Lisa I Iezzoni
Dados Biográficos
| ID | 5134528 |
|---|---|
| NOME | Lisa I Iezzoni |
| PRENOMES | Lisa I |
| SOBRENOME | Iezzoni |
| ASSINATURA | IEZZONI L I |
| AFILIAÇÕES | Harvard University |
| ORCID | 0000-0002-1416-5039 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 62 |
| TOTAL DE CITAÇÕES | 55 |
| TOTAL COMO AUTOR | 62 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1987 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 4 |
Barriers to health care among rural adults by disability status
PURPOSE: Access to health care supports both individual and population health. Ample research demonstrates access barriers faced by rural residents and people with disabilities; however, less research has examined access barriers for rural residents by disability status or explored differences across multiple types of access barriers. This brief report addresses this gap by examining 11 financial and nonfinancial barriers to accessing health care…
Tailored vs. General Covid-19 prevention for adults with mental disabilities residing in group homes
ClinicalTrials.gov, NCT04726371, 27/01/2021. https://clinicaltrials.gov/study/NCT04726371
Reducing Disparities Through Online Accessibility Information
This Viewpoint describes the need for more health care organizations to include disability accessibility information on their websites and to improve physical access for patients with disabilities
Impairment and Disability Identity and Perceptions of Trust, Respect, and Fairness
In this cross-sectional survey study of US adults, health care perceptions differed between groups defined by impairment status and disability identity. These findings suggest that, alongside functional measures, health systems should capture disability identity to better address disparities for people with impairments
Physicians’ Perceptions Of People With Disability And Their Health Care
More than sixty-one million Americans have disabilities, and increasing evidence documents that they experience health care disparities. Although many factors likely contribute to these disparities, one little-studied but potential cause involves physicians' perceptions of people with disability. In our survey of 714 practicing US physicians nationwide, 82.4 percent reported that people with significant disability have worse quality of life than …
Implications of Physical Access Barriers for Breast Cancer Diagnosis and Treatment in Women With Mobility Disability
Notations described physical access barriers for breast cancer detection and treatment, with limited planning for mitigating barriers. Despite 2017 promulgation of federal Standards for Accessible Medical Diagnostic Equipment, implementing these standards requires further rulemaking
Associations Between Disability and Breast or Cervical Cancers, Accounting for Screening Disparities
INTRODUCTION: Studies suggest that women with disability experience disparities in routine, high-value screening services, including mammograms and Papanicolaou (Pap) tests. However, few studies have explored whether women with disability have higher risks than other women of developing breast or cervical cancers. METHODS: The authors analyzed 2010, 2013, 2015, and 2018 National Health Interview Surveys, which involved civilian, noninstitutionali…
Beyond Technical Standards
Efforts to include people with disability as students and practitioners in the health professions have gained momentum in recent years. However, prevailing technical standards at U.S. medical schools have biases that can prevent or impede their admission, promotion, and graduation. These standards derive from an approach first promulgated in 1979 and have since remained largely unaltered. Current technical standards at most medical schools are no…
Explicit Disability Bias in Peer Review
Department of Medicine, Mongan Institute Health Policy Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA The author declares no conflict of interest. Reprints: Lisa I. Iezzoni, MD, MSc, Department of Medicine, Mongan Institute for Health Policy, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA 02114. E-mail: [email protected]
Adaptive parenting strategies used by mothers with physical disabilities caring for infants and toddlers
There is a paucity of information concerning adaptive parenting strategies utilised by mothers with physical disabilities, particularly during early motherhood. The purpose of this study is to describe the adaptive strategies used by mothers with physical disabilities during early motherhood. This qualitative study included semi-structured telephone interviews between January and March 2014 with US mothers with a range of physical disabilities wh…
Family Attitudes and Reactions toward Pregnancy among Women with Physical Disabilities
Why Increasing Numbers of Physicians with Disability Could Improve Care for Patients with Disability
Erroneous assumptions among health care professionals about the daily lives, preferences, values, and expectations of persons with disability can contribute to documented health care disparities, faulty communication, and substandard quality of care affecting this heterogeneous population. Efforts to reduce racial and ethnic disparities have focused on expanding diversity in the physician workforce. Would expanding the numbers of physicians with …
Recommendations about Pregnancy from Women with Mobility Disability to Their Peers
Pregnancy Characteristics and Outcomes among Women at Risk for Disability from Health Conditions Identified in Medical Claims
Disparities in Receipt of Breast and Cervical Cancer Screening for Rural Women Age 18 to 64 with Disabilities
Maternal Characteristics, Pregnancy Complications, and Adverse Birth Outcomes Among Women With Disabilities
OBJECTIVES: The objective of this study is to describe the maternal characteristics, pregnancy complications, and birth outcomes among a representative sample of Rhode Island women with disabilities who recently gave birth. METHODS: Data from the 2002-2011 Rhode Island Pregnancy Risk Assessment Monitoring System survey were analyzed. RESULTS: Approximately 7% of women in Rhode Island reported a disability. Women with disabilities reported signifi…
Health Risk Factors and Mental Health Among US Women with and without Chronic Physical Disabilities by Whether Women are Currently Pregnant
Prevalence and Risk Factors for Postpartum Depression Symptoms Among Women with Disabilities
Breast and Cervical Cancer Screening Disparities Associated with Disability Severity
Conditions Causing Disability and Current Pregnancy Among US Women With Chronic Physical Disabilities
BACKGROUND: Growing numbers of reproductive-age US women with chronic physical disabilities (CPD) are becoming pregnant. Little is known about the health conditions causing their CPD. OBJECTIVES: To identify health conditions causing CPD among reproductive-age women and specifically among currently pregnant women. RESEARCH DESIGN: Cross-sectional, nationally representative National Health Interview Survey data from 2006 to 2011. SUBJECTS: A total…
Prevalence of Current Pregnancy Among US Women With and Without Chronic Physical Disabilities
BACKGROUND: The number of US women of childbearing age who have chronic physical disabilities (CPD) is increasing. However, little is known about their reproductive experiences. Historically, women with physical disabilities have confronted stigmatized attitudes about becoming pregnant. OBJECTIVES: To explore the national prevalence of current pregnancy among women with and without CPD; examine differences in current pregnancy prevalence between …
Imperatives for HSR Addressing
Department of Medicine, Mongan Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, Boston, MA The author declares no conflict of interest. Reprints: Lisa I. Iezzoni, MD, MSc, Department of Medicine, Mongan Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Room 901B, Boston, MA 02114. E-mail: [email protected]
Aging with an existing physical disability
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Eliminating Health And Health Care Disparities Among The Growing Population Of People With Disabilities
Fifty-four million people in the United States are now living with disabilities. That number will grow substantially in the next thirty years, as the "baby-boom" generation ages and many of today's children and young adults mature and experience complications related to overweight and obesity. This reality poses a major challenge to the health care and policy communities. People with disabilities confront disadvantages from social and environment…
Last Word
Harvard Medical School, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA The author declares no conflict of interest. Reprints: Lisa I. Iezzoni, MD, MSc, Director, Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford St., Suite 901H, Boston, MA 02114. E-mail: [email protected]
Judging hospitals by severity-adjusted mortality rates
OBJECTIVES: This research examined whether judgments about a hospital's risk-adjusted mortality performance are affected by the severity-adjustment method. METHODS: Data came from 100 acute care hospitals nationwide and 11880 adults admitted in 1991 for acute myocardial infarction. Ten severity measures were used in separate multivariable logistic models predicting in-hospital death. Observed-to-expected death rates and z scores were calculated w…
Admission and mid-stay MedisGroups scores as predictors of death within 30 days of hospital admission
We examined the ability of MedisGroups, a severity measure based on clinical data abstracted from the medical record, to predict mortality 30 days following admission. MedisGroups measures severity both on admission and approximately one week into the hospital stay. The data base was a random sample of 20,985 admissions of Medicare beneficiaries with one of six conditions from 833 hospitals in seven states between January 1985 and May 1986. In al…
Adaptive parenting strategies used by mothers with physical disabilities caring for infants and toddlers
There is a paucity of information concerning adaptive parenting strategies utilised by mothers with physical disabilities, particularly during early motherhood. The purpose of this study is to describe the adaptive strategies used by mothers with physical disabilities during early motherhood. This qualitative study included semi-structured telephone interviews between January and March 2014 with US mothers with a range of physical disabilities wh…
Trends in Obesity and Arthritis Among Baby Boomers and Their Predecessors, 1971–2002
Objectives. We examined trends in obesity and arthritis prevalence among the “baby boom” (born 1946–1965) and “silent” (born 1926–1945) generations. Methods. We conducted birth cohort analyses using successive waves of the National Health and Nutrition Examination Survey (1971–2002). Results. Obesity rates increased markedly, beginning earlier in life with each successive birth cohort. When the members of the silent generation were aged 35–44 yea…
Resource Disparities in Treating Persons With Disabilities for Four Common Cancers
This study explored whether cumulative Medicare outlays on breast, colorectal, lung, and prostate cancer treatment differ between persons with versus without disabilities. The authors used linked Surveillance, Epidemiology and End Results—Medicare data to compute reimbursements between cancer cases originally entitled to Medicare because of Social Security Disability Insurance (SSDI) and those receiving Old Age and Survivors Insurance (OASI) bene…
Disease Staging and PMCs
Since the adoption of Medicare's Prospective Payment System (PPS), critics have raised concerns about the degree of variation in cost per case due to variability in severity of illness within DRGs. Using hospital (Part A) costs for all Medicare beneficiaries hospitalized in Michigan during 1982, this paper applies multivariate techniques to test the ability of two state-of-the-art case-mix measures to either replace or act as a severity modifier …
Sources of Hospital Cost Variation by Urban-Rural Location
Under current law, Medicare's Prospective Payment System (PPS) recognizes a 25% differential in standardized average costs per admission between rural and urban areas. Using Medicare Part A and B claims data from four states across the country, this paper employs descriptive and multivariate techniques to explain the underlying sources of cost variation. DRG mix and within-DRG severity differences were found to contribute only 10–15% to the overa…
Admission MedisGroups Score and the Cost of Hospitalizations
Concerns about the insensitivity of Medicare's diagnosis-related groups (DRGs) to illness severity heightened interest in the potential of alternative patient classification systems to improve the fairness of hospital reimbursement. This article examines the ability of admission MedisGroups score to explain the costs of hospital stays. The database contained 54,112 patients 65 years or older discharged in 28 high-frequency DRGs from 1984 to the m…
Authors?? Response
1Center for Health Economics Research Needham, Massachusetts 2Boston University Medical Center, Evans Memorial, Department of Clinical Research and Medicine, Health Care Research Unit Boston, Massachusetts
Data Requirements
From the Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Hospital, Boston, Massachusetts
Classification Approach and Measures of Performance
From the Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Hospital, Boston, Massachusetts
Severity of Illness Measures
From the Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Hospital, Boston, Massachusetts
Conclusions
From the Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Hospital, Boston, Massachusetts
Framing the Question
From the Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Hospital, Boston, Massachusetts
Admission and mid-stay MedisGroups scores as predictors of death within 30 days of hospital admission
We examined the ability of MedisGroups, a severity measure based on clinical data abstracted from the medical record, to predict mortality 30 days following admission. MedisGroups measures severity both on admission and approximately one week into the hospital stay. The data base was a random sample of 20,985 admissions of Medicare beneficiaries with one of six conditions from 833 hospitals in seven states between January 1985 and May 1986. In al…
Admission and Mid-Stay MedisGroups?? Scores as Predictors of Hospitalization Charges
This study examines the ability of MedisGroups, a severity measure based on clinical data abstracted from the medical record, to predict hospitalization charges. MedisGroups measures severity both on admission and approximately 1 week into the hospital stay. The data base contained 23,361 admissions of Medicare beneficiaries in six conditions from 836 hospitals in seven states between January 1985, and May 1986. In all six conditions, higher admi…
The Utility of Severity of Illness Information in Assessing the Quality of Hospital Care
This research explored whether differentiating patients whose severity of illness worsened, improved, or remained the same over the hospital stay is a good screen for quality of care. The hypothesis was that substandard care is more likely to occur among patients who have worsened. Severity was measured using the Computerized Severity Index (CSI) and MedisGroups in 233 patients who had experienced acute myocardial infarction and 279 who had under…
Predicting In-Hospital Mortality
Hospital mortality statistics derived from administrative data may not adjust adequately for patient risk on admission. Using clinical data collected from the medical record, this study compared the ability of six models to predict in-hospital death, including one model based on administrative data (age, sex, and principal and secondary diagnoses), one on admission MedisGroups score, and one on an approximation of the Acute Physiology Score (APS)…
Medis Groups Data Bases
IEZZONI, LISA I. MD, MSC; HOTCHKIN, ELIZABETH K. BA; ASH, ARLENE S. PHD; SHWARTZ, MICHAEL PHD; MACKIERNAN, YEVGENIA BA Author Information
Identifying Complications of Care Using Administrative Data
The Complications Screening Program (CSP) is a method using standard hospital discharge abstract data to identify 27 potentially preventable in-hospital complications, such as post-operative pneumonia, hemorrhage, medication incidents, and wound infection. The CSP was applied to over 1.9 million adult medical/surgical cases using 1988 California discharge abstract data. Cases with complications were significantly older and more likely to die, and…
Predicting In-Hospital Mortality The Importance of Functional Status Information
Monitoring risk-adjusted outcomes is the centerpiece of efforts to ensure health care quality. Because data collection is expensive, questions arise concerning what information is essential to adjust for risk. This investigation used retrospective analysis of existing, computerized clinical databases containing laboratory test results, information on chronic coexisting conditions, and nursing evaluations of functional status to predict in-hospita…
Judging hospitals by severity-adjusted mortality rates
OBJECTIVES: This research examined whether judgments about a hospital's risk-adjusted mortality performance are affected by the severity-adjustment method. METHODS: Data came from 100 acute care hospitals nationwide and 11880 adults admitted in 1991 for acute myocardial infarction. Ten severity measures were used in separate multivariable logistic models predicting in-hospital death. Observed-to-expected death rates and z scores were calculated w…
The Importance of Comorbidities in Explaining Differences in Patient Costs
OBJECTIVES: The authors examine to what extent comorbidities contribute to differences in patient hospital costs. METHODS: The medical record data for this study were collected from 15 metropolitan Boston hospital for 4,439 patients admitted mostly in 1985 for one of eight common conditions. Massachusetts hospital discharge abstract data for 1985 and 1993 also were used. Comorbidities were identified from the medical record for the 15-hospital da…
Severity Measurement Methods and Judging Hospital Death Rates for Pneumonia
Payers and policymakers are increasingly examining hospital mortality rates as indicators of hospital quality. To be meaningful, these death rates must be adjusted for patient severity. This research examined whether judgments about an individual hospital's risk-adjusted mortality is affected by the severity adjustment method. Data came from 105 acute care hospitals nationwide that use the Medis-Groups severity measure. The study population was 1…
Financial Pressure and Competition
Using data from the American Hospital Association and the Medicare program, the authors analyzed the effects of financial pressure and market competition on changes in several measures of performance of 1,435 acute care hospitals between 1987 and 1989. Over the observation period, the least profitable hospitals constrained their growth in total expenses to half that for the most profitable hospitals (13.3% versus 27.6%) by limiting the growth of …
What Health Services Researchers Need To Know About the Health Insurance Portability and Accountability Act
Division of General Medicine and Primary Care; Department of Medicine; Beth Israel Deaconess Medical Center; Boston, Massachusetts Dr. Iezzoni is a member of the National Committee on Vital and Health Statistics (NCVHS). The views expressed here are those of Dr. Iezzoni alone, and do not necessarily represent the position of the NCVHS
Predicting In-Hospital Deaths from Coronary Artery Bypass Graft Surgery
OBJECTIVES: Severity-adjusted death rates for coronary artery bypass graft (CABG) surgery by provider are published throughout the country. Whether five severity measures rated severity differently for identical patients was examined in this study. METHODS: Two severity measures rate patients using clinical data taken from the first two hospital days (MedisGroups, physiology scores); three use diagnoses and other information coded on standard, co…
Screening Inpatient Quality Using Post-Discharge Events
BACKGROUND: Decreasing hospital lengths of stay (LOS) hamper efforts to detect and to definitively treat complications of care. Patients leave before some complications are identified. OBJECTIVES: To develop a computerized method to screen for hospital complications using readily available administrative data from outpatient and nonacute care within 90 days of discharge. DESIGN: We developed the Complications Screening Program for Outpatient data…
Does Clinical Evidence Support ICD-9-CM Diagnosis Coding of Complications
BACKGROUND: Hospital discharge diagnoses, coded by use of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), increasingly determine reimbursement and support quality monitoring. Prior studies of coding validity have investigated whether coding guidelines were met, not whether the clinical condition was actually present. OBJECTIVE: To determine whether clinical evidence in medical records confirms selecte…
Use of Administrative Data to Find Substandard Care
OBJECTIVE: The use of administrative data to identify inpatient complications is technically feasible and inexpensive but unproven as a quality measure. Our objective was to validate whether a screening method that uses data from standard hospital discharge abstracts identifies complications of care and potential quality problems. DESIGN: This was a case-control study with structured implicit physician reviews. SETTING: Acute-care hospitals in Ca…
Medicine (57 obras) · Family medicine (22 obras) · Healthcare Policy and Management (22 obras) · Internal Medicine (22 obras) · Internal Medicine (18 obras) · Emergency Medicine (16 obras) · Emergency Medicine (16 obras) · Environmental health (16 obras) · Health care (16 obras) · Population (16 obras)