About

David L. Chin is a researcher at the Computational Social Science Institute and the Department of Health Promotion and Policy at the University of Massachusetts Amherst. His work as a health services researcher focuses on three main domains: the development of outcome measures to quantify quality, value, and safety in healthcare; the application of novel statistical and computational approaches for inference from high-dimensional correlated data; and health policy innovation. His methodology is data-driven and quantitative, utilizing diverse data sources such as electronic health records, clinical registries, statewide all-payer administrative claims, nationwide private payer data, and Department of Defense clinical records to measure patient outcomes. Chin's ongoing projects include developing novel instruments to measure Serious Reportable Events occurring in hospitals, studying the impact of public reporting on cardiovascular procedure outcomes, and exploring quantum computing applications for health outcomes and policy. His work emphasizes the integration of data analysis and methodological innovation to advance healthcare quality and policy.

Research topics

• Medicine
• Internal medicine
• Oncology
• Emergency medicine
• Family medicine

Selected publications

• Political Boundaries, Health Care Gaps: The Link Between Gerrymandering and Federally Qualified Health Center Availability

  American Journal of Public Health · 2025-11-13

  articleOpen accessSenior author

  Objectives. To examine how gerrymandering affects federally qualified health center (FQHC) availability in North Carolina. Methods. We used data from 2004 to 2022 and spatial regression models to correlate gerrymandering metrics with FQHC availability and utilization at the zip code level. Results. Gerrymandering severity is inversely associated with FQHC availability and utilization. For example, individuals in communities split evenly between 2 state senate districts in this 18-year period (from the end of 2004 through 2022) traveled about 30% farther to their nearest FQHC in 2022 than individuals in communities entirely within a district, and they were up to 20% less likely to visit an FQHC. Increased electoral competitiveness also reduced FQHC availability and utilization. Residential segregation was not linked to FQHC availability or gerrymandering severity. Conclusions. Gerrymandering weakens local political representation and may lead to reduced access to vital health care services—a structural issue with far-reaching implications for health equity and national policy reform. ( Am J Public Health. Published online ahead of print November 13, 2025:e1–e8. https://doi.org/10.2105/AJPH.2025.308284 )

  PublisherOA PDFDOI

• Effectiveness of Implementation of an Enhanced Recovery Program in Bariatric Surgery

  Journal of Surgical Research · 2024-11-01 · 5 citations

  article
  PublisherDOI

• A scoping review of empathy recognition in text using natural language processing

  Journal of the American Medical Informatics Association · 2023-12-13 · 7 citations

  reviewOpen accessSenior authorCorresponding

  OBJECTIVE: To provide a scoping review of studies on empathy recognition in text using natural language processing (NLP) that can inform an approach to identifying physician empathic communication over patient portal messages. MATERIALS AND METHODS: We searched 6 databases to identify relevant studies published through May 1, 2023. The study selection was conducted through a title screening, an abstract review, and a full-text review. Our process followed the PRISMA-ScR guidelines. RESULTS: Of the 2446 publications identified from our searches, 39 studies were selected for the final review, which summarized: (1) definitions and context of empathy, (2) data sources and tested models, and (3) model performance. Definitions of empathy varied in their specificity to the context and setting of the study. The most common settings in which empathy was studied were reactions to news stories, health-related social media forums, and counseling sessions. We also observed an expected shift in methods used that coincided with the introduction of transformer-based models. DISCUSSION: Aspects of the current approaches taken across various domains may be translatable to communication over a patient portal. However, the specific barriers to identifying empathic communication in this context are unclear. While modern NLP methods appear to be able to handle empathy-related tasks, challenges remain in precisely defining and measuring empathy in text. CONCLUSION: Existing work that has attempted to measure empathy in text using NLP provides a useful basis for future studies of patient-physician asynchronous communication, but consideration for the conceptualization of empathy is needed.

  PublisherOA PDFDOI

• Exploring Disparities in Awarding VA Service-Connected Disability for Post-Traumatic Stress Disorder for Active Duty Military Service Members from Recent Conflicts in Iraq and Afghanistan

  Military Medicine · 2020-01-01 · 10 citations

  articleOpen access

  INTRODUCTION: We explore disparities in awarding post-traumatic stress disorder (PTSD) service-connected disability benefits (SCDB) to veterans based on gender, race/ethnicity, and misconduct separation. METHODS: Department of Defense data on service members who separated from October 1, 2001 to May 2017 were linked to Veterans Administration (VA) administrative data. Using adjusted logistic regression models, we determined the odds of receiving a PTSD SCDB conditional on a VA diagnosis of PTSD. RESULTS: A total of 1,558,449 (79% of separating service members) had at least one encounter in VA during the study period (12% female, 4.5% misconduct separations). Females (OR 0.72) and Blacks (OR 0.93) were less likely to receive a PTSD award and were nearly equally likely to receive a PTSD diagnosis (OR 0.97, 1.01). Other racial/ethnic minorities were more likely to receive an award and diagnosis, as were those with misconduct separations (award OR 1.3, diagnosis 2.17). CONCLUSIONS: Despite being diagnosed with PTSD at similar rates to their referent categories, females and Black veterans are less likely to receive PTSD disability awards. Other racial/ethnic minorities and those with misconduct separations were more likely to receive PTSD diagnoses and awards. Further study is merited to explore variation in awarding SCDB.

  PublisherOA PDFDOI

• Predicting and Planning for Musculoskeletal Service-Connected Disabilities in VA Using Disability for Active Duty OEF/OIF Military Service Members

  Military Medicine · 2020-01-01 · 12 citations

  articleOpen access

  INTRODUCTION: Musculoskeletal (MSK) conditions are commonly seen among military service members (SM) and Veterans. We explored correlates of award of MSK-related service-connected disability benefits (SCDB) among SM seeking care in Veterans Affairs (VA) hospitals. MATERIALS AND METHODS: Department of Defense data on SM who separated from October 1, 2001 to May 2017 were linked to VA administrative data. Using adjusted logistic regression models, we determined the odds of receiving MSK SCDB. RESULTS: A total of 1,558,449 (79% of separating SM) had at least one encounter in VA during the study period (7.8% disability separations). Overall, 51% of this cohort had at least one MSK SCDB (88% among disability separations, 48% among normal). Those with disability separations (as compared to normal separations) were significantly more likely to receive MSK SCDB (odds ratio 2.37) as were females (compared to males, odds ratio 1.15). CONCLUSIONS: Although active duty SM with disability separations were more likely to receive MSK-related service-connected disability ratings in the VA, those with normal separations also received such awards. Identifying those at highest risk for MSK-related disability could lead to improved surveillance and prevention strategies in the Department of Defense and VA health care systems to prevent further damage and disability.

  PublisherOA PDFDOI

• Repurposing Clinical Decision Support System Data to Measure Dosing Errors and Clinician-Level Quality of Care

  Journal of Medical Systems · 2020-09-08 · 5 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Do the 2018 Leapfrog Group Minimal Hospital and Surgeon Volume Thresholds for Esophagectomy Favor Specific Patient Demographics?

  Annals of Surgery · 2019-08-13 · 21 citations

  article

  OBJECTIVE: We examine how esophagectomy volume thresholds reflect outcomes relative to patient characteristics. SUMMARY BACKGROUND DATA: Esophagectomy outcomes are associated with surgeon and hospital operative volumes, leading the Leapfrog Group to recommend minimum annual volume thresholds of 7 and 20 respectively. METHODS: Patients undergoing esophagectomy for cancer were identified from the 2007-2013 New York and Florida Healthcare Cost and Utilization Project's State Inpatient Databases. Logit models adjusted for patient characteristics evaluated in-hospital mortality, complications, and prolonged length of stay (PLOS). Median surgeon and hospital volumes were compared between young-healthy (age 18-57, Elixhauser Comorbidity Index [ECI] <2) and older-sick patients (age ≥71, ECI >4). RESULTS: Of 4330 esophagectomy patients, 3515 (81%) were male, median age was 64 (interquartile range 58-71), and mortality was 4.0%. Patients treated by both low-volume surgeons and hospitals had the greatest mortality risk (5.0%), except in the case of older-sick patients mortality was highest at high-volume hospitals with high-volume surgeons (12%). For mortality <1%, annual hospital and surgeon volumes needed were 23 and 8, respectively; mortality rose to 4.2% when volumes dropped to the Leapfrog thresholds of 20 and 7, respectively. Complication rose from 53% to 63% when hospital and surgeon volumes decreased from 28 and 10 to 19 and 7, respectively. PLOS rose from 19% to 27% when annual hospital and surgeon volumes decreased from 27 and 8 to 20 and 7, respectively. CONCLUSIONS: Current Leapfrog Group esophagectomy volume guidelines may not predict optimal outcomes for all patients, especially at extremes of age and comorbidities.

  PublisherDOI

• Does one size fit all? An evaluation of the 2018 Leapfrog Group minimal hospital and surgeon volume thresholds for lung surgery

  Journal of Thoracic and Cardiovascular Surgery · 2019-10-01 · 21 citations

  articleOpen access
  PublisherOA PDFDOI

• Mental Health Outcomes Among Military Service Members After Severe Injury in Combat and TBI

  Military Medicine · 2019-12-28 · 38 citations

  articleOpen access1st authorCorresponding

  INTRODUCTION: Studies examining the mental health outcomes of military personnel deployed into combat zones have focused on the risk of developing post-traumatic stress disorder conferred by mild or moderate traumatic brain injury (TBI). However, other mental health outcomes among veterans who sustained critical combat injuries have not been described. MATERIALS AND METHOD: We examined the associations of moderate and severe TBI and combat injury with the risk for anxiety and mood disorders, adjustment reactions, schizophrenia and other psychotic disorders, cognitive disorders, and post-traumatic stress disorder. We conducted a retrospective cohort study of U.S. military service members critically injured in combat during military operations in Iraq and Afghanistan from February 1, 2002, to February 1, 2011. Health care encounters from (1) the Department of Defense (DoD) Trauma Registry (TR), (2) acute and ambulatory care in military facilities, and (3) civilian facilities are reimbursed by Tricare. Service members who sustained severe combat injury require critical care. We estimated the risk of mental health outcomes using risk-adjusted logit models for demographic and clinical factors. We explored the relationship between TBI and the total number of mental health diagnoses. RESULTS: Of the 4,980 subjects who met inclusion criteria, most injuries occurred among members of the Army (72%) or Marines (25%), with mean (SD) age of 25.5(6.1) years. The prevalence of moderate or severe TBI was 31.6% with explosion as the most common mechanism of injury (78%). We found 71% of the cohort was diagnosed with at least one poor mental health condition, and the adjusted risk conferred by TBI ranged from a modest increase for anxiety disorder (odds ratio, 1.27; 95% confidence interval [CI], 1.11-1.45) to a large increase for cognitive disorder (odds ratio, 3.24; 95% CI, 2.78-3.77). We found TBI was associated with an increased number of mental health diagnoses (incidence rate ratio, 1.52; 95% CI, 1.42-1.63). CONCLUSIONS: Combat-associated TBI may have a broad effect on several mental health conditions among critically injured combat casualties. Early recognition and treatment for trauma-associated mental health are crucial to improving outcomes among service personnel as they transition to post-deployment care in the DoD, Department of Veterans Affairs, or community health systems.

  PublisherOA PDFDOI

• Association Between Specialist Office Visits and Health Expenditures in Accountable Care Organizations

  JAMA Network Open · 2019-07-10 · 16 citations

  articleOpen accessSenior authorCorresponding

  Importance: Accountable care organizations (ACOs) aim to control health expenditures while improving quality of care. Primary care has been emphasized as a means to reduce spending, but little is known about the implications of using specialists for achieving this ACO objective. Objective: To examine the association between ACO-beneficiary office visits conducted by specialists and the cost and utilization outcomes of those visits. Design, Setting, and Participants: This cross-sectional study obtained data on 620 distinct ACOs from the Centers for Medicare & Medicaid Services Shared Savings Program Accountable Care Organizations Public-Use Files from April 1, 2012, to September 30, 2017. Generalized estimating equation models were used for analysis of ACOs, adjusting for ACO-beneficiary health status, Medicare enrollment groups, ACO size, and proportion of participating specialists. Exposures: Specialist encounter proportion, the percentage of office visits provided by a specialist, was categorized into 7 discrete groups: less than 35%, 35% to less than 40%, 40% to less than 45% (reference group), 45% to less than 50%, 50% to less than 55%, 55% to less than 60%, and 60% or greater. Main Outcomes and Measures: The primary outcome was total expenditures (given in US dollars) per assigned beneficiary person-year. The secondary outcomes were total numbers of emergency department visits, hospital discharges, skilled nursing facility discharges, and magnetic resonance imaging orders. Results: In total, the data set included 1836 ACO-year (number of participation years per ACO) observations for 620 distinct ACOs. Those ACOs with a specialist encounter proportion of 40% to less than 45% had $1129 (95% CI, $445-$1814) lower per-beneficiary person-year spending than did ACOs in the lowest specialist encounter proportion group and had $752 (95% CI, $115-$1389) lower per-beneficiary person-year spending compared with ACOs in the highest specialist encounter proportion group. Monotonic decreases in emergency department visits, hospital discharges, and skilled nursing facility discharges were observed with increasing specialist encounter proportion. Conversely, monotonic increases in magnetic resonance imaging volume discharges were observed with increasing specialist encounter proportion. Conclusions and Relevance: These findings suggest that an ACO's ability to reduce spending may require sufficient involvement in care processes from specialists, who seem to complement the intrinsic primary care approach in ACOs.

  PublisherOA PDFDOI

Frequent coauthors

• Branimir I. Šikić

  Stanford Cancer Institute

  86 shared

• Ranjana H. Advani

  Stanford University

  85 shared

• Bert L. Lum

  82 shared

• John M. Bennett

  81 shared

• Gordon W. Dewald

  Mayo Clinic in Arizona

  81 shared

• Peter L. Greenberg

  Stanford University

  81 shared

• Jacob M. Rowe

  Rambam Health Care Campus

  81 shared

• Kathleen Dugan

  81 shared

Education

• Ph.D., Graduate Group in Epidemiology

  University of California Davis

  2013

• B.S., Chemistry and Biochemistry

  University of California Santa Cruz

  1999