Health Services Research Commons^™

Opioid Use Treatment Via Telemedicine: Treatment Options For Rural Maine, Benjamin Knapp

Thinking Matters Symposium Archive

The ongoing opioid crisis has overwhelmed the traditional opioid use disorder (OUD) treatment resources across America. The treatment resources in rural communities have been especially hard hit as geographic and financial barriers limit service capacity. Telemedicine, or medicine delivered via remote means, has been proposed as a potential solution to the lack of conventional opioid treatment resources in rural Maine. Current legalities in the US prohibit telemedicine being used to prescribe opioid agonist drugs, and insurance reimbursement for telemedicine remains a major barrier. This qualitative content analysis looks at the existing research on telemedicine's treatment efficacy for use with OUD …

Usability And Acceptability Of An Electronic Clinical Decision Support Tool For Antibiotic Selection For Common Pediatric Infections In Outpatient Rural Healthcare Clinics, Sammi Simpson, Karen Johnson, Amy Hite, Kristi Frisbee, Anuradha Ghosh

Posters

The purpose of this project was to determine the potential role of an electronic clinical decision support tool (ECDST) for optimizing antibiotic prescribing practices in rural clinical practice. The specific aim was to evalu­ate the usability and acceptability of an ECDST for antibiotic prescribing in pediatric patients in outpatient ru­ral health clinics. The data was collected from providers working with pediatric patients at Community Health Center of Southeast Kansas. The ECDST used in this project was found to have a high usability value and was accepted as a potential tool for clinical practice by the majority of the providers who …

Elevating Communities Into Self-Sufficiency Through Federally-Funded Health Partnerships, Nalleli Martinez

Master's Projects and Capstones

Purpose: This qualitative study is to identify programing that encourages increased self-sufficiency in SNAP recipients. The goal was to identify themes related to successful self-sufficiency programming at federally-funded health centers/health programs (HCHPs). The study also investigated the role of social determinants of health in relation to achieving self-sufficiency.

Method: A series of 45-minute to 1-hour-long interviews were conducted to explore the perspectives of seven total staff at seven federally-funded HCHPs across the U.S. western region. Using Nvivo, a qualitative data analysis software, responses were categorized into six themes: patient-centered care, one-stop-shop/integrated care model, community partnerships, organizational and staff support, leadership …

Identifying Challenges Different Provider Group Encounter In Managing Opioid Use Disorder, Chinonye Anumaka

Muskie School Capstones and Dissertations

The Centers for Disease and Control (CDC) describes opioid use disorder (OUD) also known as opioid addiction as the problematic pattern of opioid use leading to clinically significant impairment or distress. In 2016, about 2.1 million people were diagnosed of OUD in the US. In Maine, York County has the third highest drug overdose response and had 166 deaths occurring between 2012-2016. York County is a designated medically underserved area and has a shortage of provider workforce and limited treatment infrastructure. To further understand the challenges providers in York County encounter in managing patients with OUD, 6 focus groups was …

A Comparative Analysis Of Primary Care Practice Payment Models: Practice And System Level Implications, Travis Masood

Muskie School Capstones and Dissertations

EXECUTIVE SUMMARY

The purpose of this capstone was to (1) assess the likely effects of various primary care practice reimbursement models on quality of care and costs, (2) assess each reimbursement model’s applicability relative to practice size, and (3) analyze each model’s practice and system level implications. This was done through the conduction of a comparative analysis of current practice reimbursement models. The questions addressed in this analysis include:

• What are the primary, practice reimbursement models currently being used?
• What are the implications of these models on quality and costs?
• Are these reimbursement models applicable in all practice types (e.g. …

Exploring Mobility Help-Seeking Behavior Among People With Physical Disabilities: A Case Study Of Jaipur Foot, Alex Podell

Independent Study Project (ISP) Collection

It is estimated that as many as 90 million people living in India experience some sort of disability (The World Bank, 2007). As India’s population keeps growing and aging, not only will the medical aspects, but also the societal impacts of disability need to be brought to the forefront of discussion, developmental strategy, and policy implementation. This study sought to analyze factors influencing the process of seeking help from formal and informal sources for people with physical disabilities. Data was collected from 10 people with physical disabilities receiving a variety of mobility aids from the NGO, Bhagwan Mahaveer Viklang Sahayata …

The Prescribing Patterns Of Gabapentin And Pregabalin In A Medicaid Population Amid The Opioid Epidemic, Sarah Sullivan

Theses and Dissertations

OBJECTIVE: Drug overdoses continue to be the leading cause of accidental death in the United States resulting in a nationwide crisis. Opioids, many of them prescription, are now the primary cause of drug overdose related deaths. Gabapentinoids are being promoted by the Centers for Disease Control and Prevention as a safer alternative to opioids and have steadily been rising in prescribing rates. However, growing concern is mounting on the potential for gabapentinoid misuse. The goal of this dissertation was to deepen the knowledge and understanding of how gabapentinoids are currently being prescribed, with an emphasis on their co-prescribing with an …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Rethinking Health Services Measurement For Indigenous Populations, Angela Mashford-Pringle, Ian Ring, Fadwa Al-Yaman, John Waldon, Michelle Chino

School of Public Health Faculty Research

Indigenous people around the world experience shorter life expectancy, poorer health outcomes, and on average have less social capital, than non-Indigenous people in their respective countries. While national goals are to lower mortality and morbidity rates of Indigenous people, much evidence exists that indicates there is almost no Indigenous involvement in data collection, policy development, program implementation and development and measurement of services. A more holistic and culturally relevant framework is presented to improve services and outcomes for Indigenous populations.

Rethinking Health Services Measurement For Indigenous Populations, Michelle Chino Dr, Angela Mashford-Pringle, Ian Ring, Fadwa Al-Yaman, John Waldon

School of Public Health Faculty Research

Indigenous people around the world experience shorter life expectancy, poorer health outcomes, and on average have less social capital, than non-Indigenous people in their respective countries. While national goals are to lower mortality and morbidity rates of Indigenous people, much evidence exists that indicates there is almost no Indigenous involvement in data collection, policy development, program implementation and development and measurement of services. A more holistic and culturally relevant framework is presented to improve services and outcomes for Indigenous populations.

Patient Engagement And Attitudes Toward Using The Electronic Medical Record For Medical Research: The 2015 Greater Plains Collaborative Health And Medical Research Family Survey., Ann M. Davis, Lawrence P. Hanrahan, Alex F. Bokov, Sarah Schlachter, Helena H. Laroche, Lemuel Russell Waitman, Gpc Height Weight Research Team

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Electronic health records (EHRs) are ubiquitous. Yet little is known about the use of EHRs for prospective research purposes, and even less is known about patient perspectives regarding the use of their EHR for research.

OBJECTIVE: This paper reports results from the initial obesity project from the Greater Plains Collaborative that is part of the Patient-Centered Outcomes Research Institute's National Patient-Centered Clinical Research Network (PCORNet). The purpose of the project was to (1) assess the ability to recruit samples of adults of child-rearing age using the EHR; (2) prospectively assess the willingness of adults of child-rearing age to participate …

Operationalization Of Bi-Directional Screening For Tuberculosis And Diabetes In Private Sector Healthcare Clinics In Karachi, Pakistan, Mashal S. Basir, Shifa Salman Habib, Syed M A. Zaidi, Saira Khowaja, Hamidah Hussain, Rashida A. Ferrand, Aamir J. Khan

Community Health Sciences

Background: Many countries are facing overlapping epidemics of tuberculosis (TB) and diabetes mellitus (DM). Diabetes increases the overall risk of developing Tuberculosis (TB) and contributes to adverse treatment outcomes. Active screening for both diseases can reduce TB transmission and prevent the development of complications of DM. We investigated bi-directional TB-DM screening in Karachi, Pakistan, a country that ranks fifth among high TB burden countries, and has the seventh highest country burden for DM.
Methods: Between February to November 2014, community-based screeners identified presumptive TB and DM through verbal screening at private health clinics. Individuals with presumptive TB were referred for …

An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández

Department of Public Health Scholarship and Creative Works

The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. Objective: The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. Methods: The …

Kajian Kebutuhan Pengembangan Rumah Sakit Pemerintah Daerah Kelas B Di Provinsi Sulawesi Utara, Puput Oktamianti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The existence of regulations regarding regional referrals established by the central government, encourages the North Sulawesi regional government to provide regional referral hospitals that have service capabilities as class B hospitals. For the development of North Sulawesi Provincial Hospital in the future, basic information on services, facilities, facilities and infrastructure, as well as market coverage that depends on system governance, HR capabilities, physical buildings and equipment and resources. The purpose of this study is to examine the service needs of North Sulawesi Provincial Hospital which includes demographic studies, socio-economic studies, studies of morbidity and mortality, study of policies and regulations, …

Srategi Pemasaran Rsud Prof. Dr. H.M. Chatib Quzwain Sarolangun Jambi Tahun 2018, Ahmad Bajri, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Undang-Undang No.36/2009 Pasal 34 Ayat 2 states that the community has the right to obtain health protection from the state. In order to regulate comprehensive health protection for the community, the government requires all hospitals, both government and private hospitals to take part in the National Health Insurance / JKN Program. In this regard, the General Hospital of Prof. Dr. H.M. Chatib Quzwain is a class C regional hospital that has only been operating since 2008, so there are still many shortcomings and limitations, especially in the field of services and supporting facilities. Knowing this, efforts have been made to …

Penerapan Metode Abc Indeks Kritis Dalam Pengelolaan Persediaan Obat Di Instalasi Farmasi Rumah Sakit Xyz Pekanbaru, Riau Tahun 2018, Monika Noviera Susanto, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The process of making the XYZ Hospital formulary by the Therapy Pharmacy Team (TFT) has not considered the critical level of a medicine for patients. The failure to carry out the assessment has caused an unplanned purchase of the medicine that needed immediately and affecting patient safety. The ABC method can identify drugs that must always be available and worth a large investment. There is no cost control of drug supplies at XYZ Hospital because data on the value of investment in drugs have not been analyzed. This study uses a qualitative research design by applying the ABC index critical …

Implementasi Green Hospital Di Rsud R. Syamsudin, Sh Dengan Kriteria Kerangka Kinerja Ekselen Malcolm Baldrige, Haniah Alatas, Dumilah Ayuningtyas

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The existence of green hospital is very necessary to overcome climate change which can cause disruption to human health and the environment, because hospitals are one of the contributors to pollution. RSUD R. Syamsudin, SH became a member of the Global Green and Healthy Hospital and is committed to implementing ten agendas, namely leadership, chemicals, waste, energy, water, transportation, food, pharmacy, buildings, and purchasing. Aim of this study is to analyze the implementation of green hospital with the Malcolm Baldrige Criteria Framework for Excellence Performance. Malcolm Baldrige Criteria evaluates based on seven criteria which isleadership, strategy, customer, measurement, analysis, and …

Strategi Peningkatan Mutu Dan Keselamatan Pasien Di Rumah Sakit Umum Daerah Kepulauan Seribu Tahun 2019 – 2023, Agus Ariyanto Haryoso, Dumilah Ayuningtyas

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Quality of service and patient savety now adays has become the main demand of hospital customer, even now, become one of evaluation point in hospital accreditation. Nevertheless, quality and patient savety in Kepulauan Seribu Public Hospital (RSUD Kepulauan Seribu) has not been accredited yet. RSUD Kepulauan Seribu plans to increase quality and patient savety so that can go through accreditation. This thesis aims to arrange strategies of Quality improvement and Patient Savety in Years 2019- 2023. The study in this thesis is qualitative. The study digs informations from informans to obtain internal and external factors hich used to arrange strategies. …

Influence Of Decentralization And Type Of Patient On Loss To Follow-Up Among Multidrug-Resistant Tuberculosis Patients In Indonesia From 2014 To 2015, Noerfitri Noerfitri, R. Sutiawan, Tri Yunis Miko Wahyono, Pratiwi Ayuningtyas Hartono

Kesmas

Drug-resistant tuberculosis (TB) patients have a greater risk of loss to follow-up (LTFU) than drug-sensitive TB patients, due to their longer treatment duration. This study aimed to determine the influence of decentralization and patient type on LTFU among multidrug-resistant TB (MDR-TB) patients in Indonesia. A retrospective cohort study was conducted at all MDR-TB treatment healthcare facilities in Indonesia from 014 to 2015. Using total sampling technique, 961 patients were examined and sampled. Of these patients, 86.03% were decentralized. Patients were classified into types as follows: 35.17% were “relapse” patients, 5.52% were “new,” 13.94% were classified as “after LTFU” patients, 23.10% …

Analisa Pengelolaan Kebutuhan Logistik Farmasi Pada Instalasi Farmasi Rs Mbsd Periode Juli 2017- Juni 2018analisa Pengelolaan Kebutuhan Logistik Farmasi Pada Instalasi Farmasi Rs Mbsd Periode Juli 2017- Juni 2018analisa Pengelolaan Kebutuhan Logistik Farmasi Pada Instalasi Farmasi Rs Mbsd Periode Juli 2017- Juni 2018, Suherman Suherman, Atik Nurwahyuni

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

There is still a vacuum in the availability of medicines on a monthly basis, raising questions about how to manage pharmaceutical logistics in MBSD Hospital Pharmacy Installation. The purpose of this research is to find out how the logistics management system of drug supplies and various problems that occur at each stage of implementation in the MBSD Hospital Pharmacy Installation. This research uses descriptive and analytical methods that are quantitative and qualitative by conducting in-depth interviews, document review, and calculation of ABC drug classifications to then calculate the Economic Order Quantity value and Re Order Point time on drugs classified …