Quality Of Care In Community Health Centers And Factors Associated With Performance, 2013 George Washington University
Quality Of Care In Community Health Centers And Factors Associated With Performance, Peter Shin, Jessica Sharac, Sara J. Rosenbaum, Julia Paradise
Geiger Gibson/RCHN Community Health Foundation Research Collaborative
Federally funded community health centers are a key source of comprehensive primary care for medically underserved communities, serving more than 20 million patients in 2011. The Affordable Care Act (ACA) expanded the health center program significantly to help meet the increased demand for health care that is expected as millions of the uninsured gain health coverage, beginning in 2014. Especially given health centers’ growing role, evidence of the quality of care they provide is of keen interest. Most research shows high performance by health centers relative to various standards, but some gaps have also been found, and suitable benchmarks for …
The Effect Of Electronic Medical Record Sophistication On U.S. Hospital Emergency Department Efficiency, 2013 Union College - Schenectady, NY
The Effect Of Electronic Medical Record Sophistication On U.S. Hospital Emergency Department Efficiency, Imran Chaudhri
Honors Theses
A key concern in emergency departments (EDs) is their overall efficiency, One proposed solution to making EDs more efficient is the use of electronic medical records (EMRs). This paper seeks to determine if varying levels of EMR sophistication have an effect on measures of emergency department efficiency. Furukawa (2011) found that EMR sophistication had varying effects on ED efficiency. Fully functional EMRs significantly improved ED efficiency in multiple measures, while basic EMR varied on its effects on efficiency. Since Furukawa’s results are somewhat inconclusive, this study aims to see if these effects are longstanding. I hypothesize that as EMR became …
Uncompensated Care And Quality Assurance Among Rural Hospitals, 2013 Marshall University
Uncompensated Care And Quality Assurance Among Rural Hospitals, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse
Doohee Lee
Health care disparities in rural areas remain significant in the U.S. health care industry. Uncompensated care makes health care disparities in rural areas worse, and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic-downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. Given that many rural residents experience difficulty accessing high quality care and given the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality-care barriers and opportunities and suggested strategies to strengthen the position of rural hospitals …
What's Happening: May 27, 2013, 2013 MaineHealth
What's Happening: May 27, 2013, Maine Medical Center
What's Happening
No abstract provided.
Cost Of Medical Detoxification Among Drug And Alcohol Users In A Private Texas Hospital, 2013 Marshall University
Cost Of Medical Detoxification Among Drug And Alcohol Users In A Private Texas Hospital, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Purpose – The purpose of this paper is to estimate the costs of medical detoxification among patients with alcohol and substance abuse disorders. Design/methodology/approach – The study data was drawn from a medical detoxification program in a community hospital in Texas. Secondary data analysis of 1337 cases from three years was reviewed. Age, gender, race, alcohol, cocaine, cannabis, amphetamines, sedatives, opioids, financial classification, cost, length of stay (LOS) and cost by LOS were analyzed using Kruskal-Wallis test and Mann-Whitney U-test. Findings – The sample comprised of 42.8 percent women and 57.2 percent males. The mean cost and cost by LOS …
Electronic Medical Records: Is It Working In Long Term Health Care?, 2013 Marshall University
Electronic Medical Records: Is It Working In Long Term Health Care?, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …
Kawasaki Syndrome In Texas, 2013 Marshall University
Kawasaki Syndrome In Texas, Alberto Coustasse, Julius J. Larry, Witold Migala, Cody Arvidson, Karan P. Singh
Alberto Coustasse, DrPH, MD, MBA, MPH
The authors examined hospitalization rates of Kawasaki Syndrome (KS) among Texas children to isolate clusters, identify demographic disparities, and suggest possible causative factors. Using a retrospective cross-sectional study design, they studied 330 KS cases from 2,818,460 hospital discharges. The majority of the cases (61.5%) occurred within the 1-4-years-old category, representing the highest hospitalization rate (14.3 per 100,000 children). Almost 75% of the KS population was less than 5 years old, with hospitalization rates approximately 8 times higher than that of all other children (p < .05). KS diagnosis occurred for only 49.4% of all KS cases upon admission. Along with high-density …
To The Bitter End: Disparities In End-Of-Life Care, 2013 Marshall University
To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie
Alberto Coustasse, DrPH, MD, MBA, MPH
Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …
Electronic Medical Records In Long-Term Care, 2013 Marshall University
Electronic Medical Records In Long-Term Care, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …
Accountable Care Organization Musical Chairs: Will There Be A Seat Remaining For The Small Group Or Solo Practice?, 2013 Marshall University
Accountable Care Organization Musical Chairs: Will There Be A Seat Remaining For The Small Group Or Solo Practice?, Amy Vaughan, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
When it was introduced in the Affordable Care Act of 2010 as the new 2012 payment model for Medicare, an accountable care organization (ACO) was a new and untested concept in healthcare delivery and payment. The authors estimated the likelihood of engagement in ACOs by small group and solo healthcare practitioners. An evaluation of five case studies showed that significant organizational, financial, and technological challenges had to be met in order to launch an ACO. Sufficient resources to meet those challenges were best supplied by large organizations. Small or solo practices participated only through varying levels of integration as salaried …
Uncompensated Care And Quality Assurance Among Rural Hospitals, 2013 Marshall University
Uncompensated Care And Quality Assurance Among Rural Hospitals, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Health care disparities in rural areas remain significant in the U.S. health care industry. Uncompensated care makes health care disparities in rural areas worse, and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic-downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. Given that many rural residents experience difficulty accessing high quality care and given the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality-care barriers and opportunities and suggested strategies to strengthen the position of rural hospitals …
Disparities In Disability Among Non-Hispanic Black Elders: Results From The National Interview Survey 2001–2003, 2013 Marshall University
Disparities In Disability Among Non-Hispanic Black Elders: Results From The National Interview Survey 2001–2003, Alberto Coustasse, Dennis Emmett, Nimisha Patel, Alicia Pekar
Dennis Emmett
A drastically increasing elderly population and disparity among disability poses a concern for the US health care industry. This retrospective cross-sectional study analyzed whether ADL and IADL disabilities were different among non-Hispanic white (NHW) and non-Hispanic black (NHB) populations age 65 and over. Data was retrieved from the 2001–2003 National Health Interview Survey (NHIS) for comparing NHBs and NHWs using chi-square analysis for bivariate comparisons. For both elderly NHBs and elderly NHWs, increased rates of disability were reported for being over 75, female, single, and having lower education. NHBs reported statistically higher disability rates for ADL, IADL, and for any …
Disparities In Disability Among Non-Hispanic Black Elders: Results From The National Interview Survey 2001–2003, 2013 Marshall University
Disparities In Disability Among Non-Hispanic Black Elders: Results From The National Interview Survey 2001–2003, Alberto Coustasse, Dennis Emmett, Nimisha Patel, Alicia Pekar
Alberto Coustasse, DrPH, MD, MBA, MPH
A drastically increasing elderly population and disparity among disability poses a concern for the US health care industry. This retrospective cross-sectional study analyzed whether ADL and IADL disabilities were different among non-Hispanic white (NHW) and non-Hispanic black (NHB) populations age 65 and over. Data was retrieved from the 2001–2003 National Health Interview Survey (NHIS) for comparing NHBs and NHWs using chi-square analysis for bivariate comparisons. For both elderly NHBs and elderly NHWs, increased rates of disability were reported for being over 75, female, single, and having lower education. NHBs reported statistically higher disability rates for ADL, IADL, and for any …
Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, 2013 Marshall University
Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, Alberto Coustasse, Andrea L. Lorden, Vishal Nemarugommula, Karan P. Singh
Alberto Coustasse, DrPH, MD, MBA, MPH
The financial ramifications of uncompensated care cost (UCC) on the healthcare industry have been difficult to quantify. With the lack of a standardized definition of uncompensated care and the need to account for the uninsured, indigent, and immigrant populations, the authors identified $190 million of UCC from Southwestern border hospitals for emergency room treatment of undocumented immigrants and $934 million of uncompensated care charges for 23 hospitals in a Texas county, which translated to $353 million of UCC. Although lawmakers passed the Medicare Prescription Drug Improvement and Modernization Act (2003) to address the growing imbalance, the shortfall of funds highlights …
Disparities In Adl And Iadl Disabilities Among Elders Of Hispanic Subgroups In The United States: Results From The National Health Interview Survey 2001-2003, 2013 Marshall University
Disparities In Adl And Iadl Disabilities Among Elders Of Hispanic Subgroups In The United States: Results From The National Health Interview Survey 2001-2003, Alberto Coustasse, Sejong Bae, Cody Arvidson, Karan P. Singh, Fernando Trevino
Alberto Coustasse, DrPH, MD, MBA, MPH
The authors compared disability and functional limitation among elder Hispanic subgroups by using data from the 2001-2003 National Health Interview Survey (National Center for Health Statistics 2008a). The authors applied chi-square analysis for bivariate comparisons and used multiple logistic regression analyses for making comparisons, estimating odds ratios, and predicting disabilities. Results revealed a 21.4% rate of disability of any type in Hispanics. Puerto Ricans reported the highest rates of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) disabilities compared with other Hispanic subgroups (Mexicans, Cubans, Central and South Americans) and reported a higher rate than did …
Examining Universal Primary Healthcare Through Community-Based Initiatives, 2013 Oglethorpe University
Examining Universal Primary Healthcare Through Community-Based Initiatives, Donald E. Warden
Oglethorpe Journal of Undergraduate Research
This paper examines enacting community-based primary healthcare programs and initiatives. It looks at the weaknesses of past attempts, the successes of current attempts, and gives insight into ways everyday citizens can change the way the world does healthcare. There are social, economic, and political barriers as to why these programs are not enacted. Since 1978, Member states of the United Nations strive towards healthcare for all. The original 1978 Declaration of Alma-Ata sets the bar at achieving this goal by the year 2000. Now in the 21st century, the world still battles inadequate healthcare. Nations continue to strive towards …
What's Happening: May 20, 2013, 2013 MaineHealth
What's Happening: May 20, 2013, Maine Medical Center
What's Happening
No abstract provided.
What's Happening: May 13, 2013, 2013 MaineHealth
What's Happening: May 13, 2013, Maine Medical Center
What's Happening
No abstract provided.
Members In Mind: Outreach & Education Strategies For Co-Op Insurance Plans. Final Report, 2013 University of Southern Maine, Muskie School of Public Service
Members In Mind: Outreach & Education Strategies For Co-Op Insurance Plans. Final Report, Elizabeth Rogers
Muskie School Capstones and Dissertations
As envisioned by the federal policymakers who designed the Patient Protection and Affordable Care Act of 2011 (ACA), and the state-based health leaders who are founding them, Consumer Oriented and Operated Plans (CO-OPs) are intended to be a different kind of insurer: non-profit partners in health and healthcare. While many Americans (including Mainers) should welcome this new model, CO-OPs face challenges in establishing brand recognition and capturing the hearts and minds of consumers. The purpose of this research project was to support CO-OPs, particularly Maine’s CO-OP, Maine Community Health Options (MCHO), in assessing and developing communications strategies that enable individuals …
Do User Fees Increase Tuberculosis Notifications?, 2013 Macalester College
Do User Fees Increase Tuberculosis Notifications?, Chioma Y. Chukwumah
Economics Honors Projects
Public health sectors around the world strive to provide accessible and affordable care. Tight government budgets and growing populations lead countries to consider adding or raising charges to health care consumers. These user fees may affect the quality, equity and revenue of health care. This paper investigates the impact of user fees on notifications of tuberculosis. In the panel data composed of 176 countries from 1960 to 2012, I find no evidence that suggests user fees increase tuberculosis. In contrast, I find strong and robust evidence suggesting user fees are associated with fewer new cases of tuberculosis.