Journal of health and human services administration最新文献

The United Arab Emirate (UAE) of Dubai, faces significant adolescent health problems. In 2009, evidence based clinical guidelines were developed for primary health care professionals in Dubai to help reduce adolescent health problems. This research study explores adolescents' self-reports about health education services received between 2008 and 2010. The sample consisted of 730 public high school students in grades 10 through 12 between the ages of 15 and 19. 357 (48.9%) of the sample were males and 373 (51.1%) were female. The major language spoken in the home was Arabic (77.4%). All students completed a 27-item survey in Arabic that was adapted from the Young Adult Health Care Survey (YAHCS). The YAHCS is a 56-item research instrument traditionally administered in English and Spanish. The sample reported they had received little or no health education from their health care providers. 94.2% reported receiving no information about using a helmet for bicycle and motorbike safety; 88.2% reported receiving no information about drug use; and 81.9% reported that they received no information about smoking. The instrument also explored the health education material students received within the last 12 months. 65.5% of the sample reported seeing and/or hearing safety tips; 84.9% reported hearing and/or seeing health information about healthy diet, physical activity and exercise; and 79.2% reported seeing and/or hearing information about the risks of smoking and substance abuse.

In the last five years, the American public health emergency preparedness and response system has been tested by two significant threats, H1N1 and Ebola. While neither proved as dangerous as initially feared, these viruses highlighted on-going issues with collaborations in the field of public health and health care. Strengths were identified within the network, but also challenges that must be resolved before the U.S. faces a major pandemic. Employing interview data from public health emergency response practitioners and documentary evidence from the H1N1 and Ebola responses, this qualitative analysis uses the grounded theory approach to identify key areas for collaborative improvement. The grounded theory developed calls for a stronger policy framework at the federal level to facilitate more collaboration between U.S. agencies and facilitate more collaboration at the state and local level.

The health care system, and hospitals, underwent considerable restructuring and downsizing in the early to mid-1900s in several countries as governments cut costs to reduce their budget deficits. Studies of the effects of these efforts on nursing staff and hospital functioning in various countries generally reported negative impacts with threats to job security emerging as an important outcome of these changes. Health care restructuring and hospital downsizing is again being implemented as governments struggle to reduce deficits at a time of worldwide economic recession in 2008/2010. This study examines correlates and consequences of job insecurity among Canadian nursing staff, with a focus on nurses’ well-being. Data were collected from 290 nursing staff working in hospitals in Ontario, Canada. Feelings of job insecurity in the sample as a whole were relatively low. Personal demographics and work situation characteristics were generally uncorrelated with feelings of job insecurity. Consistent with previous findings, perceived job insecurity was once again associated with less favorable work and well-being outcomes. Some suggestions for more successful approaches to addressing levels of subjective job insecurity are offered.

The aim of this descriptive study was to establish and describe the national incidence, cost, and outcomes of patients that undergo medical transfer. Using discharge data from the Nationwide Inpatient Sample 2011, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, the dataset was analyzed using weighted frequency distribution. Approximately 1.6 million patients are transferred yearly. Transferred patients experience a mean length of stay of 9.3 days (std dv 13.5) versus 4.3 days for patients not transferred (std dv 6.0), and cost more than twice as much (mean $19,234) versus those not transferred (mean $9,469). Additionally, patients who undergo inter-facility transfer cost an additional $15.8 billion annually. Interhospital patient transfers require closer scrutiny regarding appropriateness and future policy implications.

Global disparities in health form a complex issue adversely affecting much of the world's population. What has been found is that national income and other general socio-economic factors are strong determinants of population health (Houweling, 2005 & Schell, 2007). In countries where resources are less, people are much less healthy than people living in rich countries. In wealthier countries that have made immense progress in health indicators, the resulting change in age structure and morbidity and mortality patterns portends even greater financial demands on the health sector.This study noted the trends in several health indicators versus economic indicators and related it to low income, lower middle income, upper middle income and high income countries. We noted that there is improvement in all health indicators along with an increasing GNI per Capita and GDP. In low income regions though, the rate of improvement is slower as opposed to high income countries. However, there is progress, which is leading to an increase in aging population.

Depression is one of the leading causes of disability for all ages and genders in the United States. Historically, depression had been viewed as a condition that only affected older adults; however, in recent years health professionals have recognized depression as a serious condition also affecting adolescence and young adults. The purpose of this study was to identify whether gender was a risk factor of depression within the adolescent and young adult population as literature shows that depression can impact growth and development, school performance, peer or family relationship and at times can be fatal. Data from the 2005-2006 National Health and Nutrition Examination Survey was studied to gain understanding into the predictive relationship between adolescent depression and gender. The hypothesis that gender is a predictive factor for depression in this population was supported.

This study uses the data set from Kaiser Permanente to examine the post implementation of a preventive and chronic care that utilizes clinical information system, delivery system design, and clinical decision support to maximize the office visit. The analysis suggests a significant positive relationship between frequency of utilization rates to address preventive and chronic care gaps. There is no implication of a significant positive relationship with the successfully captured rate, which satisfies closing the care gap within 45 days. The use of the preventive care tool will assist members in satisfying the preventive care gap, cervical cancer screening, within 45 days of the encounter.

Objective: This paper examines the hospital management practices of manipulating financial earnings within the bounds of generally accepted accounting principles (GAAP).

Study design: We conduct regression analyses that relate earnings management to hospital characteristics to assess the economic determinants of hospital earnings management behavior.

Method and data: From the CMS Cost Reports we collected hospital financial data of all U.S. hospitals that request reimbursement from the federal government for treating Medicare patients, and regress discretionary accruals on hospital size, profitability, asset liquidity, operating efficiency, labor cost, and ownership.

Results: Hospitals with higher profit margin, current ratio, working capital, days of patient receivables outstanding and total wage are associated with more earnings management, whereas those with larger size and higher debt level, asset turnover, days cash on hand, fixed asset age are associated with lower level of earnings manipulation. Additionally, managers of non-profit hospitals are more likely to undertake some form of window-dressing by manipulating accounting accruals without changing business models or pricing strategies than their public hospital counterparts.

Conclusions: We provide direct evidence of the use of discretionary accruals to manage financial earnings among U.S. hospitals and the finding has profound policy implications in terms of assessing the pervasiveness of accounting manipulation and the overall integrity of financial reporting in this very special public and quasi-public service sector.