A James O''Malley
Biographic Data
| ID | 1726642 |
|---|---|
| NAME | A James O''Malley |
| GIVEN NAMES | A James |
| FAMILY NAME | O''Malley |
| SIGNATURE | MALLEY A J O |
| AFFILIATIONS | Dartmouth College |
| ORCID | 0000-0001-8389-6217 |
| VERIFIED | Yes |
| TOTAL WORKS | 38 |
| TOTAL CITATIONS | 22 |
| WORKS AS AUTHOR | 38 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2006 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Rural–urban disparities in primary care and geographic continuity of care for children with medical complexity
PURPOSE: Rural-residing children with medical complexity (CMC) may receive fragmented care given clinician shortages in rural communities. This study characterized differences in continuity of care between rural- and urban-residing CMC, applying novel measures of geographic care continuity and assessing associations between continuity, neighborhood social disadvantage, and unplanned hospital utilization. METHODS: This retrospective cohort study a…
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…
Network threats to causal inference
Researchers and practitioners rely on randomized controlled trials (RCTs) to make causal inferences. However, most people who participate in RCTs are part of multiple, overlapping social networks that shape their behaviors and attitudes. As a result, variations in trial participants’ and non-participants’ network positions may impede the generalizability of a RCT’s conclusions. The current project evaluates the extent and impact of these variatio…
Travel burden and bypassing closest site for surgical cancer treatment for urban and rural oncology patients
PURPOSE: We examined the relationship between travel burden for surgical cancer care and rurality, geographic bypass of the nearest surgical facility, cancer type, and mortality outcomes. METHODS: Using Medicare claims and enrollment data (2016-2018) from beneficiaries with cancer of the colon, rectum, lung, or pancreas, we measured travel times to: the nearest surgical facility and facility used. For those who bypassed the nearest, we examined t…
Changes in US Primary Care Access and Capabilities During the Covid-19 Pandemic
In this cohort study, over the time period including the COVID-19 pandemic, primary care practices reported a decline in access to care, while average practice capabilities improved. Integrated practice ownership and ACO participation were both associated with better access and capability scores, suggesting that value-based payment and integrated care delivery support the development of higher-quality primary care. Variations across practices poi…
Oncology Physician Turnover in the United States Based on Medicare Claims Data
OBJECTIVE: Physician turnover rates are rising in the United States. The cancer workforce, which relies heavily on clinical teamwork and care coordination, may be more greatly impacted by turnover. In this study, we aimed to characterize oncologists who move to identify targets for recruitment and retention efforts. METHODS: We identified medical, radiation, and surgical oncologists who treated Medicare beneficiaries diagnosed with breast, colore…
Organizational characteristics associated with sustained participation in internal quality improvement
Clinician-Spoken Plain Language in Health Care Encounters
Rural–urban disparities in health care delivery for children with medical complexity and moderating effects of payer, disability, and community poverty
PURPOSE: Children with medical complexity (CMC) may be at increased risk of rural-urban disparities in health care delivery given their multifaceted health care needs, but these disparities are poorly understood. This study evaluated rural-urban disparities in health care delivery to CMC and determined whether Medicaid coverage, co-occurring disability, and community poverty modified the effects of rurality on care delivery. METHODS: This retrosp…
The role of comorbidities, medications, and social determinants of health in understanding urban‐rural outcome differences among patients with heart failure
PURPOSE: There is now a 20% disparity in all-cause, excess deaths between urban and rural areas, much of which is driven by disparities in cardiovascular death. We sought to explain the sources of these disparities for Medicare beneficiaries with heart failure with reduced ejection fraction (HFrEF). METHODS: Using a sample of Medicare Parts A, B, and D, we created a cohort of 389,528 fee-for-service beneficiaries with at least 1 heart failure hos…
Safety Net Primary Care Capabilities After the Covid-19 Pandemic
The results of this survey study suggest that FQHCs outperformed non-FQHC practices on important care processes while serving a patient population with lower incomes who are medically underserved compared with patients in other practice types. Legislation to expand funding for the FQHC program should improve services for underserved populations and target current non-FQHC safety net practices to serve these populations. Increased support for thes…
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
Network spillover effects associated with the ChooseWell 365 workplace randomized controlled trial to promote healthy food choices
The impact of adding cost information to a conversation aid to support shared decision making about low‐risk prostate cancer treatment
BACKGROUND: Decision aids help patients consider the benefits and drawbacks of care options but rarely include cost information. We assessed the impact of a conversation-based decision aid containing information about low-risk prostate cancer management options and their relative costs. METHODS: We conducted a stepped-wedge cluster randomised trial in outpatient urology practices within a US-based academic medical center. We randomised five clini…
The Confident study protocol
NCT05168800 at ClinicalTrials.gov, registered December 23, 2021
The diffusion of health care fraud
Many studies have examined the diffusion of health care innovation but less is known about the diffusion of health care fraud. In this paper, we consider the diffusion of potentially fraudulent Medicare home health care billing in the United States during 2002-16, with a focus on the 21 hospital referral regions (HRRs) covered by local Department of Justice (DOJ) anti-fraud "strike force" offices. We hypothesize that patient-sharing across home h…
Validation of the Emotional Tone Index for Families (Etif)
Despite the importance of emotional closeness (EC) in families, few researchers have accurately measured the construct in a systemic way. Additionally, existing measures rely on ratings from one informant, typically the mother, to provide information on closeness within the entire family system. We examined EC in 140 individuals (37 families) using the Emotional Tone Index for Families (ETIF), a novel, multi‐informant measure that obtains bidirec…
Social connections and the healthfulness of food choices in an employee population
Influence of Peer Physicians on Intensity of End-of-Life Care for Cancer Decedents
BACKGROUND: The intensity of end-of-life care varies substantially both within and between areas. Differing practice patterns of individual physicians are likely influenced by their peers. OBJECTIVE: To assess whether intensity of end-of-life care previously provided by a physician's peers influences patterns of care at the end-of-life for that physician's patients. RESEARCH DESIGN: Observational study. SUBJECTS: A total of 185,947 fee-for-servic…
The social network context of HIV stigma
Using Collabo Rate , a brief patient‐reported measure of shared decision making
INTRODUCTION: CollaboRATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate CollaboRATE scores and response rates across multiple clinical settings with varied patient populations. METHOD: All adult patients at three United States primary care practices were eligible to complete CollaboRATE post-visit. To i…
What matters most
NCT03136367 at ClinicalTrials.gov Protocol version: Manuscript based on study protocol version 2.2, 7 November 2017
Assessing Variation in Implantable Cardioverter Defibrillator Therapy Guideline Adherence With Physician and Hospital Patient-sharing Networks
BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy is used for primary prevention of death among people with heart failure, and new evidence in 2005 on its effectiveness changed practice guidelines in the United States. OBJECTIVES: The objective of this study is to examine how the connectedness of physicians and hospitals, measured using network analysis, relates to guideline-consistent ICD implantation. RESEARCH DESIGN: We construc…
Polio vaccine hesitancy in the networks and neighborhoods of Malegaon, India
Social network targeting to maximise population behaviour change
Polio vaccine hesitancy in the networks and neighborhoods of Malegaon, India
The social network context of HIV stigma
Results from using a new dyadic-dependence model to analyze sociocentric physician networks
Social connections and the healthfulness of food choices in an employee population
Network spillover effects associated with the ChooseWell 365 workplace randomized controlled trial to promote healthy food choices
Derivation and Confirmation of Scales Measuring Medical Directors’ Attitudes About the Hospitalization of Nursing Home Residents
Objectives: To derive and confirm scales measuring medical director’s attitudes about hospitalization of nursing home residents. Method: The authors surveyed nursing facility medical directors about the necessity of hospitalizing residents for eight clinical conditions and compared the ratings to those obtained from an expert panel to derive a relative hospitalization score. They also asked about factors that might influence hospitalization decis…
Inside the Health Disparities Collaboratives
BACKGROUND: Quality improvement collaboratives (QICs) based on the Chronic Care Model (CCM) are widely used models for improving medical care, but there has been little information to date about the specific projects undertaken by participants in these collaboratives and their outcomes. OBJECTIVES: To describe initiatives undertaken by community health centers (CHCs) participating in QICs (the Health Disparities Collaboratives) for asthma, cardio…
Strategies to Improve Chronic Disease Management in Seven Metro Boston Community Health Centers
Strategies to Improve Chronic Disease Management in Seven Metro Boston Community Health Centers Chima D. Ndumele, MPH , Beverley E. Russell, PhD, MPH , John Z. Ayanian, MD, MPP , Bruce E. Landon, MD, MBA , Thomas Keegan, PhD , A. James O’Malley, PhD , and LeRoi S. Hicks, MD, MPH What Is the Purpose of This Study? • This study was intended to gain insight from health care professionals at local community health centers regarding barriers to optima…
Strategies to Improve Chronic Disease Management in Seven Metro Boston Community Health Centers
Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients
Geographic Area Variations in the Medicare Health Plan Era
BACKGROUND: Prior research identified variations in care experiences across Medicare health plans (Medicare Advantage [MA]), but the relative amount of variation in MA and traditional fee-for-service (FFS) Medicare is unknown. OBJECTIVES: Compare variation and correlations of beneficiary reports of care experiences across geographic areas in MA and FFS. METHODS: Using the 2001 to 2004 Medicare CAHPS surveys, we analyzed 14 measures of care experi…
Improving Observational Study Estimates of Treatment Effects Using Joint Modeling of Selection Effects and Outcomes
BACKGROUND: When 2 treatment approaches are available, there are likely to be unmeasured confounders that influence choice of procedure, which complicates estimation of the causal effect of treatment on outcomes using observational data. OBJECTIVE: To estimate the effect of endovascular (endo) versus open surgical (open) repair, including possible modification by institutional volume, on survival after treatment for abdominal aortic aneurysm, acc…
Physician Patient-sharing Networks and the Cost and Intensity of Care in US Hospitals
BACKGROUND: There is substantial variation in the cost and intensity of care delivered by US hospitals. We assessed how the structure of patient-sharing networks of physicians affiliated with hospitals might contribute to this variation. METHODS: We constructed hospital-based professional networks based on patient-sharing ties among 61,461 physicians affiliated with 528 hospitals in 51 hospital referral regions in the US using Medicare data on cl…
Using Administrative Data to Identify Naturally Occurring Networks of Physicians
BACKGROUND: Physicians naturally form networks. Networks could form a rational basis for Accountable Care Organizations (ACOs) for defined populations of Medicare beneficiaries. OBJECTIVES: To use methods from network science to identify naturally occurring networks of physicians that might be best suited to becoming ACOs. RESEARCH DESIGN, SUBJECTS, AND MEASURES: Using nationally representative claims data from the Medicare program for CY 2006 on…
Medicare Part D Plan Generosity and Medication Use Among Dual-eligible Nursing Home Residents
BACKGROUND: In 2006, dual-eligible nursing home residents were randomly assigned to a Medicare Part D prescription drug plan (PDP). Subsequently, residents not enrolled in qualified plans at the start of the next year were rerandomized. PDPs vary in generosity through differences in medication coverage and utilization management. Therefore, residents' assigned plans may be relatively more or less generous for their particular drugs. The impact of…
High-Risk Medication Use by Nursing Home Residents Before and After Hospitalization
BACKGROUND: Two prominent challenges in nursing home care are ensuring appropriate medication use and achieving high-quality care as residents transition from the hospital to the nursing home. Research about prescribing practices at this important clinical juncture is limited. OBJECTIVE: To analyze the use of high-risk medications by nursing home residents before and after being hospitalized. We define high-risk medications using the Beers criter…
Results from using a new dyadic-dependence model to analyze sociocentric physician networks
Social network targeting to maximise population behaviour change
Do Patients at Sites With High RCT Enrollment Propensity Have Better Outcomes
BACKGROUND: Concerns about randomized controlled trial (RCT) generalizability typically center on characteristics of RCT patient participants. Possibly there are RCT site characteristics that distinguish RCT outcomes from those that can be expected in non-RCT settings. OBJECTIVES: To examine whether site propensity toward RCT enrollment is associated with recovery outcomes for patients and whether the association differs between patients who part…
Reprint of
Polio vaccine hesitancy in the networks and neighborhoods of Malegaon, India
Using Collabo Rate , a brief patient‐reported measure of shared decision making
INTRODUCTION: CollaboRATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate CollaboRATE scores and response rates across multiple clinical settings with varied patient populations. METHOD: All adult patients at three United States primary care practices were eligible to complete CollaboRATE post-visit. To i…
What matters most
NCT03136367 at ClinicalTrials.gov Protocol version: Manuscript based on study protocol version 2.2, 7 November 2017
Assessing Variation in Implantable Cardioverter Defibrillator Therapy Guideline Adherence With Physician and Hospital Patient-sharing Networks
BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy is used for primary prevention of death among people with heart failure, and new evidence in 2005 on its effectiveness changed practice guidelines in the United States. OBJECTIVES: The objective of this study is to examine how the connectedness of physicians and hospitals, measured using network analysis, relates to guideline-consistent ICD implantation. RESEARCH DESIGN: We construc…
Influence of Peer Physicians on Intensity of End-of-Life Care for Cancer Decedents
BACKGROUND: The intensity of end-of-life care varies substantially both within and between areas. Differing practice patterns of individual physicians are likely influenced by their peers. OBJECTIVE: To assess whether intensity of end-of-life care previously provided by a physician's peers influences patterns of care at the end-of-life for that physician's patients. RESEARCH DESIGN: Observational study. SUBJECTS: A total of 185,947 fee-for-servic…
The social network context of HIV stigma
Validation of the Emotional Tone Index for Families (Etif)
Despite the importance of emotional closeness (EC) in families, few researchers have accurately measured the construct in a systemic way. Additionally, existing measures rely on ratings from one informant, typically the mother, to provide information on closeness within the entire family system. We examined EC in 140 individuals (37 families) using the Emotional Tone Index for Families (ETIF), a novel, multi‐informant measure that obtains bidirec…
Social connections and the healthfulness of food choices in an employee population
The impact of adding cost information to a conversation aid to support shared decision making about low‐risk prostate cancer treatment
BACKGROUND: Decision aids help patients consider the benefits and drawbacks of care options but rarely include cost information. We assessed the impact of a conversation-based decision aid containing information about low-risk prostate cancer management options and their relative costs. METHODS: We conducted a stepped-wedge cluster randomised trial in outpatient urology practices within a US-based academic medical center. We randomised five clini…
The Confident study protocol
NCT05168800 at ClinicalTrials.gov, registered December 23, 2021
The diffusion of health care fraud
Many studies have examined the diffusion of health care innovation but less is known about the diffusion of health care fraud. In this paper, we consider the diffusion of potentially fraudulent Medicare home health care billing in the United States during 2002-16, with a focus on the 21 hospital referral regions (HRRs) covered by local Department of Justice (DOJ) anti-fraud "strike force" offices. We hypothesize that patient-sharing across home h…
Medicine (31 works) · Family medicine (18 works) · Nursing (16 works) · Environmental health (12 works) · Internal Medicine (12 works) · Primary Care and Health Outcomes (11 works) · Psychology (11 works) · Health care (9 works) · Healthcare Systems and Technology (9 works) · Healthcare Policy and Management (8 works)