Nancy Abramson Wolfson Endowed Chair in Health Services Research
Professor of Pediatrics and Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine
Professor of Health Care Management, Wharton School, University of Pennsylvania
The Children’s Hospital of Philadelphia
Center for Outcomes Research
3535 Market Street, Suite 1029
Philadelphia, PA 19104
Director, Center for Outcomes Research: Development of new health care outcome measures, statistical methodology in outcomes research including multivariate matching, clinical economics, measuring health care quality, health care disparities, medical decision making, outcomes of care in cancer
Nancy Abramson Wolfson Endowed Chair in Health Services Research, The Children’s Hospital of Philadelphia
Professor of Pediatrics, University of Pennsylvania Perelman School of Medicine
Professor of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine
Professor of Health Care Management, University of Pennsylvania Wharton School
A.B. (summa), Washington University, Department of Economics, St. Louis, Missouri (1976)
M.D., Johns Hopkins Medical School, Baltimore, Maryland (1980)
Ph.D., The University of Pennsylvania (Department of Health Care Systems, The Graduate Group in Managerial Science and Applied Economics), Philadelphia, Pennsylvania (1990)
Dr. Silber is the Nancy Abramson Wolfson Endowed Chair in Health Services Research at the Children’s Hospital of Philadelphia, Professor of Pediatrics and Anesthesiology & Critical Care at the Perelman School of Medicine at the University of Pennsylvania, and Professor of Health Care Management at the Wharton School at the University of Pennsylvania. He is a Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania.
Dr. Silber is an internationally known authority on outcomes measurement and severity adjustment for both adult and pediatric applications. He created the quality of care measure Failure-to-Rescue (FTR) in 1992 that has been adopted as three specific quality measures by the National Quality Forum (NQF). He has also developed two length of stay outcome measures: Prolonged Length of Stay and Conditional Length of Stay, now applied to both pediatric and adult populations. With Paul Rosenbaum he developed the Omega measure that evaluates outcome measures by estimating the relative contribution of patient to hospital characteristics associated with a specific outcome. He has published extensively on all aspects of the theory of outcomes measure and model development and validation, as well as the applications of outcomes measures to pressing public health issues. Much of his recent work focuses on the use of multivariate matching when comparing outcomes, specifically with respect to problems in both pediatric and adult medicine and surgery, disparities, and cancer. Dr. Silber has twice been awarded the Article of the Year Award in Health Services Research from AcademyHealth, the leading professional organization concerning Health Services Research in the U.S.
Dr. Silber helped to establish and has served as the Director of the Center for Outcomes Research since its inception in 1997. The center is a multidisciplinary health services research hub for Children’s Hospital of Philadelphia and University of Pennsylvania investigators and external academic and institutional collaborators which aims to improve health outcomes through the development, testing and application of innovative, practical metrics which serve as tools to transform the quality and efficiency of health care.
Dr. Silber’s current research interests include the development of new health care outcome measures, statistical methodology in outcomes research including multivariate matching, clinical economics, measuring health care quality, health care disparities, medical decision making and outcomes of care in cancer.
Recent Peer-Reviewed Publications (since 2009):
- Silber JH, Rosenbaum PR, Romano PS, Rosen AK, Wang Y, Teng Y, Halenar MJ, Even-Shoshan O, Volpp KG. Hospital teaching intensity, patient race, and surgical outcomes. Arch Surg 2009; 144:113-121. PMID: 19221321; PMC2814447.
- Silber JH, Lorch SA, Rosenbaum PR, Medoff-Cooper B, Bakewell-Sachs S, Millman A, Mi L, Even-Shoshan O, Escobar GJ. Time to send the preemie home? Additional maturity at discharge and subsequent healthcare costs and outcomes. Health Serv Res 2009; 44:444-463. PMID: 19207592. PMC2677048.
- Lorch SA, Silber JH, Even-Shoshan O, Millman A. Use of prolonged travel to improve pediatric risk adjustment models. Health Serv Res 2009; 44:519-541. PMID: 19207591; PMC2677052.
- Bakewell-Sachs S, Medoff-Cooper B, Escobar GJ, Silber JH, Lorch SA. Infant functional status: The timing of physiologic maturation of premature infants. Pediatrics, 2009; 123:e878-e886. PMID: 19403481.
- Feudtner C, Hexem KR, Shabbout M, Feinstein JA, Sochalski J, Silber JH. Prediction of pediatric death in the year after hospitalization: A population-level retrospective cohort study. J Palliative Medicine 2009; 12:160-169. PMID: 19207060; PMC2656437.
- Prasad M, Iwashyna TJ, Christie JD, Kramer AA, Silber JH, Volpp KG, Kahn JM. Effect of work-hours regulations on intensive care unit mortality in United States teaching hospitals. Crit Care Med 2009; 37:2564-2569. PMID: 19623042; PMC2849632.
- Rosen AK, Loveland SA, Romano PS, Itani KMF, Silber JH, Even-Shoshan O, Halenar MJ, Teng Y, Zhu J, Volpp KG. Effects of resident duty hour reform on surgical and procedural patient safety indicators among hospitalized VA and Medicare patients. Med Care 2009; 47:723-731. PMID: 19536029; PMC3893754.
- Putt M, Long JA, Montagnet C, Silber JH, Chang VW, Liao K, Schwartz JS, Pollack CE, Wong Y, Armstrong K. Racial differences in the impact of comorbidities on survival among elderly men with prostate cancer. Med Care Res Rev 2009; 66:409-435. PMID: 19357389; PMC2780425.
- Silber JH, Rosenbaum PR, Rosen AK, Romano PS, Itani KMF, Cen L, Mi L, Halenar MJ, Even-Shoshan O, Volpp KG. Prolonged hospital stay and the resident duty hour rules of 2003. Med Care 2009; 47:1191-1200. PMID: 19786912; PMC3279179.
- Volpp KG, Rosen AK, Rosenbaum PR, Romano PS, Itani KMF, Bellini L, Even-Shoshan O, Cen L, Wang Y, Halenar MJ, Silber JH. Did duty hour reform lead to better outcomes among the highest risk patients? J Gen Intern Med 2009; 24:1149-1155. PMID: 19455368; PMC2762498.
- Rosenbaum PR and Silber JH. Sensitivity analysis for equivalence and difference in an observational study of neonatal intensive care units. J Am Stat Assoc 2009; 104:501-511.
- Rosenbaum PR and Silber JH. Amplification of sensitivity analysis in matched observational studies. J Am Stat Assoc 2009; 104:1398-1405. PMID: 22888178; PMC3416023.
- 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. Health Serv Res 2010; 45:24-41. PMID: 19780853; PMC2813435.
- Lorch SA, Wade KC, Bakewell-Sachs S, Medoff-Cooper B. Silber JH, Escobar GJ. Antibiotic use in premature infants after discharge from the Neonatal Intensive Care Unit. Clin Pediatr 2010; 49:249-257. PMID: 19448131.
- Friese CR, Earle CC, Silber JH, Aiken LH. Hospital characteristics, clinical severity, and outcomes for surgical oncology patients. Surgery 2010; 147:602-609. PMID: 20403513; PMC2858347.
- Silber JH, Rosenbaum PR, Brachet TJ, Ross RN, Bressler LJ, Even-Shoshan O, Lorch SA, Volpp KG. The Hospital Compare mortality model and the volume-outcome relationship. Health Serv Res 2010; 45:1148-1167. PMID: 20579125; PMC2965498.
- Silber JH, Kaestner R, Even-Shoshan O, Wang Y, Bressler LJ. Aggressive treatment style and surgical outcomes. Health Serv Res 2010; 45:1872-1892. PMID: 20880043; PMC3029844.
- Neuman MD, Fleisher LA, Even-Shoshan O, Mi L, Silber JH. Nonoperative care for hip fracture in the elderly: The influence of race, income, and comorbidities. Med Care 2010; 48:314-320. PMID: 20355262; PMC Journal – In Process.
- Friese CR, Silber JH, Aiken LH. National Cancer Institute cancer center designation and 30-day Mortality for hospitalized, immunocompromised cancer patients. Cancer Invest 2010; 28:751-757. PMID: 20504224; PMC2906620.
- Kaestner R, Silber JH. Evidence on the efficacy of inpatient spending on Medicare patients. Milbank Q 2010; 88:560-594. PMID: 21166869; PMC3037176.
- Armstrong K, Randall TC, Polsky D, Moye E, Silber JH. Racial differences in surgeons and hospitals for endometrial cancer treatment. Med Care 2011; 49:207-214. PMID: 21150796; PMC3332036.
- Neuman MD, David G, Silber JH, Schwartz JS, Fleisher LA. Changing access to emergency care for patients undergoing outpatient procedures at ambulatory surgery centers: Evidence from Florida. Med Care Res Rev 2011; 68:247-258. PMID: 20675344.
- Press MJ, Silber JH, Rosen AK, Romano PS, Itani KMF, Zhu J, Wang Y, Even-Shoshan O, Halenar MJ, Volpp KG. The impact of resident duty hour reform on hospital readmission rates among Medicare beneficiaries. J Gen Intern Med 2011; 26:405-411. PMID: 21057883; PMC3055962.
- Kaplan HC, Lorch SA, Pinto-Martin J, Putt M, Silber JH. Assessment of surfactant use in preterm infants as a marker of neonatal intensive care unit quality. BMC Health Serv Res 2011; 11:22. PMID: 21281485; PMC3045285.
- Silber JH, Rosenbaum PR, Even-Shoshan O, Mi L, Kyle F, Teng Y, Bratzler DW, Fleisher LA. Estimating anesthesia time using the Medicare claim: A validation study. Anesthesiology 2011; 115:322-333. PMID: 21720242; PMC3273329.
- Zubizarreta JR, Reinke CE, Kelz RR, Silber JH, Rosenbaum PR. Matching for several sparse nominal variables in a case-control study of readmission following surgery. Am Stat 2011; 65:229-238. PMC4237023.
- Yang D, Small DS, Silber JH, Rosenbaum PR. Optimal matching with minimal deviation from fine balance in a study of obesity and surgical outcomes. Biometrics 2012; 68:628-636. PMID: 22008180; PMC3966214.
- Silber JH, Rosenbaum PR, Kelz RR, Reinke CE, Neuman MD, Ross RN, Even-Shoshan O, David G, Saynisch PA, Kyle FA, Bratzler DW, Fleisher LA. Medical and financial risks associated with surgery in the elderly obese. Ann Surg 2012; 256:79-86. PMID: 22566017; PMC3623296.
- Reinke CE, Kelz RR, Zubizarreta JR, Mi L, Saynisch P, Kyle FA, Even-Shoshan O, Fleisher LA, Silber JH. Obesity and readmission in elderly surgical patients. Surgery 2012; 152:355-362. PMID: 22938896; PMC3637915.
- Neuman MD, Silber JH, Elkassabany NM, Ludwig JM, Fleisher LA. Comparative effectiveness of regional versus general anesthesia for hip fracture surgery in adults. Anesthesiology 2012; 117:72-92. PMID: 22713634.
- Zubizarreta, JR, Neuman MD, Silber JH, Rosenbaum PR. Contrasting evidence within and between institutions that supply treatment in an observational study of alternative forms of anesthesia. J Am Stat Assoc 2012; 107:901-915. NIHMSID 523535. PMC Journal – In Process.
- Shea JA, Weissman A, McKinney S, Silber JH, Volpp KG. Internal medicine trainees' views of training adequacy and duty hour restrictions in 2009. Acad Med 2012; 87:889-894. PMID: 22622211; PMC3386471.
- Navathe AS, Silber JH, Small DS, Rosen AK, Romano PS, Even-Shoshan O, Wang Y, Zhu J, Halenar MJ, Volpp KG. Teaching hospital financial status and patient outcomes following ACGME duty hour reform. Health Serv Res 2013; 48:476-98. PMID: 22862427; PMC3626351.
- Rosenbaum PR and Silber JH. Using the exterior match to compare two entwined matched control groups. Am Stat 2013; 67:67-75.
- Volpp KG, Small DS, Romano PS, Itani KMF, Rosen AK, Even-Shoshan O, Wang Y, Bellini L, Halenar MJ, Korovaichuk S, Zhu J, Silber JH. Teaching hospital five-year mortality trends in the wake of duty hour reforms. J Gen Intern Med 2013; 28:1048-1055. PMID: 23592241; PMC3710388.
- Tubbs-Cooley HL, Cimiotti JP, Silber JH, Sloane DM, Aiken LK. An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions. BMJ Qual Saf 2013; 22:735-42. PMID: 23657609; PMC3756461.
- Kelz RR, Reinke CE, Zubizarreta JR, Wang M, Saynisch P, Even-Shoshan O, Reese PP, Fleisher LA, Silber JH. Acute kidney injury, renal function, and the elderly obese surgical patient: A matched case-control study. Ann Surg 2013; 258:359-363. PMID: 23676533; PMC3931547.
- Silber JH, Rosenbaum PR, Ross RN, Even-Shoshan O, Kelz RR, Neuman MD, Reinke CE, Ludwig JM, Kyle FA, Bratzler DW, Fleisher LA. Racial disparities in operative procedure time: The influence of obesity. Anesthesiology 2013; 119:43-51. PMID: 23719571; PMC3889464.
- Silber JH, Rosenbaum PR, Clark AS, Giantonio BJ, Ross RN, Teng Y, Wang M, Niknam BA, Ludwig JM, Wang W, Even-Shoshan O, Fox KR. Characteristics associated with differences in survival among black and white women with breast cancer. JAMA 2013; 310:389-397. PMID: 23917289.
- Navathe A, Silber JH, Zhu J, Volpp KE. Does admission to a teaching hospital affect acute myocardial infarction survival? Acad Med 2013; 88:475-482. PMID: 23425988.
- Guevara JP, Moon J, Hines EM, Fremont E, Wong A, Forrest CB, Silber JH, Pati S. Continuity of public insurance coverage: A systematic review of the literature. Med Care Res Rev 2014; 71:115-137. PMID: 24227811.
- Silber JH, Romano PS, Itani KMF, Rosen AK, Small D, Lipner RS, Bosk CL, Wang Y, Halenar MJ, Korovaichuk S, Even-Shoshan O, Volpp KG. Assessing the effects of the 2003 Resident Duty Hours Reform on internal medicine board scores. Acad Med 2014; 89:644-651. PMID: 24556772. PMC4139168.
- Neuman MD, Rosenbaum PR, Ludwig JM, Zubizaretta JR, Silber JH. Anesthesia technique, mortality, and length of stay after hip fracture surgery. JAMA 2014; 311:2508-2517. PMID: 25058085.
- Neuman MD, Silber JH, Magaziner JS, Passarella MA, Mehta S, Werner RM. Survival and functional outcomes after hip fracture among nursing home residents. JAMA Intern Med 2014; 174:1273-1280. PMID: 25055155; PMC4122620.
- Reese PP, Bloom RD, Feldman HI, Rosenbaum P, Wang W, Saynisch P, Tarsi NM, Mukherjee N, Garg AX, Mussell A, Shults J, Even-Shoshan O, Townsend RR, Silber JH. Mortality and cardiovascular disease among older live kidney donors. Am J Transplant 2014; 14:1853-1861. PMID: 25039276; PMC4105987.
- Forrest CB and Silber JH. Concept and measurement of pediatric value. Acad Pediatr 2014; 14:S33-8. PMID: 25169455.
- Silber JH, Rosenbaum PR, Ross RN, Ludwig JM, Wang W, Niknam BA, Mukherjee N, Saynisch PA, Even-Shoshan O, Kelz RR, Fleisher LA. Template matching for auditing hospital cost and quality. Health Serv Res 2014; 49:1446-1474. PMID: 24588413.
- Silber JH, Rosenbaum PR, Ross, RN, Ludwig JM, Wang W, Niknam BA, Saynisch PA, Even-Shoshan O, Kelz RR, Fleisher LA. A hospital-specific template for benchmarking its cost and quality. Health Serv Res 2014; 49:1475-1497. PMID: 25201167.
- Patel MS, Volpp KG, Small DS, Hill AS, Even-Shoshan O, Rosenbaum L, Ross RN, Bellini L, Zhu J, Silber JH. Association of the 2011 ACGME resident duty hour reforms with mortality and readmissions among hospitalized Medicare patients. JAMA 2014; 312:2364-2373. PMID: 25490327.
- Pati S, Wong AT, Calixte RE, Ludwig J, Zeigler A, Localio AR, Moon J, Silber JH. Medicaid and CHIP retention among children in 12 states. Acad Pediatr 2015; 15:249-257. PMID: 25454028.
- Silber JH, Rosenbaum PR, Ross RN, Niknam BA, Ludwig JM, Wang W, Clark AS, Fox KR, Wang M, Even-Shoshan O, Giantonio BJ. Racial disparities in colon cancer survival. A matched cohort study. Ann Intern Med 2014; 161:845-854. PMID: 25506853.
- Pimentel SD, Kelz RR, Silber JH, Rosenbaum PR. Large, sparse optimal matching with refined covariate balance in an observational study of the health outcomes produced by new surgeons. J Am Stat Assoc 2015. DOI:10.1080/01621459.2014.997879 [Epub ahead of print]. NIHMSID 659005; PMC Journal – In Process.
- Silber JH, Rosenbaum PR, Kelz RR, Gaskin DJ, Ludwig JM, Ross RN, Niknam BA, Hill A, Wang M, Shoshan O, Fleisher LA. Examining causes of racial disparities in general surgical mortality: Hospital quality versus patient risk. Med Care 2015 (Accepted for publication).