Health Services Research Commons^™

Determinants Of Family Planning Unmet Needs In West Java And Policy Recommendations During The Covid-19 Pandemic (Based On Advanced Analysis Of 2019 Skap Data), Ayudina Larasanti, Dumilah Ayuningtyas, Rina Herartri Herartri, Margareth Maya Parulianta Naibaho

Journal of Indonesian Health Policy and Administration

The Unmet Need for Family Planning (KB) in 2019 is still far from the 2015-2019 Strategic Plan target set at 9.91 percent. Seventeen provinces have a percentage of Unmet Need KB above the national figure (14.4 percent). One of them is WestJava Province, with a percentage of Unmet Need of 14.8%. Provinces with a high number ofUnmet Needs require the attention of policymakers, especially in the COVID-19 pandemic. West Java is the high-risk red zone category of COVID-19. Increased public awareness of the transmission of Covid-19 is an additional constraint to reducing the Unmet Need for family planning in the …

Evaluation Of The Implementation Of The Performance-Based Capitation Policy (Kbk) At The Merial Health Clinic Of Dki Jakarta City In 2020, Muktamar Umakaapa, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

To improve the quality of health services at Primary Health Care (FKTP) in implementing the National Health Insurance Program in Indonesia, the government has issued a performance-based capitation payment (KBK) policy at the FKTP. This study aims to evaluate the performance-based capitation payment policy in Merial Health clinic from the aspects of effectiveness, efficiency, facilities and infrastructure, availability of human resources, adequacy, and legal compliance. This study performed in-depth interviews and document reviews. The results showed that the effectiveness of the policy has been optimal but is still constrained by the socialization of the KBK policy and visits to health …

Swot Analysis Of Psbb Policy Implementation At Public Facilities Or Areas In Bekasi City In March-June 2020, Lidya Dwijayani

Journal of Indonesian Health Policy and Administration

: The government of Bekasi City has released specific policies related to PSBB, which started from April 15, 2020, until the fifth amendment that will be over on July 2, 2020, due to the high prevalence of confirmed COVID-19 cases in Bekasi City. Methods: Our study using a combination approach between Media Content Analysis for collecting the secondary data and SWOT analysis plus Trias Policy Analysis in evaluation and identification the role of several elements related to specific policies released from the Government of Bekasi City. Result: There are some best recommendations based on our SWOT analysis and Trias Policy …

A Study On Legal Policy Of Pharmacy Education And Pharmacy Workers Related To The Urgency Of Establishing Pharmacy Law, Rasta Naya Pratita, Adang Bachtiar

Journal of Indonesian Health Policy and Administration

According to the 1945 Constitution of the Republic of Indonesia, health is one of the basic human rights. One of the aspects that support health is the aspect of pharmacy. Pharmacy workers consist of Pharmacists and Pharmacy Technical Workers according to Law No. 36/2014 regarding Health Workers. In practice, pharmacy education in Indonesia is considered not sufficient to prepare the pharmacy workforce. There are currently contradictions in the applied pharmaceutical policy, where the number of pharmacy undergraduate programs is 279, while the number of pharmacist study programs is only 45. This results in an imbalance of graduates. There is a …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

The Associations Of Chronic Stress, Social Support, Health Behaviors And Metabolic Syndrome Among Hispanic Women, Edna Esquer

Dissertations

The Associations of Chronic Stress, Social Support, Health Behaviors and Metabolic Syndrome Among Hispanic Women

Background: Metabolic syndrome (MetS) prevalence is 25% among Mexican American women 30 – 49 years of age, compared to 22% among non-Hispanic Whites in the United States. Little is known about the additional contributions of chronic stress, social support and health behaviors to the development of MetS among this population.

Purpose: Describe the associations between chronic stress, social support, and health behaviors and the presence of MetS in Hispanic women living in an underserved community.

Methods: A retrospective cohort study design. The Adult Treatment Panel …

Identifying Causes Of Readmission At Unm Hospital, Jewel Meyer-Hagen Ms3, Justine Yang Ms3, Christopher Bartlett Md, Avanika Mahajan Ms3, Susie Pham Ms3, Ishan Shah Do, Harsh Sharma Md, Jessie Rogers Md, Brianna Muller Md, Julia Howard Do, Radha Denmark Np, Gabriel Palley Md, Anthony Worsham Md

Quality Improvement/Patient Safety Symposium

Background/Introduction:

Inadequate coordination of care and poor transition of care quality are known contributors to hospital readmission. Patient readmission is a known risk factor for poor patient outcomes. Department of Internal Medicine (DOIM) readmission rate was 13.18% during fiscal year (FY) 2020, and is 13.58% to date during FY21. The objective of this study is to identify system-based drivers of readmission, understand why the readmission rate has increased from FY20 to FY21, and design interventions to address identified gaps.

Methods:

Developed a survey using RedCap. Retrospective chart review of 104 randomly selected patients discharged from UNMH during fiscal year 2020 …

Development And Psychometric Properties Of Surveys To Assess Provider Perspectives On The Barriers And Facilitators Of Effective Care Transitions, Maurice C. Johnson Jr., Helen Liu, Joann Sorra, Jane Brock, Brianna Gass, Jing Li, Jessica Miller Clouser, Karen Hirschman, Deborah Carpenter, Huong Q. Nguyen, Mark V. Williams

Center for Health Services Research Faculty Publications

Background
The quality of the discharge process and effective care transitions between settings of care are critical to minimize gaps in patient care and reduce hospital readmissions. Few studies have explored which care transition components and strategies are most valuable to patients and providers. This study describes the development, pilot testing, and psychometric analysis of surveys designed to gain providers’ perspectives on current practices in delivering transitional care services.

Methods
We underwent a comprehensive process to develop items measuring unique aspects of care transitions from the perspectives of the three types of providers (downstream, ambulatory, and hospital providers). The process …

Men And Oral Health: A Review Of Sex And Gender Differences, Martin S. Lipsky, Sharon Su, Carlos J. Crespo, Man Hung

OHSU-PSU School of Public Health Faculty Publications and Presentations

Sex and gender related health disparities in oral health remain an underappreciated and often over looked aspect of well-being. The goal of this narrative review is to identify sex and gender related oral health disparities by summarizing the current literature related to differences in oral health between men and women. The review identified that men are more likely to: ignore their oral health, have poorer oral hygiene habits, and experience higher rates of periodontal disease, oral cancer, and dental trauma. Men also visit dentists less frequently and compared to women seek oral treatment more often for an acute problem and …

Effects Of Social Determinants Of Health In Progression To Type 2 Diabetes, Folabi I. Ariganjoye

Applied Research Projects

The prevalence of prediabetes and diabetes in the United States and around the world has increased faster than expected in the last 30 years. The economic burden this costs a nation can be astronomic both in terms of expense and loss in productivity. One-third of U.S. adults, 86 million people, have prediabetes. Effective management is needed that can reach these 86 million, and others at high risk, to reduce their progression to diagnosed Type 2 diabetes. After the literature review, there was not enough literature to support how these led to the progression to diabetes. The abundant literature is centered …

Examination Of Access, Utilization, And Barriers To Care Among Special Populations In The United States, Jed R. Hansen

Theses & Dissertations

Utilizing healthcare services is a complex phenomenon in the United States. While system-level barriers and facilitators of care, along with individual consumer choices, are known to affect access and subsequent use of services, the interaction among the factors that lead to utilization remains unknown. Examining access and utilization of healthcare services using a consumer framework incorporating both access barriers and facilitators and consumer-level dimensions that affect choice in seeking care may inform access and utilization research. The purposes of this dissertation were 1) to explore the presence of facilitators and barriers to care in ambulatory healthcare locations for non-emergent care …

The Role Of Primary Care Physicians In Post-Partum Depression (Ppd), Elizabeth Bowman

Rowan-Virtua Research Day

Background

• Symptoms of depression lasting longer than 2 weeks following birth
• 10-15% of new mothers affected yet 50% of cases go undiagnosed
• Long-lasting consequences for the mother, baby, and father
• Multi-factorial condition

Conclusion

• Primary care providers are the first-line defense against PPD
• Many providers are resistant to PPD screenings
• Interventions from primary care providers are effective

Mental Health Outcomes At A Student-Run Free Clinic, Jessica-Sophie Horoschak, Riya Tandra, Sahil Parikh, Shayna Peterzell, Roma Padalkar, Tara Pellegrino

Rowan-Virtua Research Day

In this project we aim to:

1. Assess the outcomes of screening, management, and diagnosis for patients at the Rowan Community Health Center (RCHC).

2. Compare the outcomes of screening, management, and diagnosis between different groups (gender, race, income, insurance status) using validated surveys.

3. There is a need for accessible and affordable primary care in the South Jersey area, which the RCHC is hoping to meet.

Hypothesis:

The quality of mental health care available to patients at the RCHC is comparable to that at other insured practices.

Measuring The Impact Of The Affordable Care Act Medicaid Expansion On Access To Primary Care Using An Interrupted Time Series Approach, Elizabeth A. Brown, Brandi M. White, Walter J. Jones, Mulugeta Gebregziabher, Kit N. Simpson

Health and Clinical Sciences Faculty Publications

BACKGROUND: The Patient Protection and Affordable Care Act of 2010, commonly referred to as the Affordable Care Act (ACA), was created to increase access to primary care, improve quality of care, and decrease healthcare costs. A key provision in the law that mandated expansion of state Medicaid programme changed when states were given the option to voluntarily expand Medicaid. Our study sought to measure the impact of ACA Medicaid expansion on preventable hospitalization (PH) rates, a measure of access to primary care.

METHODS: We performed an interrupted time series analysis of quarterly hospitalization rates across eight states from 2012 to …

Lip Biopsy Trends In The United States: A 7-Year Review Of Medicare Provider Utilization And Payment Database, Nardin Awad, Fady Awad, Amanda Azer

Rowan-Virtua Research Day

Biopsy of the lip is a procedure most used by dermatologists in order to obtain histopathological evaluation of a lesion. It has remained the definitive method of diagnosis for many pathologies, including malignancy. However, although the incidence of lip malignancy has been relatively unchanged since 2012, the number of lip biopsies performed has not followed the same trend, but rather steeply declined since. In this study, the national trends in lip biopsies are evaluated. The Medicare Provider Utilization and Payment (MPUP) database was used to evaluate these practice trends in Medicare providers.

Lipid Profile And Admission/Discharge Locations As Predictors Of 60 Day Readmission In Adults 65 Or Older With Type 2 Diabetes Mellitus, Zac Dalton, Terrie Ginsberg, Matthew Mclaughlin

Rowan-Virtua Research Day

Introduction: Reducing 30 and 60 day hospital readmissions is critical to our healthcare systems. Older folks with type 2 diabetes mellitus (T2DM) account for a disproportionate amount of readmissions. Through recognizing factors that correlate to readmissions, patients at risk may be identified.

Objective: To conduct a retrospective review of electronic medical records (EMR) to determine if there is an association between the lipid profile and admission and discharge locations of hospitalized older adults and whether they were rehospitalized 60-days post discharge.

Methods: EMRs were reviewed of 86 randomly selected consenting participants who were admitted to a community hospital and were …

Loss Of Obstetric Services In Rural Appalachia: A Qualitative Study Of Community Perceptions, Caroline R. Efird, David Dry, Rachel F. Seidman

Journal of Appalachian Health

Background: As rural hospitals across the United States increasingly downsize or close, the availability of inpatient obstetric services continues to decline in rural areas. In rural Appalachia, the termination of obstetric services threatens to exacerbate the existing risk of adverse birth outcomes for women and infants, yet less is known about how the cessation of these services affects the broader community.

Purpose: The purpose of this paper is to explain how the loss of local obstetric services affects perceptions of healthcare among multi-generational residents of a remote, rural Appalachian community in western North Carolina.

Methods: An interdisciplinary team of researchers …

An Intersectional Analysis Of Lgbtq+ Healthcare In The United States, Nicole Niles

Senior Honors Projects

LGBTQ+ healthcare has made some significant progress in the last few decades, yet countless studies have shown that the American healthcare system still lags behind in equitable healthcare. My project sought to identify the issues that prevent the LGBTQ+ community from receiving quality healthcare, which involved the curation of over twenty academic journal articles for an annotated bibliography, along with a paper discussing these articles.

One of the most important concepts to gender studies is intersectionality. Coined by legal theorist Kimberlé Crenshaw in 1989, intersectionality describes the concept of how one’s individual characteristics, including race, class, and gender, intersect and …

Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky

Capstone Experience: Master of Public Health

Unbefriended patients often experience an extended length of stay in the hospital while their medical providers await legal appointment of a public guardian to make their medical decisions. The medically unnecessary days the unbefriended patient spends in the hospital equates to high costs for the hospital, but more importantly, negative health outcomes for the patient. The purpose of this study is to provide literature and data to support recommendations for possible changes in Nebraska’s public guardianship appointment process. A literature review seeks to answer: (1) What is the median hospital length of stay for an unbefriended patient without a guardian …

Social Justice Attitudes And Health: A Cross Sectional Study, Edward Donovan

Senior Honors Projects

Background: Increasingly, social justice is being considered as a key factor associated with health outcome. In addition, there is growing interest in exploring perception of discrimination in healthcare settings. This study explored perceptions of social justice, health care discrimination, health care status and utilization of healthcare resources. The investigators predict a significant association between the level of social justice awareness and healthcare utilization based on the hypothesis that those who are cognizant of social inequities are more likely to be informed self-advocates in healthcare settings.

Methods: First, a survey was created based on a review of existing literature. The …

Medicare-Paid Naloxone: Trends In Non-Metropolitan And Metropolitan Areas, Chris Delcher, Yue Cheng, Minji Sohn, Jeffery C. Talbert, Patricia R. Freeman

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Medicare pays for the largest share (> 30%) of naloxone dispensed from retail pharmacies in non-metropolitan areas.
• Medicare-paid dispensing has grown since 2013, but from 2017-2018 dispensing growth in non-metropolitan areas slowed considerably compared to metropolitan areas (42% v 121%, respectively).
• As of 2018, the rate of naloxone dispensing to Medicare enrollees in metropolitan areas was approximately double that in non-metropolitan areas (4.9 v 2.9 per 1,000 enrollees, respectively).

Access To Healthcare For The Hispanic/Latino Population, Rebecca Loritz

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: The U.S. Hispanic/Latino population faces significant barriers to accessing healthcare. The most common barriers Latinos face are language barriers, cost barriers, immigration statuses, insurance coverage barriers, transportation barriers, health literacy and education barriers, as well as lack of access to healthcare providers. These barriers impact not only their ability to access healthcare but also the quality of healthcare they receive.

Purpose: To synthesize the existing literature evaluating that identifies barriers to healthcare.

Methods: CINAHL and PubMed were systematically searched, along with a manual internet search for journal articles that studied access to care issues for the Latino population in …

Factors Associated With Health Coverage Gaps And Cost Barriers To Health Services In U.S. Adults Before And After The Aca, Danielle Kilchenstein

Loma Linda University Electronic Theses, Dissertations & Projects

Background

Health law known as the Affordable Care Act (ACA) was passed in 2010 and implemented in 2014 in the U.S. It was intended to reduce cost burdens to health coverage and care.

Purpose

Self-reported health coverage gaps and cost barriers to physical, mental, dental care, and prescription medications of U.S adults before and after the implementation of the ACA in 2014 were examined to determine impacts of health reform on marginalized populations.

Methodology

Cross-sectional secondary data analysis was conducted using National Health Interview Survey Data from the Integrated Public Use Microdata Set (2010-2017). The 140,341 surveys represented an average …

A Descriptive Case Study Of The Challenges Of Drug And Alcohol Counselors, Ruben Herron

Graduate Theses and Dissertations

Substance abuse is the number one public health problem in Oklahoma and nationally. Annual related expenses of substance abuse in Oklahoma are nearly $2 billion. This qualitative descriptive case study asks the question what are the challenges of substance-abuse counseling? The researcher will be describing in detail the history of drug and alcohol treatment and counseling in America. Using interviews, observations and document collection which will allow the interviews voices to be heard.

Agreement Success Plan, Miranda Holtz

Capstone Projects and Master's Theses

Monterey County Health Department’s Administration Bureau works with contracts and agreements for the Public Health Bureau, which detail what services programs will complete so that they can receive funding or maintain a partnership with the County. The problem was that a large portion of the management analyst’s time was dedicated towards technical support for agreements. The Agreement Success Pan is aimed to increase efficiency by aiding program staff with agreements through a Prezi, which is similar to a self-paced webinar. The project had three phases; interviews of program supervisors or managers, gathering supporting documents, and final launch. Afterward, a questionnaire …

Rurality As A Moderator Of Perception Of Need For Medical Care And Patient Satisfaction, Kyndal Grammer

Electronic Theses and Dissertations

Many individuals experience barriers to accessing medical care, especially in rural areas. Some barriers are attitudinal and represent perceptions of quality care. Patient satisfaction and perceived need for medical care are two such attitudinal barriers related to health care utilization, yet the relationship between these variables has not been explored. Using data from an online survey, the current study examined the association between these variables, and further, whether rurality status moderated this association. Results indicated a significant correlation between patient satisfaction and perception of need. Although the overall moderation model was significant, perception of need was not significantly associated with …

Improving Data Access And Use For Hiv Biomedical Prevention Interventions, Project Soar

HIV and AIDS

Over the past decade, biomedical prevention interventions—including voluntary medical male circumcision (VMMC) and oral pre-exposure prophylaxis (PrEP)—have resulted in substantial gains in controlling the global HIV epidemic. Despite the inclusion of these highly effective interventions in multinational strategies and global prevention toolkits, their effective implementation rests upon context-specific, data-driven delivery to priority populations and geographies. Project SOAR has contributed to the evidence base by increasing access to and use of data through user-friendly interfaces and dissemination strategies, advancing VMMC and PrEP as vital prevention interventions in the global discourse. SOAR’s biomedical prevention portfolio has supported data-driven planning, implementation, and monitoring …

Optimizing Delivery Of Hiv Testing Services To Strengthen The Continuum Of Care, Project Soar

HIV and AIDS

HIV testing is a critical entry point to life-saving antiretroviral therapy (ART) for those diagnosed with HIV and to prevention services for those at high risk of acquiring HIV. Despite advances in testing, there remain a variety of social and programmatic challenges that prevent access to HIV testing services, particularly for men and key populations. HIV program managers and policymakers are increasingly invested in understanding how best to deliver HIV testing services to different populations and to maximize health system resources at facility and community levels. Project SOAR has contributed to the evidence base and catalyzed research use by examining …

Approaches To Research Utilization And Capacity Strengthening, Project Soar

HIV and AIDS

Research plays a critical role in strengthening programming and policymaking. Donors and other stakeholders are increasingly focused on ensuring that their research investments yield positive health and development outcomes. Yet, there are many challenges in ensuring study findings are used by relevant decisionmakers to inform policies and programs. Recognizing the need to invest in research uptake efforts beyond dissemination of final findings, Project SOAR utilized an active approach to facilitating research utilization (RU) to fulfil the commitment of implementation science to promote the systematic uptake of research finding into routine practice. Project SOAR assembled and implemented a systematic and proactive …

Improving Patient Outcomes Through Innovative, Community-Based Hiv Treatment Strategies, Project Soar

HIV and AIDS

Despite the availability of life-saving treatment for HIV, several barriers prevent patient access to high-quality services. HIV program managers and policymakers have shown increasing interest in understanding how best to deliver HIV treatment to different populations and maximize health-system resources at facility and community levels. Project SOAR recognizes the key role that treatment services play in achieving UNAIDS’ 90-90-90 goals for controlling the HIV epidemic through testing, treatment, and viral suppression by 2020. Project SOAR has contributed to the evidence base and catalyzed research use by assessing innovative strategies for antiretroviral treatment (ART) delivery that support different populations in remaining …