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Contributing Factors to the Patient Burden of Work

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Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and

Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient, resulting in higher health care costs, less than desirable outcomes, and a large strain on the patient and caregiver's daily lives. There are several ways that people have tried to create a comprehensive theoretical framework to understand the system from multiple perspectives. This work will expand existing theoretical frameworks that observes the relationship between the patient, their social networks, and health care services such as the Burden of Treatment Theory. Consisting of a comprehensive, multidisciplinary literature review, research was derived from the disciplines of medicine, informatics, management, and ethics. In this paper, I attempt to identify key contributing factors and then develop and categorize these stressors into a typology. Since there are many contributing factors that affect the burden of work at multiple levels, a nested typology will be used which will link micro- and macro-leveled pressures to a single system while also showcasing how each level interacts and is influenced by the others. For the categorization of the contributing factors, they will be sorted into individual actors, organizational level, and macro-level factors. The implications of this work suggest that a combination of historical shifts, structural design, and secondary effects of policy contribute to patients' burden of work.

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  • 2017-05

Barriers to Healthcare Access within Native American Populations

Description

Introduction: Health disparities for the Native American population in the United States have been well documented for years. Native Americans face many barriers to healthcare access, including low socioeconomic status,

Introduction: Health disparities for the Native American population in the United States have been well documented for years. Native Americans face many barriers to healthcare access, including low socioeconomic status, historical trauma, and lack of access to healthcare facilities. Barriers to healthcare and challenges associated with achieving optimal health among Native Americans contribute to health disparities within these populations. If these barriers are to be overcome, they must be understood and addressed. Purpose: The purpose of this review was to identify barriers to healthcare access for Native American populations as well as strategies to address barriers. Method: A preliminary scan of several online databases was conducted. Key terms used in the search included American Indians, Native American, healthcare, healthcare access, health disparities, barriers, and intervention. Articles were selected based on relevance, and data from each chosen article were extracted and categorized. Results: The initial search resulted in 272 articles of potential interest. Based on the abstract review, 32 were deemed relevant, and full text reviews were completed. Based on the full text review, an additional 10 articles were excluded, resulting in a final review of 22 articles. The articles addressed barriers related to various health conditions: cancer treatment, drug or alcohol use, maternal and child health, historical trauma, diabetes and chronic illnesses, and oral health. Conclusion: Native Americans face several barriers to healthcare access that are associated with social, physical, and mental health disparities. Successful efforts to address these barriers include patient-centered, culturally-competent interventions. Others include interventions which focus on community involvement.

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  • 2017-12

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Framework to Develop a Social Determinants of Health Screener for Clinics Serving Vulnerable Populations

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This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's

This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.

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  • 2018-05

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Analysis of Screening Tools for Identifying Sex Trafficking Victims in the Medical Setting

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The purpose of this study was to create a screening tool specifically for the identification of sex trafficking victims in the medical setting through the analysis of existing human trafficking

The purpose of this study was to create a screening tool specifically for the identification of sex trafficking victims in the medical setting through the analysis of existing human trafficking screening tool studies geared towards use in the medical setting. Screening questions from these studies were compiled and modified into a survey that was distributed to healthcare professionals through the nationwide HEAL (Health Professional Education, Advocacy, Linkage) Trafficking listserv. Each screening tool study demonstrated benefits and disadvantages that were helpful in the sampling and selection of screening tool questions. The small sample size and a lack of data on the attitudes of medical professionals on sex trafficked victims were noted as limitations to this study. Further implications for this study would include validating the screening tool questions in a medical setting to determine the sensitivity of the survey in identifying patients as possible sex trafficking victims.

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  • 2018-05