Stanford University

Health Care

Can health coaches improve decision making for elderly with cancer?

Background: Cancer is the second leading cause of death in the United States and disproportionately affects elderly patient populations. Many describe poor quality of life and experience, unnecessary suffering, and treatment options with little benefit. Additionally, many elderly patients with cancer also are less likely to receive a full diagnosis or engage in shared-decision making. No studies have evaluated the influence of health coaches and shared-decision making tools on patient and caregiver experiences and receipt of goal concordant care.

Migration, Poverty Alleviation and Wellbeing of the Elderly: Population Modeling for Rural Western China

The researchers developed models for the time course of the economic demography of remote Chinese villages that takes into account the migration, and sometimes return, of the villagers, the predicted remittances, the costs for maintenance of those remaining in the villages (mainly parents and children of the migrants), and the marriage squeeze on males, which is very pronounced in remote rural China. They constructed formal mathematical models that include the above-mentioned features, as well as the rate of migration (which is available from our data).

Readmissions and Chronic Disease in the Elderly

This study aimed to expand knowledge regarding chronic disease and readmissions in the elderly The  researchers conducted a retrospective analysis of California Office of Statewide Health Planning and Development Patient Discharge Data, 2000-2009, which includes all adults age 18 and older with a non-federal acute care hospital discharge (n= 29,009,966 discharges). We identified 7- and 30-day all cause readmissions (ACR) and potentially preventable readmissions (PPR), and then analyzed relationships between index and readmission hospitalizations for each metric.

Effect of Social Isolation and Loneliness on Health Care Utilization

The researchers assessed the effect of social isolation and loneliness on healthcare utilization (costs and frequency of care) using longitudinal survey data from the Health and Retirement Survey (HRS) linked to Medicare administrative claims data. This study provides the first representative picture of the correlation social isolation and loneliness have with total Medicare costs.

Margaret Triyana

Shorenstein APARC
Encina Hall C331
616 Serra Street
Stanford, CA 94305-6055

(650) 724-5656 (650) 723-6530
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2013-2014 Asia Health Policy Postdoctoral Fellow
triyana_photo.jpg PhD

Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.

Triyana received a PhD in Public Policy from the University of Chicago in 2013.

 

Working Papers

“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“

“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”

“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”

“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)

Region-based v. Distance-based Information in Emergency Health Risk Communication: Evidence from the Fukushima Daiichi Nuclear Disaster

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A tremendous amount of radioactive products were discharged as a result of the accident at the Fukushima nuclear power plant in March 2011, which resulted in radioactive contamination of the plant and surrounding areas. While geographical distribution of radioactive iodine, tellurium, and cesium in the surface soils was smoothly (but not always systematically) widespread all over the region, health risk information by the government, media, and other organizations is most likely to be given in terms of administrative boundaries (cf. prefectures, municipalities, etc.) and/or distance from the radiation source.

This paper estimates the effect of such health risk information rather than the actual health risks of radiation on land and other prices in different locations. We find that the prefecture and municipality border effects – but not the distance effect from the nuclear power plant – are significantly related to a reduction in land and other prices after the accident. This shows that people responded to health risk information based on administrative boundaries rather than the actual health risk of radiation after the disaster. Although health risk information based on prefecture and municipality boundaries has an obvious advantage of distilling large and complex risk information into a simple one, the government, media, and other organizations need to recognize and carefully examine the potential of misclassifying non-contaminated areas into contaminated prefectures. Doing so will avoid unintentional consequences to the region’s economy.

Hiroaki Matsuura is currently Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies, University of Oxford and a Junior Research Fellow of St. Antony’s College. His main interests are health economics and demography, with a special interest in the relation between laws and population health. Hiroaki received his B.A. in Economics from Keio University, M.A. in Social Science from the University of Chicago, M.S. in Project Management from Northwestern University’s McCormick School of Engineering and Applied Science, and Sc.D. in Global Health and Population (Economics track) from Harvard University’s School of Public Health. In the past, he was affiliated with Institute of Quantitative Social Sciences, Human Rights in Development, and Takemi Program in International Health at Harvard University. He also worked as a research assistant at the National Bureau of Economic Research. His doctoral dissertation research explores a right to health or to health care in national constitutions of 157 countries and state constitutions of the 50 U.S. states and estimates the impact of introducing (or removing) a right to health or to health care into national and state constitutions on health system and population health outcomes. His most recent article, “The Right to Health in Japan: Challenges of a Super Aging Society and Implication from Its 2011 Public Health Emergency” (with Eriko Sase) will be appeared on “Advancing the Human Right to Health”, edited by José M. Zuniga, Stephen P. Marks, and Lawrence O. Gostin, Oxford University Press, 2013. 

Daniel and Nancy Okimoto Conference Room

Hiroaki Matsuura Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies Speaker University of Oxford
Seminars

What's out there? Microbial diversity, security, and the public health

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More information TBA. 

 

Speaker bio:

David A. Relman, M.D., is the Thomas C. and Joan M. Merigan Professor in the Departments of Medicine, and of Microbiology and Immunology at Stanford University, and chief of infectious diseases at the Veterans Affairs Palo Alto Health Care System in Palo Alto, California. He is also co-director of the Center for International Security and Cooperation and senior fellow at the Freeman Spogli Institute for International Studies at Stanford University.

Dr. Relman’s primary research focus is the human indigenous microbiota (microbiome), and in particular, the nature and mechanisms of variation in patterns of microbial diversity and function within the human body, and the basis of microbial community resilience. His work was some of the first to employ modern molecular methods in the study of the microbiome, and provided the first in-depth sequence-based analyses of microbial community structure in humans. During the past few decades, his research has included pathogen discovery and the development of new strategies for identifying previously-unrecognized microbial agents of disease. A resulting publication was cited by the American Society for Microbiology as one of the 50 most important papers in microbiology of the twentieth century. He has also served as an advisor to a number of agencies and departments within the U.S. Government on matters pertaining to host-microbe interactions, emerging infectious diseases, and biosecurity. He co-chaired a widely-cited 2006 study by the National Academies of Sciences (NAS) on “Globalization, Biosecurity, and the Future of the Life Sciences”, and served as vice-chair of a 2011 National Academies study of the science underlying the FBI investigation of the 2001 anthrax mailings. He currently serves as a member of the National Science Advisory Board for Biosecurity (2005-), a member of the Committee on Science, Technology, and Law at the National Academy of Science (2012-15), a member of the Science, Technology & Engineering Advisory Panel for Lawrence Livermore National Laboratory (2012-), as Chair of the Forum on Microbial Threats at the Institute of Medicine (NAS) (2007-), and as President of the Infectious Diseases Society of America (2012-2013).

Dr. Relman received an S.B. (Biology) from MIT (1977), M.D. (magna cum laude) from Harvard Medical School (1982), completed his clinical training in internal medicine and infectious diseases at Massachusetts General Hospital, served as a postdoctoral fellow in microbiology at Stanford University, and joined the faculty at Stanford in 1994. He received an NIH Director’s Pioneer Award in 2006, was elected a Fellow of the American Academy of Microbiology in 2003 and the American Association for Advancement of Science in 2010, and was elected a Member of the Institute of Medicine in 2011.

 

 

Reuben W. Hills Conference Room

David Relman

CISAC
Stanford University
Encina Hall, E209
Stanford, CA 94305-6165

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Senior Fellow at the Freeman Spogli Institute for International Studies
Thomas C. and Joan M. Merigan Professor
Professor of Medicine
Professor of Microbiology and Immunology
1-RSD13_085_0052a-001.jpg MD

David A. Relman, M.D., is the Thomas C. and Joan M. Merigan Professor in the Departments of Medicine, and of Microbiology and Immunology at Stanford University, and Chief of Infectious Diseases at the Veterans Affairs Palo Alto Health Care System in Palo Alto, California. He is also Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford, and served as science co-director at the Center for International Security and Cooperation at Stanford from 2013-2017. He is currently director of a new Biosecurity Initiative at FSI.

Relman was an early pioneer in the modern study of the human indigenous microbiota. Most recently, his work has focused on human microbial community assembly, and community stability and resilience in the face of disturbance. Ecological theory and predictions are tested in clinical studies with multiple approaches for characterizing the human microbiome. Previous work included the development of molecular methods for identifying novel microbial pathogens, and the subsequent identification of several historically important microbial disease agents. One of his papers was selected as “one of the 50 most important publications of the past century” by the American Society for Microbiology.

Dr. Relman received an S.B. (Biology) from MIT, M.D. from Harvard Medical School, and joined the faculty at Stanford in 1994. He served as vice-chair of the NAS Committee that reviewed the science performed as part of the FBI investigation of the 2001 Anthrax Letters, as a member of the National Science Advisory Board on Biosecurity, and as President of the Infectious Diseases Society of America. He is currently a member of the Intelligence Community Studies Board and the Committee on Science, Technology and the Law, both at the National Academies of Science. He has received an NIH Pioneer Award, an NIH Transformative Research Award, and was elected a member of the National Academy of Medicine in 2011.

Stanford Health Policy Affiliate
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David Relman Thomas C. and Joan M. Merigan Professor, Departments of Medicine and of Microbiology and Immunology, Stanford School of Medicine; CISAC Co-Director; FSI Senior Fellow; Stanford Health Policy Affiliate Speaker
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