Dr. Kahn is a practicing general internist and health services researcher. She is a Professor of Medicine at the David Geffen School of Medicine within the Division of General Internal Medicine and Health Services Research.
Dr. Kahn's research focus on the quality of care measurement methods and policy evaluation allowed her to lead some of the nation's major national and local evaluations of the impact of health policy on clinical care and outcomes. She began her career working on the measurement of appropriateness, which led to several high impact manuscripts. She led the work studying the appropriateness of gastrointestinal procedures, which involved developing methods for assessing reasons for a procedure in the inpatient and ambulatory settings. She was one of the first health services researchers to write about comorbidity and complexity of patient's conditions as an important consideration when studying appropriateness and quality of care.
She led the national evaluation of the effect of the DRG-based Prospective Payment System on Quality of Care. This work was recognized nationally and internationally as foundational in the quality of care measurement. It was published in 1990 in an entire issue of JAMA dedicated to the work of the team she led. That work related to six inpatient clinical conditions and required the development of new methods for abstracting clinically detailed data from the medical record, and for linking hospitalized patients with post-discharge follow-up. Her team was the first to report (in 1990) the high rates of hospital readmission within 30 days of discharge. It was also the first to report instability at discharge (using measures she developed) related to the new prospective payment system, and a significant increase in death rates associated with that instability. Dr. Kahn conducted some work comparing quality in Canada and the United States.
Dr. Kahn expanded her work to study quality in obstetrics, rheumatoid arthritis, sepsis, colorectal cancer screening, chronic diseases in the ambulatory setting, and cancer in population-based cohorts. She sought to understand how, if at all, quality of care measures would need to be different across clinical conditions. She was a Principal Investigator for the National Initiative of Cancer Care Quality (NICCQ), an ASCO-funded study that included the development of quality measures related to diagnosis, treatment, management of treatment adverse effects, and post-treatment monitoring. The study showed most patients with breast or colorectal cancer in five U.S. metropolitan regions studied, received recommended care based on expert-established quality-of-care measures. However, opportunities for improvement in clinical care were also documented and disseminated, as a means to motivate such improvements. This work was also important in identifying challenges for a national monitoring system for cancer patients.
In a follow-up to this work, Dr. Kahn was a Principal Investigator for the NCI-funded Cancer Care Outcomes Research and Surveillance (CanCORS) project, leading the work in Los Angeles County, the most populous of CanCORs sites. With this work, Dr. Kahn collaborated with colleagues across the nation and mentored many junior researchers. Her prior experience leading large studies and studying quality across multiple clinical conditions, allowed her to have substantial inputs into the methods used for CanCORS.
During the last ten years, Dr. Kahn has led several of the nation's important health policy evaluations. One example is her leadership of the Evaluation of the CMS Federally Qualified Health Center Demonstration that studied primary care transformation to patient-centered medical homes. She was a senior author on this paper published in NEJM.
Dr. Kahn has received national recognition for her work demonstrating that better inpatient quality of care is associated with better patient outcomes (1990), and for her work demonstrating that better ambulatory care is associated with better health-related quality of life (2007). She received the Damon Runyon Mentorship Award for Study of Quality of Care in 2000, which was the first such award granted for health services research/ health policy by the Damon Runyon Foundation. In 2014, she was invited by the Department of Defense, along with a small, select group of national quality of care leaders to assess DOD's review of the quality of the nation's Military Health System. From 2014-2017, she was recognized with a three-year term as Distinguished Chair in Health Care Delivery Measurement and Evaluation, while continuing her ongoing work at UCLA.
She has published more than 200 peer-reviewed original research papers, including 80 original papers since 2010. These have appeared, often with her as first or senior author, in high-impact journals, including New England Journal of Medicine, JAMA, Journal of Clinical Oncology, JAMA Internal Medicine, Journal of National Cancer Institute, Milbank Quarterly, and Health Affairs. The breadth of clinical journals in which her publications appear, speaks highly of the impact of her work across clinical and policy disciplines. Her array of co-authors also speaks to her extensive mentorship across the years.
Dr. Kahn has been very successful in garnering funds for research and policy evaluations including funding from NIH, Center for Medicare and Medicaid Services, Agency for Healthcare Policy and Research, and from state and local Health Departments. She presents her work at national and local meetings, serves on the Editorial Board for the Journal of General Internal Medicine, and reviews for multiple journals.
Medical Board Certification
- Chrischilles EA, Pendergast JF, Kahn KL, Wallace RB, Moga DC, Harrington DP, Kiefe CI, Weeks JC, West D, Zafar SY, Fletcher RH. Adverse events among elders receiving chemotherapy for advanced non-small cell lung cancer. Journal of Clinical Oncology. 2010 Feb 1;28(4):620-7. PMCID: PMC2815997.
- Keating NL, Landrum MB, Rogers SO, Baum SK, Virnig BA, Huskamp HA, Earle CC, Kahn KL. Physician factors associated with discussions about end-of-life care. Cancer. 2010 Feb 15;116(4): 998-1006. PMCID: PMC2819541.
- Kahn KL, Adams JL, Weeks JC, Chrischilles EA, Schrag D, Ayanian JZ, Kiefe CI, Ganz PA, Bhoopalam N, Potosky AL, Harrington DP, Fletcher RH. Adjuvant Chemotherapy Use and Adverse Events among Older Patients with Stage III Colon Cancer. Journal of the American Medical Association. 2010 Mar 17;303(11):1037-1045. PMCID: PMC2893553.
- Van Ryn M, Sanders S, Kahn KL, Van Houtven C, Griffin JM, Martin M, Atienza AA, Phelan S, Finstad D, Rowland J. Objective burden, resources, and other stressors among informal caregivers of cancer: A hidden quality issue? Psycho-oncology. 2011 Jan;20(1):44-52. PMCID: PMC20201115.
- Kahn, KL., Ryan, G., Beckett, M. et al. Bridging the gap between basic science and clinical practice: a role for community clinicians. Implementation Sci 6, 34 (82011).
- Silberman G, Kahn KL. Burdens on research imposed by institutional review boards. The state of the evidence and its implications for regulatory reform. Milbank Quarterly. 2011 Dec;89(4):599-627. doi: 10.1111/j.1468-0009.2011.00644.x.
- Catalano PJ, Ayanian JZ, Weeks JC, Kahn KL, Landrum MB, Zaslavsky, AM, Lee J, Pendergast J, Harrington DP. Representativeness of participants in the Cancer Care Outcomes Research and Surveillance (CanCORS) consortium relative to Surveillance, Epidemiology and End Results (SEER) program. Medical Care. April 2012;50(4):277-362.
- Rose-Ash DE, Tisnado DM, Tao ML, Malin JL, Adams JL, Ganz PA, Kahn KL. Prevalence, predictors, and patient outcomes associated with physician co-management: Findings from the Los Angeles Women's Health Study. Health Services Research. 2012 Jun;47(3 Pt 1):1091-116. doi: 10.1111/j.1475-6773.2011.01359.x.
- Kahn KL, Mendel P, Leuschner KJ, Hiatt L, Gall EM, Siegel S, Weinberg DA. The National Response for Preventing Healthcare-associated Infections: Research and Adoption of Prevention Practices. Medical Care. 2014 Feb;52(2) Suppl 1:S33-S45. doi: 10.1097/mlr.0000000000000084. PMID: 24430264.
- Hussey PS, Timbie JW, Burgette LF, Wenger NS, Nyweide DJ, Kahn KL. Appropriateness of advanced diagnostic imaging ordering before and after implementation of clinical decision support systems. Journal of the American Medical Association. 2015 Jun 2;313(21):2181-2182. doi: 10.1001/jama.2015.5089. PMID: 26034960.
- Wright AA, Keating NL, Ayanian JZ, Chrischilles EA, Kahn KL, Ritchie CS, Weeks JC, Earle CC, Landrum ME. Family Perspectives on Aggressive Cancer Care Near the End of Life. Journal of the American Medical Association. 2016 Jan 19;315(3):284-92. doi: 10.1001/jama.2015.18604. PMID: 26784776 PMCID: PMC4919118.
- Mendel P, Chen EK, Green HD, Armstrong C, Timbie JW, Kress AM, Friedberg MW, Kahn KL. Pathways to Medical Home Recognition: A Qualitative Comparative Analysis (QCA) of the PCMH Transformation Process. Health Services Research. 2017 Dec 15. doi:10. 111/1475-6773.12803. PMID: 29248823.
- Mahmud A, Timbie JW, Malsberger R, Setodji CM, Kress A, Hiatt L, Mendel P, Kahn KL. Examining differential performance of 3 medical home recognition programs. The American Journal of Managed Care. 2018 Jul;24(7):334-340. PMID: 30020753.
Rose AJ, Timbie JW, Setodji C, Friedberg MW, Malsberger R, Kahn KL. Primary Care Visit Regularity and Patient Outcomes: an Observational Study. J Gen Intern Med. (Jan 2019). Jan; 34(1):82-89. PMID: 30367329.
- Timbie JW, Hussey PS, Setodji CC, Kress A, Malsberger R, Lavelle TA, Friedberg MW, Wensky SG, Giuriceo KD, Kahn KL. Association Between Patient-Centered Medical Home Capabilities and Outcomes for Medicare Beneficiaries Seeking Care from Federally Qualified Health Centers. Journal of General Internal Medicine. 2017 May 26. doi: 10.1007/s11606-017-4078-y. PMID: 28550610 PMCID: PMC5570742.
- Dr. Kahn has led a weekly health services research seminar for the Division of General Internal Medicine and Health Services Research from 1993 to present, and a monthly faculty multi-level mentoring program since 2000. From 2012 to present, she has been a member of both the Department of Medicine Quality Council and the Faculty Practice Group’s Quality Measurement and Improvement Committee (QMIC). She has participated as a Judge for the Research Day Poster session for five years.
- Dr. Kahn has also served as Faculty Leader of the Division Meetings from 1993-2017, and as Associate Division Chief for Research for the Division of GIM/HSR during that period. She was Co-Director of the Community Engagement Research Program for the first three UCLA CTSI Applications (2009-2019, an active participant in the CTSI Community Engagement Core).
- Dr. Kahn has received the Article-of-the Year Award from the Association for Health Services Research (1995) and again from Health Services Research (the journal, 2007).