MD – Harvard Medical School, Boston, MA
Residency – Surgery, Stanford University, Stanford, CA

Biography: Dr. Charles Liu is interested in exploring the intersection of general surgery and health services research, with a focus on access to and outcomes of surgical care in underserved communities. Clinically, his interests are in trauma and emergency general surgery as well as colorectal surgery.  

Dr. Liu’s main NCSP project is titled, “Out-of-Pocket Spending by Surgical and Trauma Patients Following Implementation of the Affordable Care Act.”  His mentorship team at UCLA included Dr. Melinda Maggard-Gibbons, Dr. Yusuke Tsugawa, Dr. Thomas Rice, Dr. Jose Escarce, and Dr. Debra Saliba (VA), and he was additionally advised by Drs. Thomas Weiser, David Spain, and Arden Morris at the Stanford University Department of Surgery. The study was a quasi-experimental analysis of the impact of the Affordable Care Act’s component reforms, most notably the ACA insurance marketplaces, on out-of-pocket spending for surgery and trauma patients.  The aims included: 1) describing the impact of the ACA insurance marketplaces on out-of-pocket spending, health insurance premiums, and likelihood of catastrophic heath expenditure in adults who underwent a surgical procedure; 2) describing the impact of the ACA on out of pocket spending, health insurance premiums, and likelihood of catastrophic health expenditures in adults who had an inpatient hospitalization or ED visit for trauma; and 3) describing the impact of the ACA on these spending outcomes among US veterans both enrolled and not enrolled in the Veterans Health Administration system. 

Dr. Liu was selected to present his protocol work at the AcademyHealth Annual Research Meeting in Washington, DC in June 2019, at the American Association for the Surgery of Trauma Annual Meeting in Dallas, TX in September 2019, and at the American College of Surgeons Clinical Congress in San Francisco, CA in October 2019.  He previously presented on “Impact of Affordable Care Act Implementation on Catastrophic Health Expenditures among Trauma Patients at a California Safety Net Hospital” at the 2018 American College of Surgeons Clinical Congress, and his work on changes in out-of-pocket spending among US veterans was also accepted for presentation at the 2020 AcademyHealth Annual Research Meeting. 

Dr. Liu has published multiple manuscripts during his fellowship.  He was co-author with NCSP alumnus Dr. Tarak Trivedi on the article, “Injuries Associated with Standing Electric Scooter Use,” in JAMA Network Open in 2019.  The publication received widespread media attention and was highlighted in Business Insider, CBS News and other national and international news sources.  Dr. Liu was a co-author on a Department of Veterans Affairs report titled, “Cost-Effectiveness of Leg Bypass versus Endovascular Therapy for Critical Limb Ischemia: A Systematic Review,” included in a VA Evidence-Based Synthesis Program Report in March 2019.  In addition, Dr. Liu co-authored three articles regarding the US Affordable Care Act and out of pocket spending.  These articles are 1) “Association of the US Affordable Care Act With Out-of-Pocket Spending and Catastrophic Health Expenditures Among Adult Patients With Traumatic Injury,” in JAMA Network Open, February 2020.  2) ”Impact of the Affordable Care Act Insurance Marketplaces on Out-of-Pocket Spending among Surgical Patients,” in the Annals of Surgery, Epub March 26, 2020.  3) ”Catastrophic expenditures in California trauma patients after the Affordable Care Act: reduced financial risk and racial disparities,” American Journal of Surgery, Epub April 20, 2020.  

After completing the NCSP fellowship, Dr. Liu returned to Stanford University to continue general surgery residency.