Health Services Research Commons^™

Substance Abuse Treatment In Correctional Versus Non-Correctional Settings: Analysis Of Racial/Ethnic And Gender Differences, George Pro, Ricky Camplain, Samantha Sabo, Julie Baldwin, Paul A. Gilbert

Journal of Health Disparities Research and Practice

Background

Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants …

Older Adults Hospitalized For Pneumonia In The United States: Incidence, Epidemiology, And Outcomes., Forest W. Arnold, Andrea Reyes-Vega, Vidyulata Salunkhe, Stephen P. Furmanek, Christian Furman, Laura Morton, Anna Johan Faul, Pam Yankeelov, Julio A. Ramirez

Faculty and Staff Scholarship

OBJECTIVES: To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN: This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING: The study took place in all nine acute care hospitals for adults in Louisville, …

Utilization Of Dental Services Among Medicaid Enrolled Pregnant Women In Virginia, Shillpa Naavaal, Tegwyn Brickhouse, Jonathan W. Yu, Joann Wells

Philips Institute for Oral Health Research Publications

The study evaluated the impact of the Virginia Medicaid dental benefit on dental services utilization among pregnant women enrolled in Medicaid. Data from a total of 10,395 women who had at least one dental claim during the 2015-2017 period were included in the study. The number of dental visits and dental services utilized per person grew from an average of 2.2 visits and 7 services in 2015 to 3.1 visits and 10.5 services in 2017, respectively. In 2017, of all dental services used, 6% were for preventive services and 59% were for treatment services. Continued efforts and targeted interventions are …

Universal Healthcare: Good Or Bad?, Danielle Tait

Student Research Poster Presentations 2020

The topic of universal healthcare seems to come up quite a bit in political platforms, but what does it really mean for Americans? By allowing universal healthcare, instead of private insurance companies, we as a nation will see an increase in healthy citizens, the economy will save money, and patients will be more satisfied with their healthcare. Although we do not have concrete evidence, studies project that universal healthcare will bring immense benefits to America’s healthcare.

Assessing Access To Healthcare For Limited English Proficient Patients, Hannah Bergamini

Mahurin Honors College Capstone Experience/Thesis Projects

Patients with limited English skills often face additional struggles when accessing medical care. These patients, referred to as limited English proficient (LEP) patients, are unable to communicate directly with their physician. This lack of direct communication typically results in unique challenges for the patient and provider. Due to these challenges, LEP patients often have poorer health statuses and experience poorer health outcomes. However, when provided with access to qualified medical interpreters, many of these challenges facing LEP patients can be ameliorated. Therefore, using qualified interpreters is an important component in improving the access to healthcare for LEP patients. To determine …

Diversification Of Research Methodological Approach During Model Enhancements In Health Information System Research, Uche Ikenyei

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.

Lincoln County Community Paramedicine Data Collection Initiative, Katie Rosingana Ba, Evelyn Ali Bs, Karen Pearson Mlis, Ma

Substance Use Research & Evaluation

No abstract provided.

Unintended Consequences Of Population Health In Medical Home Contracts With Mcos To Improve Quality Of Care, Mildred Scott

MUSC Theses and Dissertations

Public policy efforts to improve population health are important. However, any public policy may have unintended consequences, and the risk of these side-effects may be substantial if they include payment incentives to providers or economic incentives for patients. A recent policy initiative The Population Health Medical Home Contracts with MCOs to Improve Quality of Care is the focus of this study. The Center for Medicare and Medicaid Services (CMS) implemented a quality initiative to improve the quality of healthcare and services for patients with Medicare and Medicaid benefits to improve Healthcare Effectiveness Data and Information Set (HEDIS) Measures. As a …

Mitigating The Risk Of Financial Distress And Closure In Rural Hospitals: A Multiple Case Study, Christopher Brian Wiggs

MUSC Theses and Dissertations

Few studies have explored strategies rural hospitals have implemented to lower the risk of financial distress and closure. The objective of this doctoral project is to explore factors rural hospital stakeholders consider when determining the most appropriate business model for their organization. A multiple case study design was utilized to explore key factors considered in the decision-making processes at three rural hospitals in the southeastern Unites States with varying business models and characteristics. Nine rural hospital stakeholders including administrators, clinician, and community leaders participated in semi-structured interviews. Interviews were recorded, transcribed, and analyzed using an inductive coding process. Seven themes …

A Rural Mother's Guide To Breastfeeding, Haley Tillett

Undergraduate Honors Theses

Breastfeeding is considered as the gold standard of infant health (CDC, n.d.). The benefits provided to both the baby and mother by breastfeeding are unmatched when compared to formula feeding. Recent studies have shown a disparity in rates of breastfeeding, primarily in rural areas. This may be due, in part, to the fact that mothers in rural areas may not have equal access to resources and support they need to successfully breastfeed due to geographic isolation. This guide will provide an overview of breastfeeding resources in rural communities with a focus on Kittitas Valley, Washington. Resources include but are not …

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Eye Screening In U.S. Adults With Diabetes: Examination Of Trends, Racial And Ethnic Differences, And Contribution Of Medicaid Expansion, Meps 2010-2017, Karon Lewis

College of Graduate Studies: Theses & Dissertations

Diabetic retinopathy (DR) is a prevalent cause of vision impairment and blindness among adults in the United States. Early diagnosis of DR through dilated eye examinations can reduce the risk of vision impairment or loss. Differences in eye examination rates by race and ethnicity have been suggested by prior studies emphasizing importance of increasing insurance coverage and access to care among minority populations. The Affordable Care Act aimed to expand health insurance coverage and improve access to care. This study examined trends overall and by race and ethnicity in eye examination rates and the contribution of Medicaid expansion on changes …

Assessing The Efficiency Of Sub-National Units In Making Progress Towards Universal Health Coverage: Evidence From Pakistan, Faraz Khalid, Maria Petro Brunal, Abdul Sattar, Samia Laokri, Matthew Jowett, Wajeeha Raza, David R. Hotchkiss

Community Health Sciences

The World Health Report 2010 encourages countries to reduce wastage and increase efficiency to achieve Universal Health Coverage (UHC). This research examines the efficiency of divisions (sub-provincial geographic units) in Pakistan in moving towards UHC using Data Envelop Analysis. We have used data from the Pakistan National Accounts 2011-12 and the Pakistan Social Living and Measurement Survey 2012-13 to measure per capita pooled public health spending in the divisions as inputs, and a set of UHC indicators (health service coverage and financial protection) as outputs. Sensitivity analysis for factors outside the health sector influencing health outcomes was conducted to refine …

Physician Empathy In Public And Private Internal Medicine Residency Training Programs In Pasig City, Rafael Carlos C. Aniceto, Dave Ryan A. Dela Cruz, Mary Stephanie M. Dofitas, Kenneth Brian M. Fernando, Melody Hope L. Lee Yu, Joseph Anthony Lachica

Ateneo School of Medicine and Public Health Publications

Research Question:
What are the levels of patient-perceived and self-assessed physician empathy among internal medicine (IM) residents in two tertiary hospitals in Pasig City? Is there a significant difference in patient-perceived and self-assessed physician empathy levels between public and private tertiary hospitals?

Background:
Empathy is important because it has been speculated to have a positive effect on patient outcomes; it is a skill that can be learned and developed.

Objectives:
This study obtained quantitative measurements of patient-perceived and self-assessed physician empathy. Empathy levels between public and private tertiary hospitals were compared.

General Study Design:
This study utilized a quantitative cross-sectional …

Quality Of Medical Care For Adults With Intellectual/Developmental Disabilities, Priya Chandan

Theses and Dissertations

QUALITY OF MEDICAL CARE FOR ADULTS WITH INTELLECTUAL/DEVELOPMENTAL DISABILITIES

By Priya Chandan, M.D., M.P.H.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of

Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2020.

Director: Director: Gloria J. Bazzoli, Ph.D.

Bon Secours Professor, Department of Health Administration

People with intellectual/developmental disabilities (IDD) are difficult to identify in administrative data, limiting the ability to study the quality of health care provided to this population. This study utilized clinical diagnoses to define a sample of hospitalized patients with IDD in the largest publicly available all-payer inpatient care database—the …

The Association Between The Medicare Bundled Payments Initiative And Cardiac Rehabilitation Enrollment, Jing Li

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Cardiac rehabilitation (CR) represents a proven-effective intervention in secondary prevention that can stabilize, slow or reverse cardiovascular disease (CVD) progression, facilitate the ability of the patient to preserve or resume an active and functional contribution to the community, and reduce the risk of future cardiovascular events. Despite multiple guideline recommendations for CR and coverage by Medicare and most health plans, participation in CR remains low. Bundled payments are one of the suggested reforms designed to move health care providers toward to value-based care and is very applicable to the CR utilization in patients diagnosed with acute myocardial infarction (AMI) or …

Utilization Of A Community Pharmacy-Based Service For The Treatment Of Uncomplicated Urinary Tract Infections In Scotland, Robert Borchardt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: In November 2013, Scotland piloted a program in Grampian for the treatment of Urinary Tract Infections (UTIs) in community pharmacies, increasing health access for patients and reducing general practitioner workload. This program became known as ‘Pharmacy First’ and was later implemented nationwide in November 2017. This paper seeks to understand utilization of the Pharmacy First program across Scotland by patients and potential barriers to access.

Methods: Using data from the Prescribing Information System collected by the National Health Service of Scotland from July 2013 to April 2019, orders for uncomplicated UTIs were gathered by examining all nitrofurantoin and trimethoprim …

Association Between Participation In Annual Physical Examinations And Risk Factors For Noncommunicable Diseases In Adults With Disabilities: Evidence From Shanghai, China, Yugang Li, Qi Zhang, Xiaohong Li, Mei Sun, Jun Lu, Gang Chen

Community & Environmental Health Faculty Publications

The relationships between regular participation in annual physical examinations and the risk factors for noncommunicable diseases (NCDs) among adults with disabilities remains unclear. To address this gap, we used data from 130,899 individuals with disabilities in Shanghai (2014-2016) and evaluated four risk factors for NCDs: hypertension, hyperglycemia, hyperlipidemia, and being overweight. Overall, 4540 individuals participated in annual physical examinations across all three years and 11,388 missed examinations in 2015 (group without regular participation). Chi-squared tests and binary logistic regression were used to assess differences in patient characteristics and explore correlations between variables. Significant differences in age (χ² = 102.620, …

Tobacco Use And Nicotine Withdrawal Among Patients With Mental Illness, Yazan Daher Al-Mrayat

Theses and Dissertations--Nursing

People with mental illness (MI) are disproportionately affected by tobacco use compared to the general population. In fact, it is estimated that people with MI consume approximately 44% of cigarettes smoked in the United States. Moreover, the MI population is at greater risk for the negative social, economic, and health consequences associated with tobacco use and are reported to have 25-year shorter life expectancies than the general population. The impact of tobacco use is further noticeable among patients with MI who require psychiatric hospitalization. Quitting smoking in this population has been linked to fewer discharges against medical advice, better quality …

Contextualizing Performance Of Coordinated Care Network Of Veteran Services In Virginia, Marina Saitgalina, Donta Council

School of Public Service Faculty Publications

Coordinated care network is an approach to human service delivery that is recognized to improve client outcomes at a reduced cost. However, general mixed findings on the effectiveness of coordinated care networks warrant research contextualization. This article seeks to discover factors influencing the performance of a coordinated care network delivering social services to veterans and their families. The study provides a contextual analysis of a coordinated care network launched in 2016 in southeastern Virginia for two samples of 1,512 and 375 veterans and their families. Results of the regression analyses indicate that initial progress has been made both in efficiency …