Health Services Research Commons^™

Factors Influencing The Variation In Gms Prescribing Expenditure In Ireland, Aisling Conway Lenihan, S. Ahern, J. Cronin, N. Woods

Dept. of Management & Enterprise Publications

Background

Pharmaceutical expenditure growth is a familiar feature in many Western health systems and is a real concern for policymakers. A state funded General Medical Services (GMS) scheme in Ireland experienced an increase in prescription expenditure of 414 % between 1998 and 2012. This paper seeks to explore the rationale for this growth by investigating the composition (Anatomical Therapeutic Chemical (ATC) Group level 1 & 5) and drivers of GMS drug expenditure in Ireland in 2012.

Methods

A cross-sectional study was carried out on the Health Service Executive-Primary Care Reimbursement Service (HSE-PCRS) population prescribing database (n = 1,630,775). Three …

Aligning Delivery & Financing Systems To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Systems for Action Research Program supports research on how best to organize, finance, and deliver the constellation of services and supports that promote health and well-being in American communities, including but extending beyond the medical care and public health sectors. This session describes work underway through the S4A program and future research priorities, building on a strong scientific foundation in the fields of health services research (HSR) and public health services & systems research (PHSSR).

Integrating Health Services & Systems: What We Know, Think We Know, And Need To Learn, Glen P. Mays

Health Management and Policy Presentations

The delivery and financing systems for medical care, public health, and social and community services pursue many common goals and serve overlapping groups of families and communities. Unfortunately, in most American communities these systems interact in complex and often poorly understood ways through fragmented funding vehicles, information flows, governance and decision-making structures, institutional relationships, implementation rules and strategies, and professional and interpersonal connections. New research approaches are required to untangle these interactions and expose novel pathways of influence that can support equitable improvements in service delivery, resource use, health impact, and wellbeing. This presentation will summarize evidence from recent studies …

Measuring Multi-Sector Contributions To Public Health Delivery Systems & Population Health, Glen P. Mays

Health Management and Policy Presentations

The National Longitudinal Survey of Public Health Systems has followed a nationally-representative cohort of U.S. communities since 1998 to measure the scope of public health activities implemented in each community and the range of organizations and sectors that contribute to each activity. With 16 years of follow-up observations, this survey allows us to study the effects of demographic, economic, and policy shocks on public health delivery systems, and estimate the health effects attributable to delivery system change.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Delivery and financing systems for public health services vary widely across U.S. communities, raising questions about the comparative effectiveness and efficiency of alternative structures. We summarize recent approaches for measuring alternative system configurations and estimating their health and economic effects.

Knowledge And Behavior Change Of People Living With Hiv Through Nutrition Education And Counseling, Fitri Hudayani, Ratu Ayu Dewi Sartika

Kesmas

HIV, AIDS, dan gizi saling berhubungan. Pada Unit Pelayanan Terpadu HIV Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, layanan edukasi dan konseling gizi disediakan secara kolaboratif untuk orang yang hidup dengan HIV. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan dan konseling gizi terhadap pengetahuan dan perilaku orang yang hidup dengan HIV. Penelitian ini dilakukan dengan desain kuasi eksperimental menggunakan kelompok perlakuan dan kontrol. Kelompok perlakuan terdiri dari 25 sampel dan 29 sampel untuk kelompok kontrol, dilakukan sebelum dan setelah perlakuan. Sampel berusia dewasa antara 18 – 50 tahun dipilih dengan menerapkan kriteria inklusi dan eksklusi. Sampel uji-t berpasangan digunakan …

Cadmium Contamination In Farmland Soil And Water Near Zinc Mining Site, Kanitta Jiraungkoorskul, Sara Arphorn, Mathuros Tipayamongholgul, Wattasit Siriwong

Kesmas

Penelitian ini merupakan penelitian potong lintang yang dilakukan di Kecamatan Phatadpaeng, Kota Mae Sod, Provinsi Tak, Thailand. Penelitian ini bertujuan untuk mengetahui konsentrasi kadmium pada air dan tanah pertanian serta pada pemukiman petani dan rumah tangga. Konsentrasi kadmium pada 48 sampel tanah dan air pemukiman petani, 12 sampel rumah tangga, enam sampel tanah pertanian, dan delapan sampel air pertanian ditelusuri menggunakan Graphite Furnace Atomic Absorption Spectrophotometer. Uji Mann-Whitney U digunakan untuk analisis perbedaan konsentrasi kadmium antara tanah pertanian dan tanah pemukiman, air pertanian dan air pemukiman. Hasil penelitian menunjukkan tidak terdapat perbedaan secara statistik pada seluruh matriks, namun air dan …

Study On Clinical, Histopathological Features And Evaluation Results Of Skin Cancer Treatment In Can Tho Oncology Hospital, Nguyen Van Qui, Phan Nguyen Ngoc

Kesmas

Kanker kulit, diagnosis kanker paling umum, cenderung mengalami peningkatan. Kondisi ini secara khusus merupakan isu penting di negara-negara maju. Penelitian ini bertujuan untuk mendeskripsikan fitur klinis, fitur hispatologis, komplikasi dan hasil pengobatan bedah awal kanker kulit di Rumah Sakit Onkologi Can Tho dari tahun 2014 sampai 2015. Penelitian deskriptif prospektif ini melibatkan seluruh pasien dengan kanker kulit nonmelanoma yang diuji dan diobati di Rumah Sakit Onkologi Can Tho dari Juli 2014 sampai Maret 2015. Terdapat 78 kasus terpilih. Kanker kulit ditemukan lebih umum pada pasien yang lebih tua. Prevalensi karsinoma sel basal ditemukan lebih tinggi dibandingkan karsinoma sel skuamosa dengan …

Communication Of Parents, Sexual Content Intake And Teenage Sexual Behavior At Senior High School In Banjarmasin City, Rusmilawaty Rusmilawaty, Yuniarti Yuniarti, Tri Tunggal

Kesmas

Perilaku seks bebas di kalangan remaja Kota Banjarmasin belakangan ini semakin mengkhawatirkan para orangtua. Kurangnya pendidikan seksologi berdampak para remaja cenderung melakukan hubungan seksual pranikah yang akan berakibat pada kehamilan yang tidak diinginkan dan pernikahan dini. Komunikasi orangtua-anak dan paparan media baik media cetak maupun elektronik merupakan cara untuk mengurangi perilaku seksual berisiko. Tujuan penelitian ini untuk mengetahui hubungan komunikasi orangtua dan asupan muatan seksual dengan perilaku seksual remaja sekolah menengah atas (SMA) di Kota Banjarmasin. Untuk mencapai tujuan tersebut, penelitian survei analitik dengan pendekatan potong lintang dilakukan pada bulan Juli – Oktober 2015 di dua sekolah negeri dan satu …

Influence Of Household Environment And Maternal Behaviors To Upper Respiratory Infection Among Toddlers, Reny Fahdiyani, Ardini S. Raksanagara, Hadyana Sukandar

Kesmas

Infeksi saluran pernapasan akut atas (ISPA atas) di negara berkembang menyebabkan morbiditas tinggi pada anak bawah usia lima tahun (balita). Kementerian Kesehatan Republik Indonesia melaporkan bahwa ISPAnonpneumonia meningkat 2,6% dari tahun 2007 ke 2011. Faktor risiko yang dapat berkontribusi termasuk lingkungan dan perilaku. Penelitian ini bertujuan untuk menyelidiki faktor perilaku dan lingkungan dengan ISPA atas pada balita. Studi kasus kontrol ini dilakukan dari Februari-April 2015 pada balita di Tamansari yang merupakan daerah kumuh di Kota Bandung. Kasus adalah 55 ibu dengan balita menderita ISPA atas yang datang ke puskesmas, sedangkan kontrol dua kali lebih besar dari kasus dipilih dari lingkungan …

Predisposing Factors With Complementary Feeding Practices Among 9-11 Month-Old Infants In Jakarta Urban Slum Area, Septriana Septriana, Gita Ardelia Suhartono

Kesmas

Penyebab utama kekurangan gizi selain dari penyakit infeksi adalah pola asuh yang tidak sesuai dan pemberian makan yang optimal menjadi salah satu cara untuk mengatasi konsekuensi jangka panjang dari kekurangan zat gizi. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor pendukung praktik pemberian makanan pendamping air susu ibu (MPASI) pada bayi usia 9 - 11 bulan di daerah kumuh perkotaan Jakarta. Penelitian potong lintang ini melibatkan 50 orang pengasuh bayi usia 9 – 11 bulan. Data dikumpulkan melalui wawancara menggunakan kuesioner. Tidak terdapat hubungan yang bermakna antara usia pengasuh dengan praktik pemberian makan (nilai p = 0,645). Demikian juga dengan …

Residential Density, Parents’ Sexual Activity And Teenage Sexual Behavior In Yogyakarta, Luluk Rosida, Evi Martha, Besral Besral

Kesmas

Pada daerah kumuh dan padat, orangtua sering terpaksa harus berbagi ruang tidur dengan anak-anaknya sehingga anak-anaknya sudah terpapar dengan aktivitas seksual sejak dini. Penelitian ini bertujuan mengetahui kepadatan hunian, aktivitas seksual orangtua, dan efeknya terhadap perilaku seksual remaja di Yogyakarta. Penelitian ini menggunakan desain potong lintang dengan mewawancarai 268 keluarga yang memiliki anak remaja yang dipilih secara acak di daerah kumuh perkotaan dan daerah pedesaan pada bulan Maret – Mei 2015. Analisis data dilakukan menggunakan uji kai kuadrat dan regresi-cox multivariat. Hasil penelitian ini menunjukkan bahwa orangtua yang tinggal di hunian padat memiliki risiko dua kali lebih besar untuk melakukan …

Effects Of Mothers’ Attitude As Breeders And Distance Of Stockyard Toward Diarrhea Incidence Among Toddlers, Yarmaliza Yarmaliza, Sugito Sugito, Teuku Reza Ferasyi, Nurliana Nurliana, Razali Razali

Kesmas

Diare merupakan penyakit dengan perubahan bentuk dan konsentrasi tinja yang melembek sampai mencair, dan bertambahnya frekuensi buang air besar lebih dari biasanya (tiga kali atau lebih dalam sehari). Di Provinsi Aceh, terdapat kasus diare sebanyak 48/1.000 kelahiran hidup pada 2013. Di Kabupaten Aceh Barat, pada tahun 2014 terdapat 1.071 kasus, sedangkan di Kecamatan Meureubo terdapat sebanyak 70 kasus pada anak bawah lima tahun (balita). Penelitian ini bertujuan untuk mengetahui hubungan sikap ibu sebagai peternak dan jarak kandang ternak terhadap kejadian diare pada balita di wilayah kerja Puskesmas Kecamatan Meureubo. Penelitian ini dilakukan secara potong lintang pada bulan Juli – September …

Re-Framing Informal Family Caregiving, Magdalena T. Ornstein-Sloan

Dissertations, Theses, and Capstone Projects

Informal family caregivers are the backbone of the long-term care system, providing an estimated 80% of the long-term care in the United States. Caregivers provide care to people with disabilities, the ill and older adults, often with little to no outside assistance from the formal long-term care system. Although caregivers receive attention in the academic literature, mainstream media and within public policy and services development, caregiver services continue to remain underutilized. The focus on service provision has various goals, including the desire to lessen the burden caregivers experience by providing services so they can provide care at home longer than …

Factors Associated With Unmet Needs Among African-American Dementia Care Providers, P. J. Desin, Allison M. Caban-Holt, Erin L. Abner, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed …

Chapter 5: Health Resources, Carol L. Watwood

DLPS Faculty Publications

No abstract provided.

Electronic Medical Records (Emr): An Empirical Testing Of Factors Contributing To Healthcare Professionals’ Resistance To Use Emr Systems, Emmanuel Patrick Bazile

CCAC Theses and Dissertations

The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to resistance on the part of physicians, nurses, and clinical administrators. In 2010, only 25% of office-based physicians have basic EMR systems and only 10% have fully functional systems. One of the hindrances believed to be responsible for the slow implementation rates of EMR systems is resistance from healthcare professionals not truly convinced …

Addressing Racial Disparities In Breast Cancer Treatment Delays: An Application Of Group Model Building (Gmb), Faustine Williams, Nancy Zoellner, Maisha Flannel, L. Noel, J. Habif, P. Hovmand, Sarah Gehlert

ETSU Faculty Works

No abstract provided.

Across The States: Do Long Term Services & Supports Policies Affect The Number Of Nursing Home Residents With Low-Care Needs?, Mary Otis

MPA/MPP/MPFM Capstone Projects

Long term care for the elderly has been steadily gaining salience in the public policy realm for many years. The federal government has been vigorously studying and exploring solutions, including the Centers for Medicare and Medicaid Services’ (CMS) efforts to expand access to home and community-based services (HCBS) in order to reduce dependence on institutional care. These federal efforts include various incentive programs and policies recently offered under the Affordable Care Act. However, data on the strength of each state’s long term services and supports system has not been easily accessible until recently. The report “Raising Expectations: A State Scorecard …

Measurement Challenges In Shared Decision Making: Putting The ‘Patient’ In Patient‐Reported Measures, Paul J. Barr, Glyn Elwyn

Dartmouth Scholarship

Measuring clinicians' shared decision-making (SDM) performance is a key requirement given the intensity of policy interest in many developed countries - yet it remains one of the most difficult methodological challenges, which is a concern for many stakeholders. In this Viewpoint Article, we investigate the development of existing patient-reported measures (PRMs) of SDM identified in a recent review. We find that patients were involved in the development of only four of the 13 measures. This lack of patient involvement in PRM development is associated with two major threats to content validity, common to all 13 PRMs of SDM: (i) an …

Influence Of Public Insurance On Healthcare Access And Cancer Care, Wafa W. Tarazi

Theses and Dissertations

Medicaid expansion under the Affordable Care Act (ACA) facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Tennessee’s Medicaid program experienced a dramatic Medicaid contraction when the program disenrolled approximately 170,000 nonelderly adults in 2005. Pre-ACA expansions were associated with better access to and utilization of healthcare services. However, little is known about the effect of these policy changes on improvement in health outcomes for women diagnosed with breast cancer, access to care for cancer survivors, and the effect of generosity and duration of expansion on access to care.

This dissertation has three …

Cancer Health Literacy And Hospitalization In The First Five Years Following A Cancer Diagnosis, Laura A. Cartwright

Theses and Dissertations

BACKGROUND: The field of health literacy research has been focused recently on developing more accurate measurement tools and understanding the relationship between health literacy and health outcomes. Individuals with lower levels of health literacy have worse health outcomes, including hospitalization rates, compared to those with adequate health literacy. This relationship has yet to be examined in the cancer patient population, although significant relationships between health literacy and cancer knowledge, screening behavior and quality of life have been found. This study is the first to examine the relationship between health literacy and hospitalization rates in a cancer patient population, and the …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

Standardized Patient Encounters Periodic Versus Postencounter Evaluation Of Nontechnical Clinical Performance, T. Robert Turner, Mark W. Scerbo, Gayle A. Gliva-Mcconvey, Amelia M. Wallace

Psychology Faculty Publications

Introduction: Standardized patients are a beneficial component of modern healthcare education and training, but few studies have explored cognitive factors potentially impacting clinical skills assessment during standardized patient encounters. This study examined the impact of a periodic (vs. traditional postencounter) evaluation approach and the appearance of critical verbal and nonverbal behaviors throughout a standardized patient encounter on scoring accuracy in a video-based scenario.

Methods: Forty-nine standardized patients scored either periodically or at only 1 point in time (postencounter) a healthcare provider's verbal and nonverbal clinical performance during a videotaped standardized patient encounter. The healthcare provider portrayed in this study was …

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

Health Care Service Disparity: Factors Associated With The Distribution Of Primary Care Physicians, Robert L. Morgan

Senior Honors Projects, 2010-2019

Primary care physicians operate on the front lines of health care. Although primary care physicians play a critical role in improving health outcomes, workforce trends in the United States show a growing shortage of primary care physicians as demand for primary care rises. In conveying the importance of primary care physicians, the worsening physician shortage, the inequitable distribution of providers, and the lackluster institutional response thus far, this paper calls into question the effectiveness of current indicators used to identify underserved areas and provide appropriate government assistance. Through the use of data from the 2010 census and American Medical Association …

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Feasibility Of A Peer Support Oriented Dialectical Behavior Therapy Skills Training Massive Open Online Course For Emotion Dysregulation, Rachel Gill

Senior Theses

Public interest in mental health care modernization has steadily gained momentum since ratifying The United States Health Care Affordability Act (U.S. Office of the Legislative Counsel, 2010). Furthermore, with 1 in every 1000 people seeking online support for mental health issues (DeAndrea & Anthony, 2013), research concerning the development of virtual mental health applications is critical to ensure science guides their innovation. To this end, this study explores the feasibility of a mental health intervention that unites the experiential, recovery-oriented, and self-determined values of mental health peer support (Kaufman et al., 2014) with dialectical behavior therapy skills training (DBT-ST) (Linehan, …

A Community-Based Participatory Approach To Understanding Health Beliefs, Policies, Barriers, And Solutions Related To The Health Disparities Of Marshallese Cofa Migrants In Arkansas., Pearl Anna Mcelfish

Graduate Theses and Dissertations

Public policies have different effects on different populations groups and can perpetuate health disparities among some populations. My research utilizes community-based participatory approach to research in the examination of one unique population: the Marshallese. This dissertation research presents three papers that are part of a cohesive research agenda predicated on community-based participatory research (CBPR) to facilitate policy-oriented learning. My research can be used to inform health policy, health care services, and health education. Chapter Two presents the article titled: Health Beliefs of US Marshallese Regarding Type 2 Diabetes.

This article explores the research question: what health beliefs related to diabetes …

Disability Prevention Programs For Older People: Factors Associated With Medical And Nursing Care Costs, Takaaki Ikeda, Susumu Yanagawa, Kenichi Murakami, Toshiyuki Inoue, Takamasa Tsurumi

Kesmas

Penelitian ini bertujuan untuk mengklarifikasi faktor-faktor yang terkait dengan biaya medis dan perawatan lanjut usia (lansia) yang tinggal di panti sosial serta menyarankan program pencegahan disabilitas yang efektif. Total partisipan dalam penelitian ini adalah 83 orang (29 laki-laki dan 54 perempuan; usia rata-rata 81,2 ± 6,3 tahun) pada 1 November – 28 Desember 2014. Penelitian ini membandingkan biaya medis dan perawatan rata-rata per bulan dengan rata-rata nasional bagi yang berusia ≥ 65 tahun. Uji regresi logistik dilakukan untuk memeriksa keterkaitannya dengan biaya medis dan perawatan. Mereka yang pergi ke luar rumah ≥ 3 kali seminggu tiga kali lebih kecil kemungkinannya …