Grace Jin

All Publications

• SAFER framework for moving forward on the medical device right to repair BMJ INNOVATIONS He, S., Lai, D., Jin, G., Lee, J. 2022

  View details for DOI 10.1136/bmjinnov-2022-000936

  View details for Web of Science ID 000874818200001

• Charges for Initial Visits for Uninsured Patients at Musculoskeletal Urgent Care Centers in the US JAMA NETWORK OPEN Yousman, L. C., Hsiang, W. R., Khunte, A., Najem, M., Jin, G., Mosier-Mills, A., Jain, S., Wiznia, D. 2022; 5 (5): e229968

  Abstract

  In recent years, specialized musculoskeletal urgent care centers (MUCCs) have opened across the US. Uninsured patients may increasingly turn to these orthopedic-specific urgent care centers as a lower-cost alternative to emergency department or general urgent care center visits.To assess out-of-pocket costs and factors associated with these costs at MUCCs for uninsured and underinsured patients in the US.In this survey study, a national secret shopper survey was conducted in June 2019. Clinics identified as MUCCs in 50 states were contacted by telephone by investigators using a standardized script and posing as uninsured patients seeking information on the out-of-pocket charge for a new patient visit.State Medicaid expansion status, clinic Medicaid acceptance status, state Medicaid reimbursement rate, median income per zip code, and clinic region.The primary outcome was each clinic's out-of-pocket charge for a level 3 visit, defined as a new patient office visit requiring medical decision-making of low complexity. Linear regression was used to examine correlations of price with clinic policy against accepting Medicaid, median income per zip code, and Medicaid reimbursement for a level 3 visit.Of 565 MUCCs identified, 558 MUCCs were able to be contacted (98.8%); 536 of the 558 MUCCs (96.1%) disclosed a new patient visit out-of-pocket charge. Of those, 313 (58.4%) accepted Medicaid insurance and 326 (60.8%) were located in states with expanded Medicaid at the time of the survey. The mean (SD) price of a visit to an MUCC was $250 ($110). Clinic policy against accepting Medicaid (β, 22.91; 95% CI, 12.57-33.25; P < .001), higher median income per zip code (β, 0.00056; 95% CI, 0.00020-0.00092; P = .003), and increased Medicaid reimbursement for a level 3 visit (β, 0.737; 95% CI, 0.158-1.316; P = .01) were positively correlated with visit price. The overall regression was statistically significance (R2 = 0.084; P < .001).In this survey study, MUCCs charged a mean price of $250 for a new patient visit. Medicaid acceptance policy, median income per zip code, and Medicaid reimbursement for a level 3 visit were associated with differences in out-of-pocket charges. These findings suggest that accessibility to orthopedic urgent care at MUCCs may be limited for underinsured and uninsured patients.

  View details for DOI 10.1001/jamanetworkopen.2022.9968

  View details for Web of Science ID 000791487600004

  View details for PubMedID 35503219

  View details for PubMedCentralID PMC9066286

• Get Us PPE: A Self-Organizing Platform Ecosystem for Supply Chain Optimization during COVID-19 SUSTAINABILITY Bala, R., Sarangee, K. R., He, S., Jin, G. 2022; 14 (6)

  View details for DOI 10.3390/su14063175

  View details for Web of Science ID 000774403300001

• Caregiver Burden and Dementia: A Systematic Review of Self-Report Instruments JOURNAL OF ALZHEIMERS DISEASE Tu, J., Jin, G., Chen, J., Chen, Y. 2022; 86 (4): 1527-1543

  Abstract

  As the demand for dementia care grows rapidly worldwide, heavy "caregiver burden" has been associated with stress and depression. Even so, standard metrics for interdisciplinary research of caregiver burden are limited.The objective of the present review is to recommend valid, reliable, and comprehensive self-report instruments of caregiver burden.A systematic review was performed using four databases, searched in April 2021. Articles that established or evaluated self-report instruments for dementia caregiver burden were included, while studies that involved non-dementia caregivers or did not clearly define caregiver burden were excluded. Established guidelines for reliability and agreement studies were used to assess quality and risk of bias. Assessments of self-report instruments were made based on reliability, validity, feasibility, and quality of psychometric evaluations, and comparative evaluations were presented in visual form using radar graphs.Search terms yielded 1,720 articles, and 40 were included in the systematic review after excluding those of low quality. Based on the results of these studies, we recommend the Zarit Burden Interview, Screen for Caregiver Burden, Caregiver Burden Interview, and Burden Scale for Family Caregivers, due to their validity, reliability, and inclusion of multiple subjective and objective dimensions of burden.Targeting specific sources of caregiver burden can help prevent negative outcomes for both dementia patients and caregivers. Future studies should apply self-report instruments to measure and address caregiver burden longitudinally.

  View details for DOI 10.3233/JAD-215082

  View details for Web of Science ID 000784452600003

  View details for PubMedID 35253744

• Patient Electronic Access to Final Radiology Reports: What Is the Current Standard of Practice, and Is an Embargo Period Appropriate? RADIOLOGY Mezrich, J. L., Jin, G., Lye, C., Yousman, L., Forman, H. P. 2021; 300 (1): 187-196

  Abstract

  Patients have a right to their medical records, and it has become commonplace for institutions to set up online portals through which patients can access their electronic health information, including radiology reports. However, institutional approaches vary on how and when such access is provided. Many institutions have advocated built-in "embargo" periods, during which radiology reports are not immediately released to patients, to give ordering clinicians the opportunity to first receive, review, and discuss the radiology report with their patients. To understand current practices, a telephone survey was conducted of 83 hospitals identified in the 2019-2020 U.S. News & World Report Best Hospitals Rankings. Of 70 respondents, 91% (64 of 70) offered online portal access. Forty-two percent of those with online access (27 of 64 respondents) reported a delay of 4 days or longer, and 52% (33 of 64 respondents) indicated that they first send reports for review by the referring clinician before releasing to the patient. This demonstrates a lack of standardized practice in prompt patient access to health records, which may soon be mandated under the final rule of the 21st Century Cures Act. This article discusses considerations and potential benefits of early access for patients, radiologists, and primary care physicians in communicating health information and providing patient-centered care. © RSNA, 2021.

  View details for DOI 10.1148/radiol.2021204382

  View details for Web of Science ID 000663974200029

  View details for PubMedID 33944630

• Urgent Care Centers Delay Emergent Surgical Care Based on Patient Insurance Status in The United States Hsiang, W. R., Wiznia, D., Yousman, L., Najem, M., Mosier-Mills, A., Jin, G., Jain, S., Khunte, A., Davis, K. A., Forman, H. P., Schuster, K. M. LIPPINCOTT WILLIAMS & WILKINS. 2020: 548-553

  Abstract

  Patients may call urgent care centers (UCCs) with urgent surgical conditions but may not be properly referred to a higher level of care. This study aims to characterize how UCCs manage Medicaid and privately insured patients who present with an emergent condition.Using a standardized script, we called 1245 randomly selected UCCs in 50 states on 2 occasions. Investigators posed as either a Medicaid or a privately-insured patient with symptoms of an incarcerated inguinal hernia. Rates of direct emergency department (ED) referral were compared between insurance types.A total of 1223 (98.2%) UCCs accepted private insurance and 981 (78.8%) accepted Medicaid. At the 971 (78.0%) UCCs that accepted both insurance types, direct-to-ED referral rates for private and Medicaid patients were 27.9% and 33.8%, respectively. Medicaid patients were significantly more likely than private patients to be referred to the ED [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.09-1.60]. Private patients who were triaged by a clinician compared to nonclinician staff were over 6 times more likely to be referred to the ED (OR 6.46, 95% CI 4.63-9.01). Medicaid patients were nearly 9 times more likely to have an ED referral when triaged by a clinician (OR 8.72, 95% CI 6.19-12.29).Only one-third of UCCs across the United States referred an apparent emergent surgical case to the ED, potentially delaying care. Medicaid patients were more likely to be referred directly to the ED versus privately insured patients. All patients triaged by clinicians were significantly more likely to be referred to the ED; however, the disparity between private and Medicaid patients remained.

  View details for DOI 10.1097/SLA.0000000000004373

  View details for Web of Science ID 000639399600010

  View details for PubMedID 32932304

• Prevalence, Characteristics, and Costs of Urgent Care Center Membership Programs JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Hsiang, W., Jin, G., Forman, H., Wiznia, D. 2020; 324 (5): 513-514

  Abstract

  This study uses simulated patient phone calls to a random selection of US urgent care clinics (UCCs) to describe the proportion that offer membership programs with access to discounted visits for recurring fees and the characteristics (affiliations, accreditations, population income) and fees and charges of those that do.

  View details for DOI 10.1001/jama.2020.7317

  View details for Web of Science ID 000561261900024

  View details for PubMedID 32749481

  View details for PubMedCentralID PMC7403913