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Fri, March 12, 2010

Peter Ubel, MD, spoke recently at the DeVos Medical Ethics Colloquy at Grand Valley State University in Grand Rapids, Michigan. Dr. Ubel's presentation, "Rationing vs. Rationalizing Health Care," was covered by news outlets in western Michigan. To see a clip from television reports, go to http://www.peterubel.com.

Dr. Andrew Barnosky stepped down from his role as Adult Ethics Committee chair, which is a position he has served for the last 16 years. CBSSM Faculty member Dr. Andrew G. Shuman will be the new committee chair. Dr. Barnosky will continue as a member of the faculty and a member of the Committee. The UMHS press release can be found here.

Carl Schneider, JD

Faculty

Carl E. Schneider is the Chauncey Stillman Professor for Ethics, Morality, and the Practice of Law and is a Professor of Internal Medicine. He was educated at Harvard College and the University of Michigan Law School, where he was editor in chief of the Michigan Law Review. He served as law clerk to Judge Carl McGowan of the United States Court of Appeals for the District of Columbia Circuit and to Justice Potter Stewart of the United States Supreme Court. He became a member of the Law School faculty in 1981 and of the Medical School faculty in 1998. 

Last Name: 
Schneider

Funded by National Institutes of Health

Funding Years: 2014-2016

Nearly half of patients undergoing coronary artery bypass grafting (CABG) nationwide are exposed to red blood cell (RBC) products. While large volumes (3+ units) of transfusions may be delivered to a given patient to preserve life in cases of acute blood loss, evidence suggests that even small amounts (1-2 units) of RBCs often transfused to address poor oxygen delivery are associated with a 16% increase in a patient's risk of mortality and a 27% increase in morbidity, even after case mix adjustment. It is vitally important to allocate RBC products appropriately, given both that cardiac surgery utilizes between 20-25% of the total national blood supply, and the Red Cross reports that 32 of their 36 regions had less than a day's supply available to meet hospital needs. In short, it is important to improve our understanding of how and in what context decisions are made regarding 1-2 units of RBCs, given its association with morbidity, mortality and resource utilization. Growing evidence suggests that some transfusions may be discretionary. In the state of Michigan, nearly 40% of CABG patients are exposed to 1-2 units of RBCs, although the absolute rate varies 32% across institutions. Center-specific variation in transfusion practices is likely attributed to thelack of consensus regarding the indications, setting and hematocrit trigger for transfusions. Given this uncertainty, transfusion rates may be the consequence of differences in organizational (e.g. protocols, types of decision-makers, lack of performance feedback regarding transfusion practice) and provider (e.g. knowledge, beliefs concerning the benefit/harm of transfusions, and inclination to transfuse) factors. Interventions to reduce the rate of unnecessary transfusions first require identifying the set of determinants (at the organizational or provider level) that mot fully explain the observed variation in RBC utilization across regional medical centers. We will use the prospective data and infrastructure of the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC), a consortium of all 33 cardiac surgical programs in Michigan, to: (1) Develop, pilot, and implement surveys to hospitals and clinical providers within the state of Michigan to describe determinants of 1-2 units of RBC transfusions during cardiac surgery, and (2) Identify the primary organizational and provider characteristics contributing to variability in transfusions. Results from this study will set the sage for a behavioral modification study aimed at reducing the rate of RBC transfusions in the setting of cardiac surgery.

PI(s): Richard Prager, Donald Likosky

Co-I(s): Darin Zahuranec, Min Zhang, Marc Zimmerman, Milo Engoren

Funded by the U.S. Centers for Medicare and Medicaid Services

Funding Years: 2015-2016

The central objective of the Healthy Michigan Plan is to improve the health and well-being of Michigan residents by extending health care coverage to low-income adults who are uninsured or underinsured. The program also introduces a number of reforms, including cost-sharing for individuals with incomes above the Federal Poverty Level, the creation of individual MI Health Accounts to record health care expenses and cost-sharing contributions, and opportunities for beneficiaries to reduce their cost-sharing by completing health risk assessments and engaging in healthy behaviors. This project conducts the evaluation of Michigan's Medicaid expansion, the Healthy Michigan Plan (HMP).

PI(s): John Ayanian

Co-I(s): Tammy Chang, Sarah Clark, Matthew Davis, A M Fendrick, Susan Goold, Adrianne Haggins, Richard Hirth, Edith Kieffer, Jeffrey Kullgren, Sunghee Lee, Ann-Marie Rosland

Researchpalooza

Wed, August 27, 2014, 11:00am to 2:00pm
Location: 
Circle Drive in front of Med Sci I

 

This will be the first year that CBSSM will be participating in Researchpalooza. Please come and enjoy the fun!

 

Wednesday, August 27, 2014
11:00 a.m. - 2:00 p.m.
Circle Drive in front of Med Sci I

 

All UMHS employees from the Hospitals and Health Centers and Medical School are invited to celebrate this annual event.

Stop by the University Hospital Courtyard and Medical School Circle Drive for:

  • Ice Cream sundaes and sugar-free alternatives
  • Karaoke and musical entertainment
  • Festival Games
  • Department and vendor tables with information and giveaways

 

For more info: http://medicine.umich.edu/medschool/research/office-research/research-news-events/researchpalooza

Funded by National Institutes of Health; National Institute on Aging

Funding Years; 2011-2016

A cornerstone of the nation's social science research infrastructure, the Panel Study of Income Dynamics (PSID) is a longitudinal survey of a nationally representative sample of U.S. families. Begun in 1968, 36 waves of data have now been collected on PSID families and their descendents. Its long-term measures of economic and social wellbeing have spurred researchers and policy makers to attend to the fundamental dynamism inherent in social and behavioral processes. The PSID is increasingly being used to answer innovative social and behavioral research questions in the context of an aging society. This application proposes to collect, process, and disseminate three modules in the 2013 and 2015 waves of the PSID: 1. Health module: Including 15 minutes of survey questions on health status, health behaviors, health insurance coverage & health care costs. Linkages to the National Death Index and Medicare will be extended; 2. Wealth module: Including 10 minutes of survey questions on wealth, active savings, and pensions. Linkage to Social Security earnings and benefits records for active sample and decedents will be undertaken for the first time, and a new module to minimize errors in reports of wealth changes will be developed and implemented; and 3. Wellbeing module with related psychosocial measures: We will design and implement a mixed-mode (web/mail out) questionnaire to collect content from both respondents and spouses about their wellbeing and related psychosocial measures (e.g., personality, intelligence), with an experiment to identify (and allow researchers to adjust for if necessary) mode effects. After collection, the data will be processed and distributed in the PSID Online Data Center, which will allow users to create customized extracts and codebooks using a cross-year variable index.

PI(s): Robert Schoeni

Co-I(s): Charles Brown, James House, Mick Couper

Jeff Kullgren's editorial "Injecting Facts Into the Heated Debates Over Medicaid Expansion" was recently published in the Annals of Internal Medicine. In this editorial, Dr. Kullgren reviews Wherry and Miller's study on the effects of ACA on coverage, access, utilization, and health. 

Wherry LR, Miller S. Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions. A quasi-experimental study. Ann Intern Med 2016

Link to IHPI article.

CBSSM Seminar: Minal Patel, PhD, MPH

Thu, September 08, 2016, 3:00pm to 4:00pm
Location: 
NCRC Building 10, Conference Rm G065

Minal R. Patel, PhD, MPH
Assistant Professor, Health Behavior & Health Education

"Addressing cost-related non-adherence to treatment regimens: preliminary approaches and next steps"

Drs.  Shuman, Vercler, De Vries and Firn have been awarded a CME Innovations Grant from the Office of Continuous Professional Development to develop a multidisciplinary ethics curriculum for practicing clinicians across UMHS critical care units.

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