Neil Wenger
Biographic Data
| ID | 4630937 |
|---|---|
| NAME | Neil Wenger |
| GIVEN NAMES | Neil |
| FAMILY NAME | Wenger |
| SIGNATURE | WENGER N |
| AFFILIATIONS | University of California, Los Angeles |
| ORCID | 0000-0002-9884-3967 |
| VERIFIED | Yes |
| TOTAL WORKS | 24 |
| TOTAL CITATIONS | 14 |
| AUTHOR COUNT | 24 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1991 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 2 |
End-of-Life Care and Health Care Spending for Medicare Beneficiaries With Dementia in Accountable Care Organizations
Using nationally representative data on beneficiaries with dementia at EOL, this quasi-experimental study found no evidence that EOL care processes, outcomes, or spending changed with ACO entry for Medicare fee-for-service beneficiaries vs non-ACO beneficiaries. Alternative payment models to ACOs may be needed to coordinate high-quality care with lower spending for beneficiaries with dementia at the EOL
Letter
To the Editors:We write in response to Byram and Reiner’s recent paper addressing differential rates of MAiD utilisation in California and Canada (Byram & Reiner, 2024). We applaud their efforts to
Palliative Care and Advance Care Planning Intervention Fidelity Monitoring
Over the past decade, the Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale, comparative effectiveness clinical trials evaluating palliative care and advance care planning interventions. These are complex multicomponent interventions that need robust but flexible fidelity monitoring. Fidelity is necessary to maintain both internal and external validity within palliative care intervention research and to ultimately e…
Assessing Representativeness of Seriously Ill Patient Survey Responders in a Pragmatic Clinical Trial
A tailored survey and recruitment strategy yielded a representative sample of seriously ill, largely older, primary care respondents in the context of a pragmatic clinical trial
Patient and caregiver goals for dementia care
Is Patient-Perceived Severity of a Geriatric Condition Related to Better Quality of Care
BACKGROUND: Care for falls and urinary incontinence (UI) among older patients is inadequate. One possible explanation is that physicians provide less recommended care to patients who are not as concerned about their falls and UI. OBJECTIVE: To test whether patient-reported severity for 2 geriatric conditions, falls, and UI, is associated with quality of care. RESEARCH DESIGN: Prospective cohort study of elders with falls and/or fear of falling (n…
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…
Measuring the Quality of Care Provided to Dually Enrolled Medicare and Medicaid Beneficiaries Living in Nursing Homes
OBJECTIVES: To adapt the Assessing Care of Vulnerable Elders project nursing home (NH) specific quality indicators (QIs), for use with routinely collected data, and to evaluate which clinical conditions and types of care were inadequately measured using these data sources. DESIGN: Retrospective cohort study. SETTING: Nursing homes. PARTICIPANTS: NH residents 66 years of age and older dually enrolled in Medicare and Medicaid in 19 California count…
Multimorbidity is Associated With Better Quality of Care Among Vulnerable Elders
BACKGROUND: Older patients with multiple chronic conditions may be at higher risk of receiving poorer overall quality of care compared with those with single or no chronic conditions. Possible reasons include competing guidelines for individual conditions, burden of numerous recommendations, and difficulty implementing treatments for multiple conditions. OBJECTIVES: We sought to determine whether coexisting combinations of 8 common chronic condit…
The Effect of a Quality Improvement Initiative on the Quality of Other Aspects of Health Care
PROBLEM: Policymakers and clinicians are concerned that initiatives to improve the quality of care for some conditions may have unintended negative consequences for quality in other conditions. OBJECTIVE: We sought to determine whether a practice redesign intervention that improved care for falls, incontinence, and cognitive impairment by an absolute 15% change also affected quality of care for masked conditions (conditions not targeted by the in…
Measuring the Quality of Care Provided to Community Dwelling Vulnerable Elders Dually Enrolled in Medicare and Medicaid
CONTEXT: Small studies suggest that the quality of healthcare provided to older patients needs improvement. However, measuring the quality of care for larger groups of older adults is difficult. OBJECTIVE: To measure the quality of care in a community-dwelling vulnerable geriatric population using administrative data to apply quality indicators (QIs) from the Assessing Care of Vulnerable Elders project. DESIGN, SETTING, AND PARTICIPANTS: Cohort s…
Comorbidity and Quality of Care
Medical Care: December 2007 - Volume 45 - Issue 12 - p 1233 doi: 10.1097/MLR.0b013e31815b97bf
Comparison of Administrative Data and Medical Records to Measure the Quality of Medical Care Provided to Vulnerable Older Patients
BACKGROUND: Administrative data are used to determine performance for publicly reported in health plan "report cards," accreditation status, and reimbursement. However, it is unclear how performance based on administrative data and medical records compare. METHODS: We compared applicability, eligibility, and performance on 182 measures of health care quality using medical records and administrative data during a 13-month period for a random sampl…
Variations in provider conceptions of integrative medicine
The Effects of Payment Method on Clinical Decision-Making
BACKGROUND: The influence of payment mechanisms on physician decisions is not well understood. OBJECTIVES: The objective of this study was to test 2 null hypotheses: 1) physicians' clinical decisions would not be influenced by payment incentives; and 2) physicians would have equal concern about medical decisions made under capitation or fee-for-service (FFS) arrangements. RESEARCH DESIGN: We conducted a physician survey in which patient insurance…
A prospective study of predictors of adherence to combination antiretroviral medication
A Comparison Study of Multiple Measures of Adherence to HIV Protease Inhibitors
BACKGROUND: Poor adherence to HIV protease inhibitors may compromise the effectiveness of treatment. Few studies have compared methods for measuring adherence or have related adherence measures to a clinical outcome. OBJECTIVE: To examine the relationship among a composite score of adherence, the three primary measures of adherence, and HIV virologic response. DESIGN: Longitudinal cohort study. SETTING: Public HIV clinic. PATIENTS: 108 HIV-infect…
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…
Development of a brief scale to measure acculturation among Japanese Americans
Objective: To introduce a brief scale for measuring the level of acculturation among Japanese Americans and to describe its development and utility. We also evaluate the relationship of demographic characteristics with acculturation in one sample of Japanese Americans. Participants and Data Collection Methods: Pilot survey of a convenience sample of 70 Japanese American adults and survey of a random sample of 1,097 members of Japanese American Co…
The Care of HIV-Infected Adults in the United States
BACKGROUND AND METHODS: In order to elucidate the medical care of patients with human immunodeficiency virus (HIV) infection in the United States, we randomly sampled HIV-infected adults receiving medical care in the contiguous United States at a facility other than military, prison, or emergency department facility during the first two months of 1996. We interviewed 76 percent of 4042 patients selected from among the patients receiving care from…
Is access to medical care associated with receipt of HIV testing and counselling
Lack of timely HIV testing leads to missed prevention opportunities and poor prevention counselling may be related to further disease spread. We examined the association of self-reported access to medical care with receiving HIV testing and preventive counselling services among a sample of patients with HIV disease prior to hospitalization. We conducted a cross-sectional interview of 217 Los Angeles patients hospitalized with HIV-related illness …
Changes Over Time in the Use of Do Not Resuscitate Orders and the Outcomes of Patients Receiving Them
OBJECTIVES: Do not resuscitate (DNR) orders are increasingly common, though there has been little evaluation of their changing use. The authors contrasted the use and outcomes of DNR orders for nationally representative samples of Medicare patients hospitalized with specific diagnoses in 1981 to 1982 and 1985 to 1986. METHODS: Using ordinary least squares regression to adjust for patient and hospital characteristics, the authors compared use, tim…
When patients first suspect and find out they are infected with the human immunodeficiency virus
To evaluate how individuals infected with the human immunodeficiency virus (HIV) became aware of their infection, when they first suspected they were infected with HIV and factors associated with suspecting HIV infection, we surveyed 227 patients at an urban outpatient HIV clinic. Though nearly all patients acknowledged risk factors for HIV, 60% reported that they did not suspect that they were infected until they received a positive HIV antibody…
Reduction of high-risk sexual behavior among heterosexuals undergoing HIV antibody testing
BACKGROUND. We evaluated the effect of HIV antibody testing on sexual behavior and communication with sexual partners about AIDS risk among heterosexual adults at a clinic for sexually transmitted diseases. METHODS. We randomized 186 subjects to receive either AIDS education alone (the control group) or AIDS education, an HIV antibody test, and the test results (the intervention group). These subjects were then followed up 8 weeks later. RESULTS.…
Variations in provider conceptions of integrative medicine
Reduction of high-risk sexual behavior among heterosexuals undergoing HIV antibody testing
BACKGROUND. We evaluated the effect of HIV antibody testing on sexual behavior and communication with sexual partners about AIDS risk among heterosexual adults at a clinic for sexually transmitted diseases. METHODS. We randomized 186 subjects to receive either AIDS education alone (the control group) or AIDS education, an HIV antibody test, and the test results (the intervention group). These subjects were then followed up 8 weeks later. RESULTS.…
Reduction of high-risk sexual behavior among heterosexuals undergoing HIV antibody testing
BACKGROUND. We evaluated the effect of HIV antibody testing on sexual behavior and communication with sexual partners about AIDS risk among heterosexual adults at a clinic for sexually transmitted diseases. METHODS. We randomized 186 subjects to receive either AIDS education alone (the control group) or AIDS education, an HIV antibody test, and the test results (the intervention group). These subjects were then followed up 8 weeks later. RESULTS.…
When patients first suspect and find out they are infected with the human immunodeficiency virus
To evaluate how individuals infected with the human immunodeficiency virus (HIV) became aware of their infection, when they first suspected they were infected with HIV and factors associated with suspecting HIV infection, we surveyed 227 patients at an urban outpatient HIV clinic. Though nearly all patients acknowledged risk factors for HIV, 60% reported that they did not suspect that they were infected until they received a positive HIV antibody…
Changes Over Time in the Use of Do Not Resuscitate Orders and the Outcomes of Patients Receiving Them
OBJECTIVES: Do not resuscitate (DNR) orders are increasingly common, though there has been little evaluation of their changing use. The authors contrasted the use and outcomes of DNR orders for nationally representative samples of Medicare patients hospitalized with specific diagnoses in 1981 to 1982 and 1985 to 1986. METHODS: Using ordinary least squares regression to adjust for patient and hospital characteristics, the authors compared use, tim…
The Care of HIV-Infected Adults in the United States
BACKGROUND AND METHODS: In order to elucidate the medical care of patients with human immunodeficiency virus (HIV) infection in the United States, we randomly sampled HIV-infected adults receiving medical care in the contiguous United States at a facility other than military, prison, or emergency department facility during the first two months of 1996. We interviewed 76 percent of 4042 patients selected from among the patients receiving care from…
Is access to medical care associated with receipt of HIV testing and counselling
Lack of timely HIV testing leads to missed prevention opportunities and poor prevention counselling may be related to further disease spread. We examined the association of self-reported access to medical care with receiving HIV testing and preventive counselling services among a sample of patients with HIV disease prior to hospitalization. We conducted a cross-sectional interview of 217 Los Angeles patients hospitalized with HIV-related illness …
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…
Development of a brief scale to measure acculturation among Japanese Americans
Objective: To introduce a brief scale for measuring the level of acculturation among Japanese Americans and to describe its development and utility. We also evaluate the relationship of demographic characteristics with acculturation in one sample of Japanese Americans. Participants and Data Collection Methods: Pilot survey of a convenience sample of 70 Japanese American adults and survey of a random sample of 1,097 members of Japanese American Co…
A Comparison Study of Multiple Measures of Adherence to HIV Protease Inhibitors
BACKGROUND: Poor adherence to HIV protease inhibitors may compromise the effectiveness of treatment. Few studies have compared methods for measuring adherence or have related adherence measures to a clinical outcome. OBJECTIVE: To examine the relationship among a composite score of adherence, the three primary measures of adherence, and HIV virologic response. DESIGN: Longitudinal cohort study. SETTING: Public HIV clinic. PATIENTS: 108 HIV-infect…
A prospective study of predictors of adherence to combination antiretroviral medication
The Effects of Payment Method on Clinical Decision-Making
BACKGROUND: The influence of payment mechanisms on physician decisions is not well understood. OBJECTIVES: The objective of this study was to test 2 null hypotheses: 1) physicians' clinical decisions would not be influenced by payment incentives; and 2) physicians would have equal concern about medical decisions made under capitation or fee-for-service (FFS) arrangements. RESEARCH DESIGN: We conducted a physician survey in which patient insurance…
Comparison of Administrative Data and Medical Records to Measure the Quality of Medical Care Provided to Vulnerable Older Patients
BACKGROUND: Administrative data are used to determine performance for publicly reported in health plan "report cards," accreditation status, and reimbursement. However, it is unclear how performance based on administrative data and medical records compare. METHODS: We compared applicability, eligibility, and performance on 182 measures of health care quality using medical records and administrative data during a 13-month period for a random sampl…
Variations in provider conceptions of integrative medicine
Multimorbidity is Associated With Better Quality of Care Among Vulnerable Elders
BACKGROUND: Older patients with multiple chronic conditions may be at higher risk of receiving poorer overall quality of care compared with those with single or no chronic conditions. Possible reasons include competing guidelines for individual conditions, burden of numerous recommendations, and difficulty implementing treatments for multiple conditions. OBJECTIVES: We sought to determine whether coexisting combinations of 8 common chronic condit…
The Effect of a Quality Improvement Initiative on the Quality of Other Aspects of Health Care
PROBLEM: Policymakers and clinicians are concerned that initiatives to improve the quality of care for some conditions may have unintended negative consequences for quality in other conditions. OBJECTIVE: We sought to determine whether a practice redesign intervention that improved care for falls, incontinence, and cognitive impairment by an absolute 15% change also affected quality of care for masked conditions (conditions not targeted by the in…
Measuring the Quality of Care Provided to Community Dwelling Vulnerable Elders Dually Enrolled in Medicare and Medicaid
CONTEXT: Small studies suggest that the quality of healthcare provided to older patients needs improvement. However, measuring the quality of care for larger groups of older adults is difficult. OBJECTIVE: To measure the quality of care in a community-dwelling vulnerable geriatric population using administrative data to apply quality indicators (QIs) from the Assessing Care of Vulnerable Elders project. DESIGN, SETTING, AND PARTICIPANTS: Cohort s…
Comorbidity and Quality of Care
Medical Care: December 2007 - Volume 45 - Issue 12 - p 1233 doi: 10.1097/MLR.0b013e31815b97bf
Measuring the Quality of Care Provided to Dually Enrolled Medicare and Medicaid Beneficiaries Living in Nursing Homes
OBJECTIVES: To adapt the Assessing Care of Vulnerable Elders project nursing home (NH) specific quality indicators (QIs), for use with routinely collected data, and to evaluate which clinical conditions and types of care were inadequately measured using these data sources. DESIGN: Retrospective cohort study. SETTING: Nursing homes. PARTICIPANTS: NH residents 66 years of age and older dually enrolled in Medicare and Medicaid in 19 California count…
Is Patient-Perceived Severity of a Geriatric Condition Related to Better Quality of Care
BACKGROUND: Care for falls and urinary incontinence (UI) among older patients is inadequate. One possible explanation is that physicians provide less recommended care to patients who are not as concerned about their falls and UI. OBJECTIVE: To test whether patient-reported severity for 2 geriatric conditions, falls, and UI, is associated with quality of care. RESEARCH DESIGN: Prospective cohort study of elders with falls and/or fear of falling (n…
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…
Patient and caregiver goals for dementia care
Assessing Representativeness of Seriously Ill Patient Survey Responders in a Pragmatic Clinical Trial
A tailored survey and recruitment strategy yielded a representative sample of seriously ill, largely older, primary care respondents in the context of a pragmatic clinical trial
Palliative Care and Advance Care Planning Intervention Fidelity Monitoring
Over the past decade, the Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale, comparative effectiveness clinical trials evaluating palliative care and advance care planning interventions. These are complex multicomponent interventions that need robust but flexible fidelity monitoring. Fidelity is necessary to maintain both internal and external validity within palliative care intervention research and to ultimately e…
End-of-Life Care and Health Care Spending for Medicare Beneficiaries With Dementia in Accountable Care Organizations
Using nationally representative data on beneficiaries with dementia at EOL, this quasi-experimental study found no evidence that EOL care processes, outcomes, or spending changed with ACO entry for Medicare fee-for-service beneficiaries vs non-ACO beneficiaries. Alternative payment models to ACOs may be needed to coordinate high-quality care with lower spending for beneficiaries with dementia at the EOL
Letter
To the Editors:We write in response to Byram and Reiner’s recent paper addressing differential rates of MAiD utilisation in California and Canada (Byram & Reiner, 2024). We applaud their efforts to
Medicine (23 works) · Family medicine (9 works) · Gerontology (8 works) · Health care (8 works) · Nursing (8 works) · Geriatric Care and Nursing Homes (7 works) · Internal Medicine (7 works) · MEDLINE (7 works) · Palliative Care and End-of-Life Issues (7 works) · Psychology (7 works)