Digital Commons Network^™

Examining The Impact Of A Health Course On Lifelong Learner Attitudes Toward Psychedelic And Entheogenic Substances, Dustin B. Larrazolo

Cal Poly Humboldt theses and projects

This study examined the impact of a three-week Osher Lifelong Learning Institute (OLLI) health course, “Far Out” Medicine: The Science and History of Psychedelics, on midlife and older adult learners’ knowledge, attitudes, and perspectives regarding psychedelic and entheogenic substances. Eleven midlife and older adults (ages 40 - 80; M = 59.0, SD = 15.35) completed matched pre- and post-course surveys assessing demographic characteristics, factual knowledge, attitudes, personal willingness, and social or policy views. The sample was highly educated (1 associate, 5 bachelor’s, 3 master’s, and 2 doctoral degrees) and demonstrated strong internal consistency and response convergence across repeated measures. …

All-Terrain Vehicle Injuries Among Youth: A Multidimensional Analysis Of Injury Patterns In West Virginia And Safety Laws Across High-Fatality States, Sabrina Chyann Beal

Graduate Theses, Dissertations, and Problem Reports (ETD)

All-terrain vehicles (ATVs) pose significant injury risks, particularly among youth. These powerful machines are widely used across recreational and rural settings. West Virginia consistently ranks among the top five states for ATV-related deaths and injuries. Safety equipment and requirements are often not followed nor enforced, causing children and adolescents to be the most vulnerable group because they tend to not wear safety equipment such as helmets, ride on roadways, carry passengers, and operate oversized ATVS. This study examined ATV injury patterns from the WVU Medicine Trauma Registry and ATV laws across the five states with the highest reported fatalities. This …

State Of The States: Blueprints For Building Age-Friendly Futures, Megan Stubbs-Richardson, Lauren E. Etheredge, Tockie V. Hemphill, Zaccheus J. Ahonle, Danielle K. Nadorff

Publications

Executive Summary:

Mississippi’s aging population growth mirrors national trends and suggests a need to establish equitable and sustainable age-friendly policies and programs. This report offers an overview of the best practices from age-friendly states, which can be adapted to meet unique challenges and opportunities for Mississippi’s aging population. We highlight five age-friendly policy areas that can improve Mississippi’s livability.

• Aging in Place: Best practices from California, Florida, and Massachusetts can be adapted to promote aging in place through structural changes to homes via universal design and home modifications, or through supportive housing programs and home care.

• Cross-Sector Collaboration: …

Beyond Diagnostic Thresholds: Measures Of The Maternal Cardiometabolic Health Continuum And Their Association With Placental Function, Elizabeth Cook Anderson

Dartmouth College Ph.D Dissertations

Diabetes and hypertension during pregnancy adversely impact maternal and offspring health. Altered placental function is hypothesized to be involved, but impacts of elevated glucose and blood pressure (BP) within the subclinical range are unknown. The objective of this thesis is to evaluate how elevated glucose and BP, above and below diagnostic thresholds, impact measures of placental development and function including gross morphology (Aim 1), histopathology (Aim 2), and maternal circulating miRNAs (Aim 3), many of which originate in the placenta. Gross morphology and histopathology data from the New Hampshire Birth Cohort Study were used for Aims 1 and 2, and …

Sars-Cov-2 Genomic Surveillance Using Self-Collected Saliva Specimens During Occupational Testing Programs, Andy T. Schnaubelt, David Brett-Major, Janet Williamson, Bailey Barcal, Julie Carstens, Ashley Peer, Michael R. Wiley, M. Jana Broadhurst

Journal Articles: Epidemiology

Continually emerging SARS-CoV-2 variants pose challenges to clinical and public health interventions, necessitating sustainable approaches to real-time variant monitoring. This case study describes an innovative SARS-CoV-2 screening and surveillance program that demonstrates the utility of sequencing-based variant monitoring using self-collected saliva specimens. We conducted saliva-based SARS-CoV-2 screening in occupational settings in Omaha, Nebraska from December 2021 through November 2022. 8,372 saliva specimens collected from 1,480 participants were tested for SARS-CoV-2 RNA by extraction-free PCR, with 334 positive samples referred for whole-genome sequencing analysis. Program utilization, quality metrics, and sequencing outputs were compared across sites. Specimen quality was high across program …

Understanding The Pathogenesis Of Uveitis In Ebola Virus Disease Survivors: An Observational Cohort And Cross-Sectional Study Protocol For Clinical, Molecular Virologic And Immunologic Characterisation, Caleb D. Hartley, Susanne Linderman, Tolulope Fashina, Laura Ward, Carolyn Drews-Botsch, Catherine Pratt, Sanjana Kuthyar, Alcides Filho Fernandes, Ye Huang, Charlene Choo, Nam Nguyen, Jessica Carag, Jill Morgan, Colleen S. Kraft, Angela L. Hewlett, David Brett-Major, John S. Schieffelin, Robert F. Garry, Donald Grant, Grant A. Justin, Christopher D. Conrady, Justine R. Smith, Brent R. Hayek, Shiama Balendra, Nisha Acharya, Thuy Doan, Anais Legand, Pierre Formenty, Xiankun Zeng, Ibrahim Conteh, Matthew Jusu Vandy, Lloyd Harrison-Williams, Jalikatu Mustapha, Zikan Koroma, Michael R. Wiley, Ian Crozier, Jean-Claude Mwanza, Jessica G. Shantha, Rafi Ahmed, Steven Yeh, Smile And Evict-Vr Investigator Study Groups

Journal Articles: Epidemiology

INTRODUCTION: The 2013-2016 Western African outbreak of the Ebola virus disease (EVD), the largest recorded outbreak since the discovery of Ebola virus (EBOV) in 1976, destabilised local health systems and left thousands of survivors at risk for postacute sequelae, including vision-threatening uveitis. In an EVD survivor with severe panuveitis, the detection of persistent EBOV in the aqueous humour, long after clearance of acute viremia, focused clinical and research attention on the host-EBOV interaction in the unique terrain of ocular immune privilege. Despite the recognition that uveitis is common and consequential in EVD survivors, our understanding of pathogenesis is extremely limited, …

Hpv Vaccination In The U.S. Midwest: Barriers And Facilitators Of Initiation And Completion In Adolescents And Young Adults, Kristyne D. Mansilla Dubon, Edward S. Peters, Shinobu Watanabe-Galloway, Abraham Degarege

Journal Articles: Epidemiology

Background/Objectives: HPV vaccination uptake among adolescents and young adults in the US remains low, and coverage in the Midwest falls short of the Healthy People 2030 goal of 80%. Methods: A cross-sectional survey of adolescents and young adults was conducted to identify facilitators and barriers to HPV vaccination uptake among adolescents and young adults in the Midwest. Results: Out of 1306 individuals aged 13-26 years, 397 (30.4%) were fully vaccinated (2-3 doses), 124 (9.5%) had received one dose, 324 (24.8%) were unvaccinated, and 461 (35.3%) were unsure of their vaccination status. Awareness of HPV vaccines (OR: 2.4, …

Psychological Impacts In Exercise Riders And Professional Jockeys Following Injury, Kelley M. Renner

Theses and Dissertations--Kinesiology and Health Promotion

One of the most well-known equestrian sports, horse racing, is not only a cornerstone of Kentucky’s economy, but also a vital part of its culture, with professional jockeys playing an essential role in the local communities and traditions that define the state. Despite its popularity and financial impact, mental health challenges within the sport have continually been shrouded in silence and ignored in research (Ball et al., 2007). Equally concerning is the high injury prevalence, and psychological impact of these injuries (e.g., psychological distress, depression, anxiety, loss of identity, and self-esteem (King et al., 2022; Losty et al., 2019; McConn-Palfreyman …

Improving Hpv Vaccine Rates For Aboriginal Young People Through A Social Media Campaign: An Interrupted Time Series, Natalie A. Strobel, Jocelyn Jones, Kim Gates, Simon L. Turner, Joanne E. Mckenzie, Daniel R. Mcaullay

Research outputs 2022 to 2026

Human papillomavirus (HPV) is a common sexually transmitted infection that can lead to HPV-related cancers such as cervical cancer and other cancers such as anal, vaginal, and penile cancer. HPV rarely produces symptoms and cannot be cured or treated; therefore, vaccination is essential to protect against HPV and HPV-related diseases. However, young Aboriginal and Torres Strait Islander (hereafter, respectfully, ‘Aboriginal’) people are not receiving their HPV vaccine dose, resulting in missed opportunities to be protected from HPV-related cancers. Health promotion is a critical way to empower people to take ownership over and control their health and is a core function …

Evaluating The Efficacy Of A Serious Game To Deliver Health Education About Invasive Meningococcal Disease: Clustered Randomized Controlled Equivalence Trial, Lauren Bloomfield, Julie Boston, Martin Masek, Lesley Andrew, Donna Barwood, Amanda Devine

Research outputs 2022 to 2026

Background: Invasive meningococcal disease (IMD) is a serious, vaccine-preventable infectious disease that can be life-threatening. Teaching adolescents about the early detection and prevention of IMD can be challenging in a school environment, with educators reporting they lack confidence or expertise to cover this in the classroom environment. Professional guest educators are an alternative to cover specialist topics such as IMD; however, time and resourcing constraints can mean that these educators are not always available. Serious games may be an alternative to face-to-face education, where complex health information may be delivered via self-directed gameplay. Objective: This study aims to develop a …

Effectiveness, Acceptability, And Cost-Effectiveness Of Digital Health Interventions For Diabetes Self-Management In Adults With Or Without Hypertension: An Umbrella Review Protocol, Min Zhang, Jiahui Ge, Xinrong Yu, Tian Wang, Fenglan Wang, Madalo Gloria Kalero Kuchawo, Li Ge

Research outputs 2022 to 2026

Objective: This review will synthesize evidence on the effectiveness, acceptability, and cost-effectiveness of digital health interventions in implementing and maintaining effective self-management among adults (≥ 18 years) with diabetes, with or without comorbid hypertension. Introduction: Diabetes and hypertension are becoming the most challenging global health burdens. Growing evidence underscores the effectiveness of digital health interventions for diabetes and hypertension. However, it is unclear whether these strategies can be recommended to improve diabetes self-management among adults with or without hypertension in primary health care. Inclusion criteria: We will include systematic reviews (with or without meta-analysis) examining the effectiveness, acceptability, and cost-effectiveness …

Enhancing Nutrition Information Utilisation, Confidence, And Role Legitimacy And Adequacy Among Early Childhood Education Professionals Through Evidence-Based Online Training, Ruth Wallace, Ros Sambell, Shih Ching Fu, Johnny Lo, Elizabeth J. Cook, Amanda Devine

Research outputs 2022 to 2026

This study evaluated the effectiveness of an online short course based on the Health Promoting Schools Framework and specifically designed for Early Childhood Education and Care (ECEC) professionals. The short course aimed to enhance ECEC professionals’ nutrition knowledge, confidence, role legitimacy and adequacy to model healthy behaviours, teach healthy food habits and create health-promoting environments. Participants (n = 116) working at Australian ECEC services were assigned to control (n = 62) or intervention (n = 54) groups. Both groups completed a pre-intervention survey. The intervention group accessed the four-week course and completed the post-intervention survey. The control group completed a …

Cause Of Death? -- It's Probably Not What's Reported On The Death Certificate, Lauren R. Roth

Lewis & Clark Law Review

In the age of big data, this country has a data problem—inaccurate and incomplete information in death certificates. The problem has long been hidden by the numbers reported—as have the people whose deaths go uncounted, but the COVID-19 pandemic unveiled the scope of the issue. Since the beginning of the pandemic, “excess deaths” (i.e., any deaths above the number predicted by existing mortality models) have increased significantly. Most of these excess deaths are likely attributable to COVID-19 because the decedent was never tested for COVID-19 or it was one of multiple factors contributing to their death. Other deaths are uncounted …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

Improving Nurse Knowledge And Attitudes Through Education On Integrative Pain Management In A Medical-Surgical Unit: A Quality Improvement Project, Samantha Hamilton

Master's Theses and Capstones

Abstract

Background: Pain management in medical-surgical microsystems is complex, with many patients experiencing acute and chronic pain that can be difficult to control. Nurses often receive limited continuing education on integrative and comprehensive pain management strategies, highlighting a need to improve their knowledge and attitudes toward evidence-based, multimodal approaches.

Local Problem: Nurses in this 38-bed medical-surgical microsystem identified a gap in education related to integrative pain management strategies. This may lead to a reliance on pharmacological interventions and missed opportunities for holistic, patient-centered care

Methods: A 25-day quality improvement project was conducted using an asynchronous educational PowerPoint on integrative …

Modeling Vaccination Strategies And Intervention Impacts On Infectious Disease Dynamics, Elizabeth B. Amona

Theses and Dissertations

This dissertation explores how mathematical and statistical modeling can inform vaccination strategies and evaluate the impact of interventions during infectious disease outbreaks. Motivated by the challenges observed during the COVID-19 pandemic, the research integrates compartmental modeling, Bayesian inference, and agent-based simulation to assess policy effectiveness and disease control across varying contexts. The first study develops a SEIRDV model that incorporates government interventions and vaccination rollout to examine COVID-19 dynamics in Qatar. A Bayesian approach is used to estimate parameters and compute time-varying transmission rates. The model captures shifts in transmission following policy changes and quantifies the reduction in deaths attributable …

The Impact Of Covid-19 Pandemic On Economic Convergence Between Developed And Developing Nations, Lucile Sabas, Williams Kwasi Peprah [email protected], Carmelita Troy, Quentin Sahly

Faculty Publications

This study investigates convergence between developed and developing countries’ GDP during the pre-COVID-19 era (1960-2019) and post-COVID-19 era (2020-2023) using World Bank data and the Augmented Dickey-Fuller (ADF) test. For the pre-COVID period, results show no significant convergence, with an ADF statistic of −1.78 and a P = 0.39, likely due to disparities in industrialization and governance. Similarly, post-COVID results (ADF statistic −1.2, P = 0.67) also suggest no convergence, possibly exacerbated by pandemic-related challenges. The study highlights that structural barriers and the pandemic have hindered economic convergence.

Formation, Operation, And Maintenance Of A Community Advisory Board For Research With Lgbtq+ Parents, Aubrey Jones, Olivia S. Yinger, Rachel H. Farr, Keisa Fallin-Bennett, Sabrina Beiring, Cassi Crouse, Carolyn Greenstrom

Transforming Communities

Community-engaged research is becoming increasingly popular to promote health equity. Objective: The purpose of this paper is to describe the formation, operation, and maintenance of a community advisory board (CAB) of LGBTQ+ parents and healthcare providers who work with LGBTQ+ parents. Method: Using Newman and colleagues outline, we describe the formation, operation, and maintenance phases of our CAB process. Inclusion criteria for CAB members is as follows, CAB members must be 18 years of age or older, live in the U.S., and (a) self-identify as LGBTQ+ and have had a child in the NICU more than five years prior to …

Association Between Knowledge, Attitude, And Practice On Dietary Fiber Intake And Body Mass Index Among Undergraduate Students In Universiti Kebangsaan Malaysia, Arimi Fitri Mat Ludin, Munirah Ismail, Mohd Sham Othman, Divya Vanoh, Chai Huoy Tyng, Irdina Ibrahim, Jasmine Lavang Surang, Muhammad Adam Jayiddin, Noor Afiifah Ibrahim, Nur Arina Shazrina Abdullah, Nur Athirah Harun, Nur Fatihah Rashidi, Lew Leong Chen

Makara Journal of Health Research

Background: A fiber-rich diet lowers the risk of various diseases by increasing fecal bulk, shortening intestinal transit time, and stimulating intestinal flora. This study examines the association between knowledge, attitude, and practice (KAP) regarding dietary fiber intake and body mass index (BMI) among Dentistry and Software Engineering undergraduates.

Methods: This cross-sectional study included 95 Dentistry and 92 Software Engineering students at the Universiti Kebangsaan Malaysia. The KAP questionnaire was analyzed for its reliability using Cronbach’s alpha and distributed through email.

Results: Most respondents had normal weight. The Software Engineering students had a higher percentage of overweight and …

Threat Of Hypercholesterolemia In Urban Adults And Its Associates: Evidence From A Community-Based Study, Ambika Rani Yadav, Priya Keshari

Makara Journal of Health Research

Background: Hypercholesterolemia is an abnormality of lipids. It is a crucial modifiable risk factor for cardiovascular diseases. There is a paucity of community-based studies on hypercholesterolemia in the adult population in India. Given this context, the study aims to assess the prevalence and spectrum of hypercholesterolemia, along with its associated factors, among adult residents of urban areas in Prayagraj district, Uttar Pradesh, India.

Methods: This community-based cross-sectional study was done on 536 urban adult subjects (30 to 59 years) of Prayagraj, India, selected by multistage sampling procedure. The predesigned and pretested interview schedule was used to obtain socio-demographic …

The Impact Of Immigrants On The Number And Type Of Births, Neset Gumusburun, Ergun Mendes

Makara Journal of Health Research

Background: Although cesarean section is a life-saving procedure in certain situations, it may result in complications for maternal and infant health when conducted, especially for nonmedical purposes. The civil war in Syria has significantly modified the demographic and ethnic structure of Turkey, which has affected the number and type of births occurring here. In this study, we aimed to determine the effect of the increasing Syrian refugee patient population on primary cesarean section rates in Kilis/Turkey.

Methods: In this retrospective cohort study, pregnant women who gave birth at the State Hospital in the Kilis province in Turkiye between …

Factors Affecting Early Marriage In Dau District, Malang Regency, Agus Tiyaningsih, Endyka Erye Frety, Rize Budi Amalia, Budi Prasetyo

Preventia: The Indonesian Journal of Public Health

Indonesia still in 8th largest early marriage rate in the world. Many factors cause early marriage to occur, therefore this study aims to analyze the factors that influence early marriage in Dau District, Malang Regency. To analyze the factors that influence early marriage in Dau District, Malang Regency. The design of this study was observational analytic use Cross Sectional approach. The population in this study were women who married in 2022 in Dau District of Malang Regency, amount 511 women and the sample were 60 women. The independent variables in this study are education, family income, surrounding cultural beliefs, peers, …

Strategy For Improving Smoking Cessation Services In Primary Health Care, Evita Rosdiana Hutapea, Risky Kusuma Hartono

Preventia: The Indonesian Journal of Public Health

Amidst the rising numbers of smokers in Indonesia and the increasing burden of smoking-related diseases on the country, the Smoking Cessation Services (SCS) still fail to operate optimally. The aim of this research is to develop a more effective strategy for the SCS model based on the challenges encountered during its implementation. The research method employed qualitative study with a case study approach. The research location was in Depok City, chosen as a national exemplary of SCS. Research period from February to May 2024. Data collection was conducted through in-depth interviews and observations at Community Health Centers who involved in …

Prevention Of Obesity In The Elderly Through Health Promotion Interventions: Literature Review, Miranda Gracia Salsabila, Ernawaty Ernawaty, Indah Berliana Fauziah

Preventia: The Indonesian Journal of Public Health

The incidence of obesity among the elderly is rising in many countries, including Indonesia. To address this issue, effective interventions are necessary to change lifestyle and dietary habits, such as through social marketing and health promotion initiatives for the elderly. Preventing obesity in this demographic through social marketing can involve educational campaigns, intervention programs, community empowerment, and collaboration with various stakeholders. This study aims to identify strategies to prevent obesity in the elderly through health promotion interventions. The study is a literature review following the PRISMA 2009 protocol. Articles were sourced from Google Scholar, ScienceDirect, and PubMed databases, focusing on …

Targeting Safety: Hazard Identification And Risk Assessment In The Work Of Wood Carving In Tunjungsekar, Malang City, Using The Hiradc Method, Resti Novita Sari, Awanda Putra Pratama, Maharani Rohma Hidayanti, Nadia Rosalinda, Nurmila Kurnia, Shalma Khoirun Nisa, Anita Sulistyorini

Preventia: The Indonesian Journal of Public Health

The furniture industry in Tunjungsekar Subdistrict has become one of the leading industrial centers in Malang City, successfully boosting the local economy by employing 90 percent of the workforce. However, this industry faces productivity challenges due to an ergonomically unfavorable work environment. Therefore, practical actions and in-depth analysis are needed to improve the work environment issues. This study aims to identify hazards and assess risks associated with the work of wood carving artisans in Tunjungsekar, Malang City, using the HIRADC (Hazard Identification, Risk Assessment, and Determining Control) method. Identification was carried out through direct observation and interviews with artisans, followed …

Relationship Between Personal Hygiene And Environmental Sanitation To The Presence Of Escherichia Coli Bacteria In Food, Erica Ardhana Fathimah Azzahra, Vivi Novianti, Muhammad Al-Irsyad

Preventia: The Indonesian Journal of Public Health

Food safety is one of the significant public health issues, especially in developing countries. The extraordinary incidence of food poisoning and a high number of cases of gastrointestinal infections in Malang City indicate infection with the bacteria that cause dysentery, namely E.coli. This study evaluated hygiene-sanitation practices at food stalls in Area Terusan Ambarawa Malang City. This study aimed to identify Escherichia coli bacteria in 11 food stalls and assess the relationship of environmental sanitation and personal hygiene of food handlers to the presence of E.coli. This study used a quantitative descriptive design with a cross-sectional approach, data collection using …

Analisis Situasi Masalah Kesehatan Penyakit Tidak Menular Di Kota Depok Tahun 2023, Elvi Nora Simanjuntak, Asri Adisasmita Prof, Hidayat Nuh Ghazali Djajuli

Jurnal Epidemiologi Kesehatan Indonesia

Indonesia faces one of the biggest health challenges stemming from non-communicable diseases (degenerative diseases). The incidence of this health problem has shone a spotlight on the international community of both modern and traditional societies in all parts of the world. The shift in lifestyle from traditional to modern living is one of the factors that has led to the high number of degenerative disease cases in Indonesia. Currently, the number of people sickened by these non-communicable diseases continues to increase even at a young age with stroke, heart disease, and diabetes. Depok City as one of the cities that has …

Factors Affecting The Adoption Of Malaria Interventions For Pregnant Women In Tanzania: Tanzania Demographic Health Survey 2022, Melisa Nyamukondiwa, Asri C. Adisasmita, Renti Mahkota, Same Betera

Jurnal Epidemiologi Kesehatan Indonesia

Tanzania is endemic to malaria and pregnant women due to their vulnerability are among the high-risk groups. The adoption of malaria interventions targeted to pregnant women is affected by a number of factors. A cross-sectional study using secondary data from Tanzania Demographic Health Survey (TDHS) for 2022 was used. A logistic regression was used for bivariate analysis to identify factors affecting the adoption of malaria interventions during pregnancy in Tanzania. Data from pregnant women between 15 to 49 years (N=1408) were analyzed in this study. Insecticide treated nets (ITNs) and intermittent preventive therapy in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) were the …

Faktor Yang Memengaruhi Kinerja Verifikasi Dokter Verifikator Internal Medis Dalam Proses Klaim Pasien Jaminan Kesehatan Nasional Di Rumah Sakit Cipto Mangunkusumo, Immanuel Natanael Tarigan, Puput Oktamianti, Ede Surya Darmawan

Jurnal Ekonomi Kesehatan Indonesia

Since the implementation of the National Health Insurance, hospitals must be able to manage JKN claims properly. One way to properly manage the situation is by employing a medical internal verification doctor. This study aims to determine the factors that influence the performance of medical internal verification doctor based on the percentage of claim eligibility that has been verified. The research was conducted using a case study method with a qualitative and quantitative approach. The study was conducted on 16 medical internal verification doctors using questionnaires and in-depth interviews. The results of the study found that the performance of medical …

Analisis Klaim Pending, Verifikasi Dan Audit Pascaklaim Jaminan Kesehatan Nasional, Anugrah Aulia Ulil Amri, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

The implementation of Indonesia’s National Health Insurance (JKN) poses new challenges for hospitals as service providers. Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, the program’s administrator, now routinely conducts post-claim verifications and audits after claims have been paid. This often results in claim adjustments or even full reversals of previously reimbursed amounts. This case study examines JKN claim management at a Type D General Hospital in 2022, focusing on pending claims, verification, and post-claim audits, using a systems theory framework. Key issues in pending claims include incomplete medical records (29%), insufficient supporting documents (24%), and coding errors (21%). Post-claim problems primarily …