Health Services Research Commons^™

Why Do They Do That?: Looking Beyond Typical Reasons For Non-Urgent Ed Use Among Medicaid Patients, Cynthia J. Sieck, Jennifer L. Hefner, Randy Wexler, Chris A. Taylor, Ann S. Mcalearney

Patient Experience Journal

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences …

Uninsured Free Clinic Patients’ Experiences And Perceptions Of Healthcare Services, Community Resources, And The Patient Protection And Affordable Care Act, Akiko Kamimura, Jeanie Ashby, Ha Trinh, Liana Prudencio, Anthony Mills, Jennifer Tabler, Maziar Nourian, Fattima Ahmed, Justine Reel

Patient Experience Journal

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. There has been a paucity of free clinic research with the few studies employing a quantitative design. The purpose of this study is to conduct an in-depth qualitative exploration of free clinic patients’ experience and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act (ACA). Free clinic adult patients (n=35) participated in four focus groups between June and July 2014 (one Spanish group in June, and two English groups and one Spanish group in July) …

Why Human Resources Policies And Practices Are Critical To Improving The Patient Experience, Shari Berman

Patient Experience Journal

While providing patient-centered care seems to be a goal for many organizations, delivering on this goal requires practices which are embedded in the organization, which incent patient-centered behavior. The author argues Human Resources (HR) policies, procedures and programs are key to supporting an organizations’ vision and culture. This means an HR executive partnering with the CEO who sets the vision and HR builds programs to support the vision. As the organization understands what is important to patients and how to best serve them, HR can build patient care improvement into every aspect of the organization. The author describes how competency …

‘First, Do No Harm’: Shifting The Paradigm Towards A Culture Of Health, Karen Luxford

Patient Experience Journal

Over the past 17 years since the release of the Institute of Medicine report ‘To Err is Human’,¹ health services and agencies around the world have increasingly focused on improving the safety and quality of health care. Historically, the commitment by health care professionals to ‘first do no harm’ has produced a focus on the absence of interventions that may cause adverse outcomes. This clinical approach links to the Hippocratic Oath which includes the promise "to abstain from doing harm". The Oath reminds clinicians to first consider the possible harm that any intervention might do. This approach to interactions …

The Experience Era Is Upon Us, Jason A. Wolf Phd

Patient Experience Journal

In this moment in healthcare, the challenges for those in the system are dynamically shifting and the perspectives, desires and needs of the healthcare consumer are putting positive and lasting pressures on how healthcare works that will shift healthcare from where it has been to where it must go. At the heart of this transition are the ideas framing an experience era, where collaborative, consumer-focused and purposeful actions can and will lead to a healthcare system returning to its fundamental calling, that of human beings caring for human beings. In doing so we can change the nature of healthcare and …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika C. Ziller Phd, Zachariah T. Croll Ba, Andrew F. Coburn Phd

Access / Insurance

Created by the Affordable Care Act (ACA), Consumer Operated and Oriented Plans (CO-OPs) are private, non-profit health insurers that were designed to increase insurance plan choice and lower premiums in the Health Insurance Marketplaces. Early analyses of the ACA suggested that CO-OPs may be particularly beneficial for rural communities, where fewer individual and small group health insurance options have traditionally been available.

This Research and Policy Brief, authored by research staff at the Maine Rural Health Research Center, explores the early availability and role of CO-OPs in rural and urban counties. We describe the regional distribution and market prevalence of …

School Policy, Food And Physical Activity Environment, And Childhood Obesity, Ruicui Liu

Health Services Research Dissertations

The purpose of this study is to examine the effect of school food and physical activity environments on energy balance-related behaviors and Body Mass Index (BMI) and to simulate the effect of school-based nutrition and physical activity policies on childhood obesity prevention. Four models based on the Social Ecological Framework of childhood obesity were developed. Parameters of these models were calibrated and validated with empirical data derived from the Early Childhood Longitudinal Study – Kindergarten Class of 1998-99 and the 2003-2004 National Health and Nutrition Examination Study. The correlation between observed and simulated BMI was 0.85 for 5th grade children …

The Effects Of Job Characteristics On Home Care Workers’ Well-Being And Job Performance: Understanding The Psychosocial Effects Of Relational Care, Emily C. Franzosa

Dissertations, Theses, and Capstone Projects

Home care workers are the lowest-paid and most precarious segment of the health care industry. Although these workers provide critical, non-medical support that allows elderly and disabled individuals to remain in their homes, the workforce is highly unstable, due to low wages, a lack of supportive benefits like health coverage, paid leave and retirement support, poor working conditions and a physically and emotionally demanding workload. But a lack of consensus around the nature and value of home care has made “quality”, in terms of both jobs and care provision, difficult to define, measure or improve. While home care is a …

Pharmacy Use By Dual-Eligible Non-Elderly Veterans With Private Healthcare Insurance, Brian C. Lund, Mary E. Charlton, Alan N. West

Dartmouth Scholarship

The Veterans Health Administration (VHA) is the largest nationally integrated healthcare system in the United States, operating 168 medical centers and more than 1000 community based outpatient clinics. However, many veterans seek care outside the VHA system, particularly when they are also covered by state or federal programs such as Medicare or Medicaid, or have access to private health insurance, often through employment. Concerted efforts have been made to facilitate communication and coordinate care between VHA and private sector healthcare, but concurrent use of these systems adds to an already fragmented U.S health care system.

An Examination Of African Americans' Utilization Of Health Care, Brittany Powell

Dissertations

The study examined the relationship between perceptions of discrimination, social support, quality of health care received, and utilization of health care services among African Americans. Data was analyzed from 99 African American respondents that completed either an online or paper questionnaire. The responses demonstrated significant relationships existed between discrimination and quality of health care as well as social support and utilization of health care. Results concluded that the more discrimination one perceives, the lower quality of health care they are to expect, and therefore they are less likely to utilize services. However, the data also reflected that even in the …

Variation Of Driving Skill Among Elderly Drivers Compared To Young Drivers In Japan, Indri Hapsari Susilowati, Akira Yasukouchi

Kesmas

Penelitian ini menganalisis kemampuan mengemudi pada pengemudi lanjut usia (lansia) dibandingkan dengan usia muda di Jepang dan melihat keterampilan mengemudi yang kurang sehingga dapat memengaruhi risiko kecelakaan di jalan raya. Subjek penelitian adalah pengemudi usia muda dan lansia, terdiri dari 10 mahasiswa (20 - 24 tahun) dan 25 pengemudi lansia (14 laki-laki dan 11 perempuan) berasal dari The Silver Menpower Center, organisasi bagi lansia > 60 tahun. Pengemudi lansia dibagi menjadi dua kelompok, yaitu lansia 1 berusia 60 - 65 tahun (10 orang) dan lansia 2 berusia > 65 tahun (15 orang). Kemampuan mengemudi dievaluasi dengan simulator permainan mengemudi dalam laboratorium. Analisis …

Rural-Based Health Promotion Model For Pregnant Women In Banyumas District, Elviera Gamelia, Dian Anandari, Dyah Umiyarni Purnamasari

Kesmas

Penelitian sebelumnya menunjukkan bahwa pengetahuan pelayanan prenatal di wilayah pedesaan masih rendah yang berdampak pada perilaku buruk sehingga mengembangkan model promosi kesehatan dibutuhkan untuk meningkatkan pengetahuan prenatal, sikap dan perilaku. Penelitian ini bertujuan untuk mengembangkan model promosi kesehatan pelayanan prenatal di wilayah pedesaan berdasarkan penilaian kebutuhan. Penelitian dilakukan pada Juni 2015 dengan pendekatan kualitatif melibatkan 16 ibu hamil pertama di trimester ketiga dengan kehamilan berisiko sebagai informan kunci dan 16 anggota keluarga yang tinggal bersama ibu hamil dan mengetahui kehidupan sehari-harinya, 27 bidan dan 3 tokoh agama sebagai informan tambahan. Teknik pengumpulan data adalah wawancara mendalam dan observasi untuk ibu …

Role Of Hearth Program With Undernutrition Incidence Among Toddlers In Tangerang City, Gizella Gizella, Dany Hilmanto, Dedi Rachmadi

Kesmas

Kelompok yang rentan terhadap gizi kurang adalah balita. World Health Organization (WHO) menyatakan kematian anak bawah lima tahun (balita) akibat gizi kurang sebesar 54% pada tahun 2002. Di Indonesia, prevalensinya mengalami peningkatan dari 17,9% pada tahun 2010 menjadi 19,6% pada tahun 2013. Di Kota Tangerang, terdapat 1,43% balita yang mengalami gizi buruk pada tahun 2013. Penelitian ini bertujuan untuk membuktikan secara valid hubungan antara Program Pos Gizi yang meliputi perilaku pemberian makan, perilaku kebersihan balita, perilaku mencari pelayanan kesehatan dan perilaku pengasuhan balita dengan kejadian gizi kurang pada balita. Penelitian ini merupakan penelitian kuantitatif, potong lintang, menggunakan data primer serta …

Good Corporate Governance Implementation And Performance Of Civil Servant, Muhammad Hasan, Dumilah Ayuningtyas, Misnaniarti Misnaniarti

Kesmas

Dalam rangka mencapai visi dan misi, setiap rumah sakit harus menjalankan tata kelola perusahaan yang baik (Good Corporate Governance/GCG). Penerapan GCG sendiri bertujuan untuk meningkatkan kinerja pegawai secara optimal, yang akhirnya akan meningkatkan kinerja organisasi. Penelitian ini bertujuan untuk menganalisis hubungan penerapan prinsip-prinsip GCG terhadap kinerja pegawai negeri sipil (PNS) Rumah Sakit Umum Lapangan Natuna Kabupaten Kepulauan Anambas. Jenis penelitian ini adalah deskriptif analitik dengan desain potong lintang pada 56 PNS. Pengumpulan data dilakukan pada tahun 2012 dengan kuesioner terstruktur. Digunakan analisis dengan uji kai kuadrat dan regresi logistik, dan untuk penyederhanaan model dilakukan eliminasi terhadap faktor perancu dengan menggunakan …

Well Water Consumed And Urolithiasis In Gedangsari Subdistrict, Yogyakarta, Sulistyawati Sulistyawati, Fardhiasih Dwi Astuti, Ruri Trisasri, Asep Rustiawan

Kesmas

Tanah di wilayah Kecamatan Gedangsari mengandung batuan kapur. Masyarakat di daerah ini banyak yang mengkonsumsi air minum dari sumur gali yang mengandung kadar kalsium tinggi, dan banyak yang menderita urolithiasis. Penelitian ini bertujuan untuk mendapatkan gambaran distribusi kalsium atau Ca(OH)2 pada air sumur dan menjelaskan hubungannya dengan kejadian urolithiasis. Penelitian dilakukan di Kecamatan Gedangsari, Kabupaten Gunungkidul selama Juli sampai November 2013. Penelitian dilakukan secara potong lintang dengan konfirmasi uji titrasi di laboratorium. Sejumlah 94 sampel sumur dipilih secara acak dari populasi 3.849 sumur. Kriteria pemilihan sampel adalah sumur gali yang telah digunakan untuk minum oleh penduduk berusia lebih dari 30 …

Identification Of Pathogenic Leptospira In Rat And Shrew Populations Using Rpob Gene And Its Spatial Distribution In Boyolali District, Dyah Widiastuti, Zumrotus Sholichah, Agustiningsih Agustiningsih, Nastiti Wijayanti

Kesmas

Leptospirosis merupakan masalah kesehatan di Indonesia. Hingga April 2014, dilaporkan kasus leptospirosis yang ditularkan oleh tikus di Kabupaten Boyolali dengan angka kematian 83,3%. Genus Leptospira terdiri dari ratusan serovar dan tipe genetik yang hidup di pelbagai jenis habitat. Pengelompokan spesies Leptospira berdasarkan gen rpoB dapat digunakan karena tingkat polimorfisme gen tersebut tinggi. Penelitian ini bertujuan untuk mengidentifikasi serovar bakteri Leptospira pada populasi tikus di Kabupaten Boyolali menggunakan analisis hubungan kekerabatan didasarkan pada polimorfisme gen rpoB dan menggambarkan distribusi spasial tikus positif Leptospira di Kabupaten Boyolali. Penelitian potong lintang dilaksanakan pada bulan April 2014 di Desa Sindon Kecamatan Ngemplak dan Desa …

Environmental, Behavioral Factors And Filariasis Incidence In Bintan District, Riau Islands Province, Zainul Ikhwan, Lucky Herawati, Suharti Suharti

Kesmas

Tingkat mikrofilaria filariasis di Kabupaten Bintan masih tinggi, khususnya di Kecamatan Teluk Bintan, Teluk Sebong, dan Sri Kuala Lobam. Penelitian ini bertujuan untuk mengetahui hubungan faktor risiko lingkungan (faktor fisik, biologi, kimia, sosial budaya, ekonomi) dan faktor perilaku dengan kejadian filariasis. Jenis penelitian observasional analitik yang dilakukan pada Mei – September 2015 dengan desain kasus kontrol, yang terdiri dari jumlah kasus 33 orang penderita filariasis dan kontrol 65 orang bukan penderita filariasis dengan teknik cluster sampling. Populasi penelitian adalah masyarakat di Kabupaten Bintan. Data yang diperoleh dianalisis menggunakan uji kai kuadrat dan regresi logistik. Hasil menunjukkan adanya hubungan pengetahuan (nilai …

Measles Immunization And Vitamin A For Prevention Of Pneumonia In Indonesia, Ratno Widoyo

Kesmas

Pneumonia merupakan penyebab kematian tertinggi pada anak di Indonesia setelah diare. Pengendalian pneumonia dapat dilakukan dengan peningkatan cakupan imunisasi campak, pertusis, Streptococcus pneumoniae (Spn), dan Haemophilus influenzae b (Hib). Vaksin Spn dan Hib belum masuk ke dalam kategori imunisasi wajib di Indonesia. Vaksin campak lebih memiliki pengaruh langsung terhadap pneumonia dibandingkan dengan vaksin pertusis. Pemberian imunisasi yang disertai pemberian vitamin A akan meningkatkan titer antibodi pada anak. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian imunisasi campak dan vitamin A terhadap kejadian pneumonia. Metode penelitian adalah potong lintang dengan menggunakan 13.062 data anak yang terdapat pada data Survei Demografi dan Kesehatan …

Living With Traumatic Brain Injury In A Rural Setting: Supports And Barriers Across The Continuum Of Care, Anne L. Harrison, Elizabeth G. Hunter, Heather Thomas, Paige Bordy, Erin Stokes, Patrick H. Kitzman

Physical Therapy Faculty Publications

Purpose: Traumatic brain injury (TBI) is prevalent in Kentucky and comes with a high cost in care and quality of life for individuals and caregivers affected. Many people living with the condition of TBI have unmet needs. Research among people living with TBI in rural areas is limited. The purposes of this study were to (1) increase understanding of the lived experience of people with TBI and caregivers in rural regions of Kentucky across the continuum of their care and (2) provide their perspectives on barriers and facilitators of optimal function and well-being.

Methods: A qualitative descriptive interview study was …

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …

Geographical Location And Stage Of Breast Cancer Diagnosis: A Systematic Review Of The Literature, Faustine Williams, Aimee S. James, Stephen Jeanetta

ETSU Faculty Works

Objective: To examine systematically the literature on the effect of geographical location variation on breast cancer stage at diagnosis, race/ethnicity, and socioeconomic status.

Methods. Eight electronic databases were searched using combination of key words. Of the 312 articles retrieved from the search, 36 studies from 12 countries were considered eligible for inclusion.

Results. This review identified 17 (47%) of 36 studies in which breast cancer patients residing in geographically remote/rural areas had more late-stage diagnosis than urban women. Ten (28%) studies reported higher proportions of women diagnosed with breast cancer resided in urban than rural counties. Nine …

Study On Public Health Financing In Pidie Jaya District In 2013, Hanifah Hasnur, Purnawan Junadi

Journal of Indonesian Health Policy and Administration

Albeit high dependency on central government transfer (around 69% of total health expenditure), funding from local PAD has been increasing. The revenue shall support priority health programs. This study aims to analyze local health financing system and as input for health program planning. Health financing portrait how fund being spent, and identfying who the agents are as well as the beneficiaries. The study shows spending on health from local budget is Rp130,000. Expenditures on operational costs for direct activities and community-based health efforts or Upaya Kesehatan Masyarakat (UKM) are still low (41%). Puskesmas needs to do more health-related activities for …

The Effectiveness Of The Posyandu And Its Relation To Leadership And Management, Husnah Maryati, Vetty Yulianty Permanasari

Journal of Indonesian Health Policy and Administration

Data on infant mortality in the city of Bogor has increased from 26 to be 62 cases in 2013. Posyandu is one of the facility in a society that runs the health program where one goal is carrying out activities to accelerate the decline in the death rate of mothers and babies. The problems at posyandu in Bogor is the number of active cadres continue to decline while cadre recruitment insufficient, and less active of the function of The National Working team of posyandu. The report of newborn deaths by 2013 and 2014 stated that more than half (55 and …

Policy Implementation Of Health Coverage For Indonesian Migrant Workers, Risky Kusuma Hartono, Budi Hidayat, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The purpose of this research is to analyze the policy implementation of health coverage for TKI. This research uses a qualitative method with in-depth interview. The framework of this research consists of the aspect of the advisable policy, the implementation factors, and the schematic representation of the problem by using SWOT. The result of this research is the health insurance owned by TKI comes from TKI insurance, the membership of JKN, and insurance during their employment abroad. TKI insurance policy is the instruction of Law No. 39 of 2004 which regulates the obligation of the ownership of the social security …

An Analysis Of The Implementation Of The Policy To Integrate Of National Defense Components In Managing Non-Military Threats In The Health Sector, Sugeng Winarno, Prastuti Soewondo

Journal of Indonesian Health Policy and Administration

This research was based on the Minister of Defense’s Decree No. 16/2012 that stated that all national defense components to integrate into one unit when they encounter military and non-military threats. The Ministry of Health, as the main player, and other governmental and private agencies would also play a role in overcoming complex and multidimensional non-military threats, especially in the health sector. Among those threats are infectious diseases such as HIV/AIDS and Ebola. We aim to discover the implementation process of the law above in the management of those two diseases. This was a qualitative analytical research with in-depth interviews. …

An Analysis Of The Usage Patterns Of Health Services Funded Through Capitation And Noncapitation In Government Owned Primary Healthcare Facilities In The District Of Pandeglang, Arovian Yuliardi, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

The National Health Insurance (JKN) is basically a form of managed care, a technique that integrates health costing and service quality through cost control and quality control. In that concept, the Puskesmas acts as the government’s primary healthcare facility, its vanguard. The aim of this research is to discover and analyze the healthcare usage patterns funded by capitation and non-capitation in government primary healthcare facilities (FKTP). This was an analytical study utilizing a cross-sectional design. 615 patients visiting the government’s FKTP were involved in this research. The results indicated that 47.3% of patients utilizing the government’s FKTP at Pandeglang district …

An Analysis Of The National Health Insurance Policy Implementation In 2014 (Presidential Regulation No. 12 And 111/2013 On Health Insurance) From The Regulator’S Position, Muhammad Arief Rosyid Hasan, Puput Oktamianti, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

JKN (National Health Insurance) is a government program that aims to provide health assurance for all Indonesian citizens for a healthy, productive, and prosperous life. In the two years after JKN was implemented, various problems occurred. This research used the qualitative approach with the Edward II implementation theory. Results of the research indicated that there were problems in communication, stemming from the lack of socialization and inharmonic regulations, there was also the problem of the lack of healthcare resources. From the disposition side, the policy makers often obstructs the implementation preparation, this is evident from the information on determining the …

A Tool To Cost Environmental Health Services In North Carolina Local Health Departments, Nancy L. Winterbauer, Simone Singh, Ashley Tucker, Lisa M. Harrison

Frontiers in Public Health Services and Systems Research

Introduction: The cost of providing a basic set of public health services necessary not been well-described. Recent work suggests public health practitioners are unlikely to have the empirically-based financing information necessary to make informed decisions regarding practice. The purpose of this paper is to describe the development of a costing tool used to collect primary data on the number of services provided, staff employed, and costs incurred for two types of mandated environmental health services: food and lodging inspections and onsite water services.

Methods: The tool was iteratively reviewed, revised, and piloted with local health department (LHD) environmental health and …

Using The Theory Of Fundamental Causes To Show The Potential Effects Of Socioeconomic Status On Surgical Outcomes, Mehwish Qasim, A.B.D.

Journal of Health Disparities Research and Practice

Surgical procedures are both costly and common. There are large differences in surgical outcomes both within and between hospitals based on patient characteristics such as measures of income. In both 2000 and 2009, patients residing in low-income communities had worse morbidity and mortality rates, across a wide range of quality indicators. In this review, the author will explicate the Theory of Fundamental Causes as it relates to surgical care, review key empirical findings and address potential limitations of the theory. This review will provide a platform for researchers to discuss current research in surgical disparities using the Theory of Fundamental …