Susan L Ettner
Dados Biográficos
| ID | 298062 |
|---|---|
| NOME | Susan L Ettner |
| PRENOMES | Susan L |
| SOBRENOME | Ettner |
| ASSINATURA | ETTNER S L |
| AFILIAÇÕES | University of California, Los Angeles |
| ORCID | 0000-0001-9445-8917 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 48 |
| TOTAL DE CITAÇÕES | 200 |
| TOTAL COMO AUTOR | 48 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1994 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2022 |
| ÍNDICE H | 7 |
Comparing Gold-standard Copayment and Coinsurance Values From Claims Processing Engines to Values Derived From Behavioral Health Claims Databases
BACKGROUND: While researchers use patient expenditures in claims data to estimate insurance benefit features, little evidence exists to indicate whether the resulting measures are accurate. OBJECTIVE: To develop and test an algorithm for deriving copayment and coinsurance values from behavioral health claims data. SUBJECTS: Employer-sponsored insurance plans from 2011 to 2013 for a national managed behavioral health organization (MBHO). MEASURES:…
The relationship between educational attainment and hospitalizations among middle-aged and older adults in the United States
Educational attainment is a strong predictor of hospitalizations for middle-aged and older US adults. Health mediates most of the education-hospitalization gradients. The heterogeneous results across age, gender, race, and ethnicity groups should inform further research on health disparities
Evaluation of a National Care Coordination Program to Reduce Utilization Among High-cost, High-need Medicaid Beneficiaries With Diabetes
BACKGROUND: Medical, behavioral, and social determinants of health are each associated with high levels of emergency department (ED) visits and hospitalizations. OBJECTIVE: The objective of this study was to evaluate a care coordination program designed to provide combined "whole-person care," integrating medical, behavioral, and social support for high-cost, high-need Medicaid beneficiaries by targeting access barriers and social determinants. R…
Trends in Costs of Care and Utilization for Medicaid Patients With Diabetes in Accountable Care Communities
BACKGROUND/OBJECTIVES: Medicaid beneficiaries with diabetes have complex care needs. The Accountable Care Communities (ACC) Program is a practice-level intervention implemented by UnitedHealthcare to improve care for Medicaid beneficiaries. We examined changes in costs and utilization for Medicaid beneficiaries with diabetes assigned to ACC versus usual care practices. RESEARCH DESIGN: Interrupted time series with concurrent control group analysi…
Life Chaos is Associated with Reduced HIV Testing, Engagement in Care, and ART Adherence Among Cisgender Men and Transgender Women upon Entry into Jail
Effectiveness of a Peer Navigation Intervention to Sustain Viral Suppression Among HIV-Positive Men and Transgender Women Released From Jail
Importance: Diagnosis of human immunodeficiency virus (HIV) infection, linkage and retention in care, and adherence to antiretroviral therapy are steps in the care continuum enabling consistent viral suppression for people living with HIV, extending longevity and preventing further transmission. While incarcerated, people living with HIV receive antiretroviral therapy and achieve viral suppression more consistently than after they are released. N…
Month Cost Outcomes of Community Engagement Versus Technical Assistance for Depression Quality Improvement
Compared with RS, CEP had higher planning and training costs with similar service-use costs
Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults
Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving
The Mental Health Parity and Addiction Equity Act Evaluation Study
OBJECTIVE: The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA's impact on BH expenditures and utilization among "carve-in" enrollees. METHODS: We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled i…
The Associations of Area-Level Violent Crime Rates and Self-Reported Violent Crime Exposure with Adolescent Behavioral Health
The impact of welfare reform on the health insurance coverage, utilization and health of low education single mothers
Depressive symptomatology and fall risk among community-dwelling older adults
Individual- and Neighborhood-Level Determinants of Fear of Violent Crime Among Adolescents
Fear of violent crime is common among adolescents in urban settings; however, little is known about individual- and neighborhood-level determinants of fear. A generalized ordered logit model was used to analyze individual- and neighborhood-level variables among 2474 adolescents. Seeing violence significantly reduced the probability of feeling unafraid, as did higher levels of social disorder. The more block faces where police were visible, the hi…
Claims-based Identification Methods and the Cost of Fall-related Injuries Among US Older Adults
OBJECTIVES: Compare expenditures of fall-related injuries (FRIs) using several methods to identify FRIs in administrative claims data. RESEARCH DESIGN: Using 2007-2009 Medicare claims and 2008 Health and Retirement Survey data, FRIs were identified using external-cause-of-injury (e-codes 880/881/882/884/885/888) only, e-codes plus a broad set of primary diagnosis codes, and a newer approach using e-codes and diagnostic and procedural codes. Linea…
Predictors of Out-of-ACO Care in the Medicare Shared Savings Program
IMPORTANCE: Patients treated outside of their Medicare Shared Savings Program (MSSP) accountable care organization (ACO) likely benefit less from the ACO's integration of care. Consequently, the MSSP's open-network design may preclude ACOs from improving value in care. OBJECTIVES: Quantify out-of-ACO care in a single urban ACO and examine associations between patient-level predictors and out-of-ACO expenditures. RESEARCH DESIGN: Secondary data an…
Personality disorders and body weight
We examine the impact of Axis II personality disorders (PDs) on body weight. PDs are psychiatric conditions that develop early in life from a mixture of genetics and environment, are persistent, and lead to substantial dysfunction for the affected individual. The defining characteristics of PDs conceptually link them with body weight, but the direction of the relationship likely varies across PD type. To investigate these links, we analyze data f…
Cost-related Nonadherence by Medication Type Among Medicare Part D Beneficiaries With Diabetes
BACKGROUND: Despite the rollout of Medicare Part D, cost-related nonadherence (CRN) among older adults remains a problem. OBJECTIVES: To examine the rate and correlates of self-reported CRN among a population of older persons with diabetes. RESEARCH DESIGN: Cross-sectional. SUBJECTS: A total of 1264 Part D patients with diabetes, who entered the coverage gap in 2006. MEASURES: Initial administrative medication lists were verified in computer-assi…
Fish et al. Respond
We appreciate Levine's response to our article.1 We agree that the reasons individuals are obese are complex and most likely have several different etiologies; for years, research has focused on both individual and neighborhood characteristics. While we understand the concern that reducing our understanding of the epidemic to well-characterized mechanisms may imply simplicity, we respectfully disagree that because of the complexity of the topic, …
Association of Claims-based Quality of Care Measures With Outcomes Among Community-dwelling Vulnerable Elders
BACKGROUND: Few studies examine the link between measured process of care and outcome. OBJECTIVE: To evaluate the relationship of claims-based assessment of process of care to subsequent function and survival. RESEARCH DESIGN: Retrospective cohort study using claims from 1999 to assess performance on 41 quality indicators (QIs) from the Assessing Care of Vulnerable Elders (ACOVE) measurement set on functional decline and death in 2000. SETTING: C…
A Preliminary Analysis of the Receipt of Mental Health Services Consistent With National Standards Among Children in the Child Welfare System
Objectives. We sought to examine the extent to which children in the child welfare system receive mental health care consistent with national standards. Methods. We used data from 4 waves (3 years of follow-up) of the National Survey of Child and Adolescent Well-Being, the nation's first longitudinal study of children in the child welfare system, and the Area Resource File to examine rates of screening, assessment, and referral to mental health s…
Association of Perceived Neighborhood Safety on Body Mass Index
Objectives. We sought to determine whether there is an association between perceived neighborhood safety and body mass index (BMI), accounting for endogeneity. Methods. A random sample of 2255 adults from the Los Angeles Family and Neighborhood Survey 2000–2001 was analyzed using instrumental variables. The main outcome was BMI using self-reported height and weight, and the main independent variable was residents’ report of their neighborhood saf…
Heavy drinking and health promotion activities
Costs of care for people living with combined HIV/Aids, chronic mental illness, and substance abuse disorders
To determine healthcare access and costs for triply diagnosed adults, we examined baseline data from the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study, a multi-site cohort study of HIV+ adults with co-occurring mental and substance abuse disorders conducted between 2000 and 2004. Baseline interviews were conducted with 1138 triply diagnosed adults in eight predominantly urban sites nationwide. A modified version of Structured Inter…
Triply-diagnosed patients in the HIV/Aids Treatment Adherence, Health Outcomes and Cost Study
Although AIDS is a chronic illness, little is known about the patterns and correlates of long-term care use among triply diagnosed HIV patients. We examined nursing and home care use among 1,045 participants in the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study, a multi-site study of HIV-positive patients with at least one mental health and one substance disorder. Patient interviews and medical record review data were used to examin…
The Well-Being of Parental Caregivers of Children with Activity Limitations
Socioeconomic Status and Health
This study examines the interconnections among education-as a proxy for socioeconomic status-stress, and physical and mental health by specifying differential exposure and vulnerability models using data from The National Study of Daily Experiences (N = 1,031). These daily diary data allowed assessment of the social distribution of a qualitatively different type of stressor than has previously been examined in sociological stress research-daily s…
The Impact of Psychiatric Disorders on Labor Market Outcomes
Analyzing data on 2,225 men and 2,401 women from the National Comorbidity Survey, the authors examine the impact of psychiatric disorders on employment and, among those employed, work hours and income. They find that psychiatric disorders significantly reduced employment among both men and women. They also find evidence of small reductions in the conditional work hours of men and a substantial drop in the conditional income of men and women, alth…
The timing of preventive services for women and children
OBJECTIVES: This study investigated the causal effect of having a usual source of medical care on the timing of preventive services by women and children. METHODS: Data on 17,110 children and 23,488 women from the 1988 and 1990 National Health Interview Surveys were used to estimate ordered probit models of the effect of having a usual source of medical care on the time since the last receipt of each preventive service (routine checkups for child…
The Impact of “Parent Care” on Female Labor Supply Decisions
Data from the 1986–1988 Survey of Income and Program Participation panels were used to analyze how informal-caregiving of disabled elderly parents affected female labor supply. Instrumental variables analyses suggested that coresidence with a disabled parent leads to a large, significant reduction in work hours, due primarily to withdrawal from the labor force. Although the impact of nonhousehold member caregiving was insignificant, evidence of a…
Measuring the human cost of a weak economy
A Preliminary Analysis of the Receipt of Mental Health Services Consistent With National Standards Among Children in the Child Welfare System
Objectives. We sought to examine the extent to which children in the child welfare system receive mental health care consistent with national standards. Methods. We used data from 4 waves (3 years of follow-up) of the National Survey of Child and Adolescent Well-Being, the nation's first longitudinal study of children in the child welfare system, and the Area Resource File to examine rates of screening, assessment, and referral to mental health s…
Association of Perceived Neighborhood Safety on Body Mass Index
Objectives. We sought to determine whether there is an association between perceived neighborhood safety and body mass index (BMI), accounting for endogeneity. Methods. A random sample of 2255 adults from the Los Angeles Family and Neighborhood Survey 2000–2001 was analyzed using instrumental variables. The main outcome was BMI using self-reported height and weight, and the main independent variable was residents’ report of their neighborhood saf…
The Associations of Area-Level Violent Crime Rates and Self-Reported Violent Crime Exposure with Adolescent Behavioral Health
The impact of welfare reform on the health insurance coverage, utilization and health of low education single mothers
Socioeconomic Status and Health Among Californians
Health inequalities manifest as a gradient, rather than as a distinction between “haves” and “have nots.” Therefore, eliminating health inequalities will require targeting interventions at segments of the entire population, not just particular subgroups at the disadvantaged end of the social hierarchy. Developing such interventions, however, has been stymied by an unclear understanding of how socioeconomic status (SES) influences health. The lite…
Depressive symptomatology and fall risk among community-dwelling older adults
State variations in supplemental security income enrollment for children and adolescents
OBJECTIVES: The purpose of this study was to determine the effects of poverty, program generosity, and health on state variations in enrollment of children and adolescents in the Supplemental Security Income (SSI) program during recent program expansions. METHODS: The relationship of state SSI rates for 1989 and 1992 to child poverty, health, and program generosity were determined by multiple regression. RESULTS: The mean percentage of children e…
Utilization of Formal and Informal Home Care by Aids Patients in Boston
The assumption that intravenous (i.v.) drug users have weaker informal support networks than homosexual men has led to opposing policy recommendations: one emphasizes outreach and more formal (paid) home care for i.v. drug users, whereas the other maintains that formal home care programs are less effective for this risk group due to the lack of informal (unpaid) caregivers to coordinate efforts. Data from interviews with a sample of 231 persons w…
The Impact of “Parent Care” on Female Labor Supply Decisions
Data from the 1986–1988 Survey of Income and Program Participation panels were used to analyze how informal-caregiving of disabled elderly parents affected female labor supply. Instrumental variables analyses suggested that coresidence with a disabled parent leads to a large, significant reduction in work hours, due primarily to withdrawal from the labor force. Although the impact of nonhousehold member caregiving was insignificant, evidence of a…
New evidence on the relationship between income and health
The Opportunity Costs of Elder Care
This study uses data from the 1987 National Survey of Families and Households to estimate the impact of caring for disabled elderly parents on the work hours of men and women. Instrumental variable techniques were used to correct for possible endogeneity bias. Work hours were consistently reduced by caregiving, although the effect was significant only for women providing care to parents residing outside the household. The magnitude of the caregiv…
The timing of preventive services for women and children
OBJECTIVES: This study investigated the causal effect of having a usual source of medical care on the timing of preventive services by women and children. METHODS: Data on 17,110 children and 23,488 women from the 1988 and 1990 National Health Interview Surveys were used to estimate ordered probit models of the effect of having a usual source of medical care on the time since the last receipt of each preventive service (routine checkups for child…
Medicaid participation among the eligible elderly
This study uses data from the Survey of Income and Program Participation to address three issues: (1) what were the 1987 rates of Medicaid participation and private insurance coverage among elderly predicted to be categorically eligible and medically needy?; (2) how did these rates change between 1987 and 1992?; and (3) which factors influence insurance choices among persons who are categorically eligible for Medicaid? The 1987 Medicaid participa…
Measuring the human cost of a weak economy
The Impact of Psychiatric Disorders on Labor Market Outcomes
Analyzing data on 2,225 men and 2,401 women from the National Comorbidity Survey, the authors examine the impact of psychiatric disorders on employment and, among those employed, work hours and income. They find that psychiatric disorders significantly reduced employment among both men and women. They also find evidence of small reductions in the conditional work hours of men and a substantial drop in the conditional income of men and women, alth…
Trends in Alternative Medicine Use in the United States, 1990-1997
CONTEXT: A prior national survey documented the high prevalence and costs of alternative medicine use in the United States in 1990. OBJECTIVE: To document trends in alternative medicine use in the United States between 1990 and 1997. DESIGN: Nationally representative random household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997, respectively. PARTICIPANTS: A total of 1539 …
Contribution of Psychosocial Factors to Socioeconomic Differences in Health
The National Survey of Mid‐life Developments in the United States (MIDUS) is one of several studies that demonstrate socioeconomic gradients in mortality during midlife. When MIDUS findings on self‐reported health, waist to hip ratio, and psychological well‐being were analyzed for their possible roles in generating socioeconomic differences in health, they revealed clear educational gradients for women and men (i.e., higher education predicted be…
State variations in supplemental security income enrollment for children and adolescents
OBJECTIVES: The purpose of this study was to determine the effects of poverty, program generosity, and health on state variations in enrollment of children and adolescents in the Supplemental Security Income (SSI) program during recent program expansions. METHODS: The relationship of state SSI rates for 1989 and 1992 to child poverty, health, and program generosity were determined by multiple regression. RESULTS: The mean percentage of children e…
The Influence of Psychiatric Disorders on Patients' Ratings of Satisfaction With Health Care
OBJECTIVES: Patient ratings of satisfaction with health care have been used by patients, insurers, and employers seeking data to compare the quality of health plans and systems of care. Concerns with these ratings include their subjective nature and potential for being influenced by patient characteristics unrelated to the quality of their care. The authors examined the influence of an active psychiatric disorder on patient satisfaction with heal…
The Relationship Between Continuity of Care and the Health Behaviors of Patients
BACKGROUND: Implicit in "any willing provider" and "freedom of choice" legislation is the assumption that ongoing provider relationships lead to better patient outcomes on average. Although previous studies have identified associations of usual source of care with medical utilization, its relationship to patient lifestyle has not been examined. OBJECTIVE: To determine the effect of having a usual physician on health behaviors. METHODS: Data on 3,…
Resource Utilization of Patients With Hypochondriacal Health Anxiety and Somatization
OBJECTIVES: To examine the resource utilization of patients with high levels of somatization and health-related anxiety. DESIGN: Consecutive patients on randomly chosen days completed a self-report questionnaire assessing somatization and health-related, hypochondriacal anxiety. Their medical care utilization in the year preceding and following completion of the questionnaire was obtained from an automated patient record. The utilization of patie…
Contribution of Major Diseases to Disparities in Mortality
BACKGROUND: Mortality from all causes is higher for persons with fewer years of education and for blacks, but it is unknown which diseases contribute most to these disparities. METHODS: We estimated cause-specific risks of death from data from the National Health Interview Survey conducted from 1986 through 1994 and from linked vital statistics. Using these risk estimates, we calculated potential years of life lost and potential gains in life exp…
Socioeconomic Status and Health Among Californians
Health inequalities manifest as a gradient, rather than as a distinction between “haves” and “have nots.” Therefore, eliminating health inequalities will require targeting interventions at segments of the entire population, not just particular subgroups at the disadvantaged end of the social hierarchy. Developing such interventions, however, has been stymied by an unclear understanding of how socioeconomic status (SES) influences health. The lite…
Economic evaluations of HIV treatment and health research with people diagnosed with HIV infection and co-occurring mental health and substance use disorders
This paper describes the research challenges involved in measuring costs in economic evaluations of patients who are coping simultaneously with HIV/AIDS and co-occurring mental health and substance abuse disorders-especially in multi-site studies. We describe the general issues that arise in measuring costs for this population and suggest some operational solutions for their resolution, drawing from our experience in a recent multi-site health se…
Accommodating Ethnic Diversity
BACKGROUND: Studies have confirmed ethnic disparities in the use of hospice services and identified barriers that minorities face in accessing care. OBJECTIVES: We sought to determine whether hospices provide services that might affect minority participation. RESEARCH DESIGN: We surveyed California hospices to determine whether programs use diverse health care providers and volunteers, offer translation, diverse spiritual care, or outreach materi…
Socioeconomic Status and Health
This study examines the interconnections among education-as a proxy for socioeconomic status-stress, and physical and mental health by specifying differential exposure and vulnerability models using data from The National Study of Daily Experiences (N = 1,031). These daily diary data allowed assessment of the social distribution of a qualitatively different type of stressor than has previously been examined in sociological stress research-daily s…
Differences in Cause-Specific Mortality Between Latino and White Adults
BACKGROUND: Understanding differences in cause-specific mortality between Latinos and whites is important for targeting future public health interventions and research aimed at eliminating health disparities. OBJECTIVES: We sought to determine the contribution of specific causes of death to Latino-white differences in mortality. RESEARCH DESIGN: Using nationally representative data, we estimated cause-specific mortality risks, which were then use…
Impact of Changes in Medicare Home Health Care Reimbursement on Month-to-Month Home Health Utilization Between 1996 and 2001 for a National Sample of Patients Undergoing Orthopedic Procedures
BACKGROUND: Beginning October 1, 1997, Medicare implemented a series of major changes to the Home Health (HH) reimbursement system. Reimbursements were first significantly reduced under the Interim Payment System (IPS) and then relaxed slightly until implementation of the HH Prospective Payment System (PPS) on October 1, 2000. OBJECTIVE: The objective of this study was to examine the impact of reimbursement policy on HH care utilization. RESEARCH…
Educational disparities in health behaviors among patients with diabetes
The relationship between educational attainment and health behaviors was modest in strength for most behaviors. Over the life course, the cumulative effect of reduced practice of multiple self-care behaviors among less educated patients may play an important part in shaping the social health gradient
Triply-diagnosed patients in the HIV/Aids Treatment Adherence, Health Outcomes and Cost Study
Although AIDS is a chronic illness, little is known about the patterns and correlates of long-term care use among triply diagnosed HIV patients. We examined nursing and home care use among 1,045 participants in the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study, a multi-site study of HIV-positive patients with at least one mental health and one substance disorder. Patient interviews and medical record review data were used to examin…
The Well-Being of Parental Caregivers of Children with Activity Limitations
Educational Disparities in Rates of Smoking Among Diabetic Adults
Objectives. We assessed educational disparities in smoking rates among adults with diabetes in managed care settings. Methods. We used a cross-sectional, survey-based (2002–2003) observational study among 6538 diabetic patients older than 25 years across multiple managed care health plans and states. For smoking at each level of self-reported educational attainment, predicted probabilities were estimated by means of hierarchical logistic regressi…
Medicine (45 obras) · Environmental health (25 obras) · Psychology (22 obras) · Gerontology (20 obras) · Health care (18 obras) · Psychiatry (18 obras) · Demography (17 obras) · Family medicine (17 obras) · Gerontology (15 obras) · Population (14 obras)