Health Services Administration Commons^™

Faktor Yang Memengaruhi Kinerja Verifikasi Dokter Verifikator Internal Medis Dalam Proses Klaim Pasien Jaminan Kesehatan Nasional Di Rumah Sakit Cipto Mangunkusumo, Immanuel Natanael Tarigan, Puput Oktamianti, Ede Surya Darmawan

Jurnal Ekonomi Kesehatan Indonesia

Since the implementation of the National Health Insurance, hospitals must be able to manage JKN claims properly. One way to properly manage the situation is by employing a medical internal verification doctor. This study aims to determine the factors that influence the performance of medical internal verification doctor based on the percentage of claim eligibility that has been verified. The research was conducted using a case study method with a qualitative and quantitative approach. The study was conducted on 16 medical internal verification doctors using questionnaires and in-depth interviews. The results of the study found that the performance of medical …

Analisis Klaim Pending, Verifikasi Dan Audit Pascaklaim Jaminan Kesehatan Nasional, Anugrah Aulia Ulil Amri, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

The implementation of Indonesia’s National Health Insurance (JKN) poses new challenges for hospitals as service providers. Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, the program’s administrator, now routinely conducts post-claim verifications and audits after claims have been paid. This often results in claim adjustments or even full reversals of previously reimbursed amounts. This case study examines JKN claim management at a Type D General Hospital in 2022, focusing on pending claims, verification, and post-claim audits, using a systems theory framework. Key issues in pending claims include incomplete medical records (29%), insufficient supporting documents (24%), and coding errors (21%). Post-claim problems primarily …

Evaluasi Ekonomi Total Hip Arthroplasty Protokol Enhance Recovery After Surgery Dibandingkan Konvensional Di Rsup Fatmawati Jakarta, Hanna Elisabet Lumbangaol, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Total hip arthroplasty (THA) is a common orthopedic procedure performed to replace damaged hip joints with prostheses. The demand for this procedure is expected to rise in the future. Enhanced Recovery After Surgery (ERAS) has been introduced as an evidence-based, multidisciplinary approach aimed at optimizing postoperative recovery and reducing hospital length of stay. This study aims to evaluate the costs and effectiveness, including hospital stay duration and surgical success rates, of THA using the ERAS protocol compared to conventional approaches. This cross-sectional study involved data collection from healthcare providers between January 2020 and May 2023. The analysis showed that both …

Factors Affecting Waiting Times To Enter Opioid Use Disorder Treatment In The United States With A Particular Focus On Potential Biological Sex Disparity, Stanley Nkemjika, Kenneth Oforeh, Connie Olwit, Olaniyi Olayinka, Terence Tumenta

Department of Psychiatry and Human Behavior Faculty Papers

AIM: Opioid use disorder (OUD) is the problematic use of licit or illicit opioids. Thus far, the literature on biological sex differences in accessing treatment is scarce. Hence, we hypothesize that biological sex has a moderating effect on OUD treatment accessibility. We aim to explore biological sex differences in treatment disparities and its role in wait time to enter OUD treatment.

METHOD: Using the 2018 Treatment Episode Data Set Discharge, the national sample representative of OUD patients in the substance use disorder treatment facilities within the 50 states of the United States was 382,547. Univariate and multivariable logistic analysis of …

Improved Adherence To Lipid Screening In The Pediatric Cardiology Clinic: A Quality Improvement Project, Rachel Magnan, Thomas Murphy, Lauren Rosenthal, Aparna Prasad, Anjali Chelliah, Stuart Kaufman, Donna Timchak, Lindsey Mcphillips, Saira Siddiqui

Department of Pediatrics Faculty Papers

INTRODUCTION: Lipid screening identifies at-risk patients to facilitate cardiovascular risk reduction. National pediatric guidelines recommend universal lipid screening between 9-11 and 17-21 years of age. We aimed to improve adherence to lipid screening for all age-appropriate outpatient pediatric cardiology visits from a baseline of 35% to 90% between November 2021 and July 2023.

METHODS: All outpatient visits for patients 9-11 and 17-21 years were included. Chart review and an Epic electronic health record report identified patients screened, lipid test results, and need for further testing. A P-chart was generated. After establishing a baseline for 8 weeks, interventions, including an Epic …

Importance Of The Hemoglobin Glycation Index For Risk Of Cardiovascular And Microvascular Complications And Mortality In Individuals With Type 2 Diabetes (Endocrinol Metab 2024;39:732-47, Claudia Regina Lopes Cardoso Et Al.), Stuart A. Chalew

School of Medicine Faculty Publications

No abstract provided.

Dental Clinic Deserts In The Us: Spatial Accessibility Analysis, Md Shahinoor Rahman, Jeffrey C. Blossom, Ichiro Kawachi, Renuka Tipirneni, Hawazin W. Elani

School of Public Health Faculty Publications

IMPORTANCE: Little is known about the spatial accessibility to dental clinics across the US. OBJECTIVE: To map the spatial accessibility of dental clinics nationally and to examine the characteristics of counties and US Census block groups with dental care shortage areas. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of US dental clinics in 2023 using data from the IQVIA national practitioners' database, which includes 205 762 active dentists. Data were analyzed from November 2023 to April 2024. EXPOSURES: Socioeconomic characteristics of block groups and counties including rurality, area deprivation, racial and ethnic segregation, and uninsured population. MAIN OUTCOMES AND MEASURES: Enhanced …

Bio-Preparedness In A Global Context: Multi-Site International Study Investigating Global Health Security Challenges In Egypt, Oman, And The United States, Rima M. Al Balushi

Theses & Dissertations

The COVID-19 pandemic exposed myriad vulnerabilities globally within public health systems, from inadequate bio-risk management in laboratories to overwhelming utilization of hospital resources and disparities in vaccine access and uptake. The Global Health Security Index (GHSI), which critically evaluates health security domains including health systems and risk environments, reports serious weaknesses in global health security. This dissertation aims to investigate critical aspects of global health security domains by examining factors impacting biosafety and biosecurity capacities in laboratories in Egypt, healthcare resource utilization in hospitals in Oman relating to acute respiratory infections (ARI), and COVID-19 vaccine uptake in the United States. …

Innovations In Genicular Outcomes Registry (Igor): Protocol For A Real-World Registry Study Of Treatments For Knee Osteoarthritis, Vinod Dasa, William Mihalko, Adam Rivadeneyra, Joshua Urban, Andrew Wickline, David Rogenmoser, Andrew Concoff, Andrew Spitzer, Michael A. Mont

School of Medicine Faculty Publications

BACKGROUND: Osteoarthritis (OA) is the leading cause of disability among US adults and most commonly affects the knee. Guidelines for knee OA treatment include behavioral, nonpharmacological, pharmacological, and surgical interventions. While emerging knee OA treatments show promise for pain control, data gaps remain regarding the efficacy, safety, comparative effectiveness, and real-world value of treatments. OBJECTIVES: The Innovations in Genicular Outcomes Registry (IGOR) is prospectively collecting real-world data to assess clinical effectiveness, safety, health-related quality of life, and healthcare resource utilization of knee OA treatments. DESIGN: The IGOR is a prospective, observational, longitudinal, multicenter registry (NCT05495334) examining knee OA pain treatment …

Factors Associated With Receipt Of Tobacco Treatment Integrated With Nurse Navigation In A Centralized Lung Cancer Screening Program At An Urban Academic Medical Center, Christine S. Shusted, Sarah Mukhtar, James Lee, Brooke Ruane, Emily Muse, Lawrence Emeigh-Mcbride, Eboni Gatson-Anderson, Gregory C. Kane, Kuang-Yi Wen, Hee-Soon Juon, Julie A. Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

PURPOSE: Optimal approaches for tobacco treatment counseling among individuals who currently smoke and are undergoing shared decision-making (SDM) and lung cancer screening (LCS) are unknown. The objective of this cross-sectional study was to determine the rate of reported interest in tobacco treatment counseling and pharmacotherapy among individuals who currently smoke and are receiving integrated nurse navigation for LCS and tobacco treatment in a centralized LCS Program.

METHODS: We identified individuals undergoing SDM through our centralized LCS Program between March 2021 and March 2022. The LCS Program tobacco treatment protocol includes counseling both in-person and via telephone during SDM, LCS results …

Medicare To Veterans Affairs Cost Shifting-A Challenging Conundrum, Kenneth W. Kizer, Said A. Ibrahim

JeffMD Academic Affairs

No abstract provided.

A Latent Class Assessment Of Healthcare Access Factors And Disparities In Breast Cancer Care Timeliness, Matthew Dunn, Didong Li, Marc Emerson, Caroline Thompson, Hazel Nichols, Sarah Van Alsten, Mya Roberson, Stephanie Wheeler, Lisa Carey, Terry Hyslop, Jennifer Elston Lafata, Melissa Troester

Kimmel Cancer Center Faculty Papers

BACKGROUND: Delays in breast cancer diagnosis and treatment lead to worse survival and quality of life. Racial disparities in care timeliness have been reported, but few studies have examined access at multiple points along the care continuum (diagnosis, treatment initiation, treatment duration, and genomic testing).

METHODS AND FINDINGS: The Carolina Breast Cancer Study (CBCS) Phase 3 is a population-based, case-only cohort (n = 2,998, 50% black) of patients with invasive breast cancer diagnoses (2008 to 2013). We used latent class analysis (LCA) to group participants based on patterns of factors within 3 separate domains: socioeconomic status ("SES"), "care barriers," and …

The Benefits Of Telehealth Among Disadvantaged Communities, Anoosh Arshad

Honor’s College Freeman Research Journal

This study aims to understand how the widespread integration of telehealth services affects underserved communities, helping reduce health disparities in this group. Telemedicine includes various technologies and applications, supported by extensive research, public health, administrative, and patient-care benefits, to adapt to different fields. It involves clinical applications that focus on patient care, like making health decisions, and nonclinical applications like arranging board meetings. Telehealth is a health platform that uses communication technologies that allow doctors and patients to meet online through video and telephone visits, ensuring that patients receive high-quality care. It increases access to healthcare by removing geographical and …

Increased Prevalence Of Peripheral Vestibular Disorder Among Patients With Fabry Disease, Tzong Hann Yang, Sudha Xirasagar Mbbs., Ph.D, Yen Fu Cheng, Chin Shyan Chen, Herng Ching Lin

Publications

Background: Although peripheral vestibular disorder is a non-fatal complication of Fabry disease, fatalities have been reported in some case reports and case series. To date, no studies have examined the relative risk of peripheral vestibular disorder in patients with Fabry disease compared to the general population without the condition. Due to the high prevalence of Fabry disease in East Asia and the potential shared pathogenic pathways between Fabry disease and vasculopathy, we conducted a study using a nationwide population-based dataset to compare the prevalence of peripheral vestibular disorder between patients with Fabry disease and matched comparison patients. Methods: Data was …

Associations Of Head And Neck Cancers With Herpes Zoster In The Preceding Five Years, Chao Hung Chen, Sudha Xirasagar Mbbs., Ph.D, Shih Han Hung, Herng Ching Lin, Chin Shyan Chen

Publications

This population-based study investigated the risk of having had prior herpes zoster within five years preceding a diagnosis of head and neck cancer. We conducted a case-control study that included 9,191 patients with a diagnosis of head and neck cancer in Taiwan’s Longitudinal Health Insurance Database 2010 and 36,764 matched controls. We assessed the odds of patients with head and neck cancer having had a diagnosis of herpes zoster during the five years preceding head and neck cancer using multiple logistic regression analysis. The prevalence of prior herpes zoster among the total sample was 4.6%, 7.9% and 3.8% among patients …

Prevalence Of Hearing Loss, Tinnitus, Vertigo And Sudden Deafness Among Patients With Polymyositis And Dermatomyositis, Shih Han Hung, Sudha Xirasagar Mbbs., Ph.D, Luong Huu Dang, Nguyen Kieu Viet-Nhi, Yen Fu Cheng, Chin Shyan Chen, Herng Ching Lin

Publications

Little is known about a possible association of autoimmune inner ear disease among patients diagnosed with polymyositis (PM)/dermatomyositis (DM). This study aimed to explore differences in the prevalence of inner ear symptoms among patients with and without PM/DM using a nationwide population-based dataset. Data for this study were retrieved from the Taiwan National Health Insurance Research Database. The study sample included 1622 patients diagnosed with PM/DM and 8109 propensity-score matched comparison patients without PM/DM. We performed multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence interval (CI) for tinnitus, hearing loss, sudden deafness, and vertigo among patients with …

Sexual Orientation, Gender Identity And Virologic Failure Among People With Hiv: A Cohort Study In All Of Us Research Program, Fanghui Shi, Ruilie Cai, Buwei He, Xiaoming Li Ph.D., Xueying Yang Ph.D., Sharon Weissman, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Sexual and gender minorities (SGMs) are at higher risk of HIV incidence compared to their heterosexual cisgender counterparts. Despite the high HIV disease burden among SGMs, there was limited data on whether they are at higher risk of virologic failure, which may lead to potential disease progression and increased transmission risk. The All of Us (AoU) Research Program, a national community-engaged program aiming to improve health and facilitate health equity in the United States by partnering with one million participants, provides a promising resource for identifying a diverse and large volunteer TGD cohort. Leveraging various data sources available through …

The Dynamic Risk Factors Of Cardiovascular Disease Among People Living With Hiv: A Real-World Data Study, Ziang Liu, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Haoyuan Gao, Shujie Chen, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: This study aims to investigate the incidence and dynamic risk factors for cardiovascular diseases (CVD) among people living with HIV (PLWH).

Methods: In this population-based statewide cohort study, we utilized integrated electronic health records data to identify adult (age ≥ 18) who were diagnosed with HIV between 2006 and 2019 and were CVD event-free at the HIV diagnosis in South Carolina. The associations of HIV-related factors and traditional risk factors with the CVD incidence were investigated during the overall study period, and by different follow-up periods (i.e., 0-5yrs, 6-10yrs 11-15yrs) using multivariable logistic regression models.

Results: Among 9,082 eligible …

The Relationship Between Gender And Experienes Of Weight Stigma From Healthcare Providers, Isabella J. Aceituno, Shannon Sagert

Undergraduate Research Symposium Posters

Healthcare providers are a common source of weight stigma, which is associated with lower physician trust, poorer patient outcomes, and the avoidance of healthcare services. Currently, there is a lack of consensus in research on whether women and men are equally likely to experience weight stigma from healthcare providers. The present study examined whether gender differences exist in weight stigma received from healthcare providers in childhood or adulthood, comfort seeking medical care, and healthcare avoidance. Adult participants (N = 196) reported the frequency at which they experienced stigmatizing experiences in healthcare environments in the past 12 months and during childhood …

The Southern Nevada Care Economy: Challenges And Opportunities, Tripp Umbach

Policy Briefs and Reports

National policymakers increasingly recognize the care economy as an essential economic driver, contributing $648 billion annually to the U.S. economy and supporting 3.6 million jobs. The care economy is also critical in driving economic development and prosperity in Southern Nevada. Yet, as this Tripp Umbach analysis finds, Southern Nevada’s care economy dramatically underperforms compared to national benchmarks and peer regions. High caregiving costs and limited access to care for children, seniors, and individuals with disabilities in Southern Nevada strain families, businesses, and public resources. This burden reduces workforce participation, productivity, and economic growth. Low pay and high turnover among care …

Identifying Barriers To Hepatitis B And Delta Screening, Prevention, And Linkage To Care Among People Who Use Drugs In Philadelphia, Pennsylvania, Usa, Beatrice Zovich, Catherine Freeland, Holly Moore, Kara Sapp, Anousha Qureshi, Amy Jessop, Rachel Holbert, Fiona Borondy-Jenkins, Quinn Plunkett, Chari Cohen

Student Papers, Posters & Projects

BACKGROUND: People who use drugs (PWUD) are at increased risk for blood-borne viruses, including hepatitis B (HBV) and delta (HDV). Despite the public health threats both viruses present, awareness remains low among at-risk communities and providers who serve them. This study assessed barriers to HBV and HDV prevention, diagnosis, and linkage to care, evaluated existing levels of knowledge, and identified educational needs and preferences among both PWUD and service providers.

METHODS: For this mixed-methods study, data were collected through an anonymous online provider-focused survey, and interviews with PWUD, non-medical staff, and healthcare providers at a harm reduction organization in Philadelphia, …

Factors Influencing Patient Satisfaction With Zambia's National Health Insurance Scheme: A Systematic Literature Review Using Empirical Evidence From Nigeria And Ghana, Wesley Kapaya Mwambazi, Abubaker Qutieshat

Patient Experience Journal

Universal Health Coverage (UHC) has become important for African nations as they strive to provide equitable healthcare access to all citizens. Implementing a successful National Health Insurance Scheme (NHIS) is crucial to achieving this goal. In pursuit of achieving UHC, Zambia launched the NHIS in 2019 with the ambitious goal of reaching 100% coverage by 2021. Some of those enrolled had reported varying levels of satisfaction with the NHIS services. Understanding patient satisfaction with NHIS-provided services is therefore essential for improving its implementation and enhancing NHIS patient satisfaction. Following PRISMA guidelines, a systematic review of empirical studies from Nigeria and …

Commentary: Obstructive Sleep Apnea In The Hemodialysis Population: Are Clinicians Putting Existing Scientific Evidence Into Practice?, Aleena Jamal, Som Singh, Fawad Qureshi

SKMC Student Presentations and Publications

No abstract provided.

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S Diaz, Kaitlyn Ann Bartholomew, Julia S Evans, Maria R Johnson, Jeffrey Zhou, Deeksha Ajeya

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M. Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S. Diaz, Kaitlyn Ann Bartholomew, Julia S. Evans, Maria R. Johnson, Jeffrey Zhou, Deeksha Ajeya

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

Implementation Science And Pediatric Diabetes: A Scoping Review Of The State Of The Literature And Recommendations For Future Research, Julia Price, Jaclynn Hawkins, Daniel J. Amante, Richard James, Debra Haire-Joshu

Department of Medicine Faculty Papers

PURPOSE OF REVIEW: This scoping review aimed to identify implementation science (IS) research in pediatric diabetes, report integration of IS theory and terminology, and offer guidance for future research.

RECENT FINDINGS: Of 23 papers identified, 19 were published since 2017 and 21 focused on type 1 diabetes. Most involved medical evidence-based practices (EBPs; n = 15), whereas fewer focused on psychosocial (n = 7) and diabetes education (n = 2). The majority either identified barriers and facilitators of implementing an EBP (n = 11) or were implementation trials (n = 11). Fewer studies documented gaps in EBP implementation in standard …

Anesthesia For Bronchoscopy-An Update, Basavana Goudra, Lalitha Sundararaman, Prarthna Chandar, Michael Green

Department of Anesthesiology Faculty Papers

The field of interventional pulmonology has grown immensely and is increasingly recognized as a subspecialty. The new procedures introduced in the last decade pose unique challenges, and anesthesiologists need to readapt to their specific demands. In this review, we extensively discuss the pathophysiology, technical aspects, preprocedural preparation, anesthetic management, and postprocedural challenges of many new procedures such as navigational bronchoscopy, endobronchial valve deployment, and bronchial thermoplasty. Majority of these procedures are performed under general anesthesia with an endotracheal tube. Total intravenous anesthesia with rocuronium as a muscle relaxant seems to be the standard US practice. The easy availability and proven …

Α4 Nicotinic Acetylcholine Receptors In Lipopolysaccharide-Related Lung Inflammation, J. Ritzenthaler, Walter H. Watson, Jesse Roman

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Sepsis remains an important healthcare challenge. The lungs are often affected in sepsis, resulting in acute lung injury characterized by inflammation. Mechanisms involving lipopolysaccharide (LPS) stimulation of toll-like receptor (TLR) signaling with induction of proinflammatory pathways have been implicated in this process. To date, however, studies targeting these pathways have failed to improve outcomes. We have found that LPS may also promote lung injury through the activation of α4 nicotinic acetylcholine receptors (α4 nAChRs) in immune cells. We observed increased expression of α4 nAChRs in human THP-1 monocytic cells exposed to LPS (100 ng/mL, 24 h). We also observed that …

Trends In Gaps Of Care For Patients With Congenital Heart Disease: Implications For Social Determinants Of Health And Child Opportunity Index, Abbas H. Zaidi, Adam Alberts, Devyani Chowdhury, Claude Beaty, Benjamin Brewer, Ming Hui Chen, Sarah D. De Ferranti

Department of Surgery Faculty Papers

BACKGROUND: Lifelong continuity of care is essential for patients with congenital heart disease (CHD) to maximize health outcomes; unfortunately, gaps in care (GIC) are common. Trends in GIC and of social determinants of health factors contributing to GIC are poorly understood.

METHODS AND RESULTS: This retrospective cohort study included patients with CHD, aged 0 to 34 years, who underwent surgery between January 2003 and May 2020, followed up at a pediatric subspeciality hospital. Patients were categorized as having simple, moderate, and complex CHD based on 2018 American Heart Association and American College of Cardiology guidelines. Social determinants of health, such …

93rd Annual Georgia Public Health Association Meeting And Conference Report, Jimmie H. Smith Jr, Angela Peden, Patrina L. Bowles

Journal of the Georgia Public Health Association

The 93^rd Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 3-5, 2023. The goal of the 2023 Georgia Public Health Association Annual Meeting and Conference was to assemble emerging public health professionals, current practitioners, academicians, governing entities, and community stakeholders for educational opportunities and networking to support the vision and mission of GPHA.

The theme for the 2023 Georgia Public Health Association Annual Meeting and Conference theme was selected by the GPHA Executive Board during a meeting in the early fall of …