Medicine and Health Sciences Commons^™

Pmh Connect, English (Greyscale For Printing), Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Implicit Racial Bias In Physicians: Racial Disparity In Opioid Prescriptions In United States Emergency Departments, Anjali Ta

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Over the past 30 years, a documented racial disparity in opioid prescriptions in U.S. emergency care departments has persisted despite overall prescription trends fluctuating throughout the rise and fall of the early 2000’s opioid epidemic. Consistently, Blacks and other minorities receive lower levels of opioid analgesics when presenting with conditions or characterizing pain levels similar to white patients. This study focuses on identifying the mechanisms of implicit racial bias, quantified by scores on the Implicit Bias Association Test (IAT), that influences physicians’ abilities to equitably assess and treat pain of racially diverse patient populations. Research has shown that physicians with …

Assessing Efficiency Of Public Health And Medical Care Provision In Oecd Countries After A Decade Of Reform, Yasar A. Ozcan, Jaya Khushalani

Health Administration Publications

The objective of this study was to examine the change in efficiency of health care systems of 34 OECD countries between 2000 and 2012, a period marked by significant health reform in most OECD countries. This paper uses a novel Dynamic Network Data Envelopment Analysis (DNDEA) model to analyze the efficiency of the public health system and the medical care system of these OECD countries independently along with assessing the efficiency of their overall health system. This helps understand the relative priorities for improving the overall health system. The data for this study was obtained from the OECD Health Facts …

Can Plan Recommendations Improve The Coverage Decisions Of Vulnerable Populations In Health Insurance Marketplaces?, Andrew J. Barnes, Yaniv Hanoch, Thomas Rice

Health Administration Publications

Objective

The Affordable Care Act’s marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool—plan recommendations—in improving marketplace decisions.

Study Setting

Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia.

Study Design

We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. …

Accountable Care Organizations And Transaction Cost Economics, Stephen S. Farnsworth Mick, Patrick D. Shay

Health Administration Publications

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of …

A Comparison Of A Multistate Inpatient Ehr Database To The Hcup Nationwide Inpatient Sample, Jonathan P. Deshazo, Mark A. Hoffman

Health Administration Publications

Background

The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data.

Methods

In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010.

Results

The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent …

A Comparison Of A Multistate Inpatient Ehr Database To The Hcup Nationwide Inpatient Sample, Jonathan P. Deshazo, Mark A. Hoffman

Health Administration Publications

Background

The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data.

Methods

In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010.

Results

The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent …

Procalcitonin Identifies Cell Injury, Not Bacterial Infection, In Acute Liver Failure, Jody A. Rule, Linda S. Hynan, Nahid Attar, Corron Sanders, William J. Korzun, William M. Lee, Acute Liver Failure Study Group

Health Administration Publications

Background

Because acute liver failure (ALF) patients share many clinical features with severe sepsis and septic shock, identifying bacterial infection clinically in ALF patients is challenging. Procalcitonin (PCT) has proven to be a useful marker in detecting bacterial infection. We sought to determine whether PCT discriminated between presence and absence of infection in patients with ALF.

Method

Retrospective analysis of data and samples of 115 ALF patients from the United States Acute Liver Failure Study Group randomly selected from 1863 patients were classified for disease severity and ALF etiology. Twenty uninfected chronic liver disease (CLD) subjects served as controls.

Results …

Barriers And Disparities In Emergency Medical Services 911 Calls For Stroke Symptoms In The United States Adult Population: 2009 Brfss Survey, Munseok Seo, Charles Begley, James R. Langabeer, Jami L. Dellifraine

Health Administration Publications

Introduction: This study examines barriers and disparities in the intentions of American citizens, when dealing with stroke symptoms, to call 911. This study hypothesizes that low socioeconomic populations are less likely to call 911 in response to stroke recognition. Methods: The study is a cross-sectional design analyzing data from the Centers for Disease Control’s 2009 Behavioral Risk Factor Surveillance Survey, collected through a telephone-based survey from 18 states and the District of Columbia. The study identified the 5 most evident stroke-warning symptoms based on those given by the American Stroke Association. We conducted appropriate weighting procedures to account for the …

A National Survey Of The Arrangements Managed-Care Plans Make With Physicians, Marsha R. Gold , Sc.D., Robert Hurley , Ph.D., Timothy Lake , M.P.P., Todd Ensor, Robert Berenson , M.D.

Health Administration Publications

Abstract

Background. Despite the growth of managed care in the United States, there is little information about the arrangements managed-care plans make with physicians.

Methods. In 1994 we surveyed by telephone 138 managed-care plans that were selected from 20 metropolitan areas nationwide. Of the 108 plans that responded, 29 were group-model or staff-model health maintenance organizations (HMOs), 50 were network or independentpractice–association (IPA) HMOs, and 29 were preferred-provider organizations (PPOs).

Results. Respondents from all three types of plan said they emphasized careful selection of physicians, although the group or staff HMOs tended to have more demanding requirements, …

Transmission Of Human Immunodeficiency Virus Type 1 From A Seronegative Organ And Tissue Donor, R.J. Simonds , M.D., Scott D. Holmberg M.D., M.P.H., Richard L. Hurwitz , M.D., Theresa R. Coleman , B.A., Scott Bottenfield , R.N., Lois J. Conley , M.T., M.P.H., Sherry H. Kohlenberg , M.H.A., Kenneth G. Castro , M.D., Beverley A. Dahan , B.A., Charles A. Schable , M.S., Mark A. Rayfield , Ph.D., Martha F. Rogers , M.D.

Health Administration Publications

Abstract

BACKGROUND

Since 1985, donors of organs or tissues for transplantation in the United States have been screened for human immunodeficiency virus type 1 (HIV-1), and more than 60,000 organs and 1 million tissues have been transplanted. We describe a case of transmission of HIV-1 by transplantation of organs and tissues procured between the time the donor became infected and the appearance of antibodies. The donor was a 22-year-old man who died 32 hours after a gunshot wound; he had no known risk factors for HIV-1 infection and was seronegative.

METHODS

We reviewed the processing and distribution of all the …