Harkness Project Title: Defining and Rating Quality in Nursing Home Care
Mentor: Robert H. Brook, M.D., Sc.D.
Placement: RAND Corporation
Biography at time of Harkness Fellowship: Ciaran O'Neill, a 2001–02 Commonwealth Fund Harkness Fellow in Health Care Policy, is a reader in health economics and policy at the University of Ulster in Northern Ireland. Before taking up his current position he was a lecturer in health economics at the University of Nottingham and a lecturer in economics at the Queens University of Belfast. He also spent just over a year as a senior consultant economist at the HELM Corp. in Northern Ireland. O’Neill was director of the first master’s in health economics and management course offered in Ireland and co-founder and chair of the Health Economics Association of Ireland. He acts as advisor to the Northern Ireland Assembly’s Health Committee, serves on the Northern Ireland Forum for Health and Social Care Research, and has published more than 30 peer-reviewed academic papers as well as numerous reports on a variety of economics and health issues. His research interests include the economics of care for older persons, health technology assessment, and health and health care in its social context.
Project: O’Neill’s study investigated the relationship between nursing home quality and a range of potentially related factors, including for-profit/non-profit status. He used data on over 1,000 nursing homes in California, collected by the Office of Statewide Health Planning and Development (OSHPD), the On-line Survey Certification and Reporting System (OSCAR), and state licensing and statistical reports. Multivariate techniques were used to examine the relationship between deficiency citations (a commonly used measure of quality) and possible explanatory variables.
Career Activity Since Fellowship
Dean of Business, Public Policy and Law, 2013-2014
Named as "one of the six national Health Research Board Leaders in Ireland," 2013
Current Position: Professor of Economics, Northern University of Ireland, Galway. (Updated 1/2014)
Hayes S, Hogan M, Dowd H, Doherty E, O'Higgins S, Nic Gabhainn S, MacNeela P, Murphy AW, Kropmans T, O'Neill C, Newell J, McGuire BE. Comparing the clinical-effectiveness and cost-effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a waiting list control among adults with chronic pain: study protocol for a randomised controlled trial. BMJ Open. 2014 Jul 2;4(7):e005092.
O'Neill S, Sweeney J, Patterson CC, Menzies-Gow A, Niven R, Mansur AH, Bucknall C, Chaudhuri R, Thomson NC, Brightling CE, O'Neill C, Heaney LG; on behalf of the British Thoracic Society Difficult Asthma Network. The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax. 2014 Jun 10.
Davies F, Risør MB, Melbye H, Spigt M, Brookes-Howell L, O'Neill C,Godycki-Cwirko M, Wollny A, Andreeva E, Butler C, Francis N. Primary and secondary care clinicians' views on self-treatment of COPD exacerbations: A multinational qualitative study. Patient Educ Couns. 2014 Aug;96(2):256-63.
Doherty E, Walsh B, O'Neill C. Decomposing socioeconomic inequality in child vaccination: results from Ireland. Vaccine. 2014 Jun 5;32(27):3438-44.
Walsh T, Barr PJ, Thompson R, Ozanne E, O'Neill C, Elwyn G. Undetermined impact of patient decision support interventions on healthcare costs and savings: systematic review. BMJ. 2014 Jan 23;348:g188.
Carney P, Gavin A, O'Neill C. The role of private care in the interval between diagnosis and treatment of breast cancer in Northern Ireland: an analysis of Registry data. BMJ Open. 2013 Dec 3;3(12):e004074.
Doherty E, O'Neill C. Estimating the health-care usage associated with osteoarthritis and rheumatoid arthritis in an older adult population in Ireland. J Public Health (Oxf). 2013 Oct 3.
O'Neill C, McGregor P, Merkur S. United Kingdom (Northern Ireland): Health system review. Health Syst Transit. 2012;14(10):xiii-xix, 1-90. Review.
Carney P, O'Neill S, O'Neill C. Determinants of breast cancer screening uptake in women, evidence from the British Household Panel Survey. Soc Sci Med. 2013 Apr;82:108-14.
Agus AM, Kinnear H, O'Neill C, McDowell C, Crealey GE, Gavin A. Description and predictors of hospital costs of oesophageal cancer during the first year following diagnosis in Northern Ireland. Eur J Cancer Care (Engl). 2013
Gillespie P, O’Neill C, Adams E, Turner K, O’Donovan D, Brugha R, Vaughan D, O’Connell E, Cormican M, Balfe M, Coleman C, Fitzgerald M, Fleming C 'The Cost and Cost Effectiveness of Opportunistic Screening for Chlamydia trachomatis in Ireland' Sexually Transmitted Infections 2012.
Gillespie P, O Neill C, Avalos G, Dunne FP 'New estimates of Costs of Universal Screening for GDM in Ireland' Irish Medical Journal 2012 (Supplement), 105 (5):15-18.
Carney P, O'Neill S, O'Neill C 'Determinants of breat cancer screening uptake in women, evidence from the British Household Panel Survey' Social Science And Medicine 2012.
Murray A, Kinnear H, O’Neill C, McDowell C, Crealey GE, Gavin A 'Description and predictors of hospital costs of oesophageal cancer during the first year following diagnosis in Northern Ireland' European Journal Of Cancer Care 2012.
McGregor P, McKee P, O’Neill C 'Understanding the changing pattern of GP utilization in England under New Labour, 1997-2003' Public Administration, 2012.
Ó Céilleachair A, Hanly P, Skally M, O’Neill C, Fitzpatrick P, Kapur K, Staines A, Sharp L 'Cost comparisons and methodological heterogeneity in cost-of-illness studies: The example of colorectal cancer' Medical Care 2012.
Burns R, Walsh B, O’Neill S, O’Neill C 'An examination of variations in the uptake of Prostate Cancer Screening within and between the countries of the EU-27' Health Policy 2012.
Burns, R,Walsh, B,Sharp, L,O'Neill, C 'Prostate cancer screening practices in the Republic of Ireland: the determinants of uptake' Journal Of Health Services Research & Policy 2012 17 :206-211
Telford, CJ,O'Neill, C 'Changes in dental health investment across the adolescent years'. British dental journal 2012, 212.
Doherty E., Dee, A and O’Neill C 'Estimating the impact of overweight and obesity related healthcare use in the Republic of Ireland using Slán data' Economic And Social Review 2012, 43: 227-250.
Archbold, S., Sach, T., O'Neill, C., Lutman, M. and Gregory, S. 'Parental perspectives on cochlear implantation: Part two - outcomes for child and family' Deafness and Education International 2012.
Tickle M, Worthington HV, Donaldson M, Killough S, O'Neill C, Crealey G, et al. 'Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services' BMC Oral Health 2012.
Telford C, Murray L, Donaldson M, O’Neill C 'An analysis examining socio-economic variations in the provision of NHS general dental practitioner care under a fee for service contract among adolescents: Northern Ireland Longitudinal Study' Community Dentistry and Oral Epidemiology 2012.
O’Neill C, Gamble J, Lindsay JT, Heaney LG. 'The impact of non-adherence to inhaled long-acting β2-agonist / steroid combination therapy on healthcare costs in difficult to treat asthma' Pharmaceutical Medicine 2012.
Fardal O, O’Neill C, Gjermo P et al. 'The Lifetime Direct Cost of Periodontal Treatment - A Case Study from a Norwegian Specialist Practice' Journal of Periodontology 2012.
Walsh B, Silles M, O’Neill C. 'The role of private medical insurance in socioeconomic inequalities in cancer screening uptake in the Republic of Ireland' Health Economics 2012.
Walsh, B,Silles, M,O'Neill, C 'The importance of socio-economic variables in cancer screening participation: A comparison between population-based and opportunistic screening in the EU-15' Health Policy 2011, 101 :269-276.
Burden, DJ,Hunt, O,Johnston, CD,Stevenson, M,O'Neill, C,Hepper, P 'Psychological Status of Patients Referred for Orthognathic Correction of Skeletal II and III Discrepancies' Angle Orthodontist 2010, 80 :43-48.
O'Reilly D, O'Dowd T, Thompson KJ, Murphy AW, Kelly A, O'Neill C, Shyrane E, Steele K, Bury G, Gilliland A. 'Attitudes of general practitioners to prehospital thrombolysis' Irish Medical Journal 2008, 101 (5):137-139.
Gillespie, P,O'Neill, C,Avalos, G,O'Reilly, M,Dunne, F 'The cost of universal screening for gestational diabetes mellitus in Ireland' Diabetic Medicine 2011, 28 :912-918.
O’Neill C, Coughlan D. 'The importance of adherence and the role of non-financial barriers in it' Journal Of Clinical Therapeutics 2011, 33 (9):1222-1224.
O'Neill, C. 'Orphan Drugs: how might the risk they present to budgets be better managed'. Journal of Clinical Therapeutics 2010, 32 (9):1-2.
Walsh, B., Silles, M., O'Neill, C. 'A Cross-Border Comparison of Breast and Cervical Cancer Screening Uptake' Irish Medical Journal 2010, 103 (10).
O'Neill, C. & Wallis, C. 'Home healthcare: emerging evidence for NHS commissioners'. Journal of Care Services Management 2009, 3 (4):357-363.
Fortumn, H., O'Neill, C., Taylor, R., Lenthall, R., Nikolopoulos, T., Lightfood, G., O'Donoghue, G., Mason, S. Baguley, D., Jones, H., Mulvaney, C. 'The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history' Health Technology Assessment 2009, 13 (18: iii-iv~ ix-xi):1-154.
Fleming, I., Monaghan, P., Gavin, A. and O'Neill, C. 'Factors influencing hospital costs of lung cancer treatment' European Journal of Health Economics 2008, 9 (1):79-86.
McGregor, P., McKee, P. and O'Neill, C. 'The role of non-need factors in individual GP utilization analysis and its implications for the pursuance of equity: a cross country comparison' European Journal of Health Economics 2008, 9 (2):147-156.
Galway, K. J., Murphy, A. W., O'Reilly, D., O'Dowd, T., O'Neill, C., Shryane, E., et al. 'Perceived and reported access to the general practitioner: an international comparison of universal access and mixed private/public systems' Ir Med J 2007, 100 (6):494-497.
O'Reilly, D., O'Neill, C., O'Dowd, T., Galway, K., Gilliland, A., Kelly, A., et al. 'Patients' attitudes to co-payments for general practitioner services: do they reflect the prevailing system?' J Health Serv Res Policy 2007, 12 (4):197-201.
Ke, K. M., Montgomery, A., Stevenson, M., O'Neill, C. and Chakravarthy, U. 'Formal and informal care utilisation amongst elderly persons with visual impairment' British Journal of Opthalmology 2007, 91 (10):1279-1281.
Ke, K. M., Chakravarthy. U. and O'Neill, C. 'Economic Cost of Age-related Macular Degeneration: A review of recent research' Drugs and Ageing 2006, 23 :217-225.
McGregor, P., McKee, P. and O'Neill, C. 'GP utilization in Northern Ireland: Exploiting the gatekeeper function' Economic and Social Review 2006, 37 (1):71-90.
Murtagh, E., O'Neill, C., McAllister, D., Kee, F., MacMahon J. and Heaney, L. G. 'A cross-sectional comparison of direct medical care costs among COPD and Asthma patients living in the community in Northern Ireland' Treatments in Respiratory Medicine 2006, 5 (6):495-501.
Archbold, S., Sach, T., O'Neill C, Lutman, M., Gregory, S. 'Deciding to have a cochlear implant and subsequent after-care: parental perspectives' Deafness and Education International 2006, 8 (4):190-206.
O'Neill, B., Bradley, J. M., Heaney, L., O'Neill, C. and MacMahon, J. 'Short burst oxygen therapy in chronic obstructive pulmonary disease' International Journal of Clinical Practice 2005, 59 (7):751-753.
Schweizer, A. K., Hughes, C. M., MaCauley, D. C., O'Neill, C. 'Managing Urinary Tract Infections in Nursing Homes: A Qualitative Assessment' Pharm World Sci 2005 :159-165.
Kitchener, M., O'Neill, C. and Harrington, C. 'Chain reaction: An exploratory study of nursing home bankruptcy in California' Journal of Aging and Social Policy 2005, 17 (4):19-35.
McAlister, D. A., Hughes, C. M., Fleming, I. and O'Neill, C. 'Costs of pharmacological care of the elderly' Reviews in Clinical Gerontology 2004, 14 (1):1-8.
O'Halloran, P., Murray, L., Beringer, T., Kernohan, G. and O'Neill, C., et al. 'A cluster randomised controlled trial to evaluate a policy of making hip protectors available to residents of nursing homes' Age and Ageing 2004, 33 (6):582-588.
O'Neill, C., Lutman, M. E., Archbold, S. M., Gregory, S. & Nikolopoulous, T. 'Parents and their implanted child: development of a survey to elicit parental views and experiences' International Journal of Pediatric Otorhinolaryngology 2004, 68 (2):149-160.
Ozolins, M., Eady, E. A., Avery, A., Cunliffe, W. J., Li Wan Po, A. and O'Neill, C., et al. 'Randomised controlled trial of five antimicrobial regimens for the treatment of mild to moderate inflammatory acne vulgaris in the community' The Lancet 2004 :2188-2195.
Fleming, I., Monaghan, P., Murray, L., Gavin, A. and O'Neill, C. 'The economics surrounding cancer screening and treatment' Hospital Radiologist 2004, 4 (2):31-32.
O'Neill, C., Feenan, D., Hughes, C. and McAlister, D. A. 'Physician and family assisted suicide: results from a study of public attitudes in Britain' Social Science and Medicine 2003, 57 (4):721-731.
Sach, T., O'Neill, C., Whynes, D. W. K., Archbold, S. M. and O'Donoghue, G. M. 'Cost effectiveness in paediatric cochlear implantation: using individual data to enhance efficiency' International Journal of Technology Assessment in Health Care 2003, 19 (2):421-431.
Kitchener M, O’Neill C, Harrington C. “Chain reaction: An exploratory study of nursing home bankruptcy in California.” Journal of Aging and Social Policy 2005; 17 (4): 19-35.
O'Neill C, Harrington C, Kitchener M, Saliba D. "Quality of Care in Nursing Homes: An Analysis of The Relationships Among Profit, Quality and Ownership." Medical Care, December 2003.
O'Neill C, Sweitzer A, Hughes C, Jamison J, "Cost of Pharmacological Care of the Elderly: Implications for Health Care Resources." Drugs and Ageing, 2003;20(4):253–61.