Use of evidence-based management in healthcare administration decision-making.

Purpose The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics. Design/methodology/approach A cross-sectional study was conducted among US healthcare leaders. Spearman's correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0. Findings One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders' values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous "use of EBMgt" response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman's correlation indicated statistically significant relationships between healthcare leaders' use of EBMgt and healthcare organization bed size ( rs = 0.217, n = 152, p < 0.01), attitude towards EBMgt ( rs = 0.517, n = 152, p < 0.01), and the number of organization employees ( rs = 0.195, n = 152, p = 0.016). Originality/value This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.

Evaluating nutrition risk factors and other determinants of use of an urban congregate meal program by older African Americans.

Rapid growth in both the number of older U.S. adults and diversity in the population suggests increased and disparate demands for nutrition services. Funded by the Older Americans Act (OAA), the primary purpose of congregate meal services is to keep older Americans nutritionally secure and living independently in the community. Understanding characteristics that influence older African Americans' use of congregate meal services is important for development of culturally sensitive networks and program policies. With a sample of 151 community-dwelling older African Americans, a descriptive exploratory design was used to explore predisposing, enabling, and need characteristics that influence use of a congregate meal service and to examine the relationship between nutritional risk and service use. Provider-oriented structural enablers (awareness and transportation) that promote or impinge on elderly persons' use of a congregate meal service were also examined. Multivariate analysis indicated that among program participants, nutrition risk and living arrangement had significant influence on service use. Additionally, nutrition risk was higher among respondents who did not participate in congregate meal service compared to their participant counterparts.

Access, quality and costs of prenatal diagnosis.

The background risk of birth defects ranges from 2 to 5%. These birth defects are responsible for 30% of all admissions to pediatric hospitals and are responsible for a large proportion of neonatal and infant deaths. Medicine and Genetics have taken giant steps in their ability to detect and treat genetic disorders in utero. Screening tests for prenatal diagnosis should be offered to all pregnant women to assess their risk of having a baby with a birth defect or genetic disorder. Psychosocial and financial factors, inadequate insurance coverage, and the inability to pay for health care services are some of the known barriers to healthcare. These barriers are particularly magnified when there is a language barrier. From an economical standpoint it has been demonstrated that prenatal diagnosis has the potential of saving millions of dollars to our healthcare system. But when patients do not have the resources to access prenatal care and prenatal diagnosis cost shifting occurs, escalating healthcare costs. Our current healthcare system promotes inequalities in its delivery. With the existing barriers to access, quality, and costs of prenatal diagnosis we are confronted with an inefficient and flawed system.