Health Services Research Commons^™

Perilaku Seksual Berisiko Pengguna Narkotika, Rico Januar Sitorus, Merry Natalia

Kesmas

Penyalahgunaan narkotika yang melakukan hubungan seksual sebelum menikah, dan berganti-ganti mitra seksual merupakan perilaku berisiko. Masalah yang diakibatkan penyalahgunaan narkotika sangat kompleks, seperti masalah sosial dan kesehatan. Kecenderungan pengguna narkotika melakukan perilaku seksual dini dan tidak aman semakin memperparah kondisi kualitas hidup pecandu dan tentunya berdampak besar pada kelangsungan hidup di masa depan. Tujuan penelitian ini adalah mengetahui determinan perilaku seksual berisiko di kalangan pengguna narkotika. Metode penelitian adalah potong lintang menggunakan data sekunder kajian rekam medis di instalasi Medical Psikiatric Evaluation di rumah sakit ketergantungan obat (RSKO) Jakarta tahun 2013. Populasi penelitian adalah pasien ketergantungan narkotika yang dirawat inap …

Ketidaktepatan Sasaran Jamkesmas Berdasarkan Kriteria Miskin Pendataan Program Perlindungan Sosial, Umi Luthfiah, Ery Setiawan, Sindu Setia Lucia

Kesmas

Peserta Jaminan Kesehatan Masyarakat (Jamkesmas) hingga tahun 2010 mencapai 76,4 juta jiwa mencakup masyarakat miskin dan tidak mampu, sedangkan peserta Jaminan Kesehatan Daerah (Jamkesda) mencapai 31,6 juta jiwa. Secara prinsip, program Jamkesda dibentuk untuk memfasilitasi masyarakat miskin dan kurang mampu di luar kuota Jamkesmas yang dibiayai oleh pemerintah daerah. Penelitian ini bertujuan untuk meninjau ketepatan sasaran peserta program Jamkesmas berdasarkan kriteria miskin Pendataan Program Perlindungan Sosial (PPLS). Sumber data yang digunakan adalah data Survei Sosial Ekonomi Nasional (Susenas) tahun 2012. Populasi dari penelitian ini adalah seluruh rumah tangga di Indonesia tahun 2012. Sampel penelitian adalah rumah tangga terpilih dari masing-masing …

Studi Intervensi Klaster Kawasan Tanpa Rokok Pada Tingkat Rumah Tangga, Najmah Najmah, Fenny Etrawati, Yeni Yeni, Feranita Utama

Kesmas

Perilaku merokok memberikan dampak negatif, baik bagi perokok aktif maupun pasif, ditinjau dari sudut pandang kesehatan maupun ekonomi. Regulasi mengenai Kawasan Tanpa Rokok (KTR) yang telah diterbitkan belum ada yang mengatur mengenai penerapan KTR di tingkat rumah tangga. Penelitian ini bertujuan untuk mengidentifikasi perubahan perilaku melalui intervensi terpadu KTR pada tingkat rumah tangga. Penelitian dilakukan pada bulan Juli - September 2014 menggunakan desain cluster trial pada empat desa di Kabupaten Ogan Ilir, Sumatera Selatan. Selanjutnya, 200 sampel kepala keluarga dipilih melalui metode cluster random sampling. Intervensi yang dilakukan meliputi konseling terpadu, pemberian permen pengganti rokok, dan tabungan sehat. Hasil penelitian …

Efektivitas Collaborative Governance Dalam Pelayanan Komprehensif Berkesinambungan Untuk Menanggulangi Hiv/Aids, Argyo Demartoto

Kesmas

Di tingkat nasional dan daerah telah terdapat kebijakan publik, program dan kegiatan untuk menanggulangi HIV/AIDS, namun jumlah kasus HIV/AIDS meningkat setiap tahun. Tujuan penelitian ini untuk mengetahui efektivitas collaborative governance antarpemangku kepentingan dalam pelayanan komprehensif berkesinambungan untuk menanggulangi HIV/AIDS di Kota Surakarta. Penelitian ini merupakan studi kasus jenis exploratory. Informan ditentukan dengan menggunakan purposive sampling. Pengumpulan data dilakukan pada 2 Juli – 2 September 2013 dengan wawancara mendalam, observasi, focus group discussion, dan dokumentasi. Teknik analisis data dengan model analisis interaktif. Hasil penelitian menunjukkan bahwa pemberi dan penerima layanan berperan dalam penanggulangan HIV/AIDS sesuai tugas dan fungsinya masing-masing. Program pencegahan …

A Cost Analysis Of The 1-2-3 Pap Intervention, Kristina M. Rabarison, Rui Li, Connie L. Bish, Robin C. Vanderpool, Richard A. Crosby, Mehran S. Massoudi

Frontiers in Public Health Services and Systems Research

Background: Cervical cancer places a substantial economic burden on our healthcare system. The three-dose human papillomavirus (HPV) vaccine series is a cost-effective intervention to prevent HPV infection and resultant cervical cancer. Despite its efficacy, completion rates are low in young women aged 18 through 26 years. 1-2-3 Pap is a video intervention tested and proven to increase HPV vaccination completion rates.

Purpose: To provide the full scope of available evidence for 1-2-3 Pap, this study adds economic evidence to the intervention’s efficacy. This study tested the economies of scale hypothesis that the cost of 1-2-3 Pap intervention per number of …

Preliminary Evaluation Of The Disease Surveillance System During Influenza Outbreaks Of Pandemic Scale, Eric Meisheri, Diana M. Prieto, Peter Holvenstot, Richard Vanenk

Frontiers in Public Health Services and Systems Research

In the United States it is currently unknown whether the influenza surveillance system is capable of producing timely and accurate data for case estimation during an outbreak of pandemic scale. This simulation provides a preliminary evaluation of the surveillance system’s ability to collect data and produce timely and accurate trends of cases confirmed with an influenza virus. For the evaluation, a computer-based simulation of the data-collection process was used, which was validated with real demographic and epidemiologic information. The results were analyzed to determine the most significant behavioral and operational factors influencing the data collection and to propose the exploration …

Treatment Plan Adherence To Guidelines In Senior Adult Oncology Patients, Amy R. Mackenzie, Md, Andrea M. Barsevick, Phd, Ronald Myers, Phd, Ludmila De Oliveira Koch, Md, Scott W. Keith, Phd, Thomas Wolf, Ma, James Cocroft, Ma, Joshua Schoppe, Mph, Ulysses Williams Iii, Andrew Chapman, Do

Department of Medical Oncology Faculty Papers

Materials & Methods:

• Review of 287 records
• Patients ≥ 65 years old with new diagnosis of cancer
• Seen by 6, dual-boarded hematologists/ oncologists practicing in an urban academic cancer center
• Treatment plans compared to national guidelines to determine plan adherence status
• Patients were recommended:

Adherent plan (AP) or Non-adherent plan (N-AP)

The Star Rating System And Medicare Advantage Plans, Lisa Sprague

National Health Policy Forum

With nearly 30 percent of Medicare beneficiaries opting to enroll in Medicare Advantage (MA) plans instead of fee-for-service Medicare, it’s safe to say the MA program is quite popular. The Centers for Medicare & Medicaid Services (CMS) administers a Star Ratings program for MA plans, which offers measures of quality and service among the plans that are used not only to help beneficiaries choose plans but also to award additional payments to plans that meet high standards. These additional payments, in turn, are used by plans to provide additional benefits to beneficiaries or to reduce cost sharing—added features that are …

Improving Rhode Island’S Health Care System: Lessons From The Cuban Model, Sarah R. Moffitt

Senior Honors Projects

Improving Rhode Island’s health care system: lessons from the Cuban model

Cuba is world renowned for its health care system. In regards to international health crises, Cuba is a leader in sending workers abroad and training doctors from all over the world. Within its own borders, the Cuban model provides free access to all citizens in which every individual has a primary care provider. Cuba boasts high vaccination rates, a long life expectancy, low infant mortality rate, and a population that is one of the healthiest in the western hemisphere.

The purpose of this research project is to evaluate the …

First Steps Phase Iii Initiative: Improving Oral Health And Healthy Weight In Children Final Evaluation Report, Carolyn E. Gray Mph, Kimberley S. Fox Mpa

Population Health & Health Policy

This report summarizes evaluation findings from Phase III and assesses change in oral health and healthy weight screening rates, referrals and related office system procedures in participating practices. The report also highlights challenges encountered and lessons learned in implementing changes to office systems, in responding to state policy changes, and in collecting and tracking oral health and healthy weight measures at the practice-level to inform quality improvement.

Chhs May 2015 E-Newsletter,, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

C-Train - The Care Transitions Innovation - Analysis Of Program Impacts, Bill J. Wright, Keri B Vartanian, Megan Holtorf, Nicole Olson, Leif Rustvold, Honora Englander (C-Train Program Contact)

Articles, Abstracts, and Reports

No abstract provided.

Effects Of Dehydration On Changes In Arterial Stiffness With Passive Heating, Az Satterfield

Health, Human Performance and Recreation Undergraduate Honors Theses

Context: There is an inverse relationship between baseline arterial stiffness and the change in arterial stiffness with passive heating. However, it is unknown whether this relationship is affected by dehydration. Objective: To investigate the effect of acute dehydration on arterial stiffness during passive heat stress. Design: Two randomized counter-balanced trials. Setting: Laboratory. Patients or Other Participants: Eleven healthy males (age=24.5 ± 2.8 years, body mass=76.6 ± 9.1 kg, body fat=16.8 ± 6.4%). Interventions: In one trial subjects were dehydrated (DE) and in another euhydration (EU) was maintained during passive heating to a 1.5°C increase in body temperature. Subjects were euhydrated …

Bridging The Location Gap: Physician Perspectives Of Physician-Pharmacist Collaboration In Patient Care (Bridge Phase Ii), Keri D. Hager, Donald Uden, Daniel M. Tomaszewski

Pharmacy Faculty Articles and Research

Background: To optimize patient outcomes, the patient-centred medical home model emphasizes comprehensive team-based care. Pharmacists are qualified to enhance appropriate medication use and help improve patient outcomes through provision of medication therapy management (MTM) services. To optimally provide MTM, pharmacists must effectively collaborate with physicians. This study explored factors that influence pharmacist-physician collaboration.

Methods and Findings: A convenience sample of five physicians participated in semi-structured interviews and the resulting data were analyzed using qualitative methods. Transcripts of the interviews were independently coded for themes by two researchers. Five themes emerged: trustworthiness, role specification, relationship initiation, effects on practice, …

Policy Considerations For Community Health Workers In An Era Of Health Reform, Sara Kahn-Troster

Muskie School Capstones and Dissertations

In order to better understand how CHWs are being integrated in state health reform initiatives, including facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health, the author, working in collaboration with the National Academy for State Health Policy (NASHP), developed a nation-wide scan of CHW policy activity, published online as State Community Health Worker Models in February, 2015. The CHW chart gives a comprehensive look at how states are utilizing CHWs as part of quality improvement, health care reform, and expanded models of public health.

Evidence Informed Checklist Increase Patient Experience Of Quietness During A Hospital Stay, Monica Alborg

Muskie School Capstones and Dissertations

This checklist is made to be used by staff at hospitals, especially nurse managers and quality improvement specialists. A staff member can pick and choose what items on the checklist are feasible to implement within their organization. Ongoing quality improvement strategies are suggested in the checklist to remain abreast of ways to mitigate noise in hospitals.

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …

Texas Physicians' Awareness And Utilization Of Genetic Services, Callie L. Jenevein

Dissertations and Theses (Open Access)

The number of disorders for which genetic testing is available has increased nearly 500% in the past 15 years. Access to the majority of genetic tests and services hinges on physicians’ ability to identify patients at risk for genetic disease and provide appropriate testing and counseling or refer to genetic specialists. Recent research demonstrates the need for referrals to genetic specialists by showing that many physicians lack skills required to perform appropriate genetic services, such as making proper risk assessments, providing genetic counseling, ordering genetic testing and interpreting results. However, little research exists on physicians’ awareness and utilization of genetic …

Puerto Rican Mother-Child Communication About Sexuality And Sexual Health: Results From An Ethnographic Community Survey In Springfield, Ma, María Idalí Torres, Phillip Granberry, Sarah Rustan

Gastón Institute Publications

This bilingual report presents data from an ethnographic survey on the experiences of Spanish-speaking Puerto Rican mothers communicating with children ages 10 to 19 regarding sexuality and sexual health. Results of this survey will be used as baseline data to evaluate a media campaign promoting Puerto Rican mother-child communication. This Spanish media campaign was implemented from March to May, 2015 using public service announcements in television, radio, and newspapers and on public transportation.

In this report, we use three main concepts with specific definitions: mother, sexuality, and sexual health protection, defined as follows. Mother is defined as the female adult …

Impact Of The Heart Watch Program On Patients At Risk Of Developing Metabolic Syndrome, Prediabetes Or Cardiovascular Disease, Jennifer T. Fink, Kathryn K. Havens, Julia A. Schumacher, Renee E. Walker, George L. Morris Iii, David A. Nelson, Maharaj Singh, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose

Metabolic syndrome is a set of metabolic risk factors associated with increased risk of developing cardiovascular disease and type 2 diabetes mellitus. We retrospectively evaluated the effectiveness of a lifestyle modification program (Heart WATCH) geared toward reducing development of chronic disease in women deemed at risk for metabolic syndrome, prediabetes and/or cardiovascular disease.

Methods

Our institution’s Heart WATCH program consists of screening sessions with a multidisciplinary team (physician/nurse, nutritionist and psychologist), a minimum of three visits with a nurse practitioner and weekly follow-up phone calls for a 14-week period. Sociodemographic variables were obtained at initial visit. Biometric testing indices …

Book Review: Being Mortal: Illness, Medicine And What Matters In The End, Sue Sutton

Patient Experience Journal

In her review of Being Mortal: Illness, Medicine and What Matters in the End written by Atul Gawande, MD, Sue Sutton shares both the insights of Dr. Gawande and their important perspectives for person-centered experience. She reinforces that in this day of increased focus on understanding patient’s expectations and patient-focused care, Dr. Gawande compels us to learn how to have the difficult conversations about what really matters. She closes the review with a compelling quote from the author, "I never expected that among the most meaningful experiences I’d have as a doctor— and, really, as a human being— would come …

Creating And Integrating A New Patient Experience Leadership Role: A Consultative Approach For Partnering With Executive And Clinical Leaders, Denise M. Kennedy

Patient Experience Journal

Many healthcare organizations are creating new leadership roles to add subject matter expertise and structure to their patient experience improvement efforts. The patient experience field is emerging, however, so there are many questions about this role’s function and how best to structure it in the organization for maximal effectiveness.

This article explores the benefits of a consultative approach for improving the patient experience. Previous research on management consulting and the integration of new roles in established organizations is briefly reviewed. Mayo Clinic Arizona’s (MCA) comprehensive, "7-prong" service model is revisited. Developed and implemented in 2008, the model is predicated on …

The Patient Portal And Abnormal Test Results: An Exploratory Study Of Patient Experiences, Traber Giardina, Varsha Modi, Danielle Parrish, Hardeep Singh

Patient Experience Journal

Many health care institutions are implementing patient portals that allow patients to track and maintain their personal health information, mostly in response to the Health Information Technology for Economic and Clinical Health Act requirements. Test results review is an area of high interest to patients and provides an opportunity to foster their involvement in preventing abnormal test results from being overlooked, a common patient safety concern. However, little is known about how patients engage with portals to review abnormal results and which strategies could facilitate that interaction in order to ensure safe follow-up on abnormalities. The objective of this qualitative …

Health Information Technology: A Key Ingredient Of The Patient Experience, Matthew Werder

Patient Experience Journal

In this exploration to understand the linkages of health information technology (HIT) and patient experience, a comprehensive literature search was conducted using the key words, “information technology, HIT, patient experience, patient satisfaction, and technology”, on the MEDLINE, PubMed, and EMBASE databases resulting in over 1,000 citations. Eventually, 35 of the most relevant articles were reviewed and 11 identified as key references to include in beginning to explore the question, as the transformation of healthcare continues, how can technology enable a positive return on investment to a patients’ perception of their care in an organization and how can technology impact the …

Variations In The Patients’ Hospital Care Experience By States’ Strategy For Medicaid Expansion: 2009-2013, Edmund Becker, Kenton Johnston Phd, Jaeyong Bae, Jason M. Hockenberry Phd, Ariel C. Avgar, Sandra Liu, Ira Wilson, Arnold Milstein Md, Mph

Patient Experience Journal

Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 period for all 50 states and the District of Columbia grouped by those states that (1) did not expand, (2) expanded Medicaid through Section 1115 waivers, (3) expanders early, and (4) expanded Medicaid concurrent with the new ACA legislation.

Our findings reveal that those states that opted out of Medicaid expansion typically started with …

Cancer Patients’ Experiences Of Error And Consequences During Diagnosis And Treatment, Henriette Lipczak, Liv H. Dørflinger, Christine Enevoldsen, Mette M. Vinter, Jeanne L. Knudsen

Patient Experience Journal

The study objective was to investigate patient experienced error during diagnosis and treatment of cancer. The design included a nationwide patient survey on quality and safety in Danish cancer care. Responses regarding patient experienced error were separately analyzed, quantitative responses using descriptive statistics and qualitative responses using systematic text analysis. Study participants included 6,720 adult patients with a first time diagnosis of cancer registered between May 1st and August 31st 2010. The patients received a questionnaire concerning their experiences of care received by general practitioners, specialist practitioners and at the hospital. A response rate of 65% was achieved. 10 – …

Patient Complaints As Predictors Of Patient Safety Incidents, Helen L. Kroening, Bronwyn Kerr, James Bruce, Iain Yardley

Patient Experience Journal

Patients remain an underused resource in efforts to improve quality and safety in healthcare, despite evidence that they can provide valuable insights into the care they receive. This study aimed to establish whether high-level patient safety incidents (HLIs) were predictable from preceding complaints, enabling complaints to be used to prevent HLIs. For this study complaints received from November 2011 through June 2012 and HLI incident reports from April through September 2012 were examined. Complaints and HLIs were categorised according to location or specialty and the themes they included. Data were analysed to look for correlations between number of complaints and …

Weighting Patient Satisfaction Factors To Inform Health Care Providers Of The Patient Experience In The Age Of Social Media Consumer Sentiment, Blaine Parrish, Amita N. Vyas, Grace Douglass

Patient Experience Journal

The researchers explored the possibility that patients would go beyond simple ranking and could give weight to previously validated and reliable patient satisfaction factors, while also describing their online habits related to the patient experience and health seeking information in order to inform medical providers on what patients say matters most when evaluating satisfaction with their provider. One thousand one hundred and sixty-four adults completed a 13- item web-based quantitative survey, developed by public health researchers, to weight patient satisfaction factors and describe online health seeking habits of patients across the United States. Proportional weights for each of the patient …

Measuring Patient Experience In A Safety Net Setting: Lessons Learned, Nina Shabbat, Katy Dobbins, Sonja Seglin, Kristin Davis

Patient Experience Journal

Safety net providers have faced barriers in administering patient experience surveys due to a lack of resources and survey expertise, but this problem has received little attention in the literature. In this manuscript, we offer lessons learned from the administration of a patient experience survey at a mid-size behavioral health care agency serving a safety net population. Specifically, we discuss resource needs, methods of increasing response rate among transient populations, methods for engaging stakeholders and clinical staff in quality improvement initiatives, and considerations for responding to setbacks and challenges dynamically. We also offer insight on the effective dissemination of results …

Patient Satisfaction Reported By In-Visit And After-Visit Surveys, Rukiya Wongus, Nicholas H. Schluterman, Sharon Feinstein, Nihkolle Mcgirt, Deborah R. Greenberg, David B. Schwartz

Patient Experience Journal

Patient experience measurement has become a basic requirement for every healthcare provider organization. Yet, when the timing and mode of survey administration are considered, there is skepticism about the usefulness of ‘after- visit’ patient experience surveys to measure satisfaction and identify opportunities to improve service or health care quality. The aim of this observational study was to compare patient satisfaction among those who rated the patient experience at the conclusion of their outpatient appointment while still in the office, to that among those who rated the patient experience up to one month after their outpatient appointment via a mailed survey. …