Digital Commons Network^™

Double-Blind Randomised Trial Of Saline Solution For Gargling And Nasal Rinsing In Sars-Cov-2 Infection, Sebastian R Espinoza, Lexton Trauffler, Amir Shamshirsaz, Alireza Shamshirsaz, Andres Espinoza, Jimmy Espinoza, Alice O'Brien

Faculty, Staff and Student Publications

Background: Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Methods: Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days. The low-saline solutions contained 2.13 g of salt dissolved in eight ounces of warm water, while the high-saline solution contained six grams of …

The Role Of Social Health Insurance In Achieving Universal Health Coverage In Asia: A Systematic Review, Afaf Jauhar, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as …

Potential Of Right Ventricular Function Assessment With Echocardiography In Transcatheter Aortic Valve Replacement, Yoshihisa Morita, Taro Kariya, Michael Dougherty, Andrew Peters, Nicholas Ruggiero

Division of Cardiology Faculty Papers

BACKGROUND: Right ventricular (RV) function assessment by echocardiography can be challenging due to its complex morphology. Also, increasing use of sedation rather than general anesthesia for transfemoral approach transcatheter aortic valve replacement (TAVR) reduces the need for intraoperative transesophageal echocardiography (TEE). Recent clinical studies have demonstrated the importance of 3-dimensional (3D) echocardiography and a longitudinal strain for RV function assessment. In this study, we compared RV function echocardiographic assessment methodologies in TAVR and investigated its clinical utility.

METHODS: This was a prospective, observational study of TAVR at a large academic hospital. Inclusion criteria were adult patients undergoing TAVR requiring intraoperative …

From Surviving To Thriving: Key Considerations For Weight Control Across Diverse Cancer Survivorship Populations, Justin C. Brown, Marlyn Allicock, Carmina G. Valle, Tanya Agurs-Collins

School of Medicine Faculty Publications

BACKGROUND: Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of dying from at least 16 types of cancer. The prevalence of obesity has increased more rapidly in cancer survivors compared with the general population. Tailored weight management strategies are needed to improve prognosis and health outcomes in the growing population of cancer survivors. However, certain cancer survivor population subgroups require unique consideration when developing weight management strategies. METHODS: In a symposium convened by The Obesity Society during ObesityWeek 2023 titled "From Surviving to Thriving: Key Considerations for Weight Control Across Diverse Cancer Survivorship Populations," …

Factors Affecting Waiting Times To Enter Opioid Use Disorder Treatment In The United States With A Particular Focus On Potential Biological Sex Disparity, Stanley Nkemjika, Kenneth Oforeh, Connie Olwit, Olaniyi Olayinka, Terence Tumenta

Department of Psychiatry and Human Behavior Faculty Papers

AIM: Opioid use disorder (OUD) is the problematic use of licit or illicit opioids. Thus far, the literature on biological sex differences in accessing treatment is scarce. Hence, we hypothesize that biological sex has a moderating effect on OUD treatment accessibility. We aim to explore biological sex differences in treatment disparities and its role in wait time to enter OUD treatment.

METHOD: Using the 2018 Treatment Episode Data Set Discharge, the national sample representative of OUD patients in the substance use disorder treatment facilities within the 50 states of the United States was 382,547. Univariate and multivariable logistic analysis of …

Development And Evaluation Of An Implementation Strategy To Increase Hpv Vaccination Among Underserved Youth Across Texas: A Protocol Paper, Paula M Cuccaro, Jihye Choi, Lara S Savas, Efrat K Gabay, Mayra Aguilar Mcbride, Amy Montelongo Eldridge, Timothy J Walker

Faculty, Staff and Student Publications

BACKGROUND: All for Them is a theory-based and evidence-informed multilevel, multicomponent program delivered through schools to increase HPV vaccination among medically underserved youth across Texas. Given the potential logistical challenges of program implementation, understanding how to best support the implementation and sustainment of the program is critical. The overall goals of this study are twofold: 1) develop a multifaceted implementation strategy, Implementing All for Them (IM-AFT); and 2) evaluate the impact of IM-AFT on implementation outcomes for schools and healthcare providers to successfully implement All for Them in their respective settings.

METHODS: This study is underpinned by a comprehensive and …

Challenges And Opportunities In Implementing And Enforcing India’S Loose Cigarette Sales Ban: A Qualitative Stakeholder Analysis, Mayank Sakhuja, Daniela B. Friedman Ph.D., Mark M. Macauda Phd, Mph, James R. Hebert Scd, Mangesh S. Pednekar, Prakash C. Gupta, James F. Thrasher Ph.D., Ma, Ms

Faculty Publications

Introduction Several Indian states have banned the sale of loose cigarettes, and India is considering a national ban. This study examines the perceptions of policymakers, implementers, and law enforcement officials regarding the implementation and enforcement of this ban. Methods Between May–October 2022, we conducted in-depth interviews with 26 key stakeholders involved in tobacco control in two Indian cities, Delhi (where the ban was not implemented) and Mumbai (where the ban was in effect). Participants included representatives from various government departments such as police, municipal corporations, FDA, health, and civil society organizations / NGOs such as Vital Strategies, World Health Organization, …

Effect Of Improving Food Security On Parenting Practices And Caregiver–Adolescent Relationships: Qualitative Findings Of An Income-Generating Agricultural Intervention In Rural Kenya, Maricianah A. Onono, Lila Sheira, Edward A. Frongillo Jr., Gladys Odhiambo, Pauline Wekesa, Amy Conroy, Elizabeth A. Bukusi, Craig R. Cohen, Sheri D. Weiser

Faculty Publications

Background

Despite the recognised links between food insecurity and parenting, few studies have evaluated the perceived impacts of livelihood or food security interventions on parental practices, intra-household functioning, adolescent behaviour and psychosocial outcomes in HIV-affected households in sub-Saharan Africa.

Aims

The study aimed to understand the perceived effects of food security on parenting practices and how this was experienced by both adolescent girls (aged 13–19 years) and their caregivers in rural Kenya.

Method

We conducted semi-structured, individual interviews with 62 caregiver–adolescent dyads who were participants in the adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a …

Improving Pediatric Magnetic Resonance Imaging Safety By Enhanced Non-Technical Skills And Team Collaboration, Masashi Uramatsu, Hidekuni Takahashi, Paul Barach, Yoshikazu Fujisawa, Megumi Takahashi, Shiro Mishima, Gaku Yamanaka

College of Population Health Faculty Papers

BACKGROUND: Safe pediatric magnetic resonance imaging (MRI) ideally relies on non-sedative techniques, as avoiding risky sedation is inherently safer. However, in practice, sedation often becomes unavoidable, particularly for younger children or those with anxiety, to ensure motion-free, high-quality imaging. This narrative review explores the current practices and proposes strategies to enhance safety in pediatric MRI examinations.

METHODS: We identified and analyzed 247 studies addressing various aspects of pediatric MRI safety, including sedation protocols, patient monitoring, and team-based management approaches.

RESULTS: Safe sedation requires careful drug selection tailored to individual needs, continuous monitoring, and robust emergency preparedness. While efforts are underway …

Impact Of American Thyroid Association's Revised Cancer Management Guidelines On Thyroid Cancer Incidence Trends: A Retrospective Cohort Study, 2000-2020, Pierre Fwelo, Natalia I Heredia, Ruosha Li, Ayrton Bangolo, Vignesh K Nagesh, Simcha Weissman, Xianglin L Du

Faculty, Staff and Student Publications

Background: The past four decades have seen a steady increase in thyroid cancer in the United States (US). This study investigated the impact of the American Thyroid Association (ATA)'s revised cancer management guidelines on thyroid cancer incidence trends and how the trends varied by socioeconomic, histologic, geographic, and racial and ethnic characteristics from 2000 to 2020.

Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER) database to identify thyroid cancer cases diagnosed among US patients between 2000 and 2020. We employed joinpoint regression software to fit, assess, and compare thyroid cancer incidence trends over time stratified by …

Conceptualizing Self-Reported Adverse Childhood Experiences: From Epidemiologic Exposure To Psychometric Latent Variable, Marianna D. Lanoue, Richard W. Hass

College of Population Health Faculty Papers

In this paper, we apply a measurement science perspective to explore both the epidemiologic and psychometric frameworks for the conceptualization, operationalization and assessment of self-reported adverse childhood experiences (srACEs). The epidemiologic paradigm suggests that srACEs are 'exposures', while the psychometric paradigm views responses on srACEs instrumentation as 'indicators'. It is the central premise of this paper that srACEs cannot be both exposures and indicators of scales. We review issues of reliability and validity from both perspectives, examine the degree of agreement between objective and subjective reports of childhood maltreatment and the implications of poor agreement, and conclude that the for …

Health Literacy On Physical Therapy Among Senior Citizens With Physical Disability And Community Health Workers, Kriza G. Ganotisi, Faye Angelene J. Barangay, Andrew A. Galang, Wina Frances Q. Lazaro, Christopher U. Rivera, Ryan Dean T. Sucgang

Philippine Journal of Physical Therapy

Introduction. This study was conducted to determine the health literacy on physical therapy (PT) among senior citizens with physical disability and community health workers (CHWs). Specifically, it identified the sociodemographic profile of the CHWs and senior citizens with physical disability, their extent of health literacy on PT as to prose, document and numeracy and how health policies, availability of PT programs, and available equipment and facilities for the rendition of PT services affect their health literacy.

Methods. This study employed a descriptive research design. The respondents of the study involved 18 CHWs and 29 senior citizens. It was conducted in …

Improved Adherence To Lipid Screening In The Pediatric Cardiology Clinic: A Quality Improvement Project, Rachel Magnan, Thomas Murphy, Lauren Rosenthal, Aparna Prasad, Anjali Chelliah, Stuart Kaufman, Donna Timchak, Lindsey Mcphillips, Saira Siddiqui

Department of Pediatrics Faculty Papers

INTRODUCTION: Lipid screening identifies at-risk patients to facilitate cardiovascular risk reduction. National pediatric guidelines recommend universal lipid screening between 9-11 and 17-21 years of age. We aimed to improve adherence to lipid screening for all age-appropriate outpatient pediatric cardiology visits from a baseline of 35% to 90% between November 2021 and July 2023.

METHODS: All outpatient visits for patients 9-11 and 17-21 years were included. Chart review and an Epic electronic health record report identified patients screened, lipid test results, and need for further testing. A P-chart was generated. After establishing a baseline for 8 weeks, interventions, including an Epic …

Measurement Of Breast Artery Calcification Using An Artificial Intelligence Detection Model And Its Association With Major Adverse Cardiovascular Events, Suzanne Rose, Josette Hartnett, Zachary Estep, Daniyal Ameen, Shweta Karki, Edward Schuster, Rebecca Newman, David Hsi

Department of Medicine Faculty Papers

Breast artery calcification (BAC) obtained from standard mammographic images is currently under evaluation to stratify risk of major adverse cardiovascular events in women. Measuring BAC using artificial intelligence (AI) technology, we aimed to determine the relationship between BAC and coronary artery calcification (CAC) severity with Major Adverse Cardiac Events (MACE). This retrospective study included women who underwent chest computed tomography (CT) within one year of mammography. T-test assessed the associations between MACE and variables of interest (BAC versus MACE, CAC versus MACE). Risk differences were calculated to capture the difference in observed risk and reference groups. Chi-square tests and/or Fisher's …

Managing The Cost Of Services For People With Disabilities: An International Approach. Part I: Poland, Dana Pugh, Jaroslaw Richard Romaniuk

Faculty Scholarship

Introduction: The cost of care for people with disabilities is rising, whereas all forms of support for them are decreasing. Countries and communities develop different ways to serve the disabled. We examined the comprehensive state of care from the perspective of cost management of services for individuals with disabilities in Poland. Method: This paper is based on a review of relevant international literature, with a special focus on the situation in Poland. A keyword search was completed in both Polish- and English-language databases. Results: In Poland, people with disabilities usually live with their families, and specialized services are offered outside …

A Comprehensive Usability And Economic Analysis Of Heat-Related Wearable Technologies: Applications To Occupational Health, Ryan T. Cannady

Theses & Dissertations

The purpose of this research was to analyze the usability and economic considerations of real-time wearable technologies that are implemented in occupational settings to assess risk of heat stress and heat strain. The study population included current agriculture workers and Department of Energy (DOE), Environmental Management (EM) contractors. We employed a mixed-methods approach to comprehensively analyze the usability and economic considerations of heat-related technologies. Specifically, our approach assessed three distinct aspects the applications of these technologies in occupational settings to comprehensively address our research objective: (1) worker perceptions of heat-related wearable technologies, (2) field-based assessment of these heat-related wearable technologies, …

Bio-Preparedness In A Global Context: Multi-Site International Study Investigating Global Health Security Challenges In Egypt, Oman, And The United States, Rima M. Al Balushi

Theses & Dissertations

The COVID-19 pandemic exposed myriad vulnerabilities globally within public health systems, from inadequate bio-risk management in laboratories to overwhelming utilization of hospital resources and disparities in vaccine access and uptake. The Global Health Security Index (GHSI), which critically evaluates health security domains including health systems and risk environments, reports serious weaknesses in global health security. This dissertation aims to investigate critical aspects of global health security domains by examining factors impacting biosafety and biosecurity capacities in laboratories in Egypt, healthcare resource utilization in hospitals in Oman relating to acute respiratory infections (ARI), and COVID-19 vaccine uptake in the United States. …

Racial And Ethnic Differences In Outcomes Of Neonates Born At Less Than 30 Weeks' Gestation, 2018-2022, Nansi S. Boghossian, Marco Geraci, Erika M. Edwards, Jeffrey D. Horbar

Faculty Publications

Importance: Previous research has examined outcomes among very preterm newborns by the birthing parent's race and ethnicity, but knowledge about these trends during the COVID-19 pandemic is limited. Objective: To examine trends in outcomes among Black, Hispanic, and Asian preterm newborns compared with White preterm newborns. Design, Setting, and Participants: This cohort study (2018-2022) took place at 774 neonatal intensive care units in the Vermont Oxford Network. Participants were newborns born at 22 to 29 weeks' gestation. Exposure: Race and ethnicity. Main Outcomes and Measures: The primary outcomes were mortality and complications, including respiratory distress syndrome, necrotizing enterocolitis (NEC), early-onset …

Community, State And Professionalism: Negotiating The Experience Of Community Health Workers In The Provision Of Maternal And Child Health Services In Tanzania, Chakupewa Joseph Mpambije

Journal of Humanities and Social Sciences

Research on community health workers (CHWs) has been on the increase in the past decades in Tanzania, focusing on the provision of maternal and child health (MCH) services. While performing their tasks, CHWs work within three constructs: the community, the state, and their professionalism. However, as CHWs work within these constructs, there exists scanty literature which discourses their experiences within the realm of the community, the state and their professionalism. This review aimed to articulate how these constructs facilitate or inhibit CHWs’ performance in improving MCH services. It employed a scoping review method in which peer-reviewed articles and grey literature …

Unraveling The Relationship Between Sleep Behaviors And Physical Activity In The United States: Insights From 2015 To 2020 Nhanes Data, Deepali K Ernest, Bipin Singh, Fathimath Shamna, Elizabeth A Onugha, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Physical activity is an important component of metabolic health. However, little is known about the impact of specific types/intensities of physical activity on sleep health, especially among ethnically diverse populations. We examined the association of various sleep behaviors with moderate to vigorous work/recreational activity.

Methods: Self-reported data from the National Health and Nutrition Examination Survey 2015-2020 were cross-sectionally analyzed for a sample of 11,039 participants in the United States (U.S.). Weighted univariate logistic regressions determined unadjusted associations, while weighted multivariable regression models adjusting for age, sex, ethnicity, BMI categories, and socio-economic status assessed the multivariable associations with moderate and …

Deceased Donor Renal Allograft Utility In Adult Single And Multi-Organ Transplantation In The United States, Peter J. Altshuler, Adam S. Bodzin, Kenneth A. Andreoni, Pooja Singh, Anju Yadav, Jaime M. Glorioso, Ashesh P. Shah, Carlo B. Ramirez, Warren R. Maley, Adam M. Frank

Department of Surgery Faculty Papers

BACKGROUND: Deceased donor multiorgan transplants utilizing kidneys (MOTs) can improve outcomes for multiorgan recipients but reduces kidneys for chronic renal failure patients.

METHODS: We reviewed the Organ Procurement and Transplantation Network database from 2015 through 2019, for adult deceased donor kidney transplants. Recipients were classified as kidney transplant alone (KTA) (n = 62,252) or MOTs pancreas-kidney, simultaneous pancreas-kidney (n = 3,976), liver-kidney, simultaneous liver-kidney (n = 3,212), heart-kidney, simultaneous heart-kidney (n = 808), and "other"-kidney, simultaneous "other" kidney (n = 73).

RESULTS: Liver, heart, and lung-alone transplants were at least 7 times more frequent than their MOT correlate, whereas the …

Seasonal Pollen Increases Traffic Fatalities In The United States, Monica Deza

Population Health Research Brief Series

Traffic fatalities are the among the leading causes of death in the United States. Motor vehicle crash death rates have declined overall in the U.S. in recent decades, but there is substantial variation in rates across the country. Due to climate change, exposure to pollen has increased in various parts of the U.S. The antihistamine response triggered by pollen can result in poor physical and cognitive symptoms, thus impacting an individual’s ability to drive and increasing the risk of motor vehicle fatalities. This brief summarizes findings from a study that used data from the National Allergy Bureau (NAB) Pollen and …

Mental Health Care Disparities Among Us Pregnant Individuals In 2020–2021: A Cross-Sectional Study, Julisa Tindall, Monique J. Brown Ph.D., Mph, Peiyin Hung

Faculty Publications

Purpose

To examine maternal characteristics associated with perceived unmet mental health needs and mental health care settings, focusing on residential rurality and race/ethnicity.

Methods

This cross-sectional study analyzed self-reported unmet mental health needs and mental health care settings among 1097 pregnant respondents in the 2020–2021 National Survey on Drug Use and Health, incorporating the complex sampling weights for national representativeness.

Findings

Non-Hispanic Black pregnant individuals and those living in nonmetro rural areas reported lower odds of unmet mental health needs compared to those in large metro areas and non-Hispanic White individuals. Pregnant individuals in nonmetro rural areas and non-Hispanic other …

Pathways From Socioeconomic Factors To Major Cardiovascular Events Among Postmenopausal Veteran And Nonveteran Women: Findings From The Women's Health Initiative, Hind A Beydoun, May A Beydoun, Rebecca L Kinney, Simin Liu, Rona Yu, Matthew Allison, Robert B Wallace, Qian Xiao, Longjian Liu, Philippe Gradidge, Su Yon Jung, Hilary A Tindle, Shawna Follis, Robert Brunner, Jack Tsai

Faculty, Staff and Student Publications

BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.

METHODS AND RESULTS: A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which …

Total Organic Carbon Analysis Of Residual Contaminants In Bioreactor Equipment: A Cleaning Verification Study Using Surface Swabbing, Ciara E. Fitzpatrick, James J. Roche

SURE Journal: Science Undergraduate Research Experience Journal

Contamination is a major issue in the biopharmaceutical industry. Bioreactors must be meticulously cleaned to remove residual impurities and avoid cross-contamination. Cleaning validation is necessary to ensure residual contaminants are reduced to the lowest acceptable limits. Bacterial cells represent the paramount challenge in manufacturing equipment cleaning because they are composed of insoluble organic contaminants. Total organic carbon (TOC) analysis is a fast, highly sensitive, and inexpensive analytical technique commonly used to evaluate the approximate level of organic contamination.

A study was conducted to assess the effectiveness of cleaning procedures in the removal of contaminants from bioreactor equipment by measuring the …

The Doing, Being, Becoming, And Belonging Of Intergenerational Collective Occupations, Gladys Garcia, Jazminne Orozco-Arteaga

Fall 2024 OTD Capstone Symposium

Background: Older adults have been globally recognized as a vulnerable population. Literature has indicated that intergenerational engagement can decrease social isolation for older adults, but there is a gap in understanding intergenerational co-occupational engagement and how these engagements can improve quality of life and fulfillment of self-identity. The purpose of this qualitative research study was to generate knowledge of how relationships and occupations performed with individuals from a younger generation impacted sense of well-being. Through the lens of Doing, Being, Becoming and Belonging (Wilcock, 2006), the study sought to increase understanding of this lived experience to promote intergenerational practice within …

Reducing Detroit’S Heart Disease Risk: The Role Of Social Determinants Of Health And Health Behaviors, Caress A. Dean, Rebecca Milan, Maidah Raja, Swathi Radhakrishnan

Michigan Journal of Public Health

Introduction: The age-adjusted death rates related to heart disease have been increasing in Detroit, Michigan. Recognizing public health professionals' role in promoting and protecting community health, this study examined the relationship between cardiovascular health and health beliefs, behavior tracking, and social determinants of health among Detroit residents.

Methods: This cross-sectional study was guided by the World Health Organization's conceptual framework of social determinants of health, which classifies social determinants into structural (e.g., socioeconomic factors) and intermediary (e.g., behavioral factors) categories. From May 2019 to August 2021, 394 residents of Detroit were recruited to complete a survey about their …

Patient-Reported Functional Outcomes And Treatment-Related Regret In Hispanic And Spanish-Speaking Men Following Prostate Cancer Treatment, Andrea A. Lopez, Bashir Al Awamlh, Li-Ching Huang, Zhiguo Zhao, Tatsuki Koyama, Karen E. Hoffman, Christopher J. Wallis, Kerri Cavanaugh, Ruchika Talwar, Alicia K. Morgans, Michael Goodman, Ann S. Hamilton, Xiao-Cheng Wu, Jie Li, Brock B. O'Neil, David F. Penson, Daniel A. Barocas

School of Public Health Faculty Publications

OBJECTIVES: Compare functional outcomes and treatment-related regret over 10 years in Spanish- and English-speaking Hispanic men compared to non-Hispanic men following treatment of localized prostate cancer. METHODS AND MATERIALS: Data from a prospective cohort study of men with localized prostate cancer treated with active surveillance, radical prostatectomy or radiotherapy were used to examine the effect of survey language (Spanish speaking vs. English speaking) and ethnicity (Hispanic vs. non-Hispanic) on functional outcomes and treatment-related regret over 10 years. Outcomes were measured using validated questionaries adjusting for baseline patient and disease characteristics. RESULTS: A total of 770 men were included, 12% were …

Maternal Adverse Childhood Experiences And Infant Visual-Limbic White Matter Development, Catherine H. Demers, Benjamin L. Hankin, Mercedes Hoeflich Haase, Erin Todd, M. Camille Hoffman, C. Neill Epperson, Martin A. Styner, Elysia Poggi Davis

Psychology: Faculty Scholarship

Background

Maternal adverse childhood experiences (ACEs) are robust predictors of mental health for both the exposed individual and the next generation; however, the pathway through which such intergenerational risk is conferred remains unknown. The current study evaluated the association between maternal ACEs and infant brain development, including an a priori focus on circuits implicated in emotional and sensory processing.

Methods

The sample included 101 mother-infant dyads from a longitudinal study. Maternal ACEs were assessed with the Adverse Childhood Questionnaire dichotomized into low (0 or 1) and high (≥2) groups. White matter microstructure, as indexed by fractional anisotropy (FA), was assessed …

Does Physician-Hospital Vertical Integration Affect Hospital Output?, Soumya Upadhyay, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Background: Physician-hospital vertical integration is gaining steam but it is unclear how they affect hospital output.

Objective: To examine the direct impact of vertical integration on hospital output.

Design: A pooled design with 6-year data using linear regressions was used. Then, panel data design with hospital fixed effects was used.

Methods: We linked American Hospital Association data (2016-2021) with AHRQ Comparative Health System Performance Initiative’s Compendium (2018, 2020, 2021; 34 987 hospital-year observations) to develop new measures of vertical integration and assess its relationship with several measures of hospital output including annualized total admissions, total number of inpatients days, …