Journal of Healthcare Management最新文献

{"title":"Prevalence of Diabetic Keto Acidosis and Associated Factors among Newly Diagnosed Patients with Type One Diabetic Mellitus at Dilla University Referral Hospital, September 9th/2017 – May 30th/2019: South Ethiopia; Crossectional Study","authors":"E. Alem, Girma Zeleke, Mandefreo Baharu, H. Amare","doi":"10.36959/569/457","DOIUrl":"https://doi.org/10.36959/569/457","url":null,"abstract":"Background: Diabetic Ketoacidosis (DKA) is one of the most serious acute complications of Diabetes Mellitus (DM) and the leading cause of morbidity and mortality in young adults with type 1 diabetes. The mortality rate for DKA ranges from 2 to 5% in developed countries and 6 to 24% in developing countries. Even though many DKA patients were seen in emergency unit of Ethiopian hospitals and health centers, little is known about precipitating factors and clinical-laboratory features of DKA among Ethiopian patients and information is scant to promote better health service to prevent mortality due to DKA. So the aim of this study is to assess the prevalence and associated risk factors of DKA in newly diagnosed Type 1 Diabetic patients in Dilla University Referral Hospital (DURH) from September 9th/2017-May 30th/2019. Method: Quantitative institutional based study was conducted among 421 newly diagnosed type one diabetic patients. Data was double entered from the paper-based abstraction sheet into Epi info version 7 and exported to SPSS version 20 for analysis. A descriptive analysis was performed. Bivariate and multivariate logistic analysis was done to identify factors associated with the magnitude of Keto acidosis. Variables with p-value less than 0.05 were declared as having significant association between factors and dependent variable. Result: The magnitude of Diabetic Keto Acidosis (DKA) in newly diagnosed patients with type one diabetic Mellitus (T1DM) was found to be 38%. The significant predictors of Diabetic Keto Acidosis (DKA) among newly diagnosed patients with type one diabetic Mellitus (T1DM) were young age of the adult, family history of diabetes and infection prior to onset of Diabetic Keto Acidosis (DKA). Conclusion: The overall magnitude of Diabetic Keto Acidosis (DKA) in adults with newly diagnosed type 1 diabetes is high. In particular, adults between 18-25 years of age have a high risk of Diabetic Keto Acidosis (DKA) at onset of diabetes mellitus. Young Age, first degree relatives with Diabetic Mellitus (DM) and infection prior to Diabetic Keto Acidosis (DKA) are found to be the significant explanatory variable of Diabetic Keto Acidosis (DKA) in primary onset of T1DM.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"18 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84895856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRACTITIONER APPLICATION: Process Improvement in Patient Pathways: A Case Study Applying Accelerated Longitudinal Design With Decomposition Method.","authors":"R. Chandran","doi":"10.1097/JHM-D-19-00194","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00194","url":null,"abstract":"428 Volume 64, Number 6 • November/December 2019 (Eds.), Health operations management: Patient flow logistics in health care. New York, NY: Routledge. Wijeysundera, H. C., Wang, X., Tomlinson, G., Ko, D. T., & Krahn, M. D. (2012). Techniques for estimating health care costs with censored data: An overview for the health services researcher. ClinicoEconomics and Outcomes Research, 4, 145–155. Yabroff, K. R., Warren, J. L., Knopf, K., Davis, W. W., & Brown, M. L. (2005). Estimating patient time costs associated with colorectal cancer care. Medical Care, 43(7), 640–648. Young, T. A. (2005). Estimating mean total costs in the presence of censoring: A comparative assessment of methods. PharmacoEconomics, 23(12), 1229–1242. Zevalkink, J., & Berghout, C. C. (2006). Expanding the evidence base for the cost-effectiveness of long-term psychoanalytic treatment. Journal of the American Psychoanalytic Association, 54(4), 1313–1319. Zweifel, P., Breyer, F., & Kifmann, M. (2009). Health economics. Heidelberg, Germany: Springer Nature.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48727233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lean Management and U.S. Public Hospital Performance: Results From a National Survey.","authors":"Justine Po, T. Rundall, S. Shortell, J. Blodgett","doi":"10.1097/JHM-D-18-00163","DOIUrl":"https://doi.org/10.1097/JHM-D-18-00163","url":null,"abstract":"EXECUTIVE SUMMARY\u0000Many public hospitals have adopted Lean management methodology, but little is known about the extent of Lean adoption or the relationship between Lean adoption and hospital performance. Using data from the 2017 National Survey of Lean/Transformational Performance Improvement in Hospitals, linked with data from the American Hospital Association 2015 Annual Hospital Survey and 2015 Centers for Medicare & Medicaid Services data on hospital performance, we compare public hospitals with nonprofit and for-profit hospitals on the rate of Lean adoption and the extent of Lean implementation. We also assess the associations between Lean adoption by the end of 2014 and measures of public hospital financial performance, patient outcomes, and patient satisfaction measured in 2015.Among the 288 public hospitals that responded to the survey, 54.2% reported that they had adopted Lean. The average length of time of Lean implementation was 4.58 years. The mean number of units in which Lean was implemented was 11.9 out of 29 possible hospital units, with the emergency department (ED) being the unit in which Lean was most frequently implemented. The most common Lean practices used were daily huddles, plan-do-study-act cycles, visual management, and use of standard work. Lean adoption by 2014 was significantly associated in the direction predicted with earnings before interest, taxes, depreciation, and amortization margin (b = .042, p < .020) and percentage of patients leaving the ED without being seen (b = -0.610, p < .068). No significant associations were found between Lean adoption and patient outcomes or patient satisfaction.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-18-00163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43821123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH","authors":"","doi":"10.1097/jhm-d-19-00192","DOIUrl":"https://doi.org/10.1097/jhm-d-19-00192","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jhm-d-19-00192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47031500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRACTITIONER APPLICATION: Patient Engagement Functionalities in U.S. Hospitals: Is Early Adoption Associated With Financial Performance?","authors":"Peter V Huynh","doi":"10.1097/JHM-D-19-00197","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00197","url":null,"abstract":"396 Volume 64, Number 6 • November/December 2019 JHM-D-19-00197 Senge, P. (1990). The fifth discipline: The art & practice of the learning organization. New York, NY: Doubleday Currency. Teece, D., & Pisano, G. (1994). The dynamic capabilities of firms: An introduction. Industrial and Corporate Change, 3(3), 537–556. Teece, D. J., Pisano, G., & Shuen, A. (1997). Dynamic capabilities and strategic management. Strategic Management Journal, 18(7), 509–533. Toscos, T., Daley, C., Heral, L., Doshi, R., Chen, Y. C., Eckert, G. J., ... Mirro, M. J. (2016). Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: A quasiexperimental study. Journal of the American Medical Informatics Association, 23(1), 119–128. doi: 10.1093/jamia/ocv164 Walker, D. M., Sieck, C. J., Menser, T., Huerta, T. R., & Scheck McAlearney, A. (2017). Information technology to support patient engagement: Where do we stand and where can we go? Journal of the American Medical Informatics Association, 24(6), 1088–1094. doi: 10.1093/jamia/ocx043 Weingart, S. N., Rind, D., Tofias, Z., & Sands, D. Z. (2006). Who uses the patient internet portal? The PatientSite experience. Journal of the American Medical Informatics Association, 13(1), 91–95. Wernerfelt, B. (1984). A resource-based view of the firm. Strategic Management Journal, 5(2), 171–180. Zeger, S. L., & Liang, K. Y. (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrics, 42(1), 121–130.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47008235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRACTITIONER APPLICATION: Can Organizational Leaders Sustain Compassionate, Patient-Centered Care and Mitigate Burnout?","authors":"John Campbell","doi":"10.1097/JHM-D-19-00196","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00196","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"64 6 1","pages":"413-414"},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61781610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRACTITIONER APPLICATION: Strategies for Delivering Value-Based Care: Do Care Management Practices Improve Hospital Performance?","authors":"Kimberly J Miller","doi":"10.1097/JHM-D-19-00193","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00193","url":null,"abstract":"Jain, Thorpe, Hockenberry, and Saltman address a critically important strategy for delivering value-based care: the relationship of care management processes with hospital performance. The value-based care payment structure affects not only the delivery and quality of care but also the future viability of healthcare organizations. As delivery and payment models continue to make the transition from a volume-driven structure to a more patient-centric care management model, organizations and individual care providers must raise the bar on their performance. The authors state that a hospital’s ability to perform well in value-based care has more to do with its internal organizational processes than the structure of the organization. As a hospital leader, I have also found this to be true. Yes, there are significant initial costs associated with implementation of foundational changes in care management and coordination. Over time, however, these changes can yield increasingly positive results for the patients’ well-being and the organization’s value-based care metrics. The initial, incremental changes accelerate as providers gain a deeper understanding of the new model of care delivery and their individual and team roles in the outcomes. Central to our successful implementation and positive outcomes was transparent and frequent communication among all team members in the organization. We achieved this success via multiple avenues of communication, and one of the most effective channels was the use of clear, concise dashboards that outlined results as compared to benchmarks and best performers. Healthcare providers are driven by evidence-based data, and information that is prominently displayed and shared across the organization advances adoption of the new strategies to better serve the patients. In addition, communication of vision and objectives for care delivery must be fully aligned throughout the organization, starting with the CEO and continuing through the chief medical officer and chief nursing officer. I further believe that focusing on financial metrics alone will not improve quality and lower costs to any meaningful degree. Internal processes also must be restructured, and the voices of the patient and providers must be considered. When value-based care initially began to make an impact on financial performance, the dollars at risk for any given organization were low. As the value-based care model has evolved, the dollars at risk have increased. My experience supports a slow start to learn","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43641761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kenneth L. Johnson, PhD, FACHE, Associate Dean and Professor, Weber State University.","authors":"","doi":"10.1097/JHM-D-19-00195","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00195","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46443920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Engagement Functionalities in U.S. Hospitals: Is Early Adoption Associated With Financial Performance?","authors":"O. Asagbra, F. Zengul, Darrell Burke","doi":"10.1097/JHM-D-18-00095","DOIUrl":"https://doi.org/10.1097/JHM-D-18-00095","url":null,"abstract":"EXECUTIVE SUMMARY\u0000U.S. hospitals are in various stages in their adoption of health information technology (HIT) with patient engagement functionalities. The Health Information Technology for Economic and Clinical Health Act of 2009 allocated $30 billion to incentivize the adoption and use of HIT. This study aims to identify hospital characteristics of early patient engagement functionality adoption and compare the financial performance of groups of hospitals that offer these functionalities according to Rogers' adopter categories. The combined data from the American Hospital Association Annual Survey and Information Technology Supplement, Centers for Medicare & Medicaid cost reports, and Health Resources & Services Administration Area Health Resource Files from 2008 to 2013 yielded a sample of 696 unique acute care hospitals. Three adopter categories-early adopters, early majority, and late majority-were created. Generalized estimating equations were used to examine the financial performance (operating margin, return on assets, total margin, operating expenses, revenue per inpatient day) across the adopter types. Compared to early adopter hospitals, operating margins were lower for early majority hospitals (β = -.407, p < .05) and late majority hospitals (β = -.608, p < .05). Moreover, compared to early adopter hospitals, late majority hospitals exhibited significantly lower operating revenue (β = -.087, p < .01) and operating expenses (β = -.064, p < .01) per inpatient day. No significant relationships were observed when comparing these groups based on total margin and return on assets. Hospital administrators should consider the positive financial outcomes associated with early adoption of patient engagement functionalities in the decision-making process.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-18-00095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49335854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH","authors":"","doi":"10.1097/jhm-d-19-00183","DOIUrl":"https://doi.org/10.1097/jhm-d-19-00183","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jhm-d-19-00183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48711073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}