Comparison of Births by Provider, Place, and Payer in New Hampshire

2017 ◽  
Vol 18 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Lynette Hamlin
Keyword(s):  
New Hampshire ◽  
Maternity Care ◽  
Secondary Analysis ◽  
Birth Certificate ◽  
Hospital Setting ◽  
Payer Source ◽  
Care Outcomes ◽  
Rural State ◽  
Policy Argument

This study examines maternity care in a rural state by birth attendant, place of birth, and payer of birth. It is a secondary analysis of birth certificate data in New Hampshire between the years 2005 and 2012. Results revealed that in New Hampshire, the majority of births occurred in the hospital setting (98.6%). Physicians attended 75.8% of births, certified nurse midwives attended 17%, and certified professional midwives attended 1%. Medicaid coverage was the payer source for 28% of all births, compared with 44.9% nationally. Women with a private payer source were more likely than women with Medicaid or other payer sources to have a cesarean section. The findings demonstrate quality of care outcomes among a range of clinicians and settings, providing a policy argument for expanding maternity care options.

Customer's self-audit to improve the technical quality of maternity care in Tabriz: a community trial

2016 ◽  
Vol 22 (5) ◽  
pp. 309-317 ◽  
Author(s):  
Kamal Gholipour ◽  
Jafar Tabrizi ◽  
Mohammad asghari-Jafarabadi ◽  
Shabnam Iezadi ◽  
Nasrin Farshbaf ◽  
...  
Keyword(s):  
Maternity Care ◽  
Technical Quality ◽  
Community Trial

Associations of Age, Gender, and Family Income with Quality of Life in Children With Advanced Cancer

2021 ◽  
pp. 104345422199232
Author(s):  
Piera C. Robson ◽  
Mary S. Dietrich ◽  
Terrah Foster Akard
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Family Income ◽  
Hematologic Malignancy ◽  
Secondary Analysis ◽  
Quality Of Life Inventory ◽  
Younger Age ◽  
Self Reports ◽  
Life Inventory

Background: Children with cancer often experience decreased quality of life (QOL) throughout the illness trajectory. The purpose of this study was to explore the associations of demographic characteristics with QOL in children with advanced cancer. Methods: This secondary analysis was part of a larger randomized clinical trial that evaluated the efficacy of a legacy intervention for children (7–17 years) with relapsed/refractory cancer and their primary parent caregivers. Assessments included child self-reports on the Pediatric Quality of Life Inventory (PedsQL) Cancer Module. Researchers used descriptive and linear regression statistical methods. Results: Children ( n = 128) averaged 10.9 years (SD = 3.0). The majority were female ( n = 68, 53%), white ( n = 107, 84%), had a hematologic malignancy ( n = 67, 52%), with family incomes of $50,000 or less ( n = 81, 63.3%). Statistically significant positive associations of both age and income level with PedsQL scores were observed ( p < .05) but not gender ( p > .05). The strongest correlations for age were with the procedural anxiety ( beta = 0.42), treatment anxiety ( beta = 0.26), and total ( beta = 0.28) scores (all p < .01). In general, there was a positive correlation between family income levels and PedsQL scores ( p < .05). The strongest correlations for income were with nausea ( R = 0.49), appearance ( R = 0.44), pain, and treatment anxiety (both R = 0.42) (all p < .01). Associations adjusted for age remained essentially the same (all p < .01). Discussion: Children with advanced cancer with lower family income and younger age are at high risk for poorer QOL. Oncology nurses should seek to identify families who may benefit from additional resources to promote QOL.

scholarly journals Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047102
Author(s):  
Gemma Louch ◽  
Abigail Albutt ◽  
Joanna Harlow-Trigg ◽  
Sally Moore ◽  
Kate Smyth ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
Patient Safety ◽  
Adverse Events ◽  
Grey Literature ◽  
Good Practice ◽  
Hospital Setting ◽  
Eligibility Criteria ◽  
Infant Outcomes ◽  
Safety Outcomes

ObjectivesTo produce a narrative synthesis of published academic and grey literature focusing on patient safety outcomes for people with learning disabilities in an acute hospital setting.DesignScoping review with narrative synthesis.MethodsThe review followed the six stages of the Arksey and O’Malley framework. We searched four research databases from January 2000 to March 2021, in addition to handsearching and backwards searching using terms relating to our eligibility criteria—patient safety and adverse events, learning disability and hospital setting. Following stakeholder input, we searched grey literature databases and specific websites of known organisations until March 2020. Potentially relevant articles and grey literature materials were screened against the eligibility criteria. Findings were extracted and collated in data charting forms.Results45 academic articles and 33 grey literature materials were included, and we organised the findings around six concepts: (1) adverse events, patient safety and quality of care; (2) maternal and infant outcomes; (3) postoperative outcomes; (4) role of family and carers; (5) understanding needs in hospital and (6) supporting initiatives, recommendations and good practice examples. The findings suggest inequalities and inequities for a range of specific patient safety outcomes including adverse events, quality of care, maternal and infant outcomes and postoperative outcomes, in addition to potential protective factors, such as the roles of family and carers and the extent to which health professionals are able to understand the needs of people with learning disabilities.ConclusionPeople with learning disabilities appear to experience poorer patient safety outcomes in hospital. The involvement of family and carers, and understanding and effectively meeting the needs of people with learning disabilities may play a protective role. Promising interventions and examples of good practice exist, however many of these have not been implemented consistently and warrant further robust evaluation.

scholarly journals The quality of intervention reporting in trials of therapeutic exercise for hip osteoarthritis: a secondary analysis of a systematic review

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Louise C. Burgess ◽  
Thomas W. Wainwright ◽  
Khara A. James ◽  
Johan von Heideken ◽  
Maura D. Iversen
Keyword(s):  
Systematic Review ◽  
Secondary Analysis ◽  
Internal Validity ◽  
Hip Osteoarthritis ◽  
Therapeutic Exercise ◽  
Quality Of Reporting ◽  
Effective Interventions ◽  
Randomised Controlled ◽  
Intervention Reporting

Abstract Background Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA. Methods Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on Exercise Reporting Template (CERT) to evaluate intervention reporting. Correlations between quality assessment scores and CERT and TIDieR scores evaluated the relationship between internal validity and external applicability. The year of publication was compared to the quality of reporting scores. Results Fourteen RCTs were included in the analysis. On average, studies were awarded 9.43 ± 1.95 out of 12 points for the TIDieR checklist (range 4–12) and 13.57 ± 4.01 out of 19 points for the CERT (range 5–19). Pearson’s correlation coefficient suggested that the quality of reporting had improved over time and that there was a fair, positive relationship between internal validity and external applicability. Discussion Whilst the quality of intervention reporting is improving, many RCTs of therapeutic exercise in HOA lack the detail necessary to allow accurate evaluation and replication. Researchers are encouraged to utilise the standardised reporting guidelines to increase the translation of effective interventions into clinical practice.

scholarly journals Parental incarceration affects children’s emotional and behavioral outcomes: A longitudinal cohort study of children aged 9 to 13 years

2021 ◽  
pp. 016502542199591
Author(s):  
Daragh Bradshaw ◽  
Ann-Marie Creaven ◽  
Orla T. Muldoon
Keyword(s):  
Cohort Study ◽  
Relationship Quality ◽  
Child Outcomes ◽  
Behavioral Outcomes ◽  
Secondary Analysis ◽  
Parental Incarceration ◽  
Child Relationship ◽  
Children And Parents ◽  
The Impact

Parental incarceration (PI) is negatively associated with emotional, educational, and psychological child outcomes. However, few studies explore potential mechanisms through which these outcomes are transmitted or the means by which prosocial outcomes might develop. This study used data from two waves of a population cohort study of children aged 9 years and followed up aged 13 years living in Ireland. Children and parents ( N = 8,568) completed measures of PI, primary caregiver (PCG) depression, PCG-child relationship quality, and child behavioral adjustment. We then conducted a secondary analysis on this national longitudinal study of children in Ireland. Using sequential mediation models, we observed a mediated indirect effect of PI on prosocial outcomes via PCG depression and PCG-child relationship quality. PI at age 9 was associated with increased difficulties and reduced prosocial behavior at age 13. Additionally, PI at age 9 affected PCG depression and the PCG-child relationship quality. Additionally, child prosocial outcomes, and emotional and behavioral difficulties were less apparent where PI had a weaker effect on PCG depression and the quality of PCG-child relationship. Supports that can mitigate the impact of PI for vulnerable caregivers and children are discussed.

scholarly journals Hybrid intelligence in hospitals: towards a research agenda for collaboration

2021 ◽  
Author(s):  
Milad Mirbabaie ◽  
Stefan Stieglitz ◽  
Nicholas R. J. Frick
Keyword(s):  
Hospital Setting ◽  
Care Process ◽  
Future Research ◽  
Conversational Agents ◽  
Actual Application ◽  
Reasonable Approach ◽  
Hybrid Intelligence ◽  
Application Of Cas ◽  
Successful Collaboration

AbstractSuccessful collaboration between clinicians is particularly relevant regarding the quality of care process. In this context, the utilization of hybrid intelligence, such as conversational agents (CAs), is a reasonable approach for the coordination of diverse tasks. While there is a great deal of literature involving collaboration, little effort has been made to integrate previous findings and evaluate research when applying CAs in hospitals. By conducting an extended and systematic literature review and semi-structured expert interviews, we identified four major challenges and derived propositions where in-depth research is needed: 1) audience and interdependency; 2) connectivity and embodiment; 3) trust and transparency; and 4) security, privacy, and ethics. The results are helpful for researchers as we discuss directions for future research on CAs for collaboration in a hospital setting enhancing team performance. Practitioners will be able to understand which difficulties must be considered before the actual application of CAs.

scholarly journals A Systematic Review of Self-Report Instruments for the Measurement of Anxiety in Hospitalized Children with Cancer

2021 ◽  
Vol 18 (4) ◽  
pp. 1911
Author(s):  
Gomolemo Mahakwe ◽  
Ensa Johnson ◽  
Katarina Karlsson ◽  
Stefan Nilsson
Keyword(s):  
Hospital Setting ◽  
Self Report ◽  
Hospitalized Children ◽  
Abstract Concepts ◽  
Children With Cancer ◽  
Language Difficulties ◽  
Self Reports ◽  
Psychometric Quality ◽  
Communication Challenge

Anxiety has been identified as one of the most severe and long-lasting symptoms experienced by hospitalized children with cancer. Self-reports are especially important for documenting emotional and abstract concepts, such as anxiety. Children may not always be able to communicate their symptoms due to language difficulties, a lack of developmental language skills, or the severity of their illness. Instruments with sufficient psychometric quality and pictorial support may address this communication challenge. The purpose of this review was to systematically search the published literature and identify validated and reliable self-report instruments available for children aged 5–18 years to use in the assessment of their anxiety to ensure they receive appropriate anxiety-relief intervention in hospital. What validated self-report instruments can children with cancer use to self-report anxiety in the hospital setting? Which of these instruments offer pictorial support? Eight instruments were identified, but most of the instruments lacked pictorial support. The Visual Analogue Scale (VAS) and Pediatric Quality of Life (PedsQL™) 3.0 Brain Tumor Module and Cancer Module proved to be useful in hospitalized children with cancer, as they provide pictorial support. It is recommended that faces or symbols be used along with the VAS, as pictures are easily understood by younger children. Future studies could include the adaptation of existing instruments in digital e-health tools.

scholarly journals Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
The Novel ◽  
Patient Privacy ◽  
Pediatric Endocrinology ◽  
Quality Of Patient Care ◽  
Care Outcomes ◽  
Novel Coronavirus ◽  
The Impact

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

scholarly journals Measuring perceived adequacy of staffing to incorporate nurses’ judgement into hospital capacity management: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045245
Author(s):  
Carmen J E M van der Mark ◽  
Hester Vermeulen ◽  
Paul H J Hendriks ◽  
Catharina J van Oostveen
Keyword(s):  
Psychometric Properties ◽  
Scoping Review ◽  
Care Delivery ◽  
Hospital Setting ◽  
Workforce Planning ◽  
Nurse Staffing ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Factors Influencing

BackgroundMatching demand and supply in nursing work continues to generate debate. Current approaches focus on objective measures, such as nurses per occupied bed or patient classification. However, staff numbers do not tell the whole staffing story. The subjective measure of nurses’ perceived adequacy of staffing (PAS) has the potential to enhance nurse staffing methods in a way that goes beyond traditional workload measurement or workforce planning methods.ObjectivesTo detect outcomes associated with nurses’ PAS and the factors that influence PAS and to review the psychometric properties of instruments used to measure PAS in a hospital setting.Design and methodsA scoping review was performed to identify outcomes associated with PAS, factors influencing PAS and instruments measuring PAS. A search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete and Embase databases identified 2609 potentially relevant articles. Data were independently extracted, analysed and synthesised. The quality of studies describing influencing factors or outcomes of PAS and psychometric properties of instruments measuring PAS were assessed following the National Institute for Health and Care Excellence quality appraisal checklist and the COnsensus-based Standards for the selection of health Measurement INstruments guidelines.ResultsSixty-three studies were included, describing 60 outcomes of PAS, 79 factors influencing PAS and 21 instruments measuring PAS. In general, positive PAS was related to positive outcomes for the patient, nurse and organisation, supporting the relevance of PAS as a staffing measure. We identified a variety of factors that influence PAS, including demand for care, nurse supply and organisation of care delivery. Associations between these factors and PAS were inconsistent. The quality of studies investigating the development and evaluation of instruments measuring PAS was moderate.ConclusionsMeasuring the PAS may enhance nurse staffing methods in a hospital setting. Further work is needed to refine and psychometrically evaluate instruments for measuring PAS.

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