My research has focused on the impact of changes in clinical care delivery and policy on healthcare quality and cost, clinical efficiency, and equity. I created the Venn diagram below to illustrate the overlap between the health services research I do and my engagement in quality improvement and other aspects of applied improvement science.
Health Services Research: Focus on Social Determinants of Health
I study how social determinants of health—such as socioeconomic status and neighborhood context—drive disparities in healthcare utilization, costs, and outcomes, particularly in pediatric populations. My work examines links between community-level factors and metrics like inpatient costs and rehospitalization rates.
Improvement Science: Quality Improvement and Associated Methods
Although much of my applied improvement science work is internal (not published), some of my publications relate to approaches for enhancing systematic uptake of research findings and other evidence-based practices into clinical practice.
Observational Cohort Studies: Operationalizing and Modeling Quality
A key methodological challenge I have addressed in observational cohort studies involves developing objective measures of disease severity, treatment response, and the quality—including equity—of care processes and outcomes. The projects outlined below illustrate the range of analyses I have led or co-led to operationalize and model these constructs. Collectively, this work has contributed to advancing the science of quality measurement using augmented electronic health record data.
Healthcare Cost Analyses
This set of studies models drivers of the cost of care in different settings by patient-, encounter-, and facility-level factors.
Marion R. Sills, MD, MPH 