Public Health Commons^™

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Community & Environmental Health Faculty Publications

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

A Step By Step Methodological Approach To Appraise The Quality Of Written Feedback Using Comment Analysis, Lubna Ghazal, Raisa B. Gul, Amina Aijaz Khowaja

School of Nursing & Midwifery

Several studies have been conducted to analyze the quality of written feedback given by teachers on students’ written assignments. However, it has been observed that there is no clear existing method or tool to facilitate the analysis of teachers’ written feedback. This paper aims to document a step by step methodological approach to analyze teachers’ comments and appraise the quality of feedback on students’ written assignments. A self-initiated tool was developed from the comment analysis process which revealed the use of various formats and modes employed to provide written feedback to the students. In addition, this tool helped to determine …

Research Proposal: Emrs Changing Patient Medication Errors, Kerry Moore

Applied Research Projects

In 2009 the federal government initiated the American Recovery and Reinvestment Act (ARRA) in efforts to improve timely and quality health care. This new initiative promised to provide great incentives to health care providers who took advantage of the program by implementing electronic medical records (EMRs) within their facilities, clinics, and practices. Coupled with tight deadlines and the incentive of reimbursement, the health care world has been witness to an influx of EMRs being developed by vendors and implemented at health care facilities. The rate at which these EMRs have been implemented has been astounding. So fast, the health care …

The Impact Of The Hospital Acquired Conditions (Hac) Initiative For Catheter-Associated Urinary Tract Infections: Is It Really Improving Patient Care?, Shannon Hargis

Applied Research Projects

This research study focuses on the CMS, pay-for-performance, inpatient initiative regarding hospital acquired conditions (HAC) and present on admission (POA) identification of illnesses and injuries and studies conducted upon the initiatives that have measured outcome since the implementation of the program. This study is a focused assessment of numerous studies regarding the overall outcome of the initiative thus far, which was implemented in 2007. The goal of this research is to ascertain the effectiveness of the HAC initiative and possible factors that have positively or negatively impacted the overall outcomes in regard to Catheter-Associated Urinary Tract Infections (CAUTI).

The Impact Of Ehr Usability Issues On The Perceived Efficiency Of Non-Clinical Hospital-Based Ehr Users, Natasha Ocean

Applied Research Projects

A survey-based study of the impact of the EHR systems usability issues on the perceived efficiency of work among non-clinical users in the hospital settings was performed June 20th to July 24th 2015. There were 160 valid responses. The results were processed in SPSS (IBM statistical application) and I determined the usability dimensions with the greatest impact on efficiency, for all EHRs and for the major EHRs (Meditech, Epic and Cerner). Helpfulness was the most frequent problem for users of all EHRs.

The survey is experimental and cross-sectional. The format was 20 Likert-type questions, along with screening and demographic questions. …

Development And Preliminary Validation Of A Nonmedical Prescription Drug Motives Questionnaire, Lauren Ashleigh Milner

Graduate Theses and Dissertations

The prevalence of nonmedical prescription drug (NMPD) use continues to increase among emerging adult populations; however, little is known about the motivations behind this use. The current study aimed to extend previous research by developing and validating the first known comprehensive NMPD motives measure. As such, the primary focus of the current study was to examine evidence for the reliability and validity of the NMPD Motives Questionnaire by assessing the factor structure, internal consistency, and construct validity of the motives scale. Participants were drawn from a larger study of college student substance use behaviors and attitudes (N = 1,427; Mage= …

Community-Based Participatory Research To Adapt Health Measures For Use By People With Developmental Disabilities, Christina Nicolaidis, Dora Raymaker, Marsha Katz, Mary Oschwald, Rebecca Goe, Sandra Leotti, Leah Grantham, Eddie Plourde, Janice Salomon, Rosemary B. Hughes, Laurie E. Powers, Partnering With People With Disabilities To Address Violence Consortium

School of Social Work Faculty Publications and Presentations

Background: People with developmental disabilities (DD) are often not included as participants in research owing to a variety of ethical and practical challenges. One major challenge is that traditional measurement instruments may not be accessible to people with DD. Participatory research approaches promise to increase the participation of marginalized communities in research, but few partnerships have successfully used such approaches to conduct quantitative studies people with DD.

Objective: To use a community-based participatory research (CBPR) approach to create an accessible, computer-assisted survey about violence and health in people with DD, and to psychometrically test adapted health instruments.

Methods …

Socially Constructing Drug Addicts From The Poor: A Critical Discourse Analysis, Kalynn Susan Amundson

Graduate Theses and Dissertations

Welfare drug testing was authorized by the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, and has subsequently garnered extensive legislative interest in numerous states. This policy raises several questions, which are the subjects of the two journal articles and one manuscript included in this dissertation.

The first article addresses the question of a possible confluence of War on Drugs and Welfare Reform policies as evidenced through welfare drug testing policy, and indicated by continuity in policymakers’ rhetoric. This study examines federal-level policymakers’ debate discourse in these two policy streams. The analysis finds themes of the Social pathology, …

Patients Recording Clinical Encounters: A Path To Empowerment? Assessment By Mixed Methods, Glyn Elwyn, Paul James Barr, Stuart W. Grande

Dartmouth Scholarship

Objective: To examine the motivations of patients recording clinical encounters, covertly or otherwise, and why some do not wish to record encounters. Design: Mixed-methods analysis of survey data and nested semistructured interviews. Setting: Survey to UK audience, using social media and radio broadcast. Participants: 168 survey respondents, of whom 161 were 18 years of age or older (130 completions). Of the 56 participants who agreed to be contacted, we included data from 17 interviews.

Pengaruh Kepemimpinan Manajemen Rumah Sakit Dalam Iklim Keselamatan Pasien Di Rumah Sakit Sentra Medika Cibinong Tahun 2013, Regina Angelia Suwignjo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Transformational leadership as one of leadership style become the most important factor to build a patient safety culture in hospital environment and ensure the program will run succesfully to promote patient safety hospital services. The transformational leadership style indicator is intellectual stimulation, inspirational motivation, idealized influence, and individual consideration. Indicator of patient safety climate is management commitment, employee empowerment, reporting system, reward system and organizational identity. The aim of the study was to obtain every leadership factor that affect patient safety climate and which one is the most prominent leadership factor that influenced the patient safety climate in Sentra Medika …

Analisis Implementasi Kebijakan Dokter Spesialis Jaga On Site Di Instalasi Gawat Darurat Rumah Sakit Dr. Mohammad Hoesin Palembang, Kms Anhar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Since the introduction of the National Health Insurance Program January 1, 2014 has been an increase in patients visit to hospital-government hospitals. Emergency Department (ED) Hospital is a unit leader in the provision of hospital services. The increasing amount of patients visit especially in dr. Moh. Hoesin Palembang (RSMH) raises complex issues which experienced by other hospitals both at world, national and regional. Although the problems in the ED is complex they still expected to provide a certifiable quality service in accordance with the Decree of the Minister of Health no. 856 in 2009 about ED service standards. The problems …

Analisis Budaya Organisasi Dan Budaya Keselamatan Pasien Sebagai Langkah Pengembangan Keselamatan Pasien Di Rsia Budi Kemuliaan Tahun 2014, Afrisya Iriviranty

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Establishing patient safety culture is the first step in patient safety improvement.Therefore we need an assessment of patient safety culture in hospitals. Patient safety culture is part of the organizational culture, so that the study of organizational culture needed to be a guidance in developing patient safety. The aims of this study is to determine the patient safety culture among clinical staff in RSIA Budi Kemuliaan and identify organizational culture profiles. This study is descriptive with qualitative interpretation and analysis. It was found that teamwork within the unit is the strongest dimension of patient safety culture. While staffing and non-punitive …

Kelengkapan Resume Medis Dan Kesesuaian Penulisan Diagnosis Berdasarkan Icd-10 Sebelum Dan Sesudah Jkn Di Rsu Bahteramas, Fera Retno Mangentang

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Medical resume is the summary of the whole medical treatment and care provided by medical doctor to patient. Completeness of medical resume is the reflection of the quality of medical record and serives provided by hospital. Diagnostic must be completely written in accordance with ICD-10. This research used mix method, with cross sectional quantitative method to find out the relation between the characteristic of medical doctor with the completeness of the medical resume and compliance with the diagnostic guidelines based on ICD-10. Result of the research proved that there is a relation between the characteristic of medical doctor with the …

Analisis Konsep Lean Thinking Pelayanan Laboratorium Pada Pasien Ugd Rs Masmitra Bekasi, Relia Sari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Thesis describes the improvement of quality and laboratory services at. Masmitra Hospital through Lean method which aims to create value by reducing errors and waiting time. This study is a qualitative analytical research method by observation, interviews and data analysis to analyze the flow process of laboratory services for ER patients. The results showed that laboratory services at Masmitra Hospital still found delays which is prooven on the Current State Value Stream Map where 39% of the activities are non-value - added and 7 types of waste as well as through the aplication of Lean Tools has created improvement ideas …

Analisis Biaya Satuan Dan Kualitas Hidup Penderita Gagal Ginjal Kronik Yang Menggunakan Tindakan Hemodialisis Di Rumah Sakit Tebet Tahun 2015, Anggun Nabila

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The research aims to describe unit cost of hemodialysis and quality of life of Chronic Kidney Disease patients who use hemodialysis as a therapy at Tebet Hospital in 2015. Unit cost is calculated based on hospital perspective. Developing questioner of quality of life of Chronic Kidney Disease (CKD) patients (Dialysis Health Related Quality of Life) and clinical pathway of hemodialysis. Dialysis Health Related Quality of Life has 13 dimensions (sense of taste, sleep disorders, mobility, fatigue, anxiety, emotional, pain, self-care, daily activities (working, shopping, study, travelling, etc), communication, social interaction, being isolated, the burdens of others), measuring utility and time …

Analisis Sistem Penyelenggaraan Rekam Medis Di Instalasi Rekam Medis Rs “X” Tangerang Periode April-Mei 2015, Novita Nuraini

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aims to analyze the medical records implementation system (input, process, output, feedback and control) in the "X" Hospital Tangerang period from April to May 2015. This research is a mixed method. The data collected by observation, interview, documentation. Results: The medical record system implementation was not running optimally so this is due to produce output completeness of medical record file is only 55.2%, while the timeliness of the provision of medical record file is only 31%. This relates to the control and the process does not complete the analysis of the file. Suggestion: Hospital activate Control Committee of …

Maximizing The Impact Of Training Initiatives For Health Professionals In Low-Income Countries: Frameworks, Challenges, And Best Practices, Corrado Cancedda, Paul E. Farmer, Vanessa Kerry, Tej Nuthulaganti, Kirstin W. Scott, Eric Goosby, Agnes Binagwaho

Dartmouth Scholarship

Corrado Cancedda and colleagues outline a framework for health professional training initiatives in low-income countries.

Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This session highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This methods workshop examines the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures. This paper profiles examples of using SNA principles and methods to study the implementation …

Learning From Network Analysis: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This methods workshop highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This session will examine the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures.

Learning From Delivery System Behavior, Dynamics & Interactions To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

A new "Systems for Action" national research program flows directly from the Robert Wood Johnson Foundation's Culture of Health action framework. This program will build evidence on how best to align the delivery and financing systems for medical care, public health, and community services & supports so as to promote wellbeing and resiliency, realize efficiencies in resource use, and reduce inequities in health.

Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health “system capital”; and (2) the effects of these changes on preventable mortality and resource use. …

High-Risk Travel Distance And Number Of Primary Care Visits In A North Carolina Medicaid Population, Justin Allred, Christopher Duffrin, Jason Brinkley, John Jones

Frontiers in Public Health Services and Systems Research

Background: With nearly 20% of the U.S. population in rural areas, a lack of access to primary care may cause rural residents to forego recommended preventive care procedures, and suffer higher morbidity rates than their urban counterparts.

Methods: Medicaid billing data from 2009 to 2011 were analyzed to calculate the distance and duration that a Medicaid patient population had to travel when seeking primary care in the 29 rural counties of eastern North Carolina. Primary care codes were analyzed to detect any differences in access patterns for various complexity levels of physician visits. Data were also used to evaluate health …

The National Health Security Preparedness Index: National Advisory Committee Meeting, Glen P. Mays, Michael Childress, Anna Goodman Hoover, Chris Bollinger

Health Management and Policy Presentations

This meeting of the National Advisory Committee for the National Health Security Preparedness Index program discussed strategies for improving the theoretical framework, measures, and analytic methodologies used in assessing and comparing preparedness levels across U.S. states and the nation as a whole.

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.

Intensive Transition Team - Analysis Of Program Impacts, Bill J. Wright, Keri B Vartanian, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Improving Influenza And Tdap Vaccination During Pregnancy: A Cluster-Randomized Trial Of A Multi-Component Antenatal Vaccine Promotion Package In Late Influenza Season, A. T. Chamberlain, K. Seib, K. A. Ault, E. S. Rosenberg, Paula M. Frew, M. Cortés, E. A. S. Whitney, R. L. Berkelman, W. A. Orenstein, S. B. Omer

Environmental & Global Health Faculty Research

Background Evidence-based interventions to improve influenza vaccine coverage among pregnant women are needed, particularly among those who remain unvaccinated late into the influenza season. Improving rates of antenatal tetanus, diphtheria and acellular pertussis (Tdap) vaccination is also needed.

Prehipertensi Pada Obesitas Abdominal, Lia Churniawati, Santi Martini, Catharina Umbul Wahyuni

Kesmas

Prehipertensi banyak terjadi pada penderita obesitas abdominal. Prevalensi obesitas abdominal di Kabupaten Gresik sebesar 21,5%. Kepatuhan diet penderita prehipertensi dengan obesitas abdominal diperlukan untuk mengurangi risiko terjadinya hipertensi. Prehipertensi dan hipertensi berhubungan dengan pelbagai komplikasi pada hampir seluruh organ. Penelitian ini bertujuan untuk menganalisis determinan prehipertensi pada obesitas abdominal di Kabupaten Gresik. Penelitian ini dilaksanakan di Kabupaten Gresik pada November 2013 - November 2014 dengan rancangan penelitian potong lintang. Responden adalah pasien yang datang ke unit rawat jalan puskesmas yang diambil secara konsekutif sejumlah 74 orang. Responden berusia antara 25 - 64 tahun, mengalami obesitas abdominal, tidak hamil, tidak hipertensi, …

Cemaran Mikroba Escherichia Coli Dan Total Bakteri Koliform Pada Air Minum Isi Ulang, Rolan Sudirman Pakpahan, Intje Picauly, I Nyoman W. Mahayasa

Kesmas

Jumlah layanan air minum melalui depot air minum di Kota Kupang meningkat dengan rata-rata 1,44 setiap tahun sejak 2010, sementara tidakterdapat jaminan kualitas air minum isi ulang memenuhi syarat setiap saat. Hasil pemeriksaan sampel air minum isi ulang di Kota Kupang tahun 2013 menunjukkan 37,5% tercemar mikroba. Tujuan penelitian ini adalah menganalisis cemaran mikroba dan mengetahui determinan cemaran Escherichia coli (E. coli) dan total koliform pada air minum isi ulang. Penelitian ini menggunakan desain studi potong lintang periode Januari Maret 2015. Populasi penelitian berjumlah 51 depot air minum yang ditentukan menggunakan teknik total sampling. Analisis data dilakukan secara univariat, analisis …

Akses Jaminan Kesehatan Nasional Pada Pekerja Seks Perempuan, Ni Made Sri Nopiyani, Putu Ayu Indrayathi, Rina Listyowati, I Ketut Suarjana, Pande Putu Januraga

Kesmas

Pekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun …

Pengaruh Teknik Marmet Terhadap Kelancaran Air Susu Ibu Dan Kenaikan Berat Badan Bayi, Anita Widiastuti, Siti Arifah, Wiwin Renny Rachmawati

Kesmas

Bayi lahir cukup bulan memiliki naluri menyusu 20 - 30 menit setelah dilahirkan. Namun, fakta menunjukkan produksi dan ejeksi air susu ibu (ASI) yang sedikit di hari-hari pertama menyebabkan banyak ibu yang mengalami ketidakefektifan proses menyusui. Tidak terproduksinya ASI diakibatkan karena kurangnya rangsangan hormon prolaktin. Teknik marmet merupakan perpaduan memerah dan memijat payudara pada ibu nifas yang dapat merangsang hormon pada proses menyusui. Penelitian ini bertujuan untuk mengetahui perbedaan pengaruh teknik marmet dengan masase payudara pada ibu nifas tiga hari postpartum terhadap kelancaran ASI dan kenaikan berat badan bayi. Penelitian ini menggunakan desain pre-experimental bentuk perbandingan kelompok statistik yang dilakukan …