Public Health Commons^™

What Quantifies Good Primary Care In The United States? A Review Of Algorithms And Metrics Using Real-World Data, Yun Wang, Jianwei Zheng, Todd Schneberk, Yu Ke, Alexandre Chan, Tao Hu, Jerika Lam, Mary Gutierrez, Ivan Portillo, Dan Wu, Chi-Hung Chang, Yang Qu, Lawrence Brown, Michael B. Nichol

Pharmacy Faculty Articles and Research

Primary care physicians (PCPs) play an indispensable role in providing comprehensive care and referring patients for specialty care and other medical services. As the COVID-19 outbreak disrupts patient access to care, understanding the quality of primary care is critical at this unprecedented moment to support patients with complex medical needs in the primary care setting and inform policymakers to redesign our primary care system. The traditional way of collecting information from patient surveys is time-consuming and costly, and novel data collection and analysis methods are needed. In this review paper, we describe the existing algorithms and metrics that use the …

Surgical Patients’ Hospital Experience Scores: Neighborhood Context Conceptual Framework, Ashley Wendell Kranjac, Dinko Kranjac, Michelle A. Fortier, Pat Patton, Brad Giafaglione, Zeev N. Kain

Sociology Faculty Articles and Research

Objective:

Through geocoding the physical residential address included in the electronic medical record to the census tract level, we present a novel model for concomitant examination of individual patient-related and residential context-related factors that are associated with patient-reported experience scores.

Summary Background Data:

When assessing patient experience in the surgical setting, researchers need to examine the potential influence of neighborhood-level characteristics on patient experience-of-care ratings.

Methods:

We geocoded the residential address included in the electronic medical record (EMR) from a tertiary care facility to the census tract level of Orange County, CA. We then linked each individual record to the …

Race, Ethnicity, And Insurance: The Association With Opioid Use In A Pediatric Hospital Setting, Louis Ehwerhemuepha, Candice D. Donaldson, Zeev N. Kain, Vivian Luong, Michelle A. Fortier, William Feaster, Michael Weiss, Daniel Tomaszewski, Sun Yang, Michael Phan, Brooke N. Jenkins

Psychology Faculty Articles and Research

Background

This study examined the association between race/ethnicity and health insurance payer type with pediatric opioid and non-opioid ordering in an inpatient hospital setting.

Methods

Cross-sectional inpatient encounter data from June 2013 to June 2018 was retrieved from a pediatric children’s hospital in Southern California (N = 55,944), and statistical analyses were performed to determine associations with opioid ordering.

Results

There was a significant main effect of race/ethnicity on opioid and non-opioid orders. Physicians ordered significantly fewer opioid medications, but a greater number of non-opioid medications, for non-Hispanic African American children than non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic White pediatric …

Nicaragua's Response To Covid-19 – Authors' Reply, Mateo Jarquin, Andrea M. Prado, Benjamin Gallo Marin

History Faculty Articles and Research

An author's to John Perry's commentary ("Nicaragua's Response to COVID-19"), which was itself written in response to Mather, Gallo Marin, Medina Perez, et al.'s "Love in the Time of COVID-19: Negligence in the Nicaraguan Response".

Original article: Salazar Mather TP, Gallo Marin B, Medina Perez G, et al. Love in the time of COVID-19: negligence in the Nicaraguan response. The Lancet Global Health. 2020;8(6):e773. doi:10.1016/S2214-109X(20)30131-5 Perry's commentary: Perry J. Nicaragua’s response to COVID-19. The Lancet Global Health. Published online April 2020. doi:10.1016/S2214-109X(20)30218-7

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Prevalence Of Diabetes Mellitus, Hypertension, And Dyslipidemia In Student-Run Screening Clinics For Rural Communities In The Sierra Norte Of Puebla, Mexico, Sean Navin, Daniel M. Tomaszewski

Pharmacy Faculty Articles and Research

Background: The growing prevalence of hypertension (HTN), diabetes mellitus (DM), and in Mexico highlights the need for preventative health care services. Rural communities worldwide lack access to such services. The purpose of this study was to describe the prevalence of HTN, DM, and dyslipidemia in student-run screening clinics in rural communities of the Sierra Norte of Puebla, Mexico to better understand the role the clinics play for the patients served.

Methods: Data were collected from patients from rural, Mexican towns participating in free pharmacy student-run screening clinics. Patients consented to have their de-identified information pooled for re-search. Screenings …

Evaluating Patient Preferences For Different Incentive Programs To Optimize Pharmacist-Provided Patient Care Program Enrollment, Daniel M. Tomaszewski, Tim Cernohaus, Rajiv Vaidyanathan

Pharmacy Faculty Articles and Research

BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM).

OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference.

METHODS: This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTMeligible beneficiaries from 2 employer groups and included …

Managing The Cost Of Diabetes, Laressa Bethishou

Pharmacy Faculty Articles and Research

"This is of concern to health care providers because inadequate management of diabetes results in short- and long-term complications. Patients with diabetes and no health insurance have fewer physician visits and are prescribed fewer medications for management of their diabetes. Patients with diabetes make up 11.9% of all emergency department visits in the United States.Hispanic and non-Hispanic blacks are at greater risk for developing diabetes and serious associated health complications, including chronic kidney disease. This may be attributed to a combination of genetics, diet, and exercise. However, access to health care resources may also play an important role."

How Nurse-Led Practices Perceive Implementation Of The Patient-Centered Medical Home, Rosemary Frasso, A. Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-Mcarthur, Michelle Miller-Day, Robert Gabbay, Peter F. Cronholm

Communication Faculty Articles and Research

Purpose

The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model.

Methods

Data were collected through in-depth interviews with providers and staff in nurse-led practices.

Results

These data suggest two categories of processes that facilitate the integration of PCMH in …

"A Guide To The California Immunization Registry And Its Use To Enhance The Delivery Of Immunization Services, Albert Bach, Jeffery A. Goad, Steven P. Nickell

Pharmacy Faculty Articles and Research

Pharmacists in California are assuming a greater role as independent providers of immunizations for children and adults under Senate Bill 493 (SB 493). One of the requirements for pharmacists as independent providers of immunizations in California is that they must report their administered doses to the California immunization registry system (CAIR). The National Vaccine Advisory Committee Standards for Immunization Practice also supports this practice by recommending that all immunizing providers report vaccinations to their local and state immunization information systems (IIS). This document presents background and specific features of CAIR; best practice recommendations for the use of IIS lookup, forecasting, …

“In Principle We Have Agreement, But In Practice It Is A Bit More Difficult": Obtaining Organizational Buy-In To Patient-Centered Medical Home Transformation, Janelle Applequist, Michelle Miller-Day, Peter F. Cronholm, Robert Gabbay, Deborah S. Bowen

Communication Faculty Articles and Research

The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis …

Financial Hardship From Purchasing Medications For Senior Citizens Before And After The Medicare Modernization Act Of 2003 And The Patient Protection And Affordable Care Act Of 2010: Findings From 1998, 2001, And 2015, Anthony W. Olson, Jon C. Schommer, David A. Mott, Lawrence M. Brown

Pharmacy Faculty Articles and Research

BACKGROUND: The Medicare Modernization Act of 2003 (Medicare Part D) added prescription drug coverage for senior citizens aged 65 years and older and applied managed care approaches to contain costs. The Patient Protection and Affordable Care Act of 2010 (ACA) had the goals of expanding health care insurance coverage and slowing growth in health care expenditures.

OBJECTIVES: To (a) describe the proportion of senior citizens who had prescription drug insurance coverage and the proportion who experienced financial hardship from purchasing medications in 2015, and (b) compare the findings with those collected in 1998 and 2001.

METHODS: Data were obtained in …

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

Predictive Factors Of Patient Satisfaction With Pharmacy Services In South Korea: A Cross-Sectional Study Of National Level Data, Sunkyung Lee, Onyeka P. Godwin, Kyungah Kim, Euni Lee

Pharmacy Faculty Articles and Research

Objectives
Patient satisfaction has emerged as a prerequisite to improving patients’ health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data.

Methods
A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES) data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health.

Results
A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom …

The Role Of Community Pharmacy-Based Vaccination In The Usa: Current Practice And Future Directions, Albert Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number …

Assessing Health Conditions And Medication Use Among The Homeless Community In Long Beach, California, Mok Thoong Chong, Jason Yamaki, Megan Harwood, Richard D'Assalenaux, Ettie Rosenberg, Okezie Aruoma, Anupam Bishayee

Pharmacy Faculty Articles and Research

Objective: Persons experiencing homelessness are a vulnerable population and are at increased risk for morbidity and all-cause mortality compared to the general population. This study sought to evaluate medication use, regular physician visits, and identify health conditions among the homeless population of Long Beach, California.

Methods: Two "brown bag" medication review events were held at homeless shelters in the Long Beach area. Demographic information, medication use, and comorbid disease states were obtained through surveys.

Findings: Three-fourths of the cohort (95 participants) consisted of males, and the average age of participants was 48 years. Psychiatric disorders and cardiovascular disease were the …

Provision Of Health Care Services In Canada: Challenges And Opportunities, Rosa Rodriguez-Monguio, Enrique Seoane-Vazquez, Fernando Antoñanzas Villar

Pharmacy Faculty Articles and Research

The Canadian health care system provides comprehensive coverage of hospital and outpatient care, including therapeutic, diagnostic and preventive services. The level of coverage of services varies across the country. This study examines the key characteristics of the Canadian health and long-term care systems; presents a structured analysis of the insurance, financing and provision of health and long-term care services in Canada; describes the main challenges of the Canadian health and long-term care systems; and concludes with feasible opportunities for the Canadian health policy.

Main challenges to the Canadian system are related to population ageing; prevalence of avoidable diseases caused by …