across different care domains suggest that low-quality and high-quality cancer care delivery may coexist within Veterans Affairs hospitals
Predicting support for non-pharmaceutical interventions during infectious outbreaks
Non-pharmaceutical interventions (NPIs) are an important public health tool for responding to infectious disease outbreaks, including pandemics. However, little is known about the individual characteristics associated with support for NPIs, or whether they are consistent across regions. This study draws on survey data from four regions-Hong Kong, Singapore, Taiwan, and the United States-collected following the Severe Acute Respiratory Syndrome (S…
Examining the Role of Patient Experience Surveys in Measuring Health Care Quality
Patient care experience surveys evaluate the degree to which care is patient-centered. This article reviews the literature on the association between patient experiences and other measures of health care quality. Research indicates that better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health c…
Impact of a High-deductible Health Plan on Outpatient Visits and Associated Diagnostic Tests
BACKGROUND: By shifting a greater share of out-of-pocket medical costs to consumers, high-deductible health plans (HDHP) might discourage use of essential outpatient services. OBJECTIVE: The objective of the study was to examine the impact of an HDHP on outpatient visits and associated laboratory and radiology tests. RESEARCH DESIGN/SUBJECTS: We used a pre-post with comparison group study design to examine the differential change in outpatient se…
National Trends in Hospitalizations for Sickle Cell Disease in the United States Following the FDA Approval of Hydroxyurea, 1998–2008
BACKGROUND: Patients with sickle cell disease (SCD) can suffer frequent hospital admissions for painful vasoocclusive crises. Hydroxyurea was approved by the FDA in 1998 to decrease the morbidity of SCD, but nationwide hospitalizations for SCD in the United States since 1998 have not been evaluated. We hypothesized that the availability of hydroxyurea for SCD would be associated with a decrease in hospitalizations for SCD over time. OBJECTIVE: To…
Elderly Breast and Colorectal Cancer Patients’ Clinical Course
BACKGROUND: The social and medical environments that surround people are each independently associated with their cancer course. The extent to which these characteristics may together mediate patients' cancer care and outcomes is not known. METHODS: Using multilevel methods and data, we studied elderly breast and colorectal cancer patients (level I) within urban social (level II: ZIP code tabulation area) and health care (level III: hospital serv…
Are Comparisons of Patient Experiences Across Hospitals Fair? A Study in Veterans Health Administration Hospitals
BACKGROUND: Surveys are increasingly used to assess patient experiences with health care. Comparisons of hospital scores based on patient experience surveys should be adjusted for patient characteristics that might affect survey results. Such characteristics are commonly drawn from patient surveys that collect little, if any, clinical information. Consequently some hospitals, especially those treating particularly complex patients, have been conc…
The Oregon Experiment — Effects of Medicaid on Clinical Outcomes
BACKGROUND: Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects. METHODS: Approximately 2 years after the lottery, we obtained data from 6387 adults who were randomly selected to be able to apply for Medicaid coverage and 5842 adults who were not…
Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents
Context Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (ie, suicide ideation, plans, and attempts).\n\nObjectives To estimate the lifetime prevalence of suicidal behaviors among US adolescents and the associations of retrospectively reported, temporally primary DSM-IV disorders with the subsequent o…
Trauma Exposure and Posttraumatic Stress Disorder in a National Sample of Adolescents
Health care payments in the asia pacific
Studies that examine economic burden attributable to health care payments should include measures of impoverishment and indebtedness
Representativeness of Participants in the Cancer Care Outcomes Research and Surveillance Consortium Relative to the Surveillance, Epidemiology, and End Results Program
BACKGROUND: The research goals of the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium are to determine how characteristics and beliefs of patients, providers, and health care organizations influence the treatments and outcomes of individuals with newly diagnosed lung and colorectal cancers. As CanCORS results will inform national policy, it is important to know how they generalize to the United States population with these can…
Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample
Methodological Approaches to Understanding Causes of Health Disparities
Understanding health disparity causes is an important first step toward developing policies or interventions to eliminate disparities, but their nature makes identifying and addressing their causes challenging. Potential causal factors are often correlated, making it difficult to distinguish their effects. These factors may exist at different organizational levels (e.g., individual, family, neighborhood), each of which needs to be appropriately c…
Education and race-ethnicity differences in the lifetime risk of alcohol dependence
OBJECTIVES: While lower socioeconomic status (SES) is related to higher risk for alcohol dependence, minority race-ethnicity is often associated with lower risk. This study attempts to clarify the nature and extent of social inequalities in alcohol dependence by investigating the effects of SES and race-ethnicity on the development of alcohol dependence following first alcohol use. DESIGN: Cross-sectional analysis of data from the National Epidem…
Contraceptive Use, Birth Spacing, and Autonomy
Oportunidades , a conditional cash‐transfer program instituted in Mexico in 1997, provides cash incentives to mothers to invest in the health and education of family members. Drawing from data gathered by Mexico's National Institute of Public Health, this study assesses the effect of the program on contraceptive use and birth spacing among titulares (female household heads) living in rural areas during the experimental period, 1998–2000, and duri…
Sexual Assault Victimization and Mental Health Treatment, Suicide Attempts, and Career Outcomes Among Women in the US Army
Objectives. To examine associations of administratively recorded sexual assault victimization during military service with subsequent mental health and negative career outcomes among US Army women controlling for nonrandom victimization exposure. Methods. We used data from the Army Study to Assess Risk and Resilience in Servicemembers to apply propensity score methods to match all 4238 female Regular Army soldiers with administratively recorded s…
Predicting support for non-pharmaceutical interventions during infectious outbreaks
Non-pharmaceutical interventions (NPIs) are an important public health tool for responding to infectious disease outbreaks, including pandemics. However, little is known about the individual characteristics associated with support for NPIs, or whether they are consistent across regions. This study draws on survey data from four regions-Hong Kong, Singapore, Taiwan, and the United States-collected following the Severe Acute Respiratory Syndrome (S…
Testing for Statistical Discrimination by Race/Ethnicity in Panel Data for Depression Treatment in Primary Care
Enhanced physician-patient communication and use of standardized depression instruments may reduce statistical discrimination arising from clinical uncertainty and be useful in reducing racial/ethnic inequities in depression treatment
Undiagnosed Hypertension and Hypercholesterolemia Among Uninsured and Insured Adults in the Third National Health and Nutrition Examination Survey
Uninsured adults are much less likely than insured adults to receive routine checkups or preventive services, including screening for hypertension and hypercholesterolemia.1 To obtain nationally representative estimates of undiagnosed hypertension and hypercholesterolemia by insurance status, we analyzed the Third National Health and Nutrition Examination Survey (NHANES III).2,3
Triple-System Modeling of Census, Post-Enumeration Survey, and Administrative-List Data
Dual-system measurement of census coverage using a post-enumeration survey has been criticized for correlation bias, resulting when responses to the census and survey are not independent. A third system provides additional information to assess that independence. This study focuses on urban Black male adults, using data from the 1988 Dress Rehearsal Census and its Post-Enumeration Survey and from other government sources. Results using a variety …
Physician Experiences With, and Ratings of, Managed Care Organizations in Massachusetts
BACKGROUND: Physicians can provide important information about how managed care plans affect the delivery of health care. Assessments of the quality of managed care plans have rarely used physician evaluations. OBJECTIVES: To elicit physician evaluations of managed care plans and to determine factors associated with those evaluations. RESEARCH DESIGN: Physicians were asked in a mail survey to evaluate a managed care plan they were associated with…
The Impact of Having Parents Report About Both Their Own and Their Children's Experiences With Health Insurance Plans
OBJECTIVES: The aim of this study was to determine whether parents rate their children's care differently when they also rate their own care than when they do not. METHODS: Subjects were employees of Washington State who had been enrolled in a health plan for at least 6 months and who had at least one covered child. Subjects were randomly assigned to four study groups that were surveyed using different protocols. To assess the stability of respon…
Sex differences in assessments of the quality of medicare managed care
Dimensions of Consumer-Assessed Quality of Medicare Managed-Care Health Plans
OBJECTIVES: We investigated relationships at the health-plan level among member ratings of and reports on plans in the Consumer Assessment of Health Plans Survey (CAHPS). We sought a more parsimonious description of the reports that can be used in analyses of the distribution and correlates of consumer-assessed quality. SUBJECTS: There were 89,419 Medicare beneficiaries enrolled in 212 Medicare managed-care health plans who responded to CAHPS in …
Impact of Sociodemographic Case Mix on the Hedis Measures of Health Plan Quality
BACKGROUND: The widely used Health Plan Employer Data and Information Set (HEDIS) measures may be affected by differences among plans in sociodemographic characteristics of members. OBJECTIVE: The objective of this study was to estimate effects of geographically linked patient sociodemographic characteristics on differential performance within and among plans on HEDIS measures. RESEARCH DESIGN: Using logistic regression, we modeled associations b…
Adjusting for Patient Characteristics When Analyzing Reports From Patients About Hospital Care
OBJECTIVES: To determine which patient characteristics are associated with reports and ratings of hospital care, and to evaluate how adjusting reports and ratings for hospital differences in such variables affects comparisons among hospitals. DESIGN: A telephone survey of a sample of patients hospitalized in 22 hospitals in a single city and a statewide mail survey of hospitalized patients. MEASURES: The surveys assessed: respect for patients' pr…
National Quality Monitoring of Medicare Health Plans
BACKGROUND: The clinical quality of health plans varies. The associations between different measures of health plan quality are incompletely understood. OBJECTIVE: To assess the relationships between enrollee reports on the quality of health plans as measured by the Consumer Assessment of Health Plans Study (CAHPS 2.0) survey and the clinical quality of care measured by the Medicare Health Plan Employer Data and Information Set (HEDIS). DESIGN: O…
Language Proficiency and the Enrollment of Medicaid-Eligible Children in Publicly Funded Health Insurance Programs
Using Survey Measures to Assess Risk Selection among Medicare Managed Care Plans
This paper quantifies risk selection among competing Medicare managed care plans, using beneficiary survey data from the Consumer Assessments of Health Plans Survey. Selection, measured by variation in plan-level prevalence of health conditions and predicted costs, was substantial. A plan with moderate (one standard deviation) adverse selection would have predicted costs 11.6% above an average plan. Only a small part of this variation was explain…
How Do They Compare
OBJECTIVES: The Consumer Assessment of Health Plans Survey (CAHPS) includes an adult version and also a child version for parents or caretakers to rate children's care in health plans. This study examined how adult and child assessments differed in ranking health plans and explored whether the differences justified the additional cost and respondent burden in administering both surveys. METHODS: Data were from 136 commercial health plans particip…
Dimensions of Plan Performance for Sick and Healthy Members on the Consumer Assessments of Health Plans Study 2.0 Survey
BACKGROUND: The quality of health plan care may differ for members in good and poor health. OBJECTIVE: To determine whether reports from sick and healthy members reflect distinct aspects of plan performance. RESEARCH DESIGN: Mean health plan scores were analyzed on the 1998 and 1999 Medicare Managed Care (MMC) Consumer Assessments of Health Plans (CAHPS) surveys, treating responses from sick and healthy members as separate plan measures. Alternat…
Factors Affecting Response Rates to the Consumer Assessment of Health Plans Study Survey
OBJECTIVES: Assess the determinants of nonresponse to a consumer health care survey. METHODS: The first (1997; CAHPS 1.0) and third (1999; CAHPS 2.0) Medicare managed care (MMC) CAHPS surveys collected data on 215 and 365 health plan reporting units, respectively. Data indicated which beneficiaries responded by mail, responded by phone, could not be located, and did not respond. InterStudy data described plan characteristics. chi2 tests and logis…
Using Telephone Interviews to Reduce Nonresponse Bias to Mail Surveys of Health Plan Members
OBJECTIVE: To assess the nonresponse bias associated with mail-survey returns and the potential for telephone interviews with nonrespondents to reduce that bias. METHODS: A mail survey about health care experiences was conducted with samples of 800 members in each of four health plans. Subsequent attempts were made to interview nonrespondents by telephone. RESULTS: Response rates for the mail surveys averaged 46%; the telephone effort raised the …
Undiagnosed Hypertension and Hypercholesterolemia Among Uninsured and Insured Adults in the Third National Health and Nutrition Examination Survey
Uninsured adults are much less likely than insured adults to receive routine checkups or preventive services, including screening for hypertension and hypercholesterolemia.1 To obtain nationally representative estimates of undiagnosed hypertension and hypercholesterolemia by insurance status, we analyzed the Third National Health and Nutrition Examination Survey (NHANES III).2,3
Completeness of Information on Adjuvant Therapies for Colorectal Cancer in Population-Based Cancer Registries
BACKGROUND: Population-based cancer registries represent a potentially valuable tool to evaluate treatment; however, information on the completeness of registry treatment data is sparse. OBJECTIVE: To evaluate the completeness of registry treatment data for patients with colorectal cancer and to identify predictors of complete reporting. RESEARCH DESIGN: We surveyed physicians or reviewed office records of 1956 northern California patients diagno…
Clinical calibration of DSM‐IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH‐CIDI)
An overview is presented of the rationale, design, and analysis plan for the WMH‐CIDI clinical calibration studies. As no clinical gold standard assessment is available for the DSM‐IV disorders assessed in the WMH‐CIDI, we adopted the goal of calibration rather than validation; that is, we asked whether WMH‐CIDI diagnoses are ‘consistent’ with diagnoses based on a state‐of‐the‐art clinical research diagnostic interview (SCID; Structured Clinical …
The US National Comorbidity Survey Replication (NCS‐R)
The National Comorbidity Survey Replication (NCS‐R) is a survey of the prevalence and correlates of mental disorders in the US that was carried out between February 2001 and April 2003. Interviews were administered face‐to‐face in the homes of respondents, who were selected from a nationally representative multi‐stage clustered area probability sample of households. A total of 9,282 interviews were completed in the main survey and an additional 5…
Too much ado about two-part models and transformation?
Evaluating the Planned Substitution of the Minimum Data Set-Post Acute Care for Use in the Rehabilitation Hospital Prospective Payment System
OBJECTIVE: The objective of this study was to evaluate the payment implications of substituting the Minimum Data Set-Post Acute Care (MDS-PAC) for the FIM trade mark instrument for use in the planned prospective payment system (PPS) for inpatient rehabilitation hospitals. FIM trade mark is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activites, Inc. RESEARCH DESIGN: We used a prospective cross-sec…
Prevalence and Treatment of Mental Disorders, 1990 to 2003
BACKGROUND: Although the 1990s saw enormous change in the mental health care system in the United States, little is known about changes in the prevalence or rate of treatment of mental disorders. METHODS: We examined trends in the prevalence and rate of treatment of mental disorders among people 18 to 54 years of age during roughly the past decade. Data from the National Comorbidity Survey (NCS) were obtained in 5388 face-to-face household interv…
Continuity of Health Insurance Coverage for Children with Special Health Care Needs
Integrating Research on Racial and Ethnic Disparities in Health Care Over Place and Time
From the *Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts; and the †Division of General Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Reprints: Alan M. Zaslavsky, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115. E-mail: [email protected]. Dr. Ayanian is a consultant to RTI International on the de…
The Prevalence and Correlates of Adult ADHD in the United States
Objective: Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates. Method: A screen for adult ADHD was included in a probability subsample (N=3,199) of 18–44-year-old respondents in the National Comorbidity Survey Replication, a nationally representative household survey that used a lay-administered diagnostic interview to assess a wide range of DSM-IV disorders. Blind…
Profiling Providers on Use of Adjuvant Chemotherapy by Combining Cancer Registry and Medical Record Data
PURPOSE: Treatment information collected by cancer registries can be used to monitor the provision of guideline-recommended chemotherapy to colorectal cancer patients. Incomplete information may bias comparisons of these rates. We developed statistical methods that combine data from a registry and physicians' records to assess hospital quality. DATA: From California Cancer Registry data, we selected all patients (n=12,594) newly diagnosed with st…
Medicine (62 obras) · Health care (31 obras) · Healthcare Policy and Management (27 obras) · Environmental health (24 obras) · Family medicine (24 obras) · Psychology (24 obras) · Psychiatry (22 obras) · Patient Satisfaction in Healthcare (19 obras) · Demography (18 obras) · Nursing (17 obras)