Health Outcome is defined as “a change in a patient’s current and future health status that can be attributed to antecedent health care” (Donabedian 1980). Health outcomes can range from having a sense of well-being to significant weight loss or gain, to reduced health functions, to death. Factors contributing to health outcomes include patients’ health status, illness, co-morbidities and genetics along with healthcare access, demographics, socio-economics, and environmental conditions among others.
What We Do - Selected Projects
We analyze the current state for specific health outcomes and populations, and the potential for improving health outcomes through the implementation of policy and network interventions.
Comparing Health Outcomes between Infants Born to Adult and Teen Mothers:
The health status of an infant during the first year of life has been shown to be associated with health outcomes later in life. Studies have investigated longer-term outcomes for infants born to teens and found they are at risk for lower educational attainment, lower income and unemployment, increased risk for incarceration, increased health care costs and foster care, and increased risk of teen pregnancy for the child, especially in lower income populations. The focus of this research is on the health and wellbeing of infants during the first year of life, comparing health outcomes of infants born to teenage mothers to those born to adult mothers nationwide.
Pediatric Asthma
In some cases, an indirect measure of an outcome is used. For example, an asthma attack may cause the outcome of the swelling and narrowing of the airways, which results in a reduced ability to breathe. Often, such a severe outcome could lead to an emergency department (ED) visit or even hospitalization. However, not all ED visits are due to a severe asthma condition, many visits being preventable through primary and specialist care and through adherence to medication. When analyzing a potential intervention to improve health outcomes for asthma care, the rate of ED visits due to asthma is one targeted measure. In our research, we investigate not only the contributing factors to a high rate of ED visits but also potential interventions that could result in a reduction in the expected number of ED visits or hospitalizations.
Cystic Fibrosis
In projects concerning Cystic Fibrosis (CF), one primary health outcome is a change in the Percent Predicted FEV1 (%FEV1) of a particular patient. This specific medical measurement is both the underlying health outcome and the indicator that a health outcome has occurred. Using the patient-level registry data provided by the Cystic Fibrosis Foundation, we evaluate whether there is a statistically significant association between health outcomes, particularly %FEV1, and geographic access to accredited CF clinics while controlling for genetics of the patients as well as age, demographics and socio-economic status.
Publications
Published by the Health Analytics Group
Pujol, T., Serban, N., Swann, J., Kottke, M. (2021) "Assessing Health and Wellness Outcomes of Infants Born to Adolescent Mothers", Journal of Maternal and Child Health, 25(5):821-831.
Smith, A., Serban, N., Fitzpatrick, A. (2019), Asthma Prevalence Among Medicaid-enrolled Children, Journal of Allergy and Clinical Immunology: In Practice, 7(4):1207-1213.
Serban, N. (2019). Healthcare System Access: Measurement, Inference and Intervention, John Wiley & Sons, NJ.
Pujol, T., Serban, N., Swann, J., Kottke, M. (Accepted August 2018) Determining the Uptake of CDC MEC Guidelines for Contraceptive Usage of Chronically Ill Women, Preventive Disease Control, in press.
Garcia, E., N. Serban , J. Swann, and A. Fitzpatrick (2015). “A Study of the Impact of Geographic Access on Severe Health Outcomes for Pediatric Asthma”, Journal of Allergy and Clinical Immunology, featured as New Research Article, 136(6):610-618.
Rouse, W.B., Serban, N. (2014). Understanding and Managing the Complexity of Healthcare, MIT Press.
Griffin, S.O., Bailey, W., Brunson, D., Griffin, P.M., Jones, J. (2012). “Burden of Oral Disease among Older Adults and Implications for Public Health Priorities”, American Journal of Public Health, Vol. 102, pp. 411-418.
Shi, P., P. Keskinocak, J. Swann, and B. Lee (2010). “The Impact of Mixing Pattern Changes from Holidays and Traveling on Outcomes during an Influenza Pandemic.” BMC Public Health 10:778.
Ashok,. M., Griffin, P.M., and Halpern, M. (2010). "Impact of Clinical and Non-clinical Factors on the Choice of HER2 Test for Breast Cancer", Cancer Investigation, Vol. 28, No. 7, pp. 735-742.
Other Publications
Parrish RG. Measuring population health outcomes. Prev Chronic Dis 2010;7(4): A71. http://www.cdc.gov/pcd/issues/2010/jul/10_0005.htm. Accessed.
Donabedian, A. (1980), The Definition of Quality and Approaches to its Assessment, Health Administration Press, Ann Arbor, Michigan.