Tal Gross - Academia.edu (original) (raw)
Papers by Tal Gross
Diabetes Care, 2016
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Global Health Action, 2016
Initiating antiretroviral therapy (ART) early during tuberculosis (TB) treatment increases surviv... more Initiating antiretroviral therapy (ART) early during tuberculosis (TB) treatment increases survival; however, implementation is suboptimal. Implementation science studies are needed to identify interventions to address this evidence-to-program gap. The Start TB Patients on ART and Retain on Treatment (START) Study is a mixed-methods, cluster-randomized trial aimed at evaluating the effectiveness, cost-effectiveness, and acceptability of a combination intervention package (CIP) to improve early ART initiation, retention, and TB treatment success among TB/HIV patients in Berea District, Lesotho. Twelve health facilities were randomized to receive the CIP or standard of care after stratification by facility type (hospital or health center). The CIP includes nurse training and mentorship, using a clinical algorithm; transport reimbursement and health education by village health workers (VHW) for patients and treatment supporters; and adherence support using text messaging and VHW. Routine data were abstracted for all newly registered TB/HIV patients; anticipated sample size was 1,200 individuals. A measurement cohort of TB/HIV patients initiating ART was recruited; the target enrollment was 384 individuals, each to be followed for the duration of TB treatment (6-9 months). Inclusion criteria were HIV-infected; on TB treatment; initiated ART within 2 months of TB treatment initiation; age ≥18; English- or Sesotho-speaking; and capable of informed consent. The exclusion criterion was multidrug-resistant TB. Three groups of key informants were recruited from intervention clinics: early ART initiators; non/late ART initiators; and health care workers. Primary outcomes include ART initiation, retention, and TB treatment success. Secondary outcomes include time to ART initiation, adherence, change in CD4+ count, sputum smear conversion, cost-effectiveness, and acceptability. Follow-up and data abstraction are complete. The START Study evaluates a CIP targeting barriers to early ART implementation among TB/HIV patients. If the CIP is found effective and acceptable, this study has the potential to inform care for TB/HIV patients in high-burden, resource-limited countries in sub-Saharan Africa.
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Journal of Health Care for the Poor and Underserved, 2015
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The Review of Economics and Statistics, 2014
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The Journal of Urology, 2015
Regionalization of surgical care has improved the quality of care for bladder cancer patients. Th... more Regionalization of surgical care has improved the quality of care for bladder cancer patients. This paper explores if regionalization has benefited whites and blacks equally. A New York State inpatient database was used to identify all patients undergoing cystectomy for bladder cancer from 1997 to 2011. Hospital volume was classified in quintiles based on the number of cystectomies performed in the first 5 years of the study. Logistic regression was used to assess the association between race and use of low-volume/very low-volume (LV/VLV) hospitals. Racial disparities were further characterized using stratification by time period and racial composition of a subject's community. A total of 8,168 patients undergoing cystectomy for bladder cancer were included in the analysis. Compared with white race, black race was associated with a higher likelihood of LV/VLV hospital utilization (odds ratio [OR]: 1.59; 95% confidence interval [CI]: 1.26-2.02). These disparities were most prominent in 2002-2006 (OR: 2.51; 95% CI: 1.64-3.85), but did not persist in 2007-2011 (OR: 1.46; 95% CI: 0.92-2.32). Blacks living in black communities had the highest likelihood of LV/VLV hospitalization during all periods of increased regionalization (2002-2006 OR: 4.14; 95% CI: 1.84-9.34 and 2007-2011 OR: 2.40; 95% CI: 1.07-5.39). Regionalization of cystectomies have transiently worsened racial disparities in bladder cancer care, though such disparities have not persisted over time. Specific efforts may be needed to address the consequences of regionalization in particularly vulnerable subpopulations, such as black patients living in black communities, where disparities have persisted.
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Review of Economics and Statistics, 2014
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Review of Economics and Statistics, 2013
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The Quarterly Journal of Economics, 2014
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Journal of Public Economics, 2011
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Journal of Human Resources, 2014
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Journal of Economic Behavior & Organization, 2014
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American Economic Journal: Economic Policy, 2012
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Journal of Policy Analysis and Management, 2014
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Mortality disparities between high school dropouts and high school graduates may be widening over... more Mortality disparities between high school dropouts and high school graduates may be widening over time. These changes could simply reflect demographic changes among dropouts over time or could represent changes to the cognitive or social benefits of education itself. We used a unique dataset that contains 32 years of survey data, 38 years of mortality follow-up data, and a wide array of psychological, sociological, cognitive, and demographic questions to explore the underlying causes of widening disparities in survival among high school dropouts relative to graduates. We focus on individuals surveyed from 1978 through 1997, and focus on ten-year survival for each respondent. We confirm that mortality disparities between high school dropouts and high school graduates have widened over time. We also find that the racial composition, parental education, racial mix of neighborhoods, income, and verbal IQ of high school dropouts and high school graduates have changed greatly over the past three decades. However, while each of these factors is itself an important determinant of survival, we find that none of these factors (or combinations of them) explain the widening mortality disparities by high school graduation status over the two time periods we study. The widening disparities in survival time by educational attainment we observe are not linked to changes in the socio-demographic characteristics of high school dropouts relative to high school graduates.
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Diabetes Care, 2016
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Global Health Action, 2016
Initiating antiretroviral therapy (ART) early during tuberculosis (TB) treatment increases surviv... more Initiating antiretroviral therapy (ART) early during tuberculosis (TB) treatment increases survival; however, implementation is suboptimal. Implementation science studies are needed to identify interventions to address this evidence-to-program gap. The Start TB Patients on ART and Retain on Treatment (START) Study is a mixed-methods, cluster-randomized trial aimed at evaluating the effectiveness, cost-effectiveness, and acceptability of a combination intervention package (CIP) to improve early ART initiation, retention, and TB treatment success among TB/HIV patients in Berea District, Lesotho. Twelve health facilities were randomized to receive the CIP or standard of care after stratification by facility type (hospital or health center). The CIP includes nurse training and mentorship, using a clinical algorithm; transport reimbursement and health education by village health workers (VHW) for patients and treatment supporters; and adherence support using text messaging and VHW. Routine data were abstracted for all newly registered TB/HIV patients; anticipated sample size was 1,200 individuals. A measurement cohort of TB/HIV patients initiating ART was recruited; the target enrollment was 384 individuals, each to be followed for the duration of TB treatment (6-9 months). Inclusion criteria were HIV-infected; on TB treatment; initiated ART within 2 months of TB treatment initiation; age ≥18; English- or Sesotho-speaking; and capable of informed consent. The exclusion criterion was multidrug-resistant TB. Three groups of key informants were recruited from intervention clinics: early ART initiators; non/late ART initiators; and health care workers. Primary outcomes include ART initiation, retention, and TB treatment success. Secondary outcomes include time to ART initiation, adherence, change in CD4+ count, sputum smear conversion, cost-effectiveness, and acceptability. Follow-up and data abstraction are complete. The START Study evaluates a CIP targeting barriers to early ART implementation among TB/HIV patients. If the CIP is found effective and acceptable, this study has the potential to inform care for TB/HIV patients in high-burden, resource-limited countries in sub-Saharan Africa.
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Journal of Health Care for the Poor and Underserved, 2015
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The Review of Economics and Statistics, 2014
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The Journal of Urology, 2015
Regionalization of surgical care has improved the quality of care for bladder cancer patients. Th... more Regionalization of surgical care has improved the quality of care for bladder cancer patients. This paper explores if regionalization has benefited whites and blacks equally. A New York State inpatient database was used to identify all patients undergoing cystectomy for bladder cancer from 1997 to 2011. Hospital volume was classified in quintiles based on the number of cystectomies performed in the first 5 years of the study. Logistic regression was used to assess the association between race and use of low-volume/very low-volume (LV/VLV) hospitals. Racial disparities were further characterized using stratification by time period and racial composition of a subject's community. A total of 8,168 patients undergoing cystectomy for bladder cancer were included in the analysis. Compared with white race, black race was associated with a higher likelihood of LV/VLV hospital utilization (odds ratio [OR]: 1.59; 95% confidence interval [CI]: 1.26-2.02). These disparities were most prominent in 2002-2006 (OR: 2.51; 95% CI: 1.64-3.85), but did not persist in 2007-2011 (OR: 1.46; 95% CI: 0.92-2.32). Blacks living in black communities had the highest likelihood of LV/VLV hospitalization during all periods of increased regionalization (2002-2006 OR: 4.14; 95% CI: 1.84-9.34 and 2007-2011 OR: 2.40; 95% CI: 1.07-5.39). Regionalization of cystectomies have transiently worsened racial disparities in bladder cancer care, though such disparities have not persisted over time. Specific efforts may be needed to address the consequences of regionalization in particularly vulnerable subpopulations, such as black patients living in black communities, where disparities have persisted.
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Review of Economics and Statistics, 2014
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Review of Economics and Statistics, 2013
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The Quarterly Journal of Economics, 2014
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Journal of Public Economics, 2011
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Journal of Human Resources, 2014
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Journal of Economic Behavior & Organization, 2014
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American Economic Journal: Economic Policy, 2012
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Journal of Policy Analysis and Management, 2014
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Mortality disparities between high school dropouts and high school graduates may be widening over... more Mortality disparities between high school dropouts and high school graduates may be widening over time. These changes could simply reflect demographic changes among dropouts over time or could represent changes to the cognitive or social benefits of education itself. We used a unique dataset that contains 32 years of survey data, 38 years of mortality follow-up data, and a wide array of psychological, sociological, cognitive, and demographic questions to explore the underlying causes of widening disparities in survival among high school dropouts relative to graduates. We focus on individuals surveyed from 1978 through 1997, and focus on ten-year survival for each respondent. We confirm that mortality disparities between high school dropouts and high school graduates have widened over time. We also find that the racial composition, parental education, racial mix of neighborhoods, income, and verbal IQ of high school dropouts and high school graduates have changed greatly over the past three decades. However, while each of these factors is itself an important determinant of survival, we find that none of these factors (or combinations of them) explain the widening mortality disparities by high school graduation status over the two time periods we study. The widening disparities in survival time by educational attainment we observe are not linked to changes in the socio-demographic characteristics of high school dropouts relative to high school graduates.
Bookmarks Related papers MentionsView impact