A data mining approach in home healthcare: outcomes and service use

BACKGROUND: The purpose of this research is to understand the performance of home healthcare practice in the US. The relationships between home healthcare patient factors and agency characteristics are not well understood. In particular, discharge destination and length of stay have not been studied using a data mining approach which may provide insights not obtained through traditional statistical analyses. METHODS: The data were obtained from the 2000 National Home and Hospice Care Survey data for three specific conditions (chronic obstructive pulmonary disease, heart failure and hip replacement), representing nearly 580 patients from across the US. The data mining approach used was CART (Classification and Regression Trees). Our aim was twofold: 1) determining the drivers of home healthcare service outcomes (discharge destination and length of stay) and 2) examining the applicability of induction through data mining to home healthcare data. RESULTS: Patient age (85 and older) was a driving force in discharge destination and length of stay for all three conditions. There were also impacts from the type of agency, type of payment, and ethnicity. CONCLUSION: Patients over 85 years of age experience differential outcomes depending on the condition. There are also differential effects related to agency type by condition although length of stay was generally lower for hospital-based agencies. The CART procedure was sufficiently accurate in correctly classifying patients in all three conditions which suggests continuing utility in home health care

Perceptions of quality across the maternal care continuum in the context of a health financing intervention: Evidence from a mixed methods study in rural Malawi

Background: In 2013, Malawi with its development partners introduced a Results-Based Financing for Maternal and Newborn Health (RBF4MNH) intervention to improve the quality of maternal and newborn health-care services. Financial incentives are awarded to health facilities conditional on their performance and to women for delivering in the health facility. We assessed the effect of the RBF4MNH on quality of care from women’s perspectives. Methods: We used a mixed-method prospective sequential controlled pre- and post-test design. We conducted 3060 structured client exit interviews, 36 in-depth interviews and 29 focus group discussions (FGDs) with women and 24 in-depth interviews with health service providers between 2013 and 2015. We used difference-in-differences regression models to measure the effect of the RBF4MNH on experiences and perceived quality of care. We used qualitative data to explore the matter more in depth. Results: We did not observe a statistically significant effect of the intervention on women’s perceptions of technical care, quality of amenities and interpersonal relations. However, in the qualitative interviews, most women reported improved health service provision as a result of the intervention. RBF4MNH increased the proportion of women reporting to have received medications/treatment during childbirth. Participants in interviews expressed that drugs, equipment and supplies were readily available due to the RBF4MNH. However, women also reported instances of neglect, disrespect and verbal abuse during the process of care. Providers attributed these negative instances to an increased workload resulting from an increased number of women seeking services at RBF4MNH facilities. Conclusion: Our qualitative findings suggest improvements in the availability of drugs and supplies due to RBF4MNH. Despite the intervention, challenges in the provision of quality care persisted, especially with regard to interpersonal relations. RBF interventions may need to consider including indicators that specifically target the provision of respectful maternity care as a means to foster providers’ positive attitudes towards women in labour. In parallel, governments should consider enhancing staff and infrastructural capacity before implementing RBF

Sexual Priming, Gender Stereotyping, and Likelihood to Sexually Harass: Examining the Cognitive Effects of Playing a Sexually-Explicit Video Game

The present study examines the short-term cognitive effects of playing a sexually explicit video game with female “objectification” content on male players. Seventy-four male students from a university in California, U.S. participated in a laboratory experiment. They were randomly assigned to play either a sexually-explicit game or one of two control games. Participants’ cognitive accessibility to sexual and sexually objectifying thoughts was measured in a lexical decision task. A likelihood-to-sexually-harass scale was also administered. Results show that playing a video game with the theme of female “objectification” may prime thoughts related to sex, encourage men to view women as sex objects, and lead to self-reported tendencies to behave inappropriately towards women in social situations

College Women’s Feminist Identity: A Multidimensional Analysis with Implications for Coping with Sexism

This study examined components of women’s feminist identity and possible relations to their reported coping responses to sexism. A sample of 169 undergraduate women (M = 19.4 y, SD = 1.2) from diverse ethnic backgrounds completed surveys assessing their experiences and gender-related views. The first set of analyses revealed that women’s social gender identity, exposure to feminism, and gender-egalitarian attitudes independently contributed to feminist identification; moreover, non-stereotyping of feminists further predicted feminist self-identification. A second set of analyses tested the relative contribution of feminist identity components to women’s cognitive appraisals of coping responses to sexual harassment. Seeking social support was predicted by self-identification as a feminist (for White European American women only). Confronting was predicted by social gender identity, non-stereotyping of feminists, and public identification as a feminist. Findings highlight possible components of women’s feminist identity and their possible impact on coping responses to sexism