Summaries of Independent Scientist (K) Awards

FitzGerald, John

Institution: University of California at Los Angeles (UCLA)
Grant Title: Impact of Medicare Polices on Utilization and Outcomes
Grant Number:  K08 HS013168
Duration: 4 years (2002-2006)
Total Award: $491,000

Project Description: This research examined the impact of the Balanced Budget Act expenditure cuts on post-acute care utilization and clinical outcomes on a 100 percent sample of Medicare patients who had undergone elective joint replacement surgery or surgical management of hip fracture.  It also investigated managed care cost-shifting to the fee-for-service sector by studying managed care disenrollment prior to planned surgery (elective joint replacement) and disenrollment prior to unplanned surgery (hip fracture).

Career Goals: Dr. FitzGerald is a board-certified rheumatologist interested in applying the methodology of health economics to study fiscal policies that impact the care of patients suffering from arthritis and other rheumatic diseases.   He received his M.D. and M.P.H. at Tufts University in Boston and his Ph.D. in Health Services at UCLA.  He is an Assistant Professor in the UCLA Department of Medicine, Division of Rheumatology.

Progress to Date: This grant has been completed.  It was found that the implementation of the short stay transfer policy led to stabilization of acute care length of stay and reduced probably of "early" transfer to post-acute care.  Further, implementation of the home health interim payment system led to reductions in the probability of home health selection and reduction in the number of home health visits provided.

Highlights and Specific Accomplishments:

• Professional Societies:
  • American College of Rheumatology, Clinical Investigator Fellowship Award.
  • Arthritis Foundation, Arthritis Investigator Award.
  • Arthritis Foundation, Arthritis Investigator Award.
  • American College or Rheumatology, Clinical Investigator Fellowship.
  • American College of Rheumatology, Senior Fellow Award.

K-Generated Publications:

FitzGerald J, Orav J, Lee T, et al. Patient quality of life during the 12-months following total joint replacement surgery. Arthritis & Rheumatism (Arthritis Care & Research) 2004. 41(1):100-09

FitzGerald J, Wenger N.  Internal medicine residency didactic lectures:  Who attends and is attendance related to medical licensing exam scores?  Academic Medicine 2003. 78(1):84-89.

FitzGerald JD, Mangione C, Boscardin W, et al. Impact of changes in Medicare home health reimbursement on month-to-month home health utilization between 1996-2001 for a national sample of patients undergoing orthopedic procedures.  Medicare Care 2006. 44(9):870-78.

FitzGerald JD, Boscardin W, Hahn B, et al. Impact of the Medicare short stay transfer policy on patients undergoing major orthopedic surgery.  Health Service Research 2007. 44(1):25-44.

Weng, H, FitzGerald J. Current issues in joint replacement surgery. Current Opinion in Rheumatology 2005. 18(2):163-9.

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