Search PubMed⌕ Search

Biomedical subjects

K H Dansky

Publications and source records attributed to K H Dansky.

At least 19 recordsLinked to original sources
PubMed1999

How telehomecare affects patients.

The emergence of telemedicine as an acceptable mode of health care delivery creates opportunities and challenges for home care providers. As part of strategic planning and deployment of a telemedicine project, agencies must ask questions, such as, is this technology suitable for elderly clients? Can patients with multiple, chronic conditions benefit? Are caregivers willing to take on the responsibility of additional equipment in the home? Agencies must consider these and other issues when planning and evaluating a telemedicine project.

Community Health Nursing↗
PubMed1998

Profiles of hospital, physician, and home health service use by older persons in rural areas.

Using data from the Medicare Current Beneficiary Survey, we identify differences in hospital days, home health visits and physician office visits across five geographical categories. After controlling for individual characteristics and availability of health care providers, we find significant differences in service use. Results show greater use of home health care and less use of physician office visits and hospital care in rural areas. Because service use exhibits patterns of substitution and complementarity, future research on the use of health services needs to move beyond modeling the use of single services to modeling the range of services used.

Aged↗
PubMed1998

The use of health care services by people with diabetes in rural areas.

Current standards of health care support the view that diabetes can be managed in an outpatient setting, thereby preventing costly hospitalization. Yet, recent studies on access to care suggest that rural residents do not receive the same services for diabetes care as their urban counterparts. This study identifies differences in use for three types of services-hospital care, home health visits, and physician office visits--by geographical location. Using a sample of 6,698 Medicare beneficiaries, the authors performed multivariate analysis of variance to test the influence of geographical differences on each type of service use after controlling for the other types of service use and individual factors. Results showed significant differences among the geographical categories, with diabetic individuals in the most sparsely populated communities reporting fewer physician office visits and more home health visits than their urban counterparts. Because this pattern may have a negative impact on health outcomes, additional research is needed to determine the optimal array of services necessary to manage chronic diseases, such as diabetes, in rural areas.

Aged↗
PubMed1998

Pre- and post-control model research on end-users' satisfaction with an electronic medical record: preliminary results.

This study reports early results of a project that addresses the process of computerizing medical records in multiple ambulatory care sites of a health system. The study focuses on end-user attitudes before, during, and after implementation, through the use of questionnaires, interviews, and participant observation. Knowledge about end-user attitudes prior to computerization may contribute to planning for the training and implementation process. Tailoring these processes to meet the varying needs of user groups may result in a higher level of functional use of the system and less stress to the persons involved in its use. One implementation plan may not work for all sites when there are differences in size of the clinic, work flow patterns prior to implementation, and computer experience among personnel. Preliminary analysis of post-installation questionnaires and interviews six months after the installation point to a number of areas that might be usefully addressed in future installation efforts.

Attitude of Health Personnel↗
PubMed1997

Patient satisfaction with ambulatory healthcare services: waiting time and filling time.

Customer satisfaction is an important measure of service quality in healthcare organizations. This study investigated the relationship between patient waiting and satisfaction with ambulatory healthcare services, with waiting times divided into segments of the patient-care episode. Two management techniques to alter perceptions of waiting were also examined. Regression models measuring the effect of waiting times on satisfaction found that the total time spent waiting for the clinician was the most significant predictor of patient satisfaction. Informing patients how long their wait would be and being occupied during the wait were also significant predictors of patient satisfaction. These results show that waiting times, even if they cannot be shortened, can be managed more effectively to improve patient satisfaction.

Acute Disease↗
PubMed1996

Developing and using a patient satisfaction survey: a case study.

Patient satisfaction is an important component of quality management in student health services. Satisfaction can influence if, where, and when a student seeks care, follows instructions, and continues a relationship with a specific provider. This case study describes the rationale for and process used in designing a system to measure patient satisfaction for the university health services at The Pennsylvania State University. In addition to collecting information about the health center from its clients, the authors obtained valuable information about survey development, administration, and data management. Their experience will guide future efforts to improve both the quality of services offered and the methods the health center uses to measure clients' satisfaction with those services.

Adolescent↗
PubMed1996

Using TQM to improve management of home health aides.

Home health aides are at the front line of the home health industry, raising quality of care issues and human resource (HR) management challenges. Total quality management (TQM) provides a framework to help meet those challenges. The authors investigated the relationship between TQM and HR effectiveness in home health agencies. Results suggest that TQM practices are related to HR effectiveness. Suggestions are offered to make human resource management consistent with a TQM culture.

Home Care Services↗
PubMed1996

After hospitalization: home health care for elderly persons.

The immediate post-hospitalization outcomes for elderly individuals who received home health services after discharge were compared with those who did not receive home health services. The needs of individuals with cognitive impairment and the "old-old" were major foci of interest. Assessment instruments included the Mini-Mental State Exam, the Delirium Symptom Interview, and the Everyday Problem Solving Test. Data on the use of health services after hospital discharge were collected. Results showed that patients age 80 and older, who received skilled nursing services, were less likely to report health problems or complications than those who had not received skilled nursing services. Because the old-old elderly are more likely to have problems during the immediate post-hospitalization period, this group of patients should be targeted for needs assessment and discharge planning.

Aged↗
PubMed1996

Understanding hospital referrals to home health agencies.

Using resource dependency theory and transaction-cost economics theory, we examined the simultaneous effects of a vertical integration strategy and environmental complexity on home health agency (HHA) referrals by hospitals. Discharge data for calendar year 1990 from 61 Pennsylvania hospitals were analyzed. Using hospital ownership of home health agencies and urban versus rural location as the primary independent variables, a logistic regression model calculated the probability of HHA referral, after controlling for long-term care beds and patient characteristics. Results showed that HHA ownership was a significant predictor of home health referrals for both rural and urban hospitals, although the effect was greater for urban hospitals. These results suggest that hospitals are actively using referrals to home healthcare in response to environmental pressures. As these pressures increase, hospitals will benefit from tight linkages with home health providers.

Aged↗
PubMed1996

Discriminant analysis: a technique for adding value to patient satisfaction surveys.

Quality improvement in healthcare organizations requires effective measurement of patient satisfaction. This paper describes a methodology that identifies dimensions of care most closely associated with overall perceptions of quality. A patient satisfaction survey was mailed to 2,055 discharged patients of 13 home health agencies. Patients were asked to evaluate service dimensions of home health relating to scheduling, nursing care, home health aide services, and discharge arrangements. Overall satisfaction with quality of services was used as the dependent variable in two discriminant analysis equations. Eleven dimensions discriminated between "excellent" and "good" quality, and seven dimensions discriminated between "satisfactory" and "unsatisfactory" quality. Using discriminant analysis, items most closely associated with quality indeces can be identified and used in CQI initiatives.

Data Collection↗
PubMed1995

The impact of healthcare reform on rural home health agencies. Issues and responses.

Healthcare reform will have an impact on home health services, but the extent of change depends on which elements are legislated. The author discusses major issues of reform related to rural home health agencies. Several proactive strategies are recommended, including staffing for a community-based care model, linkages with health providers and community agencies, and political agendas to direct local, state, and national policies related to rural home health services.

Capitation Fee↗
PubMed1994

Human resources management practices and patient satisfaction in home health care.

Patient satisfaction is an important issue for home health providers. This study tested the influence of organizational factors, particularly human resource management practices, on quality of care, as measured by patient satisfaction. Six hundred ninety-six patients of thirteen home health agencies were surveyed to test the influence of organizational factors on five dimensions of patient satisfaction. Organizational variables included size of the agency, staffing characteristics, educational preparation of RNs, continuing education, and compensation. We found that full-time staffing, the number of BSN-prepared RNs, and percent of budget allocated to benefits all predicted high patient satisfaction scores.

Data Collection↗