Health Services Administration Commons^™

Clinician Attitudes And Experiences In Screening Patients For Social Determinants Of Health Using Prapare, Pranav Rane, Mathew B. Weimer M.D., Adam Baus

Journal of Appalachian Health

Introduction: Social Determinants of Health (SDOH) are the conditions in which people are born, grow, live, work, and age. SDOH significantly influence health outcomes; as such, healthcare systems should screen for patients’ social needs. PRAPARE is standardized screening tool designed to assess and address patients’ social needs.

Purpose: This study examines SDOH screening at Valley Health Systems, a federally qualified health center based in Huntington, West Virginia. The aim of this research is to assess clinician attitudes and experiences in using the PRAPARE tool to screen for SDOH.

Methods: A self-administered online survey was conducted from April to May 2022 …

Addressing Barriers To Equitable Telehealth For Older Adults, Bruce Leff, Christine S. Ritchie, Kristin L. Rising, Kendell Cannon, Liane Wardlow

Jefferson Center for Connected Care Faculty Papers

No abstract provided.

Impact Of Primary Care Benefits On Healthcare Utilisation And Estimated Out-Of-Pocket Expenses In Urban, Rural And Remote Settings In The Philippines, Janelle Micaela S. Panganiban, Romelei Camiling-Alfonso, Josephine T. Sanchez, Regine Ynez H. De Mesa, Gillian Sandigan, Arianna Maever L. Amit, Mia P. Rey, Johanna Faye E. Lopez, Noleen Marie Fabian, Cara Lois T. Galingana, Nannette Bernal-Sundiang, Maria Rhodora N. Aquino, Chad Lester Lastrilla, Miguel Callo, Carol Stephanie Chua Tan-Lim, Leonila F. Dans, Jose Rafael A. Marfori, Ramon Pedro Paterno, Antonio L. Dans

Ateneo School of Medicine and Public Health Publications

Background

This study aimed to determine the effects of primary care interventions on healthcare utilisation and estimated out-of-pocket (OOP) expenses in selected urban, rural and remote settings in the Philippines.

Methodology

Context-specific measures relating to expanding healthcare provider networks, augmenting the health human workforce and subsidising transportation costs were implemented to strengthen primary care systems. In this study, two key outcomes were monitored: (1) monthly healthcare utilisation measured by the total number of outpatient consultations per site and (2) change in OOP expenses from baseline to endline within a 1 year study period.

Results

All sites had a positive trend …

The Healing Power Of Antitrust, Theodosia Stavroulaki

Northwestern University Law Review

Millions of Americans live in hospital deserts—communities where people lack geographic access to hospitals and primary care physicians. People living in these deserts often miss doctor appointments, delay necessary care, and stop adhering to their treatment. In this way, hospital deserts exacerbate the health disparities plaguing America. This Article demonstrates that hospital deserts are not inevitable but the result of several business strategies—including noncompete agreements and merging with competitors—and antitrust enforcers’ unwillingness to recognize these harmful practices as antitrust violations. To cure the issue of hospital deserts, this Article makes three proposals. First, antitrust enforcers and the courts should expand …

A Proposed Mhealth Intervention To Address Patient Barriers To Colposcopy Attendance: Qualitative Interview Study Of Clinic Staff And Patient Perspectives, Jennifer Hemler, Rachel Wagner, Brittany Sullivan, Myneka Macenat, Erin Tagai, Jazmarie Vega, Enrique Hernandez, Suzanne Miller, Kuang-Yi Wen, Charletta Ayers, Mark Einstein, Shawna Hudson, Racquel Kohler

Department of Medical Oncology Faculty Papers

BACKGROUND: Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural and psychosocial barriers to following up with colposcopy are problematic for minoritized women. Evidence-based interventions using patient navigation and tailored telephone counseling, including the Tailored Communication for Cervical Cancer Risk (TC3), have modestly improved colposcopy attendance. However, the efficacious TC3 intervention is human resource-intense and could have greater reach if adapted for mobile health, which increases convenience and access to health information.

OBJECTIVE: This study aimed to describe feedback from clinic staff members involved in colposcopy processes and patients referred for colposcopy regarding adaptions …

Organizational Readiness For Implementation: A Qualitative Assessment To Explain Survey Responses, Maria Mcclam, Lauren Workman, Timothy J. Walker, Emanuelle M. Dias, Derek W. Craig, Joe R. Padila, Andrea E. Lamont, Abraham Wandersman, Maria E. Fernandez

Faculty Publications

Background

One factor considered essential to successful implementation is organizational readiness. The purpose of this study was to explore ways to improve the measurement of organizational readiness, and in particular to refine a preliminary measure based on the Readiness = Motivation x innovation Specific Capacity x General Capacity (R = MC2) heuristic. We assessed the experiences of staff in Federally Qualified Health Centers (FQHC) implementing evidence-based interventions (EBIs) designed to increase colorectal cancer screening (CRCS) who previously completed the survey and aimed to understand their perspectives on why our data were positively skewed.

Methods

We conducted a series of qualitative …

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society …

Is There An Association Between Living In A Rural Area And The Incidence Of Postoperative Complications Or Hospital Readmissions Following Left Ventricular Assist Device (Lvad) Implantation, Compared To Urban Lvad Recipients? A Systematic Review., Samrat Gollapudi, Abhiram Gollapudi, Sri Banala, Sheraj Singh, Kiran Tadi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Left ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end-stage heart failure. While LVAD implantation can enhance survival rates and quality of life, the procedure has its risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.

METHODS: A comprehensive literature review examined studies that compared postoperative outcomes between rural and urban LVAD recipients. Data on adverse events, hospitalizations, and mortality rates were extracted, focusing …

Association Of State Cannabis Legalization With Cannabis Use Disorder And Cannabis Poisoning, Jayani Jayawardhana, Jialin Hou, Patricia Freeman, Jeffery C. Talbert

Health Management and Policy Faculty Publications

IMPORTANCE Whether state implementation of medical and recreational cannabis laws is associated with increased cannabis use disorder (CUD) and/or cannabis poisoning among adults is not evident.

OBJECTIVE To examine state-level medical and recreational cannabis laws’ associations with CUD and cannabis poisoning, overall and by sex and age subgroups.

DESIGN, SETTING, AND PARTICIPANTS In this longitudinal cohort study, state-level CUD and cannabis poisoning diagnoses from January 2011 to December 2021 were examined across all 50 US states and the District of Columbia before and after the implementation of medical and recreational cannabis laws (MCLs and RCLs, respectively) using a staggered adoption …

Demographic Variation In Continuous Glucose Monitoring Utilisation Among Patients With Type 1 Diabetes From A Us Regional Academic Medical Centre: A Retrospective Cohort Study, 2018–2021, Omer Atac, Kory R. Heier, Daniela Moga, John L. Fowlkes, Min-Woong Sohn, Aaron J. Kruse-Diehr, Teresa M. Waters, Mary E. Lacy

Health Management and Policy Faculty Publications

Objective: While continuous glucose monitoring (CGM) utilisation has been increasing among patients with type 1 diabetes (T1D), few studies have examined patterns of use across age, race/ethnicity and insurance status together. In this study, we examine CGM utilisation among patients with T1D from a regional academic medical centre across all insurance types.

Design and Setting: This is a retrospective cohort study including both paediatric and adult patients with T1D who visited a regional academic medical centre between 1 January 2018 and 31 December 2021.

Methods: Patients were followed from the date of their first T1D encounter during the study period …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Third Party Negotiated Hospital Pricing In Rural And Urban Hospitals Within 12 U.S. States, Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert

Rural & Underserved Health Research Center Publications

No abstract provided.

Drone Medical Package Delivery For Improved Transportation And Better Patient Outcomes Final Implementation Report, Amro El-Adle, Madeline Alden, Yin-Hsuen Chen, Melissa Davidson

Information Technology & Decision Sciences Faculty Publications

The Drone Medical Package Delivery for Improved Transportation and Better Patient Outcomes planning and prototyping grant involves five partners, including Accomack-Northampton Planning District Commission (A-NPDC), Riverside Health System, Old Dominion University (ODU), Virginia Institute for Spaceflight & Autonomy (VISA), Virginia Innovation Partnership Corporation (VIPC), and DroneUp. The partners worked together to address access, safety, reliability and sustainability for medical and emergency response package delivery via drone, specifically, where the use of aerial drones could lead to better patient outcomes and improved safety and emergency response.

The goal of the project was to develop an operational prototype that woul evolve into …

An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.

METHODS: The Medical Expenditure Panel Survey data (2010-2021) …

Perceptions Of The Health Care System As Mediators In The Association Between Experiences Of Discrimination, Communication From Providers, And Gaps In Mammography, Hannah Cohen-Cline

Articles, Abstracts, and Reports

No abstract provided.

Providing Healthcare Access For The African Population Using An International Care Coordination System: A Case Study Of Nigeria And Ghana, Aminat B. Nwaonumah

College of Graduate Studies: Theses & Dissertations

Introduction: Healthcare access is a major population health challenge among underserved populations in many parts of the world, and the situation in Africa is no exception. Foreign aid, a significant component of healthcare financing in Africa, has played a crucial role in mitigating communicable diseases. However, there is a lacuna in care for non-communicable diseases, such as chronic illnesses, especially among the elderly. This study explored an innovative approach to expanding healthcare access in Nigeria and Ghana through care coordination sponsored by migrant family members residing in the United States. Beyond foreign aid, this research elucidates how the International Care …

Is Pathogen Molecular Testing Reshaping Outpatient Antibiotic Prescribing?, Barbara D. Alexander, William D. Irish, Adriana E. Rosato, Barry I. Eisenstein, Maren S. Fragala, Steven E. Goldberg, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

Longitudinal Viral Load Clustering For People With Hiv Using Functional Principal Component Analysis, Yunqing Ma, Xueying Yang Ph.D., Jiayang Xiao, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Longitudinal measures of viral load (VL) are critical in monitoring the HIV status. While multiple lab indicators exist for monitoring measures of VL, research on clustering historical/longitudinal VL measures is limited. Analyzing longitudinal VL patterns rather than aggregated measures offers deeper insights into HIV status. This study uses functional data clustering to classify longitudinal VL patterns and characterize each cluster by demographics, comorbidities, social behaviors, and CD4 count.

Methods: Adult PWH diagnosed from 2005 to 2015 in South Carolina with a 5-year minimum follow-up were included. We compared functional principal component analysis (FPCA), K-means, hierarchical clustering, and Gaussian mixture …