Jeffrey H. Silber, MD, PhD

jeff_silber_smallerNarrow.jpg
Director, Center for Outcomes Research
Nancy Abramson Wolfson Endowed Chair in Health Services Research, Children's Hospital of Philadelphia
Professor of Pediatrics, Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania
Professor of Health Care Management, Wharton School, University of Pennsylvania
 
Contact Information
The Children's Hospital of Philadelphia
3535 Market Street, Suite 1029
Philadelphia, PA 19104
Phone:  215-590-5635
Fax:  215-590-2378
 
Biographical Information
Dr. Silber helped to establish the Center for Outcomes Research with Dr. William Greeley in 1997 and has served as its director since its inception.  Dr. Silber is an internationally known authority on outcomes measurement and severity adjustment for both adult and pediatric applications. He created the adult 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’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.   
 
Dr. Silber earned an MD from the Johns Hopkins School of Medicine in 1980 and a PhD in Health Care Management (formerly Health Care Systems) at the Wharton School at the University of Pennsylvania in 1990.  He was a Robert Wood Johnson Clinical Scholar at the University of Pennsylvania from 1983 to 1985.  He was named the first Nancy Abramson Wolfson Endowed Chair in Health Services Research in 2013.  
 
Publications

Silber JH and Forrest CB. Concept and measurement of pediatric value. Acad Pediatr, in press.

Silber JH, Rosenbaum PR, Ross, RN, Ludwig JM, Wang W, Niknam BA, Saynisch PA, Even-Shoshan O, Kelz RR, Fleisher LA. Hospital-specific template matching for auditing hospital cost and quality. Health Serv Res, in press.

Neuman M, Rosenbaum PR, Ludwig JM, Zubizaretta JR, Silber JH. Anesthesia technique, mortality, and length of stay after hip fracture surgery.  JAMA, 2014 June 25; 311(24):2508-17.

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 June 23. [Epub ahead of print]

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; doi: 10.1111/1475-6773.12156. PubMed

Silber JH, Romano PS, Itani KM, 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. PubMed

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(2):115-137. PubMed

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. PubMed

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. PubMed

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. PubMed

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(9):735-742. PubMed

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. PubMed

Navathe AS, Silber JH, Zhu J, Volpp KG. Does admission to a teaching hospital affect acute myocardial infarction survival? Acad Med. 2013; 88(4):475-482. PubMed

Rosenbaum PR and Silber JH. Using the exterior match to compare two entwined matched control groups. Am Stat. 2013; 67:67-75.

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; 48:476-498. PubMed

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.

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(3):355-62. PubMed

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(1):72-92. PubMed

Shea JA, Weissman A, McKinney S, Silber JH, Volpp KG. Internal medicine trainees' views of training adequacy and duty hours restrictions in 2009. Acad Med. 2012;87(7):889-94. PubMed

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(2):628-36. PubMed

Silber JH, Rosenbaum PR, Kelz RR, Reinke CE, Neuman MD, Ross RN, Even-Shoshan O, David G, Saynisch PA, Kyle FA, Bratzler DW, Fleischer LA. Medical and financial risks associated with surgery in the elderly obese. Ann Surg. 2012; 256(1):79-86. PubMed

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. PubMed.

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(4):229-238.

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. PubMed

Armstrong K, Randall TC, Polsky D, Moye E, Silber JH. Racial differences in surgeons and hospitals for endometrial cancer treatment. Med Care. 2011;49(2):207-14. PubMed

Press MJ, Silber JH, Rosen AK, Romano PS, Itani KM, 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(4):405-11. PubMed

Volpp KG, Friedman W, Romano PS, Rosen A, Silber JH. Residency training at a crossroads: duty-hour standards. 2010. Ann Intern Med. 2010;153(12):826-8. PubMed

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(2):247-58. PubMed

Kaestner R, Silber JH: Evidence on the efficacy of inpatient spending on medical patients. Milbank Q. 2010; 88:560-594. PubMed (AcademyHealth Article-of-the-Year)

Silber JH, Kaestner R, Even-Shoshan O, Wang Y, Bressler LJ: Aggressive treatment style and surgical outcomes. Health Serv Res. 2010; 45:1872-1892. PubMed (AcademyHealth Article-of-the-Year)

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(5 Pt 1):1148-67. PubMed

Neuman MD, Fleisher LA, Even-Shoshan O, Mi L, Silber JH: Non-Operative Care for Hip fracture in the elderly: The influence of race, income, and comorbidities. Med Care. 2010; 48(4):314-20. PubMed

Friese CR, Earle CC, Silber JH, Aiken LH: Hospital characteristics, clinical severity, and outcomes for surgical oncology patients. Surgery. 2010; 147(5):602-9 PubMed

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(1):24-41. PubMed

Rosenbaum PR, Silber JH: Amplification of sensitivity analysis in matched observational studies. J Amer Stat Assoc. 2009; 104(488):1398-1405. PubMed

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; 47:1-11. PubMed.

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(9):2564-9. PubMed

Rosen AK, Loveland SA, Romano PS, Itani KM, 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 Veterans Health Administration and Medicare patients. Med Care. 2009;47(7):723-31. PubMed

Volpp KG, Rosen AK, Rosenbaum PR, Romano PS, Itani KM, 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? Journal of General Internal Medicine. 2009; 24(10):1149-55. PubMed

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. Clinical Pediatrics. 2010; 49(3):249-57. PubMed

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 Services Research. 2009; 44:444-463. PubMed

Lorch SA, Silber JH, Even-Shoshan O, Millman A. Use of Prolonged Travel to Improve Pediatric Risk Adjustment Models. Health Services Research. 2009; 44:519-541. PubMed

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(5):e878-86. PubMed

Putt M, Long JA, Montagnet C, Silber JH, Chang VW, Kaijun Liao, Schwartz JS, Pollack CE, Wong YN, Armstrong K. Racial differences in the impact of comorbidities on survival among elderly men with prostate cancer. Med Care Res Rev. 2009; 66(4):409-35. PubMed

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. Archives of Surgery. 2009;144(2):113-20; discussion 121. PubMed

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 Palliat Med. 2009;12(2):160-9. PubMed

Wade KC, Lorch SA, Bakewell-Sachs S, Medoff-Cooper B, Silber JH, Escobar GJ. Pediatric care for preterm infants after NICU discharge: high number of office visits and prescription medications. J Perinatol. 2008; 28(10):696-701. PubMed

Lorch SA, Millman AM, Zhang X, Even-Shoshan O, Silber JH. The impact of admission day crowding on the length of stay of pediatric hospitalizations. Pediatrics. 2008;121:e718-e730. PubMed

Rosenbaum PR, Silber JH. Aberrant effects of treatment. Journal of the American Statistical Association. 2008;103:240-247.

Friese CR, Lake ET, Aiken LH, Silber JH, Sochalski J. Hospital nurse practice environments and outcomes for surgical oncology patients. Health Serv Res. 2008; 43(4):1145-63. PubMed

Lorch SA, Wade KC, Bakewell-Sachs S, Medoff-Cooper B, Escobar GJ, Silber JH. Racial differences in the use of respiratory medications in premature infants after discharge from the Neonatal Intensive Care Unit. Journal of Pediatrics. 2007;151:604-610. PubMed

Silber JH, Romano PS, Rosen AK, Wang Y, Even-Shoshan O, Volpp KG. Failure-To-Rescue: Comparing Definitions to Measure Quality of Care. Medical Care. 2007;45(10):918-25. PubMed

Volpp KG, Rosen AK, Rosenbaum PR, Romano PS, Even-Shoshan O, Wang Y, Bellini L, Behringer T, Silber JH. Mortality Among Hospitalized Medicare Beneficiaries in the First Two Years Following ACGME Resident Duty Hour Reform. The Journal of the American Medical Association. 2007;298(9):975-983 . PubMed

Volpp KG, Rosen AK, Rosenbaum PR, Romano PS, Even-Shoshan O, Canamucio A, Bellini L, Behringer T, Silber JH. Mortality Among Patients in VA Hospitals in the First Two Years Following ACGME Resident Duty Hour Reform. The Journal of the American Medical Association. 2007; 298(9):984-992. PubMed

Tabak YP, Johannes RS, Silber JH. Using automated clinical data for risk adjustment: development and validation of six disease-specific mortality predictive models for pay-for-performance. Med Care. 2007;45(8):789-805. PubMed

Silber JH, Rosenbaum PR, Polsky D, Ross RN, Even-Shoshan O, Shwartz JS, Armstrong KA, Randall TC. Does ovarian cancer treatment and survival differ by the specialty providing chemotherapy? J Clin Oncol. 2007; 25(10):1169-75. PubMed

Seifert HA, Howard DL, Silber JH, Jobes DR. Female gender increases the risk of death during hospitalization for pediatric cardiac surgery. J Thorac Cardiovasc Surg. 2007; 133(3):668-75. PubMed

Weiner MG, Ross SJ, Mathew JI, Millman AM, Even-Shoshan O, Fox KR, Silber JH. Estimating the costs of chemotherapy-associated adverse event clusters. Health Services and Outcomes Research Methodology. 2007; 7:1-21.

Silber JH, Rosenbaum PR, Zhang X, Even-Shoshan O. Estimating anesthesia and surgical procedure times from Medicare anesthesia claims. Anesthesiology. 2007; 106(2):346-355. PubMed

Silber JH, Rosenbaum PR, Zhang X, Even-Shoshan O. The influence of patient and hospital characteristics on anesthesia time in Medicare patients undergoing general and orthopedic surgery. Anesthesiology. 2007; 106(2):356-364. PubMed

Rosenbaum PR, Ross R, Silber JH. Minimum distance matched sampling with fine balance in an observational study of treatment for ovarian cancer. Journal of the American Statistical Association. 2007; 102:75-83.

Polsky D, Randall TC, Ross RN, Even-Shoshan O, Silber JH. Variation in chemotherapy utilization in ovarian cancer: the relative contribution of geography. Health Services Research. 2006; 41(6):2201-2218. PubMed

Fiks AG, Alessandrini EA, Luberti AA, Ostapenko S, Zhang X, Silber JH. Identifying factors predicting immunization delay for children followed in an urban primary care network using an electronic health record. Pediatrics. 2006; 118(6):e1680-6. PubMed

Silber JH, Rosenbaum PR, Trudeau ME, Chen W, Zhang X, Rapaport RK, Mosher RE, Even-Shoshan O. Changes in prognosis after the first postoperative complication. Medical Care. 2005; 43:122-131. PubMed

Silber JH, Rosenbaum PR, Trudeau ME, Chen W, Zhang X, Lorch SA, Kelz RR, Mosher RE, Even-Shoshan O. Preoperative antibiotics and mortality in the elderly. Annals of Surgery. 2005; 242:107-114. PubMed

Tabak YP, Johannes RS, Silber JH, Kurtz SG. Should Do-Not-Resuscitate status be included as a mortality risk adjustor? The impact of DNR variations on performance reporting. Med Care. 2005 Jul;43(7):658-66. PubMed

Silber JH. Role of afterload reduction in the prevention of late anthracycline cardiomyopathy. Pediatr Blood Cancer. 2005; 44(7):607-13. PubMed

Silber JH. Challenges in conducting a pediatric longitudinal prevention study: lessons from the ACE-inhibitor after anthracycline trial. Progress in Pediatric Cardiology. 2005; 20:65-70.

McGuire KJ, Bernstein J, Polsky D, Silber JH. The 2004 Marshall Urist award: delays until surgery after hip fracture increases mortality. Clin Orthop Relat Res. 2004; (428):294-301. PubMed

Ginsberg JP, Cnaan A, Zhao H, Clark BJ, Paridon SM, Chin AJ, Rychik J, Hogarty AN, Barber G, Rutkowski M, Kimball TR, DeLaat C, Steinherz LJ, Silber JH. Using health-related quality of life measures to predict cardiac function in survivors exposed to anthracyclines. J Clin Oncol. 2004; 22(15):3149-55. PubMed

Silber JH, Cnaan A, Clark BJ, Paridon SM, Chin AJ, Rychik J, Hogarty AN, Cohen MI, Barber G, Rutkowski M, Kimball, TR, DeLaat C, Steinherz LJ, Zhao H. Enalapril to prevent cardiac function decline in long-term survivors of pediatric cancer exposed to anthracyclines. Journal of Clinical Oncology. 2004; 5:820-828. PubMed

Lorch SA, Zhang X, Rosenbaum PR, Evan-Shoshan O, Silber JH. Equivalent lengths of stay in pediatric patients hospitalized in rural and non-rural hospitals. Pediatrics. 2004; 114:e400-e408. PubMed

Greevy R, Lu B, Silber JH, Rosenbaum P. Optimal multivariate matching before randomization. Biostatistics. 2004; 5(2):263-75. PubMed

Howard DL, Silber JH, Jobes DR. Do regulations limiting residents' work hours affect patient mortality? J Gen Intern Med. 2004; 19(1):1-7. PubMed

Silber JH, Rosenbaum PR, Even-Shoshan O, Shabbout M, Zhang X, Bradlow ET, Marsh, RR. Length of stay, conditional length of stay, and prolonged stay in pediatric asthma. Health Services Research. 2003; 38:867-886.PubMed

Silber JH, Kennedy SK, Even-Shoshan O, Chen W, Mosher RE, Showan AM, Longnecker DE. Anesthesiologist board certification and patient outcomes. Anesthesiology. 2002; 96:1044-1052. PubMed

Rosenbaum PR, Silber JH. Matching and thick description in an observational study of mortality after surgery. Biostatistics. 2001;2(2):217-32. PubMed

Silber JH, Rosenbaum PR, Trudeau ME, Even-Shoshan O, Chen W, Zhang X, Mosher RE. Multivariate matching and bias reduction in the surgical outcomes study. Medical Care. 2001; 39:1048-1064. PubMed

Silber JH, Cnaan A, Clark BJ, Paridon SM, Chin AJ, Rychik J, Hogarty AN, Cohen MI, Barber G, Rutkowsky M, Kimball TR, Delaat C, Steinherz LJ, Zhao H, Tartaglione MR. Design and baseline characteristics for the ACE Inhibitor After Anthracycline (AAA) study of cardiac dysfunction in long-term pediatric cancer survivors. Am Heart J. 2001; 142(4):577-85. PubMed

Silber JH, Kennedy SK, Even-Shoshan O, Chen W, Koziol LF, Showan AM, Longnecker DE. Anesthesiologist direction and patient outcomes. Anesthesiology. 2000; 93:152-163. PubMed

Silber JH, Gleeson S, Zhao H. The influence of chronic disease on resource utilization in common acute pediatric conditions: financial concerns for children's hospitals. Archives of Pediatric & Adolescent Medicine. 1999; 153:169-179. PubMed

Silber JH, Rosenbaum PR, Koziol LF, Sutaria N, Marsh RR, Even-Shoshan O. Conditional length of stay. Health Services Research. 1999; 34:349-363. PubMed

Silber JH, Fridman M, Shpilsky A, Even-Shoshan O, Smink DS, Jayaraman J, Fox KR, Pauly MV. Modeling the cost effectiveness of GCSF use in early stage breast cancer. Journal of Clinical Oncology. 1998; 16:2435-2444. PubMed

Silber JH, Fridman M, DiPaola RS, Erder MH, Pauly MV, Fox KR. First cycle blood counts and subsequent neutropenia, dose reduction or delay in early stage breast cancer therapy. Journal of Clinical Oncology. 1998; 16:2392-2400. PubMed

Silber JH, Rosenbaum PR. A spurious correlation between hospital mortality and complication rates: the importance of severity adjustment. Medical Care. 1997; 35:OS77-OS92. PubMed

Silber JH, Rosenbaum PR, Williams SV, Ross RN, Schwartz JS. The relationship between choice of outcome measure and hospital rank in general surgical procedures: implications for quality assessment. International Journal for Quality in Health Care. 1997; 9:193-200. PubMed

Silber, JH, Williams SV, Krakauer H, Schwartz, JS. Hospital and patient characteristics associated with death after surgery:  A study of adverse occurrence and failure to rescue. Medical Care. 1992; 30(7):615-629. JSTOR