Health Services Research Commons^™

California Network Project: Ecosystems, Partnerships, & Power Building Report, Core (Center For Outcomes Research & Education)

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Descriptive Exploration Of Overdose Codes In Hospital And Emergency Department Discharge Data To Inform Development Of Drug Overdose Morbidity Surveillance Indicator Definitions In Icd-10-Cm, Leigh M. Tyndall Snow, Katelyn E. Hall, Cody Curtis, Allison L. Rosenthal, Emilia Pasalic, Sarah Nechuta, James W. Davis, Bretta Jane Jacquemin, Sherani R. Jagroep, Peter Rock, Elyse Contreras, Barbara A. Gabella, Katherine A. James

Peer Reviewed Articles

Background: In October 2015, discharge data coding in the USA shifted to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), necessitating new indicator definitions for drug overdose morbidity. Amid the drug overdose crisis, characterising discharge records that have ICD-10-CM drug overdose codes can inform the development of standardised drug overdose morbidity indicator definitions for epidemiological surveillance.

Methods: Eight states submitted aggregated data involving hospital and emergency department (ED) discharge records with ICD-10-CM codes starting with T36-T50, for visits occurring from October 2015 to December 2016. Frequencies were calculated for (1) the position within the diagnosis billing fields where …

Gender And Racial Disparity For Hospital Emergency Service Usage In Usa: A Quantitative Analysis For Various Age Groups During 2010–2017., Subhendra N. Sarkar, Anthony F. Devito, Evans Lespinasse, Faisal Khosa

Publications and Research

Background: Annually emergency department (ED) services are utilized by more than 100 million Americans making ED usage trends important determinants of healthcare quality, outcomes and cost. Previous workers have demonstrated the existence of disparity in various healthcare services in USA although a comprehensive analysis has not been undertaken. Dahlgren and Whitehead rainbow model has offered insights for multiple factors of influence on an individual’s health and focuses on the relationships among these factors. The Commission on Social Determinants of Health (CSDH; WHO initiatives) suggests that the social and environmental factors are at the root of most of the inequalities responsible …

Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Contraceptive use in Ghana has remained low despite annual increases since 2012. Having a high unmet need for family planning (FP) suggests that there may be barriers to access and uptake. Over time, several policies, including Ghana’s Costed Implementation Plan from 2015–20, have suggested FP initiatives to improve contraceptive use yet they have not been entirely implemented. Further, although FP was included in the health insurance act passed in 2003, amended in 2008, and revised in 2012, which indicated that health-care benefits include FP, people continue to pay out of pocket for services at National Health Insurance Authority facilities because …

The Role Of The Opioid Crisis In Elder Abuse, Kimberly I. Snow Mhsa, Jennifer Pratt, Stuart Bratesman Mpp

Disability & Aging

As the opioid crisis has deepened over the past twenty years, its effect on individuals and families, including older adults, has grown. To find out how the opioid crisis might be impacting elder abuse, neglect, and exploitation in Maine, we conducted a mixed methods analysis of 2015-2018 Maine Adult Protective Services (APS) investigations to determine: 1) Did opioid-related investigations increase over time? 2) Do investigations involving opioid misuse or abuse differ from investigations that don’t involve opioids? 3) What themes or features of cases involving opioid misuse or abuse by clients and/or perpetrators emerge from the data?

Key Findings: The …

Frontline Health: Harmonizing Metrics, Advancing Evidence, Accelerating Policy—Project Overview Brief, Frontline Health Project

Reproductive Health

Despite decades of technological and medical progress globally, half the world’s population still lacks access to essential health care due to insufficient numbers and types of health workers, especially in remote settings. There is growing recognition that well-supported community health workers (CHWs) are essential for effective delivery of primary health care (PHC). Despite broad consensus on the importance of CHWs, few countries have successfully integrated them as part of PHC at scale, and many lack official statistics on the performance of CHW programs. USAID, UNICEF, and the Bill & Melinda Gates Foundation developed a Memorandum of Understanding to collaborate on …

Assessment Of Community Pharmacists’ Involvement In Public Health Promotion Services In Beirut, Lebanon, Mira Medawar, Maha Aboul Ela, Souraya Domiati

BAU Journal - Health and Wellbeing

Background: The role of pharmacists is growing globally; the shift from the traditional role of preparing and dispensing medications, to a role in medication therapy management and public health services is started to be acceptable worldwide.

Objective: The aim of the study was to assess the participation level of community pharmacists’ in certain public health services promotion as well as the barriers that hindered such provision.

Method: A questionnaire based study has been carried targeting Lebanese community pharmacists working in Beirut, Lebanon. Socio-demographic information, types of public health consultations offered in the pharmacy, and the barriers confronted by the community …

Pengaruh Bauran Pemasaran Terhadap Kepuasan Pasien Yang Diperoleh Dari Tingkat Kunjungan Pasien Ke Rumah Sakit: Literature Review, Akhmad Safi’I, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Efforts to satisfy consumer needs are carried out by every company with various strategies and methods with the hope that consumers will be satisfied and will make repeat purchases. If a consumer has turned into a loyal customer because his satisfaction is fulfilled, then the consumer will not switch to other similar company products or services. In the context of a hospital as well, people will selectively choose a hospital that they consider satisfied with hospital services and the impact on loyalty obtained from increased patient visits. This article aims to determine the effect of the marketing mix on patient …

Strategi Pemasaran Program Green Laboratory Menuju Green Hospital Dengan Metode Segmenting, Targeting, And Positioning Serta Marketing Mix Di Rsup Dr. Sardjito, Yogyakarta, Purbosari Purbosari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Health services have the main objective of improving health and preventing disease with the community as the main target. The demand for service needs from hospital customers has shifted towards a complete service based on the comfort and safety of the hospital environment. The green hospital policy is the answer to the shift in demands for the quality of hospital services for the community. In an effort to realize Dr. Sardjito as an environmentally friendly hospital (green hospital), the Integrated Laboratory Installation (ILK) has great potential to contribute through its role as a green laboratory. One of the efforts that …

Strategi Pemasaran Dalam Pengembangan Pelayanan Klinik Estetika, Maria Wahyu Daruki, I Nyoman Gede Bayu Wiratama Suwedia

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Aesthetic Services is growing in many big cities and developing cities in Indonesia. It is due to the tendency of people who want to improve their physical performance, in the era of national health insurance, private hospitals must also improve and add services to clients while maintaining good service and adding new services which can be another source of income for hospital. Services provided with mottto from Bhakti Rahayu Hospital Denpasar "we care and we serve" Bhakti Rahayu Hospital Denpasar wants to be able to provide beauty and skin care services to the community at large with low prices and …

Strategi Pemasaran Program In Vitro Fertilization (Ivf) Dengan Metode Segmenting, Targeting, And Positioning Dan 4p (Product, Place, Price, Promotion) Di Denpasar, Bali, Ida Ayu Wirastuti, Ni Putu Ayu Prima Dewi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Medical services related to infertility, In Vitro Fertilization (IVF), or often called IVF, are apparently increasingly in demand by the people of Indonesia. This is shown by the continued growth of patients in the country who use medical services related to IVF. Within a year, the growth reached 25%. In fact, the potential market is predicted to reach 200 thousand patients. Bali Royal Hospital is one of the private hospitals located in Denpasar City, where one of the superior services owned by the Hospital is IVF or IVF. Where this IVF program has also been present in several hospitals in …

Best Bets: Vouchers For Rights-Based, Voluntary Family Planning—International Evidence On Financing Of Family Planning, Benjamin Bellows, Moazzam Ali, Ali M. Mir

Reproductive Health

To meet the FP2020 and Sustainable Development Goals (SDGs), significant investments are required by countries and donors in priority areas, including sustainable financing, reaching all adolescents, expanding availability of services to the poorest and hard-to-reach populations, and improving the quality and increasing the range of methods available. Studies show that vouchers can substantially contribute to SDG goals by expanding contraceptive access and choice among underserved populations. Vouchers can be an effective financing tool to enhance equity, increase access, and improve the quality of FP services available to underserved populations within Pakistan.

Peningkatan Mutu Dan Kemampuan Pelayanan Laboratoriumoratorium Di Rs Harapan Sehati, Eko Suprayogi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

According to Permenkes RI No. 411/Menkes/Per/III/2010, Clinical Laboratoriumoratory is a health laboratoriumoratory that carries out clinical specimen examination services to obtaininformation about individual health, especially to support efforts to diagnose diseases, and restore health. Therefore, clinical laboratoriumoratory requirements have also been determined according to its level (pratama, middle or major). The Harapan Sehat Hospital (Harti Hospital) is a hospital that was physically built as a General Hospital with a classification of C with a capacity of 110 beds (TT). The profile of the laboratoriumoratory at Harti Hospital, prior to repairs, was the pratama general clinical laboratoriumoratory that collaboratoriumorated with outside …

Timeliness Of Ehdi Benchmarks In Infants With A Nicu Admission Greater Than Five Days: Analysis From A Retrospective Cohort, Caitlin Sapp, Tammy O'Hollearn, Elizabeth Ann Walker

Journal of Early Hearing Detection and Intervention

The purpose of this study was to examine the timeline of early hearing healthcare in infants with a history of lengthy (> 5 days) admission to a neonatal intensive care unit (NICU) compared to non-NICU peers. We compiled four years of state Early Hearing Detection and Intervention (EHDI) records from 156,335 infants using a statewide administrative database. We compared age at the time of newborn hearing screening, diagnostic audiological evaluation, and entry into early intervention in NICU infants and non-NICU infants. We also compared the proportion of NICU and non-NICU infants meeting prescriptive EHDI timing benchmarks based on the Joint …

The Impact Of Medicare Insurance Plans Upon Healthcare Services Utilization Considering Patients' Characteristics And Their Access To Medical Care, Steven Stout

Dissertations

The annual average cost of healthcare for services utilization by a Medicare beneficiary is projected to grow from about $10,000 to over $16,000 by 2023. As an ongoing initiative to address this trend, the federal government contracts with private insurance companies and other entities, called Medicare Advantage Organizations (MAOs), to develop and administer alternative health insurance plans designed to contain service utilization and costs. One feature of some Medicare Advantage plans is the presence of risk-bearing contracts with primary care physician organizations that voluntarily accept financial responsibility for the overall cost of care for patients attributed to them. In this …

A Prospective Study Of Patterns Of Regret In The Year After Hysterectomy, Roopina Sangha, Andrew Bossick, Wan-Ting K. Su, Chad Coleman, Neha Chavali, Ganesa Wegienka

Journal of Patient-Centered Research and Reviews

Purpose: This study sought to identify patterns of self-reported regret after hysterectomy.

Methods: Women undergoing hysterectomy for a benign indication were recruited in the 2 weeks prior to surgery. Women reported demographics and completed validated questionnaires (Decisional Regret Scale, Patient Health Questionnaire-9, Decisional Conflict Scale, and the Comprehensive Score for Financial Toxicity) up to 7 times over the first year postsurgery. Medical records were reviewed for clinical and operative details. Latent class growth mixture models were applied to the repeated regret scores to identify patterns after hysterectomy. Clinical and other participant characteristics were compared across the classes.

Results: Three latent …

Discordance In Perceptions Of Barriers To Breast Cancer Treatment Between Hispanic Women And Their Providers, Swapna Reddy, Mary Saxon, Nina Patel, Matthew Speer, Tiffany Ziegler, Nirali Patel, Madison Ziegler, Stephany Esquivel, Andrea Daniella Mata, Asha Devineni, Pooja Paode, Nitika Thawani, Subhakar Mutyala

Journal of Patient-Centered Research and Reviews

Despite comparable screening and incidence rates that are 26% below that of non-Hispanic Whites, Hispanic women present with breast cancer at more advanced stages of disease, representing a continuing and troubling health disparity for this population. Reducing these disparities warrant more innovative research approaches to better understand perspectives of Hispanic patients regarding barriers to treatment and how these perspectives compare to those of their providers. A pilot qualitative study was conducted at a major urban cancer center in Arizona that measured both patient and provider perspectives regarding barriers to treatment. Through a multimethod qualitative analysis, researchers surveyed patients and providers …

Action Items For Breast Cancer Awareness Month, Deanna J. Attai

Journal of Patient-Centered Research and Reviews

This special issue introduction provides a brief history of Breast Cancer Awareness Month and focuses on patient populations often omitted from annual marketing campaigns. The importance of research is emphasized as a means to improve the outcomes of people with metastatic breast cancer and male breast cancer as well as to address health care inequities related to breast cancer diagnosis and treatment.

Parental Concerns And Uptake Of Childhood Vaccines In Rural Tanzania – A Mixed Methods Study, Lavanya Vasudevan, Joy Noel Baumgartner, Sara Moses, Esther Ngadaya, Sayoki Godfrey Mfinanga, Jan Ostermann

Faculty Publications

Background

Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.

Methods

Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. …

An Evaluation Of The Coverage Of Theoretically Based Implementation Factors In Disseminated Classroom Physical Activity Programs., Hannah G. Calvert, Hannah G. Lane, Carolina M. Bejarano, Kelli Snow, Kate Hoppe, Nicole Alfonsin, Lindsey Turner, Jordan A. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

Classroom-based physical activity (CBPA) is increasingly recommended as a method to support children's physical activity, health, and academic performance. Many adoption-ready programs exist to aid in the implementation of CBPA in schools; yet, implementation rates remain low. The purpose of this study was to evaluate the extent to which resources provided by adoption-ready CBPA programs addressed theory-based implementation contextual factors to support implementation. Existing CBPA programs (N = 37) were identified through Internet searches and all materials (e.g., implementation guides) provided by each program were coded for their inclusion of 51 implementation factors based on the Consolidated Framework for Implementation …

Supporting Academic Primary Care Teams Serving Refugees: A Qualitative Study, Gabrielle Waclawik Md Mph, Fabiana Kotovicz, Devin Walsh-Felz Md Mph, Savitri Tsering Mssw, Nancy Pandhi Md Mph Phd

Journal of Refugee & Global Health

Introduction: Primary care providers continue to experience significant challenges when caring for refugee patients, yet they are often refugees’ initial point of contact with the U.S. health care system. The purpose of this qualitative study is to expand our understanding of the experiences of academic primary care team members during clinical encounters with refugee patients.

Methods: This multi-perspective, qualitative study included physicians (faculty and residents), nurse practitioners, pharmacists, nurses, and medical assistants (n=10), who have been working with refugee patients for at least one year at two family medicine residency clinics and/or a community health center. Semi-structured in-person interviews were …

Covid-19 Treatment Resource Disparities And Social Disadvantage In New York City, Jason A. Douglas, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

Black and Hispanic communities in the U.S. have endured a disproportionate burden of COVID-19-related morbidity and mortality. Racial and ethnic health disparities such as these are frequently aggravated by inequitable access to healthcare resources in disadvantaged communities. Yet, no known studies have investigated disadvantaged communities' access to COVID-19-related healthcare resources. The current study accordingly examined racial and ethnic differences in (1) April 2020 COVID-19 total and positive viral test rates across 177 New York City (NYC) ZIP Code Tabulation Areas (ZCTA); and (2) November 2019–April 2020 licensed and intensive care unit (ICU) hospital bed access across 194 NYC ZCTAs. Pairwise …

Project Soar Research Informs National Policy Change In Tanzania Expanding Access To Hiv Services For Marginalized Populations, Population Council

Research Utilization and Impact Briefs

A recent Project SOAR study evaluated community-based delivery of antiretroviral treatment to female sex workers (FSWs) in Tanzania, demonstrating the value of this approach to improve HIV care. Informed by these findings, the Government of Tanzania changed national guidance to allow for community-based HIV treatment to better meet the needs of marginalized populations, including FSWs.

Measuring Service Quality And Assessing Its Relationship To Contraceptive Discontinuation: A Prospective Cohort Study In Pakistan And Uganda, Karen T. Chang, Nirali M. Chakraborty, Amanda M. Kalamar, Waqas Hameed, Ben Bellows, Karen A. Grépin, Agha Xaher Gul, Sarah E K. Bradley, Lynn M. Atuyambe, Dominic Montagu

Community Health Sciences

Background: The quality of contraceptive counseling that women receive from their provider can influence their future contraceptive continuation. We examined (1) whether the quality of contraceptive service provision could be measured in a consistent way by using existing tools from 2 large-scale social franchises, and (2) whether facility quality measures based on these tools were consistently associated with contraceptive discontinuation.
Methods: We linked existing, routinely collected facility audit data from social franchise clinics in Pakistan and Uganda with client data. Clients were women aged 15-49 who initiated a modern, reversible contraceptive method from a sampled clinic. Consented participants completed an …

Influence Of Incentive Design And Organizational Characteristics On Wellness Participation And Health Outcomes, Jessica Grossmeier, David J. Mangen, David R. Anderson, Stefan B. Gingerich, Rebecca J. Mitchell, Mary T. Imboden, Gordon D. Kaplan, Gregg M. Gascon, Seth A. Serxner, Tony Bodak

Faculty Publications - Department of Kinesiology

Objective: To explore how changing incentive designs influence wellness participation and health outcomes.

Methods: Aggregated retrospective data were evaluated using cluster analysis to group 174 companies into incentive design types. Numerous statistical models assessed between-group differences in wellness participation, earning incentives, and over-time differences in health outcomes.

Results: Four incentive design groups based on requirements for earning incentives were identified. The groups varied in support for and participation in wellness initiatives within each company. All four design types were associated with improved low density lipoprotein (LDL)(P < 0.01), three with improved blood pressure (P < 0.001), and two with improved fasting glucose (P < 0.03). No incentive plan types were associated with improved body mass index (BMI), but designs predominantly focused on health outcomes (eg, Outcomes-Focused) exhibited a significant increase over time in BMI risk.

Conclusion: Incentive design and organizational characteristics impact population-level participation and health outcomes.

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham

Senior Theses

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and the dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. …

Facing Covid-19: Knowledge, Attitudes, Practices, And Challenges Of Healthcare Providers, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). During this study, 60 health care providers that represented 60 unique health facilities in Punjab’s Rahim Yar Khan district were interviewed by telephone, to evaluate how much they know about COVID-19 symptoms, prevention, and treatment, as well as their individual attitudes, practices, and challenges during the ongoing pandemic. To assess how the situation evolved during the critical first three months of …

Poor Women's Reproductive Health And Family Planning Challenges And Needs During The Covid-19 Pandemic, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). The study conducted 164 interviews by telephone with beneficiaries of the Benazir Income Support Programme (BISP) in Rahim Yar Khan, Pakistan, previously surveyed in 2019, to determine how much those most vulnerable to the effects of COVID-19 know about the disease and its effects, in addition to understanding the pandemic’s effects on their lives, including their mental health and well-being as …

Household And Personal Air Pollution Exposure Measurements From 120 Communities In Eight Countries: Results From The Pure-Air Study, Matthew Shupler, Perry Hystad, Aaron Birch, Daniel Miller-Lionberg, Matthew Jeronimo, Raphael E. Arku, Yen Li Chu, Rehman Khawaja, Romaina Iqbal, Khawar Kazmi

Community Health Sciences

Background: Approximately 2·8 billion people are exposed to household air pollution from cooking with polluting fuels. Few monitoring studies have systematically measured health-damaging air pollutant (ie, fine particulate matter [PM_2·5] and black carbon) concentrations from a wide range of cooking fuels across diverse populations. This multinational study aimed to assess the magnitude of kitchen concentrations and personal exposures to PM_2·5 and black carbon in rural communities with a wide range of cooking environments.
Methods: As part of the Prospective Urban and Rural Epidemiological (PURE) cohort, the PURE-AIR study was done in 120 rural communities in eight countries …