Public Health Commons^™

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not …

Determinants Of Nurse Turnover In Rural Primary Health Centres At Micro, Meso And Macro Levels Within The Health System Of Tamil Nadu, India: A Study Protocol, Ponnambily Chandy Ms, Bart Criel Dr, Lakshmi L Dr

Manipal Journal of Nursing and Health Sciences

Introduction: Nurses play a critical role in delivering patient care services at the grassroots level. But, frequent nurse turnover in rural primary health centres (PHCs) becomes a barrier in achieving health goals in Tamil Nadu (TN), which is the highest populated state in South India. Objective: The study aims to identify the determinants of nurse turnover in rural PHCs and to inform the policy-making at micro, meso, and macro levels within the health system of Tamil Nadu, India. Methods: We will adopt an integrative qualitative design consisting of five phases. In phase 1, we will do a rapid literature review …

Adding Customized Electron Energy Beams To Truebeam Linear Accelerators, Song Gao, Manickam Muruganandham, Weiliang Du, Jared Ohrt, Rajat J Kudchadker, Peter A Balter

Faculty, Staff and Student Publications

Purpose: To better meet clinical needs and facilitate optimal treatment planning, we added two new electron energy beams (7 and 11 MeV) to two Varian TrueBeam linacs.

Methods: We worked with the vendor to create two additional customized electron energies without hardware modifications. For each beam, we set the bending magnet current and then optimized other beam-specific parameters to achieve depths of 50% ionization (I50 ) of 2.9 cm for 7 MeV and 4.2 cm for the 11 MeV beam with the 15 × 15 cm2 cone at 100 cm source-to-surface distance (SSD) by using an ionization chamber profiler (ICP) …

Translating Electronic Health Record-Based Patient Safety Algorithms From Research To Clinical Practice At Multiple Sites, Andrew J Zimolzak, Hardeep Singh, Daniel R Murphy, Li Wei, Sahar A Memon, Divvy K Upadhyay, Saritha Korukonda, Lisa Zubkoff, Dean F Sittig

Faculty, Staff and Students Publications

INTRODUCTION: Researchers are increasingly developing algorithms that impact patient care, but algorithms must also be implemented in practice to improve quality and safety.

OBJECTIVE: We worked with clinical operations personnel at two US health systems to implement algorithms to proactively identify patients without timely follow-up of abnormal test results that warrant diagnostic evaluation for colorectal or lung cancer. We summarise the steps involved and lessons learned.

METHODS: Twelve sites were involved across two health systems. Implementation involved extensive software documentation, frequent communication with sites and local validation of results. Additionally, we used automated edits of existing code to adapt it …

Assessing Covid-19 Booster Hesitancy And Its Correlates: An Early Evidence From India, Geetanjali C. Achrekar, Kavita Batra, Yashashri Urankar, Ravi Batra, Naved Iqbal, Sabiha A. Choudhury, Deepti Hooda, Roohi Khan, Suraj Arora, Aditi Singh, Francesco Chirico, Manoj Sharma

School of Medicine Faculty Research

The emergence of SARS-CoV-2 mutants, waning immunity, and breakthrough infections prompted the use of booster doses of the COVID-19 vaccine to fight against the pandemic. India started booster doses in January 2022 and it is critical to determine the intention of booster dose uptake and its correlates. Therefore, the current cross-sectional study aimed to investigate booster dose acceptability and associated predictors among the Indian population. A convenience sampling technique was utilized to recruit a sample of 687 Indian residents. A 55-item psychometric validated survey tool was used to assess booster dose acceptability, vaccine literacy and vaccine confidence. Univariate, bivariate, and …

Stres Dan Strategi Coping Remaja Pengguna Narkoba Yang Menjalani Program Pasca Rehabilitasi Di Badan Narkotika Nasional Provinsi Jawa Timur, Tisnalia Merdya Andyastanti, Oedojo Soedirham, Rika Subarniati

Preventia: The Indonesian Journal of Public Health

Drug abuse is a problem that must be taken seriously. Coping strategies are ways to deal with situations that are felt to be pressing and burden a person beyond their capabilities. The purpose of this study was to examine the coping strategies possessed by adolescent drug users who are currently undergoing a post-rehabilitation program at the National Narcotics Board (BNN) of East Java. The research method uses a qualitative method with a phenomenological approach. The sampling technique is similar to the purposive sampling technique. In-depth interviews were conducted with five adolescent informants who underwent post-rehabilitation programs at BNN East Java. …

Faktor Pada Perawat Yang Berhubungan Dengan Persepsi Melaporkan Kejadian Tidak Diharapkan (Ktd) Di Rumah Sakit Prima Medika Denpasar Tahun 2020, I Putu Wirama, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospital is complex and full of risk medical facility. Adverse events reporting is one part of the patient safety system that has an important roles to improve the hospital’s quality. Nurses have the longest contact's time with patients so they become the most important component in reporting the Adverse Event Reporting. This study aims to determine the factors that affects perception in adverse event reporting at Prima Medika Hospital Denpasar 2020. Prima MedikaHospitalis a type C private hospital.This studies quantitative study using a cross- sectional design with 140 nurses as samples and conducted in June 2020. The nurses’s perception who …

Analisis Produk Katering Sehat Di Rumah Sakit Izza Menggunakan St (Segmenting, Targeting, Positioning) Dan 4p (Product, Price, Place, Promotion), Helmi Agustian

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The food industry (culinary business) is an industry that is always in demand by the public. During the current COVID-19 pandemic, public awareness of adopting a healthy lifestyle is increasing. Choosing a healthier diet is one way. Izza Hospital is one of the private hospitals in the Cikampek area, which has its Nutrition Installation Unit. As a hospital where most patients are BPJS, there has never been any development of new service products related to patient nutrition. The research conducted is descriptive. The primary data is collected by distributing questionnaires to 100 patients receiving treatment at outpatient care. The results …

Evaluation Of Medical Waste Management Before And During The Covid-19 Pandemic At Sentra Medika Hospital Cikarang, Enny Mar’Atus Sholihah, Amal Chalik Sjaaf

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

One of important things in managing Coronavirus Disease 2019 (COVID-19) pandemic is managing medical waste production. Medical waste management start from waste sort until waste manage by licensed parties, both of patients’ waste and health workers’ waste. Sentra Medika Hospital Cikarang is one of the referral hospitals that handles COVID-19. This research is a descriptive analytic study. Researchers analyze hazardous and toxic waste management before and during a pandemic by conducting interviews with the nursing unit and using secondary data. Secondary data was obtained from the hospital environmental health unit. There is no significant differences medical waste before and during …

Transformasi Digital Sebagai Bagian Dari Strategi Pemasaran Di Rumah Sakit Siloam Palangka Raya Tahun 2020, Kevin Chrisanta Budiyatno

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Digital transformation in healthcare is implemented through a technology-based approach to improve patient-centered care. In relation to marketing strategic planning, digital transformation is included within the marketing mix of product, promotion, and place. Assessment of healthcare technology development can be based on seven major areas, which are 1) Integrated management of information technology in health; 2) Medical images; 3) Electronic Medical Record; 4) Information technology and portable devices in health; 5) Access to e-Health; 6) Telemedicine; and 7) Privacy of medical data. Digital transformation in Siloam Hospitals Palangka Raya has shown to improve cost efficiency and work process flow, although …

The Use Of Occupational Therapy Services In Outpatient Mental Health, Kelsey A. Wasik, Matt T. Valois, Kaylee M. Essenberg, Kelcie P. Beck

Masters Theses

The purpose of this study is aimed to explore the structure and utilization details of occupational therapy in outpatient behavioral health settings. Two occupational therapists participated in qualitative phenomenological interviews which were transcribed and analyzed using the thematic approach. A total of two themes emerged: billing and coverage, and education and advocacy. Participants identified there are necessary factors for reimbursement of services, in addition to the need for education and advocacy for occupational therapists to practice in outpatient behavioral health settings. Future research should be aimed at recruiting more participants, occupational therapists, and from other roles in these clinics such …

Analisis Resume Medis Rawat Inap Tidak Lengkap Dengan Menggunakan Konsep Masaaki: Sort, Straighten, Scrub, Systematize, Sustain (5s) Di Rsu Parama Sidhi Singaraja Bali, Idn Yunita Pratiwi, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The quality of the hospital’s medical resume is one of hospital’s services quality indicator, which Parama Sidhi General Hospital still have figure of 17,1% for the incompleteness of medical record data (KLPCM). The goal of this research is to improve the attending physician medical resume’s completion through Sort, Straighten, Scrub, Systematize, and Sustain concept (5S) by acknowledged connection between 5S concept and medical resume completeness efforts based on continues improvement. This research is a mixed method analysis, by using primary and secondary data. The secondary data showed 26,80% among 1362 medical resume files were not completed. Univariate analysis of the …

Time-To-Event Modeling For Hospital Length Of Stay Prediction For Covid-19 Patients, Yuxin Wen, Md. Fashiar Rahman, Yan Zhuang, Michael Pokojovy, Honglun Xu, Peter Mccaffrey, Alexander Vo, Eric Walser, Scott Moen, Tzu-Liang Bill Tseng

Engineering Faculty Articles and Research

Providing timely patient care while maintaining optimal resource utilization is one of the central operational challenges hospitals have been facing throughout the pandemic. Hospital length of stay (LOS) is an important indicator of hospital efficiency, quality of patient care, and operational resilience. Numerous researchers have developed regression or classification models to predict LOS. However, conventional models suffer from the lack of capability to make use of typically censored clinical data. We propose to use time-to-event modeling techniques, also known as survival analysis, to predict the LOS for patients based on individualized information collected from multiple sources. The performance of six …

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up identified in …

Utility Of The Motivation To Change Lifestyle And Health Behaviors For Dementia Risk Reduction Scale (Mclhb-Drr) Based On A North American Sample, Angelina E. Witbeck

Dissertations

As the population ages, the prevalence rates of dementia continue to increase. Without a cure or promising treatment for dementia, the best course of lowering the prevalence rates of dementia is through preventative measures. Through an electronic survey, the study utilized the MCLHB-DRR scale to determine whether (1) gender, age, educational background, and socioeconomic status will impact the motivational factors to change lifestyle and health behaviors to reduce the risk of developing dementia and (2) direct experiences with individuals that have a dementia diagnosis are likely to impact one's motivational factors to change lifestyle and health behaviors to reduce the …

Non-Metropolitan And Metropolitan Trends In Mental Health Treatment Availability In Community Health And Community Mental Health Centers, Tyrone F. Borders, Timothy Williams, Katherine Youngen, Julia Cecil

Rural & Underserved Health Research Center Publications

Key Findings

The supply of community mental health centers (CMHCs) decreased substantially from 2000 to 2019 and became nearly non-existent in non-metropolitan counties.

• The number of CMHCs in non-metropolitan counties declined from 182 to 15.
• The number of CMHCs in metropolitan counties declined from 582 to 104.

The supply of community health centers (CHCs) offering mental health services increased substantially over the same time period, or from 2000 to 2019.

• The number of CHCs in non-metropolitan counties increased from 184 to 573.
• The number of CHCs in metropolitan counties increased from 126 to 797.

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Lactating Justice: Constructing A Society Economically Focused On Optimizing Health Through Human Lactation, Shadley Hobour

Dissertations, Theses, and Capstone Projects

This paper uses a qualitative research method to answer if a Universal Base Income would be a good economic policy to adopt to optimize Black chestfeeding. The key idea this thesis aims to clarify is how anti Blackness is killing Black people and how one economic policy could improve health. In this essay, I will break down the significance and importance of human lactation for lifelong better health, and investment in a UBI would especially work as a preventative measure for several health issues Black people experiences.

The Racial And Ethnic Diversity Of The Family Physician Workforce In Non-Metropolitan And Metropolitan Counties, Lars E. Peterson, Zachary J. Morgan

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• The family physician workforce is becoming more racially diverse; however, non-metropolitan family physicians are not.
• Using data from over 24,000 family physicians who either registered to continue their American Board of Family Medicine (ABFM) certification or completed the graduate survey from 2017 to 2019, we found that early career family physicians are more diverse than later career physicians (66.9% vs. 72.8% White; 58.3% vs. 44.0% female) but, in both groups, the percentage of White non-metropolitan family physicians was even higher (82.7% to 90.5%).
• Minority non-metropolitan family physicians, particularly Black and Native American/Alaska Native physicians, are more …

Find Your Flow: A Menstrual Health Social Media Campaign, Sarah Hamp-Adams

Kinesiology and Public Health

In many cultures, menstruation is surrounded by silence and shame instead of being celebrated as a sign of health and vitality. Globally, challenges, including stigma surrounding menstruation, create barriers for menstruators (White, 2013; Crawford, 2014; Garg, 2015). It proves to be difficult for young menstruators to navigate menarche due to the taboos and socio-cultural restrictions surrounding menstruation (Sharma,2015). Encouraging women to have open conversations about their periods is necessary to combat these challenges.

To understand how to address the stigmas around menstruation, the researchers first conducted a literature review, revealing that education messages via the Internet, posters, storytelling, and peer …

Frequency Of Use And Preferences For Information And Communication Technologies In Patients With Sleep Apnea: A Multicenter, Multinational, Observational Cross-Sectional Survey Study, Veronica R. Jaritos, Emanuel Vanegas, Juan Facundo Nogueira, Sebastian Leiva Agüero, Vanina Giovini, Jorge Rey De Castro, Yadira Rodríguez Reyes, José Luis Carrillo Alduenda, Pammela Torres Gittaim, Zaira Romero, Azza Sarfraz

Department of Paediatrics and Child Health

Background: Obstructive sleep apnea (OSA) is a condition characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. An accessible method to facilitate self-management education is through information and communication technologies (ICTs).
Purpose: To assess the frequency of and preferences for ICT use in patients with sleep apnea.
Methods: A multicenter, multinational, observational cross-sectional survey study was conducted between 2018 and 2019 in sleep units in different countries of Latin America, including patients of both genders older than 18 years with a diagnosis of sleep apnea. Participants were asked to complete 20 questions in a …

Risk For Post-Colonoscopy Irritable Bowel Syndrome In Patients With And Without Antibiotic Exposure: A Retrospective Cohort Study, Ravy K Vajravelu, Jordan M Shapiro, Josephine Ni, Shivani U Thanawala, James D Lewis, Hashem B El-Serag

Faculty, Staff and Students Publications

BACKGROUND & AIMS: Laboratory studies have demonstrated that antibiotic use in conjunction with bowel purgatives causes alterations to the gut microbiota. Because gut microbiota changes may be a trigger for the development of irritable bowel syndrome (IBS), we sought to assess whether individuals who undergo bowel cleansing for colonoscopy and have concurrent antibiotic exposure develop IBS at higher rates than individuals who undergo colonoscopy without antibiotic exposure.

METHODS: We used data from Optum's de-identified Clinformatics Data Mart Database in the United States to study a cohort of 50- to 55-year-olds who underwent screening colonoscopy. Individuals exposed to antibiotics within 14 …

Benign Prostatic Hyperplasia (Bph): A Comprehensive Analysis Of The Malaise And Summarizing Possible Management Options Through Phytotherapeutic Agents, Shan Sasidharan, Kumarapillai Parameswaran Srinivasakumar, Sandeep Poddar, Amiya Bhaumik, Sreemoy Kanti Das, Hareendran Nair J

Kesmas

Benign prostatic hyperplasia (BPH) is a severe illness affecting middle-aged and geriatric male patients. This disease normally occurs at the age of 40 or above and is also associated with sexual dysfunction. Alpha-blockers and 5α-reductase inhibitors are the preferred drugs practiced to treat BPH. However, invasive surgical therapy remains the gold standard for managing the condition in the case of refractory and intricate BPH conditions. Due to the fear of sexual dysfunction and the detrimental influence on their quality of life, most patients seek to avoid synthetic drugs and surgery. For this reason, several patients turn to phytotherapy and other …

Treatment Adherence And Incidence Of Coronary Heart Disease In Type 2 Diabetes Mellitus Patients, Ahmad Sahlan Baniu, Rani Sauriasari, Woro Riyadina, Pradana Soewondo

Kesmas

Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed …

Local Wisdom Enriching Complementary Feeding Practices During Disaster Situations In Indonesia, Astuti Astuti, Happy Hayati, Fajar Tri Waluyanti, Dessie Wanda

Kesmas

This study aimed to analyze complementary food fulfillment during disaster situations in Indonesia since it frequently experiences natural disasters and young children face unique challenges related to their feeding needs in disaster situations. This qualitative case study based on the Mount Merapi eruption and Sumedang landslide in 2021 collected data using observations, forum group discussions, and in-depth interviews; then, a thematic analysis was conducted. This study involved 17 participants, including Non-governmental Organizations (NGO) activists, health workers, residents involved in making complementary foods, and primary caregivers of children aged 6–24 months. This study found that there were five themes generated from …

Muscle Dysmorphia In Fitness Center Members: Its Affecting Factors And Impacts, Deny Yudi Fitranti, Nurmasari Widyastuti, Etika Ratna Noer, Ayu Rahadiyanti, Fillah Fithra Dieny, Rachma Purwanti, Dewi Kurnia Sandi, Widya Destikasari

Kesmas

Muscle dysmorphia (MD) has several impacts on the decline in social and health functions. This study aimed to determine the correlation between MD with eating behaviors and exercise loading among fitness center members and analyze the factors affecting it. This study used a cross-sectional design with 100 subjects chosen by a consecutive sampling method at three fitness centers in Semarang City. The subjects were all male members of an active fitness center between 17 and 45 years. The data of MD were obtained using the Drive Muscular Scale (DMS), while eating behavior data were obtained using the Eating Attitude Test-40 …

Determinants Of The Coexistence Dual Form Of Malnutrition In Pairs Of Mother And Child Aged 6 – 59 Months In Bogor District 2019, Maulina Dwi Krismanita, Triyanti Triyanti, Ahmad Syafiq, Trini Sudiarti

Kesmas

The dual form of malnutrition (DFM) is defined as multiple nutritional problems in the same household and time. This study aimed to determine the related factor to DFM incidence in pairs of mothers and children aged 6–59 months in Bogor District in 2019. This cross-sectional study used secondary data on the Nutrition and Health of Babakan Madang Subdistrict Toddlers in 2019 and Nutrition Intake and Stunting of Children Under-Five in Bogor District, West Java Province, involving a total sample of 274 households. The dependent variable in this study was DFM, while the independent variables were maternal age during pregnancy, maternal …

The Influence Of Intrapersonal Constraints On Travel Intention Of People At High Risk From Covid-19 During The New Normal, Dyah Widiyastuti, Ikasari Kusuma Wardhani

Kesmas

Due to the COVID-19 pandemic, tourism constraints have created a challenge for inclusive tourism, especially for older people and people with comorbidities. This study examined intrapersonal constraints’ effect on the travel intentions of people facing fewer opportunities for tourism due to the COVID-19 pandemic, which could disrupt their well-being fulfillment. The data were collected through an online survey of Jakarta citizens aged 46 years and older from the end of June to September 2021, and a total of 337 responses were accumulated. This study applied partial least square structural equation modeling to test the moderating effect of intrapersonal constraints toward …

Zoom Fatigue During The Covid-19 Pandemic: Is It Real?, Putri Winda Lestari, Adhila Fayasari

Kesmas

The coronavirus disease 2019 (COVID-19) pandemic has caused drastic changes to social lives moreover the activities done outside, such as work and school. The policy of large-scale social restrictions (LSRR)/Pembatasan Sosial Berskala Besar (PSBB), which makes people stay at home, also plays an important role in changing the face-to-face activity online. As a solution to the major change, people use video conferencing to keep in touch and still feel like doing "offline" activities. The increasing use of video conferencing has raised concerns about the resulting fatigue, termed "Zoom fatigue." This study aimed to describe Zoom fatigue during the COVID-19 pandemic …

Diabetes Mellitus And Mortality Among Covid-19 Patients In Jakarta, March-August 2020, Endang Widuri Wulandari, Sudarto Rotnoatmodjo, Ngabila Salama

Kesmas

Diabetes mellitus (DM) comorbidity is one of the risk factors for coronavirus disease 2019 (COVID-19) mortality. This study aimed to determine the association of comorbid DM and mortality among COVID-19 confirmed cases in DKI Jakarta Province, controlled with confounding variables from March to August 2020. The study design was a retrospective cohort using cox proportional hazard regression, with a total sample of 1,480. The data consisted of 740 COVID-19 cases with and 740 without comorbid DM. The inclusion criteria were COVID-19 confirmed cases with polymerase chain reaction (PCR) laboratory testing reported to the DKI Jakarta Provincial Department of Health, and …