Health Services Research Commons^™

From Diagnosis To Routine Care In Type 1 Diabetes In Children: Parents’ Experiences, Géraldine Heilporn, Maude Laberge, André Côté, Monia Rekik

Patient Experience Journal

Having a child who lives with a Type 1 Diabetes (T1D) can represent a high burden for parents. The objective of our study is to identify and analyze the main challenges expressed by parents so that health care services better meet the needs of parents of T1D children. Semi-structured interviews were conducted with parents of 19 T1D children regarding detection and diagnosis, initial management at the hospital, post-discharge adaptation including daycare or school reintegration, and long-term T1D monitoring. Data analysis was performed following an inductive approach. The results showed a lack of knowledge regarding T1D in the society, especially for …

Refugees' Perceptions Of Primary Care: What Makes A Good Doctor's Visit?, Anne Mutitu, Bev Zabler, Jeana M. Holt

Patient Experience Journal

Redesigning primary care is a national priority, as the United States (US) struggles with issues of poor access, high cost, and suboptimal quality. Refugees are among the populations who suffer from America’s disjointed health care system, resulting in disproportionate health disparities. Although there are many studies on refugee health, few share refugees' perceptions of primary care. We asked local refugees who were seen for primary care services at a midwestern academic nurse-led clinic, what makes a good doctor's visit?  The clinic served as the hub of a federally funded refugee Community Centered Health Home (CCHH) pilot project. This qualitative study …

Engaging Under- And/Or Never-Engaged Populations In Health Services: A Systematic Review, Lesley Moody, Erica Bridge, Vidhi Thakkar, Naomi Peek, Tanvi Patel, Suman Dhanju, Simron Singh

Patient Experience Journal

Patient engagement is a mechanism used to facilitate person-centred care, however, has not been realized in all patient populations. Often, many marginalized populations still remain under- and/or never-engaged. The purpose of this systematic review was to: 1) identify methods or interventions that have been used to engage under- and/or never-engaged populations in health services and 2) identify outcomes that are associated with engaging under- and/or never-engaged populations in health services. A comprehensive search using the Ovid MEDLINE, EMBASE and CINAHL databases was conducted to examine literature between January 2002 and January 2015. Twenty-nine studies met the inclusion criteria. Data was …

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

The Future Of Patient Experience: Five Thoughts On Where We Must Go From Here, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

In looking to the future, we must never forget it is grounded in today and the steps that brought us to this point. Those efforts and actions that led to where we stand now set the foundation for all we can do and what we will accomplish as we look to the future. This idea of not looking too far ahead without knowing where you stand is fundamental in human nature. Far too often we have let our gaze to the future miss the people right in front of us or overlook the significance of the moment in which we …

Understanding Lung Cancer Resources And Barriers Among Worksites With Mostly Male Employees In Eight Rural Kentucky Counties: A Focus Group Discussion, Jennifer Redmond Knight, Lucy Hollingsworth Williamson, Debra K. Armstrong, Elizabeth A. Westbrook

Health Management and Policy Faculty Publications

Kentucky has the highest cancer incidence and mortality rates in the United States, and lung cancer is Kentucky's leading cause of cancer deaths. Males in Kentucky have higher lung incidence and mortality rates than females. Through support from the SelfMade Health Network, Kentucky developed a Regional Resource Lead Organization that collaboratively developed a multi-component worksite intervention on lung cancer among male populations. The intervention targets eight Kentucky counties. The first component and focus of this manuscript included focus group meetings with organizational representatives in each county that provide health, educational, and social services to men and worksites. The focus groups …

Hospital Closures And Short-Run Change In Ambulance Call Times, Sookti Chaudhary, Alison F. Davis, Kenneth R. Troske, Suzanne Troske

Rural & Underserved Health Research Center Publications

We measure one aspect of how access to emergency care through ambulance services changes for patients when a hospital closes. We empirically estimate the time needed to transport a patient to an emergency department in an ambulance in the period immediately after the hospital closes. We find urban patients in zip codes where a hospital closes have a small change in transportation time, where rural patients average an estimated 15.7 additional minutes – a 46% increase compared to the year before the closure. This increase is primarily the result of an almost 100 percent increase in the time it takes …

Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd

Rural Health Clinics

The Rural Health Clinic (RHC) Program is one of the nation’s oldest rural primary care programs. A key feature of the RHC Program is Medicare and Medicaid volume-appropriate, cost-based reimbursement, which is designed to sustain these vulnerable rural primary care providers. Medicare currently pays RHCs for the lesser of reasonable costs (expressed as an adjusted cost per visit) for a defined package of RHC services or a per-visit reimbursement cap, from which provider-based RHCs owned by hospitals with fewer than 50 beds are exempt. Although the per-visit cap is updated periodically, RHC administrators, policymakers, and stakeholders question whether the updates …

Analisis Produk Layanan Rawat Inap Di Rsud Wangaya Denpasar Berdasarkan Stp (Segmenting, Targeting, Positioning) Dan 4 P (Product, Price, Place, Promotion), Ni Putu Sri Wahyuni

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Service marketing strategy will increase the level of customer satisfaction with marketing mix consisting of 4 P (product, price, place, promotion) and supported by modern STP marketing strategies (Segmenting, Targeting and Positioning) as a technique to look for market opportunities, so that the hospital is able to provide health services according to customer needs. Descriptive research has been conducted to describe a situation objectively, to solve the problem being faced. The data used are secondary data that includes inpatient visit data, occupancy data for inpatient rooms, and community satisfaction data in inpatient rooms. Based on the results of the study, …

Improving Patient Safety And Hospital Service Quality Through Electronic Medical Record: A Systematic Review, Muhammad Firdaus

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

To understand the Electronic medical records (EMR) role in improving patient safety and hospital’s service quality. Articles that included and assessed for the eligibility in this review was an article that show an effect of patient’ safety, and product quality in hospital in correlation on using EMR. The most important function of EMR implementation is to improve patient safety in hospital, in addition to reducing cost. EMR reduce excess cost of Hospital Acquired Condition (HAC) by 16%, reduce death due to HAC by 34%. Doctor and nurse’s belief that the quality of patient data is better when EMR are easier …

Analisis Kinerja Dokter Verifikator Internal Dalam Menurunkan Angka Klaim Pending Di Rsud Koja Tahun 2018, Ayu Nadya Kusumawati, Pujianto Pujianto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The doctor's internal verifier has an important task in reducing the number of pending claims especially for controlling the suitability of coding with diagnoses on medical resumes. This research explain that the performance of internal verifier doctors in reducing the number of pending claims in Koja Hospital in 2018 by reviewing claims files and observations on claim data from 2017 to 2019. This study uses an intervention evaluation study design by analyzing quantitative and qualitative data. The method used is to compare data coding errors on pending hospitalization claims Pre-intervention and Post-Intervention doctor internal verifiers both in number of claims …

Analisis Ketidaklengkapan Rekam Medis Pasien Rawat Inap Di Rumah Sakit Dharma Kerti Tabanan, Made Karma Maha Wirajaya, Ni Made Umi Kartika Dewi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

One parameter to determine the quality of health services in hospitals are information from medical records that is good and complete. Based on observations, there are some pieces of missing medical records and there are still some incomplete medical records. This study aim to analysis the complete inpatients medical records at Dharma Kerti Tabanan Hospital. This study was descriptive study conducted at the Dharma Kerti Tabanan Hospital. This study use 232 inpatients medical records and use systematic random sampling. Based on the results of the analysis found that in terms of completeness of identification, classified as incomplete (99.14%). In terms …

Pengaruh Pelaksanaan Code Stemi Terhadap Strategi Pemasaran Rsupn Dr Cipto Mangunkusumo, Eka Ginanjar, Amal Chalik Sjaaf, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Nowadays, the competition in the hospital industry business is getting tougher. For this reason, hospitals are required to have innovations and strategies to attract patients. One of the necessary things to encourage patients to come to the hospital is a good hospital marketing strategy. This research aims to identify the impact of CODE STEMI program on the marketing strategy of the Cipto Mangunkusumo National General Hospital. This research uses quantitative methods by tracking medical records and administrative documents, as well as qualitative methods by observation and in-depth interviews. The results showed a decrease in mortality, MACE, door to balloon time, …

Analysis Of Marketing Mix Element Affecting Medical Tourism, Tiara Edithia Natalia, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Medical tourism sector, for third world nowadays, is a multifactorial sector that has slowly risen to the point of becoming one of the industries that produces income and pretty competitive in the world, and also has been considered as sophisticated tourism in modern field. This study aims to investigate the elements of the marketing mix and other factors that influence medical tourism. Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) was used in this study From 11 articles reviewed, it’s found that almost all of the marketing mix element were related to medical tourism in a country. Some …

Strategi Pemasaran Pelayanan Home Care Rumah Sakit Umum Bhakti Rahayu Denpasar, I Nyoman Gede Bayu Wiratama Suwedia, Maria Wahyu Daruki

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Changes in the pattern of diseases to degenerative diseases and chronic diseases are growing lately and many hospitals have not yet developed chronic disease services. Bhakti Rahayu General Hospital has one of them Home Care (HC) services that has been running but has not developed well due to the lack of marketing to patients with categories and diagnoses of diseases that can be treated with HC, so it is necessary to develop and plan strategies in marketing home care services as one of the hospital's earnings. This study was conducted using a pattern of observation and participation; in-depth interviews with …

Factors Influencing Family Burden In Pediatric Hematology/Oncology Encounters, Hannah R. Abrams, Hayden S. Leeds, Heidi V. Russell, Melody B. Hellsten

Journal of Patient-Centered Research and Reviews

Purpose: Caring for a child with cancer or hematologic disease places unique stress on a family unit. Families’ subjective experience of this care-related burden mediates the relationship between cost and health-related outcomes. While financial costs are well described for families of pediatric hematology/oncology patients, it is unclear how cost and other factors each contribute to families’ overall experience of care-related burden. This study identifies and groups the challenges that families report and describes their association with overall reported burden.

Methods: This mixed-methods analysis of a cross-sectional single-center study was conducted via structured, self-administered questionnaire provided to inpatient and outpatient caregivers …

"The Healing Of America" And The Next Steps For American Healthcare, Carter A. Hanson

Student Publications

An exploration of three healthcare systems—France, United Kingdom, and Canada—and what can be learned for them. Elements from the three national systems are combined into a proposal for reforming the American healthcare system into a devolved single-payer system.

Regional Variation In Chronic Kidney Disease And Associated Factors In Hypertensive Individuals In Rural South Asia: Findings From Control Of Blood Pressure And Risk Attenuation-Bangladesh, Pakistan And Sri Lanka, Liang Feng, Hithanadura Asita De Silva, Imtiaz Jehan, Anuradhani Kasturiratne, Gulshan Himani, Mohammad Abul Hasnat, Tazeen Jafar, Cobra-Bps Study Group

Community Health Sciences

Background: We aimed to determine the prevalence of chronic kidney disease (CKD) and its cross-country variation among hypertensive individuals in rural Bangladesh, Pakistan and Sri Lanka. We also explored the factors associated with CKD in these populations.
Method: We studied baseline data from the Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka (COBRA-BPS) trial, an ongoing cluster randomized controlled trial on 2643 hypertensive adults ≥40 years of age from 30 randomly selected rural clusters, 10 in each of the three countries. CKD was defined as an estimated glomerular filtration rate (eGFR) /min/1.73 m2 or a urine albumin:creatinine …

Understanding Young Adult Survivors Of Childhood Cancers’ Participation In Late Effects Screening: A Mixed Methods Approach, Kristen Trost Mantlo

Health Services Research Dissertations

Significant advancements in the treatment of childhood cancers have helped to increase the 5-year survival rate from 56% in the early 1970s to approximately 80-85% in the early 2000s (Greenlee, Murray, Bolden, & Wingo, 2000; Hampton, 2005). Treatment modalities such as chemotherapy and radiation have led to many serious long-term side effects, known as late effects. Between 60% and 90% of survivors develop some form of long-term chronic condition due to their treatment and up to 40% of those conditions will be life-threatening (Howlader, N. et al., 2013). While the majority of young adult survivors of childhood cancer are at …

The Upper East Side Vs Central Harlem: What Is Responsible For The Dermatology Disparities That Shaped These Communities?, Zakiya Cush, Jeffrey Weinberg

Annual SHSP Student Research and Scholarship Day

Very few studies have been done to understand why there is a paucity of dermatology practices in the Central Harlem (CH) community in Manhattan. This ecological and exploratory study will identify factors such as, geographical location, race, socioeconomic status, health care and medical education, as reasons why there is a disparity between the dermatology services in the CH community versus the Upper East Side (UES) of Manhattan. Thus, examining the differences in the neighborhoods as a mediator, it is hypothesized there is a need for increased dermatology practices to CH, as not catering to the clinical needs of a community …

World Health Organization Cardiovascular Disease Risk Charts: Revised Models To Estimate Risk In 21 Global Regions, Stephen Kaptoge, Lisa Pennells, Dirk De Bacquer, Marie Therese Cooney, Maryam Kavousi, Gretchen Stevens, Leanne Margaret Riley, Stefan Savin, Taskeen Khan, Servet Altay, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions.

Methods: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history …

Hematological Indices Of Pesticide Exposure Rice Farmers In Southern Thailand, Wiyada Kwanhian, Supabhorn Yimthiang, Siriuma Jawjit, Junjira Mahaboon, Udomratana Vattanasit, Phiman Thirarattanasunthon

Kesmas

The most common pesticides used in rice farming are organophosphates and carbamates. These pesticides inhibit acetylcholinesterase (AChE) activity, resulting in excessive levels of acetylcholine accumulation and disrupted neurotransmission. This study compared AChE activity and hematological parameters between pesticide-using rice farmers, non-pesticide using rice farmers, and non-agricultural occupational groups (non-farmers). Pesticide residues that accumulated in rice and the water and soil of the study area were also determined. AChE activity of all participants showed 10 from 87 samples (11.49%) as borderline depressed, with 50% of these being pesticide-using farmers. Most of the hematological parameters were normal in all samples. However, platelet …

Analysis Of Traditional Health Care In Three Community Health Centers In West Java Province, Indonesia, 2018, Adik Wibowo, Evita Diniawati, Than Tun Sein

Kesmas

The National Traditional Health Care set up three objectives for its implementation at the health centers, whereby health staff to be trained on traditional health and provide accupressure care, able to collect data, register and provide technical guidance to traditional healers and guide individuals in the use of traditional medicine and herbs. This qualitative research aimed to analyze the implementation of traditional health care at 3 subdistrict health centers Ciomas, Ciawi and Caringin in district Bogor. Data was collected through document analysis, observation and indepth inteview. Each health center has trained staff in accupressure but care is hindered by lack …

Behavior Problem Impact To Decreasing Kidney Function Among Migrant Workers, Laily Isroin, Made Suandika

Kesmas

Indonesian Workers were undergoing 18% of hemodyalysis from the number of hemodyalysis patients. They did not know about CRF. The study aimed to analyze the behavior of migrant workers who were suffering hemodyalysis. The study used a qualitative design with a phenomenological approach, that is carried out on former migrant workers who suffer from chronic kidney failure. Indepth interview used as data collection. While data validation used triangulation and confirmability. Data analysis techniques was done by reducing and interpreting the data. The study show migrant workers behavior before becoming migrant workers were very pathetic. They often drunk kind of energy …

Effects Of Son Preference On Contraceptive Use In Bangladesh, Mohammad Nazmul Hoq

Kesmas

Son preference resulting from traditional beliefs, social customs and economic benefits including support of aging parents is widespread not only in Bangladesh but also in many Asian and African countries, which are believed for low levels of contraceptive use. To carry out the research task effectively and efficiently, the research work extracted 16,858 currently married women aged 15-49 out of 17,863 ever-married women from a nationally representative 2014 Bangladesh Demographic and Health Survey Data (BDHS, 2014) set. Levels of contraceptive prevalence rate of the respondents having only daughters is found only 48.4, which is remarkably lower than the national average …

The Risk Of Hypertension In Adulthood As A Consequence Of Adolescent Obesity, Demsa Simbolon, Epti Yorita, Ruzita Abd Talib

Kesmas

Population increase in adolescence are associated with increased overweight and obesity problems. If this problem not early intervention will have an impact on increasing hypertension prevalence and risk of death. This research aimed to explain the consequences of overweight and obesity in adolescent to hypertension in adults. The study used Indonesian Family Life Survey (IFLS) data with a retrospective cohort study. Adolescent BMI measurements on 2007 and the risk of hypertension on 2014. Population are all adolescents aged 10-20 years in 2007. Sample of 1,697 adolescent who randomly IFLS 2007 with the inclusion criteria: biological children and a single birth, …

Duration Of Hormonal Contraception And Risk Of Cervical Cancer, Yuni Kusmiyati, Annisaputri Prasistyami, Heni Puji Wahyuningsih, Hesty Widyasih, Qorinah Estiningtyas Sakilah Adnani

Kesmas

The use of long hormonal contraceptives can disrupt the balance of estrogen in the body, resulting in abnormal cell changes. This study aimed to determine a correlation between the duration of hormonal contraception and risk of cervical cancer. This study used a case-control design. The population were patients who had examined at a cancer installation and obstetrics-gynecology polyclinic Dr. Sardjito Hospital in 2018. Case samples were 95 women have cervical cancer diagnosis and control were 95 women with a negative pap smear. Sampling with random sampling. Dependent variable cervical cancer and independent variable the duration of hormonal contraception are obtained …

Private Midwives’ Perceptions On Barriers And Enabling Factors To Voluntary Counselling And Hiv Test (Vct) In Bali, Indonesia, Dinar Saurmauli Lubis, Lpl Wulandari, Ni Luh Putu Suariyani, Kadek Tresna Adhi, Sari Andajani

Kesmas

In Indonesia, more than half of pregnant women seek antenatal care (ANC) at private midwifery clinics. The midwives play an important role in advocating for voluntary counseling and testing (VCT) uptake among pregnant women during ANC. This study examined midwives’ perception of barriers and enabling factors with regards to refer pregnant women for HIV testing. The study was conducted in Denpasar City and Badung District, two localities in Bali with high HIV prevalence. Two focus groups discussions with 15 private midwives and five in-depth interviews were conducted. Data were transcribed verbatim and thematic analysis methods were used to examine patterns …

Challenges To Diabetes Self-Management For Adults With Type 2 Diabetes In Low-Resource Settings In Mexico City: A Qualitative Descriptive Study, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Denise Marron, Rosabelle Conover, Roberta Delvy, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from Seguro Popular in Mexico City.

Methods: This was a qualitative descriptive study conducted in three Seguro Popular primary care clinics in Mexico City using convenience sampling. Semi-structured interviews were conducted with participants and data were analyzed using a content analysis approach.

Results: The …

Effectiveness Of Community Outreach Hiv Prevention Programs In Vietnam: A Mixed Methods Evaluation, Lora L. Sabin, Katherine Semrau, Mary Bachman Desilva, Le T T Loan, Jennifer J. Beard, Davidson H. Hamer, Jordan Tuchman, Ted Hammett, Nafisa Halim, Manisha Reuben, Aldina Mesic, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background

In 2014, Vietnam was the first Southeast Asian country to commit to achieving the World Health Organization’s 90–90-90 global HIV targets (90% know their HIV status, 90% on sustained treatment, and 90% virally suppressed) by 2020. This pledge represented further confirmation of Vietnam’s efforts to respond to the HIV epidemic, one feature of which has been close collaboration with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Starting in 2004, PEPFAR supported community outreach programs targeting high-risk populations (people who inject drugs, men who have sex with men, and sex workers). To provide early evidence on program impact, …