Assess Health Care Providers Research Articles

A study of the quality of knowledge about child autism among doctors of different specialties planning to work in the field of physical and rehabilitation medicine

BACKGROUND: In recent decades, a steady increase in the prevalence of autism spectrum disorders around the world has been reported. It is known that autism spectrum disorders requires early diagnosis and medical intervention. By identifying the risks of autism spectrum disorders, doctors can help the child and family get qualified help as soon as possible. Given the variety of functional disorders in autism spectrum disorders, these patients require special rehabilitation programs and therefore physicians planning work in the field of physical therapy and medical rehabilitation should be oriented in this problem.
 AIMS: To determine the level of awareness of the problem of autism spectrum disorders among doctors of different specialties planning to work in the field of physical and rehabilitation medicine.
 MATERIAL AND METHODS: A survey was conducted on the KCAHW questionnaire of 105 doctors of 8 medical specialties who underwent primary retraining in the cycle "Physical and Rehabilitation Medicine" at the Department of Physical Therapy, Sports Medicine and Medical Rehabilitation of the Russian Medical Academy of Continuous Professional Education.
 RESULTS: According to the results of filling out the KCAHW questionnaire, the median of correct answers was 14 [7; 19] out of 19 possible, which is the average value of the level of knowledge about autism spectrum disorders. Our research shows that there is a lack of knowledge in the relationship between autism and epilepsy and mental retardation, as well as the relationship between the disease and poor nutrition. Among the respondents, there was also a misunderstanding about the age of the child at which the first signs of autism spectrum disorders can be suspected: 60 (57.1%) of the survey participants correctly determined that autism begins in childhood, 35 (33.3%) of the surveyed doctors believed that autism occurs in infancy, and 10 (9.5%) people indicated the neonatal period.
 CONCLUSION: The KCAHW questionnaire is a reliable tool for assessing health care providers' knowledge of childhood autism. The conducted research allows us to conclude that doctors are not sufficiently knowledgeable in the field of knowledge about autism spectrum disorders. The totality of all the respondents' answers indicates the importance of additional information about modern research on the problem of autism spectrum disorders for all doctors planning further work in the field of physical and rehabilitation medicine.

Knowledge, Attitude and Practices of Pharmacovigilance and Adverse Drug Reaction Reporting Among Pharmacists Working at Alkarak Governorate, Jordan

Background: Pharmacovigilance (PV) is the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problem. Since adverse drug reactions (ADRs) are considered worldwide as one of the most common public health problems that affect all groups of patients; the assessment of healthcare providers' knowledge, attitude, and practice of PV and ADRs reporting will provide an in-depth look at the reasons behind the lack of reports. Objectives: This study aims to assess the overall knowledge, attitude, and practice of PV and ADRs reporting among pharmacists working at Alkarak Governorate, Jordan. Methods: A cross-sectional study was conducted during the period from 20th February till 20th April 2021. All employed pharmacists working at Alkarak Governorate were eligible to participate using a structured-interview based-questionnaire. The Bivariate correlation test with the Pearson's (r) was used to assess the correlations between metric variables, independent samples t-test and the one-way ANOVA tests were also applied. The SPSS IBM program version 21 and the Stand-Alone FACTOR program were used for the statistical data analysis. The level of significance was set to be ≤ 0.050. Results: The majority of the pharmacists were females (74.4%), most of respondents (84.9%) had a Bachelor's degree in pharmacy. The pharmacists showed a moderately overall knowledge of PV (58.7%), positive attitudes toward their perceived ADRs reporting importance (78%), and toward selective ADRs reporting (62.8%), a moderate effort exerted by those pharmacists regarding the practice of ADRs reporting process (55.8%). The main barrier was that pharmacists did not know how to report (72.1%). Conclusion: Pharmacists had a moderate PV and ADRs reporting knowledge on average. Positive attitudes toward perceived ADRs reporting importance and moderate level of agreement on focusing on the well-known and serious ADRs. The result denotes a moderate effort exerted by those pharmacists on ADRs reporting practices. Pharmacists faced a moderately high perceived difficulties and extra burden (barriers).

Quality of cancer care in a low-resource setting: A single-center observational study.

e18622 Background: There are challenges in access to healthcare in developing countries. The quality of care is however an important consideration in achieving sustainable positive outcomes during patient management. This study, therefore, aimed to assess this measure of cancer care in our setting. Methods: A cross-sectional study of sixty-three patients with malignancy, who had or were planned for cancer treatment, was performed. Information on their demographic and clinical characteristics were obtained. Quality of cancer care was measured using the Consumer Assessment of Healthcare Providers and Systems instrument. SPSS was used for data analysis and p-value < 0.05 was considered significant. Results: Their average age was 60.0 (43.8 – 69.3) years. Twenty (31.7%) had gastrointestinal malignancy while 17 (27.0%), 15 (23.8%) and 11 (17.5%) had prostate, breast and cervical cancer respectively. The median duration since cancer diagnosis was 4.0 (2.0 – 14.0) months. Regarding support provided by the care team to manage the cancer and the effects of its treatment; majority of the respondents, 30 (54.5%), answered in a negative tone. Similarly, the majority of the respondents did not select the maximum score on the scale in the aspects of receiving timely appointments, care, and information; communication between the cancer care team and patients; information use for care co-ordination; and the availability to give information when required (Table). Despite this, patient rating of their cancer care team and their overall experience was 8.0 ± 1.8 and 7.8 ± 2.0 respectively. There was however a significant difference in the latter between those who had cancer recurrence in comparison to those who did not experience this event (6.8 ± 2.2 versus 8.2 ± 1.7, p = 0.048). Conclusions: Even though the general rating of the experience of these patients was high; the gaps highlighted in the areas of patient support, communication and navigation and their sub-optimal experience during cancer recurrence could be further improved to enhance the delivery of cancer care in this limited resource setting.[Table: see text]

0355 Which hospitals are the quietest at night? It’s not The US News Top 20 Institutions

Abstract Introduction The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey distributed by The Center for Medicare and Medicaid (CMS) services measures patient perceptions of hospital experience and impacts annual CMS reimbursement. This study focuses on the “Quiet at Night” variable, to identify the top box institutions and identify the key characteristics that enable their success. Methods Using the Linear Mean Scores and the Star Ratings’ inherent clustering algorithm and RStudio™, the top box scorers amongst the 5 Star Rated hospitals were isolated and grouped together as CMS Top Rated “Quiet at Night” Hospitals. These Star Ratings and the key characteristics of these institutions were compiled and compared to the US News Honor Roll Hospitals (2019-2020) to ascertain trends and determine the predictive value of the HCAHPS “Quiet at Night”' hospitals' characteristics. Results The mean Star Rating for CMS Top Rated “Quiet at Night” Hospitals was 5.00 compared to that of the US News Honor Roll Hospitals which was 2.67. An unpaired t-test of this data found a two-tailed P value of less than 0.0001, which is considered statistically significant under all conventional significance levels (Table 1). In comparing the key characteristics for these two lists documented by the American Hospital Directory a stark difference emerged between these groups with those that scored well on the “Quiet at Night'' question identifying as predominantly privately controlled, specialized, surgical facilities with very few total hospital beds. Conclusion This study was the first of its kind to critically analyze hospitals that score well on the CMS “Quiet at Night” and compare them to the US News Honor Roll Best Hospitals. With the knowledge that these scores impact CMS reimbursement, it is important to determine the cultural and organizational shifts that enable hospitals to be top performers on the “Quiet at Night” metric. A greater understanding of how top CMS hospitals so efficiently provide care in a sleep protective way may help inform larger institutions about Best Practices. Support (If Any)

Healthcare provider awareness of the recent FDA approval on first diagnostic tests for extragenital testing for chlamydia and gonorrhea

To assess healthcare provider awareness of the Food and Drug Administration (FDA) 2019 approval of nucleic acid amplification tests (NAAT) using extragenital specimens for chlamydia and gonorrhea, several questions were included in fall 2020 Porter Novelli's DocStyles survey, a US nationally representative semi-annual web-based survey of healthcare providers. There were 1502 respondents included in this study, 1000 family practitioners/internists as primary care physicians (PCPs), 251 obstetricians/gynecologists (OBs/GYNs), and 251 nurse practitioners/physician assistants (NP/PA). Awareness of this FDA approval was 34.3% overall and significantly varied by provider specialty: 45.0% for OB/GYN versus 23.5% for NP/PA, p < 0.01. OB/GYN had the lowest rate of ordering any extragenital gonorrhea and chlamydia tests in the past 12 months (31.6%) versus the other providers (ranging from 46.2% for NP/PA to 60.7% for PCP). The respondents were more likely to be aware of the FDA approval if they had ordered extragenital chlamydia or gonorrhea testing for men who have sex with men (MSM) than those who did not order the tests for MSM (72.3% versus 43.7%, p < 0.01). Of 1502 respondents, lack of reimbursement as a barrier to ordering extragenital tests for chlamydia and gonorrhea was most mentioned (16.6%) overall and did not significantly vary by provider's specialty. Further outreach is needed to educate healthcare providers on the changes in the FDA approval for extragenital gonorrhea and chlamydia testing so that they can provide comprehensive care to their patients and to reduce the potential for antimicrobial resistance.

Health Care Providers’ Education, Awareness, and Attitudes Toward Female Genital Mutilation/Cutting: A Canadian Survey

Assess health care providers’ awareness, knowledge, clinical experience, and attitudes towards medicalization and ethical/legal obligations surrounding female genital mutilation (FGM).

Evaluation of health care providers’ knowledge about physical activity promotion for adults with physical disability in Diyala City

Background: Adults with disabilities are three times more likely than adults without disabilities to suffer from heart disease, stroke, diabetes, or cancer. Despite the fact that physical activity can help minimize the impact of many chronic conditions, approximately half of persons with disabilities do not participate in physical activity in their spare time. Caregivers' knowledge plays an important role in such people's health rehabilitation. Therefore, thus aimed to assess health care providers knowledge about physical activity promotion for disabled adults. Methods: A convenience sample of 47 health care providers was recruited using a non-probability sampling approach in Diyala Hospitals for a descriptive cross-sectional study. The questionnaire's dependability was established through a pilot research, and it was subsequently presented to experts for validation. The total number of items in the questionnaire for knowledge related to physical activity promotion was 23. The data was acquired using a self-reporting method and evaluated using descriptive and inferential statistical data analysis techniques. Results: The study's findings revealed that the majority of respondents were young male caretakers. According to the study's findings, 59.5 percent of caregivers had insufficient understanding about how to promote physical exercise.

Temporal trends in self-reported general and mental health status among colorectal cancer patients: racial/ethnic disparities in a population-based analysis.

Patient-reported outcomes are essential to patient-centered cancer care. We sought to determine the relationships between colorectal cancer (CRC) diagnosis and trends in self-reported general health status (GHS) and mental health status (MHS) among racial/ethnic groups. We used population-based Surveillance, Epidemiology, and End Results (SEER)-Consumer Assessment of Healthcare Providers and Systems (CAHPS) data to identify CRC patients diagnosed from 1996 to 2011 who reported GHS and/or MHS on a CAHPS survey within 6years before or after diagnosis and were 65 or older at survey completion. Multivariable logistic regression assessed relationships of patient race/ethnicity and CRC diagnosis with the odds of reporting fair or poor GHS or MHS. Five thousand five hundred forty-five patients reported GHS and/or MHS within 6years before CRC diagnosis and 4,604 reported GHS and/or MHS within 6years after diagnosis. 80.9% were non-Hispanic white (NHW), 7.1% were non-Hispanic black (NHB), 6.7% were Hispanic, and 5.3% were non-Hispanic Asian. Being diagnosed with CRC was associated with increased odds of reporting fair or poor GHS (OR = 1.55, 95% CI = 1.40-1.72) and MHS (OR = 1.33, 95% CI = 1.13-1.58). For GHS, this trend held for all race/ethnicities except NHBs, and for MHS, this trend held for NHWs and Hispanics only. CRC diagnosis is an important driver of increased likelihood of fair and poor GHS and MHS, but the relationship is complicated by effect modification by race/ethnicity. Efforts to further understand the race/ethnicity-specific relationships between CRC diagnosis and declines in GHS and MHS are necessary to promote equitable care for all patients.

Evaluation of Health Care Providers’ Knowledge about Health Restoration for Adults with Physical Disability in Diyala City

Background: Adults with disabilities are three times more likely than adults without disabilities to suffer from heart disease, stroke, diabetes, or cancer. Despite the fact that physical activity can help minimize the impact of many chronic conditions, approximately half of persons with disabilities do not participate in physical activity in their spare time. Caregivers' knowledge plays an important role in such people's health rehabilitation. Therefore, thus aimed to assess health care providers knowledge about physical activity promotion for disabled adults. Material and Methods: A convenience sample of 47 health care providers was recruited using a non-probability sampling approach in Diyala Hospitals for a descriptive cross-sectional study. The questionnaire's dependability was established through a pilot research, and it was subsequently presented to experts for validation. The total number of items in the questionnaire for knowledge related to health restoration was 13. The data was acquired using a self-reporting method and evaluated using descriptive and inferential statistical data analysis techniques. RESULTS: The study's findings revealed that the majority of respondents were young male caretakers. According to the study's findings, 48.9 percent of caregivers had insufficient understanding about how to promote physical exercise. There were differences in knowledge with regards health restoration and caregivers gender (p=0.059), years of experience (p=0.001), job description (p=0.001) and training courses (p=0.001). Conclusions: The study concludes that the knowledge in terms of health restoration for disabled adults, health care providers expressed a poor level due to influencing factors such as diploma graduated and nurses specialist is significantly associated poor knowledge. The Directorate of Health needs to adopt guidelines related to the international standard in the management of disability and to rely on specializations from those who have a high level of education in caring for the disabled. Keywords: Evaluation, Health Care Provides, Health Restoration.

General and mental health status following colorectal cancer treatment and its association with mortality among a racially diverse population-based cohort.

45 Background: Patient-reported outcomes (PROs) are recognized as strong predictors of cancer prognosis, outcomes, and care. However, racial/ethnic minorities with colorectal cancer (CRC) tend to report poorer general health status (GHS) and mental health status (MHS) compared to non-Hispanic whites. The objectives of this study were to determine: (1) if there are racial/ethnic differences in GHS and MHS within 36 months of CRC diagnosis and (2) if poorer GHS and MHS in recently diagnosed CRC patients are associated with mortality. Methods: We used the population-based Surveillance, Epidemiology, and End Results (SEER)-Consumer Assessment of Healthcare Providers and Systems (CAHPS) dataset to analyze Medicare beneficiaries aged ≥65 years who were diagnosed with CRC between 1998 and 2011, received surgical resection for their tumor, and completed a CAHPS survey within 6-36 months post-diagnosis. CAHPS surveys captured patient-reported GHS and MHS on a five-point Likert scale ranging from “poor” to “excellent.” We used stepwise multivariable logistic regression to examine associations between patient race/ethnicity and fair or poor health status, adjusting for clinical and sociodemographic factors. Additionally, a multivariable Cox proportional hazards regression was used to determine the risks of mortality associated with fair or poor GHS and MHS. Results: Of 1,867 patients with CRC, 79.5% were non-Hispanic white (NHW), 6.4% were non-Hispanic black (NHB), 7.5% were Hispanic, and 6.6% were non-Hispanic Asian (NHA). In Model 1 of our stepwise logistic regression, NHB patients had higher unadjusted odds for fair or poor GHS (OR 1.56, 95% CI 1.06-2.28) compared to NHW patients while Hispanic patients had higher unadjusted odds for both fair or poor GHS (1.48, 1.04-2.11) and MHS (1.92, 1.23-3.01). In Model 2, this relationship persisted after adjusting for clinical factors, with NHB patients being more likely to report fair or poor GHS (1.62, 1.10-2.40) and Hispanic patients being more likely to report fair or poor GHS (1.49, 1.04-2.13) and MHS (1.92, 1.22-3.00). In Model 3, after adjusting for both clinical and sociodemographic factors, the association between race/ethnicity and fair or poor GHS ( p = 0.53) and MHS ( p = 0.23) no longer remained. Reporting fair or poor GHS and MHS was associated with a greater risk of mortality among all CRC patients (HR 1.52, 95% CI 1.31-1.76 and 1.62, 1.34-1.99, respectively). Conclusions: Our study illustrates that racial/ethnic differences in PROs are largely driven by sociodemographic factors as opposed to clinical factors. As fair or poor GHS and MHS shortly after diagnosis reflect a higher risk of mortality in CRC patients, efforts to understand unmet biopsychosocial concerns may help further elucidate racial differences in CRC survival that may be otherwise overlooked in standard clinical practice.

Patient care satisfaction and emergency room utilization among young adult colorectal cancer survivors during the SARS-CoV-2 pandemic.

34 Background: Survivors of colorectal cancer (CRC) are at risk for late effects of therapy and recurrence of cancer. With recurrence rates ranging between 30-40% (Siegal et al., 2020), consistent, survivor-focused follow-up care is needed for early detection of late effects and recurrence (Jeffery et al., 2019). CRC-related care delivery has been significantly disrupted by the SARS-CoV-2 pandemic, with decreases of 40% in CRC services in the United States between April 2020 and 2019 (Jammu, 2020). Consequentially, survivors may be left with fewer options for care, potentially causing increases in emergency room (ER) utilization. Methods: This cross-sectional study examined the patterns of ER utilization during the SARS-CoV-2 pandemic among young adult CRC survivors and assessed the relationship between self-reported care satisfaction and ER use. Eligible participants were diagnosed with colon or rectal cancer between 18-39 years, between 6-36 months from diagnosis/relapse, English speaking, and based in the United States. Questions on care satisfaction were Consumer Assessment of Healthcare Providers and Systems (CAHPS) questions. A multivariable logistic regression was conducted to assess the association between patient satisfaction and ER utilization, adjusting for factors related to the pandemic. Covariates for this analysis were chosen based on a significance of p &lt; 0.1 at the univariate level, as well as general clinical significance. Results: The overall sample was N = 196, mean age (SD) was 32.1 years (4.5), and 116 survivors (59%) were male. Tumor location was colon or rectal in 42% and 57%, respectively, and the majority (56%) were diagnosed with stage 2 disease; 42.6% reported relapsed disease, and 20% had an ostomy. The majority of survivors (72.5%) had between 1-4 visits to an emergency room in the last 12 months and were categorized as normal users. Approximately 24.7% of the sample had greater than 4 visits to the ER in the last 12 months and were categorized as super-utilizers (Johnson et al., 2015). Colorectal cancer survivors that reported a delay in their follow-up cancer care as a result of the pandemic were two times (OR: 2.05, 95% CI 0.99, 4.24) more likely to be super-utilizers of the ER. Higher self-reported satisfaction with overall care was associated with a 13.7% (OR: 0.86, 95%CI: -0.68, 1.09) lower likelihood of being a super-utilizer. Conclusions: This study found strong associations between delays in care, self-reported care satisfaction, and being a super-utilizer of the ER during the pandemic among young adult CRC survivors off treatment. Increasing patient satisfaction and minimizing care interruptions amongst this vulnerable population may aid in mitigating over-utilization in the ER during an ongoing pandemic.

Medication error awareness among health care providers in Palestine: A questionnaire-based cross-sectional observational study

BackgroundIncreased awareness among healthcare professionals regarding medication errors and the establishment of a medication error reporting system can significantly reduce the prevalence of medication errors. Unfortunately, Palestine lacks a regulatory system for the control, reporting, and education of medication errors. ObjectivesThis study aimed to assess the awareness of medication errors and reporting of medication errors in the Palestinian medical community. MethodsA cross-sectional observational study was conducted using a self-administered survey involving doctors, nurses, and pharmacists in Palestine. The survey consisted of 20 questions to assess healthcare providers' awareness and course of actions related to medication errors. Data were collected from February 2020 to April 2020. Statistical Package for the Social Sciences (SPSS) was used for data analysis. This study was approved by the ethical committee of Birzeit University. ResultsA total of 394 participants were included, including 202 nurses, 114 doctors, and 78 pharmacists. 203 (51.5%) had a good awareness level of medication errors, whereas 126 (32%) and 65 (16.5%) had average awareness and poor awareness levels, respectively. In addition, 66.0% of providers did not inform the patients after recognizing the error. Fear of legal or social consequences and being too busy are significant barriers to reporting medication errors. Moreover, 35 % of all providers were not aware of the reporting system in their institutions or the reporting methodology, and only 26% of all participants confirmed that their institutions provided continuous education on medication errors. ConclusionThis study revealed differences in healthcare professionals' awareness of medication errors. The study's findings emphasize the urgent need to adopt appropriate measures to raise awareness about medication errors among healthcare providers in Palestine. Furthermore, establishing a regulatory policy and a national medication error reporting system to improve medication safety.

Patient Experience with In-Person and Telehealth Visits Before and During the COVID-19 Pandemic at a Large Integrated Health System in the United States.

BackgroundInformation about telehealth versus in-office visits and how patient experience before compared to during the COVID-19 pandemic is important for healthcare planning.ObjectiveTo compare patient experience by visit type and before and during the pandemic.DesignSurvey of patients assessing ambulatory care before and during the pandemic.ParticipantsA total of 58,500 adult patients (13,928 primary care and 44,581 specialty physician visits) at a large integrated health system with 197 clinics on the west coast of the United States. The majority were female (59%), 55 or older (65%), and non-Hispanic White (55%), and had an in-office visit (87%) while 10% had a tele-video and 3% a phone visit.Main MeasuresConsumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey 3.0 doctor communication, care coordination, access, and office staff composites; an overall rating of the doctor; and whether the patient would recommend the doctor to family and friends.Key ResultsPatient experience with telehealth visits was as positive as or more positive than that with traditional office-based visits. Doctor communication on tele-video visits was viewed as slightly more positive than that of in-office or phone visits. Tele-video visits were also slightly more positive than in-office visits for care coordination, overall rating of the doctor, and willingness to recommend to family and friends. Office staff were viewed less positively on the phone than tele-video or in-office visits. Patient experience was similar before and during the COVID-19 pandemic (e.g., on a 0–100 possible range with a higher score being better, doctor communication was 94.4 before and 94.9 during).ConclusionsThe positive experiences with telehealth, especially tele-video, may be due to patient appreciation of efforts made to maintain access, the focused nature of telehealth visits, and help by staff for navigation technical issues. Lessons learned about delivering responsive telehealth care can be used to ensure high-quality care after the pandemic.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-07196-4.

Average Time Spent in Referral Process and its Determinants Among Clients of Maternal and Child Health Service in 2 Districts of Jimma Zone, Ethiopia.

Background: The time spent between referring and receiving health facilities is an important determinant of the outcome of the referred patients/clients especially among women in low-income countries due to poor access to early and appropriate referrals. Thus, the aim of this study is to assess the average time spent between referring and service utilization at receiving health facility. Methods: A cross-sectional study was employed by using time and motion approach. Structured questionnaire and observation checklist were used for collecting data. SPSS 21 version was used for data analysis and binary and multivariable logistic regression analysis was carried out to identify a variable that has a significant association on the basis of OR, 95% confidence interval, and a P value of less than .05. Result: A total of 266 women participated in the study with the mean age of the study population is 24.65 (±5.03) years. The majority, (223 (83.8%)) of the participants came for maternal health services and more than half, (143 (53.8%)) of the respondents were self-referrals. Among the referred cases, the main reason for the referral was for further evaluation and management. Women spent a maximum of 540 min on the way to arrive at receiving health facility. Residence and distance were the predictor variables for average time spent. Conclusion: In general, women wait a maximum of one and half hours to contact health care providers for assessment and more than two-fifth of the women wait more than 3 h to get the service at receiving health facility.

Health Care Providers' Knowledge, Attitude and Practice Toward Counterfeit Medicines in Mizan-Tepi University Teaching Hospital, South West Ethiopia: A Cross-Sectional Study.

There is a paucity of evidence-based information regarding healthcare professionals’ awareness and views toward counterfeit medicines in developing countries. Therefore; this is aimed to assess health care providers’ knowledge, attitude, and practice toward counterfeit medicines in Mizan-Tepi University Teaching Hospital, South West Ethiopia. A cross-sectional study was conducted among health care providers working in Mizan-Tepi University Teaching Hospital from December 2020 to January 2021. A total of 171 health care providers participated in the study. Data were collected through self-administered structured questionnaires developed by reviewing similar surveys with some modifications. The data analyzed using a Statistical Package for Social Sciences (SPSS, version 21). Variables with P value <.05 were considered as statistically significant. Large proportions of the study participants (84.2%) have information on counterfeit drugs and 15.8% of them described counterfeit medicine as product with toxic impurities. 50.3% of them were able to distinguish a counterfeit drug from the genuine drug. 8.2% of the participants demonstrated that counterfeit medicine can be identified by physical observation of labeling, color appearance and packaging. 61.4% of the study respondents revealed that strong legal action can prevent circulation of counterfeit medicine. Professional distribution was significantly associated with the attitude of health care providers toward counterfeit medicines (P < .05). Accordingly, public health officers and midwifery health care providers were more likely to have poor attitude toward counterfeit medicines (AOR = 6.09, CI (1.798-20.69) and (AOR = 3.98(1.54-10.25)) respectively as compared to nurses. This study demonstrated the importance of awareness creation to all health care providers. Drug regulatory bodies and concerning bodies must play an active role in designing appropriate program and policy to enhance health professionals’ knowledge and attitude toward CFM. There is also a need of empowering the practitioners in identifying counterfeit drugs by simple observations.

Attitudes toward safe abortion care and its associated factors among health care providers working in public health facilities in eastern Ethiopia.

Objectives:The main aim of this study was to assess health care providers’ attitudes toward safe abortion services and its associated factors in public health facilities of Harar city, Eastern Ethiopia.Methods:Facility-based cross-sectional study was conducted among 411 health care providers who were working at public health facilities in Harari regional state, in eastern Ethiopia. A simple random sampling technique was used to select study participants. Data were collected using self-administered questionnaires, and collected data were entered into EpiData version 4.6 and then exported to SPSS version 26 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analysis were carried out to compute the prevalence of the outcome variables and to identify factors associated with the outcome variable, respectively. Adjusted odds ratio at 95% confidence interval and p-value < 0.05 was used to declare a significant association.Results:More than half (58.4%, 95% confidence interval: 53.8–63.2) of the health care providers had a favorable attitude toward safe abortion care. Being male (adjusted odds ratio = 2.90; 95% confidence interval: 1.80–4.65), ever trained on safe abortion (adjusted odds ratio = 2.55; 95% confidence interval: 1.39–4.66), familiarity with the current abortion law of Ethiopia (adjusted odds ratio = 2.38; 95% confidence interval: 1.40–4.05), preference of unrestricted abortion law (adjusted odds ratio = 1.86; 95% confidence interval: 1.15–3.02), and being medical doctors or health officers (adjusted odds ratio = 1.90; 95% confidence interval: 1.06–3.41) were the factors significantly associated with health care providers’ favorable attitude toward safe abortion care.Conclusion:Approximately three in five of the health care providers working at public health facilities had a favorable attitude toward safe abortion care in eastern Ethiopia. We suggest giving pre-service or in-service training on safe abortion care and supporting health care providers to be familiar with the country’s abortion laws are crucial to improve health care providers’ attitudes toward safe abortion service in Ethiopia.

Home Health Agencies With More Socially Vulnerable Patients Have Lower Experience-of-Care Ratings

Little is known about the disparities in patient experience of home health (HH) care related to social vulnerability. This study examined the relationships of patient Medicare-Medicaid dual eligible status and race and ethnicity with patient experience of HH care. We analyzed national data from the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS), Outcome and Assessment Information Set, Medicare claims and Area Health Resources File for 11,137 Medicare-certified HH agencies (HHA) that provided care for Medicare beneficiaries in 2017. Patient-reported experience of care star ratings (1-5) in HHCAHPS included 3 domains (professional care delivery, effective communication, and specific issues in direct patient care) with each dichotomized into high (4-5) and low (1-3) experience of care. The proportion of patients with dual eligibility and the proportion of racial/ethnic minorities were summarized at the HHA level. HHA with higher proportion of dual eligible patients were less likely to have high experience of care rating in professional care delivery (smallest Odds Ratio [OR]=0.514; 95% CI: 0.397, 0.665; p<0.001), effective communication (smallest OR=0.442, 95% CI: 0.336, 0.583; p<0.001), and specific direct care issues (smallest OR=0.697, 95% CI: 0.540, 0.899; p=0.006). HHA with higher proportion of racial/ethnic minorities were also less likely to have high patient experience of care rating across all three domains (smallest OR=0.265, 95% CI: 0.189, 0.370; p<0.001). Disparities in patient experience of HH care exist and they are associated with low income and racial/ethnic minority status, indicating substantial unmet needs among these socially vulnerable patients.

Construction and Performance of the Hospice Care Index Claims-Based Quality Measure

As part of the Medicare Hospice Benefit (MHB), hospices submit claims containing information that allows policy makers to assess hospice quality, help policy makers improve the MHB, and increase patients’ experiences of care. We examine ten different hospice quality indicators related to the provision of services and patterns of live discharge. We calculated indicators using 100% Medicare fee-for-service (FFS) claims from October 1, 2018 through September 30, 2019. A hospice’s total score among all ten indicators is referred to as their Hospice Care Index (HCI), with a possible high score of 10. We examined all hospices with at least 20 discharges. After exclusion, we examined 4,155 hospices representing 1,562,003 beneficiaries. Most hospices earn a high HCI score: over 85% of hospices had scores of eight or more. At the same time, there were some lower scoring hospices: one in ten hospices scored seven on the index, and the remaining 4.9% scored six or lower. We find that on average hospices with higher HCI scores have better Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice ratings. Among hospices with a score of ten, 85.1% of caregivers reported they would definitely recommend the hospice vs. 82.9% of caregivers of patients receiving treatment from hospices with a score of seven or less. Using the HCI, the Centers for Medicare and Medicaid Services and hospice patient caregivers can assess hospices across a broad set of indicators. Policymakers and hospices should monitor these ten indicators to understand their performance relative to peers.

Connecticut’s Veterans-Directed Care Program Outcomes Compared to HCBS Waiver Participants: HCBS CAHPS Results

Connecticut (CT) Veterans Directed Home and Community Based Services Program (VDC) is an innovative Veterans Administration (VA) services option providing veterans at risk of institutionalization with person-centered consumer-directed long-term services and supports at home. Funded by an Administration for Community Living grant, the CT Department of Aging and Disability Services partnered with the VA, the five CT Area Agencies on Aging, and UConn Health Center on Aging (UConn). UConn researchers conducted the Consumer Assessment of Healthcare Providers and Systems in Home and Community Based Services (HCBS CAHPS) survey with VDC participants (n=36) from October 2019 through March 2020. The standardized, validated HCBS CAHPS survey, which Connecticut administers to individuals in most CT Medicaid HCBS programs, is a universal, cross-disability tool to assess/improve the quality of HCBS programs. Analyses compared VDC participants’ program experiences to survey results from individuals in the Connecticut Home Care Program (CHCP) (for older adults) (n=629), Personal Care Assistance (PCA) (n=282), and Acquired Brain Injury (ABI) (n=327) waiver programs. Notably, more VDC participants (91%) knew who their support broker was, compared to CHCP, ABI, and PCA (82%, 79%, and 72%, respectively) who knew their case manager; 91% of VDC participants gave their support broker the highest rating, compared to 66% to 74% of participants in other programs who rated their case manager. This study provides strong evidence that the CT VDC program is positively impacting veterans and that the AAAs and support brokers are effectively helping them receive the HCBS they need in a consumer-directed way.

Health Care Provider Characteristics Associated With Colorectal Cancer Screening Preferences and Use

ObjectiveTo assess health care provider (HCP) preferences related to colorectal cancer (CRC) screening overall, and by HCP and patient characteristics. Participants and MethodsWe developed a survey based on the Theoretical Domains Framework to assess factors associated with CRC screening preferences in clinical practice. The survey was administered online November 6 through December 6, 2019, to a validated panel of HCPs drawn from US national databases and professional organizations. The final analysis sample included 779 primary care clinicians (PCCs) and 159 gastroenterologists (GIs). ResultsHCPs chose colonoscopy as their preferred screening method for average-risk patients (96.9% (154/159) for GIs, 75.7% (590/779) for PCCs). Among PCCs, 12.2% (95/779) preferred multi-target stool DNA (mt-sDNA), followed by fecal immunochemical test (FIT), (7.3%; 57/779) and guaiac-based fecal occult blood test (gFOBT) (4.8%; 37/779). Preference among PCCs and GIs generally shifted toward noninvasive screening options for patients who were unable to undergo invasive procedures; concerned about taking time from work; unconvinced about need for screening; and refusing other screening recommendations. Among PCCs, preference for mt-sDNA over FIT and gFOBT was less frequent in larger compared with smaller clinical practices. Additionally, preference for mt-sDNA over FIT was more likely among PCCs with more years of clinical experience, higher patient volumes (> 25/day), and practice locations in suburban and rural settings (compared to urban). ConclusionBoth PCCs and GIs preferred colonoscopy for CRC screening of average-risk patients, although PCCs did so less frequently and with approximately a quarter preferring stool-based tests (particularly mt-sDNA). PCCs’ preference varied by provider and patient characteristics. Our findings underscore the importance of informed choice and shared decision-making about CRC screening options.