Neil R Powe
Dados Biográficos
| ID | 184002 |
|---|---|
| NOME | Neil R Powe |
| PRENOMES | Neil R |
| SOBRENOME | Powe |
| ASSINATURA | POWE N R |
| AFILIAÇÕES | Johns Hopkins University |
| ORCID | 0000-0003-2347-3620 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 41 |
| TOTAL DE CITAÇÕES | 117 |
| TOTAL COMO AUTOR | 41 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1990 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2023 |
| ÍNDICE H | 4 |
Hospital Equity Rating Metrics—Promise, Pitfalls, and Perils
This Viewpoint addresses several considerations regarding equity metrics across hospital regulatory and accrediting organizations and suggestions for improvement
Association between neighborhood social cohesion, awareness of chronic diseases, and participation in healthy behaviors in a community cohort
Community engagement and neighborhood social cohesion may be important targets for promotion of healthy behaviors and cardiovascular disease prevention. More research is needed to understand the different associations of NSC and healthy behaviors by race
Racial Disparities in Creatinine-based Kidney Function Estimates Among HIV-infected Adults
Our findings suggest that clinicians may want to consider estimating glomerular filtration rate without the race coefficient in Blacks with HIV
Diversity in Clinical and Biomedical Research
Esteban Gonzalez Burchard and colleagues explore how making medical research more diverse would aid not only social justice but scientific quality and clinical effectiveness, too.
Chronic Kidney Disease Identification in a High-Risk Urban Population
African American and Non-African American Patients' and Families' Decision Making About Renal Replacement Therapies
We conducted focus group meetings of African American and non-African American patients with end-stage renal disease (six groups) and their family members (six groups), stratified by race/ethnicity and treatment. We elicited differences in participants' experiences with shared decision making about initiating renal replacement therapy (RRT; that is, hemodialysis, peritoneal dialysis, or a kidney transplant). Patients were often very sick when ini…
Do Minority Patients Use Lower Quality Hospitals
Employing three years of inpatient discharge data from 11 states and inpatient and patient safety quality indicators from the Agency for Healthcare Research and Quality (AHRQ), this paper explored whether minority (black, Hispanic, and Asian) patients used lower quality hospitals. We found that the association between the share of minority patients and hospital quality depended on how quality was measured and varied by race and ethnicity. Hospita…
External Validity of the Cardiovascular Health Study
BACKGROUND: The Cardiovascular Health Study (CHS), a population-based prospective cohort study, has been used to identify major risk factors associated with cardiovascular disease and stroke in the elderly. OBJECTIVE: To assess the external validity of the CHS. RESEARCH DESIGN: Comparison of the CHS cohort to a national cohort of Medicare beneficiaries and to Medicare beneficiaries residing in the CHS geographic regions. SUBJECTS: CHS participant…
Barriers to recruiting underrepresented populations to cancer clinical trials
Racial and ethnic minorities, older adults, rural residents, and individuals of low socioeconomic status are underrepresented among participants in cancer‐related trials. The authors conducted a systematic review to determine the barriers to participation of underrepresented populations in cancer‐related trials. Their search included English‐language publications that reported original data on the recruitment of underrepresented groups to cancer …
Longitudinal Study of Depressive Symptoms and Health-Related Quality of Life During Pregnancy and After Delivery
Weight Loss Programs for Urban-based, Postpartum African-American Women
Relation between level or change of hemoglobin and generic and disease-specific quality of life measures in hemodialysis
Preferences for Current Health and Their Association With Outcomes in Patients With Kidney Disease
BACKGROUND: Patients with chronic disease who express stronger preference for their current health might be expected to have better outcomes than patients who assign lower utility to their current health state. OBJECTIVE: We sought to examine associations between preferences for current health and outcomes in a national cohort of incident hemodialysis patients. METHODS: In 567 patients treated at 74 clinics, we measured patients' preferences by t…
Comorbidity and Outcomes of Coronary Artery Bypass Graft Surgery at Cardiac Specialty Hospitals Versus General Hospitals
BACKGROUND: Cardiac specialty hospitals assert better patient outcomes and efficiency, whereas general hospitals contend they attract healthier patients. OBJECTIVES: To ascertain whether increased cardiac specialization of a hospital's services is associated with improved outcomes for coronary artery bypass graft (CABG) surgery and whether patients with and without comorbid disease have equivalent outcomes to their counterparts at general hospita…
Individual and neighborhood socioeconomic status and progressive chronic kidney disease in an elderly population
Clinical Information Technology Capabilities in Four U.S. Hospitals
BACKGROUND: Few tools exist to quantify the performance of a hospital's information system from a user perspective. OBJECTIVES: Our objective was to develop and evaluate a survey-based metric that assesses the automation and usability of a hospital's information system. RESEARCH DESIGN AND METHODS: This is a cross-sectional study of 117 physicians and 3 chief information officers (CIOs) working in 2 community hospitals with historically low inves…
The association between women’s health information use and health care visits
Do Drug Prices Reflect Development Time and Government Investment
BACKGROUND: Lengthy development times are cited by the pharmaceutical industry as one reason for high drug prices. OBJECTIVE: We compared the prices of different groups of drugs after accounting for development time, government support, market size, and other drug characteristics. DESIGN: We conducted a retrospective study of 180 human therapeutic drugs categorized into 8 drug groups by assembling data on drug development times, government suppor…
Cultural Competence
OBJECTIVE: We sought to synthesize the findings of studies evaluating interventions to improve the cultural competence of health professionals. DESIGN: This was a systematic literature review and analysis. METHODS: We performed electronic and hand searches from 1980 through June 2003 to identify studies that evaluated interventions designed to improve the cultural competence of health professionals. We abstracted and synthesized data from studies…
Barriers to Health Care Access Among the Elderly and Who Perceives Them
Objectives. We evaluated self-perceived access to health care in a cohort of Medicare beneficiaries. Methods. We identified patterns of use and barriers to health care from self-administered questionnaires collected during the 1993–1994 annual examination of the Cardiovascular Health Study. Results. The questionnaires were completed by 4889 (91.1%) participants, with a mean age of 76.0 years. The most common barriers to seeing a physician were th…
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–N…
The Impact of International Medical Graduate Status on Primary Care Physicians’ Choice of Specialist
BACKGROUND: Approximately one fourth of practicing physicians in the United States graduated from medical schools in other countries. It is unknown how the role of international medical graduate status affects physician decision-making. OBJECTIVE: The objective of this study was to determine whether a primary care physicians' knowledge of a specialist's international medical graduate status affects his or her decision to refer patients to that sp…
Race and trust in the health care system
Objective.A legacy of racial discrimination in medical research and the health care system has been linked to a low level of trust in medical research and medical care among African Americans.While racial differences in trust in physicians have been demonstrated, little is known about racial variation in trust of health insurance plans and hospitals.For the present study, the authors analyzed responses to a cross-sectional telephone survey to ass…
Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race
BACKGROUND: African-American patients who visit physicians of the same race rate their medical visits as more satisfying and participatory than do those who see physicians of other races. Little research has investigated the communication process in race-concordant and race-discordant medical visits. OBJECTIVES: To compare patient-physician communication in race-concordant and race-discordant visits and examine whether communication behaviors exp…
Designing and evaluating interventions to eliminate racial and ethnic disparities in health care
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–N…
Barriers to Health Care Access Among the Elderly and Who Perceives Them
Objectives. We evaluated self-perceived access to health care in a cohort of Medicare beneficiaries. Methods. We identified patterns of use and barriers to health care from self-administered questionnaires collected during the 1993–1994 annual examination of the Cardiovascular Health Study. Results. The questionnaires were completed by 4889 (91.1%) participants, with a mean age of 76.0 years. The most common barriers to seeing a physician were th…
Individual and neighborhood socioeconomic status and progressive chronic kidney disease in an elderly population
Geographic Socioeconomic Status, Race, and Advanced-Stage Breast Cancer in New York City
Objectives. This study examined the association between a residential area's socioeconomic status (SES), race, and advanced-stage breast cancer in New York City. Methods. The cross-sectional study design used breast cancer information for 37 921 cases diagnosed in New York City from 1986 to 1995. Residential education and income levels were based on the 1990 census and ascribed to each case by zip code. Associations between race, area SES, and ad…
African American and Non-African American Patients' and Families' Decision Making About Renal Replacement Therapies
We conducted focus group meetings of African American and non-African American patients with end-stage renal disease (six groups) and their family members (six groups), stratified by race/ethnicity and treatment. We elicited differences in participants' experiences with shared decision making about initiating renal replacement therapy (RRT; that is, hemodialysis, peritoneal dialysis, or a kidney transplant). Patients were often very sick when ini…
Risk Reduction From Low Osmolality Contrast Media
Decisions regarding the use of and reimbursement for new medical technologies frequently involve complex cost-quality trade-offs. Among physicians, hospital administrators, and insurers, interindividual variation in the value of benefits attributable to these technologies often leads to conflicting opinions about their appropriate use. Although society now encourages patient involvement in such decisions, few methods for obtaining patient valuati…
Alternative Methods for Formal Literature Review and Meta-Analysis in AHCPR Patient Outcomes Research Teams
Formal literature review and synthesis is an important component of Patient Outcomes Research Teams (PORTs) and the development of clinical practice guidelines supported by the Agency for Health Care Policy and Research (AHCPR). Investigators face unresolved methodological issues and practical problems in carrying out this work because the use of such systematic reviews is relatively new in medicine. In addition, standard meta-analytic methods ma…
The Relationship of Provider Organizational Status and Erythropoietin Dosing in End Stage Renal Disease Patients
Controversy exists as to whether provider organizational characteristics such as profit status and setting are associated with the content of medical care or efficiency with which care is rendered. Following FDA approval of human recombinant erythropoietin (EPO) for use in clinical practice, Medicare approved coverage for beneficiaries in its end stage renal disease program and established a fixed payment per dose. Because cost of EPO administrat…
A Survey of Current Problems in Meta-Analysis
The United States Agency for Health Care Policy and Research brought together representatives from each of the Patient Outcomes Research Teams (PORTs) as the Inter-PORT Meta-Analysis Work Group. The purpose of the meeting was to discuss a wide range of problems the panel had encountered in the area of meta-analysis. Several actual problems were presented, and tentative solutions to those problems were given. The PORTs had to consider issues such …
Systemwide Provider Performance in a Medicaid Program
OBJECTIVES: This study illustrates how claims data can be applied to examine cost and clinical performance of providers in the Medicaid program. METHODS: The authors conducted a cross-sectional analysis of Medicaid beneficiaries in Maryland with diabetes mellitus, hypertension, and asthma treated on an ambulatory basis by hospital-based outpatient departments, physician office-based providers, and community health centers. The study year was July…
Identification of patient attitudes and preferences regarding treatment of depression
Technology Coverage Decisions by Health Care Plans and Considerations by Medical Directors
OBJECTIVES: Decisions made by private health care plans as to whether to cover new medical technology have a significant impact on access, diffusion, and costs. This study describes the variation in health plan coverage of different laser technologies and the types of considerations used in making coverage decisions for them. METHODS: In a cross-sectional national survey of medical directors at private plans, medical directors indicated current c…
Why Don't Physicians Follow Clinical Practice Guidelines?
CONTEXT: Despite wide promulgation, clinical practice guidelines have had limited effect on changing physician behavior. Little is known about the process and factors involved in changing physician practices in response to guidelines. OBJECTIVE: To review barriers to physician adherence to clinical practice guidelines. DATA SOURCES: We searched the MEDLINE, Educational Resources Information Center (ERIC), and HealthSTAR databases (January 1966 to…
The Health Status of the Journal
Weinberger, Morris PhD; Tierney, William M. MD; Burnam, Audrey PhD; Duncan, Pamela W. PhD, PT; Escarce, José J. MD, PhD; Hays, Ron D. PhD; Horner, Ronnie D. PhD; McHorney, Colleen A. PhD; Oddone, Eugene Z. MD; Romano, Patrick MD; Powe, Neil R. MD, MPH, MBA; Stearns, Sally PhD Author Information
Mental Health Service Utilization by African Americans and Whites
OBJECTIVE: To compare mental health service utilization and its associated factors between African Americans and whites in the 1980s and 1990s. DESIGN: Household-based longitudinal study with baseline interviews in 1981 and follow-up interviews from 1993 to 1996. SETTING: The Baltimore Epidemiologic Catchment Area (ECA) Follow-Up. SUBJECTS: Subjects included 1,662 adults (590 African Americans and 1,072 whites). MAIN OUTCOME VARIABLE: Use of ment…
The Role of Peer-Reviewed Journals in Science
Weinberger, Morris PhD; Tierney, William M. MD; Ayanian, John Z. MD, MPP; Burnam, Audrey PhD; Escarce, Jose J. MD, PhD; Hays, Ron D. PhD; Horner, Ronnie D. PhD; McHorney, Colleen A. PhD; Oddone, Eugene Z. MD; Romano, Patrick MD; Powe, Neil R. MD, MPH, MBA; Stearns, Sally C. PhD Author Information
Relation of Gender and Health Insurance to Cardiovascular Procedure Use in Persons With Progression of Chronic Renal Disease
BACKGROUND: Women often are less likely than men to receive diagnostic and therapeutic invasive procedures for coronary disease. OBJECTIVE: To examine the relation between gender, health insurance, and access to cardiovascular procedures over time in persons with chronic illness. RESEARCH DESIGN: Seven-year longitudinal analyses in a cohort from the United States Renal Data System. SUBJECTS: National random sample of women and men who progressed …
Medical Care
Indonesia merupakan negara agraris yang kaya akan hasil pertaniannya, salah satunya yang terbesar yaitu padi. Padi ini kemudian diolah menjadi beras yang merupakan makanan pokok bagi sebagian besar masyarakat di Indonesia. Permasalahan yang muncul adalah kualitas beras tersebut yang masih tercampur antara beras utuh, beras patah, dan beras menir yang nantinya akan berpengaruh terhadap harga jual beras tersebut. Untuk mengatasi permasalahan di ata…
Designing and evaluating interventions to eliminate racial and ethnic disparities in health care
Geographic Socioeconomic Status, Race, and Advanced-Stage Breast Cancer in New York City
Objectives. This study examined the association between a residential area's socioeconomic status (SES), race, and advanced-stage breast cancer in New York City. Methods. The cross-sectional study design used breast cancer information for 37 921 cases diagnosed in New York City from 1986 to 1995. Residential education and income levels were based on the 1990 census and ascribed to each case by zip code. Associations between race, area SES, and ad…
Is Health Plan Employer Data and Information Set Performance Associated With Withdrawal From Medicare Managed Care
BACKGROUND: Withdrawals of health plans from Medicare have affected more than 1.6 million beneficiaries. Some plans claim that providing higher quality care raises costs, lowers profits, and spurs withdrawal because plans cannot sustain high quality care under current payment levels. OBJECTIVE: To assess whether higher performance by Medicare health plans on quality indicators was associated with withdrawal. DESIGN: Retrospective cohort study. SU…
Race and Gender Differences in Willingness to Donate Blood and Cadaveric Organs
BACKGROUND: Recent efforts to recruit blood and organ donors have only marginally improved demographic disparities in willingness to donate. Few studies have examined which factors are most important in explaining race and gender disparities in willingness to donate. OBJECTIVES: To assess race and gender differences in willingness to donate blood and cadaveric organs, and to determine the extent to which several factors (including sociodemographi…
Race and trust in the health care system
Objective.A legacy of racial discrimination in medical research and the health care system has been linked to a low level of trust in medical research and medical care among African Americans.While racial differences in trust in physicians have been demonstrated, little is known about racial variation in trust of health insurance plans and hospitals.For the present study, the authors analyzed responses to a cross-sectional telephone survey to ass…
Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race
BACKGROUND: African-American patients who visit physicians of the same race rate their medical visits as more satisfying and participatory than do those who see physicians of other races. Little research has investigated the communication process in race-concordant and race-discordant medical visits. OBJECTIVES: To compare patient-physician communication in race-concordant and race-discordant visits and examine whether communication behaviors exp…
Barriers to Health Care Access Among the Elderly and Who Perceives Them
Objectives. We evaluated self-perceived access to health care in a cohort of Medicare beneficiaries. Methods. We identified patterns of use and barriers to health care from self-administered questionnaires collected during the 1993–1994 annual examination of the Cardiovascular Health Study. Results. The questionnaires were completed by 4889 (91.1%) participants, with a mean age of 76.0 years. The most common barriers to seeing a physician were th…
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–N…
The Impact of International Medical Graduate Status on Primary Care Physicians’ Choice of Specialist
BACKGROUND: Approximately one fourth of practicing physicians in the United States graduated from medical schools in other countries. It is unknown how the role of international medical graduate status affects physician decision-making. OBJECTIVE: The objective of this study was to determine whether a primary care physicians' knowledge of a specialist's international medical graduate status affects his or her decision to refer patients to that sp…
The association between women’s health information use and health care visits
Do Drug Prices Reflect Development Time and Government Investment
BACKGROUND: Lengthy development times are cited by the pharmaceutical industry as one reason for high drug prices. OBJECTIVE: We compared the prices of different groups of drugs after accounting for development time, government support, market size, and other drug characteristics. DESIGN: We conducted a retrospective study of 180 human therapeutic drugs categorized into 8 drug groups by assembling data on drug development times, government suppor…
Cultural Competence
OBJECTIVE: We sought to synthesize the findings of studies evaluating interventions to improve the cultural competence of health professionals. DESIGN: This was a systematic literature review and analysis. METHODS: We performed electronic and hand searches from 1980 through June 2003 to identify studies that evaluated interventions designed to improve the cultural competence of health professionals. We abstracted and synthesized data from studies…
Medicine (36 obras) · Health care (16 obras) · Family medicine (15 obras) · Internal Medicine (15 obras) · Psychology (15 obras) · Gerontology (12 obras) · Nursing (11 obras) · Gerontology (10 obras) · Internal Medicine (10 obras) · Cohort (9 obras)