Chuan-Fen Liu
Dados Biográficos
| ID | 5534154 |
|---|---|
| NOME | Chuan-Fen Liu |
| PRENOMES | Chuan-Fen |
| SOBRENOME | Liu |
| ASSINATURA | LIU C |
| AFILIAÇÕES | VA Puget Sound Health Care System |
| VERIFICADO | Não |
| TOTAL DE OBRAS | 22 |
| TOTAL DE CITAÇÕES | 0 |
| TOTAL COMO AUTOR | 22 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1998 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2022 |
| ÍNDICE H | 0 |
How Did Veterans’ Reliance on Veterans Health Administration Outpatient Care Change After Expansion of the Veterans Community Care Program
BACKGROUND: The Veterans Community Care Program (VCCP) aims to address access constraints in the Veterans Health Administration (VA) by reimbursing care from non-VA community providers. Little existing research explores how veterans' choice of VA versus VCCP providers has evolved as a significant VCCP expansion in 2014 as part of the Veterans Access, Choice, and Accountability Act. OBJECTIVES: We examined changes in reliance on VA for primary car…
Events Associated With Changes in Reliance on the Veterans Health Administration Among Medicare-eligible Veterans
OBJECTIVES: We can learn something about how Veterans value the Veterans Health Administration (VHA) versus community providers by observing Veterans' choices between VHA and Medicare providers after they turn 65. For a cohort of Veterans who were newly age-eligible for Medicare, we estimated the change in VHA reliance (VHA outpatient visits divided by total VHA and Medicare visits) associated with specific events: receiving a life-threatening di…
Response to The Methodological Challenges of Using Veterans Benefits Administration Disability Codes to Ascertain Agent Orange Exposure Among Vietnam Theater Veterans With Service-connected Disabiliti…
Maynard, Charles PhD*,†; Batten, Adam BA‡; Liu, Chuan-Fen PhD*,†; Nelson, Karin MD, MSHS*,†,‡,§; Fihn, Stephan D. MD, MPH†,§ Author Information
Predicting Primary Care Use Among Patients in a Large Integrated Health System
OBJECTIVE: Most Veterans Affairs (VA) Health Care System enrollees age 65+ also have the option of obtaining care through Medicare. Reliance upon VA varies widely and there is a need to optimize its prediction in an era of expanding choice for veterans to obtain care within or outside of VA. We examined whether survey-based patient-reported experiences improved prediction of VA reliance. METHODS: VA and Medicare claims in 2013 were linked to cons…
The Methodological Challenges of Using Veterans Benefits Administration Disability Codes to Ascertain Agent Orange Exposure Among Vietnam Theater Veterans With Service-connected Disabilities
Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, …
The Impact of a Change in the Price of VA Health Care on Utilization of VA and Medicare Services
INTRODUCTION: The passage of the Veterans Access, Choice, and Accountability Act of 2014 has expanded the non-Veteran Affairs (VA) care options for eligible US Veterans. In order for these new arrangements to provide the best care possible for Veterans, it is important to understand the relationship between VA and non-VA care options. The purpose of this study was to use another recent VA policy change, one that increased the reimbursement rate t…
Impact of Multisystem Health Care on Readmission and Follow-up Among Veterans Hospitalized for Chronic Obstructive Pulmonary Disease
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common causes of readmission at Veterans Affairs (VA) hospitals. Previous studies demonstrate worse outcomes for veterans with multisystem health care, though the impact of non-VA care on COPD readmissions is unknown. OBJECTIVE: To examine the association of use of non-VA outpatient care with 30-day readmission and 30-day follow-up among veterans admitted to the VA for CO…
The Burden of Mental Illness Among Veterans
BACKGROUND: Little is known about how Veterans with service-connected conditions use health care provided by the Veterans Health Administration (VHA). OBJECTIVES: To ascertain what proportion of Veterans with service-connected conditions used VHA health care and whether it varied according to type of condition, combined disability rating, age, sex, military rank, or other characteristics and whether there were differences in receipt of inpatient …
A First Look at PCMH Implementation for Minority Veterans
BACKGROUND: Implementation of Patient Aligned Care Teams (PACT), a patient-centered medical home model, has been inconsistent among the >900 primary care facilities in the Veterans Health Administration. OBJECTIVE: Estimate if the degree of PACT implementation at a facility varied with the percentage of minority veteran patients at the facility. RESEARCH DESIGN: Cross-sectional, facility-level analysis of PACT implementation measures in 2012. SUB…
Weekend Discharges and Length of Stay Among Veterans Admitted for Chronic Obstructive Pulmonary Disease
BACKGROUND: Discharge rates are substantially lower on weekends, though the impact on hospital length of stay (LOS) is not fully understood. OBJECTIVES: The primary objective was to examine the association of weekend discharges with hospital LOS. We also examined the association of weekend discharges with readmission, mortality, and postdischarge follow-up. RESEARCH DESIGN AND METHODS: A cohort study of 25,301 patients who were admitted to Vetera…
Reducing Time-dependent Bias in Estimates of the Attributable Cost of Health Care–associated Methicillin-resistant Staphylococcus aureus Infections
BACKGROUND: Previous estimates of the excess costs due to health care-associated infection (HAI) have scarcely addressed the issue of time-dependent bias. OBJECTIVE: We examined time-dependent bias by estimating the health care costs attributable to an HAI due to methicillin-resistant Staphylococcus aureus (MRSA) using a unique dataset in the Department of Veterans Affairs (VA) that makes it possible to distinguish between costs that occurred bef…
Association Between Local Area Unemployment Rates and Use of Veterans Affairs Outpatient Health Services
BACKGROUND: Prior research indicates that federal spending on Medicare, Medicaid, and other government health programs accelerated during the Great Recession. OBJECTIVES: To examine whether local unemployment was associated with utilization of Veterans Affairs Health Care System (VA) primary care, specialty care, and mental health services during 2004-2012. RESEARCH DESIGN: We analyzed utilization of VA health services at the clinic level using f…
Patient-Centered Medical Home Implementation and Primary Care Provider Turnover
BACKGROUND: The Veterans Health Administration (VHA) began implementing a patient-centered medical home (PCMH) model of care delivery in April 2010 through its Patient Aligned Care Team (PACT) initiative. PACT represents a substantial system reengineering of VHA primary care and its potential effect on primary care provider (PCP) turnover is an important but unexplored relationship. This study examined the association between a system-wide PCMH i…
Measures of Adherence to Oral Hypoglycemic Agents at the Primary Care Clinic Level
BACKGROUND: Prior research found that in the Veterans Affairs health care system (VA), the proportion of patients adherent to oral hypoglycemic agents varies from 50% to 80% across primary care clinics. This study examined whether variation in patient and facility characteristics determined those differences. METHODS: Retrospective cohort study of 444,418 VA primary care patients with diabetes treated in 559 clinics in fiscal year (FY) 2006-2007.…
Reliance on Veterans Affairs Outpatient Care by Medicare-eligible Veterans
OBJECTIVE: To examine longitudinal changes in Medicare-eligible veterans' reliance on the Department of Veterans Affairs (VA) healthcare system for primary and specialty care over 4 years. METHODS: We merged VA administrative and Medicare claims data to examine outpatient use during fiscal years (FY) 2001 to 2004 by 15,520 Medicare-eligible veterans who used VA primary care in FY2000. Reliance on VA outpatient care was defined as the proportion o…
Nurse Staffing and Patient Care Costs in Acute Inpatient Nursing Units
OBJECTIVE: Studies suggest that a business case for improving nurse staffing can be made to increase registered nurse (RN) skill mix without changing total licensed nursing hours. It is unclear whether a business case for increasing RN skill mix can be justified equally among patients of varying health needs. This study evaluated whether nursing hours per patient day (HPPD) and skill mix are associated with higher inpatient care costs within acut…
Line Authority for Nurse Staffing and Costs for Acute Inpatient Care
There is little empirical evidence evaluating the effects of recent, widespread changes in nurse executive roles and nursing management structures on the costs of patient care. This retrospective cross-sectional study examined the relationship between line authority for nurse staffing and patient care costs (total, nursing, and non-nursing cost) using data from 124 Department of Veterans Affairs (VA) medical centers. After controlling for patient…
Medicare Managed Care Enrollment by Disability-Eligible and Age-Eligible Veterans
OBJECTIVE: To assess factors associated with enrollment in a Medicare advantage (MA) plan versus Medicare fee-for-service plan in 2000-2004 by Medicare-eligible veterans. We also assessed whether these factors differed between disability-eligible veterans and age-eligible veterans. METHODS: Medicare claims data, VA administrative data, and 2000 census data were constructed in a retrospective cohort study of 20,581 age-eligible veterans and 7541 d…
The Association Between Nursing Factors and Patient Mortality in the Veterans Health Administration
CONTEXT: Nurse staffing is not the same across an entire hospital. Nursing care is delivered in geographically-based units, with wide variation in staffing levels. In particular, staffing in intensive care is much richer than in nonintensive care acute units. OBJECTIVE: To evaluate the association of in-hospital patient mortality with registered nurse staffing and skill mix comparing hospital and unit level analysis using data from the Veterans H…
Predicting Costs of Care Using a Pharmacy-Based Measure Risk Adjustment in a Veteran Population
BACKGROUND: Although most widely used risk adjustment systems use diagnosis data to classify patients, there is growing interest in risk adjustment based on computerized pharmacy data. The Veterans Health Administration (VHA) is an ideal environment in which to test the efficacy of a pharmacy-based approach. OBJECTIVE: To examine the ability of RxRisk-V to predict concurrent and prospective costs of care in VHA and compare the performance of RxRi…
Construction and Characteristics of the RxRisk-V
BACKGROUND: Assessment of disease burden is the key to many aspects of health care management. Patient diagnoses are commonly used for case-mix assessment. However, issues pertaining to diagnostic data availability and reliability make pharmacy-based strategies attractive. Our goal was to provide a reliable and valid pharmacy-based case-mix classification system for chronic diseases found in the Veterans Health Administration (VHA) population. OB…
The Demand for Health Insurance by Employees in a Voluntary Small Group Insurance Program
OBJECTIVES: This study examined the decisions of small group employees to enroll in prepaid plans offered through Healthcare Group of Arizona (HCGA), a state-sponsored and state-administered voluntary insurance program. METHODS: The study population included 653 potential employee enrollees who were offered the option of two health plans between January 1993 and June 1993, with 447 enrolling in one of the two plans. Data sources included two tele…
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The Demand for Health Insurance by Employees in a Voluntary Small Group Insurance Program
OBJECTIVES: This study examined the decisions of small group employees to enroll in prepaid plans offered through Healthcare Group of Arizona (HCGA), a state-sponsored and state-administered voluntary insurance program. METHODS: The study population included 653 potential employee enrollees who were offered the option of two health plans between January 1993 and June 1993, with 447 enrolling in one of the two plans. Data sources included two tele…
Predicting Costs of Care Using a Pharmacy-Based Measure Risk Adjustment in a Veteran Population
BACKGROUND: Although most widely used risk adjustment systems use diagnosis data to classify patients, there is growing interest in risk adjustment based on computerized pharmacy data. The Veterans Health Administration (VHA) is an ideal environment in which to test the efficacy of a pharmacy-based approach. OBJECTIVE: To examine the ability of RxRisk-V to predict concurrent and prospective costs of care in VHA and compare the performance of RxRi…
Construction and Characteristics of the RxRisk-V
BACKGROUND: Assessment of disease burden is the key to many aspects of health care management. Patient diagnoses are commonly used for case-mix assessment. However, issues pertaining to diagnostic data availability and reliability make pharmacy-based strategies attractive. Our goal was to provide a reliable and valid pharmacy-based case-mix classification system for chronic diseases found in the Veterans Health Administration (VHA) population. OB…
The Association Between Nursing Factors and Patient Mortality in the Veterans Health Administration
CONTEXT: Nurse staffing is not the same across an entire hospital. Nursing care is delivered in geographically-based units, with wide variation in staffing levels. In particular, staffing in intensive care is much richer than in nonintensive care acute units. OBJECTIVE: To evaluate the association of in-hospital patient mortality with registered nurse staffing and skill mix comparing hospital and unit level analysis using data from the Veterans H…
Line Authority for Nurse Staffing and Costs for Acute Inpatient Care
There is little empirical evidence evaluating the effects of recent, widespread changes in nurse executive roles and nursing management structures on the costs of patient care. This retrospective cross-sectional study examined the relationship between line authority for nurse staffing and patient care costs (total, nursing, and non-nursing cost) using data from 124 Department of Veterans Affairs (VA) medical centers. After controlling for patient…
Medicare Managed Care Enrollment by Disability-Eligible and Age-Eligible Veterans
OBJECTIVE: To assess factors associated with enrollment in a Medicare advantage (MA) plan versus Medicare fee-for-service plan in 2000-2004 by Medicare-eligible veterans. We also assessed whether these factors differed between disability-eligible veterans and age-eligible veterans. METHODS: Medicare claims data, VA administrative data, and 2000 census data were constructed in a retrospective cohort study of 20,581 age-eligible veterans and 7541 d…
Reliance on Veterans Affairs Outpatient Care by Medicare-eligible Veterans
OBJECTIVE: To examine longitudinal changes in Medicare-eligible veterans' reliance on the Department of Veterans Affairs (VA) healthcare system for primary and specialty care over 4 years. METHODS: We merged VA administrative and Medicare claims data to examine outpatient use during fiscal years (FY) 2001 to 2004 by 15,520 Medicare-eligible veterans who used VA primary care in FY2000. Reliance on VA outpatient care was defined as the proportion o…
Nurse Staffing and Patient Care Costs in Acute Inpatient Nursing Units
OBJECTIVE: Studies suggest that a business case for improving nurse staffing can be made to increase registered nurse (RN) skill mix without changing total licensed nursing hours. It is unclear whether a business case for increasing RN skill mix can be justified equally among patients of varying health needs. This study evaluated whether nursing hours per patient day (HPPD) and skill mix are associated with higher inpatient care costs within acut…
Measures of Adherence to Oral Hypoglycemic Agents at the Primary Care Clinic Level
BACKGROUND: Prior research found that in the Veterans Affairs health care system (VA), the proportion of patients adherent to oral hypoglycemic agents varies from 50% to 80% across primary care clinics. This study examined whether variation in patient and facility characteristics determined those differences. METHODS: Retrospective cohort study of 444,418 VA primary care patients with diabetes treated in 559 clinics in fiscal year (FY) 2006-2007.…
Association Between Local Area Unemployment Rates and Use of Veterans Affairs Outpatient Health Services
BACKGROUND: Prior research indicates that federal spending on Medicare, Medicaid, and other government health programs accelerated during the Great Recession. OBJECTIVES: To examine whether local unemployment was associated with utilization of Veterans Affairs Health Care System (VA) primary care, specialty care, and mental health services during 2004-2012. RESEARCH DESIGN: We analyzed utilization of VA health services at the clinic level using f…
Patient-Centered Medical Home Implementation and Primary Care Provider Turnover
BACKGROUND: The Veterans Health Administration (VHA) began implementing a patient-centered medical home (PCMH) model of care delivery in April 2010 through its Patient Aligned Care Team (PACT) initiative. PACT represents a substantial system reengineering of VHA primary care and its potential effect on primary care provider (PCP) turnover is an important but unexplored relationship. This study examined the association between a system-wide PCMH i…
Weekend Discharges and Length of Stay Among Veterans Admitted for Chronic Obstructive Pulmonary Disease
BACKGROUND: Discharge rates are substantially lower on weekends, though the impact on hospital length of stay (LOS) is not fully understood. OBJECTIVES: The primary objective was to examine the association of weekend discharges with hospital LOS. We also examined the association of weekend discharges with readmission, mortality, and postdischarge follow-up. RESEARCH DESIGN AND METHODS: A cohort study of 25,301 patients who were admitted to Vetera…
Reducing Time-dependent Bias in Estimates of the Attributable Cost of Health Care–associated Methicillin-resistant Staphylococcus aureus Infections
BACKGROUND: Previous estimates of the excess costs due to health care-associated infection (HAI) have scarcely addressed the issue of time-dependent bias. OBJECTIVE: We examined time-dependent bias by estimating the health care costs attributable to an HAI due to methicillin-resistant Staphylococcus aureus (MRSA) using a unique dataset in the Department of Veterans Affairs (VA) that makes it possible to distinguish between costs that occurred bef…
A First Look at PCMH Implementation for Minority Veterans
BACKGROUND: Implementation of Patient Aligned Care Teams (PACT), a patient-centered medical home model, has been inconsistent among the >900 primary care facilities in the Veterans Health Administration. OBJECTIVE: Estimate if the degree of PACT implementation at a facility varied with the percentage of minority veteran patients at the facility. RESEARCH DESIGN: Cross-sectional, facility-level analysis of PACT implementation measures in 2012. SUB…
Impact of Multisystem Health Care on Readmission and Follow-up Among Veterans Hospitalized for Chronic Obstructive Pulmonary Disease
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common causes of readmission at Veterans Affairs (VA) hospitals. Previous studies demonstrate worse outcomes for veterans with multisystem health care, though the impact of non-VA care on COPD readmissions is unknown. OBJECTIVE: To examine the association of use of non-VA outpatient care with 30-day readmission and 30-day follow-up among veterans admitted to the VA for CO…
The Burden of Mental Illness Among Veterans
BACKGROUND: Little is known about how Veterans with service-connected conditions use health care provided by the Veterans Health Administration (VHA). OBJECTIVES: To ascertain what proportion of Veterans with service-connected conditions used VHA health care and whether it varied according to type of condition, combined disability rating, age, sex, military rank, or other characteristics and whether there were differences in receipt of inpatient …
The Methodological Challenges of Using Veterans Benefits Administration Disability Codes to Ascertain Agent Orange Exposure Among Vietnam Theater Veterans With Service-connected Disabilities
Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, …
The Impact of a Change in the Price of VA Health Care on Utilization of VA and Medicare Services
INTRODUCTION: The passage of the Veterans Access, Choice, and Accountability Act of 2014 has expanded the non-Veteran Affairs (VA) care options for eligible US Veterans. In order for these new arrangements to provide the best care possible for Veterans, it is important to understand the relationship between VA and non-VA care options. The purpose of this study was to use another recent VA policy change, one that increased the reimbursement rate t…
Response to The Methodological Challenges of Using Veterans Benefits Administration Disability Codes to Ascertain Agent Orange Exposure Among Vietnam Theater Veterans With Service-connected Disabiliti…
Maynard, Charles PhD*,†; Batten, Adam BA‡; Liu, Chuan-Fen PhD*,†; Nelson, Karin MD, MSHS*,†,‡,§; Fihn, Stephan D. MD, MPH†,§ Author Information
Predicting Primary Care Use Among Patients in a Large Integrated Health System
OBJECTIVE: Most Veterans Affairs (VA) Health Care System enrollees age 65+ also have the option of obtaining care through Medicare. Reliance upon VA varies widely and there is a need to optimize its prediction in an era of expanding choice for veterans to obtain care within or outside of VA. We examined whether survey-based patient-reported experiences improved prediction of VA reliance. METHODS: VA and Medicare claims in 2013 were linked to cons…
Events Associated With Changes in Reliance on the Veterans Health Administration Among Medicare-eligible Veterans
OBJECTIVES: We can learn something about how Veterans value the Veterans Health Administration (VHA) versus community providers by observing Veterans' choices between VHA and Medicare providers after they turn 65. For a cohort of Veterans who were newly age-eligible for Medicare, we estimated the change in VHA reliance (VHA outpatient visits divided by total VHA and Medicare visits) associated with specific events: receiving a life-threatening di…
How Did Veterans’ Reliance on Veterans Health Administration Outpatient Care Change After Expansion of the Veterans Community Care Program
BACKGROUND: The Veterans Community Care Program (VCCP) aims to address access constraints in the Veterans Health Administration (VA) by reimbursing care from non-VA community providers. Little existing research explores how veterans' choice of VA versus VCCP providers has evolved as a significant VCCP expansion in 2014 as part of the Veterans Access, Choice, and Accountability Act. OBJECTIVES: We examined changes in reliance on VA for primary car…
Medicine (21 obras) · Health care (16 obras) · Family medicine (14 obras) · Primary Care and Health Outcomes (13 obras) · Veterans Affairs (12 obras) · Chronic Disease Management Strategies (10 obras) · Healthcare Policy and Management (9 obras) · Gerontology (8 obras) · Gerontology (8 obras) · Internal Medicine (8 obras)