Medicine and Health Sciences Commons^™

The Relationship Between Insurance And Health Outcomes Of Diabetes Mellitus Patients In Maryland: A Retrospective Archival Study, Soo-Hoon Lee, Samuel L. Brown, Andrew A. Bennett

Management Faculty Publications

Background

Past studies examining the health outcomes of diabetes mellitus (DM) patients found that social determinants of health disparities were associated with variabilities in health outcomes. However, improving access to healthcare, such as health insurance, should mitigate negative health outcomes. The aim of the study was to explore the association between four types of health insurance, namely, Medicare Fee-For-Service (FFS), Medicare Managed Care (MC), Private FFS, and Private MC plans, and the health outcomes of DM patients, controlling for patients’ social determinants of health.

Methods

This is a retrospective cross-sectional archival record study to explore the relationships between types of …

A Health Care Comparison Of Areas In Ghana And In The United States, Lindsey Matsumoto

Honors Projects

The health care system is an important factor for the well-being of the human population all around the world, and yet, health care can differ greatly depending on a variety of factors including location and culture. When referring to health care, it is appropriate to include skilled physicians, hospitals, care clinics, and medical equipment. This article conducts a literature review that compares the health care systems of two countries, the Republic of Ghana and the United States of America. This information is relevant for not only expanding one’s knowledge, but also for travel purposes, as both countries have highly populated …

Standardized Bedside Handoff: One Organization's Journey., Shanon Fucik

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

The Health Care Systems Of The United States And Spain: A Comparison, Tasia Harman

Senior Honors Theses

When it comes to understanding and improving the United States health care system, comparison and analysis with the health care system of another country provides valuable insights. In this thesis, the United States’ health care system was compared to that of Spain, as the health care system of Spain is generally ranked well above the United States in terms of quality, function, and cost. In the comparison, information such as the health of the population, the quality of health care received, accessibility, and health care costs indicate the state of the health care systems and their ability to function well …

Which Activities Count? Using Experimental Data To Understand Conceptualizations Of Physical Activity, Rachel Cusatis, Dana Garbarski

Sociology: Faculty Publications and Other Works

US health surveys consistently report that men and those with higher socioeconomic status (SES) engage in more physical activity than women and lower SES counterparts, using questions that ask about physical activity during leisure time. However, social characteristics such as gender and SES shape understandings of and access to leisure-based physical activity as well as other domains where healthy activity is available – namely house work, care work, and paid work. Thus, the physical activity of US adults may look different when what counts as physical activity expands beyond leisure activity.

The current study uses Amazon’s Mechanical Turk platform …

The Emerging Issue Of Hepatitis C Virus In The United States And In West Virginia, Alberto Coustasse Dr.Ph. Md,Mba, Mph, Maggie Phillips Rn, Bsn, Mha, Jumana Abboud Mha, Neha Botre Mha, David P. Paul Iii

Management Faculty Research

Introduction:

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S., Especially in West Virginia. If it is undetected and left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear promising, although somewhat expensive. West Virginia, a predominantly rural state, is beginning to face a mounting financial crisis due to HCV.

Purpose of the Study:

The purpose of this study was to examine the effects of early identification and treatment for patients …

Patient And Hospital Characteristics Predictive Of Inferior Vena Cava Filter Usage In Venous Thromboembolism Patients: A Study From The 2013 To 2014 Nationwide Readmissions Database, Amie Goodin, Ming Chen, Driss Raissi, Qiong Han, Hong Xiao, Joshua Brown

Radiology Faculty Publications

To examine the association between patient and hospital characteristics and inferior vena cava filter (IVCF) utilization in patients with venous thromboembolism (VTE).

The 2013 to 2014 Nationwide Readmissions Database was used to define a cohort of patients with VTE aged ≥ 18 after a primary VTE diagnosis. Comorbidities of interest were classified via diagnosis codes and IVCF placement was identified via procedure code. Chi square analysis tested differences between patient and hospital-level characteristics and whether or not IVCFs were placed. A hierarchical logistic regression model estimated the relationship between patient-level factors (demographics, socioeconomic status, comorbidities), hospital-level factors (bed size, teaching …

Clinician-Investigator Training And The Need To Pilot New Approaches To Recruiting And Retaining This Workforce., Alison K Hall, Sherry L Mills, P Kay Lund

Neurology Faculty Publications

Clinician–investigators, also called physician–scientists, offer critical knowledge and perspectives that benefit research on basic science mechanisms, improved diagnostic and therapeutic approaches, population and outcomes medicine, health policy, and health services, yet few clinically trained health professionals pursue a research career. Sustaining this workforce requires attention to the unique challenges faced by investigators who must achieve clinical and research competence during training and their careers. These challenges include the duration of required clinical training, limited or discontinuous research opportunities, high levels of educational debt, balancing the dual obligations and rewards of clinical care and research, competition for research funding, and the …

Chagas Heart Disease: A United States National Study, Srikanth Yandrapalli, Prakash Harikrishnan, Abdallah Sanaani, Wilbert S. Aronow, Sachin Sule, Alan L. Gass, Chhaya Aggarwal, William H. Frishman, Gregg C. Fonarow, Gregg M. Lanier, Howard A. Cooper, Julio Panza

NYMC Faculty Posters

No abstract provided.

Clinical Performance Measures And Quality Improvement System Considerations For Dental Education, Joseph W. Parkinson, Gregory G. Zeller

Oral Health Practice Faculty Publications

Quality improvement and quality assurance programs are an integral part of providing excellence in health care delivery. The Dental Quality Alliance and the Commission on Dental Accreditation recognize this and have created standards and recommendations to advise health care providers and health care delivery systems, including dental schools, on measuring the quality of the care delivered to patients. Overall health care expenditures have increased, and the Affordable Care Act has made health care, including dentistry, available to more people in the United States. These increases in cost and in the number of patients accessing care contribute to a heightened interest …

Monitoring Harm Perceptions Of Smokeless Tobacco Products Among U.S. Adults: Health Information National Trends Survey 2012, 2014, 2015, Shari P. Feirman, Elisabeth A. Donaldson, Mark Parascandola, Kimberly Snyder, Cindy Tworek

Food and Drug Administration Papers

Introduction: Changes to the U.S. smokeless tobacco landscape in recent years include a change to health warnings on packages, the implementation of bans in some stadiums, and the launch of a federal youth pre- vention campaign. It is unclear whether such changes have impacted consumer beliefs about smokeless tobacco. This study examines relative harm perceptions of smokeless tobacco compared to cigarettes among adults and assesses changes in smokeless tobacco harm perceptions over time.

Methods: We analyzed data from three cycles (2012, 2014, 2015) of the Health Information National Trends Survey (HINTS). Using 2015 data, we assessed bivariate associations between smokeless …

Identification And Use Of Frailty Indicators From Text To Examine Associations With Clinical Outcomes Among Patients With Heart Failure., Yijun Shao, April F Mohanty, Ali Ahmed, Charlene R Weir, Bruce E Bray, Rashmee U Shah, Douglas Redd, Qing Zeng-Treitler

Clinical Research and Leadership Faculty Publications

Frailty is an important health outcomes indicator and valuable for guiding healthcare decisions in older adults, but is rarely collected in a quantitative, systematic fashion in routine healthcare. Using a cohort of 12,000 Veterans with heart failure, we investigated the feasibility of topic modeling to identify frailty topics in clinical notes. Topics were generated through unsupervised learning and then manually reviewed by an expert. A total of 53 frailty topics were identified from 100,000 notes. We further examined associations of frailty with age-, sex-, and Charlson Comorbidity Index-adjusted 1-year hospitalizations and mortality (composite outcome) using logistic regression. Frailty (≤ 4 …

The Status Of Public Health Services & Systems Research In The Us: Implications For British Columbia, Glen P. Mays

Health Management and Policy Presentations

Research on the organization, financing, and delivery of public health services has accelerated in the U.S. in recent years. This applied scholarship has been fueled in part by the changes and natural experiments created by global economic recession and by comprehensive federal and state health reforms. Co-occuring changes in public health organization and financing have occurred in Canada and more specifically in British Columbia, where valuable scholarship on public health delivery is also underway. This presentation reviews the progress and current directions of PHSSR scholarship in the U.S., and identifies opportunities and implications for British Columbia.

Financial Position And Adoption Of Electronic Health Records: A Retrospective Longitudinal Study, Jay J. Shen, Gregory O. Ginn

Public Health Faculty Publications

AIM: Financial barriers are a major factor of slow electronic health record (EHR) adoption among US hospitals. All existing literature focuses on relationships between current or short-term financial position and EHR adoption. This study examines relationship between financial position in previous years and the current level of EHR adoption.

METHODS: Retrospective longitudinal data were extracted from (1) the 2009 American Hospital Association (AHA) EHR implementation survey; (2) the 2002 and 2006 Centers for Medicare & Medicaid Cost Reports; and (3) the 2002 and 2006 AHA Annual Survey containing organizational and operational data. The final sample was 2,701 acute care hospitals …

Association Between Triptanuse And Cardiac Contraindications In An Insured Migraine Population, Daisy Ng-Mak, Phd, Valerie P. Pracilio, Mph, Stephen Silberstein, Md, Joseph Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Neil I. Goldfarb

College of Population Health Lectures, Presentations, Workshops

Background

Safety concerns exist when using triptansto treat patients with cardiac contraindications.

–Triptans cause vasoconstriction, a safety concern for migraineurswith cardiovascular (CV) disease or other cardiac risk factors.

–All triptans contain contraindications in their package inserts to avoid use in patients with cardiac conditions.

•Previous research indicates that clinicians are less likely to prescribe triptansin patients with CV disease or CV risk factors.

Limited research has examined the proportion of migraine patients with cardiovascular disease or those individuals who were concurrently treated with triptans.

Association Between Hospitals Caring For A Disproportionately High Percentage Of Minority Trauma Patients And Increased Mortality: A Nationwide Analysis Of 434 Hospitals., Adil H. Haider, Sharon Ong'uti, David T. Efron, Tolulope A. Oyetunji, Marie L. Crandall, Valerie K. Scott, Elliott R. Haut, Eric B. Schneider, Neil R. Powe, Lisa A. Cooper, Edward E. Cornwell

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To determine whether there is an increased odds of mortality among trauma patients treated at hospitals with higher proportions of minority patients (ie, black and Hispanic patients combined).

DESIGN: Hospitals were categorized on the basis of the percentage of minority patients admitted with trauma. The adjusted odds of in-hospital mortality were compared between hospitals with less than 25% of patients who were minorities (the reference group) and hospitals with 25% to 50% of patients who were minorities and hospitals with more than 50% of patients who were minorities. Multivariate logistic regression (with generalized linear modeling and a cluster-correlated robust …

International Evidence On Medical Spending., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

The 46th Actuarial Research Conference, Poster session I, University of Connecticut, Storrs, CT. August 11, 2011.

Poster conclusions:

• U.S. spending is high.
• Long tailed medical linked insurance may be easier to write in the U.S.
• U.S. healthcare cost curve is not outrageous.
• Average spending
• Low volatility

Poster is associated with this paper: http://jdc.jefferson.edu/healthpolicyfaculty/45/

International Evidence On Medical Spending., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the American Statistical Association Health Policy Statistics Section.9th International Conference on Health Policy Statistics, Cleveland, OH.

14 PowerPoint slides

Presentation associated with this paper: http://jdc.jefferson.edu/healthpolicyfaculty/45/.

Strategies For Financing Healthcare Costs Over The Long Term., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the American Statistical Association Health Policy Statistics Section. 9th International Conference on Health Policy Statistics, Poster session I, Cleveland, OH.

Funding to support this work came from AHRQ grant R36 HS018835-01.

Policy Implications:

-Health insurance companies should use a broad, diversified investment portfolio as their optimal investment strategy -Insurance regulators should be focused on longer term lines of health insurance

High Frequency Evidence On Variation In Spending Growth., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the American Statistical Association Health Policy Statistics Section. 9th International Conference on Health Policy Statistics, Poster session I, Cleveland, OH.

Policy Implications:

• Health insurance regulation should include compensation for taking on riskier groups.
• Health programs should focus on changing needs for risk management versus health management throughout the life cycle.

Funding to support this work came from AHRQ grant R36 HS018835-01.

International Evidence On Medical Spending., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the Casualty Actuarial Society 2011 Seminar on Reinsurance, Philadelphia, PA.

Handouts are also available at: http://www.casact.org/education/reinsure/2011/handouts/C17-Lieberthal.pdf

the audio is available at: http://www.casact.org/education/reinsure/2011/audio/C17.mp3

and it is associated with the paper: http://jdc.jefferson.edu/healthpolicyfaculty/45/

23 PowerPoint slides.

Identifying Inaccuracies On Emergency Medicine Residency Applications., Eric D Katz, Lee Shockley, Lawrence Kass, David Howes, Janis P Tupesis, Christopher Weaver, Osman R Sayan, Victoria Hogan, Jason Begue, Diamond Vrocher, Jackie Frazer, Timothy Evans, Gene Hern, Ralph Riviello, Antonio Rivera, Keith Kinoshita, Edward Ferguson

Department of Emergency Medicine Faculty Papers

BACKGROUND: Previous trials have showed a 10-30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. METHODS: This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans …

The Drama Of Dysfunction: Value Conflict In Us Managed Care, Diana D. Mrotek

WCBT Faculty Publications

The transformation of the American health care environment from retrospective fee-for-service to managed care has been both rapid and chaotic. This period of change has been infected by value conflict, evoking unconscious processes in system participants as they have attempted to cope with personally threatening situations. This article attempts to elucidate this process by presenting an account of events and accompanying value conflict as it occurred over time. It also includes a systems analysis of the rapidly changing mosaic of unconscious processes that resulted from the divergent values held by the public and health care professionals, using various organization behavior …

Health Care Reform.... Practical Manifestations Of Theoretical Values, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.