Dr. Casalino is interested in comparative effectiveness research focused on the health care delivery system. Put simply, this means asking: which types of organizations, using which types of processes, provide higher quality, cost-effective care? For example: at present, large numbers of primary care and specialist physician practices are being purchased by hospitals. Does this lead to higher or lower quality care? Higher or lower cost care? Delivery system comparative effectiveness research also asks: what are the effects of incentives created by public and private payors in influencing the types of organization that succeed (and thus become more prevalent) and the processes they use to provide care? Dr. Casalino is particularly interested in unintended consequences of policies and in the effects of policies and of the organization of practice on physician professionalism and on racial/ethnic and socioeconomic disparities in health care delivery.
At present, Dr. Casalino is working on projects that (1) seek to define the demography of physician practices in the U.S., to describe the processes used by practices to improve care, and to analyze which factors are related to increased use of such processes; (2) analyze the relationship between different types or practices, different types of processes, and the quality and cost of care provided; (3) seek to identify physician referral networks, describe their characteristics, and analyze which types of network provide better care; (4) analyze the effect of pay for performance programs on physician practices located in sociodemographically disadvantaged areas; (5) analyze the effects of a large program that helps small practices in disadvantaged areas install electronic medical records and use them to improve care; (6) explore ways in which the primary care workday might be transformed.
Dr. Casalino uses several research methods, including medical record review, surveys, linkage of survey data to Medicare claims data, interviews and case studies. He is particularly interested in mixed methods research. In addition, he has written a number of conceptual articles and reports intended to introduce new problems and/or to help provide new frameworks for thinking about problems.
