scholarly journals Decoding Nonadherence to Hypertensive Medication in New York City: A Population Segmentation Approach

2019 ◽  
Vol 10 ◽  
pp. 215013271982931 ◽  
Author(s):  
Yan Li ◽  
Foram Jasani ◽  
Dejun Su ◽  
Donglan Zhang ◽  
Lizheng Shi ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Antihypertensive Medication ◽  
Care Providers ◽  
Antihypertensive Medications ◽  
Targeted Interventions ◽  
Population Segmentation ◽  
Segmentation Approach ◽  
Do So

Objective: Nearly one-third of adults in New York City (NYC) have high blood pressure and many social, economic, and behavioral factors may influence nonadherence to antihypertensive medication. The objective of this study is to identify profiles of adults who are not taking antihypertensive medications despite being advised to do so. Methods: We used a machine learning–based population segmentation approach to identify population profiles related to nonadherence to antihypertensive medication. We used data from the 2016 NYC Community Health Survey to identify and segment adults into subgroups according to their level of nonadherence to antihypertensive medications. Results: We found that more than 10% of adults in NYC were not taking antihypertensive medications despite being advised to do so by their health care providers. We identified age, neighborhood poverty, diabetes, household income, health insurance coverage, and race/ethnicity as important characteristics that can be used to predict nonadherence behaviors as well as used to segment adults with hypertension into 10 subgroups. Conclusions: Identifying segments of adults who do not adhere to hypertensive medications has practical implications as this knowledge can be used to develop targeted interventions to address this population health management challenge and reduce health disparities.

Compliance with Patients' End-of-Life Wishes by Nursing Homes in New York City with Conscience Policies

2002 ◽  
Vol 44 (1) ◽  
pp. 57-76 ◽  
Author(s):  
Cynthia K. Hosay
Keyword(s):  
New York ◽  
New York City ◽  
Nursing Homes ◽  
End Of Life ◽  
Health Care Providers ◽  
York City ◽  
New York State ◽  
Care Providers ◽  
Nursing Home Patients ◽  
Right To Refuse Treatment

Nursing home patients have a constitutional right to refuse treatment. The Patient Self-Determination Act confirmed that right. State laws address the obligations of health care providers and facilities to honor that right. The New York State law is more specific than those of many other states. It allows exemptions for “reasons of conscience” and imposes a number of requirements on nursing homes claiming such an exemption, including the transfer of a patient to a home that will honor an end-of-life wish. This study, conducted by FRIA,1 investigated the refusal of some nursing homes in New York City to carry out patients' end-of-life wishes because of conscience-based objections. The study also investigated the willingness of homes which did not have such policies to accept patients transferring from a home with a policy so that the patient's end-of-life wishes would be honored. Implications for administrators, policy makers, and regulators are discussed.

scholarly journals Patient Satisfaction With Telemedicine During the COVID-19 Pandemic: Retrospective Cohort Study

10.2196/20786 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e20786 ◽  
Author(s):  
Ashwin Ramaswamy ◽  
Miko Yu ◽  
Siri Drangsholt ◽  
Eric Ng ◽  
Patrick J Culligan ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Cohort Study ◽  
Patient Satisfaction ◽  
Health Care Providers ◽  
York City ◽  
Academic Medical Center ◽  
Disruptive Innovation ◽  
Future Research ◽  
Care Providers

Background New York City was the international epicenter of the COVID-19 pandemic. Health care providers responded by rapidly transitioning from in-person to video consultations. Telemedicine (ie, video visits) is a potentially disruptive innovation; however, little is known about patient satisfaction with this emerging alternative to the traditional clinical encounter. Objective This study aimed to determine if patient satisfaction differs between video and in-person visits. Methods In this retrospective observational cohort study, we analyzed 38,609 Press Ganey patient satisfaction survey outcomes from clinic encounters (620 video visits vs 37,989 in-person visits) at a single-institution, urban, quaternary academic medical center in New York City for patients aged 18 years, from April 1, 2019, to March 31, 2020. Time was categorized as pre–COVID-19 and COVID-19 (before vs after March 4, 2020). Wilcoxon-Mann-Whitney tests and multivariable linear regression were used for hypothesis testing and statistical modeling, respectively. Results We experienced an 8729% increase in video visit utilization during the COVID-19 pandemic compared to the same period last year. Video visit Press Ganey scores were significantly higher than in-person visits (94.9% vs 92.5%; P<.001). In adjusted analyses, video visits (parameter estimate [PE] 2.18; 95% CI 1.20-3.16) and the COVID-19 period (PE 0.55; 95% CI 0.04-1.06) were associated with higher patient satisfaction. Younger age (PE –2.05; 95% CI –2.66 to –1.22), female gender (PE –0.73; 95% CI –0.96 to –0.50), and new visit type (PE –0.75; 95% CI –1.00 to –0.49) were associated with lower patient satisfaction. Conclusions Patient satisfaction with video visits is high and is not a barrier toward a paradigm shift away from traditional in-person clinic visits. Future research comparing other clinic visit quality indicators is needed to guide and implement the widespread adoption of telemedicine.

scholarly journals Public Health Management of Persons Under Investigation for Ebola Virus Disease in New York City, 2014-2016

2019 ◽  
Vol 134 (5) ◽  
pp. 477-483
Author(s):  
Ann Winters ◽  
Maryam Iqbal ◽  
Isaac Benowitz ◽  
Jennifer Baumgartner ◽  
Neil M. Vora ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health Care Providers ◽  
York City ◽  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Health Staff ◽  
Care Providers

During 2014-2016, the largest outbreak of Ebola virus disease (EVD) in history occurred in West Africa. The New York City Department of Health and Mental Hygiene (DOHMH) worked with health care providers to prepare for persons under investigation (PUIs) for EVD in New York City. From July 1, 2014, through December 29, 2015, we classified as a PUI a person with EVD-compatible signs or symptoms and an epidemiologic risk factor within 21 days before illness onset. Of 112 persons who met PUI criteria, 74 (66%) sought medical care and 49 (44%) were hospitalized. The remaining 38 (34%) were isolated at home with daily contact by DOHMH staff members. Thirty-two (29%) PUIs received a diagnosis of malaria. Of 10 PUIs tested, 1 received a diagnosis of EVD. Home isolation minimized unnecessary hospitalization. This case study highlights the importance of developing competency among clinical and public health staff managing persons suspected to be infected with a high-consequence pathogen.

scholarly journals Patient Satisfaction With Telemedicine During the COVID-19 Pandemic: Retrospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Ashwin Ramaswamy ◽  
Miko Yu ◽  
Siri Drangsholt ◽  
Eric Ng ◽  
Patrick J Culligan ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Cohort Study ◽  
Patient Satisfaction ◽  
Health Care Providers ◽  
York City ◽  
Academic Medical Center ◽  
Disruptive Innovation ◽  
Future Research ◽  
Care Providers

BACKGROUND New York City was the international epicenter of the COVID-19 pandemic. Health care providers responded by rapidly transitioning from in-person to video consultations. Telemedicine (ie, video visits) is a potentially disruptive innovation; however, little is known about patient satisfaction with this emerging alternative to the traditional clinical encounter. OBJECTIVE This study aimed to determine if patient satisfaction differs between video and in-person visits. METHODS In this retrospective observational cohort study, we analyzed 38,609 Press Ganey patient satisfaction survey outcomes from clinic encounters (620 video visits vs 37,989 in-person visits) at a single-institution, urban, quaternary academic medical center in New York City for patients aged 18 years, from April 1, 2019, to March 31, 2020. Time was categorized as pre–COVID-19 and COVID-19 (before vs after March 4, 2020). Wilcoxon-Mann-Whitney tests and multivariable linear regression were used for hypothesis testing and statistical modeling, respectively. RESULTS We experienced an 8729% increase in video visit utilization during the COVID-19 pandemic compared to the same period last year. Video visit Press Ganey scores were significantly higher than in-person visits (94.9% vs 92.5%; <i>P</i>&lt;.001). In adjusted analyses, video visits (parameter estimate [PE] 2.18; 95% CI 1.20-3.16) and the COVID-19 period (PE 0.55; 95% CI 0.04-1.06) were associated with higher patient satisfaction. Younger age (PE –2.05; 95% CI –2.66 to –1.22), female gender (PE –0.73; 95% CI –0.96 to –0.50), and new visit type (PE –0.75; 95% CI –1.00 to –0.49) were associated with lower patient satisfaction. CONCLUSIONS Patient satisfaction with video visits is high and is not a barrier toward a paradigm shift away from traditional in-person clinic visits. Future research comparing other clinic visit quality indicators is needed to guide and implement the widespread adoption of telemedicine.

Chicago's Food Trucks: Wrapped in Red Tape

2012 ◽  
Vol 12 (1) ◽  
pp. 62-65
Author(s):  
geoff dougherty
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Court Ruling ◽  
Construction Sites ◽  
Major City ◽  
Food Trucks ◽  
Industrial Parks ◽  
Red Tape ◽  
Do So

Nationwide, trucks brought in $630 million last year, an increase of 3.6 percent over the previous year. However, the rise of the food trucks hasn't come without trouble. A recent court ruling held that vendors in New York City aren't allowed to park in metered parking spaces. Truck operators in suburban Washington, D.C., are hamstrung by the hodgepodge of regulations that vary from one municipality to the next. A license to cook in one city is no protection from a citation in the next. Chicago wraps food trucks in more red tape than perhaps any other major city. Food-truck vendors are forbidden to cook on their trucks—or even do so much as slice a sandwich in half. In practicality, such restrictions limit the city's food-truck fleet to the small catering trucks known as “roach coaches” that typically serve construction sites and industrial parks.

scholarly journals Pneumonia-Associated Hospitalizations, New York City, 2001-2014

2018 ◽  
Vol 133 (5) ◽  
pp. 584-592 ◽  
Author(s):  
Christopher H. Gu ◽  
David E. Lucero ◽  
Chaorui C. Huang ◽  
Demetre Daskalakis ◽  
Jay K. Varma ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
The United States ◽  
Hospitalization Rate ◽  
Hospital Death ◽  
Principal Diagnosis ◽  
Poverty Level ◽  
Discharge Data ◽  
Targeted Interventions

Objectives: Death certificate data indicate that the age-adjusted death rate for pneumonia and influenza is higher in New York City than in the United States. Most pneumonia and influenza deaths are attributed to pneumonia rather than influenza. Because most pneumonia deaths occur in hospitals, we analyzed hospital discharge data to provide insight into the burden of pneumonia in New York City. Methods: We analyzed data for New York City residents discharged from New York State hospitals with a principal diagnosis of pneumonia, or a secondary diagnosis of pneumonia if the principal diagnosis was respiratory failure or sepsis, during 2001-2014. We calculated mean annual age-adjusted pneumonia-associated hospitalization rates per 100 000 population and 95% confidence intervals (CIs). We examined data on pneumonia-associated hospitalizations by sociodemographic characteristics and colisted conditions. Results: During 2001-2014, a total of 495 225 patients residing in New York City were hospitalized for pneumonia, corresponding to a mean annual age-adjusted pneumonia-associated hospitalization rate of 433.8 per 100 000 population (95% CI, 429.3-438.3). The proportion of pneumonia-associated hospitalizations with in-hospital death was 12.0%. The mean annual age-adjusted pneumonia-associated hospitalization rate per 100 000 population increased as area-based poverty level increased, whereas the percentage of pneumonia-associated hospitalizations with in-hospital deaths decreased with increasing area-based poverty level. The proportion of pneumonia-associated hospitalizations that colisted an immunocompromising condition increased from 18.7% in 2001 to 33.1% in 2014. Conclusion: Sociodemographic factors and immune status appear to play a role in the epidemiology of pneumonia-associated hospitalizations in New York City. Further study of pneumonia-associated hospitalizations in at-risk populations may lead to targeted interventions.

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