Martey Dodoo | University of Maryland Global Campus (original) (raw)
Papers by Martey Dodoo
Most people with poor mental health are cared for in primary care settings, despite many barriers... more Most people with poor mental health are cared for in primary care settings, despite many barriers. Efforts to provide everyone a medical home will require the inclusion of mental health care if it is to succeed in improving care and reducing costs. Major primary care ...
American family physician, Jan 15, 2007
Health-related behavioral counseling can and should be a central offering in the medical home. Pr... more Health-related behavioral counseling can and should be a central offering in the medical home. Primary care practices currently address unhealthy behaviors with their patients, but most practices lack the integrated approaches needed to effectively change these behaviors. Revisions in practice and financing are necessary to fully realize this capacity, which could affect the millions of patients served by the largest health care delivery platform in the United States.
PEDIATRICS, 2006
Pediatric workforce studies suggest that there may be a sufficient number of pediatricians for th... more Pediatric workforce studies suggest that there may be a sufficient number of pediatricians for the current and projected US child population. These analyses do not fully consider the role of family medicine in the care of children. Family physicians provide 16% to 26% of visits for children, providing a medical home for one third of the child population, but face shrinking panels of children. Family medicine's role in children's health care is more stable in rural communities, for adolescents, and for underserved populations. For these populations, in particular, family medicine's role remains important. The erosion of the proportion of visits to family medicine is likely caused by the rapid rise in the number of pediatricians relative to a declining birth rate. Between 1981 and 2004, the general pediatrician population grew at 7 times the rate of the US population, and the family physician workforce grew at nearly 5 times the rate. The number of clinicians caring for ch...
American family …, 2009
1. Am Fam Physician. 2009 Oct 15;80(8):872. Title VII's decline: shrinking investment in the... more 1. Am Fam Physician. 2009 Oct 15;80(8):872. Title VII's decline: shrinking investment in the primary care training pipeline. Harrison B, Bazemore AW, Dodoo MS, Teevan B, Wittenburg H, Phillips RL Jr. PMID: 19835349 [PubMed - indexed for MEDLINE]. Publication Types: ...
American Journal of Preventive Medicine, 2008
American Journal of Preventive Medicine, 2008
Background: Primary care offices have been characterized as underutilized settings for routinely ... more Background: Primary care offices have been characterized as underutilized settings for routinely addressing health behaviors that contribute to premature death and unnecessary suffering. Practical tools are needed to routinely assess multiple health risk behaviors among diverse primary care patients. The performance of a brief set of behavioral measures used in primary care practice is reported here. Methods: Between August 2005 and January 2007, 75 primary care practices assessed four health behaviors, using a 21-item patient self-report questionnaire for adults or a 16-item questionnaire for adolescents. Data were collected via telephone, paper, or electronic means, either with or without assistance. The performance of these measures was evaluated by describing risk-behavior prevalences, combinations of risk behaviors, and missing data. Results: Of 227 adolescents and 5358 adults, most patients completed all of the survey questions. Two or more unhealthy behaviors were reported by 47.1% of adolescents and 69.2% of adults. Percentages of adults who completed all the survey items varied by health behavior: tobacco use, 98.5%; diet, 98.2%; physical activity, 96.2%; alcohol use, 85.1%. Missing data rates were higher for unassisted patient self-reporting. Conclusions: A relatively brief set of health behavior measures was usable in a variety of primary care settings with adults and adolescents. The performance of these measures was uneven across behaviors and administration modes, but yielded estimates of unhealthy behaviors consistent overall with what would be expected based on published population estimates. Further work is needed on measures for alcohol use and physical activity to bring practical assessment tools for key health behaviors to routine primary care practice.
Health Affairs, 2009
Health care spending varies in unexplained ways, and physicians&a... more Health care spending varies in unexplained ways, and physicians' behavior is thought to explain much of the variation. We studied the spending effects of having different usual sources of care, focusing on variations associated with the type of facility or physician specialty. Based on analyses of data from the 2001-2004 Medical Expenditure Panel Surveys, we found significant differences in annual spending, especially for adults. Use of and spending for subspecialists were similar to those for general internists, and both were significantly higher than those for family physicians. Variation in spending might be the result of training differences among primary care specialties.
Journal of the American College of Radiology, 2013
The aim of this study was to investigate trends in utilization and spending for medical imaging, ... more The aim of this study was to investigate trends in utilization and spending for medical imaging, using medical visits resulting in imaging as a novel metric of utilization. Utilization and spending for medical imaging were examined using (1) Medicare Part B claims data from 2003 to 2011 to measure per-enrollee spending and (2) household component events data on the elderly Medicare-age population from the Medical Expenditure Panel Survey from 2003 to 2010 to measure utilization as a function of clinical encounters. Annual health spending and Medicare payments for imaging for the elderly population grew from 294perenrolleein2003to294 per enrollee in 2003 to 294perenrolleein2003to418 in 2006 and had declined to $390 by 2011. Over this entire time, however, annual medical visits by a similar Medicare-age (≥ 65 years old) population resulting in imaging trended consistently downward, from 12.8% in 2003 to 10.6% in 2011. Despite early growth and then more recent declines in average Medicare spending per enrollee since 2003, the percentage of patient encounters resulting in medical imaging has significantly and consistently declined nationwide. Spending alone is thus an incomplete measure of changes in the role and utilization of medical imaging in overall patient care. As policymakers focus on medical imaging, a thoughtful analysis of payment policy influencing imaging utilization, and its role in concurrent and downstream patient care, will be critical to ensure appropriate patient access.
![Research paper thumbnail of Reforming Welfare and Rewarding Work: Final Report on the Minnesota Family Investment Program. Volume 1: Effects on Adults [and] Volume 2: Effects on Children](https://attachments.academia-assets.com/80311538/thumbnails/1.jpg)
](The Minnesota Family Investment Program (MFIP) began in 1994 as a major welfare initiative that d... more The Minnesota Family Investment Program (MFIP) began in 1994 as a major welfare initiative that differed from the Aid to Families with Dependent Children (AFDC) by featuring the following elements: financial incentives to work; participation requirements for long-term welfare recipients; and simplification of welfare rules and procedures. In volume 1, MFIP's effects on adults were evaluated as part of a comprehensive evaluation during which the program's impacts on 14,639 randomly assigned participants and a subsample of 3,245 participants were examined through a review of baseline characteristics and administrative records data and a 36-month survey of the subsample. MFIP proved more effective than AFDC in terms of the employment and earnings gains achieved by one-parent and two-parent families. (One hundred thirteen tables/figures are included. The following items are among the items appended: an evaluation of STRIDE in Hennepin County; data on participants' knowledge of programs and perception of benefit time limits; an evaluation of the food stamps only group; discussions of data issues and a survey response analysis; data on quarterly impacts on employment, earnings, and welfare benefits; a discussion of the effects of participation on two-parent families; and estimated net gains and losses for members of the Child Outcomes Sample. The bibliography lists 76 references. In Volume 2, Reproductions supplied by EDRS are the best that can be made from the original document. Upon request, this information will be made available from the Minnesota Department of Human Services in an alternative format, such as Braille, large print, or audiotape. For information about MDRC and copies of our publications, see our Web site: www.mdrc.org. MDRC® is a registered trademark of the Manpower Demonstration Research Corporation.
American Family Physician, Jun 15, 2008
A convergence of three policies could reduce physician Medicare payments by 14.9 to 22.3 percent ... more A convergence of three policies could reduce physician Medicare payments by 14.9 to 22.3 percent in 2008, which could jeopardize access for Medicare beneficiaries in underserved areas. Congress and the Executive Branch should coordinate their roles in setting Medicare payment policy, because their overlapping decisions can have additive impact.
American Family Physician, Apr 1, 2009
With a costly obesity epidemic, policy makers must recognize factors that may influence obesity n... more With a costly obesity epidemic, policy makers must recognize factors that may influence obesity not only for each person, but also across communities. Increased primary care physician density on the county level is associated with decreased obesity rates. As we move to restructure the primary care workforce and engage our patients and communities in behavior change, the implications of this association merit closer investigation.
Context: Personal characteristics are often used to explain barriers or delays in accessing healt... more Context: Personal characteristics are often used to explain barriers or delays in accessing healthcare for individuals. Ecological measures, like poverty level, are sometimes used as near-proxies for healthcare access problems for communities and populations. We combined these methods to develop indices of healthcare access deprivation or difficulty accessing care for individuals in geographically small areas in the US. In an earlier step we reviewed previous studies, identified factors associated with poor access to care and developed parsimonious models that explain poor access to healthcare at the individual level using a national survey and logistic regression methods. Design: We used data from the 2002 and 2003 National Health Interview Surveys and our earlier models that identified individual-level predictors of healthcare access deprivation, and constructed individual indices of access deprivation. We geo-coded the data and merged them including the indices with 2000 US Censu...
PURPOSE To assess the utilization of advanced brain imaging (ABI) in Medicare outpatients. METHOD... more PURPOSE To assess the utilization of advanced brain imaging (ABI) in Medicare outpatients. METHOD AND MATERIALS Using 5% research identifiable files for 2007, 740,057 new and 12,023,520 established outpatient (i.e., non-inpatient, non-emergency) evaluation and management (E&M) clinical encounters for Medicare fee-for-service beneficiaries were identified. Contemporaneous treating physician Current Procedural Terminology (CPT) codes were used to categorize patient complexity. 25,306 encounters were identified in which ABI (brain CT and/or MRI) was performed within a 4-week (2 weeks before and/or after) window of any E&M visit. Data were analyzed to determine the various associations. RESULTS Of 740,057 new patient encounters, 489,017 (66.1%) were of lower complexity and 251,040 (33.9%) were of higher complexity. Brain CT was performed in 1,360 (0.18%) of all encounters, corresponding to 712 (0.15%) lower and 648 (0.26%) higher complexity encounters (odds ratio 1.77, 95% confidence in...
Objective: To assess the possible impacts of proposed legislation in the 2007 SCHIP Bill to refor... more Objective: To assess the possible impacts of proposed legislation in the 2007 SCHIP Bill to reform the Medicare Physician Services Payment Method. Methods: The main elements of proposed legislation in the 2007 SCHIP Bill to reform the Medicare Physician Services Payment Method was: (1) replacement of the current payment method with one that retains the essential formulae but substitutes six spending targets based on procedures/services; (2) a mechanism for retiring the $54 billion Medicare Part B deficit. Using CBO projections of key variables and our econometric model (published elsewhere) we simulated the main elements of the proposed legislation, and assessed its impact on the Medicare reimbursement rate, patients, and providers, from 2008 2018. Findings: The Medicare Conversion Factor (CF) for all six spending target groups will decline 38% until 2018. The primary care and prevention group could realize continued growth if held to an alternate set of spending targets or if spend...
Context: The published literature is now unambiguous on the importance of always considering the ... more Context: The published literature is now unambiguous on the importance of always considering the multi-dimensional nature of access to medical care. Regrettably many attempts to measure access to medical care services have not done that. They have analyzed data on whole populations not insurance and population sub-groups. Many have ignored cost, affordability, and access to auxiliary medical services like prescription medications as access factors. This study aims at assessing the consequences of these omissions, by carrying out the more comprehensive analysis. Objective: Use nationally representative data to determine whether some health care providers were closing their doors to some insurance groups. Determine if there is a declining trend in access to medical services over the recent past. Methods: We analyzed data from 2001-2006 NHIS and 2003 Household survey of CTS, created two measures of access from the data from 9 survey questions, and analyzed data on 7 insurance groups. W...
Most people with poor mental health are cared for in primary care settings, despite many barriers... more Most people with poor mental health are cared for in primary care settings, despite many barriers. Efforts to provide everyone a medical home will require the inclusion of mental health care if it is to succeed in improving care and reducing costs. Major primary care ...
American family physician, Jan 15, 2007
Health-related behavioral counseling can and should be a central offering in the medical home. Pr... more Health-related behavioral counseling can and should be a central offering in the medical home. Primary care practices currently address unhealthy behaviors with their patients, but most practices lack the integrated approaches needed to effectively change these behaviors. Revisions in practice and financing are necessary to fully realize this capacity, which could affect the millions of patients served by the largest health care delivery platform in the United States.
PEDIATRICS, 2006
Pediatric workforce studies suggest that there may be a sufficient number of pediatricians for th... more Pediatric workforce studies suggest that there may be a sufficient number of pediatricians for the current and projected US child population. These analyses do not fully consider the role of family medicine in the care of children. Family physicians provide 16% to 26% of visits for children, providing a medical home for one third of the child population, but face shrinking panels of children. Family medicine's role in children's health care is more stable in rural communities, for adolescents, and for underserved populations. For these populations, in particular, family medicine's role remains important. The erosion of the proportion of visits to family medicine is likely caused by the rapid rise in the number of pediatricians relative to a declining birth rate. Between 1981 and 2004, the general pediatrician population grew at 7 times the rate of the US population, and the family physician workforce grew at nearly 5 times the rate. The number of clinicians caring for ch...
American family …, 2009
1. Am Fam Physician. 2009 Oct 15;80(8):872. Title VII's decline: shrinking investment in the... more 1. Am Fam Physician. 2009 Oct 15;80(8):872. Title VII's decline: shrinking investment in the primary care training pipeline. Harrison B, Bazemore AW, Dodoo MS, Teevan B, Wittenburg H, Phillips RL Jr. PMID: 19835349 [PubMed - indexed for MEDLINE]. Publication Types: ...
American Journal of Preventive Medicine, 2008
American Journal of Preventive Medicine, 2008
Background: Primary care offices have been characterized as underutilized settings for routinely ... more Background: Primary care offices have been characterized as underutilized settings for routinely addressing health behaviors that contribute to premature death and unnecessary suffering. Practical tools are needed to routinely assess multiple health risk behaviors among diverse primary care patients. The performance of a brief set of behavioral measures used in primary care practice is reported here. Methods: Between August 2005 and January 2007, 75 primary care practices assessed four health behaviors, using a 21-item patient self-report questionnaire for adults or a 16-item questionnaire for adolescents. Data were collected via telephone, paper, or electronic means, either with or without assistance. The performance of these measures was evaluated by describing risk-behavior prevalences, combinations of risk behaviors, and missing data. Results: Of 227 adolescents and 5358 adults, most patients completed all of the survey questions. Two or more unhealthy behaviors were reported by 47.1% of adolescents and 69.2% of adults. Percentages of adults who completed all the survey items varied by health behavior: tobacco use, 98.5%; diet, 98.2%; physical activity, 96.2%; alcohol use, 85.1%. Missing data rates were higher for unassisted patient self-reporting. Conclusions: A relatively brief set of health behavior measures was usable in a variety of primary care settings with adults and adolescents. The performance of these measures was uneven across behaviors and administration modes, but yielded estimates of unhealthy behaviors consistent overall with what would be expected based on published population estimates. Further work is needed on measures for alcohol use and physical activity to bring practical assessment tools for key health behaviors to routine primary care practice.
Health Affairs, 2009
Health care spending varies in unexplained ways, and physicians&a... more Health care spending varies in unexplained ways, and physicians' behavior is thought to explain much of the variation. We studied the spending effects of having different usual sources of care, focusing on variations associated with the type of facility or physician specialty. Based on analyses of data from the 2001-2004 Medical Expenditure Panel Surveys, we found significant differences in annual spending, especially for adults. Use of and spending for subspecialists were similar to those for general internists, and both were significantly higher than those for family physicians. Variation in spending might be the result of training differences among primary care specialties.
Journal of the American College of Radiology, 2013
The aim of this study was to investigate trends in utilization and spending for medical imaging, ... more The aim of this study was to investigate trends in utilization and spending for medical imaging, using medical visits resulting in imaging as a novel metric of utilization. Utilization and spending for medical imaging were examined using (1) Medicare Part B claims data from 2003 to 2011 to measure per-enrollee spending and (2) household component events data on the elderly Medicare-age population from the Medical Expenditure Panel Survey from 2003 to 2010 to measure utilization as a function of clinical encounters. Annual health spending and Medicare payments for imaging for the elderly population grew from 294perenrolleein2003to294 per enrollee in 2003 to 294perenrolleein2003to418 in 2006 and had declined to $390 by 2011. Over this entire time, however, annual medical visits by a similar Medicare-age (≥ 65 years old) population resulting in imaging trended consistently downward, from 12.8% in 2003 to 10.6% in 2011. Despite early growth and then more recent declines in average Medicare spending per enrollee since 2003, the percentage of patient encounters resulting in medical imaging has significantly and consistently declined nationwide. Spending alone is thus an incomplete measure of changes in the role and utilization of medical imaging in overall patient care. As policymakers focus on medical imaging, a thoughtful analysis of payment policy influencing imaging utilization, and its role in concurrent and downstream patient care, will be critical to ensure appropriate patient access.
The Minnesota Family Investment Program (MFIP) began in 1994 as a major welfare initiative that d... more The Minnesota Family Investment Program (MFIP) began in 1994 as a major welfare initiative that differed from the Aid to Families with Dependent Children (AFDC) by featuring the following elements: financial incentives to work; participation requirements for long-term welfare recipients; and simplification of welfare rules and procedures. In volume 1, MFIP's effects on adults were evaluated as part of a comprehensive evaluation during which the program's impacts on 14,639 randomly assigned participants and a subsample of 3,245 participants were examined through a review of baseline characteristics and administrative records data and a 36-month survey of the subsample. MFIP proved more effective than AFDC in terms of the employment and earnings gains achieved by one-parent and two-parent families. (One hundred thirteen tables/figures are included. The following items are among the items appended: an evaluation of STRIDE in Hennepin County; data on participants' knowledge of programs and perception of benefit time limits; an evaluation of the food stamps only group; discussions of data issues and a survey response analysis; data on quarterly impacts on employment, earnings, and welfare benefits; a discussion of the effects of participation on two-parent families; and estimated net gains and losses for members of the Child Outcomes Sample. The bibliography lists 76 references. In Volume 2, Reproductions supplied by EDRS are the best that can be made from the original document. Upon request, this information will be made available from the Minnesota Department of Human Services in an alternative format, such as Braille, large print, or audiotape. For information about MDRC and copies of our publications, see our Web site: www.mdrc.org. MDRC® is a registered trademark of the Manpower Demonstration Research Corporation.
American Family Physician, Jun 15, 2008
A convergence of three policies could reduce physician Medicare payments by 14.9 to 22.3 percent ... more A convergence of three policies could reduce physician Medicare payments by 14.9 to 22.3 percent in 2008, which could jeopardize access for Medicare beneficiaries in underserved areas. Congress and the Executive Branch should coordinate their roles in setting Medicare payment policy, because their overlapping decisions can have additive impact.
American Family Physician, Apr 1, 2009
With a costly obesity epidemic, policy makers must recognize factors that may influence obesity n... more With a costly obesity epidemic, policy makers must recognize factors that may influence obesity not only for each person, but also across communities. Increased primary care physician density on the county level is associated with decreased obesity rates. As we move to restructure the primary care workforce and engage our patients and communities in behavior change, the implications of this association merit closer investigation.
Context: Personal characteristics are often used to explain barriers or delays in accessing healt... more Context: Personal characteristics are often used to explain barriers or delays in accessing healthcare for individuals. Ecological measures, like poverty level, are sometimes used as near-proxies for healthcare access problems for communities and populations. We combined these methods to develop indices of healthcare access deprivation or difficulty accessing care for individuals in geographically small areas in the US. In an earlier step we reviewed previous studies, identified factors associated with poor access to care and developed parsimonious models that explain poor access to healthcare at the individual level using a national survey and logistic regression methods. Design: We used data from the 2002 and 2003 National Health Interview Surveys and our earlier models that identified individual-level predictors of healthcare access deprivation, and constructed individual indices of access deprivation. We geo-coded the data and merged them including the indices with 2000 US Censu...
PURPOSE To assess the utilization of advanced brain imaging (ABI) in Medicare outpatients. METHOD... more PURPOSE To assess the utilization of advanced brain imaging (ABI) in Medicare outpatients. METHOD AND MATERIALS Using 5% research identifiable files for 2007, 740,057 new and 12,023,520 established outpatient (i.e., non-inpatient, non-emergency) evaluation and management (E&M) clinical encounters for Medicare fee-for-service beneficiaries were identified. Contemporaneous treating physician Current Procedural Terminology (CPT) codes were used to categorize patient complexity. 25,306 encounters were identified in which ABI (brain CT and/or MRI) was performed within a 4-week (2 weeks before and/or after) window of any E&M visit. Data were analyzed to determine the various associations. RESULTS Of 740,057 new patient encounters, 489,017 (66.1%) were of lower complexity and 251,040 (33.9%) were of higher complexity. Brain CT was performed in 1,360 (0.18%) of all encounters, corresponding to 712 (0.15%) lower and 648 (0.26%) higher complexity encounters (odds ratio 1.77, 95% confidence in...
Objective: To assess the possible impacts of proposed legislation in the 2007 SCHIP Bill to refor... more Objective: To assess the possible impacts of proposed legislation in the 2007 SCHIP Bill to reform the Medicare Physician Services Payment Method. Methods: The main elements of proposed legislation in the 2007 SCHIP Bill to reform the Medicare Physician Services Payment Method was: (1) replacement of the current payment method with one that retains the essential formulae but substitutes six spending targets based on procedures/services; (2) a mechanism for retiring the $54 billion Medicare Part B deficit. Using CBO projections of key variables and our econometric model (published elsewhere) we simulated the main elements of the proposed legislation, and assessed its impact on the Medicare reimbursement rate, patients, and providers, from 2008 2018. Findings: The Medicare Conversion Factor (CF) for all six spending target groups will decline 38% until 2018. The primary care and prevention group could realize continued growth if held to an alternate set of spending targets or if spend...
Context: The published literature is now unambiguous on the importance of always considering the ... more Context: The published literature is now unambiguous on the importance of always considering the multi-dimensional nature of access to medical care. Regrettably many attempts to measure access to medical care services have not done that. They have analyzed data on whole populations not insurance and population sub-groups. Many have ignored cost, affordability, and access to auxiliary medical services like prescription medications as access factors. This study aims at assessing the consequences of these omissions, by carrying out the more comprehensive analysis. Objective: Use nationally representative data to determine whether some health care providers were closing their doors to some insurance groups. Determine if there is a declining trend in access to medical services over the recent past. Methods: We analyzed data from 2001-2006 NHIS and 2003 Household survey of CTS, created two measures of access from the data from 9 survey questions, and analyzed data on 7 insurance groups. W...