Health Services Research and Managerial Epidemiology最新文献

{"title":"Understanding the Difference Between Healthcare Informatics and Healthcare Data Analytics in the Present State of Health Care Management","authors":"T. Wan, V. Gurupur","doi":"10.1177/2333392820952668","DOIUrl":"https://doi.org/10.1177/2333392820952668","url":null,"abstract":"The purpose of this article is to perform a scientific analysis of the definitions associated with healthcare informatics and healthcare data analytics. Additionally, the authors attempt to redefine the scientific pursuit of healthcare informatics and healthcare data analytics. This commentary can assist the thinking of informaticians and data analysts working in healthcare management and practice. The authors also provide a brief insight on the possible future direction of informatics and analytics associated with healthcare.","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"PP 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84315669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Health Cost Repartition Among Diseases in the Presence of Multimorbidity.","authors":"Valentin Rousson,&nbsp;Jean-Benoît Rossel,&nbsp;Yves Eggli","doi":"10.1177/2333392819891005","DOIUrl":"10.1177/2333392819891005","url":null,"abstract":"<p><p>We consider the nontrivial problem of estimating the health cost repartition among different diseases in the common case where the patients may have multiple diseases. To tackle this problem, we propose to use an iterative proportional repartition (IPR) algorithm, a nonparametric method which is simple to understand and to implement, allowing (among other) to avoid negative cost estimates and to retrieve the total health cost by summing up the estimated costs of the different diseases. This method is illustrated with health costs data from Switzerland and is compared in a simulation study with other methods such as linear regression and general linear models. In the case of an additive model without interactions between disease costs, a situation where the truth is clearly defined such that the methods can be compared on an objective basis, the IPR algorithm clearly outperformed the other methods with respect to efficiency of estimation in all the settings considered. In the presence of interactions, the situation is more complex and will deserve further investigation.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"6 ","pages":"2333392819891005"},"PeriodicalIF":1.6,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392819891005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of Lifesaving Maternal and Child Health Commodities and Associated Factors in Public and Private Health Facilities of Addis Ababa, Ethiopia.","authors":"Dagim Damtew,&nbsp;Fikru Worku,&nbsp;Yonas Tesfaye,&nbsp;Awol Jemal","doi":"10.1177/2333392819892350","DOIUrl":"https://doi.org/10.1177/2333392819892350","url":null,"abstract":"<p><strong>Background: </strong>Inaccessible, unaffordable, and poor quality care are the key underlying reasons for the high burden of maternal and child morbidity and mortality in low- and middle-income countries.</p><p><strong>Objective: </strong>To assess the availability of lifesaving maternal and child health (MCH) commodities and associated factors in public and private health facilities of Addis Ababa, Ethiopia, 2016.</p><p><strong>Methods: </strong>Institutional-based, descriptive cross-sectional study was carried out in the selected health facilities (29 publics and 6 private) in Addis Ababa. The data were collected through pretested, structured questionnaire, and in-depth interviews. For the quantitative analysis, data were analyzed using SPSS version 20 statistical software, SPSS Inc. Descriptive statistics were used to summarize the variables, and the Spearman correlation test was run to determine the predictors of the outcome variables. For the qualitative data, the data were handled manually and transformed into categories related to the topics and coded on paper individually in order to identify themes and patterns for thematic analysis.</p><p><strong>Result: </strong>The overall availability of the lifesaving MCH commodities in the health facilities was 74.3%. There is a moderate, positive association between the availability of lifesaving MCH commodities with the adequacy of budget (<i>r_s</i> = 0.485, <i>P</i> < .001), use of more than 1 selection criteria during selection (<i>r_s</i> = 0.407, <i>P</i> = .015), and training given to health facilities on logistics management (<i>r_s</i> = 0.490, <i>P</i> = .003).</p><p><strong>Conclusion: </strong>The availability of the lifesaving MCH commodities in the health facilities was within the range of fairly high to high. Adequacy of budget, use of more than 1 selection criteria during selection, and training given on logistics management were the predictors of the availability of the commodities.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"6 ","pages":"2333392819892350"},"PeriodicalIF":1.6,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392819892350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Satisfaction With Providers: Do Patient Surveys Give Enough Information to Help Providers Improve Specific Behaviors","authors":"F. North, S. Tulledge-Scheitel","doi":"10.1177/2333392819885284","DOIUrl":"https://doi.org/10.1177/2333392819885284","url":null,"abstract":"Background: Patient satisfaction surveys ask patients specific questions about provider behavior such as whether they were satisfied with the provider’s instructions about medications or time spent with the patient. It’s unclear how responses to these surveys can help providers focus on specific behaviors to improve. Methods: In a primary care setting, we analyzed Press Ganey patient experience survey responses. We examined the 10 questions dealing with satisfaction specific to the care provider experience. We used the “Top Box” counts (counts of most favorable responses) and Top Box% (percentage of most favorable response) for categorical and continuous measures of patient satisfaction. Results: For 12 consecutive months, 652 providers of 1014 accumulated at least 300 total responses from patients for the 10 provider-related questions. Only 8 of the 652 providers had significant differences (P < .05) in Top Box% for the 10 questions. Correlation of responses between the questions were between 0.86 and 0.96. Analysis of variance showed that 87% of the total variation in the Top Box% of the 10 questions was between providers and only 13% within providers. Factor analysis found no independent factors within the 10 questions (ie, a one factor model was sufficient; P < .0001). Conclusion: Patient survey questions appear to ask about specific provider behaviors that contribute to patient experience. However, the responses to 10 different questions are highly correlated and may not give providers or management enough statistically significant information to focus patient experience improvement efforts for individual providers.","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"12 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91340027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do All Hospital Systems Have Market Power? Association Between Hospital System Types and Cardiac Surgery Prices.","authors":"Sung W Choi,&nbsp;Avi Dor","doi":"10.1177/2333392819886414","DOIUrl":"https://doi.org/10.1177/2333392819886414","url":null,"abstract":"<p><strong>Objective: </strong>This study explores the price implications of hospital systems by analyzing the association of system characteristics with selected cardiac surgery pricing.</p><p><strong>Data source: </strong>Using a large private insurance claim database, the authors identified 11 282 coronary artery bypass graft (CABG) cases and 49 866 percutaneous coronary intervention (PCI) cases from 2002 to 2007.</p><p><strong>Study design: </strong>We conducted a retrospective observational study using generalized linear models.</p><p><strong>Principal findings: </strong>We found that the CABG and PCI prices in centralized health and physician insurance systems were significantly lower than the prices in stand-alone hospitals by 4.4% and 6.4%, respectively. In addition, the CABG and PCI prices in independent health systems were significantly lower than in stand-alone hospitals, by 15.4% and 14.5%, respectively.</p><p><strong>Conclusion: </strong>The current antitrust guidelines tend to focus on the market share of merging parties and pay less attention to the characteristics of merging parties. The results of this study suggest that antitrust analysis could be more effective by considering characteristics of hospital systems.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"6 ","pages":"2333392819886414"},"PeriodicalIF":1.6,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392819886414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quasi-Experimental Study Examining the Impact and Challenges of Implementing a Fitness-Based Health Risk Assessment and a Physical Activity Counseling Intervention in the Workplace Setting","authors":"Naomi C. Hamm, D. Kehler, J. Hay, Andrew N. Stammers, S. Strachan, D. Bouchard, T. Duhamel","doi":"10.1177/2333392819884183","DOIUrl":"https://doi.org/10.1177/2333392819884183","url":null,"abstract":"Objectives: Few adults participate in enough physical activity for health benefits. The workplace provides a unique environment to deliver heath interventions and can be beneficial to the employee and the employer. The purpose of the study was to explore the use of a physical activity counseling (PAC) program and a fitness-based health risk assessment (fHRA) in the hospital workplace. Methods: A workplace-based intervention was developed utilizing a PAC program and an fHRA to improve physical activity levels of employees. Hospital employees were enrolled in a 4-month PAC program and given the option to also enroll in an fHRA program (PAC + fHRA). Physical activity was assessed by accelerometry and measured at baseline, 2 months, and 4 months. Changes in musculoskeletal fitness for those in the fHRA program were assessed at baseline and 2 months. Results: For both groups (PAC n = 22; PAC + fHRA n = 16), total and moderate to vigorous physical activity in bouts of 10 minutes or more increased significantly by 18.8 (P = .004) and 10.2 (P = .048) minutes per week at each data collection point, respectively. Only participants with gym memberships demonstrated increases in light physical activity over time. Those in the fHRA group significantly increased their overall musculoskeletal fitness levels from baseline levels (18.2 vs 21.7, P < .001). There was no difference in the change in physical activity levels between the groups. Conclusions: A PAC program in the workplace may increase physical activity levels within 4 months. The addition of an fHRA does not appear to further increase physical activity levels; however, it may improve overall employee musculoskeletal fitness levels.","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"61 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83928207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residential Counselors and Self Care: A Retrospective Qualitative Study of Archival Interview Data","authors":"Rebekah Lemmons, Stephen A. Zanskas","doi":"10.1177/2333392819867017","DOIUrl":"https://doi.org/10.1177/2333392819867017","url":null,"abstract":"Objectives: The purpose of this qualitative inquiry was to understand the barriers related to effective self-care for master’s level residential counselors. Methods: Archival interview transcripts of 77 residential counselors were analyzed utilizing a social constructivist lens to identify perceived barriers to effective self-care. Themes related to levels of self-care influences including individual, supervisory, and organizational barriers to effective self-care emerged. Results: Results reflected those themes specifically by indicating that counselors can take steps to actively engage in wellness pursuits to promote self-care. Similarly, supervisors and organizations can enhance or impede a counselor’s ability to engage in self-care. Conclusions: Counselors should select work settings that have both supervisory and organizational supports for self-care. This includes encouraging a culture of wellness through support, development, coverage for time off, and other related areas. Implications show that practices and policies are needed to promote effective self-care across individual, supervisory, and agency domains.","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"60 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86062759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Care Administrator Perspectives on Prevention Guidelines and Healthy Lifestyle Counseling in a Primary Care Setting in New York State.","authors":"Julie Sorensen,&nbsp;Helene Johansson,&nbsp;Lars Jerdén,&nbsp;James Dalton,&nbsp;Henna Sheikh,&nbsp;Paul Jenkins,&nbsp;John May,&nbsp;Lars Weinehall","doi":"10.1177/2333392819862122","DOIUrl":"https://doi.org/10.1177/2333392819862122","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of chronic disease and treatment costs have been steadily increasing in the United States over the past few decades. Primary prevention and healthy lifestyle counseling have been identified as important strategies for reducing health-care costs and chronic disease prevalence. This article seeks to examine decision-makers' experiences and self-perceived roles in guideline and lifestyle counseling implementation in a primary care setting in the United States.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with administrators at a health-care network in Upstate New York and with state-level administrators, such as insurers. Decision-makers were asked to discuss prevention guidelines and healthy lifestyle counseling, as well as how they support implementation of these initiatives. Interviews were analyzed using a thematic analysis framework and relevant sections of text were sorted using a priori codes.</p><p><strong>Results: </strong>Interviews identified numerous barriers to guideline implementation. These included the complexity and profusion of guidelines, the highly politicized nature of health-care provision, and resistance from providers who sometimes prefer to make decisions autonomously. Barriers to supporting prevention counseling included relatively time-limited patient encounters, the lack of reimbursement mechanisms for counseling, lack of patient resources, and regulatory complexities.</p><p><strong>Conclusions: </strong>Our research indicates that administrators and administrative structures face barriers to supporting prevention activities such as guideline implementation and healthy lifestyle counseling in primary care settings. They also identified several solutions for addressing existing primary prevention barriers, such as relying on nurses to provide healthy lifestyle support to patients. This article provides an important assessment of institutional readiness to support primary prevention efforts.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"6 ","pages":"2333392819862122"},"PeriodicalIF":1.6,"publicationDate":"2019-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392819862122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41199341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can a Different Formulation of Vitamin D3 Allow Savings? An Analysis From an Italian Regional Perspective","authors":"Mario Sanò, P. Dutto, S. D’Anna, C. Rognoni","doi":"10.1177/2333392819861881","DOIUrl":"https://doi.org/10.1177/2333392819861881","url":null,"abstract":"Vitamin D3 reported in Italy in 2017 the net expenditure of almost €180 million, reaching the first place for consumption and the third place for conventional pharmaceutical spending. The aim of the study was to evaluate whether a shift of vitamin D3 prescriptions toward 100 000 IU formulation, less costly, could allow savings from the health-care perspective. An approach promoting the prescription of this formulation has been applied in a local health authority (ASL CN2) in Piedmont Region (Italy) starting from 2015. The retail pharmaceutical market and the consumption of vitamin D3 has been analyzed from year 2014 to 2017 in order to evaluate differences in expenditures. Despite an increase in consumption, the introduction of the new formulation enabled ASL CN2 to save about €280 000 in 2017 considering the regional average expenditure per 1000 inhabitants as a reference. If Piedmont Region had presented an average expenditure in line with that of ASL CN2, the annual regional savings would have exceeded €7 million in 2017 alone. A shift of vitamin D3 prescriptions toward 100 000 IU formulations would allow reducing costs from the payer perspective. Savings may be used to contain public pharmaceutical expenditure or can be allocated to fund other health-care technologies and services.","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"19 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2019-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76666967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study of Stress and the Perceived Style of Decision-Making in Clinicians and Patients With Cancer.","authors":"Elaina Vivian, Hellen Oduor, Laurie Lundberg, Allison Vo, Parvez S Mantry","doi":"10.1177/2333392819855397","DOIUrl":"10.1177/2333392819855397","url":null,"abstract":"<p><strong>Background and aims: </strong>Perceived stress and mindfulness can impact medical decision-making in both patients and clinicians. The aim of this study was to conduct a cross-sectional evaluation of the relationships between stress, mindfulness, self-regulation, perceptions of treatment conversations, and decision-making preferences among clinicians. Also, perceptions of treatment conversations and decision-making preferences among patients with cancer were evaluated.</p><p><strong>Methodology: </strong>Survey instruments were developed for clinicians and patients incorporating previously published questions and validated instruments. Institutional review board approval was obtained. Patients, physicians, and advanced practice providers from a tertiary referral center were asked to complete surveys. Continuous variables were evaluated for normality and then bivariate relationships between variables were evaluated using χ², Fisher's exact test, Cochran-Mantel-Haenszel (CMH) row mean scores differ statistic, or Kruskal-Wallis tests, where appropriate. Significance was defined at <i>P < .</i>05. All tests were conducted using SAS v.9.4.</p><p><strong>Results: </strong>77 patients and 86 clinicians (60.1% and 43% response rates, respectively) participated in the surveys. More clinicians who reported feeling \"great/good\" said they always/sometimes had enough time to spend with patients (66.1%) compared to those that hardly ever/never had enough time (26.3%), χ²(1, N = 75) = 6.62, <i>P</i> = .0101; CMH row mean scores differ statistic). Interestingly, 40.3% of patients preferred a paternalistic style of decision-making compared to 6.3% of clinicians, χ²(2, N = 146) = 27.46, <i>P</i> < .0001; χ² test. Higher levels of dispositional mindfulness (Mindful Attention Awareness Scale) were found among clinicians who reported they felt \"great/good\" (median = 4.5) as compared to those who reported that they were \"definitely stressed/stressed out\" (3.3), χ²(2, N = 80) = 10.32, <i>P</i> = .0057; Kruskal-Wallis test. Higher levels of emotional self-regulation (Emotional Regulation Questionnaire-Cognitive Reappraisal facet) were found among clinicians who reported they felt \"great/good\" (median = 31.0) compared to those who reported that they were \"definitely stressed/stressed out\" (20.0), χ²(2, N = 79) = 8.88, <i>P</i> = .0118; Kruskal-Wallis test.</p><p><strong>Conclusion: </strong>In order to have meaningful conversations about treatment planning, an understanding of mental well-being and its relationship to decision-making preferences is crucial for both oncology patients and clinicians. Our results show that for clinicians, lower perceived stress was associated with higher levels of mindfulness (experiencing the present moment), emotional self-regulation, and spending more time with patients. Larger prospective studies are needed to validate these findings.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"6 ","pages":"2333392819855397"},"PeriodicalIF":1.5,"publicationDate":"2019-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/5d/10.1177_2333392819855397.PMC6572899.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37359303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}