Health Services Research Commons^™

The American Public’S Perception Of Illegal Steroid Use: A National Survey, 2013, Gary Siperstein, Neil Romano, Gizem Iskenderoglu, Anthony Roman, Floyd J. Fowler Jr., Max Drascher

Center for Social Development and Education Publications

Through the surge of news about doping scandals in the media, it is expected that the public is aware of the magnitude of the problem among professional athletes; however, it is uncertain whether the public is aware that the problem often starts when athletes are younger. To this end, the National Baseball Hall of Fame and Museum, the Taylor Hooton Foundation, and the Professional Baseball Athletic Trainers Society partnered with the Center for Social Development and Education and the Center for Survey Research at the University of Massachusetts Boston to conduct the most comprehensive national opinion survey to date to …

Cultural Competency In Health Care: Framework, Training And Evaluation - A Review Of The Literature, Diana Salas Coronado

Center for Social Policy Publications

Healthcare professionals are now more aware of the challenges they face when providing healthcare services to a culturally and racially diverse population. Cultural competency has emerged as a framework for understanding health disparities among racial and ethnic groups in particular, but also for women, the elderly, sexual orientation and gender identity, people with disabilities, and religious minorities. Although there are several definitions of cultural competency, each emphasizes the need for healthcare systems and providers to be aware of and responsive to patients’ cultural perspectives and backgrounds. One example defines cultural competency as “a set of congruent behaviors, attitudes, and policies …

A Mathematical Modeling Framework For Phlebotomist Scheduling And Blood Draw Assignments In Laboratory Medicine, Laquanda T. Leaven

Dissertations

Laboratory services in healthcare delivery systems play a vital role in inpatient care. Studies have shown that laboratory data affects approximately 65% of the most critical decisions on admission, discharge, and medication. Laboratory testing accounts for approximately 10% of hospital billing. Reducing laboratory costs would contribute to reducing total healthcare cost, which is one of the major goals for the U.S. healthcare delivery system. This research focuses on improving the performance of the hospital laboratory in a large hospital system. The intention of this study is to identify and then optimize the most critical stage to improve the entire laboratory …

An Economic Model To Value Companion Diagnostics In Non-Small-Cell Lung Cancer, Robert D. Lieberthal, Kellie Dudash, Rita S. Axelrod, Neil I. Goldfarb

College of Population Health Faculty Papers

Aim: An economic model was used to evaluate the potential economic impact and cost–effectiveness of companion diagnostic testing for patients with non-small-cell lung cancer (NSCLC). Materials & methods: A decision analysis model examined alternative patient management strategies for patients with advanced NSCLC who were not amenable to surgical treatment. A review of the literature provided the variables used to develop a timely base case and sensitivity analysis. A potential future scenario was also modeled. The model includes three options: conventional treatment (CT), new treatment (NT) and companion diagnostic (CD) strategy. Results: In the base case analysis based upon current data, …

Legal Issues With The Electronic Health Record, Hannah Jackson

Applied Research Projects

Introduction

The purpose of this paper is to make readers aware of the legal issues in the electronic health record (EHR) and the risks involved so they can be prepared. It is also to help provide solution to those who are already dealing with the risks. The goal of this Project is to reach out to health care facilities who are about to embark on a new chapter in health care that we call, the EHR. Everyone should know the risks of a product before purchasing and that is what my research will show.

Method

I used The Journal of …

Electronic Health Record Incentive Program Demonstrates Adoption Association With Improved Care, Keith Rosenbaum

Applied Research Projects

This study used Meaningful Use (MU) payment information as a proxy for electronic health record (EHR) adoption linked to Centers for Medicare and Medicaid (CMS) data indicating quality to demonstrate the association of EHR adoption with improved care. The CMS quality indicators used were comprised of data from the value-based purchasing (VBP) program, readmission reduction program, and hospital compare mortality data. Results showed a positive association of EHR adoption with the VBP data, which most closely aligns the MU achievement period with the quality measure period. Readmission and mortality data showed negative and neutral associations, respectively, with a less aligned …

Anesthesia Information Management Systems: A Review Of The History, The Products, And The Adoption Of These Systems, Emily G. Hoffner

Applied Research Projects

Anesthesia Information Management Systems (AIMS) have been growing in popularity and use over the past decade, but widespread adoption of these systems by anesthesia groups and hospitals across the country is yet to occur. The promise of AIMS reaches beyond basic anesthesia recordkeeping into a realm of complex, integrated systems with enhanced billing, improved regulatory requirements, improved communication amongst caregivers, and reduced medical-legal exposure. In fact, AIMS have been shown to improve patient care and can increase the financial performance of a group. Despite the documented benefits of AIMS, adoption of these systems is low. This paper will review the …

Correctional Telemedicine And Its Benefits For Female Inmates, Chelsea Oliver

Applied Research Projects

The purpose of this study is to identify health issues that are specific to the female population of correctional institutions and how telemedicine would be beneficial in providing healthcare to same. A questionnaire was developed using information from literature on the topics obtained from a variety of places. Once the questionnaire was completed, a randomly selected group of telemedicine providers received the questionnaire, along with an introduction and information on the study that was being conducted.

The barriers of this study came from telemedicine providers either not responding to the questionnaire entirely or the providers only being able to answer …

Closing The Meaningful Use Gap Between Small And Large Practices, Crystal L. Jones

Applied Research Projects

The Lack of Meaningful Use Awareness in small practices is very prevalent. One may ask why there is such a gap in MU Awareness amongst small and large practices. The answer is quite the same across the board for small practices, “Cost”. This misfortune has resulted in many small practice physicians and staff being objective to the adoption of an electronic health record system. They are indifferent about the penalties that will be enforced soon, if they do not follow suite with the guidelines mandated by the ARRA. Essentially, this thesis will provide statistical data on the adoption rate of …

An Evaluation Of The Role Of The Originator Of Catastrophic Edits/Data Overwrites Within The Veteran Health Administration, Britney Braxton

Applied Research Projects

Objective: To determine which job function causes or creates a large number of Catastrophic Edit/ Data Overwrites within VHA.

Methods: The study is based on data extracted from the Catastrophic Edits Monthly Reports reported by the HC IdM Team staff on the CEs that have occurred on the MPI. Catastrophic Edits (CEs) reported by the HC IdM team between November 2011 through December 2012 are examined.

Result: Out of the 2736 Potential Identity Changes, 115 actually resulted in a CE. The number of CEs created by each job title ranged from 1% by Employee Health Clerk to 28% by Eligibility …

Increasing Patient Engagement In The African American Community Through Personal Health Record Use, Andrea Perkins

Applied Research Projects

Personal Health records have many potential benefits to patients, caregivers and institutions. In order to meet meaningful use standards EHR systems must allow patients to be able to access and easily download their healthcare records and images for their own use. Previous studies have shown that African Americans are less likely to enroll in a personal health record than other ethnic populations. This study was done to research and identify possible barriers the have limited the utilization of personal health record use in the African American community. A preliminary survey and focus group were convened to discuss issues affecting PHR …

United States: Mental Health Issues In An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pharmacology and Nutritional Sciences Faculty Publications

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this chapter was to identify mental health problems in an adolescent medicine clinic population in Lexington, Kentucky and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. Of the patient population, 68% were urban, whereas 32% were rural. In terms of gender, 40% of the patients were male and 60% were female, 80% …

2013 Children’S Legislative Briefing Book, Nevada Institute For Children’S Research And Policy, Children’S Advocacy Alliance, Denise Tanata Ashby, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

The purpose of this Legislative Briefing Book is to provide a quick snapshot of some of the most pressing issues facing Nevada’s children in order to provide advocates and policymakers with a stepping stone in creating positive changes to improve the lives of Nevada’s children. While this book will not cover every issue facing our children, it is intended to highlight some of those where state policy may have an impact, covering issues in education, health, safety and security, and the juvenile justice system. Diligent efforts need to be made during the 2013 Legislative Session to improve policies, procedures and …

Teen Pregnancy Prevention Program Year Three Outcome Evaluation Report For The Southern Nevada Health District, Nevada Institute For Children’S Research And Policy, Southern Nevada Health District, Dawn Davidson, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

In the fall of 2010 the Southern Nevada Health District (SNHD) was awarded funding from the Federal Office of Adolescent Health to implement an evidence based teen pregnancy prevention curriculum. They have partnered with the Department of Juvenile Justice Services, the Clark County Department of Family Services, and the City of Las Vegas to offer this curriculum to the youth in juvenile detention, probation, community centers, and life skills classes for youth aging out of the foster care system. The Nevada Institute for Children’s Research and Policy (NICRP) has been contracted to complete the outcome evaluation for this program and …

Association Between Patient Experience And Hospital Financial Performance Pre And Post Implementation Of Centers For Medicare And Medicaid Services (Cms) Pay For Performance Initiative, Anthony C. Stanowski

MUSC Theses and Dissertations

Hospitals are the ultimate service providers in that no goods are produced. Hospital employees and independent providers deliver a highly technical set of services with the noble goal of improving the state of wellness of their patients. Historically, the hospital industry considered satisfying patients as secondary to conquering the disease of the patient. CMS' implementation of a Pay-For-Performance (P4P) system, within the context of a Value Based Purchasing (VBP) program, altered providers' perspective by associating a financial reward/penalty based on how well hospitals satisfied patients, as well as based on the provision of core clinical processes. In future years, the …

Approaches That Will Yield Greater Success When Implementing Self-Administered Electronic Data Capture Ict Systems In The Developing World With An Illiterate Or Semi-Literate Population, Stanley J. Mierzwa, Samir Souidi, Irene Friedland, Sarah A. Littlefield, Lauren L. Katzen, Craig Savel, Deborah Boccio, Saumya Ramarao

Reproductive Health

The Information Technology (IT) Group at the Population Council responded to a need for a technology solution that would help researchers obtain more accurate responses to survey questions that concerned subject matter of a sensitive nature. The IT Group had three goals: (1) to enhance research by obtaining the best data possible, (2) to operate successfully in the local environment and be welcomed by the local populations, and (3) to increase the efficiency and cost-effectiveness of the survey process. This paper outlines approaches to consider when designing and implementing self-administered information and communications technology (ICT) questionnaires in developing countries, and …

Children Served By Mainecare, 2012: Survey Findings, Nathaniel J. Anderson Ms, Mph, Kimberley Fox Mpa, Deborah Thayer Mba, Zachariah T. Croll Mph

Medicaid

The purpose of the annual Survey of Children Served by MaineCare is to monitor the quality of services delivered by MaineCare, the State's Medicaid and CHIP program. The 2012 survey examines the experiences of families with children. ages 0-17, who are enrolled in MaineCare using a standardized survey instrument (Consumer Assessment of Healthcare Providers and Systems--CAHPS--4.0H Child Medicaid Health Plan Survey). MaineCare scores very favorably compared with national benchmarks on CAHPS measures of Getting Needed Care, Getting Care Quickly, and How Well the Child's Doctors Community, with ratings at or above the 75th percentile on all the composites and individual …

Snp-Snp Interaction Network In Angiogenesis Genes Associated With Prostate Cancer Aggressiveness, Hui-Yi Lin, Ernest K. Amankwah, Tung-Sung Tseng, Xiaotao Qu, Dung-Tsa Chen, Jong Y. Park

School of Public Health Faculty Publications

Angiogenesis has been shown to be associated with prostate cancer development. The majority of prostate cancer studies focused on individual single nucleotide polymorphisms (SNPs) while SNP-SNP interactions are suggested having a great impact on unveiling the underlying mechanism of complex disease. Using 1,151 prostate cancer patients in the Cancer Genetic Markers of Susceptibility (CGEMS) dataset, 2,651 SNPs in the angiogenesis genes associated with prostate cancer aggressiveness were evaluated. SNP-SNP interactions were primarily assessed using the two-stage Random Forests plus Multivariate Adaptive Regression Splines (TRM) approach in the CGEMS group, and were then re-evaluated in the Moffitt group with 1,040 patients. …

Nevada Children’S Policy Update Bill And Bill Draft Requests - 2013 Nv Legislative Session, The Nevada Institute For Children’S Research And Policy, Children’S Advocacy Alliance

Nevada Institute for Children's Research and Policy Reports

Bill and Bill Draft Requests for 2013 NV Legislative Session for Nevada Children’s Policy Update.

Analysis Of Vitamin D Status At Two Academic Medical Centers And A National Reference Laboratory: Result Patterns Vary By Age, Gender, Season, And Patient Location, Jonathan R. Genzen, Jennifer T. Gosselin, Thomas C. Wilson, Emilian Racila, Matthew D. Krasowski

Psychology Faculty Publications

Background: Testing for 25-hydroxyvitamin D [25(OH)D] has increased dramatically in recent years. The present report compares overall utilization and results for 25(OH)D orders at two academic medical centers - one in New York and one in Iowa – in order to characterize the vitamin D status of our inpatient and outpatient populations. Results are also compared to those from a national reference laboratory to determine whether patterns at these two institutions reflect those observed nationally.

Methods: Retrospective data queries of 25(OH)D orders and results were conducted using the laboratory information systems at Weill Cornell Medical College / New York Presbyterian …

Plain Language Review Of Cardiovascular Health Among Indigenous Australians, Caitlin Gray

Research outputs 2013

This document summarises, in plain language, information about the cardiovascular health status of Aboriginal and Torres Strait Islander peoples. It provides information about :

• the various cardiovascular diseases and their risk factors
• the extent of cardiovascular disease (CVD) among Aboriginal and Torres Strait Islander people, including prevalence, hospitalisation and death rates
• types and levels of care for Aboriginal and Torres Strait Islander CVD patients
• strategies and programs that aim to improve the cardiovascular health status of Aboriginal and Torres Strait Islander people.

The publication is a plain language summary of the Review of cardiovascular health among Indigenous Australians (2013) by …

Bridging The Gap Between Health And Justice, Lior Gideon

Publications and Research

No abstract provided.

Plain Language Review Of Physical Activity Among Indigenous Australians, Caitlin Gray

Research outputs 2014 to 2021

This review provides information on physical activity among Aboriginal and Torres Strait Islander people. It is a valuable overview for people working in the area and aims to assists in the development/refinement of policies, strategies and programs. This review of physical activity among Aboriginal and Torres Strait Islander Australians has been prepared by the Australian Indigenous HealthInfoNet as a part of our contributions to 'closing the gap' in health between Aboriginal and Torres Strait Islander people and other Australians by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers …

The Influence Of Race And Socioeconomic Status On Routine Screening Practices Of Physician Assistants, Deshana Ann Collett

Theses and Dissertations--Educational Policy Studies and Evaluation

Health disparities in minorities and those of low socioeconomic status persist despite efforts to eliminate potential causes. Differences in the delivery of services can result in different healthcare outcomes and therefore, a health disparity. Some of this difference in care may attribute to discrimination resulting from clinical biases and stereotyping which may provide a possible source for the persistence of health disparities. Health disparities may occur because the delivery of services at some level is inadequate. Disparities resulting from the quality and quantity of care delivered by a practitioner result in differentiated delivery of healthcare, thus unequal health outcomes. The …

Integrated Services Post (Posyandu) As Sociocultural Approach For Primary Health Care Issue, Oedojo Soedirham

Kesmas

Kelahiran posyandu pada tahun 1980-an merupakan usaha pemerintah Indonesia untuk meningkatkan status kesehatan masyarakat, mengikuti panggilan internasional, Deklarasi Alma Ata (Kazakhstan) tentang kesehatan masyarakat tahun 1978. Konsep kunci deklarasi tersebut adalah partisipasi masyarakat. Di Indonesia, partisipasi masyarakat disebut “gotong royong”. Masyarakat memainkan peran penting dalam meningkatkan kesehatan masing-masing. Untuk melibatkan masyarakat dalam kesehatan masyarakat, relawan harus direkrut dan dilatih untuk mengenal isu-isu kesehatan masyarakat dasar. Gagasan mengenai relawan yang disebut kader (village health worker) tersebut diajukan agar relawan sebagai bagian dari masyarakat dapat lebih mudah menyampaikan program-program kesehatan karena lebih dekat dibandingkan pejabat kesehatan masyarakat. Di dalam artikel ini dibahas …

Changes In Latitudes, Changes In Attitudes: Fqhcs And Community Clinics In A Reformed Health Care Market, Jessamyn Taylor

National Health Policy Forum

The Patient Protection and Affordable Care Act of 2010 and the Supreme Court’s related decision have significantly shifted the health care landscape for safety net providers. Federally qualified health centers (FQHCs) are a mainstay of primary care for the uninsured and those with limited access to care. This paper focuses on the impact of health reform on FQHCs given the significant federal investment in them through grants, Medicaid, and Medicare reimbursement. Where noteworthy, the effect on non-FQHC community clinics is also discussed. The implications of Medicaid coverage expansions (or lack thereof in states that choose not to expand), Medicaid disproportionate …

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Drug Overdose Morbidity And Mortality In Kentucky, 2000-2010: An Examination Of Statewide Data, Including The Rising Impact Of Prescription Drug Overdose On Fatality Rates, And The Parallel Rise In Associated Medical Costs, Terry Bunn, Svetla Slavova

Kentucky Injury Prevention and Research Center Special Report

From Foreword:

Kentucky has seen an explosion in fatal poisonings, particularly prescription drug related fatalities, in the last decade. In 2009, Kentucky had the 5^th highest drug overdose rate in the US, increased from the 6^th highest drug overdose fatality rate determined in 2008 (CDC WONDER). Kentucky also had the 5^th highest nonmedical use of opioid pain relievers, and 11^th highest for opioid pain reliever sales in the nation (CDC, MMWR Report November 4, 2011). These drug overdose mortality statistics are extremely startling and only begin to reveal the devastating mental, emotional, and economic toll and …

Building A Strategic Framework For Comparative Effectiveness Research In Complementary And Integrative Medicine, Claudia M. Witt, Margaret Chesney, Richard Gliklich, Lawrence Green, George Lewith, Bryan Luce, Anne Mccaffrey, Shelly Rafferty Withers, Harold C. Sox, Sean Tunis, Brian M. Berman

Dartmouth Scholarship

The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM) to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER): (1) CER studies should be made a priority in this field; (2) stakeholders should be engaged at every stage …