Research Interests: clinical economics, development of new health care outcome measures, health care disparities, measuring health care quality, medical decision making, outcomes of care in cancer, statistical methodogy in outcomes research including multivariate matching
Dr. Silber holds the Nancy Abramson Wolfson Endowed Chair in Health Services Research at the Children’s Hospital of Philadelphia and is a Professor of Pediatrics and Anesthesiology & Critical Care at the Perelman School of Medicine at the University of Pennsylvania, and Professor of Health Care Management at the Wharton School at the University of Pennsylvania. He is a Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania.
Dr. Silber is an internationally known authority on outcomes measurement and severity adjustment for both adult and pediatric applications. He created the adult quality of care measure Failure-to-Rescue (FTR) in 1990 that has been adopted as three specific quality measures by the National Quality Forum (NQF). He has also developed two length of stay outcome measures: Prolonged Length of Stay and Conditional Length of Stay, now applied to both pediatric and adult populations. With Paul Rosenbaum he developed the Omega measure that evaluates outcome measures by estimating the relative contribution of patient to hospital characteristics associated with a specific outcome, and the method of Template Matching to compare hospital cost and quality. He has published extensively on all aspects of the theory of outcomes measure and model development and validation, as well as the applications of outcomes measures to pressing public health issues. Much of his recent work focuses on the use of multivariate matching when comparing outcomes, specifically with respect to problems in both pediatric and adult medicine and surgery, disparities, and cancer. Dr. Silber has twice been awarded the Article of the Year Award in Health Services Research from AcademyHealth, the leading professional organization concerning Health Services Research in the U.S.
Dr. Silber helped to establish and has served as the Director of the Center for Outcomes Research since its inception in 1997. The center is a multidisciplinary health services research hub for Children’s Hospital of Philadelphia and University of Pennsylvania investigators and external academic and institutional collaborators which aims to improve health outcomes through the development, testing and application of innovative, practical metrics which serve as tools to transform the quality and efficiency of health care.
Dr. Silber teaches two courses at the University of Pennsylvania: HCMG212 – Health Care Quality and Outcomes: Measurement and Management at the Wharton School and EPI580 – Outcomes Research at the Perelman School of Medicine.
Rachel R. Kelz, Morgan M. Sellers, Bijan A. Niknam, James E. Sharpe, Paul R. Rosenbaum, Alexander S. Hill, Hong Zhou, Lauren L. Hochman, Karl Y. Bilimoria, Kamal Itani, Patrick S. Romano, Jeffrey H. Silber (2019), A national comparison of operative outcomes of new and experienced surgeons, Annals of Surgery, (to appear).
Jeffrey H. Silber, Lisa M. Bellini, Judy A. Shea, Sanjay V. Desai, David F. Dinges, Mathias Basner, Orit Even-Shoshan, Alexander S. Hill, Lauren L. Hochman, Joel T. Katz, Richard N. Ross, David M. Shade, Dylan Small, Alice L. Sternberg, James Tonascia, Kevin G. Volpp, David A. Asch, for the iCOMPARE Research Group (2019), Patient Safety Outcomes under Flexible and Standard Resident Duty-Hour Rules, New England Journal of Medicine, 380, pp. 905-914.
Mathias Basner, David A. Asch, Judy A. Shea, Lisa M. Bellini, Michele Carlin, Adrian J. Ecker, Susan K. Malone, Sanjay V. Desai, Alice L. Sternberg, James Tonascia, David M. Shade, Joel T. Katz, David W. Bates, Orit Even-Shoshan, Jeffrey H. Silber, Dylan Small, Kevin G. Volpp, Christopher G. Mott, Sara Coats, Daniel J. Mollicone, David F. Dinges for the iCOMPARE Research Group (2019), Sleep and Alertness in a Duty-Hour Flexibility Trial in Internal Medicine, New England Journal of Medicine, 380, pp. 915-923.
Jeffrey H. Silber, Paul R. Rosenbaum, Richard N. Ross, Joseph G. Reiter, Bijan A. Niknam, Alexander S. Hill, Diana M. Bongiorno, Shivani A. Shah, Lauren L. Hochman, Orit Even-Shoshan, Kevin R. Fox (2018), Disparities in breast cancer survival by socioeconomic status despite Medicare and Medicaid insurance, Milbank Quarterly, 96 (4), pp. 706-754.
Judy A. Shea, Jeffrey H. Silber, Sanjay V. Desai, David F. Dinges, Lisa M. Bellini, James Tonascia, Alice L. Sternberg, Dylan Small, David M. Shade, Joel Thorp Katz, Mathias Basner, Krisda H. Chaiyachati, Orit Even-Shoshan, David Westfall Bates, Kevin G. Volpp, David A. Asch, the iCOMPARE Research Group (2018), Development of the Individualised Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education (iCOMPARE) Trial: a Protocol Summary of a National Cluster-randomised Trial of Resident Duty Hour Policies in Internal Medicine, BMJ Open, 8(9):e021711.
Jeffrey H. Silber, Joseph Reiter, Paul R. Rosenbaum, Qingyuan Zhao, Dylan Small, Bijan Niknam, Alexander Hill, Lauren Hochman, Rachel Kelz, Lee Fleisher (2018), Defining multimorbidity in older surgical patients, Medical Care, 56 (8), pp. 701-710.
Bijan A. Niknam, Alexander F. Arriaga, Paul R. Rosenbaum, Alexander S. Hill, Richard N. Ross, Orit Even-Shoshan, Patrick S. Romano, Jeffrey H. Silber (2018), Adjustment for atherosclerosis diagnosis distorts the effects of percutaneous coronary intervention and the ranking of hospital performance, Journal of the American Heart Association, 7(11):e008366.
Sanjay V. Desai, David A. Asch, Lisa M. Bellini, Krisda H. Chaiyachati, Manqing Liu, Alice L. Sternberg, James Tonascia, Alyssa M. Yeager, Jeremy M. Asch, Joel T. Katz, Mathias Basner, David W. Bates, Karl Y. Bilimoria, David F. Dinges, Orit Even-Shoshan, David M. Shade, Jeffrey H. Silber, Dylan Small, Kevin G. Volpp, and Judy A. Shea for the iCOMPARE Research Group (2018), Education Outcomes in a Duty-Hour Flexibility Trial in Internal Medicine, New England Journal of Medicine, 378, pp. 1494-1508.
Kwonsang Lee, Dylan Small, Jesse Y. Hsu, Jeffrey H. Silber, Paul R. Rosenbaum (2018), Discovering effect modification in an observational study of surgical mortality at hospitals with superior nursing, Journal of the Royal Statistical Society, Series A, 181 (2), pp. 535-546.
Jeffrey H. Silber, Paul R. Rosenbaum, Wei Wang, Shawna R. Calhoun, Joseph G. Reiter, Orit Even-Shoshan, William J. Greeley (2018), Practice style variation in Medicaid and Non-Medicaid children with complex chronic conditions undergoing surgery, Annals of Surgery, 267 (2), pp. 392-400.
Individual research of an experimental nature with a member of the standing faculty leading to a written paper. The grade is based primarily on a serious term paper describing original research carried out by the student. Students must submit a proposal prior to registering. During the semester, students must attend two seminars to discuss planning and independent research project, ethical concerns in research and writing a scientific paper. Attendance at the meetings is mandatory. Students doing more than one credit of independent study will be required to present a poster at the annual BBB Symposium.
Continuation of BIBB 399 research. Students will be required to give an oral presentation of their research at the annual BBB symposium Honors Seminar and attend weekly seminars.
This course is divided into two main parts. The first part addresses issues related to the measurement of quality in health care. Included is a review of theclassical structure-process-outcome quality paradigm. The paradigm's strengths and limitations are addressed. This part especially focuses on outcome measure of quality and examines the validity of alternative measures. The second part deals with observational, or quasi-experimental, research studies. It addresses the advantages and limitations of alternative designs, and covers the role of clinical risk adjustment in observational studies of medical interventions. It focuses on the problem of selection bias, and reviews recent methods for dealing with this bias, such as instrumental variables.
This is a tutorial given by each student's advisor. Advisor and student meet weekly. Topics include: discussion and review of epidemiologic concepts and principles, guided readings in the epidemiology of a specific health area, and the development of the research protocol.
These are a series of tutorial sessions conducted by the student's advisor, which are to support the student's efforts in developing a research protocol, designing a designing a research project, and completing the study.
This course will familiarize students with methods used to assess the quality of hospital or provider health care using outcomes data, and to understand and evaluate studies involving health care outcomes. Students are exposed to the mechanics of hospital quality evaluation and challenged to evaluate the medical and health services research literature on health care evaluation, as well as to make inferences regarding hospital quality and the comparison or rankings of hospitals or providers. Topics will include the history of health care outcomes analysis; the conceptual framework for outcome studies; consumer demand for information; an overview of medical data and data collection systems; a description of outcome statistics and severity adjstments currently in use; the study of excess variation in outcomes; and the use of guidelines to assess outcomes. By the end of the course, students will have developed a thorough appreciation of the current methods used by policy makers, researchers, and health care providers to evaluate medical outcomes, as well as those used by consumers to choose hospitals and providers.
Arranged with members of the Faculty of the Health Care Systems Department. For further information contact the Department office, Room 204, Colonial Penn Center, 3641 Locust Walk, 898-6861.
This course is intended to provide entering doctoral students with information on the variety of health economics models, methods, topics, and publication outlets valued and used by faculty in the HCMG doctoral program and outside of it. The course has two main parts: the first, to acquaint students with theoretical modeling tools used frequently by health economists. This part of the course involves a number of lectures coupled with students' presentations from the health economics, management and operations research community at Penn on a research method or strategy they have found helpful and they think is important for all doctoral students to know.
This course is divided into two main parts. The first part addresses issues related to the measurement of quality in healthcare. Included is a review of the classical-structure-process-outcome quality paradigm. The paradigm's strengths and limitations are addressed. This part especially focuses on outcome measures of quality and examines the validity of alternative measures. The second part deals with observational, or quasi-experimental, research studies. It addresses the advantages and limitations of alternative designs, and covers the role of clinical risk adjustment in observational studies of medical interventions. It focuses on the problem of selection bias, and reviews recent methods for dealing with this bias, such as instrumental variables.
By “matching” patients across a group of hospitals, a new paper co-authored by two Wharton professors suggests a fairer and more accurate way of assessing the quality of health care providers.Knowledge @ Wharton - 2014/05/20