Edward Guadagnoli, PhD, is a professor of health care policy in the Department of Health Care Policy at Harvard Medical School. He is also an assistant epidemiologist in the Department of Medicine at Brigham and Women’s Hospital.
Dr. Guadagnoli’s research focuses on evaluating the quality and outcomes of health care, examining access to health care, and evaluating health care interventions. His work in the area of cancer care has touched on all of these topics. He has studied the quality of and access to cancer care in various regions of the United States, and he has led an evaluation of an intervention to improve discussion of treatment options between patients and their surgeons. He is currently leading a study to examine how well publicly available data, such as Medicare billing data and hospital discharge data, can characterize the quality of care provided to women with breast cancer. As part of another project, he is studying the factors associated with prescription of and compliance with tamoxifen therapy in patients diagnosed with early-stage breast cancer. He is also a member of the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, which is studying the quality of care provided to patients with lung or colorectal cancer treated across the United States.
Since arriving at Harvard, Dr. Guadagnoli has been involved in several large-scale projects to study the quality of care for patients with cardiovascular disease. His work in this area focuses on understanding the factors related to variation in practice across geographic areas and on determining how variation in practice is associated with the quality of care provided to patients. He recently completed an evaluation of the quality of cardiac care services provided by the Veterans Health Administration. He is also involved in a project to develop quality indicators for the care of patients with acute myocardial infarction, congestive heart failure, or hypertension.
As part of his work in the areas of quality of care assessment and evaluation of health care interventions, Dr. Guadagnoli is leading an evaluation of the Health Disparities Collaboratives program, which is an effort of the Bureau of Primary Health Care to improve the quality of care in the nation’s community health centers and to reduce health disparities. This evaluation will involve 60 community health centers from throughout the country and nearly 10,000 patients with diabetes, asthma, or hypertension. A more recent interest involves evaluating the effect of managed care on the quality of health care. Dr. Guadagnoli recently reported that the delivery of appropriate care for acute myocardial infarction, as defined by established standards, varies for those Medicare beneficiaries enrolled in managed care versus those who receive care in the traditional fee-for-service setting. He is currently leading a study to determine which features of managed care are associated with the quality of care provided to patients with diabetes and hypertension, and he is leading several studies that will examine the association between the level of managed care in a market and the quality of care for patients with acute myocardial infarction or cancer.
Dr. Guadagnoli is also interested in understanding how to improve the rate of organ donation in the United States. This work has focused on assessing the process of making a donation request in the hospital, but he has also studied the public’s and providers’ attitudes and beliefs about donation. He recently completed a study that estimated the organ donor potential in the United States and that evaluated the performance of the nation’s organ procurement organizations.
Dr. Guadagnoli has served on review panels for the National Institutes of Health and the Agency for Healthcare Research and Quality (AHRQ). He is currently a member of AHRQ’s Health Services Research Dissemination and Implementation Review Committee and a member of the National Cancer Institute’s Expert Liaison Group of the Breast Cancer Surveillance Consortium. From 1994 to 1996 he was a Picker/Commonwealth Scholar studying various aspects of patient participation in decision making about medical treatment. Dr. Guadagnoli received his BA degree from Providence College and MA and PhD degrees in experimental psychology from the University of Rhode Island.