Health Services Administration Commons^™

The Risk Of Interstitial Lung Disease In Psoriatic Arthritis Versus Psoriasis: A Retrospective Nationwide Database Analysis (2014-24), Andrew Engel, Christopher Xie, Ross Summer, Giorgos Loizidis

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

OBJECTIVES: Psoriasis (PsO) is a systemic autoimmune disease primarily characterized by erythematous plaques on the skin. While extra-dermal manifestations like psoriatic arthritis (PsA) are well recognized, data linking PsO to interstitial lung disease (ILD) remain limited. This study aimed to evaluate whether patients with PsA have a higher risk of developing ILD compared with patients with PsO.

METHODS: A retrospective analysis of the TriNetX US database (2014-24) was performed. Adult patients with PsO or PsA treated with systemic immunosuppressive medications were included, excluding those with other autoimmune diseases. ILD risk in PsO and PsA cohorts was compared with a reference …

Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan

Faculty Publications

Background

Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.

Objectives

This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.

Methods

Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …

Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan

Faculty Publications

Background

Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.

Objectives

This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.

Methods

Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …

The Influence Of Compensation From Wages And Benefits On Healthcare Workers' Performance In Healthcare Services, Jiddan Azizan Hakim, Ghania Danisha Maharani, Riswandy Wasir, Alif Indah Melani, Cahya Arbitera

Journal of Indonesian Health Policy and Administration

This study aims to evaluate the influence of compensation, including wages, incentives, and benefits, on the performance of health workers in primary health centers and hospitals. A literature review was conducted using Google Scholar and PubMed, focusing on articles published in the last 5–10 years. From an initial search yielding 1,021 articles, nine were selected based on inclusion criteria. The results show that direct compensation (salary) and indirect compensation (benefits) have a positive impact on health worker performance. However, the effect of incentives varies depending on implementation. Motivation and job satisfaction were mediating factors that strengthened the relationship between compensation …

Strengthening Occupational Health And Safety (Ohs) In Schools To Minimize Risks For Students, Teachers, And Visitors: Policy Recommendation, Wiwik Eko Pertiwi, Hanifa Maher Denny, Yuliani Setyaningsih, Agung Dwi Laksono

Journal of Indonesian Health Policy and Administration

Vocational schools equip students with practical skills and expose them to industry-related hazards, making Occupational Health and Safety (OHS) a crucial aspect of the school environment. This study aims to identify key factors behind the weak implementation of OHS in vocational schools. A literature review used articles published between 2017–2024 from national and international journals. The review found poor OHS implementation stems from lack of awareness, inadequate policies, insufficient infrastructure, weak safety culture, and negligence in accident prevention. To address these issues, the study recommends OHS education and training, improvement of school infrastructure, curriculum integration, formation of safety teams, and …

Staff Expectancies In Conducting Ship Hygiene And Sanitation Inspections: A Qualitative Study At Banten Class I Port Health Quarantine Office, Lukman Waris, Budiman Budiman, Hany Puspita Aryani

Journal of Indonesian Health Policy and Administration

Sea transport plays a vital role in the movement of goods and passengers, yet it simultaneously poses a potential risk for the transmission of infectious diseases, both nationally and internationally. Ship hygiene and sanitation inspection (HSI) is a strategic measure to control such risks, and the outcomes of these inspections are influenced by the expectations of the implementing officers. This study explores how staff expectancy at the Banten Class I Port Health Quarantine Office affects the quality of HSI. A qualitative study using the Rapid Assessment Procedure (RAP) was conducted with 80 staff members across five work units. Data were …

Guidelines For The Creation And Implementation Of A School-Based Vision Program For The Greater Seattle Area, Suzanna P. Gill

Honors Projects

Proper vision care contributes to a child’s ability to perform academically as well as their overall health and wellbeing. Pediatric vision care begins with vision screening, which occurs in public schools in Washington state. These vision screenings allow for possible vision issues to be identified in children. They are not, however, a replacement for eye examinations that help determine what is causing the problem and provide treatment. A substantial proportion of children that are recommended to receive the exams will not, partially because Washington does not require parents to take their children to eye care professionals. These children are more …

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …

Improving Healthcare Access Among Hunter College Students – Suggestions For A Hunter College Student Health Center, Jacob Villorente

Publications and Research

This study investigates disparities in healthcare access among students at CUNY Hunter College, an urban public university in Manhattan serving over 22,000 students. 89% of Hunter students receive financial aid, with 67% of students receiving Pell grants. Hunter College only offers limited health services, primarily short-term mental health counseling and wellness workshops. A cross-sectional survey (n = 33) assessed insurance status, coverage (dental, vision, psychiatric), access barriers (e.g., transportation), mental health symptoms, and impacts to academia. While 69.7% of respondents reported comprehensive insurance, students with public insurance (Medicaid, Medicare) experienced substantially higher access barriers than those with employer-sponsored plans and …

Advancing Remote Monitoring For Patients With Alzheimer Disease And Related Dementias: Systematic Review, Mohmmad Arif Shaik, Fahim Islam Anik, Md Mehedi Hasan, Sumit Chakravarty, Mary Dioise Ramos, Mohammad Ashiqur Rahman, Sheikh Iqbal Ahamed, Nazmus Sakib

School of Nursing Faculty Publications

BACKGROUND: Using remote monitoring technology in the context of Alzheimer disease (AD) care presents exciting new opportunities to lessen caregiver stress and improve patient care quality. The application of wearables, environmental sensors, and smart home systems designed specifically for patients with AD represents a promising interdisciplinary approach that integrates advanced technology with health care to enhance patient safety, monitor health parameters in real time, and provide comprehensive support to caregivers. OBJECTIVE: The objectives of this study included evaluating the effectiveness of various remote sensing technologies in enhancing patient outcomes and identifying strategies to alleviate the burden on health care professionals …

Evaluating Algorithmic Bias On Biomarker Classification Of Breast Cancer Pathology Reports, Jordan Tschida, Mayanka Chandrashekar, Alina Peluso, Zachary Fox, Patrycja Krawczuk, Dakota Murdock, Xiao-Cheng Wu, John Gounley, Heidi A. Hanson

School of Public Health Faculty Publications

OBJECTIVES: This work evaluated algorithmic bias in biomarkers classification using electronic pathology reports from female breast cancer cases. Bias was assessed across 5 subgroups: cancer registry, race, Hispanic ethnicity, age at diagnosis, and socioeconomic status. MATERIALS AND METHODS: We utilized 594 875 electronic pathology reports from 178 121 tumors diagnosed in Kentucky, Louisiana, New Jersey, New Mexico, Seattle, and Utah to train 2 deep-learning algorithms to classify breast cancer patients using their biomarkers test results. We used balanced error rate (BER), demographic parity (DP), equalized odds (EOD), and equal opportunity (EOP) to assess bias. RESULTS: We found differences in predictive …

Over-The-Counter Cold Medication Usage Self-Efficacy Among Undergraduate Students In The United States, Ray Goodwin

Honors Theses

Background

This study looks at the trends in over-the-counter medication usage and self-efficacy among undergraduate college students in the United States. Over-the-counter (OTC) medications serve as the most easily accessible and commonly purchased medications and can be used as a basis to determine this demographic’s attitudes and behaviors towards self-medication. In addition, undergraduates represent a diverse population for analyzing differences among demographic groups.

Methods

A Qualtrics survey was sent out to undergraduates across the US via a panel, and the team received 403 useable responses. As part of a larger study, the survey presented participants with four different scenarios at …

Building Community Through Food And Health: Student Initiatives To Address Food Insecurity In Mississippi, Sarah E. Sawaya

Honors Theses

This thesis explores food insecurity in Oxford and Lafayette County, Mississippi, within the broader context of state, national, and global challenges. Over a four-year period, student-led and community organizations collaborated to design programs that addressed both food access and chronic illness prevention through education, outreach, and direct service. Community input was gathered through health screenings, campus engagement, and informal interviews with residents, which guided the development of practical tools like recipe kits, QR code-based cookbooks, and on-site health education. These efforts were rooted in local partnerships and shaped by the lived experiences of those most affected. This project demonstrates that …

Is Anterior Cervical Discectomy And Fusion More Expensive At Quaternary Care Centers? An Application Of Time-Driven Activity-Based Costing, Jay Trivedi, Advith Sarikonda, Adam Leibold, D. Mitchell Self, Nikolaos Mouchtouris, Steven R. Glener, Ashmal Sami, Kavantissa M. Keppetipola, Emily Isch, Joshua Pelta-Heller, Srinivas Prasad, Ashwini Sharan, James Harrop, Alex R. Vaccaro, Ahilan Sivaganesan

Department of Neurosurgery Faculty Papers

OBJECTIVE: Hospital setting is postulated to be a key driver of cost variation for neurosurgical procedures. Limitations in contemporary costing methodologies have led to the development of time-driven activity-based costing (TDABC). This study applies TDABC to anterior cervical discectomy and fusion (ACDF) to compare intraoperative costs at quaternary care centers versus satellite hospitals affiliated with the same health network.

METHODS: Nine hundred and fifty-eight ACDF cases performed at two quaternary care hospitals (n = 806) and six satellite hospitals (n = 152) were reviewed. Process maps were created to map the intraoperative episode, and TDABC methodology was used to calculate …

Optimising Non-Cycloplegic Screening Strategies For Early Detection Of Pre-Myopia And Myopia In Young Children, Síofra Harrington, Michael Moore, James Loughman, Ian Flitcroft, Veronica O'Dwyer

Articles

Purpose: Early detection of myopia is essential to delay its onset and progression. Pre-myopia, defined by an inadequate hyperopic reserve, increases myopia risk in childhood. However, effective screening methods remain limited. This study aimed to develop practical non-cycloplegic screening methods for pre-myopia and myopia in 6- to 7-year-olds to support earlier interventions.

Methods: This cross-sectional study of 621 Irish schoolchildren (mean age: 7.12 ± 0.45 years; 51.8% boys) assessed uncorrected distance visual acuity (UDVA). Cycloplegic spherical equivalent refraction (SER) classified refractive status (myopia: SER ≤ −0.50D; pre-myopia: SER > −0.50 ≤ 0.75D). Pre- and post-cycloplegic SER were measured using the Welch …

Rural Access To Certified Community Behavioral Health Clinics (Ccbhcs), Aaron P. Smith, Jeffrey Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

▪ The number of Certified Community Behavioral Health Clinics (CCBHCs) expanded from 2022 to 2023, increasing from 371 to 480. Most of the growth was driven by rural counties (57.9% increase, 126 to 199) while urban counties increased by 14.7% (245 to 281).

▪ The number of services offered at CCBHCs is similar in both rural and urban localities, but urban CCBHCs were more likely to offer services that cater to a diverse client base, such as speaking different languages, and nicotine cessation programs. Rural CCBHCs were more likely to have programs for minors, veterans, and …

Exploring Anticoagulant Prescription Disparities: A Focus On Hispanic Patient Care, Michael Acevedo, Vanessa Veltre

Rowan-Virtua Research Day

Anticoagulants play a critical role in preventing thromboembolic events, yet disparities persist in their prescription among minority populations. This presentation explores inequities in anticoagulant prescribing patterns, with a specific focus on Hispanic patient care. Using retrospective electronic health record data, we analyzed the prescription rates of warfarin versus direct oral anticoagulants (DOACs) among adults with clinical indications for anticoagulation. Our findings reveal that Hispanic patients are significantly less likely to receive DOACs compared to non-Hispanic White patients, even after adjusting for demographics, comorbidities, and insurance status. Contributing factors include language barriers, lack of insurance, and potential implicit bias in provider …

The Repercussions Of Race-Based Egfr On The Morbidity & Mortality Of Black Children With Renal Disease, Angelina Siino

Rowan-Virtua Research Day

This study investigates the implications of race-based adjustments in estimated glomerular filtration rate (eGFR) calculations on the health outcomes of Black children with renal disease. Historically, a race coefficient has been added to eGFR calculations for patients identified as Black, resulting in an artificial inflation of kidney function by approximately 16%. This inflation can delay the classification of chronic kidney disease (CKD), postpone eligibility for essential interventions like preemptive kidney transplantation, and prolong reliance on maintenance dialysis. Through a comprehensive literature review of peer-reviewed U.S. medical journal articles published between 2000 and 2023, this work explores how these clinical delays …

Relationship Between Maternal Mortality And Zip Code In New Jersey, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality remains a pressing public health concern in the United States, with significant disparities influenced by geography and social determinants of health. This study investigates the relationship between zip code-level factors and maternal mortality rates (MMR) in New Jersey (NJ), a state with demographic and socioeconomic diversity. Using data from the NJ Department of Health, CDC, and recent literature, I identified patterns correlating higher MMR with areas experiencing poverty, limited access to healthcare, and predominantly minority populations. Counties such as Essex, Union, and Cumberland—classified as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)—exhibited particularly high vulnerability. These …

Scoping Literature Review: The Role Of Leptin In Autism Spectrum Disorder (Asd) And Associated Obesity, Diana B. Riestra, Andrea Iannuzzelli

Rowan-Virtua Research Day

Overweight and obesity (OW/OB) are significant concerns among individuals with Autism Spectrum Disorder (ASD), yet the underlying causes remain unclear. Emerging evidence points to metabolic and hormonal factors—particularly leptin, a hormone involved in appetite regulation—as potential contributors. This scoping review examined five key studies from 2003 to 2024 that investigated the relationship between leptin and ASD in overweight populations. Across studies, individuals with ASD consistently exhibited elevated leptin levels compared to controls. While some findings also noted changes in other adipokines, such as lower resistin or progranulin, leptin was the most consistently dysregulated. These patterns suggest systemic alterations in energy …

The Affordable Care Act: Analyzing Rates Of Healthcare Claim Denial, Lauren Sitter

Political Science Theses and Capstones

The United States healthcare industry is an integral aspect of every American’s life. The Affordable Care Act (ACA) in 2010 reformed the healthcare system by expanding coverage to millions of Americans and eliminating claim denials due to pre-existing conditions. It requires participating states to submit transparency data. Despite these reforms, coverage denials continue and vary by plan category, metal level, and among different states. I analyze data from The Kaiser Family Foundation (2023) and The CommonWealth Fund to test the correlation between claim denial and a variety of variables, including state political culture, plan type, metal level, and out-of-pocket costs. …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

Evaluating Surge Capacity In The Emergency Department: A Comprehensive Literature Review On Preparedness And Response Frameworks, Tanner J. Riscoe

Capstone Experience: Master of Public Health

Medical surge capacity in emergency departments is influenced by four critical factors: staff, stuff, space, and systems. Understanding these factors and the interplay between them is critical. Emergency departments are increasingly encountering issues with overcrowding, patient boarding, and medical surge events causing interruptions in care and depleting critical resources. Coordination of medical surge is challenging during normal operations but is intensified during times of crisis. This comprehensive literature review seeks to better understand the current state of the literature surrounding surge preparedness and response in emergency departments across the United States, identify gaps in the current literature, and ultimately recommend …

Evaluating The Impact Of Community Gardens On Social Equity And Public Health: A Case Study Of Caramel Connections Foundation's (Ccf) Seeds Of Joy Community Garden, Elizabeth Pinder

Electronic Theses, Projects, and Dissertations

Community gardens have been increasingly recognized as effective public health interventions that address food insecurity, foster social cohesion, and promote environmental sustainability. This evaluation examines the impact of the Caramel Connections Foundation (CCF) Seeds of Joy Community Garden in Ontario, California, by assessing its effectiveness in advancing social equity, improving public health outcomes, and fostering community engagement. Using an evaluation framework, this study measures key program outcomes, including improvements in community well-being, inclusivity, and access to green spaces.

A mixed-methods evaluation design was applied, incorporating process and impact evaluation methodologies. Secondary data collected from CCF’s existing program records, survey responses, …

Refractive Error And Axial Length (Real) Study: Feasibility Of A Population Study In The United States, Sarah E. Singh Dr, Lisa A. Ostrin, Kristen Kerber Dr, Concepcion Cayle, Celia Gong Dr, Lal Barsha Dr, Ian Flitcroft, Síofra Harrington, James Loughman, Kathryn Saunders Prof, Fuensanta Vera-Diaz Dr

Articles

Myopia is the most common eye disease and a leading cause of blindness. A contemporary, large, and ethnically and geographically diverse study of ocular biometry and refractive error in children in the United States is needed to help better describe differences between myopic and nonmyopic eyes.

This is an initial cross-sectional report from the Refractive Error and Axial Length Growth Curve Study that includes ocular component data as a function of age, gender, and geographic location. This feasibility report will inform a planned larger longitudinal ocular growth study in children in the United States.

Cross-sectional data on children, ages 3 …

Prescription For Progress: A Retention Plan To Heal The Dying Nurse Workforce, Margaret Curd

Senior Honors Theses

The United States is currently facing an unprecedented nursing shortage which stems from many variables, including a lack of clinical rotation sites for students, increased burnout among current nurses, and a growing retiring workforce. Rising nurse turnover rates negatively impact patient outcomes, which should concern all levels of management. One specific hospital facing such an impact is Advocate Christ Medical Center in Oak Lawn, Illinois. This thesis seeks to address their substandard staffing ratios in an extensive, holistic strategic retention plan. Metrics for proving the plan’s success are provided alongside a discussion of proper calculations for each.

Unveiling Patient Satisfaction: Exploring Demographics, Interactions, And Health-Seeking Behavior, Vanessa B. Crowther, Cassandra Shaw-Johnson, Robbya R. Green-Weir, Pia S. Woodley, Marilyn A. Weatherspoon, Errick D. Farmer, Arlesia L. Mathis

Patient Experience Journal

Objective: This study examined the social context of the patient visit (demographics, waiting room experience, patient-provider interaction) and their relationship to satisfaction with the quality of care when seeking medical treatment. It also examined satisfaction as a predictor variable for its effect on three patient behavioral outcomes. Methods: The study was implemented using a cross-sectional quantitative design among adults aged 18 and older. One hundred fifty-eight participants responded to the survey, and the final sample size was n = 147. We employed advanced data analysis, hierarchical regression, three-way ANOVA, linear regression, and logistic regression to examine four outcome variables. Results: …

Inequities In The Rehabilitation Process Of Musculoskeletal Injuries In Maine, Devon A. Grant

Thinking Matters Symposium

Since 2016, Maine’s population has grown as a result of migration and a welcoming of refugees. Changes in state demographics influence the population’s and individuals’ social determinants of health (SDOH) (ie., “where people live, learn, work, and play”) and health literacy (ie., a person’s ability to find, understand, and use information to inform health-related decisions). This project aims to identify the health inequities or disparities throughout Southern Maine in the care of injuries to the lower extremity, such as the knee or ankle, as well as explore factors that influence the healthcare outcomes of athletes in surrounding communities. This study …

What Are The Minimum Dimensions In A Marketing Plan Required For Starting Or Improving Marketing In A Small, New Home Health Agency?, Patrick Baker

MUSC Theses and Dissertations

Objective: To fulfill an unmet need for practical, parsimonious assistance for examples of a practical marketing plan for new, small home health care agencies. The home health (HH) care industry needs customized marketing plans tailored to the unique requirements of small, emerging HH agencies. These plans are essential for navigating the competitive market driven by an aging population and technological advancements. However, the industry's emphasis on this specific aspect is significantly lacking.

Methodology: We reviewed the published literature, numerous books and websites and selected sources that provided practical, small-scale approaches to marketing for health care organizations. We identified specific marketing …

Supreme Court Case Study: The Variation In Rates Of Miscarriage Management Care And Post-Abortion Care Across The Us Before And After The Supreme Court Decision, Ted Sibrian Jr.

MUSC Theses and Dissertations

The paper examines abortion care and the management of miscarriages following the Roe v. Wade decision in restrictive states that do not allow medical intervention due to the vague legal terms. This research evaluates the need to establish protocols for providers when faced with nonviable pregnancies requiring medical intervention. Additionally, the paper highlights the impact across the US on women’s health outcomes by emphasizing the care for miscarriage management. This multi-method paper reviews the current literature on miscarriage management and spontaneous abortion MarketScan® data from commercially insured individuals with an age range of 18-50 years old by regions across the …