Medicine and Health Sciences Commons^™

Machine Learning Approaches To Understanding And Predicting Cancer Screening Follow Through With Population And Health System Data, Matthew Davis

MUSC Theses and Dissertations

Introduction

Cancer is the second leading cause of death in the United States and cancer screening is a primary tool to reduce mortality. However, not all who are recommended to be screened actually follow through. This study investigates whether electronic medical record and geographic data is suitable to predict which patients are at risk of missing recommended screenings. The goal of this investigation is to design a data informed system that can automate the prediction of those at risk for missing screenings and provide insights into underlying reasons. This will enable resources to be focused to increase cancer screening adherence, …

Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, Carole Berini

MUSC Theses and Dissertations

Community health worker interventions have shown potential to improve health outcomes and reduce inequities particularly for patients with chronic diseases such as type 2 diabetes (T2D). However, there is a lack of support for CHW integration in the delivery of health care. The recent COVID pandemic may have affected outcomes for T2D patients and exacerbated existing inequities in care. This dissertation aimed to address three broad questions through three separate manuscripts. The first one was a systematic literature review to examine the impact of community health workers on health outcomes for rural US populations. The second and third papers used …

Hiv Treatment Utilization: An Exploration Of One Ryan White Clinic, Joseph Powe

MUSC Theses and Dissertations

According to the findings of recent research, the HIV epidemic is still an active problem all over the world. Some racial and ethnic groups have a significantly higher likelihood of contracting HIV, even though many efforts have been made at all levels of government, from the municipal to the federal, to raise public awareness of the recognized risk. There are two focal points for the HIV epidemic. While prevention is essential, infected patients must also be encouraged to continue treatment to accomplish viral suppression and delay the onset of AIDS. When we look more deeply at a local Ryan White …

Cost Effectiveness Of Buprenorphine When Used Long Term Versus Short Term Use, Ty Hudgens

MUSC Theses and Dissertations

Since 1999, nearly 841,000 people have died from a drug overdose (CDC, 2022), and substance use disorder (SUD) continues to be a crisis that faces communities across the country. As the crisis continues across communities, the need for medication-assisted opioid use disorder (MOUD) therapy continues to surge.

This was a retrospective analysis of archival data from large national data sources. We constructed well-matched cohorts of patients with short and long-term use of MOUD using propensity score matching of 3 months of baseline data. To measure the cost effectiveness of short-term buprenorphine use verse long-term buprenorphine use.

What Are The Barriers To Midwife Service Utilization Among Low-Risk Pregnant Women In Florida?, Ileana Cruz

MUSC Theses and Dissertations

Background and Need: Midwives are healthcare professionals that are educated, trained, licensed, and regulated to provide primary care; gynecologic, prenatal care; care during pregnancy, childbirth, postnatal care; and care of the normal newborn during the first 28 days of life (Florida Senate, 2021; Association of Women's Health, Obstetric and Neonatal Nurses [AWHONN], 2016). The Midwives Alliance of North America also defined these professionals as providers who support labor and birth through relationships of trust and confidence with their patients (Midwives Alliance of North America [MANA], n.d.). If complications arise during pregnancy, midwives collaborate with other physicians and refer the case …

Increased Physician Literacy As An Intervention To Improve Value-Based Care And Reduce Cost In The Surgical Setting, Melissa Boyles

MUSC Theses and Dissertations

The primary goal of this scoping review was to identify studies where an intervention of education and awareness of surgical supply costs with surgeons was employed as a possible stimulus for healthcare organization cost reduction in the surgical/procedural service space.

Surgical procedures are performed on approximately 25 percent of all inpatient hospital admissions. In 2018 that equated to 14.4 million surgical procedures and $210.3 billion dollars in health system costs. Surgical Procedures are a substantial portion of healthcare system expenditure and are one of the highest revenue producing services provided to patients. Additionally, there exists high variability in costs based …

Time Is Brain: How A Descriptive Analysis Of Telestroke Metrics Can Improve Program Performance, Christopher Cordero

MUSC Theses and Dissertations

In the event of an acute ischemic stroke, 1.9 million neurons are lost in the brain per minute. Since the inception of thrombolytic therapy and mechanical thrombectomy as effective tools in the treatment of acute ischemic stroke, the focal point of quality improvement in this field has become the time to treatment delivery. As rural and more interspersed environments exhibit high disability and mortality rates associated with these acute neurological conditions, inequities in timely care delivered to these patient populations persist. Limitations in access are now abated by the extension of neurologist expertise into these areas via Telestroke. This study …

Food Deserts Impact On Hospital Admissions In Malnourished Patients Residing In Florida, Joshua Cartwright

MUSC Theses and Dissertations

Objective: The primary objective of this study is to evaluate the impacts of food deserts on hospital admissions for individuals residing in the state of Florida.

Methods: The study design is a retrospective research cohort study analysis of Healthcare Cost Utilization Project (HCUP) data. Inpatient data for the entire state of Florida will be utilized. ICD 10 codes were used to identify malnutrition to evaluate health care utilization by zip code using a geospatial analysis identifying areas known to be food deserts based on United States Department of Agriculture (USDA) designated food census tracts. The data was accessed for the …

Characterizing Pediatric Unilateral Brain Damage: Unilateral Spatial Neglect, Balance, And More, Emerson Hart

MUSC Theses and Dissertations

Pediatric unilateral brain damage is a costly, impactful condition. There are many subsequent impairments that children experience after pediatric unilateral brain damage, two of which are unilateral spatial neglect (USN) and balance impairments. This project aims to compile the existing literature regarding USN in children, analyze insurance billing data to characterize the population, and evaluate balance and USN in a small case-control cohort of children with and without unilateral brain damage. The literature search elucidated the scant literature available addressing USN, including a lack of quality assessments to definitively identify USN. Insurance billing analyses showed an incredibly heterogeneous group, very …