Health Services Research Commons^™

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Glen Mays

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health. METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …

The Cost-Effectiveness Of Combination Treatment Consisting Of Either Cetuximab Or Panitumumab Plus Folfiri Versus Treatment With Bevacizumab Plus Folfiri As First-Line Treatment For Kras Wild-Type Metastatic Colorectal Cancer Patients In Ontario, Emmanuel M.G. Ewara

Electronic Thesis and Dissertation Repository

I conducted a cost-effectiveness analysis of combination cetuximbab or panitumumab plus FOLFIRI as first-line treatment for patients with metastatic colorectal cancer (MCRC) from the perspective of the Ontario healthcare payer. I developed a Markov decision analytical model to simulate the lifetime costs and benefits of each treatment option. The model was parameterized using data collected from administrative databases in the province of Ontario and from published clinical trials. In the base case scenario, treatment consisting of bevacizumab plus FOLFIRI was found to dominate other treatment options. The ICER values were found to be sensitive to the efficacy of first-line treatment, …

Importance Performance Analysis Pelayanan Jaminan Sosial Kesehatan Di Puskesmas Swakelola Pembina, Asmaripa Ainy, Misnaniarti Misnaniarti, Nur Alam Fajar

Kesmas

Kunjungan pasien Jaminan Sosial Kesehatan (Jamsoskes) di puskesmas pembina selama tahun 2009 adalah 24.014 orang. Kunjungan per catur wulan memperlihatkan trend yang menurun. Jumlah pengunjung puskesmas pembina pada periode bulan Januari – April 2009 adalah 9.295 orang, pada Mei – Agustus 2009 adalah 8.162 orang, dan September – Desember 2009 adalah 6.557 orang. Hal ini dapat disebabkan oleh minat masyarakat yang rendah untuk menggunakan Jamsoskes. Oleh sebab itu, perlu dilakukan kajian kualitas pelayanan Jamsoskes menurut perspektif pasien. Penelitian dengan desain cross sectional ini menggunakan data primer yang dilakukan dengan metode wawancara terstruktur atau survei. Sampel terdiri dari 100 pasien Jamsoskes …

Child Maltreatment Outpatient Visits To Kentucky Non-Federal Acute Care Hospitals, 2008-2010, Marjorie Stanek, Michael Singleton, Svetla Slavova, Terry Bunn

Kentucky Injury Prevention and Research Center Special Report

No abstract provided.

Lessons From The Trenches: Meeting Evaluation Challenges In School Health Education, Michael Young, George Denny, Joseph Donnelly

Department of Public Health Scholarship and Creative Works

BACKGROUND: Those involved in school health education programs generally believe that health education programs can play an important role in helping young people make positive health decisions. Thus, it is to document the effects of such programs through rigorous evaluations published in peer‐reviewed journals.

METHODS: This paper helps the reader understand the context of school health program evaluation, examines several problems and challenges, shows how problems can often be fixed, or prevented, and demonstrates ways in which challenges can be met. A number of topics are addressed, including distinguishing between curricula evaluation and evaluation of outcomes, types of evaluation, identifying …

Contribution Of Behavioral Risk Factors And Obesity To Socioeconomic Differences In Colorectal Cancer Incidence, Chyke Doubeni, Jacqueline Major, Adeyinka Laiyemo, Mario Schootman, Ann Zauber, Albert Hollenbeck, Rashmi Sinha, Jeroan Allison

Chyke A. Doubeni

BACKGROUND:Health behaviors are known risk factors for colorectal cancer and are more common in low socioeconomic status (SES) populations. We evaluated the extent to which behavioral risk factors and body mass index (BMI) explain SES disparities in colorectal cancer incidence, overall and by tumor location.

METHODS: We analyzed prospective National Institutes of Health-AARP Diet and Health Study data on 506 488 participants who were recruited in 1995-1996 from six US states and two metropolitan areas and followed through 2006. Detailed baseline data on risk factors for colorectal cancer, including health behaviors, were obtained using questionnaires. SES was measured by self-reported …

Seeing Recovery Through The Eyes Of Ethnic And Cultural Minorities, Linda M. Cabral, Kathy Muhr, Judith A. Savageau

Judith A. Savageau

Describes a study that sought to better understand how persons with mental health conditions from two cultural groups, Latino and Deaf/Heard of Hearing (D/HH), access recovery-oriented and peer support services. Results from this study helped to inform the Massachusetts Department of Mental Health regarding system improvements that could be made to better serve these populations.

Self-Reported Colorectal Cancer Screening Of Medicare Beneficiaries In Family Medicine Vs. Internal Medicine Practices In The United States: A Cross-Sectional Study, Angela (Young) Higgins, Anna R. B. Doubeni, Karon L. Phillips, Adeyinka O. Laiyemo, Becky A. Briesacher, Jennifer Tjia, Chyke A. Doubeni

Jennifer Tjia

BACKGROUND: The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians.

METHODS: Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main …

Self-Reported Colorectal Cancer Screening Of Medicare Beneficiaries In Family Medicine Vs. Internal Medicine Practices In The United States: A Cross-Sectional Study, Angela Higgins, Anna Doubeni, Karon Phillips, Adeyinka Laiyemo, Becky Briesacher, Jennifer Tjia, Chyke Doubeni

Chyke A. Doubeni

BACKGROUND: The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians. METHODS: Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main …

Obesity And Health Care Utilization Trends In Canada During The Period 1996-7 To 2009-10, Michael Lebenbaum

Electronic Thesis and Dissertation Repository

In Canada, there have been large improvements in the management of chronic diseases attributed to obesity such as diabetes, hypertension and high cholesterol since the 1990s. How this trend has impacted the health care utilization patterns of obese individuals relative to normal weight individuals is unknown in Canada. This study examined health care utilization across categories of body mass index in Canada during the time period 1996 to 2010 using the 1996-7 National Population Health Survey and the 2000-1 and 2009-10 Canadian Community Health Surveys. I found that there were significant declines in the intensity of utilization of general practitioner/family …

Achieving Consensus On Measure-Driven Child Health Quality: Maine’S Improving Health Outcomes For Children Initiative, Martha Elbaum Williamson Mpa, Nargiza Fuzailova Md, Mph, Kimberley S. Fox Mpa

Population Health & Health Policy

This brief describes Maine’s process for selecting child health quality measures, including identified strengths and limitations of the CHIPRA core measures that led to the inclusion of additional state-specific measures and the factors considered for selection. Subsequent articles will describe how measures have been implemented and used to improve child health quality and how they have been integrated into systems of care (e.g. health information technology systems, policy changes).

The Development Of Hiv-Prevention Programs In Public Health Centers And Their Impact On Women: Opportunities For Changes In The City Of Buenos Aires - El Desarrollo De Programas De Prevención Contra El Vih Y Sus Impactos En Las Mujeres En El Primer Nivel De Atención. Oportunidades Por Cambios En La Ciudad De Buenos Aires., Anna Longo

Independent Study Project (ISP) Collection

The focus of my research is the implementation and continued efforts of HIV-prevention plans that are provided in primary care public health centers in the city of Buenos Aires. Much of the outline for these programs has been created and maintained by la Coordinación SIDA, a government-based AIDS group that works to organize and moderate public sector prevention efforts in the city. Public health centers are an effective channel through which HIV-prevention can be provided, due to the fact that they are often very integrated in their communities and tend to have a good sense of the social context that …

The Plan Score, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Selecting Measures Of Public Health Service Delivery: Results From A Delphi Survey For The Mprove Study, Glen Mays

Glen Mays

This database contains detailed, sortable results from the expert panel Delphi survey used to rate candidate measures of public health service delivery to be used in the Multi-Network Practice and Outcome Variation Examination Study (MPROVE), conducted by the Public Health Practice-Based Research Networks (PBRN) Program.

Selecting Measures Of Public Health Delivery: Results Of A Delphi Survey For The Mprove Study, Glen Mays

Glen Mays

The Multi-Network Practice and Outcomes Variation Examination Study (MPROVE) supports six participating public health practice-based research networks (PBRNs) in selecting a common set of service delivery measures for use in analyzing geographic variation in delivery across local communities. This report presents results from an expert panel Delphi survey used to rate candidate measures on a set of selection criteria, in order to select the final set of measures for study.

Design Of A Prostate Cancer Patient Navigation Intervention For A Veterans Affairs Hospital, Narissa J. Nonzee, June M. Mckoy, Alfred W. Rademaker, Peter Byer, Thanh H. Luu, Dachao Liu, Elizabeth A. Richey

Dartmouth Scholarship

Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP) aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA) hospital in Chicago.

Perubahan Status Kelembagaan Dan Kualitas Pelayanan Pasien Rumah Sakit, Dadang Kusnadi

Kesmas

Kenyamanan, keamanan, dan kepuasan pelayanan pasien merupakan fenomena pelayanan yang mencerminkan kualitas. Tujuan penelitian ini adalah untuk mengetahui pengaruh implementasi kebijakan perubahan status kelembagaan rumah sakit terhadap kualitas pelayanan pasien. Penelitian ini menggunakan desain kuantitatif dan metode explanatory survey. Metode analisis meliputi regresi linier multipel dengan uji validitas product moment pearson, uji reliabilitas teknik alpha cronbach, uji hipotesis path analysis dan uji statistik (t), serta transformasi data skala likert dengan alat ukur method of succesive interval. Populasi adalah pegawai rumah sakit sebanyak 1.072 orang dan sampel sebanyak 92 orang yang ditentukan dengan teknik stratified random sampling. Data dikumpulkan dengan wawancara …

Determinan Kepatuhan Bidan Di Desa Terhadap Standar Antenatal Care, Guspianto Guspianto

Kesmas

Upaya menurunkan kematian ibu menjadi prioritas utama program pembangunan kesehatan nasional. Pelayanan antenatal care (ANC) menjadi bagian dari “Empat Pilar Safe Motherhood” sebagai kebijakan Kementerian Kesehatan untuk mempercepat penurunan angka kematian ibu (AKI). Kualitas layanan ANC dari aspek kinerja bidan di desa diukur antara lain dengan parameter tingkat kepatuhan terhadap standar ANC dalam memberikan kepuasan kepada ibu hamil. Penelitian ini bertujuan untuk mengetahui berbagai faktor yang berhubungan dengan kepatuhan bidan di desa terhadap standar ANC. Desain penelitian cross sectional ini menggunakan data sekunder Dinas Kesehatan Kabupaten Muaro Jambi dengan sampel 165 bidan di desa. Penelitian ini menemukan tingkat kepatuhan bidan …

Social Support As A Determinant Of Health Related Quality Of Life In Breast Cancer Survivors In California, Faiza Rab

Electronic Thesis and Dissertation Repository

Objective:

To evaluate the relationship between perceived social support and HRQOL (physical and emotional) in low SES breast cancer survivors.

Methods:

A cross-sectional study design was used to measure perceived social support at 18 months and HRQOL at 3 years after breast cancer diagnosis using MOS SS and MOS SF-36, respectively. Multiple regression analyses were used to evaluate the relationship.

Results:

Menopause at the time of diagnosis, adjunct chemotherapy, adjunct radiation therapy, co-morbidities, treatment side effects and depression were negatively associated with PCS scores (p < 0.01). Treatment side effects, anxiety and depression were negatively associated with MCS scores (p < 0.01).

Conclusions:

Perceived social support was not associated with HRQOL in low SES breast cancer survivors …