scholarly journals Closures and Other Anchor Characteristics of for-profit Hospitals: A Cross-sectional Study

2021 ◽  
Author(s):  
Berkeley Franz ◽  
Cory Cronin ◽  
Vanessa Rodriguez ◽  
Kelly Choyke ◽  
Janet E. Simon ◽  
...  
Keyword(s):  
Population Health ◽  
Cross Sectional Study ◽  
Full Time ◽  
Sectional Study ◽  
Cross Sectional ◽  
American Hospital ◽  
For Profit ◽  
Anchor Institutions ◽  
Significant Difference

Abstract Background:By definition, anchor institutions have a long-term presence in their communities. Case studies of nonprofit anchor hospitals are common, but it is not clear whether for-profit hospitals are stable enough to fill this role. Our purpose is to determine whether for-profit hospitals are stable enough to fill the role of anchor institutions by strengthening their communities and elevating population health through a long-term presence stabilizing local economies. Methods: In this cross-sectional study, we analyzed national, secondary data between 2008 and 2017 compiled from the Dartmouth Atlas of Health Care, the American Hospital Association Annual Survey, and County Health Rankings. We used descriptive statistics to calculate the number of closures and mergers of hospitals of different ownership type, as well as the employment data. Using logistic regression, we assess whether for profit hospitals had higher odds of closing and merging, controlling for both organization and county characteristics.Results: For-profits are less stable than other hospitals, experiencing disproportionately more closures and mergers over time; a multivariate analysis found that this was a statistically significant difference. Additionally, for-profit hospitals have fewer full-time employees relative to their size than hospitals of other ownership types, as well as lower total payroll expenditures.Conclusions: Our findings suggest that for-profit hospitals are more efficient in terms of operating expenses, but this also may translate into a lower level of economic investment in the surrounding community. For-profit hospitals may also not have the stability required to serve as long-standing anchor institutions. Nonetheless, these organizations still have considerable potential due to their size, tax contributions, and impact on vulnerable communities where other types of hospitals have not been able to operate successfully. Identifying new policy incentives to engage these institutions may help improve population health in surrounding communities.

scholarly journals For-profit hospitals as anchor institutions in the United States: a study of organizational stability

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Berkeley Franz ◽  
Cory E. Cronin ◽  
Vanessa Rodriguez ◽  
Kelly Choyke ◽  
Janet E. Simon ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
The United States ◽  
Full Time ◽  
American Hospital ◽  
American Hospital Association ◽  
Community Factors ◽  
For Profit ◽  
Anchor Institutions ◽  
Significant Difference

Abstract Background Anchor institutions, by definition, have a long-term presence within their local communities, but it is uncertain as to whether for-profit hospitals meet this definition; most research on anchor institutions to date has been limited to nonprofit organizations such as hospitals and universities. Accordingly, this study aims to determine whether for-profit hospitals are stable enough to fulfill the role of anchor institutions through a long-term presence in communities which may help to stabilize local economies. Methods This longitudinal study analyzes national, secondary data between 2008 and 2017 compiled from the Dartmouth Atlas of Health Care, the American Hospital Association Annual Survey, and County Health Rankings. We use descriptive statistics to calculate the number of closures and mergers of hospitals of different ownership type, as well as staffing levels. Using logistic regression, we also assessed whether for-profit hospitals had higher odds of closing and merging, controlling for both organization and community factors. Results We found for-profit hospitals to be less stable than their public and nonprofit hospital counterparts, experiencing disproportionately more closures and mergers over time, with a multivariable analysis indicating a statistically significant difference. Furthermore, for-profit hospitals have fewer full-time employees relative to their size than hospitals of other ownership types, as well as lower total payroll expenditures. Conclusions Study findings suggest that for-profit hospitals operate more efficiently in terms of expenses, but this also may translate into a lower level of economic contributions to the surrounding community through employment and purchasing initiatives. For-profit hospitals may also not have the stability required to serve as long-standing anchor institutions. Future studies should consider whether for-profit hospitals make other types of community investments to offset these deficits and whether policy changes can be employed to encourage anchor activities from local businesses such as hospitals.

scholarly journals Time in Therapeutic Range, Quality of Life and Treatment Satisfaction of Patients on Long-Term Warfarin for Non-Valvular Atrial Fibrillation: A Cross-Sectional Study

2020 ◽  
Author(s):  
Diana-Leh-Ching Ng ◽  
Natasya Marliana Bt Abdul Malik ◽  
Chee-Shee Chai ◽  
Greta-Miranda-Kim-Choo Goh ◽  
Seng-Beng Tan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Treatment Satisfaction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background:The use of warfarin in patients with non-valvular atrial fibrillation (NVAF) can be challenging. In this study, we evaluate the time in therapeutic range (TTR), health-related quality of life (HRQoL) and treatment satisfaction of patients on long-term warfarin for NVAF. The HRQoL and treatment satisfaction were compared based on the TTR.Methods:A cross-sectional study was conducted among patients on warfarin for NVAF who attended the anticoagulant clinic of a tertiary cardiology referral center in Sarawak from 1st June 2018 to 31st May 2019. Patients’ TTR was calculated by using Rosendaal technique, while their HRQoL and treatment satisfaction were assessed by using Short Form 12 Health Survey version 2 (SF12v2) and Duke Anticoagulant Satisfaction Scale (DASS), respectively. Results: A total of 300 patients were included, with mean TTR score of 47.0 ± 17.3%. The physical component summary (PCS) and mental component summary (MCS) score of SF-12v2 were 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The total score for DASS was 55.2 ± 21.3, while the score for limitations (L), hassles and burdens (H&B) and positive psychological impacts (PPI) were 18.0 ± 10.0, 15.6 ± 9.1 and 21.6 ± 5.9, respectively. Seventy-three (24.3%) patients had good TTR (≥ 60%), with mean of 70.2 ± 8.7%; while 227 (75.5%) patients with poor TTR had significantly lower mean of 39.5 ± 11.9% (p = 0.006). There was no significant difference in the score of PCS (p = 0.150), MCS (p = 0.919) and each domain of SF-12v2 (p = 0.184 – 0.684) between good and poor TTR, except for social functioning (p = 0.019). The total DASS score was also not significantly different between group (p = 0.779). Similar non-significant difference was also reported in all the DASS sub dimensions (p = 0.502 – 0.699).Conclusions:Majority of the patients on long-term warfarin for NVAF in the current study have poor TTR. Their HRQoL and treatment satisfaction are independent of their TTR. Achieving a good TTR do not compromise the HRQoL and treatment satisfaction. Therefore, appropriate measures should be taken to optimise INR control, failing which direct oral anticoagulant therapy should be considered.

scholarly journals Time in Therapeutic Range, Quality of Life and Treatment Satisfaction of Patients on Long-Term Warfarin for Non-Valvular Atrial Fibrillation: A Cross-Sectional Study

2020 ◽  
Author(s):  
Diana-Leh-Ching Ng ◽  
Natasya Marliana Bt Abdul Malik ◽  
Chee-Shee Chai ◽  
Greta-Miranda-Kim-Choo Goh ◽  
Seng-Beng Tan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Treatment Satisfaction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background: The use of warfarin in patients with non-valvular atrial fibrillation (NVAF) can be challenging. In this study, we evaluate the time in therapeutic range (TTR), health-related quality of life (HRQoL) and treatment satisfaction of patients on long-term warfarin for NVAF. The HRQoL and treatment satisfaction were compared based on the TTR.Methods: A cross-sectional study was conducted among patients on warfarin for NVAF who attended the anticoagulant clinic of a tertiary cardiology referral center in Sarawak from 1st June 2018 to 31st May 2019. Patients’ TTR was calculated by using Rosendaal technique, while their HRQoL and treatment satisfaction were assessed by using Short Form 12 Health Survey version 2 (SF12v2) and Duke Anticoagulant Satisfaction Scale (DASS), respectively. Results: A total of 300 patients were included, with mean TTR score of 47.0 ± 17.3%. The physical component summary (PCS) and mental component summary (MCS) score of SF-12v2 were 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The total score for DASS was 55.2 ± 21.3, while the score for limitations (L), hassles and burdens (H&B) and positive psychological impacts (PPI) were 18.0 ± 10.0, 15.6 ± 9.1 and 21.6 ± 5.9, respectively.Seventy-three (24.3%) patients had good TTR (≥ 60%), with mean of 70.2 ± 8.7%; while 227 (75.5%) patients with poor TTR had significantly lower mean of 39.5 ± 11.9% (p = 0.006). There was no significant difference in the score of PCS (p = 0.150), MCS (p = 0.919) and each domain of SF-12v2 (p = 0.184 – 0.684) between good and poor TTR, except for social functioning (p = 0.019). The total DASS score was also not significantly different between group (p = 0.779). Similar non-significant difference was also reported in all the DASS sub dimensions (p = 0.502 – 0.699).Conclusions: Majority of the patients on long-term warfarin for NVAF in the current study have poor TTR. Their HRQoL and treatment satisfaction are independent of their TTR. Achieving a good TTR do not compromise the HRQoL and treatment satisfaction. Therefore, appropriate measures should be taken to optimise INR control, failing which direct oral anticoagulant therapy should be considered.

scholarly journals Time in therapeutic range, quality of life and treatment satisfaction of patients on long-term warfarin for non-valvular atrial fibrillation: a cross-sectional study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Diana-Leh-Ching Ng ◽  
Natasya Marliana Bt Abdul Malik ◽  
Chee-Shee Chai ◽  
Greta-Miranda-Kim-Choo Goh ◽  
Seng-Beng Tan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Treatment Satisfaction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background The use of warfarin in patients with non-valvular atrial fibrillation (NVAF) can be challenging. In this study, we evaluate the time in therapeutic range (TTR), health-related quality of life (HRQoL) and treatment satisfaction of patients on long-term warfarin for NVAF. The HRQoL and treatment satisfaction were compared based on the TTR. Methods A cross-sectional study was conducted among patients on warfarin for NVAF who attended the anticoagulant clinic of a tertiary cardiology referral center in Sarawak from 1st June 2018 to 31st May 2019. Patients’ TTR was calculated by using Rosendaal technique, while their HRQoL and treatment satisfaction were assessed by using Short Form 12 Health Survey version 2 (SF12v2) and Duke Anticoagulant Satisfaction Scale (DASS), respectively. Results A total of 300 patients were included, with mean TTR score of 47.0 ± 17.3%. The physical component summary (PCS) and mental component summary (MCS) score of SF-12v2 were 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The total score for DASS was 55.2 ± 21.3, while the score for limitations (L), hassles and burdens (H&B) and positive psychological impacts (PPI) were 18.0 ± 10.0, 15.6 ± 9.1 and 21.6 ± 5.9, respectively. Seventy-three (24.3%) patients had good TTR (≥ 60%), with mean of 70.2 ± 8.7%; while 227 (75.5%) patients with poor TTR had significantly lower mean of 39.5 ± 11.9% (p = 0.006). There was no significant difference in the score of PCS (p = 0.150), MCS (p = 0.919) and each domain of SF-12v2 (p = 0.184–0.684) between good and poor TTR, except for social functioning (p = 0.019). The total DASS score was also not significantly different between group (p = 0.779). Similar non-significant difference was also reported in all the DASS sub dimensions (p = 0.502–0.699). Conclusions Majority of the patients on long-term warfarin for NVAF in the current study have poor TTR. Their HRQoL and treatment satisfaction are independent of their TTR. Achieving a good TTR do not compromise the HRQoL and treatment satisfaction. Therefore, appropriate measures should be taken to optimise INR control, failing which direct oral anticoagulant therapy should be considered.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

scholarly journals Comparison of predicted psychological distress among workers between artificial intelligence and psychiatrists: a cross-sectional study in Tsukuba Science City, Japan

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046265
Author(s):  
Shotaro Doki ◽  
Shinichiro Sasahara ◽  
Daisuke Hori ◽  
Yuichi Oi ◽  
Tsukasa Takahashi ◽  
...  
Keyword(s):  
Neural Network ◽  
Artificial Intelligence ◽  
Psychological Distress ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Explanatory Variables ◽  
The Neural Network ◽  
Significant Difference ◽  
Total Data

ObjectivesPsychological distress is a worldwide problem and a serious problem that needs to be addressed in the field of occupational health. This study aimed to use artificial intelligence (AI) to predict psychological distress among workers using sociodemographic, lifestyle and sleep factors, not subjective information such as mood and emotion, and to examine the performance of the AI models through a comparison with psychiatrists.DesignCross-sectional study.SettingWe conducted a survey on psychological distress and living conditions among workers. An AI model for predicting psychological distress was created and then the results were compared in terms of accuracy with predictions made by psychiatrists.ParticipantsAn AI model of the neural network and six psychiatrists.Primary outcomeThe accuracies of the AI model and psychiatrists for predicting psychological distress.MethodsIn total, data from 7251 workers were analysed to predict moderate and severe psychological distress. An AI model of the neural network was created and accuracy, sensitivity and specificity were calculated. Six psychiatrists used the same data as the AI model to predict psychological distress and conduct a comparison with the AI model.ResultsThe accuracies of the AI model and psychiatrists for predicting moderate psychological distress were 65.2% and 64.4%, respectively, showing no significant difference. The accuracies of the AI model and psychiatrists for predicting severe psychological distress were 89.9% and 85.5%, respectively, indicating that the AI model had significantly higher accuracy.ConclusionsA machine learning model was successfully developed to screen workers with depressed mood. The explanatory variables used for the predictions did not directly ask about mood. Therefore, this newly developed model appears to be able to predict psychological distress among workers easily, regardless of their subjective views.

scholarly journals Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043814
Author(s):  
Mesfin Tadese ◽  
Andargachew Kassa ◽  
Abebaw Abeje Muluneh ◽  
Girma Altaye
Keyword(s):  
Risk Factors ◽  
Academic Performance ◽  
University Students ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Point ◽  
Significant Difference ◽  
Associated Risk Factors

ObjectivesThe study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.Design and methodInstitution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.Setting and participantsEthiopia (2019: n=647 female university students).OutcomesThe primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.ResultsThe prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).ConclusionsDysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

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