1999 HSR&D Annual Meeting
ABSTRACT BOOK
Table of Contents
Listing of Conference Presentations by Session
Plenary Presentations…………………………………………………………2
Concurrent Paper Sessions
Session A …………………………………………………………….2
Session B …………………………………………………………….3
Session C …………………………………………………………….3
Session D …………………………………………………………….4
Workshops…………………………………………………………….4
Session E …………………………………………………………….4
Session F …………………………………………………………….5
Session G …………………………………………………………….6
Session H …………………………………………………………….6
Workshops …………………………………………………………..7
Posters ……………………………………………………………….8
Session I …………………………………………………………….12
Session J …………………………………………………………….12
Session K ……………………………………………………………14
Session L ……………………………………………………………14
Workshops ………………………………………………………….15
Complete Listing of Abstracts Submitted* by Title ……………………….16
Abstracts* …………………………………………………………………..23
Author Index ……………………………………………………………….193
*This document includes all of the submitted abstracts that were rated as acceptable methodologically. Many of these submitted abstracts would have made excellent presentations had meeting time and space permitted. These abstracts are included here as a useful reference for VA managers, researchers and other individuals who have expressed an interest in identifying individuals with particular research expertise.
1999 HSR&D Annual Meeting
Plenary Presentations, Concurrent Papers, Workshops and Poster
Listed by Session
Plenary Paper Session:Thursday, February 25, 1999 9:25AM-10:25AM
PresenterAbstract #Title
Berlowitz 1Are we Improving the Quality of Nursing Home Care: The Case of PressureUlcers?
Fihn 2Variations in Condition-Specific Health Status Among VA General Internal Medicine Clinics
Wilkins 3Patient Preferences in PSA Screening: The Impact of Shared Decision-Making Videos
Yano 4Effectiveness of VA Primary Care Firm Systems:
Preliminary Findings
Concurrent Paper Sessions
Session A:Thursday, February 25, 1999 10:40AM-12:00PM
General Mental Health Access
Presenter Abstract #Title
Hankin 5Do Patients with Mental Disorders “Unnecessarily” Use more Medical Services? Policy Implications for Mental Health Capitation
Hoff 6A Comparison of VA to Public Sector Mental Health Patients: the Connecticut Outcomes Study
Leslie 7Comparing Quality of Mental Health Care in Public Sector and Privately Insured Populations: First Efforts and Methodological Challenges
Leslie 8Comparing Reimbursement Models for VA Mental Health Services
Rosenheck 9Impact of Primary Care Satellite Clinics on Access to General Health Care Services and Mental Health Services
Session B:Thursday, February 25, 1999 10:40AM-12:00PM
HIV/Hepatitis C
PresenterAbstract #Title
Bennett 10Corticosteroid Utilization and Outcomes in HIV Associated Pneumocystis Carinii Pneumonia: Three-fold Higher Mortality among Severely Ill Patients when Corticosteroids given by CEC Guidelines
Bozzette 11Use of Centralized VA Data Registry to Assess Quality of HIV Care
Muir 12The Prevalence of Hepatitis C in a Sample of Severely Mentally Ill Veterans
Dawson 13Management of Hepatitis C at the VA Puget Sound Health Care System
Roselle 14Hepatitis C Virus Infection and Addiction Disorders in Department of Veterans Affairs Facilities Nationwide
Session C: Thursday, February 25, 1999 10:40AM-12:00PM
Quality Databases
PresenterAbstract #Title
Geraci 15Mortality after Cardiac Bypass Surgery: Prediction from Administrative versus Clinical Data
Gordon 16The Houston Approach to Optimal Risk-Adjustment Using Administrative Data
Johnson 17A Markov Model of Severity of Illness States and Hospital Mortality
Johnson 18Hospital Profiles of Mortality from Cardiac Bypass Surgery: Effect of Definition of Outcome Based on Administrative versus Clinical Data
Szeto 19Accuracy of Computer Identified Diagnoses in a VA General Medicine Clinic
Session D:Thursday, February 25, 1999 10:40AM-12:00PM
Prostate
PresenterAbstract #Title
Kim 20Prostate Cancer Quality of Life and Outcomes Research among Patients with Low Socioeconomic Status: An Overview of the VA Cancer of the Prostate Outcomes Study (VA CaPOS)
Yano 21Prevalence of Lower Urinary Tract Symptoms and Associated Resource Utilization among VA Primary Care Patients
Wilt 22Relative Effectiveness of Androgen Suppressive Therapies for Advanced Prostate Cancer
Zemencuk 23Men’s Beliefs about the Benefits of and Professional Recommendations for PSA Screening
Saint 24Preventing Urinary Tract Infection using Urinary Catheters Coated with Silver Alloy: a Cost-Effectiveness Analysis
WorkshopsThursday, February 25, 1999 10:40am-12:00pm
PresenterAbstract #Title
Bradham 25HSR&D Development Center Workshop
Ibrahim 26Internet-Based Education for Epidemiology
Reiber 27Using National VA Data in Health Services and Epidemiologic Research
Session E:Thursday, February 25, 1999 3:45pm-5:30pm
Health-Related Quality of Life: Patient Centered Measures
PresenterAbstract #Title
Burman 28Continuity of Care as a Determinant of Patient Satisfaction. Results from the ACQUIP Study.
Burman 29Patient Satisfaction Among Veterans Varies by Disease Condition but not by Symptom Burden. Results from the ACQUIP Study.
Session E:(continued)Thursday, February 25, 1999 3:45pm-5:30pm
Health-Related Quality of Life: Patient Centered Measures
PresenterAbstract #Title
Gralnek 30A Disease-Targeted Measure of Health-Related Quality of Life (HRQOL) for Patients with Chronic Liver Disease: The LDQOL 1.0.
McDonell 31Measuring the Job Satisfaction of Providers in VA Primary Care: the Seattle Provider Satisfaction Questionnaire (SPSQ)
Selim 32Patient Characteristics and Patterns of use of Lumbar Spine Radiographs: Results from the Veterans Health Study.
Starks 33Positive Effects of a Workbook-centered Advance Care Planning Intervention.
Peck 34Measuring Patient Expectations: Does the Measurement Instrument Affect the Number of Expectations Elicited and Patient Satisfaction?
Session F:Thursday, February 25, 1999 3:45pm-5:30pm
Special Populations
PresenterAbstract #Title
Dubbert 35Barriers to Walking for Exercise in Elderly Primary Care Patients.
Dubbert 36Validity of Physical Activity Recall in Urban and Rural Elderly Men.
Evans 37Multidisciplinary Rehabilitation versus Medical Care use of Meta-Analysis to Determine the Clinical Effectiveness of Physical Medicine.
Ibrahim 38Racial Variation in Congestive Heart Failure Mortality among the Elderly.
Kiefe 39African American Veterans with Coronary Artery Disease Report Worse Health and Less Satisfaction with Care than Whites: Results from the ACQUIP Survey.
Collins 40Racial Variation in Mortality Following Elective Surgery for Vascular Disease
Session F: (continued)Thursday, February 25, 1999 3:45pm-5:30pm
General Health Services Research
PresenterAbstract #Title
Morton 41 Antimicrobial Prophylaxis for Urinary Tract Infection in Persons with Spinal Cord Dysfunction.
Session G:Thursday, February 25, 1999 3:45pm-5:30pm
General Health Services Research
PresenterAbstract #Title
Baldwin 42Predictors of Outcomes in Patients with Type 2 Diabetes Mellitus
Sipler 43Variations in Institutional Review Board (IRB) Approvals for Allowing Third Party Medical Record Reviews of HIV-infected Individuals without Patient Consent. The Multicity PCP Quality of Care Study.
Garvey 44Tailoring Smoking Cessation Treatments Based on Nicotine Dependence Level and Depression Status of Patients.
Sherman 45The Effectiveness of Bupropion vs. Bupropion Plus Nicotine Patch in a Smoking Cessation Clinic.
Whited 46Reliability and Accuracy of Dermatologists’ Digital Image Consultations.
Wright 47 Use of VA Services by Medicare HMO Enrollees.
Wright 48Validating Ascertainment of Mortality Using Multiple Administrative Data.
Session H:Thursday, February 25, 1999 3:45pm-5:30pm
Access/Use of Health Care
PresenterAbstract #Title
Borowsky 49Veterans’ Preferences for Transfer of Primary Care to Community Based Outpatient Clinics (CBOC): Association with Health Status, Satisfaction with VA Care, and Prior use of VA Care.
Session H: (continued)Thursday, February 25, 1999 3:45pm-5:30pm
Access/Use of Health Care
PresenterAbstract #Title
Byrne 50Effect of Facility-Level Characteristics on Primary Care Enrollment and Bed-days of Care.
Dresselhaus 51Determinants of House Staff Time Use in the Inpatient
Setting
Gifford 52Effects of Race, Income, and Psychological Well-being on HIV Patient Decisions about Emergency Department (ED) Use.
Lam 53Cost-effectiveness of the Primary Care Provider Program at the West Los Angeles VAMC.
Thompson 54The Impact of Involving LPNs in Colorectal Cancer Screening
Washington 55A Standardized Method for Assessing Urgency Among Walk-in VA Patients.
WorkshopsThursday, February 25, 1999 3:45pm-5:30pm
PresenterAbstract #Title
Barnett 56Determining the Cost of VA Health Care
Hendricks 57Using VHA Administrative Data to Measure Performance: Methodological Issues of HEDIS
Rosen 58Implementing Ambulatory Care Case-Mix Measures in the VA: From Theory to Practice
PostersThursday, February 25,1999 5:30pm-8:00pm
PresenterAbstract #Title
Bauer 59Are Clinical Practice Guidelines Implemented in Clinical Practice?
Bauer 60VA Cooperative Study #430: “Reducing the Efficacy-Effectiveness Gap in Bipolar Disorder”
Bittner 61Consistent Satisfaction Measured by American Board of Internal Medicine Patient Satisfaction Questionnaire Following Initial Evaluation of inpatients by VA Medical Center Interns.
Bosworth 62The Effect of Depression on Change in Stroke Patients’ Physical and Mental Health.
Chaney 63Implementing Depression Screening in Primary Care: An Effective Strategy?
Chapko 64Coronary Artery Stent Outcomes in Department of Veterans Affairs Medical Centers.
Cronkite 65Symptom-Based Predictors of a Ten-Year Course of Treated Depression.
Czarnowski 66Family Satisfaction with VA Hospice Care.
Druss 67Mental Health Services Delivery in the Department of Veterans Affairs: Treatment in Psychiatric, Primary Care, and Specialty Medical Settings.
Dubbert 68Provider Advice and Walking for Exercise in Elderly Primary Care, and Specialty Medical Setting.
Evans 69Evaluating Screening Criteria for Adverse Outcomes in Medical Patients
Gaehde 70A Pilot Study: Telecare in the Management of Diabetes.
Posters (continued)Thursday, February 25,1999 5:30pm-8:00pm
PresenterAbstract #Title
Good 71Assessing VA’s National Formulary Policy by Physician Survey.
Harada 72Does Military Status Influence Use of VA Ambulatory Care?
Hasenberg 73How Primary Care Providers Treat Depression: Attitudes, Skills, Barriers and Personal Experience.
Hechtel 74The Use of Ambulatory Care Sensitive Hospitalization as a Qualitative Indicator of Primary Care.
Humphreys 75Treatment can Enhance the Effectiveness of Substance Abuse Self-Help Groups.
Jones 76Do Oral Health-Related Quality of Life Measures Relate to use of Dental Care?
Kazis 77Health Outcomes of Veterans using SF-36V: 1998 National Survey of Ambulatory Care Patients.
Keane 78Multi-Site Research: Overcoming Hurdles.
King 79Toward Gender-Aware VA Health Care: Staff Ideology, Sensitivity, and Knowledge.
Kressin 80Is Depression Associated with Oral Health-Related Quality of Life?
Kubal 81An Overview of the Decision Support System.
Lee 82Establishing Clinical Equivalence: An Example from a Study of Self-care Center versus Full-care Hemodialysis.
Lee 83Evaluating the Effect of Primary Care Clinic Visits on Survival for Hospitalization.
Lee 84The Economic Impact of Automated Primary Screening for Cervical Cancer: Use of a Markov Chain Model.
Lohr 85Patient-Centered Alternative to Psychiatric Hospitalization.
Posters (continued)Thursday, February 25,1999 5:30pm-8:00pm
PresenterAbstract #Title
Loveland 86VA Utilization by Level of Diagnostic Cost Group (DCG) Predicted Risk.
Maciejewski 87Mortality and Days of Survival for Medicare Beneficiaries in the Fee-for-Service and HMO Systems.
Mares 88Recidivism among Veterans with Schizophrenia Living in Board and Care: An Outcome Evaluation of the Community Residential Care Program.
Meier 89Patterns of Medical Treatment for Congestive Heart Failure (CHF) in a Veteran Population.
Menke 90Comparison of Health Care Use and Outcomes for HIV-Infected Patients in VA versus Non-VA Settings.
Menke 91Developing Algorithms to Define Episodes of Care.
Mittman 92Designing Guidelines for Successful Dissemination and Implementation: The California Guidelines for Alzheimer’s Disease Management.
Penrod 93Health and Functional Status Differences between Veterans Admitted to State Veterans Homes Compared to Community Nursing Homes.
Piette 94Access to Care among Adults with Diabetes in VA and County Clinics.
Pietz 95Ambulatory Care Groups and SF-36 Mental and Physical Component Summary Scores.
Pogach 96Development of a Case Mix Adjustment Model for Hemoglobin Alo.
Pyne 97Extending the use of the Self-Administered Quality of Well-Being Scale to Patients with Depression.
Posters (continued)Thursday, February 25,1999 5:30pm-8:00pm
PresenterAbstract #Title
Ren 98The Relationship Between Functional Status and Satisfaction of Care Among Patients Served by the Veterans Health Administration.
Render 99VISN 10 Automated ICU Severity Adjustment Tool: SISVISTA
Rosansky 100Psychogeriatric Interventions Saves Inpatient Costs: Preliminary Findings.
Souchek 101One-Year Mortality Rates for all Users of the VA Medical Care System.
Steele 102Accelerometer Activity Monitoring in a Sedentary Population: Methodology, Clinical Utility, Validity
Steinhauser 103Defining the Attributes of the Quality of Dying: Perspectives of Patients, Families and Health Care Providers.
VanDeusen Lukas 104Integrating VA Medical Centers.
Weaver 105Characteristics and Outcomes of Women Undergoing Hysterectomies in VA Facilities.
Whooley 106Depression, Falls, and Risk of Fracture in Older Women.
Wu 107Comparing Approaches to Predict Decline in Functional Status in the VA Long-Term Care Population.
Zalenski 108ACI-TIPI Intervention in the Triage of Urgest Care Patients with Chest Pain
Pre-Post-Doctoral Poster SessionThursday, February 25, 1999 5:30pm-8:00pm
PresenterAbstract #Title
Bokhour 109Improving the Quality of Interdisciplinary Team Meetings: The use of In-Depth Qualitative Research to Understand Team Processes.
Chun 110 Gender Differences in Addiction Severity, Health Status, and Psychosocial Functioning in Veterans with Substance Use Disorders.
Cotton 111Seeking Care in the VA: What Differentiates Level of VA use for Women Veterans?
Curran 112Depression Post-Alcohol Treatment and Drinking Outcomes; Implications for Clinical Intervention and Research Design.
Fink 113Efficacy and Safety of Medical Interventions for Male Erectile Dysfunction: A Systematic Review.
Gardner 114The Effect of Electrical Stimulation on Chronic Wound Healing: A Meta-Analysis.
Kemppainen 115Predictors of Quality of Life in AIDS Patients.
Licht 116Variations and Conflicts in Clinical Practice Guideline Recommendations: Sources and Implications.
Miller 117A Population-Based Survey of Tuberculosis Symptoms: Insight into the Utility of Symptom-Based Screening for Active Disease.
Rosen 118Consistency of Self-Administered ASI Composites with the Interview ASI.
Session I:Friday, February 26, 1999 8:00am-9:30am
General Epidemiology
PresenterAbstract #Title
Branch 119Rediscovering the Patient’s Role in Receiving Health Promotion Services.
Session I:Friday, February 26, 1999 8:00am-9:30am
General Epidemiology
PresenterAbstract #Title
Fink 120The Accuracy of Physical Examination to Detect Abdominal Aortic Aneurysm.
MacLean 121The Risk of Gastrointestinal Complications from Nonsteroidal Anti-inflammatory Drugs: a Meta-Analysis.
Nachtigall 122Depression, Self-Care, and Glycemic Control in Patients with Diabetes Mellitus.
Provenzale 123Colorectal Cancer: Risk Factors for Advanced Disease – Comparison of Stage at Diagnosis with SEER Cancer Statistics.
Reiber 124Epidemiology Education Preferences of VA Administrators, Clinicians and Researchers.
Session J:Friday, February 26, 1999 8:00am-9:30am
Quality
PresenterAbstract #Title
Murdoch 125Impact of a Low-cost Intervention on the Cholesterol Awareness of Older Veterans Enrolled in an Ambulatory Care Clinic.
Luck 126Measuring the Validity of Chart Abstraction: Should we use it as a Quality Improvement Tool?
McDonell 127Validation of a Computerized Adaptation of the Charlson Index using the SF-36 Among VA Outpatients.
Niakan 128Appropriateness of Quinidine use at a Veterans Affairs Medical Center.
Sales 129Testing the Performance of VHA’s 1997 Ambulatory Care Survey Instrument
Young 130Patient-Level and Facility-Level Factors Affecting Patient Satisfaction Ratings of VA Care.
Session K:Friday, February 26, 1999 8:00am-9:30am
Health Services Research/Cost
PresenterAbstract #Title
Chang 131Comparing Facilities on Functional Status Decline: A Hierarchical Bayes Linear Modeling Approach.
Hughes 132 Cost Effectiveness of Team Managed Home Based Primary Care.
Hynes 133Cost Effectiveness of a Primary Care Intervention: Results from a VA Cooperative Study.
Meier 134Cost Savings Associated with Limited Academic Detailing to Promote Hypertension (HTN) Clinical Practice Guidelines.
Phillips 135The Impact of Per-Episode Payment for Medicare Home Health Care on the Use of Non-Medicare Services: A Randomized Control Trial.
Saint 136Cost-effectiveness of Antiseptic-impregnated Central Venous Catheters in the Critically Ill.
Session L:Friday, February 26, 1999 8:00am-9:30am
Mental Health
PresenterAbstract #Title
Covinsky 137Depressive Symptoms and Three-Year Mortality in Hospitalized Elders.
Lenert 138Conflicts in Values for Health Outcomes in Schizophrenia.
Linn 139Evaluating the Effectiveness of Telemedicine for Enhancing Compliance in the Treatment of Schizophrenia.
Mansell 140Validity of a Alcohol Severity Measure in Ambulatory Patients with Alcohol Disorders.
Owen 141 Guideline-Concordant Antipsychotic Dose and Outcomes of Routine Care for Schizophrenia.
Session L: (continued)Friday, February 26, 1999 8:00am-9:30am
Mental Health
PresenterAbstract #Title
Murdoch 142Gender Differences in VA Disability Benefits for PTSD after Controlling for Combat Exposure.
WorkshopsFriday, February 26, 1999 8:00am-9:30am
PresenterAbstract #Title
Captain 143Using Focus Group Methodology in the VA System.
Lee 144Evaluating Health Care Organizational Change: Benefits and Limitations of Hierarchical and Structural Equation Modeling.
Pugh 145VA National Guidelines, Strategies for Implementation, Local Modifications, and Ways to Quantitatively Assess Guideline Impact.
Complete Listing of Abstracts Submitted
Listed Alphabetically by Title
This listing includes all of the submitted abstracts that were rated as acceptable methodologically. Many of these submitted abstracts would have made excellent presentations had meeting time and space permitted. Abstracts NOT presented at the meeting are indicated with an asterisk.
Abstract Title Abstract #
A Comparison of VA to Public Sector Mental Health Patients: the Connecticut 6
Outcomes Study
A Disease-Targeted Measure of Health-Related Quality of Life (HRQOL) for Patients 30
with Chronic Liver Disease: The LDQOL 1.0
A Markov Model of Severity of Illness States and Hospital Mortality17
A Pilot Study: Telecare in the Management of Diabetes70
A Population-based Survey of Tuberculosis Symptoms: Insight into the Utility of 117
Symptom-based Screening for Active Disease
A Standardized Method for Assessing Urgency Among Walk-in VA Patients55
*Accelerometer Activity Monitoring in a Sedentary Population: Methodology, Clinical 102
Utility, Validity
Access to Care Among Adults with Diabetes in VA and County Clinics94
Accuracy of Computer Identified Diagnoses in a VA General Medicine Clinic19
ACI-TIPI Intervention in the Triage of Urgest Care Patients with Chest Pain 108
African American Veterans with Coronary Artery Disease Report Worse Health and Less 39
Satisfaction with Care than Whites: Results Form the ACQUIP Survey
Ambulatory Care Groups and SF-36 Mental and Physical Component Summary Scores95
*Ambulatory Care Sensitive Hospitalizations for Veterans in Rural Nebraska 146
An Overview of the Decision Support System81
Antimicrobial Prophylaxis for Urinary Tract Infection in Persons with Spinal Cord41
Dysfunction
Appropriateness of Quinidine use at a Veterans Affairs Medical Center 128
Are Clinical Practice Guidelines Implemented in Clinical Practice?59
*Are U.S. Veterans Still the Forerunners of Retirement Migration 147
Are we Improving the Quality of Nursing Home Care: the Case of Pressure Ulcers 1
Assessing VA’s National Formulary Policy by Physician Survey71
*Barriers to Adherence to Highly Active Antiretroviral Therapy as Expressed by 148
People Living with HIV/AIDS
Barriers to Walking for Exercise in Elderly Primary Care Patients35
*Cancer Related Fatigue: Traversing the Edge 149
Characteristics and Outcomes of Women Undergoing Hysterectomies in VA Facilities 105
Colorectal Cancer: Risk Factors for Advanced Disease Comparison of Stage at 123
Diagnosis with SEER Cancer Statistics
Comparing Approaches to Predict Decline in Functional Status in the VA Long-Term 107
Care Population
Comparing Facilities on Functional Status Decline: A Hierarchical Bayes Linear 131
Modeling Approach
Comparing Quality of Mental Health Care in Public Sector and Privately Insured 7
Populations: First Efforts and Methodological Challenges
Comparing Reimbursement Models for VA Mental Health Services8
Abstract #
Comparison of Health Care Use and Outcomes for HIV-Infected Patients in VA versus 90
Non-VA Settings
Conflicts in Values for Health Outcomes in Schizophrenia 138
Consistency of Self-Administered ASI Composites with the Interview ASI 118
Consistent Satisfaction Measured by American Board of Internal Medicine Patient 61
Satisfaction Questionnaire Following Initial Evaluation of Inpatients by VA
Medical Center Interns
Continuity of Care as a Determinant of Patient Satisfaction. Results from the ACQUIP Study 28
Coronary Artery Stent Outcomes in Department of Veterans Affairs Medical Centers 64
Corticosteroid Utilization and Outcomes in HIV Associated Pneumocystis Carinii 10
Pneumonia: Three-fold Higher Mortality among Severely Ill Pateints when
Corticosteriods Given by CEC Guidelines
Cost Effectiveness of a Primary Care Intervention: Results from a VA Cooperative Study 133
Cost Effectiveness of Team Managed Home Based Primary Care 132