Debra Saliba
Biographic Data
| ID | 5537235 |
|---|---|
| NAME | Debra Saliba |
| GIVEN NAMES | Debra |
| FAMILY NAME | Saliba |
| SIGNATURE | SALIBA D |
| AFFILIATIONS | RAND Corporation |
| ORCID | 0000-0001-5177-6616 |
| VERIFIED | Yes |
| TOTAL WORKS | 17 |
| TOTAL CITATIONS | 6 |
| WORKS AS AUTHOR | 17 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2003 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 2 |
Key Informants’ Visions and Solutions to Improve Home- and Community-Based Services for Older Adults and Persons With Dementia
Recent decades have seen state successes in rebalancing Medicaid long-term care from institutional care (e.g., nursing homes) into home and community settings. However, significant barriers can prevent access to home and community-based services (HCBS) among older adults and persons with dementia. Qualitative research on potential innovations and solutions in the contemporary context with attention to a wider range of state-level policy contexts …
End-of-Life Care for Older Adults With Dementia by Race and Ethnicity and Physicians’ Role
Findings from this cohort study suggest that non-Hispanic Black and Hispanic decedents with dementia received more intensive end-of-life care despite higher rates of billed advance care planning and palliative care counseling than non-Hispanic White decedents. Observed racial and ethnic variations were not explained by differences in the physicians treating them
Self-efficacy change among diverse family caregivers in dementia care
NCT03786471
Implementation of US Post-Acute Care Payment Reform and Covid-19 Policies
In fiscal year 2020, new national Medicare payment models were implemented in the two most common post-acute care settings (i.e., skilled nursing facilities (SNFs) and home health agencies (HHAs)), which were followed by the emergence of COVID-19. Given concerns about the unintended consequence of these events, this study protocol will examine how organizations responded to these policies and whether there were changes in SNF and HHA access, care…
Barriers and Facilitators to Home- and Community-Based Services Access for Persons With Dementia and Their Caregivers
System refinements, such as incentivizing cognitive screening, can improve detection and increase access to HCBS. Disparities in HCBS access experienced by minoritized persons with dementia may be addressed through culturally competent awareness campaigns and policies that recognize the necessity of familial caregivers in supporting persons with dementia. These findings can inform efforts to ensure more equitable access to HCBS, improve dementia …
Culturally Competent Clinical Care for Older Sexual Minority Adults
STUDY OBJECTIVE: As recent efforts to improve culturally competent clinical care (CCCC) have largely overlooked older LGB adults, we conducted a scoping review of position statements, empirical, and non-empirical research and suggest action steps. METHODS: We followed PRISMA Extension for Scoping Reviews Guidelines and searched for articles 1/1/11-3/14/19 (n = 1210) and other resources (n = 52), deduplicating, dually screening abstracts (n = 1,15…
Examination of the New Short-Stay Nursing Home Quality Measures
In 2016, the Centers for Medicare & Medicaid Services (CMS) introduced 3 new quality measures (QMs) to its report card, Nursing Home Compare (NHC). These measures-rehospitalizations, emergency department visits, and successful discharges to the community-focus on short-stay residents. We offer a first analysis of nursing homes' performance in terms of these new measures. We examined their properties and distribution across nursing homes using des…
Care Experiences Among Medicare Beneficiaries With and Without a Personal Physician
BACKGROUND: Having a "personal" physician is a critical element to care continuity. Little is known about which older adults are more likely to lack personal physicians and if their care experiences differ from those with a personal physician. OBJECTIVE: The objective of this study was to describe care experiences and characteristics associated with not having a personal physician. RESEARCH DESIGN: We compare rates of lacking a personal physician…
Redesign of an Electronic Clinical Reminder to Prevent Falls in Older Adults
BACKGROUND: Falls are the leading cause of unintentional injury among US older adults. Guidelines recommend screening patients for fall risk, and providing exercise for patients with gait and balance problems. We redesigned an electronic clinical reminder to improve identification and management of Veterans at high risk for falls, and piloted the reminder in 3 Veterans Health Administration community-based outpatient clinics. METHODS: This projec…
Health Care for American Indian and Alaska Native Women
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…
Veterans Health Administration and Indian Health Service
BACKGROUND: The Veterans Health Administration (VHA) and Indian Health Service (IHS) have executed an agreement to share resources to improve access and health outcomes for American Indian and Alaska Native (AIAN) veterans. OBJECTIVES: To describe the extent of dual use, health needs, and utilization patterns for IHS-enrollees served by VHA and IHS. Our objective is to fill those gaps in knowledge to inform strategic planning between these federa…
Identification of American Indian and Alaska Native Veterans in Administrative Data of the Veterans Health Administration and the Indian Health Service
We sought to determine the extent to which the Indian Health Service (IHS) identified enrollees who also use the Veterans Health Administration (VHA) as veterans. We used a bivariate analysis of administrative data from fiscal years 2002–2003 to study the target population. Of the 32259 IHS enrollees who received care as veterans in the VHA, only 44% were identified by IHS as veterans. IHS data underestimates the number of veterans, and both IHS …
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…
Challenges in Measuring Nursing Home and Home Health Quality
Background: The availability of patient assessment data collected by all Medicare- and Medicaid-certified nursing homes (NHs) (the Minimum Data Set [MDS]) and home health agencies (HHAs) (the Outcome and Assessment Information Set [OASIS]) provides an opportunity to measure quality of care in these settings. Objective: The objective of this study was to examine methodologic issues encountered as these datasets are used to report the nation's heal…
Function and Response of Nursing Facilities During Community Disaster
Objectives. We sought to describe the role and function of nursing facilities after disaster. Methods. We surveyed administrators at 144 widely dispersed nursing facilities after the Los Angeles Northridge earthquake. Results. Of the 113 (78%) nursing facilities that responded (11 365 beds), 23 sustained severe damage, 5 closed (625 beds), and 72 lost vital services. Of 87 nursing facilities implementing disaster plans, 56 cited problems that pla…
Quality of Care in Nursing Homes
BACKGROUND: Recent work has highlighted a negative correlation between proprietary status and nursing home quality of care. This relationship might be explained by the context in which proprietary homes operate. However, another possible explanation is that some proprietary homes take excessive profit to the detriment of care quality. OBJECTIVE: To examine the relationship between profit levels and quality in proprietary and nonproprietary nursin…
Barriers and Facilitators to Home- and Community-Based Services Access for Persons With Dementia and Their Caregivers
System refinements, such as incentivizing cognitive screening, can improve detection and increase access to HCBS. Disparities in HCBS access experienced by minoritized persons with dementia may be addressed through culturally competent awareness campaigns and policies that recognize the necessity of familial caregivers in supporting persons with dementia. These findings can inform efforts to ensure more equitable access to HCBS, improve dementia …
Identification of American Indian and Alaska Native Veterans in Administrative Data of the Veterans Health Administration and the Indian Health Service
We sought to determine the extent to which the Indian Health Service (IHS) identified enrollees who also use the Veterans Health Administration (VHA) as veterans. We used a bivariate analysis of administrative data from fiscal years 2002–2003 to study the target population. Of the 32259 IHS enrollees who received care as veterans in the VHA, only 44% were identified by IHS as veterans. IHS data underestimates the number of veterans, and both IHS …
Function and Response of Nursing Facilities During Community Disaster
Objectives. We sought to describe the role and function of nursing facilities after disaster. Methods. We surveyed administrators at 144 widely dispersed nursing facilities after the Los Angeles Northridge earthquake. Results. Of the 113 (78%) nursing facilities that responded (11 365 beds), 23 sustained severe damage, 5 closed (625 beds), and 72 lost vital services. Of 87 nursing facilities implementing disaster plans, 56 cited problems that pla…
Quality of Care in Nursing Homes
BACKGROUND: Recent work has highlighted a negative correlation between proprietary status and nursing home quality of care. This relationship might be explained by the context in which proprietary homes operate. However, another possible explanation is that some proprietary homes take excessive profit to the detriment of care quality. OBJECTIVE: To examine the relationship between profit levels and quality in proprietary and nonproprietary nursin…
Function and Response of Nursing Facilities During Community Disaster
Objectives. We sought to describe the role and function of nursing facilities after disaster. Methods. We surveyed administrators at 144 widely dispersed nursing facilities after the Los Angeles Northridge earthquake. Results. Of the 113 (78%) nursing facilities that responded (11 365 beds), 23 sustained severe damage, 5 closed (625 beds), and 72 lost vital services. Of 87 nursing facilities implementing disaster plans, 56 cited problems that pla…
Challenges in Measuring Nursing Home and Home Health Quality
Background: The availability of patient assessment data collected by all Medicare- and Medicaid-certified nursing homes (NHs) (the Minimum Data Set [MDS]) and home health agencies (HHAs) (the Outcome and Assessment Information Set [OASIS]) provides an opportunity to measure quality of care in these settings. Objective: The objective of this study was to examine methodologic issues encountered as these datasets are used to report the nation's heal…
Identification of American Indian and Alaska Native Veterans in Administrative Data of the Veterans Health Administration and the Indian Health Service
We sought to determine the extent to which the Indian Health Service (IHS) identified enrollees who also use the Veterans Health Administration (VHA) as veterans. We used a bivariate analysis of administrative data from fiscal years 2002–2003 to study the target population. Of the 32259 IHS enrollees who received care as veterans in the VHA, only 44% were identified by IHS as veterans. IHS data underestimates the number of veterans, and both IHS …
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…
Health Care for American Indian and Alaska Native Women
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…
Veterans Health Administration and Indian Health Service
BACKGROUND: The Veterans Health Administration (VHA) and Indian Health Service (IHS) have executed an agreement to share resources to improve access and health outcomes for American Indian and Alaska Native (AIAN) veterans. OBJECTIVES: To describe the extent of dual use, health needs, and utilization patterns for IHS-enrollees served by VHA and IHS. Our objective is to fill those gaps in knowledge to inform strategic planning between these federa…
Redesign of an Electronic Clinical Reminder to Prevent Falls in Older Adults
BACKGROUND: Falls are the leading cause of unintentional injury among US older adults. Guidelines recommend screening patients for fall risk, and providing exercise for patients with gait and balance problems. We redesigned an electronic clinical reminder to improve identification and management of Veterans at high risk for falls, and piloted the reminder in 3 Veterans Health Administration community-based outpatient clinics. METHODS: This projec…
Examination of the New Short-Stay Nursing Home Quality Measures
In 2016, the Centers for Medicare & Medicaid Services (CMS) introduced 3 new quality measures (QMs) to its report card, Nursing Home Compare (NHC). These measures-rehospitalizations, emergency department visits, and successful discharges to the community-focus on short-stay residents. We offer a first analysis of nursing homes' performance in terms of these new measures. We examined their properties and distribution across nursing homes using des…
Care Experiences Among Medicare Beneficiaries With and Without a Personal Physician
BACKGROUND: Having a "personal" physician is a critical element to care continuity. Little is known about which older adults are more likely to lack personal physicians and if their care experiences differ from those with a personal physician. OBJECTIVE: The objective of this study was to describe care experiences and characteristics associated with not having a personal physician. RESEARCH DESIGN: We compare rates of lacking a personal physician…
Culturally Competent Clinical Care for Older Sexual Minority Adults
STUDY OBJECTIVE: As recent efforts to improve culturally competent clinical care (CCCC) have largely overlooked older LGB adults, we conducted a scoping review of position statements, empirical, and non-empirical research and suggest action steps. METHODS: We followed PRISMA Extension for Scoping Reviews Guidelines and searched for articles 1/1/11-3/14/19 (n = 1210) and other resources (n = 52), deduplicating, dually screening abstracts (n = 1,15…
Implementation of US Post-Acute Care Payment Reform and Covid-19 Policies
In fiscal year 2020, new national Medicare payment models were implemented in the two most common post-acute care settings (i.e., skilled nursing facilities (SNFs) and home health agencies (HHAs)), which were followed by the emergence of COVID-19. Given concerns about the unintended consequence of these events, this study protocol will examine how organizations responded to these policies and whether there were changes in SNF and HHA access, care…
Barriers and Facilitators to Home- and Community-Based Services Access for Persons With Dementia and Their Caregivers
System refinements, such as incentivizing cognitive screening, can improve detection and increase access to HCBS. Disparities in HCBS access experienced by minoritized persons with dementia may be addressed through culturally competent awareness campaigns and policies that recognize the necessity of familial caregivers in supporting persons with dementia. These findings can inform efforts to ensure more equitable access to HCBS, improve dementia …
Key Informants’ Visions and Solutions to Improve Home- and Community-Based Services for Older Adults and Persons With Dementia
Recent decades have seen state successes in rebalancing Medicaid long-term care from institutional care (e.g., nursing homes) into home and community settings. However, significant barriers can prevent access to home and community-based services (HCBS) among older adults and persons with dementia. Qualitative research on potential innovations and solutions in the contemporary context with attention to a wider range of state-level policy contexts …
End-of-Life Care for Older Adults With Dementia by Race and Ethnicity and Physicians’ Role
Findings from this cohort study suggest that non-Hispanic Black and Hispanic decedents with dementia received more intensive end-of-life care despite higher rates of billed advance care planning and palliative care counseling than non-Hispanic White decedents. Observed racial and ethnic variations were not explained by differences in the physicians treating them
Self-efficacy change among diverse family caregivers in dementia care
NCT03786471
Medicine (15 works) · Geriatric Care and Nursing Homes (9 works) · Nursing (9 works) · Health care (8 works) · Family medicine (7 works) · Business (6 works) · Political science (6 works) · Dementia and Cognitive Impairment Research (5 works) · Gerontology (5 works) · Nursing homes (5 works)