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All ETDs from UAB

Theses/Dissertations

2022

Executive Doctor of Science (DSc) School of Health Professions

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The Relationship Between Nurse And Therapy Staffing Levels And The Medicare Patient-Driven Payment Model Reimbursement During The Covid-19 Pandemic, Roland T. Shapley Jr Jan 2022

The Relationship Between Nurse And Therapy Staffing Levels And The Medicare Patient-Driven Payment Model Reimbursement During The Covid-19 Pandemic, Roland T. Shapley Jr

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The Patient Driven Payment Model (PDPM) brought about a paradigm shift in the way skilled nursing facilities are reimbursed, by linking complexity of care to beneficiary need, expanding case-mix adjusted components by including a non-therapy ancillary and speech language pathology component, and limiting the volume of therapy services provided. The COVID-19 pandemic wreaked havoc upon the nursing home industry that gave rise to high patient and staff infections and fatalities, declining occupancy rates, and nursing shortages, compelling the Department of Health and Human Services to provide $4.9 billion in CARES Funding to skilled nursing facilities (SNFs). Using Payroll Based Journal, …


Assessing The Impact Of The Covid-19 Pandemic On Metastatic Lung Cancer Time To Treatment Initiation, Health Care Resource Utilization, And Costs In The United States, Teresa M. Zyczynski Jan 2022

Assessing The Impact Of The Covid-19 Pandemic On Metastatic Lung Cancer Time To Treatment Initiation, Health Care Resource Utilization, And Costs In The United States, Teresa M. Zyczynski

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The COVID-19 pandemic has derailed normal operations in the health care delivery systems in the United States (US) and globally, providing prioritized care to patients seeking acute management of the novel coronavirus and its complications. Simultaneously, cancer screening tests have decreased, resulting in decreased rates of cancer diagnoses and referrals to oncologists. The purpose of this study was to assess time to treatment initiation (TTI) with systemic cancer therapy in patients with newly diagnosed metastatic lung cancer, metastatic lung cancer-related and total healthcare resource utilization (HCRU) and costs during the pandemic/post-pandemic period compared with the pre-pandemic period. The retrospective claims …


Predictors Of Us Hospital Responsiveness To International Patient Inquiries, Suzanne M. Garber Jan 2022

Predictors Of Us Hospital Responsiveness To International Patient Inquiries, Suzanne M. Garber

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Medical travel has been growing at a steady rate as global travel has also increased. However, with the advent of COVID-19, all global travel came to a screeching halt, including travel intended for medical purposes across borders. Now that travel is resuming worldwide, American hospital administrators are anxious to fill their beds with more profitable, international patients to make up for revenue losses incurred during the pandemic. Existing literature on the topic of medical tourism focuses on the role of patient initiative, choice, and risk-taking behaviors with little mention of hospital leadership’s ability or desire to construct a management strategy, …


The Relationship Between State Level Funding, Designated Trauma Centers, And Trauma Related Morbidity, Ginger Henry Jan 2022

The Relationship Between State Level Funding, Designated Trauma Centers, And Trauma Related Morbidity, Ginger Henry

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This study examined the relationship of funding and the number of designated trauma centers and age-adjusted trauma mortality across the 50 states. State level funding was defined as monies that were paid to the designated trauma hospitals in aggregate by state and by year for the years 2008 to 2017. The number of designated trauma hospitals were considered in the categories of total number of state trauma hospitals and designation levels 1 through 4. Age-adjusted mortality included the ICD-10 codes for trauma from the WISQARS database. The strategic adaptation theory was used to inform the trauma hospital manager’s need to …


Shared Savings Bonus In Mssp And Its Association With Length Of Participation, Terry D. Knight Jan 2022

Shared Savings Bonus In Mssp And Its Association With Length Of Participation, Terry D. Knight

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Accountable Care Organizations (ACOs) are integrated groups of providers responsible for reducing cost and improving quality for a group of individuals. Medicare began using these organizations in 2012, after the passage of the Affordable Care Act (ACA), to move away from traditional fee-for-service reimbursement. This alternative payment model is the Medicare Shared Savings Program (MSSP). MSSP affords ACOs the opportunity to receive a portion of the savings they achieve if specific cost targets and quality benchmarks are met. Length of participation time in the alternative payment model may increase the ACOs’ ability to achieve savings. The analysis of MSSP savings …


Applying The Hospitalist Model Of Care To Cardiovascular Acute Care Delivery, Ginger K. Biesbrock Jan 2022

Applying The Hospitalist Model Of Care To Cardiovascular Acute Care Delivery, Ginger K. Biesbrock

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The hospitalist model for managing patients in the hospital setting has been in existence for over 20 years. The hospitalist model for non-specialty care has been found to improve the efficiency of care, maintain quality of care, and support a higher degree of guideline adherence. However, there has been little research focusing on the use of the hospitalist model for specialty care. As cardiovascular programs have begun to adopt the hospitalist model, many are asking if this model is more effective than the traditional model. The main concern is the potential disruption to the patient-physician relationship that occurs with the …


Mevisit: Value-Based Approach To Primary Care Delivery By Mtelemedicine Utilization Applied Through Lean Principles, Neil Coyer Thornbury Jan 2022

Mevisit: Value-Based Approach To Primary Care Delivery By Mtelemedicine Utilization Applied Through Lean Principles, Neil Coyer Thornbury

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Background: Significant issues of inconsistent patient services in the U.S. health system impact health outcomes and create high cost. Limitations of immobility, inefficiency, and accessibility sacrifice patient treatment, delay recovery, and escalate health risks from the lack of primary care physicians. The primary purpose of this study was to examine meVisit, a connective mobile technology, as a feasible primary care solution to address escalating health costs by reducing emergency room (ER) visits and inpatient admissions (IA). Methods: The feasibility study applied descriptive and inferential statistics to secondary data (n=4,024) and compared the two independent patient groups from the same large …


The Effect Of Federally Qualified Health Centers (Fqhcs) Prevalence On Uncompensated Care In Us Hospitals, Kena R. Norris Jan 2022

The Effect Of Federally Qualified Health Centers (Fqhcs) Prevalence On Uncompensated Care In Us Hospitals, Kena R. Norris

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Over the past two decades, uncompensated care in U.S. hospitals has grown at a staggering rate and reached $46.4 billion in 2013. It began to decline in 2014, due to the passage of the Patient Protection and Affordable Care Act (ACA), but is now on the rise again. Uncompensated care is typically affected by policy and market factors such as legislative changes and an increase in the number of uninsured. While hospitals continue to serve as critical safety net providers, they are often not the only or most appropriate facility to serve the indigent in U.S. communities. Instead, federally qualified …


The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn Jan 2022

The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn

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Hospital Acquired Infections (HAIs) are among the top five leading causes of death in the United States (Scott, 2009). Estimates of the annual direct medical costs of HAIs to U.S. hospitals have ranged from $28,400,000,000 to $33,800,000,000 (Scott, 2009). Many leading health care organizations have agreed that there is a link between infection prevention and the spread of HAIs (Allegranzi, 2009). This study explored health care workers’ hand hygiene compliance and whether automated compliance reporting improved compliance. A new system powered by technology called Near Field Magnetic Induction (NFMI) found a significant increase in compliance upon introduction of an automated …


The Effect Of Integrative Medicine Interventions On Patient Activation Measure, Rochelle F. Richards Jan 2022

The Effect Of Integrative Medicine Interventions On Patient Activation Measure, Rochelle F. Richards

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Activated patients believe they have essential roles in achieving and maintaining their health. Patient activation is strongly related to improved clinical outcomes (Hibbard, 2017; Greene, 2013). The study’s primary purpose is to evaluate the use of Integrative Medicine Interventions (IMIs) and their relationship to patient activation levels; and to investigate the association between IMI protocols and patient activation levels on patient reported outcomes (PROs) for those with chronic diseases, specifically chronic fatigue and mental health-related conditions of anxiety and depression, using the principles of Integrative Medicine’s (IM) whole-person approach as the model of care in independent IM practices across the …


The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados Jan 2022

The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados

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Two significant events transpired in Louisiana that had sweeping changes for the healthcare system between 2013 and 2016: (1) the privatization of the nation's only stateowned Charity Hospital System via cooperative endeavor agreements with local, private hospitals known as public-private-partnerships (PPP), and (2) the implementation of Medicaid expansion, referred to as implementation of the Affordable Care Act (ACA). Either event independently could have had significant utilization and financial implications for hospitals. This retrospective, quasi-experimental research implemented a generalized estimating equation (GEE) analysis to examine the effects of PPP and ACA on Medicaid patient emergency department utilization by PPP hospital designation, …


An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge Jan 2022

An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge

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Healthcare organizations drive to achieve hospital measures has much to do with strategies put in place by the executive leadership team and resources of the firm. Forces such as regulatory changes reducing hospital payments and external forces such as social injustices leave executives turning to innovative ways to improve the bottomline. This study examined the Chief Diversity Officer (CDO) and the relationship with hospitals measures of financial performance and patient experience for hospitals with a CDO and without a CDO. Hospitals with a CDO can deploy organizational strategies such as diversity management and cultural competencies. These strategies are important because …


The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley Jan 2022

The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley

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Advancements in medical knowledge are producing significant improvements in medical technology, developing breakthrough drug therapies, advancing the practice of medicine, and improving outcomes for cancer patients. However, there are delays in getting new and improved therapies incorporated into routine clinical use, depriving cancer patients of valuable and potentially lifesaving treatments. The purpose of this study was to examine the rate of adoption of new cancer drug discoveries into routine clinical practice in non-academic cancer centers. The process of adoption takes a period of time to embrace new therapies, due in part to a prescriber’s need to gain greater comfort with …


Strategic Balance In Healthcare Organizations, Corey Spraberry Jan 2022

Strategic Balance In Healthcare Organizations, Corey Spraberry

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The purpose of this dissertation was to assess the relationship between service mix offerings relative to competitors and firm performance. Specifically, this study explores if an optimal point of service offerings in the competitive market is associated with financial performance. This study is important to both researchers and healthcare leaders as it helps understand the relationship between optimal service mix and firm performance. The results find a relationship that suggests a differentiated service mix compared to a generalized service mix is associated with financial performance. Additionally, hospital characteristics are associated with service duplication and differentiation. The findings of this research …