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April 21, 2022
HSR&D Announces Best Research Paper of the Year Award Recipient
Liam Rose, PhD
A Palo Alto-based team led by Liam Rose, PhD, is the recipient of the 2021 HSR&D Best Research Paper of the Year Award, which honors a single article or collection of articles resulting from one or more HSR&D- or QUERI-funded investigations. Research studies also must involve Veterans, with results that are important to Veterans’ health and care, and to the VA healthcare system.
Dr. Rose, along with Marion Aouad, PhD, Laura Graham, PhD, Lena Schoemaker, MS, and Todd Wagner, PhD, authored the article, “Association of Expanded Health Care Networks with Utilization among Veterans Affairs Enrollees,” which was published in JAMA Network Open in October 2021. This paper reports results from the HSR&D-funded study, “Utilization and Health Outcomes for Veterans with Expanded Health Care Access.” The authors were interested in how recent VA expansions of community care eligibility might affect health care utilization. This is a difficult question to answer because those who use more community care tend to be different from those who use VA more often. Utilizing causal inference methods, they determined that the VA Choice Act caused a significant increase in outpatient (+3%), laboratory (+3%), prescription (+1%), and psychotherapy (+8%) visits without changes to inpatient use or mortality. Increased outpatient use was most concentrated among Veterans with more service-connected disabilities – and among younger Veterans without service-connected disabilities.
These results have already contributed directly to decisions facing VA leaders and Congress. The Choice Act expanded community care eligibility for approximately 700,000 enrollees. The MISSION Act, which replaced the Choice Act, further expanded care for an additional 3 million Veterans. With many more individuals now eligible, it is likely that the increase in encounters induced by these programs will further increase, with pressure to shift resources away from VA provision and into community care. This translates into millions of additional encounters per year that VA must account for, along with the increased burden of monitoring and tracking costs, quality, and outcomes across systems. Dr. Rose and colleagues continue to work with the Office of Veterans Access to Care (OVAC) on making the best use of these findings.
Dr. Rose is a health economist with HSR&D’s Health Economics Resource Center (HERC) and HSR&D’s Center for Innovation to Implementation (Ci2i): Fostering High-Value Care, both in Palo, Alto, CA. He is also affiliated with Stanford-Surgery Policy Improvement Research and Education (S-SPIRE). Dr. Aouad is an Assistant Professor of Economics at UC Irvine, having completed a post-doctoral fellowship at S-SPIRE. Dr. Graham is an investigator at HERC and is also affiliated with S-SPIRE. Ms. Shoemaker is an analyst at HERC. Dr. Wagner is the director of HERC as well as a Professor of Medicine in the Stanford Department of Surgery.
HSR&D thanks the Palo Alto team for their exceptional work and contributions to the literature, which help VA improve access to the best quality of healthcare for Veterans.
HSR&D also thanks the following Best Research Paper of the Year Nominees for their outstanding work and contributions to the field of health services research.
- Ziyad Al-Aly, MD, part of VA St. Louis Health Care, for the article “High-dimensional characterization of post-acute sequelae of COVID-19.” Nature. June 2021.
- Katharine Bloeser, MSW, PhD, part of the War Related Illness and Injury Study Center (WRIISC) at the VA New Jersey Health Care System, for the article “Because the country, it seems though, has turned their back on me: Experiences of institutional betrayal among Veterans living with Gulf War Illness.” Social Science & Medicine. September 2021.
- Guneet Jasuja, PhD, MPH, and Rani Elwy, PhD, both part of the Bridge QUERI Rapid Response Team and HSR&D’s Center for Healthcare Organization and Implementation Research (CHOIR) in Bedford and Boston, MA, for the article “Attitudes and intentions of US Veterans regarding COVID-19 vaccination.” JAMA Network Open. November 3, 2021.
- John Fortney, PhD, part of HSR&D’s Denver/Seattle Center of Innovation, for the article “Comparison of tele-integrated care and tele-referral care for treating complex psychiatric disorders in primary care: A pragmatic randomized comparative effectiveness trial.” JAMA Psychiatry. November 1, 2021.
- Brendan Heiden, MD, MPHS, and Daniel Eaton, Jr., MPH, and Varun Puri, MD, MSCI, all part of the VA St. Louis Health Care System, for the article “Comparison between Veteran and non-Veteran populations with clinical stage I non-small cell lung cancer undergoing surgery.” Annals of Surgery. May 11, 2021.
- Lucinda Leung, MD, PhD, part of HSR&D’s Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), for the article “Are Veterans getting their preferred depression treatment? A National Observational Study in the Veterans Health Administration.” Journal of General Internal Medicine. October 6, 2021.
- Nader Massarweh, MD, MPH, part of VA Atlanta Health Care, for the article “Comparative effectiveness of risk-adjusted cumulative sum and periodic evaluation for monitoring hospital perioperative mortality.” Medical Care. July 1, 2021.
- Christopher Miller, PhD, part of HSR&D’s Center for Healthcare Organization and Implementation Research (CHOIR), for the article “An economic analysis of the implementation of team-based collaborative care in outpatient general mental health clinics.” Medical Care. October 2020.
- April Mohanty, PhD, MPH, part of HSR&D’s Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), for the article “Inequities in hypertension control in the US exposed and exacerbated by COVID-19 and the role of home blood pressure and virtual health care during and after the COVID-19 pandemic.” Journal of the American Heart Association. May 2021.
- Amol Navathe, MD, PhD, part of HSR&D’s Center for Health Equity Research & Promotion (CHERP), for the article “A machine learning approach to identify distinct subgroups of Veterans at risk for hospitalization or death using administrative and electronic health record data.” PLoS One. February 2021.
- Hallie Prescott, MD, MSc, part of HSR&D’s Center for Clinical Management Research (CCMR), for the Research Letter “Readmission and death after initial hospital discharge among patients with COVID-19 in a large multi-hospital system.” JAMA. January 2021.
- Hardeep Singh, MD, MPH, part of HSR&D’s Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), for the article “Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments.” JAMIA. September 18, 2021.
- Steven Weisbord, MS, MSc, FASN, and Walid Gellad, MD, MPH, part of HSR&D’s CHERP, for the article “Source of post-transplant care and mortality among kidney transplant recipients dually enrolled in VA and Medicare.” Clinical Journal of the American Society of Nephrology. March 2021.