Dissertations / Theses: 'ACT Health'

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Ross, Kate. "Sectioned under the Mental Health Act." Thesis, University of Plymouth, 1995. http://hdl.handle.net/10026.1/2498.

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This project looks at the experience of being sectioned under the 1983 Mental Health Act for acute psychiatric patients. The view is taken that sectioning in itself is a major intervention and hence should be the subject of research scrutiny. The views of two groups of participants, sectioned and informal inpatients, are compared using a variety of survey techniques including standardised questionnaires, structured interviews and open ended questions. It was found that being sectioned did not have a major impact on patients' experience of hospital treatment or their understandings of mental health issues although the sectioned patients did place less value on the medical aspects of their care and some sectioned patients showed a degree of internality for their health care that was not present in the informal group. Locus of control and transactional analysis were both found to be useful theoretical perspectives from which to examine patients' experiences. In general, the psychiatric patients who participated in the project valued the human contacts they made in hospital far more than their medical treatment. They also tended to attribute the cause of their psychiatric difficulties to non-medically based models of mental health based on childhood experiences, life events, human relationships and stress.

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Holdorf, Sandra. "Affordable Care Act Impacts." Thesis, Baker College (Michigan), 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=3742238.

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The 2010 Affordable Care Act has affected access and availability to medical services because states have increased the number of individuals on Medicaid and health exchanges have offered coverage to those who previously lacked it. The purpose of this qualitative exploratory case study was to identify whether the Affordable Care Act affects access to and availability of medical services, and to identify alternatives to how medical practices are formed and operated to accommodate an increase in patients. The study was based on Geyman’s theory of economics and Glasser’s consumer choice theory. Research questions addressed the effects the Affordable Care Act has had on providers’ schedules and patients’ appointments. Data collection involved interviews with six health care providers (four from Michigan and two from Maryland), three administrators (one each from Michigan, Maryland, and Kentucky), and six patients (three from Michigan, two from Maryland, and one from Kentucky). Results showed that under the Affordable Care Act newly insured Medicaid individuals are seeking care more often, whereas those with private insurance are seeking medical treatment less often. Increased out-of-pocket costs were the reason given by privately insured individuals for the decrease in obtaining medical care. The study did not find evidence of patients waiting longer to book an appointment with a medical practice or shortened visits. The study will inform the efforts of providers to address changes in access and availability of medical care due to implementation of the Affordable Care Act.

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Melkumyan, Vladimir. "The effects of the Americans with Disabilities Act Amendments Act of 2008 on people with mental illness." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1523167.

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The purpose of this thesis was to present a policy analysis of the Americans with Disabilities Act Amendments Act (ADAAA) of2008. Particular emphasis was placed on the legislation's protections for people with mental illness. Specifically, this project used David Gil's analytic framework to assess the strengths and limitations of the policy and its impact on social work clients and society as a whole The analysis demonstrates that there have been many positive changes since the passage of the Americans with Disabilities Act (ADA), and more are expected under the ADAAA. However, the analysis also suggests that there remain many issues and unintended consequences concerning people with mental disability, including access problems for minorities. By revealing these issues that must be dealt with, this analysis clearly indicates the importance of commitment to social justice and cultural competence in social work practice. The recommendations for future research are discussed.

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Skinner, Laura. "Negotiating uncertainty : mental health professionals’ experiences of the Mental Health Act assessment process." Thesis, University of Leicester, 2006. http://hdl.handle.net/2381/8972.

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Tanenbaum, Joseph Elias. "The Association of Health Care Delivery and Payment Innovations with Avoidable Hospitalizations." Case Western Reserve University School of Graduate Studies / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case1530814492308274.

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Quast, Troy Clarence. "The Telecommunications Act of 1996 and Medicaid health maintenance organizations." [Gainesville, Fla.] : University of Florida, 2006. http://purl.fcla.edu/fcla/etd/UFE0014440.

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Larkin, Christine M. A., and N/A. "Social work and racism : a case study in ACT Health." University of Canberra. Education, 1994. http://erl.canberra.edu.au./public/adt-AUC20060815.160708.

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A Feminist Action Research methodology was used as a collaborative process with five ACT Health social workers based at the Community Health Centres and four at the Woden Valley Hospital. The primary purpose of the study was to investigate, both through critical reflection and action in their work setting, the participants' relevance or otherwise to Aboriginal people in the ACT and region. Behind this is the question of how encapsulated social work is by racism. The impetus for the study arose from my unresolved concerns regarding these issues, having been a social worker in ACT Health for 6 years, to 1990. Decisions on how to proceed involved a process of ongoing consultation between the participant social workers and myself. Exploratory meetings were held in March and April, with an ongoing program being held 2-3 weekly from June to September, followed by a review in December. Most gatherings were specific to the Woden Valley Hospital or Community Health settings. However two half-day workshops were held for all the participants. All the sessions from June were taped. Aboriginal leaders were consulted, as were several managers in ACT Health. The phenomena of institutional, cultural and personal racism were addressed by the social workers through discussion, exercises, and anti-racist initiatives in their work setting. They found that significant time restraints presented an example of institutional racism working against their good intentions. Another dimension arose from implicitly racist education in social work courses when most of the participants undertook their undergraduate courses in the 1960s and 1970s. Aspects related to professionalism such as its language and separation of a personal and professional self were indicative of cultural racism. Stories of personal racism were shared, in the context of raised awareness leading to changing those attitudes and behaviours. The fact that the study took place in 1993 - a watershed year for Aboriginal/white relations in Australia - seemed to lead to greater momentum for the project. The social workers found that participation in this study increased their knowledge of, and their confidence - both actual and potential - in interaction with Aboriginal people. However, they also understood these to be just small steps towards greater justice for the indigenous people. An outcome of the project has been involving some colleagues in similar anti-racist actions to those the social workers participated in during the time of the study. The action research project has continued on in different ways, beyond 1993, despite my withdrawal as 'the researcher' who took the initiative.

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Stricker, Anna M. "The Affordable Care Act: Year One." Scholarship @ Claremont, 2015. http://scholarship.claremont.edu/scripps_theses/677.

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The Affordable Care Act (ACA) was designed to reduce the number of citizens who do not have health insurance, and reduce the prices of health insurance premiums. Using multiple regression analysis, the effects of the components of the ACA, along with baseline characteristics of the states, are examined in relation to ACA premium prices and the rate of uninsured. We find that premium prices are higher in states with more uninsured, and states with more obesity have more uninsured. This is most likely related to pre-ACA practice of excluding people with pre-existing conditions from health insurance coverage, yet still caring for those uninsured individuals in emergency departments and hospitals, while passing on the costs of their care to those with insurance. When examining the specific components of the ACA, we find that premium prices are lower in states that implemented state run Internet exchanges, and that less people are uninsured in states that implemented state sponsored Internet exchanges. The other elements of the ACA, namely the number of available insurance plans, and the number of ACO’s, had no effect on either the premium prices or the number of uninsured. Given the possible influence of the political opposition to the ACA on the general population’s cooperation with the ACA, the political dominance of the states was also examined, but found to have no effect on either premium price or the number of uninsured. In conclusion, we find that states with higher rates of uninsured have higher premium rates, and states with higher rates of obesity have more uninsured. After one year of the ACA, we can measure the effect of Internet exchanges on reducing premium prices and the expansion of Medicaid on reducing the uninsured.

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Ayo, Carmen I. "Florida security of communications act: friend or foe?" Honors in the Major Thesis, University of Central Florida, 1997. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/165.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.
Bachelors
Health and Public Affairs
Criminal Justice and Legal Studies

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Seebold, Marianne. "Service users' experiences of being sectioned under the Mental Health Act." Thesis, University of Southampton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442868.

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Ball, Laurence Francis Joseph. "Older people and the use of the Mental Health Act (1983)." Thesis, University of Birmingham, 2013. http://etheses.bham.ac.uk//id/eprint/3851/.

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This thesis explores the use of the Mental Health Act (MHA)(1983) with older people(65+) by providing a multi-perspective insight as expressed by those involved in the process. In particular, it focuses on the personal and social circumstances in which decisions to compulsorily detain older people are made. The thesis comprises two elements; one documentary, one qualitative. The documentary study was over a four year period (2000-2003) gathering demographic data around various themes including numbers of older people detained, gender, age, diagnosis and the relevant section used to detain the older person under the MHA(1983) This provided an insight into the scale of the phenomenon. Within the qualitative study, 58 semi-structured interviews were conducted providing fifteen case studies which were then thematically described and interpreted using Interpretative Phenomenological Analysis. Semi-structured 1:1 interviews were adopted to allow participants the opportunity to express their personal experience. The thesis concluded that at times, some older people and their caregivers became passive recipients of mental health services, mainly through power inequalities, particularly at the time of assessment and discharge.

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Fanning, John. "Risk and the Mental Health Act 2007 : jeopardising liberty, facilitating control?" Thesis, University of Liverpool, 2013. http://livrepository.liverpool.ac.uk/14013/.

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This Ph.D thesis evaluates the impact of the concept of risk on mental health law and policy in England following the introduction of the Mental Health Act 2007, which amended the Mental Health Act 1983. First, the thesis investigates the role played by risk as the principal policy driver of the 2007 Act, arguing that the concept’s renewed significance heralds an era of ‘New Medicalism’ in which the law’s determinative power is reduced in order to foster a greater responsiveness to patients’ risks. Secondly, it argues that the works of Ulrich Beck and Anthony Giddens, which popularised the ‘Risk Society’ perspective, and Michel Foucault, who developed the ‘Governmentality’ thesis, help to illuminate the prevailing trends in mental health policy in the 21st Century. The author contends that Foucault’s Governmentality thesis may provide the theoretical foundation on which the concept of risk was deployed by the policy-makers who shaped the 2007 Act. Thirdly, the thesis discusses the reason why risk is such a difficult concept to understand from a legal point of view. It shows that risk-based statutory provisions have the potential to undermine certainty in decision-making processes and notionally make it difficult for patients to predict the nature and extent of their engagement with mental health services. It also demonstrates that risk is a problematic concept for the courts, which have preferred to leave it as a matter of fact. Fourthly, and as a corollary, the thesis hypothesises that because of the greater prominence given to risk there is now more control of, and less liberty for, patients with mental disorder following the introduction of the 2007 Act. To test this, the author draws upon literature examining the current state of play in mental health practice, the legal oversight of psychiatric decision-making, and the significance of law reform on mental health practice. He finds that in fact the law is rarely determinative of mental health decision-making and that legislative changes do not fundamentally alter the functioning of the compulsory powers. As a result, there is no evidence to suggest that the 2007 Act has jeopardised patients’ liberty whilst facilitating greater control over them. For that reason, the final chapter offers a defence of the concept of risk in mental health law. It argues that while the law can never achieve certainty, the concept’s inclusion reflects the realities of mental health practice and allows decision-makers to operate according to their training and expertise. This chapter argues that mental health practitioners possess a level of knowledge and understanding of risk which defies objective explication. While mental health policy may be shaped by the desire to control deviance and the law may be drafted to accomplish that end, the reality is that practitioners invariably achieve the ‘right’ outcome notwithstanding legal and policy uncertainties. The thesis concludes that the 2007 Act has aligned the law with the realities of mental health practice and, for that reason, has not directly jeopardised liberty.

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Vaghela, Pratiksha. "A Socio-Ecological Model of Affordable Care Act Acceptance." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5789.

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Background: Since 1965, there have not been any major revisions of the healthcare laws in the United States, until the recent implementation of the Affordable Care Act (ACA). However, ACA is not well understood and is often controversial. The purpose of this study is to: (1) evaluate the relationship between the employers’ and the employees’ perceptions regarding the ACA mandates for small businesses, (2) evaluate the relationship between the self-reported and the tested knowledge of individuals regarding the ACA mandates for small businesses, and (3) determine if socio-demographic factors influence individual’s perception of the law. Based on the gathered information, we aim to develop a socio-ecological model of ACA acceptance to address the barriers and facilitators to implementing the new law and recommend changes to address any deficits. Method: An online questionnaire was distributed anonymously to employees and employers of small businesses. The data gathered included information on the participants' knowledge and perceptions on the law and their socio-demographic information. Kendall correlation test, generalized linear regression models and bootstrapping resampling method were employed to detect differences in the perceptions & knowledge of employees and employers, to evaluate the association between self-reported and tested knowledge, and to generate a SEM model of ACA perception and acceptance. Results: Based on the analysis, we found that job status significantly affects the individual perception of the law (p = 0.004). The study showed a statistically significant negative association between the self-reported knowledge and the actual-tested knowledge of individuals (r= -0.4174, p-value of 0.01159). We found that interpersonal level had the highest impact on perception (coefficient of 5.67, p-value0.05). Conclusion: Individual perception is a key factor in adoption of new policies. A socio-ecological model of ACA acceptance can be a powerful tool in addressing the barriers and facilitators to the successful implementation of the new law and to modify the policies to address any deficits in the law.

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Cook, Emilee J. "Older Americans Act of 1965, Title III| A policy analysis." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1523330.

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The purpose of this thesis was to conduct a policy analysis of Title III of the Older Americans Act of 1965 (P.L. 106-501 ). The policy was enacted to assist older adults in combating food insecurity and malnutrition. The policy specifies that federal funding be allocated to states, in order for the states to provide both congregate meal programs and home-delivered meal services to older adults. For this reason, a more in-depth analysis of Title III of the Older Americans Act was conducted in this project, in order to better understand the nutritional needs of older adults, and the need for nutritional services for the older adult population. This study utilized David Gil's policy analysis framework to analyze Title III of the Older Americans Act of 1965 and the analysis indicated that its implementation has not produced the policy's intended outcomes and has not produced its intended goals of reducing food insecurity within the U.S. older adult population.

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Clinton, Chelsea, and Chelsea Clinton. "Choosing Health Insurance: Public, Private or None?" Thesis, University of Oregon, 2012. http://hdl.handle.net/1794/12390.

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I estimate two models of consumer health insurance choices where individual attributes and e.g., income, age, gender, cost, etc. affect qualification for specific programs e.g., Medicaid and Medicare, but also affect the choices individuals make. From these results, I assess how these attributes affect health insurance choices using the 2008 Medical Expenditure Panel Survey. I then use these results to predict how individual health insurance choices change with the implementation of the Patient Protection and Affordable Care Act (ACA) in 2014. My predictions estimate that more 50 percent of those who become eligible for Medicaid under ACA will switch to Medicaid or choose to have both Private and Medicaid insurance.

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Terner, Annika. "Predefined Headings in a Multi-professional Electronic Health Record : Professionals’ Application, Aspects of Health and Health Care and Correspondence to Legal Requirements." Licentiate thesis, Uppsala universitet, Forskning om funktionshinder och habilitering, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-246853.

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The overall aim of this thesis was to investigate predefined headings in a Swedish county council multi-professional EHR system in terms of their shared application, what aspects of health and health care they reflected, and their correspondence to legal requirements. An analysis of 3 596 predefined headings, applied to 20 398 104 occasions by eight professional groups, was conducted. Less than 2% of the predefined headings were applied by all eight professional groups, whereas 60% were not shared at all between the professional groups. A classification of the predefined headings revealed that 13% were “Specialist terms”, which were the least ambiguous predefined headings, 46% were “Terms for specific purposes”, which are less ambiguous than the “Common words” (28%), which were the most ambiguous predefined headings according to the sociolinguistic method employed. The remaining predefined headings (13%) were sorted into “Unclassified headings”. A qualitative content analysis of the predefined headings yielded 23 subcategories grouped into five categories: Description of the patient, Health care process, Resources employed, Administrative documentation, and Development and research. A comparison of the 23 subcategories to the Patient Data Act showed, first, that 15 of 23 subcategories corresponded to four legal requirements, second, that there were legal requirements with a focus on patient rights that were not being met, and third, that there were eight subcategories of predefined headings that could not be attributed to the legal provisions of the Patient Data Act. In conclusion, the proportion of shared predefined headings in the EHRs was limited. The predefined headings in the multi-professional EHRs did not constitute a joint language for specific purposes. A meaningful structure comprising categories and subcategories of different aspects of health and health care as reflected in the applied predefined headings was identified. The structure reflected a wide range of health and health care. No subcategory corresponded to the three legal requirements concerning patient rights. Future research should include professionals’ and patients’ understanding of predefined headings, the correspondence of documented notes to predefined headings and how the documentation in the EHR has had an impact on patient safety.

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Sillars, Dawn. "Balancing Act: Female Surgeons Adaptations to the Operating Environment." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1546611638366225.

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McKnight, Madalyn. "Utilization of Preventative Care Services by African Americans Post-Affordable Care Act." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7700.

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Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and health education. The health belief model was used to determine how belief and modifying factors influence health decisions. The quantitative study required use of a secondary dataset to determine utilization of preventative care services, insurance affordability, future access to care and understanding of the health care law. The study included testing the statistical significance of these factors among African Americans, White Americans, and Hispanic Americans who participated in the Healthy Americas Survey. Using the program SPSS to process data analyzation and organize output, results reveal that African American participants are concerned about the future ability to access and afford care. With a history of distrust amongst African Americans and the health industry, social implications are for administrators and providers to bridge the gap by offering health education to those in their immediate communities and requesting and implementing feedback from those same individuals.

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Rapaport, Joan. "A relative affair : the Nearest Relative under the Mental Health Act 1983." Thesis, Anglia Ruskin University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249787.

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Ashmore, Russell John. "The implementation of Section 5(4) of the Mental Health Act 1983." Thesis, Sheffield Hallam University, 2012. http://shura.shu.ac.uk/20619/.

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Section 5(4) (nurse's holding power) of the Mental Health Act 1983 empowers mental health nurses to legally prevent an informal in-patient from leaving hospital for up to six hours. The section may be applied for the patient's health or safety or the protection of others. Since its introduction in September 1983 there have been 34,000 applications of the section, an average of 1460 per annum. The application of Section 5(4) is likely to: lead to further detention under the Act; have implications for the practice of nurses; and affect the care received by patients in the aftermath of its use. However, the literature review revealed a paucity of research on the subject. The existing research has focused on three main areas: nurses' opinions of their holding power; their knowledge of Section 5(4); and trends associated with the implementation of the section. However, no attempts have been made to examine the events before, during and after the implementation of Section 5(4). This qualitative study sought to address this deficit by examining why and how Section 5(4) was implemented from the perspective of the nurses and patients involved in the process. A collective case study approach was utilised to generate data from one mental health NHS Trust over a period of one year. Data were generated from three sources: archival (statistical) records on 803 applications of the section; documentary accounts of the detention process, for example nursing notes; and interviews with 30 nurses and four patients. Within- and cross-case narrative analysis was undertaken on the data set. The method of narrative analysis employed was developed specifically for this study. The analysis produced a six-part typology of nurses' stories that explained why Section 5(4) was implemented. The six types were: 'health, safety or protection'; Tack of knowledge'; 'catalyst'; 'medical inaction'; 'self-protection'; and 'last resort'. The analysis also constructed a collective story of nurses' experiences that identified the key stages in the detention process. Stories were also constructed from patients' experiences of being detained. These stories generated in-depth accounts of patients' admission to hospital, the events leading up to their detention, the implementation of Section 5(4), and the aftermath of their experiences. The implications of the study's findings are considered for education, policy, practice and research and focus on four main areas: informal admission to hospital; information giving; reasons for implementing Section 5(4); and the consequences of the detention for both nurses and patients.

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Oshegbo, Godwin. "Effects of Patient Protection and Affordable Care Act on Behavioral Health Access." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4978.

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About 50% of adults in the United States suffer from at least 1 mental health challenge in their lifetime. Annually, mental health and substance use disorders cost the United States about $800 billion, leaving individuals with unaffordable cost of care and the nation with diminished productivity and revenue. With the Essential Health Benefits and Medicaid expansion under the Patient Protection and Affordable Care Act (PPACA), healthcare resources were created to address gaps in behavioral healthcare. There is a need to understand how the healthcare law has influenced the availability of behavioral health services and access to needed care. This study explored the lived experiences of 10 behavioral health service recipients to identify the benefits and challenges of the PPACA on behavioral health services. Participants from Anne Arundel County, Maryland, were purposefully selected and interviewed face-to-face. Relative advantage, compatibility, and complexity were characteristics of the diffusion of innovation theory used for the exploration of this research. Based on the interpretive phenomenological approach, Nvivo 11 Pro was used for data coding, management, organization, and analysis. There was the shared belief among participants that the PPACA improved their access to adequate and affordable behavioral healthcare. Effective network of care and having health insurance seemed to have improved health outcomes. Findings from this study highlight issues of common interest to healthcare stakeholders while providing reasonable platforms for objectively addressing complex challenges, which tend to undermine the possibility of adopting policies that could yield positive dividends for all parties involved.

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Allan, Stuart. "The Corporate Manslaughter and Corporate Homicide Act 2007 or the Health and Safety (Offences) Act 2008 : corporate killing and the law." Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7376/.

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This thesis examines the regulatory and legislative approach taken in the United Kingdom to deal with deaths arising from work related activities and, in particular, deaths that can be directly attributed to the behaviour of corporations and other organisations. Workplace health and safety has traditionally been seen in the United Kingdom as a regulatory function which can be traced to the very earliest days of the Industrial Revolution. With an emphasis on preventing workplace accidents and ill-health through guidance, advice and support, the health and safety legislation and enforcement regime which had evolved over the best part of two centuries was considered inadequate to effectively punish corporations considered responsible for deaths caused by their activities following a series of disasters in the late twentieth and early twenty-first centuries. To address this apparent inadequacy, the Corporate Manslaughter and Corporate Homicide Act 2007 was introduced creating the offence of corporate manslaughter and corporate homicide. Based on a gross breach of a relevant duty of care resulting in the death of a person, the Act effectively changed what had previously considered a matter of regulation, an approach that had obvious weaknesses and shortcomings, to one of crime and criminal law. Whether this is the best approach to dealing with deaths caused by an organisation is challenged in this thesis and the apparent distinction between ‘criminal’ and ‘regulatory’ offences is also examined. It was found that an amended Health and Safety at Work etc. Act 1974 to include a specific offence of corporate killing, in conjunction with the Health and Safety (Offences) Act 2008 would almost certainly have resulted in a more effective approach to dealing with organisations responsible for causing deaths as consequence of their activities. It was also found that there was no substantive difference between ‘regulatory’ and ‘criminal’ law other than the stigma associated with the latter, and that distinction would almost certainly disappear, at least in the context of worker safety, as a consequence of the penalties available following the introduction of the Health and Safety (Offences) Act 2008.

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Crow, Maartje Gezina Seinen. "Police intervention under the Mental Health Act: A comparison of rural and urban approaches." Thesis, University of Ottawa (Canada), 1997. http://hdl.handle.net/10393/10106.

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Description of research. This thesis explores how police intervene with clientele signalled as mentally ill, or acting in such a way that the presence of a mental health problem is perceived. Officers were interviewed in rural and urban detachments and forces in neighbouring jurisdictions in Eastern Ontario. All of the officers interviewed were bound by the same legislation and guidelines with respect to mental health and to policing, described in the theoretical framework of this thesis. Rural and urban perceptions are compared to determine differences in the areas explored: available information, general knowledge, descriptions of incidents, causes of disturbed behaviour, police actions, and interactions with community or health authorities to whom clients may be referred for further mental health interventions. Research method. The thesis compares non-directive interview material for differences in and within themes addressed. Seven interviews, all with male officers, are analyzed. Three interviews were conducted in urban stations; four in rural detachments. In both of the compared groups, one officer is a senior officer and all others are constables. The choices of topic, research subject, and other features of the methodology are defended based on feminist and other critical analyses of traditional sociological research. (Abstract shortened by UMI.)

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Morriss, L. "Accomplishing social work identity in interprofessional mental health teams following the implementation of the Mental Health Act 2007." Thesis, University of Salford, 2014. http://usir.salford.ac.uk/30876/.

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The main objective of the thesis was to explore how social work Approved Mental Health Professionals accomplished social work identity when seconded to Mental Health Trusts. The project has examined the identity work that the social workers engaged in as they located themselves within interprofessional interagency community mental health teams. Insights from ethnomethodology and conversation analysis have been used to examine the interview data. Following Wieder (1974), the findings chapters are presented in two parts. In the first part, the focus is on the interviews as a resource and thus there is a more traditional reporting of what the social workers talked about in the interviews. Throughout the interviews, the social workers were concerned to delineate what was ‘real’ social work. Real social work was depicted as involving autonomous work in the community with mental health service users; this is the ‘authentic realm of social work’ (Pithouse 1998 p.21). Social work identity was portrayed as intrinsic to the self with congruence between personal and professional identity and values. However, the social workers struggled to define social work. Instead of having a clearly defined role, social work was depicted as intangible; as being without clear margins and boundaries, filling in the gaps left by other professions. Notions of ‘dirty work’ (Hughes 1948) and the implications of being seconded to a Health Trust are also discussed. The analytic focus shifts in the second part to the interview as a topic, specifically to how social work identity was accomplished within the interview as interaction. Matters such as being a member, the part played by the use of humour in the interviews, and the interaction as a research interview are explored. Finally, there is an examination of how social work identity was accomplished through the telling of atrocity stories.

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Kereri, Dovison. "Relationship between Affordable Care Act and Emergency Department Visits." Diss., NSUWorks, 2018. https://nsuworks.nova.edu/hpd_hs_stuetd/11.

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Affordable Care Act (ACA) was passed and implemented to expand insurance coverage, reduce health care cost, and improve the quality of care. The purpose of this dissertation study was to investigate whether the ACA insurance expansion correlates with the number of visits made to emergency departments (EDs). The quasi-experimental design interrupted time series was utilized in the analysis. The ED visits were compared using MANOVA to determine the relationship between ED visits and ACA and canonical correlation analysis to assess the strength of the relationship and the extent to which independent variables could predict the dependent variable. The hypothesis was that the ACA will reduce the uninsured, increase the insured, and reduce the ED visits. The relationship between number of ED visits and the ACA will present whether the uninsured patients contributed significantly to the ED overcrowding. Analysis of secondary data from four EDs (H1, H2, H3, and H4) in the Chicago area showed that 484,742 visits were made, and 2,801 were excluded due to unknown payer type. Medicaid patients recorded the largest number of visits (181,226) while the uninsured patients recorded the least number of visits (56,572). The ED visits decreased by 6% from 2012 to 2013 (pre-ACA) and increased by 4% from 2013 to 2105 (post-ACA). The ACA implementation increased the people with insurance who visited the EDs by 11%. The results demonstrated a strong relationship between ACA and ED visits. The correlation of the variables (hospital and year) and ED visits demonstrated that the hospital could explain 97% of the Medicaid visits and 87% of uninsured while the year could predict 82.6% of the uninsured visits and 52.5% of Medicaid visits.

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Fletcher, Rebecca Adkins. "The Social Life of Health Behaviors: The Political Economy and Cultural Context of Health Practices." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/506.

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Relocating health behaviors within a political-economic framework, this article utilizes health behavior and health insurance governance perspectives to showcase the complexities of cultural and economic factors (e.g., job lock, wage differentials, social location, and health insurance status) that influence choices in efforts to mitigate the financial burden of health risk. By exploring the financial links to health behaviors that emerged through ethnographic participant observation and semistructured interviews with community and union members of the United Steelworkers and Retail, Wholesale, and Department Store Union in a metropolitan Central Appalachian community in 2007–8, this article argues for expanding the health behaviors concept to include a broader array of actions individuals and families take to better their health and well-being in the context of neoliberal shifting of risk management to individuals through increased consumer market-based cost-sharing health insurance disincentives. In so doing, this article argues for the importance of social and political-economic context in health behaviors and in evaluating health policy, including the Affordable Care Act.

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Berry, Wendy. "Lived Experiences of the Individual Mandate of the Affordable Care Act." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5827.

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In 2014, the individual mandate of the Affordable Care Act (ACA) came into effect. More than 7 million Americans paid a tax penalty for not carrying insurance during the previous tax year. Millions of others were forced to purchase a health insurance plan to avoid that penalty. This study filled a gap in public health policy research by incorporating qualitative data to offer narratives along with statistical data that could help explain health outcomes to make successful policy changes in 2019. The purpose of this study was to research the use of market competitive theory by learning people's lived experiences and how they made the decision to participate in the ACA. The theoretical foundation was based on the social justice theory when mandating that citizen's purchase or pay. The method for this research was a qualitative interpretive phenomenological thematic approach with triangulation using the snowball effect and the hermeneutic circle method of analysis. The sample size included 6 volunteers who identified as either purchasing health insurance or paying the individual mandate penalty during a recorded interview. The findings answered the first research question by showing that the 6 participants found reason to carry health insurance based on their lived experiences and desire to maintain wellness overall. Findings for the second research question indicated that the individual mandate penalty did not increase the likelihood that the 6 participants would purchase healthcare insurance based on their lived experiences. This study supports the need for continued ACA qualitative research to identify more themes on how people make decisions regarding their health care that could provide positive social health policy change for the future.

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Terry-Lawrence, Nadine. "Affordable Care Act and Racial Inequity in Breast Cancer Survival Rates." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7762.

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African American women are more likely than White women to be diagnosed with breast cancer after the disease has progressed to advanced stages. Further, African American women experience higher breast cancer mortality rates than White women at all stages of cancer diagnosis. The purpose of this quantitative comparative study was to examine differences between implementation of the Affordable Care Act (ACA) and 5-year breast cancer survival rates among African American and White women. The independent variable was African American women and White women who were survivors of breast cancer after the ACA implementation; the dependent variables were breast cancer survival rates after ACA implementation. Data were gathered from the Surveillance, Epidemiology, and End Results (SEER) program for the time period between 2010 and 2015. The theoretical foundation for this study was Penchansky and Thomas’s concept of healthcare access. This quantitative study followed a retrospective design using cohort data from the SEER program. Data were analyzed via independent samples t-test and chi-square test of association. Results indicated that White women had a higher 5-year survival rate than African American women; the association between race and survival was significant. White women survived also survived breast cancer for more months, on average, than African American women. Findings indicate that racial disparities in breast cancer survival have endured, post ACA. The primary social change implication is that more research is needed to improve the breast cancer survival rates of African American women. The ACA may be working to help reduce the racial disparities in breast cancer survival, but providing access to healthcare is not necessarily enough.

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Nix, Tanya. "Evolution of Physician-Centric Business Models Under Patient Protection and Affordable Care Act." Thesis, Walden University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3641824.

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For several decades, the cost of medical care in the United States has increased exponentially. Congress enacted the Patient Protection and Affordable Care Act (PPACA) of 2010 to ensure affordable healthcare to the citizens of the United States. The purpose of this case study was to explore physicians' perspectives regarding physician-centric business models evolving under the requirements of PPACA legislation. Complex adaptive systems formed the conceptual framework for this study. Data were gathered through face-to-face, semistructured interviews and e-mail questionnaires with a purposeful sample of 20 participants across 14 medical specialties within Northeast Texas. Participant perceptions were elicited regarding opinions of PPACA legislation and the viability of business models under the PPACA. In addition, a word cloud was used to identify 3 prevalent or universal themes that emerged from participant interviews and questionnaires, including (a) use of mid-level practitioners, (b) changes to provider practices, and (c) lack of business education. The implications for positive social change include the potential to develop innovative models for the delivery of medical care that will improve the health of the aggregate population. Healthcare leaders may use the findings to advance the evolution of physician business models that meet the needs of healthcare stakeholders. These findings may also inform healthcare leaders of the need to develop cost-effective and innovative organizational models that are distinct to individual patient populations.

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Imam, Nimrah H. "The Limits of Accessibility Under the Affordable Care Act." Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/scripps_theses/916.

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The Patient Protection and Affordable Care Act (ACA) aimed to increase accessibility to medical resources for those previously uninsured. Certainly, the ACA has expanded insurance to millions of Americans, however, the evidence and discourse surrounding health accessibility calls into question why, despite the growth of insured Americans, the increase in health insurance coverage under the ACA has not lead to greater accessibility for low income minorities. I propose that disparities in preventive care, the emergency room, and primary care provider services stand as barriers for low income minorities. Insurance coverage does not necessarily equate to greater accessibility if individuals do not have the means to utilize those resources.

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Greenberg, Garred Samuel. "Impact of Massachusetts Health Care Reform on Asthma Mortality." Thesis, Boston College, 2013. http://hdl.handle.net/2345/3138.

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Thesis advisor: Marvin Kraus
Thesis advisor: Matt Rutledge
The state of Massachusetts implemented a health care reform in 2006 that induced a number of changes to its health care system. Studies regarding this reform bear a certain degree of predictive power on the national scale because the reform was used as a model for the Affordable Care Act, the highly controversial national health care reform law passed in 2010. Most of the research on health care reform focuses on the costs, not the quality, of health care. I utilized a difference-in-differences statistical design to isolate the impact of the Massachusetts reform on the state's asthma mortality rate, a health care quality indicator. Given certain assumptions, my empirical results indicate that the reform led to a 45.38% reduction in asthma mortality in Massachusetts. Due to the similarity between the Massachusetts and the national health care reform laws, I drew the conclusion that national asthma mortality rates will decrease after 2014 when certain key provisions of the national reform come into play
Thesis (BA) — Boston College, 2013
Submitted to: Boston College. College of Arts and Sciences
Discipline: Economics Honors Program
Discipline: Economics

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Taylor, Alexis Anne. "Secret practices : an evaluation of the discourse and decision making practices of a child mental health agency." Thesis, University of Exeter, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294479.

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Nieves, Rafael. "Perceptions of Senior Citizens in Central Florida Regarding Quality of Care Under the Patient Protection and Affordable Care Act (ACA)." Honors in the Major Thesis, University of Central Florida, 2013. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/958.

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On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their perceived effects on the healthcare quality provided to them under this law. Four sections of PPACA bill, thought to specifically pertain to the elderly, were selected for this study; respondents were asked their opinions regarding PPACA's aspects of: (1) the reform on preventive healthcare services; (2) Medicare Part D (prescription drugs); (3) Medicare; and (4) Medicaid. This thesis employed both qualitative and quantitative methodologies; data were collected and analyzed with findings presented and discussed.
B.S.
Bachelors
Health and Public Affairs
Health Management and Informatics

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Smith, Anna Jo Bodurtha. "Adult-Oriented Health Insurance Reform and Children's Health Insurance: the Massachusetts Experience and Implications for the Affordable Care Act." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:27007737.

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BACKGROUND: The Massachusetts health reform and the Affordable Care Act (ACA) were focused on adults, but have the potential to reduce uninsurance and increase access to affordable health care for children. Little is known about the impact of Massachusetts health reform on children, including the vulnerable sub-population of children with special health care needs (CSHCN). OBJECTIVES: The first two aim of this thesis were to examine whether Massachusetts health reform was associated with lower levels of child uninsurance, increased access to care, and improved financial protection for: (1) children generally and (2) CSHCN specifically. The third aim of this thesis is to explore ESI eligibility among uninsured children and uninsured CSHCN prior to the implementation of ACA’s individual and employer mandates in 2015. METHODS: For aims 1 and 2, we used a difference-in-differences approach to compare changes in uninsurance, access to care, and financial protection (CSHCN only) in the intervention group, Massachusetts, and the comparison group, other states, before and after Massachusetts health reform. For children overall, we used parent-reported data from the 2003, 2007, and 2011-2012 National Survey of Children’s Health. For CSHCN, we used parent-reported data from the 2005-2006 and 2009-2010 National Survey of Children with Special Health Care Needs. For aim 3, we conducted a cross-sectional analysis using the 2011-2012 National Survey of Children’s Health to estimate the proportions of uninsured children and uninsured CHSCN, who were eligible for ESI, but not enrolled, and to assess the barriers that parents reported to obtaining ESI for their uninsured, ESI-eligible children. RESULTS: Massachusetts health reform was not associated with significant changes in uninsurance for children overall or CSHCN. Access to a personal doctor increased for children previously-eligible for public insurance and did not change for children overall or CSHCN. Access to specialty care increased for children newly-eligible for public insurance under Massachusetts health reform and for privately-insured CSHCN. For CSHCN, there were no significant changes in financial protection under Massachusetts health reform. Nationwide, one-fifth of uninsured children—around 1.2 million children, including 174,000 uninsured CSHCN—were eligible for ESI, but not enrolled prior to ACA implementation. Cost and application difficulties were the main barriers to ESI enrollment. CONCLUSION: Massachusetts health reform had some positive impact on children’s access to care, but did not decrease uninsurance or improve financial protection. Comparable provisions within the ACA may produce similarly modest outcomes for children and CSHCN. Child-oriented reforms, including making ESI more affordable and enrollment easier, may be necessary to reduce uninsurance and significantly increase access to affordable health care for children.

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Orabueze, Ngozi Nkechi. "Challenges for Providers Working in Assertive Community Treatment." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6363.

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This project explored the challenges confronting clinicians who work with the Assertive Community Treatment Program (ACT), a government-sponsored clinic-based program providing services for individuals with persistent and recurrent mental health challenges in a large metropolitan city in the southern United States. The project involved semi-structured interviews with 15 health care clinicians to explore what they perceived as challenges and their recommendations for addressing them. Themes were organized around the 6 dimensions of the the relationship-based care model: leadership, teamwork, professional nursing, care delivery, resources, and outcomes. Identified patient challenges included transportation, lack of health insurance, housing, acceptance of certified peer specialists, the stigma of seeking help for mental health issues, problems with tracking patients, family interference, and fear of discharge from the program. Challenges related to the work environment were identified as poor pay for mental health staff, increasing paper work, professional boundaries, and balancing work demand and personal experiences. Recommendations to address challenges included open communication, interdisciplinary meetings to improve coordination of resources, increased support for family participation, and community support for mental health services. This project adds to the knowledge on ACT programs and will assist organizations planning or delivering ACT services in channeling resources to areas recommended by ACT clinicians. Recommended organizational changes will provide a positive social change to improve care of individuals with mental health challenges in the community.

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Grills, Derek. "The Healthy, Hunger-Free Kids Act and High School Obesity." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1381.

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United States high school student obesity rates have doubled in the past 30 years to 13%, threatening the health of millions of adolescents. To mitigate the epidemic, Congress passed the Healthy, Hunger-Free Kids Act (HHFKA) in 2010, which mandated significant changes to school nutrition and physical education. From a public policy perspective, the HHFKA changed school nutrition and exercise policy to affect obesity rates by changing intake and energy expenditure at school, though no study using national-level data examined this relationship. As such, the purpose of the study was to examine whether HHFKA policy compliance had a statistically significant effect on high school obesity rates. The theoretical framework for this study was the energy imbalance theory (EIT), as developed by James Hill, Holly Wyatt, and John Peters. The research questions focused on the relationship of HHFKA nutrition changes and childhood obesity rates. The study used Pearson's Product-moment correlation to test for a simple correlation between Compliance Scores and High School obesity rates. Findings revealed no statistically significant correlation between state high school student obesity rates and HHFKA compliance scores. Future research is needed to validate the findings after more time has passed with the HHFKA mandates in effect. The implications for social change include informing the debate over the efficacy of implementing the HHFKA as currently written to mitigate childhood obesity.

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Fletcher, Rebecca Adkins. "There and Back Again: Applying Regional Health Disparities to Contextualize the Affordable Care Act." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/515.

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Stewart, Ailsa E. "The implementation of Adult Support and Protection (Scotland) Act (2007)." Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7083/.

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The main areas considered within this qualitative study are the extent to which the Adult Support and Protection (Scotland) Act (2007) (ASPA) impacts upon the civil and human rights of adults’ by exploring the “problem” it was developed to resolve, the reality of implementation and the construction of thresholds for intervention in practice. Despite a level of clarity about the need for this legislation inconsistencies of understanding about where the ASPA should be targeted created challenges for implementation, particularly around the issue of capacity. The scope of the population for whom the ASPA was intended remains sizeable and broadly unformed. The vision of the framers that the ASPA would provide support and protection for a range of adults at risk of harm without being overly intrusive in their lives appears, at least partly, to have been realised. Challenges to implementation have largely focused on; the parameters of the ASPA and the population it aims to protect, the conceptualising of what an adult protection referral might consist of and the impact of this understanding on thresholds for intervention. Procedural challenges identified were specifically related to the involvement of health and the understanding of adult protection of other stakeholders, for example the police, inconsistent recording of data and information sharing. The interaction between formal and informal knowledge and consideration of a range of key concepts drawn upon by practitioners to determine thresholds for intervention creates a built in inconsistency of approach with a clear element of subjectivity. The rights based approach integral to all intervention under the ASPA, was well applied by the practitioners in the study and could be considered to have protected the citizenship of the adults to some extent. Perhaps more accurately it could be said that the already conditional citizenship experienced by many of the adults was not further eroded.

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Malik, Fauzia Aman. "Social life of health policy : an anthropological inquiry into the Affordable Care Act (ACA) and HIV/AIDS care in Atlanta, Georgia." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/33266.

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The purpose of this thesis is to ethnographically explore the social life of health reform policy. This thesis focuses on the Ponce Center, a safety net HIV clinic in Atlanta. The thesis engages with a fragmented healthcare world, and the inhabitants of these worlds who are charged with rectifying the fragmentation and make care possible. They are, in technical language, service providers, whether they are policy-makers, patients, or political activists. In order to make the healthcare and policy worlds functional, the AIDS community in Atlanta perceive their first task as attempting to connect aspects of the fragmented healthcare assemblage that are otherwise disparate. The core theme of this thesis is articulations, translations, and piecing together aspects of everyday life particularly with regard to various ways of contending with fragmentation. This thesis explores the relationship between the affective, ideological, physical and structural dynamics of inequality, poverty, vulnerability, identity, and a sense of community and belonging. This thesis is about the policy processes. It does not focus on policy-making, but policy interpretation, implementation, and enactment in Atlanta, Georgia. The thesis tracks the appropriation and contestation of the Affordable Care Act (ACA) as a site of interaction between the experience of HIV as a pre-existing condition, inequitable access to treatment through health insurance, and larger social policy and poverty discourses. Finally, it considers the processes by which major policy reforms draw in disparate actors, who are embedded in complex networks of power and resource relations - assemblages - and inevitably play a role in reshaping society.

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Naugle, Barbra Alyson. "Physical Therapy Students’ Knowledge of The Americans with Disabilities Act of 1990." The Ohio State University, 1997. http://rave.ohiolink.edu/etdc/view?acc_num=osu1389365280.

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Yunusa, Vakkai Roseline Jindori. "Health Status, Health Care Access, Literacy and Numeracy among Members of Immigrant Communities: The Relationship of Perceptions, Awareness and Concerns Regarding the Health Care Act." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1439308175.

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42

Palmer, Michelle Dawn. "Exploring Section 136 of the Mental Health Act (1983/2007) from a psychological perspective." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5345/.

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This thesis brings together a series of work undertaken in partial fulfilment of the Doctorate in Clinical Psychology. Volume I – Research: Literature review; empirical paper; and public dissemination document providing an accessible summary of this volume. The literature review draws together the extant literature on what is known about what happens when the police detain people experiencing mental health crises. It offers a systematic search of relevant bibliographic databases, and findings are discussed within the context of the limitations of the review and the implications for future practice and research. In building on the work of this review, the empirical paper goes on to explore how police officers understand and experience the use of Section 136 of the Mental Health Act (1983/2007). This study employed interpretative phenomenological analysis to explore ten officers’ (from the English Midlands) experiences of this aspect of their work. Volume II – Clinical practice reports: Outlining work undertaken on placements from adult, older adult, learning disability, and physical health specialties. The reports consist of: a case study illustrating a dual formulation approach; a service evaluation; a single case experimental design study; a case study; and the abstract for an oral presentation of a case study.

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McNally, Carolyn Anne. "People with intellectual disabilities (ID) : experience of detention under the Mental Health Act (1983)." Thesis, University of Sheffield, 2006. http://etheses.whiterose.ac.uk/14879/.

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BACKGROUND: Fundamental to the development of research knowledge are studies establishing user views and experiences of service delivery. However, currently there are no published studies providing insight into the experience of detention for people with intellectual disability. SPECIFIC AIMS: This study explores the experiences of people with intellectual disability of detention under the Mental Health Act (1983). The study seeks to provide insight into their perceptions of the act of detention and associated emotional responses. METHOD: Transcripts of semi-structured one to one interviews (N=7) were analysed using Interpretative Phenomenological Analysis. Participants had mild-moderate ID and been detained under the Mental Health Act. All participants had been detained in the 2-year period, prior to the study. FINDINGS: Four themes common across participants were identified: (a). 'perception of self in the world'; (b). 'a negative event', (c). emotional response to the act of detention; and finally Cd). family relationships. A number of valuable insights emerged including: the impact of perceived lack of control over self and experiences of vulnerability, powerlessness and victimisation, both prior to, and following the act of detention; participants' sense of care Vs punishment; the development of 'role' within the system and attribution of blame. DISCUSSION: This study expands the current literature regarding the experiences of people with intellectual disabilities from their perspective, the emotional impact of traumatic experiences and differences in coping styles: Ideas for future research are also provided.

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Parisian, Esther Elizabeth. "Health Care Reform and Rural Hospitals: Opportunities and Challenges under the Affordable Care Act." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1313596532.

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Xu, Yan. "Using data to answer questions of public health importance for ACT Health, with an emphasis on routinely-collected linked data." Master's thesis, Canberra, ACT : The Australian National University, 2017. http://hdl.handle.net/1885/144601.

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My field placement was with the Epidemiology Section in the Population Health Protection and Prevention Division at ACT Health. Within this placement, I have completed four projects for this thesis: an analysis of Emergency Department (ED) data; a gastroenteritis outbreak investigation; an evaluation of a population health survey and, for my main project, a study of unplanned hospital readmissions. One of the motivations for undertaking these projects was to promote better use of the routinely-collected linked data to answer questions of public health importance for ACT Health. My data analysis project was an analysis of frequent ED use in the Australian Capital Territory (ACT). This is the first study to quantify and characterise ED frequent users in the ACT. The results support existing evidence that frequent users tend to be older, female, and/or single, and commonly present with pain-related conditions. The data also showed that compared to non-frequent ED users, frequent users were more likely to be referred by police, corrective or community services; arrive by ambulance, not wait to be assessed, or leave at their own risk. In addition, we investigated visit intervals, rarely reported on in other studies. This study found around one third of frequent users returned within 7 days, with 41% of their visits having the same diagnosis as the last visit. Early identification and follow-up in the community for frequent users will assist in the development of targeted strategies to improve health service delivery to this vulnerable group. Unexpected return to hospital has negative impacts on families and healthcare systems. We examined which conditions have the highest rates of readmission and contribute most to 30-day unplanned readmissions in the ACT, and which patient characteristics are associated with readmissions. The study identified a 30-day unplanned readmission rate of 6.2%, with admission rates highest for alcohol-related liver disease (19.2%), and heart valve disorders (17.4%). Older age and comorbidities are strong predictors for 30-day unplanned readmissions. For some conditions the rates were relatively high, suggesting areas to target for reducing readmissions. Therefore, when developing preventative strategies and post-discharge plans, particular consideration should be given to patients at older age or with underlying comorbidities. As part of the ACT Health Survey Program (HSP), the ACT General Health Survey (GHS) is a computer-assisted telephone interviewing survey conducted every year among ACT residents. My evaluation of the GHS found that it is a useful tool to monitor trends of overweight, obesity, nutrition and physical activity for adults and children in the ACT. The data collected are used to provide evidence to understand and analyse overweight and obesity patterns in the ACT and create awareness of unhealthy lifestyles. However, improvements could be made in a few areas, including: developing a proper evaluation plan and a data quality statement, increasing the sample size and the proportion of young people in the sample population. I also carried out an outbreak investigation of foodborne gastroenteritis that occurred among staff and public members at a large national institution in Canberra. I conducted two studies for this outbreak – a retrospective cohort study and a case control study. The epidemiological, environmental and laboratory evidence suggested the outbreak was caused by C. perfringens toxin Type A, with the likely vehicles of transmission being butter chicken and rice. The findings of this investigation suggest that a breakdown in temperature control and good food handling practices may have resulted in C. perfringens bacterium growing rapidly and producing a toxin which caused the illness. This project also indicated that the value of a second epidemiological study was questionable given the limited time and resources available.

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Fay, John Everett. "California employer perspectives on older working adults specific to the Affordable Care Act health insurance mandate." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1570831.

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The Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act or the ACA, introduced legislation that mandated all large employers to offer health insurance to their employees or a monetary penalty will be assessed. The mandate inherently impacted employers with older workers. This paper analyzed how California employers viewed their older workers specific to the ACA through qualitative interviews. Sample size of ten (N =10) participants in the study: eight employers and two professionals managing health insurance plans. Themes emerged from participant employers who viewed their older workers as valuable and like family, while the age of the older workers did not influence the participant employers during the decision making process to offer a health plan in light of the ACA's mandate.

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Bracey, Kimberly Vaunterice. "Experiences of Parents With Chronically Ill Children Regarding the Affordable Care Act." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6975.

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Ways in which the implementation of the Patient Protection and Affordable Care Act (ACA) affect parents with chronically ill children are not well understood. The purpose of this phenomenographic study was to gain greater insight into the perceived experiences of parents of chronically ill children regarding implementation of the ACA in a southern state. Argyris's intervention theory provided the framework for the study. Face-to-face interviews were conducted with a purposeful sample of 12 female parents who are caregivers of chronically ill children. Data were analyzed and coded to identify categories and themes. Findings indicated that parents view physicians and policymakers as key actors in their communities to create more equitable services for parents of chronically ill children through the expansion of Medicaid services in southern state. Many participants did not perceive that the ACA had made significant changes to services received prior to its implementation. Findings may assist health care providers, insurance companies, legislators, and other policymakers to develop appropriate health care policies and interventions to lessen the financial burden experienced by parents of chronically ill children. Providing more support services that address the physical, emotional, and financial needs of parents may improve the health outcomes of their chronically ill children.

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Collins, James Patrick, and n/a. "POLICY IMPLEMENTATION AND ADMINISTRATIVE ARCHITECTURE Using the Purchaser Provider Model to Implement ACT Health and Community Care Delivery Policy." University of Canberra. Government, 2009. http://erl.canberra.edu.au./public/adt-AUC20091215.140820.

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In their seminal work on policy implementation, Pressman and Wildavsky (1973:143) have argued that 'there is no point in having good ideas if they cannot be carried out.' The use of a New Public Management (NPM) service delivery approach in the Australian Capital Territory (ACT) health area, referred to as the Purchaser Provider Model (PPM), was seen as one of those good ideas. The then-ACT Government hoped that the use of this model as part of its public policy reform agenda would assist it in successfully achieving its goal of restraining the growth of ACT public health care costs. The PPM was in operation between 1996 and 2002, when it was discontinued, suggesting a policy implementation failure. In this thesis, the PPM is used as a case study as a basis for supporting the argument that the administrative architecture through which public policy is implemented plays a crucial part in the success or otherwise of the implementation of that policy, especially in the area of public service delivery. The administrative architecture is defined as, the administrative components that have been designed to assist the implementation of public policy. To undertake the analysis the PPM is expressed in terms of the following three extremely important components of the administrative architecture: - the configuration of role and role relationships; - resource allocation arrangements; and - the performance management framework. Pattern matching logic in conjunction with the literature is used to show how crucial was the part played by the above components and hence the administrative architecture in the implementation of public policy. While the thesis provides compelling evidence (based on the case study and the academic literature) to support its claim, the crucial part played by the administrative architecture in the implementation of public policy, especially in the area of service delivery, has hitherto received little attention in the implementation literature.

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Norbeck, Angela J. "Health Insurance Literacy Impacts on Enrollment and Satisfaction with Health Insurance." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5387.

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Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to test hypotheses of four predictive relationships between (a) HI enrollment and HIL with HI terms; (b) marketplace enrollment and HIL with HI terms; (c) satisfaction with HI and HIL with HI access to care; and (d) satisfaction with HI and HIL with HI cost of care. Results indicated that participants with high HIL with HI terms had 4.2 times higher odds that those with low HIL to be enrolled in HI and 81% higher odds than those with low HIL to be enrolled in marketplace HI. The most significant relationship indicated that participants with high HIL with HI activities had 12.8 times higher odds than those with low HIL to have high satisfaction with access to care and 8.8 times higher odds than those with low HIL participants to have high satisfaction with cost of care. The finding that low HIL is associated with lower enrollment and lower satisfaction with HI has implications for social change. Policymakers may have the opportunity to utilize this study to promote policies that promote higher HIL, which may lead to increased HI enrollment and improved satisfaction with HI selection.

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Nield, Robert, and n/a. "Alientated students' perceptions of school organizational health." University of Canberra. Education, 1990. http://erl.canberra.edu.au./public/adt-AUC20060824.130208.

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This thesis explores alienated students' perceptions of the organizational health of a Year 7 to 10 A.C.T. high school. The study emerged at the theoretical level from a concern that school effectiveness studies focussed too narrowly on student academic attainment as an indicator of an effective school. A broader view of effectiveness would hopefully show that in the case of comprehensive co-educational government high schools, student alienation could have a powerful effect in undermining the achievement of academic goals in such schools. Because these schools have little control over their student clientele and require compulsory student attendance until age 15, it seemed a degree of alienation was inevitable. The task for high school administrators, it was hypothesized, lay in minimizing these alienation levels in order to reduce the impact such student alienation might have on other school effectiveness indicators like teacher commitment, teacher morale and time on task in classes. My experience as a practitioner, in the Student Welfare area of a large ACT government high school, also indicated that the traditional "top down" strategy of much research in the field of Educational Administration that concentrated on the perspectives of principals and teachers only gave one view of the processes within a school. The other, complementary "bottom up" view came from students. In particular, it was hypothesized, the perspectives the most alienated students in a government high school held towards the organizational health of the school might represent an unusual test of school effectiveness. This was because the commitment of such students towards the school and its stated academic goals was most problematic. The promotion of a school "culture" or "ethos" that could integrate low level and high level alienation students, and thereby foster school effectiveness, appeared to be possible only to the extent that high level alienation students could be kept on side or neutralized by high school administrators. These speculations were largely confirmed in this study. Apart from the interaction of sex and year level with alienation, the other major finding was that teacher consideration, or the extent to which teachers show concern for students as individuals, was the only organizational health dimension that produced a significant difference between students on the basis of alienation level. In short, the study is not concerned with student alienation as such. Rather it is concerned with understanding how alienated students perceive a relatively effective school. This would hopefully enable that alienation to be minimized and managed.

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Dissertations / Theses on the topic 'ACT Health'

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