Publications by authors named "Virginia Mika"
Limited English proficient patients are prone to adverse health care effects compared to English proficient patients, including decreased access to care, lower health literacy, and worse clinical outcomes. This report describes a multi-modal medical interpreter program at a safety-net health system designed for the emerging Afghan population in San Antonio, Texas.
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- The study aimed to investigate how different insurance types (Private, Medicare, Medicaid/Uninsured) affect 30-day Emergency Department visits and readmissions in a safety-net hospital serving diverse patients.
- It found that Medicaid/Uninsured patients had significantly higher odds of urgent surgeries, complications, ED visits, and readmissions compared to Private insurance patients, while Medicare patients showed similar odds as Private patients.
- The conclusions highlight that Medicaid/Uninsured patients drive higher hospitalization costs and complications, with safety-net hospitals facing lower reimbursements and penalties under Medicare’s Hospital Readmission Reduction Program.
Background/purpose: Medicare's Hospital Readmission Reduction Program disproportionately penalizes safety-net hospitals (SNH) caring for vulnerable populations. This study assessed the association of insurance type with 30-day emergency department visits/observation stays (EDOS), readmissions, and cumulative costs in colorectal surgery patients.
Methods: Retrospective inpatient cohort study using the National Surgical Quality Improvement Program (2013-2019) with cost data in a SNH.
Background: Surgical outcome/cost analyses typically focus on single outcomes and do not include encounters beyond the index hospitalization.
Study Design: This cohort study used NSQIP (2013-2019) data with electronic health record and cost data risk-adjusted for frailty, preoperative acute serious conditions (PASC), case status, and operative stress assessing cumulative costs of failure to achieve textbook outcomes defined as absence of 30-day Clavien-Dindo level III and IV complications, emergency department visits/observation stays (EDOS), and readmissions across insurance types (private, Medicare, Medicaid, uninsured). Return costs were defined as costs of all 30-day emergency department visits/observation stays and readmissions.
Unlabelled: Association of insurance type with colorectal surgical complications, textbook outcomes (TO), and cost in a safety-net hospital (SNH).
Background: SNHs have higher surgical complications and costs compared to low-burden hospitals. How does presentation acuity and insurance type influence colorectal surgical outcomes?
Methods: Retrospective cohort study using single-site National Surgical Quality Improvement Program (2013-2019) with cost data and risk-adjusted by frailty, preoperative serious acute conditions (PASC), case status and open versus laparoscopic to evaluate 30-day reoperations, any complication, Clavien-Dindo IV (CDIV) complications, TO, and hospitalization variable costs.
Ask Me 3: improving communication in a Hispanic pediatric outpatient practice.
Am J Health Behav
November 2007
Objective: To implement Ask-Me-3, a program that encourages patients to ask questions of physicians, in a low-income, predominantly Hispanic pediatric practice.
Methods: We publicized Ask-Me-3 with posters/brochures in clinic. We interviewed parents before and 6 months after implementation to determine if they knew about and used the Ask-Me- 3 questions.
A significant portion of the US population has serious problems with both literacy and understanding how to effectively use and understand health-related information. An understanding of the breadth and significance of this problem and its impact on health outcomes is now clear. Interventions and strategies for effectively working with patients with limited literacy must be developed and evaluated.
View Article and Find Full Text PDFBackground: Depression frequently occurs in combination with diabetes mellitus, adversely affecting the course of illness.
Objective: To determine whether enhancing care for depression improves affective and diabetic outcomes in older adults with diabetes and depression.
Design: Preplanned subgroup analysis of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) randomized, controlled trial.