Medical Care最新文献

{"title":"Impact of Geriatrics Comanagement on Pain Medication Prescribing for Older Adults Across 3 Surgical Specialties: A Pre-Post Study.","authors":"Mark J Simone, Seyoun Kim, Ingrid M Nembhard, Lisa M Walke","doi":"10.1097/MLR.0000000000002371","DOIUrl":"https://doi.org/10.1097/MLR.0000000000002371","url":null,"abstract":"<p><strong>Background: </strong>Older injured patients are at risk for inappropriate pain management, including undertreatment of their pain and inappropriate medication use. The primary aim of this study was to examine the impact of geriatric comanagement on pain medication prescribing in hospitalized older adults.</p><p><strong>Setting: </strong>Single-site urban academic hospital.</p><p><strong>Participants: </strong>Patients aged 65 years and older admitted to orthopedic trauma, general trauma, and neurosurgery services.</p><p><strong>Methods: </strong>Pre-post intervention study from 2017 to 2020, using propensity score matching. We compared pain medication prescribing before and after implementation of a geriatric comanagement program. We tracked whether pain medications were received during hospitalization, and the total number of administrations per patient for each class of pain medications.</p><p><strong>Results: </strong>A total of 2640 patients were included, and analytic sample sizes varied by outcome and subsample studied. Comanaged patients in the postintervention group were more likely to receive pain medications than the preintervention group (14.2%, 95% CI: 4.0-24.4, P=0.006), including opioids (20.1%, 95% CI: 2.5-37.6, P=0.025) and nonopioids (15.6%, 95% CI: 4.0-27.3, P=0.009). Comanaged patients had an increase in the administration of nonopioids (62.1%, P<0.001) without a significant increase in the administration of opioids.</p><p><strong>Conclusion: </strong>The introduction of geriatric comanagement was associated with changes in pain medication prescribing practices. While our study did not include pain outcome measures, the observed changes in pain medication prescribing add to the growing evidence supporting the benefits of geriatric comanagement models of care because appropriate prescribing facilitates pain management.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entrepreneurial Activity Among Independent Urology Groups.","authors":"Arnav Srivastava, Xiu Liu, Kassam S Faraj, Samuel R Kaufman, Avinash Maganty, Addison Shay, Mary Oerline, Paula Guro, Preeti Chachlani, Dawson Hill, Anqi Sun, Vahakn B Shahinian, Brent K Hollenbeck","doi":"10.1097/MLR.0000000000002372","DOIUrl":"10.1097/MLR.0000000000002372","url":null,"abstract":"<p><strong>Background: </strong>Independent physician groups may develop novel revenue streams through ownership of services (eg, radiology equipment, ambulatory surgery centers), supplementing fee-for-service income. This form of entrepreneurial activity and its implied incentives for utilization may influence physician behavior and patient management. We developed an index measuring entrepreneurial activity of independent urology groups and assessed its association with diagnostic testing in men with benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>We identified Traditional Medicare beneficiaries with BPH presenting to an independent urology group between 2017 and 2019. Using factor analysis of 9 unique ownership characteristics, we developed an index measuring entrepreneurial activity of independent urology groups (0-100-point scale). We assessed the relationship between the entrepreneurial index and 3 types of testing within 90 days of the initial new patient visit. At the patient level, we measured completion of a urinalysis (guideline-recommended), optional BPH testing (eg, ultrasound, cystoscopy), and testing unrelated to a BPH workup (ie, prostate-specific antigen, testosterone).</p><p><strong>Results: </strong>The urology group entrepreneurial index ranged from 0 to 97.2, with 20.6% (n=706/3430) of groups owning at least 1 ancillary service (ie, index >0). Among 49,285 men, an increasing entrepreneurial index (per 10-point increase) was associated with greater odds of undergoing a urinalysis (OR=1.13; 95% CI: 1.09-1.18; P<0.001), optional BPH tests (OR=1.05; 95% CI: 1.02-1.09; P=0.002), and testing unrelated to BPH (OR=1.21; 95% CI: 1.15-1.27; P<0.001).</p><p><strong>Conclusions: </strong>Entrepreneurial activity in urology, through ownership of ancillary services, is concentrated in a subset of groups. Among men presenting with BPH, the index was associated with increased guideline-recommended, optional, and unrelated testing.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Race/Ethnicity, Socioeconomic Status, and Acute Myocardial Infarction Mortality: Between-Hospital Versus Within-Hospital Disparities.","authors":"Sadia Farzana, Ali Moghtaderi, Andy Ye Yuan, Qian Eric Luo, Vinay Kini, Bernard Black","doi":"10.1097/MLR.0000000000002344","DOIUrl":"10.1097/MLR.0000000000002344","url":null,"abstract":"<p><strong>Background: </strong>Prior work often finds racial/ethnic differences in mortality following acute myocardial infarction (AMI), but is subject to selection bias. Similar selection issues arise for differences associated with socioeconomic status (SES).</p><p><strong>Objectives: </strong>Re-examine the association between patient race/ethnicity, area-level socioeconomic status (area-SES), and post-AMI mortality using a data source that limits patient selection of hospital or cardiologist, or vice-versa, and which lets us distinguish between-hospital from within-hospital sources of differences.</p><p><strong>Research design: </strong>We compare mortality disparities with no controls, with controls typical of the prior literature (\"typical controls\"), and more extensive controls, including hospital, cardiologist, and calendar quarter fixed effects (FEs).</p><p><strong>Subjects: </strong>The study uses a 100% sample of 681,000 Medicare Fee-for-Service patients aged 68+ hospitalized for incident (first) AMI over 2008-2019.</p><p><strong>Measures: </strong>Post-AMI mortality in-hospital, within 30 days after discharge and over periods up to 3 years post-discharge. We study patients with ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (nSTEMI) separately.</p><p><strong>Results: </strong>With no or typical controls, Blacks, Hispanics, and Asians have higher in-hospital mortality than Whites; lower SES also predicts higher mortality. However, higher mortality is substantially explained by between-hospital differences in mortality rates. Longer-term mortality is higher for Black patients, consistent with the importance of post-discharge pathways.</p><p><strong>Conclusions: </strong>Post-AMI disparities in outcomes can be strongly affected by selection effects, especially the tendency for poor and minority persons to be treated at lower-quality hospitals. Disparities measurement and policy discussions should distinguish access-related hospital sorting from within-hospital processes and pay greater attention to post-discharge pathways.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"540-549"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Medicare Claims-Based Approach to Identifying Tele-ICU Capability and Utilization Across US Hospitals.","authors":"Karan Rai, Anuj B Mehta, James F Burke, Nathan E Brummel","doi":"10.1097/MLR.0000000000002337","DOIUrl":"10.1097/MLR.0000000000002337","url":null,"abstract":"<p><strong>Background: </strong>Tele-ICU adoption has expanded, yet no validated claims-based method exists to identify tele-ICU capability or utilization. Reliance on self-reported survey data limits national assessment of delivery models and outcomes.</p><p><strong>Objectives: </strong>To develop a Medicare claims-based approach to identify tele-ICU capability and utilization, evaluate concordance with the American Hospital Association Annual Survey Database (AHAASD), and describe hospital and patient characteristics.</p><p><strong>Research design: </strong>Retrospective cross-sectional study using 2021 Medicare 5% Limited Data Set Part A and B claims and the 2021 AHAASD. Tele-ICU-capable hospitals were identified using tele-ICU claims among Medicare beneficiaries during inpatient hospitalizations and emergency department visits and defined as hospitals with ≥1 claim. We compared these hospitals with hospitals reporting tele-ICU capability in the AHAASD.</p><p><strong>Results: </strong>We identified 1193 tele-ICU claims from 344 hospitals. Among 3932 AHA respondents, 947 reported tele-ICU capability; 110 hospitals were identified by both methods. Relative to AHAASD, claims exhibited 11.6% sensitivity, 95.0% specificity, and 42.6% positive predictive value. Most hospitals submitted 1-2 claims, while a minority generated most claims. Compared with tele-ICU hospitals identified by AHAASD, hospitals identified only by claims were more likely to be rural, for-profit, noncritical access, and had more ICU beds and ventilators but fewer intensivists. Among 1,008,106 ICU patients, 680 (0.1%) had tele-ICU claims and demonstrated higher acuity.</p><p><strong>Conclusions: </strong>Tele-ICU claims identify a small, specific subset of hospitals actively billing for tele-ICU care and capture clinically meaningful encounters. Combining claims with survey data may improve national measurement of tele-ICU adoption and inform operational and policy assessments.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"500-506"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Hospital Mergers and Hospital-Level Nursing Factors, Nurse Well-Being, and Nurse-Sensitive Patient Safety and Quality-of-Care Outcomes: A Scoping Review.","authors":"Kathleen E Fitzpatrick Rosenbaum, Anand R Habib, Mark Schlesinger, Janene Batten, Deena Kelly Costa","doi":"10.1097/MLR.0000000000002341","DOIUrl":"10.1097/MLR.0000000000002341","url":null,"abstract":"<p><strong>Background: </strong>Hospital mergers have proliferated across the United States, yet a comprehensive understanding of how mergers affect nurses and patients is lacking.</p><p><strong>Objective: </strong>Determine the known associations between US hospital mergers and hospital-level factors that influence nursing, nurse well-being, and nurse-sensitive patient safety and quality-of-care outcomes.</p><p><strong>Research design: </strong>A scoping review of systematically searching 10 databases comprised of business and health care literature up to January 2025.</p><p><strong>Results: </strong>We found 1775 articles; 10 met our inclusion criteria and were included in the analysis: 5 quantitative, 3 qualitative, 2 multimethods. Only 3 studies analyzed data from 2003 or later. Although data were sparse and older, we found that hospital mergers introduced organizational changes in nursing-nurse staffing, leadership, and operations. Whether nurse-sensitive patient safety and quality-of-care outcomes improved post-merger was equivocal. Qualitatively, nurses described poor communication, a perceived lack of trust in leadership, a loss of identity and unity, decreased morale, increased fear or uncertainty, and issues with equal and/or respectful treatment. Employed study methods and designs, as well as a dearth of recent studies, influenced the ability to draw strong causal and/or detailed conclusions, especially about newly emerging issues in today's health care system.</p><p><strong>Conclusions: </strong>Our findings suggest that hospital mergers may impact nurses and the nursing workforce. As hospital mergers continue to increase, future research with recent data and rigorous methods is needed to develop timely and applicable policy to mitigate any potential harms and leverage potential benefits of hospital mergers for nurses and patients.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"525-539"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of a Rural Hospital Global Budget Alternative Payment Model on Patterns of Cancer Surgery.","authors":"Lindsay M Sabik, Jacob Whitman, Donald S Bourne, Zhaojun Sun, Eric T Roberts, Jonathan G Yabes, Manisha Bhattacharya, David Bartlett, Jeremy M Kahn, Bruce L Jacobs","doi":"10.1097/MLR.0000000000002336","DOIUrl":"10.1097/MLR.0000000000002336","url":null,"abstract":"<p><strong>Background: </strong>Rural patients often experience barriers accessing high-quality surgical care. The Pennsylvania Rural Health Model (PARHM) aimed to improve rural health through all-payer hospital global budgets and transformation plans, which may influence hospitals' incentives and capacity to provide various surgical services, including cancer surgery.</p><p><strong>Objectives: </strong>Examine the association between PARHM and patterns of cancer surgery overall, by timing of entry into PARHM, and by cancer type.</p><p><strong>Research design: </strong>Stacked difference-in-differences (DID) models including hospital service area (HSA)-level propensity score weights, comparing patients living in HSAs with hospitals participating in PARHM to those in HSAs with eligible nonparticipating hospitals.</p><p><strong>Subjects: </strong>Patients in eligible HSAs who had surgery between 2016 and 2023 for one of 11 cancers with evidence of surgical volume-outcome relationships.</p><p><strong>Measures: </strong>Surgery at a high-volume, Commission on Cancer (CoC) accredited, or National Cancer Institute (NCI)-designated hospital, and travel distance to the surgical hospital.</p><p><strong>Results: </strong>The sample included 22,728 cancer surgeries for patients across 60 HSAs. Pooled estimates indicate no statistically significant differential changes in outcomes. In HSAs served by the 2019 cohort of PARHM hospitals (smaller and more remote facilities), PARHM was associated with a differential increase in surgery at CoC hospitals (DID estimate: 8.7 percentage points, 95% CI: 1.5- 16.0). We observed differential increases in surgery at CoC hospitals for colon and rectal cancers, and decreases in surgery at CoC and high-volume hospitals for liver cancer and at NCI centers for bladder cancer.</p><p><strong>Conclusion: </strong>PARHM had limited overall effects on surgical cancer care, with some variation across hospitals and cancer types.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"492-499"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Method to Apply Race and Ethnicity Observation for Nursing Home Residents Using Multiple Medicare Administrative Datasets.","authors":"Catherine C Cohen, Andrew W Dick, Leah V Estrada, Patricia W Stone","doi":"10.1097/MLR.0000000000002339","DOIUrl":"10.1097/MLR.0000000000002339","url":null,"abstract":"<p><strong>Background: </strong>Nursing homes (NHs) in the United States serve about 1.2 million residents. Different NH resident groups, including by race and ethnicity (R/E), experience different health outcomes in this setting. Multiple R/E measures exist for this population, but all have drawbacks. It is known that some R/E groups are underrepresented by these measures. Missing and inaccurate R/E classification in national data hinders research efforts to understand health outcomes.</p><p><strong>Objective: </strong>We developed a method to improve R/E classification of NH residents using multiple datasets for enhanced accuracy and completeness.</p><p><strong>Research design: </strong>This was a retrospective, observational study using 2011-2022 data from the Minimum Data Set 3.0 (MDS) and the Master Beneficiary Summary File (MBSF). We assessed missingness and consistency of variables and created a nuanced, mutually exclusive R/E measure based on the MDS race variables and added information from the MBSF RTI race variable.</p><p><strong>Subjects: </strong>All Medicare-eligible residents in CMS-certified NHs are identifiable in the MDS and MBSF data (2011-2022).</p><p><strong>Results: </strong>The merged data included 19,491,681 individuals and 206,985,444 assessments. Individual residents in the MDS had low missingness (1.74%) and high consistency (97.29%) on R/E data. Integrating MBSF and MDS data reduced missingness (0.03%) and increased Hispanic resident representation (3.92%-6.12%). New categorization of White and Black, Hispanic and Black, and White and other races reduced the \"other/multiracial\" category from 2.14% to 0.67%.</p><p><strong>Conclusions: </strong>Using multiple data sources for R/E classification enhances the identification of NH demographics, which is important for researchers to have more accurate data. The increase in Hispanic residents after imputing RTI race suggests potential correction for self-underreporting. This method retains self-reporting standards while improving data completeness.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"507-511"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding Risk for Acute Care Utilization in Housing-Insecure Adults: A National Study of a Hot Spotter Program in the US Veterans Health Administration.","authors":"Neeraj Singh, Monika Srivastav","doi":"10.1097/MLR.0000000000002343","DOIUrl":"10.1097/MLR.0000000000002343","url":null,"abstract":"","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"550"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Variation in Missing Race and Ethnicity Data in Minimum Data Set 3.0.","authors":"Jennifer Tjia, Francesca L Troiani, Anna Wyndham, Sruthi Tanikella, Joshua Rumbut, Maira A Castaneda-Avila","doi":"10.1097/MLR.0000000000002335","DOIUrl":"10.1097/MLR.0000000000002335","url":null,"abstract":"<p><strong>Background: </strong>Race and ethnicity measures in administrative data can vary geographically. The extent of this challenge in US nursing homes is not well described.</p><p><strong>Objectives: </strong>To describe geographic variation in missing race and ethnicity data in the Minimum Data Set (MDS) 3.0 and Medicare claims, and to compare discrepancies across data sources.</p><p><strong>Research design: </strong>Cross-sectional study.</p><p><strong>Subjects: </strong>Medicare beneficiaries with MDS 3.0 records between 2014 and 2018. The Medicare Beneficiary Summary File provided demographic information.</p><p><strong>Measures: </strong>Missingness of MDS race and ethnicity data by state, and misclassification of Medicare race and ethnicity enrollment database (EDB) and Research Triangle Institute (RTI) variables compared with MDS. We calculate the sensitivity, specificity, and positive predictive value of the EDB and RTI variables relative to the MDS.</p><p><strong>Results: </strong>Among 18.1 million nursing home residents pooled across 2014-2018, geographic variation in missing race and ethnicity in the MDS 3.0 ranged from 1.2% to 14.7%. Compared with MDS, misclassification of residents classified as Hispanic in MDS ranged from 48.1% to 89.2% for EDB and 0.5% to 44.8% for RTI. Misclassification of residents classified as Asian American/Pacific Islander in MDS ranged from 29.4% to 77.2% for EDB and 12.7% to 65.4% for RTI. Misclassification of residents classified as Black ranged from 0% to 14.2% for EDB and 0% to 16.2% for RTI. Overall, the RTI variables provided better sensitivity and specificity of race and ethnicity than the EDB.</p><p><strong>Conclusion: </strong>Missing race and ethnicity data in the MDS varies geographically, as do discrepancies between MDS and EDB and RTI variables. Thoughtful consideration of these issues is recommended when handling missing MDS race and ethnicity data.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"473-482"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing Research With a Veteran Research Engagement Panel: Lessons Learned From Eight Years of Partnering.","authors":"Jennifer M Gierisch, Elly Thompson, Matthew Tucker, Laurel Koss, Brandolyn White, Nathan A Boucher","doi":"10.1097/MLR.0000000000002340","DOIUrl":"10.1097/MLR.0000000000002340","url":null,"abstract":"<p><strong>Background: </strong>While community engagement is an evidence-based strategy, less is known about how longstanding community engagement panels are used in practice, and how their input is incorporated by researchers.</p><p><strong>Objective: </strong>To describe the types of consultations requested from a community engagement panel comprised of veterans and veteran caregivers, the research stages at which consultation was sought, and the ways investigators reported using panel feedback.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive content analysis of administrative documents from 52 panel consultations completed between 2017 and 2022 at a VA health systems research center. Data sources included consultation requests, structured meeting notes, and 6 or 12-month follow-up reports, when available. We classified each consultation by research phase and characterized the focus of recommendations.</p><p><strong>Results: </strong>Most consultations occurred during study development (52%), followed by intervention delivery (23%). Fewer consultations focused primarily on outreach, outcomes, or dissemination. No consultations centered on enrollment/consent or data analysis/interpretation. Panel recommendations most often addressed communication, project focus and goals, tailoring to Veteran preferences, barriers to participation, and study material accessibility. In 12 projects with follow-up reports, investigators described VetREP feedback as relevant, specific, and action-oriented. Investigators reported using panel feedback to revise materials, refine protocols, strengthen grant applications, and inform subsequent projects.</p><p><strong>Conclusions: </strong>Our longstanding Veteran engagement panel most often informed research during study development and intervention planning. These findings support longstanding panels that consult across multiple studies as a practical consultation mechanism for improving patient-centeredness in research design. Our study also highlights gaps in later-stage patient engagement and the need for more systematic documentation of engagement impacts over time to advance engagement science.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"521-524"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}