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In health services research, we want to understand better how our complex health care system works, ultimately to improve its performance and create a system that we can be proud of.
David Grembowski
Professor
Professor, Oral Health Sciences
Adjunct Professor, Sociology

David Grembowski also holds an appointment in the Department of Dental Public Health Sciences in the School of Dentistry. Professor Grembowski teaches social determinants of population health and health program evaluation, and his evaluation interests address prevention and the performance of health care systems. His studies have examined efforts to improve quality by increasing access to care in integrated delivery systems; managed care and physician referrals; managed care and patient-physician relationships; cost-effectiveness of preventive services for older adults; fluoridation effects on oral health and dental demand; financial incentives and dentist adoption of preventive technologies; effects of dental insurance on dental demand, and the link between mother and child access to dental care.

Research Interests:
Design and performance of health care systems; prevention; technology diffusion; program evaluation; survey research

SciVal Experts Profile

Contact Information

email:   grem@u.washington.edu

office:   H-689, Health Sciences Building

address:
University of Washington
1959 NE Pacific Street
Seattle, WA 98195-7660

campus box:   357660
voice:   206-616-2921
fax:   206-543-3964

staff contact:
Alice Gronski

voice: 206-543-7952
fax: 206-543-3964
agronski@u.washington.edu

Education

PhD   University of Washington, 1982   (Urban Planning)
MA   Washington State University, 1975   (Sociology)
BA   Washington State University, 1973   (Sociology)

Teaching   (Department of Health Services Courses)

Recent Publications



Grembowski D, Anderson ML, Ralston JD, Martin DP, Reid R. Does a large-scale organizational transformation toward patient-centered access change the utilization and costs of care for patients with diabetes? Med Care Res Rev. 2012 Oct;69(5):519-39. doi: 10.1177/1077558712446705. Epub 2012 May 31.  PMID: 22653416
PubMed
DOI


Milgrom P, Huebner CE, Mancl L, Garson G, Grembowski D. Counseling on Early Childhood Caries transmission by dentists. J Public Health Dent. 2012 Sep 13. doi: 10.1111/j.1752-7325.2012.00356.x. [Epub ahead of print]  PMID: 22970775
PubMed
DOI


Bekemeier B, Grembowski D, Yang YR, Herting JR. Local public health delivery of maternal child health services: are specific activities associated with reductions in Black-White mortality disparities? Matern Child Health J. 2012 Apr;16(3):615-23.  PMID: 21505777
PubMed
DOI


Bekemeier B, Grembowski D, Yang Y, Herting JR. Leadership matters: local health department clinician leaders and their relationship to decreasing health disparities. J Public Health Manag Pract. 2012 Mar;18(2):E1-E10.  PMID: 22286291
PubMed
DOI


Rodriguez HP, Perry L, Conrad DA, Maynard C, Martin DP, Grembowski DE. The Reliability of Medical Group Performance Measurement in a Single Insurer's Pay for Performance Program. Med Care. 2012 Feb;50(2):117-23.  PMID: 21993058
PubMed
DOI


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Dissertation, Thesis & Capstone Committees (recent HSERV graduates)

2012
Chair, thesis committee for Glen Felias-Christensen
Transition of care: Evaluating the Harborview Medical Center diabetes recent discharge clinic

2012
Chair, dissertation committee for Stephanie Kneeshaw-Price
The implications of neighborhood crime and parents' perceptions of crime on children's physical activity and resulting health outcomes and health care use

2012
Chair, thesis committee for Nicole Murray
Survey of non-dental providers' assessment and management of xerostomia in patients with mental health disorders

2011
Member, thesis committee for Sandy Bodner
Prevelence of dental carries n school children

2011
Member, thesis committee for Dimitry Davydow
The association of comorbid depression with intensive care unit admission in patients with diabetes

2011
Chair, dissertation committee for Meredith Fort
Evaluation of a primary health care demonstration project in rural Guatemala: Quality, coverage, utilization and impact

2011
Chair, thesis committee for Elysia Gonzales
A program evaluation of Planned Parenthood of the Great Northwest's Healthy Sexuality series

2010
Member, thesis committee for Jane Edelson
A process evaluation of the stress management and relaxation techniques for health intervention (Health SMART): a cognitive-behavioral stress management intervention

2010
Member, dissertation committee for Courtney Lyles
Patient and Provider Factors, Patient-Reported Racial/Ethnic Discrimination in the Healthcare Setting, and Quality of Care in the Diabetes Study of Northern California (DISTANCE)

2010
Member, thesis committee for Amardeep Mann
Are there significant associations between patient socio-demographic factors, patient health status, and patient participation in health care?

2010
Member, dissertation committee for Myra Parker
Self-Rated Health in African American and American Indian Populations

2010
Chair, thesis committee for Emily Purchia
Evaluation of maternity support services in King County, Washington: Effect of budget cuts on utilization

2009
Member, dissertation committee for Forest Kim
Evaluating the impact of TRICARE for Life on Medicare-eligible military retirees

2009
Member, thesis committee for Elizabeth Knaster
Risk factors for protection order failure

2009
Member, thesis committee for Maren Olson
The Impact of Income and Income Inequality on Infant Health Outcomes in the United States: An Aggregate Analysis of Statewide Information

External Funding (sampling of recent awards from UW SAGE data)

Data De-identification Services
King County Executive
PI:   Grembowski           Dates:    2/1/2013 - 1/31/2015

Health Services Research Training Program at the University of Washington 2012-2013
Agency for Healthcare Research and Quality (AHRQ)
PI:   Grembowski           Dates:    7/1/2012 - 6/30/2013

Data De-identification Services
King County Executive
PI:   Grembowski           Dates:    2/1/2012 - 1/31/2013

Budget cuts and health outcomes: Examining a natural experiment
Robert Wood Johnson Foundation
PI:   Bekemeier           Dates:    12/1/2011 - 11/30/2013

Health Services Research Training Program at the University of Washington 2011-2012
Agency for Healthcare Research and Quality (AHRQ)
PI:   Martin           Dates:    7/1/2011 - 6/30/2012

Health Care Payment Reform: Lessons from Regional Innovation
Robert Wood Johnson Foundation
PI:   Conrad           Dates:    5/1/2011 - 10/31/2013

Diffusion of Anticipatory Guidance to Prevent ECC Disease Transmission: Secondary Analysis of a Dataset from Oregon Care Provider Study
National Institute of Dental and Craniofacial Research (NIDCR)
PI:   Milgrom           Dates:    12/1/2010 - 11/30/2012

ARRA--Medications and Outcomes in Diabetes
Agency for Healthcare Research and Quality (AHRQ)
PI:   Grembowski           Dates:    10/1/2010 - 9/30/2012

Health Services Research Training Program at the University of Washington 2010-2011
Agency for Healthcare Research and Quality (AHRQ)
PI:   Martin           Dates:    7/1/2010 - 6/30/2011

Health Services Research Training Program at the University of Washington
Agency for Healthcare Research and Quality (AHRQ)
PI:   Martin           Dates:    7/1/2009 - 6/30/2010

Health Services Research Training Program at the University of Washington
Agency for Healthcare Research and Quality (AHRQ)
PI:   Martin           Dates:    7/1/2007 - 6/30/2013

Projects

Payment Reform Evaluation Project: Lessons from State and Regional Payment Reform
This project, funded by the Robert Wood Johnson Foundation (Douglas Conrad, PI; David Grembowski, Co-PI), will perform cross-cutting evaluation of eight payment reform efforts designed to promote high-value health care outcomes through leveraging existing market knowledge, partnerships and resources in different states and regions of the United States.
http://depts.washington.edu/payeval
Physician Networks and Children with Chronic Conditions
Funded by the Agency for Health Care Research and Quality. For children with asthma or diabetes, the purposes of this study are to examine whether out-of-network benefits and cost-sharing of managed health plans are associated with the likelihood of seeing an in-network vs. out-of-network physician, and secondly, to examine whether health quality and expenditures are similar or different for children seeing in-network vs. out-of-network physicians.
Linking Mother and Child Access to Dental Care
In Washington state's Medicaid population of children aged 3-6 years old, the aim is to determine whether having a mother with a regular source of dental care is associated with greater utilization of dental care and oral health in children in four racial/ethnic groups: White (non-Hispanic), Hispanic, African American, and other groups. Funded by the National Institute of Dental and Craniofacial Research.
Caries Prevention Study
Although new, effective technologies have emerged for controlling caries in children, only a minority of dentists have adopted them. A randomized trial is being conducted to determine whether financial incentives and provider education can increase dentist adoption of these technologies, and in turn, whether adoption results in reduced caries incidence and restorative services among at risk children with capitation dental insurance. Funded by NIDCR and Washington Dental Service.
Improving Access to Improve Quality: Evaluation of an Organizational Innovation
Funded by the Robert Wood Johnson Foundation, the study is an evaluation of Group Health Cooperative's "Access Initiative." This innovation includes offering patients same-day appointments to primary care physicians, allowing them direct access to most specialists, and providing physicians with a $40 million clinical information system that offers up-to-the-minute patient health information. The study will determine how the initiative affects factors such as cost, utilization of services, quality of care, member enrollment, and patient and provider satisfaction.

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