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Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina 2022 CUNY School of Public Health

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …


Using Machine Learning To Analyze Children’S Drawings As Indicators Of Mental Well-Being, Nicholas R. Lawrie 2022 University of San Francisco

Using Machine Learning To Analyze Children’S Drawings As Indicators Of Mental Well-Being, Nicholas R. Lawrie

Master's Theses

Human figure drawings are a well-studied diagnostic tool for emotional distress in children. Cleft lip/palate is one of the most common birth defects in the world, and has been shown to negatively impact emotional well-being in childhood which can have negative economic consequences in adulthood. Utilizing a dataset of human figure drawings from children in India and survey data on mental health, this paper will assess the impact of corrective surgery on mental health outcomes, as well as assess the validity of the drawing emotional indicators themselves. The results indicate that while the emotional indicators may not be valid in …


Hospital Costs Of Post-Operative Delirium: A Systematic Review, Md. Parvez Mosharaf, Khorshed Alam, Nicholas Ralph, Jeff Gow 2022 University of Rajshahi

Hospital Costs Of Post-Operative Delirium: A Systematic Review, Md. Parvez Mosharaf, Khorshed Alam, Nicholas Ralph, Jeff Gow

Journal of Perioperative Nursing

Aims: In this systematic review, the primary aim is to investigate the hospital cost burden attributed to post-operative delirium (POD). A secondary aim is to examine how patient length of stay (LOS) in hospital varies across the selected studies.

Background: POD is a common occurrence after major surgery and leads to serious medical complications. It is associated with increased morbidity and double the risk of mortality from surgery compared to non-delirious patients. POD increases patient LOS in hospital and increases the economic burden on patients and the health system.

Design: A systematic review was conducted.

Method: Published articles in English …


Population Aging And Healthcare Costs In China And Japan, Sean Brown 2022 University of Mississippi

Population Aging And Healthcare Costs In China And Japan, Sean Brown

Honors Theses

This study focuses on the natural demographic phenomenon known as population aging and its intersection with healthcare expenditures. Healthcare spending can be a major burden on a country’s economy, so it is important to accurately assess the connection between these two factors. Population aging occurs when countries reach a point in their demographic transitions characterized by declining total fertility rates and high life expectancy. This natural but undesirable position has implications for virtually all aspects of society, and all countries are trending towards aging. This study examines the cases of China and Japan in an effort to assess the validity …


Factors Influencing The Need For And Access To Ivf Treatment, Catherine Alapatt, Yoona Choe, Anthony Knepp, Shika Veera, Shawna M Rotoli 2022 Rowan University

Factors Influencing The Need For And Access To Ivf Treatment, Catherine Alapatt, Yoona Choe, Anthony Knepp, Shika Veera, Shawna M Rotoli

Rowan-Virtua Research Day

Infertility is defined as the inability for a couple to become pregnant after 12 months of regular unprotected sexual intercourse. Infertility can stem from an issue with the female reproductive tract, the male reproductive tract, or both. Individuals struggling with infertility seek medical assistance for a successful reproductive course. However, there are many aspects outside of pathology that may encourage or deter an individual to elect for medical assistance such as in vitro fertilization (IVF). In vitro fertilization is defined as a medical procedure in which an egg is fertilized outside the body. The increased usage of IVF demonstrates the …


The Effect Of Covid-19 On Depression In Hispanic Vs. Non-Hispanic Populations In South Jersey, Rana Cheikhali, Daniel Casal 2022 Rowan University

The Effect Of Covid-19 On Depression In Hispanic Vs. Non-Hispanic Populations In South Jersey, Rana Cheikhali, Daniel Casal

Rowan-Virtua Research Day

The COVID-19 pandemic has been challenging for Americans and the world as a whole. It has especially taken a toll on mental health. Studies show that the incidence of depression in the United States was three times greater during the pandemic compared to pre-pandemic times. One specific community in the United States that has been greatly affected by the pandemic is the Hispanic American community. Many Americans across the country have received federal surveys that aim to determine the social and economic impacts of COVID-19. Results revealed that the Hispanic population had the greatest rise in mental illness, with 40% …


Political, Racial, And Household Income Barriers For Access To Healthcare In Illinois Counties, Kennedy Bray '23 2022 Illinois Mathematics and Science Academy

Political, Racial, And Household Income Barriers For Access To Healthcare In Illinois Counties, Kennedy Bray '23

Student Publications & Research

Access to health care impacts many people throughout the United States, as it restricts their ability to solve their health concerns. People who have the highest risk of a lack of access include people who are uninsured, people a part of a specific social class, or people belonging to a specific political party. In a particular geographical region, these factors could lead to groups of people suffering because of circumstances that they cannot control in their region. In my project, I determine how better access to healthcare and the percentage of people insured are affected by a measurement of the …


True Price Of A Pack: Tobacco Expenditure And Height-For-Age In Indonesia, Madeline Helfer 2022 William & Mary

True Price Of A Pack: Tobacco Expenditure And Height-For-Age In Indonesia, Madeline Helfer

Undergraduate Honors Theses

While the negative impact of tobacco on the health of smokers is well known, the ways in which smoking impacts the health of the smoker’s children is less understood. This study explores whether tobacco expenditure increases the risk of stunting among children under the age of five in Indonesia, where smoking and stunting rates are among the highest in Southeast Asia. Given the severe income constraints faced by poor Indonesian households, large tobacco expenditure potentially “crowds-out” spending on nutrition, worsening the nutritional health of children in smoking households. To examine this relationship, I use a sample of children under the …


Economic Impact Of The Western Africa Ebola Outbreak--A Holistic Approach, Xufeng Liu 2022 William & Mary

Economic Impact Of The Western Africa Ebola Outbreak--A Holistic Approach, Xufeng Liu

Undergraduate Honors Theses

The 2014 Western Africa Ebola Epidemic was one of the most severe epidemics in the region’s history, creating considerable health and economic burdens on the affected countries. The first part of this paper relies on several macroeconomic databases from 2009 to 2019 to evaluate the aggregate economic impact of Ebola both in the short- and medium-run. We also use household surveys to assess the microeconomic effects of Ebola on employment and household non-farm enterprises (HNFE) at different phases of the outbreak in Sierra Leone. Our primary estimation method is the Difference-in-Differences approach with the canonical specification where we compare outcome …


Out-Of-Pocket Healthcare Costs And Undesirable Healthcare Expenditures, Cody Sanford Taylor 2022 William & Mary

Out-Of-Pocket Healthcare Costs And Undesirable Healthcare Expenditures, Cody Sanford Taylor

Undergraduate Honors Theses

Healthcare costs in the U.S. have risen over recent decades, and this issue was a focal point of the last several national election cycles. I investigate the relationship between out-of-pocket healthcare costs and incidences of catastrophic and impoverishing healthcare expenditure. I also explore whether other important factors, such as demographic, personal health, and those related to the healthcare system change the likelihood of such healthcare expenditures. Lastly, I use a difference in means method and logistic regressions to analyze the probability of incurring undesirable healthcare expenses and the impacts of relevant factors for certain subsections of the U.S. population. I …


Endodontic Management Of Mandibular First Molar With Four Roots - A Rare Case Report With Clinical Management Guidelines, Shaikh Shahbaz, Huma Iftekhar, Sharique Alam, Zehra Shavez 2022 Department of Conservative Dentistry & Endodontics, Aligarh Muslim University, Aligarh, India

Endodontic Management Of Mandibular First Molar With Four Roots - A Rare Case Report With Clinical Management Guidelines, Shaikh Shahbaz, Huma Iftekhar, Sharique Alam, Zehra Shavez

Journal of Dentistry Indonesia

Mandibular molar is usually two rooted with one mesial and one distal root. Additional roots are rare which requires accurate diagnosis and a methodical and scrupulous endodontic treatment. Objective: This paper aims to report the endodontic management of an unusual case of a mandibular permanent first molar with four roots (two mesial & two distal) and provide a clinical guideline to detect and manage these variant cases. Case report: A 15-year-old boy reported with a deep carious lesion in the lower left first molar (#36). The apical root contour of #36 on an intraoral periapical radiograph taken in different angulations …


Evaluation Of The Effect Of Two Polishing Techniques And Thermocycling Process On Surface Roughness, Hardness, And Color Stability Of Composites, Muhammet Fidan, Zeynep Dereli 2022 Department of Restorative Dentistry, Faculty of Dentistry, Usak University, Usak, Turkey

Evaluation Of The Effect Of Two Polishing Techniques And Thermocycling Process On Surface Roughness, Hardness, And Color Stability Of Composites, Muhammet Fidan, Zeynep Dereli

Journal of Dentistry Indonesia

Objectives: The aim of this study was to evaluate the effect of two polishing techniques and 10.000 thermocycles on the color stability, surface roughness, and hardness of two nanohybrid (Tetric N-Ceram, Escom100) and one bulkfill (Filtek) resin composites. Methods: A total of 60 specimens were prepared using three resin composites and 20 discs from each composite. Specimens for each composite were randomly divided into two different polishing groups (Optrapol rubber and Sof-Lex discs) (n=10). Surface roughness (Ra, μm), microhardness (VHN), and color change (ΔE00) values were measured pre- and post-thermocycling. Two-way analysis of variance (ANOVA) was used to evaluate …


Effect Of Brushing Time With A Whitening Dentifrice On Surface Roughness Of Anterior Composite Resins, Ahmet Hazar, Sinem Akgül, Sibel Koçak, Mustafa Murat Koçak 2022 Department of Restorative Dentistry, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey

Effect Of Brushing Time With A Whitening Dentifrice On Surface Roughness Of Anterior Composite Resins, Ahmet Hazar, Sinem Akgül, Sibel Koçak, Mustafa Murat Koçak

Journal of Dentistry Indonesia

Objectives: This study aimed to compare the surface roughness of three anterior composite resins with different filler size, rate, and shape after brushing for 5000, 10000, and 20000 cycles with a whitening dentifrice. Methods: 44 disk-shaped specimens of each material (5mm diameter, 2mm depth) G-aenial Anterior, Harmonize, Asteria were prepared and divided into four groups according to the brushing cycles (Initial, 5000, 10000, and 20000 cycles). Initial surface roughness values (Ra-values) were assessed using a profilometer and measurements were repeated after each brushing cycle. 4 specimens from each composite resin were observed by scanning electron microscopy before and after brushing. …


A Comparison Of Four Different Methods Of Prediction Of Mesiodistal Widths Of Unerupted Permanent Canines And Premolars, Waqar Jeelani, Washma Asad, Maheen Ahmed 2022 Department of Orthodontics, Faculty of Dentistry, Bakhtawar Amin Medical and Dental College, Multan, Pakistan

A Comparison Of Four Different Methods Of Prediction Of Mesiodistal Widths Of Unerupted Permanent Canines And Premolars, Waqar Jeelani, Washma Asad, Maheen Ahmed

Journal of Dentistry Indonesia

The success of orthodontic treatment depends upon the accurate assessment of mesiodistal widths of unerupted canines and premolars in mixed dentition stage. There are several methods available for mixed dentition analysis with dubious reliability in our population. Objective: To statistically develop new prediction equations for Pakistani subjects to predict the widths of unerupted upper canines and premolars (U345) and lower canine and premolars (L345) using mesiodistal widths of lower incisors (I1I2) and lower incisors and first molars (I1I2M1) and compare their performance with previously established methods of Moyers and Tanaka-Johnston. Methods: Study was conducted using the data from the dental …


Salivary Iga Depression In Drug-Influenced Gingival Enlargement Among Hypertensive Patients, Muhammad Annurdin Sabarudin, Haslina Taib, Wan Majdiah Wan Mohamad, Siti Lailatul Akmar Zainuddin, Wan Syamimee Wan Ghazali, Ahmad Azhar Misran 2022 Department of Periodontology and Community Oral Health, Faculty of Dentistry, Universiti Sains Islam Malaysia, Jalan Pandan Utama, Kuala Lumpur, Malaysia; School of Dental Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia

Salivary Iga Depression In Drug-Influenced Gingival Enlargement Among Hypertensive Patients, Muhammad Annurdin Sabarudin, Haslina Taib, Wan Majdiah Wan Mohamad, Siti Lailatul Akmar Zainuddin, Wan Syamimee Wan Ghazali, Ahmad Azhar Misran

Journal of Dentistry Indonesia

Drug-influenced gingival enlargement (DIGE) among hypertensive patients is commonly associated with antihypertensive drugs such as calcium channel blockers (CCBs). Immune response alteration is one of the proposed mechanisms for DIGE. Immunoglobulin A (IgA) in saliva which involves in defense mechanism was shown to be affected in patients with DIGE. Objective: This study aimed to determine the association of salivary IgA level with DIGE. Methods: This cross-sectional study comprised 47 hypertensive patients who had consumed antihypertensive drugs for at least 3 months. Twenty-one (44.7%) males and 26 (55.3%) females had participated in this study. Data was analyzed using SPSS version 26.0. …


Indie Illness: An Evaluation Of The Orphan Drug Act, Nicholas Castellanos 2022 University of Mississippi

Indie Illness: An Evaluation Of The Orphan Drug Act, Nicholas Castellanos

Honors Theses

The purpose of this study is to evaluate the Orphan Drug Act of 1983 by subtracting the cost of incentives for drug development from the estimated value created by each drug in the form of quality-adjusted life-year gains. Data regarding costs of incentives is retrieved from the FDA as well as a report released by the National Organization for Rare Disorders. Data regarding value created by each drug is retrieved from a Freedom of Information Act request to the FDA, the CEA registry, and a report released by the US Department of Health and Human Sciences. Sufficient data was available …


Trade Liberalization And The Social Determinants Of Health: A Case Study Of Nafta's Impact On Mexico From 1994 To 2005, Maria Trubetskaya 2022 University of Denver

Trade Liberalization And The Social Determinants Of Health: A Case Study Of Nafta's Impact On Mexico From 1994 To 2005, Maria Trubetskaya

Undergraduate Theses, Capstones, and Recitals

Given the increased transnationalization of borders and economic interdependence between countries in the Global North and South, it is imperative to address how these trends impact the health and well being of the populations involved. The conventional neoliberal economic framework, however, falls short in explaining these dynamics due to its overemphasis of proximal determinants of health as direct consequences of commodification and free market activities. In congruence with those theoretical limitations, there is a limited assessment of more distal determinants – the social determinants of health (SDOH) – that are arguably more consequential for health and are interrelated with the …


The Impact Of Afghan Opium Cultivation On The U.S. Opioid Epidemic, Zachary Wahab Cheek 2022 University of Nebraska-Lincoln

The Impact Of Afghan Opium Cultivation On The U.S. Opioid Epidemic, Zachary Wahab Cheek

UNL Student Research Days Posters, Undergraduate

I argue here that increases in Afghan opium cultivation, the most prolific in the world, has depressed American prescription opioid and heroin prices, thereby increasing abuse risk in U.S. addict populations and increasing death rates. Utilizing a two-stage regression model with a sparse dataset from several national and international sources, I find evidence that a one percent increase in Afghan opium production is associated with a 0.122 percent increase in prescription opioid overdose deaths, and a 0.367 percent increase in heroin overdose deaths. Assessing the 2001-2002 Taliban opium ban with an identification strategy, I find that in this timeframe prescription …


A Comparative Analysis Of Migrant Health Policies And Practices In The Us And Switzerland, Rebecca Mak 2022 SIT Study Abroad

A Comparative Analysis Of Migrant Health Policies And Practices In The Us And Switzerland, Rebecca Mak

Independent Study Project (ISP) Collection

Migrants compose a large proportion of the population in both the US and Switzerland. The social vulnerability of migrants has been well-established in literature, but few studies have attempted to compare healthcare policies and approaches that most effectively support migrant health using multiple measures.

To fill this gap in the literature, this study will comparatively analyze of the efficacy of US and Switzerland migrant health policies and services by assessing access to and quality of care for migrants in each country. Four main features of healthcare systems were analyzed: insurance policy, healthcare utilization, NCD outcomes, and patient perceptions of care. …


The Effects Of The Affordable Care Act Dependent Coverage Mandate On Parents’ Labor Market Outcomes, KIM, KOH Kanghyock 2022 Singapore Management University

The Effects Of The Affordable Care Act Dependent Coverage Mandate On Parents’ Labor Market Outcomes, Kim, Koh Kanghyock

Research Collection School Of Economics

We examine the labor market impacts of the Affordable Care Act dependent mandate (ACA-DM), which has significantly increased dependent children's health insurance coverage through parents’ employer-sponsored health benefits. Using data from the American Community Survey, we find that the ACA-DM reduced parents’ annual wages by about $2,600. However, the probability of employment and working hours only decreased marginally. The back-of-the-envelope calculation indicates that the magnitude of the estimated wage impact is similar to the increased insurance premium of a family plan due to the ACA-DM. These findings imply that a deadweight loss associated with the expansion of dependent health coverage …


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