THE IMPLEMENTATION OF EPORTFOLIOS IN AN ONLINE GRADUATE PROGRAM

A myriad of research has documented that an ePortfolio provides a comprehensive platform for learners to record their mastery of practical skillsets, create meaning from their learning, and reflect upon years of experiences. An ePortfolio also serves as a powerful digital resume and useful marketing vehicle to attract prospective employers. This case study examined the impacts of implementing ePortfolios in a capstone course of an online master’s program in health care administration. Students’ perceptions of this powerful pedagogical tool and the process of creating a Portfolio were explored. The findings supported previous research on the implementation of ePortfolios in various programs. Students enjoyed the ePortfolio process, critically evaluated their academic work and accomplishments, and valued peer-reviewed feedback offered by their peers. There were challenges observed in this study. While some challenges were unique to the study population, others were also disclosed in previous empirical studies. Recommendations were made for better integration of ePortfolios into the curricula of a program. Limitations and future research were also presented in this paper. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0954/a.php" alt="Hit counter" /></p>

Permanent stoma: a quality outcome in treatment of rectal cancer and its impact on length of stay

Background This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility. Methods Rectal cancer patients who underwent elective surgery between January 2015 and December 2018 were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients. Results Of 2630 rectal cancer patients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, advanced age, having open surgery, residence in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p < 0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p < 0.001). Conclusions Patients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Having permanent stoma was higher in patients living in South West Florida, patients with Medicaid insurance, and in the uninsured. Additionally, the payer type significantly affected the length of stay.

Permanent Stoma: A Quality Outcome in Treatment of Rectal Cancer and Its Impact on Length of Stay

Background This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility.MethodsRectal cancer patients were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic, and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients.ResultsOf 2,630 rectal cancer patients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, residing in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p<0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p<0.001). ConclusionsPatients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Additionally, the payer type significantly affected the length of stay and odds of receiving a permanent stoma.

Surgeon Gender and Post-Operative In-Hospital Mortality

Background: Prior studies report improved mortality rates for patients of female internists, few studies have evaluated the effect of surgeon gender on post-operative mortality. Methods: A retrospective analysis using the Agency for Health Care Administration Florida database from 2010-2015 examined patients undergoing one of 25 selected surgical procedures. Surgeon gender (self-reported), number of Medicare beneficiaries and years of experience were imported from CMS Physician Compare/Provider Utilization & Payment Data set using NPI. 25 procedures of varying complexity from all subspecialties were selected. For each procedure, inverse probability of treatment weighting (IPTW) was used to match cases performed by male vs female surgeons to achieve maximum balance between the groups. Results: There were 73,994 admissions for patients undergoing surgical procedures performed by 2,828 surgeons(361 females, 2467 males). Fewer patients who had emergent procedures performed by female surgeons died in the hospital(291/13957,2.08% vs 348/14017,2.48% p=0.026). Those who underwent the following procedures had significantly lower rates of in-hospital mortality if the surgeon was female: CABG(2/387,0.52% vs 8/387,2.07%), mastectomy(2/4797,0.04% vs 10/4797,0.21%), open cholecystectomy(7/955,0.73% vs 17/955, 1.78%) all p≤0.05. Conclusion: Patients who underwent CABG, mastectomy and open cholecystectomy had lower rates of in-hospital mortality if the surgeon was female while male surgeons did not have a significant mortality advantage for any procedure. Further studies examining national data may provide additional insight regarding the effect of surgeon gender on patient outcomes.

Athletic Trainers' Selection Behaviors Related to Multi-Session Continuing Education Conferences

Context Continuing education (CE) in athletic training is commonly achieved at multi-session conferences. Objectives To explore athletic trainers' (ATs') planning practices at multi-session conferences regarding format types, preferred domains of athletic training practice, and ideal number of concurrent sessions. Design Cross-sectional survey with quantitative and qualitative questions. Setting Web-based Patients or Other Participants 8660 ATs surveyed Intervention(s) We established content and face validity and piloted the tool before use. We distributed the survey via email weekly for 6 weeks. Trustworthiness of qualitative data was established with multiple-analyst triangulation and external auditing. Data were collected through a Web-based survey comprised of demographic questions and questions regarding CE choices. Main Outcome Measure(s) Quantitative data- measures of central tendency, standard deviations, and frequencies; qualitative- inductive coding method. Results 908 ATs responded (response rate = 10.5%) and 767 were included in analysis. Respondents (age, y = 38 ± 11; females = 367, males = 249, missing/prefer not to answer = 151; 15 ± 11 years of clinical experience) most preferred to attend workshops (78%, n = 598/767), large-group lectures (75.9%, n = 582/767), and small-group lectures (63.5%, n = 487/767). They were motivated to select preferred session formats by learning preferences (38.4%, n = 239/623) and interest in the topic (37.4%, n = 233/623). Examination, assessment, and diagnosis was the most preferred domain (80.7%, n = 619/767). Health care administration and professional responsibility was least preferred (41.9%, n = 321/767). Practical application was the main influencer (53.4%, n = 337/631) to attend sessions. Almost half (49.7%, n = 381/671) of respondents stated that their CE selection behaviors changed depending on the number of concurrent sessions. They prioritized sessions by interest when conflicts occurred (31.4%, n = 211/671). Conclusion Reducing feelings of indecision and ensuring applicable sessions for ATs is important. Multi-session conferences should include sessions that align with attendee preferences relative to domains of practice and session formats. However, attendee preferences provide faulty guidance for CE decision-making and should not be the only mechanism to drive planning.

Analysis of Radio diagnostic test referrals in government hospitals

In any treatment taken by patient, cost is an important dimension. These days, diagnostic tests comprise of a significant part of the health cost borne by patient for the treatment. Catastrophic expenditure is a commonly discussed issue by the health care administration. It is often argued that, outsourcing of the medical diagnostic tests is quite frequent. Daniel et al observed in their research survey that there were so many institutes which were outsourcing the tests.

Availability of Audiology Services in Assisted Living Communities in Florida

Florida has one of the largest populations of older adults in the U.S., and as a result the state also has a high prevalence of hearing loss. Given the growth of assisted living as a housing option for older adults, the purpose of this study was to determine the availability of audiology services in assisted living communities (ALCs) across Florida. Data on ALC location, characteristics and audiology service availability were collected from the Florida Agency for Health Care Administration (AHCA). County socioeconomic data were collected from the U.S. Department of Labor. Logistic regression and chi2 tests were used to examine the relationship between county socioeconomics and whether an ALC provided audiology services. We found that of the 3090 ALCs in Florida, audiology services were present in only 57 (3.2%). ALCs with audiology services were significantly more likely to be located in counties with a higher education level and a higher average income. This suggests a shortage of ALCs with audiology services in counties where residents have fewer resources. The results are concerning, given that individuals with fewer resources are less able to pay for audiology services on their own and evidence showing that poor hearing health late in life impacts individuals’ health and quality of life. Policy implications will be discussed, including the need for more ALCs to provide audiology services in counties with fewer resources. One possible solution is tele-audiology, which would enable a single audiologist to diagnose and prescribe hearing aids to patients in underserved areas.

COVID-19 mild cases determination from correlating COVID-line calls to reported cases

One of the most challenging keys to understand COVID-19 evolution is to have a measure on those mild cases which are never tested because their few symptoms are soft and/or fade away soon. The problem is not only that they are difficult to identify and test, but also that it is believed that they may constitute the bulk of the cases and could be crucial in the pandemic equation. We present a novel and simple algorithm to extract the number of these mild cases by correlating a COVID-line phone calls to reported cases in given districts. The key assumption is to realize that, being a highly contagious disease, the number of calls by mild cases should be proportional to the number of reported cases. Whereas a background of calls not related to infected people should be proportional to the district population. We present the plain mathematics of the method and as a working example we apply it to Buenos Aires Province (Argentina), where it is being currently used. The implementation of this algorithm by other regions would be straightforward and would provide compelling information to the corresponding Health Care Administration.

Administration above Administrators: The Changing Technology of Health Care Management

This paper measures the costs and types of administrative inputs in health care. We use data on labor and nonlabor inputs by industry and categorize them as administrative or not. We find that nonlabor inputs are a critical part of administrative spending, over and above labor inputs. Trends in nonlabor administrative input spending have differed dramatically from that of labor input spending for hospitals over the last 20 years. Hospitals have substituted away from office workers and toward externally purchased inputs. The share of managers and technical workers in administration has grown. The technology of health care administration is changing.