Medicine and Health Sciences Commons^™

Does Ceo Education Matter? The Relationship Between Doctoral-Educated Hospital Ceos And Organizational Performance, Kofi Ali Cash

All ETDs from UAB

One of the most pressing issues in healthcare strategic leadership research is identifying which hospital chief executive officer (CEO) characteristics possess a significant and favorable relationship to organizational performance. However, little is known about the relationship between hospitals led by doctoral-educated CEOs and organizational performance. This study adds to our knowledge by examining the relationship between doctoral-educated hospital CEOs and selected financial and patient safety outcomes. UET served as the theoretical framework and guided the examination of the relationship between the selected dependent and independent variables. This study’s population included 509 acute-care hospitals across nine states, requiring a minimum four-year …

The Prescription Drug Monitoring Program And Its Effect On Drug Overdose Mortalities, Charles Lee

All ETDs from UAB

The opioid epidemic is a growing concern, and the health and economic impacts on rural and urban counties are increasing. Between 1999 and 2019, approximately 841,000 people died from drug overdoses involving heroin, synthetic opioids, and prescribed opioids with 71,000 dying in 2019. This study examined the relationship between drug overdose mortalities and three independent variables, (a) Medicaid expansion, (b) Years PDMP active, and (c) Academic detailing engagement. Results of this study will contribute to the literature by determining if the Medicaid expansion, years prescription drug monitoring programs active, and academic detailing engagement decrease drug overdose mortalities. This study includes …

Impact Of Federally Qualified Health Centers (Fqhc) And Look-Alikes (Fqhc Lal) Participating In The 340b Drug Pricing Program, Shannon Burger

All ETDs from UAB

The 340B Drug Pricing Program intends to enable community health providers to deliver care more easily to vulnerable populations. Safety net providers were designated as eligible entities through an act of Congress and were allowed access to prescription drug savings. Existing studies have focused on hospital participation in the program, overlooking the impact of Federally Qualified Health Centers (FQHC) and FQHC Look-alikes (FQHC LAL) and legislative intent. This study aimed to fill this gap by comparing the effectiveness of FQHCs and FQHC LALs participating in the 340B Drug Pricing Program. Specifically, the study examined the influence of the status of …

An Examination Of The Relationship Between Mobile Apps And Healthcare Outcomes: A Patient Engagement And Patient Satisfaction Perspective, Khaled Hamad Alkhalifa

All ETDs from UAB

Background: Mobile apps are rapidly becoming an essential tool for hospitals to be competitive in a rapidly evolving healthcare market driven by patient expectations. The effectiveness of mobile apps is not fully understood, and more research needs to be done to evaluate their impact on patient satisfaction. More specifically, the role of patient engagement in this relationship needs to be investigated, given the rapid improvement in health behavior-changing mobile apps.Objective: This study aimed to examine (1) whether hospitals providing mobile apps are associated with higher patient satisfaction and patient engagement scores, (2) whether mobile app usability impacts this relationship, and …

The Effects Of Mobile Shielding On Scatter Radiation In The Cardiac Catheterization Laboratory, Lancer Smith

All ETDs from UAB

This research evaluates the effectiveness of a Specialized Cardiac Catheterization Laboratory Shielding Device (SCCLSD) compared to traditional shielding methods in reducing occupational exposure to scattered x-rays, contributing to the ongoing enhancement of radiation safety in the cardiac catheterization laboratory (CCL) setting. The upper component of the SCCLSD comprises a mobile, transparent barrier with lead-equivalent malleable drapes designed to conform to the patient's body contours. It is height-adjustable, creating a protective shield against scatter radiation generated during CCL procedures. The lower portion of the SCCLSD replaces traditional lead-lined drapes, extending further down the table and incorporating additional shielding for staff protection.An …

Senior Executive Experience And The Performance Of Healthcare Organizations, John Patrick Walsh

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SENIOR EXECUTIVE EXPERIENCE AND THE PERFORMANCE OF HEALTHCARE ORGANIZATIONS JOHN P. WALSH HEALTH SERVICES ADMINISTRATION ABSTRACT The healthcare industry has become increasingly complex over the past two decades causing concern for stakeholders of hospitals and health systems regarding the future viability. Given the tumultuous times, understanding who is best suited to lead these organizations is essential. While some work has been done studying certain characteristics of the Senior Leaders of these organizations, none have looked at the relationship between the Senior Leader’s work experience comparing those with for-profit experience and those without and performance. Using Upper Echelon’s Theory as a …

Understanding The Impact Of Hospital Price Transparency Initiatives On Consumer Decision-Making To Purchase Healthcare Services, Neel Pathak

All ETDs from UAB

This study examined the influence of hospital list price information on individuals' decision-making to purchase healthcare services. The study collected quantitative data from 550 individuals by administering a hospital price transparency survey. Findings indicate that awareness of hospital list prices and quality outcomes metrics was high, but utilization rates were relatively low among survey participants. Demographic variations were explored with respect to the awareness and utilization of hospital list prices. Quality outcomes and recommendations from friends, family, and physicians emerged as the most important attributes influencing decision-making to purchase healthcare services whereas hospital list prices and social media had a …

A Study To Examine The Relationship Between Ceo Characteristics And Organizational Performance In The Us Pharmaceutical And Biopharmaceutical Industries, Wafick K. Mohamed

All ETDs from UAB

This study examined the relationship between CEO tenure, sex, level of education, and organizational performance across 229 U.S. publicly traded pharmaceutical and biopharmaceutical companies. The Upper Echelons Theory was used to guide this research on how CEO characteristics could impact organizational performance. Fifteen hypotheses were developed and tested to evaluate the statistically significant relationship between CEO tenure, sex, level of education, and the organizational performance demonstrated in the abnormal stock return valuation and the number of FDA-approved drug products in clinical trial phases (phases 1, 2, and 3) for each company. This quantitative, non-experimental, and cross-sectional study was completed by …

The Relationship Between Nurse And Therapy Staffing Levels And The Medicare Patient-Driven Payment Model Reimbursement During The Covid-19 Pandemic, Roland T. Shapley Jr

All ETDs from UAB

The Patient Driven Payment Model (PDPM) brought about a paradigm shift in the way skilled nursing facilities are reimbursed, by linking complexity of care to beneficiary need, expanding case-mix adjusted components by including a non-therapy ancillary and speech language pathology component, and limiting the volume of therapy services provided. The COVID-19 pandemic wreaked havoc upon the nursing home industry that gave rise to high patient and staff infections and fatalities, declining occupancy rates, and nursing shortages, compelling the Department of Health and Human Services to provide $4.9 billion in CARES Funding to skilled nursing facilities (SNFs). Using Payroll Based Journal, …

Assessing The Impact Of The Covid-19 Pandemic On Metastatic Lung Cancer Time To Treatment Initiation, Health Care Resource Utilization, And Costs In The United States, Teresa M. Zyczynski

All ETDs from UAB

The COVID-19 pandemic has derailed normal operations in the health care delivery systems in the United States (US) and globally, providing prioritized care to patients seeking acute management of the novel coronavirus and its complications. Simultaneously, cancer screening tests have decreased, resulting in decreased rates of cancer diagnoses and referrals to oncologists. The purpose of this study was to assess time to treatment initiation (TTI) with systemic cancer therapy in patients with newly diagnosed metastatic lung cancer, metastatic lung cancer-related and total healthcare resource utilization (HCRU) and costs during the pandemic/post-pandemic period compared with the pre-pandemic period. The retrospective claims …

Predictors Of Us Hospital Responsiveness To International Patient Inquiries, Suzanne M. Garber

All ETDs from UAB

Medical travel has been growing at a steady rate as global travel has also increased. However, with the advent of COVID-19, all global travel came to a screeching halt, including travel intended for medical purposes across borders. Now that travel is resuming worldwide, American hospital administrators are anxious to fill their beds with more profitable, international patients to make up for revenue losses incurred during the pandemic. Existing literature on the topic of medical tourism focuses on the role of patient initiative, choice, and risk-taking behaviors with little mention of hospital leadership’s ability or desire to construct a management strategy, …

The Relationship Between State Level Funding, Designated Trauma Centers, And Trauma Related Morbidity, Ginger Henry

All ETDs from UAB

This study examined the relationship of funding and the number of designated trauma centers and age-adjusted trauma mortality across the 50 states. State level funding was defined as monies that were paid to the designated trauma hospitals in aggregate by state and by year for the years 2008 to 2017. The number of designated trauma hospitals were considered in the categories of total number of state trauma hospitals and designation levels 1 through 4. Age-adjusted mortality included the ICD-10 codes for trauma from the WISQARS database. The strategic adaptation theory was used to inform the trauma hospital manager’s need to …

Shared Savings Bonus In Mssp And Its Association With Length Of Participation, Terry D. Knight

All ETDs from UAB

Accountable Care Organizations (ACOs) are integrated groups of providers responsible for reducing cost and improving quality for a group of individuals. Medicare began using these organizations in 2012, after the passage of the Affordable Care Act (ACA), to move away from traditional fee-for-service reimbursement. This alternative payment model is the Medicare Shared Savings Program (MSSP). MSSP affords ACOs the opportunity to receive a portion of the savings they achieve if specific cost targets and quality benchmarks are met. Length of participation time in the alternative payment model may increase the ACOs’ ability to achieve savings. The analysis of MSSP savings …

Applying The Hospitalist Model Of Care To Cardiovascular Acute Care Delivery, Ginger K. Biesbrock

All ETDs from UAB

The hospitalist model for managing patients in the hospital setting has been in existence for over 20 years. The hospitalist model for non-specialty care has been found to improve the efficiency of care, maintain quality of care, and support a higher degree of guideline adherence. However, there has been little research focusing on the use of the hospitalist model for specialty care. As cardiovascular programs have begun to adopt the hospitalist model, many are asking if this model is more effective than the traditional model. The main concern is the potential disruption to the patient-physician relationship that occurs with the …

Mevisit: Value-Based Approach To Primary Care Delivery By Mtelemedicine Utilization Applied Through Lean Principles, Neil Coyer Thornbury

All ETDs from UAB

Background: Significant issues of inconsistent patient services in the U.S. health system impact health outcomes and create high cost. Limitations of immobility, inefficiency, and accessibility sacrifice patient treatment, delay recovery, and escalate health risks from the lack of primary care physicians. The primary purpose of this study was to examine meVisit, a connective mobile technology, as a feasible primary care solution to address escalating health costs by reducing emergency room (ER) visits and inpatient admissions (IA). Methods: The feasibility study applied descriptive and inferential statistics to secondary data (n=4,024) and compared the two independent patient groups from the same large …

The Effect Of Federally Qualified Health Centers (Fqhcs) Prevalence On Uncompensated Care In Us Hospitals, Kena R. Norris

All ETDs from UAB

Over the past two decades, uncompensated care in U.S. hospitals has grown at a staggering rate and reached $46.4 billion in 2013. It began to decline in 2014, due to the passage of the Patient Protection and Affordable Care Act (ACA), but is now on the rise again. Uncompensated care is typically affected by policy and market factors such as legislative changes and an increase in the number of uninsured. While hospitals continue to serve as critical safety net providers, they are often not the only or most appropriate facility to serve the indigent in U.S. communities. Instead, federally qualified …

The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn

All ETDs from UAB

Hospital Acquired Infections (HAIs) are among the top five leading causes of death in the United States (Scott, 2009). Estimates of the annual direct medical costs of HAIs to U.S. hospitals have ranged from $28,400,000,000 to $33,800,000,000 (Scott, 2009). Many leading health care organizations have agreed that there is a link between infection prevention and the spread of HAIs (Allegranzi, 2009). This study explored health care workers’ hand hygiene compliance and whether automated compliance reporting improved compliance. A new system powered by technology called Near Field Magnetic Induction (NFMI) found a significant increase in compliance upon introduction of an automated …

The Effect Of Integrative Medicine Interventions On Patient Activation Measure, Rochelle F. Richards

All ETDs from UAB

Activated patients believe they have essential roles in achieving and maintaining their health. Patient activation is strongly related to improved clinical outcomes (Hibbard, 2017; Greene, 2013). The study’s primary purpose is to evaluate the use of Integrative Medicine Interventions (IMIs) and their relationship to patient activation levels; and to investigate the association between IMI protocols and patient activation levels on patient reported outcomes (PROs) for those with chronic diseases, specifically chronic fatigue and mental health-related conditions of anxiety and depression, using the principles of Integrative Medicine’s (IM) whole-person approach as the model of care in independent IM practices across the …

The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados

All ETDs from UAB

Two significant events transpired in Louisiana that had sweeping changes for the healthcare system between 2013 and 2016: (1) the privatization of the nation's only stateowned Charity Hospital System via cooperative endeavor agreements with local, private hospitals known as public-private-partnerships (PPP), and (2) the implementation of Medicaid expansion, referred to as implementation of the Affordable Care Act (ACA). Either event independently could have had significant utilization and financial implications for hospitals. This retrospective, quasi-experimental research implemented a generalized estimating equation (GEE) analysis to examine the effects of PPP and ACA on Medicaid patient emergency department utilization by PPP hospital designation, …

An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge

All ETDs from UAB

Healthcare organizations drive to achieve hospital measures has much to do with strategies put in place by the executive leadership team and resources of the firm. Forces such as regulatory changes reducing hospital payments and external forces such as social injustices leave executives turning to innovative ways to improve the bottomline. This study examined the Chief Diversity Officer (CDO) and the relationship with hospitals measures of financial performance and patient experience for hospitals with a CDO and without a CDO. Hospitals with a CDO can deploy organizational strategies such as diversity management and cultural competencies. These strategies are important because …

The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley

All ETDs from UAB

Advancements in medical knowledge are producing significant improvements in medical technology, developing breakthrough drug therapies, advancing the practice of medicine, and improving outcomes for cancer patients. However, there are delays in getting new and improved therapies incorporated into routine clinical use, depriving cancer patients of valuable and potentially lifesaving treatments. The purpose of this study was to examine the rate of adoption of new cancer drug discoveries into routine clinical practice in non-academic cancer centers. The process of adoption takes a period of time to embrace new therapies, due in part to a prescriber’s need to gain greater comfort with …

Strategic Balance In Healthcare Organizations, Corey Spraberry

All ETDs from UAB

The purpose of this dissertation was to assess the relationship between service mix offerings relative to competitors and firm performance. Specifically, this study explores if an optimal point of service offerings in the competitive market is associated with financial performance. This study is important to both researchers and healthcare leaders as it helps understand the relationship between optimal service mix and firm performance. The results find a relationship that suggests a differentiated service mix compared to a generalized service mix is associated with financial performance. Additionally, hospital characteristics are associated with service duplication and differentiation. The findings of this research …

The 340b Drug Pricing Program: Are 340b Covered Entities Providing More Services And More Uncompensated Care?, Isabell M. Pacheco

All ETDs from UAB

The 340B Drug Pricing Program enacted in 1992 requires pharmaceutical manufacturers participating in the Medicaid program to provide statutorily defined discounts on "covered outpatient drugs" purchased by government-supported facilities, known as covered entities, that are expected to serve the nation's most vulnerable patient populations. The Program has been under copious scrutiny by industry stakeholders and Presidential Executive Orders that threaten its macrocosm. While previous research suggests that health systems with a mix of 340B participating and non-participating locations are not associated with expanded access to care, additional research is needed to determine if entities participating in the 340B Drug Pricing …

The Effect Of Medicaid Expansion On Hospitals Allowance For Bad Debt, Tara B. Dixon

All ETDs from UAB

The management of bad debt is a complex issue for hospitals, and if mismanaged, can impact the organization's current and future financial stability. The expansion of Medicaid through the Patient and Affordable Care Act (ACA) was expected to lessen the bad debt reported by hospitals by increasing the number of insured lives. Hospital managers understand that a certain percentage from the accounts receivables will end up being uncollectable; however, strategically planning for bad debt and estimating a more accurate allowance requires a specific level of strategic planning. Allowance for bad debt should not be a guessing game but should be …

Fqhcs, Health Center Controlled Network Affiliation And Performance, Armika Jessica Berkley

All ETDs from UAB

Since the mid-1960s, Federally Qualified Health Centers (FQHCs) have been funded by the U.S. federal government to provide access to preventative and primary care for medically underserved communities. The federal government’s involvement in the funding of FQHCs was a response to extreme poverty, economic instability, and civil unrest related to the Civil Rights movement. Adoption of value-based care delivery practices to improve clinical and financial performances among FQHCs has been slow. This slow adoption has been attributable to cost, lack of expertise, and support. Since August 1994, the Department of Health Resources and Services Administration (HRSA), the funding source for …

Does Interdisciplinary Care Team Care Management Improve Health Quality And Demonstrate Cost Effectiveness?, F Cardwell Feagin Jr

All ETDs from UAB

The U. S. healthcare system faces unsustainable rising healthcare costs. Health care cost as a percentage of gross domestic product is expected to rise to 19.4 percent by 2027 (Wilson, 2019). This unstainable rise in healthcare costs is creating a problem for consumers of healthcare. By 2030, the average annual healthcare spending per working household, including premium and out-of-pocket expenditures, is estimated to be 33.9 percent of median compensation (Girod et al., 2016). Also, lawmakers and policymakers face funding issues of healthcare. A key finding of this study is that field-based interdisciplinary care team care management, with an algorithm selecting …

The Association Between Medicaid Expansion, Medicaid Disproportionate Share Payments And The Financial Performance Of Safety Net Hospitals, Jon Law

All ETDs from UAB

Safety Net Hospitals (SNHs) provide necessary emergency and acute care to all individuals, regardless of their ability to pay for health care. Medicaid Expansion and Disproportionate Share (DSH) payments are two Medicaid programs that may mitigate the financial vulnerability of SNH’s. Some assert that Medicaid Expansion, as part of the Patient and Affordable Care Act (ACA), may provide financial relief for SNHs. It offers payment mechanisms for millions of uninsured individuals. DSH expenditures per capita for each state vary widely. There is some likelihood that SNHs in some states may benefit greater than others. The study was framed within the …

Is There A Relationship Between Leadership Characteristics And Services Provided Among Ihs Urban Indian Health Programs?, George Grant Tribble

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IS THERE A RELATIONSHIP BETWEEN LEADERSHIP CHARACTERISTICS AND SERVICES PROVIDED AMONG IHS URBAN INDIAN HEALTH PROGRAMS?GEORGE G. TRIBBLE HEALTHCARE LEADERSHIP ABSTRACT The Native American population has faced and been impacted by a wide range of actions throughout the last few hundred years. The loss of cultural norms and way of life continues to manifest itself through various socioeconomic concerns. At the center of the Native American leadership model is a disciplined and culturally specific guidance structure. The Urban Indian Health Program (UIHP) was created by the Indian Health Service to establish a culturally appropriate health care delivery model for Native …

The Relationship Of Debt Ratio And Financial Performance For Large Nfp Health Systems, Mark Lombardi

All ETDs from UAB

This dissertation was a quasi-experimental research study exploring the relationship between long-term to debt capitalization ratio and financial performance in an environment where interest rates remained historically low and stable, while investment returns in the U.S. equity markets increased year over year. The study reviewed 142 not for profit health systems and examined total and non-operating margins along with long-term debt to capitalization ratio to determine if margins increased as long-term debt increased. Researchers have discussed the opportunity that not for profit health systems have to utilize low cost, tax-exempt debt to maintain or grow their endowments and in turn …

The Comparison Of Two Diabetes Self-Management Education Programs In The Reduction Of Patient A1c Levels, Edward Sharpless

All ETDs from UAB

This dissertation was a quasi-experimental research study exploring the effectiveness of two educational teaching methods with patients with diabetes. One teaching method utilized an education framework called the Conversation Map tools, a group-based, highly interactive learning experience using colorful visual tools, activity cards and sharing of real-life experiences. The other method was a traditional, lecture-style class taught by a health educator using overhead slides and handouts.

Secondary data from a regional health system in the Western U.S. was used to test the hypothesis that participants in the Conversation Map classes would report a larger drop in A1c levels compared to …