Health Services Administration Commons^™

Measuring Quality At The Surgeon Level, Elias A Chamely, Jonah J Stulberg

Faculty, Staff and Student Publications

Patients expect high-quality surgical care and increasingly are looking for ways to assess the quality of the surgeon they are seeing, but quality measurement is often more complicated than one might expect. Measurement of individual surgeon quality in a manner that allows for comparison among surgeons is particularly difficult. While the concept of measuring individual surgeon quality has a long history, technology now allows for new and innovative ways to measure and achieve surgical excellence. However, some recent efforts to make surgeon-level quality data publicly available have highlighted the challenges of this work. Through this chapter, the reader will be …

Examining The Associations Of The Kidney Allocation System With Patient Sensitivity, Wait Time To Transplant, And Donor Distance, Shamika Danielle Jones

Theses and Dissertations

Background

The Kidney Allocation System (KAS) was created in 2014 to address long wait times for a kidney transplant, inappropriately matched kidneys, and high re-transplantation rates. This research examines the associations of the KAS with the percentage of sensitized patients receiving a kidney transplant, wait time to transplant and the distance between donor and recipient hospitals.

Methods

Data from the Scientific Registry of Transplant Recipients (SRTR) was used for this research. The study population included adults over 18 in the United States who received a kidney transplant between December 4, 2009, and December 4, 2018. Patients simultaneously waitlisted for other …

Patient Experiences And Disparities In Telehealth Hiv Care During The Covid-19 Pandemic: Study Results From The Southern United States, Valerie Yelverton

Theses and Dissertations

Background: To maintain HIV care continuity during the COVID-19 pandemic, most HIV care facilities in the United States adopted telehealth. However, not everyone was participating in telehealth equally. This dissertation seeks to understand experiences with and the use of telehealth in HIV care, and decision processes guiding the selection of visit type during the COVID-19 pandemic.

Methods: Qualitative interviews explored people living with HIV’s (PWH) and HIV care provider’s experiences with telehealth HIV care and visit type decision processes. Quantitative analyses of electronic health record (EHR) data characterized patterns of and disparities in telehealth HIV care during the COVID-19 pandemic. …

Complementary And Integrative Health (Cih) And Opioid Use Among Adults With Chronic Noncancer Pain In The Us, Yi-Wen Shih

Theses and Dissertations

Chronic noncancer pain (CNCP) is defined as persistent pain lasting for more than three months due to conditions other than malignancy. This condition affects one in five American adults annually. The prescribing of opioids to individuals experiencing CNCP has been recognized as a critical contributor to the ongoing opioid crisis. In 2016, the Centers for Disease Control and Prevention (CDC) recommended Complementary and Integrative Health (CIH) as a nonpharmacologic treatment to be used among adults with CNCP. Despite the potential benefits of CIH for pain relief, there may be a discrepancy between individuals with CNCP and their insurance coverage for …

Analysis Of The Distribution Of Health Workers And Health Facilities In Karanganyar Regency In 2022, Annisaa Annisaa, Ema Novita Deniati

Preventia: The Indonesian Journal of Public Health

Health, as one of the pillars of a nation's development, has an important role. This is in line with the understanding of the World Health Organization that there are 12 public health indicators as proxies for health indicators in the Sustainable Development Goals. However, in Karanganyar Regency, the typography is located on the slopes of Mount Lawu, and most of them are rural areas, resulting in an uneven distribution of health workers and health service facilities. Therefore, this study aims to determine the distribution of health workers in Karanganyar Regency so that it can be a concern in formulating policies …

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

Diabetes Prevalence And Monitoring In Nonmetropolitan And Metropolitan Areas Within A Commercially Insured U.S. Population, Lindsey R. Hammerslag, Jeffery Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Enrollees living in nonmetropolitan areas had 22% higher likelihood of having diabetes, even after controlling for factors like age and region.
• The prevalence of diabetes in 2019-2020 was 7.9% in nonmetropolitan areas and 6.2% in metropolitan areas.
• Annual hemoglobin A1c (HbA1c) testing occurred for 85.1% of nonmetropolitan and 85.7% of metropolitan enrollees with diabetes. After controlling for other factors, we found significantly lower testing for those in nonmetropolitan areas.
• For diabetic enrollees, having an HbA1c test in 2019 was associated with an 8% decrease in the likelihood of non-cardiovascular complications related to diabetes and a 6% …

Incidence Of Chronic Kidney Disease Following Acute Coronavirus Disease 2019 Based On South Carolina Statewide Data, Roy O. Mathew, Jiajia Zhang Ph.D., Xueying Yang, Shujie Chen, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: Coronavirus disease 2019 (COVID-19) was associated with severe acute illness including multiple organ failure. Acute kidney injury (AKI) was a common finding, often requiring dialysis support.

Objective: Define the incidence of new clinically identified chronic kidney disease (CKD) among patients with COVID-19 and no pre-existing kidney disease.

Design Participants: The South Carolina (SC) Department of Health and Environmental Control (DHEC) COVID-19 mandatory reporting registry of SC residents testing for COVID-19 between March 2020 and October 2021 was included.

Design Main Measures: The primary outcome was a new incidence of a CKD diagnosis (N18.x) in those without a pre-existing diagnosis …

Strengthening The Marketing Of Pediatric Cardiac Surgery Services To Support The Transformation Of Health Services In Indonesia, Felicia Gunardi, Puput Oktamianti

Journal of Indonesian Health Policy and Administration

This study aims to determine the marketing strategy 7P carried out by cardiac surgery services in Indonesia and to identify actionable policy recommendations. This study is observational descriptive research. Data were collected from Cardiothoracic and Vascular surgeons and hospital websites with cardiac surgery services. Through the marketing analysis approach of 7P, this study identifies problems and policy recommendations that can be alternative solutions. The price of the service is high, but most of the patients used BPJS, and it is found that the hospital rate is higher than BPJS claims. The actionable recommendation to respond to it is that the …

Hospital Ambulance Standardization In Jakarta: Narrative Review, Roy Michael Suranta, Ascobat Gani

Journal of Indonesian Health Policy and Administration

Ambulance is one of the hospital infrastructures that must meet service standards, security, and occupational safety and health in hospital operations. Therefore, it is the obligation of every hospital to ensure the standard of ambulance service. In the DKI Jakarta area, every ambulance, including hospital ambulances, must meet the standards in accordance with regulations and have an ambulance operating license. Based on data until the end of 2021, there were 82 (34.9%) hospital ambulances in Jakarta that carried out the recommendation process for an ambulance operation license from a total of 235 hospital ambulances, meaning that most hospital ambulances in …

Implementation Analysis Of The Pariaman City Regional Regulation No. 9 Of 2015 Concerning The Drinking Water Depot Business Permit, Melia Roza

Journal of Indonesian Health Policy and Administration

To regulate the existence of Drinking Water Depots (DAM) in the city of Pariaman, the Pariaman City government issued Regional Regulation (Perda) Kota Pariaman No. 9 of 2015 concerning Business Permits for Drinking Water Depots. However, many depot owners do not implement these regulations. The purpose of this study was to analyze the implementation of Pariaman City Regional Regulation No. 9 of 2015 concerning Drinking Water Depot Business Permits. This research is a type of qualitative research. Data collection was carried out through in-depth interviews with informants involved in the implementation of Pariaman City Regional Regulation No. 9 of 2015 …

Perceptions Of Health Workers Regarding The Covid-19 Vaccine Report Application In Ogan Ilir Regency, South Sumatra, Haerawati Idris, Amrina Rosyada, Anggun Budiastuti, Nurmalia Ermi

Journal of Indonesian Health Policy and Administration

The Lapor Vaksin COVID-19 Application was developed to support a vaccination coverage surveillance database sourced from community self-report. This application provides data on vaccination coverage and allows users to view updates to educational content about vaccines and visualization of COVID-19 vaccine data in real-time. This study aims to analyze the perception among health worker about Lapor Vaksin COVID-19 application in the community. This study uses descriptive research with a case study design. This study was conducted in September 2021 through a virtual zoom meeting, in Ogan Ilir Regency, South Sumatra. The research sample was 42 health workers consisting of vaccine …

Health Care Spending For Cardiovascular Disease Under National Health Insurance Scheme In Indonesia Before And During Covid-19: Descriptive Analysis And Policyrecommendations, Atik Nurwahyuni, Prastuti Soewondo, Mardiati Nadjib, Yuli Farianti, Mazda Novi Mukhlisa, Helmi Wahyuningsih, Emmy Ridhawaty Mangunsong, Athiyah Athiyah, Yunita Yunita, Sekar Arum Handarbeni Sayekti, Kurnia Sari, Amila Megraini

Journal of Indonesian Health Policy and Administration

The Cardiovascular disease (CVD) prevalence continues to increase. This study aims to identify the CVD spending and utilization in the Indonesia National Health Insurance (JKN) scheme 2017-2021 using the JKN claims classified by Disease Accounts analyzed descriptively. The CVD spending increased by $125,4 million in 2019 compared to 2017 and mostly for the hospital (91% in 2019) with the highest spending occurring in the age above 60 years. Moreover, the hospital inpatient spending was dominated during these five years. The highest portion of spending by severity level was at mild level, followed by moderate and severe levels. Health facilities’ capacities …

Nutrition In Times Of Crisis: A Qualitative Study In Siargao Island, Philippines, During The Covid-19 Pandemic, Gideon Lasco, Vincen Gregory Yu, Julie Madelo Compra, Phetdavanh Leuangvilay, Rapeepong Suphanchaimat, Yunting Zhang, Charina Javier

Development Studies Faculty Publications

Objectives

Despite the public-health significance of both malnutrition and crises, little has been done to explore the convergence of the two domains and develop ways to improve policies and practices, especially in rural communities. This article remedies that knowledge gap by focusing on nutrition-related changes, responses, and practices during crisis situations in Siargao Island, Philippines, using the COVID-19 pandemic as a backdrop.

Methods

Forty-six (46) semi-structured interviews were conducted among parents, caregivers, local health workers, and local officials of Del Carmen, Siargao Island. Principles of thematic analysis were applied to data analysis using NVivo 12. Afterwards, the preliminary data were …

Association Of Selected State Policies And Requirements For Buprenorphine Treatment With Per Capita Months Of Treatment, Bradley D. Stein, Brendan K. Saloner, Olivia K. Golan, Barbara Andraka-Christou, Christina M. Andrews Ph.D., Andrew W. Dick, Corey S. Davis, Flora Sheng, Adam J. Gordon

Faculty Publications

IMPORTANCE Expanding the use of buprenorphine for treating opioid use disorder is a critical component of the US response to the opioid crisis, but few studies have examined how state policies are associated with buprenorphine dispensing. OBJECTIVE To examine the association of 6 selected state policies with the rate of individuals receiving buprenorphine per 1000 county residents. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used 2006 to 2018 US retail pharmacy claims data for individuals dispensed buprenorphine formulations indicated for treating opioid use disorder. EXPOSURES State implementation of policies requiring additional education for buprenorphine prescribers beyond waiver training, continuing medical …

Shifting Gears: - The Expected Post-Transplant Survival (Epts) Usefulness In The Era Of Continuous Distribution- Examination Of The United Network Of Organ Sharing (Unos) Database 2000-2020, Vaughn Whittaker, Vaughn Easton Whittaker

NYMC Student Theses and Dissertations

The allocation of organs is a constantly evolving area of transplantation. The latest iteration of this process is a move toward continuous distribution of organs. This process considers dynamic factors instead of static constraints that box patients into certain categories. The expected post-transplant survival of patients is one of these dynamic factors that will be included in the assessment of patients' place in a continuous distribution allocation process. However, the predictive value of this construct is questionable, given that it uses only four factors (age, diabetes diagnosis, years on dialysis, and previous transplant) to represent complex patients who are on …

Hiv Treatment Utilization: An Exploration Of One Ryan White Clinic, Joseph Powe

MUSC Theses and Dissertations

According to the findings of recent research, the HIV epidemic is still an active problem all over the world. Some racial and ethnic groups have a significantly higher likelihood of contracting HIV, even though many efforts have been made at all levels of government, from the municipal to the federal, to raise public awareness of the recognized risk. There are two focal points for the HIV epidemic. While prevention is essential, infected patients must also be encouraged to continue treatment to accomplish viral suppression and delay the onset of AIDS. When we look more deeply at a local Ryan White …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Extensive research evidence demonstrates that implicit bias can lead to differential treatment of patients based on race, gender, weight, age, income, language, and insurance status. Evidence-based interventions that couple implicit bias mitigation with therapeutic communication skills can contribute to the delivery of equitable care.

Local Problem: Implicit bias in healthcare occurs when unconscious behavior that is not favorable to the patient population served perpetuates unequal treatment and contributes to poor healthcare outcomes.

Methods: Knowledge of implicit bias in the nursing staff was assessed through a validated and reliable survey tool before and after participation in an online LMS …

Health Disparities: Ranking Horry County's Most Disadvantaged Communities, Stephen Borders, Jacob Bradley, Mackenzie Cannon, William Hall

Public Health

Horry County is a rapidly growing region in South Carolina, with a diverse population of over 300,000 residents. Despite this growth, the county faces significant health challenges, including high rates of chronic diseases, such as diabetes and obesity, and a shortage of healthcare providers in certain areas. These challenges are exacerbated by the county's socio-economic disparities, with many low-income residents lacking access to basic health services. Our approach is to address these challenges by identifying the areas within the county with the greatest unmet needs, also known as disadvantaged communities. By identifying the needs of Horry County’s most disadvantaged communities, …