Author Contributions: Dr Snyder had full access
to all of the data in the study and takes responsibility for the integrity
of the data and the accuracy of the data analysis.
Study concept and design: Snyder, Anderson.
Acquisition of data: Snyder, Anderson.
Analysis and interpretation of data: Snyder,
Drafting of the manuscript: Snyder.
Critical revision of the manuscript for important
intellectual content: Anderson.
Statistical analysis: Snyder.
Obtained funding: Snyder.
Study supervision: Anderson.
Financial Disclosures: None reported.
Funding/Support: This project was supported
by grants 1 R36 HS014509 and T32 HS 00029 from the Agency for Healthcare Research
Role of the Sponsor: The conclusions presented
are solely those of the authors and do not represent those of Delmarva Foundation,
Qualis Health, IPRO, HealthInsight, or the Centers for Medicare and Medicaid
Services. However, these groups were provided 30 days to review the manuscript
prior to its submission. The funding organization had no participation in
the study other than supporting Dr Snyder’s doctoral education and dissertation
Acknowledgment: The authors acknowledge the
assistance of Delmarva Foundation for Medical Care, Inc, Qualis Health, IPRO,
HealthInsight, and the Centers for Medicare and Medicaid Services in providing
data that made this research possible. Special thanks to Matthew E. Fitzgerald,
DrPH, and Mariana Albert Lesher, MS, from Delmarva Foundation, Sharon Eloranta,
MD, and Greg Baumgardner, MS, from Qualis Health, Anthony Shih, MD, MPH, and
Ti-Kuang Lee, ScM, from IPRO, and Michael Silver, MPH, and Emily Sim, MStat,
from HealthInsight. Finally, many thanks to dissertation committee members
Leon Gordis, MD, DrPH, Giovanni Parmigiani, PhD, and Donald Steinwachs, PhD.