Medicine and Health Sciences Commons^™

Non-Urgent Use Of Emergency Departments By Rural And Urban Adults, Erika Ziller Phd, Carly Milkowski, Zachariah Croll, Yvonne Jonk Phd

Access / Insurance

This study, conducted by researchers at the Maine Rural Health Research Center, provides updated information and addresses gaps in knowledge about rural non-urgent ED use. Understanding the rates of non-urgent ED use among rural adults and the factors associated with this use can inform policy and practice efforts to reduce unnecessary and inappropriate use of EDs in rural communities.

Hospital emergency departments (EDs) serve a vital role in the US health care system, providing lifesaving, around-the-clock care to patients in acute health situations. However, use of the ED for non-urgent care is costly and reflects a suboptimal care setting, with …

Patient Satisfaction Among Saudi Academic Hospitals: A Systematic Review, Ahmed Ali Alasiri, Saad A. Alotaibi, Eric Schussler

Rehabilitation Sciences Faculty Publications

Purpose: To systematically review the patient's satisfaction (PS) levels within academic hospitals in Saudi Arabia from January 2012 to the end of October 2022.

Data Sources: Articles were gathered from PubMed, ProQuest, Google Scholar and Web of Science.

Study selection/data extraction: This review identified studies that assessed PS in Saudi Arabian university hospitals. Articles published before January 2012, as well as commentary letters, conference papers, theses and dissertations, were excluded. The study employed the five domains of PS as outlined by Boquiren et al. Two independent reviewers independently identified qualifying studies, used the Joanna Briggs Institute tools …

Graduate Medical Education In The Mountain West, Mohit Pande, Nicole Diaz Del Valle, Yashesvi Sharma, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines Graduate Medical Education (GME) metrics in the Mountain West (Arizona, Colorado, Nevada, New Mexico, and Utah). The original report from the Association of American Medical Colleges (AAMC) includes data from all 50 states and includes measures of graduate medical education and the facilities needed to conduct graduate medical education. This fact sheet builds upon data previously published in fact sheets on Nevada medical residencies for the 2021, 2022, and 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of …

Impact Of Receiving Hospital On Out-Of-Hospital Cardiac Arrest Outcome: Racial And Ethnic Disparities In Texas, Ryan Huebinger, Marina Del Rios, Benjamin S Abella, Bryan Mcnally, Carrie Bakunas, Richard Witkov, Micah Panczyk, Eric Boerwinkle, Bentley Bobrow

Journal Articles

Background Factors associated with out-of-hospital cardiac arrest (OHCA) outcome disparities remain poorly understood. We evaluated the role of receiving hospital on OHCA outcome disparities. Methods and Results We studied people with OHCA who survived to hospital admission from TX-CARES (Texas Cardiac Arrest Registry to Enhance Survival), 2014 to 2021. Using census data, we stratified OHCAs into majority (>50%) strata: non-Hispanic White race and ethnicity, non-Hispanic Black race and ethnicity, and Hispanic or Latino ethnicity. We stratified hospitals into performance quartiles based on the primary outcome, survival with good neurologic outcome. We evaluated the association between race and ethnicity and …

Emergency Preparedness And Response: Examining Rural Hospitals (Rhs) Communication Systems Before, During, And After A Natural Disaster, Geremy D. Lloyd

Electronic Theses and Dissertations

Introduction: Rural Hospitals (RHs) have distinctive characteristics that constitute unparalleled challenges. One of those challenges is the ability to communicate effectively in a disaster, impacting the various effects on the affected society. Research has shown that effective emergency preparedness and response (EPR) communication is paramount when communicating informed details about emergent events. Despite the evolving complexities of communication and the technology associated with disaster communication, very few studies have successfully investigated RHs communication systems before, during, and after a natural disaster. The purpose of this study was to examine and assess RHs communication systems and to highlight the strengths, identify …

Information And Communication Technology Applications And Use In Medical Records And Information Management In Selected Hospitals In Ijebu Ode Local Government Area, Ogun State., Aderonke Ogungbade Cln, Oluwatobi Abdul Mr

Library Philosophy and Practice (e-journal)

This study investigated the information and communication technology application and use in medical records and information management in selected hospitals in Ijebu-Ode Local Government Area of Ogun State. The Objectives of the study found out the level of application and compliance of ICT and also investigated the challenges facing the application. The survey research design was adopted while total enumeration sampling technique was used in the selection of samples. Questionnaire was used to gather data for this study while mean and standard deviation frequency counts and percentages was used in data analysis. Findings shows that the information and communication tools …

Structural And Social Determinants Of Opioid Abuse Among Florida-Based Hospitals, Donald R. Haley, Hanadi Hamadi, Jing Xu, Mei Zhao, Anh Viet Tran Nguyen, Dayana Martinez

Florida Public Health Review

Background: With over two million people suffering from opioid abuse disorders, the Centers for Medicare and Medicaid Services has identified opioid abuse as a key priority. Florida is one of eight states labeled as a high-burden opioid abuse and is an “epicenter” for opioid use and misuse.

Purpose: The purpose of this study was to discover potential predictors of opioid abuse in Florida by exploring specific healthcare delivery, geographic, and patient demographic factors.

Methods: A retrospective longitudinal study design was used to examine four years (2014-2017) of Florida inpatient administrative discharge data across 173 hospitals of opioid abuse rate. …

Value-Based Reimbursements In The Us Health Care Market : Direct And Spillover Effects Of Medicare Readmissions Program, Soumyadeb Chatterjee

Legacy Theses & Dissertations (2009 - 2024)

In this thesis, I take up the question of how the Medicare penalties introduced by the Hospital Readmissions Reduction program (HRRP) impacted the US health care system. The demand side of US health care system is highly fragmented where hospitals and other providers have to serve very different kinds of patients from different payers. Since the majority of a hospital's income is drawn from Medicare, a sharp reduction in its reimbursements is bound to have an effect on its health care delivery to all patients.

Endogenous Policy Design In Healthcare : A Case Study Of Emergency Department Crowding, Katrina Alexandra Hull

Legacy Theses & Dissertations (2009 - 2024)

The United States’ health care system has faced growing per capita use, and subsequent crowding, of the emergency department since the 1990’s, evidenced by longer wait times and the institution of ambulance diversions. Emergency departments are but one element of a complex system, with difficulties which persist despite policy efforts.

How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver

All Faculty Scholarship

Forty years after the publication of the first systematic study of adverse medical events, there is greater access to information about adverse medical events and increasingly widespread acceptance of the view that patient safety requires more than vigilance by well-intentioned medical professionals. In this essay, we describe some of the ways that medical liability insurance organizations contributed to this transformation, and we catalog the roles that those organizations play in promoting patient safety today. Whether liability insurance in fact discourages providers from improving safety or encourages them to protect patients from avoidable harms is an empirical question that a survey …

Servant Leadership Characteristics And Empathic Care: Developing A Culture Of Empathy In The Healthcare Setting, Mark Anthony Martin

Antioch University Dissertations & Theses

The purpose of this study was to assess the degree to which servant leadership characteristics are exhibited in medical group practices, and the degree to which servant leadership characteristics correlated with measures of empathic care. This study featured an explanatory mixed methods research design embedded in appreciative inquiry. A total of 189 mid-level practitioners consisting of nurse practitioners, physician assistants, and practice mangers responded to a 32-item scale survey that featured a six-point Likert scale to measure servant leadership items and a 10-point continuous scale to assess measures of empathic care. The servant leadership items were based on the seven …

Early Data From The Maine Ombudsman’S Hospital Advocacy Program: A Deeper Look At Difficult To Place Patients, Joseph Zamboni

Muskie School Capstones and Dissertations

There is little data available on the complex cause and effect of delayed hospital discharge; however, some evidence suggests that long-stay patients tend to be complex, older, and sicker. In Maine, a 2014 Maine Health Association report found complex hospital patients were waiting weeks, months and sometimes over a year in Maine Hospitals before accessing long-term services and supports. In response to these concerns around delayed discharge from hospitals, the First Regular Session of the 127th Maine Legislature created the Commission to study Difficult to Place Patients. The Commission ultimately passed Legislation that gave the Maine Long- Term Care Ombudsman …

Postmodern Social Control: Dividuals And Surveillance, Ernest M. Oleksy

The Downtown Review

As a society's foundational philosophy changes, so, too, will its forms of social control. By using the works of thinkers like Deleuze and Foucault as pivot points, the dynamic nature of social interactions and the agents to mediate those actions shall be investigated. This article includes findings from archival analysis written in a journalistic prose for simplicity of consumption.

Nonprofit Hospital Community Benefit Requirements: An Exploration Of National Health Policy Models, Justin P. Swearingen

Dissertations and Theses

Introduction: Nonprofit hospital organizations are public charities with complete tax immunity. Such exemptions are worth $24.6 billion and impact the health of hundreds of millions of people, yet what these charities must do to meet the current “community benefit standard” to maintain their tax-exempt status remains a policy debate. To help inform policymaking, an evaluation of four national requirement models was performed: Tax Value Requirement (at least the value of the tax exemptions must be spent on community benefit), Grassley Requirement (at least 5% of revenue must be spent on community benefit), Expense Requirement (at least 3% of expenses must …

After Closure: Options For Pursuing A High Performance Rural Health System, Andrew F. Coburn Phd

Rural Hospitals (Flex Program)

Presented at the 2017 National Rural Health Association Annual Meeting. Coburn, a member of the Rural Policy Research Institute Panel, discussed the following key questions: What kind of rural health system is possible in places that cannot support a full-service hospital? How does a rural community navigate the transition from hospital-centric care toward new models that deliver high performance? What implementation support will be needed? Coburn noted that there is no single model for re-configuring the rural health system after hospital closure; local assets, affiliations and partnerships, financial and delivery flexibility and capacities must be critically assessed to determine the …

Nurses Are Underutilised In Antimicrobial Stewardship E Results Of A Multisite Survey In Paediatric And Adult Hospitals, Mona Mostaghim, Thomas Snelling, Brendan J. Mcmullan, Pamela Konecny, Stuart Bond, Suman Adhikari, Adriana J. Chubaty, Cathy Lovell, Beata Bajorek

Faculty of Science, Medicine and Health - Papers: part A

Objectives: Explore perceptions and attitudes of nurses in regard to antimicrobial stewardship (AMS), their roles as nurses, and identify differences in perceptions and attitudes across paediatric and adult settings. Methods: Electronic survey administered to nursing staff across three public Australian tertiary institutions with AMS facilitated by a shared electronic approval and decision support system. Results: Overall 65% (93/142) of nurses who completed the survey were familiar with the term AMS, and 75% recognised that they were expected to have a role alongside other disciplines, including ward pharmacists (paediatric 88%, adult 73%; p = 0.03). Hand hygiene and infection control (86%), …

The Economic Burden Attributable To A Child’S Inpatient Admission For Diarrheal Disease In Rwanda, Fidele Ngabo, Mercy Mvundura, Lauren Gazley, Maurice Gatera, Celse Rugambwa, Eugene Kayonga, Yvette Tuyishme, Jeanne Niyibaho, Jason M. Mwenda, Philippe Donnen, Philippe Lepage, Agnes Binagwaho, Deborah Atherly

Dartmouth Scholarship

Backround:

Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.

Methods:

This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and …

Differences Between For-Profit And Nonprofit Hospitals: Perceived Quality And Access, Michael Ray Eiland

Walden Dissertations and Doctoral Studies

Despite a large body of literature addressing the issue, questions remain about whether nonprofit hospitals provide more community benefit than do for-profit hospitals. This lack of information impacts governments, hospitals, and the healthcare industry, as stakeholders attempt to generate requirements to which hospitals should adhere to maintain nonprofit status, and thus tax exemption. This study addressed this lack of information by examining U.S. hospitals through the lens of stewardship theory to determine whether nonprofits are better stewards of the public good than for-profits, and thus likely to provide higher quality and access. The study applied logistic regression to Centers for …

The Relationship Between Hospital Safety Culture And Variation In Adverse Events : What Is The Evidence From Nys Hospitals?, Kathleen Ciccone

Legacy Theses & Dissertations (2009 - 2024)

Background: There is widespread acknowledgement that patients often suffer from adverse events that occur in the provision of medical care (Leape et al., 1991; Kohn et al., 2000). A notable percentage of these events stem from poor practices and unreliable hospital safety systems (Leape et al., 1991; Kohn et al., 2000; Chassin, 2013). Although the literature has been mixed regarding the association between perception of safety culture in hospitals and rates of adverse events, policy makers and healthcare thought-leaders have called on hospital leadership to improve safety culture as one strategy for decreasing harm to patients.

Exploring The Process, Models, And Outcomes Of Hospital-Public Health Partnerships, Danielle M. Varda, Jessica H. Retrum, Carrie Chapman

Frontiers in Public Health Services and Systems Research

Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) requirement that hospitals conduct community health needs assessments, taking into greater consideration the public health of their respective communities. This has led to growing strategies to develop partnerships between hospitals and public health (PH) as a way to meet these needs¹. Meantime, there is a need for data on Hospital-PH partnerships, due to the growing emphasis that these types of partnerships get implemented in practice. In this paper we analyze a secondary data set to explore how hospitals and public health …

Memorial Hospital Collection, 1873 – 1990: A Finding Aid, Kristine M. Reinhard

Kristine M. Sjostedt

The Memorial Hospital Collection comprises annual reports and other material by or about The Memorial Hospital in Worcester, Massachusetts.

Predictors Of Emergency Room And Hospital Utilization Among Adults With Intellectual And Developmental Disabilities (Idd) In New York City, Meghan G. Blaskowitz

Legacy Theses & Dissertations (2009 - 2024)

Background. Avoidable emergency room (ER) visits and hospital admissions among people with intellectual and developmental disabilities (IDD) contribute significantly to rising Medicaid costs. The Affordable Care Act (ACA) and New York State (NYS) Medicaid Redesign Team have identified a critical need to reduce ER and hospital utilization in an effort to contain healthcare costs and improve quality of care. Study Objective. This study identifies independent predictors of medical and behavioral/psychiatric ER and hospital utilization for a cohort of individuals with IDD (n=597) residing in supported living arrangements in New York City, the most Medicaid-dense region of NYS. Methods. A retrospective …

Carter, Tim Lee, 1910-1987 (Mss 80), Manuscripts & Folklife Archives

MSS Finding Aids

Finding aid only for Manuscripts Collection 80. Correspondence, photographs, audiotapes, film, clippings, general office files, and records of legislative proceedings relating to the political career of Tim Lee Carter, U.S. Representative (Republican) for Kentucky's Fifth Congressional District, 1965-1981.

Nutrition Screening: Time To Address The Skeletons In The Bedroom Closet As Well As Those In Hospitals, Karen E. Charlton

Karen E. Charlton

Ever since Dr Charles Butterworth's seminal article in 19741 on the widespread prevalence of malnutrition in hospitalised patients and its detrimental effect on recovery, attempts have been made to improve the detection of malnutrition through screening initiatives. However, despite compelling evidence that those who are either malnourished at admission or become malnourished during their hospital stay experience increased surgical complications, greater morbidity and increased length of hospital stay2,3 as well as higher rates of mortality at 12 months,4,5 malnutrition often remains undetected and untreated because it is not considered to be a clinical priority. Even overt signs of malnutrition are …

The Long-Term Coercive Effect Of State Community Benefit Laws On Hospital Community Health Orientation, Charles B. Moseley, Jay J. Shen, Gregory O. Ginn

Nevada Journal of Public Health

This study is an examination of the long-term coercive effect of state community benefit laws (CB Laws) on the provision of community health activities in U.S. acute care hospitals. The sample included all the not-for-profit and investor owned acute care hospitals for which 1994 and 2006 AHA Annual Survey data were available. A panel design was used to longitudinally examine the effect that state CB Laws had on hospital community health orientation activities and the provision of health promotion services, after controlling for the influence of other organizational and environmental variables that might affect these activities and services. The authors …

What Do Stakeholders Consider The Key Issues Affecting The Quality Of Foodservice Provision For Long-Stay Patients, K. Walton, P. G. Williams, Linda C. Tapsell

L. C. Tapsell

This study aimed to elicit concerns of key stakeholders regarding food service provision to long stay hospital patients. Seventeen focus groups and four individual interviews were conducted involving six stakeholder groups: dietitians, nutrition assistants, patients, nurses, food service assistants and food service managers. Ninety-eight participants (20 male; 78 female) were recruited from public and private hospitals in New South Wales, Australia. Each of the focus groups and individual interviews was conducted in the hospital setting where free and open discussions could be digitally recorded. Transcripts were prepared from the digital recordings and QSR Nvivo 2.0™ qualitative analysis software was used …

End Of Life Decisions In The Nicu: The Value Of New Life And The Degree To Which Religion Plays A Role In These Ethical Decisions, Maria Battaglia

Honors Theses

This thesis explored the role of religion as a social variable affecting end of life decisions in the NICU. The existing literature has studied many factors that are a part of the tough ethical decisions made in the NICU with some reference to religion. However, there is not adequate attention given to religion specifically. In order to further expand upon religion, various members composing the medical teams of two hospitals were interviewed. The interviewees included neonatologists, nurses, chaplains, and a social worker. This thesis found that religion is a variable that matters more than the existing literature has claimed. Often, …

Implementing A Mobile Wireless Environment In A Hospital Ward: Encouraging Adoption By Nursing, Julie Fisher, Linda Dawson, Stephen Weeding, Liza Heslop

Associate Professor Linda Dawson

Sophisticated technology is commonplace in most hospitals and increasingly mobile devices are being used in hospitals by clinical staff. Although the growth in mobile device usage in hospitals has the potential to contribute to better health and medical services delivery, nurses and doctors are still very reliant on paper-based information. Much of the research reported to date has focused on technical and design issues around mobile devices. Research that has focused on mobile device use in practice has tended to be from the perspective of doctors. This paper describes research which investigated key issues that arose as a result of …

Measurung Plate Waste In Hospitals, Karen L. Walton, Jacquie Krassie

Faculty of Health and Behavioural Sciences - Papers (Archive)

It has been suggested that the median plate wastage in hospitals is approximately 30% (range of 6–65%). The level of hospital food wastage is influenced by numerous parameters, including the menu, the setting, diet type, the type of food service distribution system used and its flexibility. Some food wastage is inevitable, as appetites are unpredictable. However, large amounts of food waste have a huge financial cost; and more importantly, it indicates that patients are not likely to be meeting their nutritional requirements. ‘Food is an integral and important part of a patient’s treatment but the food must be consumed if …

Facilitating Emergence: Complex, Adaptive Systems Theory And The Shape Of Change, Peter Martin Dickens

Antioch University Dissertations & Theses

This study used Principal Component Analysis to examine factors that facilitate emergent change in an organization. As organizational life becomes more complex, today’s dominant management paradigms no longer suffice. This is particularly true in a health care setting where multiple sources of disease interacting with each other meet with often-competing organizational priorities and accountabilities in a highly complex world. This study identifies new ways of approaching complexity by embracing the capacity of complex systems to find their own form of order and coherence. Based on a review of the literature, interviews with hospital CEOs, and my organization development practice experience …