Health Services Administration Commons^™

The Association Of Adult Medicaid Beneficiaries’ Characteristics And Their Experience During The Covid-19 Pandemic, Frank R. Tortorella

Dissertations and Theses (Open Access)

Background: The COVID-19 pandemic disrupted the United States’ safety net program, Medicaid, for low-income individuals affecting access to care, increasing enrollment, and requiring new approaches to care delivery. The literature shows that beneficiaries’ personal characteristics influence their healthcare experience. This study investigated the association between Medicaid beneficiary characteristics and experience with their Medicaid health plan, examined if COVID-19 negatively impacted experience, and tested if COVID-19 moderated the relationship between beneficiary characteristics and experience.

Methods: The research sample was 76,976 adult Medicaid beneficiaries who voluntarily completed the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) health plan surveys in 2018 …

Rethinking Health Systems Responsiveness In Low- And Middle-Income Countries: Validation Study, Meesha Iqbal, Cecilia Ganduglia Cazaban, Robert Morgan, Cici Bauer, Sameen Siddiqi

Faculty, Staff and Student Publications

BACKGROUND: Health systems responsiveness (HSR) is the ability of systems to respond to legitimate non-health expectations of the population. The concept of HSR by the World Health Organization (WHO) includes respect for dignity, individual autonomy, confidentiality, prompt attention to care, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. The WHO tool is applied globally to assess HSR in low, middle, and high-income countries.

OBJECTIVE: We have revised the conceptual framework of HSR following a rigorous systematic review and made it specific for low- and middle-income countries (L&MICs). This study is designed to …

Learning From The Implementation Of A Surgical Opioid Reduction Initiative In An Integrated Health System: A Qualitative Study Among Providers And Patients, Willemijn L A Schäfer, Julie K Johnson, Meagan S Ager, Cassandra B Iroz, Reiping Huang, Salva N Balbale, Jonah J Stulberg

Faculty, Staff and Student Publications

BACKGROUND: Surgical opioid overprescribing can result in long-term use or misuse. Between July 2018 and March 2019, the multicomponent intervention, Minimizing Opioid Prescribing in Surgery (MOPiS) was implemented in the general surgery clinics of five hospitals and successfully reduced opioid prescribing. To date, various studies have shown a positive outcome of similar reduction initiatives. However, in addition to evaluating the impact on clinical outcomes, it is important to understand the implementation process of an intervention to extend sustainability of interventions and allow for dissemination of the intervention into other contexts. This study aims to evaluate the contextual factors impacting intervention …

Preparing Healthcare Education For An Ai-Augmented Future, Jiajie Zhang, Susan H Fenton

Faculty, Staff and Student Publications

Artificial intelligence (AI) fundamentally transforms healthcare education as a knowledge enterprise, creating a distributed cognitive system composed of the human brain, which remains relatively unchanged, and AI-based knowledge and cognitive functions, which have accelerated exponentially in scale and power. Education must focus on developing skills to collaborate with AI and on achieving outcomes like problems solved and discoveries made. Curriculum and education policies also need to adapt to this transformation.

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 …

Measuring Quality At The Surgeon Level, Elias A Chamely, Jonah J Stulberg

Faculty, Staff and Student Publications

Patients expect high-quality surgical care and increasingly are looking for ways to assess the quality of the surgeon they are seeing, but quality measurement is often more complicated than one might expect. Measurement of individual surgeon quality in a manner that allows for comparison among surgeons is particularly difficult. While the concept of measuring individual surgeon quality has a long history, technology now allows for new and innovative ways to measure and achieve surgical excellence. However, some recent efforts to make surgeon-level quality data publicly available have highlighted the challenges of this work. Through this chapter, the reader will be …

Mortality And Major Adverse Cardiovascular Events In Hospitalized Patients With Atrial Fibrillation With Covid-19, Lucas Wang, Lawrence Hoang, Kristopher Aten, Mujahed Abualfoul, Victor Canela, Sri Prathivada, Michael Vu, Yi Zhao, Manavjot Sidhu

Faculty, Staff and Student Publications

COVID-19 results in increased incidence of cardiac arrhythmias, including atrial fibrillation (AF). However, little is known about the combined effect of AF and COVID-19 on patient outcomes. This study aimed to determine if AF, specifically new-onset AF (NOAF), is associated with increased risk of mortality and major adverse cardiovascular events (MACEs) in hospitalized patients with COVID-19. This multicenter retrospective analysis identified 2,732 patients with COVID-19 admitted between March and December 2020. Data points were manually reviewed in the patients' electronic health records. Multivariate logistic regression was used to assess if AF was associated with death or MACE. Patients with AF …

Bending The Patient Safety Curve: How Much Can Ai Help?, David C Classen, Christopher Longhurst, Eric J Thomas

Faculty, Staff and Student Publications

This paper reviews the current state of patient safety and the application of artificial intelligence (AI) techniques to patient safety. This paper defines patient safety broadly, not just inpatient care but across the continuum of care, including diagnostic errors, misdiagnosis, adverse events, injuries, and measurement issues. It outlines the major current uses of AI in patient safety and the relative adoption of these techniques in hospitals and health systems. It also outlines some of the limitations of these AI systems and the challenges with evaluation of these systems. Finally, it outlines the importance of developing a proactive agenda for AI …

National Cross-Sectional Study On Cost Consciousness, Cost Accuracy, And National Medical Waste Reduction Initiative Knowledge Among Pediatric Hospitalists In The United States, Benjamin C Lee, Matt Hall, Ladan Agharokh, Andrew G Yu, Kavita Parikh, Samir S Shah

Faculty, Staff and Student Publications

BACKGROUND/OBJECTIVE: Despite initiatives to reduce waste and spending, there is a gap in physician knowledge regarding the cost of commonly ordered items. We examined the relationship between pediatric hospitalists' knowledge of national medical waste reduction initiatives, self-reported level of cost-consciousness (the degree in which cost affects practice), and cost accuracy (how close an estimate is to its hospital cost) at a national level.

METHODS: This cross-sectional study used a national, online survey sent to hospitalists at 49 children's hospitals to assess their knowledge of national medical waste reduction initiatives, self-reported cost consciousness, and cost estimates for commonly ordered laboratory studies, …

Fostering A High-Functioning Team In Cancer Care Using The 4r Oncology Model: Assessment In A Large Health System And A Blueprint For Other Institutions, Raymond Liu, Christine B Weldon, Elizabeth Linehan, Nancy Gordon, Thea Abbe, Marti Hennings, Henie James, Jed Katzel, Chun Ng, Megumi Tomita, Jeffrey B Velotta, Stephanie Ossowski, Lori C Sakoda, Sharon Likely Sprague, Anna Dowling, Kimberly Beringer, Arliene Ravelo, Elaine Yu, Julia R Trosman

Faculty, Staff and Student Publications

PURPOSE: Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and strains the oncology workforce. We assessed whether the 4R Oncology model for team-based interdependent care delivery and patient self-management affected team functioning in a large community-based health system.

METHODS: 4R was deployed at four locations in breast and lung cancers and assessed along four characteristics of high-functioning teams: recognition as a team internally and externally; commitment to an explicit shared goal; enablement of interdependent work to achieve the goal; and engagement in regular reflection to adapt objectives and processes. …

Final Evaluation Of La Door: Proposition 47 Grant Program, Melissa M Labriola, Danielle Sobol, Stephanie Brooks Holliday, Heather Sims

Faculty, Staff and Student Publications

The Los Angeles Diversion, Outreach, and Opportunities for Recovery program (LA DOOR) was designed by the Los Angeles City Attorney's Office (LACA) to provide a comprehensive, health-focused, preventative approach that proactively engages individuals at elevated risk of returning to LACA on a new misdemeanor offense related to substance use, mental illness, or homelessness. LA DOOR was funded through the grant program of Proposition 47. Programs funded through Proposition 47 are intended to serve individuals with a history of criminal justice involvement and mental health issues or substance use disorders and to offer mental health services, substance use disorder treatment, and …

Ms021: Sworn Oath Affirming No Exposure To Yellow Fever In The Past 20 Days, George D. Neal

John P. McGovern, MD Collection

Sworn oath signed by George Neal of Navasota City, TX, attesting he had not been in an infected district or community with yellow fever in the past 20 days. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: The Climate Of Texas In Relations To The Distribution Of Diseases And The Effects Of Climate And Weather Changes In Causing Diseases And Deaths, Issac Monroe Cline

John P. McGovern, MD Collection

Book, "The Climate of Texas in Relations to the Distribution of Diseases and the Effects of Climate and Weather Changes in Causing Diseases and Deaths", by Dr. Isaac Cline, published by Strickland Printing Company. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Yellow Fever Quarantine Proclamation, James S. Hogg

John P. McGovern, MD Collection

Quarantine Proclamation issued by the Governor of Texas, J.S. Hogg, declaring a quarantine against the City of Brunswick, Georgia, due to yellow fever epidemic. Signed and sealed by J.S. Hogg. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Correspondence, Henry Eustice Mccullough

John P. McGovern, MD Collection

Letter written by Henry McCulloch on TX Institute for Deaf and Dumb letterhead to Governor Frank R. Lubbock requesting help getting General W.P. Harrison to run for treasurer. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Notice To Clean/Sanitize Property Issued By The Office Of The Health Physician In Galveston, Tx, George W. Peete

John P. McGovern, MD Collection

Notice from Office of the Health Physician in Galveston, TX, issued to W.G.? To clean Lot No. 5 and empty privy on or before May 21, 1875, or be held liable to fines and penalties imposed by city ordinance, signed by G.W. Peete. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Hospital Ledger, St. Mary's Infirmary

John P. McGovern, MD Collection

Hospital ledger listing patients admitted and treated during the month of January 1871 at the rate of 75 cents per day, signed by Dr. C.H. Wilkinson. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Receipt For Medical And Post-Mortem Services, Greenville S. Dowell

John P. McGovern, MD Collection

Receipt for medical services, medications, and post-mortem rendered to Lena? Hamilton, female prisoner, by Dr. Dowell, Coroner. Inscription at bottom asks the County Court to raise his salary from $20 to $40 a month and to continue to furnish medicine. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Receipt For Medicine Purchased, E F. Schmidt

John P. McGovern, MD Collection

Receipt for drugs, medications bought and paid for by Mr. Oehring from E.F. Schmidt, druggist and apothecary. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Correspondence, William R. Smith

John P. McGovern, MD Collection

Correspondence written by Dr. William R. Smith to Judy? offering sympathy and condolences for the death(s)? Of family members also writes of his own illness from yellow fever in Galveston and talks about the medical care he has provided to victims, namely soldiers, of the yellow fever epidemic, Dickson Bayou, TX. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Receipt For Medical Services Rendered, J. B.O. Lancton

John P. McGovern, MD Collection

Receipt for medical services rendered, See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Probate Claim, Thomas C. Cook

John P. McGovern, MD Collection

Claim filed against Estate of M.W. (illegible) for medical services rendered by Dr. Cook. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Probate Claim, John J. Walter

John P. McGovern, MD Collection

Claim filed against Estate of W. M.? For medical services rendered (cupping, bleeding, and injections). See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Probate Claim, Thomas J. Heard (1814-1899)

John P. McGovern, MD Collection

robate claim filed against Estate of Matthew W. Marin for medical treatment renderd to decedent by Dr. Heard, See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Receipt For Medicine Purchased, H. C.L. Aschoff

John P. McGovern, MD Collection

Receipt to Judge Dean for medications purchased from H.C.L. Aschoff, Druggist. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Receipt For Prescriptions Purchased, J. S. Nichols

John P. McGovern, MD Collection

Paid receipt for prescriptions provided by Dr. Nichols to Judge Dean. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Probate Claim, Edward Randall

John P. McGovern, MD Collection

Additional claims filed against Estate of Pilant for medical services rendered, paid in full with interest by admininstrator of estate. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Receipt For Medical And Obstetrical Services Rendered, V. Friendman

John P. McGovern, MD Collection

Receipt of payment for medical and obstetrical services rendered to servants of Mr. Seawell. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Itemized Bill And Probate Claim For Medical Services, Medications Rendered, Edward Randall

John P. McGovern, MD Collection

Itemized bill/claim filed against Estate of J.W. Pilant for medical services provided. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.

Ms021: Receipt For Medicine Purchased, Nicholas Descomps Labadie (1802-1867)

John P. McGovern, MD Collection

Receipt to Dr. Labadie for drugs, medications bought from James Syme. See more at John P. McGovern, MD Collection of Texas Historical Medical Documents and its finding aid.