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Dissertations / Theses on the topic 'Health system'
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Gopal, Thania. "Health systems in the news: The influence of media representations on health system functioning in the Western Cape health system." Master's thesis, Faculty of Health Sciences, 2018. http://hdl.handle.net/11427/30152.
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Health systems are complex systems characterised by constant change and a web of interwoven relationships, connections, and interactions. Health Policy and Systems Research has called for multidisciplinary approaches to understanding health systems. Like health systems, the media has also been described as an important social institution in modern society that is deeply embedded within the sociocultural and political context. The role of the media as societal watchdog; as a mechanism to improve accountability; as a platform for debate; and as a facilitator of community engagement has been recognised. Within public health, the role of mass media as a tool in health promotion and health communication campaigns is well-established. Media representation research involves the analysis of discourses in media and has been used to study a range of public health issues. However, there is a major gap in representation studies of health systems, in high-, middle- and low income countries. This mixed methods study aimed to describe representations of the South African Western Cape provincial health system by analysing dominant discourses emerging from the English-language mainstream print and online news media (1994-2018). A media content analysis was first conducted to highlight the main themes, followed by a discourse analysis to provide a deeper interrogation of underlying issues. This study suggests that the way a health system is represented in the media potentially influences health system functioning in a variety of ways – for example, how ‘people’ in the system make meaning of discourses, which in turn influences decision-making. ‘Negative’ representations (for example, of a weak or stressed health system), may contribute to a lack of both health worker and patient trust in the health system with a host of undesirable repercussions, such as low health worker morale, health workers failing to speak up for patients, or poor quality of care. The study recommends capacity building of a diversity of people (such as citizens, communities, health workers, civil society) at different levels of the health system to enable them to engage with the media, and mitigate the less desirable repercussions. Further research is needed to, a) consider the effects of media on health systems more carefully, more frequently, and in more contexts; b) find more effective ways to think of media as part of the health system, rather than an instrumental tool, or an external influence; c) to understand how media architecture (the social, political and economic environment in which media are situated) may influence emerging discourses; and d) to understand how media can influence people’s agency and community participation, particularly in the context of responsive and people-centred health systems.
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Cano, Olmos Luis Mohamed, and Rojas Luis Isaias Jesus Cabrera. "Health Records in the Mexican Health System." Thesis, Internationella Handelshögskolan, Högskolan i Jönköping, IHH, Företagsekonomi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-45285.
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This thesis address one of the most important topics for the human being; health. Specifically, the research is about the deficiencies of the health system in Mexico. This paper shows the importance, how the system works and its current situation in the country. The purpose of this research is, based on the Pareto principle (20% vs 80%), to find how to solve most problems with the least possible investment. It was found that the common denominator in the problems was the process and flow of information of the patients; specifically, the health records. The researchers address the issue at first explaining in a deep way the health records to highlight their importance in the health care system. In order to corroborate this finding in the literature; The researchers designed an interview, which was applied to physicians from the two main health institutions in Mexico in order to collect the necessary information to develop the thesis. Since the design of the research is qualitative; the necessary social context is given to be able to understand the analysis and the results; likewise, the authors explain in detail the methodology used. In spite of other important factors that were found such as the lack of results despite the investment and deficiencies in the infrastructure; It was concluded that, in fact, most of the problems were derived from the problems of health records. These results are important because it gives a parameter of what must be corrected first in order to have the expected results and a better health system.
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Tomar, Shivanjali. "PROLOGUE : Health Information System." Thesis, Umeå universitet, Institutionen Designhögskolan, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-79315.
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Prologue is a health information system developed for underserved communities in Bihar, India. It is aimed at helping people living in poverty and with low literacy to take the right steps to manage their and their family’s health. Bihar suffers from one of the worst healthcare records in the country. This is as much due to the lack of access to the right information as it is due to the economic condition of the region. The inaccessibility of information is aggravated by the complex social set up in these communities, for e.g. women aren’t allowed to leave their homes and community has the strongest influence on an individual’s decision making. To make sure that right information permeates even to the most inaccessible user groups, especially women and to uplift community’s awareness as a whole, two different communication channels were designed-an interactive radio show and a public installation.
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Rosen, Ceruolo Melissa Beth. "Data driven health system." Thesis, Massachusetts Institute of Technology, 2013. http://hdl.handle.net/1721.1/79531.
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Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, 2013.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 106-110).
Effective use of data is believed to be the key to address systemic inefficiencies in health innovation and delivery, and to significantly enhance value creation for patients and all stakeholders. However, there is no definition for health data. Rather, data in health is an assortment of observations and reports varying from science to clinical notes and reimbursement claims that emerge from practice rather than design. What is health data? In this thesis we try to answer that question by looking at the system of health almost exclusively as a system that generates, transforms, and interprets data. We overview the different meanings data has throughout the health system, we analyze systematically the inefficiencies and trends as they emerge from data, and propose a new architecture for the system of health in which data is not present by accident. The result of this thesis is a new architecture for the system of health that is consistent with its present state but also consistent with a future learning system and a redefinition of value in health care that is patient and information centric.
by Melissa Beth Rosen Ceruolo.
S.M.
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Ling, Meng-Chun. "Senior health care system." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2785.
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Senior Health Care System (SHCS) is created for users to enter participants' conditions and store information in a central database. When users are ready for quarterly assessments the system generates a simple summary that can be reviewed, modified, and saved as part of the summary assessments, which are required by Federal and California law.
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zhu, chenguang. "Data mining system in E-health system." Thesis, Mittuniversitetet, Avdelningen för informations- och kommunikationssystem, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-21127.
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Chen, Chen. "Health economic analysis of China's health insurance system." Thesis, University of York, 2016. http://etheses.whiterose.ac.uk/17451/.
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This thesis consists of 3 chapters plus an introductory chapter and a concluding chapter. They are on three different topics, but they are all related to China’s health insurance system from 2000 to 2011. Chapter 1 is the introduction to the thesis, providing background to the Chinese insurance system, the theoretical underpinning of the three chapters, a description of the datasets used in the thesis, and an overview of the thesis. Chapter 2 investigates whether there is adverse or advantageous selection in China’s private health insurance market before 2003. We found evidence in favour of adverse selection in a pure private insurance market. For the public insurance group where people already got covered by a public insurance but face the choice of buying a supplementary private insurance, we found advantageous selection. Chapter 3 examines whether implementing nearly universal coverage in 2009 led to a decrease in individual preventive behaviour prior to illness, termed ex-ante moral hazard. We exploit the longitudinal dimension of data from 2006 and 2009 and use Coarsened Exact Matching methods. The results do not provide strong evidence for ex-ante moral hazard. Chapter 4 aims at evaluating whether there is ex-post moral hazard after the introduction of universal coverage. We measured ex-post moral hazard as the impact of co-payment rate on treatment cost, to assess the variation of total medical expenditure to patients due to the decrease of price. We conclude that there is ex-post moral hazard in outpatient services after the reform of universal coverage in China. Chapter 5 is the concluding chapter, including a summary of the findings, policy implications, strength and limitations of the thesis, and challenges for future research.
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Henriksson, Dorcus Kiwanuka. "Health systems bottlenecks and evidence-based district health planning : Experiences from the district health system in Uganda." Doctoral thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-329082.
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In low-income countries where maternal and child mortality remains high, there is limited use of context-specific evidence for decision making and prioritization of interventions in the planning process at the sub-national level, such as the district level. Knowledge on the utility of tools and interventions to promote use of district-specific evidence in the planning process is limited, yet it could contribute to the prioritization of high-impact interventions for women and children. This thesis aims to investigate, in the planning process, the use of district-specific evidence to identify gaps in service delivery in the district health system in Uganda in order to contribute to improving health services for women and children. Study I evaluated the use of the modified Tanahashi model to identify bottlenecks for service delivery of maternal and newborn interventions. Study II and III used qualitative methods to document the experiences of district managers in adopting tools to facilitate the utilization of district-specific evidence, and the barriers and enablers to the use of these tools in the planning process. Study IV used qualitative methods, and analysis of district annual health work plans and reports. District managers were able to adopt tools for the utilization of district-specific evidence in the planning process. Governance and leadership were a major influence on the use of district-specific evidence. Limited decision space and fiscal space, and limited financial resources, and inadequate routine health information systems were also barriers to the utilization of district-specific evidence. Use of district-specific evidence in the planning process is not an end in itself but part of a process to improve the prioritization of interventions for women and children. In order to prioritize high impact interventions at the district level, a multifaceted approach needs to be taken that not only focuses on use of evidence, but also focuses on broader health system aspects like governance and leadership, the decision and fiscal space available to the district managers, limited resources, and inadequate routine health information systems.
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Portman, Emily. "Making The Healthy Choice: Exploring Health Communication In The Food System." ScholarWorks @ UVM, 2016. http://scholarworks.uvm.edu/graddis/614.
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The Academy of Nutrition and Dietetics and the Cooperative Extension System are organizations that serve the public and agricultural communities, respectively. Within these broad organizations are two groups of food systems professionals, registered dietitian nutritionists (RDNs) and Extension agents, who are utilizing communication as a critical point of access for health-related issues. Both groups of professionals negotiate organizational structure in order to construct their own health knowledge and, subsequently, communicate accurate information to their constituents. Understanding the ways that these professionals navigate their roles as health communicators are important for contributing to public discourse about how health knowledge is created and disseminated.
Specifically, for the first article, I conducted semi-structured interviews with RDNs to analyze the ways in which they navigate both commercial and health messaging from industry groups at their largest organizational meeting. Industry affiliations have historically been a controversial aspect of Academy operations, yet little research has explored RDNs unique experiences with industry. Findings revealed RDNs have varied interpretations of industry messages and are utilizing strategies to negotiate interactions with industry. The spectrum of RDN interpretation suggests that formal dietetic training should address media literacy strategies in order to help RDNs navigate a complex message landscape.
For the second article, through national focus groups with Extension professionals, I sought to understand how Extension is responding to healthcare reform changes and how this has translated into programming for their constituents. Extension participants reported a lack of available resources to improve their own health insurance knowledge, which has impacted their abilities to serve their constituents effectively. Findings emphasized a need for both collaborations both within Extension and across other agencies in order to improve health insurance access for agricultural communities.
By researching these two organizations, I hope to contribute to new understandings about how professionals navigate and communicate knowledge related to public health. Both articles have practical implications for each group, and they also offer examples of opportunities to utilize leverage points for structural change within the food system.
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Mak, Yuen-yung, and 麥菀容. "Hong Kong's health financing system." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B50255745.
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Despite attempts to contain health care cost, healthcare expenditure has been surging worldwide. Healthcare financing remains high on the political agenda and nations are struggling hard to balance cost containment with service quality, accessibility, efficiency, etc (Froetschel 2011). Hong Kong, of no exception, faces increasing pressure to raise public expenditure on health and is seeking new ways to finance healthcare. This paper attempts to provide an overview of Hong Kong’s existing health financing system and identify possible reform options.published_or_final_version
Politics and Public Administration
Master
Master of Public Administration
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Alonzo, Chester, Michael Besco, Theresa Inman, Michael Jourdain, Regina McNeil, and Clive Sugama. "System engineering health and visualization." Thesis, Monterey, California: Naval Postgraduate School, 2014. http://hdl.handle.net/10945/44657.
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Approved for public release; distribution is unlimitedIncludes supplementary materials.
Complex warfighter systems are increasingly required for continuing United States dominance, which drives a need for high quality Systems Engineering (SE) processes. A System Engineering Health and Visualization (SEHV) capability is needed so that leadership can gain insight into potential SE risk areas, allowing them to be proactive instead of reactive to issues leading to program failures, thus saving time, effort, and costs. This capstone’s purpose was to determine if an automated means of collecting and displaying SE data trends is feasible and effective. To accomplish this, the team analyzed stakeholder’s requirements and performed a literature study on SE leading indicators. Modeling and simulation was performed to further analyze these requirements and provide the best means to obtain SE health data from Space and Naval Warfare System Center Atlantic (SSC-A). This developed the SEHV architecture to include data integration strategy. A conceptual model for the SEHV capability was produced along with acquisition strategies and cost estimates. The research shows a need to incorporate an automated SEHV system into SSC-A’s organization to improve efficiencies in data calls and management insight into the SE health of a program. Additionally, the team identified future research requirements and provided recommendations for management consideration.
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Castelli, Adriana. "Measurement of health system performance." Thesis, University of York, 2008. http://etheses.whiterose.ac.uk/14145/.
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Zhang, Yanzhen. "Health care system in China." Thesis, Virginia Tech, 1994. http://hdl.handle.net/10919/43605.
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Ndossa, А. "Health care system in Tanzania." Thesis, Сумський державний університет, 2013. http://essuir.sumdu.edu.ua/handle/123456789/33768.
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The health system in Tanzania follows the pattern of government structures of leadership in the form of hierarchy. The national health care system has a pyramidal structure that prioritized primary care at affordable costs to majority of people. It consists of the Village Health Service, District Hospitals, Regional Hospitals, Consultant Hospitals.
When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/33768
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Rangel, Monica. "HEALTH AND WELLNESS INFORMATION SYSTEM." CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/943.
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The greatest wealth is health. It is sometimes said your health is a function of what you are not doing, not what you are currently doing. The degree to which individuals can attain, process, and comprehend the necessary health information and services they need to make proper health decisions is vital for optimal health and well-being.
This project documents the analysis, design, development, and implementation of a prototype web-based data-driven health & wellness system targeted for college students. The architecture for this system uses business intelligence to develop a smart online platform for real-time analysis based on inputs entered by its users.
The objective is to develop modules that can be used to provide meal plan options that dietitians can recommend to students, while also providing a standard wellness health check. This also promotes constant awareness for students with specialized health diets. User-health and wellness history of each Student is collected and stored for generating progress and wellness reports for end users. The dietitian can monitor the user in real time through the data collected and stored in the data server. Users can monitor their own progress. The system incorporates user context and feedback to personalize each user's lifestyle.
Implementation of this system provides a complete and easy to use integrated system that promotes the process of analyzing wellness and improving the user’s overall health. The system is designed to be in a non-clinical setting and hence more lifestyle-oriented compared to other health-oriented systems. It is thus more relevant and convenient to student’s everyday life context.
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Yang, Hui, and h. yang@latrobe edu au. "Priorities and Strategies for Health Information System Development in China - How Provincial Health Inforamtion Systems Support Regional Health Planning." La Trobe University. Public Health, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20050818.135812.
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China is moving towards a market economy. The greater use of market forces has made China richer, accelerated modernisation and increased productive efficiency but has created new problems, including, in the health sector, problems of inequity and allocative inefficiency. From 1997, the Chinese government committed to a national policy of regional health planning (RHP), as part of a broader commitment to harmonising social and economic development. However, RHP has been slow to impact on the equity and efficiency problems in health care.
Planning requires information; better health decision-making requires better health information. Information systems constitute a resource that is vital for the health planning and the management of the health system. Properly developed, managed and used, health information systems are a highly cost-effective resource for the nation and its regions. Bureaucratic resistance, one of critical reasons is that regional health planners gained insufficient support from information system. Health information needs to adopt into the new way of government health management.
The objective of the study is to contribute to the development of China�s health information system (HIS) over the next 5-10 years, in particular to suggest how provincial health information systems could be made more useful as a basis for RHP. The existing HIS is examined in relation to its support for and relevance to RHP, including policy framework, institutional structures and resources, networks and relationships, data collection, analysis, quality and accessibility of information as well as the use of information in support of health planning. Data sources include key informant interviews, a questionnaire survey and various policy documents. Qualitative (questionnaire survey on provincial HIS) and quantitative (key informant interviews) approaches are used in this study. Document analysis is also conducted.
The research examines information for planning within the macro and historical context of health planning in China, in particular having regard to the impacts and implications of the transition to a market economy. It is evident that the implementation of RHP has been retarded by poor performance of information system, particularly at the provincial level. However, the implementation of RHP has also been complicated by fragmented administrative hierarchies, weak implementation mechanisms and contradictions between different policies, for example, between improved planning and the encouragement of market forces in health care.
To support RHP which is needs based, has a focus on improving allocative efficiency and is adapted to the new market development will require new information products and supports including infrastructure reform and capacity development. Provincial HIS needs to move from being data generators and transmitters to becoming information producers and providers. Health planning has moved to greater use of population-based benchmark and demand-side control. Therefore, information products should be widened from supply side data collection (in particular assets and resources) to include demand-side collection and analysis (including utilisation patterns and community surveys of opinion and experience). The interaction between users (the planners) and producers (the HIS) should be strengthened and regional networks of information producers and planners should be established.
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Scott, Vera Eileen. "A health system perspective on factors influencing the use of health information for decision-making in a district health system." University of the Western Cape, 2016. http://hdl.handle.net/11394/4907.
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Philosophiae Doctor - PhDThis research explores a poorly understood area of health systems: the nature of managerial decision-making in primary healthcare facilities, and the information that informs decision-making at this level. Located in the emerging field of Health Policy and System Research, this research draws on constructivist and participatory perspectives to understand the role of information and, more broadly, learning and knowledge in decisions that primary healthcare managers make, and the systemic factors influencing this. Using a multiple case study design with iterative cycles of in-depth data collection and analysis over a three year period, it examined the decision-making and information use in three cases of managerial responsibility in 17 primary healthcare facilities in a sub-district in Cape Town. The cases were: improving efficiency of service delivery, implementing programme priorities and managing leave of absence. Using multiple strategies for engaging primary healthcare facility managers, often as co-researchers of their own practice, the research sought to elicit both their explicit and tacit, experience-based knowledge on these phenomena. Key insights gained in the research are that firstly, operational health management at facility level is less linear and simple than policy-makers and planners often assume, and is, instead, characterised by considerable on-the-spot problem solving and people management to meet multiple agendas, which can be surprisingly complex. Secondly, contrary to prevailing views, managers do actively use information in decision-making, but require a wide range of information which is outside of the current, and indeed the globally-advocated, health information system (HIS). Thirdly, they not only use, but generate, information in their management routines and practices, and must learn from experience in order to adapt new interventions for successful implementation in their facilities and communities. This research thus makes explicit the value and use of informal information and knowledge in decision-making. It demonstrates, amongst others, a relationship of functional interdependence between the use of formal information in the HIS, and informal information and knowledge, suggesting that the latter has the potential to improve the use and utility of formal health information by making sense of it within the local context. Furthermore, building on the public policy literature on governance, this research develops a model to understand the multiple contextual influences on decision-making and information use, showing the central role of values and relationships across the health system. It proposes a causal mechanism for strengthening the use of information in decision-making. Finally, in giving priority to the informational needs of facility managers, this research offers a bottom-up perspective which argues for an integrated approach to health system strengthening which moves beyond atomised treatment of HIS strengthening. It suggests the need to re-think how to support facility managers by re-positioning the HIS relative to organisational learning, and leadership and management development.
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Karki, Jiban Kumar. "Health system actors' participation in primary health care in Nepal." Thesis, University of Sheffield, 2016. http://etheses.whiterose.ac.uk/15799/.
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Background: Nepal was an early adopter of World Health Organization's (WHO) Primary Health Care (PHC) approach with Community Participation (CP) for delivery of basic health care service. These approaches have formed the mainstay of efforts related to provision of health care services in Nepal. However, it has struggled with its implementation because of developmental challenges, poverty, civil war and geography. Hence, it becomes important to seek to understand the dynamics around CP and PHC and how these relate to broader development challenges in the country. The main aim of this research is to understand how various Health System Actors participate in PHC in Nepal and what its implications are in PHC Methods: In order to understand CP in PHC a qualitative case study method was undertaken. Forty-one semi-structured interviews, four focus group discussions (FGD) and observation were conducted with 26 groups of grass root level and district level health systems actors in two Village Development Committees (VDC) of Sindhupalchok district of Nepal in 2014. This study examined how these actors understand PHC and CP, how they participate in it and what motivates or hinders them to participate in PHC. The results are based on data collected from interviews, FGDs, observation and the field notes. Results: There was very low understanding about PHC and CP among actors in these VDCs. Often, CP for these actors was a 'tokenistic participation' which was limited to material contribution, voluntary labour and financial donation in PHC infrastructure development and maintenance. Participation in Health Facility Management Committees and Female Community Health Volunteer were the only mechanisms of CP in PHC, which rarely represented community views. Existing traditional health system was not taken into account. Decisions were imposed top down without considering local context, practices and without involvement of local actors. The main motivations for CP amongst participants were material benefit, social recognition and religious merits whereas geography, opportunity cost, lack of awareness and socio-cultural discrimination, were barriers to participation. Discussions/Conclusions: PHC with CP needs to be contextualized to accommodate, learn and benefit from the existing traditional health system. Similarly, a stronger policy measure is needed to minimize if not to eradicate the discrimination against gender, caste, ethnicity and poverty to increase CP in PHC. In the current socio political situation, geography and current status of infrastructural development in Nepal, neither the government nor the nongovernmental / private sector alone are able to address the increased health care need. Therefore, a wider broad partnership based PHC with CP is recommended as a way forward to ensure basic health care service in Nepal. This has been even more important where reconstruction of the health system is underway after the devastating 2015 earthquake, for the community to feel ownership of local health system.
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Lyan, Dmitriy Eduard. "Performance dynamics in military behavioral health clinics." Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/90690.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, June 2013.Cataloged from PDF version of thesis. "June 2012."
Includes bibliographical references (pages 113-116).
The prevalence of Post Traumatic Stress Disorder (PTSD) and other related behavioral health conditions among active duty service members and their families has grown over 100% in the past six years and are now estimated to afflict 18% of the total military force. A 2007 DoD task force on mental health concluded that the current military psychological health care system is insufficient to meet the needs of the served population. In spite of billions of dollars committed to hundreds of programs and improvement initiatives since then, the system continues to experience provider shortages, surging costs, poor access to and quality of care as well as persistently high service-related suicide rates. We developed a model to study how the resourcing policies and incentive structures interact with the operations of military behavioral health clinics and contribute to their ability to provide effective care. We show that policies and incentives skewed towards increased patient loads and improvement in access to initial care result in a number of vicious cycles that reinforce provider shortages, increase costs and decrease access to care. Additionally we argue that insufficient informational feedback contributes to incorrect attributions and the persistence of ineffective policies. Finally we propose a set of policies and enabling performance metrics that can contribute to sustained improvement in system performance by turning death spirals into virtuous cycles leading to higher provider and patient satisfaction, better quality of care and more efficient resource utilization contributing to better healthcare outcomes and increased levels of medical readiness.
by Dmitriy Eduard Lyan.
S.M. in Engineering and Management
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Wu, Min 1976. "Secure Health Information Sharing System (SHARE)." Thesis, Massachusetts Institute of Technology, 2001. http://hdl.handle.net/1721.1/86761.
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Mtwazi, L. M. "A district health system for Khayelitsha." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51564.
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Thesis (MPA)--Stellenbosch University, 2000.ENGLISH ABSTRACT: Sharp divisions featured between curative and preventative health care in the Public Health Services of South Africa before the democratisation process. There was fragmentation in authority structures and inequalities between urban and rural areas as well as along racial lines. This resulted in a situation where there was duplication and inequality in the distribution of resources amongst the different levels of health care which led to costly inefficient and ineffective health services. The introduction of the White Paper Towards the Transformation of Health System in South Africa in 1997, aims at the restructuring of health services towards a unified health system which is capable of delivering quality health care to all in a caring environment. The District Health System (DHS) is featured as the key to ensuring decentralised, equitable Primary Health Care (PHC) to all the citizens of South Africa. This study looks at the reorganisation of health services in the clinics and the day hospitals which are rendered by the Health Department of The City of Tygerberg and the Community Health Service Organisation (CHSO) of the Provincial Administration of the Western Cape(P AWC) in Khayelitsha with the aim of achieving comprehensive PHC services. Inthe absence of legislation for the integration of health services, initiatives for the achievement of quality comprehensive PHC within the district are envisaged.
AFRIKAANSE OPSOMMING: Openbare Gesondheidsdienste in Suid Afrika was voor die demokratieseringsproses gekenmerk deur 'n skeidig tussen kuratiewe en voorkomende gesondheidsdienste. Daar was fragmentasie van bestuurstrukture, ongelykheid tussen stedelike en landelike gebiede asook ongelykheid op grond van ras. Dit het gelei tot duplisering van, en ongelykheid in, die verspreiding van hulpbronne op die verskillende vlakke van gesondheidssorg. Die Witskrif op die Transformasie van Gesondheidstelsels in Suid-Afrika, 1997, fokus op die herstrukturering van gesondheidsdienste en het 'n verenigde gesondheidstelsel ten doel wat daartoe in staat is om gehalte gesondheidsorg in 'n sorgsame omgewing aan almal te lewer. Die Distriksgesondheidstelsel (DGS) word gekenmerk deur gedesentraliseerde, gelykmatige Primêre Gesondheidsorg (PGS) dienslewering aan al die inwoners van Suid-Afrika. Hierdie studie kyk na die herorganisering van gesondheidsdienste wat deur die gesondheidsdepartement van die Stad Tygerberg en die Gemeenskapsgesondheidsdiens organisasie van die Provinsiale Administrasie van die Wes-Kaap (PAWK) in die klinieke en daghospitale in Khayelitsha gelewer word met die doel om omvattende Primêre Gesondheidsorgdienste te voorsien. Weens die afwesigheid van wetgewing vir die integrasie van gesondheidsdienste word inisiatiwe vir die bereiking van gehalte omvattende Primêre Gesondheidsorg binne die distrik beoog.
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Ashwin, Belle. "WIRELESS INTELLIGENT STRUCTURAL HEALTH MONITORING SYSTEM." VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1626.
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Metal structures are susceptible to various types of damages, including corrosion, stress damage, pillowing deformation, cracks etc. These kinds of damages in the metal structures occur mainly due to operational conditions and exposure to the environment. Our research involves a portable integrated wireless sensor system with video camera and ultrasound capabilities which is being developed to investigate corrosion damage on real structures in real time. This system uses images of the metal surfaces, which are captured from an integrated wireless sensor and then quantified and analyzed using computational intelligence. The quantification of the obtained images is done with specialized component analysis software which enhances and performs wavelet transforms on the received images. Through this quantized analysis of the images we can detect and isolate regions of degradation on the metal surface. We believe that the final developed system will allow us to detect damage in metallic structures in its early stages, thereby ensuring proper safety and maintenance of its structural health. This system will further be targeted towards medical applications with capabilities of remote health monitoring. The initial target areas being bone structure and cancer detection and analysis. Applying such a wireless data capture system in these areas will reveal a broad spectrum of the usage of such an application system.
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Fosmoe, Kristofer D. "A systems perspective on army health and discipline." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/100371.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references.
Healthy and Disciplined Soldiers provide a unique competitive advantage to the United States Army that cannot be replaced by the acquisition of technological weapons systems. The United States Army system for managing health and discipline has historically been robust; however, the prolonged conflicts in Iraq and Afghanistan have highlighted the need to reexamine the system of health and discipline policies, its architecture, and the dynamic effects on junior leader behavior. This thesis provides an analysis of this system by exploring the dynamic relationship between leader development, health and discipline, and an emphasis on warfighting mission capabilities. The author demonstrates the tradeoffs between mission capabilities, and leader development of Soldier health and discipline through a mixed methods approach that combines quantitative analysis of the published Army literature and qualitative field interviews. This thesis analyzes the architecture of the Army Health Promotion system, highlighting risks to capability development if the system architecture is not consistently managed across installations. The author applies the object-process method to describing architectural models of policy systems and system dynamics causal loop diagrams to explain the evolution of the system during the post 9-11 war period. The author also uses quantitative article subject search to validate qualitative descriptions of the system behaviors. The author suggests that there is some risk in the Army failing to more effectively manage Soldier health and discipline due to failing to properly describe the intended architecture of the Army Health Promotion system, resulting in architectural differences between installations. The author also recommends several potential system changes to affect the dynamics of the leader development.
by Kristofer D. Fosmoe.
S.M. in Engineering and Management
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Thomson, Sarah. "Voluntary health insurance and health system performance in the European Union." Thesis, London School of Economics and Political Science (University of London), 2011. http://etheses.lse.ac.uk/226/.
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This thesis examines the usefulness of voluntary health insurance (VHI) as a lever for improving health system performance. It posits that VHI may further health policy goals if it addresses gaps in statutory coverage, if it does not make those who rely on statutory coverage worse off, and if those who need VHI have access to it. The thesis presents four studies that analyse markets for VHI in the European Union; developments in public policy towards VHI, including the implications of the EUlevel regulatory framework for VHI; the impact of VHI on health system performance; the effects of allowing people to choose between statutory and voluntary health insurance; and VHI’s influence on consumer mobility where insurers compete to offer statutory benefits. The thesis finds that while VHI is critical to financial protection in some countries, it does not always address key gaps in statutory coverage or reach those who need it, and the depth of its coverage has declined over time, even in heavily regulated markets. VHI has a regressive effect on equity in health financing, lowers equity in the use of health services and does not seem to have a positive effect on efficiency, partly because insurers in many countries lack appropriate incentives. What is more, a failure to align incentives across VHI and statutory health insurance can undermine the efficiency of public spending on health. Many of VHI’s negative effects can be attributed to poor policy design. Policy makers can try and ensure VHI contributes to rather than undermines health system performance through the following mechanisms: better understanding of VHI’s interaction with the health system; stronger policy design, focusing on aligning incentives in pursuit of health policy goals and ensuring efficiency in the use of public resources; willingness and capacity to regulate the market to secure financial and consumer protection; and regular monitoring and evaluation.
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Hsieh, Sheau-Ling 1952. "Distributed multimedia collaborative system framework for tele-healthcare remote consultation systems." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/284034.
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The Remote Consultation and Diagnosis (RCD) in Global Picture Archiving and Communication System (Global PACS) is a unique suite of multimedia telemedicine applications developed at the University of Arizona. The applications support real-time patients' data, image files, audio and video consultation and diagnosis annotation exchanges. The RCD enables joint collaboration between pathologists, radiologists, or physicians while they are at distant geographical locations. This project provides four RCD scenarios, i.e., Case Review, Case Acquire, Store and Forward Analysis, as well as Interactive Diagnosis and Consultation. The RCD Global PACS environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA), Java Database Connectivity (JDBC), and Java language provide the capability to combine the RCD Global PACS resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL, ORB, Event Service, IIOP, JDBC/ODBC, legacy system wrapping and Java implementation are explored. This distributed collaborative CORBA/JDBC based framework will challenge the advanced, medical information management requirements. It also makes the RCD Global PACS both hardware and software technologically independent. As our research and development extend, we will continue to incorporate the latest advances in computer technology. RCD Global PACS is not another new tool in telemedicine, but rather a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes. It is a whole new way of practicing in telemedicine. We ensure that the RCD Global PACS project has long-term, comprehensive solutions for today and tomorrow's healthcare needs.
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Al-Yaemni, Asmaa Abdullah. "Does universal health care system in Saudi Arabia achieve equity in health and health care?" Thesis, University of Liverpool, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.526777.
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Adekunle, Toluwani E. "Towards Health System Strengthening: Analyzing the adoption of the WHO Health Systems Thinking Framework in the Nigerian and Botswana National Health Policies." Ohio University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1430146924.
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Lam, Lawrence G. "Digital Health-Data platforms : biometric data aggregation and their potential impact to centralize Digital Health-Data." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/106235.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, School of Engineering, System Design and Management Program, Engineering and Management Program, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references (page 81).
Digital Health-Data is being collected at unprecedented rates today as biometric micro sensors continue to diffuse into our lives in the form of smart devices, wearables, and even clothing. From this data, we hope to learn more about preventative health so that we can spend less money on the doctor. To help users aggregate this perpetual growth of biometric "big" data, Apple HealthKit, Google Fit, and Samsung SAMI were each created with the hope of becoming the dominant design platform for Digital Health-Data. The research for this paper consists of citings from technology strategy literature and relevant journalism articles regarding recent and past developments that pertain to the wearables market and the digitization movement of electronic health records (EHR) and protected health information (PHI) along with their rules and regulations. The culmination of these citations will contribute to my hypothesis where the analysis will attempt to support my recommendations for Apple, Google, and Samsung. The ending chapters will encompass discussions around network effects and costs associated with multi-homing user data across multiple platforms and finally ending with my conclusion based on my hypothesis.
by Lawrence G. Lam.
S.M. in Engineering and Management
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Kanu, Alhassan Fouard. "Health System Access to Maternal and Child Health Services in Sierra Leone." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7394.
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The robustness and responsiveness of a country's health system predict access to a range of health services, including maternal and child health (MCH) services. The purpose of this cross-sectional study was to examine the influence of 5 health system characteristics on access to MCH services in Sierra Leone. This study was guided by Bryce, Victora, Boerma, Peters, and Black's framework for evaluating the scaleup to millennium development goals for maternal and child survival. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment dataset, which comprised 100% (1, 284) of the country's health facilities. Data analysis included bivariate and multivariate logistic regressions. In the bivariate analysis, all the independent variables showed statistically significant association with access to MCH services and achieved a p-value < .001. In the multivariate analysis; however, only 3 predictors explained 38% of the variance (R� = .380, F (5, 1263) = 154.667, p <.001). The type of health provider significantly predicted access to MCH services (β =.549, p <.001), as did the availability of essential medicines (β= .255, p <.001) and the availability of basic equipment (β= .258, p <.001). According to the study findings, the availability of the right mix of health providers, essential medicines, and basic equipment significantly influenced access to MCH services, regardless of the level and type of health facility. The findings of this study might contribute to positive social change by helping the authorities of the Sierra Leone health sector to identify critical health system considerations for increased access to MCH services and improved maternal and child health outcomes.
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Gaddam, Sathvik Reddy. "Structural health monitoring system| Filtering techniques, damage localization, and system design." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10144825.
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Material testing is a major concern in many manufacturing and aeronautical industries, where structures require periodic inspection using equipment and manpower. Environmental Noise (EN) is the major concern when localizing the damage in real time. Inspecting underlying components involves destructive approaches. These factors can be alleviated using Non Destructive Testing (NDT) and a cost effective embedded sensor system.
This project involves NDT implementation of Structural Health Monitoring (SHM) with filtering techniques in real time. A spectrogram and a scalogram are used to analyze lamb response from an embedded array of Piezo Transducers (PZT). This project gives insights on implementing a real time SHM system with a sensor placement strategy and addresses two main problems, namely filtering and damage localization. An Adaptive Correlated Noise Filter (ACNF) removes EN from the lamb response of a structure. A damage map is developed using Short Time Fourier Transform (STFT), and Continuous Wavelet Analysis (CWA).
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Bukhari, Syed Asif Abbas, and Sajid Hussain. "Intelligent Support System for Health Monitoring of elderly people." Thesis, Blekinge Tekniska Högskola, Sektionen för datavetenskap och kommunikation, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-5132.
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The use of information and communications technology (ICT) to provide medical information, interaction between patients and health-service providers, institution-to-institution transmission of data, in known as eHealth. ICT have become an inseparable part of our life, it can integrate health care more seamlessly to our everyday life. ICT enables the delivery of accurate medical information anytime anywhere in an efficient manner. Cardiovascular disease (CVD) is the single leading cause of death, especially in elderly people. The condition of heart is monitor by electrocardiogram (ECG). The Electrocardiogram (ECG) is widely used clinical tool to diagnose complex heart diseases. In clinical settings, resting ECG is used to monitor patients. Holter-based portable monitoring solutions capable of 24 to 48-hour ECG recording, they lack the capability of providing any real-time feedback in case of alarming situation. The recorded ECG data analyzed offline by doctor. To address this issue, authors propose a functionality of intelligence decision support system, in heart monitoring system. The proposed system has capability of generate an alarm in case of serious abnormality in heart, during monitoring of heart activity.
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Bennett, Cudjoe A. "Urban Health Systems Strengthening| The Community Defined Health System for HIV/AIDS and Diabetes Services in Korogocho, Kenya." Thesis, The George Washington University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10146927.
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Background: Low- and middle-income countries have been experiencing unprecedented rates of urbanization. Rapid urbanization has attributed to an upsurge in non-communicable diseases, such as diabetes, cardiovascular diseases, and cancers in these countries. Most low- and middle-income countries are also still struggling to control communicable diseases such as HIV/AIDS, tuberculosis, and malaria. This phenomenon, described as the double burden of disease, places greater strains on urban health systems and vulnerable urban populations, such as slum dwellers, who are likely to bear the brunt of any negative health outcomes. Given the potential impacts of urbanization and quality of health services on poverty and disease in the urban poor, there is urgent need to study urban health systems and the ways in which services can be made more available, accessible, and acceptable to socioeconomically disadvantaged and culturally/ethnically diverse populations.
Objectives: This dissertation is a case study that investigated the community-defined health system for Korogocho slum residents in Nairobi, Kenya. Specifically, the purpose of the research study was to (1) determine the readiness of health workers to provide HIV- and diabetes-related services, (2) define the components of the health system as perceived by Korogocho residents; that is, determine the community-defined health system, (3) assess the factors that affect health service utilization with respect to HIV/AIDS and diabetes prevention, care, and treatment, and (4) make recommendations for improving the availability, accessibility, and acceptability of health services for Korogocho residents.
Methods: The case study research employed both quantitative and qualitative methods. Three complementary peer-review quality manuscripts were developed. Manuscript 1 presents results from one of the first assessments of health provider readiness to provide HIV/AIDS- and diabetes-related services using data from the Demographic and Health Survey’s Kenya Service Provision Assessment. A cross-sectional quantitative study was conducted. Readiness was defined as health workers having the training to provide the minimum HIV/AIDS services as prescribed by key government policies. Data analysis was conducted using STATA version 13 to assess the readiness of health workers in terms of a weighted proportion of providers from facility levels 2-4 who were trained in essential HIV/AIDS- and diabetes-related services according to Kenya’s national guidelines. Manuscript 2 details the results of a qualitative inquiry to understand the community-defined health system and identify factors that influence Korogocho residents’ health utilization behavior, especially in relation to HIV/AIDS and diabetes services. Manuscript 3 utilized a qualitative assessment to determine the role of informal health providers (those who have not received a Western biomedical model of medical training) in health service delivery to the Korogocho community. In both Manuscripts 2 and 3, semi-structured interviews were conducted with community members and informal health providers, respectively. Qualitative sampling was conducted with the purpose of generating a conceptual model of the urban health system for slum residents. Analysis of semi-structured qualitative interviews with community members and informal health providers in Manuscripts 2 and 3 was completed through an iterative process using NVivo 11 for Mac.
Results: The results of this research demonstrate the complexity of urban health systems. Korogocho residents utilize health services from a variety of facilities and providers from both the formal and informal sectors. Their health utilization behavior is primarily influenced by the availability, accessibility, and acceptability of health services, health facilities, and health providers. Informal health providers play a critical role in terms of expanding the availability and accessibility of health services to Korogocho residents. The results of this case study also reveal that training levels of health providers in Nairobi for the delivery of HIV- and diabetes-related services are low. On average, 12% of health workers interviewed in the 2010 Kenya service provision assessment reported having training in the previous 2 years in the full complement of essential HIV-related services as prescribed by Kenyan Government policies. There were similar low proportions of training for the provision of diabetes-related services among the three health worker cadres included in this analysis of the 2010 Kenya service provision assessment. Moreover, the community’s perceptions of the availability and accessibility of diabetes services lagged behind HIV services.
Conclusions: The results of this research reveal key information that can impact the health systems strengthening agenda, particularly for improving the availability and accessibility of health services to the urban poor. It is also clear from this research that there is an urgent need to scale up the training of health providers to handle the current double burden of disease. Further, among socioeconomically disadvantaged populations, such as urban slums, the intentional incorporation of informal providers into the health system is a key step towards ensuring that much needed health services reach the urban poor.
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Zweigenthal, Virginia E. M. "The contribution of public health medicine specialists to South Africa's health system." Doctoral thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/22843.
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Background: While South Africa's Constitution, health legislation and policies value public health (PH) approaches, Public Health Medicine (PHM) specialists are largely invisible in the health services. Despite this, many undertake specialist training. The reasons for this mismatch, for doctors' motivations for this training, and the career paths of PHM specialists are not known – nor is it known if their practice is aligned with the intentions of trainers, policy makers and employers. Postulates for their invisibility are that they are not required, are unknown, are interchangeable, not 'service-ready' or unavailable. Aims: This thesis investigates the match between 'desired', 'actual' and 'intended' use of doctors with PH expertise in contemporary South Africa. It explores the motivations of doctors undertaking PH studies, the actual careers of PHM specialists and the intended roles of this cadre of staff. Methods: Firstly, through an electronic survey, motivations for studying and career paths of doctors completing Master of Public Health (MPH) at the University of Cape Town – the foundational PH training for selected specialist training – were examined. Secondly, through focus groups and in-depth interviews, motivations for specialist training, anticipated career paths and perspectives of the future of PHM and of specialists-intraining (registrars), were probed. An on-line survey of PHM specialists' career paths, their reflections on the speciality's value and future was undertaken. Finally, through in-depth interviews, a qualitative study explored the perspectives of key stakeholders in South Africa's health service about PHM's value in the context of current health system reform. Findings: A number of factors underlie PHM's absence in the services. In post-apartheid South Africa, PH functions have been overshadowed by an inordinate focus on 'personal' curative services. Under current legislation, PHM is largely not a requirement for service positions, resulting in many participants (20%) not registering as specialists. PH practice is context-specific and its core functions are practised by others, resulting in overlapping boundaries between PHM and other trained professionals. Together with poor advocacy for the speciality, these resulted in PHM largely being eclipsed in health system design. In 2010, PHM comprised less than 200 specialists, mainly mature doctors who are increasingly female. There was a close match between 'desired', 'actual' and 'intended' roles of PHM specialists. Unlike doctors who undertook MPH studies to obtain research and technical skills, together with population approaches for career progression, PHM registrars and specialists trained to impact on health systems, underpinned by a commitment to social justice. Specialists' broad theoretical and experiential training produced versatile professionals able to work in complex service settings, with competencies spanning strategic and technical functions, which fast-tracked them for leadership. In 2010, a third of PHM specialists worked for the state health sector and a third for universities, mostly as managers or academics; the rest in NGOs, research institutions or independently. Besides those in 'joint appointment' health service and academic posts, less than a handful worked in designated service specialist posts. Specialists were highly satisfied with their careers. The majority had worked in the state sector at one time, but many had left to pursue academic and other careers. Although salaried specialists' remuneration had improved following the Occupational Specific Dispensation (OSD), this had not affected those in management and would not attract prospective specialists to management positions unless the work environment favouring autonomy and innovation improved. Despite an uneven presence, study participants agreed that the PHM's contribution centred on a 'public health intelligence' function – finding and interpreting information; supporting services through management and leadership; providing policy making and planning capacity and research at various levels. Some argued for PHM to be a requirement for senior line management posts in the future. Conclusions and recommendations: South Africa's current health reform is an opportunity for PHM to refine its professional identity, competencies and location. Being cognisant of its multi-disciplinary nature, it must locate itself in a common identity of a profession and workforce, in "a fabric of many professions dedicated to a common endeavour".10 A 'public health identity' needs to be constructed, reflecting the diverse PH professional functions.11 The desired size, shape and roles of the PH workforce, including PHM specialists, needs to be addressed through fora of PH stakeholders – the governmental health sector, civil society employers, universities, existing and prospective specialists - focussing on positions for specialists and PH professionals, the creation of posts, the design of training curricula, and registrar placements. Research that evaluates and explores the development of the PH workforce in South Africa, comparing it with other country settings, will inform the development and competency of the profession, and the health sector that aims to "improve quality of life for all".
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Gremu, Chikumbutso David. "Building an E-health system for health awareness campaigns in poor areas." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017930.
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Appropriate e-services as well as revenue generation capabilities are key to the deployment and the sustainability for ICT installations in poor areas, particularly common in developing country. The area of e-Health is a promising area for e-services that are both important to the population in those areas and potentially of direct interest to National Health Organizations, which already spend money for Health campaigns there. This thesis focuses on the design, implementation, and full functional testing of HealthAware, an application that allows health organization to set up targeted awareness campaigns for poor areas. Requirements for such application are very specific, starting from the fact that the preparation of the campaign and its execution/consumption happen in two different environments from a technological and social point of view. Part of the research work done for this thesis was to make the above requirements explicit and then use them in the design. This phase of the research was facilitated by the fact that the thesis' work was executed within the context of the Siyakhula Living Lab (SLL; www.siyakhulaLL.org), which has accumulated multi-year experience of ICT deployment in such areas. As a result of the found requirements, HealthAware comprises two components, which are web-based, Java applications that run in a peer-to-peer fashion. The first component, the Dashboard, is used to create, manage, and publish information for conducting awareness campaigns or surveys. The second component, HealthMessenger, facilitates users' access to the campaigns or surveys that were created using the Dashboard. The HealthMessenger was designed to be hosted on TeleWeaver while the Dashboard is hosted independently of TeleWeaver and simply communicates with the HealthMessenger through webservices. TeleWeaver is an application integration platform developed within the SLL to host software applications for poor areas. Using a core service of TeleWeaver, the profile service, where all the users' defining elements are contained, campaigns and surveys can be easily and effectively targeted, for example to match specific demographics or geographic locations. Revenue generation is attained via the logging of the interactions of the target users in the communities with the applications in TeleWeaver, from which billing data is generated according to the specific contractual agreements with the National Health Organization. From a general point of view, HealthAware contributes to the concrete realizations of a bidirectional access channel between Health Organizations and users in poor communities, which not only allows the communication of appropriate content in both directions, but get 'monetized' and in so doing becomes a revenue generator.
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Bekui, A. M. "A health management information system for the district health services in Ghana." Thesis, University of Leeds, 1990. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.492369.
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Jenkins, Juliette Swanston. "Community Health Worker's Perceptions of Integration into the Behavioral Health Care System." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6908.
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Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl's five stream confluence policy process theory and Lipsky's street level bureaucracy theory provided the foundation to explore the perceptions of the CHWs about their integration into the behavioral health care system; the problems, policies, processes, and programs that impacted their ability to be integrated into the behavioral health team; and their function as a street level bureaucrat to facilitate their integration. A deductive iterative coding approach was used, culminating in the identification of the following 6 themes: health system utilization of CHW behavioral health integration, official policy recognition of the CHW profession, accountability for CHW integration, CHW practice support, integrated health care team management of physical and mental health and behavior, and building the CHW profession. The social change implications of this study are that CHWs' integration into the broadly defined, integrated, physical and mental behavioral health team can support having a more cost-effective way toward having healthy people and communities because they link the community to health and social services and advocate for quality care.
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Wang, Xiaoyang. "Aircraft fuel system prognostics and health management." Thesis, Cranfield University, 2012. http://dspace.lib.cranfield.ac.uk/handle/1826/7214.
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This thesis contains the specific description of Group Design Project (GDP) and
Individual Research Project (IRP) that are undertaken by the author and form
part of the degree of Master of Science.
The target of GDP is to develop a novel and unique commercial flying wing
aircraft titled FW-11. FW-11 is a three-year collaborative civil aircraft project
between Aviation Industry Corporation of China (AVIC) and Cranfield University.
According to the market analysis result conducted by the author, 250 seats
capacity and 7500 nautical miles were chosen as the design targets.
The IRP is the further study of GDP, which is to enhance the competitive
capability by deploying prognostics and health management (PHM) technology
to the fuel system of FW-11. As a novel and brand-new technology, PHM
enables the real-time transformation of system status data into alert and
maintenance information during all ground or flight operating phases to improve
the aircraft reliability and operating costs. Aircraft fuel system has a great
impact on flight safety. Therefore, the development of fuel system PHM concept
is necessary.
This thesis began with an investigation of PHM, then a safety and reliability
analysis of fuel system was conducted by using FHA, FMEA and FTA.
According to these analyses, fuel temperature diagnosis and prognosis were
chosen as a case study to improve the reliability and safety of FW-11. The PHM
architecture of fuel temperature had been established. A fuel temperature
prediction model was also introduced in this thesis.
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Almalohi, Mussaad. "Implementing Health Information Exchange System: Saudi Arabia." Digital Commons at Loyola Marymount University and Loyola Law School, 2015. https://digitalcommons.lmu.edu/etd/350.
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In Saudi Arabia, medical errors are at an alarming level. Lack of a Health Information Exchange (HIE) system is one the greatest reasons for medical errors in the Kingdom. Health care in many countries has evolved with the invention of electronic health information exchange system, henceforth HIE. This research paper purposes to implement HIE in Saudi Arabia, which entirely does not have a system of the sort. It is imperative instill HIE in the health care system in Saudi to allow physicians, nurses, health care facilities as well as patients to electronically share medical information in a safe and secure manner.
Many countries such as United States, New Zealand and Germany have had great success with the HIE system and have reported vast benefits. Benefits of HIE are such as reduction of health care cost as well as decreasing medical errors. For Saudi Arabia to reach the same heights, many stakeholders will be involved in the triumph of the HIE system in the Kingdom of Saudi Arabia. The biggest contributor will be the Ministry of Health, which will be in charge of implementing as well as making the system mandatory in the main four hospitals in the country: Shomasy, Kind Saud University Hospital, Ministry of interior Hospital and Ministry of Defense Hospital. Each hospital having their own current medical information recording system, will now have one universal system that is made sure to be secure and safe for patients as well as other participating organizations who have access to the HIE system.
The main concentration of the HIE system in Saudi Arabia will be in the emergency care of these four hospitals. It is crucial to have an organized and controlled way of recording as well as accessing patient medical records electronically, in a fast and effective way. This paper proposes that an HIE system in Saudi Arabia will reduce the cost of medical care and decrease medical errors. Through the use of Lean thinking and the use of quality tools, the HIE system will be able to change and increase the reliably as well as effectiveness of Urgent Care in the country and therefore have consequent benefits as well. Also, understanding who is going to play a great role in the triumph of the HIE system, such as the Ministry of Health and knowing what stakeholders will need to be affiliated and contribute will lead the project to a better success.
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Jasti, Madhu Narasimha Rao. "IoT based remote patient health monitoring system." Kansas State University, 2017. http://hdl.handle.net/2097/38268.
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Master of ScienceDepartment of Computer Science
Daniel A. Andresen
With an improvement in technology and miniaturization of sensors, there have been attempts to utilize the new technology in various areas to improve the quality of human life. One main area of research that has seen an adoption of the technology is the healthcare sector. The people in need of healthcare services find it very expensive this is particularly true in developing countries. As a result, this project is an attempt to solve a healthcare problem currently society is facing. The main objective of the project was to design a remote healthcare system. It’s comprised of three main parts. The first part being, detection of patient’s vitals using sensors, second for sending data to cloud storage and the last part was providing the detected data for remote viewing. Remote viewing of the data enables a doctor or guardian to monitor a patient’s health progress away from hospital premises. The Internet of Things (IoT) concepts have been widely used to interconnect the available medical resources and offer smart, reliable, and effective healthcare service to the patients. Health monitoring for active and assisted living is one of the paradigms that can use the IoT advantages to improve the patient’s lifestyle. In this project, I have presented an IoT architecture customized for healthcare applications. The aim of the project was to come up with a Remote Health Monitoring System that can be made with locally available sensors with a view to making it affordable if it were to be mass produced. Hence the proposed architecture collects the sensor data through Arduino microcontroller and relays it to the cloud where it is processed and analyzed for remote viewing. Feedback actions based on the analyzed data can be sent back to the doctor or guardian through Email and/or SMS alerts in case of any emergencies.
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Projo, Nucke Widowati Kusumo. "Dual practice in developing country health system." Thesis, Paris 1, 2019. http://www.theses.fr/2019PA01E012.
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Le terme «médecin à double pratique» dans cette recherche désigne les médecins qui travaillent dans des établissements de santé publics appartenant au gouvernement et qui exercent en même temps une pratique privée. Nous utilisons la combinaison d’un double régime et de mécanismes d’assurance dans l’analyse pour rendre compte de la décision du patient d’avoir accès à un établissement de santé et de la décision du médecin concernant le lieu de travail dans plusieurs situations: pas de double pratique - pas d'assurance, pas de double pratique avec assurance, double pratique sans assurance et double pratique avec assurance. La dernière question justifie la situation dans laquelle la situation offre le plus grand avantage en prenant le bien-être total provenant de l’utilité du patient, des revenus du fournisseur, de la compagnie d’assurance et du transfert gouvernemental. Nous considérons deux types de bien-être; le premier est le bien-être à long terme où le prix et la qualité ont plus de temps pour s'adapter à leur équilibre. La seconde est le bien-être à court terme où nous examinons l’effet immédiat de la présence d’une double pratique ou d’une double assurance dans le système, en maintenant le prix et les qualités constantsThe term of “dual practice physician” in this research refers to physicians who work in public health care facility owned by government and at the same time also engaged in private practice. Part one will analyse the relationship between public and private provider under dual practice regulation in term of price and quality setting in the public facility. This theoretical work is vital to link dual practice from demand and supply side that appears in Part two and Part three. The research wants to answer particular questions on how a private provider selects its price and quality level after knowing the public price and quality set by government under dual practice compared to non-dual practice regulation. The model also emphasizes the existence of insurance scheme in the system. Health care access enhancement in developing country usually takes one of two forms increasing the supply through allowing physicians to have dual jobs and increasing financial access through insurance coverage
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Melo, José Manuel Santos. "OralCard: web information system for oral health." Master's thesis, Universidade de Aveiro, 2011. http://hdl.handle.net/10773/7651.
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Mestrado em Engenharia de Computadores e TelemáticaOs sistemas de informação na web assumem-se cada vez mais como um recurso indispensável para os que estudam as ciências biomédicas. Uma das áreas de estudo destas ciências incide na cavidade oral e nas proteínas que nela residem. Existem variadas plataformas online que permitem a pesquisa de dados específicos a microorganismos e a proteínas associadas, mas estes dados são genéricos e não são desenhados para casos de estudo específicos. Este trabalho tem como objectivo desenvolver uma estratégia e um protótipo para o armazenamento de informação relacionada com a cavidade oral, visando a sua utilização em investigação. Uma preocupação diferenciadora prende-se com o objectivo de integrar dados obtidos experimentalmente com referências existentes na web e estudadas por outras entidades. O protótipo desenvolvido permite aos investigadores na área das ciências biomédicas, sem conhecimentos específicos em bases de dados, pesquisar proteínas, doenças e genes, e integrar novos resultados de ensaios na base de dados existente.
Information systems on the web are becoming important resources for those studying biomedical sciences. One area of study of these sciences focuses on the oral cavity and on proteins that reside in it. Several online platforms provide specific knowledge on multiple microorganisms and associated proteins, but these are generic and are not designed for specific case studies. This work aims to develop a strategy and a prototype for the storage of information related to the oral cavity, aiming their use in research. It will integrate data collected from experimental results with existing references on the web and explored by other entities. The prototype allows researchers in the biomedical sciences, without particular expertise in databases, searching for proteins, genes and diseases, and integrating new test results in the existing database.
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Jones, Mary J. "A 21st century national public health system." Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Sept/08Sep%5FJones.pdf.
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Thesis (M.A. in Security Studies (Homeland Security and Defense))--Naval Postgraduate School, September 2008.Thesis Advisor(s): Bellavita, Christopher. "September 2008." Description based on title screen as viewed on November 5, 2008. Includes bibliographical references (p. 121-126). Also available in print.
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Vasudevan, Sridhar. "Secure telemedicine system for home health care." Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1254.
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Thesis (M.S.)--West Virginia University, 2000.Title from document title page. Document formatted into pages; contains vi, 94 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 92-93).
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OLGIATI, STEFANO. "The sustainability of the Lombardia health system." Doctoral thesis, Università degli Studi di Milano-Bicocca, 2012. http://hdl.handle.net/10281/28483.
Full textAbstract:
The cœteris paribus trend of growth of the Lombardia Hospital System epidemiological, demographic, economic and financial variables analyzed in this research in the period 1997-2009 is not sustainable in the long-term, for the purpose of this research to the year 2050.
Even if in the period 2002-2009 some financial and epidemiological adjustment has indeed been attempted (as highlighted by the Financial Function), in particular with yearly activity budgetary financial constraints and compulsory transfers from acute to ambulatory care (as highlighted by the Epidemiological Function), by means of which short-term financial equilibrium has temporarily been maintained, this same adjustment does not guarantee long-term epidemiological, demographic, economic and financial sustainability (as highlighted by the Sustainability Function).
The Italian Ministero dell’Economia e delle Finanze is indeed intervening in curbing the growth rate of public health expenditure by fixing it at a definite percent of the national gross domestic product (circa 7.2%). Most of the savings are based on the reduction of personnel.
Since health funds are pooled and equally allocated on a risk adjusted capitarian basis, the same savings will be required on the part of Lombardia.
However, if savings are to be made, the underlying epidemiological trends (increase in complexity, invariance in the acute inpatient cases length of stay, increase in intensity), as highlighted by the Epidemiological Function, have to be addressed as well, which introduces the bi-faced question if such savings are sustainable or if their epidemiological effects are acceptable.
If there is an almost general consensus among both health operators and regulators in Italy and Lombardia that both effectiveness and efficiency are the main drivers of the long term sustainability of a health system, it appears from the first applications of the model presented here that the Italian and Lombardia Hospital System is still governed by a tendency to manage the short term effects of rising medical, labor and variable costs in general, than by a much more challenging direct intervention into the epidemiological and operational parameters governing the health system in the long term.
Certainly, an excellent clinical effectiveness has been achieved, even if, in order to be sustainable in the long term, increases in clinical quality must be proportional to the reduction in the economic waste of financial resources, both in the form of excess costs of the public providers and excess profits in the private ones.
Once again, the authors of this paper argue that there can be no health without equity, no equity without quality, and no quality without sustainability.
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Liu, Zongchang. "Cyber-Physical System Augmented Prognostics and Health Management for Fleet-Based Systems." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522321192371536.
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Erdil, Nadiye Özlem. "Systems analysis of electronic health record adoption in the U.S. healthcare system." Diss., Online access via UMI:, 2009.
Find full textAbstract:
Thesis (Ph. D.)--State University of New York at Binghamton, Thomas J. Watson School of Engineering and Applied Science, Department of Systems Science and Industrial Engineering, 2009.Includes bibliographical references.
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de, Araújo José Luiz. "Health sector reform in Brazil, 1995-1998 : an health policy analysis of a developing health system." Thesis, University of Leeds, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.431546.
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Clernon, George. "Exploring the wireless sensor node tradespace within Structural Health Monitoring." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/100370.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references (pages 69-74).
Historically, Structural Health Monitoring (SHM) involved visually or acoustically observing a structure and if damage was detected, remedial action was undertaken to repair or replace it. For example, as early as 6,500 BC, potters were known to listen for audible sounds during the cooling of their ceramics, signifying structural failure. In 1864 the UK parliament legislated for dam monitoring after a dam failure lead to the deaths of 254 people. The Golden Gate and Bay Bridges in San Francisco were monitored by Dean S. Carder in 1937 to determine "the probabilities of damage due to resonance" during an earthquake. Given the technological limitations of the last century, the predominant focus of SHM has been on identifying and understanding the global modal properties of a structure. However, the promise of SHM is the detection of any damage to infrastructure at the earliest possible moment from an array of sensors and actuators. To achieve this goal, not only global but local facets of the structure must be monitored. If this promise is realized, it will be possible to design bridges closer to their tolerances, to extend their operational lives, and to switch servicing to more cost-effective condition based maintenance. Such changes will reduce construction and maintenance costs while still providing the same level of service. This thesis will explore the wireless sensor node tradespace with the specific intent of delving into the areas limiting large scale, high density, localized coverage of structural health monitoring of bridges.
by George Clernon.
S.M. in Engineering and Management
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Trpišovský, Josef. "Možnosti řešení zdravotních rizik." Master's thesis, Vysoká škola ekonomická v Praze, 2009. http://www.nusl.cz/ntk/nusl-150165.
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The thesis is primarily oriented on economic aspects of health systems. It contains the analysis and description of health risks, health-insurance systems (models) and current status of Czech health system. Czech health system is described and scarified. Analysis of weak points, status of reforms and also a design of possible solutions are integral parts of this thesis. Both public and commercial approaches to health and insurance systems are involved, including current commercial insurance products which are available on Czech market.
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Gudes, Ori. "Developing a framework for planning healthy communities : the Logan Beaudesert health decision support system." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/50783/1/Ori_Gudes_Thesis.pdf.
Full textAbstract:
In the last few decades, the focus on building healthy communities has grown significantly (Ashton, 2009). There is growing evidence that new approaches to planning are required to address the challenges faced by contemporary communities. These approaches need to be based on timely access to local information and collaborative planning processes (Murray, 2006; Scotch & Parmanto, 2006; Ashton, 2009; Kazda et al., 2009). However, there is little research to inform the methods that can support this type of responsive, local, collaborative and consultative health planning (Northridge et al., 2003). Some research justifies the use of decision support systems (DSS) as a tool to support planning for healthy communities. DSS have been found to increase collaboration between stakeholders and communities, improve the accuracy and quality of the decision-making process, and improve the availability of data and information for health decision-makers (Nobre et al., 1997; Cromley & McLafferty, 2002; Waring et al., 2005). Geographic information systems (GIS) have been suggested as an innovative method by which to implement DSS because they promote new ways of thinking about evidence and facilitate a broader understanding of communities. Furthermore, literature has indicated that online environments can have a positive impact on decision-making by enabling access to information by a broader audience (Kingston et al., 2001). However, only limited research has examined the implementation and impact of online DSS in the health planning field. Previous studies have emphasised the lack of effective information management systems and an absence of frameworks to guide the way in which information is used to promote informed decisions in health planning. It has become imperative to develop innovative approaches, frameworks and methods to support health planning. Thus, to address these identified gaps in the knowledge, this study aims to develop a conceptual planning framework for creating healthy communities and examine the impact of DSS in the Logan Beaudesert area. Specifically, the study aims to identify the key elements and domains of information that are needed to develop healthy communities, to develop a conceptual planning framework for creating healthy communities, to collaboratively develop and implement an online GIS-based Health DSS (i.e., HDSS), and to examine the impact of the HDSS on local decision-making processes. The study is based on a real-world case study of a community-based initiative that was established to improve public health outcomes and promote new ways of addressing chronic disease. The study involved the development of an online GIS-based health decision support system (HDSS), which was applied in the Logan Beaudesert region of Queensland, Australia. A planning framework was developed to account for the way in which information could be organised to contribute to a healthy community. The decision support system was developed within a unique settings-based initiative Logan Beaudesert Health Coalition (LBHC) designed to plan and improve the health capacity of Logan Beaudesert area in Queensland, Australia. This setting provided a suitable platform to apply a participatory research design to the development and implementation of the HDSS. Therefore, the HDSS was a pilot study examined the impact of this collaborative process, and the subsequent implementation of the HDSS on the way decision-making was perceived across the LBHC. As for the method, based on a systematic literature review, a comprehensive planning framework for creating healthy communities has been developed. This was followed by using a mixed method design, data were collected through both qualitative and quantitative methods. Specifically, data were collected by adopting a participatory action research (PAR) approach (i.e., PAR intervention) that informed the development and conceptualisation of the HDSS. A pre- and post-design was then used to determine the impact of the HDSS on decision-making. The findings of this study revealed a meaningful framework for organising information to guide planning for healthy communities. This conceptual framework provided a comprehensive system within which to organise existing data. The PAR process was useful in engaging stakeholders and decision-making in the development and implementation of the online GIS-based DSS. Through three PAR cycles, this study resulted in heightened awareness of online GIS-based DSS and openness to its implementation. It resulted in the development of a tailored system (i.e., HDSS) that addressed the local information and planning needs of the LBHC. In addition, the implementation of the DSS resulted in improved decision- making and greater satisfaction with decisions within the LBHC. For example, the study illustrated the culture in which decisions were made before and after the PAR intervention and what improvements have been observed after the application of the HDSS. In general, the findings indicated that decision-making processes are not merely informed (consequent of using the HDSS tool), but they also enhance the overall sense of ‗collaboration‘ in the health planning practice. For example, it was found that PAR intervention had a positive impact on the way decisions were made. The study revealed important features of the HDSS development and implementation process that will contribute to future research. Thus, the overall findings suggest that the HDSS is an effective tool, which would play an important role in the future for significantly improving the health planning practice.