Health Services Administration Commons^™

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 …

Temporal Changes In Racial Disparities Of Hiv Linkage To Care From 2013 To 2020: A Statewide Cohort Analysis, Fanghui Shi, Katherine E. Weaver, Chen Zhang, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Xueying Yang

Faculty Publications

Background: Racial disparities have historically existed regarding HIV care outcomes, including linkage to care. This study aims to explore the contribution of contextual features (e.g., socioeconomic and structural environmental factors) to the temporal change of county-level racial disparities in linkage to care.

Methods: This is a statewide population-based retrospective cohort study. The patient-level variables in the South Carolina HIV registry system were used to calculate the aggregated county-level linkage to care percentage. Then, we used four indices to measure racial disparities in the county-level percentage of timely linkage to care, i.e., the Black-White ratio, index of disparity (ID), weighted ID, …

Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral

Faculty Publications

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …

Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50–59 years vs 18–29 years, aHR: 0.43, 95% CI: [0.34, …

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.

Metadata Makes Big Data Useful For Ai/Ml-Ready, Equitable Pandemic Response, Sudarshan Anand, Miae Lee, Seshadri S. Vasan

Research outputs 2022 to 2026

While genomic data helps understand the pathogen and its evolution, patient metadata is critical to get the host side of the picture, so that the pandemic response is effective and equitable.

Clinical Relevance: We highlight the importance of patient stratification and metadata to help develop diagnostics, therapies and vaccines as the pathogen (virus) evolves.

Faktor Yang Memengaruhi Kinerja Verifikasi Dokter Verifikator Internal Medis Dalam Proses Klaim Pasien Jaminan Kesehatan Nasional Di Rumah Sakit Cipto Mangunkusumo, Immanuel Natanael Tarigan, Puput Oktamianti, Ede Surya Darmawan

Jurnal Ekonomi Kesehatan Indonesia

Since the implementation of the National Health Insurance, hospitals must be able to manage JKN claims properly. One way to properly manage the situation is by employing a medical internal verification doctor. This study aims to determine the factors that influence the performance of medical internal verification doctor based on the percentage of claim eligibility that has been verified. The research was conducted using a case study method with a qualitative and quantitative approach. The study was conducted on 16 medical internal verification doctors using questionnaires and in-depth interviews. The results of the study found that the performance of medical …

Analisis Klaim Pending, Verifikasi Dan Audit Pascaklaim Jaminan Kesehatan Nasional, Anugrah Aulia Ulil Amri, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

The implementation of Indonesia’s National Health Insurance (JKN) poses new challenges for hospitals as service providers. Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, the program’s administrator, now routinely conducts post-claim verifications and audits after claims have been paid. This often results in claim adjustments or even full reversals of previously reimbursed amounts. This case study examines JKN claim management at a Type D General Hospital in 2022, focusing on pending claims, verification, and post-claim audits, using a systems theory framework. Key issues in pending claims include incomplete medical records (29%), insufficient supporting documents (24%), and coding errors (21%). Post-claim problems primarily …

Evaluasi Ekonomi Total Hip Arthroplasty Protokol Enhance Recovery After Surgery Dibandingkan Konvensional Di Rsup Fatmawati Jakarta, Hanna Elisabet Lumbangaol, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Total hip arthroplasty (THA) is a common orthopedic procedure performed to replace damaged hip joints with prostheses. The demand for this procedure is expected to rise in the future. Enhanced Recovery After Surgery (ERAS) has been introduced as an evidence-based, multidisciplinary approach aimed at optimizing postoperative recovery and reducing hospital length of stay. This study aims to evaluate the costs and effectiveness, including hospital stay duration and surgical success rates, of THA using the ERAS protocol compared to conventional approaches. This cross-sectional study involved data collection from healthcare providers between January 2020 and May 2023. The analysis showed that both …

Factors Affecting Waiting Times To Enter Opioid Use Disorder Treatment In The United States With A Particular Focus On Potential Biological Sex Disparity, Stanley Nkemjika, Kenneth Oforeh, Connie Olwit, Olaniyi Olayinka, Terence Tumenta

Department of Psychiatry and Human Behavior Faculty Papers

AIM: Opioid use disorder (OUD) is the problematic use of licit or illicit opioids. Thus far, the literature on biological sex differences in accessing treatment is scarce. Hence, we hypothesize that biological sex has a moderating effect on OUD treatment accessibility. We aim to explore biological sex differences in treatment disparities and its role in wait time to enter OUD treatment.

METHOD: Using the 2018 Treatment Episode Data Set Discharge, the national sample representative of OUD patients in the substance use disorder treatment facilities within the 50 states of the United States was 382,547. Univariate and multivariable logistic analysis of …

Improved Adherence To Lipid Screening In The Pediatric Cardiology Clinic: A Quality Improvement Project, Rachel Magnan, Thomas Murphy, Lauren Rosenthal, Aparna Prasad, Anjali Chelliah, Stuart Kaufman, Donna Timchak, Lindsey Mcphillips, Saira Siddiqui

Department of Pediatrics Faculty Papers

INTRODUCTION: Lipid screening identifies at-risk patients to facilitate cardiovascular risk reduction. National pediatric guidelines recommend universal lipid screening between 9-11 and 17-21 years of age. We aimed to improve adherence to lipid screening for all age-appropriate outpatient pediatric cardiology visits from a baseline of 35% to 90% between November 2021 and July 2023.

METHODS: All outpatient visits for patients 9-11 and 17-21 years were included. Chart review and an Epic electronic health record report identified patients screened, lipid test results, and need for further testing. A P-chart was generated. After establishing a baseline for 8 weeks, interventions, including an Epic …

Importance Of The Hemoglobin Glycation Index For Risk Of Cardiovascular And Microvascular Complications And Mortality In Individuals With Type 2 Diabetes (Endocrinol Metab 2024;39:732-47, Claudia Regina Lopes Cardoso Et Al.), Stuart A. Chalew

School of Medicine Faculty Publications

No abstract provided.

Dental Clinic Deserts In The Us: Spatial Accessibility Analysis, Md Shahinoor Rahman, Jeffrey C. Blossom, Ichiro Kawachi, Renuka Tipirneni, Hawazin W. Elani

School of Public Health Faculty Publications

IMPORTANCE: Little is known about the spatial accessibility to dental clinics across the US. OBJECTIVE: To map the spatial accessibility of dental clinics nationally and to examine the characteristics of counties and US Census block groups with dental care shortage areas. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of US dental clinics in 2023 using data from the IQVIA national practitioners' database, which includes 205 762 active dentists. Data were analyzed from November 2023 to April 2024. EXPOSURES: Socioeconomic characteristics of block groups and counties including rurality, area deprivation, racial and ethnic segregation, and uninsured population. MAIN OUTCOMES AND MEASURES: Enhanced …

Bio-Preparedness In A Global Context: Multi-Site International Study Investigating Global Health Security Challenges In Egypt, Oman, And The United States, Rima M. Al Balushi

Theses & Dissertations

The COVID-19 pandemic exposed myriad vulnerabilities globally within public health systems, from inadequate bio-risk management in laboratories to overwhelming utilization of hospital resources and disparities in vaccine access and uptake. The Global Health Security Index (GHSI), which critically evaluates health security domains including health systems and risk environments, reports serious weaknesses in global health security. This dissertation aims to investigate critical aspects of global health security domains by examining factors impacting biosafety and biosecurity capacities in laboratories in Egypt, healthcare resource utilization in hospitals in Oman relating to acute respiratory infections (ARI), and COVID-19 vaccine uptake in the United States. …

Innovations In Genicular Outcomes Registry (Igor): Protocol For A Real-World Registry Study Of Treatments For Knee Osteoarthritis, Vinod Dasa, William Mihalko, Adam Rivadeneyra, Joshua Urban, Andrew Wickline, David Rogenmoser, Andrew Concoff, Andrew Spitzer, Michael A. Mont

School of Medicine Faculty Publications

BACKGROUND: Osteoarthritis (OA) is the leading cause of disability among US adults and most commonly affects the knee. Guidelines for knee OA treatment include behavioral, nonpharmacological, pharmacological, and surgical interventions. While emerging knee OA treatments show promise for pain control, data gaps remain regarding the efficacy, safety, comparative effectiveness, and real-world value of treatments. OBJECTIVES: The Innovations in Genicular Outcomes Registry (IGOR) is prospectively collecting real-world data to assess clinical effectiveness, safety, health-related quality of life, and healthcare resource utilization of knee OA treatments. DESIGN: The IGOR is a prospective, observational, longitudinal, multicenter registry (NCT05495334) examining knee OA pain treatment …

Factors Associated With Receipt Of Tobacco Treatment Integrated With Nurse Navigation In A Centralized Lung Cancer Screening Program At An Urban Academic Medical Center, Christine S. Shusted, Sarah Mukhtar, James Lee, Brooke Ruane, Emily Muse, Lawrence Emeigh-Mcbride, Eboni Gatson-Anderson, Gregory C. Kane, Kuang-Yi Wen, Hee-Soon Juon, Julie A. Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

PURPOSE: Optimal approaches for tobacco treatment counseling among individuals who currently smoke and are undergoing shared decision-making (SDM) and lung cancer screening (LCS) are unknown. The objective of this cross-sectional study was to determine the rate of reported interest in tobacco treatment counseling and pharmacotherapy among individuals who currently smoke and are receiving integrated nurse navigation for LCS and tobacco treatment in a centralized LCS Program.

METHODS: We identified individuals undergoing SDM through our centralized LCS Program between March 2021 and March 2022. The LCS Program tobacco treatment protocol includes counseling both in-person and via telephone during SDM, LCS results …

Medicare To Veterans Affairs Cost Shifting-A Challenging Conundrum, Kenneth W. Kizer, Said A. Ibrahim

JeffMD Academic Affairs

No abstract provided.

A Latent Class Assessment Of Healthcare Access Factors And Disparities In Breast Cancer Care Timeliness, Matthew Dunn, Didong Li, Marc Emerson, Caroline Thompson, Hazel Nichols, Sarah Van Alsten, Mya Roberson, Stephanie Wheeler, Lisa Carey, Terry Hyslop, Jennifer Elston Lafata, Melissa Troester

Kimmel Cancer Center Faculty Papers

BACKGROUND: Delays in breast cancer diagnosis and treatment lead to worse survival and quality of life. Racial disparities in care timeliness have been reported, but few studies have examined access at multiple points along the care continuum (diagnosis, treatment initiation, treatment duration, and genomic testing).

METHODS AND FINDINGS: The Carolina Breast Cancer Study (CBCS) Phase 3 is a population-based, case-only cohort (n = 2,998, 50% black) of patients with invasive breast cancer diagnoses (2008 to 2013). We used latent class analysis (LCA) to group participants based on patterns of factors within 3 separate domains: socioeconomic status ("SES"), "care barriers," and …

The Benefits Of Telehealth Among Disadvantaged Communities, Anoosh Arshad

Honor’s College Freeman Research Journal

This study aims to understand how the widespread integration of telehealth services affects underserved communities, helping reduce health disparities in this group. Telemedicine includes various technologies and applications, supported by extensive research, public health, administrative, and patient-care benefits, to adapt to different fields. It involves clinical applications that focus on patient care, like making health decisions, and nonclinical applications like arranging board meetings. Telehealth is a health platform that uses communication technologies that allow doctors and patients to meet online through video and telephone visits, ensuring that patients receive high-quality care. It increases access to healthcare by removing geographical and …