Health and Medical Administration Commons^™

Did Maryland’S All-Payer Global Budget Revenue Model Change Hospital Margins And Revenue Per Discharge? A Difference-In-Differences Analysis Of Maryland And Massachusetts, 2010–2023, Kola Adegoke

Health & Biomedical Sciences Faculty Publications

Background: Maryland implemented an all-payer hospital global budget revenue (GBR) model in 2014 to decouple hospital revenue from volume and improve revenue predictability. This study evaluated whether Maryland’s 2014 GBR implementation was associated with differential changes in hospital total margins, inpatient revenue per discharge, and COVID-period margin volatility relative to Massachusetts.

Methods: A matched hospital-year panel for Maryland and Massachusetts spanning 2010–2023 (2,261 matched observations) was constructed by merging Medicare cost report-based financial measures with provider characteristics using CMS certification identifiers. Two-way fixed-effects difference-in-differences models with hospital and year fixed effects and hospital-clustered standard errors estimated post-2014 changes in outcomes …

A Longitudinal Analysis Of Hospital Consumer Evaluation In Virginia, Tulay Akmandor Inac

Health Services Research Dissertations

Suboptimal patient experience signals a need to improve clinical efficacy, patient safety, and healthcare quality. The COVID-19 pandemic intensified hospital resource and staffing demands, reducing hospitals’ capacity to invest in patient experience improvement. Prior studies remain limited because many lack longitudinal structure and organized theoretical models, making temporal inference difficult and weakening analyses of patient experience disparities. To address these limitations, this dissertation incorporates three studies examining patient experience and pandemic-related effects.

In state-level markets comparable to Virginia, limited research has examined longitudinal patient experience trends across regional hospital systems using HCAHPS scores. The first study uses descriptive trend analysis …

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Pharmacist Quality Of Work-Life During Covid-19 Pandemic In Cagayan De Oro, Junnin Gay Labrigas Garay, Rugine Riel D. Barsobia, Zoe Kyra Evasco, Bonnie Louise Elorde

Pacific Journal of Health

During the COVID-19 pandemic, pharmacists have been one of the most accessible healthcare workers working in the frontline providing the medication and drug needs of patients. Their roles and responsibilities in work expanded and to some redefined as the pandemic hit. Adjustments in their work, and workplaces were also implemented in adherence to the pandemic situation. The quality of work life of frontline pharmacists were affected because of the changes brought by the pandemic. A descriptive qualitative study design was used to determine the pharmacist’s quality of work-life during the COVID-19 pandemic in Cagayan de Oro City. The place was …

Assessing The Impact Of The Covid-19 Pandemic On Mental Health In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Emily Reilly, Jessica Ivanov, Victoria Youssef, Lily Roessler, Maikel Monsour, Nils Brolis

Rowan-Virtua Research Day

Background

Mental health is an important part of patient care, therefore it is imperative to understand how it’s recognized and treated. Socioeconomic status and the COVID19 pandemic contribute to disproportionate incidences of mental illness^{1, 2, 10, 11, 12}. This study uses data from a student-run clinic, the Rowan-Virtua Community Health Center (RVCHC), to examine disparities in mental health needs and screenings among the local population.

Hypothesis

It was hypothesized that underserved populations are at a disadvantage when it comes to both mental health screenings and treatment due to restricted access to healthcare and other unmet needs. Additionally, the …

An Exploration Of Substance Abuse By Healthcare Workers During The Covid-19 Pandemic: A Scoping Review, Andrew Hills

Capstone Experience: Master of Public Health

Objective

This scoping review aims to identify available literature and research on substance abuse by healthcare workers (HCWs) during the COVID-19 pandemic to examine whether the stress of their duties during the pandemic exacerbated existing issues of substance abuse.

Methods

A literature search using PubMed and Google Scholar using Harzing Publish or Perish identified 100 relevant professionally-authored, peer-reviewed, English-language academic articles published between 2015 and 2025 on substance abuse by HCWs. Exclusions were done via a review of the abstract and then from the full text, reducing the number of articles to three from those three articles which generated an …

Duty To Care And Job Turnover Intention In The Post-Pandemic Nursing Workforce, Cathleen A. Lopez

Nursing Theses and Dissertations

Natural and human-made disasters are increasing in number and intensity. In 2020, approximately 688.3 million people required assistance from disaster response personnel. During a disaster or pandemic, nurses must weigh their personal and/or family safety against the ethical code of caring for others. The purpose of this convergent mixed-methods study was to examine duty to care and job turnover intention of registered nurses working in patient-facing roles. A convergent mixed method design was used to address research questions by employing the Nash Duty to Care Scale (NDCS) and the Turnover Intent Scale (TIS-6). Open-ended survey questions were used to explore …

Lessons Learned From The Covid-19 Pandemic Crisis Management In The Gaza Strip: A Qualitative Study., Belal Aljamal

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

Aims of the study: The main aim of this study was to discover the lessons learned from the COVID-19 pandemic crisis management from health policymakers' perspective in the Gaza Strip. Methods: The researcher used a qualitative design, targeting 25health policymakers using a purposeful sampling technique and face-to-face semi-structured interviews to collect data. To analyze the interview data, the directed qualitative content analysis approach was used.

Results: All interviewees agreed that the Palestinian Ministry of Health (MoH) managed the COVID-19pandemic well despite the insufficient resources and lack of experience. More specifically, the average of most participants’ assessments of Palestinian MoH “Preparedness” …

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society …

Learning Dissemination Strategies: Lessons From The Covid-19 Pandemic In Training Healthcare Professionals In Disease Management, Kishan Vishanagra

Honors Undergraduate Theses

The COVID-19 pandemic presented many challenges for global healthcare systems, requiring rapid training and dissemination of disease management strategies among healthcare professionals. This study conducts a systematic review of 37 studies to examine the learning dissemination methods created and utilized during the COVID-19 pandemic, focusing on just-in-time training for disease management. This study identifies four core training topics: airway management, infection control, cardiopulmonary resuscitation, and patient triage. This study also categorizes delivery methods into in-situ simulation-based training, online e-learning platforms, online simulation-based training, and hybrid training models. Findings highlight that simulation-based training methods proved effective for invasive high-risk procedures, while …

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 …

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 …

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 …

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: …

My Journey With Tinnitus, Jack Curtain

Narrative Medicine: Essays on Health and Care

No abstract provided.

The Effect Of Covid-19 Pandemic On Sanitation Practices And Anxiety In The General Population, Leah Cliatt, Joanna Petrides

Rowan-Virtua Research Day

Background: Illness anxiety and fear of contracting coronavirus increased considerably during the COVID-19 pandemic. The media, being in lockdown, and cyberchondria had the largest impact on the population’s anxiety surrounding illness. While this kind of reaction to illness is expected during the pandemic, there is limited data on post-pandemic illness anxiety levels in the general population. Patients’ perception of disease impacts medicine at every level; medical professionals need to understand the concerns and fears of their patients in order to treat the post-pandemic patient. We hypothesized that sanitation practices and anxiety surrounding illness have not returned to baseline pre-COVID-19 …

The Impact Of The Covid-19 Mask Mandate On Effective Communication Between Healthcare Providers And Deaf/Hoh Patients, Antonia J. Conti, Alexa Gingerich

Rowan-Virtua Research Day

During the peak of the COVID-19 pandemic, many countries mandated the use of facial masks in public environments, especially in healthcare settings.[3] While this was beneficial in reducing the spread of the coronavirus disease, it created many challenges for the deaf/HoH community.[4] In particular, it limited effective communication between healthcare providers and deaf/HoH patients. It was found that masks limit word recognition for both deaf/HoH and non-deaf/HoH individuals. Additionally, both surgical and N95 masks hinder word recognition for deaf/HoH individuals and significantly impact communication during medical appointments.

Investigating Risk Factors Contributing To The High Incidence Of Covid-19 Among The Diné People Of The Navajo Nation, Elizabeth Lila Reynolds

Rowan-Virtua Research Day

Background: COVID-19 became international news in December 2019 and subsequently impacted global health. The research shows that the Diné people of the Navajo Nation were one of the most severely impacted populations¹. The Navajo Nation is a region spanning Arizona, New Mexico, and Utah that is composed of North American indigenous people known as the Diné. Purpose: To explore the risk factors contributing to the increased rates of COVID-19 infection and severity of infection among the Diné people. Methods: This literature review research process utilized PubMed and JAMA to find scholarly articles on this topic. Search terms …

Singh Thattha Beard Covering Technique And Quantitative Fit Testing Of A Tight-Fitting Filtering Facepiece (Ffp3), Harmann Singh, Allen Ecker, Todd Schachter, Thomas Boyle, Matthew Vanek

Rowan-Virtua Research Day

The study aimed to evaluate the effectiveness of the Singh Thattha beard covering technique when quantitatively fit testing tight-fitting filtering face masks (N95 respirators) on male members of the Sikh religious group. During the COVID-19 pandemic, Sikh healthcare workers faced the difficult decision of either shaving their unshorn beards to continue their profession or finding alternative solutions to maintain adequate respiratory protection. The study used a quantitative fit test method to measure the number of particles inside and outside the mask, calculating a fit factor. Participants performed exercises while wearing an N95 respirator and then repeated the exercises with a …

Observational Analysis For Predicting Initial Spikes In Testing Volume Of Cohorts Inside And Outside Of A Regional Covid-19 Screening Program, Adam M. Franks, Seth Bergeron, Tammy Bannister, Justin Spradling, Tamara Lowe, Paris Johnson, Rajan Lamichhane, Stephen M. Petrany

Marshall Journal of Medicine

BACKGROUND Containing the highly contagious SARs-CoV-2 pathogen requires a safe and effective screening program. The aim of this observational cohort study is to analyze a regional testing center and identify factors predicting testing rates that direct supply and staffing needs.

METHODS A drive-through SAR-CoV-2 regional testing facility was created. Number of tests and positive results were collected for eighteen months. Data for testing demand was compared to positive results, percent positive rates (PPR), known external factors, and county PPR. Dissimilarities were contrasted with dynamic time warp and a detailed agreement analysis. The Grainger’s test was utilized to assess the degree …

The Lived Experiences Of Counselors-In-Training Completing Practicum And Internship During Covid-19, Shelby Lauren Dillingham

Counseling & Human Services Theses & Dissertations

COVID-19’s classification as a pandemic in March 2020 changed numerous professions as they adjusted to social distancing expectations. Mental health providers particularly encountered transitions that included higher acuity caseloads, working different hours, and increased exposure to COVID-19. Counselors-in-training (CIT) faced the dilemma of earning their clinical hours in a safe manner, especially CITs working within integrated healthcare settings, such as hospitals or clinics. Despite some research with licensed professional counselors, limited research exists examining CITs' experiences working during the COVID-19 pandemic. This study sought to understand the lived experiences of CITs who completed their clinical hours in an integrated behavioral …

Understanding The Importance Of Administrative Mental Health Support For Frontline Nurses Post Covid-19, Sarah Mah

Nursing | Senior Theses

During the peak of the COVID-19 pandemic, intensive care units and critical care units were overwhelmed with the number of patients that were on the floors. It was during this time that nurses were experiencing the most mental health decline.

Several factors can be associated with the rapid decline of nurses’ mental health. However, these issues could ultimately stem from the lack of action taken by healthcare administration. This includes increased workload and the lack of PPE, resources institutional support. Because these units played such a vital role during the pandemic, it is imperative that healthcare administrators do what they …

Unpacking The Influencing Factors Of Telehealth Usage Among Older Consumers, Xiaojing Sheng, Yuri Martirosyan, Khondoker Sayeed Hossain, Reto Felix, Arjun Singh

Marketing Faculty Publications

This research unpacks the challenges and motivations of telehealth usage among older consumers—an understudied population in the extant telehealth literature. Through surveying a sample of older consumers who regularly migrate to winter in the southern areas of the United States, our qualitative analysis uncovers motivations (i.e., convenience, ease of use, efficiency, and a forced option) and challenges (i.e., telehealth limitations, privacy concerns, and lack of trust, access, and skills) of older consumers’ telehealth usage. Further, logistic regression identifies attitude toward telehealth, gender, and health status as significant predictors of telehealth usage behavior. Contributions to theory and practice are also discussed.

Creating The New Normal: A Historical Approach To Understanding Marketing Agility And Its Implications Across Business, Healthcare, And Social Welfare In A Post Pandemic World, Elan Burton, Delancy Bennett, Linda Burton

Atlantic Marketing Journal

The purpose of this article is to expand our understanding of how marketing agility shapes business, healthcare, and social welfare policy and societal responses to global pandemics. We set the stage for this discussion by presenting an historical exemplar case of marketing agility during the 1918 Influenza pandemic in the US. Next, we outline a necessary conceptual revision and update to previous treatments of marketing agility relative to historical pandemics considering the recent COVID-19 pandemic. Our novel conceptualization focuses on a firm’s (business, healthcare, social welfare) prompt response to dynamic and turbulent circumstances beyond the control of the firm (Araújo …

Screening For Food And Nutrition Insecurity In The Healthcare Setting: A Cross-Sectional Survey Of Non-Medicaid Insured Adults In An Integrated Healthcare Delivery System, Carmen Byker Shanks, Nancy P Gordon

Faculty, Staff and Student Publications

OBJECTIVES: Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity …

Emergency Remote Teaching And Transition To Nursing Practice During The Covid-19 Pandemic: An Interpretative Phenomenological Analysis, Carrie Watkins Jeffrey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this phenomenological study was to explore the lived experience of new nurses in the United States who experienced Emergency Remote Teaching (ERT) for most or all of their nursing education during the COVID-19 pandemic and how they perceive ERT influenced their transition to practice during their first year as registered nurses.

Background: The National Council of State Boards of Nursing reports that in 2021, the overall pass rate for first-time NCLEX-RN® demonstrated the sharpest decline since 2013. Most of the 185,000 nursing students who took the exam in 2021 and 2022 received their nursing education during …

Catheter-Associated Urinary Tract Infections: Patient Characteristics, Treatment, And Clinical Outcomes In One South Texas Acute Care Hospital, Kimberly A. Ambrosini, Jose Campo Maldonado

Research Colloquium

Background: Catheter-associated urinary tract infections (CA-UTIs) account for 40 percent of nosocomial infections worldwide. Their elimination is at the forefront of quality improvement in one South Texas acute care hospital.

Methods: Over a period of 6 months, five CA-UTIs occurred in one South Texas acute care hospital. These cases were identified via regular surveillance by Infection Prevention staff and the Laboratory Department of the hospital. This research reviews patient age, sex, length of stay, bacteria contracted, appropriate antibiotic use, patient characteristics, and overall outcomes.

Results: Between the months of July and December 2021, 5 CAUTIs were contracted. Patients ranged in …

Impact Of Academic Golden Weekend Initiative On Academic Success For An Internal Medicine Clerkship, Elif S. Duran, Maria A. Alvarenga, Stephanie Onyechi, Jose E. Campo Maldonado

Research Colloquium

Background: COVID-19 precautions led to a change in the number of protected weekends for the UTRGV Internal Medicine Clerkship, going from 2 protected weekends to none. The aim of Academic Golden Weekends during a fully inpatient clerkship has been to maximize the student experience by providing enough time to balance all the necessary components of the student experience. Starting April 26, 2021, all cohorts completing their Internal Medicine Clerkship as third-year medical students had 3 protected weekends.

Methods: Two surveys were created to compare the pre-intervention and post-intervention cohorts. The surveys focused on student satisfaction regarding the time they had …

Patient And Provider Perceptions Of Rapid Telehealth Implementation During The Covid-19 Pandemic, Ryan G. Seibert, Amanda K. Stephenson, Aubrey K. Podell, Yuxiu K. Lei, Sheri K. Keitz

The Lahey Journal

Introduction: Despite unprecedented telehealth adoption during the COVID-19 pandemic, its post-pandemic preservation remains uncertain. Understanding key stakeholders’ perspectives on telehealth during the pandemic can inform evidence-based policies and promote effective, sustainable virtual-based care.

Methods: Patients and providers who completed telehealth visits during the early pandemic in primary care, subspecialty, and surgical outpatient clinics at a large community-based academic medical center in New England were surveyed via telephone interviews or electronic surveys. Thematic analyses of qualitative comments further characterized experiences.

Results: Of 1,729 eligible patients called, 969 were contacted and 778 participated (response rate 80.3% among contacted patients). Among 753 eligible …

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …