Health Services Administration Commons^™

Implementation Of A Patient Satisfaction Survey At A Free Community Clinic: A Quality Improvement Project, Nora O'Sullivan

DNP Projects

Background: The uninsured, underinsured, and underserved populations in the US are impacted by health disparities and have unique experiences with healthcare. Yet, settings which serve these populations – the “safety net”- are not adequately supported to gather patient experience data. In Connecticut, Fairfield County has a higher percentage of uninsured people than the overall state. Additionally, this population has demonstrated higher frequency of emergency department utilization than the overall population. Therefore, processes to measure the barriers to accessing quality care and patient experience and satisfaction with care are needed in safety net clinics to promote elimination of health disparities and …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

Female Infertility And Maternal And Infant Outcomes In South Carolina – The Role Of Insurance Type, Chelsea Mencio Norregaard

Theses and Dissertations

The overall objective of this research study was to examine the association between fertility treatments and maternal and infant birth outcomes, and to understand what role insurance type plays in these associations.

This retrospective statewide cohort study utilized population-based birth certificate data from January 2018 – December 2021in South Carolina, linked to all-payer claims data for outpatient services, inpatient admissions/discharges, and emergency department visits. Key exposure variables included insurance type and fertility treatment, depending on Aim. Key outcomes of interest included fertility treatment (Aim 1); maternal outcomes (Aim 2) including severe maternal morbidity, cesarean delivery without medical indication, elective labor …

Revealing Geographic Transmission Pattern Of Covid-19 Using Neighborhood-Level Simulation With Human Mobility Data And Seir Model: A Case Study Of South Carolina, Huan Ning, Zhenlong Li, Shan Qiao, Chengbo Zeng, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Direct human physical contact accelerates COVID-19 transmission. Smartphone mobility data has emerged as a valuable data source for revealing fine-grained human mobility, which can be used to estimate the intensity of physical contact surrounding different locations. Our study applied smartphone mobility data to simulate the second wave spreading of COVID-19 in January 2021 in three major metropolitan statistical areas (Columbia, Greenville, and Charleston) in South Carolina, United States. Based on the simulation, the number of historical county-level COVID-19 cases was allocated to neighborhoods (Census block groups) and points of interest (POIs), and the transmission rate of each allocated place was …

Increased Physician Literacy As An Intervention To Improve Value-Based Care And Reduce Cost In The Surgical Setting, Melissa Boyles

MUSC Theses and Dissertations

The primary goal of this scoping review was to identify studies where an intervention of education and awareness of surgical supply costs with surgeons was employed as a possible stimulus for healthcare organization cost reduction in the surgical/procedural service space.

Surgical procedures are performed on approximately 25 percent of all inpatient hospital admissions. In 2018 that equated to 14.4 million surgical procedures and $210.3 billion dollars in health system costs. Surgical Procedures are a substantial portion of healthcare system expenditure and are one of the highest revenue producing services provided to patients. Additionally, there exists high variability in costs based …

Sources Of Stress, Burnout, And Career Decisions Of Male Health And Nursing Professionals: A Qualitative Inquiry Of The Challenges During The Covid-19 Pandemic, Luis Miguel Dos Santos

The Qualitative Report

The human resources and workforce shortage of registered health and nursing professionals has been a long-term problem in health systems internationally, particularly during the COVID-19 pandemic. Many health and nursing professionals face stress and burnout, which may influence their career decisions and long-term human resources development. The purpose of this study is to investigate and understand the relationship(s) between sources of stress and the reasons why male health and nursing professionals decide to leave the profession within the next six months. With the employment of the social cognitive career and motivation theory and general inductive approach with 40 male health …

Telemedicine, Not The Panacea We Thought It Would Be. A Tale Of Caution, Ahmed Elkhapery, Syed Faiz Abbas, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

In the last few decades, the growing use of telemedicine has allowed access to healthcare at reduced costs and increased monitoring of chronic conditions, especially in underserved and rural areas. It is a tool of great value in low-income countries where there is a paucity of specialists. In the height of the COVID-19 pandemic, telemedicine was used to screen patients with COVID-19 like symptoms and send them to test sites directly. This helped minimize unnecessary healthcare staff and patient exposure to the infection and helped decompress ERs. Due to a lack of testing resources, many mildly symptomatic patients were presumed …

Logic Model And Data System Recommendations, Claire Devine, Natalie Royal Kenton, Kristen Lacijan, Maggie Weller

Articles, Abstracts, and Reports

No abstract provided.

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 …

Health Care Provider’S Perceptions Of The Transition Between Pediatric To Adolescent And Adulthood: A Qualitative Inquiry, Antoinette W. Coward, Andrea E. Mcdonald

The Journal of the Research Association of Minority Professors

This study examines the current practices provided from pediatric to adult health care for children with special health care needs at FQHCs using the Six Core Elements of Health Care. Methods: A phenomenological approach was used to recruit and interview ten (10) health leaders from FQHCs. The participants were recruited through this letter sent to the Mid-Atlantic Association of Community Health Center. The researchers-initiated contact with the key informant to introduce them to the study. After consent was obtained, demographic information collected, and interviews were scheduled. During the semi-structured interview session, the key informant was asked questions related to their …

From In-Person To Virtual: A Case Study Of An Animal-Assisted Visiting Program In A Pediatric Setting, Whitney Romine

People and Animals: The International Journal of Research and Practice

This article focuses on the practical aspects of converting a successful in-person AAA program to a virtual program in a health care setting including human, canine, and physical resources; animal welfare considerations; training, infection control, and safety guidelines; and visit delivery procedures. In 1992, an interdisciplinary team at Akron Children’s Hospital founded the Doggie Brigade, an animal-assisted activities (AAA) program where volunteer therapy dogs and their handlers visit pediatric patients. The program has become a cornerstone of the hospital’s culture over its now 30-year tenure. In March 2020, the announcement of the COVID-19 pandemic forced health care organizations to suspend …

Time Is Brain: How A Descriptive Analysis Of Telestroke Metrics Can Improve Program Performance, Christopher Cordero

MUSC Theses and Dissertations

In the event of an acute ischemic stroke, 1.9 million neurons are lost in the brain per minute. Since the inception of thrombolytic therapy and mechanical thrombectomy as effective tools in the treatment of acute ischemic stroke, the focal point of quality improvement in this field has become the time to treatment delivery. As rural and more interspersed environments exhibit high disability and mortality rates associated with these acute neurological conditions, inequities in timely care delivered to these patient populations persist. Limitations in access are now abated by the extension of neurologist expertise into these areas via Telestroke. This study …

Southern Oregon Peer Workforce Project Presentation, Lizzie Fussell, Roxanne Marsillo

Articles, Abstracts, and Reports

No abstract provided.

Additional Priorities For Peer Services Brief, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.

Peer Training And Certification Brief, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.

Southern Oregon Peer Workforce Project Report, Lizzie Fussell, Roxanne Marsillo, Natalie Royal Kenton, Maggie Weller

Articles, Abstracts, and Reports

No abstract provided.

Peer Supervision And Support Brief, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.

Peer Professional Development And Career Path Brief, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.

User Perceptions Of The Quality Of The Pedulilindungi Application Based On The Dimensions Of Electronic Service Quality (E-Service Quality) During The Covid-19 Pandemic, Gabriela Bianca, Kurnia Sari, Purnawan Junadi

Journal of Indonesian Health Policy and Administration

The use of a contact tracing application is one of the efforts made to overcome the global COVID-19 pandemic with an increasing number of cases. The contact tracing application used in Indonesia is PeduliLindungi which is one of the requirements for accessing public areas, which was initially applied to the Java-Bali region. However, in its use, there are still challenges that affect the quality of electronic services. This study aims to analyze user perceptions of the service quality of the PeduliLindungi application based on the E-Servqual dimension. The method used is observational with a quantitative approach using a cross-sectional design. …

Dispute Analysis Of Claims For Patients With Covid-19: A Case Study At Hospital X Class B In Bantul Regency, Beby Antika Putri, Firdaus Hafidz, Yulita Hendrartini

Journal of Indonesian Health Policy and Administration

The Indonesian Government established referral hospitals for COVID-19 as an effort in combating the pandemic. Referral hospitals for COVID-19 submit their services’ claims to the Ministry of Health. Hospital X in Bantul experienced challenges in submitting COVID-19 claims and underwent claim disputes which caused delays in payment process. This research aimed to explore the factors that led to the disputes over the COVID-19 claims. This descriptive research was conducted with a qualitative approach, using in-depth interviews and observations. The additional descriptive analysis used secondary data COVID-19 claim dispute file reports from 2020. The results showed that the highest criteria of …

Policy Considerations For The Utilization And Rationalization Of Ppe In Maternal Care During Covid-19 Pandemic – Literature Review, Mas Aditya Soebangil, Ascobat Gani, Puput Oktamianti

Journal of Indonesian Health Policy and Administration

Policies regarding utilizing and rationalizing Personal Protective Equipment (PPE) during the COVID-19 pandemic challenge every healthcare service provider. Within the maternal health sector, it is suspected that the negative perception of patients and the lack of implementation and compliance with infection prevention and control policies disrupt the quality of care provided. This research is a narrative review highlighting all proper considerations for using and rationalizing PPE within the maternal health sector. Articles are gathered and filtered from well-known scientific publishing sites, and ten articles became the main discussion of this research. The utilization of PPE impacts all levels of maternal …

Potrait Of Public Private Partnership Policy Substances In Regional Hospitals In Indonesia, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

Public Private Partnership (PPP) is a strategy of the Indonesian Government to deal with budget constraints and overcome gaps in infrastructure, access, and quality of health services. PPP on the operational cooperation (KSO) model is the oldest and most widely applied practice by regional hospitals in Indonesia. The implementation of KSO must refer to government policies in the form of laws and regulations. Since its initial implementation until today, the Ministry of Home Affairs, as the body that oversees the local government, has not carried out a comprehensive evaluation of the KSO policy. This study was carried out by conducting …

Implementation Of Mrsa Nasal Swabs As An Antimicrobial Stewardship Intervention To Decrease Anti-Mrsa Therapy In Covid-19 Infection, Alaina Dekerlegand, Emily Johnston, Britney Mellor, Melanie Rae Schrack, Catherine O’Neal

School of Medicine Faculty Publications

In the early stages of treating patients with SARS-CoV-2, limited information was available to guide antimicrobial stewardship interventions. The COVID-19 Task Force and Antimicrobial Stewardship Committee, at a 988-bed academic medical center, implemented the use of methicillin-resistant Staphylococcus aureus (MRSA) nasal swab polymerase chain reaction (PCR) testing to assist with the de-escalation of anti-MRSA therapy in patients with suspected superimposed bacterial pneumonia in COVID-19. A retrospective study was conducted to evaluate the impact of MRSA nasal swab PCR testing on the rate of anti-MRSA therapy between 13 April 2020 and 26 July 2020. A total of 122 patients were included …

Protocol For Validation Of The Global Scales For Early Development (Gsed) For Children Under 3 Years Of Age In Seven Countries, Vanessa Cavallera, Gillian Lancaster, Melissa Gladstone, Maureen M. Black, Gareth Mccray, Ambreen Nizar, Salahuddin Ahmed, Muhammad Imran Nisar, Farzana Begum, Fyezah Jehan

Department of Paediatrics and Child Health

Introduction: Children's early development is affected by caregiving experiences, with lifelong health and well-being implications. Governments and civil societies need population-based measures to monitor children's early development and ensure that children receive the care needed to thrive. To this end, the WHO developed the Global Scales for Early Development (GSED) to measure children's early development up to 3 years of age. The GSED includes three measures for population and programmatic level measurement: (1) short form (SF) (caregiver report), (2) long form (LF) (direct administration) and (3) psychosocial form (PF) (caregiver report). The primary aim of this protocol is to validate …

Can Health Outcomes And Inequalities Be Improved While Containing Costs? The Role Of Voluntary Health Insurance In Universal Health Care Systems In The Oecd, Paige Bristow

International Relations Honors Papers

While European countries have improved health outcomes through universal healthcare systems (UHC), they also face pressures to contain the high cost of these systems. In order to control expenses, governments have reduced services covered under UHC and increased co-payments. Voluntary health insurance (VHI) can help cover gaps in publicly financed health coverage, but this is not affordable for all. Since people with higher socioeconomic status are more likely to have VHI and medical providers are incentivized to prioritize people with VHI, VHI tends to exacerbate inequalities in access to health care. Similarly, high out-of-pocket costs worsen healthcare. This research focuses …

Moderation Effect Of Community Health On The Relationship Between Racial/Ethnic Residential Segregation And Hiv Viral Suppression In South Carolina: A County-Level Longitudinal Study From 2013 To 2018, Fanghui Shi, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Xiaowen Sun, Zhenlong Li, Chengbo Zeng, Huan Ning, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: Viral suppression is the ultimate goal of the HIV treatment cascade and a primary endpoint of antiretroviral therapy. Empirical evidence found racial/ethnic disparities in viral suppression among people living with HIV (PWH), but the evidence of the relationship between racial/ethnic residential segregation and place-based viral suppression is scarce. Further exploring potential structural moderators in this relationship has substantial implications for healthcare policymaking and resource allocation. The current study aimed to investigate the spatial-temporal disparities in the HIV viral suppression rate across 46 counties in South Carolina from 2013 to 2018. We also examined the impact of racial/ethnic residential segregation …

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 …

Drawing On The Strengths Of Community Health Workers To Address Sexually Transmitted Infections: Roles, Medicaid Reimbursement, And Partnerships, Naomi Seiler, Katie Horton, Paige Organick-Lee, Claire Heyison, Alexis Osei, Greg Dwyer, Aaron Karacuschansky, Mekhi Washington, Amanda Spott

Health Policy and Management Informal Communications

Rates of bacterial sexually transmitted infections (STIs) in the United States are high and, largely, still soaring. Though chlamydia cases have decreased slightly since 2017, gonorrhea and syphilis have increased by 25% and 68%, respectively, and congenital syphilis has increased by 184%. Bacterial STI can lead to pain, infertility, and even, in the case of syphilis and congenital syphilis, death. With appropriate detection and treatment, all of these STIs are curable. And yet a range of barriers between communities and the healthcare system perpetuate the STI epidemic.

Community health workers (CHWs) could play a key role in helping bridge the …

Sexually Transmitted Infections And Social Determinants Of Health: Emerging Opportunities In The Medicaid Program, Naomi Seiler, Katie Horton, Paige Organick-Lee, Mekhi Washington, Taylor Turner, Lily Ryan

Health Policy and Management Informal Communications

No abstract provided.

Congenital Syphilis In The Medicaid Program: Assessing Challenges And Opportunities Through The Experiences Of Seven Southern States, Naomi Seiler, Claire Heyison, Paige Organick-Lee, Aaron Karacuschansky, Gregory Dwyer, Alexis Osei, Helen Stoll, Katie Horton

Health Policy and Management Informal Communications

Congenital syphilis (CS) is an infection acquired in utero that can lead to devastating outcomes, including stillbirth, infant death, or long-term health complications. Over the past decade, rising national rates of syphilis, including among women, have led to major increases in congenital syphilis cases and deaths.

CS is tragic and costly, but it is also preventable. With appropriate testing and treatment during prenatal care, syphilis in a pregnant woman can be identified and treated, and transmission to the fetus averted.

The Medicaid program is the payer for nearly half of all births in the U.S., making the program a crucial …