Health Services Research Commons^™

A Trip To Healthcare, David E. Matz

Patient Experience Journal

This narrative shares how my experience with two colonoscopies and three surgeries in one year taught me that I am not so good at engaging in treatment decisions. I thought I was. This essay sets out where I made my mistakes, why I believe I made those mistakes, and how the hospitals, intentionally or not, made good decision-making harder. I offer two suggestions for enhancing the role of the patient in decision-making including 1) Every doctor in a diagnostic-decision-making interview should use the sentence “You have some choices here.” The doctor will have preferences, of course, but the patient needs …

The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave Debronkart

Patient Experience Journal

This essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we …

Pushing The Boundaries Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

This special issue is designed to push the boundaries of patient experience a little farther. Beyond just examples of applying the critical principles of patient and family centered care or even practices of patient engagement, we have been pushed to move further down the perspective of partnership, to the era of “doing with” in which healthcare now finds itself. The idea of involvement as the descriptor selected to frame this issue, was due to its broad and representative nature. It reflects all the words on involving patients mentioned above, but gets further along to participation and ownership (or activation as …

Using Timelines To Visualize Service Use Pathways To Alcohol Treatment, Lynda Berends, Michael Savic

The Qualitative Report

Many people in alcohol and other drug treatment are clients of other services, however there is limited consideration of the combinations and sequences of services and systems that they use. We used data visualization to analyze and re-present findings from a large research project on clients’ service use and referral sources in the year preceding alcohol treatment entry. Data were from 16 “high-end” service users with alcohol problems and analysis involved constructing individual text and timeline summaries and a visual encoding system to show service type and referral source. Three distinct service use pathways were identified and a visual model …

“That Pain Is Genuine To Them”: Provider Perspectives On Chronic Pain In University Student Populations, Alexandra C.H. Nowakowski, Kaitlyn E. Barningham, Charlyn D. Buford, Martin Laguerre, J. E. Sumerau

The Qualitative Report

We explored provider attitudes about and experiences in chronic pain management for university student populations. Our central question was: “What do providers at a large university campus health care center experience in the process of offering pain management services?” We explored instrumental, behavioral, emotional, and attitudinal dimensions of our participants’ experiences using a qualitative case study approach. Data were gathered through semi-structured interviews with 10 health care providers at the student health center for a large research university in Florida. Interviews captured providers’ background and experiences in providing pain management to student patients with diverse needs. We used grounded theory …

The Effects Of Insurance Status On Pediatric Traumatic Brain Injury Outcomes: A Literature Review, Anthony Fabio, Austin Murray, Michelle Mellers, Stephen Wisniewski, Michael Bell

Journal of Health Disparities Research and Practice

Objective: To review the literature that describes the effects of insurance status on traumatic brain injury (TBI) outcomes among pediatric patients to understand how policies related to access to health insurance changes TBI outcomes. Method: This review was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA). A search of OVID Medline was conducted in May of 2016 for all years for peer-reviewed articles that included keywords related to “brain injuries” and “insurance status”. Articles were included if authors conducted a separate analysis of children aged 0 to 18. Articles were excluded if the TBI was the …

Socioeconomic Determinants Of Health Disparities By Race And Ethnicity: The Mediating Role Of Social, Psychological And Behavioral Factors, Amanuel Zimam Melekin

Dissertations and Theses

Socioeconomic status (SES) is inversely related to health status. Disparities in health status among races and ethnic groups are partly attributable to differences in SES, but the indirect pathways by which SES may influence health status are not widely studied.

Using the Health and Retirement Study (HRS) data, this dissertation examined the pathways by which SES, via social, psychological, and behavioral factors predicted physical impairment and overnight hospitalization, and asked whether these indirect relationships differed by race/ethnicity. The HRS is a nationally representative multistage area probability sample administered biennially to respondents over the age of 51 and their spouses. Data …

A Randomized Trial Of Brief Assessment Interventions For Young Adults Who Use Drugs In The Club Scene, Steven P. Kurtz, Mance E. Buttram, Maria E. Pagano, Hilary L. Surratt

Center for Health Services Research Faculty Publications

Background—Efficacious interventions to reduce drug use and its consequences for club drug using populations are not apparent in the literature. We tested interviewer-(CAPI) and self-administered (ACASI) comprehensive health and social risk assessments as distinct interventions compared to waitlist control.

Methods—750 men and women ages 18-39 with multidrug use and heterosexual behavior were randomized in equal proportions to the three conditions. Instrumentation included well-tested measures of drug use, risky sex, mental distress and substance dependence.

Results—The sample was 56% male; mean age=25. Reported risk behaviors and health consequences did not differ by assessment modality. Adjusted HLM analyses showed …

Unmet Needs And Service Utilization By Informal Caregivers, Ryan Marie Diduk-Smith

Health Services Research Dissertations

The number of Americans expected to live into their 80’s and 90’s is growing at an increased rate in the United States, and the numbers of those aging adults with multiple chronic conditions also continues to grow. It is estimated that by 2050, there will be 89 million adults over the age of 65 years living in the United States. For a variety of reasons, including policy, personal, and financial reasons, many aging adults are choosing to “age in place” or to remain in the community. With the increase in the numbers of aging adults in the community, the ability …

Breast Cancer Screening In Patients With Newly Diagnosed Lung And Colorectal Cancer: A Population-Based Study Of Utilization, Gelareh Sadigh, Ruth C. Carlos, Kevin C. Ward, Jeffrey M. Switchenko, Renjian Jiang, Kimberly E. Applegate, Richard Duszak Jr.

Radiology Faculty Publications

Purpose—To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls.

Methods—Female fee-for-service Medicare beneficiaries who were ≥ 67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as …

Screening For Syphilis In Cases Of Suspected Gonorrhea And Chlamydia Infections, Kumara Nibhanipudi, K Cody

NYMC Faculty Publications

Background. In all cases of suspected sexually transmitted infections (STIs), it has been routine practice to screen for syphilis with a blood sample. The incidence of syphilis seems to be lower than that of commonly screened STIs. Objective. The objective of our study was to determine whether it is cost-effective to screen for syphilis with serological testing in cases of suspected gonorrhea and chlamydia infections. Hypothesis. Our hypothesis is that it is not cost-effective to screen for syphilis in cases of presumed gonorrhea and chlamydia infections. Methods. Our study is a New York Medical College institutional …

Mchd Student Health Centers Needs Analysis - Needs Assessment, Bill J. Wright, Re Buckley, Fanny Rodriguez, Jt Thompson, Kristen Dulacki, Natalie Royal Kenton

Articles, Abstracts, and Reports

No abstract provided.

Analisia Kinerja Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2011- 2013 Berdasarkan Balanced Scorecard, Laisa Muliati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUDAM as public sector organizations BLUD status, health services should be held responsible, effective and efficient. It required comprehensive tools as a form of accountability to the community or the owner. Balanced scorecard by many nonprofits regarded as a comprehensive measuring tool. Namely the customer perspective, financial, internal business process perspective and the perspective of growth and learn. to analyze the performance of RSUDAM years 2011-2013 based balanced scorecard.The data analysis univariate analysis (descriptive). Data processing with methods of qualitative and quantitative studies of secondary data research activities in 2011-2013 show that: 1) The performance of the customer's perspective: Patient …

Intervensi Continuous Improvement Rawat Jalan Rumah Sakit Haji Jakarta, Teguh Ariotejo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The process of general patient care in the outpatient installation of Haji Hospital Jakarta when viewed from the outpatient mobility flow since registration until the patient came home seen the flow that makes the patient walk back and forth to the cashier or to the supporting room service (laboratory and radiology). This is of course a waste of time and the movement of patients. Therefore, continuous improvement is needed in the effort to improve the quality and efficiency of service to the patient in the outpatient installation of Jakarta Hajj Hospital.

Faktor-Faktor Yang Mempengaruhi Net Death Rate (Ndr) Stroke Di Rsud Dr. Kanujoso Djatiwibowo Balikpapan Tahun 2014, Rosjidah Rahmawati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study is seeking the impact of structure and process as the quality aspect according to Donabedian's theory that affecting to the Net Death Rate (NDR) Stroke disease. Selected data source are Stroke patients, consisting of Intracerebral Haemorrhage and Cerebral Infarction at Dr Kanujoso Djatiwibowo Balikpapan Hospital in the year 2014. This study is a qualitative research using descriptive analytic retrospective method. Structure and Process Factors that are influencing each other. It reveals that Structure Factors in hospitalization that are affecting sequentially are the condition of the patient, facilities, policies and human resource. On the other hand it reveals that …

Penerapan Lean Manajemen Pada Pelayanan Rawat Jalan Pasien Bpjs Rumah Sakit Hermina Depok Tahun 2017, Elisabeth Dyah Noviani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The length of waiting time in the hospital outpatient service is important for efficient hospital service. Long waiting time leads to accumulating queue and inefficient service. This study was aimed to analyze the application of lean method on outpatient BPJS services at Hermina Depok Hospital in 2017. This qualitative research method investigated the time spent by BPJS outpatient patient by applying lean method and observing the outpatient service flow condition. The results showed that 90% service time was a non-value added activities and only 10% of value-added activities. After conducting future state analysis with the proposed improvement with simulative lean …

Review Sistematik: Elemen-Elemen Utama Dalam Membangun Budaya Keselamatan Pasien Di Rumah Sakit, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient safety culture in a hospital setting is the foundation for all health care activities,with the aim to provide safe and comfortable environment throughout the healing process of the patients. This systematic review aims to describe:1) the relationship between hospital as an organization and patient safety culture,2) the traditional and the modern concepts on patient safety, 3)the seven basic elements as founda tion of hospital patient safety culture and 4) the instrument to analyse hospital patient safety culture. The paradigm has changed from traditional way of punishing hospital staff when doing medical error to the just culture, with the philosophy …

Analisis Biaya Dan Faktor-Faktor Penentu Inefisiensi Layanan Hemodialisis Pada Pasien Gagal Ginjal Kronik Rumah Sakit Rk Charitas Palembang Tahun 2016, Noer Triyanto Rusli

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Enactment of JKN in hospital changes the payment system from retrospective payment (fee for service) into prospective payment (INA-CBG's). As a healthcare facility, RK Charitas Hospital has a role to provide not only quality but also to consider cost effective of services. This study aimed to analyze costs and identify the determinants of the inefficiency of hemodialysis services in patients with chronic renal failure at RK Charitas Hospital. This is a descriptive analysis research using primary and secondary data. Approach of cost analysis is Activity Based Costing (ABC) with "Bottom Up" method. ABC method is used to allocate costs by …

Greater Involvement Of Hiv-Infected Peer-Mothers In Provision Of Reproductive Health Services As "Family Planning Champions" Increases Referrals And Uptake Of Family Planning Among Hiv-Infected Mothers., Peter Mudiope, Ezra Musingye, Carolyne Onyango Makumbi, Danstan Bagenda, Jaco Homsy, Mai Nakitende, Mike Mubiru, Linda Barlow Mosha, Mike Kagawa, Zikulah Namukwaya, Mary Glenn Fowler

Journal Articles: Health Services Research & Administration

BACKGROUND: In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic.

METHODS: The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification …

Greater Involvement Of Hiv-Infected Peer-Mothers In Provision Of Reproductive Health Services As "Family Planning Champions" Increases Referrals And Uptake Of Family Planning Among Hiv-Infected Mothers., Peter Mudiope, Ezra Musingye, Carolyne Onyango Makumbi, Danstan Bagenda, Jaco Homsy, Mai Nakitende, Mike Mubiru, Linda Barlow Mosha, Mike Kagawa, Zikulah Namukwaya, Mary Glenn Fowler

Journal Articles: Health Services Research & Administration

BACKGROUND: In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic.

METHODS: The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification …

Use Of Social Adaptability Index To Explain Self-Care And Diabetes Outcomes, Jennifer A. Campbell, Rebekah J. Walker, Brittany L. Smalls, Leonard E. Egede

Center for Health Services Research Faculty Publications

Background: To examine whether the social adaptability index (SAI) alone or components of the index provide a better explanatory model for self-care and diabetes outcomes.

Methods: Six hundred fifteen patients were recruited from two primary care settings. A series of multiple linear regression models were run to assess (1) associations between the SAI and diabetes self-care/outcomes, and (2) associations between individual SAI indicator variables and diabetes self-care/outcomes. Separate models were run for each self-care behavior and outcome. Two models were run for each dependent variable to compare associations with the SAI and components of the index.

Results: The SAI has …

Retention In Health: Improving Hiv Retention Within The Sf Community Health Network, Miguel A. Ibarra

Master's Projects and Capstones

Previous work on HIV retention improvement has focused on improving access to care for communities who are either at-risk of falling out of care or who have difficulty engaging in medical care for the first time due to socio-cultural barriers. The San Francisco Department of Public Health (SFDPH), with the support of Project PRIDE, a CDC three-year demonstration project geared towards supporting health departments in implementing public health strategies to reduce new HIV infections within the men who have sex with men (MSM) and transgender communities, is seeking to improve HIV patient retention throughout the San Francisco Community Health Network …

Prevalence And Predictors Of Herbal Medicine Use Among Adults In The United States, Mohamed Rashrash, Jon C. Schommer, Lawrence M. Brown

Pharmacy Faculty Articles and Research

Objective: To describe the prevalence of herbal medicine use among US adults and to assess factors associated with and predictors of herbal use. Design: The data for herbal products use were collected from the 2015 National Consumer Survey on the Medication Experience and Pharmacists’ Roles. Chi-square test was used to analyz factors associated with herbal use, and predictors of herbal use were assessed with logistic regression analysis. Results: Factors associated with herbal supplement use include age older than 70, having a higher than high school education, using prescription medications or over-thecounter (OTC) medications, and using a mail-order …

Cancer Center Regional Benchmarks For Psychosocial Care, Desiree R. Azizoddin

Loma Linda University Electronic Theses, Dissertations & Projects

The American College of Surgeons (ACoS) Commissions on Cancer (CoC) formulated and implemented standard 3.2 for Psychosocial Distress Screening. This standard requires that all accredited cancer centers evaluate psychosocial distress and provide appropriate triage and intervention for all cancer patients. Over the past decade, Loma Linda University Medical Oncology Center (LLUMOC) administration, physicians, nurses, psychosocial care staff, and chaplaincy collaborated to implement a psychosocial screening and referral program throughout cancer patient services. This current research includes qualitative analysis assessing strengths and barriers of the psychosocial program at LLUMOC from the perspective of LLUMOC providers and two directors of Supportive Care …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Controlling Factors That Potentially Against Transmission Of Dengue Hemorrhagic Fever At State Elementary Schools In Yogyakarta, Tri Baskoro Tunggul Satoto, Nur Alvira, Tri Wibawa, Ajib Diptyanusa

Kesmas

Sekolah dasar merupakan tempat yang dapat mengakibatkan peningkatan penyakit dengue pada anak karena faktor lingkungan, adanya potensi penularan, belum adanya system manajemen lingkungan yang baik dan beberapa upaya pengendalian yang tidak lagi efektif. Penelitian ini bertujuan untuk mengetahui faktor yang berpotensi terhadap penularan demam berdarah dengue bagi anak, sehingga sistem kewaspadaan dini dapat ditegakkan. Jenis penelitian ini adalah analitik dengan rancangan potong lintang. Penelitian dilaksanakan pada 91 sekolah dasar negeri di Kota Yogyakarta. Variabel yang diobservasi adalah serotype virus DEN, resistensi insektisida, kepadatan vektor,dan kondisi fisik sekolah. Analisis data menggunakan analisis deskriptif dan korelasi-regresi (a = 0.05). Hasil menunjukkan bahwa …

Risk Factors Of Acute Respiratory Infections In Practice Area For Community Of Medical Students In Semarang, Siti Thomas Zulaikhah, Purwito Soegeng, Titiek Sumarawati

Kesmas

Infeki saluran pernapasan akut (ISPA) menempati urutan pertama dari 10 besar penyakit di Puskesmas Bangetayu dengan persentase terbanyak di Kelurahan Penggaron Lor. Keterampilan untuk mempelajari distribusi dan frekuensi penyakit serta faktor determinan yang memengaruhi manusia sangat diperlukan untuk menetapkan intervensi yang paling efektif untuk meningkatkan derajat kesehatan masyarakat. Perlu dilakukan penelitian untuk mengetahui faktor risiko yang paling dominan berhubungan dengan kejadian ISPA di lokasi praktik komunitas mahasiswa Fakultas Kedokteran Universitas Islam Sultan Agung Semarang. Penelitian ini menggunakan desain potong lintang dengan jumlah responden 100 orang dan sampel dikumpulkan dengan menggunakan stratified random sampling. Sepuluh variabel yang diteliti adalah faktor risiko …

Counterfeit Medicines In Socioeconomic Perspective, Desy Nuryunarsih Nuryunarsih

Kesmas

Obat-obatan palsu berpotensi mencapai 70% dari pasaran obat internasional dengan proporsi terbanyak ditemukan di negara berkembang. Meningkatkan kesadaran masyarakat akan adanya obat-obatan palsu akan secara langsung memengaruhi permintaan produk obat palsu yang akhirnya akan mengurangi kegiatan pemalsuan obat. Akan tetapi, meningkatkan pengetahuan masyarakat akan bahaya obat-obatan palsu tidaklah mudah sebab profesi kesehatan masyarakat harus juga mempertimbangkan keberagaman faktor-faktor sosial, ekonomi dan pendidikan. Laporan ini menelaah artikel jurnal yang ditelaah oleh kelompok seminat, laporan media, laporan resmi pemerintah dan non-pemerintah. Sebanyak 179 artikel (dari 1990 sampai 2014) ditelaah untuk mengetahui hubungan antara indeks pembangunan manusia (IPM) dari USA, Jepang, Brasil, Iran, …

The Use Of “Kakayu Dental Flipbook” In Oral Health Knowledge Improvement For Elementary School Students In Depok, Rikawarastuti Rikawarastuti, Eka Anggreni, Rahaju Budiarti, Nurlaila Ramadhan Suid

Kesmas

Perlu adanya edukasi untuk meningkatkan pengetahuan anak Indonesia tentang pentingnya memelihara kesehatan gigi dan mulut. Penelitian ini bertujuan untuk menjelaskan hubungan antara faktor siswa sekolah dasar seperti kelas, usia, jenis kelamin dengan jumlah anak dalam keluarga atau faktor ekonomi seorang ibu rumah tangga atau berpenghasilan tetap, yang dipengaruhi oleh peningkatan pengetahuan dari edukasi kesehatan gigi dan mulut. Disain penelitian quasi experiment pre-test dan post-test tanpa desain grup kontrol melibatkan 141 siswa yang dipilih melalui purposive sampling. Sampel tersebar pada siswa kelas IV, V, dan VI sekolah dasar swasta di Depok, Jawa Barat, Indonesia pada April-Oktober 2016. Data penelitian diperoleh dari …

Extrovert Personality Type And Prolonged Second Stage Of Labor, Yuni Kusmiyati, Chandra Tyas Nurfitria, Suherni Suherni, Heni Puji Wahyuningsih

Kesmas

Kepribadian dapat memengaruhi respons individu yang dapat berdampak pada proses persalinan lama. Penelitian sebelumnya menunjukkan adanya hubungan kepribadian dengan waktu persalinan. Tipe kepribadian ekstrover (tipe A) cenderung lebih rentan terhadap stres dibandingkan orang dengan tipe kepribadian introvert (tipe B). Penelitian ini bertujuan untuk mengetahui hubungan tipe kepribadian ekstrover dan variabel luar (pendidikan, ekonomi, usia ibu dan paritas) dengan persalinan kala II lama. Studi kasus kontrol dilakukan pada 156 ibu bersalin yang memenuhi kriteria inklusi pada tahun 2015 di Yogyakarta. Sampel kasus adalah 52 ibu dengan persalinan kala II lama dan kontrol adalah 104 ibu dengan persalinan kala II normal. Penelitian …