Public Health Commons^™

Audit Implementasi Clinical Pathway Diare Akut Di Rumah Sakit Anak Dan Bunda Harapan Kita Tahun 2016, Desy Rachma Sari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aims to determine the implementation of clinical pathway of acute diarrhea with the audit process. This type of research is quantitative and qualitative by using operational research concept with document review method, data analysis and in-depth interview. The result of the research shows that the audit topic is the implementation of clinical pathway of acute diarrhea with the aim to assessing completeness of clinical pathway, compliance of primary responsible physician, primary responsible nurse, nutrition and pharmacy and assessing the length of stay with clinical pathway. Assessment standard used is the national standard that is KARS. The result of …

Kajian Implementasi Mutu Dengan Pendekatan Integrasi Six Sigma Dan Tqm Melalui Penilaian Malcolm Baldridge Di Rumah Sakit Charitas Palembang, Jessihana Morgan Manurung

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospitals increasingly are expected to provide better health services (Muchtar, 2011). Excellent service and quality have an impact on customer satisfaction and loyalty. One measure of quality achievement is customer loyalty. Charitas Hospital had a decline in customer loyalty from 2013 to 2015 by 80%. It was determined by a decrease in the quality indicators that BOR, LOS, TOI, GDR, NDR which dropped on the last three years (Data RS-Caritas, 2016). Quality management TQM and Six Sigma respectively conceptually and empirically proven as a quality improvement method to improve organizational performance. How is the quality of service at the Charitas …

Percepatan Pemulangan Pasien Rawat Inap Dengan Konsep Lean Di Rumah Sakit Masmitra, Alamsyah Alamsyah

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The process discharge of patients in hospital Masmitra is still not optimal, because there is no groove that describes the process of returning the patient as a whole. By applying the concept of Lean, value stream mapping current conditions which shows that the process of returning patients there were 41 activities and only 51% are value added, and of course has implications for wastage. From the analysis of the root causes of acquired ideas repair, and then carried into the re-design of the new process flow is considered ideal to produce a total of only 17 activities, 83% of which …

Perlukah Keselamatan Pasien Menjadi Indikator Kinerja Rs Blu?, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The government which is the Ministry of Health through its regulations mandates the importance of patient safety. This can be seen from the mention of patient safety in the four articles in Undang-Undang Number 44 Year 2009 about Hospital and specifically in the Minister of Health Regulation. The importance of patient safety issues in hos pitals is not directly proportional to the performance indicators of the BLU Hospital written inPeraturan Direktur Jenderal Pembendaharaan Number 34 Year 2014 about the Guidelines for Performance Appraisal of Public Ser vice Bodies for Health Services. In this regulation, it can be seen that the …

The Scoping Review Method: Mapping The Literature In “Structural Change” Public Health Interventions, Rosie Hanneke, Yuka Asada, Lisa D. Lieberman, Leah Christina Neubauer, Michael C. Fagan

Department of Public Health Scholarship and Creative Works

This case discusses how we used scoping review methodology to map the literature in an emergent area of research, “structural change” public health interventions. Scoping reviews are similar to systematic reviews in both scale and rigor; both of these literature review methodologies are comprehensive approaches to reviewing the literature on a topic. However, while a systematic review attempts to answer a specific, targeted research question, a scoping review is designed to map and categorize all of the literature on a broad topic. For this reason, it is an excellent method to employ in emergent research areas, in which researchers have …

Evaluating Collaborate In A Clinical Setting: Analysis Of Mode Effects On Scores, Response Rates And Costs Of Data Collection, Paul J. Barr, Rachel C. Forcino, Rachel Thompson, Elissa M. Ozanne, Roger Arend, Molly Ganger Castaldo, A. James O'Malley, Glyn Elwyn

Dartmouth Scholarship

Shared decision-making (SDM) has become a policy priority, yet its implementation is not routinely assessed. To address this gap we tested the delivery of CollaboRATE, a 3-item patient reported experience measure of SDM, via multiple survey modes.To assess CollaboRATE response rates and respondent characteristics across different modes of administration, impact of mode and patient characteristics on SDM performance and cost of administration per response in a real-world primary care practice.Observational study design, with repeated assessment of SDM performance using CollaboRATE in a primary care clinic over 15 months of data collection. Different modes of administration were introduced sequentially including paper, …

How Nurse-Led Practices Perceive Implementation Of The Patient-Centered Medical Home, Rosemary Frasso, A. Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-Mcarthur, Michelle Miller-Day, Robert Gabbay, Peter F. Cronholm

Communication Faculty Articles and Research

Purpose

The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model.

Methods

Data were collected through in-depth interviews with providers and staff in nurse-led practices.

Results

These data suggest two categories of processes that facilitate the integration of PCMH in …

Mental Health Status And Access To Health Care Services For Adults In Maine, Erika C. Ziller Phd, Barbara Leonard Mph

Access / Insurance

Maine people with poor mental health describe significant challenges with affordability and access to health care. A new report released by the Maine Health Access Foundation (MeHAF) and the University of Southern Maine, Mental Health Status and Access to Health Care Service for Adults in Maine, describes how adults 18 and older in Maine who report depression and poor mental health have many barriers to getting health care. These results have important implications for planning in a time when major changes in health insurance coverage are expected.

Analyzing data from the ongoing federal/state public health survey, the Behavioral Risk …

Acceptability Of Hiv Testing Sites Among Rural And Urban African Americans Who Use Cocaine, D. Keith Branham, Tyrone F. Borders, Katharine E. Stewart, Geoffrey M. Curran, Brenda M. Booth

Health Management and Policy Faculty Publications

African Americans (AAs) who use cocaine in the Southern region of the U.S. have a relatively high risk of HIV and need for HIV testing. Among this group, those residing in rural areas may have less favorable opinions about common HIV testing sites, which could inhibit HIV testing. We examined rural/urban variations in their acceptability of multiple HIV testing sites (private physician clinic, local health department, community health center, community HIV fair, hospital emergency department, blood plasma donation center, drug abuse treatment facility, and mobile van or community outreach worker). Results from partial proportional odds and logistic regression analyses indicate …

A Critical Discussion Of Patient Engagement In Research, Andrea Elaine Bombak, Heather M. Hanson

Journal of Patient-Centered Research and Reviews

Patients are increasingly expected to take a more involved role in research. Funding for some projects now requires incorporating patients’ viewpoints or involvement in research processes. While intended to achieve commendable goals, it is important to critically assess the means used to achieve these aims. Presently, there may be issues of valuing only certain epistemologies, failing to evaluate existing programs and their impacts, marginalizing less “engaged” patients, and promoting only tokenism. These are areas that require exploration and reflection before assuming that patient engagement approaches are sufficient or the only means of incorporating patient perspectives into research.

Understanding And Using Patient Experience Feedback To Improve Health Care Quality: Systematic Review And Framework Development, Emmanuel Kumah, Felix Osei-Kesse, Cynthia Anaba

Journal of Patient-Centered Research and Reviews

Patient experience data is increasingly collected worldwide; however, questions persist regarding how it is used to improve health care quality. Synthesizing information from the existing literature, we have developed an empirically based framework to help organizations and managers understand what to do with patient experience feedback to improve health care quality at the organizational level. We identified six post-data collection/analysis activities, which were categorized into three main themes: 1) make sense of the data, 2) communicate and explain the data, and 3) plan for improvement. Our framework suggests that simply executing a survey will not improve performance. It is necessary …

An Analysis Of The Factors That Influence The Implementation Of The Policy For Monitoring Schoolchildren Meals Monitoring At Batam City, Ahmad Rafqi, Wiku Bakti Bawono Adisasmito

Journal of Indonesian Health Policy and Administration

Schoolchildren are assets for the development of the nation. Therefore, healthy meals at schools are very important, because for them, it covers about 25-36% of the daily energy requirements. Unhealthy eating habits or consumption of nutrition deficient meals may cause stunting, cardiovascular diseases, cancer, diabetes, and osteoporosis. In the short term it may also cause dental caries, anemia, overweight children and obesity. Around 40-44% of meals at schools do not satisfy the food safety requirements. To increase the quality of the meals at the schools, the community should be empowered to perform independent monitoring of school meals. This is inscribed …

The Political Aspects Of The Establishment Of The Planning And Budgeting Policy For The Directorate Of Occupational And Sports Health Of The Ministry Of Health, Ben Fauzi Ramadhan, Hasbullah Thabrany, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

The process to establish a planning and budgeting policy in the Directorate for Occupational and Sports Health is very dynamic and it fluctuates according to the goals and priorities of the policy. This research aims to ascertain how far the political aspects influences the establishment process. This research was a qualitative research accomllished through in-depth interviews with related parties. The framework used the planning and budgeting systems model and process/cycle. Results of this research indicated that politics played a major role in the policy establishment process in conflicts, cooperation, and negotiations when setting the size and allocation of the budget …

Analysis Of Factors Affecting Patient Satisfaction Jkn Non Pbi At Primary Health Care In East Jakarta District 2016, Cahya Arbitera, Amal Chalik Sjaaf, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

Health development in the period 2015-2019 is Indonesia Sehat program with the goal to improve the health and nutritional status of the community through health and community empowerment efforts which are supported with financial protection and health care equity. Social Health Security Agency (BPJS) as JKN organizers estimate in 2015 is a deficit of more than 6 trillion rupiahs. In 2016, the deficit is estimated to be 11 trillion rupiahs. This study used a cross sectional study design. The population in this study were outpatients at the sub-district Kramat Jati and Pasar Rebo primary health care with the total number …

Evaluation Of Poor Area Understanding Under Cigarettes In Lebak District, Nurhasanah Nurhasanah, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

Regional Regulation of Lebak District No.17 of 2006 on the Implementation of Order, Hygiene and Beauty is a derivative form of Government Regulation No.109 Year 2012 About Security of Materials Containing Addictive Substance in the form of Tobacco Products for Health. One of the mandate in the regulation is the establishment of Non Smoking Area (KTR) as an effort to protect the public against the health risks caused by the environment contaminated with tobacco smoke. Because health hazards caused by cigarettes not only affect the smokers but also passive smokers. WHO even mentioned that less than 6 million people died …

An Analysis Of The Hospital Bylaws Policies To Protect Healthcare Workers Against Indictments Of Adverse Events, Ade Leana, Adang Bachtiar

Journal of Indonesian Health Policy and Administration

One of the functions of hospital bylaws are a means to provide legal protection for all all parties that are related to the hospital. Legal protection is essential for prosecuted hospital staff members. One of the reasons for indictments is adverse events. The goal of this research is to discover how the hospital by-laws protects the hospital staff in the event of an indictment based on an adverse event and how the by-laws adhere to the guidelines in a comprehensive way. The research design used the qualitative method. The results of this research indicates that the hospital by-laws of RSKO …

A Chart Review Of Acute Care Inter-Hospital Transfers From Rural Wv Hospitals, Dilip Nair, Freddie Vaughan, Katherine Bennett

Marshall Journal of Medicine

Abstract

Objective: To document the characteristics of acute care patient transfers from rural West Virginia hospitals.

Data Sources/Study Setting: Hospital patient charts in rural West Virginia hospitals

Design: We examined 40 acute care patient transfers from rural West Virginia hospitals for patients’ age, gender, race and primary health insurance, the diagnosis and desired specialty service. We compared patients who were not transferred. For each transfer we collected data on the reason for transfer, the availability of beds of the appropriate acuity level as well as the availability of the relevant specialty at the time of transfer.

Principal Findings: Transferred patients …

Need Vs. Supply Analysis Of The New Haven Public Bus System, Stan Mathis

Yale Day of Data

ABSTRACT:

The aim of the study was to assess how well the public transportation system of New Haven County was matched to the public transit need using publicly available geospatial datasets from state and federal sources. Geospatial bus stop data was extracted from public State of Connecticut data sets. Census tract geography was extracted from US Census TIGER files while census tract aggregated household vehicle access data was queried from the American Community Survey data access server. A census tract’s Need was defined as percentage of households reporting access to zero vehicles; its supply was defined as the number of …

Emergency Department Utilization: A Qualitative Analysis Of Illinois Medical Home Network Patients., Crystal M. Glover, Yanina A. Purim-Shem-Tov

Journal of Health Disparities Research and Practice

Background

Inappropriate emergency department (ED) use continues to plague healthcare in terms of disease management and costs. In 2012, the State of Illinois implemented Medical Home Network (MHN) where Medicaid recipients were assigned to primary care providers to, in part, reduce overreliance on EDs. However, MHN patients have continued to use EDs.

Objective

The purpose of this study is to provide a qualitative analysis of Medicaid patient-identified barriers to primary care, facilitators of emergency use, and related mental health and psychosocial factors.

Methods

Patients who presented themselves at the ED located at an urban, academic medical center participated in one-time, …

Namibia : Hiv As A National Issue, Elisabeth Vlasak

Global Public Health

Namibia is located on the southwestern coast of Africa, bordering Angola, Botswana, Zambia, South Africa, and the Atlantic Ocean. Namibia has a population of 2,265,000, as of 2016. Namibia has many challenges, including food insecurity and malnutrition, access to health services, unequal distribution of wealth, but HIV/AIDS is one of the country’s leading challenges. It is estimated that the overall adult infection rate of HIV/AIDS is 15.4% and it is the leading cause of death in Namibia. Adults ages 18-24 are the most at-risk for the disease. Some of the major risk factors are declining condom use, misinformation, social stigma, …

Haiti : A Water Crisis, John Karras

Global Public Health

Haiti has always been a country stricken with poverty, and to have such a devastating earthquake hit them in 2010 was detrimental to any plans they had to improve the country. The earthquake negatively contributed to the very same water system the Haitian government was trying to improve. The massive 7.0 earthquake broke some of the water channels, which ultimately lead to the growth of many Cholera colonies in the pipes. This all led to the Cholera outbreak in October 2010. More recently, Haiti has been in a slightly better state, but not well enough for the people to live …

Mammography Utilization In African American Women, April D. Kidd

Electronic Theses and Dissertations

Purpose: Breast cancer presents differently among women causing breast cancer health disparities with women of color disproportionally shouldering later-stage screening, incidence, and treatment, and greater mortality. This study assessed 10 predictors and rates of recent and long-term mammography utilization for women 43-79 years of age to better understand differences among age strata and races. This was the first study to use both the calculated Gail Risk scores (calculates absolute breast cancer risk over time intervals) from the 2010 National Health Interview Survey (NHIS) and a temporary homelessness variable in predicting mammography utilization using national-level data.

Theoretical Framework: A modified Behavioral …

Perceived Discrimination And Self-Rated Health In The Immigrant Population Of The Basque Country, Spain, Elena Rodriguez-Alvarez, Yolanda Gonzalez-Rabago, Luisa N. Borrell, Nerea Lanborena

Publications and Research

Objective

To examine the effect of perceived discrimination and self-rated health among the immigrant population in the Basque Country, Spain, and determine whether this effect varies according to region of origin, age, sex and education. Methods

Descriptive cross-sectional study. The study population included immigrants aged 18 and older residing in the Basque Country. Data from the 2014 Foreign Immigrant Population Survey (n=3,456) were used. Log-binomial regression was used to quantify the association between perceived discrimination and self-rated health before and after checking for the selected characteristics. Results

Almost 1 in 10 immigrant adults reports perceiving discrimination. In adjusted analyses, the …

Visualizing The Diffusion Of Digital Mammography In New York State, Francis P. Boscoe, Xiuling Zhang

Epidemiology & Biostatistics Faculty Scholarship

Digital mammography saw rapid adoption during the first decade of the 2000s. According to data maintained by the Food and Drug Administration, which regulates mammography machines, fewer than 1 percent of the machines in 2001 were digital. By 2014, this figure had risen to 94%. We were interested in identifying the times and locations where the technology was introduced within the state of New York as a way of illustrating the uneven introduction of this technology. While the diffusion of medical innovation has been well-studied, there have not been many instances where maps or geographic information science methods have been …

Evolving Workforce Roles In Medicare Next Generation Acos, Clese E Erikson

Health Workforce Research Center Publications

The purpose of this study was to explore key workforce strategies in Next Generation Accountable Care Organizations (Next Gen ACOs), the latest evolution in Medicare ACOs. We conducted semi-structured interviews with leaders from seven of the initial 18 Next Gen ACOs to better understand their perceptions regarding how workforce roles are changing to support the Next Gen ACO model. Key Questions:

1. What new and expanded roles for existing health workforce members are reported by Next Generation ACO leaders?
2. Has use of the health workforce changed as a result of Next Gen waivers for telehealth, home visits, and use of SNFs? …

The Changing Roles Of Community Health Workers, Mary-Beth Malcarney, Patricia Pittman, Leo Quigley, Naomi Seiler, Katie B. Horton

Health Workforce Research Center Publications

Community Health Workers (CHWs) have been gaining attention from policymakers because of their unique role in addressing health disparities and socioeconomic drivers of disease, and because of their potential integration into the health care delivery system. To date, there has been limited research specifically describing the variation in CHWs’ roles and relationships, and how that variation relates to management, to financing, to health system integration, and to the competencies CHWs should have in different contexts.

This report provides a snapshot of the varied landscape of CHW programs to better understand how CHWs are integrating with the health system both in …

Burden Of Illness And Pharmacoeconomic Evaluation Of Lumacaftor/Ivacaftor In Cystic Fibrosis, Pratyusha Vadagam

Electronic Theses and Dissertations

Objectives: (1) To estimate the burden of illness in cystic fibrosis (CF) using 2010-2014 Medical Expenditure Panel Survey (MEPS) data, and (2) to conduct a pharmacoeconomic evaluation of lumacaftor/ivacaftor in the treatment of CF.

Methods: The study was conducted in two parts. Part 1 involved a retrospective analysis using individuals in MEPS database with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of 277.00 for a principal diagnosis of CF. Dependent variables were cumulative and out-of-pocket (OOP) expenditures and independent variables included patient demographics and clinical characteristics. Unweighted and weighted estimates of expenditure in CF group, …

Examining The Activities, Effectiveness, And Contribution Of Local Health Departments Using A National Longitudinal Survey Of Public Health Systems, Lava R. Timsina

Theses and Dissertations--Epidemiology and Biostatistics

Health services research and public health services and systems research in the past have contributed to a strong foundation of evidence-based progress in organizing, financing, and delivering medical care and public health strategies across the United States. The purpose of this dissertation was to examine disparities in public health systems and in the delivery of population health services in communities served by these systems using nationally representative data from the National Longitudinal Survey of Local Public Health Systems (1998, 2006, 2012, and 2014).

Data from the 1998 cohort of 497 local health jurisdictions serving at least 100,000 residents, and from …

University Of Montana Students And The Gardasil Vaccine, Markie C. Glidewell

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Gardasil^® is a vaccine for human papilloma virus (HPV), a sexually transmitted virus that can cause genital warts, cervical cancer, and other diseases. Males and females ages 9-26 are recommended to receive the Gardasil^® vaccination. Most students attending the University of Montana (UM) are within the recommended age range for Gardasil^® vaccination and would benefit from receiving it if they have not yet done so. Gardasil^® is available at the Health Services Pharmacy on the UM campus and is often covered by insurance plans with no patient copay. In the fall semester of 2016, surveys were …

Barriers To Glaucoma Case Finding As Perceived By Optometrists In Ireland, Catriona Barrett, Colm O'Brien, John Butler, James Loughman

Articles

Background: This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system.

Methods: A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practice in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly.

Results: One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra …