Other Medicine and Health Sciences Commons^™

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Abstracts From The 24th Annual Health Care Systems Research Network Conference, April 11–13, 2018, Minneapolis, Minnesota

Journal of Patient-Centered Research and Reviews

Founded in 1994, the Health Care Systems Research Network (HCSRN) is a consortium of 18 research centers that are housed in community-based health systems. The organization's annual conference serves as a venue for research teams to disseminate scientific findings, stimulate new collaborations, and share insights about conducting research in real-world care-delivery settings. Abstracts accepted for presentation at HCSRN 2018 are published within this supplement of the Journal of Patient-Centered Research and Reviews.

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …

Examining Injury Data Reporting Practices Among Wildland Firefighters, Erin M. Boggs

Graduate Student Theses, Dissertations, & Professional Papers

Wildland Firefighter (WLFF) Crews lack an injury surveillance program to collect information on non-traumatic and traumatic injuries. Tactical athletes including: police, military and structural firefighters all have a variety of collection systems in place for injury data collection. The lack of injury data prevents WLFF crews from identifying high-risk environments, implementing injury prevention programs, and improving the overall quality of care on the job. Over the last several decades the recent rise in wildfire occurrences and wildfire suppression costs creates a need for healthy and strong individuals in the field. The cost of firefighter salaries and medical care can be …

Lessons Learned From Revising The Cancer Plan For Michigan, Dilhara Muthukuda Mph, Debbie Webster Bsn, Rn, Lmsw, Polly Hager Msn, Rn, Sarah Mott Mph, Ms, Rdn

Michigan Journal of Public Health

Comprehensive Cancer Control (CCC) programs are a collaborative method to address cancer burden. Each CCC program is required to have a cancer plan to guide activities to reduce the cancer burden in their jurisdiction and should reflect the most recent research and evidence-based strategies. In 2015, Michigan set out to revise its CCC plan that met the needs of its coalition while using a participatory process involving its network of approximately 100 stakeholders. A collaborative approach involving multiple workgroups was used to develop the criteria and content for the CCC plan. The Michigan Department of Health and Human Services (MDHHS) …

A Comparison Of Quality Indicators Between Medicare Accountable Care Organizations And Health Maintenance Organizations Using Publicly Available Data, William W. Campbell Iii

Theses and Dissertations

The purpose of this study is to explore differences in quality between Medicare Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). Three outcomes measures reported by these plans use different methodologies but possess enough alignment to permit comparison: percent of diabetic patients with last HbA1c > 9.0%, colon cancer screening rate and ER visits per 1,000. These outcomes are the dependent variables (DV). A secondary purpose is to explore differences in quality based on the size of the beneficiary population served, using the same measures.

As the Medicare program faces threats to its solvency in coming decades, with 10,000 baby …

A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra

Master's Theses

Tuberculosis (TB), is one of the top ten causes of death worldwide. TB is commonly linked to poverty and creates poverty as it is the single largest cause of death in the 15-49-year-old age group in South-East Asia (WHO, 2017). It is also linked to the HIV population, and its leading cause of death. TB is effected by socio-economic factors, cultural factors, and health policy. My goal of this dissertation is to identify systematic approaches that shall support the mission set by World Health Organization (WHO): to eliminate TB globally by the year 2050. Measures might include addressing social barriers …

Improving Service Delivery Through Provider Training: A Process Evaluation Of The Veterans Affairs Palo Alto Health Care System “Commitment To Serve” Workshop, Ismael Barrera

Master's Projects

As the customer-focused management strategies gradually advances into all of the VISNs [Veterans Integrated Service Networks], the Veterans Health Administration in Palo Alto, California implemented a customer service training program for employees to meet the diverse and complex needs of its customers. This research will analyze whether participants in this training, known as Commitment to SERVE, believe that it is achieving its goal. In other words, does the Veterans Affairs Palo Alto Health Care System (VAPAHCS) staff perceive the Commitment to SERVE workshop as a beneficial customer service training program?

Measuring The Impact Of Patient-Engaged Research: How A Methods Workshop Identified Critical Outcomes Of Research Engagement, Ellis C. Dillon, Leah Tuzzio, Sarah Madrid, Heather Olden, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

Purpose: While strategies to evaluate the influence of engaging patient partners in research, such as the Patient-Centered Outcomes Research Institute (PCORI) WE-ENACT surveys, are beginning to emerge, a systematic set of measures for assessing the impact of patient engagement in research (PER) on study approaches and outcomes is lacking. This article describes a workshop and process used to identify and develop Critical Outcomes of Research Engagement (COREs). It proposes preliminary measures for assessing the impact of PER on the research process and outcomes of research studies.

Methods: A group of 24 researchers and 5 patient partners participated in a PCORI-funded …

Positive Impact On Patient Satisfaction And Caregiver Identification Using Team Facecards: A Quality Improvement Study, Nicole M. Martin, Khalil Odeh, Lamya Boujelbane, Marvi V. Rijhwani, Susan Olet, Aijaz Noor, Colleen Nichols, Richard Battiola

Journal of Patient-Centered Research and Reviews

Background: Patients satisfaction is an increasingly important metric in measuring the quality of care that hospitals and physicians provide. It can be difficult for patients to remember their providers and their roles, all of which may potentially impact a patient’s overall satisfaction.

Purpose: To see if giving facecards with pictures and names of caregivers and description of roles improved patient satisfaction and identification of care team members.

Methods: Team facecards were designed and distributed to the patients during the interventional period of the study. Patients’ identification of team members, the role of each physician and overall satisfaction was measured using …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Evaluating Patient Preferences For Different Incentive Programs To Optimize Pharmacist-Provided Patient Care Program Enrollment, Daniel M. Tomaszewski, Tim Cernohaus, Rajiv Vaidyanathan

Pharmacy Faculty Articles and Research

BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM).

OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference.

METHODS: This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTMeligible beneficiaries from 2 employer groups and included …

Strategi Pemasaran Poli Bedah Estetik Bali Royal Hospital (Bros) Denpasar, Deity Indrayati Nugraha

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aims to create a good marketing strategy to determine the problems faced so it is expected that in the end the number of visits to the aesthetic surgery surgery BROS Denpasar has increased. This research uses qualitative method with observation, and in-depth interview. From the product-price mix, there are several strategies, namely by providing variations of products or additional services, buying aesthetic surgical instruments with the latest technology, and can also lower the rates of aesthetic surgery services. For the price place mix, the strategy is to move the esthetic surgical poly to a more private room. The …

Analisis Kesiapan Rumah Sakit Umum Daerah Kramat Jati Menjadi Health Promoting Hospital Tahun 2017, Winarto Winarto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The readiness of Regional General Hospital (RSUD) of Kramat Jati to become Health Promoting Hospital (HPH) is very important based on Health Promotion Standard of Ministry of Health Republic of Indonesia Year 2011. Therefore, the purpose of this research is to know the preparedness of RSUD Kramat Jati become Health Promoting Hospital, done by qualitative approach. The results showed that from six (6) standard of hospital health promotion, one (1) standard of hospital health promotion has been fulfilled by RSUD Kramat Jati, while five (5) standard of health promotion of hospital have not been fulfilled. Preparation of technical policies for …

Analisis Kesiapan Sistem Remunerasi Berdasarkan Peraturan Gubernur Provinsi Dki Jakarta Nomor 222 Tahun 2016 Di Rsud Pesanggrahan Tahun 2017, Endah Kartika Dewi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUD Pesanggrahan as a Health Service Unit of Special Capital Region of Jakarta which has applied financial pattern of Regional Public Service Board (BLUD). This research uses quantitative with simulation of system calculation to be applied and qualitative with explore stakeholder perception readiness with indepth interview. From the result of research it is known that in general the informant is satisfied with the income received now. And from the simulate conducted, RSUD Pesanggrahan has not been able to apply the system based on Governor Regulation No. 222/2016 yet. Suggestion to the Health Department as a regulator is to give the …

Analisis Elemen Bauran Pemasaran Yang Mempengaruhi Loyalitas Pelanggan Rumah Sakit: Systematic Review, Elisabeth Dewi Agustine

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Increasing the number of hospitals improves the competitive of medical services. Hospitals must have the right marketing strategy to retain old customers and attract new customers. To increase of the hospital customer loyalty, the marketing mix can be use as tool. Aim: To know the marketing mix elements that influence the loyalty of hospital customers. Preferred report items for systematic reviews and meta-analyzes (PRISMA) are evidence based methods for performing systematic reviews. There are 33.33% of the 9 studies that mention 7 elements (product, price, place, people, process, physical evidence, promotion) in the marketing mix, all of which affect the …

Analisis Penerapan Program Pencegahan Dan Pengendalian Infeksi Di Ruang Rawat Inap Rsud Tebet Tahun 2017, Tetyana Madjid

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The focus of this research is indentifying infection prevention and control program in Tebet hospital through observation of nursing action on infusion, bandage, injecting and waste management, and indentifying nurse’s characteristics, policies, facilities, monitoring and reporting of infection. This research using qualitative and quantitative approach. Unit analysis of this research is 105 of actions mentioned above by all nurses in the inpatient room. The results of this study show that most of the actions performed by the nurses were good, analysis with univariat, bivariat and logistic regression of multivariat. The most affecting variables is the reporting of infection. Suggestions for …

Analisis Standar Kompetensi Tenaga Kesehatan Di Rumah Sakit Bhakti Yudha Depok Tahun 2017, Syifa Silviana

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Competency of healthcare provider has significant impact on performance of the hospital. Measuring competency of healthcare provider are essential to improve better quality of service provisioned. The study evaluates competency of healthcare provider at Bhakti Yudha Hospital by using the competency standards established by multiple organizations of Indonesian national healthcare provider association mapped against eight units of health provider. The result stated that competency level of healthcare providers at Bhakti Yudha Hospital have had not met the expectations. It is concluded that working experiences and number of relevant training received has significant impact on competency level of healthcare provider.

Penerapan Lean Thinking Untuk Mereduksi Waktu Boarding Pasien Igd Ke Rawat Inap Di Rsud Koja Tahun 2017, Theryoto Theryoto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The implementation of the National Health Insurance Program (Program JKN) affects the increased number of patients to emergency unit and boarding patients that resulting crowding in the emergency unit. Koja Hospital has implemented bed management in order to reduce the boarding time of emergency unit patients but has not succeeded, so an effort to help reducing the boarding time of emergency unit patients to inpatient in order to continuous improvement was done using the lean thinking principle. This research uses operational research method and intervention with PDCA (Plan, Do, Check, Action) cycle. The study revealed that lean thinking approach could …

Managing The Cost Of Diabetes, Laressa Bethishou

Pharmacy Faculty Articles and Research

"This is of concern to health care providers because inadequate management of diabetes results in short- and long-term complications. Patients with diabetes and no health insurance have fewer physician visits and are prescribed fewer medications for management of their diabetes. Patients with diabetes make up 11.9% of all emergency department visits in the United States.Hispanic and non-Hispanic blacks are at greater risk for developing diabetes and serious associated health complications, including chronic kidney disease. This may be attributed to a combination of genetics, diet, and exercise. However, access to health care resources may also play an important role."

Drawbacks Of Utilizing The Logit Link In Propensity Score Weighting Adjustment, Evrim Oral

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

International Black-Market Organ Trade, Marni E. Granzow

Student Publications

The human organ trade is a global epidemic as citizens of developed-countries look to developing-countries to find organ donors, specifically exploiting the poor for their own personal gain. The impoverished organ donors are treated in an inhumane manner, as they are often left with serious medical complications and are not treated equally in the transaction.

Prevalence And Predictors Of Herbal Medicine Use Among Adults In The United States, Mohamed Rashrash, Jon C. Schommer, Lawrence M. Brown

Pharmacy Faculty Articles and Research

Objective: To describe the prevalence of herbal medicine use among US adults and to assess factors associated with and predictors of herbal use. Design: The data for herbal products use were collected from the 2015 National Consumer Survey on the Medication Experience and Pharmacists’ Roles. Chi-square test was used to analyz factors associated with herbal use, and predictors of herbal use were assessed with logistic regression analysis. Results: Factors associated with herbal supplement use include age older than 70, having a higher than high school education, using prescription medications or over-thecounter (OTC) medications, and using a mail-order …

Commencement Program 2017, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2017 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The University Honorees

26 | The Programs, The School Honorees, and The Speakers

• School of Medicine, 27
• School of Pharmacy, 52
• School of Dentistry, 64
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication Sciences and Disorders, Health Informatics and Information Management, Nutrition and Dietetics, Physician Assistant Sciences, Radiation …

When One Is Sick And Two Need Help: Caregivers’ Perspectives On The Negative Consequences Of Caring, Ilja Ormel, Susan Law, Courtney Abbott, Mark Yaffe, Marc Saint-Cyr, Kerry Kuluski, Debbie Josephson, Ann C. Macaulay

Patient Experience Journal

Informal or family caregivers contribute significantly to individual care, and to the Canadian healthcare system, yet receive limited support from governments, institutions, and healthcare professionals in recognition of their role, or in response to their health and social care needs – often due to the negative consequences of caregiving. Learning about the diversity of others’ experiences can positively influence personal decision-making, reduce feelings of isolation, as well as promote adjustment to a personal situation. For caregivers, however, few resources exist that provide reliable information on others’ experiences. We collected the narratives of caregivers’ experiences of caring for someone with a …

Impact Of Health Policy Changes On Emergency Medicine In Maryland Stratified By Socioeconomic Status, Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barreuto, Jon M. Hirshon

Publications and Research

Introduction: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD’s Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue. We stratified our analysis by the socioeconomic status (SES) of the ED patient population.

Methods: We collected monthly mean data including patient volume, hospitalization percentages, …

Lactose Intolerance: An Overview Of The Facts And Their Implications, Noelle M. Yeo

Honors Program: Senior Projects (Public)

Lactose intolerance is often blamed for the symptoms such as bloating, diarrhea, gas, abdominal pain, and nausea, that ail many people. Patients often do not seek proper diagnosis from a physician and create their own treatment plans, severely restricting lactose intake, without professional guidance. Even those who do seek the care of a physician find that diagnosis is complicated by less-than ideal testing and confusion due to the symptoms common to many other conditions. The misconceptions and inability to confirm a diagnosis of lactose intolerance can cause nutrient deficiencies in these patients, as well as begin a pattern of unnecessary …

Sex-Dependent Effects Of Ho-1 Deletion From Adipocytes In Mice, Peter A. Hosick, Mary Frances Weeks, Michael W. Hankins, Kyle H. Moore, David E. Stec

Department of Exercise Science and Physical Education Scholarship and Creative Works

Induction of heme oxygenase-1 (HO-1) has been demonstrated to decrease body weight and improve insulin sensitivity in several models of obesity in rodents. To further study the role of HO-1 in adipose tissue, we created an adipose-specific HO-1 knockout mouse model. Male and female mice were fed either a control or a high-fat diet for 30 weeks. Body weights were measured weekly and body composition, fasting blood glucose and insulin levels were determined every six weeks. Adipocyte-specific knockout of HO-1 had no significant effect on body weight in mice fed a high-fat diet but increased body weight in female mice …

It Takes An Instigator, Vision And Passion, Promoting Health In Haiti: Developing A Partnership Between An Impoverished Nation And An Ngo To Develop Advanced Practice Nursing Education, A Case Study, Carol Roye Edd, Rn, Andrea Sonenberg Phd, Whnp, Cnm-Bc

Wilson Center for Social Entrepreneurship

Four nurse educators went to Haiti after the 2012 earthquake to help rebuild the School of Nursing in Port-au-Prince. They were alarmed by the low level of health care in Haiti. Most people have no care, and those that do are treated by nurses who are not trained to do so. This article details the steps the nurses went through to start a family nurse practitioner program in Haiti to address the need for primary care and discusses how they created the partnerships necessary to start such an innovative program at the University of Haiti.