Health Services Research Commons^™

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience: Master of Public Health

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Perception Of Lean Adoption Among Emergency Department Personnel In Public Hospitals In Selangor, Malaysia, Azizul Rahman Mohamad Jamil, Mohd Rizal Abdul Manaf, Sharifa Ezat Wan Puteh, Kiran Ganesh Balakrishnan

Makara Journal of Health Research

Background: This research aims to assess the perceptions of the staff working in emergency departments in Selangor, Malaysia, regarding the adoption of lean management and identify the factors that affect their perceptions.

Methods: A cross-sectional study using the Lean in Healthcare Questionnaire was conducted with 251 respondents, which consisted of doctors, nurses and medical assistants employed in three selected hospitals.

Results: One-way analysis of variance (ANOVA) showed a significant difference in every domain score in accordance with the occupation category. For the domain process, a significant negative correlation was found between age and domain score (r = …

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …

Implementation Of Psychiatric Collaborative Care Management In Rural Primary Care Practices, Ryan Dean Kruis

MUSC Theses and Dissertations

Behavioral health (BH) disorders are highly prevalent in the United States and especially concerning in rural communities which disproportionately lack access to BH services. While models for integrating BH into primary care, such as psychiatric collaborative care management (CoCM), have shown promise in mitigating the BH crisis, implementation in rural communities has proved challenging.
This dissertation examines implementation of CoCM nationally and in rural settings through three distinct aims. First, a claims-based retrospective cohort study was used to determine whether commercially insured patients receiving CoCM had lower acute BH care utilization and cost as compared to similar patients not receiving …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

The Dearth Of Knowledge Of Health Insurance Literacy Within The United States, Katherine A. Conzet

Honors Thesis

This literature review and cross-comparison were conducted to combine resources that bring to light the lack of knowledge on health insurance, the impact of this low health insurance literacy (HIL), and the lack of research being done in this subject field. This thesis analyzes and compares different research that measures HIL levels and compares these findings. At the same time, this thesis presents the complex history of health insurance and how this understanding can contribute to lower population HIL and proposes different ways to accurately measure HIL. The purpose is to show the necessity for more research into the field …

Developing A Health Equity-Minded Curriculum: The Impacts Of Cancer Care, Leanna Ross, Camille Ashley, Julianne Luttrell, Krismae Jimenez

Articles, Abstracts, and Reports

No abstract provided.

Learning From The Implementation Of A Surgical Opioid Reduction Initiative In An Integrated Health System: A Qualitative Study Among Providers And Patients, Willemijn L A Schäfer, Julie K Johnson, Meagan S Ager, Cassandra B Iroz, Reiping Huang, Salva N Balbale, Jonah J Stulberg

Faculty, Staff and Student Publications

BACKGROUND: Surgical opioid overprescribing can result in long-term use or misuse. Between July 2018 and March 2019, the multicomponent intervention, Minimizing Opioid Prescribing in Surgery (MOPiS) was implemented in the general surgery clinics of five hospitals and successfully reduced opioid prescribing. To date, various studies have shown a positive outcome of similar reduction initiatives. However, in addition to evaluating the impact on clinical outcomes, it is important to understand the implementation process of an intervention to extend sustainability of interventions and allow for dissemination of the intervention into other contexts. This study aims to evaluate the contextual factors impacting intervention …

Experiences Of Women In Sierra Leone Relating To Accessing Breast Cancer Treatment, Anne Neville, Magdeline Aagard Dr.

Journal of Sustainable Social Impact

The lack of consistent access to breast cancer care and treatment remains a significant problem for women diagnosed with breast cancer in Sierra Leone. The instability of the political structure has created an environment with a high level of illiteracy and financial hardship among the female population, resulting in a significant deficiency in information relating to symptoms and the detection of breast cancer. To study the lived experience of women living in Sierra Leone who were diagnosed with breast cancer, I [the first author] used a descriptive phenomenological approach. I conducted semi-structured interviews based on Andersen and Newman’s healthcare utilization …

The National Status Of Pharmacists’ Ability To Prescribe Hormonal Contraceptives, Aleese Smith, Urvi Patel, Alexandra Arledge, Josie Young, Erin Johanson

Annual Research Symposium

The scope of practice for pharmacists first expanded in California and Oregon with the ability to prescribe hormonal contraceptives to patients in their communities. Since 2016, over 33 states now allow for pharmacist prescribing of birth control in their pharmacy practice laws.

90% of Americans live within 5 miles of a retail pharmacy, making community pharmacies an accessible resource who may otherwise be unable to access contraceptives. The gap in care experienced by certain patient populations is now being filled by pharmacists with their ability to prescribe birth control.

The Influence Of The Green Hospital Implementation Policy On The Energy Saving Behavior Of Xyz Hospital Employees Using The Theory Of Planned Behavior Approach, Dika Asmawati, Wiku Bakti Bawono Adisasmito, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

This research uses the Theory of Planned Behavior as the theoretical framework to analyze the relationship between the implementation of green hospital policy and energy-saving behaviors of employees in the hospital environment. The study's sample consists of 150 permanent employees, and the statistical data are analyzed using the Structural Equation ModelingPartial Least Square (SEM-PLS) technique. The analysis results indicate that implementing the green hospital policy influences the supportive factors of behavior: attitudes, subjective norms, and perceived behavioral control. However, the tests also reveal that subjective norms do not positively correlate with the energy-saving behaviors of employees at the hospital. The …

The Effect Of Compensation Policy And Work Discipline On Nurse Productivity At Dr. H. Marzoeki Mahdi Mental Hospital Bogor In 2023, Icha Tiara Devi Febrianti, Helen Andriani

Journal of Indonesian Health Policy and Administration

Health worker productivity problems due to suboptimal institutional management still often occur, including at the dr. H. Marzoeki Mahdi Mental Hospital (RSJMM). Nurses are the most significant number of health workers in hospitals with a high level of patient intervention; inappropriate treatment risks decreasing work productivity. This research aims to analyze the effect of financial compensation, non-financial compensation, and work discipline on nurse productivity at RSJMM. The research study used a quantitative approach by distributing questionnaires to 205 nurses. The results showed partially (1) financial compensation has no significant effect on nurse productivity (Sig. value 0.953 > 0.05, β=0.002); (2) Non-financial …

Design Of Computerized Patient Registration Application System At Tanjung Pati Health Center, Oktamianiza Oktamianiza, Vitratul Ilahi, Kalasta Ayunda Putri, Yulfa Yulia, Rahmadhani Rahmadhani

Journal of Indonesian Health Policy and Administration

One of the shortcomings of manual patient registration systems is the procedures that affect the efficiency of service care to patients. Therefore, researchers are interested in designing a computerized patient registration application using Microsoft Access software. The type of research used is Research and Development (R&D). This research was conducted at Tanjung Pati Community Health Center, with in-depth interviews with two registration officers. The research results show that the data elements needed to design the patient registration application system, sourced from the Patient Registration Book, will be developed by creating an application system using UML modeling. The application system undergoes …

Analysis Of Needs And Service Capacity Of Bpjs At First-Level Healthcare Facilities In Bandung District, Rizki Amalia Rahmah, Mursyid Hasan Basri

Journal of Indonesian Health Policy and Administration

The community's need for BPJS services at Primary Health Facilities (FKTP) can be well met if adequate service capacity is available. This research aims to analyze the gap between the needs and capacity of BPJS services in FKTPs in Bandung District. This quantitative study uses secondary data owned by Dinas Kesehatan Provinsi Jawa Barat and BPJS Kesehatan Kantor Cabang Soreang. The calculation of needs uses the number of BPJS participants registered in each FKTP, and the calculation of service capacity is based on the duration of service and the number of general practitioners in the FKTP. Out of the 187 …

Relationship Of Remuneration Policy To The Performance Of Specialist Doctors In The Kramat Jati Regional General Hospital In 2022, Roy Michael Suranta, Ascobat Gani, Adang Bachtiar

Journal of Indonesian Health Policy and Administration

The number and types of hospitals in Jakarta are constantly increasing, causing competition for customers or patients. Hospitals owned by the DKI Jakarta provincial government face challenges in providing specialist doctor services with the best performance for the community, this is closely related to the rewards offered to specialist doctors. One of the regional government's efforts to improve the performance of specialist doctors is by issuing regulations on remuneration for hospitals. This research aims to determine the relationship between remuneration policy and the performance of specialist doctors at Kramat Jati Regional Hospital. The research was conducted using a case study …

Analyzing Health Care Delivery Costs From 2011 To 2020 In The Emergency Departments And Overall Hospital Costs, Jacob A. Corey

The Journal of Purdue Undergraduate Research

No abstract provided.

Real-World Dispensing Of Buprenorphine In California During Prepandemic And Pandemic Periods, Yun Wang, Alexandre Chan, Richard Beuttler, Marc L. Fleming, Todd Schneberk, Michael Nichol, Haibing Lu

Pharmacy Faculty Articles and Research

Introduction: The opioid overdose crisis in the United States has become a significant national emergency. Buprenorphine, a primary medication for individuals coping with opioid use disorder (OUD), presents promising pharmacokinetic properties for use in primary care settings, and is often delivered as a take-home therapy. The COVID-19 pandemic exacerbated the scarcity of access to buprenorphine, leading to dire consequences for those with OUD. Most existing studies, primarily focused on the immediate aftermath of the COVID-19 outbreak, highlight the challenges in accessing medications for opioid use disorder (MOUDs), particularly buprenorphine. However, these studies only cover a relatively short timeframe. Methods: To …

Research Action Brief: Healthcare Experiences And Perceptions As Drivers Of Gaps In Mammography, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

Challenges In Post Graduate General Surgery Training In Tanzania: A Trainee’S Perspective, Shabbir Adamjee

Master of Surgery

v>

General Surgery residency training is a complex vigorous program which includes long working hours and complex surgical cases, in order to develop and attain the knowledge and the skills the trainee needs by the end of the program. Worldwide, general surgery programs have high attrition rates and residents have identified challenges which may be work related, related to social wellbeing and/or the residency program structure. Tanzania has public and private institutions providing general surgery residency training and although most have a quality assessment program the data is not readily available. Each institution has its personalized curriculum with its unique …

Factors Associated With Antiretroviral Drug Resistance Mutations Among Plhiv Failing To Achieve Virological Suppression On Second Line Treatment In Tanzania., Mabula M. Mabelele

Master of Internal Medicine

v> Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major public health problem affecting an estimated 38.4 million people globally, with the (54%) of them being from the Eastern and Southern African regions. Despite progress in the availability of multiple classes of antiretroviral drugs and early initiation of treatment with cART, many patients still fail therapy in the first and second-line regimens due to drug resistance driven by continuous acquisition of drug resistance mutation (DRMs). DRMs are high among adults failing treatment regimens, ranging between 50-97%.

Acceptability And Feasibility Of Screening With A Pediatric Care Provider-Led Social Determinants Of Health Identification Tool, Alison Eyre, Janice Cohen, Sarah Funnell, Lynsey James, Sheena Guglani, Hounaida Abi Haidar, Lindy Samson, Michelle Ward, Radha Jetty, Megan Harrison, John Lyons Dr., Leigh Fraser-Roberts, Susan Bennet, Douglas Archibald, Soha Khorsand, Tobey Audcent

Health Management and Policy Faculty Publications

Background Complex social determinants of health may not be easily recognized by health care providers and pose a unique challenge in the vulnerable pediatric population where patients may not be able to advocate for themselves. The goal of this study was to examine the acceptability and feasibility of health care providers using an integrated brief pediatric screening tool in primary care and hospital settings.

Methods The framework of the Child and Adolescent Needs and Strengths (CANS) and Pediatric Intermed tools was used to inform the selection of items for the 9-item Child and Adolescent Needs and Strengths-Pediatric Complexity Indicator (CANS-PCI). …

Leveraging Local Knowledge To Contextualize The Opioid Epidemic Within Healing Communities Study Communities: A Photovoice Protocol, Peter Balvanz, Ramona G. Olvera, Margaret Louise Mcgladrey, Marisa Booty, Dacia Beard, Sylvia Ellison, Craig Mcclay, Monica Nouvong, Carrie B. Oser, Owusua Yamoah, Linda Sprague Martinez

Health Management and Policy Faculty Publications

Since its inception 30 years ago, Photovoice has gained increasing popularity as a research method and more recently has been incorporated within randomized controlled trial (RCT) designs. Photovoice is a participatory action research method that pairs photography with focus group discussions to record community strengths and concerns, build critical consciousness, and reach policymakers. Adherence of Photovoice implementation to these original tenets of Photovoice varies. This article provides the Photovoice protocol developed by the authors to improve the methodological rigor of Photovoice integration into RCTs and help contextualize the landscape for the HEALing Communities Study (HCS: NCT04111939), a greater than $350 …

A Sampling Strategy For Longitudinal And Cross-Sectional Analyses Using A Large National Claims Database, Timothy L. Mcmurry, Jennifer M. Lobo, Soyoun Kim, Hyojung Kang, Min-Woong Sohn

Health Management and Policy Faculty Publications

Importance: The United States (US) Medicare claims files are valuable sources of national healthcare utilization data with over 45 million beneficiaries each year. Due to their massive sizes and costs involved in obtaining the data, a method of randomly drawing a representative sample for retrospective cohort studies with multi-year follow-up is not well-documented.

Objective: To present a method to construct longitudinal patient samples from Medicare claims files that are representative of Medicare populations each year.

Design: Retrospective cohort and cross-sectional designs.

Participants: US Medicare beneficiaries with diabetes over a 10-year period.

Methods: Medicare Master Beneficiary Summary Files were used to …

Implementing Social Determinants Of Health Data Collection In A Large Urban Pediatric Hospital Setting, Stormee Williams, Kristina Hill, Barry Owen, Forest Melton

Research

No abstract provided.

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …

A Position Analysis Of Bpjs Claims Administration Officers And Verifiers (Case Study: Jambi Province Regional Mental Hospital), Hanisah Hanisah, Asmaripa Ainy, Iwan Stia Budi

Preventia: The Indonesian Journal of Public Health

The high coverage rate of handling partially rejected claim financing reaching 7.34% of the total 19,476 cases in the Outpatient Unit of the Jambi Provincial Mental Hospital (RSJD) in 2022, is closely related to the quality of human resources (HR) in this case, the claims officer and the suitability of what is done with the job description, job specifications and standard operating procedures (SOP) that have been made. This study aimed to analyze the position of administrative officers and claim verifiers in the outpatient unit of the Jambi Provincial Mental Hospital. This research used a qualitative method. Information was collected …

Evaluation Of A Community Based Teaching Hospital’S Geriatric Emergency Medicine Initiative, Josette Hartnett, Isabel Muronzi-Belfon, Suzanne J. Rose

Journal of Geriatric Emergency Medicine

INTRODUCTION: To accommodate the complex healthcare needs of the rising geriatric population, Stamford Hospital’s (SH) emergency department (ED) began a Geriatric Emergency Medicine Initiative (GEMI) in 2018 to improve our ED environment, practices, and focused assessments for our community-dwelling older adults.

METHODS: This retrospective program evaluation describes SH’s novel ED processes for at-risk older adults and compares GEMI and non-GEMI assessed patient outcomes using aggregate frequencies on throughput metrics such as length of stay (LOS), 72 hour and 30-day re-admission rates, and other outcomes of interest. Chi-square tests and group t-tests were used for all analyses with a p-value of …

Organizational Change In Saudi Healthcare Settings: Evaluating Organizational And Individual Readiness For Change, And The Mediating Role Of Readiness For Change Between Management Support And Commitment To Change., Sultan Alsaif

Electronic Theses and Dissertations

BACKGROUND: To respond to the constantly changing environment and developments of healthcare, leaders of healthcare organizations have been trying to introduce and implement transformations that allow their organizations to be able to operate effectively and efficiently to meet the shifts in healthcare demand and to deal with new patterns of health issues, comply with the new policies, and to enhance their present in the market. Thus, it is important for managers to determine the level of readiness for implementing organizational changes from to perspectives. These perspectives include organizational readiness for change and individual readiness for change. METHOD: This first manuscript …