Cost Implications of Competition Among Federally Qualified Health Centers.

Federally Qualified Health Centers (FQHCs) are pivotal in delivering healthcare services to underserved populations in the United States. While the number of FQHCs and FQHC look-alikes has been increasing, intensifying competition, limited research has examined the cost implications associated with this growing competition among FQHCs. This study aims to fill the research gap by analyzing the relationship between the level of competition among FQHCs and the cost of care per patient.

Using Community Health Advisors to Increase Lung Cancer Screening Awareness in the Black Belt: a Pilot Study.

Disease stage at the time of diagnosis is the most important determinant of prognosis for lung cancer. Despite demonstrated effectiveness of lung cancer screening (LCS) in reducing lung cancer mortality, early detection continues to elude populations with the highest risk for lung cancer death. Consistent with the national rate, current screening rate in Alabama is dismal at 4.

Do Patient Engagement IT Functionalities Influence Patient Safety Outcomes? A Study of US Hospitals.

Objective: Patient engagement using health information technology (IT) functionalities can be a powerful tool in managing their own care for better health outcomes. Therefore, this study explores whether patient engagement IT functionalities and electronic health record (EHR) can affect patient safety outcomes.

Design: Using longitudinal study design for general acute care hospitals within the United States, we examine the interaction effects of EHR and patient engagement IT functionalities on patient safety outcomes (adverse incident rate) using a generalized estimating equation.

Texting Older Sisters to Step to Manage Obesity in Older Black Women: A Feasibility Study.

Introduction: Black women are disproportionately classified as overweight or obese and physically inactive. Social support and culturally relevant and age-appropriate physical active interventions are needed to reduce inactivity and to prevent weight gain among this group. Mobile-health text messages have shown to be an acceptable, feasible and interactive way to promote physical activity among older Black women.

Inpatient Telehealth and Coronavirus Disease 2019 Outcomes: Experiences in Alabama.

During the early months of the coronavirus disease 2019 (COVID-19) pandemic, hospitals were concerned about preserving personal protective equipment. UAB Hospital Medicine designed a strategy to outfit acute care patient rooms on a COVID-19 unit with telemedicine technology to allow for remote clinician rounding. To describe one hospital's experience with inpatient telehealth and compare outcomes between patients with and without inpatient telehealth visits.

Where Are the New Federally Qualified Health Center Sites? Uncovering FQHC Expansion and Ambulatory Care Policy Implications.

So-called "geographic expansion race," health care organizations expand physical facilities to different geographical locations as a way to foster growth. This study furthers knowledge on Federally Qualified Health Centers' (FQHCs') geographical expansion in relation to the local market's payer mix. The results indicated that areas with a higher proportion of Medicaid patients with fewer uninsured are more likely to see new FQHC sites opening.

Hospital Cultural Competency Leadership and Training is Associated with Better Financial Performance.

Goal: An organization's cultural competency reflects its ongoing capacity to provide high-quality, equitable, safe, and patient-centered care. Cultural competency leadership and training (CCLT) influences organizational cultural competency, which could affect organizational performance. Policies regarding health disparities point to the need for hospitals to become culturally competent.

Physical Activity Promotion in a Safety-net Clinic: Does the Provider Make a Difference? A Pilot Study.

Background: Despite the long-term health benefits of physical activity, many Americans across the lifespan do not meet the recommended levels. However, physical activity discussions in the clinic setting may hold promise. The of this study aimed to understand health care providers' beliefs and practices about physical activity discussions being a part of patients' healthcare treatment.

Factors that Determine Comprehensive Categorical Classification of EHR Implementation Levels.

Electronic Health Records (EHRs) have the potential to alleviate patient safety mistakes. Of the various levels of EHR, advanced or higher-level functionalities of EHR are designed to improve patient safety. Certain organizational and environmental factors may pose as barriers toward implementing all of the functionalities, leaving certain hospitals intermediate between basic and comprehensive levels of implementation.

Promoting Physical Activity Through Policy at a Single Safety-Net Clinic: A Pilot Study.

Background: Physical inactivity is a major issue for African Americans that contributes to increased risk for chronic conditions including obesity, heart disease, diabetes, and cognitive decline. The of this single-clinic pilot study aimed to determine if a physical activity policy would increase primary-care provider discussions of physical activity during clinic visits using the Exercise is Medicine initiative as a guide.

Methods: The study design involved data collection at three time points.

Intention to Use Behavioral Health Data From a Health Information Exchange: Mixed Methods Study.

Background: Patients with co-occurring behavioral health and chronic medical conditions frequently overuse inpatient hospital services. This pattern of overuse contributes to inefficient health care spending. These patients require coordinated care to achieve optimal health outcomes.

Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal.

Background: The aim of this study was to identify the range of ways that safety net hospitals (SNHs) have been empirically operationalized in the literature and determine the extent to which patterns could be identified in the use of empirical definitions of SNHs.

Methods: We conducted a PRISMA guided systematic review of studies published between 2009 and 2018 and analyzed 22 articles that met the inclusion criteria of hospital-level analyses with a clear SNH definition.

Results: Eleven unique SNH definitions were identified, and there were no obvious patterns in the use of a definition category (Medicaid caseload, DSH payment status, uncompensated care, facility characteristics, patient care mix) by the journal type where the article appeared, dataset used, or the year of publication.

The effects of hospital-physician financial integration on adverse incident rate: An agency theory perspective.

Background: Patient safety is an important aspect of quality of care. Physicians' alignment with hospitals by means of financial integration may possibly help hospitals achieve their quality goals. Most research examines the effects of financial integration on financial performance.

Environmental and Organizational Factors Associated with Hospital Use of GPO Services.

Given the potential benefits of Group Purchasing Organizations in cost-containment efforts for hospitals on supplies and purchased services, an important question that remains unanswered is what conditions support or hinder the utilization of GPOs by hospitals. Therefore, this study explores the relationship between GPO use by hospitals and their market and organizational characteristics. Data on hospital GPO utilization and other organizational characteristics were combined with secondary hospital market characteristics.

CEO Turnover Among U.S. Acute Care Hospitals, 2006-2015: Variations by Type of Geographic Area.

Recent reports have documented rising rates of CEO turnover. This phenomenon can have negative implications for hospitals and their surrounding communities, particularly in under-resourced rural communities. Ostensibly, components of the Affordable Care Act have addressed some of these resource challenges and may have helped to slow the CEO turnover trend in rural areas.

Trends in US Hospital Provision of Health Promotion Services, 1996-2014.

Hospitals have long played important roles in the provision of health promotion services (HPS) in local communities, defined as activities that enable people to increase control over and improve their health, including programs such as disease prevention and wellness. Nearly 2 decades ago, researchers cross-sectionally documented the provision of HPS by hospitals, but little research has been done to update this work or document how HPS have changed over time. This study assessed changes in the provision of HPS among US hospitals between 1996 and 2014.

WIC Cash Value Voucher Redemption Behavior in Jefferson County, Alabama, and Its Association With Fruit and Vegetable Consumption.

Purpose: To examine cash value voucher (CVV) redemption behavior and its association with fruit and vegetable (FV) consumption among women who participate in the Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Design: Cross-sectional.

Setting: Jefferson County, Alabama.

Correlates of interorganizational relationship strategies among critical access hospitals.

Background: Interorganizational relationships (IORs) between hospitals and other health care providers have many potential benefits for critical access hospitals (CAHs) that operate in resource-constrained environments. Given the potential benefits of IORs, especially for CAHs, it is important to identify the conditions that support or hinder IOR development. However, most research examining IORs isolates individual types of relationships while ignoring the practical reality that many hospitals participate in a portfolio of relationships simultaneously.

Are there differences in health information exchange by health system type?

Background: Despite the potential of health information exchange (HIE) to improve safety and reduce cost, hospitals have been slow to adopt HIE with only 30% of U.S. hospitals doing so in 2012.