Health Services Administration Commons^™

Transorbital Alternating Current Stimulation In A Double-Masked Randomized Clinical Trial: Visual Functional Effect And Quality Of Life, Maria De Los Angeles Ramos Cadena, Ashley Sohn, Heather Livengood, Ting-Fang Lee, Batsheva Rubin, Jiyuan Hu, Bernhard A. Sabel, Rachel Matayev, Joseph Panarelli, Gadi Wollstein, Joel S. Schuman

Wills Eye Hospital Papers

PURPOSE: To determine the efficacy and safety of repetitive transorbital alternating current stimulation (rtACS) treatment by assessing vision-related quality of life and visual function outcome in subjects treated with rtACS versus sham-control.

STUDY DESIGN: Double masked, randomized, sham-controlled clinical trial (NCT03188042).

SUBJECTS: Sixteen subjects with moderate-to-advanced glaucoma (visual field [VF] mean deviation [MD] ≤-6.00 decibels) randomized into sham (9 subjects) or rtACS intervention (7 subjects) groups.

METHODS: Subjects underwent 10 rtACS sessions over 2 weeks. All subjects had comprehensive ocular examination at baseline, 1-week, and 4-weeks posttreatment.

MAIN OUTCOME MEASURES: Visual acuity (VA), contrast sensitivity (CS), VF MD, number of …

Segregation By Payer In Obstetrics And Gynecology Residency Ambulatory Care Sites, Kavita Vinekar, Neena Qasba, Hannah Reiser, Erika Banks, Kavita Arora, Brownsyne Edmonds, Karen George

Department of Obstetrics and Gynecology Faculty Papers

IMPORTANCE: Many teaching hospitals in the US segregate patients by insurance status, with resident clinics primarily composed of publicly insured or uninsured patients and faculty practices seeing privately insured patients. The prevalence of this model in obstetrics and gynecology residencies is unknown.

OBJECTIVES: To examine the prevalence of payer-based segregation in obstetrics and gynecology residency ambulatory care sites nationally and to compare residents' and program directors' perceptions of differences in quality of care between payer-segregated and integrated sites.

DESIGN, SETTING, AND PARTICIPANTS: This national survey study included all 6060 obstetrics and gynecology residents and 293 obstetrics and gynecology residency program …

A Pilot Program To Improve Tb Care With Primary And Specialty Care Coordination In Tb Public Health Clinic, Priyanka Jadhav, Gabrielle Boudoin, R Miles, Shandrica Seymour, J Parham, Amy Wolfe, Juzar Ali

School of Medicine Faculty Publications

BACKGROUND: The Wetmore Tuberculosis (TB) Clinic in New Orleans serves patients who often lack primary care (PC) or specialty care (SC), which is complicated by comorbidities. An initiative to provide on-site PC and coordinate care aims to enhance TB patient management. METHODS: Data collection involved categorizing patients based on their PC status: Group I (regular PC), Group II (intermittent PC), and Group III (no PC), with on-site Nurse Practitioner-based Bridge Care (NPBC) provided as needed. RESULTS: Over 12 months, 209 out of 354 patients required NPBC and PC/SC coordination, with a 20% shift from Group III to Group I, reducing …

Digital Health Research Symposium: Closing Panel Commentary, Judd E. Hollander, Kristin L. Rising, Brian M. Dougan

Department of Emergency Medicine Faculty Papers

No abstract provided.

Barriers To Early Intervention Access In Under-Resourced Communities: Professionals' Perspectives, Georges Ambroise, Jazminne Orozco-Arteaga

Summer 2024 OTD Capstone Symposium

Limited socioeconomic resources pose a barrier to accessing early intervention (EI) services.

The study yielded 33 participants of EI professionals. The study included an online survey and an optional semi-structured interview. Following data collection, Braun and Clarke’s six-step thematic analysis was utilized to identify themes from the surveys and interview transcriptions (Braun and Clarke, 2006).

The main themes that came from the data analysis are (1) there are barriers impacting access to EI experienced by families in under-resourced communities, (2) there are current supports for families in under-resourced communities accessing EI, (3) EI professionals play a role in decreasing barriers, …

Challenges In Traumatic Spinal Cord Injury Care In Developing Countries - A Scoping Review, Mohammad Hosein Ranjbar Hameghavandi, Elaheh Khodadoust, Mahgol Sadat Hassan Zadeh Tabatabaei, Farzin Farahbakhsh, Zahra Ghodsi, Sabra Rostamkhani, Shahryar Ghashghaie, Mahkame Abbaszade, Arash Arbabi, Seyedeh Maede Hossieni, Mohsen Sadeghi-Naini, Rasha Atlasi, Samuel Berchi Kankam, Alexander Vaccaro, James Guest, Michael Fehlings, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

OBJECTIVE: To evaluate the leading challenges in developing countries' traumatic spinal cord injury (TSCI) care.

METHODS: We conducted a systematic search in electronic databases of PubMed, SCOPUS, Web of Science, EMBASE, and Cochrane Library on 16 April 2023. Studies that investigated challenges associated with the management of TSCI in developing countries were eligible for review. We extracted related outcomes and categorized them into four distinct parts: injury prevention, pre-hospital care, in-hospital care, and post-hospital care.

RESULTS: We identified 82 articles that met the eligibility criteria including 13 studies on injury prevention, 25 on pre-hospital care, 32 on in-hospital care, and …

The Role Of Telehealth And Obstetrics Capacity On Maternal Health Care: A Mixed Methods Approach, Shanikque L. Barksdale

Theses and Dissertations

Background: The United States (US) is experiencing a maternal health crisis, with rising severe maternal morbidity and mortality rates and persistent racial, ethnic, and geographic disparities. While telehealth can address access challenges, there is limited evidence of its impact on access to maternity care and outcomes among rural and minoritized communities. The overall objective of this study was to analyze the disparities in maternal outcomes and user satisfaction by hospital-based telehealth and obstetric care availability.

Methods: A convergent parallel mixed methods approach was used. A multinomial logistic regression was used to analyze whether the changes in the proportions of hospitals …

Setting Up An Ambulatory Gi Endoscopy Suite In The Usa-Anesthesia And Sedation Challenges, Basavana Goudra

Department of Anesthesiology Faculty Papers

Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. Debate continues in areas such as the selection of patients, appropriateness of procedures, and access to tertiary care. Leaders often scramble to address both critical and non-critical issues, often after the center has opened to the public. They often encounter issues which were not anticipated. In this review, we have provided comprehensive and concise information on the …

Transitions Of Care And The Prevention Of Readmissions, Beatriz Granado

Student Scholarly Projects

Unplanned hospital readmissions often result from poor discharge planning and challenges during the transition from hospital to home, including medication errors and weak communication with primary care providers. A well-organized and personalized discharge plan can significantly reduce hospital stays, lower readmission rates, minimize medication errors, and improve patient outcomes, all while decreasing healthcare costs. In post-discharge Medicare-eligible patients (P), how does transitional care coordination through organized, personalized, and patient-focused discharge planning (I), compared with standard or no transitional care coordination provided (C), affect readmissions (O) within the 30-day post-discharge phase monitored over a 10–12-week period (T)? A search was conducted …

Splenic Artery Embolization In The Treatment Of Blunt Splenic Injury: Single Level 1 Trauma Center Experience, Katelyn Gill, Sarah Aleman, Alexandra H. Fairchild, Bahri Üstünsöz, Dan Laney, Alison A. Smith, Hector Ferral

School of Medicine Faculty Publications

PURPOSE: To describe the experience of a single level 1 trauma center in the management of blunt splenic injuries (BSI). METHODS: This is a retrospective study with Institutional Review Board approval. The medical records of 450 patients with BSI treated between January 2016 and December 2022 were reviewed. Seventy-two patients were treated with splenic artery embolization (SAE), met the study criteria, and were eligible for data analysis. Spleen injuries were graded in accordance with the American Association for the Surgery of Trauma Organ Injury Scale. Univariate data analysis was performed, with P < 0.05 considered statistically significant. RESULTS: The splenic salvage rate was 90.3% (n = 65/72). Baseline demographics were similar between the groups (P > 0.05). Distal embolization with Gelfoam had similar rates …

Perceptions Of Communities Of Practice And Sense Of Belonging: Focus Groups Of Academic Pediatric Faculty, Margaret P. Huntwork, Myo T. Myint, Emma Simon, Bonnie Desselle, Amy M. Creel

School of Medicine Faculty Publications

BACKGROUND: Providing the opportunity for collaboration around a central purpose to improve skills and exchange knowledge, the Community of Practice model can be useful for faculty development. A sense of belonging enhances the engagement in communities. Yet, the barriers and contributors to academic medicine faculty's sense of belonging in communities are not as well explored. METHODS: Through focus groups with 21 academic pediatric faculty conducted between January and March 2023, this qualitative study examined knowledge of Communities of Practice and the factors that affect sense of belonging and engagement. The authors iteratively coded transcripts to generate themes. RESULTS: Community accessibility; …

Functional Multivariable Logistic Regression With An Application To Hiv Viral Suppression Prediction, Siyuan Guo, Jiajia Zhang Ph.D., Yichao Wu, Alexander C. Mclain Ph.D., James W. Hardin, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Motivated by improving the prediction of the human immunodeficiency virus (HIV) suppression status using electronic health records (EHR) data, we propose a functional multivariable logistic regression model, which accounts for the longitudinal binary process and continuous process simultaneously. Specifically, the longitudinal measurements for either binary or continuous variables are modeled by functional principal components analysis, and their corresponding functional principal component scores are used to build a logistic regression model for prediction. The longitudinal binary data are linked to underlying Gaussian processes. The estimation is done using penalized spline for the longitudinal continuous and binary data. Group-lasso is used to …

Analisis Pelaporan Nilai Kritis Hasil Pemeriksaan Laboratorium Di Rumah Sakit Mayjend Hm Ryacudu Kabupaten Lampung Utara, Rahmat Hidayat, Entuy Kurniawan, Ira Gustira Rahayu, Wiwin Wiryanti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Critical values are abnormal values indicating high-risk/pathophysiological conditions that threaten the patient's life and require immediate medical intervention. Reporting critical laboratory values must be done quickly and accurately to the patient's responsible physician (DPJP) to ensure prompt and appropriate treatment. The aim of this study is to understand the reporting of critical laboratory values and its impact on the clinical decisions of doctors. This research uses both quantitative and qualitative methods with a descriptive analysis approach. Data collection was conducted through in-depth interviews, documentation, and observation. Informants were 15 DPJP. The results of this study show that the reporting system …

Analysis Of Accessibility Of People With Sensory Disabilities In Rsud Pasar Minggu, Daffaldo Suryoputra, Masyitoh Basabih, Fify Mulyani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

People with a disability is someone who has conditions, whether physically and mentally that make a person experience difficulty in certain conditions and interact with their environment. Pasar Minggu Regional Hospital (RSUD Pasar Minggu) has achieved a general patient satisfaction indicator with satisfaction rate of 90% in 2022. This satisfaction indicator mainly comes from infrastructure and facility factors, along with the competence of service providers and costs. As a regional referral hospital, this hospital certainly has patients with physical limitations due to disabilities or illnesses. To ensure patient satisfaction can also be felt by patients with physical limitations, this study …

Gambaran Klaim Pelayanan Dialisis Di Rumah Sakit Dan Rekomendasi Kebijakan Di Level Daerah: Studi Kasus Kota Pematangsiantar, Syarif Rahman Hasibuan, Chandra Istanti Prasetyo, Ede Surya Darmawan, Vetty Yulianty Permanasari

Jurnal Ekonomi Kesehatan Indonesia

Chronic kidney disease is a global health issue affecting more than 10% of the world's population and poses a significant disease burden, especially in developing countries. In Indonesia, the National Health Insurance program (JKN) has enabled access to dialysis care for patients with chronic kidney failure, but it also presents challenges in sustaining financing. This study aims to analyze the trends in dialysis service claims in Pematangsiantar City during the period from 2017 to 2022 and project the service needs until 2025. The research design is descriptive-analytic, using claim data from BPJS Health related to dialysis procedures. Analysis is conducted …

Disability Among Older Adults With Hypertension In Southeast Asia: A Scoping Review, Utoomporn Wongsin, Arnat Wannasri, Dichapong Pongpattrachai, Tuo-Yu Chen

Journal of Demography

Background: The prevalence of chronic disease and disability is expected to increase when age increases. This study aims to investigate the published articles related to disability among older adults living with hypertension in Southeast Asia.

Study Design: A scoping review

Data source: Web of science, Pubmed, CINAHL ,Cochrane and a google search, from 2000 to 2023.

Results: There were six observational studies from Indonesia, Vietnam, Malaysia, and Thailand met our inclusion criteria. The studies mainly focus on investigating the prevalence, risk factors and sex difference in risk factors associated with disabilities among the older adults.

Conclusion: Our scoping review has …

Learning From Health Care Counselors’ Perspectives On Health Care Worker Distress: A Qualitative Analysis, Nancy Downs, Judy Davidson, Angela Haddad, Sidney Zisook

HCA Healthcare Journal of Medicine

Background

Health care provider stress and emotional distress were well documented long before the COVID-19 pandemic, and there is growing data suggesting these have increased in response to the pandemic. The goal of this study was to take advantage of the unique experiences of licensed mental health (MH) clinicians working with health care trainees and clinicians before and during the pandemic to identify how this crisis affected both ongoing as well as new sources of stress. The Healer Education, Assessment and Referral Program (HEAR) provides MH screening, support, and MH referrals to ~19 000 health care students, trainees, staff, and …

Bd Vaginal Panel Assay Results On The High-Throughput Bd Cor System Compared To The Bd Max System, Elizabeth Stonebraker, Wallace Greene, Stephanie N. Taylor, Catherine L. Cammarata, April Bobenchik, Elizabeth Lockamy

School of Medicine Faculty Publications

Molecular-based assays demonstrate excellent sensitivity for the detection of vaginitis causes. Here, the high-throughput BD Vaginal Panel for BD COR System (VP-COR) performance was compared to that of the predicate, BD MAX Vaginal Panel for BD MAX System (VP-MAX). Clinical or contrived samples were used to determine the agreement between VP-COR and VP-MAX. Acceptance criteria for VP-COR agreement were as follows: bacterial vaginosis (BV) required a positive percent agreement (PPA) point estimate of ≥ 95% and a negative percent agreement (NPA) point estimate of ≥ 98%; Candida group, Candida glabrata, Candida krusei, and Trichomonas vaginalis (TV) required a PPA and …

Clinical Trial Recruitment Of People Who Speak Languages Other Than English: A Children's Oncology Group Report, Melissa P. Beauchemin, Maria Ortega, Sheila J. Santacroce, Joanna M. Robles, Jenny Ruiz, Anurekha G. Hall, Justine M. Kahn, Cecilia Fu, Manuela Orjuela-Grimm, Grace C. Hillyer, Samrawit Solomon, Wendy Pelletier, Raul Montiel-Esparza, Lindsay J. Blazin, Cassie Kline, Alix E. Seif, Paula Aristizabal, Lena E. Winestone, Maria C. Velez

School of Medicine Faculty Publications

BACKGROUND: Persons who speak languages other than English are underrepresented in clinical trials, likely in part because of inadequate multilevel resources. We conducted a survey of institutions affiliated with the Children's Oncology Group (COG) to characterize current research recruitment practices and resources regarding translation and interpretation services. METHODS: In October 2022, a 20-item survey was distributed electronically to institutions affiliated with COG to assess consent practices and resources for recruiting participants who speak languages other than English to COG trials. Descriptive statistics were used to summarize responses; responses were compared by institution size and type as well as respondent role. …

Equity In Access For Veterans In The Va Community Care Program, Baligh R. Yehia, Said A. Ibrahim

Department of Medicine Faculty Papers

No abstract provided.

Practical Guidance On Establishing A Molecular Testing Pathway For Alterations In Homologous Recombination Repair Genes In Clinical Practice For Patients With Metastatic Prostate Cancer, Martin Schostak, Angela Bradbury, Alberto Briganti, David Gonzalez, Leonard Gomella, Joaquin Mateo, Frédérique Penault-Llorca, Albrecht Stenzinger, Alexander Wyatt, Anders Bjartell

Department of Urology Faculty Papers

CONTEXT: Prostate cancer is a molecularly heterogeneous disease that is amenable to diagnostic testing to identify patients potentially eligible for personalised treatments inform familial risk and provide relevant information about potential prognosis. Several guidelines support the integration of genomic testing in a shared decision-making framework so that both health care professionals (HCPs) and patients are involved in determining the best treatment approach.

OBJECTIVE: To review current guidelines on molecular diagnostic testing for homologous recombination repair (HRR) gene alterations in patients with metastatic prostate cancer, with the aim of providing practical considerations for effective guideline implementation and establishment of an appropriate …

“Care For Me” Companion Cart, Helen Kelly, Kristofferson Yu, John Delfeld, Tom Thomas

2024 Swedish Learning and Celebration Day

No abstract provided.

Management Overview Of The Lung Tuberculosis Control Program At The Dki Jakarta Provincial Health Office In 2023, Mutiara Kiranti, Helen Andriani

Journal of Indonesian Health Policy and Administration

Tuberculosis is one of the infectious diseases that is fatal if not cured immediately. In 2022, the success rate of tuberculosis treatment in DKI Jakarta Province is 81%, while the national target is 90%. In the field, the number of cadres to carry out contact investigations is still insufficient, so that in 2022 the coverage of contact investigations in DKI Jakarta Province will only reach 25%, while the national target is 90%. To increase the scope of successful treatment, the government should try to overcome tuberculosis, which is needed. Proper program management is required to run effectively and efficiently for …

Policy Implementation Analysis Of Antenatal Care Services At Puskesmas Negara Ratu And Puskesmas Cempaka Kabupaten Lampung Utara, Willyana Syafriyanti, Anhari Achadi

Journal of Indonesian Health Policy and Administration

The Ministry of Health has issued Minister of Health Regulation Number 21 of 2021 to strengthen maternal health services, which regulates health services during pregnancy (antenatal). The Minister of Health's regulation states that antenatal care is carried out at least six times, 2 (two) of which are examinations with a doctor using an Ultra Sonography (USG) device. Community health centers as primary services are expected to be able to provide antenatal services according to standards. The North Lampung Health Service has distributed ultrasound equipment to community health centers in the North Lampung Regency to support the implementation of antenatal services. …

Balancing Community And Individual Health Efforts By Utilizing Sub-Primary Health Care At Regions: Analysis For Policy, Rocky Setya Budi, Wiku Bakti Bawono Adisasmito, Adang Bachtiar, Elvi Rosanti

Journal of Indonesian Health Policy and Administration

Public Health Centers (PHCs) are responsible for organizing public health efforts and individual health efforts. PHCs also serve as FKTP, UPTD, sub-district supervisors, and implementers of policies and programs from the Ministry of Health. The workload of PHCs is increasing because people visit PHCs primarily for treatment, rather than seeking preventive measures to stay healthy. The PHCs have Sub-PHCs to lighten the workload of the PHCs, but there is no policy regulating Sub-PHCs to be used as FKTP. This research aims to analyze the policy of Balancing Community and Individual Health Efforts by utilizing Sub-PHCs such as FKTP. The research …

Policy Content Analysis In Minister Of Health Regulation Number 15 Of 2016 About Hajj Health Istithaah, Salman Mauluddin Idris, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

Indonesia has the world's largest Muslim population and sends the most pilgrims to Saudi Arabia. The Hajj Health Istithaah Policy in Minister of Health Regulation Number 15 of 2016 is the government's effort to carry out health screening for pilgrims before leaving so that they can perform the Hajj in a healthy and independent condition. This research was conducted using a qualitative approach by collecting data through in-depth interviews and document reviews. In this study, Walt and Gilson's Policy Triangle Model was used as a reference for reviewing the Hajj health istithaah policy, especially in the content section of the …

Island Health Crisis: Bridging Gaps In Indonesia's Healthcare Deserts, Joyce Mangoma, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

This narrative literature review examines critical healthcare challenges in Indonesia's island communities, focusing on workforce shortages, inadequate health infrastructure, and the profound impact of geographical and socioeconomic factors. Drawing from eight studies published between January 2000 and December 2023, the discussion highlights both the strengths and weaknesses of existing research. The studies were selected based on their relevance to healthcare issues in island communities, rigorous methodological approaches, and significant insights into healthcare challenges and solutions. This time frame was chosen to encompass a comprehensive evolution of healthcare challenges and responses, particularly considering the effects of the COVID-19 pandemic. Grounded in …

Differences In Immigrant And U.S. Native Born Patients’ Experiences In The American Healthcare System: A Correlational Study, Betaneya W. Daniel

Virginia Journal of Public Health

Objective: To examine any perceived barriers that might exist in the United States healthcare system and gather data on how different patients experience the system.

Methods: The study utilized a correlational analysis with usage of a Likert scale survey administered to U.S.- born natives, immigrants, and healthcare providers. The survey assessed respondents of their access to healthcare services, barriers to healthcare services, healthcare provider trust/relationships, and health institutions’ relations. Another survey assessed healthcare providers’ belief in the efficacy of their services and health institutions’.

Results: No statistically significant differences were found between U.S. natives and immigrants, but notable distinctions were …

Urgent Care Program Influences On An Integrated Health Care System, Craig H. Carter

Dissertations and Theses

The Veterans Health Administration (VHA) is the most extensive integrated health care delivery system in the world with over 20,000 physicians, 1,600 facilities, and more than 400,000 employees, caring for nine million veterans. The health care provided covers traditional outpatient and hospital-based services such as primary care, surgery, critical care, mental health, orthopedics, pharmacy, radiology, and physical therapy. Most VHA facilities offer additional medical and surgical specialties such as audiology, speech pathology, dermatology, dental, geriatrics, urology, oncology, podiatry, prosthetics, and vision care. Some of the more extensive VHA facilities offer advanced health care services, such as organ transplants and plastic …

What Is The Effect Of Telehealth And The Internet Of Medical Things (Iomt) On Outcomes When Used In At-Risk Pregnancies: A Scoping Review Of The Components Of Remote Maternal Monitoring For Hypertensive Disorders That Can Successfully Be Done Via Digital Technology?, Leighton Pitter

MUSC Theses and Dissertations

IoMT (Internet of Medical Things) is an emerging technology that facilitates individualized remote e-health services to improve patient's quality of life and satisfaction while decreasing healthcare expenditures. The objective of this scoping review is to explore the usage of IoMT and remote patient monitoring (RPM) in at-risk pregnancies for hypertensive disorders to mitigate pregnancy-related complications. IoMT and other devices in an intelligent health system can meaningfully ameliorate maternal care management in the United States (U.S.). Wearables and nearables, subcategories of IoMT, can be utilized to facilitate patient-centered care and promote excellence in health maintenance/management through a holistic continuum of care …