Health Services Administration Commons^™

Examining The Relationship Between African-Americans And Their Physicians, Genesis Weever

Symposium of Student Scholars

For years, there has been a bad history amongst the relationship between African-Americans and their fellow medical institutions. Many African-Americans do not believe that medical professionals have their best interest at heart. Oftentimes, their white counterparts may receive better care, even when they have the same condition. Many African-Americans may even face barriers that their white counterparts will not experience, and will be denied access to healthcare. This results in more deaths and critical illnesses of African-Americans. In order to discover the underlying problem and a possible solution, a review of the literature was initiated. Using a literature matrix and …

Essays On Health Care Quality: Timeliness, Equity, And Efficiency, Abubakar-Sadiq Bouda Abdulai

Dissertations

According to the National Academy of Medicine (NAM) (formerly called the Institute of Medicine), a quality health care system embodies six attributes: timeliness, equity, safety, efficiency, effectiveness, and patient-centeredness. Timeliness is to avoid unnecessary delays in care delivery for patients and caregivers; equity is to ensure that the quality of care that patients receive does not vary based on their personal characteristics; safety is to ensure that the care that is intended to help patients does not harm them; efficiency is to avoid waste and optimize resource allocation to improve care delivery; effective care is one that relies on sound …

Health Service Utilization And Expenditure In Cardio-Metabolic Conditions In The United States Adults, Kavita Mosalpuria

Theses & Dissertations

Metabolic syndrome is multicomponent risk factor for cardiovascular diseases (CVD) and type 2 diabetes that reflects the clustering of at least 3 cardiometabolic risk factors, among hypertension, impaired glucose regulations, hypercholesterolemia, and obesity. CVD are the leading cause of death in the U.S. CVD occur at earlier age and is a major cause of death and disability among people with diabetes. As compared to Japan, 13.3% to 44% of the excess CVD mortality in the U.S. can be explained by the metabolic syndrome. The prevalence of metabolic syndrome was 34.3% in 2007 to 2014 and it increases with age. Metabolic …

Building Patient Participation In Quality Of Care Through The Healthcare Stories Project: A Demonstration Program In New York State Hiv Clinics, Abigail Baim-Lance, Freda Coren, Margaret Brown, Hazel Lever, Daniel Tietz, Bruce Agins

Patient Experience Journal

There is growing recognition that patients should play a central role in defining, assessing, and improving the quality of healthcare, thereby enhancing patient experiences. Healthcare organizations struggle to meet these goals, which require becoming more patient-centered and patient-involved. The Healthcare Stories Project (HCSP), a demonstration program of the NYS Department of Health AIDS Institute, aimed to address this. HCSP comprises three, stepwise activities to: 1) Capture how patients define and experience ‘quality of care’ in the clinic; 2) Engage patients and providers as equal partners in understanding and improving the quality of care; and through partnerships, 3) Support the building …

The Right Premtm: Rasch Analysis Of A New Patient Reported Experience Measure For Use By Older People In Hospital, Louise Heuzenroeder, Jyoti Khadka, Alison Kitson

Patient Experience Journal

Healthcare rights exist to protect older people from harm and to empower older people to participate in their care with independence, choice and control. Multiple investigations revealing abuse provide evidence that older people’s rights are being breached. Older people must have the opportunity to report on their experience of care against their rights. The Right PREM^TM is a new instrument designed to measure older people’s experience of care against their healthcare rights. The objective of this cross-sectional validation study was to assess the psychometric properties of a new instrument to measure the experience of care consistent with the healthcare …

Sociodemographic Characteristics And Patient And Family Experience Survey Response Biases, Lauren N. Brinkman, Myra S. Saeed, Andrew F. Beck, Michael C. Ponti-Zins, Ndidi I. Unaka, Mary C. Burkhardt, Jareen Meinzen-Derr, Samuel P. Hanke

Patient Experience Journal

Enhancing Patient and Family Experience (PFE) is vital to the delivery of quality healthcare services. Sociodemographic differences affect health outcomes and experiences, but research is limited on biases in PFE survey methodology. We sought to assess survey participation rates across sociodemographic characteristics. This retrospective study analyzed a health system’s ambulatory PFE survey data, collected January 1 – July 31, 2019. Outcomes of interest were rates of survey response, completion, and comments. Predictors included respondent-reported race, ethnicity, language, and measure of social deprivation attached to a respondent’s home address. Addresses were geocoded to census tracts. The tract’s degree of socioeconomic deprivation …

Hospitalists Stare Down The Covid-19 Pandemic, Sutoidem Akpanudo

Marshall Journal of Medicine

Hospital medicine is the country's fastest growing medical specialty. The role of hospitalists has evolved greatly in the past few decades. Hospitalists have become the quarterbacks in the effort to fight against the COVID-19 pandemic. The pandemic has brought about a transformational change to the practice of Hospital Medicine.

Concordance And Patient-Centered Care In Medicaid Enrollees’ Care Experience With Providers, Iwimbong Kum Ghabowen, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, …

Examining The Cost And Quality Relationship In Medicare, Alexandria Fleming Delage

Theses and Dissertations

Purpose.

The purpose of this study is to evaluate the cost and quality of care dynamic among physicians billing under Medicare Fee for Service in 2018 to examine the relationship between quality and total cost of care at the physician level. Examining this relationship will advance scientific knowledge regarding the impact of increasing high value service use on healthcare costs and will provide insight in terms of expected cost outcomes of quality programs for healthcare policymakers (Salmond and Echevarria 2017; Williams, Brown, and Healy 2018).

Methods.

The study used publicly available data sets provided by the Center for Medicare and …

Content Analysis Of Digital Media Coverage Of The Human Papillomavirus Vaccine School-Entry Requirement Policy In Puerto Rico, Vivian Colón-López, Vilnery Rivera-Figueroa, Glizette O. Arroyo-Morales, Diana T. Medina-Laabes, Roxana Soto-Abreu, Manuel Rivera-Encarnación, Olga L. Díaz-Miranda, Ana P. Ortiz, Katelyn B. Wells, Coralia Vázquez-Otero, Pamela C. Hull

Behavioral Science Faculty Publications

BACKGROUND: In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11-12 years old. Evidence suggests that the content of media coverage may impact people's perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR.

METHODS: A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix …

A Cost Effectiveness Analysis Of The Nutritious Eating With Soul Study, Mary Jones Wilson

Theses and Dissertations

PURPOSE Historically, African Americans (AA) have been underrepresented in nutritionrelated behavioral research despite their disproportionate higher risk of cardiovascular disease (CVD). The Nutritious Eating with Soul (NEW Soul) Study is one of the first of its kind to recruit an AA only study group to examine CVD prevention via a clinical trial to examine changes in CVD risk factors across two cohorts who are randomly assigned to a plant-based, soul food vegan diet or low-fat omnivorous (omni) diet. The purpose of cost effectiveness analysis (CEA) is to inform clinical and policy decisions and the costs of interventions that society is …

Testing The Multi-Theory Model (Mtm) To Predict The Use Of New Technology For Social Connectedness In The Covid-19 Pandemic, Manoj Sharma, Kavita Batra, Jason Flatt

Environmental & Global Health Faculty Research

Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with social isolation. However, till today, no theory-based studies were performed to examine the determinants of technology use. Therefore, the current study aims to test theory-based determinants in explaining the adoption of new technology in a nationally representative sample during the COVID-19 pandemic (n = 382). A psychometrically reliable and valid instrument based on the multi-theory model (MTM) …

Risk Of Early-Onset Dementia Among Persons With Tinnitus: A Retrospective Case–Control Study, Yen-Fu Cheng, Sudha Xirasagar Mbbs. Ph.D., Tzong- Han Yang, Chuan-Song Wu, Yi-Wei Kao, Herng-Ching Lin

Faculty Publications

Higher rates of poor cognitive performance are known to prevail among persons with tinnitus in all age groups. However, no study has explored the association between tinnitus and early-onset dementia. We hypothesize that tinnitus may precede or occur concurrently with subclinical or early onset dementia in adults younger than 65 years of age. This case–control study used data from the Taiwan National Health Insurance Research Database, identifying 1308 patients with early-onset dementia (dementia diagnosed before 65 years of age) and 1308 matched controls. We used multivariable logistic regressions to estimate odds ratios (ORs) for prior tinnitus among patients with dementia …

A Nationwide Population-Based Study On The Association Between Land Transport Accident And Peripheral Vestibular Disorders, Herng-Ching Lin, Sudha Xirasagar Mbbs,Ph.D., Chia-Hui Wang, Yen-Fu Cheng, Tsai-Ching Liu, Tzong-Hann Yang

Faculty Publications

This case-control study aimed to investigate the association of peripheral vestibular disorders (PVD) with subsequent land transport accidents. Data for this study were obtained from Taiwan's National Health Insurance (NHI) dataset. We retrieved 8704 subjects who were newly found to have land transport accidents as cases. Their diagnosis date was used as their index date. Controls were identified by propensity score matching (one per case, n = 8704 controls) from the NHI dataset with their index date being the date of their first health service claim in 2017. Multiple logistic regressions were performed to calculate the prior PVD odds ratio …

An Investigation Of Healthcare Supports For Those With Food Allergy In Ireland, Joseph Bolger, Nicola Blake, Sneha Vinod

International Undergraduate Journal of Health Sciences

Introduction: In Ireland, around 5% of children and 3% adults have food allergy (134,000 people). This current paper describes a survey that was carried out on a subset of service-users with the aim of identifying whether there is a need for increased specialist medical services and/or for a funded charity such as Anaphylaxis Ireland, defunct since 2015.

Materials & Methods: These needs were assessed via an online survey using Google Forms. The survey was conducted from 17-27th February 2020. There were 31 questions in total, relating to topics such as symptoms, clinical wait times, satisfaction with care provided and demand …

Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 1, Issue 1, June 2021, Iujhs Full Issue

International Undergraduate Journal of Health Sciences

The full June 2021 issue (Volume 1, Issue 1) of the International Undergraduate Journal of Health Sciences

American Association For The Surgery Of Trauma Prevention Committee Review: Family Justice Centers-A Not-So-Novel, But Unknown Gem, Thomas K. Duncan, Ronald Stewart, Kimberly Joseph, Deborah A. Kuhls, Tracey Dechert, Sharven Taghavi, Stephanie Bonne, Kazuhide Matsushima

School of Medicine Faculty Research

The American College of Surgeons Committee on Trauma requires that trauma centers demonstrate adequate financial support for an injury prevention program as part of the verification process. With the ongoing challenges that arise with important social determinants of health, trauma centers have the important task of navigating a patient through the complex process of obtaining services and tools for success. This summary from the American Association for the Surgery of Trauma Prevention Committee focuses on a model that has been present for several years, but has not been brought to full awareness in the trauma world. It highlights the importance …

The Discrete-Event Modeling Of Administrative Claims (Demac) System: Dynamically Modeling The U.S. Healthcare Delivery System With Medicare Claims Data To Improve End-Of-Life Care, Rachael Chacko

Dartmouth College Undergraduate Theses

The shift of the U.S. healthcare delivery system from the treatment of acute conditions to chronic diseases requires a new method of healthcare system analysis to properly assess end- of-life (EOL) quality throughout the country. In this paper, we propose the Discrete-Event Modeling of Administrative Claims (DEMAC) system, which relies on a hetero-functional graph theory and discrete event-driven framework to dynamically model EOL care on multiple levels. The heat map visualizations produced by the DEMAC system enable the elucidation of not only patient-specific EOL care but also broader treatment patterns among providers and hospitals. As a whole, the DEMAC system …

Incompatibility Group I1 (Inci1) Plasmids: Their Genetics, Biology, And Public Health Relevance, Steven L. Foley, Pravin R. Kaldhone, Steven C. Ricke, Jing Han

United States Food and Drug Administration: Publications

Bacterial plasmids are extrachromosomal genetic elements that often carry antimicrobial resistance (AMR) genes and genes encoding increased virulence and can be transmissible among bacteria by conjugation. One key group of plasmids is the incompatibility group I1 (IncI1) plasmids, which have been isolated from multiple Enterobacteriaceae of food animal origin and clinically ill human patients. The IncI group of plasmids were initially characterized due to their sensitivity to the filamentous bacteriophage If1. Two prototypical IncI1 plasmids, R64 and pColIb-P9, have been extensively studied, and the plasmids consist of unique regions associated with plasmid replication, plasmid stability/maintenance, transfer machinery apparatus, single-stranded DNA …

Essays On Predictive And Prescriptive Analytics For Risk Monitoring And Population Screening In Healthcare Management, Yan He

Dissertations and Theses Collection (Open Access)

Due to increased aging populations and changes in lifestyles, we have witnessed an increased prevalence of various chronic and acute diseases and a drastic rise in healthcare expenditures in recent years. It is of paramount importance for public health to promote regular screening and close monitoring to detect the early onset of diseases. On the other hand, the increasing availability of healthcare data and advancement in data analytics offer a huge potential to facilitate this goal. We can analyze the vast amount of data and recommend more personalized diagnostic tests after receiving results and signals from screening tests and monitoring …

Migration As A Determinant Of Childhood Obesity In The United States And Latin America, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Rossi, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

International migration has economic and health implications. The acculturation process to the host country may be linked to childhood obesity. We use the Community Energy Balance (CEB) framework to analyze the relationship between migration and childhood obesity in Mexican households with international migrants. Using longitudinal data from the Mexican Family Life Survey (MxFLS), we examine how migrant networks affect childhood obesity in origin communities. We also review binational health programs that could be effective at tackling childhood obesity in migrant households from Mexico. Children embedded in migrant networks are at greater risk of developing overweight or obesity, suggesting a significant …

Implementation Of Childhood Obesity Prevention And Control Policies In The United States And Latin America: Lessons For Cross-Border Research And Practice, Rafael Perez-Escamilla, Mireya Vilar-Compte, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, …

Feasibility And Acceptability Of Using Mobile Health Apps In Underserved Patients With Diabetes, Jieyu Luo

Theses and Dissertations (ETD)

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. …

Comparative Analysis Of Routine Immunization Policy During Covid-19 Pandemic In Indonesia, India, And Pakistan, Dian Trisna Delfyan, Yaslis Ilyas

Journal of Indonesian Health Policy and Administration

Immunization is one of the most cost-effective public health interventions, averting an estimated 2 to 3 million deaths every year. Before the coronavirus pandemic, more than nearly 14 million children didn't receive any vaccines, and 19 million children below the age did not receive the recommended vaccines in 2019. COVID 19 is leaving many of the world's most marginalized children without access to immunization services. Some are from Indonesia, India, and Pakistan, including ten countries with the highest number of unimmunized and partially immunized children. The study aims to find out the differences in the policy of routine immunization programs …

Determinants Of Family Planning Unmet Needs In West Java And Policy Recommendations During The Covid-19 Pandemic (Based On Advanced Analysis Of 2019 Skap Data), Ayudina Larasanti, Dumilah Ayuningtyas, Rina Herartri Herartri, Margareth Maya Parulianta Naibaho

Journal of Indonesian Health Policy and Administration

The Unmet Need for Family Planning (KB) in 2019 is still far from the 2015-2019 Strategic Plan target set at 9.91 percent. Seventeen provinces have a percentage of Unmet Need KB above the national figure (14.4 percent). One of them is WestJava Province, with a percentage of Unmet Need of 14.8%. Provinces with a high number ofUnmet Needs require the attention of policymakers, especially in the COVID-19 pandemic. West Java is the high-risk red zone category of COVID-19. Increased public awareness of the transmission of Covid-19 is an additional constraint to reducing the Unmet Need for family planning in the …

Evaluation Of The Implementation Of The Performance-Based Capitation Policy (Kbk) At The Merial Health Clinic Of Dki Jakarta City In 2020, Muktamar Umakaapa, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

To improve the quality of health services at Primary Health Care (FKTP) in implementing the National Health Insurance Program in Indonesia, the government has issued a performance-based capitation payment (KBK) policy at the FKTP. This study aims to evaluate the performance-based capitation payment policy in Merial Health clinic from the aspects of effectiveness, efficiency, facilities and infrastructure, availability of human resources, adequacy, and legal compliance. This study performed in-depth interviews and document reviews. The results showed that the effectiveness of the policy has been optimal but is still constrained by the socialization of the KBK policy and visits to health …

Swot Analysis Of Psbb Policy Implementation At Public Facilities Or Areas In Bekasi City In March-June 2020, Lidya Dwijayani

Journal of Indonesian Health Policy and Administration

: The government of Bekasi City has released specific policies related to PSBB, which started from April 15, 2020, until the fifth amendment that will be over on July 2, 2020, due to the high prevalence of confirmed COVID-19 cases in Bekasi City. Methods: Our study using a combination approach between Media Content Analysis for collecting the secondary data and SWOT analysis plus Trias Policy Analysis in evaluation and identification the role of several elements related to specific policies released from the Government of Bekasi City. Result: There are some best recommendations based on our SWOT analysis and Trias Policy …

A Study On Legal Policy Of Pharmacy Education And Pharmacy Workers Related To The Urgency Of Establishing Pharmacy Law, Rasta Naya Pratita, Adang Bachtiar

Journal of Indonesian Health Policy and Administration

According to the 1945 Constitution of the Republic of Indonesia, health is one of the basic human rights. One of the aspects that support health is the aspect of pharmacy. Pharmacy workers consist of Pharmacists and Pharmacy Technical Workers according to Law No. 36/2014 regarding Health Workers. In practice, pharmacy education in Indonesia is considered not sufficient to prepare the pharmacy workforce. There are currently contradictions in the applied pharmaceutical policy, where the number of pharmacy undergraduate programs is 279, while the number of pharmacist study programs is only 45. This results in an imbalance of graduates. There is a …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, …