Medicine and Health Sciences Commons^™

Testing Cost Containment Of Future Healthcare With Maintained Or Improved Quality—The Costcares Project, Karl Swedberg, Desmond Cawley, Inger Ekman, Heather L. Rogers, Darijana Antonic, Daiga Behmane, Ida Björkman Ida Björkman, Nicky Britten, Sandra C. Buttigieg, Vivienne Byers, Mats Börjesson, Kirsten Corazzini, Andreas Fors, Bradi Granger, Boban Joksimoski, Boban Joksimoski, Roman Lewandowski, Virgilijus Sakalauskas, Einav Srulovici, Jan Törnell, Sara Wallström, Axel Wolf, Helen M. Lloyd

Other resources

Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies.

The Relationship Between Insurance And Health Outcomes Of Diabetes Mellitus Patients In Maryland: A Retrospective Archival Study, Soo-Hoon Lee, Samuel L. Brown, Andrew A. Bennett

Management Faculty Publications

Background

Past studies examining the health outcomes of diabetes mellitus (DM) patients found that social determinants of health disparities were associated with variabilities in health outcomes. However, improving access to healthcare, such as health insurance, should mitigate negative health outcomes. The aim of the study was to explore the association between four types of health insurance, namely, Medicare Fee-For-Service (FFS), Medicare Managed Care (MC), Private FFS, and Private MC plans, and the health outcomes of DM patients, controlling for patients’ social determinants of health.

Methods

This is a retrospective cross-sectional archival record study to explore the relationships between types of …

04-06-2021 Hsc Committee, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Disparities In The 2009 Swine Flu Pandemic And Covid-19: A Literature Review, Yusuf Amawi

Honors Undergraduate Theses

The purpose of this thesis was to identify causes of disparities in affliction (infection) and mortality for minority populations (Blacks, Hispanics, Asians, and American Indian/Alaskan Natives) during the Swine Flu (H1N1) and COVID-19 (Sars-Cov-2) Pandemics. A literature review was conducted gathering peer-reviewed journal articles related to racial and socioeconomic disparities in affliction and mortality during both pandemics. The model of Blumenshine et al. (2008) was used as a guide for the analysis of this thesis, and measures of exposure, susceptibility, and treatment were hypothesized as causes for the disparities experienced by the minority populations during the two pandemics. Ultimately, it …

Medical Expenditures And Health Care Utilization: A Comparison Among U.S. Adult Tobacco Consumers (I.E. Never Tobacco Users, Cigarette Smokers And Smokeless Tobacco Users), Raheema S. Muhammad

Theses and Dissertations

Introduction

Cigarette smoking poses a great economic cost on the U.S. health care system by incurring high health care expenditure and health care utilization in the adult population. Although there is a sufficient amount of information on the health care cost associated with cigarette smoking there is a gap in how other forms of tobacco use may impact healthcare expenditures and utilization in comparison to cigarette smoking. The main objectives of this study were: 1) to estimate and compare health care expenditure and health care utilization across different tobacco use groups using nationally representative data 2) to estimate and compare …

Understanding Willingness Towards Deprescribing Among Older Adults With Osteoporosis, Queenie Paltanwale

Electronic Theses and Dissertations

Objectives: To describe and identify the socio-behavioral factors predicting willingness towards deprescribing among older adults with osteoporosis.Design, Setting, and Participants: For this population-based survey study of US Medicare beneficiaries, data was obtained from the Medication Attitudes Module distributed to the participants in Round 6 (2015) of the National Health and Aging Trends Study. Our study population consisted to respondents who were diagnosed with osteoporosis in round 6 or earlier and who responded to the Medication Attitude Module. Main outcome and Measures: Response to the statement “I would like to reduce the number of medicines I am taking” was the main …

Go Talk To Your Employee: A Sequential Mediation Analysis Of Leader Communication Frequency And Employee Turnover Intent, Max Weaver

Electronic Theses and Dissertations

Employee turnover has significant negative costs to healthcare organizations. While leadership communication styles and quality have been empirically supported to reduce turnover intentions, our understanding of specific modalities of leader intervention is not well understood. This paper sought to understand how the specific act of communication frequency reduces turnover. Through the lens of Leader-Member Exchange (LMX) and role dynamic theories, mediating effects of LMX quality and job satisfaction were investigated to further understand this proposed relationship in a sample of healthcare workers in the Midwest/US. Results indicate that communication frequency was negatively related to turnover intent. Furthermore, while LMX and …

Servqual Measurement In A Healthcare Setting: Before And After Corrective Strategy Implementation, Jerome Christia, Aaron Ard, Lorraine Runion

Atlantic Marketing Journal

In the United States, the most dominant industry is services, yielding the highest volume of total employment and gross domestic product. Due to this insight, academics and business professionals continue to research and apply strategies to achieve distinctive competitive advantages in the services arena. The steady growth and increasing significance of the service sector in the United States and other developed markets has resulted in a sizeable body of related research addressing a variety of issues such as service quality and its characteristics. Healthcare is an impactful service industry that has received a considerable amount of attention. In the healthcare …

Medical Practitioners’ Intention To Use Secure Electronic Medical Records In Healthcare Organizations, Omar Enrique Sangurima

Walden Dissertations and Doctoral Studies

Medical practitioners have difficulty fully implementing secure electronic medical records (EMRs). Clinicians and medical technologists alike need to identify motivational factors behind secure EMR implementation to assure the safety of patient data. Grounded in the unified theory of acceptance and use of technology model, the purpose of this quantitative, correlational study was to examine the relationship between medical practitioners’ perceptions of performance expectancy, effort expectancy, social influence, facilitating conditions, and the intention to use secure EMRs in healthcare organizations. Survey data (N = 126) were collected from medical practitioners from the northeastern United States. The results of the multiple regression …

Synthesized Grounded Theory Expansion Of The Quadruple Aim In Acute Care Nursing, O. Ann Ann Fuller

Walden Dissertations and Doctoral Studies

AbstractConflation of moral and compassionate healthcare within the business model that is focused on customer service, disempowers, dehumanizes, and destabilizes nursing as well as the financial stability of healthcare. The purpose of this research was to determine nurses’ perceptions of how their work environment supported or contradicted a potential expansion of the quadruple aim. The quadruple aim was the primary conceptual framework for this research. The overarching research question was about how the environment of care supports professional nurses’ provision of high-quality person- centered care and bolsters meaningful and purposeful careers. The synthesized grounded theory methodology was used to collect …

Exploring Quality Management Strategies To Mitigate Culture Shock Among Cochlear Implant Users, Victor Mulume' Ambila

Walden Dissertations and Doctoral Studies

AbstractAfter the cochlear implant (CI) activation period and therapy, adult CI users who travel overseas encounter culture shock factors that paralyze their coping capability, which need normalization through management strategies during the post-cochlear-implantation process (PCIP). In the structure of the conceptual framework, a plan is presented for addressing the management strategy. An integrated system of product-process-service-care portrays the product as an active implant within an individual bearer fostering a CI user’s physical, physiological, and psychological traits. The problematic aspects alter the end users’ coping capability in an unfamiliar host environment abroad. The qualitative research approach used was a single case …

Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher

Walden Dissertations and Doctoral Studies

In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …

The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager

Walden Dissertations and Doctoral Studies

Preventive health care screening plays an essential role in reducing chronic diseases and mortality rates; yet, even as health care access has increased, African American men’s utilization of preventive screenings remains low in rural areas. The purpose of this qualitative case study was to investigate why African American men are not utilizing preventive care services and ascertaining the impact that social determinants may have on their utilization of these services. The theoretical framework of this research study comprised the social-ecological modal and health belief model to investigate the barriers to preventive care utilization in the African American community. Twelve African …

05-04-2021 Hsc Committee Meeting Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

10-12-2021 Hsc Committee Meeting Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

02-09-2021 Hsc Commmittee Meeting, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

03-08-2022 Hsc Committee, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Blue Light And Adult Sleep Outcomes, Andrew Caddas

Undergraduate Distinction Papers

This study investigated the effects blue light from self-luminous devices has on adult sleeping patterns. We investigated sleep quality and duration qualitatively with a randomized, double-blind, cross-over, placebo-controlled design with a wash-out period. Participants wore blue light blocking lenses or placebo lenses whenever they were using a self-luminous device throughout each day for one week. Each morning, participants filled out a survey to report their number of hours slept, time to fall asleep, and amount of time spent on self-luminous devices. Participants took the Pittsburgh Insomnia Rating Scale (PIRS) at the end of the one week trial (See Appendix A). …

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. …

Implementation Of Community Health Worker Education Toolkit To Promote Compliance In Managed Care Organization, Lamonica Johnson

DNP Scholarly Projects

Community health workers provide case management and care coordination services to high-risk members enrolled in Louisiana Department of Health’s Medicaid program. Centers for Medicare and Medicaid Services require states entering contracts with managed care organizations to conduct external quality reviews by an independent External Quality Review Organization. Healthcare Effectiveness Data and Information Set are quality metrics managed by the National Committee for Quality Assurance. These metrics are reported annually and required by Louisiana Department of Health. Community health workers are required to demonstrate quality accreditation and meet state specific requirement compliance through documentation. The aim of this project was to …

Improving Employee Engagement On An Inpatient Unit: A Quality Improvement Project, Holly Mccormack

DNP Scholarly Projects

BACKGROUND: Engaged employees are paramount to the success of an organization. They are more invested in their organization and the unit on which they work. This investment in the organization results in higher patient satisfaction and safety, less staff turnover, and improved quality. According to the literature, generational differences may be necessary to consider when improving employee engagement. To successfully lead a multigenerational workforce, nurse leaders should consider these differences and incorporate them into their strategic plan for employee engagement.

METHODS: A pilot survey was conducted on a medical-surgical unit to assess a perceived lack of engagement. Subsequently, work engagement …

The Lived Experiences Of African American Nurses In South Carolina Emergency Rooms, Debra A. Dixon

Walden Dissertations and Doctoral Studies

The underrepresentation of African American (AA) nurses in South Carolina (SC) emergency rooms (ERs) may affect quality patient care for AAs and all other patients in culturally diverse populations. This qualitative interpretive (hermeneutic) phenomenological study explored the lived experiences of AA nurses in several SC ERs concerning quality patient care in culturally diverse populations. Herzberg's two-factor theory and Maslow's hierarchy of needs theory framed the study. The research question investigated the lived experiences of AA ER nurses in SC ERs concerning quality patient care in culturally diverse populations. Interpretive phenomenology was used to gain insight from a sample of 17 …

Relationship Between Social Support And Childhood Trauma On Resilience, Carol Krieger

Walden Dissertations and Doctoral Studies

People who have not overcome childhood trauma and who have developed mental illnesses have difficulties dealing with life challenges. The purpose of this quantitative study used a correlational design to test any relationship between childhood trauma experience levels and resilience against life challenges in adulthood. The theoretical framework used for this study was Barnes’ social support theory. Data were collected from 104 participants over a 7-week period. Participants voluntarily answered the ACE questionnaire, 2-way support scale, and resilience scale. Key results indicate that people with mental illness who receive social support are positive impacted by that support. Receiving adequate levels …

Comparative Analysis Of Systemic Lupus Erythematosus Support Group Type On Quality Of Life, Mary Louise Giles

Walden Dissertations and Doctoral Studies

When individuals are diagnosed with systemic lupus erythematosus (SLE), they tend to go through emotional, psychological, and physical anguish that requires support. Studies have shown that a support group can provide SLE patients with an outlet in which they can share firsthand feelings and experiences and receive emotional support but it is not known if how the individual with SLE accesses online or face to face support makes a difference. The purpose of this study, guided by the Chronic Care Model, was to determine if there were differences in quality of life (QoL) for persons with SLE participating in an …

Creating A Pain Management Clinical Practice Guideline For Hospice Patients, Tiffany Ann Bowland

Walden Dissertations and Doctoral Studies

Current evidence-based research shows that pain in hospice patients is a growing problem. A gap in practice was identified as the current clinical practice guideline (CPG) in a hospice center in South Carolina was outdated and not being employed. A literature review revealed that updated CPGs provide better outcomes in pain management for end-of-life care. The project answered the practice-focused question: In the context of hospice, what are current evidence-based strategies for managing pain. The Stettler model and Kolcaba’s comfort theory guided the development of the CPG. Three nurse case managers and two physicians participated in the creation of CPG. …

The Impact Of Inpatient Boarding In North Carolina Emergency Departments, Miracle Howard

Walden Dissertations and Doctoral Studies

Currently, emergency department overcrowding has negatively impacted hospitals' financial, operational, and organizational performance globally. A contributing factor to emergency department overcrowding includes the delay of the throughput process for patients who have a time-sensitive diagnosis and are admitted to the emergency department. This causes adverse hospital outcomes such as longer length of stays and increase hospitalization cost. This study utilized secondary data to address a relationship between admitted patients who have time-sensitive diagnoses such as chest pain and chronic obstructive pulmonary disease within North Carolina emergency departments and length of stay, utilization of services, and overall hospital cost. The conceptual …

Emergency Department Utilization And Length Of Stay Among Sickle Cell Patients, Rushali Naik

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) utilize the emergency department (ED) frequently due to limited access to adult health care providers. Few providers are knowledgeable about caring for patients with sickle cell disease. This quantitative study’s purpose and research questions addressed whether there was a correlation between ED utilization and ED length of stay (LOS) pre- and post-enrollment in an adult comprehensive sickle cell clinic between the years of 2012 and 2017. The Donabedian framework was used to examine the structure, process, and outcomes related to the benefits of care in a sickle cell center. The independent variables of pre- …

Understanding Perspectives Of Clinical And Non-Clinical Healthcare Administrators On Culture And Diversity In The Healthcare Workplace, Katherine Counts

Theses and Dissertations--Community & Leadership Development

The racial and ethnic composition of the U.S. population is becoming increasingly more diverse. The 2010 U.S. Census reported a 29% increase in minority groups other than non-Hispanic Whites. In response to these changing demographics, healthcare organizations have struggled to keep pace with these trends in their hiring of a diverse staff. Healthcare leaders appear to be lagging in their efforts to make adequate changes to increase diversity in their organizations. What factors may be contributing to this inequity? One possible explanation is a limited knowledge of healthcare leaders regarding culture and diversity within the workplace. To this end, this …

Large Scale Organizational Intervention To Improve Emergency Department Throughput In A Community Hospital, Karen Elliott

DNP Scholarly Projects

Abstract

BACKGROUND: Emergency Department boarding is a well-documented systemic problem across the country. ED-2b, the time from decision to admit a patient to Emergency Department departure, is specified by the Joint Commission as a quality measure for Emergency Department boarding. ED-2b metrics have been a longstanding challenge at this community hospital outside the nation’s capital. The aim of this study was to reduce median ED-2b times by 10% compared to fiscal year 2020 (FY20). To accomplish the reduction in time, a multidisciplinary throughput committee was developed with subsequent action plans designed to improve Emergency Department throughput.

METHODS: The Plan Do …