Browsing by Author "Calumpang, Neon"

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    Regional Disparities in the Social Determinants of Stroke Severity
    (2025-04-25) Barnard, Jacobus; Lin, David; Armstrong, Grace; Calumpang, Neon; Cash, Miranda; Han, Amy
    Social determinants of health (SDOH) are known factors of stroke risk and outcomes. We aim to gain a comprehensive understanding of the impact of stroke risk-specific SDOH on stroke severity by investigating the patient population served by a regional healthcare system. We conducted a retrospective bivariate analysis of data from patients’ American Heart Association Get With The Guidelines–Stroke (AHA GWTG-S) Case Record Forms collected at three stroke centers between January 2022 and May 2024. We compared the patient ordinal modified Rankin Scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS) scores to the predictor variables of age, sex, race, Hispanic ethnicity, ZIP code, payment sources, and mode of arrival. When age-adjusted, Black or African American patients had higher mean NIHSS scores and higher rates of Minor Stroke Symptoms than White patients (p<0.01, p<0.01). ZIP Codes with higher mean NIHSS stroke scale scores correlated significantly with ZIP Codes defined by lower median household income (r=-0.61, p<0.01), lower education attainment (r=-0.71, p<0.001), and higher percentages of minority group populations (r=0.50, p<0.02). Patients with higher mean scores across all measures were those associated with using Medicare versus private insurance (p<0.0001) and those arriving at the hospital via EMS versus private transport (p<0.01). This research addresses the significance of surveying region-specific social determinants of health for insight into targeted interventions. Initiatives such as expanding stroke awareness education and increasing preventative screenings in the community may reduce disparities in stroke severity and improve outcomes in underserved areas.
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    Social Determinants of Inequities in Neurodegenerative Disease Readmissions in Northwest Indiana: An Advocacy Opportunity
    (2025-04-25) Calumpang, Neon; Armstrong, Grace; Guerrero, Jonathan; Muvuka, Baraka; Gospodarek, Kyle
    Background: Neurodegenerative diseases, such as Alzheimer's and Parkinson's disease, pose significant challenges given their progressive nature and multifaceted care needs. This research examined the intricate interplay between social determinants of health (SDOH) and hospital readmissions among individuals with neurodegenerative diseases. It is part of a Participatory Research partnership between Indiana University School of Medicine-Northwest and an urban health system in Northwest Indiana (NWI). Methods: This retrospective study analyzed a dataset generated from routine SDOH screenings and referrals in Epic using the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) for inpatient admissions from 3 NWI urban hospitals between January 2021 to April 2024. Data analysis was conducted in SPSS 29.0 with descriptive statistics, bivariate analysis (Chi-square), and multivariate analysis (binary logistic regression). This study received exemption from Indiana University Human Research Protection Program (IRB #14040). Results: The sample consisted of 1,338 patients admitted for neurodegenerative diseases. Patients were predominantly older adults (73 ± 14), publicly insured (91.5%), and 31% racial/ethnic minorities. The bivariate analysis found that readmission was significantly associated with age (p<0.001), insurance type (p=0.003), hospital (p<0.001), physical activity level (0.034), and length of stay (p<0.001). After adjusting for these factors, the multivariate analysis found higher odds of hospital readmission among patients with public insurance (OR=76.1%; p=0.028), prolonged hospital stay (OR=8.5%; p<0.001), and within a small hospital in a medically underserved area (MUA) (OR=69.6%; p<0.001). Conclusion: Understanding the impact of SDOH on hospital readmissions is crucial for developing multi-level interventions to reduce readmissions, inequities, and healthcare costs. Findings from this research underscore the critical need for policy advocacy and integrated approaches addressing SDOH as part of comprehensive readmission reduction programs. Examples of evidence-based approaches include improving access to quality neurodegenerative care in MUAs, increasing education on at-home neurodegenerative care, and comprehensive SDOH screenings and referrals.
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    Socio-Demographic and Behavioral Predictors of Ophthalmic Readmissions in Northwest Indiana
    (2025-04-25) Armstrong, Grace; Calumpang, Neon; Guerrero, Jonathan; Muvuka, Baraka
    Background: With aging populations and increasing life expectancy, the global disease burden of visual impairment is expected to rise. Timely care is essential for the prevention and treatment of vision loss, yet disparities in eye care access persist. This study investigates the social, demographic, and behavioral characteristics associated with ophthalmic readmissions as part of a participatory research partnership between Indiana University School of Medicine–Northwest and an urban health system in Northwest Indiana (NWI). Methods: This retrospective study analyzed data collected from social determinants of health (SDOH) screenings in Epic using the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) for all inpatient admissions across 3 NWI urban hospitals from January 2021 to April 2024. Data analysis included descriptive, bivariate (Chi-Square; p<0.05), and multivariate (binary logistic regression; p<0.05) analyses using SPSS 29.0. The study was exempted by the Indiana University Human Research Protection Program (IRB #14040). Results: The study sample consisted of 338 ophthalmic patients who were predominantly White (59.5%) and older adults (79 ± 18). The bivariate analysis found a statistically significant association between ophthalmic readmissions with age (p=0.026), sex (p=0.031), hospital (p=0.014), and length of stay (p<0.001). After controlling for all covariates in the multivariate analysis, increased age (OR=1.016; p=0.033), Hospital C (small hospital in a medically underserved area) (OR=2.396; p=0.006), and prolonged hospital stay (OR=1.091; p=0.002) remained significantly associated with higher odds of ophthalmic readmissions. Conclusion: These findings indicate a significant association between ophthalmic readmissions and several social determinants of health. Understanding predictors of ophthalmic readmissions is a key step towards developing more effective eye care delivery interventions.