Richard S Phillips
Biographic Data
| ID | 1680858 |
|---|---|
| NAME | Richard S Phillips |
| GIVEN NAMES | Richard S |
| FAMILY NAME | Phillips |
| SIGNATURE | PHILLIPS R S |
| AFFILIATIONS | Beth Israel Deaconess Medical Center |
| ORCID | 0000-0002-7281-7154 |
| VERIFIED | Yes |
| TOTAL WORKS | 26 |
| TOTAL CITATIONS | 32 |
| AUTHOR COUNT | 26 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1989 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 3 |
Mission-Aligned Funds Flow and the Primary Care Mission
Using Rapid-Cycle Change to Improve Covid-19 Vaccination Strategy in Primary Care
During the COVID-19 pandemic, misinformation and distrust exacerbated disparities in vaccination rates by race and ethnicity throughout the United States. Primary care, public health systems, and community health centers have shifted their vaccination outreach strategies toward these disparate, unvaccinated populations. To support primary care, we developed the SAVE Sprint model for implementing rapid-cycle change to improve vaccination rates by …
"The ambiguity of "we: Perceptions of teaming in dynamic environments and their implications
Dental Practice Integration into Primary Care: A Microsimulation of Financial Implications for Practices
Given the widespread lack of access to dental care for many vulnerable Americans, there is a growing realization that integrating dental and primary care may provide comprehensive care. We sought to model the financial impact of integrating dental care provision into a primary care practice. A microsimulation model was used to estimate changes in net revenue per practice by simulating patient visits to a primary dental practice within primary car…
Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015
Importance: Recent US health care reforms incentivize improved population health outcomes and primary care functions. It remains unclear how much improving primary care physician supply can improve population health, independent of other health care and socioeconomic factors. Objectives: To identify primary care physician supply changes across US counties from 2005-2015 and associations between such changes and population mortality. Design, Setti…
A Theoretical Logic Model of Integration in Health Care
Introduction: Recent literature has described key dimensions of integration within health care organizations but has not explored relationships among them. Clarifying these relationships can improve efforts to compare and contrast studies of “integration” in health care.Methods: To construct a novel theory of integration, we reviewed existing publications from health care and management literature. We synthesized and adapted elements from dispara…
Benchmarks for Reducing Emergency Department Visits and Hospitalizations Through Community Health Workers Integrated Into Primary Care: A Cost-Benefit Analysis
BACKGROUND: Uncertainty about the financial costs and benefits of community health worker (CHW) programs remains a barrier to their adoption. OBJECTIVES: To determine how much CHWs would need to reduce emergency department (ED) visits and associated hospitalizations among their assigned patients to be cost-neutral from a payer's perspective. RESEARCH DESIGN: Using a microsimulation of patient health care utilization, costs, and revenues, we estim…
Implications of Workforce and Financing Changes for Primary Care Practice Utilization, Revenue, and Cost: A Generalizable Mathematical Model for Practice Management
BACKGROUND: Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. OBJECTIVE: To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. RESEARCH DESIGN: We created a simulation model estimating clinic-level utilization, revenues, and exp…
Patient-physician Language Concordance and Primary Care Screening Among Spanish-speaking Patients
BACKGROUND: Language discordance between patient and physician is associated with worse patient self-reported healthcare quality. As Hispanic patients have low rates of cardiovascular and cancer screening, we sought to determine whether patient-physician language concordance was associated with differences in rates of screening. METHODS: We performed a retrospective medical record review of 101 Spanish-speaking patients cared for by 6 Spanish-spe…
Patient-Physician Language Concordance and Lifestyle Counseling Among Spanish-Speaking Patients
Do Medical Inpatients Who Report Poor Service Quality Experience More Adverse Events and Medical Errors
PURPOSE: Service quality deficiencies are common in health care. However, little is known about the relationship between service quality and the occurrence of adverse events and medical errors. We hypothesized that patients who reported poor service quality were at increased risk of experiencing adverse events and medical errors. SUBJECTS AND METHODS: Patients were interviewed during and after their admissions regarding problems experienced durin…
Complementary and Alternative Medical Therapy Use Among Chinese and Vietnamese Americans: Prevalence, Associated Factors, and Effects of Patient–Clinician Communication
Objective. We examined the use of complementary and alternative medical (CAM) therapies among Chinese and Vietnamese Americans who had limited proficiency with the English language and explore the association between patient–clinician discussions about CAM therapy use and patient assessments of quality of care. Methods. We surveyed Chinese and Vietnamese Americans who visited 11 community health centers in 8 major cities throughout the United Sta…
Health Care Expenditures Associated With Overweight and Obesity Among US Adults: Importance of Age and Race
Objectives. We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. Methods. Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. Results. Overall, the mean per capita annual health care expenditure (c…
Surveying Minorities with Limited-English Proficiency: Does Data Collection Method Affect Data Quality Among Asian Americans
BACKGROUND: Little is known about how modes of survey administration affect response rates and data quality among populations with limited-English proficiency (LEP). Asian Americans are a rapidly growing minority group with large numbers of LEP immigrants. OBJECTIVE: We sought to compare the response rates and data quality of interviewer-administered telephone and self-administered mail surveys among LEP Asian Americans. DESIGN: This was a random…
Linguistic and cultural barriers to care: Perspectives of chinese and vietnamese immigrants
Racial and ethnic disparities in cancer screening the importance of foreign birth as a barrier to care
Use of Complementary and Alternative Medicine Among Persons With Diabetes Mellitus: Results of a National Survey
Objectives. This study sought to characterize the use of complementary and alternative medicine (CAM) among persons with diabetes mellitus residing in the United States. Methods. Data from a 1997–1998 national survey (n = 2055) on CAM use were examined. Results. Ninety-five respondents reported having diabetes, of whom 57% reported CAM use in the past year; fewer respondents (35%) reported use specifically for diabetes. Therapies used for diabete…
Generalists and Oncologists Show Similar Care Practices and Outcomes for Hospitalized Late-Stage Cancer Patients
OBJECTIVE: The objective of this work was to identify similarities and differences in primary attending physicians' (generalists' versus oncologists') care practices and outcomes for seriously ill hospitalized patients with malignancy. DESIGN: This was a prospective cohort study (SUPPORT project). SETTING: Subjects were recruited from 5 US teaching hospitals; data were gathered from 1989 to 1994. SUBJECTS: Included in the study was a matched samp…
Does Clinical Evidence Support ICD-9-CM Diagnosis Coding of Complications
BACKGROUND: Hospital discharge diagnoses, coded by use of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), increasingly determine reimbursement and support quality monitoring. Prior studies of coding validity have investigated whether coding guidelines were met, not whether the clinical condition was actually present. OBJECTIVE: To determine whether clinical evidence in medical records confirms selecte…
Use of Administrative Data to Find Substandard Care: Validation of the Complications Screening Program
OBJECTIVE: The use of administrative data to identify inpatient complications is technically feasible and inexpensive but unproven as a quality measure. Our objective was to validate whether a screening method that uses data from standard hospital discharge abstracts identifies complications of care and potential quality problems. DESIGN: This was a case-control study with structured implicit physician reviews. SETTING: Acute-care hospitals in Ca…
Screening Inpatient Quality Using Post-Discharge Events
BACKGROUND: Decreasing hospital lengths of stay (LOS) hamper efforts to detect and to definitively treat complications of care. Patients leave before some complications are identified. OBJECTIVES: To develop a computerized method to screen for hospital complications using readily available administrative data from outpatient and nonacute care within 90 days of discharge. DESIGN: We developed the Complications Screening Program for Outpatient data…
Predicting In-Hospital Mortality The Importance of Functional Status Information
Monitoring risk-adjusted outcomes is the centerpiece of efforts to ensure health care quality. Because data collection is expensive, questions arise concerning what information is essential to adjust for risk. This investigation used retrospective analysis of existing, computerized clinical databases containing laboratory test results, information on chronic coexisting conditions, and nursing evaluations of functional status to predict in-hospita…
Spaces of Adventure and Cultural Politics of Masculinity: R M Ballantyne and The Young Fur Traders
Masculinities reflect the characteristics of the spaces-real and imaginary, material and metaphorical-in which they are constructed. Mapmakers, ranging from academic geographers to popular storytellers, chart masculinist geographies: Spaces in which masculinities are mapped. One important genre of masculinist geographical narrative is adventure. I explore the masculinism of adventure through a detailed, contextual reading of one particular advent…
Chlamydial cervical infection in jailed women
OBJECTIVES. The prevalence of Chlamydia trachomatis cervical infection in incarcerated adult women has not been reported. To develop a policy for testing and treatment, we determined the prevalence of and risk factors for chlamydial infection in women in a New York City jail. METHODS. Interviews and cervical cultures for C trachomatis were obtained from 101 consenting female inmates. RESULTS. Positive cultures for C trachomatis were found in 27% …
Development of the Activities of Daily Vision Scale: A Measure of Visual Functional Status
To develop a method for the evaluation of visual function in subjects with cataracts, the authors identified 20 visual activities and categorized them into five subscales (distance vision, near vision, glare disability, night driving, and daytime driving) that comprised the Activities of Daily Vision Scale (ADVS). Each subscale in the ADVS was scored between 100 (no visual difficulty) and 0 (inability to perform the activity because of visual dif…
Spaces of Adventure and Cultural Politics of Masculinity: R M Ballantyne and The Young Fur Traders
Masculinities reflect the characteristics of the spaces-real and imaginary, material and metaphorical-in which they are constructed. Mapmakers, ranging from academic geographers to popular storytellers, chart masculinist geographies: Spaces in which masculinities are mapped. One important genre of masculinist geographical narrative is adventure. I explore the masculinism of adventure through a detailed, contextual reading of one particular advent…
Chlamydial cervical infection in jailed women
OBJECTIVES. The prevalence of Chlamydia trachomatis cervical infection in incarcerated adult women has not been reported. To develop a policy for testing and treatment, we determined the prevalence of and risk factors for chlamydial infection in women in a New York City jail. METHODS. Interviews and cervical cultures for C trachomatis were obtained from 101 consenting female inmates. RESULTS. Positive cultures for C trachomatis were found in 27% …
Health Care Expenditures Associated With Overweight and Obesity Among US Adults: Importance of Age and Race
Objectives. We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. Methods. Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. Results. Overall, the mean per capita annual health care expenditure (c…
"The ambiguity of "we: Perceptions of teaming in dynamic environments and their implications
Complementary and Alternative Medical Therapy Use Among Chinese and Vietnamese Americans: Prevalence, Associated Factors, and Effects of Patient–Clinician Communication
Objective. We examined the use of complementary and alternative medical (CAM) therapies among Chinese and Vietnamese Americans who had limited proficiency with the English language and explore the association between patient–clinician discussions about CAM therapy use and patient assessments of quality of care. Methods. We surveyed Chinese and Vietnamese Americans who visited 11 community health centers in 8 major cities throughout the United Sta…
Use of Complementary and Alternative Medicine Among Persons With Diabetes Mellitus: Results of a National Survey
Objectives. This study sought to characterize the use of complementary and alternative medicine (CAM) among persons with diabetes mellitus residing in the United States. Methods. Data from a 1997–1998 national survey (n = 2055) on CAM use were examined. Results. Ninety-five respondents reported having diabetes, of whom 57% reported CAM use in the past year; fewer respondents (35%) reported use specifically for diabetes. Therapies used for diabete…
Interventions to Prevent Readmission: The Constraints of Cost and Efficacy
Decision analysis was used to examine the interrelationship of cost and success for an intervention program designed to prevent unexpected readmissions to an acute care hospital. Three separate strategies were considered: 1) intervention for patients who are at high risk for unexpected readmission; 2) intervention for all patients who are admitted to the medical service; and 3) no intervention. Risk and cost data were derived from an analysis of …
Development of the Activities of Daily Vision Scale: A Measure of Visual Functional Status
To develop a method for the evaluation of visual function in subjects with cataracts, the authors identified 20 visual activities and categorized them into five subscales (distance vision, near vision, glare disability, night driving, and daytime driving) that comprised the Activities of Daily Vision Scale (ADVS). Each subscale in the ADVS was scored between 100 (no visual difficulty) and 0 (inability to perform the activity because of visual dif…
Chlamydial cervical infection in jailed women
OBJECTIVES. The prevalence of Chlamydia trachomatis cervical infection in incarcerated adult women has not been reported. To develop a policy for testing and treatment, we determined the prevalence of and risk factors for chlamydial infection in women in a New York City jail. METHODS. Interviews and cervical cultures for C trachomatis were obtained from 101 consenting female inmates. RESULTS. Positive cultures for C trachomatis were found in 27% …
Predicting In-Hospital Mortality The Importance of Functional Status Information
Monitoring risk-adjusted outcomes is the centerpiece of efforts to ensure health care quality. Because data collection is expensive, questions arise concerning what information is essential to adjust for risk. This investigation used retrospective analysis of existing, computerized clinical databases containing laboratory test results, information on chronic coexisting conditions, and nursing evaluations of functional status to predict in-hospita…
Spaces of Adventure and Cultural Politics of Masculinity: R M Ballantyne and The Young Fur Traders
Masculinities reflect the characteristics of the spaces-real and imaginary, material and metaphorical-in which they are constructed. Mapmakers, ranging from academic geographers to popular storytellers, chart masculinist geographies: Spaces in which masculinities are mapped. One important genre of masculinist geographical narrative is adventure. I explore the masculinism of adventure through a detailed, contextual reading of one particular advent…
Screening Inpatient Quality Using Post-Discharge Events
BACKGROUND: Decreasing hospital lengths of stay (LOS) hamper efforts to detect and to definitively treat complications of care. Patients leave before some complications are identified. OBJECTIVES: To develop a computerized method to screen for hospital complications using readily available administrative data from outpatient and nonacute care within 90 days of discharge. DESIGN: We developed the Complications Screening Program for Outpatient data…
Generalists and Oncologists Show Similar Care Practices and Outcomes for Hospitalized Late-Stage Cancer Patients
OBJECTIVE: The objective of this work was to identify similarities and differences in primary attending physicians' (generalists' versus oncologists') care practices and outcomes for seriously ill hospitalized patients with malignancy. DESIGN: This was a prospective cohort study (SUPPORT project). SETTING: Subjects were recruited from 5 US teaching hospitals; data were gathered from 1989 to 1994. SUBJECTS: Included in the study was a matched samp…
Does Clinical Evidence Support ICD-9-CM Diagnosis Coding of Complications
BACKGROUND: Hospital discharge diagnoses, coded by use of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), increasingly determine reimbursement and support quality monitoring. Prior studies of coding validity have investigated whether coding guidelines were met, not whether the clinical condition was actually present. OBJECTIVE: To determine whether clinical evidence in medical records confirms selecte…
Use of Administrative Data to Find Substandard Care: Validation of the Complications Screening Program
OBJECTIVE: The use of administrative data to identify inpatient complications is technically feasible and inexpensive but unproven as a quality measure. Our objective was to validate whether a screening method that uses data from standard hospital discharge abstracts identifies complications of care and potential quality problems. DESIGN: This was a case-control study with structured implicit physician reviews. SETTING: Acute-care hospitals in Ca…
Use of Complementary and Alternative Medicine Among Persons With Diabetes Mellitus: Results of a National Survey
Objectives. This study sought to characterize the use of complementary and alternative medicine (CAM) among persons with diabetes mellitus residing in the United States. Methods. Data from a 1997–1998 national survey (n = 2055) on CAM use were examined. Results. Ninety-five respondents reported having diabetes, of whom 57% reported CAM use in the past year; fewer respondents (35%) reported use specifically for diabetes. Therapies used for diabete…
Linguistic and cultural barriers to care: Perspectives of chinese and vietnamese immigrants
Racial and ethnic disparities in cancer screening the importance of foreign birth as a barrier to care
Surveying Minorities with Limited-English Proficiency: Does Data Collection Method Affect Data Quality Among Asian Americans
BACKGROUND: Little is known about how modes of survey administration affect response rates and data quality among populations with limited-English proficiency (LEP). Asian Americans are a rapidly growing minority group with large numbers of LEP immigrants. OBJECTIVE: We sought to compare the response rates and data quality of interviewer-administered telephone and self-administered mail surveys among LEP Asian Americans. DESIGN: This was a random…
Health Care Expenditures Associated With Overweight and Obesity Among US Adults: Importance of Age and Race
Objectives. We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. Methods. Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. Results. Overall, the mean per capita annual health care expenditure (c…
Complementary and Alternative Medical Therapy Use Among Chinese and Vietnamese Americans: Prevalence, Associated Factors, and Effects of Patient–Clinician Communication
Objective. We examined the use of complementary and alternative medical (CAM) therapies among Chinese and Vietnamese Americans who had limited proficiency with the English language and explore the association between patient–clinician discussions about CAM therapy use and patient assessments of quality of care. Methods. We surveyed Chinese and Vietnamese Americans who visited 11 community health centers in 8 major cities throughout the United Sta…
Do Medical Inpatients Who Report Poor Service Quality Experience More Adverse Events and Medical Errors
PURPOSE: Service quality deficiencies are common in health care. However, little is known about the relationship between service quality and the occurrence of adverse events and medical errors. We hypothesized that patients who reported poor service quality were at increased risk of experiencing adverse events and medical errors. SUBJECTS AND METHODS: Patients were interviewed during and after their admissions regarding problems experienced durin…
Patient-Physician Language Concordance and Lifestyle Counseling Among Spanish-Speaking Patients
Patient-physician Language Concordance and Primary Care Screening Among Spanish-speaking Patients
BACKGROUND: Language discordance between patient and physician is associated with worse patient self-reported healthcare quality. As Hispanic patients have low rates of cardiovascular and cancer screening, we sought to determine whether patient-physician language concordance was associated with differences in rates of screening. METHODS: We performed a retrospective medical record review of 101 Spanish-speaking patients cared for by 6 Spanish-spe…
Implications of Workforce and Financing Changes for Primary Care Practice Utilization, Revenue, and Cost: A Generalizable Mathematical Model for Practice Management
BACKGROUND: Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. OBJECTIVE: To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. RESEARCH DESIGN: We created a simulation model estimating clinic-level utilization, revenues, and exp…
A Theoretical Logic Model of Integration in Health Care
Introduction: Recent literature has described key dimensions of integration within health care organizations but has not explored relationships among them. Clarifying these relationships can improve efforts to compare and contrast studies of “integration” in health care.Methods: To construct a novel theory of integration, we reviewed existing publications from health care and management literature. We synthesized and adapted elements from dispara…
Benchmarks for Reducing Emergency Department Visits and Hospitalizations Through Community Health Workers Integrated Into Primary Care: A Cost-Benefit Analysis
BACKGROUND: Uncertainty about the financial costs and benefits of community health worker (CHW) programs remains a barrier to their adoption. OBJECTIVES: To determine how much CHWs would need to reduce emergency department (ED) visits and associated hospitalizations among their assigned patients to be cost-neutral from a payer's perspective. RESEARCH DESIGN: Using a microsimulation of patient health care utilization, costs, and revenues, we estim…
Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015
Importance: Recent US health care reforms incentivize improved population health outcomes and primary care functions. It remains unclear how much improving primary care physician supply can improve population health, independent of other health care and socioeconomic factors. Objectives: To identify primary care physician supply changes across US counties from 2005-2015 and associations between such changes and population mortality. Design, Setti…
Dental Practice Integration into Primary Care: A Microsimulation of Financial Implications for Practices
Given the widespread lack of access to dental care for many vulnerable Americans, there is a growing realization that integrating dental and primary care may provide comprehensive care. We sought to model the financial impact of integrating dental care provision into a primary care practice. A microsimulation model was used to estimate changes in net revenue per practice by simulating patient visits to a primary dental practice within primary car…
Using Rapid-Cycle Change to Improve Covid-19 Vaccination Strategy in Primary Care
During the COVID-19 pandemic, misinformation and distrust exacerbated disparities in vaccination rates by race and ethnicity throughout the United States. Primary care, public health systems, and community health centers have shifted their vaccination outreach strategies toward these disparate, unvaccinated populations. To support primary care, we developed the SAVE Sprint model for implementing rapid-cycle change to improve vaccination rates by …
"The ambiguity of "we: Perceptions of teaming in dynamic environments and their implications
Medicine (22 works) · Health care (15 works) · Family medicine (13 works) · MEDLINE (9 works) · Emergency Medicine (8 works) · Emergency Medicine (8 works) · Internal Medicine (8 works) · Healthcare Policy and Management (7 works) · Internal Medicine (7 works) · Nursing (7 works)