Health Services Research Commons^™

The Factors That Influence Clinicians To Choose Rural Settings To Deliver Health Services, Julia Mattingly

Posters-at-the-Capitol

Years before the COVID-19 pandemic brought on a health care shortage in the United States, its rural areas were already struggling to obtain and attract primary care medical practitioners. The federal government has designed many programs with the intent of exposing clinicians to life in rural areas, but few have been successful at keeping medical practitioners in the long-term. Clinicians who are recruited to rural areas via loan repayment programs or other short-lived incentives often leave after only a few years.

In order to learn more about this long-running health policy problem, we set out to study the factors that …

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …

Containment Measures During The Covid Pandemic: The Role Of Non-Pharmaceutical Health Policies, Michael Funke, Tai-Kuang Ho, Andrew Tsang

Faculty, Staff and Student Publications

Many countries have imposed a set of non-pharmaceutical health policy interventions in an effort to slow the spread of the COVID-19 pandemic. The objective of this paper is to examine the effects of the interventions, drawing on evidence from the OECD countries. A special feature here is the mechanism that underlies the impact of the containment policies. To this end, a causal mediation analysis decomposing the total effect into a direct and an indirect effect is conducted. The key finding is a dual cause-effect channel. On the one hand, there is a direct effect of the non-pharmaceutical interventions on the …

Whistleblowing As An Anti-Corruption Strategy In Health And Pharmaceutical Organizations: A Scoping Review Protocol., Taryn Vian, Brianna Agnew Mph, Keith Mcinnes Jr

Nursing and Health Professions Faculty Research and Publications

Background

Whistleblowing can bring suspected wrongdoing to the attention of someone who is in the position to rectify the problem. Whistleblowing research can help improve effectiveness of anti-corruption efforts in the health sector.

Objective

The objective of this scoping review is to understand the extent and type of evidence on whistleblowing as an anti-corruption strategy in health and pharmaceutical organizations in low- and middle-income countries (LMICs).

Methods

This scoping review searched the PubMed, Scopus, and EMBASE databases from 2005 to 2020, limited to English language. We also searched websites of multilateral agencies or international non-governmental organizations for policy documents, guidance …

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

Analysis Of Prolanis Policy Implementation During The Covid-19 Pandemic In 2021, D.Fitria Sari Firdaus, Mardiati Nadjib

Journal of Indonesian Health Policy and Administration

Data from Basic Health Research (Riskesdas) in 2018 shows that Diabetes and Hypertension dominate chronic diseases. The Director of BPJS Kesehatan has issued Circular No. 14 of 2020 concerning health services for national health insurance participants during the COVID-19 prevention period, especially Prolanis. The policy contains an appeal to postpone the provision of services in the form of mass gathering activities such as Prolanis Gymnastics, Club Education, and and other activities. Hence, this research is needed to describe the implementation of Prolanis policies during the COVID-19 Pandemic. The study used a descriptive research design with qualitative methods and George C. …

Description Study Of Pandeglang Community Knowledge On Natural Disasters And Government Policies Related To Natural Disaster Preparedness In 2022, Novi Anggraini Ginting, Wiku Bakti Bawono Adisasmito

Journal of Indonesian Health Policy and Administration

Pandeglang Regency, which is a disaster-prone area, requires people who have sufficient knowledge to create community preparedness in dealing with disasters and can assist in the disaster mitigation process. This study aims to find out how the community's knowledge and community preparedness related to natural disasters and what efforts have been made by the government to improve the readiness of the people of Pandeglang Regency. This research method is descriptive and quantitative with 451 respondents. The results of the study showed that the people of Pandeglang Regency still did not know correctly the different types of threats or types of …

Analysis Of Factors Related To Intention-To-Use Telemedicine Services (Teleconsultation) In Jabodetabek Residents During The Covid-19 Pandemic In 2021, Isna Mutiara Salsabila, Kurnia Sari

Journal of Indonesian Health Policy and Administration

The emergence of COVID-19 pandemic has made it difficult for people to access health services. According to JKN statistics, FKTP visits was decreased from 337.69 million (2019) to 193.03 (2021). Teleconsultation, a type of telemedicine, could be the right solution so that people can still access the health services they need and protect themselves from the spread of COVID-19. There was an increase in the use of several teleconsultation applications in Indonesia during pandemic, from 4 million to more than 15 million people. However, this rate is only 7.63% of the internet users and 5.6% of the total population of …

Observational Study Of The Clinical Performance Of A Public-Private Partnership National Referral Hospital Network In Lesotho: Do Improvements Last Over Time?, Nancy A. Scott, Jeanette L. Kaiser, Brian W. Jack, Elizabeth L. Nkholongo, Allison Juntunen, Tshema Nash, Mayowa Alade, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Public-private partnerships (PPP) may increase healthcare quality but lack longitudinal evidence for success. The Queen ‘Mamohato Memorial Hospital (QMMH) in Lesotho is one of Africa’s first healthcare PPPs. We compare data from 2012 and 2018 on capacity, utilization, quality, and outcomes to understand if early documented successes have been sustained using the same measures over time. In this observational study using administrative and clinical data, we assessed beds, admissions, average length of stay (ALOS), outpatient visits, and patient outcomes. We measured triage time and crash cart stock through direct observation in 2013 and 2020. Operational hospital beds increased from 390 …

Adult Day Services In Maine: Benefits, Challenges, And Opportunities, Elizabeth Gattine Jd, Eileen Griffin Jd, Kimberly I. Snow Mhsa, Ba

Disability & Aging

In Maine and nationally, adult day services tend to be underfunded and underutilized compared to other types of long term services and supports (LTSS). In part, investment in adult day services is hampered by a lack of standardized data collection and limited research on issues of accessibility, cost-effectiveness, and the impact of adult day services on the broader health system. Lack of uniformity in state regulatory frameworks for licensing, program design, service delivery, and other administrative requirements further complicates cross-state comparisons. Considering these limitations, a key goal of this report is to provide a more detailed and comprehensive understanding of …

Model Autonomy Of Self-Finance Management For Primary Health Care To Enhance Workers’ Satisfaction, Ahmad Jet Alamin, Ossama Issac, Lina Teo, Atikah Adyas

Kesmas

This study aimed to find an appropriate model of autonomous self-finance management in primary health care (PHC) to enhance workers' satisfaction. This was a cross-sectional study in which data were collected through self-administered questionnaires from 204 workers in ten Regional Public Service Agency for Primary Health Care (RPSAPHC)/Badan Layanan Umum Daerah Pusat Kesehatan Masyarakat (BLUD Puskesmas) in Tangerang District, Banten Province, Indonesia using the partial least squares and structural equation model (PLS-SEM). A total of 73 indicators were used to examine the PHC transformation process to enhance workers' satisfaction. The indicators were grouped into three variables depending on workers' satisfaction: …

Spatial Analysis For Enhancing The Use Of Health Data Availability From Different Sources To Help The Decision-Making Process, Tris Eryando

Kesmas

Spatial analysis in public health has become a common method used by researchers to understand the distribution of public health aspects related to the surrounding environment. It can also be used to analyze individual information in the form of a dot and the location or line of aggregated information in a specific area of study. Another benefit is the possibility of using different data sources to be analyzed in one statistical model analysis, as long as the identification area is sufficiently clear as a key variable. Spatial analysis can show an object's distribution on a locational map and explain the …

Sars-Cov-2 Antibody Seroprevalence In Jakarta, Indonesia, Iwan Ariawan, Hafizah Jusril, Muhammad N Farid, Pandu Riono, Wiji Wahyuningsih, Widyastuti Widyastuti, Dwi Oktavia T L Handayani, Endang Sri Wahyuningsih, Rebekka Daulay, Retno Henderiawati, Safarina G. Malik, Rintis Noviyanti, Leily Trianty, Nadia Fadila, Khin Saw Aye Myint, Frilasita A. Yudhaputri, Neeraja Venkateswaran, Kodumudi Venkateswaran, Venkatachalam Udhayakumar, William A. Hawley, Juliette Morgan, Paul M. Pronyk

Kesmas

The SARS-CoV-2 transmission dynamics in low- and middle-income countries remain poorly understood. This study aimed to estimate the SARS-CoV-2 antibodies seroprevalence in Jakarta, Indonesia, and to increase knowledge of SARS-CoV-2 transmission in urban settings. A population-based serosurvey among individuals aged one year or older was conducted in Jakarta. Employing a multistage sampling design, samples were stratified by district, slum, and non-slum residency, sex, and age group. Blood samples were tested for IgG against three different SARS-CoV-2 antigens. Seroprevalence was estimated after applying sample weights and adjusting for cluster characteristics. In March 2021, this study collected 4,919 respondents. The weighted estimate …

A Stunting Prevention Risk Factors Pathway Model For Indonesian Districts/Cities With A Stunting Prevalence Of ≥30%, Nina Fentiana, Endang L. Achadi, Besral Besral, Abram Kamiza, Trini Sudiarti

Kesmas

The prevalence of stunting in Indonesian children aged 0-23 months is a public health problem caused by direct and indirect factors. This study aimed to discover the path of the relationship between various risk factors and the stunting prevalence of ≥30% in 165 districts/cities in Indonesia. Data were obtained from the 2018 National Basic Health Research, National Socioeconomic Survey, and the Statistics Indonesia with a cross-sectional approach. The secondary data on stunting and risk factors were aggregated at the district/city level from individual data; children aged 0-23 months. The path analysis used to determine a stunting prevention model showed that …

Determinants Of Type 2 Diabetes Mellitus Among Passive Smokers, Adinda Rahma Triyaniarta, Santi Martini, Kurnia Dwi Artanti, Sri Widati, Rizma Dwi Nastiti

Kesmas

Type 2 diabetes mellitus (T2DM) leads to complications of other diseases. The modifiable risk factors for T2DM are overweight, physical activity, hypertension, unhealthy diet, and smoking. This study aimed to analyze determinants of T2DM incidence in passive smokers among various factors. This study was conducted at Hospital X in Surabaya City, East Java Province, Indonesia, from September 2019 to April 2020. The variables were univariate, bivariate, and multivariate. Case samples were T2DM patients and passive smokers, while control samples were non-T2DM patients and passive smokers, with 52 respondents per group, of 104 total respondents. Variables statistically significant related to the …

The Effect Of Health Promotion Program On Perceived Self-Efficacy And Self-Care Practices Among Elderly With Multimorbidity In Chiang Mai, Thailand, Jukkrit Wungrath, Nuttida Khumai, Phinphot Phrommasen

Kesmas

Multimorbidity in the elderly is a major public health issue with serious consequences. This study investigated the effects of health promotion programs on perceived self-efficacy and self-care practices among the elderly with multimorbidity using a quasi-experimental study design from February to July 2021. The study samples were the elderly from Doi Saket District, Chiang Mai Province, Thailand, selected by a multistage random sampling technique. The experimental and control groups each comprised 40 elderlies with multimorbidity. All elderly participants took part in a 12-week health promotion program. The perceived self-efficacy and self-care practices of the study samples were assessed using interviews, …

Predictors Of Anxiety Toward Covid-19 Delta Variant: A Cross- Sectional Study Among Healthcare Providers In Java And Bali, Indonesia, I Ketut Swarjana, I Gede Putu Darma Suyasa, I Kadek Nuryanto

Kesmas

Health facilities are experiencing overcapacity, oxygen scarcity, and a limited number of healthcare providers due to the coronavirus disease 2019 (COVID-19), thus impacted on anxiety. This study aimed to determine predictors of anxiety among healthcare providers toward the Delta variant of COVID-19 in Indonesia. A cross-sectional study was conducted with 371 healthcare providers in Java and Bali Islands, and the snowball sampling technique was used. Data were collected using a questionnaire and distributed through social media (WhatsApp), then analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that 81 (21.8%) respondents experienced …

Perspectives On Reproductive Health Education Among Javanese Parents, Bagoes Widjanarko, Ratih Indraswari, Aditya Kusumawati, Novia Handayani

Kesmas

This study aimed to investigate the perspectives of reproductive health education among Javanese parents of children aged 9-11 years. This cross-sectional study was conducted with 12,306 parents in Semarang City, Central Java Province, Indonesia, using a purposive sampling technique. Some parents agreed that reproductive health education at home was unnecessary (29.5%), taboo (45%), difficult (73.1%), and awkward (41.5%). Most parents (72.7%) were not transparent in providing reproductive health information to their children by using other terms to name the genitals, considering the politeness aspect. Good practices of providing reproductive health information are slightly more common in mothers (54.2%), unemployed parents …

Spatial Analysis Of Seven Islands In Indonesia To Determine Stunting Hotspots, Tiopan Sipahutar, Tris Eryando, Meiwita Budiharsana

Kesmas

Indonesia is a vast country struggling to reduce its stunting prevalence. Hence, identifying priority areas is urgent. In determining areas to prioritize, one needs to consider geographical issues, particularly correlations among areas. This study aimed to discover whether stunting prevalence in Indonesia occurs randomly or in clusters; and, if it occurs in clusters, which areas are the hotspots. This ecological study used aggregate data from the 2018 National Basic Health Research and Poverty Data and Information Report from the Statistics Indonesia. This study analyzed 514 districts/cities across 34 provinces on seven main islands in Indonesia. The method used was the …

“High Spending, Poor Productivity Gains!” Assessing Public Health System (In)Efficiency And Hospital Performance In The State Of Kuwait: Would More Private Delivery Improve Healthcare?, Aljawhara Alsabah

NYMC Student Theses and Dissertations

The healthcare sector in the State of Kuwait has been nurtured for many decades by the government, where the majority of health services in the country are controlled by the Ministry of Health (MoH). Although healthcare services in public sector hospitals are at highly subsidized rates, causing private sector involvement in healthcare to be considerably low, the growing demands for private delivery of care burgeoned participation of private hospitals in Kuwait, and improving hospital efficiency and productivity is more critical and timelier than ever. This dissertation aims to analyze public health system efficiency and hospital performance in the State of …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

Three Essays About Preventing Mental And Behavioral Disorders, Snehal Lopes

All Dissertations

Prevention efforts in the public health field operate at various levels, including primary prevention among those without a disease of interest, secondary prevention among persons at high risk or showing early signs of the disease, and tertiary prevention among persons with the disease. The three essays presented in this dissertation are centered around the theme of prevention, and taken together, have implications for prevention at the primary, secondary, and tertiary levels. Specifically, the essays focus on the prevention of depressive disorders and the prevention of behavioral and mental health correlates for depression in the context of various populations (general adult, …

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Knowledge, Attitudes, And Covid-19 Prevention Practices Of Healthcare Workers In Indonesia: A Mobile-Based Cross-Sectional Survey, Besral Besral, Zulvi Wiyanti, Dion Zein Nurizin, Milla Herdayati, R Sutiawan, Martya Rahmaniati, Popy Yuniar

Kesmas

Knowledge of disease can affect attitudes and prevention practices, and wrong attitudes and practices can directly increase the risk of disease infection. This study aimed to describe the knowledge, attitudes, and COVID-19 prevention practice of healthcare workers in Indonesia and factors associated with prevention practices. A mobile-based cross-sectional survey was conducted in August 2020 with 254 healthcare workers in Indonesia. The self-administered questionnaire consisted of four parts: 1) sociodemographic information, 2) knowledge of COVID-19, 3) attitudes and anxiety toward COVID-19, and 4) COVID-19 prevention practices. The results indicated that healthcare workers in Indonesia had excellent knowledge and positive attitudes about …

Infarct Diameter For Predicting Cognitive Dysfunction In Ischemic Stroke Survivors In West Nusa Tenggara, Indonesia, Herpan Syafii Harahap, Setyawati Asih Putri, Yanna Indrayana, Hasan Amin, Fransisca Ika Mahardika

Kesmas

Cognitive dysfunction is an important consequence of ischemic stroke, which can progress in the first few years and is primarily determined by clinical factors. This study aimed to investigate the clinical determinants of cognitive dysfunction in stroke survivors in West Nusa Tenggara Province, Indonesia. This cross-sectional study assessed 255 ischemic stroke survivors with a mean age of 57.1±9.3 years old and 29–79 years old, recruited consecutively in three main hospitals in West Nusa Tenggara Province between March 2019 and October 2021. Categorical data collected included age, sex, education level, clinical determinants of ischemic stroke, and cognitive status of the patients. …

Interprofessional Collaborative Practice And Health Workers Retention At Remote Primary Health Care: Case Study From Nusantara Sehat Team-Based Program, Prastuti Soewondo, Retno Pujisubekti, Ade Widyati Prastyani, Nurul Maretia Rahmayanti

Kesmas

The Nusantara Sehat Team (NST), established in 2015 and consist of multi-professional health workers, implemented to provide comprehensive services at remote primary health cares (PHCs) for two years. This study aimed to explore how the NST leverages the Interprofessional Collaboration (IPC) and its impact on the future career prospects of health workers. Using a qualitative approach, the information was gathered from 48 informants drawn from the current 30 NST recruits and 18 alumni through semi-structured interviews. Of these 48, 20 were clinical practitioners, while the rest were non-clinical health workers. The findings revealed several challenges in promoting collaborative practice, including …

Benign Prostatic Hyperplasia (Bph): A Comprehensive Analysis Of The Malaise And Summarizing Possible Management Options Through Phytotherapeutic Agents, Shan Sasidharan, Kumarapillai Parameswaran Srinivasakumar, Sandeep Poddar, Amiya Bhaumik, Sreemoy Kanti Das, Hareendran Nair J

Kesmas

Benign prostatic hyperplasia (BPH) is a severe illness affecting middle-aged and geriatric male patients. This disease normally occurs at the age of 40 or above and is also associated with sexual dysfunction. Alpha-blockers and 5α-reductase inhibitors are the preferred drugs practiced to treat BPH. However, invasive surgical therapy remains the gold standard for managing the condition in the case of refractory and intricate BPH conditions. Due to the fear of sexual dysfunction and the detrimental influence on their quality of life, most patients seek to avoid synthetic drugs and surgery. For this reason, several patients turn to phytotherapy and other …

Treatment Adherence And Incidence Of Coronary Heart Disease In Type 2 Diabetes Mellitus Patients, Ahmad Sahlan Baniu, Rani Sauriasari, Woro Riyadina, Pradana Soewondo

Kesmas

Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed …

Local Wisdom Enriching Complementary Feeding Practices During Disaster Situations In Indonesia, Astuti Astuti, Happy Hayati, Fajar Tri Waluyanti, Dessie Wanda

Kesmas

This study aimed to analyze complementary food fulfillment during disaster situations in Indonesia since it frequently experiences natural disasters and young children face unique challenges related to their feeding needs in disaster situations. This qualitative case study based on the Mount Merapi eruption and Sumedang landslide in 2021 collected data using observations, forum group discussions, and in-depth interviews; then, a thematic analysis was conducted. This study involved 17 participants, including Non-governmental Organizations (NGO) activists, health workers, residents involved in making complementary foods, and primary caregivers of children aged 6–24 months. This study found that there were five themes generated from …