Deborah Gurewich
Biographic Data
| ID | 5534964 |
|---|---|
| NAME | Deborah Gurewich |
| GIVEN NAMES | Deborah |
| FAMILY NAME | Gurewich |
| SIGNATURE | GUREWICH D |
| AFFILIATIONS | VA Boston Healthcare System |
| ORCID | 0000-0002-9398-7646 |
| VERIFIED | Yes |
| TOTAL WORKS | 14 |
| TOTAL CITATIONS | 2 |
| WORKS AS AUTHOR | 14 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2013 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 1 |
Examining Differences in Wait Times for Primary Care in the Veterans Health Administration by Race and Ethnicity
BACKGROUND: Prior studies at the national level indicate that primary care wait times exceeded the 20-day veterans Health Administration (VA) wait time standards set for primary care. Longer wait times were also reported for Black and Hispanic versus White veterans. OBJECTIVES: Examine variation in wait time for primary care at the facility level by race and ethnicity over time and determine whether differences are due to within-facility differen…
Social needs and health outcomes in two rural Veteran populations
BACKGROUND: Addressing social needs is a priority for many health systems, including the Veterans Health Administration (VA). Nearly a quarter of Veterans reside in rural areas and experience a high social need burden. The purpose of this study was to assess the prevalence and association with health outcomes of social needs in two distinct rural Veteran populations. METHODS: We conducted a survey (n = 1150) of Veterans at 2 rural VA sites, 1 in …
Racial and Ethnic and Rural Variations in Access to Primary Care for Veterans Following the Mission Act
The results of this cross-sectional study suggest that additional research should explore the determinants and implications of utilization differences among Black and Hispanic veterans compared with White veterans. Efforts to promote equitable primary care access for all veterans are needed so that policy changes can be more effective in ensuring timely access to care for all veterans
Using the Kitagawa Decomposition to Measure Overall—and Individual Facility Contributions to—Within-facility and Between-facility Differences
BACKGROUND: Identifying whether differences in health care disparities are due to within-facility or between-facility differences is key to disparity reductions. The Kitagawa decomposition divides the difference between 2 means into within-facility differences and between-facility differences that are measured on the same scale as the original disparity. It also enables the identification of facilities that contribute most to within-facility diff…
A Multi-site Case Study of Care Coordination Between Primary Care and Specialty Care
BACKGROUND: Care coordination is critical for patients with multiple chronic conditions, but fragmentation of care persists. Providers' perspectives of facilitators and barriers to coordination are needed to improve care. OBJECTIVES: We sought to understand providers' perspectives on care coordination for patients having multiple chronic diseases served by multiple providers. RESEARCH DESIGN: Based upon our earlier survey of patients with multipl…
Medicaid Expansion and Change in Federally Qualified Health Center Accessibility From 2008 to 2016
BACKGROUND: The Affordable Care Act expanded health coverage for low-income residents through Medicaid expansion and increased funding for Health Center Program New Access Points from 2009 to 2015, improving federally qualified health center (FQHC) accessibility. The extent to which these provisions progressed synergistically as intended when states could opt out of Medicaid expansion is unknown. OBJECTIVE: To compare change in FQHC accessibility…
Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts
Introduction: Massachusetts established 17 new Medicaid accountable care organizations (ACOs) and 24 affiliated Community Partners (CPs) in 2018 as part of a large-scale healthcare reform effort to improve care value. The new ACOs will receive $1.8 billion dollars in state and federal funding over 5 years through the Delivery System Reform Incentive Program (DSRIP). The multi-faceted study described in this protocol aims to address gaps in knowle…
Veterans Affairs and Rural Community Providers’ Perspectives on Interorganizational Care Coordination
OBJECTIVE: To investigate challenges in care coordination between US Department of Veterans Affairs (VA) clinics and community providers serving rural veterans. METHODS: We completed qualitative interviews in 2017-2018 with a geographically diverse sample of 57 VA and community staff. Interviews were audio-recorded and transcribed verbatim. We used Rapid Qualitative Inquiry (RQI) to guide analyses. RESULTS: Results suggested 5 pivotal domains rel…
Rural Veterans’ Experiences With Outpatient Care in the Veterans Health Administration Versus Community Care
BACKGROUND: The 2014 Veterans Access, Choice and Accountability Act was intended to improve Veterans' access to timely health care by expanding their options to receive community care (CC) paid for by the Veterans Health Administration (VA). Although CC could particularly benefit rural Veterans, we know little about rural Veterans' experiences with CC. OBJECTIVE: The objective of this study was to compare rural Veterans' experiences with CC and V…
Did Access to Care Improve Since Passage of the Veterans Choice Act
BACKGROUND: The 2014 Veterans Choice Program aimed to improve care access for Veterans through expanded availability of community care (CC). Increased access to CC could particularly benefit rural Veterans, who often face obstacles in obtaining medical care at the Veterans Health Administration (VHA). However, whether Veterans Choice Program improved timely access to care for this vulnerable population is understudied. OBJECTIVES: To examine wait…
Interorganizational Care Coordination of Rural Veterans by Veterans Affairs and Community Care Programs
BACKGROUND: In the unique context of rural Veterans' health care needs, expansion of US Department of Veterans Affairs and Community Care programs under the MISSION Act, and the uncertainties of coronavirus disease 2019 (COVID-19), it is critical to understand what may support effective interorganizational care coordination for increased access to high-quality care. OBJECTIVES: We conducted a systematic review to examine the interorganizational c…
A Mixed Methods Study of the Association of Non-Veterans Affairs Care With Veterans’ and Clinicians’ Experiences of Care Coordination
BACKGROUND: Poor coordination between the Department of Veterans Affairs (VA) and non-VA care may negatively impact health care quality. Recent legislation is intended to increase Veterans' access to care, in part through increased use of non-VA care. However, a possible consequence may be diminished patient experiences of coordination. OBJECTIVE: The objective of this study was to determine VA patients' and clinicians' experiences of coordinatio…
Integrating Measures of Social Determinants of Health Into Health Care Encounters
There are a number of potential benefits for identifying and documenting social determinants of health in health care delivery settings
Methodological Challenges of Measuring Primary Care Delivery to Pediatric Medicaid Beneficiaries Who Use Community Health Centers
Efforts to measure quality of care have focused on ambulatory care providers. We examined the performance of community health centers serving children on Medicaid in 3 states. Descriptive analysis showed considerable patient population heterogeneity, and regression analysis demonstrated that variation explained by the assigned provider was small (mean R 2 = 4.3%) compared with the variation explained by patient demographic variables (mean R 2 = 2…
Methodological Challenges of Measuring Primary Care Delivery to Pediatric Medicaid Beneficiaries Who Use Community Health Centers
Efforts to measure quality of care have focused on ambulatory care providers. We examined the performance of community health centers serving children on Medicaid in 3 states. Descriptive analysis showed considerable patient population heterogeneity, and regression analysis demonstrated that variation explained by the assigned provider was small (mean R 2 = 4.3%) compared with the variation explained by patient demographic variables (mean R 2 = 2…
Methodological Challenges of Measuring Primary Care Delivery to Pediatric Medicaid Beneficiaries Who Use Community Health Centers
Efforts to measure quality of care have focused on ambulatory care providers. We examined the performance of community health centers serving children on Medicaid in 3 states. Descriptive analysis showed considerable patient population heterogeneity, and regression analysis demonstrated that variation explained by the assigned provider was small (mean R 2 = 4.3%) compared with the variation explained by patient demographic variables (mean R 2 = 2…
Integrating Measures of Social Determinants of Health Into Health Care Encounters
There are a number of potential benefits for identifying and documenting social determinants of health in health care delivery settings
A Mixed Methods Study of the Association of Non-Veterans Affairs Care With Veterans’ and Clinicians’ Experiences of Care Coordination
BACKGROUND: Poor coordination between the Department of Veterans Affairs (VA) and non-VA care may negatively impact health care quality. Recent legislation is intended to increase Veterans' access to care, in part through increased use of non-VA care. However, a possible consequence may be diminished patient experiences of coordination. OBJECTIVE: The objective of this study was to determine VA patients' and clinicians' experiences of coordinatio…
Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts
Introduction: Massachusetts established 17 new Medicaid accountable care organizations (ACOs) and 24 affiliated Community Partners (CPs) in 2018 as part of a large-scale healthcare reform effort to improve care value. The new ACOs will receive $1.8 billion dollars in state and federal funding over 5 years through the Delivery System Reform Incentive Program (DSRIP). The multi-faceted study described in this protocol aims to address gaps in knowle…
Veterans Affairs and Rural Community Providers’ Perspectives on Interorganizational Care Coordination
OBJECTIVE: To investigate challenges in care coordination between US Department of Veterans Affairs (VA) clinics and community providers serving rural veterans. METHODS: We completed qualitative interviews in 2017-2018 with a geographically diverse sample of 57 VA and community staff. Interviews were audio-recorded and transcribed verbatim. We used Rapid Qualitative Inquiry (RQI) to guide analyses. RESULTS: Results suggested 5 pivotal domains rel…
Rural Veterans’ Experiences With Outpatient Care in the Veterans Health Administration Versus Community Care
BACKGROUND: The 2014 Veterans Access, Choice and Accountability Act was intended to improve Veterans' access to timely health care by expanding their options to receive community care (CC) paid for by the Veterans Health Administration (VA). Although CC could particularly benefit rural Veterans, we know little about rural Veterans' experiences with CC. OBJECTIVE: The objective of this study was to compare rural Veterans' experiences with CC and V…
Did Access to Care Improve Since Passage of the Veterans Choice Act
BACKGROUND: The 2014 Veterans Choice Program aimed to improve care access for Veterans through expanded availability of community care (CC). Increased access to CC could particularly benefit rural Veterans, who often face obstacles in obtaining medical care at the Veterans Health Administration (VHA). However, whether Veterans Choice Program improved timely access to care for this vulnerable population is understudied. OBJECTIVES: To examine wait…
Interorganizational Care Coordination of Rural Veterans by Veterans Affairs and Community Care Programs
BACKGROUND: In the unique context of rural Veterans' health care needs, expansion of US Department of Veterans Affairs and Community Care programs under the MISSION Act, and the uncertainties of coronavirus disease 2019 (COVID-19), it is critical to understand what may support effective interorganizational care coordination for increased access to high-quality care. OBJECTIVES: We conducted a systematic review to examine the interorganizational c…
A Multi-site Case Study of Care Coordination Between Primary Care and Specialty Care
BACKGROUND: Care coordination is critical for patients with multiple chronic conditions, but fragmentation of care persists. Providers' perspectives of facilitators and barriers to coordination are needed to improve care. OBJECTIVES: We sought to understand providers' perspectives on care coordination for patients having multiple chronic diseases served by multiple providers. RESEARCH DESIGN: Based upon our earlier survey of patients with multipl…
Medicaid Expansion and Change in Federally Qualified Health Center Accessibility From 2008 to 2016
BACKGROUND: The Affordable Care Act expanded health coverage for low-income residents through Medicaid expansion and increased funding for Health Center Program New Access Points from 2009 to 2015, improving federally qualified health center (FQHC) accessibility. The extent to which these provisions progressed synergistically as intended when states could opt out of Medicaid expansion is unknown. OBJECTIVE: To compare change in FQHC accessibility…
Using the Kitagawa Decomposition to Measure Overall—and Individual Facility Contributions to—Within-facility and Between-facility Differences
BACKGROUND: Identifying whether differences in health care disparities are due to within-facility or between-facility differences is key to disparity reductions. The Kitagawa decomposition divides the difference between 2 means into within-facility differences and between-facility differences that are measured on the same scale as the original disparity. It also enables the identification of facilities that contribute most to within-facility diff…
Racial and Ethnic and Rural Variations in Access to Primary Care for Veterans Following the Mission Act
The results of this cross-sectional study suggest that additional research should explore the determinants and implications of utilization differences among Black and Hispanic veterans compared with White veterans. Efforts to promote equitable primary care access for all veterans are needed so that policy changes can be more effective in ensuring timely access to care for all veterans
Social needs and health outcomes in two rural Veteran populations
BACKGROUND: Addressing social needs is a priority for many health systems, including the Veterans Health Administration (VA). Nearly a quarter of Veterans reside in rural areas and experience a high social need burden. The purpose of this study was to assess the prevalence and association with health outcomes of social needs in two distinct rural Veteran populations. METHODS: We conducted a survey (n = 1150) of Veterans at 2 rural VA sites, 1 in …
Examining Differences in Wait Times for Primary Care in the Veterans Health Administration by Race and Ethnicity
BACKGROUND: Prior studies at the national level indicate that primary care wait times exceeded the 20-day veterans Health Administration (VA) wait time standards set for primary care. Longer wait times were also reported for Black and Hispanic versus White veterans. OBJECTIVES: Examine variation in wait time for primary care at the facility level by race and ethnicity over time and determine whether differences are due to within-facility differen…
Medicine (12 works) · Health care (11 works) · Primary Care and Health Outcomes (11 works) · Healthcare Policy and Management (8 works) · Gerontology (7 works) · Veterans Affairs (7 works) · Family medicine (6 works) · Environmental health (5 works) · Gerontology (5 works) · Ambulatory care (4 works)