Aggregate nursing requirement planning in a public health care delivery system

ABSTRACTThe Zika virus was largely unknown to many health care systems before the outbreak of 2015. The unique public health threat posed by the Zika virus and the evolving understanding of its pathology required continuous communication between a health care delivery system and a local public health department. By leveraging an existing relationship, NYC Health+Hospitals worked closely with New York City Department of Health and Mental Hygiene to ensure that Zika-related processes and procedures within NYC Health+Hospitals facilities aligned with the most current Zika virus guidance. Support given by the public health department included prenatal clinical and laboratory support and the sharing of data on NYC Health+Hospitals Zika virus screening and testing rates, thus enabling this health care delivery system to make informed decisions and practices. The close coordination, collaboration, and communication between the health care delivery system and the local public health department examined in this article demonstrate the importance of working together to combat a complex public health emergency and how this relationship can serve as a guide for other jurisdictions to optimize collaboration between external partners during major outbreaks, emerging threats, and disasters that affect public health. (Disaster Med Public Health Preparedness. 2018;12:689-691)

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Need for population-based survey to strengthen public health care delivery system: A program manager perspective

International Journal of Advanced Medical and Health Research ◽

10.4103/2349-4220.147997 ◽

2014 ◽

Vol 1 (2) ◽

pp. 37

Author(s):

SaurabhR Shrivastava ◽

PrateekS Shrivastava ◽

Ramasamy Jegadeesh

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Delivery ◽

Care Delivery ◽

Health Care Delivery System ◽

Population Based ◽

Public Health Care ◽

System A ◽

Program Manager ◽

Population Based Survey

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Albuminuria Testing by Race and Ethnicity among Patients with Hypertension with and without Diabetes

American Journal of Nephrology ◽

10.1159/000500706 ◽

2019 ◽

Vol 50 (1) ◽

pp. 48-54 ◽

Cited By ~ 2

Author(s):

Joi Lee ◽

Chi Chu ◽

David Guzman ◽

Valy Fontil ◽

Alexandra Velasquez ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Kidney Disease ◽

Ethnic Minorities ◽

Health Care Delivery ◽

Low Income ◽

Care Delivery ◽

Health Care Delivery System ◽

Public Health Care ◽

Racial Ethnic

Background: Detection of chronic kidney disease (CKD) with urine albumin-to-creatinine ratio (UACR) among patients with hypertension (HTN) provides an opportunity for early treatment, potentially mitigating risk of CKD progression and cardiovascular complications. Differences in UACR testing patterns among racial/ethnic populations at risk for CKD could contribute to known disparities in CKD complications. Methods: We examined the prevalence of UACR testing among low-income adult primary care patients with HTN, defined by a new administrative code for HTN or 2 clinic blood pressures >140/90 mm Hg between January 1, 2014, and January 1, 2017, in one public health-care delivery system with a high prevalence of end-stage kidney disease among race/ethnic minorities. Logistic regression was used to identify odds of UACR testing within 1 year of a HTN diagnosis, overall, and by racial/ethnic subgroup, adjusted for demographic factors, estimated glomerular filtration rate, and HTN severity. Models were also stratified by diabetes status. Results: The cohort (n = 16,414) was racially/ethnically diverse (16% White, 21% Black, 34% Asian, 19% Hispanic, and 10% other) and 51% female. Only 35% of patients had UACR testing within 1 year of a HTN diagnosis. Among individuals without diabetes, odds of UACR testing were higher among Asians, Blacks, and Other subgroups compared to Whites (adjusted OR [aOR] 1.19; 95% CI 1.00–1.42 for Blacks; aOR 1.33; 1.13–1.56 for Asians; aOR 1.30; 1.04–1.60 for Other) but were not significantly different between Hispanics and Whites (aOR 1.17; 0.97–1.39). Among individuals with diabetes, only Asians had higher odds of UACR testing compared to Whites (aOR 1.35; 1.12–1.63). Conclusions: Prevalence of UACR testing among low-income patients with HTN is low in one public health-care delivery system, with higher odds of UACR testing among racial/ethnic minority subgroups compared to Whites without diabetes and similar odds among those with diabetes. If generalizable, less albuminuria testing may not explain higher prevalence of kidney failure in racial/ethnic minorities.

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