Thomas D'Aunno
Thomas D'Aunno
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Professor of Public Health, NYU School of Global Public Health
Professor of Management, NYU Wagner Graduate School of Public Service
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Professional overview
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Thomas D'Aunno, Ph.D., is Professor of Management at New York University’s Wagner Graduate School of Public Service and Professor of Public Health at NYU’s School of Global Public Health. His research interests include institutional theory, organizational change, and the performance of healthcare organizations. D’Aunno was previously a faculty member at Columbia University, the University of Chicago, the University of Michigan, and INSEAD, where he held the Novartis Chair in Healthcare Management. He is published in leading management and health journals, including Administrative Science Quarterly, the Academy of Management Journal, Academy of Management Review, Annals of the Academy of Management, the Journal of the American Medical Association, Milbank Quarterly, American Journal of Public Health and Health Affairs. He served as Editor-in-Chief of Medical Care Research and Review, 2014-2018. He also is a past chair of the Academy of Management Division of Health Care Management, and a recipient of its Provan Award for distinguished career contributions to research in healthcare management and the Fottler award for distinguished service to the field.
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Education
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Ph.D., Organizational Psychology, University of Michigan, Ann Arbor, MichiganUniversity of Maryland, Community-Clinical Psychology, Baltimore County, MarylandB.A., Psychology, Magna Cum Laude, University of Notre Dame, Notre Dame, Indiana
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Publications
Publications
Integration of substance abuse treatment organizations into accountable care organizations : Results from a national survey
AbstractD’Aunno, T., D’Aunno, T., D'Aunno, T., Friedmann, P. D., Chen, Q., & Wilson, D. M. (n.d.).Publication year
2015Journal title
Journal of health politics, policy and lawVolume
40Issue
4Page(s)
797-819AbstractTo meet their aims of managing population health to improve the quality and cost of health care in the United States, accountable care organizations (ACOs) will need to focus on coordinating care for individuals with substance abuse disorders. The prevalence of these disorders is high, and these individuals often suffer from comorbid chronic medical and social conditions. This article examines the extent to which the nation's fourteen thousand specialty substance abuse treatment (SAT) organizations, which have a daily census of more than 1 million patients, are contracting with ACOs across the country; we also examine factors associated with SAT organization involvement with ACOs. We draw on data from a recent (2014) nationally representative survey of executive directors and clinical supervisors from 635 SAT organizations. Results showthat only 15 percent of these organizations had signed contracts with ACOs. Results from multivariate analyses show that directors' perceptions of market competition, organizational ownership, and geographic location are significantly related toSATinvolvement withACOs.We discuss implications for integrating theSAT specialty system with the mainstream health care system.International research in health care management : Its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities
AbstractD’Aunno, T., D’Aunno, T., Buttigieg, S. C., Rathert, C., D'Aunno, T. A., & Savage, G. T. (n.d.).Publication year
2015Journal title
Advances in Health Care ManagementVolume
17Page(s)
3-22AbstractPurpose-This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons between diverse health systems, international best practices, international benchmarking, cross-border health care, and cross-cultural issues have become important subjects in the health care literature. The focus has now turned to international, collaborative, cross-national, and cross-cultural research, which is by far more demanding than domestic studies. In this commentary, we explore the methodological challenges, ethical issues, pitfalls, and practicalities within international research and offer possible solutions to address them. Design/methodology/approach-The commentary synthesizes contributions from four scholars in the field of health care management, who came together during the annual meeting of the Academy of Management to discuss with members of the Health Care Management Division the challenges of international research. Findings-International research is worth pursuing; however, it calls for scholarly attention to key methodological and ethical issues for its success. Originality/value-This commentary addresses salient issues pertaining to international research in one comprehensive account.Paths to improving engagement among racial and ethnic minorities in addiction health services
AbstractD’Aunno, T., D’Aunno, T., Guerrero, E. G., Fenwick, K., Kong, Y., Grella, C., & D'Aunno, T. (n.d.).Publication year
2015Journal title
Substance Abuse: Treatment, Prevention, and PolicyVolume
10Issue
1AbstractBackground: Members of racial and ethnic minority groups are most likely to experience limited access and poor engagement in addiction treatment. Research has been limited on the role of program capacity and delivery of comprehensive care in improving access and retention among minorities with drug abuse issues. The goal of this study was to examine the extent to which access and retention are enhanced when racial and ethnic minorities receive care from high-capacity addiction health services (AHS) programs and via coordination with mental health and receipt of HIV testing services. Methods: This multilevel cross-sectional analysis involved data from 108 programs merged with client data from 2011 for 13,478 adults entering AHS. Multilevel negative binomial regression models were used to test interactions and indirect relationships between program capacity and days to enter treatment (wait time) and days in treatment (retention). Results: Compared to low-capacity programs and non-Latino and non-African American clients, Latinos and African Americans served in high-capacity programs reported shorter wait times to admission, as hypothesized. African Americans also had longer treatment retention in high-capacity programs. Receipt of HIV testing and program coordination of mental health services played an indirect role in the relationship between program capacity and wait time. Conclusions: Program capacity and coordinated services in AHS may reduce disparities in access to care. Implications for supporting low-capacity programs to eliminate the disparity gap in access to care are discussed.Adoption of Evidence-based clinical innovations : The case of buprenorphine use by opioid treatment programs
AbstractD’Aunno, T., D’Aunno, T., Andrews, C. M., D'Aunno, T. A., Pollack, H. A., & Friedmann, P. D. (n.d.).Publication year
2014Journal title
Medical Care Research and ReviewVolume
71Issue
1Page(s)
43-60AbstractThis article examines changes from 2005 to 2011 in the use of an evidence-based clinical innovation, buprenorphine use, among a nationally representative sample of opioid treatment programs and identifies characteristics associated with its adoption. We apply a model of the adoption of clinical innovations that focuses on the work needs and characteristics of staff; organizations' technical and social support for the innovation; local market dynamics and competition; and state policies governing the innovation. Results indicate that buprenorphine use increased 24% for detoxification and 47% for maintenance therapy between 2005 and 2011. Buprenorphine use was positively related to reliance on private insurance and availability of state subsidies to cover its cost and inversely related to the percentage of clients who injected opiates, county size, and local availability of methadone. The results indicate that financial incentives and market factors play important roles in opioid treatment programs' decisions to adopt evidence-based clinical innovations such as buprenorphine use.Determinants of the availability of hepatitis c testing services in Opioid treatment programs : Results from a national study
AbstractD’Aunno, T., D’Aunno, T., Frimpong, J. A., Frimpong, J. A., D'Aunno, T., & Jiang, L. (n.d.).Publication year
2014Journal title
American journal of public healthVolume
104Issue
6Page(s)
e75-e82AbstractObjectives. We examined trends and organizational-level correlates of the availability of HCV testing in opioid treatment programs. Methods. We used generalized ordered logit models to examine associations between organizational characteristics of 383 opioid treatment programs from the 2005 and 2011 National Drug Abuse Treatment System Survey and HCV testing availability. Results. Between 2005 and 2011, the proportion of opioid treatment programs offering HCV testing increased but largely because of increases in off-site referrals rather than on-site testing. HCV testing availability was higher in opioid treatment programs affiliated with a hospital and those receiving federal funds. Opioid treatment programs providing both methadone and buprenorphine were more likely to offer any HCV testing, whereas opioid treatment programs providing only buprenorphine treatment were less likely to offer on-site testing. HCV testing availability was associated with more favorable staff-to-client ratios. Conclusions. The increasing use of off-site referrals for HCV testing in opioid treatment programs likely limits opportunities for case finding, prevention, and treatment. Declines in federal funding for opioid treatment programs may be a key determinant of the availability ofHCVtesting in opioid treatment programs.Evidence-based treatment for opioid disorders : A 23-year national study of methadone dose levels
AbstractD’Aunno, T., D’Aunno, T., D'Aunno, T., Pollack, H. A., Frimpong, J. A., Frimpong, J. A., & Wuchiett, D. (n.d.).Publication year
2014Journal title
Journal of Substance Abuse TreatmentVolume
47Issue
4Page(s)
245-250AbstractEffective treatment for patients with opioid use problems is as critical as ever given the upsurge in heroin and prescription opioid abuse. Yet, results from prior studies show that the majority of methadone maintenance treatment (MMT) programs in the US have not provided dose levels that meet evidence-based standards. Thus, this paper examines the extent to which US MMT programs have made changes in the past 23. years to provide adequate methadone doses; we also identify factors associated with variation in program performance. Program directors and clinical supervisors of nationally-representative methadone treatment programs were surveyed in 1988 (n = 172), 1990 (n = 140), 1995 (n = 116), 2000 (n = 150), 2005 (n = 146), and 2011 (n = 140). Results show that the proportion of patients who received doses below 60. mg/day-the minimum recommended-declined from 79.5 to 22.8% in a 23-year span. Results from random effects models show that programs that serve a higher proportion of African-American or Hispanic patients were more likely to report low-dose care. Programs with Joint Commission accreditation were more likely to provide higher doses, as were a program that serves a higher proportion of unemployed and older patients. Efforts to improve methadone treatment practices have made substantial progress, but 23% of patients across the nation are still receiving doses that are too low to be effective.Explaining how institutions change: A review and research agenda
AbstractD’Aunno, T., & D’Aunno, T. (n.d.). (2nd eds.).Publication year
2014Abstract~HIV testing in the nation's opioid treatment programs, 2005-2011 : The role of state regulations
AbstractD’Aunno, T., D’Aunno, T., D'Aunno, T., Pollack, H. A., Jiang, L., Metsch, L. R., & Friedmann, P. D. (n.d.).Publication year
2014Journal title
Health Services ResearchVolume
49Issue
1Page(s)
230-248AbstractObjective To identify the extent to which clients in a national sample of opioid treatment programs (OTPs) received HIV testing in 2005 and 2011; to examine relationships between state laws for informed consent and pretest counseling and rates of HIV testing among OTP clients. Data Source Data were collected from a nationally representative sample of OTPs in 2005 (n = 171) and 2011 (n = 200). Study Design Random-effects logit and interval regression analyses were used to examine changes in HIV testing rates and the relationship of state laws to HIV testing among OTPs. Data Collection Data on OTP provision of HIV testing were collected in phone surveys from OTP managers; data also were collected on state laws for HIV testing. Principal Findings The percentage of OTPs offering HIV testing decreased significantly from 93 percent in 2005 to 64 percent in 2011. Similarly, the percentage of clients tested decreased from an average of 41 percent in 2005 to 17 percent in 2011. OTPs located in states whose laws do not require pretest counseling and that use opt-out consent were more likely to provide HIV testing and to test higher percentages of clients. Conclusions The results show the need to increase HIV testing among OTP clients; the results also underscore the beneficial possibilities of dropping pretest counseling as a requirement for HIV testing and of using the opt-out approach to informed consent for testing.The productivity and cost-efficiency of models for involving nurse practitioners in primary care : A perspective from queueing analysis
AbstractD’Aunno, T., D’Aunno, T., Liu, N., & D'Aunno, T. (n.d.).Publication year
2012Journal title
Health Services ResearchVolume
47Issue
2Page(s)
594-613AbstractObjective To develop simple stylized models for evaluating the productivity and cost-efficiencies of different practice models to involve nurse practitioners (NPs) in primary care, and in particular to generate insights on what affects the performance of these models and how. Data Sources and Study Design The productivity of a practice model is defined as the maximum number of patients that can be accounted for by the model under a given timeliness-to-care requirement; cost-efficiency is measured by the corresponding annual cost per patient in that model. Appropriate queueing analysis is conducted to generate formulas and values for these two performance measures. Model parameters for the analysis are extracted from the previous literature and survey reports. Sensitivity analysis is conducted to investigate the model performance under different scenarios and to verify the robustness of findings. Principal Findings Employing an NP, whose salary is usually lower than a primary care physician, may not be cost-efficient, in particular when the NP's capacity is underutilized. Besides provider service rates, workload allocation among providers is one of the most important determinants for the cost-efficiency of a practice model involving NPs. Capacity pooling among providers could be a helpful strategy to improve efficiency in care delivery. Conclusions The productivity and cost-efficiency of a practice model depend heavily on how providers organize their work and a variety of other factors related to the practice environment. Queueing theory provides useful tools to take into account these factors in making strategic decisions on staffing and panel size selection for a practice model.Review of Katherine C. Kellogg: Challenging Operations: Medical Reform and Resistance in Surgery
AbstractD’Aunno, T., D’Aunno, T., & D'Aunno, T. (n.d.).Publication year
2011Journal title
Administrative Science QuarterlyVolume
56Issue
4Abstract~HIV testing and counseling in the nation's outpatient substance abuse treatment system, 1995-2005
AbstractD’Aunno, T., D’Aunno, T., Pollack, H. A., & D'Aunno, T. (n.d.).Publication year
2010Journal title
Journal of Substance Abuse TreatmentVolume
38Issue
4Page(s)
307-316AbstractThis article examines the extent to which U.S. outpatient substance abuse treatment (OSAT) facilities provide HIV counseling and testing (C&T) to clients between 1995 and 2005. We also examine organizational and client characteristics associated with OSAT facilities' provision of HIV C&T. Data were collected from a nationally representative sample of outpatient treatment facilities in 1995 (n = 618), 2000 (n = 571), and 2005 (n = 566). Results show that in 1995, 26.8% of OSAT clients received HIV C&T; by 2005, this proportion had increased, but only to 28.8%. Further, results from random-effects interval regression analysis show that C&T is especially widespread in public and nonprofit facilities, in methadone facilities, and in units that serve injection drug users and commercial sex workers. HIV C&T was also more widespread in units that employed formal intake protocols. Despite widespread efforts to increase HIV C&T services in OSAT care, only a small and stable minority of clients receive these services. Adoption of formal intake procedures may provide one vehicle to increase provision of C&T services.Managing strategic alliances
AbstractZajac, E., D’Aunno, T., D’Aunno, T., & Burns, L. (n.d.). (L. R. Burns, E. Bradley, & B. Weiner, Eds.; 6th ed.).Publication year
2010Abstract~Motivating People
AbstractD’Aunno, T., D’Aunno, T., & Gilmartin, M. (n.d.). (L. R. Burns, E. Bradley, & B. Weiner, Eds.; 6th ed.).Publication year
2010Abstract~Review of Daniel Carpenter: Reputation and Power: Organizational Image and Pharmaceutical Regulation at the FDA
AbstractD’Aunno, T., D’Aunno, T., & D'Aunno, T. (n.d.).Publication year
2010Journal title
Administrative Science QuarterlyVolume
55Page(s)
671-672Abstract~Review of The Collaborative Public Manager: New Ideas for the Twenty-first Century Rosemary O’Leary and Lisa Blomgren Bingham, eds. Washington, DC: Georgetown University Press, 2009
AbstractD’Aunno, T., D’Aunno, T., & D'Aunno, T. (n.d.).Publication year
2010Journal title
Administrative Science QuarterlyAbstract~Institutional work and the paradox of embedded agency
AbstractD’Aunno, T., D’Aunno, T., Battilana, J., & D’Aunno, T. (n.d.).Publication year
2009Volume
9780521518550Page(s)
31-58AbstractIntroduction Institutions are social structures that are characterized by a high degree of resilience (Scott, 2001). They have a self-activating nature (Lawrence, Hardy & Phillips, 2002; Jepperson, 1991). Actors tend to reproduce institutions in a given field of activity without requiring either repeated authoritative intervention or collective mobilization (Clemens & Cook, 1999: 445). Early neo-institutional studies emphasized ways that institutions constrained organizational structures and activities, and thereby explained the convergence of organizational practices within institutional environments. They proposed that actors' need to be regarded as legitimate in their institutional environment determined their behavior. This work implicitly assumed that individuals and organizations tend to comply, at least in appearance, with institutional pressures. In fact, actors were often implicitly assumed to have a limited degree of agency. Such a conception of agency was problematic when institutional theorists started tackling the issue of institutional change. While early neo-institutional studies accounted for organizational isomorphism and for the reproduction of institutionalized practices, they did not account well for the possibility of change. Even though institutions are characterized by their self-activating nature, we know that they do change (e.g. Fligstein, 1991). Since the late 1980s, institutional theorists have started addressing the issue of institutional change. They have highlighted the role that organizations and/or individuals play in institutional change. Studies that account for the role of organizations and/or individuals in institutional change, however, face a paradox.Conclusions : The global diffusion of casemix
AbstractD’Aunno, T., D’Aunno, T., D’aunno, T., Kimberly, J. R., & De Pouvourville, G. (n.d.).Publication year
2008Page(s)
346-372AbstractIntroduction The previous chapters have presented summaries of the adoption of patient classification systems (PCS) in fifteen countries around the globe, starting with the US in 1983 and continuing through to Germany in 2005. The purpose of this final chapter is to stand back from the details of each country's experience with patient classification systems and analyze patterns of convergence and divergence in these experiences. The chapters describe some similarities, but also a great deal of variation in the definition, goals, and purposes of PCS from one country to the next as well as in the processes by which these systems were adopted. These differences lead us to ask the following questions: Why do some nations use PCS extensively, including, for example, as a payment method for health care providers, while others rely relatively little on these systems? What accounts for variation in the difficulty and duration of adoption and implementation of PCS across nations? What accounts for variation in the timing of adoption? Why have some nations just begun to use PCS, while others have used them for more than twenty years? Addressing these and related questions is important because the adoption and implementation of these systems remains incomplete both within and across nations. There may well be key lessons to be learned from examining adoption patterns, and these lessons can inform decision makers who are both current and potential users of this technology.Dosage patterns in methadone treatment : Results from a national survey, 1988-2005
AbstractD’Aunno, T., D’Aunno, T., Pollack, H. A., & D'Aunno, T. (n.d.).Publication year
2008Journal title
Health Services ResearchVolume
43Issue
6Page(s)
2143-2163AbstractObjective. To examine the extent to which U.S. methadone maintenance facilities meet established standards for minimum dosages, 1988-2005. Data Source. Data were collected from a nationally representative sample of outpatient treatment facilities in 1988 (n=172), 1990 (n=140), 1995 (n=116), 2000 (n=150), and 2005 (n=146). Study Design. Random-effects multiple regression analysis was used to examine unit characteristics associated with below recommended doses. Data Collection. Data regarding the proportion of patients who received maintenance dosages ofHealth Networks : A Success Story in Community-based Management of Heroin Addiction in France
AbstractRowell, N., Lerer, L., D’Aunno, T., & D’Aunno, T. (n.d.).Publication year
2008Abstract~The globalization of managerial innovation in health care
AbstractD’Aunno, T., D’Aunno, T., Kimberly, J. R., De Pouvourville, G., & D’aunno, T. (n.d.).Publication year
2008AbstractIn 1983, the first patient classification system to be used on a national basis, the Diagnosis Related Groups (DRGs), was adopted as part of the Prospective Payment System in the United States. This system caught the attention of health policy makers in other countries, and a number of them began to implement similar approaches. What motivated them to adopt these systems? What similarities and differences were there among their experiences in implementing these systems? What can we learn about introducing change into national health systems by comparing their experiences? The Globalization of Managerial Innovation in Health Care answers these and other questions by examining patient classification systems in fifteen different countries throughout the world. The result is a remarkable collection of case studies of how change can be introduced effectively into national health systems as well as a careful synthesis of what can be learned from them.The globalization of managerial innovation: Analyzing the diffusion of patient classification systems
AbstractKimberly, (John R., Pouvourville, G. d., D’Aunno, T., & D’Aunno, T. (n.d.).Publication year
2008Abstract~Zorggroep : Merging Five Dutch Healthcare Organizations
AbstractCagna, A.-M., D’Aunno, T., D’Aunno, T., & Gilmartin, M. (n.d.).Publication year
2008Abstract~Governance and Investment Decision Making in Healthcare Technology Transfer
AbstractSchein, D., Lerer, L., Rowell, N., D’Aunno, T., & D’Aunno, T. (n.d.).Publication year
2007Abstract~Leadership research in healthcare: A review and roadmap
AbstractD’Aunno, T., D’Aunno, T., Gilmartin, M., & D'Aunno, T. (n.d.).Publication year
2007Journal title
Academy of Management AnnalsAbstract~Leading Organizational Change : Improving Hospital Performance
AbstractBarsoux, J.-L., Gilmartin, M., Battilana, J., D’Aunno, T., & D’Aunno, T. (n.d.).Publication year
2007Abstract~
Contact
tdaunno@nyu.edu
New York, NY