# Evaluation of variability in care and outcomes for patients with gastrointestinal bleeding

> **NIH NIH K08** · UNIVERSITY OF PENNSYLVANIA · 2020 · $171,384

## Abstract

PROJECT SUMMARY
Gastrointestinal bleeding (GIB) is a major cause of inpatient hospitalizations in the United States, and
comprises a heterogeneous population with appreciable variability in patient outcomes amongst hospitals.
Nationally, 30-day mortality rates are estimated at 7%; however, mortality and readmission rates vary widely
across hospitals. Such variability suggests the potential to improve patient care and save lives by identifying
modifiable factors that influence outcomes after hospitalization with GIB. Patient-related factors, hospital
structure and processes of care play major roles in determining outcomes for many other diseases, but the
impact of these factors on outcomes related to GIB has not been adequately defined. The objective of this
proposal is to identify and understand sources of variation in care for patients with GIB, including patient-level
factors, organization (i.e. structure) and processes of care (e.g.. endoscopic and interventional radiology
utilization) amongst hospitals. Our central hypothesis is that modifiable factors impact patient outcomes during
hospitalizations for GIB, which include both structural characteristics and processes of care. Our proposal is to
build a multi-level model of patient outcomes standardized across hospitals, accounting for patient factors and
assess the impact of hospital factors, and then qualitatively explore additional processes of care, through the
following interrelated specific aims: Aim 1- To develop a risk-standardized model for GIB outcomes across
hospitals using Medicare inpatient, outpatient, and pharmaceutical claims data. To ensure generalizability and
clinical applicability, model validation will be performed in a multipayer, multicenter database and using UPenn
health system data which contains clinical variables. Aim 2 - to identify hospital factors (structures and
processes of care) associated with GIB outcomes, using a combined dataset of the aforementioned Medicare
data with American Hospital Association Annual Survey data. Aim 3 – to explore barriers and facilitators of
processes of care for inpatient GIB among hospitals with better and worse patient outcomes, using qualitative
methods. This mixed methods approach will allow for a comprehensive evaluation of drivers of variation in care
for gastrointestinal bleeding. The expected outcome for the proposed research is that it will identify important
modifiable factors in care associated with patient outcomes for those hospitalized with GIB. This can lead to
the development and validation of quality metrics to improve patient care. To facilitate completion of the
research and further the academic development of the applicant, the PI will enroll in coursework that builds on
her Master of Science by focusing on statistical methods using clustered and longitudinal data, data analytics
in confounding, and qualitative methodologies. This proposal has unequivocal and outstanding divisional and
institutional support and ...

## Key facts

- **NIH application ID:** 9976091
- **Project number:** 1K08DK120902-01A1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Shazia Mehmood Siddique
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $171,384
- **Award type:** 1
- **Project period:** 2020-07-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9976091

## Citation

> US National Institutes of Health, RePORTER application 9976091, Evaluation of variability in care and outcomes for patients with gastrointestinal bleeding (1K08DK120902-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9976091. Licensed CC0.

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