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  1. Article ; Online: Evaluation of the Impact of Discharge Clinic Follow-Up Interventions on 30-Day Readmission Rates.

    Sass, Jessica / Hampton, Debra / Edward, Jean / Cardarelli, Roberto

    Population health management

    2024  Volume 27, Issue 2, Page(s) 137–142

    Abstract: Care transition programs can result in cost avoidance and decreased resource utilization. This project aimed to determine whether implementation of a discharge clinic, referral to a community paramedicine program, or a second postdischarge call affected ... ...

    Abstract Care transition programs can result in cost avoidance and decreased resource utilization. This project aimed to determine whether implementation of a discharge clinic, referral to a community paramedicine program, or a second postdischarge call affected 30-day readmission rates. This single-center retrospective exploratory design study included 727 discharged patients without access to a primary care provider who were scheduled for a discharge clinic transitions appointment. Readmission rates were 17.7% for those who completed a discharge appointment and 24.7% for those who did not; 4% for those completing a second postdischarge call and 26% for those who did not; and 11.1% for those referred to a community paramedicine program and 24.9% for those not referred. A completed discharge clinic appointment resulted in 36% lower odds of readmission. A completed discharge clinic appointment was effective in reducing 30-day readmission rates as was a follow-up call.
    MeSH term(s) Humans ; Patient Discharge ; Patient Readmission ; Aftercare ; Retrospective Studies ; Follow-Up Studies
    Language English
    Publishing date 2024-03-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2454546-6
    ISSN 1942-7905 ; 1942-7891
    ISSN (online) 1942-7905
    ISSN 1942-7891
    DOI 10.1089/pop.2023.0273
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    Zs.A 5170: Show issues Location:
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  2. Article ; Online: Ensuring the "health" of a curricular program evaluation: Alignment and analytic quality of two instruments for use in evaluating the effectiveness of an interprofessional collaboration curriculum.

    Sampson, Shannon / Nelson, Andrew / Cardarelli, Roberto / Roper, Karen L

    Evaluation and program planning

    2023  Volume 102, Page(s) 102377

    Abstract: To cultivate competencies in interprofessional collaboration (IPC) for patient-centered, team-based care, a multi-faceted training enhancement initiative was implemented at our academic primary care residency site. Evaluation of the activities from ... ...

    Abstract To cultivate competencies in interprofessional collaboration (IPC) for patient-centered, team-based care, a multi-faceted training enhancement initiative was implemented at our academic primary care residency site. Evaluation of the activities from previously collected survey data occurred upon a 2-year review. First, the evaluation team scrutinized the instruments for alignment and appropriateness with planned IPC educational learning and behavior objectives. We found the two instruments were well supported by the literature and with appropriate evidence for validation, but were not well aligned to the objectives of this IPC training initiative, reducing appropriateness of potential inferences of the findings for this context. Second, the team assessed the analytic quality of survey results in item difficulty distribution and item fit to the requirements of a Rasch measurement model. This revealed low person separation due to high overall item agreement. Most residents agreed with most items, so the measures lacked the precision necessary to capture change in residents' IPC competency. Our instrument review serves as a reminder of the need to gather validity evidence for the use of any existing tool within a new context, and offers a generalizable strategy to evaluate data sources for appropriateness and quality within a specific program.
    MeSH term(s) Humans ; Program Evaluation ; Curriculum ; Learning ; Interprofessional Relations
    Language English
    Publishing date 2023-09-22
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2013444-7
    ISSN 1873-7870 ; 0149-7189
    ISSN (online) 1873-7870
    ISSN 0149-7189
    DOI 10.1016/j.evalprogplan.2023.102377
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  3. Article ; Online: Physical Aggression and Coronary Artery Calcification: A North Texas Healthy Heart Study.

    Fulda, Kimberly G / Roper, Karen L / Dotson, Claude H / Cardarelli, Roberto

    International journal of behavioral medicine

    2021  Volume 29, Issue 1, Page(s) 14–24

    Abstract: Background: The purpose of this study was to determine the association between aspects of hostility and coronary artery calcification (CAC) scores. Specifically, analyses differentiated between subtypes of hostility and their relation to CAC.: Methods! ...

    Abstract Background: The purpose of this study was to determine the association between aspects of hostility and coronary artery calcification (CAC) scores. Specifically, analyses differentiated between subtypes of hostility and their relation to CAC.
    Methods: A sample of 571 patients aged 45 or older with no history of cardiovascular disease completed assessments of demographic, psychosocial, and medical history, along with a radiological CAC determination. Logistic regression was used to determine the association between hostility and CAC. Hostility was measured using the Aggression Questionnaire, which measured total aggression and how aggression is manifested on four scales: Physical, Verbal, Anger, and Hostility Aggression.
    Results: Regression analyses indicated that only the physical aggression parameter was related to CAC: a 5% increase in odds of CAC presence was indicated for every point increase in physical aggression. The association remained significant in adjusted analyses. Other factors associated with CAC in adjusted analyses included: age, gender, race/ethnicity, BMI, and dyslipidemia.
    Conclusions: Psychosocial factors, such as physical aggression, are emerging factors that need to be considered in cardiovascular risk stratification.
    MeSH term(s) Aggression ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Hostility ; Humans ; Risk Factors ; Texas/epidemiology
    Language English
    Publishing date 2021-04-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 1187972-5
    ISSN 1532-7558 ; 1070-5503
    ISSN (online) 1532-7558
    ISSN 1070-5503
    DOI 10.1007/s12529-021-09989-7
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5090: Show issues Location:
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  4. Article ; Online: Patient Research Interest Differences by Gender and Race/Ethnicity: A North Texas Primary Care Practice-Based Research Network (NorTex) Study.

    Shabu, Tanjina / Espinoza, Anna M / Manning, Sydney / Cardarelli, Roberto / Fulda, Kimberly G

    Journal of the American Board of Family Medicine : JABFM

    2022  Volume 35, Issue 2, Page(s) 225–234

    Abstract: Background: Recruiting and increasing participation of women and racial/ethnic groups remains an ongoing struggle despite the National Institutes of Health Revitalization Act mandating the inclusion of these populations. This study examined gender and ... ...

    Abstract Background: Recruiting and increasing participation of women and racial/ethnic groups remains an ongoing struggle despite the National Institutes of Health Revitalization Act mandating the inclusion of these populations. This study examined gender and racial/ethnic differences in research interest in participating in Practice-Based Research Network studies focused on cardiovascular disease (CVD), diabetes, cancer, and mental health research.
    Methods: A total of 1348 participants and 18 NorTex clinics from the North Texas Primary Care Registry Project (NRP) database were included in this cross-sectional study. Participants who signed up through the registry to participate in future research projects and self-reported as non-Hispanic White, Hispanic, or non-Hispanic Black were included. Research interest in heart disease, high cholesterol, high blood pressure and heart failure were categorized as CVD; depression and anxiety were categorized as mental health; diabetes and cancer research were coded as single item dependent variables.
    Results: Of registry participants, 72% were female, 34.5% were Black, and 24.4% were Hispanic. Of participants, 70% (n = 942) were interested in CVD research, the leading area of interest. Mental health research (56.3%, n = 755) was the second highest area of interest, while cancer had the least interest (38.4%, n = 515). After controlling for age, smoking, and having a diagnosis of the medical condition, gender did not predict interest in CVD, diabetes, cancer, or mental health research. However, race/ethnicity significantly predicted interest in diabetes and cancer research.
    Conclusion: Results indicate there are racial/ethnic differences in interest in specific research topics among our registry participants. This information may be helpful to develop successful recruitment strategies.
    MeSH term(s) Cross-Sectional Studies ; Ethnicity ; Female ; Hispanic or Latino ; Humans ; Primary Health Care ; Texas/epidemiology
    Language English
    Publishing date 2022-02-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2239939-2
    ISSN 1558-7118 ; 1557-2625
    ISSN (online) 1558-7118
    ISSN 1557-2625
    DOI 10.3122/jabfm.2022.02.210340
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    Zs.A 2626: Show issues Location:
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  5. Article ; Online: Lung cancer screening in Appalachian Kentucky: The impact of Lung-RADS on subsequent testing and cancer identification.

    Cardarelli, Roberto / Madabhushi, Vashisht / Bledsoe, Kacie / Weaver, Anthony

    Journal of clinical and translational science

    2019  Volume 4, Issue 5, Page(s) 468–471

    Abstract: The National Lung Cancer Screening Trial (NLST) demonstrated the use of low dose helical computed tomography (LDCT) scans for lung cancer screening. However, the NLST was implemented in urban hospitals and prior to the Lung CT Screening Reporting and ... ...

    Abstract The National Lung Cancer Screening Trial (NLST) demonstrated the use of low dose helical computed tomography (LDCT) scans for lung cancer screening. However, the NLST was implemented in urban hospitals and prior to the Lung CT Screening Reporting and Data System (Lung-RADS). In this retrospective cohort study, 774 eligible patients received LDCT screening using Lung-RADS criteria. Eighty-four patients (10.9%) had subsequent testing performed compared to 24.2% in the NLST study. Of those with subsequent testing, 21.4% were diagnosed with lung cancer compared to only 4.6% in the NLST study. Lung-RADS significantly reduced unnecessary testing while identifying higher rates of lung cancer compared to the NLST.
    Language English
    Publishing date 2019-09-12
    Publishing country England
    Document type Journal Article
    ISSN 2059-8661
    ISSN (online) 2059-8661
    DOI 10.1017/cts.2019.416
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  6. Article ; Online: The primary care workforce: a critical element in mending the fractured US health care system.

    Cardarelli, Roberto

    Osteopathic medicine and primary care

    2009  Volume 3, Page(s) 11

    Abstract: A focus on the primary care workforce is critical when discussing plans to address the fractured United States health care system. However, we must first address the primary care physician shortage crisis when planning for health care reform which ... ...

    Abstract A focus on the primary care workforce is critical when discussing plans to address the fractured United States health care system. However, we must first address the primary care physician shortage crisis when planning for health care reform which focuses on increasing access to the US population. Initial strategies may include improving reimbursement rates for primary care services, incentivizing medical schools in making primary care training a priority, and developing robust loan-forgiveness programs for those who enter and work in primary care specialties. Planning with congressional representatives about these elements will better ensure sustainable health reform efforts are implemented.
    Language English
    Publishing date 2009-10-16
    Publishing country England
    Document type Editorial
    ZDB-ID 2267663-6
    ISSN 1750-4732 ; 1750-4732
    ISSN (online) 1750-4732
    ISSN 1750-4732
    DOI 10.1186/1750-4732-3-11
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  7. Article: Texas students take initiative.

    Cardarelli, R

    Texas medicine

    1998  Volume 94, Issue 9, Page(s) 6

    MeSH term(s) American Medical Association ; Community Medicine/education ; Education, Medical ; Health Education ; Humans ; Preventive Medicine/education ; Public Health/education ; Societies, Medical ; Students, Medical ; Texas ; United States
    Language English
    Publishing date 1998-09
    Publishing country United States
    Document type Letter
    ZDB-ID 603309-x
    ISSN 0040-4470
    ISSN 0040-4470
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    Zs.B 424: Show issues Location:
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  8. Article ; Online: Combined impact of Medicare's hospital pay for performance programs on quality and safety outcomes is mixed.

    Waters, Teresa M / Burns, Natalie / Kaplan, Cameron M / Graetz, Ilana / Benitez, Joseph / Cardarelli, Roberto / Daniels, Michael J

    BMC health services research

    2022  Volume 22, Issue 1, Page(s) 958

    Abstract: Background: Three major hospital pay for performance (P4P) programs were introduced by the Affordable Care Act and intended to improve the quality, safety and efficiency of care provided to Medicare beneficiaries. The financial risk to hospitals ... ...

    Abstract Background: Three major hospital pay for performance (P4P) programs were introduced by the Affordable Care Act and intended to improve the quality, safety and efficiency of care provided to Medicare beneficiaries. The financial risk to hospitals associated with Medicare's P4P programs is substantial. Evidence on the positive impact of these programs, however, has been mixed, and no study has assessed their combined impact. In this study, we examined the combined impact of Medicare's P4P programs on clinical areas and populations targeted by the programs, as well as those outside their focus.
    Methods: We used 2007-2016 Healthcare Cost and Utilization Project State Inpatient Databases for 14 states to identify hospital-level inpatient quality indicators (IQIs) and patient safety indicators (PSIs), by quarter and payer (Medicare vs. non-Medicare). IQIs and PSIs are standardized, evidence-based measures that can be used to track hospital quality of care and patient safety over time using hospital administrative data. The study period of 2007-2016 was selected to capture multiple years before and after introduction of program metrics. Interrupted time series was used to analyze the impact of the P4P programs on study outcomes targeted and not targeted by the programs. In sensitivity analyses, we examined the impact of these programs on care for non-Medicare patients.
    Results: Medicare P4P programs were not associated with consistent improvements in targeted or non-targeted quality and safety measures. Moreover, mortality rates across targeted and untargeted conditions were generally getting worse after the introduction of Medicare's P4P programs. Trends in PSIs were extremely mixed, with five outcomes trending in an expected (improving) direction, five trending in an unexpected (deteriorating) direction, and three with insignificant changes over time. Sensitivity analyses did not substantially alter these results.
    Conclusions: Consistent with previous studies for individual programs, we detect minimal, if any, effect of Medicare's hospital P4P programs on quality and safety. Given the growing evidence of limited impact, the administrative cost of monitoring and enforcing penalties, and potential increase in mortality, CMS should consider redesigning their P4P programs before continuing to expand them.
    MeSH term(s) Hospitals ; Humans ; Inpatients ; Medicare/economics ; Patient Protection and Affordable Care Act ; Quality of Health Care ; Reimbursement, Incentive ; United States
    Language English
    Publishing date 2022-07-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-022-08348-w
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  9. Article: Recurring Limitations in OMT Research.

    Cardarelli, Roberto

    The Journal of the American Osteopathic Association

    2006  Volume 106, Issue 3, Page(s) 112–3; author reply 113–4

    MeSH term(s) Clinical Trials as Topic ; Forecasting ; Humans ; Manipulation, Osteopathic/standards ; Manipulation, Osteopathic/trends ; Needs Assessment ; Osteopathic Medicine/standards ; Osteopathic Medicine/trends ; Research/standards ; Research/trends ; United States
    Language English
    Publishing date 2006-03
    Publishing country United States
    Document type Comment ; Comparative Study ; Letter
    ZDB-ID 410350-6
    ISSN 1945-1997 ; 0098-6151 ; 0003-0287
    ISSN (online) 1945-1997
    ISSN 0098-6151 ; 0003-0287
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    Zs.B 138: Show issues Location:
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  10. Book ; Online: U.S. total factor productivity slowdown

    Cardarelli, Roberto / Lusinyan, Lusine

    evidence from the U.S. states

    (IMF working paper ; 15/116)

    2015  

    Author's details by Roberto Cardarelli and Lusine Lusinyan
    Series title IMF working paper ; 15/116
    Keywords Produktivitätsentwicklung ; Technische Effizienz ; Föderalismus ; USA
    Language English
    Size Online-Ressource (23 S.), graph. Darst., Kt.
    Publisher IMF
    Publishing place Washington, DC
    Document type Book ; Online
    ISBN 9781513520834 ; 1513520830
    DOI 10.5089/9781513520834.001
    Database ECONomics Information System

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