Bio

Honors & Awards


  • NHMA/NHHF National Scholar Recognition, National Hispanic Medical Association/National Hispanic Health Foundation (2012)
  • ACMQ National Quality Scholar Recognition, American College of Medical Quality (2012)
  • LMSA West Community Service Excellence Award, Latino Medical Student Association (2011)
  • Most Outstanding Health Policy Research Project, Medical Scholars Research Symposium (2011)
  • CA State Senate Resolution by Senator Alex Padilla for work on Menu-labeling legislation, California State Senate (2008)
  • Firestone Medal for excellence in undergraduate research, Stanford University (2006)

Membership Organizations


  • LMSA: Latino Medical Student Association
  • SUMMA: Stanford University Minority Medical Alliance
  • AMA: American Medical Association/ CMA: California Medical Association
  • Arbor Free Clinic
  • Pacific Free Clinic
  • Anesthesia Interest Group
  • Internal Medicine Interest Group - Shenson Society

Education & Certifications


  • Bachelor of Arts, Stanford University, HUMBI-BAH (2006)
  • Bachelor of Arts, Stanford University, PSYCH-MIN (2006)

Research & Scholarship

Research Projects


  • Characterizing the No Show Patient at Lucile Packard Children's Hospital (MedScholars Project)
  • Analyzing the Effectiveness of Two Interventions Implemented at Lucile Packard Children¿s Hospital to Reduce the No Show Rate (MedScholars Project)

Publications

Journal Articles


  • Characteristics and Direct Costs of Academic Pediatric Subspecialty Outpatient No-Show Events. Journal for healthcare quality : official publication of the National Association for Healthcare Quality Perez, F. D., Xie, J., Sin, A., Tsai, R., Sanders, L., Cox, K., Haberland, C. A., Park, K. 2013

    Abstract

    BACKGROUND: Clinic no shows (NS) create a lost opportunity for provider-patient interaction and impose a financial burden to the healthcare system and on society. We aimed to: (1) to determine the clinical and demographic factors associated with increased NS rates at a children's hospital's subsubspecialty clinics and (2) to estimate the direct institutional financial costs associated with NS events. METHODS: A comprehensive database was generated from all clinic encounters for 15 subspecialty outpatient clinics (five surgical and 10 medical) between September 12, 2005 and December 30, 2010. Multivariate logistic regressions were performed to identify the variables associated with NS events. Direct costs of NS events were estimated using annual revenue for each clinic. RESULTS: A total of 284,275 encounters and 17,024 NS events were available for analysis. Public insurance coverage (Medicaid and Title V), compared to private insurance or self-pay status, was associated with an increased likelihood NS (OR 2.19, 95% CI 2.10-2.28, p < 0.0005 for Medicaid; OR 1.56, 95% CI 1.50-1.62, p < 0.0005 for Title V). Compared to patients 21-30 years of age, patients <12 years (OR 2.08, 95% CI 1.77-2.45, p < 0.0005) had increased likelihood of NS. Scheduled visits with medical subspecialists were more likely than surgical subspecialty visits to result in a NS (OR 1.69, 95% CI 1.63-1.75, p < 0.0005). The predicted annualized lost revenue associated with NS visits was estimated at $730,000 from the 15 clinics analyzed, approximately $210 per NS event. CONCLUSION: Pediatric subspecialty NS events are common, costly, and potentially preventable.

    View details for PubMedID 23551280

  • Cost-Effectiveness of Early Colectomy With Ileal Pouch-Anal Anastamosis Versus Standard Medical Therapy in Severe Ulcerative Colitis ANNALS OF SURGERY Park, K. T., Tsai, R., Perez, F., Cipriano, L. E., Bass, D., Garber, A. M. 2012; 256 (1): 117-124

    Abstract

    Inflammatory bowel diseases are costly chronic gastrointestinal diseases. We aimed to determine whether immediate colectomy with ileal pouch-anal anastamosis (IPAA) after diagnosis of severe ulcerative colitis (UC) was cost-effective compared to the standard medical therapy.We created a Markov model simulating 2 cohorts of 21-year-old patients with severe UC, following them until 100 years of age or death, comparing early colectomy with IPAA strategy to the standard medical therapy strategy. Deterministic and probabilistic analyses were performed.Standard medical care accrued a discounted lifetime cost of $236,370 per patient. In contrast, early colectomy with IPAA accrued a discounted lifetime cost of $147,763 per patient. Lifetime quality-adjusted life-years gained (QALY-gained) for standard medical therapy was 20.78, while QALY-gained for early colectomy with IPAA was 20.72. The resulting incremental cost-effectiveness ratio (?costs/?QALY) was approximately $1.5 million per QALY-gained. Results were robust to one-way sensitivity analyses for all variables in the model. Quality-of-life after colectomy with IPAA was the most sensitive variable impacting cost-effectiveness. A low utility value of less than 0.7 after colectomy with IPAA was necessary for the colectomy with IPAA strategy to be cost-ineffective.Under the appropriate clinical settings, early colectomy with IPAA after diagnosis of severe UC reduces health care expenditures and provides comparable quality of life compared to exhaustive standard medical therapy.

    View details for DOI 10.1097/SLA.0b013e3182445321

    View details for Web of Science ID 000306083300020

    View details for PubMedID 22270693

  • Cost-effectiveness Analysis of Adjunct VSL#3 Therapy Versus Standard Medical Therapy in Pediatric Ulcerative Colitis JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION Park, K. T., Perez, F., Tsai, R., Honkanen, A., Bass, D., Garber, A. 2011; 53 (5): 489-496

    Abstract

    Inflammatory bowel diseases (IBDs) are costly chronic gastrointestinal diseases, with pediatric IBD representing increased costs per patient compared to adult disease. Health care expenditures for ulcerative colitis (UC) are >$2 billion annually. It is not clear whether the addition of VSL#3 to standard medical therapy in UC induction and maintenance of remission is a cost-effective strategy.We performed a systematic review of the literature and created a Markov model simulating a cohort of 10-year-old patients with severe UC, studying them until 100 years of age or death. We compared 2 strategies: standard medical therapy versus medical therapy + VSL#3. For both strategies, we assumed that patients progressed through escalating therapies--mesalamine, azathioprine, and infliximab--before receiving a colectomy + ileal pouch anal anastamosis (IPAA) if the 3 medical therapy options were exhausted. The primary outcome measure was the incremental cost-effectiveness ratio (ICER), defined as the difference of costs between strategies for each quality-adjusted life-year (QALY) gained. One-way sensitivity analyses were performed on variables to determine the key variables affecting cost-effectiveness.Standard medical care accrued a lifetime cost of $203,317 per patient, compared to $212,582 per patient for medical therapy + VSL#3. Lifetime QALYs gained was comparable for standard medical therapy and medical therapy + VSL#3 at 24.93 versus 25.05, respectively. Using the definition of ICER <50,000/QALY as a cost-effective intervention, medical therapy + VSL#3 produced an ICER of $79,910 per QALY gained, making this strategy cost-ineffective. Sensitivity analyses showed that 4 key parameters could affect the cost-effectiveness of the 2 strategies: cost of colectomy + IPAA, maintenance cost after surgery, probability of developing pouchitis after surgery, and the quality of life after a colectomy + IPAA. High surgical and postsurgical costs, a high probability of developing pouchitis, and a low quality of life after a colectomy + IPAA could make adjunct VSL#3 use a cost-effective strategy.Given present data, adjunct VSL#3 use for pediatric UC induction and maintenance of remission is not cost-effective, although several key parameters could make this strategy cost-effective. The quality of life after an IPAA is the single most important variable predicting whether this procedure benefits patients over escalating standard medical therapy.

    View details for DOI 10.1097/MPG.0b013e3182293a5e

    View details for Web of Science ID 000296383000007

    View details for PubMedID 21694634

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