1. Optimizing Health Care Delivery and Outcomes Richard A. Hansen, PhD Gilliland Professor and Head Department of Health Outcomes Research and Policy

2. Health Spending and Outcomes

3. State ranking on health system performance Heart disease mortality rates for age 40 Healthcare Quality and Outcomes

5. Complex patients Complex care Complex systems Complex treatments Healthcare is Complex

6. Complex Patients… …or complex care? Maciejewski et al., JGIM 2014; Hansen et al., Annals of Pharmacotherapy (in press) Grant s AHRQ 1R21HS019445-01 AHRQ 1R01HS023099-01

7. Complex Care Emergency Room Visits Probability Number of 1+ Visits of Visits Odds Ratio (95%CI) IRR (95%CI) Probability of Hospital Admission Odds Ratio (95% CI) 1 Condition (lagged)Reference 2 Conditions (lagged) 1.02 (0.80, 1.29)0.98 (0.83, 1.15)1.07 (0.88, 1.29) 3+ Conditions (lagged) 1.38 (0.99, 1.91)0.86 (0.71, 1.04)1.11 (0.84, 1.46) 1 Prescriber (lagged) Reference 2 Prescribers (lagged) 1.24 (0.99, 1.56)1.15 (0.98, 1.35) 1.31 (1.09, 1.57) * 3 Prescribers (lagged) 1.58 (1.17, 2.13) * 1.18 (0.99, 1.41) 1.31 (1.01, 1.69) * 4+ Prescribers(lagged) 1.96 (1.39, 2.75) *** 1.38 (1.13, 1.70) * 1.47 (1.08, 2.01) * Grant s AHRQ 1R21HS019445-01 AHRQ 1R01HS023099-01 Maciejewski et al., JGIM 2014; Hansen et al., Annals of Pharmacotherapy (in press)

8. Complex systems Drug-related risk of bleeding across 200 million patients represented in U.S. data repositories Hansen et al., RSM (in press) Hansen et al., Drug Safety (2013) Fox et al., JBI (2013) Grants: FNIH HANSE11OMOP NPC (No Number)

9. Richard A. Hansen rah0019@auburn.edu Current and Recent Funding Funding Opportunities Complex patients and conditions AHRQ 1R21HS019445-01 (Duke) AHRQ 1R01HS023099-01 (UNC) Complex treatments and drug safety FDA 1U01FD005272-01 (Auburn) FNIH HANSE11OMOP (Auburn) National Pharmaceutical Council NIH (R01 & R18 in review) PCORI, AHRQ, CDC, FDA Interdisciplinary collaboration is key…