Health and Medical Administration Commons^™

Forecasting Covid-19 Cases, Hospital Admissions, And Deaths Based On Wastewater Sars-Cov-2 Surveillance Using Gaussian Copula Time Series Marginal Regression Model, Hueiwang Anna Jeng, Norou Diawara, Cynthia Jackson, Rekha Singh, Kyle Curtis, Raul Gonzalez, David Jurgens, Sasanka Adikari

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Modeling efforts are needed to predict trends in COVID-19 cases and related health outcomes, aiding in the development of management strategies and adaptation measures. This study was conducted to assess whether the SARS-CoV-2 viral load in wastewater could serve as a predictor for forecasting COVID-19 cases, hospitalizations, and deaths using copula-based time series modeling. SARS-CoV-2 RNA load in wastewater in Chesapeake, VA, was measured using the RT-qPCR method. A Gaussian copula time series (CTS) marginal regression model, incorporating an autoregressive moving average model and Gaussian copula function, was used as a forecasting model. Wastewater SARS-CoV-2 viral loads were correlated with …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

Analisis Klaim Pending, Verifikasi Dan Audit Pascaklaim Jaminan Kesehatan Nasional, Anugrah Aulia Ulil Amri, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

The implementation of Indonesia’s National Health Insurance (JKN) poses new challenges for hospitals as service providers. Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, the program’s administrator, now routinely conducts post-claim verifications and audits after claims have been paid. This often results in claim adjustments or even full reversals of previously reimbursed amounts. This case study examines JKN claim management at a Type D General Hospital in 2022, focusing on pending claims, verification, and post-claim audits, using a systems theory framework. Key issues in pending claims include incomplete medical records (29%), insufficient supporting documents (24%), and coding errors (21%). Post-claim problems primarily …

The Role Of Social Health Insurance In Achieving Universal Health Coverage In Asia: A Systematic Review, Afaf Jauhar, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as …

Priorities To Care Within The Military Health System: A Mixed Methods Study On Military Spouse Access To Care During Covid-19 On Okinawa, Elayne L. Wilson

Theses & Dissertations

Military spouses in Okinawa experienced denial of care at military treatment facilities and off base Japanese healthcare facilities during the COVID-19 pandemic. Over two years of travel restrictions further contributed to difficulties accessing healthcare while stationed on the island with their active-duty spouse. This study examined the implications of a priority-based access system through the TRICARE program implemented due to limited resources during COVID-19 and its impact on military spouses in a scarce medical resource environment. This concurrent mixed-methods research used a survey tool developed by Community First Hawaii to quantify access to healthcare and in-depth interviews to further explore …

Analysis Of Public Opinion Polls About Covid-19 Vaccines: Theoretical And Policy Implications For Vaccine Communication And Campaigns To Address Vaccine Hesitancy, Muhammad Ittefaq, Hong Tien Vu, Ali Zain, Tayyeb Ramazan, Gary L. Kreps

School of Communication Studies - Faculty Scholarship

This study analyzed 1432 questions asked in 19 surveys (N = 43,014) on COVID-19 vaccines between January 2020 and August 2022 using dimensions including (1) information sources about COVID-19 vaccine, (2) information about the access, effectiveness, and side effects of COVID-19 vaccine, (3) COVID-19 vaccine hesitancy (i.e. false perception, skepticism, and vaccine refusal), (4) motivations to get the COVID-19 vaccine (i.e. to perform routine activities, convenience, incentives, influences, and travel requirement), (5) false perceptions caused vaccine refusal, and (6) intentions to get vaccinated. Our results show that vaccine refusal was rampant throughout the pandemic and mostly attributed to the …

Does Physician-Hospital Vertical Integration Affect Hospital Output?, Soumya Upadhyay, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Background: Physician-hospital vertical integration is gaining steam but it is unclear how they affect hospital output.

Objective: To examine the direct impact of vertical integration on hospital output.

Design: A pooled design with 6-year data using linear regressions was used. Then, panel data design with hospital fixed effects was used.

Methods: We linked American Hospital Association data (2016-2021) with AHRQ Comparative Health System Performance Initiative’s Compendium (2018, 2020, 2021; 34 987 hospital-year observations) to develop new measures of vertical integration and assess its relationship with several measures of hospital output including annualized total admissions, total number of inpatients days, …

The Living Document: Medical Records As A Malleable Presence, Camilla Lyckblad

Proceedings from the Document Academy

Understanding why individuals might safeguard information or keep secrets in working documents such as medical records is essential for the development of good quality care, fostering an environment where both patients and staff feel secure to part with sensitive information, encouraging more honest and open communication as well as improved quality of care. This ongoing research aims to deepen comprehension of information behavior in clinical contexts, where the contemporary medical record, with its increasing properties such as open record access for patients, can be viewed as an entity that both listens and influences. This examination sheds light on the complex …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Exploring The Contribution Of Mobile Money To The Well-Being Of Rural Tanzanian Villagers And Assessing Their Readiness To Adopt A Similar Model To Advance Their Healthcare Access An Exploratory Study, Sr. Magdalena P. Chubwa

Seton Hall University Dissertations and Theses (ETDs)

Background: Healthcare for rural villages in Tanzania has always been rudimentary. Lack of the infrastructure and poverty are among the many obstacles facing this population’s access to healthcare. While, the rise of telehealth has improved access to healthcare in many parts of the world, its use in rural Tanzania has been extremely limited to poor internet access. However, given the availability of non-internet connected mobile phones in rural Tanzania, the potential to use this devise to improve healthcare access exists. Individuals using mobile phones for financial transactions may be motivated to access healthcare via telehealth by using their non-internet connected …

The Southern Nevada Care Economy: Addressing Child Care And Elder Care Challenges, The Lincy Institute

Lincy Institute Events

This community forum examines the economic and societal impact of the “care economy” in Southern Nevada in collaboration with Tripp Umbach, a nationally recognized consulting firm that provides comprehensive services including research and strategic plans to further the operations and activities of healthcare services.

Central to the care economy is elder care and child care. Having access to elder care and child care services is essential to working age adults, many of whom need one or both types of services to continue participating in the workforce. The delivery of child care and elder care services have far-reaching implications for our …

The Southern Nevada Care Economy: Challenges And Opportunities, Tripp Umbach

Policy Briefs and Reports

National policymakers increasingly recognize the care economy as an essential economic driver, contributing $648 billion annually to the U.S. economy and supporting 3.6 million jobs. The care economy is also critical in driving economic development and prosperity in Southern Nevada. Yet, as this Tripp Umbach analysis finds, Southern Nevada’s care economy dramatically underperforms compared to national benchmarks and peer regions. High caregiving costs and limited access to care for children, seniors, and individuals with disabilities in Southern Nevada strain families, businesses, and public resources. This burden reduces workforce participation, productivity, and economic growth. Low pay and high turnover among care …

Patient Engagement And Co-Creation In Healthcare Services: A Scoping Review, Thiruppavai Sundaramurthi, Smita Mathews, Ella Bermudez, Satish M. Mahajan

Patient Experience Journal

Objective: The objective of this review was to find literature related to the concepts of patient engagement and co-creation in healthcare services and identify models and/or frameworks that combined these concepts. Methods: We developed the eligibility criteria using the Population-Concept-Context framework applicable to studies with population of patients exploring the concepts of engagement and co-creation in the context of healthcare services. The search was conducted in PubMed, CINAHL, Cochrane, APA PsycINFO, and Ovid MEDLINE. We searched for articles in English with no search limitations on publication dates. Reviewers screened abstracts and full texts to identify articles for data …

Quality Of Outpatient Care In Lebanon: A Cross-Sectional Survey, Georges Choueiry, Anna Maria Henaine, Rayan Darwish, Pascale Salameh

Patient Experience Journal

Patient experience is an important driver of healthcare improvement. Yet, in Lebanon, there is a lack of studies focusing on the satisfaction of outpatients with healthcare quality. This study aims to assess the quality of outpatient care in Lebanon from the patient’s perspective and identify its determinants. A cross-sectional survey was administered, between December 2023 and January 2024, to 265 participants over 18 years old who consulted a healthcare provider, excluding dentists. We used linear regression to determine factors affecting consultation quality as perceived by the participants. Waiting time before consultations typically ranged from 5 to 15 minutes, the average …

Experiences Of Using Electronic Medical Records Among Patients From Ethnic Minority Backgrounds: A Rapid Review, Corey Adams, Reema Harrison, Alison Merchant, Narelle Arblaster, Tracey Bucknall, Kathleen Gray, Guncag Ozavci, Nilmini Wickramasinghe, Vicky Yuan, Elizabeth Manias

Patient Experience Journal

This study explores the experiences of individuals from ethnic minority backgrounds using electronic medical records (EMRs) and identifies strategies to improve the inclusivity and usability of EMRs, aiming to reduce the digital divide in their access and use. A rapid review of the literature was conducted using Medline, Embase, and CINAHL databases to identify relevant studies published between 2010 and November 2023, with the assistance of a medical librarian.

A total of 44 studies were included in the review, revealing significant disparities in EMR adoption and utilization among ethnic minority groups. Three key themes of inequality were identified: presentation of …

Patients' Perceptions: A Group Differences Study Twelve Months Before And Twelve Months During A Worldwide Pandemic, Nancy B. Valla

Patient Experience Journal

Objective: The COVID-19 pandemic subjected healthcare systems' to decreasing operational margins, enhanced regulatory scrutiny, and challenges related to patients' expectations. Until now, there was a lack of empirical evidence studying patients' perceptions prior to versus deep immersion into the pandemic. Methods: This quantitative non-experimental ex post facto causal-comparative study examined if and to what extent there were significant differences in patients' perceptions of the nurses' communications, doctors' communications, overall hospital rating, and willingness to recommend before versus during the COVID-19 pandemic for HCAHPS participating hospitals in California. The final sample size was 292 facilities grouped by two identically …

Why Human Experience Matters, Jason A. Wolf

Patient Experience Journal

As we close the 11^th volume of Patient Experience Journal and a pivotal year for experience efforts globally, it provides a moment of pause, of reflection, and an opportunity to return to purpose. As a publication accessed in over 220 countries and territories around the world, I am heartened by the fact that what is shared on these pages moves you. That what our amazing authors contribute here truly matters. This issue, with its 24 insightful articles, brings our total publication count to 570 articles. These pieces have informed us, pushed our thinking, and challenged our beliefs. This is …

Understanding The Impact Of Covid-19 On Yoga Instruction: Examining Teaching Methodology, Class Components, And Injury Patterns In The Northeastern Us, Sojung Kim, June Solow, Donald H Lein, Harshvardhan Singh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: This study aimed to examine the impact of COVID-19 on the perspectives of yoga instructors (YIs) regarding teaching methodology, class components, and yoga-related injuries among their clients DESIGN: A cross-sectional design in this study.

SETTING: A total of 407 YIs from Northeastern United States completed a customized, web-based survey.

MAIN OUTCOME MEASURES: Chi-square tests were carried out to determine changes in yoga teaching format before and during the pandemic, as well as the counts of yoga related injuries between face-to-face (FtoF) and online teaching format. Independent t tests were used to compare the characteristics of yoga teaching elements.

RESULTS: …

Hepatotoxicity Induced By Immune Checkpoint Inhibitors, Flaviu Muresan, Olga Hilda Orasan, Angela Cozma, Madalina Daiana Bancos, Lorena Ciumarnean, Mircea Vasile Milaciu, Tinca Codruta Pocol, Nicoleta Valentina Leach, Teodora Gabriela Alexescu, Ovidiu Vasile Fabian, George Ciulei, Mirela Georgiana Perne

Journal of Mind and Medical Sciences

Immune checkpoint inhibitors (ICIs) are an effective immunotherapeutic approach for cancers affecting the lung, skin, kidney, mammary gland, or certain hematologic malignancies. Regarding the prognosis of these oncological conditions, treatments with ICIs open new therapeutic perspectives with benefits for both patients and healthcare providers. A drawback of immune checkpoint inhibition is the occurrence of immune-related adverse events that can involve a wide range of organs, such as the liver. Given widespread usage of immunotherapy, the number of patients who suffer from this unwanted condition has increased. Hepatopathy induced by ICIs can be severe and can even lead to death. Detecting …

Enhancing Patient Safety: The Role Of Interdisciplinary Teams In Reducing Blood Culture Contamination, Austin Patrick Eisenberg, Fady M. Awad, Brian Watson, Mohammed Faris

HCA Healthcare Journal of Medicine

Background

Blood cultures are vital to diagnostic workups among many hospitalized patients, providing valuable information about bloodstream infections (BSIs), which cause roughly 250 000 deaths annually between North America and Europe. Despite advances in health care, blood culture contamination remains a substantial problem, with deleterious effects on patient mortality, patient and hospital costs, and microbial resistance. This article reviews the repercussions of blood culture contamination on the health care system and delineates evidence-based strategies to decrease contamination rates.

Methods

To reduce blood culture contamination rates, our health care facility undertook a quality improvement initiative. A task force was created, consisting …

Hospital Readiness To Implement Electronic Medical Records: A Systematic Literature Review, Afni Fatmasari, Mardiati Nadjib

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Implementing electronic medical records (EMR) in hospitals can increase the efficiency and effectiveness of health services. However, hospitals' readiness to adopt this technology is influenced by various complex factors. This study aims to identify factors that affect hospital readiness in implementing EMR through a systematic literature review (SLR). The SLR process followed the PRISMA method and included a literature search from Scopus, PubMed, and Cochrane databases with keywords related to RME readiness, which yielded 412 articles. After the screening and eligibility stages, 19 articles were selected for further analysis. The findings of this research identify readiness factors based on the …

Analysis Of Continuous Ambulatory Peritoneal Dialysis Service Readiness At Rsud Kota Bogor In 2023, Ni Nyoman Diah Redyardani, Dumilah Ayuningtyas

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The availability of health service facilities certainly contributes to one of the success factors in the distribution of health services in Indonesia, including renal replacement therapy (RRT) services. Through Minister of Health Regulation (PMK) No. 8 of 2022, the government ensures that patients with end-stage renal disease (ESRD) receive equal access to RRT. One of the efforts to equalize dialysis services is implementing Continuous Ambulatory Peritoneal Dialysis (CAPD) services. Therefore, RSUD Kota Bogor must prepare for CAPD services in its dialysis installations. This research analyzes the readiness and efforts to provide CAPD services at RSUD Kota Bogor. This study employs …

Length Of Stay Di Instalasi Gawat Darurat Sebagai Indikator Mutu Pelayanan Kesehatan Di Rumah Sakit X Tahun 2024, Gustiane Adriani Dwisari, Kurnia Sari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The Emergency Department (ED) is crucial for ensuring patient care and safety in hospitals. A key performance indicator is Length of Stay (LOS), where prolonged LOS can lead to overcrowding, increase the risk of adverse events, and lower patient satisfaction. This study examines the service flow, barriers, and root causes of LOS in Hospital X's ED and provides improvement recommendations. Data were gathered through observation of 30 patients, interviews, and document reviews. Lean Thinking principles and the BAS method from BASICS (Baseline, Assess, Suggest Solution, Implement, Check Result, Sustain) were used in the analysis, employing flowcharts to map the process, …

Rencana Strategis Peningkatan Kinerja Poliklinik Eksekutif Rumah Sakit X Tahun 2024 -2027: Pendekatan Balanced Scorecard, Irfan Rohot Uli Manik, Adang Bachtiar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospital X is a private hospital that has executive polyclinic services. Medical record data shows that in the last four years, the number of visits from the executive polyclinic unit has never reached the target set. This research is to prepare the strategic plan for improving the executive polyclinic of Hospital X's performance for 2024-2027. The types of data in this research are primary data and secondary data. Primary data is qualitative data from in-depth interviews, Consensus Decision Making Group (CDMG) with informants, and direct observation. Secondary data consists of quantitative data and qualitative data. Strategy implementation will be described …

Faktor Yang Berhubungan Pada Motivasi Pengguna Dan Implementasi Rekam Medis Elektronik Dengan Efisiensi Pelayanan Di Instalasi Rawat Jalan Rsud Kebayoran Lama, Jean Francis Melanny Kassiuw, Budi Hidayat

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Electronic Medical Records (EMR) have emerged as an innovative solution in healthcare because EMR offers several advantages and provides a comprehensive solution to improve health information management in today’s digital era. This study applies the Technology Acceptance Model (TAM) as its theoretical foundation, aiming to evaluate the relationship between user perceptions of key factors influencing EMR implementation and service efficiency in the Kebayoran Lama Regional Hospital outpatient unit. The research design is non-experimental with a quantitative approach, utilizing numerical data analyzed through Structural Equation Modeling (SEM). The study collected data on user perceptions regarding EMR implementation and service efficiency through …

Manajemen Rumah Sakit Dalam Kesiapsiagaan Menghadapi Bencana Di Rsud Balaraja: Metode Hospital Safety Index, Puspita Gaharu Nisaa, Robiana Modjo

National Journal of Occupational Health and Safety

Hospitals are required to provide health services under disaster conditions, serving as the front line to help survivors and patients. RSUD Balaraja of Tangerang Regency, the only Type B hospital owned by the Regency Government, is exposed to high potential disaster hazards, including floods, extreme waves, abrasions and tsunamis, as well as moderate risk of earthquakes. This study aims to analyse hospital management in disaster preparedness using a cross-sectional design with quantitative and qualitative approaches through Module 4 of the Hospital Safety Index and a phenomenological approach. The results showed that hospital management was rated as moderately safe in disaster …

Social Determinants Of Health And How They Affect A Small Rural Community (Case Study) Eastern Shore Of Maryland, Kristopher S. Durham, Lindsay Gietzen

Pacific Journal of Health

The Eastern Shore of Maryland is rural and is characterized by prevalent poverty, housing instability, lack of access to healthcare, chronic diseases, substance abuse, and issues with transportation to access healthcare services. The same problems exist for the population in Maryland and the United States. Understanding the challenges experienced by rural communities in Maryland is critical to addressing the vulnerable population. This study is an explanatory case study that examines the social determinants of health and how those affect small rural communities on the Eastern Shore of Maryland by examining literature published between 2016 and 2024. The literature reviewed resulted …

Preventing The Next Fall: The Power Of A Simple Checklist In Reducing Patient Falls, Ryan P. Bialaszewski, Michael Sander, Maria Hincapie, Rita Garza, Aurora Cavazos

MEDI 9331 Scholarly Activities Clinical Years

Background:
Preventable medical errors and adverse events in US hospitals are far too common and contribute to an estimated $17 billion annually in healthcare expenditures. Falls comprise the majority of these preventable adverse events and are a significant cause of increased healthcare costs, prolonged hospital stays, and patient morbidity and mortality. The average cost per hospital fall is estimated at $62,521 ($35,365 direct costs). Despite numerous preventative measures, the complexity of managing multiple interventions can lead to inconsistent application. Inspired by the success of surgical "time-out" checklists in operating rooms, we hypothesized that a standardized checklist for fall prevention could …

Churning The Tides Of Care: When Nurse Turnover Makes Waves In Patient Access To Primary Care, Kelley Arredondo, Ashley M Hughes, Houston F Lester, Trang N D Pham, Laura A Petersen, Lechauncy Woodard, Richard Sorelle, Cheng Rebecca Jiang, Frederick L Oswald, Daniel R Murphy, Hilary N Touchett, Joshua Hamer, Sylvia J Hysong

Faculty, Staff and Students Publications

BACKGROUND: Team-based primary care (PC) enhances the quality of and access to health care. The Veterans Health Administration (VHA) implements team-based care through Patient Aligned Care Teams (PACTs), consisting of four core members: a primary care provider, registered nurse (RN) care manager, licensed vocational nurse, and scheduling clerk. RNs play a central role: they coordinate patient care, manage operational needs, and serve as a patient point of contact. Currently, it is not known how varying levels of RN staffing on primary care teams impact patient outcomes.

OBJECTIVE: This study aims to empirically assess how the stability of RN staffing within …