Health Services Research Commons^™

Analisis Faktor-Faktor Yang Berhubungan Dengan Kepatuhan Pasien Tuberkulosis Paru Tahap Lanjutan Untuk Minum Obat Di Rs Rumah Sehat Terpadu Tahun 2015, Dewi Hapsari Wulandari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This research discussed on the This thesis aims to determine the factors that associated compliance patien lung Tuberculosis to swallowing drug at Rumah Sehat Terpadu Dompet Dhuafa Hospital 2015This research used mix methods approach with cross sectional design. This research found that there is still non compliances patient lung tuberculosis to swallowing medicine. The compliance is related on behavior (Predisposisi, Enabling, dan Reinforcing) and non behavior factor. To increase the compliance this research suggest to hospital support fot TB DOTS program, intens of counseling, support the PMO, availability of drug, and frequent recording dan reporting.

Penggunaan Konsep Lean Untuk Meningkatkan Efisiensi Pelayanan Instalasi Farmasi Rawat Jalan Di Rumah Sakit Anna Medika Bekasi, Dima Lintya Siti Karima Zahra

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The National Health Insurance which was launched on January 1, 2014, is a form of transformation and reformation of health services in Indonesia. In implementation of the JKN, Hospital Pharmacy Installation is forced to improve its quality service sustainably in order to achieve cost effective and efficient service. Lean is a management system that fully focuses on effiency with the objectives to reduce stock, service cycle time and cost. Research was conducted on outpatient pharmacy installation service at Anna Medika Bekasi Hospital in April to May 2016. It focuses on prescription process flow of non-pulvis medicine using action research method …

Analisis Besaran Biaya Obat Beberapa Penyakit Rawat Jalan Dan Faktor- Faktor Yang Mempengaruhi Di Rs. Awal Bros Bekasi Tahun 2014, Hastuti Hadiningsih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The background of this study is the high bill outpatient drug costs when compared with the costs borne by BPJS by embracing INA CBG's tariff system. So, we need a more in-depth analysis of the factors that affect the amount of health care costs. This study uses a cross-sectional study with quantitative methods, by looking at factors of age, sex, prescription drugs, doctor and health insurance status in accordance with the secondary data obtained through medical records and bills medicine outpatient services. And based on the results of the study, factors that affect the cost of the drug is age, …

Analisis Faktor Yang Berhubungan Dengan Waktu Tunggu Pemeriksaan Foto Toraks Pasien Rawat Jalan Di Instalasi Radiologi Rumah Sakit Dr. Mohammad Hoesin Palembang Tahun 2015, Muhammad Yusri

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Department of Radiology Dr. Mohammad Hoesin hospital in Palembang 2014, many patients perform chest x ray examination, whom were patients radiographic outpatient. The waiting time radiographic services in RSMH not in accordance with the Standard Minimum Service Hospital less than 3 hours. This study aims to determine the factors associated with waiting time chest X-ray. This research was conducted by measuring the waiting time to 68 selected respondents The result showed radiographic waiting time 184.44 minutes. Based on statistical test found the waiting time in the reading room is the photo that most affect the length of waiting time radiographic.

Analisis Kualitas Dan Kuantitas Tenaga Keperawatan Terhadap Persepsi Insiden Keselamatan Pasien Di Rs X Jakarta Tahun 2015, Evelyne Sumihar Friyanti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient safety has become a very important issue in health care. Everyone wants to get health care that is safe and free from unwanted injuries. Through this study, analyzed the quality and quantity of nurse perceptions of patient safety incidents in the hospital X. The study was conducted on 44 nurses and midwives using cross sectional design to examine the relationship between the variables of knowledge, education, ease of use tools, work experience, discipline and the number of nurses on patient safety incidents.

Analisis Faktor-Faktor Yang Berhubungan Dengan Efektivitas Komunikasi Perawat Dan Pasien Di Ruang Rawat Inap Rumah Sakit Harapan Mulia Kabupaten Bekasi Tahun 2015, Prasetyaningtyas Agustrianti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The study aims to determine the factors associated with the effectiveness of nurse and patient communication atinpatient unit in Harapan Mulia Hospitallocated in Bekasi Regency.It is a quantitative study with cross-sectional design.Samples are the total population amounted to 30 nurses with 60 patients as respondentsconducted in March - May 2015. The results showed that 53.3% of patients perceived that nurses’s communication was effective, further analysis with logistic regression showed no significant relationship between the characters nurses, physical and mental fatigue, language, leadership and management support for hospitals, facilities and reward with the nurses and patients communication effectiveness.

Understanding The Value Of Multi-Sector Health System Interactions, Glen P. Mays

Health Management and Policy Presentations

Recent research examines the health and economic value of multi-organizational and multi-sectoral approaches for the delivery of public health services. This presentation examines how data on these multi-organizational delivery systems and their impact can be used to solve collective action problems and stimulate collaborative solutions in public health.

Kentucky’S Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays

Health Management and Policy Presentations

This session examines recent progress toward the 2012 Institute of Medicine recommendation to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be available across the U.S. Research about the health and economic benefits of Foundational Public Health Services has begun to shape Kentucky's strategic plan for transforming the public health system.

Analytic Approaches For Causal Inference With Complex Multi-Component Interventions, Glen P. Mays, Arnold J. Stromberg, Jing Li, Mark V. Williams

Health Management and Policy Presentations

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.

Medicare's Post-Acute Care Payment: An Updated Review Of The Issues And Policy Proposals, Sally Coberly

National Health Policy Forum

Medicare spending on post-acute care provided by home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals accounted for about 10 percent of total program outlays in 2013. The Medicare Payment Advisory Commission and others have noted several long-standing problems with the payment systems for post-acute care and have suggested refinements to Medicare's post-acute care payment systems that are intended to encourage the delivery of appropriate care in the right setting for a patient's condition. The Patient Protection and Affordable Care Act of 2010 contained several provisions that affect the Medicare program's post-acute care payment systems, as …

The Impact Of Antenatal Care On Maternal Mental Health In Rural Maharashtra, Cameron Barker

India: Public Health, Policy Advocacy, and Community

This study seeks to understand the major mental health concerns experienced by pregnant women and recent mothers in rural villages in Maharashtra and how these concerns are impacted by different elements of holistic antenatal and postnatal care. The risk factors that may lead to poor maternal mental health are strongly tied to social factors and vary from community to community. Unfortunately, in most developing countries mental health takes a back seat to other health issues deemed more pressing. This is especially true for female specific illnesses, given that the overall health of women and girl children is often neglected. The …

The Perception Of Menstruation And Treatment Of Menstrual Ailments Among Tibetan Women In Mcleod Ganj, Himachal Pradesh, Kara Spafford

India: Public Health, Policy Advocacy, and Community

Despite recent incorporation of quality of life assessments into goal setting, menstrual ailments are still left out of public health initiatives in developing countries. Due to lack of studies on perceptions of menstruation and treatment options for menstrual ailments, the specific health needs of Tibetan women are not met. The present study seeks to determine how Tibetan women are influenced by societal views of menstruation and to explore access to treatment for menstrual problems in McLeod Ganj, Himachal Pradesh. A total of thirty-seven semi-structured interviews were conducted among Tibetan doctors at Men-Tsee-Khang (Tibetan Medical and Astronomy Institute) and Tibetan women …

How Social Determinants Of Health, Health-Seeking Behaviors, And Treatment Adherence Influence And Interact With Endemic Levels Of Pulmonary Tb And Mdr-Tb In Urban Rajasthan, Michelle Kagei

Independent Study Project (ISP) Collection

Tuberculosis, the worlds most deadly infectious disease, remains as one of the major causes of morbidity and mortality in modern-day India. The country has the highest burden of both tuberculosis as well as multidrug-resistant tuberculosis, a more recently emerging menace. This study focuses on the social determinants of health pertaining to tuberculosis, identifying and discussing “at-risk” groups in the population of urban Rajasthan. Jaipur was chosen as the field study location because of the city’s extensive levels of healthcare institutions and facilities. In order to identify common patient demographics as well as issues regarding treatment adherence, medical records and interviews …

Community Health Workers: Health System Integration, Financing Opportunities, And The Evolving Role Of The Community Health Worker In A Post-Health Reform Landsacape, Mary-Beth Malcarney, Patricia Pittman, Leo Quigley, Naomi Seiler, Katie B. Horton

Health Workforce Research Center Publications

Community Health Workers (CHWs) have been gaining attention from policymakers because of their unique role in addressing health disparities and socioeconomic drivers of disease, and because of their potential integration into the health care delivery system. To date, there has been limited research specifically describing the variation in CHWs’ roles and relationships, and how that variation relates to management, to financing, to health system integration, and to the competencies CHWs should have in different contexts.

The purpose of this report is to better understand the varied landscape; to offer categories of analysis that may help inform policy, management, and research; …

The Conceptualization Of Self-Identity Among Residents Of Appalachia Ohio, Jessica L. Krok-Schoen, Angela L. Palmer-Wackerly, Phokeng M. Dailey, Janice L. Krieger

Department of Communication Studies: Faculty Publications

Social identity and its association to culture, place, and health is an important, but understudied, area of research. One social group that illustrates this connection between place and identity is people living in Appalachia. This exploratory mixed-method study investigates the appropriateness of the self-concept of Ohio Appalachian adults with cancer as “Appalachian,” the context associated with that identity and its association with community identification, rural identity, Appalachian Regional Commission (ARC) status, demographic data, and clinical trial (CT) enrollment. Forty-nine adults with cancer residing in Appalachia were recruited. Participants were cancer patients who (1) were offered a randomized clinical cancer trial; …

Challenges Of Providing Timely Feedback To Residents: Faculty Perspectives, Tabassum Zehra, M. Tariq, Afaq Motiwala, Syeda Kauser Ali, John Boulet

Department for Educational Development

Objective

To explore faculty's perceptions of challenges in providing verbal feedback to the Residents and suggest ways to overcome the barriers.

Methods

As part of a larger study on feedback assessment, five focus group discussions were conducted at the Department of Medicine, Aga Khan University Hospital, Karachi, during faculty development workshops held from January to June 2010. Qualitative grounded theory was used to explore faculty perceptions of challenges in providing verbal feedback to the Residents.

Results

Of the 54 faculty members, 49(91%) participated. Four themes that emerged were 'time constraint' indicating high patient load; 'faculty related issues' indicating faculty's apprehension …

Hispanic Ethnicity Is Associated With Increased Hospital Charges After Radical Cystectomy In The United States, Mark D. Tyson, Erik P. Castle

Journal of Health Disparities Research and Practice

Objective: To examine the impact of race and ethnicity on financial charges associated with radical cystectomy (RC).

Data Sources/Study Setting: The Nationwide Inpatient Sample was used to identify patients who underwent RC for bladder cancer between 1998 and 2010.

Study Design: The primary outcome was total hospital charges adjusted for inflation. Multivariate analysis was performed using a generalized linear model on the logarithmically transformed outcome variable (total hospital charges) after adjusting for age, sex, race, Elixhauser comorbidities, surgical approach, year, primary payer, hospital and surgeon annual RC volume, hospital characteristics, and postoperative complications.

Principle findings: A total of 14,873 patients …

Challenges Of Forecasting Physician Workforce Needs Amid Delivery System Transformation, Rob Cunningham

National Health Policy Forum

As population growth and the aging of the overall population increase demand for health care, policymakers and analysts grapple with whether sufficient health care providers, particularly physicians, will be available to meet that demand. Some argue there are too few physicians already; others say our current supply-demand problems lie with efficiency. But suppose both are correct? Perhaps the real challenge is to understand how the provision of health care services is changing in response to market forces such as payment changes, patients' expectations, provider distributions, and technology innovations. This issue brief revisits what is known about evolving practice organizations, professional …

Dual Use Of Va And Non-Va Hospitals By Veterans With Multiple Hospitalizations, Alan N. West, Mary E. Charlton, Mary Vaughan-Sarrazin

Dartmouth Scholarship

Background: Veterans who are hospitalized in both VA and non-VA hospitals within a short timespan may be at risk for fragmented or conflicting care. To determine the characteristics of these “dual users,” we analyzed administrative hospital discharge data for VA-enrolled veterans of any age in seven states, including any VA or non-VA hospitalizations they had in 2004 – 2007. Method: For VA enrollees in Arizona, Iowa, Louisiana, Florida, South Carolina, Pennsylvania, or New York in 2007, we merged 2004 – 2007 discharge data for all VA hospitalizations and all non-VA hospitalizations listed in state health department or hospital association databases. …

A Comparison Of A Multistate Inpatient Ehr Database To The Hcup Nationwide Inpatient Sample., Jonathan P Deshazo, Mark A Hoffman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data.

METHODS: In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010.

RESULTS: The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent …

Presence Of Athletic Trainers In Michigan High Schools, Monica Lininger, Gayle Thompson

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Context: Each year an estimated 1.4 million sports related injuries occur annually to student-athletes at the high school level. It has been over 20 years since a systematic investigation into the presence of athletic trainers to treat these injuries in the state of Michigan has been conducted. Within the past 5 years in Michigan, licensure as well as several laws and regulations have been enacted for athletic trainers.

Purpose: To investigate the prevalence of athletic trainers in secondary schools in Michigan.

Design: Cross-sectional study.

Setting: Questionnaires were given to all 400 athletic directors in attendance of the Michigan Interscholastic Athletic …

Local Health Departments’ Costs Of Providing Environmental Health Services, Simone Singh, Nancy L. Winterbauer, Ashley Tucker, Lisa Macon Harrison

Frontiers in Public Health Services and Systems Research

Background: A detailed understanding of the costs that local health departments (LHDs) incur in the provision of public health services plays an important role in their efforts to provide services in an effective and efficient manner. However, surprisingly little evidence exists about the key cost components that LHDs incur in the provision of services.

Purpose: The purpose of this report was to provide empirical estimates of LHDs’ cost structure.

Methods: Using cost information for 2012 from 15 LHDs in North Carolina for two public health services—food and lodging and onsite water—this report first presents estimates of the total costs per …

Use Of Facebook By Local Health Departments: Usage, Public Health Themes, And Maintenance, Rakhi Trivedi, Gulzar H. Shah, Ankit Bangar

Frontiers in Public Health Services and Systems Research

Background: Recent research shows that social media offer unprecedented opportunities for communications with stakeholders in public health and other industries.

Purpose: This study examines the manner in which U.S. local health departments (LHDs) use Facebook. Public health program themes discussed on Facebook profiles of LHDs were analyzed and ranked by the frequency of mentions on Facebook.

Methods: LHDs included in the study were those indicating use of Facebook in the 2010 National Profile of Local Health Departments. Using the list from the profile study, the primary data from LHDs’ public Facebook profiles were collected over a period of 4 months. …

Trends In Health Care Delivery Systems: Implications For Cancer Prevention And Control, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act and larger economic forces are leading both health care providers and public health agencies to renegotiate their roles and responsibilities within the U.S. health system. This session reviews major changes occurring in both health care and public health delivery systems, with a focus on the implications for cancer prevention and control. The information infrastructure created by cancer registries and other health information systems are increasingly important for enabling greater coordination, alignment and accountability within the nation's changing delivery systems.

The National Health Security Preparedness Index: Proposed Updates For 2015-16, Glen P. Mays

Health Management and Policy Presentations

The U.S. Centers for Disease Control and Prevention (CDC) initiated development of the National Health Security Preparedness Index in 2012 to create a platform for measuring the nation’s progress in preparing for, responding to, and recovering from disasters and other large-scale emergencies that pose risks to health and well-being in the United States. As a measurement tool, the Index is designed to summarize levels of preparedness achieved within individual states and for the nation as a whole. This session summarizes proposed updates to the Index for 2015-16 that are designed to improve the validity and reliability of Index measures and …

Preparedness Of Hospitals In The Republic Of Ireland For An Influenza Pandemic, An Infection Control Perspective, Mary Reidy, Fiona Ryan, Dervla Hogan, Seán Lacey, Claire Buckley

Department of Mathematics Publications

When an influenza pandemic occurs most of the population is susceptible and attack rates can range as high as 40–50 %. The most important failure in pandemic planning is the lack of standards or guidelines regarding what it means to be ‘prepared’. The aim of this study was to assess the preparedness of acute hospitals in the Republic of Ireland for an influenza pandemic from an infection control perspective.

Wdph Summer Internship Report, Samantha Arsenault

Mosakowski Institute for Public Enterprise

The Mosakowski Institute is working with the Worcester Division of Public Health (DPH) in an effort that merges classroom skills and real world experience to improve the health of the Greater Worcester community. During the summer of 2015, thirteen Clark students interned with the DPH working on five projects that advanced goals of the Community Health Improvement Plans in the areas of healthy eating and activing living; substance abuse and mental health; health equity and health disparities; violence prevention, and more. More information about the summer 2015 internship projects can be found in the report.

Longitudinal Analysis Of Electronic Health Records On Staffing Mix In Community Health Centers, Bianca K. Frogner, Xiaoli Wu, Jeongyoung Park, Patricia Pittman

Health Workforce Research Center Publications

Community health centers (CHCs) have long faced clinical staffing challenges especially in rural areas of the US due to providers perceiving a lack of socioeconomic opportunities. A recent study found that CHCs are adaptable and manage to maintain productivity levels across different staffing configurations by leveraging the clinical staff available. What is unknown is how two major changes in the health care landscape—adoption of an electronic health record (EHR) system and recognition of being a patient-centered medical home (PCMH)—have impacted staffing in CHCs, which may in turn have productivity implications.

Assessment Of Nutrition Information System Using Health Metrics Network Framework, Mochamad Iqbal Nurmansyah, Catur Rosidati, Riastuti Kusuma Wardani, Badra Al-Aufa

Kesmas

Sistem informasi gizi (Sigizi) dikembangkan oleh Direktorat Bina Gizi Kementerian Kesehatan sejak 2011. Data Sigizi mencakup data penimbangan balita di posyandu, kasus gizi buruk, cakupan pemberian tablet Fe pada ibu hamil, konsumsi garam beryodium, pemberian vitamin A, dan ASI eksklusif. Penelitian ini bertujuan untuk mengukur kinerja pengelolaan Sigizi di Dinas Kesehatan Kota Tangerang Selatan menggunakan kerangka Health Metrics Network yang dikeluarkan oleh WHO tahun 2008. Sigizi merupakan sistem informasi yang diaplikasikan pada tingkat nasional dengan mekanisme pelaporan berjenjang, dari 508 kabupaten/kota menuju 34 provinsi dan bermuara di tingkat nasional. Di Provinsi Banten, terdapat delapan kabupaten/kota yang menjalankan Sigizi. Informan penelitian …

Sikap Remaja Terhadap Keperawanan Dan Perilaku Seksual Dalam Berpacaran, Desi Rusmiati, Sutanto Priyo Hastono

Kesmas

Laporan Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2007 dan 2012 menunjukkan terjadinya penurunan jumlah remaja yang memiliki sikap positif terhadap pentingnya mempertahankan keperawanan bagi seorang perempuan. Dari laporan yang sama juga diketahui adanya peningkatan perilaku seksual remaja dalam hal berpegangan tangan, berciuman bibir, petting, dan melakukan hubungan seksual. Penelitian ini bertujuan untuk membuktikan adanya hubungan antara sikap remaja terhadap keperawanan dengan perilaku seksual dalam berpacaran dengan melibatkan usia, jenis kelamin, pendidikan, tempat tinggal, usia pertama kali pacaran, pengetahuan, dan pengaruh teman sebaya sebagai variabel perancu. Penelitian ini merupakan penelitian kuantitatif dengan rancangan potong lintang menggunakan model faktor risiko dari …