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1.
Article in English | MEDLINE | ID: mdl-37407864

ABSTRACT

The socioeconomic shocks of the first COVID-19 pandemic wave disproportionately affected vulnerable groups. But did that trend continue to hold during the Delta and Omicron waves? Leveraging data from the Johns Hopkins Coronavirus Resource Center, this paper examines whether demographic inequalities persisted across the waves of COVID-19 infections. The current study utilizes fixed effects regressions to isolate the marginal relationships between socioeconomic factors with case counts and death counts. Factors include levels of urbanization, age, gender, racial distribution, educational attainment, and household income, along with time- and state-specific COVID-19 restrictions and other time invariant controls captured via fixed effects controls. County-level health outcomes in large metropolitan areas show that despite higher incidence rates in suburban and exurban counties, urban counties still had disproportionately poor outcomes in the latter COVID-19 waves. Policy makers should consider health disparities when developing long-term public health regulatory policies to help shield low-income households from the adverse effects of COVID-19 and future pandemics.

2.
Int J Qual Health Care ; 33(1)2021 Mar 09.
Article in English | MEDLINE | ID: mdl-33644795

ABSTRACT

OBJECTIVE: To identify how features of the community in which a hospital serves differentially relate to its patients' experiences based on the quality of that hospital. DESIGN: A Finite Mixture Model (FMM) is used to uncover a mix of two latent groups of hospitals that differ in quality. In the FMM, a multinomial logistic equation relates hospital-level factors to the odds of being in either group. And a multiple linear regression relates the characteristics of communities served by hospitals to the patients' expected ratings of their experiences at hospitals in each group. Thus, this association potentially varies with hospital quality. The analysis was conducted via Stata. SETTING: Hospital Ratings are measured by Hospital Compare using the HCAHPS survey, a patient satisfaction survey required by the Centers for Medicare and Medicaid Services (CMS) for hospitals in the United States. Participants: 2,816 Medicare-certified acute care hospitals across all US states.


Subject(s)
COVID-19/epidemiology , Centers for Medicare and Medicaid Services, U.S./standards , Quality Indicators, Health Care/statistics & numerical data , Socioeconomic Factors , Age Factors , Female , Humans , Linear Models , Male , Patient Satisfaction/statistics & numerical data , Residence Characteristics/statistics & numerical data , SARS-CoV-2 , Sex Factors , United States/epidemiology
3.
Int J Qual Health Care ; 33(1)2021 Feb 20.
Article in English | MEDLINE | ID: mdl-33201215

ABSTRACT

OBJECTIVES: To highlight clinical and operational issues, identify factors that shape patient responses in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and test the correlations between composite measures and overall hospital ratings. DESIGN: Responses to HCAHPS surveys were used in a partial correlation analysis to ascertain those HCAHPS composite measures that most relate to overall hospital ratings. The linear mean scores for the composite measures and individual and global items were analyzed with descriptive analysis and correlation analysis via JMP and SPSS statistical software. SETTING: HCAHPS is a patient satisfaction survey required by the Centers for Medicare and Medicaid Services for hospitals in the USA. The survey is for adult inpatients, excluding psychiatric patients. PARTICIPANTS: 3382 US hospitals. INTERVENTION: None. MAIN OUTCOME MEASURE: Pearson correlation coefficients for the six composite measures and overall hospital rating. RESULTS: The partial correlations for overall hospital rating and three composite measures are positive and moderately strong for care transition (0.445) and nurse communication (0.369) and weak for doctor communication (0.066). CONCLUSIONS: From a health policy standpoint, it is imperative that hospital administrators stress open and clear communication between providers and patients to avoid problems ranging from misdiagnosis to incorrect treatment. Additional research is needed to determine how the coronavirus of 2019 pandemic influences patients' perceptions of quality and willingness to recommend hospitals at a time when nurses and physicians show symptoms of burnout due to heavy workloads and inadequate personal protective equipment.


Subject(s)
COVID-19/epidemiology , Hospitals/standards , Patient Satisfaction , Professional-Patient Relations , Quality Indicators, Health Care , Humans , SARS-CoV-2 , Surveys and Questionnaires , United States/epidemiology
4.
J Health Organ Manag ; 32(7): 891-907, 2018 Oct 08.
Article in English | MEDLINE | ID: mdl-30465487

ABSTRACT

PURPOSE: The purpose of this paper is to explore the extent to which improving doctor-patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies. DESIGN/METHODOLOGY/APPROACH: The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC. FINDINGS: The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor-patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients' overall ratings of hospitals. RESEARCH LIMITATIONS/IMPLICATIONS: More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse. PRACTICAL IMPLICATIONS: When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program's efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use. ORIGINALITY/VALUE: The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.


Subject(s)
Communication , Physician-Patient Relations , Adolescent , Adult , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Tape Recording , Young Adult
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