Description of Research Expertise

I am a general internist and a health services researcher. My research aims to understand variation in the quality of physician (and other prescribing clinician) services to improve care for aging adults with multiple chronic conditions. To this end, I have examined several domains of physician care quality in primary care: timeliness, effectiveness, patient-centeredness, equity, and efficiency. My research agenda requires complex linkages of survey, Medicare claims, and other secondary datasets, and necessary methodological expertise in rigorous quantitative techniques to estimate causal effects using secondary data. I also have expertise in mixed-methods research including primary data collection via surveys of clinicians and interviews with patients and caregivers.


My ongoing work evaluates the role of physician integration within nursing homes in healthcare utilization and functional outcomes of older adults. Using billing data from Medicare, I developed a rich database of clinical information for a cohort of patients that received post-acute care in skilled nursing facilities between 2012 and 2019. I also developed and tested claims-based measures of physician practice organization, including a widely adopted measure of physician specialization in skilled nursing facility-based practice.

Selected Publications

Sarah E. Kler MD, SCM, L. Grisell Diaz-Ramirez MS, Kira L. Ryskina MD, MSHP, Sun Young Jeon PhD, Kanan Patel MBBS, MPH, Thomas K. M. Cudjoe MD, MPH, Christine S. Ritchie MD, MSPH, FACP, FAAHPM, Krista L. Harrison PhD, W. John Boscardin PhD, Rebecca T. Brown MD, MPH: Geriatric conditions and healthcare utilization among older adults living in subsidized housing Journal of the American Geriatrics Society : 2024.

Peacock B, Pan Z, Kim S, Jung HY, Ryskina KL.: Assessing the Volume-Outcomes Relationship for Physicians Practicing in Nursing Homes SGIM Annual Meeting, Boston, MA (poster) : 2024.

Brown RT, Zuo X, Cappola A, Ryskina KL, Coe N, Elo I, Xie D: Trends in Functional Impairment in Middle-Aged Americans, 1992-2018 SGIM Annual Meeting (poster) : 2024.

Krickus C, Kim S, Peacock B, Brown RT, Ryskina K: Functional Outcomes of Post-Acute Care in Skilled Nursing Facilities for Community-Dwelling Older Adults with and without ADRD SGIM Annual Meeting, Boston, MA (poster) : 2024.

Ryskina KL, Liang J, Ritter A, Spetz J, Barnes H.: State scope of practice restrictions and nurse practitioner practice in nursing homes: 2012-2019 Health Affairs Scholar 2 (2): qxae018,2024.

Tian Y, Shultz K, Ryskina K.: Emergency department visits by older adults receiving postacute care in skilled nursing facilities J Hosp Med 19 (1): 40-44,2024.

Ryskina KL, Geng Z, Raghavan S, Waddell KJ, Burke RE.: Association between Timing of Clinical Evaluation by a Physician or Advanced Practitioner and Risk of Rehospitalization in Older Adults Admitted to a Skilled Nursing Facility Following Hospitalization: A Cohort Study J Am Med Dir Assoc 24 (12): 1881-1887,2023.

Ryskina K, Lo D, Zhang T, Gerlach L, Bynum J, Shireman TI.: Potentially Harmful Medication Prescribing by the Degree of Physician Specialization in Nursing Home Practice: An Observational Study J Am Med Dir Assoc 24 (8): 1240-1246.e2.,2023.

Kim S, Ryskina KL, Jung HY.: Use of Clinicians Who Focus on Nursing Home Care Among US Nursing Homes and Unplanned Rehospitalization JAMA Netw Open 6 : e2318265,2023.

Tian Y, Ayyappan V, Hemmert K, Myers J, Gitelman Y, Ryskina K.: Potentially avoidable emergency department use by patients discharged to skilled nursing facilities J Hosp Med 18 (6): 524-527,2023.

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Academic Contact Information

12-30 Blockley Hall
423 Guardian Drive
Philadelphia, PA 19104
Patient appointments: 800-789-7366