Health Services Administration Commons^™

Do Hospital Closures Affect Patient Time In An Ambulance?, Suzanne Troske, Alison Davis

Rural & Underserved Health Research Center Publications

When a hospital closes in a community, patients needing emergency care may spend more time in an ambulance to receive care in an emergency department (ED). We explore how hospital closures affect the time a patient travels from an incident location where 9-1-1 was called to the ED in an ambulance.

• Rural patients average an estimated 11 additional minutes in an ambulance the year after a hospital closure in their zip code, a 76% increase compared to before the closure.
• Urban and suburban patients have no change in transportation time in zip codes where a hospital closes.
• Patients over 64 …

High Medicaid Nursing Homes: Organizational And Market Factors Associated With Financial Performance, Robert Weech-Maldonado, Justin Lord, Rohit Pradhan, Ganisher Davlyatov, Neeraj Dayama, Shivani Gupta, Larry Hearld

Faculty Publications

High Medicaid nursing homes (85% and higher of Medicaid residents) operate in resource-constrained environments. High Medicaid nursing homes (on average) have lower quality and poorer financial performance. However, there is significant variation in performance among high Medicaid nursing homes. The purpose of this study is to examine the organizational and market factors that may be associated with better financial performance among high Medicaid nursing homes. Data sources included Long-Term Care Focus (LTCFocus), Centers for Medicare and Medicaid Services’ (CMS) Medicare Cost Reports, CMS Nursing Home Compare, and the Area Health Resource File (AHRF) for 2009-2015. There were approximately 1108 facilities …

Nursing Home Quality And Financial Performance: Is There A Business Case For Quality?, Robert Weech-Maldonado, Rohit Pradhan, Neeraj Dayama, Justin Lord, Shivani Gupta

Faculty Publications

This study examines the relationship between nursing home quality and financial performance to assess whether there is a business case for quality. Secondary data sources included the Online Survey Certification and Reporting (OSCAR), Certification and Survey Provider Enhanced Reporting (CASPER), Medicare Cost Reports, Minimum Data Set (MDS 2.0), Area Resource File (ARF), and LTCFocus for all free-standing, nongovernment nursing homes for 2000 to 2014. Data were analyzed using panel data linear regression with facility and year fixed effects. The dependent variable, financial performance, consisted of the operating margin. The independent variables comprised nursing home quality measures that capture the three …

An Analysis On The Implementation Of The Human Resouces In The Health Field Planning Policy In Depok, 2017, Hani Annadoroh, Yaslis Ilyas

Journal of Indonesian Health Policy and Administration

According to the Minister of Health Regulation no. 33/2015 (Permenkes 33) on Guidelines for Composing the Human Resources in the Health Field (HRH) Planning, planning for HRH must be done from the bottom up. In 2016, Depok City has implemented the regulation, but the results were not applicable. This qualitative study analyzes the process of creating the planning document at Depok City in 2017 through in-depth interviews and documentary research. We discovered that the 2017 HRH planning document in Depok City did not completely follow all the steps stated in Permenkes 33. Ineffective communication caused lack of commitment and support …

Accupressure Program At The Health Centers In South Jakarta In 2018, Sandra Octaviani Dyah Puspita Rini, Anhari Achadi

Journal of Indonesian Health Policy and Administration

Traditional Health Services is a treatment or therapy using methods and medication that is based on the experience and skills of our ancestors that can be accounted for and is in accordance with the norms prevailing in the community. One example is acupressure, ehich is a healing method that uses pressure on certain points of the body or acupuncture points. This type of service has been regulated in various laws on traditional health. However, not all Health Centers provide this service. In South Jakarta City, there are only two Health Centers that provide acupressure services. This is a qualitative research, …

An Analysis On The Preparedness For Implementing The Minimal Standards For Service In The Health Field At Depok City In 2017, Zakiah Zakiah, Purnawan Junadi

Journal of Indonesian Health Policy and Administration

Health is one of the fundamental rights for every person, therefore it must be provided by the government. To guarantee the quality and type of health services, the Minimal Standards for Services (SPM) must be established. This includes the SPM for the productive age healthcare services (SPM BKUP). This type of healthcare is important since it covers about 60-70% of the current population. In this research, we analyzed the discrepancy between the reality and the ideal in the implementation of the SPM BKUP qualitatively through in-depth interviews, focus group discusions, and studying the related documents. We discovered that in Depok …

An Analysis On The Implementation Of The Integrated Guidance Post (Posbindu) Activities For Non-Communicable Diseases At Bogor City In 2018, Alfiyah Alfiyah, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

One of the endeavors that the government has done to prevent and control non-communicable diseases (NCD) by increasing community participation in the early detection of NCDs is the NCD Integrated Guidance Post (Posbindu). However, in 2017, only 12.96% of the residents in Bogor City accessed it. This meant that the 30% target was not reached. The in this study, we researched the implementation of the NCD Posbindu at Bogor City. Data was gathered through in-depth interviews, Focus Group Discussion (FGD), documentary research, and observations. Eleven informants was interviewed and 24 informants was involved in the FGD. Two NCD Posbindus was …

A Survey On The Community Satisfaction Index Based On Kepmenpan No. 25/M.Pan/2/2004 At Kanujoso Djatiwibowo Regional General Hospital, Balikpapan In 2018, Mieke Savitri, Dea Yasmine Armando

Journal of Indonesian Health Policy and Administration

Community Satisfaction Index (CSI) Survey is used to measure the community’s perception on the services that they receive. In hospitals, it is used to determine whether a service or facility needs to be improved or not, and where it must be improved. In 2018, a descriptive qualitative study was performed at RSUD Dr. Kanujoso which would measure the public’s perception on the services that the hospital provided. The survey was based on the 14 aspects of CSI of the State Apparatus Empowerment Minister Decree No. 25/M.PAN/2/2004. We discovered that the highest rate was held by the Hemodialysis Unit with 100% …

Market Claims And Efficacy Information In Direct‐To‐Consumer Prescription Drug Print Advertisements, Kathryn J. Aikin Phd, Kevin R. Betts Phd, Aysha Keisler Phd, Kathryn Schaefer Ziemer Phd

United States Food and Drug Administration: Publications

This study examined the impact of “New” and “#1 Prescribed” market claims and quantitative efficacy information on perceptions of a hypothetical prescription drug in a direct‐to‐consumer (DTC) print advertisement. We examined two market claims (New and #1 Prescribed), two efficacy levels (higher and lower), and a control condition without this information. Participants with diabetes were randomized to review one ad version and asked their perceptions of the ad's message, the drug's benefits, side effects and risks, doctors' opinions about the drug, and behavioral intention to use the drug, as well as recall and recognition of drug benefits and risks. Results …

Youth Perception Of Harm And Addictiveness Of Tobacco Products: Findings From The Population Assessment Of Tobacco And Health Study (Wave 1), David R. Strong, Karen Messer, Martha White, Yuyan Shi, Madison Noble, David B. Portnoy, Alexander Persoskie, Annette R. Kaufman, Kelvin Choi, Charles Carusi, Maansi Bansal-Travers, Andrew Hyland, John Pierce

United States Food and Drug Administration: Publications

Purpose: We provide a US national assessment of youth perceptions of the harm and addictiveness of six separate tobacco products, identifying a continuum of perceived harm associated with a range of products in relation to patterns of current use, former use, and susceptibility to use tobacco products.

Methods: We evaluated youth respondents (N=13,651) ages 12–17 from Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study. Analyses (2015–2016) focused on refining mea- sures of perceived harm for each product and delineating youth characteristics (demographic, tobacco use status) associated with beliefs about the harmfulness and addictiveness of tobacco …

Associations Of Risk Factors Of E-Cigarette And Cigarette Use And Susceptibility To Use Among Baseline Path Study Youth Participants (2013–2014), Michael D. Sawdey, Hannah R. Day, Blair Coleman, Lisa D. Gardner, Sarah E. Johnson, Jean Limpert, Hoda T. Hammad, Macieji L. Goniewicz, David B. Abrams, Cassandra A. Stanton, Jennifer L. Pearson, Annette R. Kaufman, Heather L. Kimmel, Cristine D. Delnevo, Wilson M. Compton, Maansi Bansal-Travers, Raymond S. Niaura, Andrew Hyland, Bridget K. Ambrose

United States Food and Drug Administration: Publications

Introduction: Improved understanding of the distribution of traditional risk factors of cigarette smoking among youth who have ever used or are susceptible to e-cigarettes and cigarettes will inform future longitudinal studies examining transitions in use.

Methods: Multiple logistic regression analysis was conducted using data from youth (ages 12–17 years) who had ever heard of e-cigarettes at baseline of the PATH Study (n = 12,460) to compare the distribution of risk factors for cigarette smoking among seven mutually exclusive groups based on ever cigarette/e-cigarette use and sus- ceptibility status.

Results: Compared to committed never users, youth susceptible to e-cigarettes, cigarettes, or …

Selection And Consumption Of Lunches By National School Lunch Program T Participants, Janet G. Peckham, Jaclyn D. Kropp, Thomas A. Mroz, Vivian Haley-Zitlin, Ellen M. Granberg

United States Food and Drug Administration: Publications

The Healthy, Hunger-Free Kids Act of 2010 requires schools participating in the National School Lunch Program (NSLP) to offer a variety of healthy food options each day. Using digital photography data collected from two suburban elementary schools in the spring of 2013, we examine NSLP participant's selection and consumption of all five NSLP lunch components ((1) milk, (2) vegetable, (3) fruit, (4) meat/meat alternate (MA), and (5) grain). We use logit regressions to analyze the selection of the various lunch components by race/ethnicity, gender, grade, and household income level. In addition, ordinary least squares regressions are used to analyze the …

Examining The Role Of Menthol Cigarettes In Progression To Established T Smoking Among Youth, James Nonnemaker, Shari P. Feirman, Anna Macmonegle, Bridget K. Ambrose, Kia J. Jackson, Megan J. Schroeder, Alexandria A. Smith, William Ridgeway, Olga Rass

United States Food and Drug Administration: Publications

Background: Menthol, a flavoring compound added to cigarettes, makes cigarettes more appealing to youth and inexperienced smokers and increases cigarettes' abuse liability. However, limited studies are available on menthol's role in smoking progression.

Methods: To assess the association between menthol in cigarettes and progression to established smoking, we used five waves of data from the Evaluation of Public Education Campaign on Teen Tobacco Cohort Study, a nationally representative longitudinal survey of U.S. youth conducted as part of “The Real Cost” evaluation. We used discrete time survival analysis to model the occurrence of two event outcomes—progression to established, current smoking and …

U.S. Adult Perceptions Of The Harmfulness Of Tobacco Products: Descriptive T Findings From The 2013–14 Baseline Wave 1 Of The Path Study, Geoffrey T. Fong, Tara Elton-Marshall, Pete Driezen, Annette R. Kaufman, K. Michael Cummings, Kelvin Choi, Jonathan Kwan, Amber Koblitz, Andrew Hyland, Maansi Bansal-Travers, Charles Carusi, Mary E. Thompson

United States Food and Drug Administration: Publications

Introduction: This study is the first nationally representative survey of U.S. adults (18+) to examine perceptions of the relative harms of eight non-cigarette tobacco products.

Methods: Data are from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study Adult Questionnaire, a nationally representative study of 32,320 adults in the United States conducted from September 2013 to December 2014.

Results: 40.7% of adults believed that electronic cigarettes were less harmful than cigarettes, and 17.8% of adults believed that hookah was less harmful than cigarettes. Those less knowledgeable about the health risks of smoking were more likely to believe …

Ua66/13/2 Ogden College Of Science & Engineering Public Health Centers, Wku Archives

WKU Archives Collection Inventories

Records related to Public Health Centers.

Ua66/13/3 Ogden College Of Science & Engineering Public Health Publications, Wku Archives

WKU Archives Collection Inventories

Publications by and about the Department of Public Health, previously known as Health & Safety.

Ua66/13/4 Ogden College Of Science & Engineering Public Health Allied Organizations, Wku Archives

WKU Archives Collection Inventories

Records related to Public Health allied organizations.

Reducing The Health Care Burden Caused By Undocumented Immigrants, Juan Carlos Garcia Ramirez

Physician Assistant Scholarly Project Posters

• Uncompensated health care and Emergency Department (ED) overcrowding are a national crisis in the United States, and uninsured patients are a major contributor. Undocumented Immigrants (UIs) are a large component of the uninsured patient population.

• The purpose of this study is to evaluate for efficacy and taxpayer value two large-scale potential solutions: Federally Qualified Health Centers (FQHCs), and expanded Medicaid.

• The method of research included a variety of key terms in electronic search databases such as CINAHL Complete, PubMed, and Google Scholar, and only articles published between 2014 and 2018 by peer- reviewed journals or gray literature …

At Risk Alcohol Consumption With Smoking By National Background: Results From The Hispanic Community Health Study/Study Of Latinos, Frank C. Bandiera, Eliseo J. Pérez-Stable, Folefac Atem, Raul Caetano, Denise C. Vidot, Marc D. Gellman, Elena L. Navas-Nacher, Jianwen Cai, Gregory Talavera, Neil Schneiderman, Robert Kaplan

United States Food and Drug Administration: Publications

Introduction: Tobacco smoking and binge or excess drinking are unhealthy behaviors that frequently co-occur. Studies of Hispanics/Latinos have mostly been of Mexican Americans although there are substantial differences in smoking and drinking by heritage background. Associated with co-use by 5 subpopulations.

Methods: Cross-sectional data of 16,412 Hispanics/Latinos from Miami, the Bronx, Chicago and San Diego collected between 2008 and 2011 as part of the HCHS/SOL were analyzed. Smoking and alcohol consumption and demographic data were measured by self-report. Prevalence of smoking and alcohol consumption and co-use were reported. Logistic regression models examined the odds of co-use of smoking and binge …

Comparing Methods For Clinical Investigator Site Inspection Selection: A Comparison Of Site Selection Methods Of Investigators In Clinical Trials, Nicholas Hein, Elena Rantou, Paul Schuette

United States Food and Drug Administration: Publications

Background During the past two decades, the number and complexity of clinical trials have risen dramatically increasing the difficulty of choosing sites for inspection. FDA’s resources are limited and so sites should be chosen with care.

Purpose To determine if data mining techniques and/or unsupervised statistical monitoring can assist with the process of identifying potential clinical sites for inspection.

Methods Five summary-level clinical site datasets from four new drug applications (NDA) and one biologics license application (BLA), where the FDA had performed or had planned site inspections, were used. The num- ber of sites inspected and the results of the …

Predictors Of Hospital Quality And Efficiency, Hoda Fotovvat

Electronic Theses and Dissertations

American hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician sharing of the patient care experience, to enhance effective pain management, and to transform patient-centered care modalities to solidify the adequacy of patient care processes. By analyzing national data sets publicly available, this …

Impact Of Prescription Opioid Access Restrictions On Alcohol-Induced Mortality In Kentucky, Changwe Park

MPA/MPP/MPFM Capstone Projects

Prescription drug monitoring programs (PDMPs) are state policy tools to combat risky opioid prescribing. Since 2012, several states began to mandate PDMP use. As mandating use laws have settled down, evaluating potential adverse events becomes possible.

In this study, I focus on alcohol-induced mortality as a potential unintended consequence via substituting alcohol for prescription opioids, since alcohol and opioids are often concurrently misused as a part of pain self-management. Therefore, the aim of this study is to analyze the unintended consequences of prescription opioid access restrictions on alcohol-induced mortality.

I compare the alcohol-induced mortality among adults during pre- and post-revision …

Everybody’S Working (But The Weakened): An Assessment Of Medicaid Work Requirements And Their Administrative Burdens, Samuel Misleh

MPA/MPP/MPFM Capstone Projects

Although Medicaid work requirements are currently halted in both Arkansas and Kentucky, this analysis utilizes the data available to make an assessment and estimate of what Kentucky’s Medicaid enrollment will look like if work requirements similar to those Arkansas had are ever implemented. The relative severity of the administrative burden of such requirements provide a tool for comparison, and a difference-in-differences analysis of the change in Medicaid enrollment between Arkansas and West Virginia, a state that has not implemented and currently has no plans to implement Medicaid work requirements, provide the bases for this estimate. After coding the work requirements …

Technology Management Maturity Assessment Model: An Exploratory Multi-Criteria Approach For Healthcare Organizations, Amir Shaygan, Tugrul Daim

Engineering and Technology Management Faculty Publications and Presentations

Maturity Models are organizational management tools that have been developed and used for decades as organizations' way of responding to the constant pressure of trying to achieve and maintain competitive advantage through concurrent innovation, quality improvement, and cost reduction. The decision makers in the healthcare industry have been no exception in reaping the benefits of determining the merits and weaknesses of strategies through systematic quality improvement provided by maturity models. Although there are many healthcare maturity models in literature, there is a lack of models that provides managers and decision makers with a systematic, multi-criteria, and quantifiable maturity model. This …

Bold Leadership Is Needed For Transforming Health Care., Dora Barilla, Huma Shah, Rick Rawson

Articles, Abstracts, and Reports

Health care in the United States is going through significant changes and is at the forefront of the political landscape. While the health care debate rages on, leaders need to forge ahead and continue to work towards population-based health care and investing in their communities in a fiscally conscious way. Many innovations are happening but more needs to be done, especially in upstream services improving the health of the community. Research shows that investing in social care services and community-based investments results in lower health care expenditures and better health outcomes. Efforts should be placed on exploring a blended medical/social …

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

Association Of Health Departments’ Completion Of A Community Health Assessment, Community Health Improvement Plan, And Strategic Plan With Better Population Health Outcomes, Kelora T. Cofer

College of Graduate Studies: Theses & Dissertations

Promoting health and well-being requires a strong public health infrastructure. This study examined the association of engagement of local health departments (LHDs) in accreditation and its pre-requisites with health outcomes in LHD jurisdictions such as the prevalence of premature death and tobacco use in the counties they serve. Two data sets, The 2016 National Profile of Local Health Departments and 2018 Community Health Rankings were linked using deterministic linkage approach, based on county FIPS codes as a unique identifier. Descriptive and multinomial logistic regression analyses were performed using SPSS Version 25. The results showed that having recently completed a community …

Digital Information Technology Use And Patient Preferences For Internet-Based Health Education Modalities: Cross-Sectional Survey Study Of Middle-Aged And Older Adults With Chronic Health Conditions, Nancy P. Gordon, Elizabeth L. Crouch

Faculty Publications

Background: Health information, patient education, and self-management (health information and advice, HIA) tools are increasingly being made available to adults with chronic health conditions through internet-based health and mobile health (mHealth) digital information technologies. However, there is limited information about patient preferences for using specific types of health information and advice resources and how preferences and usage differ by age group and education.

Objective:The objective of this study was to examine how use of digital information technologies and preferred methods for obtaining health information and advice varies by age group and education among middle-aged and older adults with chronic …

Prevalence And Factors Influencing Use Of Internet And Electronic Health Resources By Middle-Aged And Older Adults In A Us Health Plan Population: Cross-Sectional Survey Study, Elizabeth L. Crouch, Nancy P. Gordon

Faculty Publications

Background: Health care organizations are increasingly using electronic health (eHealth) platforms to provide and exchange health information and advice (HIA). There is limited information about how factors beyond internet access affect use of eHealth resources by middle-aged and older adults.

Objective: We aimed to estimate prevalence of use of the internet, health plan patient portal, and Web-based HIA among middle-aged and older adults; investigate whether similar sociodemographic-related disparities in eHealth resource use are found among middle-aged and older adults; and examine how sociodemographic and internet access factors drive disparities in eHealth resource use among adults who use the internet.

Methods: …

Adventist Healthcare: A Qualitative Study Of 19th Century Founding Governing Principles In 21st Century Adventist Hospitals, Cesiah Yareth Pimentel Melendez

Dissertations

Problem and Purpose

Founding values and principles can help organizations stay focused on fulfilling their mission. This is especially true in faith-based organizations that seek to continue their founding principles as a governing commitment to their core identity. This study identified Adventist healthcare founding principles in Ellen G. White's early health visions and explored how Adventist healthcare leaders perceived these principles as governing principles applied to current Adventist healthcare practices.

Conceptual Framework and Research Design

Two metaphors and three areas of literature review guided my approach of this qualitative study of Adventist healthcare founding principles. My first metaphor of DNA …