Quality Of Health Care For Women Research Articles

Trends in hospitalizations and emergency department visits among women with hyperglycemia in pregnancy between 2008 and 2017 in Taiwan.

We investigated health service utilization, including hospitalizations and emergency department visits, for women with hyperglycemia in pregnancy between 2008 and 2017 in Taiwan. Data from the Health and Welfare Data Science Center were used to conduct this nationwide population-based study. We identified pregnant women and the date of childbirth according to Birth Certificate Applications from 2007 to 2018. The study population was divided into four groups: known DM, newly diagnosed DM, GDM, and no DM/GDM. To assess quality of healthcare during the gestation period, trends in 30-day readmission rate, number of emergency department visits/hospitalizations per 100 childbirths, and length of hospital stay from 2008 to 2017 were examined. A total of 1830511 childbirths and 990569 hospitalizations were identified for analyses. Between 2008 and 2017, women with hyperglycemia in pregnancy (known DM, newly diagnosed DM, and GDM) had a higher rate of hospitalization, a longer length of hospital stay, and higher rates of various maternal and fetal outcomes, compared with women with no DM/GDM. Nevertheless, the differences between women with GDM and those with no DM/GDM in the aforementioned outcome measures were modest. Women with GDM had a modest decrease in the 30-day readmission rate (p for trend 0.046) with no significant difference in the number of emergency department visits during the study period. Our findings provide evidence of the quality of healthcare for women with GDM between 2008 and 2017 in Taiwan.

Applying Organizational Health Literacy to Maternal and Child Health.

Purpose Describe the development of an innovative teaching activity that applies organizational health literacy to maternal and child health (MCH). DescriptionHealth literacy is a strong predictor of health behavior and outcomes. While the study of health literacy has traditionally been confined to skills and capacities of individuals, the significant role of the social and physical environmental contexts in facilitating or hindering one's ability to obtain, understand, and make informed decision about their health has been recognized. MCH organizations play a critical role in influencing health literacy across system levels. This teaching activity aims to equip students with knowledge and skills needed to foster organizational health literacy. Assessment The teaching activity is assembled within a toolkit which includes the following: (1) instructor lesson plan; (2) interactive PowerPoint presentation with instructor notes; (3) field assignment description; (4) health literacy attribute assessment worksheets; and (5) grading rubric. The teaching tool was pilot tested by a student research team member to assess the educational value and assignment logistics, resulting in minor edits (i.e., addition of interviewer probes, and option of a group project-format to permit triangulation of multiple organizational interviews). Conclusion The field of MCH is expanding in complexity, and the demands of health systems on women, children, and families must be mediated by conscious efforts within organizations. Through teaching the importance and function of organizational health literacy to students in MCH, educators can prepare an emerging workforce to improve health literacy, and ultimately the quality of healthcare for women, children, and families.

Coordination of care and quality of healthcare for women and children in the PMAQ

The study aimed to identify the association between coordination of care and quality of healthcare for women and children in primary healthcare in Brazil. A cross-sectional study was performed with data from 30,523 teams that participated in the Program for Improvement in Access and Quality of Basic Care (PMAQ) in 2013. Logistic regression was performed, in which the dependent variable was quality of healthcare for women and children and the independent variable was level of coordination of care. The multivariate analysis included variables that presented p < 0.05. The model's fit was assessed with the Hosmer-Lemeshow test. The study assessed the results of 28,056 teams that conducted activities in coordination and healthcare for women and children simultaneously. In Brazil, the largest percentage of teams displayed low levels of coordination (68.5%). The highest levels of coordination were found in stratum 6 (57.2%) and the lowest in stratum 1 (78.5%). Among the major geographic regions, the North of Brazil showed the highest percentage of teams with low coordination (89.1%), while the Southeast had the most teams with high coordination (37.6%). More than two-thirds (70.5%) of the teams showed low quality of care in women's health, while 63.5% showed high level of care in children's health. High level of coordination is associated with high quality of care both in women's health (OR = 11.85) and children's health (OR = 8.79). The predominance of low levels of coordination of care in Brazil and low quality of healthcare for women reflect the need for coordinated action in this area.

Abstract C28: Racial and ethnic disparities in mammography utilization among women with intellectual disabilities: An exploratory mixed methods approach

Abstract Background: Racial and ethnic disparities in mammography utilization among the general population persist to this day. Women with intellectual disabilities have much lower rates of mammography receipt compared to women without ID and are diagnosed with breast cancer at more advanced stages. Among women with ID, the diverse perceptions and experiences among different racial and ethnic groups surrounding mammography utilization are unknown. The purpose of this study is to conduct a mixed methods study to explore racial and ethnic differences in mammography utilization and experience among women with ID who are Black/African American, Hispanic, and non-Hispanic White. Specific Aims: 1. Collect mammography medical records and demographic information from Black/African American, Hispanic, and non-Hispanic White women with ID to determine general trends in mammography utilization from 2010-2013. 2. Determine the barriers and facilitators contributing to mammography utilization among different racial and ethnic groups of this population via in-depth interviews. 3. Explore how culture may affect the social interactions that in turn may affect mammography utilization among this population. This approach is innovative as it combines quantitative and qualitative methodologies to data collection among a priority population. The proposed research is significant because it will increase awareness on the different racial and ethnic perspectives regarding mammography utilization among women with ID. In the long-term, the results from this research may improve the delivery of appropriate healthcare to this population to achieve a reduction in mammography disparities. In addition, expected results from this research can be considered when planning breast cancer prevention interventions within this population and may be used to enhance the quality of healthcare for women with ID. This research is funded by AHRQ GRANT11714050. Preliminary findings are expected for November 2015. Citation Format: Evelyn Arana. Racial and ethnic disparities in mammography utilization among women with intellectual disabilities: An exploratory mixed methods approach. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C28.