scholarly journals KEEPING COOL IN FLORIDA ASSISTED LIVING COMMUNITIES: BARRIERS TO POWER RULE IMPLEMENTATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S342-S342
Author(s):  
Joseph June ◽  
Debra J Dobbs ◽  
David Dosa ◽  
Lindsay J Peterson ◽  
Kathryn Hyer
Keyword(s):  
Low Income ◽  
Assisted Living ◽  
Disaster Preparedness ◽  
Financial Burden ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Ambient Air ◽  
Chi Square ◽  
Power Rule ◽  
Emergency Power

Abstract In 2018, in response to deaths of nursing home residents after Hurricane Irma, Governor Scott and the Florida legislature enacted an emergency power rule for nursing homes and assisted living communities (ALCs). It mandates these settings to have a generator to regulate ambient air temperatures during loss of primary power by Jan. 1, 2019. However, due to cost and supply challenges the implementation of these plans has been difficult, particularly for small and independently owned ALCs. The purpose of this mixed methods study is to determine the characteristics of ALCs that were able to comply with the rule and concerns raised by ALC administrators. Using data from state regulatory agencies on all Florida ALCs (N=3082), we determine associations between ALC characteristics (size, specialty license, low-income residents) and non-compliance to the rule, using chi-square and t-tests. Additionally, we conducted interviews and focus groups with ALC administrators (N=60) about issues of implementing their emergency power plan. A content analysis approach was used and Atlas.ti v7 was used for initial and axial coding. Some prevalent themes were issues with time frames, coordination between local and state regulations, and financial burden. Themes varied by size and organizational structure of ALCs. Results will inform policy-makers on the barriers faced by ALCs to implement a new regulation that may cause financial difficulties and compromise quality care. This study has implications related to disaster preparedness regulations and their effects on independent ALCs with fewer financial resources.

Basic Disaster Preparedness of Rural Community Pharmacies in 5 States

2019 ◽  
Vol 14 (3) ◽  
pp. 329-334 ◽  
Author(s):  
Paul J. Henkel ◽  
Marketa Marvanova
Keyword(s):  
Rural Community ◽  
Low Income ◽  
Rural Areas ◽  
Disaster Preparedness ◽  
Elderly Population ◽  
Community Pharmacies ◽  
Chi Square ◽  
Disaster Plan ◽  
Data Backup ◽  
Emergency Power

ABSTRACTObjectives:The aim of this study was to investigate the basic preparedness of rural community pharmacies to continue operations during and immediately following a disaster.Methods:In 2014, we conducted a telephone survey (N = 990) of community pharmacies in 3 rural areas: North Dakota/South Dakota, West Virginia, Southern Oregon/Northern California regarding whether they had a formal disaster/continuity plan, offsite data backup, emergency power generation, and/or had a certified pharmacy immunizer on staff. Logistic regression and chi square were performed using Stata 11.1.Findings:Community pharmacies in rural areas (≤50.0 persons/mile2) were less likely to have emergency power (odds ratio [OR] = 0.59; 95% confidence interval [CI]: 0.32-1.07) or certified pharmacy immunizer on staff (OR = 0.47; 95% CI: 0.34-0.64). Pharmacies in lower income areas were less likely to have emergency power and offsite data backup or a formal disaster plan (OR = 0.70; 95% CI: 0.49-0.99) compared with pharmacies in higher income areas. Community pharmacies in areas of higher percent elderly population were less likely to have emergency power (OR = 0.54; 95% CI: 0.39-0.73), or certified pharmacy immunizer on staff (OR = 0.65; 95% CI: 0.47-0.91) compared with chain pharmacies in areas with lower percent elderly population.Conclusions:Being in a rural, low-income, or high-elderly area was associated with lower likelihood of basic preparedness of community pharmacies.

scholarly journals Cost of Illness Study of Regular Out Patient Department Diabetic in a Low Income Country: A Cross Sectional Study

2019 ◽  
Vol 3 (1) ◽  
pp. 16-25
Author(s):  
V. Kattel ◽  
M. Subedi ◽  
Y. Agrawal ◽  
Z.S. Pall ◽  
S. Rani ◽  
...  
Keyword(s):  
Direct Cost ◽  
Cost Of Illness ◽  
Low Income ◽  
Financial Burden ◽  
Quality Care ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Cross Sectional ◽  
Low Income Country

Background: The burden of Diabetes in South Asia is alarming as the prevalence is higher compared to other region, living cost is low after Sub Saharan Africa and health care system are in state of expanding to be more accessible and adequate.   Objectives: The objective of the study was to assess the direct cost of illness among diabetic patient regularly visiting at outpatient department (OPD) in BPKIHS. Methods: This was a cross sectional study done in year 2018.  142 patients with at least nine visit per year were enrolled. The direct cost were calculated from the pattern of prescription of medications and laboratory investigations carried out over a year of the individual patient. The data were tabulated and analyzed. Results: Among the 142 patients on 37.5% were in mono-therapy and 62.5% were in poly-therapy. The direct cost of illness was USD 103 per annum that includes drug and investigation cost expensed at OPD visit. The average indirect cost was USD 102 per annum including travel and food. Among 142 patient the cost of illness on inpatient due to DM was USD 85.47 per event. Conclusion: The financial burden of being a diabetic in Nepal is high. Comprehensive quality care by expansion of health system and service with nominal charges to patient seems to be one of the challenges in Nepal.

Comparing shopper characteristics by online grocery ordering use among households in low-income communities in Maine

2021 ◽  
pp. 1-16
Author(s):  
Laura Y. Zatz ◽  
Alyssa J. Moran ◽  
Rebecca L. Franckle ◽  
Jason P. Block ◽  
Tao Hou ◽  
...  
Keyword(s):  
Low Income ◽  
Grocery Shopping ◽  
Sociodemographic Characteristics ◽  
Chi Square ◽  
Transaction Data ◽  
Future Studies ◽  
Number Of Children ◽  
Online Shoppers ◽  
Race Ethnicity ◽  
Improve Access

Abstract Objective: Online grocery shopping could improve access to healthy food, but it may not be equally accessible to all populations—especially those at higher risk for food insecurity. This study aimed to compare the sociodemographic characteristics of families who ordered groceries online versus those who only shopped in-store. Design: We analyzed enrollment survey and 44 weeks of individually-linked grocery transaction data. We used univariate chi-square and t-tests and logistic regression to assess differences in sociodemographic characteristics between households that only shopped in-store and those that shopped online with curbside pick-up (online only or online and in-store). Setting: Two Maine supermarkets. Participants: 863 parents or caregivers of children under 18 years old enrolled in two fruit and vegetable incentive trials Results: Participants had a total of 32 757 transactions. In univariate assessments, online shoppers had higher incomes (P<0.0001), were less likely to participate in WIC or SNAP (P<0.0001), and were more likely to be female (P=0.04). Most online shoppers were 30–39 years old, and few were 50 years or older (P=0.003). After controlling for age, gender, race/ethnicity, number of children, number of adults, income, and SNAP participation, female primary shoppers (OR=2.75, P=0.003), number of children (OR=1.27, P=0.04), and income (OR=3.91 for 186–300% FPL and OR=6.92 for >300% FPL, P<0.0001) were significantly associated with likelihood of shopping online. Conclusions: In this study of Maine families, low-income shoppers were significantly less likely to utilize online grocery ordering with curbside pick-up. Future studies could focus on elucidating barriers and developing strategies to improve access.

scholarly journals Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041870
Author(s):  
Tiara Marthias ◽  
Kanya Anindya ◽  
Nawi Ng ◽  
Barbara McPake ◽  
Rifat Atun ◽  
...  
Keyword(s):  
Panel Data ◽  
Health Service ◽  
Low Income ◽  
Health Expenditure ◽  
Service Use ◽  
Financial Burden ◽  
Panel Data Analysis ◽  
Productivity Loss ◽  
Catastrophic Health Expenditure ◽  
Health Service Use

ObjectivesTo examine non-communicable diseases (NCDs) multimorbidity level and its relation to households’ socioeconomic characteristics, health service use, catastrophic health expenditures and productivity loss.DesignThis study used panel data of the Indonesian Family Life Survey conducted in 2007 (Wave 4) and 2014 (Wave 5).SettingThe original sampling frame was based on 13 out of 27 provinces in 1993, representing 83% of the Indonesian population.ParticipantsWe included respondents aged 50 years and above in 2007, excluding those who did not participate in both Waves 4 and 5. The total number of participants in this study are 3678 respondents.Primary outcome measuresWe examined three main outcomes; health service use (outpatient and inpatient care), financial burden (catastrophic health expenditure) and productivity loss (labour participation, days primary activity missed, days confined in bed). We applied multilevel mixed-effects regression models to assess the associations between NCD multimorbidity and outcome variables,ResultsWomen were more likely to have NCD multimorbidity than men and the prevalence of NCD multimorbidity increased with higher socioeconomic status. NCD multimorbidity was associated with a higher number of outpatient visits (compared with those without NCD, incidence rate ratio (IRR) 4.25, 95% CI 3.33 to 5.42 for individuals with >3 NCDs) and inpatient visits (IRR 3.68, 95% CI 2.21 to 6.12 for individuals with >3 NCDs). NCD multimorbidity was also associated with a greater likelihood of experiencing catastrophic health expenditure (for >3 NCDs, adjusted OR (aOR) 1.69, 95% CI 1.02 to 2.81) and lower participation in the labour force (aOR 0.23, 95% CI 0.16 to 0.33) compared with no NCD.ConclusionsNCD multimorbidity is associated with substantial direct and indirect costs to individuals, households and the wider society. Our study highlights the importance of preparing health systems for addressing the burden of multimorbidity in low-income and middle-income countries.

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.

Private school vouchers for expanding secondary school access? The case of Tanzania

2018 ◽  
Vol 32 (7) ◽  
pp. 1307-1318
Author(s):  
Donald R. Baum ◽  
Jacobus Cilliers
Keyword(s):  
Secondary Education ◽  
Secondary School ◽  
Low Income ◽  
Private School ◽  
Systems Approach ◽  
Financial Burden ◽  
Low Income Countries ◽  
Urban District ◽  
Content Type ◽  
School Voucher

Purpose The purpose of this paper is to provide insight into the current contributions of private schools to education provision in Tanzania, and to consider the feasibility of a school voucher program to contribute to the expansion of the secondary school system, compared to the alternative expansion of public secondary education. Design/methodology/approach The study offers an analysis of current educational circumstances and educational goals in Tanzania, and projects differential costs and outcomes associated with various options for expanding secondary education. Data come from two sources: a census of the private schooling market in the Morogoro Urban district, conducted as part of the World Bank’s Systems Approach for Better Education Results initiative; and Tanzania’s National Panel Survey 2010–2011. Findings For those students unable to cover the full cost of secondary education, findings suggest that a targeted private school voucher would be an efficient and equitable policy mechanism for secondary school expansion. Such an approach would ease the financial burden on government for constructing all new schools, yet assure access for the most vulnerable. Originality/value The implementation of school voucher programs is increasing in low-income countries. It is important for policy makers to carefully consider the appropriateness of this type of policy intervention for their particular educational contexts. This paper models an approach by which researchers and policymakers can assess the educational circumstances of a particular location, and determine the potential effectiveness of a private school voucher policy.

scholarly journals Perawatan Diri Pada Pasien Gagal Jantung

2018 ◽  
Vol 4 (2) ◽  
Author(s):  
Dwi Prihatiningsih ◽  
Tiwi Sudyasih
Keyword(s):  
Heart Failure ◽  
Care Management ◽  
Financial Burden ◽  
Self Care ◽  
Chi Square ◽  
Cross Sectional ◽  
Low Frequencies ◽  
Heart Failure Patients ◽  
Failure Index ◽  
Care Behavior

ABSTRAKGagal jantung merupakan salah satu penyakit kardiovaskuler yang paling sering terjadi di seluruh dunia yang mengakibatkan tingginya angka mortalitas, morbiditas dan juga berdampak secara finansial terutama bagi lanjut usia. Rehospitalisasi merupakan masalah umum yang sering terjadi pada pasien gagal jantung yang sebagain besar disebabkan oleh keterlambatan dalam pengenalan gejala, pengobatan dan ketidakpatuhan diet serta kurangnya pengetahuan dan keterampilan dalam melakukan perawatan diri. Panduan penanganan gagal jantung menekankan pentingnya perilaku perawatan diri untuk menurunkan kekambuhan dan rehospitalisasi pada pasien gagal jantung. Penelitian ini bertujuan untuk menggambarkan perilaku perawatan diri pada pasien gagal jantung yang mengunjungi poliklinik jantung di RSUD Panembahan Senopati Bantul. Penelitian ini merupakan penelitian deskriptif quantitatif dengan menggunakan pendekatan cross sectional. Sampel berjumlah 74 responden yang merupakan pasien rawat jalan di poliklinik jantung pada bulan Juni hingga Juli 2018. Alat ukur yang digunakan adalah Self-Care of Heart Failure Index (SCHFI), (skor ≥70 poin=adekuat). Uji statistik chi-square digunakan untuk mengetahui hubungan antara factor sosiodemografi dengan perilaku perawatan diri pada pasien gagal jantung. Hasil penelitian ini menunjukkan bahwa perilaku perawatan diri pada sebagian besar responden masih belum adekuat dengan frekuensi perilaku perawatan diri adekuat yang masih rendah (pemeliharaan: 45±13.1 (7.7%), pengelolaan: 46±20.4 (13.0%) dan kepercayaan: 69±16.5 (38.5%)). Hanya satu faktor yaitu penyakit penyerta yang berhubungan dengan perilaku perawatan diri pada pasien gagal jantung pada dimensi kepercayaan diri. Hasil penelitian ini menunjukkan bahwa sebagian besar responden memiliki perilaku perawatan diri yang tidak adekuat seperti juga pada negara-negara lainnya sehingga diperlukan upaya untuk meningkatkan perilaku perawatan diri pada pasien gagal jantung. ABSTRACTHeart failure (HF) is one of the most prevalent cardiovascular diseases in the world which associated with significant mortality, morbidity, and huge financial burden, particularly among aging population. Rehospitalization remain a concern in the care of the heart failure patient which largerly associated with delay in symptoms recognition, treatment, diet non-compliance and also lack of knowledge and skills in heart failure self-care. Guideline on HF emphasize the important of self care in preventing symptoms and hospital readmission. This study aims to describe self-care behavior in a sample of heart failure patients. This is a descriptive cross-sectional study with non-probabilistic sample of 74 in an out-patient heart clinic from June-July 2018. Self-care was measured using the Self-Care of Heart Failure Index (SCHFI), (scores ≥70 points=adequate self-care). Chi-square test was conducted to test whether participant’s characteristics associated with self-care behavior among heart failure patients in three scales. The result shows that self-care was inadequate in most scales (self-care maintenance: 43.4±11.8, self-care management: 49.4±18.5 and self-care confidence: 68,6±14.5. Low frequencies of participants with adequate self-care also observed in the study (self-care maintenance: 5.4%, self-care management: 15.4%) and self-care confidence: 36.5%)). In self-care confidence subscale, higher scores of the SCHFI were associated with no comorbid conditions (p=0.01). None of the sociodemographic and clinical characteristics of the sample were associated with increased self-care in other 2 sub-scales. In conclusion, study shows that self-care in HF is inadequate, interventions aimed at improving self-care espescially in self-care maintenance sub-scale are greatly needed. Additional studies are needed to determine the best approach for this. 

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