Patient satisfaction studies have gained more and more attention, and there are many patient sati... more Patient satisfaction studies have gained more and more attention, and there are many patient satisfaction studies. These studies assume that patients were selected randomly and independently, but patient satisfaction surveys are described as a multistage or hierarchically structured sample. Thus, there is a need to conduct a hierarchical linear model (HLM) analysis with a large number of hospitals. This study utilized an HLM to investigate both the individual patient-level effect on the overall satisfaction rating and the effect of hospital characteristics on the combining process of patient’s overall satisfaction rating. This study used patient satisfaction data collected from 100 hospitals with the sample size of 85 766. The hospital-level characteristics include total expense per personnel, payroll expense per personnel, number of staffed beds per personnel, and number of admission per personnel. This study found that hospital characteristics influence overall rating of the hospi...
In 2014, the National Board of Public Health Examiners performed a job task analysis (JTA) to rev... more In 2014, the National Board of Public Health Examiners performed a job task analysis (JTA) to revise the Certified in Public Health (CPH) examination. The objectives of this study were to describe the development, administration, and results of the JTA survey; to present an analysis of the survey results; and to review the implications of this first-ever public health JTA. An advisory committee of public health professionals developed a list of 200 public health job tasks categorized into 10 work domains. The list of tasks was incorporated into a web-based survey, and a snowball sample of public health professionals provided 4850 usable responses. Respondents rated job tasks as essential (4), very important (3), important (2), not very important (1), and never performed (0). The mean task importance ratings ranged from 2.61 to 3.01 (important to very important). The highest mean ratings were for tasks in the ethics domain (mean rating, 3.01). Respondents ranked 10 of the 200 tasks a...
Journal of healthcare management / American College of Healthcare Executives
The purpose of this study was to investigate how patients' self-rated health status (SRHS) is... more The purpose of this study was to investigate how patients' self-rated health status (SRHS) is associated with their attribute reaction integration process and, in turn, their overall ratings of hospitals. We collected patient satisfaction data from 70 hospitals by means of a patient satisfaction questionnaire. The sample included patients who were 18 years or older and discharged from the hospital from July 1, 2011, through June 30, 2012. Data for 36,528 patients were available for analysis. We conducted multiple linear regression analysis with patients' SRHS and interaction effects with nursing care, physician care, staff care, and room, while controlling for age, gender, race, and education. Study findings showed an association between SRHS levels and the patient's overall rating of the hospital; they also revealed interaction effects with nursing care, physician care, and staff care variables in the model. The statistically significant interaction effects indicate tha...
The purpose of this article is to review the literature from 1980 to 2005 regarding organ donatio... more The purpose of this article is to review the literature from 1980 to 2005 regarding organ donation decision making by African Americans for themselves and their loved ones and recommend improvements in subsequent studies. Using the behavioral model of health services utilization as an organizing framework, the review procedure consists of a (1) search of health and medical literature using several key words and eight indexes, (2) selection of articles based on specific criteria, and (3) review of each article with regard to the population and sample used, study design, dependent variables addressed, and its findings. The review indicates that predisposing, enabling, and need factors each influence African Americans' organ donation decision making. Retrospective chart reviews provide a good design for future multivariate analyses of the many factors influencing African American decision making. Interventions to influence decision making should emphasize both community education and the process of organ procurement.
Objective: The Healthy MomsHealthy BabiesHealthy Community Initiative seeks to engage the communi... more Objective: The Healthy MomsHealthy BabiesHealthy Community Initiative seeks to engage the community to reduce infant mortality in Fort Worth, Texas, using a Life Course Perspective. To carry out this mission, we conducted focus groups to assess the awareness and understanding of the extent of infant mortality among community residents in areas having the highest infant mortality. Methods: Eight focus groups were conducted in 2011, five with women only, one with men only, one with staff of youth-serving organizations, and one with individuals working in education. The focus groups were designed and implemented using a community-based participatory approach in collaboration with a community Oversight Board. Results: Eighty-one people participated in the focus groups. Four themes emerged: 1) challenges to accessing community resources such as transportation, healthy food, and employment; 2) institutional and system-level barriers related to racism (e.g., the inability to obtain equitab...
Hypertension is a growing problem in the United States, affecting every one in four Americans. Ho... more Hypertension is a growing problem in the United States, affecting every one in four Americans. However, hypertension tends to be more common and more severe in the African American population, with one in every three African Americans suffering from hypertension. Increasing awareness, treatment and control of high blood pressure can reduce the morbidity and mortality related to hypertension. The purpose of this study is to evaluate two existing models of hypertension self management support for African-American men ages 18-44 within St. Louis: a health coach model and a parish nurse model. Health education and evaluation materials were created, and health coaches and parish nurses were trained to use these materials in conjunction with their existing models of support. Clients were recruited by nurses and coaches at various public gathering locations, and given an initial survey on their knowledge regarding hypertension management, and beliefs about barriers to care and susceptibili...
The study assesses the effects of a community agency intervention, Asthma H.E.L.P., on diagnosed ... more The study assesses the effects of a community agency intervention, Asthma H.E.L.P., on diagnosed asthmatic children's care management, health services use, and perceived quality of life. Populations of 80 children at two sites of a community agency received visits throughout the year. Asthma-educated social workers gathered information about the children's activities at each visit through a detailed checklist, and on their quality of life through an annual Juniper Survey. Two years of data have been collected. The intervention, Asthma H.E.L.P., provides families with support in the home regarding health care and asthma, environmental triggers, and suggestions for the prevention of asthma episodes. The population includes children in St. Louis inner-city areas whose parents sought assistance through the community agency. The Asthma H.E.L.P. intervention significantly impacted the process of care through the provision and use of asthma action plans for both sites, and the prov...
International quarterly of community health education, 1983
The purpose of this article is to replicate Berkanovic's study suggesting that general health... more The purpose of this article is to replicate Berkanovic's study suggesting that general health orientations are weak mediators of the relationship between sociodemographic characteristics and health protective behaviors, and thus, health education campaigns attempting to alter health orientations in target populations would have little effect on health protective behaviors. Our methodology is similar to that used by Berkanovic although additional sociodemographic factors as well as measures of general health orientations are included in the analysis of the three types of health protective behaviors (i.e., voluntary life style change, physician recommended life style change, and physician recommended treatment). Our results support Berkanovic's earlier view. The effect of attitudes toward physicians on asymptomatic life style change is also considered, and the implications for health education are discussed.
Journal of public health management and practice : JPHMP
The purpose of the study in this article was to identify The needs of public health managers with... more The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations...
Journal of healthcare management / American College of Healthcare Executives
Healthcare organizations in the United States are struggling to find ways to survive in their unc... more Healthcare organizations in the United States are struggling to find ways to survive in their uncertain and competitive environments. One of the survival strategies used by those organizations is to increase patient satisfaction. This article presents research on factors that influence hospitalized patients' satisfaction and their intention to return to and recommend the hospital. The first objective of this study was to find out, using a comprehensive set of healthcare attributes, which attributes play a more important role in increasing patient satisfaction and behavioral intentions. The second objective was to analyze the relative importance of those attributes and the nature of the relationships across the values of the attributes. More specifically, this study attempted to identify any existing curvilinear relationships among these variables. If any curvilinear relationships exist, do they show an increasing or a decreasing marginal-utility function? Included in this articl...
The objective of this study was to examine the effects of hearing impairment on the utilization o... more The objective of this study was to examine the effects of hearing impairment on the utilization of physician and hospital services in the U.S. adult population. Andersen's behavioral model of health services utilization served as the conceptual framework for the study, and data used for the analyses were taken from two years (1971, 1977) of the Health Interview Survey. Hearing impaired persons used significantly more physician services than hearing persons. Hearing impairment had no effect on the number of hospitals days used but had a significant, positive effect on hospital contact and hospital episodes. In addition, neither the type nor the severity of the impairment had a consistent effect on utilization. These findings were consistent for both years of study data. The study's findings, implications, and suggestions for future research are discussed.
In reviewing the literature and research on leadership, as conceptualized in the rational and nat... more In reviewing the literature and research on leadership, as conceptualized in the rational and natural system perspectives, we identified major trends and issues in the organizational literature on leadership. Our discussion of the implications of this literature for the study of health services organizations raised several questions, and identified them for future research.
... R. "Evaluation of College Teaching: State of the Art, 1977." Paper pre-sented to th... more ... R. "Evaluation of College Teaching: State of the Art, 1977." Paper pre-sented to the Ohio Academy of Science Psychology Division, Columbus, Ohio, 1977. ... Fox, M. "Publication Productivity among Scientists: A Critical Review." Social Studies of Science, 13 (May 1983), 285-305. ...
Health-care managers have to address many aspects of the organization, and patient satisfaction i... more Health-care managers have to address many aspects of the organization, and patient satisfaction is clearly one of the critical aspects for managers. To respond to the need of health-care managers, there have been many patient satisfaction studies. However, these studies focus on which attributes (factors such as nursing care and physician care) are more influential; they do not provide specific aspects for each attribute. In order to develop an effective intervention programme to improve patient satisfaction, more specific research outcomes are needed. This study utilized data collected between January 2007 and June 2008 from 32 hospitals representing a large, national private not-for-profit hospital system. The patient satisfaction survey included the Consumer Assessment of Healthcare Providers and Systems, Hospital version questionnaire items, and there are 31,471 cases. Two-stage multiple linear regression analyses were conducted with control variables (age, gender, perceived hea...
Patient satisfaction studies have gained more and more attention, and there are many patient sati... more Patient satisfaction studies have gained more and more attention, and there are many patient satisfaction studies. These studies assume that patients were selected randomly and independently, but patient satisfaction surveys are described as a multistage or hierarchically structured sample. Thus, there is a need to conduct a hierarchical linear model (HLM) analysis with a large number of hospitals. This study utilized an HLM to investigate both the individual patient-level effect on the overall satisfaction rating and the effect of hospital characteristics on the combining process of patient’s overall satisfaction rating. This study used patient satisfaction data collected from 100 hospitals with the sample size of 85 766. The hospital-level characteristics include total expense per personnel, payroll expense per personnel, number of staffed beds per personnel, and number of admission per personnel. This study found that hospital characteristics influence overall rating of the hospi...
In 2014, the National Board of Public Health Examiners performed a job task analysis (JTA) to rev... more In 2014, the National Board of Public Health Examiners performed a job task analysis (JTA) to revise the Certified in Public Health (CPH) examination. The objectives of this study were to describe the development, administration, and results of the JTA survey; to present an analysis of the survey results; and to review the implications of this first-ever public health JTA. An advisory committee of public health professionals developed a list of 200 public health job tasks categorized into 10 work domains. The list of tasks was incorporated into a web-based survey, and a snowball sample of public health professionals provided 4850 usable responses. Respondents rated job tasks as essential (4), very important (3), important (2), not very important (1), and never performed (0). The mean task importance ratings ranged from 2.61 to 3.01 (important to very important). The highest mean ratings were for tasks in the ethics domain (mean rating, 3.01). Respondents ranked 10 of the 200 tasks a...
Journal of healthcare management / American College of Healthcare Executives
The purpose of this study was to investigate how patients' self-rated health status (SRHS) is... more The purpose of this study was to investigate how patients' self-rated health status (SRHS) is associated with their attribute reaction integration process and, in turn, their overall ratings of hospitals. We collected patient satisfaction data from 70 hospitals by means of a patient satisfaction questionnaire. The sample included patients who were 18 years or older and discharged from the hospital from July 1, 2011, through June 30, 2012. Data for 36,528 patients were available for analysis. We conducted multiple linear regression analysis with patients' SRHS and interaction effects with nursing care, physician care, staff care, and room, while controlling for age, gender, race, and education. Study findings showed an association between SRHS levels and the patient's overall rating of the hospital; they also revealed interaction effects with nursing care, physician care, and staff care variables in the model. The statistically significant interaction effects indicate tha...
The purpose of this article is to review the literature from 1980 to 2005 regarding organ donatio... more The purpose of this article is to review the literature from 1980 to 2005 regarding organ donation decision making by African Americans for themselves and their loved ones and recommend improvements in subsequent studies. Using the behavioral model of health services utilization as an organizing framework, the review procedure consists of a (1) search of health and medical literature using several key words and eight indexes, (2) selection of articles based on specific criteria, and (3) review of each article with regard to the population and sample used, study design, dependent variables addressed, and its findings. The review indicates that predisposing, enabling, and need factors each influence African Americans' organ donation decision making. Retrospective chart reviews provide a good design for future multivariate analyses of the many factors influencing African American decision making. Interventions to influence decision making should emphasize both community education and the process of organ procurement.
Objective: The Healthy MomsHealthy BabiesHealthy Community Initiative seeks to engage the communi... more Objective: The Healthy MomsHealthy BabiesHealthy Community Initiative seeks to engage the community to reduce infant mortality in Fort Worth, Texas, using a Life Course Perspective. To carry out this mission, we conducted focus groups to assess the awareness and understanding of the extent of infant mortality among community residents in areas having the highest infant mortality. Methods: Eight focus groups were conducted in 2011, five with women only, one with men only, one with staff of youth-serving organizations, and one with individuals working in education. The focus groups were designed and implemented using a community-based participatory approach in collaboration with a community Oversight Board. Results: Eighty-one people participated in the focus groups. Four themes emerged: 1) challenges to accessing community resources such as transportation, healthy food, and employment; 2) institutional and system-level barriers related to racism (e.g., the inability to obtain equitab...
Hypertension is a growing problem in the United States, affecting every one in four Americans. Ho... more Hypertension is a growing problem in the United States, affecting every one in four Americans. However, hypertension tends to be more common and more severe in the African American population, with one in every three African Americans suffering from hypertension. Increasing awareness, treatment and control of high blood pressure can reduce the morbidity and mortality related to hypertension. The purpose of this study is to evaluate two existing models of hypertension self management support for African-American men ages 18-44 within St. Louis: a health coach model and a parish nurse model. Health education and evaluation materials were created, and health coaches and parish nurses were trained to use these materials in conjunction with their existing models of support. Clients were recruited by nurses and coaches at various public gathering locations, and given an initial survey on their knowledge regarding hypertension management, and beliefs about barriers to care and susceptibili...
The study assesses the effects of a community agency intervention, Asthma H.E.L.P., on diagnosed ... more The study assesses the effects of a community agency intervention, Asthma H.E.L.P., on diagnosed asthmatic children's care management, health services use, and perceived quality of life. Populations of 80 children at two sites of a community agency received visits throughout the year. Asthma-educated social workers gathered information about the children's activities at each visit through a detailed checklist, and on their quality of life through an annual Juniper Survey. Two years of data have been collected. The intervention, Asthma H.E.L.P., provides families with support in the home regarding health care and asthma, environmental triggers, and suggestions for the prevention of asthma episodes. The population includes children in St. Louis inner-city areas whose parents sought assistance through the community agency. The Asthma H.E.L.P. intervention significantly impacted the process of care through the provision and use of asthma action plans for both sites, and the prov...
International quarterly of community health education, 1983
The purpose of this article is to replicate Berkanovic's study suggesting that general health... more The purpose of this article is to replicate Berkanovic's study suggesting that general health orientations are weak mediators of the relationship between sociodemographic characteristics and health protective behaviors, and thus, health education campaigns attempting to alter health orientations in target populations would have little effect on health protective behaviors. Our methodology is similar to that used by Berkanovic although additional sociodemographic factors as well as measures of general health orientations are included in the analysis of the three types of health protective behaviors (i.e., voluntary life style change, physician recommended life style change, and physician recommended treatment). Our results support Berkanovic's earlier view. The effect of attitudes toward physicians on asymptomatic life style change is also considered, and the implications for health education are discussed.
Journal of public health management and practice : JPHMP
The purpose of the study in this article was to identify The needs of public health managers with... more The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations...
Journal of healthcare management / American College of Healthcare Executives
Healthcare organizations in the United States are struggling to find ways to survive in their unc... more Healthcare organizations in the United States are struggling to find ways to survive in their uncertain and competitive environments. One of the survival strategies used by those organizations is to increase patient satisfaction. This article presents research on factors that influence hospitalized patients' satisfaction and their intention to return to and recommend the hospital. The first objective of this study was to find out, using a comprehensive set of healthcare attributes, which attributes play a more important role in increasing patient satisfaction and behavioral intentions. The second objective was to analyze the relative importance of those attributes and the nature of the relationships across the values of the attributes. More specifically, this study attempted to identify any existing curvilinear relationships among these variables. If any curvilinear relationships exist, do they show an increasing or a decreasing marginal-utility function? Included in this articl...
The objective of this study was to examine the effects of hearing impairment on the utilization o... more The objective of this study was to examine the effects of hearing impairment on the utilization of physician and hospital services in the U.S. adult population. Andersen's behavioral model of health services utilization served as the conceptual framework for the study, and data used for the analyses were taken from two years (1971, 1977) of the Health Interview Survey. Hearing impaired persons used significantly more physician services than hearing persons. Hearing impairment had no effect on the number of hospitals days used but had a significant, positive effect on hospital contact and hospital episodes. In addition, neither the type nor the severity of the impairment had a consistent effect on utilization. These findings were consistent for both years of study data. The study's findings, implications, and suggestions for future research are discussed.
In reviewing the literature and research on leadership, as conceptualized in the rational and nat... more In reviewing the literature and research on leadership, as conceptualized in the rational and natural system perspectives, we identified major trends and issues in the organizational literature on leadership. Our discussion of the implications of this literature for the study of health services organizations raised several questions, and identified them for future research.
... R. "Evaluation of College Teaching: State of the Art, 1977." Paper pre-sented to th... more ... R. "Evaluation of College Teaching: State of the Art, 1977." Paper pre-sented to the Ohio Academy of Science Psychology Division, Columbus, Ohio, 1977. ... Fox, M. "Publication Productivity among Scientists: A Critical Review." Social Studies of Science, 13 (May 1983), 285-305. ...
Health-care managers have to address many aspects of the organization, and patient satisfaction i... more Health-care managers have to address many aspects of the organization, and patient satisfaction is clearly one of the critical aspects for managers. To respond to the need of health-care managers, there have been many patient satisfaction studies. However, these studies focus on which attributes (factors such as nursing care and physician care) are more influential; they do not provide specific aspects for each attribute. In order to develop an effective intervention programme to improve patient satisfaction, more specific research outcomes are needed. This study utilized data collected between January 2007 and June 2008 from 32 hospitals representing a large, national private not-for-profit hospital system. The patient satisfaction survey included the Consumer Assessment of Healthcare Providers and Systems, Hospital version questionnaire items, and there are 31,471 cases. Two-stage multiple linear regression analyses were conducted with control variables (age, gender, perceived hea...
Uploads
Papers by Richard Kurz