Health Services Research Commons^™

Feasibility And Validity Of Asking Patients To Define Individual Levels Of Meaningful Change On Patient-Reported Outcomes, Salene M.W. Jones, Yuxian Du, Ari Bell-Brown, Kaylin Bolt, Joseph M. Unger

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcomes (PROs) are frequently used in clinical care to monitor treatment response. However, most guidelines on PRO use treat all patients the same. This study tested the feasibility and validity of a method for determining individually meaningful change in PRO measures.

Methods: Participants (n = 398) completed 12 pain and distress questions to define individually meaningful change. This mixed-methods study used both quantitative and qualitative analyses, including descriptive statistics, inferential statistics, and content analysis.

Results: Two-thirds (67%) of the sample reported at least one medical condition, including depression and back pain. Most participants (70%–90%) were able to answer …

A 2-Hour Diabetes Self-Management Education Program For Patients With Low Socioeconomic Status Improves Short-Term Glycemic Control, Michael G. Jakoby Iv, Melissa Schleder, Vickie Luff, Cynthia Yergler, Albert Botchway, Cheryl Burns

Journal of Patient-Centered Research and Reviews

Diabetes self-management education (DSME) improves glycemic control, but patients with low socioeconomic status face institutional and personal barriers to receiving DSME. A retrospective single cohort study of a 2-hour group DSME program prioritizing accessibility and completion of a tightly focused curriculum was performed to determine if glycemic control improved and whether a longer, more comprehensive, prospective evaluation of the program is indicated. All patients who participated in the program from September 2017 to December 2018 were included in the analysis. The primary study endpoint was change in hemoglobin A1c (HbA1c) from baseline. A total of 58 out of 94 patients …

Defining And Characterizing Frequent Attenders: Systematic Literature Review And Recommendations, Dip Shukla, Erik Faber, Brian Sick

Journal of Patient-Centered Research and Reviews

Purpose: To decrease cost and improve efficiency, health care organizations have focused on frequent attenders — patients with high health care utilization. Prior studies have investigated singular health care settings, used varying definitions of frequent attendance, and inconsistently identified factors correlated with frequent attendance. The purpose of this article is to suggest a uniform definition of frequent attenders for different health care settings and to determine factors correlated with frequent attendance.

Methods: This systematic review of three databases identified 2761 unique articles; 174 met inclusion criteria. Studies were analyzed for their definition of frequent attenders and factors associated with frequent …

Proximity To Comprehensive Emergency Obstetric Care And The Utilization Of Facility-Based Delivery Services Across Six Low-And-Middle Income Countries, Chioma T. Amadi

Dissertations and Theses

Background: More than 90% of maternal deaths occur in low-and-middle-income countries (LMICs) and are largely attributed to preventable pregnancy-related causes. Comprehensive emergency obstetric care (EmOC), also known as signal functions, is the most effective life-saving intervention for managing obstetric and newborn emergencies. Health facilities offering delivery services are generally classified as having either comprehensive, basic or less than basic EmOC capacity based on their obstetric resources. Multiple EmOC methods are regularly utilized in characterizing facility obstetric capacity and this introduces inconsistencies that pose significant public health and policy implications for access to delivery care among women within a service environment. …

Tuberculosis Medication Nonadherence—A Qualitative Case Study, Karthick Swaminathan, Lalitha Ramakrishnan, C. S. G. Krishnamacharyulu

The Qualitative Report

India is grappling with the problem of controlling tuberculosis nearly for the past 50 years. The problem of nonadherence to treatment regimen has also worsened the situation of multidrug resistant tuberculosis (MDR-TB) in India. This article explores the factors behind nonadherence among erstwhile TB defaulters in a rural district in India. In-depth interviews with seven chronic defaulters and with healthcare professionals were conducted at a government-run Chest Clinic. In addition to in-depth interviews with defaulters and healthcare professionals, medical records and government orders related to TB control were examined extensively. Participants were also observed to understand their interaction with healthcare …

Assessing Mobile Phone Access, Usage, And Willingness Among Women To Receive Voice Message-Based Mobile Health Intervention To Improve Antenatal Care Attendance In District Thatta, Sindh, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Sarah Saleem

Community Health Sciences

Background: Pakistan has one of the highest maternal mortality ratios worldwide at 276/100,000 live births and only 51% percent of women receive four or more ANC visits. This means that there are missed opportunities for almost half of the women who were not able to seek the recommended antenatal visits. In Thatta district, the maternal mortality ratio is estimated at 313/100,000 live births. Various studies reported that mHealth interventions have proven to be effective to improve antenatal care and postnatal care services. However, the feasibility and effectiveness of mobile health interventions to increase uptake of preventive maternal healthcare services among …

Strengthening The Evidence Base For Telehealth For Abortion Service Delivery, Nadi Kaonga

Journal of Maine Medical Center

Telehealth – which is the use of information and communication technology to provide clinical services to patients remotely – provides an opportunity to extend safe abortion services to women. A recent review article on telehealth for abortion service delivery found it to be acceptable, feasible and safe when compared to in-person service delivery. Despite the promising findings, the evidence base can and should be strengthened to optimize the impact of such services for women. Areas for improvement include evaluating the efficacy and effectiveness of telehealth implementations in more remote settings and with women across variable levels of technoliteracy, conducting cost-effectiveness …

Open Public Health Data Discovery: Start With Re3data.Org, Charles J. Greenberg, Sangeeta Narang

Libraries Scholarship

Background: Open public health data consists of organized online data repositories assembled during or after public health investigations. There are enormous quantities of organized public health repository data emerging in a variety of academic, government, or non-commercial discipline or subject repositories. A new registry of research data repositories, re3data.org, has the potential to improve the identification, access, and reuse of public health data, as well as promote best practices of data preservation and management. The intention of this investigation is to provide an introduction to effective use re3data.org for access to shared open public health data.

Description: The authors examined …

Delivery Of Sexual And Reproductive Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Dina Sami Khalifa, Michelle F. Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Sarah Metek, Shailja Shah, Reena P. Jain, Daina Als, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: It is essential to provide comprehensive sexual and reproductive health (SRH) interventions to women affected by armed conflict, but there is a lack of evidence on effective approaches to delivering such interventions in conflict settings. This review synthesised the available literature on SRH intervention delivery in conflict settings to inform potential priorities for further research and additional guidance development.
Methods: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and SRH. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries …

Hpv Vaccination In Females: The Role Of Primary Health Care And Primary Health Care Providers, Brooke Bouza

Graduate Theses and Dissertations

Two reasons for subpar coverage of the Human papillomavirus (HPV) vaccine are missed clinical opportunities and nonacceptance of the vaccine upon recommendation from a medical provider. The purpose of study one was to examine factors associated with access and adherence to physician’s recommendations in association with HPV vaccine uptake. Data were obtained from National Health Interview Survey (2017). Variables theoretically related to clinical opportunities and adherence to physician’s recommendations were examined in association with HPV vaccine uptake. Univariate logistic regressions were run to determine the associations between the aforementioned variables and uptake of the HPV vaccine. Multinomial logistic regressions were …

Differential Vpu-Mediated Cd4 And Tetherin Downregulation Functions Among Major Hiv-1 Group M Subtypes, Gisele Umviligihozo, Kyle D. Cobarrubias, Sandali Chandrarathna, Steven W. Jin, Nicole Reddy, Helen Byakwaga, Conrad Muzoora, Mwebesa B. Bwana, Guinevere Q. Lee, Peter W. Hunt, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Downregulation of BST-2/tetherin and CD4 by HIV-1 viral protein U (Vpu) promotes viral egress and allows infected cells to evade host immunity. Little is known however about the natural variability in these Vpu functions among the genetically diverse viral subtypes that contribute to the HIV-1 pandemic. We collected Vpu isolates from 332 treatment-naive individuals living with chronic HIV-1 infection in Uganda, Rwanda, South Africa, and Canada. Together, these Vpu isolates represent four major HIV-1 group M subtypes (A [n = 63], B [n = 84], C [n = 94], and D [n = 59]) plus intersubtype …

Penggunaan Media Sosial Di Rumah Sakit: A Systematic Review, Andini Tri Wijayati, Angesti Drea Habsari Drea Habsari, Arinahaq Arinahaq, Fiki Kusumasari, Rosa Selvia, Rovels Agber Maywell Iroth

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The progression of Internet access changes from passive consumer interaction becomes active consumer to seek health information. Social media not only a recreational instrument but also for business and organization. Initially, consumers obtained health information from websites that were one-way (only receiving information) but nowadays social media change consumer become two directions (receiving and spread information). This eligibility study was a systematic review with PRISMA (Preferring Reposting Items for Systematic Review and Meta-Analysis Protocols) approach. Conducted by searching articles from one database Science Direct and published from January 2014 to 2019. Searching and screening proces resulted in 5 articles to …

Strategi Place Dalam Pemasaran Rumah Sakit Di Indonesia; Systematic Review, Asriyanti Bandaso, Dyani Kusumowardhan, Herlin Putri Tanjung, Lili Marliani, Megadianty Mokoginta

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospitals must have a good marketing plan to increase patient interest in using its services. Marketing mix is a marketing strategy consisting of product, price, place, promotion, people, process and physical evidence. The Place Strategy refers to the ease of consumers accessing services. For this reason, we want to know how the role of place strategy in hospital marketing mix in Indonesia. This systematic review uses the PRISMA method. Searching uses Google Scholar and Garuda Ristekdikti electronic databases. Inclusion criteria, research articles, published from 2010 to 2019, and carried out in Indonesia. The keywords are "Marketing Mix", Hospital, Place, and …

Analisis Pengaruh Bauran Pemasaran Terhadap Rumah Sakit Publik Dan Privat: Systematic Review, Tiara Edithia, Tantri Puspa Ditya, Dewi Citra Puspita

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The types of healthcare services available to patients in general may be divided into two categories – public and private hospitals. Mix-marketing element is a marketing approach that may be used to evaluate factors that affect patient tendency to choose one type of healthcare service. Aims: identify factors that affect patient tendency to choose public and private hospitals. This study implemented the Preferred report items for systematic reviews and meta-analysis (PRISMA) method. Literature search in PubMed and Google Scholar using the keywords mix-marketing element, private hospital, and public hospital resulted in six studies that use the mix-marketing element with a …

Faktor Harga Dalam Strategi Pemasaran Rumah Sakit, Silvia Evalina Tarigan, Retno Dewi Sulistyowati, Melanie Vandauli, Mia Mariani, Petra Ade Paramita Lestari Ade Paramita Lestari, Prisca Gisella

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

One element of a marketing strategy is the marketing mix. Marketing mix is growing, especially in the service sector, not only covering 4P, but including 7P. The 7P concept consists of (product, price, place, promotion, people, process, and physical environment) that is used to make decisions in making marketing communication strategies. In this literature study, particular will be discussed related to price factors in hospital marketing strategies. This literature study uses analysis methods from various sources such as textbooks, journal reference books and e-books related to price factors in hospital marketing strategies. Pricing is classified based on three approaches, including …

The Influence Of Marketing Mix In Medical Tourism, Heppi Kartika Rahmawati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Marketing mix, medical tourism, 7P marketing

Analisis Produk Layanan Layanan Rawat Inap Di Rsud Wangaya Denpasar Berdasarkan Stp Dan 4 P (Product, Price, Place Dan 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. The research conducted is descriptive research, which is a research method that aims 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 …

Pelayanan Consultation Liaison Psychiatry (Clp) Menuju Peningkatan Pelayanan Yang Lebih Holistik Di Rumah Sakit Tingkat Ii Udayana Denpasar, Rinie Indah Chandra Wirasati, Ede Surya Darmawan

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

In the past, the medical field was still dominated by a medical model approach which was still overshadowed by a physical-psychic dichotomy. The reality shows that there are a lot of 'sick' conditions that are not enough to be overcome only by a medical model approach. Many physical complaints do not show obvious physical abnormalities, as well as many physical diseases whose morbidity and mortality are strongly influenced by mental-emotional conditions. Not to mention the various conditions of chronic illness or disability, which have a mental-emotional / psychosocial impact that greatly reduces the quality of life of the patient in …

How Much Can Mexican Healthcare Providers Learn About Breastfeeding Through A Semi-Virtual Training? A Propensity Score Matching Analysis, Mireya Vilar-Compte, Rafael Pérez-Escamilla, Meztli Moncada, Diana Flores

Department of Public Health Scholarship and Creative Works

Background: Mexico has shown a worrisome decrease in breastfeeding indicators, especially in the lowest socioeconomic level. Improving breastfeeding protection, promotion, and support services through workforce development is a key area of intervention. The objective of this study is to assess the influence on breastfeeding knowledge and abilities of a semi-virtual training for primary healthcare providers assisting beneficiaries of PROSPERA in Mexico, which is one of the largest conditional cash-transfer programs in the world. Methods: Two independent cross-sectional samples of healthcare providers were drawn at baseline and post-intervention in three states of Mexico. Baseline data were collected among primary physicians, registered …

Structural And Social Determinants Of Opioid Abuse Among Florida-Based Hospitals, Donald R. Haley, Hanadi Hamadi, Jing Xu, Mei Zhao, Anh Viet Tran Nguyen, Dayana Martinez

Florida Public Health Review

Background: With over two million people suffering from opioid abuse disorders, the Centers for Medicare and Medicaid Services has identified opioid abuse as a key priority. Florida is one of eight states labeled as a high-burden opioid abuse and is an “epicenter” for opioid use and misuse.

Purpose: The purpose of this study was to discover potential predictors of opioid abuse in Florida by exploring specific healthcare delivery, geographic, and patient demographic factors.

Methods: A retrospective longitudinal study design was used to examine four years (2014-2017) of Florida inpatient administrative discharge data across 173 hospitals of opioid abuse rate. …

Pediatric Outpatient Utilization By Differing Medicaid Payment Models In The United States., Therese L Canares, Ari Friedman, Jonathan Rodean, Rebecca R Burns, Deena Berkowitz, Matt Hall, Elizabeth Alpern, Amanda Montalbano

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: In the United States (US), Medicaid capitated managed care costs are controlled by optimizing patients' healthcare utilization. Adults in capitated plans utilize primary care providers (PCP) more than emergency departments (ED), compared to fee-for-service (FFS). Pediatric data are lacking. We aim to determine the association between US capitated and FFS Medicaid payment models and children's outpatient utilization.

METHODS: This retrospective cohort compared outpatient utilization between two payment models of US Medicaid enrollees aged 1-18 years using Truven's 2014 Marketscan Medicaid database. Children enrolled > 11 months were included, and were excluded for eligibility due to disability/complex chronic condition, lack of …

Factors Affecting The Utilization Of Antenatal Care Among Married Women Of Reproductive Age In The Rural Thatta, Pakistan: Findings From A Community-Based Case-Control Study, Sumera Aziz Ali, Savera Aziz Ali, Anam Feroz, Sarah Saleem, Zafar Fatmi, Muhammad Masood Kadir

Community Health Sciences

Background: There are differences in antenatal care (ANC) utilization between urban and rural areas of Pakistan. Although multiple factors have been studied affecting the utilization of general health care services, the effect of road network distance particularly on the utilization of ANC has not been assessed. Therefore, this study aimed to determine the association between road network distance from a health care facility and utilization of the ANC among women of reproductive age in Thatta Pakistan.
Methods: A community-based case-control study was conducted in district Thatta, Pakistan. Women who did not utilize ANC services during their last pregnancy were considered …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training To The Fee-For-Service Medicare Population, Christian Rhudy, Aric Schadler, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2016, rural fee-for-service (FFS) Medicare beneficiaries represented 21.7% of the population diagnosed with diabetes, but only 2.7% of the population utilizing Diabetes Self-Management Training.
• Utilization of DSMT services in 2016 occurred in 76 rural counties and 309 urban counties.
• Average utilization rates of DSMT services were greater in rural counties than urban counties (5.5% vs. 2.5%).

Rural/Urban Disparities In The Utilization Of Health And Behavioral Assessments/Interventions In The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2016, rural county residents represented 21.8% of the fee-for-service (FFS) Medicare population, but only 1.6% of rural FFS beneficiaries live in a county with local utilization of Health and Behavioral Assessments and Interventions (HBAI) services.
• Utilization of HBAI services in 2016 occurred in 19 (9.7%) rural counties and 176 (90.3%) urban counties.
• Average utilization rates of HBAI services were higher in rural counties than urban counties (0.7% vs. 0.4%).

Rural/Urban Disparities In Utilization Of Medical Nutrition Therapy To The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2016, 21.8% of the fee-for-service (FFS) Medicare population resided in a rural county, but only 3.7% of enrollees residing in a county with utilization of Medical Nutrition Therapy (MNT) services were rural county residents.
• Utilization of MNT services in 2016 occurred in 92 rural counties and 388 urban counties.
• Average utilization rates of MNT services were greater in rural counties than urban counties (3.1% vs. 1.9%).

Major Depression, Treatment Receipt, And Treatment Sources Among Non-Metropolitan And Metropolitan Adults, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• 7.8% of non-metropolitan (weighted number of persons=2,755,020) and 7.1% of metropolitan (weighted number of persons=14,868,655) adults had past year major depression.
• Treatment receipt (seeing a health professional or using prescription medication for depressive feelings) was similar among non-metropolitan (68.0%) and metropolitan (64.6%) adults.
• A closer examination of the type and source of treatment revealed the following:

• Rates of seeing a health professional were similar among non-metropolitan (60.8%) and metropolitan (58.4%) adults, but rates of using prescription medication for depressive feelings were higher among non-metropolitan (58.2%) than metropolitan (48.6%) adults.
• Rates of visiting a general practice/family doctor …

Nih Funding For Research Underlying New Cancer Therapies, Ekaterina Galkina Cleary, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Contemporary discovery and development of cancer drugs are based on the model that investments in basic biomedical science will provide insights that can be translated into new cures. In the USA, basic research is primarily funded by the National Institutes of Health (NIH),1 which allocates half of its research budget to basic science,2 with smaller amounts contributed by philanthropy, academics, or industry.1 Basic science is formally defined as the “systematic study directed toward fuller knowledge or understanding of the fundamental aspects of phenomena and observable facts without specific application towards processes or products in mind”.3 However, science is often useinspired,4 …

Costs Of Maternity Leave To Support Breastfeeding; Brazil, Ghana And Mexico, Mireya Vilar-Compte, Graciela M. Teruel, Diana Flores-Peregrina, Grace J. Carroll, Gabriela S. Buccini, Rafael Perez-Escamilla

Department of Public Health Scholarship and Creative Works

Objective To develop a method to assess the cost of extending the duration of maternity leave for formally-employed women at the national level and apply it in Brazil, Ghana and Mexico. Methods We adapted a World Bank costing method into a five-step method to estimate the costs of extending the length of maternity leave mandates. Our method used the unit cost of maternity leave based on working women’s weekly wages; the number of additional weeks of maternity leave to be analysed for a given year; and the weighted population of women of reproductive and legal working age in a given …

Provision Of Mental Health Services By Critical Access Hospital-Based Rural Health Clinics, John A. Gale Ms, Zachariah T. Croll Mph, Nathan First Lcsw, Msw, Ma, Sara Kahn-Troster Mph

Rural Health Clinics

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural …