Public Health Commons^™

Medicaid Managed Care Restrictions On Medications For The Treatment Of Opioid Use Disorder, Maureen T. Stewart, Christina M. Andrews Ph.D., Sage R. Feltus, Dominic Hodgkin, Constance M. Horgan, Cindy Parks Thomas, Thuong Nong

Faculty Publications

Objective: To examine whether Medicaid managed care plan (MCP) utilization management policies for buprenorphine–naloxone and injectable naltrexone are related to key state Medicaid program policy decisions. Data Sources and Study Setting: We abstracted data on state Medicaid regulatory and policy information from publicly available sources and publicly available insurance benefit documentation from all 241 Medicaid MCPs operating in 2021. Study Design: In this cross-sectional study, we used bivariate and multivariate analyses to examine whether Medicaid MCP prior authorization and quantity limits on receipt of buprenorphine and injectable naltrexone were associated with key state Medicaid choices to leverage federal funds to …

Human Mobility And The Infectious Disease Transmission: A Systematic Review, M. Naser Lessani, Zhenlong Li, Fengrui Jing, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Recent decades have witnessed several infectious disease outbreaks, including the coronavirus disease (COVID-19) pandemic, which had catastrophic impacts on societies around the globe. At the same time, the twenty-first century has experienced an unprecedented era of technological development and demographic changes: exploding population growth, increased airline flights, and increased rural-to-urban migration, with an estimated 281 million international migrants worldwide in 2020, despite COVID-19 movement restrictions. In this review, we synthesized 195 research articles that examined the association between human movement and infectious disease outbreaks to understand the extent to which human mobility has increased the risk of infectious disease outbreaks. …

An Exploration Of Clinical Reasoning Using Simulation-Based Learning In Physical Therapist Education, Susannah Steele

Dissertations and Theses

BACKGROUND: Clinical reasoning instruction and assessment are vital tasks of health professions educators yet execution lacks standardization among programs in physical therapy education. This broad variability in how clinical reasoning is taught and assessed within physical therapy education makes understanding current state and improving implementation challenging. PURPOSE: The purpose of this study was to explore whether simulation-based learning is useful in facilitating the development of clinical reasoning skills in novice physical therapist students, to explore potential correlations and performance trends between two assessments measuring elements of clinical reasoning skills, and to explore the impact of thoughtfully designed simulation learning experiences …

Examining The Impact And Implementation Of Protected Administrative Time On Provider Well-Being And Service Delivery Indicators Within A Multi-State Network Of Primary Care Medical Practices, Lauren Junge-Maughan

College of Graduate Studies: Theses & Dissertations

Background:

Primary care is integral to achieving high-quality health outcomes for the population and decreasing healthcare costs. However, primary care clinicians suffer from conflicting demands, impossible expectations, and burdensome processes. With burnout and mental fatigue increasing, leadership must find innovative programs to implement in their organizations. This mixed-methods research study assessed the impact of one such intervention, protected administrative time (PRAT), on improving provider well-being.

Purpose:

The first aim was to evaluate the association of PRAT on the service delivery indicators of primary care clinicians’ productivity, average appointments per day, patient satisfaction (likelihood to recommend), clinician time to the next …

Outcomes Of Upper Gastrointestinal Bleeding In Hospitalized Covid-19 Patients In The United States: A Propensity-Score Matched Analysis Of A Large National Database, Moon Ryu, Mohammed Quazi, Niloy Ghosh, Karthik Gangu, Amir H Sohail, Asif Farooq, Babu S Maringanti, Aman Goyal, Anupa Patel, Muhammad S Khan, Abu B Sheikh

Faculty, Staff and Student Publications

Patients with cirrhosis that are hospitalized with COVID-19 infection have been found to have worse outcomes. No comparative study has been conducted between gastrointestinal (GI) bleeding in patients with cirrhosis who are diagnosed with COVID-19. We utilized the National Inpatient Sample (NIS) database to perform a retrospective analysis of 24, 050 patients diagnosed with cirrhosis and COVID-19. The identified patients were separated into variceal bleeding, nonvariceal bleeding, and no (or neither) GI bleeding groups. After performing propensity sample matching and multivariate analysis of mortality, we found no significant differences in mortality among the three groups. However, the variceal bleed group …

A Position Analysis Of Bpjs Claims Administration Officers And Verifiers (Case Study: Jambi Province Regional Mental Hospital), Hanisah Hanisah, Asmaripa Ainy, Iwan Stia Budi

Preventia: The Indonesian Journal of Public Health

The high coverage rate of handling partially rejected claim financing reaching 7.34% of the total 19,476 cases in the Outpatient Unit of the Jambi Provincial Mental Hospital (RSJD) in 2022, is closely related to the quality of human resources (HR) in this case, the claims officer and the suitability of what is done with the job description, job specifications and standard operating procedures (SOP) that have been made. This study aimed to analyze the position of administrative officers and claim verifiers in the outpatient unit of the Jambi Provincial Mental Hospital. This research used a qualitative method. Information was collected …

Interest Of Public Health Science Students Of State University Of Malang To Work In Remote Areas, Borders, And Islands, Sapto Adi, Dian Mawarni, Dita Ratna Fauzia

Preventia: The Indonesian Journal of Public Health

The health workforce distribution in Indonesia still needs to be balanced, especially in border areas and islands (DTPK), with no exception for public healthcare workers. This study aimed to determine the interest of public health science students in working in remote areas and the factors associated with the interest of public health science students to work in remote areas. This study design was cross-sectional, and a total sampling method was used. The subjects were final-year students majoring in Public Health Science at the State University of Malang. The dependent variable was the interest of public health science students to work …

Standardised Tool For The Assessment Of Bruxism, Daniele Manfredini, Jari Ahlberg, Ghizlane Aarab, Steven Bender, Alessandro Bracci, Peter A. Cistulli, Paulo Cesar Conti, Reny De Leeuw, Justin Durham, Alona Emodi-Perlman, Dominik Ettlin, Luigi M. Gallo, Birgitta Häggman-Henrikson, Christer Hublin, Takafumi Kato, Gary Klasser, Michail Koutris, Gilles J. Lavigne, Daniel Paesani, Ingrid Peroz, Peter Svensson, Peter Wetselaar, Frank Lobbezoo

School of Dentistry Faculty Publications

OBJECTIVE: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. METHODS: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. RESULTS: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting …

Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then …

Evaluation Of A Community Based Teaching Hospital’S Geriatric Emergency Medicine Initiative, Josette Hartnett, Isabel Muronzi-Belfon, Suzanne J. Rose

Journal of Geriatric Emergency Medicine

INTRODUCTION: To accommodate the complex healthcare needs of the rising geriatric population, Stamford Hospital’s (SH) emergency department (ED) began a Geriatric Emergency Medicine Initiative (GEMI) in 2018 to improve our ED environment, practices, and focused assessments for our community-dwelling older adults.

METHODS: This retrospective program evaluation describes SH’s novel ED processes for at-risk older adults and compares GEMI and non-GEMI assessed patient outcomes using aggregate frequencies on throughput metrics such as length of stay (LOS), 72 hour and 30-day re-admission rates, and other outcomes of interest. Chi-square tests and group t-tests were used for all analyses with a p-value of …

Learning From Women Veterans Who Navigate Invisible Injuries, Caregiving, And Reintegration Challenges, Nicholas A. Rattray, Diana Natividad, Katrina Spontak, Marina Kukla, Ai Nghia L. Do, Leah Danson, Richard M. Frankel, Gala True

School of Medicine Faculty Publications

Background: As women comprise a greater proportion of military service members, there is growing recognition of how their experiences in the early phase of military to civilian transitions have an important influence on their health and reintegration outcomes. Qualitative accounts of women veterans can inform programs that support transitioning service members. Objectives: We examined narratives of civilian reintegration among women veterans to understand their experiences of adjusting to community life while coping with mental health challenges. Methods/Participants: We interviewed 16 post-911 era women who were within 5 years of separating from military service and developed a case study based on …

Integrating Stakeholder Feedback Into The Design Of A Peer-Delivered Primary Care Wellness Program: A Rapid Qualitative Study, Emily M. Johnson, Kyle Possemato, Matthew Chinman, Gala True, Jacob Hedges, Brittany N. Hampton, E. Jennifer Edelman, Stephen A. Maisto

School of Medicine Faculty Publications

Background: Individuals seen in Primary Care with behavioral health concerns who decline behavioral health treatment may benefit from the support of peers (consumers in recovery from behavioral health concerns employed to support other consumers). Whole Health STEPS is a new intervention for Veterans in Primary Care with behavioral health concerns which combines essential elements of peers’ role and the Whole Health model using a stepped-care design. We incorporated stakeholder feedback in the Whole Health STEPS design to improve fit with Veterans, peers, and primary care settings. Methods: We conducted semi-structured qualitative interviews with VA staff using questions derived from the …

The Iris Registry: A Novel Approach To Clinical Registry Development In Ophthalmology, John C. Lin, Leslie Hyman, Ingrid U. Scott

Wills Eye Hospital Papers

No abstract provided.

Disease Severity Of Covid-19 In Different Phases Of The Pandemic: Do Healthcare Workers Have Better Outcomes?, Xueying Yang Ph.D., Fanghui Shi, Jiajia Zhang Ph.D., Haoyuan Gao, Shujie Chen, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Background:

This study aimed to characterize and compare the demographics, clinical profile, and COVID-19 outcomes between healthcare workers (HCWs) and non-HCWs COVID-19 patients diagnosed in different phases of the pandemic defined by the vaccine rollout policy and different variants that circulated in South Carolina (SC).

Methods:

Extracted from the statewide electronic health record data, we analyzed the clinical outcome of 34,502 HCWs and 1,071,020 non-HCWs adults diagnosed with SARS-CoV-2 between March 2, 2020 to April 14, 2022. Logistic regression models were used to explore the association between different pandemic phases and COVID-19 severity-related outcomes.

Results:

Substantial reductions in mortality were …

Racial Disparities In Adequacy Of Prenatal Care During The Covid-19 Pandemic In South Carolina, 2018–2021, Emmanuel Fabrice Julceus Md, Mph, Bankole Olatosi Ph.D., Peiyin Hung Ph.D., Jiajia Zhang Ph.D., Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background: During the COVID-19 pandemic, hospitals’ decision of not admitting pregnant women’s partner or support person, and pregnant women’s fear of contracting COVID-19 in hospitals may disrupt prenatal care. We aimed to examine whether prenatal care utilization in South Carolina varied before and during the COVID-19 pandemic, and whether the variation was different by race.

Methods: We utilized 2018–2021 statewide birth certificate data using a pre-post design, including all women who delivered a live birth in South Carolina. The Kotelchuck Index - incorporating the timing of prenatal care initiation and the frequency of gestational age-adjusted visits - was employed to …

Organizational Change In Saudi Healthcare Settings: Evaluating Organizational And Individual Readiness For Change, And The Mediating Role Of Readiness For Change Between Management Support And Commitment To Change., Sultan Alsaif

Electronic Theses and Dissertations

BACKGROUND: To respond to the constantly changing environment and developments of healthcare, leaders of healthcare organizations have been trying to introduce and implement transformations that allow their organizations to be able to operate effectively and efficiently to meet the shifts in healthcare demand and to deal with new patterns of health issues, comply with the new policies, and to enhance their present in the market. Thus, it is important for managers to determine the level of readiness for implementing organizational changes from to perspectives. These perspectives include organizational readiness for change and individual readiness for change. METHOD: This first manuscript …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

Case Sampling Vs Universal Review For Evaluating Hospital Postoperative Mortality In Us Surgical Quality Improvement Programs, Vivi W Chen, Alexis P Chidi, Tracey Rosen, Yongquan Dong, Peter A Richardson, Jennifer Kramer, David A Axelrod, Laura A Petersen, Nader N Massarweh

Faculty, Staff and Students Publications

IMPORTANCE: Representative surgical case sampling, rather than universal review, is used by US Department of Veterans Affairs (VA) and private-sector national surgical quality improvement (QI) programs to assess program performance and to inform local QI and performance improvement efforts. However, it is unclear whether case sampling is robust for identifying hospitals with safety or quality concerns.

OBJECTIVE: To evaluate whether the sampling strategy used by several national surgical QI programs provides hospitals with data that are representative of their overall quality and safety, as measured by 30-day mortality.

DESIGN, SETTING, AND PARTICIPANTS: This comparative effectiveness study was a national, hospital-level …

Exploration Of The Implementation Of An Integrated Electronic Laboratory Information Management System On Quality Diagnostics Service Indicators At A County Level Public Hospital In Western Kenya., Kelly Allen

Capstone Collection

Underinvestment in pathology and laboratory capacity caused by low visibility in research and in prioritization by public health leaders results in limited effective healthcare coverage and an estimated 1.1 million premature deaths annually in Low-and-Middle-Income Countries. Kenya’s public health laboratories provide a median 41% of the Essential Diagnostic List to their patients and in Kisumu County, as much as 44.2% of the population has little to no access to essential diagnostics. The government of Kisumu implemented the county Health Laboratory Strategic Plan 2018-2022 to address this public health challenge. Little information exists on the effectiveness of these initiatives and the …

The Impact Of Telehealth In Urgent Care Settings, Annie Dong

Applied Research Projects

Telehealth is an emerging modality of patient care and has since expanded to urgent care facilities. Urgent care facilities have been around for decades; however, along with telehealth, it has only grown in popularity in recent years due to the COVID-19 pandemic. However, the implementation and usage of telehealth in urgent care facilities is dependent on the provider being able to use it. This study aimed at looking at the perspective of the provider on the implementation and usage of telehealth in the urgent care setting.

Transforming The American Experience Of Death: What Dreams May Come?, Melinda Xu, Geoffrey A. Silvera Phd, Mha, Lyle Walton, Jane Banaszak-Holl

Patient Experience Journal

There is no means to evaluate the death experience in the US healthcare system. Other countries have established population-wide measures to evaluate and improve the dying experience for patients and their families. With an increasing population of advanced-age persons, changes in sites of death, and a continually fractured healthcare delivery system, there is a need to establish a universal assessment of the quality of death in the US. In this commentary, we outline the need for such an assessment and build off of previous literature on the various existing assessments of the quality of death that have typically been reserved …

Risk-Adjusted Cumulative Sum For Early Detection Of Hospitals With Excess Perioperative Mortality, Vivi W Chen, Alexis P Chidi, Yongquan Dong, Peter A Richardson, David A Axelrod, Laura A Petersen, Nader N Massarweh

Faculty, Staff and Students Publications

IMPORTANCE: National surgical quality improvement programs lack tools for early detection of quality or safety concerns, which risks patient safety because of delayed recognition of poor performance.

OBJECTIVE: To compare the risk-adjusted cumulative sum (CUSUM) with episodic evaluation for early detection of hospitals with excess perioperative mortality.

DESIGN, SETTING, AND PARTICIPANTS: National, observational, hospital-level, comparative effectiveness study of 697 566 patients. Identification of hospitals with excess, risk-adjusted, quarterly 30-day mortality using observed to expected ratios (ie, current criterion standard in the Veterans Affairs Surgical Quality Improvement Program) was compared with the risk-adjusted CUSUM. Patients included in the study underwent a …

Learning From Death: Health Education Considerations For Medical Tourists, Caregiving Companions, And Medical Tourism Providers, Alicia Mason, Sakshi Bhati, Ran Jiang, Elizabeth Spencer

Faculty Submissions

Medical tourism is a process in which a consumer travels from one’s health jurisdiction to receive biomedical treatments or services, thus becoming a patient. This chapter explores how global media frame cases of patient death associated with the medical tourism (MT) process between 2009-2019. A qualitative content analysis of 50 patient mortality cases found that (1) a majority of media representations of medical tourism patient death are of middle-class, minority females between 25-55 years of age seeking cosmetic surgery internationally; (2) sudden death, grief, and bereavement counseling is noticeably absent from medical tourism providers (MTPs); and (3) the acknowledgement of …

Correlates Of Immunization Timeliness In Three South Asian Countries: Secondary Analysis Of Demographic And Health Surveys, Tanzir Ahmed Shuvo

Theses and Dissertations

Despite the availability of effective vaccines, 1.5 million children under the age of 5 years die every year because of vaccine preventable diseases. Improvements in vaccine delivery infrastructure have resulted in relatively high coverage of vaccines, but many children are not receiving their vaccines on a timely basis. Timely administration of routine vaccines recommended by the Expanded Programme on Immunization (EPI) ensures maximum efficacy. It is vital to explore rates of vaccination timeliness and the correlates of timely vaccination among children to design targeted interventions for improving both coverage and timeliness. We conducted a secondary data analysis of the Demographic …

Feminization Of Sri Lankan Doctors And Key Specialties: 2000 To 2020, Dileep De Silva, Pamila Adikari, Mihiri S. Rubasinghe, Udeni L. Seneviratne

Journal of Indonesian Health Policy and Administration

The study focused on the feminization of Sri Lankan generalist doctors in all major and selected minor specialties between 2000 and 2020. The study analyzed all relevant documents by exploring Sri Lanka's male-to-female doctor and specialist ratio over 20 years. This was determined by analyzing state medical faculty records from 1990 to 2020. For better clarity, the researchers analyzed the gender ratio changes in every five-year block from 1990 to 2020. Focus groups filled PGIM's gender data fields. Five-year medical students surged from 43% to 63% between 1990 and 2020. Linear trend analysis predicts 68% of female medical students by …

Sensitive Intervention Policy Recommendations To Reduce Stunting Rates Based On Spatial Analysis Of Sanitary Factors In Dki Jakarta Province 2021, Septiria Irawati, Ema Hermawati

Journal of Indonesian Health Policy and Administration

The purpose of this study was to describe the prevalence of stunting in children under five and the percentage of proper sanitation, as well as recommendations for priority areas for stunting control interventions in the Province of the Special Capital Region of Jakarta in 2021. This study used a descriptive approach to present an overview of the percentage of sanitation and prevalence of stunting in children under five by sub-district in 38 districts in DKI Jakarta. Data is displayed as a map to show distribution areas based on high, medium, and low categories. An overlay was made between the distribution …

The Effects Of Vaccination Against Covid-19 Incidence: Is The Current Age-Priorities Appropriate?, Dian Ip Nugrahari, Nurhanifah Hamdah

Journal of Indonesian Health Policy and Administration

Age is an independent risk factor for COVID-19. Thus, the government of Indonesia prioritizes the elderly and adults with significant comorbidities for COVID-19 vaccination. To discover whether this policy is still appropriate, we evaluated the effects of vaccination against the COVID-19 incidence and infection risk.It was a retrospective cohort study of the NAR COVID-19 and Dashboard KPCPEN COVID-19 of the Depok City Health Department. The tests used to analyze the data were the chi-square and logistic regression tests. We discovered that there was a 92.7% total reduction in the COVID-19 infection rate with vaccination. The infection risk for COVID-19 in …

Policy Implementation Analysis Of Spm Health Sector For Hypertension Sufferers In South Kalimantan Province, Indonesia In 2022, Anggi Asri Rusliana Dewi, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

Hypertension is a major cardiovascular risk factor that causes disability throughout the world and among those who are not aware of their health condition, it is often referred to as the silent killer . The prevalence rate of hypertension in Indonesia is quite high. Based on Riskesdas (2018), South Kalimantan Province shows the highest prevalence of hypertension, but the percentage of hypertension sufferers who receive health services is still low. Banjarbaru City has the lowest percentage, namely 11.3% of the target of 100%. Health services for hypertension sufferers are included in the Minimum Service Standards (SPM) for the Health Sector …

Health Policy Reform Through Strengthening Indonesia's Health Resilience System, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

The National Health System in Indonesia is developing and being discussed more seriously after entering the COVID-19 pandemic. With a national health system and several existing tools, Indonesia needed more time to be ready to face the challenges of that time. Upstream health policies should be optimized to mobilize resources and increase the nation's efforts to build a national resilience system. This paper was built using selected policy documents up-to-date and reliable literature. By reviewing empirical evidence, the author believes and shows the role of strengthening health policies in building a robust national health resilience system. Indonesia has several policies …

Validity-Reliability Of The E-Healthy Diet Literacy Scale In Turkish Adults, Sevil Karahan Yılmaz, Gunay Eskici, Osman Emir Sarac

Baltic Journal of Health and Physical Activity

Introduction: This study aims to establish the validity-reliability of the Turkish version of adult e-Healthy Diet Literacy Scale and to determine its relationship with the Health Literacy Instrument Scale (short-form), the Digital Healthy Diet Literacy Scale, and participants’ characteristics. Material and Methods: Drawing on a methodological and descriptive design, this research was performed in two steps. It was conducted with 240 participants in the first step and 879 participants in the second step. The participants filled out the eHealthy Diet Literacy Scale, Health Literacy Instrument Scale (short-form), and Digital Healthy Diet Literacy Scale. The questionnaire form was sent to the …