Description of Research Expertise:
My area of expertise is health services research, perinatal epidemiology, and health economics. Our research group is focused on answering the question, “why do children have different outcomes”, whether those outcomes are health care use, morbidity and mortality, or neurocognitive outcomes. Our group focuses in three specific areas of research:
1) Quality Assessment and Measurement: We are part of the CHOP center for pediatric quality metrics, one of 7 AHRQ funded sites in the US tasked to define and validate various measures of quality. We have experience using large datasets to assess various measures of pediatric and neonatal care, including the use of hospital readmissions; neonatal complications; and neonatal mortality.
2) Racial/ethnic disparities in care: We have extensive experience quantifying the differences in outcomes between children of different racial/ethnic groups, and to use a number of sophisticated techniques to help define the factors that mediate these differences, including mediation analyses and other techniques we are developing to use on large administrative datasets and longitudinal cohort studies. We have also begun to examine how racial/ethnic disparities may explain, or not explain, observed differences in care delivered by hospitals with similar structures, such as level of NICU.
3) Organization of perinatal and pediatric care: We have several Federally-funded grants to evaluate the impact of structures of health care on perinatal outcomes, from the hospital level to the larger state level.
In addition, we are interested in factors that may explain differences in the processes of care delivered by different hospitals, and how these differences translate into differences in outcomes.
Lorch SA, Baiocchi M, Ahlberg CE, Small, DS: The differential impact of delivery hospital on the outcomes of premature infants Pediatrics 130 : 270-278,2012.
Lorch SA, Srinivas SK, Ahlberg C, Small DS: The impact of obstetric unit closures on maternal and infant pregnancy outcomes Health Serv Res 48 (2 Pt 1): 455-75,2013.
Lorch SA: Quality measurements in pediatrics: What do they assess? JAMA Pediatr 167 (1): 89-90,2013.
Lorch SA, Kroelinger CD, Ahlberg C, Barfield WD: Factors that mediate racial/ethnic disparities in US fetal death rates Am J Pub Health 102 (10): 1902-1910,2012.
Lorch SA, Maheshwari P, Even-Shoshan O: The impact of certificate of need programs on neonatal intensive care units J Perinatol 32 (1): 39-44,2012.
Goyal N, Fager C, Lorch SA: Adherence to discharge guidelines for late-preterm newborns Pediatrics 128 (1): 62-71,2011.
Tucker Edmonds B, Fager C, Srinivas S, Lorch SA: Racial and ethnic differences in use of intubation for periviable neonates Pediatrics 127 (5): e1120-e1127,2011.
Lorch SA, Baiocchi M, Silber JH, Even-Shoshan, O, Escobar GJ, Small DS: The role of outpatient facilities in explaining variations in risk-adjusted readmission rates between hospitals Hlth Serv Res 45 (1): 24-41,2010.
Lorch SA, Wade KC, Bakewell-Sachs S, Medoff-Cooper B, Escobar GJ, Silber JH: Racial differences in the use of respiratory medications in premature infants after discharge from the Neonatal Intensive Care Unit J Pediatr 151 : 604-610,2007.
Lorch SA, Silber JH, Even-Shoshan O, Millman A: Use of prolonged travel to improve pediatric risk adjustment models Health Serv Res 44 (2, Part I): 519-541,2009.