Medicine and Health Sciences Commons^™

Analyzing Pediatric Department Documentation Of Patient Social Needs With Icd-10 Z-Codes, 2019-2020, Oluwatofunmi Jummie Akinwunmi

Public Health Theses

The 10th revision of the International Classification of Diseases (ICD-10) allows healthcare professionals to document social needs with ICD-10 Z-codes. Data derived from documentation of ICD-10 Z-codes can be leveraged to identify at-risk populations for targeted intervention. However, there remains concern for underutilization of these codes particularly in the pediatric population. We sought to examine the documentation of ICD-10 Z-codes in the pediatric outpatient setting of the largest Connecticut hospital network by specialty type and age group. We examined deidentified electronic health records of pediatric outpatient patients from 2019-2020. We used descriptive statistics to measure the proportion of patients with …

Navigating A Patchwork Maze: Individuals’ Experience Of Administrative Burden When Accessing Homeless Assistance Services, Leah Robinson

Public Health Theses

Despite significant efforts to address the issue of homelessness in the United States over the past several decades, over 500,000 individuals still experience homelessness on any given night. A large portion of this persistent and high rate of homelessness can likely be attributed to the shortage of affordable housing options, the eviction crisis, and limited financial support for rental assistance found throughout the country. However, administrative burdens may also contribute to the high rate of homelessness being seen.Our study explores this question by examining 28 individuals’ experience of administrative burden when navigating the landscape of homeless assistance services in New …

Health Care Utilization And Costs For Dementia Patients In China, Fang Ba

Public Health Theses

The number of people in the world living with Alzheimer’s Disease and related dementias (ADRD) continues to rise rapidly, which places a substantial burden on people with dementia (PWD), their families, and the society. Such a burden has been rising faster in low-income and middle-income countries (LMIC) where around two-thirds of PWD live. While prior research documents dementia prevalence in China and indicates its large geographic disparities, no study to date has documented the national pattern of health care utilization, quality and costs in China. The absence of knowledge would largely impede the effective allocation of resources for combating dementia …

Analysis Of Medical Device Reclassification: An Evaluation Of The 515 Program Initiative, Tiffany Ning Hu

Public Health Theses

Background: The US Food and Drug Administration (FDA) is in charge of regulating medical devices and one key power the FDA has to ensure safety and effectiveness of these devices is risk reclassification. One example of this regulatory power is the 515 Program Initiative, where the FDA was tasked with reclassifying preamendment devices that had never undergone initial rigorous review before entering the market.

Objective: The objective of this thesis project is to characterize the device types reassessed under this program and determine what characteristics the FDA heavily considers when making a risk classification determination.

Methodology: Data was collected on …

You Win Some, You Lose Some: An Analysis Of Medicare For All’S Differential Impact On Hospital Finances, Leah Sussman

Public Health Theses

Background: High health care costs have led to an unprecedented number of policy proposals to reform the United States health care system. Proponents of Medicare For All (M4A) argue that a single-payer system would reduce costs by allowing the government to obtain better prices from providers. M4A would have varying effects on sources of hospital revenue, increasing some payment while decreasing others. This paper explores the differential effects of M4A on hospital income.

Methods: This paper uses data from CMS’s Healthcare Cost Report Information System (HCRIS) to create a baseline model reflecting hospital revenues and costs under current hospital payment …

Cost Effectiveness Of A Produce Prescription Intervention, Danielle Raso

Public Health Theses

In this study, we examined the effectiveness, cost, and cost-effectiveness of a produce prescription program. The program analyzed in this study is run by Community Health and Social Services (CHASS) Center, a Federally Qualified Health Center (FQHC) in Detroit, Michigan. The prescription produce intervention begins with eligibility screening and referral by patients’ physicians at clinical visits for eligibility. Eligible patients are then given “prescriptions” for free fruits and vegetables that they can exchange at participating farmers markets or farm stands. Farmers markets also host cooking demonstrations and distribute healthy recipes. Finally, coordinators and volunteers follow up with patients and provide …

The Health Action For Psychiatric Problems In Nigeria Including Epilepsy And Substances (Happiness) Project: A Preliminary Mixed-Method Evaluation, Casey Jia-Chyi Chu

Public Health Theses

Background: The Health Action for Psychiatric Problems in Nigeria Including Epilepsy and Substances (HAPPINESS) Project is a mental health capacity building intervention based in Imo State, Nigeria that incorporates the World Health Organization’s Mental Health Gap Action Programme (mhGAP). So far, the HAPPINESS Project has trained 36 primary care workers (doctors, nurses, and community health extension workers) in one initial training (covering 5 local government areas) and one refresher training. The goal of this project is to leverage Imo State’s widespread primary care network, to address gaps in access to mental health care.

Objective: To evaluate the impact of the …

Gaps In Mental Healthcare Use And Perceived Quality Between Privately Insured Lgb And Heterosexual Individuals In The United States, Yuki Hayashi

Public Health Theses

Previous research has identified significantly heightened levels of mental health issues and psychological distress among lesbian, gay, and bisexual (LGB) individuals in the U.S., as well as greater mental health service utilization among this population. Using a nationally representative sample of privately insured adults in the U.S., we investigate differences in mental healthcare utilization, characteristics of mental healthcare received, and perceived quality of care between LGB and heterosexual individuals. Key results find that privately insured LGB men and women are significantly more likely than their heterosexual counterparts to have used outpatient mental healthcare as well as out-of-network (OON) outpatient mental …