Health Policy Commons^™

Social Determinant Of Health Of Adults Smoking Behavior: Differences Between Urban And Rural Areas In Indonesia, Fitri Kurnia Rahim, Thunwadee Suksaroj, Isareethika Jayasvasti

Kesmas

Indonesia memiliki prevalensi perilaku merokok tertinggi di antara negara-negara di Asia Tenggara. Penelitian ini bertujuan untuk mengetahui prediktor terhadap perilaku merokok antara wilayah pedesaan dan perkotaan. Data diambil dari Global Adult Tobacco Survey. Penelitian menggunakan studi analitik potong lintang dan analisis regresi logistik ganda. Sampel berjumlah 8.305 orang dewasa Indonesia berusia ≥ 15 tahun. Penelitian menunjukkan bahwa perokok di wilayah pedesaan lebih tinggi dibandingkan di wilayah perkotaan, masing-masing 36,8% dan 31,9%. Prediktor signifikan terhadap perilaku merokok di wilayah pedesaan dan perkotaan adalah usia, pekerjaan, jenis kelamin, tingkat pendidikan, status ekonomi serta aturan merokok di dalam rumah. Di wilayah perkotaan, usia …

Effectivity Of Foot Care Education Program In Improving Knowledge, Self-Efficacy And Foot Care Behavior Among Diabetes Mellitus Patients In Banjarbaru, Indonesia, Mahdalena Mahdalena, Endang Sri Purwanti Ningsih

Kesmas

Masalah kaki diabetik di Indonesia masih merupakan masalah besar dan masih memerlukan perhatian yang optimal. Edukasi perawatan kaki adalah salah satu upaya yang harus dilakukan dalam mencegah masalah kaki untuk pasien diabetes melitus. Penelitian ini bertujuan untuk menganalisis efektivitas program pendidikan perawatan kaki dalam meningkatkan pengetahuan, efikasi diri, dan perilaku perawatan kaki pasien diabetes di wilayah Banjarbaru. Jenis penelitian yang digunakan adalah quasi experimental dengan prepost test, dilakukan di puskesmas wilayah Banjarbaru tahun 2013. Kelompok intervensi diberikan program pendidikan perawatan kaki. Sampel berjumlah 48 pasien (32 orang kelompok intervensi dan 16 orang kelompok kontrol) menggunakan teknik purposive sampling. Variabel yang …

Lack Of Exclusive Breastfeeding Among Working Mothers In Indonesia, Yulia Sari

Kesmas

Keberlangsungan proses menyusui pada saat ibu kembali bekerja merupakan isu serius yang harus segera ditindaklanjuti agar program pemberian Air Susu Ibu (ASI) eksklusif selama enam bulan pertama kehidupan dapat tercapai. Selain memberikan banyak manfaat bagi bayi, ASI juga bermanfaat bagi ibu dan pengusaha. Penelitian ini bertujuan untuk mengetahui hubungan ibu bekerja terhadap pemberian ASI eksklusif. Desain penelitian yang digunakan adalah potong lintang dengan data sekunder Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012 dengan sampel berjumlah 1.193 ibu berusia 15 – 49 tahun yang memiliki bayi berusia 0-5 bulan. Berdasarkan analisis multivariat, ibu bekerja dapat menurunkan peluang pemberian ASI eksklusif …

The Risk Of Pneumonia Among Toddlers In Lambatee, Aceh, Rapitos Sidiq, Ritawati Ritawati, Roma Sitio, Siti Hajar

Kesmas

Pneumonia merupakan salah satu masalah kesehatan global yang sangat penting pada anak bawah lima tahun (balita), khususnya pada negara-negara berkembang. Saat ini, pneumonia merupakan salah satu kasus penyebab kematian pada anak terbesar, terutama pada periode baru lahir. Di Provinsi Aceh, penyakit pneumonia merupakan penyakit urutan ke-8 dari 25 penyakit terbesar yang ditemukan di puskesmas dengan jumlah 1.112 kasus. Sedangkan besarnya kasus pneumonia pada penderita rawat jalan di Aceh mencapai 434 kasus (29,03%). Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian pneumonia pada balita. Penelitian bersifat analitik dengan desain potong lintang. Sampel penelitian adalah ibu dan balita yang berjumlah …

Motivation Variables To Use Contraceptive Among Male In Yogyakarta, Susiana Sariyati, Febrina Suci Hati, Fatimah Fatimah

Kesmas

Program Keluarga Berencana (KB) merupakan salah satu program pembangunan nasional yang sangat penting dalam rangka mewujudkan keluarga Indonesia yang sejahtera. Peran program KB sangat besar pengaruhnya terhadap kesehatan reproduksi seseorang, baik untuk kesehatan reproduksi perempuan maupun kesehatan reproduksi laki-laki. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan motivasi laki-laki pasangan usia subur dalam menggunakan kontrasepsi di Desa Bumijo, Kecamatan Jetis, Kota Yogyakarta. Jenis penelitian ini bersifat kuantitatif dengan analisis regresi logistik. Hasil penelitian menunjukkan hubungan pengetahuan dengan motivasi yaitu nilai p = 0,368. Hubungan sosial budaya dengan motivasi yaitu nilai p = 0,147. Hubungan pendidikan dengan motivasi yaitu nilai …

Coronary Heart Disease Risk Factors Among Women Aged Older Than 45 Years Old In Makassar, Masriadi Masriadi, Hasta Handayani Idrus, Arman Arman

Kesmas

Penyakit kardiovaskuler menyebabkan 8.6 juta kematian pada perempuan setiap tahun, yang merupakan penyebab kematian terbanyak, yaitu sepertiga dari seluruh kematian perempuan di seluruh dunia. Setengah dari seluruh kematian perempuan berusia di atas 50 tahun disebabkan oleh penyakit jantung dan stroke. Penelitian ini bertujuan untuk menganalisis faktor yang berhubungan dengan penyakit jantung koroner pada perempuan usia > 45 tahun di Rumah Sakit TNI AU Dody Sarjoto Makassar. Besar sampel sebanyak 76 sampel yang terdiri dari 64 kasus penyakit jantung koroner dan 12 kasus non penyakit jantung koroner. Penentuan sampel menggunakan metode purposive sampling. Data primer diperoleh melalui wawancara terhadap responden dengan menggunakan …

Basis For Development Of Business Strategic Plan Primary Health Care With Local Public Service Entity Status In Gianyar District, Putu Ayu Indrayathi, Luh Putu Sinthya Ulandari

Kesmas

Puskesmas yang berbentuk Badan Layanan Umum Daerah (BLUD) perlu membuat rencana strategi bisnis yang tepat. Penyusunan rencana strategi bisnis perlu memerhatikan pesaing yang beroperasi di sekitar wilayah kerja. Penelitian ini bertujuan untuk mempelajari aspek lingkungan internal dan eksternal di Puskesmas Ubud 1 dan Tegallalang 1 serta mengembangkan model pengembangan rencana strategi bisnis di kedua puskesmas yang berstatus BLUD tersebut. Penelitian ini merupakan penelitian deskriptif eksploratif yang dilakukan pada tahun 2014. Data dikumpulkan melalui penyebaran kuesioner dan studi dokumentasi. Sampel penelitian ditentukan secara purposif dan diambil secara non proporsional, terdiri dari kepala dan staf Puskesmas Ubud 1 dan Tegallalalng 1. Data …

Family Planning Information, Education And Communication With Contaceptive Use, Endah Winarni, Muhammad Dawam

Kesmas

Komunikasi Informasi dan Edukasi (KIE) berperan penting dalam meningkatkan pencapaian prevalensi kesertaan Keluarga Berencana (KB). Namun, prevalensi KB di Indonesia selama satu dekade terakhir (2002-2012) tidak meningkat secara signifikan, walaupun pelbagai kegiatan KIE KB telah dilaksanakan. Penelitian ini bertujuan untuk mengetahui faktor sosio ekonomi demografi yang berkaitan dengan KIE KB, pelbagai unsur KIE yang berkaitan dengan pemakaian KB, dan unsur KIE yang berpengaruh terhadap pemakaian KB. Analisis menggunakan sumber data Survei Demografi dan Kesehatan Indonesia 2012 dengan unit analisis perempuan berstatus kawin usia 15-49 tahun. Jumlah sampel yang dianalisis 33.465 perempuan berstatus kawin. Analisis menggunakan odds ratio atau rasio kecenderungan …

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale …

Caution Is Needed In Designing Pharmacy Coverage., Steven A Farmer, William B Borden

Health Policy and Management Faculty Publications

Introduction

Pharmaceuticals are a critical component of modern medical care and have contributed substantially to health and quality of life. They are also expensive, accounting for ≈10% of US health care costs.1 By the end of this year, Medicare beneficiaries are expected to spend $343 billion on medications, and drug spending is projected to grow faster than both the inpatient and outpatient care categories.2Commercial and public payers use a range of mechanisms to constrain these costs, including formularies, tiered copayments, and preauthorization. These coverage policies may have potent impacts on medication usage, and their effects deserve close …

Exploring Program Design Principles For Healthcare Career Pipeline Programs For Underserved Youth, Armando Justo, Karen Nestor, Ellen Scully-Russ

Health Workforce Speaker Series

No abstract provided.

How Will We Heal?, William H. Lane

English Faculty Publications

How will we ever heal from our recent election? Isn't that what many Americans are asking at this point in time? Deadlines being what they have to be in order to keep a lively small town paper on track. I pose these questions while writing on Halloween Eve--appropriately enough given the current state of our politics--without knowing the results of the election. I don't know who won what exactly, but I do know our country lost, having been seriously damaged over the last year and a half by a presidential campaign without precedent in American history, and I do know …

Envisioning Mechanisms For Success: Evaluation Of Ebcd At Cheo, Kristina Rohde, Mireille Brosseau, Diane Gagnon, Jennifer Schellinck, Christine Kouri

Patient Experience Journal

To advance patient engagement (PE) and more comprehensively involve patients, families, and staff in quality improvement (QI) at the Children’s Hospital of Eastern Ontario (CHEO), the Experience Based Co-Design (EBCD) approach was piloted. Set against the backdrop of envisioning factors that would facilitate success, an evaluation was designed to assess five domains: strengthening of mutual understanding, collaboration, and partnerships between patients/families and staff; a greater involvement of patients, families, and staff in QI; satisfaction with the process; the ability of EBCD to generate clear and useful data to ascertain the patient/family and staff experience; and the ability of EBCD to …

Patient Advisors: How To Implement A Process For Involvement At All Levels Of Governance In A Healthcare Organization, Marie-Pascale Pomey, Edith Morin, Catherine Neault, Veronique Biron, Lise Houle, Louise Lavigueur, Guy Bouvette, Nicole St-Pierre, Martin Beaumont

Patient Experience Journal

Patient involvement at the operational (clinical care and services), tactical (management), and strategic (board of directors and executive management) levels of establishments is increasingly sought after. To address this specific challenge, a Canadian healthcare organization, the Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, has developed an integrated strategy based on three principles: (1) shared leadership between a patient and a manager to build the strategy; (2) a clear process for recruiting, training, and coaching patient advisors (PA) so that they can participate in decision-making at the various levels of governance of the establishment; and (3) …

Using Patient Value Statements To Develop A Culture Of Patient-Centred Care: A Case Study Of An Ontario, Canada Hospital, Erica Bridge, Madelyn P. Law, Miya Narushima

Patient Experience Journal

Patient-centred care (PCC) is not a new concept; however, in recent years it has garnered increasing attention in the research literature and clinical practice. PCC in clinical practice has been found to improve clinical outcomes, resource allocation, and the patient experience. In response to the need for PCC and quality in healthcare, the Ontario, Canada government developed the Excellent Care for All Act (ECFAA) in 2010. The ECFAA imposes six obligations to Ontario hospitals, one of which is developing and publishing a Patient Declaration of Values (PDoV). The purpose of this study was to explore how a leading patient-centred Ontario …

Improving The Patient Experience Through A Commit To Sit Service Excellence Initiative, Cari D. Lidgett

Patient Experience Journal

Effective communication between nurses and patients positively impacts patient care, outcomes, and the patient experience.While in the hospital, patients receive information from multiple caregivers and are often overwhelmed and confused. Nurses make up the majority of interactions with patients and are in an ideal position to improve the patient experience from the front lines. The purpose of implementing the Commit to Sit service excellence initiative was to positively impact the patient’s perception of nurse communication by nurses sitting with their patients during each shift. Outcomes were measured by the overall nurse communication composite on the Press Ganey survey, as well …

Beyond Patient-Centered Care: Enhancing The Patient Experience In Mental Health Services Through Patient-Perspective Care, Timothy A. Carey Prof

Patient Experience Journal

Delivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To …

Why Do They Do That?: Looking Beyond Typical Reasons For Non-Urgent Ed Use Among Medicaid Patients, Cynthia J. Sieck, Jennifer L. Hefner, Randy Wexler, Chris A. Taylor, Ann S. Mcalearney

Patient Experience Journal

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences …

Uninsured Free Clinic Patients’ Experiences And Perceptions Of Healthcare Services, Community Resources, And The Patient Protection And Affordable Care Act, Akiko Kamimura, Jeanie Ashby, Ha Trinh, Liana Prudencio, Anthony Mills, Jennifer Tabler, Maziar Nourian, Fattima Ahmed, Justine Reel

Patient Experience Journal

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. There has been a paucity of free clinic research with the few studies employing a quantitative design. The purpose of this study is to conduct an in-depth qualitative exploration of free clinic patients’ experience and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act (ACA). Free clinic adult patients (n=35) participated in four focus groups between June and July 2014 (one Spanish group in June, and two English groups and one Spanish group in July) …

Why Human Resources Policies And Practices Are Critical To Improving The Patient Experience, Shari Berman

Patient Experience Journal

While providing patient-centered care seems to be a goal for many organizations, delivering on this goal requires practices which are embedded in the organization, which incent patient-centered behavior. The author argues Human Resources (HR) policies, procedures and programs are key to supporting an organizations’ vision and culture. This means an HR executive partnering with the CEO who sets the vision and HR builds programs to support the vision. As the organization understands what is important to patients and how to best serve them, HR can build patient care improvement into every aspect of the organization. The author describes how competency …

‘First, Do No Harm’: Shifting The Paradigm Towards A Culture Of Health, Karen Luxford

Patient Experience Journal

Over the past 17 years since the release of the Institute of Medicine report ‘To Err is Human’,¹ health services and agencies around the world have increasingly focused on improving the safety and quality of health care. Historically, the commitment by health care professionals to ‘first do no harm’ has produced a focus on the absence of interventions that may cause adverse outcomes. This clinical approach links to the Hippocratic Oath which includes the promise "to abstain from doing harm". The Oath reminds clinicians to first consider the possible harm that any intervention might do. This approach to interactions …

The Experience Era Is Upon Us, Jason A. Wolf Phd

Patient Experience Journal

In this moment in healthcare, the challenges for those in the system are dynamically shifting and the perspectives, desires and needs of the healthcare consumer are putting positive and lasting pressures on how healthcare works that will shift healthcare from where it has been to where it must go. At the heart of this transition are the ideas framing an experience era, where collaborative, consumer-focused and purposeful actions can and will lead to a healthcare system returning to its fundamental calling, that of human beings caring for human beings. In doing so we can change the nature of healthcare and …

Home Visiting Programs For Families Of Children Who Are Deaf Or Hard Of Hearing: A Systematic Review, Nannette Nicholson, Patti Martin, Abby Smith, Sheila Thomas, Ahmad A. Alanazi M.Aud.

Journal of Early Hearing Detection and Intervention

Prelingual hearing loss greatly restricts a child’s language development, hindering his or her behavioral, cognitive and social functioning. Although technology such as hearing aids and cochlear implants are an option for providing access to sound, they fail to teach the child how to listen or attend, how to process language (whether visual or spoken), or how to produce language and communicate. Home visiting is widely recognized as a cost-effective intervention service delivery model. Home visiting programs for promoting language development in children who are diagnosed as deaf or hard of hearing have been in existence for over 50 years, yet …

Control Of The Public Health It Physical Infrastructure: Findings From The 2015 Informatics Capacity And Needs Assessment Survey, Kelley Chester, Barbara L. Massoudi, Gulzar H. Shah

Health Policy & Management: Faculty Publications (2006-2018)

Background: Despite improvements in information technology (IT) infrastructure in public health, there is still much that can be done to improve the adoption of IT in state and local health departments, by better understanding the impact of governance and control structures of physical infrastructure.

Objective: To report out the current status of the physical infrastructure control of local health departments (LHDs) and to determine whether there is a significant association between an LHD's governance status and control of the physical infrastructure components.

Design: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in …

Public Health Staff Development Needs In Informatics: Findings From A National Survey Of Local Health Departments, Barbara L. Massoudi, Kelley Chester, Gulzar H. Shah

Health Policy & Management: Faculty Publications (2006-2018)

Context: Public health practice is information-intensive and information-driven. Public health informatics is a nascent discipline, and most public health practitioners lack necessary skills in this area.

Objective: To describe the staff development needs of local health departments (LHDs) related to informatics.

Design: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County & City Health Officials.

Participants: A total of 324 LHDs from all 50 states completed the survey (response rate: 50%).

Main Outcome Measure(s): Outcome measures included LHDs' specific staff development needs related to informatics. …

An Iterative, Low-Cost Strategy To Building Information Systems Allows A Small Jurisdiction Local Health Department To Increase Efficiencies And Expand Services, Kay Lovelace, Gulzar H. Shah

Health Policy & Management: Faculty Publications (2006-2018)

Objective and Methods: The objective of this case study was to describe the process and outcomes of a small local health department's (LHD's) strategy to build and use information systems. The case study is based on a review of documents and semi-structured interviews with key informants in the Pomperaug District Health Department. Interviews were recorded, transcribed, coded, and analyzed.

Results and Conclusions: The case study here suggests that small LHDs can use a low-resource, incremental strategy to build information systems for improving departmental effectiveness and efficiency. Specifically, we suggest that the elements for this department's success were simple information systems, …

Electronic Health Records And Meaningful Use In Local Health Departments: Updates From The 2015 Naccho Informatics Assessment Survey, Karmen S. Williams, Gulzar H. Shah

Health Policy & Management: Faculty Publications (2006-2018)

Background: Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data.

Purpose: The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs.

Methods: Data were drawn from the 2015 Informatics Capacity and Needs Assessment Survey, which used a stratified random sampling …

Incentivizing Healthy Eating In Children: An Investigation Of The “Ripple” And “Temporal” Effects Of Reward-Based Interventions, Saied Toossi

Center for Policy Research

Although previous studies have established the effectiveness of using small reward-based incentives in inducing the choice and consumption of healthier foods among children, little is known about their impact outside of experimental settings or their effectiveness over time when administered daily. This paper presents the results of a field experiment conducted to provide insight on these matters. The study employs a pretest-posttest within-subject design and was conducted at a summer program catering to low-income children between the ages of 5 and 12. Corroborating existing studies, the introduction of small reward-based incentives was found to induce large increases in the number …

Using Information Systems To Improve A Mid-Sized Local Health Department’S Effectiveness In A Time Of Rapid Change, Kay Lovelace, Gulzar H. Shah

Health Policy & Management: Faculty Publications (2006-2018)

Background: Informatics capacity building is resource and personnel intensive. Many local health departments (LHDs) face tradeoffs between using their resources to carry out existing mandates and using resources to build their capacity, for example, through informatics, to deliver essential services in a more effective and efficient manner.

Objective: The purpose of this case study is to describe how a mid-sized LHD built and used information systems to support its strategic objectives, clinical services, and surveillance.

Methods: The mid-sized LHD described here was chosen for its “best practices” in informatics capacity building and use by NACCHO's study advisory committee. To conduct …

The Health Care Expenditure And Income: A Global Perspective, Badi H. Baltagi, Raffaele Lagravinese, Francesco Moscone, Elisa Tosetti

Center for Policy Research

This paper investigates the long-run economic relationship between health care expenditure and income in the world using data on 167 countries over the period 1995-2012, collected from the World Bank data set. The analysis is carried using panel data methods that allow one to account for unobserved heterogeneity, temporal persistence, and cross-section dependence in the form of either a common factor model or a spatial process. We estimate a global measure of income elasticity using all countries in the sample, and for sub-groups of countries, depending on their geo-political area and income. Our findings suggest that at the global level, …