Outcomes

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 lung function due to asthma or cystic fibrosis, 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

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.

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.

Other proxies that can be used to measure health outcomes are utilization of medical and health care resources, such as having doctor’s visits and filling prescriptions, and missed work and school days.  We explore a baseline set of metrics for pediatric asthma along with data inference and visualization methods that can be used to summarize prevalent pathways of care.

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

Georgia Tech Contributors

Journals

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.
Moran, A., Garcia, E., Cummings, J., Serban, N. (Submitted July 2017) Healthcare Outcome Measurements for Medicaid-enrolled Children Diagnosed with Depression. Administration and Policy in Mental Health Services Research, under 2nd review.
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(3):610-8.
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.

Books

W. B. Rouse & N. Serban (2014). Understanding and Managing the Complexity of Healthcare. MIT Press

Presentations

Centers for Disease Control and Prevention, Atlanta, GA,  "Health Analytics at Georgia Tech: From Information to Knowledge to Decision Making", N. Serban, J. Swann, May, 2014. Download
Emory University, Rollins School of Public Health, Research Advisory Committee Meeting, Atlanta, GA, "Engineering in Public Health for Efficient, Effective, and Equitable Outcomes",  N. Serban, J. Swann, November, 2013. Download
Related Publications

Journals

 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.
  • Data is the new resource, and unlike money or oil sharing doesn't deplete it.
    Kairos Future
  • Information is the lifeblood of modern medicine, [and] health information technology is destined to be its circulatory system.
    David Blumenthal
  • Equal opportunity to be healthy is a right not a privilege, and therefore, healthcare is a common good, not a market commodity.
    Rouse & Serban
  • Equal opportunity to be healthy is the attainment by all people at the highest possible level of physical and mental well-being that biological limitations permit.
    Braveman & Gruskin
  • "We use the CT scan because it’s a great defense," says the CEO of another hospital not far from Stamford. "For example, if anyone has fallen or done anything around their head — hell, if they even say the word head — we do it to be safe. We can’t be sued for doing too much."
    Bitter Pill