Health Services Administration Commons^™

Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba

Electronic Theses and Dissertations

Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …

Implementation Of Control Policy Of Diphtheria Outbreak And Outbreak Response Immunization (Ori) In Kota Depok, 2017, Dian Novita Sari, Anhari Achadi

Journal of Indonesian Health Policy and Administration

Diphtheria is a contributor to an outbreak (KLB) for some regions in Indonesia, included West Java Province. Diphtheria cases had increased through 2015 - 2016, the cases increased from 59 cases to 153 cases. Depok City became one of the contributors of diphtheria cases that have fluctuating incidents. Disease trends have decreased in 2013-2015 but then increased in 2016 to 8 cases. This study discusses policy implementation, viewed from policy sources, resource arrangements, the characteristics of implementing agencies, bureaucratic structures, communications, the influence of dispositions and socio-economic and political circumstances in control of Diphtheria Outbreak and Outbreak Response Immunization (ORI) …

The Implementation Analysis Of The Inclusion Of Health Warnings And Health Information Policy On Cigarette Packaging, Diah Ekawati, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Pictorial health warnings already implemented for more than two years since June 24, 2014, however, there are no changes made following the Minister of Health Regulation No. 28 of 2013 until now. According to the results of the National Survey of Assessment of the Implementation of Pictorial Health Warning (PHW) in Indonesia in 2015 towards the compliance of the tobacco industry, it is known that the cigarette industry has not yet adhered to pictorial health warnings. The Government hopesthat the existence of the Minister of Health Regulation No. 28 can reduce the prevalence of smokers, but data from 2016 SIRKERNAS …

Puskesmas Readiness In Accreditation Implementation As Efforts To Improve The Health Service Quality In Sumbawa District, Nurul Saptorini Rahmadhani, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

. In achieving Universal Health Coverage in 2019, it is necessary to increase access and quality of health services to the community. Puskesmas accreditation is a method of improving the quality of service and patient safety as well as a condition to do collaboration with BPJS. According to Donabedian, quality of services needs to be supported by standardized structures, processes and outcomes which are oriented to internal and external customers. This study aims to analyze the readiness of Puskesmas in accreditation implementation as an effort to improve the quality of health services in Sumbawa Regency. This effort is an implementation …

The Determinant Of Outpatient Health Services Utilization For Elderly Patient In Indonesia (Susenas 2017 Data Analysis), Rizki Asriani Putri, Yaslis Ilyas

Journal of Indonesian Health Policy and Administration

Indonesia has entered an aging population as showed by the number of elderly population which has reached more than 7% of the population. Basically, the increase in the elderly population will also increase the number of illnesses, because the more a person ages, the physical condition will decrease and be more susceptible to disease. This research is a quantitative study that aims to determine the determinants of outpatient health service use for Indonesian elderly in 2017. This research used secondary data from the 2017 National Socio-Economic Survey (Susenas) results with the unit of analysis is people aged ≥ 60 years …

Analysis Of Trends In The Availability Of Indicator Drugs And Vaccines In Public Health Center For 2016-2017, Aji Wicaksono, Kemal Nazarudin Siregar

Journal of Indonesian Health Policy and Administration

The health development strategies for 2015-2019 is about improving the availability, affordability, equity and quality of pharmaceuticals and medical devices. Since the enactment of national health insurance (JKN) on January 1, 2014, the availability of drug at the public health center become a very important aspect in primary health care services. Drug logistics management is an important aspect that influences accessibility to health services including the availability of essential drugs and vaccines. The aim of this study is to explore the trend of availability indicator drugs and vaccines in public health center for the period of 2016-2017 and drug logistics …

Call For Submissions Special Issue - July 2020: Patient & Family Experience In Behavioral Health, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2020 special issue on the topic of patient & family experience in behavioral health. With a continued focus on the critical role of behavioral health in society today and a growing recognition of the importance of experience for those in behavioral health settings, a conversation on the practices in place and the identification of evidence of efforts leading to positive outcomes will be essential expanding the experience conversation in this setting. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices …

“Anyone Can Co-Design?”: A Case Study Synthesis Of Six Experience-Based Co-Design (Ebcd) Projects For Healthcare Systems Improvement In New South Wales, Australia, Tara L. Dimopoulos-Bick, Claire O'Connor, Jane Montgomery, Tracey Szanto, Marion Fisher, Violeta Sutherland, Helen Baines, Phillip Orcher, John Stubbs, Lynne Maher, Raj Verma, Victoria J. Palmer

Patient Experience Journal

Experience-based co-design (EBCD) is a quality improvement approach that is being used internationally to bring service users and health professionals together to improve healthcare experiences, systems and processes. Early evaluations and case studies of EBCD have shown promise in terms of improvements to experience and organisational processes, however challenges remain in participation around shared power and decision making, mobilisation for implementation, sustainment of improvements and measurement of outcomes. The objective of this case study was to explore the emergent issues in EBCD participation and implementation in six quality improvement projects conducted in mental health, rehabilitation, blood and bone marrow transplant, …

A Next-Day, Brief E-Survey Overcomes The Excessive Variability Seen In Cahps-Style Emergency Department Surveys So That Individual Physician Performance Can Be Assessed On A Regular Basis, Tom Scaletta, Eva Hare, Christopher Sung Lee

Patient Experience Journal

Traditional CAHPS-style emergency department (ED) surveys result in excessive variability when assessing individual physician performance. The objective of this study is to measure the variability of a brief, electronic survey (e-survey). The study team also measured the association of individual physicians to demographic data, physician and patient factors, and a physician burnout assessment tool. Data from SmartContact (SmartER, La Grange, IL) is a next-day, e-survey that takes about 30-seconds to complete. This tool was used by a hospital-employed emergency department (ED) group during calendar year 2017 across 2 EDs and 37 physicians.^1,2 Variability was estimated regarding raw patient experience …

Beneath The Surface Of Talking About Physicians: A Statistical Model Of Language For Patient Experience Comments, Taylor Turpen, Lea Matthews Md, Senem Guney Phd, Cpxp

Patient Experience Journal

This study applies natural language processing (NLP) techniques to patient experience comments. Our goal was to examine the language describing care experiences with two groups of physicians: those with scores in the top 100 and those with scores in the bottom 100 among all physicians (n=498) who received scores from patient satisfaction surveys. Our analysis showed a statistically significant difference in the language used to describe care experiences with these two distinct groups of physicians. This analysis illustrates how to apply NLP techniques in categorizing and building a statistical model for language use in order to identify meaningful language and …

A Patient Portal Push Toward Acceptance And Utilization Of The Technology, Deborah Kornacker Dnp, Rn, Kathy Fitzgerald Ph.D., Rn, Stacie Elder Ph.D.,Rn, Cne

Patient Experience Journal

Certified electronic health record technology (c-EHRT) has the capacity to enhance person-centered care through online engagement between providers and patients. A driver to portal use is the Centers for Medicare and Medicaid (CMS) Meaningful Use (MU) benchmarks. Currently, many health care centers and providers fall short in attracting patients to register and utilize online patient portals thus influencing optimal utilization of the EHR. Barriers cited in the literature include lack of stakeholder interest, multiple government policy and mandates, and lack of resources to implement standards for health information technology (HIT) standards in daily professional workflow. This program evaluation focused on …

The Digital Revolution Will See You Now: Transforming Patient Experience In The Digital Era, Emily Kagan Trenchard, Laura Semlies, Sven Gierlinger

Patient Experience Journal

Industry after industry has reinvented itself in response to upstart challengers and shifting consumer expectations that are the hallmarks of this new era. The same is true in healthcare, where we have weathered the introduction of the electronic medical records, patient portals and now interoperability. But to date our industry’s digital transformation has been guided largely by government regulation – leaving the design of the future of healthcare to be driven by policy makers and executed largely by IT departments. Meanwhile, most other industries have turned to a different guru for inspiration and guidance: the consumer. Northwell Health has undertaken …

Technology, Innovation And Transforming Healthcare Faster, Smarter And Together: A Conversation With Dr. Rasu Shrestha, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

As part of our special issue on Innovation and Technology we had the pleasure of speaking with a visionary leader, Physician and healthcare executive, Dr. Rasu Shrestha, executive vice president and chief strategy officer at Atrium Health. In the conversation with Dr. Shrestha we were able to cover the foundational ideas of innovation and technology. We also explored its opportunities and potential pitfalls. Ultimately, we looked at the topic through the lenses of the human experience we provide in healthcare and how through a clear focus on experience and the effective integration of innovation and technology in those efforts, we …

Transformations In Health Information Technology And The Impact On Patient Experience, Cynthia J. Sieck Phd, Mph, Tim R. Huerta Phd, Ms

Patient Experience Journal

Changes in the way we collect and use health information, and the technology that enables these processes, have transformed the patient experience in health care. Compared to an earlier focus on using health information technology (HIT) for clinical purposes, patients are now also significant users of HIT, spurring the development of Patient-Facing Health Information Technology (PFHIT). These tools allow patients to use and interact with their health information and healthcare providers is new and transformative ways. We suggest that while these transformations have significant positive impacts, there are three important considerations which must be included as HIT continues to evolve: …

Reframing Innovation And Technology For Healthcare: A Commitment To The Human Experience, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

This latest special issue of Patient Experience Journal focuses on the role of technology and innovation in patient experience. The articles included in this issue help us think about the ideas of innovation and health information technology (HIT) in some new and interesting ways. They also have us push the boundaries of what has framed what innovation and technology application look like in healthcare today. With this perspective, we explore the idea that HIT is not simply a process improvement tool; it is a means to elevate the human interactions at the heart of healthcare. Simultaneously in healthcare, innovation has …

Short Relative Leg Length Is Associated With Overweight And Obesity In Mexican Immigrant Women, Mireya Vilar-Compte, James Macinko, Beth C. Weitzman, Carlos M. Avendaño-Villela

Department of Public Health Scholarship and Creative Works

Background: Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare - all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured …

Depression Among Expectant And New Mothers: A Multi-Study Investigation Of Rates, Correlates, And Training For Healthcare Providers, Molly M. Long

Health Services Research Dissertations

Perinatal depression (PD) is a common concern among women. PD has been shown to have negative effects on the mother, child, and mother-child relationship. Screening for PD is inconsistent and low among healthcare providers. However, several governing organizations (e.g., The American College of Obstetricians and Gynecologists, The American Academy of Pediatrics) have provided guidelines for screening and treating PD, indicating the importance and utility of screening and treating PD by a variety of healthcare providers. Few studies, with low methodological rigor, have attempted to improve PD screening, treatment, and referral practices. Therefore, it is important to implement and assess additional …

The Role Of The Community Health Delivery System In The Health And Well-Being Of Justice-Involved Women: A Narrative Review, Sharla A. Smith, Glen P. Mays, Tracie C. Collins, Megha Ramaswamy

Health Management and Policy Faculty Publications

Background: Over seven million imprisoned and jailed women are released into the community each year and many are ill-equipped to meet the challenges of re-integration. Upon release into their community, women are faced with uncertain barriers and challenges using community services to improve their health and well-being and reuniting with families. Few studies have identified and described the barriers of the community health delivery system (CHDS)- a complex set of social, justice, and healthcare organizations that provide community services aimed to improve the health and well-being (i.e. safety, health, the success of integration, and life satisfaction) of justice-involved women. We …

Clinic Exploration Of Care Processes To Promote Colorectal Cancer Screening In Rural Accountable Care Organization Clinics: A Qualitative Case Study, Sarbinaz Bekmuratova, Jungyoon Kim, Hongmei Wang, Lufei Young, Daniel J. Schober, Li-Wu Chen

The Qualitative Report

It is essential to have an effective care process to promote colorectal cancer (CRC) screening particularly in rural areas. Primary care health care providers may have a significant impact on improving CRC screening rates among rural residents through systematic screening processes in their clinics. In this qualitative study, we aimed to explore the whole clinic processes of recommending and referring CRC screening in the rural accountable care organization (ACO) primary care clinics. We collected qualitative data through 21 semi-structured in-depth interviews with healthcare providers in rural primary care ACO clinics in Nebraska. We audio recorded and transcribed the interviews and …

Involvement Of Adults Who Are Deaf Or Hard Of Hearing In Ehdi Programs, Elizabeth Shuler-Krause, Karl R. White

Journal of Early Hearing Detection and Intervention

Consistent with a position statement of the Joint Committee on Infant Hearing (JCIH, 2007), several key organizations and groups have supported involving deaf and hard of hearing (DHH) adults in Early Hearing Detection and Intervention (EHDI) systems, including providing families of children who are DHH with opportunities to interact with adults who are DHH. This article reviews the available data on the involvement of adults who are DHH in EHDI systems to determine the availability of opportunities for families who have children who are DHH to interact with adults who are DHH, how families feel about these experiences, and to …

Family Impact Of Pediatric Hearing Loss: Findings From Parent Interviews And A Parent Support Group, Kristen L. Haddad, Wendy W. Steuerwald, Lori Garland

Journal of Early Hearing Detection and Intervention

Parents experience numerous stressors tied to their child's diagnosis as deaf or hard of hearing (DHH). This study sought to inquire about the lived experiences of parents with children who are DHH to inform the types of supports that should be provided within an audiology care coordination system. Semi-structured phone interviews were conducted with parents of children under the age of five who are DHH and patients of the Division of Audiology at Cincinnati Children’s Hospital Medical Center (CCHMC). Interview findings informed focus group questions, which were facilitated in a parent support group with parents of children who are DHH …

Exploratory Qualitative Study To Understand The Underlying Motivations And Strategies Of The Private For-Profit Healthcare Sector In Urban Bangladesh, Alayne Mary Adams, Rushdia Ahmed, Tanzir Ahmed Shuvo, Sifat Shahana Yusuf, Sadika Akhter, Iqbal Anwar

Faculty Publications

Objectives This paper explores the underlying motivations and strategies of formal small and medium-sized formal private for-profit sector hospitals and clinics in urban Bangladesh and their implications for quality and access.

Methods This exploratory qualitative study was conducted in Dhaka, Sylhet and Khulna City Corporations. Data collection methods included key informant interviews (20) with government and private sector leaders, in-depth interviews (30) with clinic owners, managers and providers and exit interviews (30) with healthcare clients.

Results Profit generation is a driving force behind entry into the private healthcare business and the provision of services. However, non-financial motivations are also emphasised …

Suicidal Thoughts, Plans, And Attempts By Non-Metropolitan And Metropolitan Residence, Kathi Harp, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

• Mean prevalence rates for suicidal thoughts, plans, and attempts were significantly higher (P < .05) among residents of non-metropolitan than large metropolitan counties.
• The adjusted odds of suicidal thoughts, plans, and attempts did not improve significantly from 2010 to 2016 among residents of any county type.
• The study findings suggest that suicide prevention interventions should be further targeted toward non-metropolitan counties. However, new interventions may need to be specifically developed to meet the unique needs of residents in non-metropolitan counties.

Redesigning Gambling Treatment Programs For Success: A Model Based Approach Toward Program Development, Jeffrey J. Marotta, Greta Coe

International Conference on Gambling & Risk Taking

Abstract

This presentation will describe a program improvement initiative launched by Oregon Problem Gambling Services to assist with the development of its 47 publicly-funded gambling treatment programs. The development approach incorporated best practices as identified by SAMHSA, the gambling disorders literature, and expert review. The resulting Technical Assistance Visit Toolkit & Gambling Treatment Program Capability Index (GTPCI) offer a streamline program improvement protocol for use specifically with gambling treatment programs. The presenters will share their experience in implementing this program development approach, merits of the model, and program results.

Implications

This presentation will introduce participants to a model and evaluation …

Addressing Lapses In Medical Education In Relation To Lgbtqia+ Healthcare Disparities, Daniel Pinto, Aubrey Olson

Rowan-Virtua Research Day

As the LGBT community gains more visibility and acceptance, the individuals identifying as LGBTQIA+ have been increasing. Unfortunately for this community, healthcare disparities for LGBT individuals continue. In fact in a national online survey done with LGBTQIA+ physicians, 65% had heard discriminatory comments made towards LGBTQIA+ patients, and 34% witnessed discriminatory care given to LGBTQIA+ patients. (Bonvinci) Rose Chapman, a senior lecturer at Curtin University Nursing School, contributed this discomfort that medical professionals seem to have with LGBTQIA+ families with socioeconomic background such as religious beliefs or familiarity with the topic. (Chapman) Nevertheless, another study published by the Medical Journal …

Ethnic And Demographic Differences In Colectomy Rates And Timing For Ulcerative Colitis: 2007-2014, Daniel Bodek, Alana Persaud, Brian Blair, Ahlawat Sushil

Rowan-Virtua Research Day

Ulcerative Colitis (UC) is a chronic inflammatory disease of the bowel, with one third of patients requiring a colectomy for fulminant disease and tissue dysplasia. In 2007, infliximab was approved for induction and maintenance of remission in UC, with some evidence to suggest a potential reduction in colectomies. The aim of this study is to examine relative colectomy rates for UC among different ethnicities from 2007 to 2014 in order to evaluate for development of new trends or disparities.

Discrepancies in colectomy rates and timing are seen in our models which mirror closely findings in a prior study from 1999-2003 …

Pre-Operative Risk Of Medical Complications Varies By Health Insurance Carrier In Moderately Obese Women: Medicaid V Medicare V Private V Self-Pay, Paul Osterdahl, Melissa Gott, Amanda Sundling, Gus J. Slotman

Rowan-Virtua Research Day

Introduction: Clinical variation by health insurance status in mixed sex bariatric surgery populations is reported, but such variation among moderately obese women is unknown.

Objective: to identify pre-operative variation by health insurance in female surgical patients.

Conclusions: Pre-operative characteristics of moderately obese women vary by insurance. Medicare’s highest risk for cardiopulmonary problems and diabetes, and Medicaid’s highest asthma, abdominal-hepatobiliary, and psychological/behavioral complications should be considered in managing moderately obese women subscribing to these carriers.

Does Ownership Make A Difference In Primary Care Practice?, Stephan Lindner, Leif I. Solberg, William L. Miller, Bijal A. Balasubramanian, Miguel Marino, K. John Mcconnell, Samuel T. Edwards, Kurt C. Stange, Rachel J. Springer, Deborah J. Cohen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: We assessed differences in structural characteristics, quality improvement processes, and cardiovascular preventive care by ownership type among 989 small to medium primary care practices.

Methods: This cross-sectional analysis used electronic health record and survey data collected between September 2015 and April 2017 as part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by the Agency for Health Care Research and Quality. We compared physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHC) by using 15 survey-based practice characteristic measures, 9 survey-based quality improvement process measures, and 4 …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Deploying Care Managers From Care Management Agencies Into Primary Care: A Pilot Study, Lauren Klein Levine

NYMC Student Theses and Dissertations

Background: As the nation shifts to value based payment programs (VBP), financial incentives drive primary care providers (PCPs) to improve outcomes and reduce costs. One method to drive physicians to focus their practices and to increase time working at the top of their licenses is the use of care management (CM) services to meet these goals but the resources needed to implement CM are a barrier. In the Hudson Valley, PCPs embedded local CM staff to provide CM services. This study assesses the provider and care manager perceived patient outcomes from CM, barriers to successful implementation, resources required, total cost …