Christopher Cochran - Academia.edu (original) (raw)

Papers by Christopher Cochran

Journal of Patient Experience, 2022

We explore whether the frequency of post-hospital discharge transitional care calls affects patie... more We explore whether the frequency of post-hospital discharge transitional care calls affects patients’ adherence to their discharge plans. We reviewed 1,000 call records of a post-discharge transitional care program run by a large U.S. tertiary care hospital in 2018–2019 and generated binary outcomes capturing patient self-reports of (1) scheduling or completing follow-up appointments, procedures, or prescription fills, (2) missing a scheduled event, and (3) reporting a new adverse clinical event. Our predictor variables captured callers’ success in completing the first and each subsequent call with discharged patients. We ran linear probability models (LPM) for each binary outcome after controlling for sociodemographic and clinical characteristics. Results indicate successful completion of the first two calls was associated with the increased probability of scheduling or completing follow-up appointment (15.5% points, p < 0.01) and follow-up procedure (13.5% points, p < 0.01),...

International Journal of Environmental Research and Public Health, 2021

The resilience of the healthcare industry, often considered recession-proof, is being tested by t... more The resilience of the healthcare industry, often considered recession-proof, is being tested by the COVID-19 induced reductions in physical mobility and restrictions on elective and non-emergent medical procedures. We assess early COVID-19 effects on the dynamics of decline and recovery in healthcare labor markets in the United States. Descriptive analyses with monthly cross-sectional data on unemployment rates, employment, labor market entry/exit, and weekly work hours among healthcare workers in each healthcare industry and occupation, using the Current Population Survey from July 2019−2020 were performed. We found that unemployment rates increased dramatically for all healthcare industries, with the strongest early impacts on dentists’ offices (41.3%), outpatient centers (10.5%), physician offices (9.5%), and home health (7.8%). Lower paid workers such as technologists/technicians (10.5%) and healthcare aides (12.6%) were hit hardest and faced persistently high unemployment, whil...

Background: Today’s rapid growth of migrant populations has been a major contributor to the human... more Background: Today’s rapid growth of migrant populations has been a major contributor to the human immunodeficiency virus (HIV) epidemic. However, relatively few studies have focused on HIV/acquired immunodeficiency syndrome (AIDS)-related knowledge, attitudes, and practice among rural-to-urban migrants in China. This cross-sectional study was to assess HIV/AIDS-related knowledge and perceptions, including knowledge about reducing high-risk sex. Methods: Two-phase stratified cluster sampling was applied and 2,753 rural migrants participated in this study. An anonymous self-administered questionnaire was conducted in Guangdong and Sichuan provinces in 2007. Descriptive analysis was used to present the essential characteristics of the respondents. Chi-square test and multiple logistic regression models were performed to examine the associations between identified demographic factors and high-risk sex, sexually transmitted disease (STD) symptoms, and access to HIV screening services amo...

Journal of Healthcare Management, 2008

General hospitals are becoming the safety net provider for the seriously mentally ill (SMI) in th... more General hospitals are becoming the safety net provider for the seriously mentally ill (SMI) in the United States, but these patients are faced with a number of potential barriers when accessing these hospitals. Hospital ownership and market forces are two potential organizational and healthcare system barriers that may affect the SMI patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s access, because the psychiatric and medical services they need are unprofitable services. This study examines the relationship among hospital ownership, market forces, and admission of the SMI patient from the emergency department into the general hospital. This was a cross-sectional study of a large sample of SMI patients from the 2002 State Inpatient Datasets for five states. Multiple logistic regression was applied in the multivariable analysis. After controlling for patient, hospital, and county covariates and when compared with not-for-profit hospitals, public hospitals were more likely to admit while investor-owned hospitals were less likely to admit SMI patients. Hospitals in competitive markets were less likely to admit while hospitals with capitation revenues were slightly less likely to admit these patients. Policy options that can address this &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;market failure&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; include strengthening the public psychiatric inpatient care system, making private health insurance coverage of the SMI more equitable, revising Medicare prospective payment system to better reimburse the treatment of the SMI, and allowing not-for-profit hospitals to count care of the SMI as a community benefit. Results of this study will be useful to healthcare managers searching for ways to reduce unnecessary administrative costs while continuing to maintain the level of administrative activities required for the provision of safe, effective, and high-quality care.

Objective: Many Southern and Southwestern states have disproportionately large percentages of low... more Objective: Many Southern and Southwestern states have disproportionately large percentages of low-income and minority families, and disparities in both preventative dental care and unmet dental need. In Nevada, the University of Nevada, Las Vegas-School of Dental Medicine (UNLV-SDM) recently opened a pediatric dental residency program to decrease health disparities. This study sought to determine if UNLV-SDM pediatric clinic is providing care to the underserved children of Clark County, Nevada. Method: Demographic and insurance information from Nevada was compared with the overall demographic profile of the UNLV-SDM pediatric patient pool (N = 2,446) using a chi-square (χ2) test, to determine if any characteristic (gender, race, age, Medicaid/CHIP status) was different than expected. Result: Compared to Nevada, more than three-fourths (76.7%) of UNLV-SDM pediatric patients were covered by Medicaid or CHIP (χ2 = 57.101, d.f. = 1; p < 0.0001). Additionally, significant percentages ...

Journal of health and human services administration, 2008

This study used a cross-sectional, multiple logistic regression design to examine the relationshi... more This study used a cross-sectional, multiple logistic regression design to examine the relationship between mental health service availability and the admission of 111,527 seriously mentally ill (SMI) patients from the emergency department (ED) in New York State in 2002. The study found that SMI patients were admitted from the ED in counties that were mental health professional shortage areas and in counties with less long-term inpatient psychiatric days. Contrary to expectations, counties with community mental health centers (CMHCs) had more admissions than counties without CMHCs. The results support prior research that indicates the need for more specialized mental health services for the SMI, including more psychiatric beds.

Journal of the Nevada Public Health Association

As the health care industry becomes increasingly complex, many leaders and practitioners in the f... more As the health care industry becomes increasingly complex, many leaders and practitioners in the field are worried about the quality and preparation of health care administration graduates (Robbins, Bradley, & Spicer, 2001). Academic health care administration ...

The Scientific World JOURNAL, 2006

The Scientific World JOURNAL, 2007

European Journal of Environment and Public Health

Worldwide, healthcare policy change ranks among the top three issues in the public's consciousnes... more Worldwide, healthcare policy change ranks among the top three issues in the public's consciousness. This study introduces a case study of pediatric hospitalizations at one hospital in Northern China. It seeks to assess whether pediatric hospitalization access, costs, and costs structures favorably changed after selected health policy reforms were implemented in China. A census of all hospital pediatric discharge data from 2015 to 2018 were collected from a general public tertiary hospital in Northern China. Using generalized linear regression, changes in charges for length of stay, daily charges, total charges per discharge, and drug charges and medical service fees as a percent of total charges were analyzed as a function of two independent variables-policy changes regarding the merger of two health insurance programs, and the zero-markup drug pricing policy. These variables were included as dummy variables for the pre-and-post change periods. The covariates used included patient age, sex, and the year. After the policy implementation, significant decreases (P<.01) were found in the length of the hospital stay (-0.49 days) and drug and medical charges (-7.63%) as a percent of total charges. A significant decrease also occurred (P<.01) in the number and percent of pediatric patients served who were self-pay after the merger of the NCMS insurance plan into the URBMI. Drug costs as a proportion of total costs also decreased significantly (P<.01). Thus, the findings revealed that the zero-markup drug pricing policy was associated with a significant decrease (P<.01) in the mean percentage markup for drug charges (P<.01). Accordingly, both health policy changes were associated with positive effects on pediatric healthcare expenditures, and access. This research suggests that as these two policies are fully implemented at public tertiary hospitals throughout China, pediatric hospital care may become even more accessible and drugs less costly.

Journal of Patient Safety

Academy of Management Proceedings

BMC health services research, Aug 22, 2016

This study aimed to measure the poverty head count ratio and poverty gap of rural Yanbian in orde... more This study aimed to measure the poverty head count ratio and poverty gap of rural Yanbian in order to examine whether China's New Rural Cooperative Medical Scheme has alleviated its medical impoverishment and to compare the results of this alternative approach with those of a World Bank approach. This cross-sectional study was based on a stratified random sample survey of 1,987 households and 6,135 individuals conducted in 2008 across eight counties in Yanbian Korean Autonomous Prefecture, Jilin province, China. A new approach was developed to define and identify medical impoverishment. The poverty head count ratio, relative poverty gap, and average poverty gap were used to measure medical impoverishment. Changes in medical impoverishment after the reimbursement under the New Rural Cooperative Medical Scheme were also examined. The government-run New Rural Cooperative Medical Scheme reduced the number of medically impoverished households by 24.6 %, as well as the relative and av...

Tropical Medicine & International Health, 2016

objectives The Chinese government has greatly increased funding for disease control and preventio... more objectives The Chinese government has greatly increased funding for disease control and prevention since the 2003 Severe Acute Respiration Syndrome crisis, but it is also concerned whether these increased resources have been used efficiently to improve public health services. We aimed to assess the efficiency of county-level Centers for Disease Control and Prevention (CDCs) of China and to identify strategies for optimising their performance. methods A total of 446 county-level CDCs were selected based on systematic sampling throughout China. The data envelopment analysis framework was used to calculate the efficiency score of sampled CDCs in 2010. The Charnes, Cooper and Rhodes (CCR) model was applied to calculate the overall and scale efficiency, and the Banker, Charnes and Cooper (BCC) model was used to assess technical efficiency. Models included three inputs and seven outputs. A projection analysis was conducted to identify the difference between projection value and actual value for inputs and outputs. results The average overall efficiency score of CDCs was 0.317, and the average technical efficiency score was 0.442 and 88.3% with decreasing returns to scale. Projection analysis indicated that all seven categories of outputs were underproduced. CDCs in the eastern region tended to perform better than CDCs in the middle and the western region. conclusions Most county-level CDCs in China were operated inefficiently. Emphasis should be put on increasing staff and general operating expenses through current governmental funding, upgrading healthcare providers' competencies and enhancing the standardisation of operational management, so that CDCs could utilise their resources more efficiently.

Electronic laboratory reporting (ELR) has been implemented in many parts of the United States, an... more Electronic laboratory reporting (ELR) has been implemented in many parts of the United States, and is perceived to be faster than traditional reporting. One large commercial laboratory provides the Southern Nevada Health District (SNHD) with 70-90% of its electronic and traditional laboratory reports, including reports of gastrointestinal (GI) illnesses. GI illnesses are a concern in Southern Nevada due to the transient population and short incubation periods of these illnesses. 1,2 Objective This project aims to compare timeliness between traditional laboratory reporting, ELR, and reporting after the implementation of TriSano, a modern electronic surveillance system, for common GI illnesses in Southern Nevada, with a prediction that ELR will be faster than traditional reports, and TriSano will be faster than the other two methods.

Nevada Journal of Public Health, 2012

The research completed for this study was funded through a grant from the Centers for Disease Con... more The research completed for this study was funded through a grant from the Centers for Disease Control and Prevention (CDC) (Grant Number U55/CCU922006-02). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Nevada State Health Division or the Centers for Disease Control and Prevention (CDC). The authors would like to thank Graciela Tena de Lara and Rocio Flores for their assistance in conducting the survey. An additional acknowledgement is made of the staff of the Women's Health Connection component at the Southern Nevada Areas Health Education.

Ethnicity & Disease, 2016

Health disparities associated with race and insurance status are widely documented. A 2003 Instit... more Health disparities associated with race and insurance status are widely documented. A 2003 Institute of Medicine report states that racial/ethnic minorities and low-income groups are disproportionately affected by medical care disparities in the United States, even after controlling for income and access to care. 1 This report suggests that, "the sources of these disparities are complex and rooted in historic and contemporary inequalities, and involve many participants at several levels, including health systems, healthcare managers, medical professionals and patients". Previous research indicates that minority patients are more likely to receive lower quality of care across a range of conditions and care processes, and have higher morbidity and mortality rates including some patient safety indicators on selected outcomes. 2-13 Patient safety indicators (PSIs), developed by the Agency for Healthcare Research and Quality (AHRQ), are a set of indicators providing information on potential in-hospital complications and adverse events following surgeries, procedures, and childbirth. The PSIs were developed after a comprehensive literature review, analysis of ICD-9-CM codes, review by a clinician panel, implementation of risk adjustment, and empirical analyses. The PSIs provide the opportunity to assess the incidence of adverse events and in-hospital complications us