Dissertations / Theses on the topic 'Healthcare utilization outcomes'
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Huang, Jacob Chao-Lun. "Healthcare Utilization and Health Outcomes: US-born and Foreign-born Elderly Asian Americans." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc804863/.
Full textJohnson, Adam M. "The Impact of Collaborative Behavioral Health on Treatment Outcomes of Diabetes." DigitalCommons@USU, 2019. https://digitalcommons.usu.edu/etd/7615.
Full textHammonds, Tracy Lynn. "The Influence of the Caregiver on Healthcare Outcomes in Patients with Chronic Obstructive Pulmonary Disease (COPD)." Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1426543939.
Full textLuu, Shyuemeng. "The Determinants of Post-discharge Healthcare Utilization and Outcomes for Veterans with Posttraumatic Stress Disorder: A Social Ecological Perspective." VCU Scholars Compass, 2000. https://scholarscompass.vcu.edu/etd/5231.
Full textJayawant, Sujata Satish. "Effect of dosing regimens on medication use, healthcare resource utilization, and costs in Medicaid enrolled Type 2 diabetes mellitus patients." The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1203710092.
Full textWu, Jun. "Statin Medication Adherence and Associated Outcomes in Type 2 Diabetes Medicaid Enrollees with Comorbid Hyperlipidemia." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1276258784.
Full textCulver, Mark, Justin VandenBerg, and Grant Skrepnek. "Clinical Outcomes and Economic Characteristics Regarding Inpatient Treatment of Brain Tumors with Implantable Wafers in the United States." The University of Arizona, 2012. http://hdl.handle.net/10150/614463.
Full textSpecific Aims: This study was aimed to evaluate inpatient clinical treatment characteristics associated with the use of intracranial implantation of chemotherapeutic wafers for malignant brain neoplasms within United States, and assess inpatient mortality and total charges regarding treatment with wafer versus without. Methods: A retrospective cohort investigation was conducted utilizing inpatient discharge records from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample from 2005 to 2009. From this nationally-representative sample, 9,455 adults aged 18 years or older were identified with malignant neoplasms of the brain treated with implantable chemotherapeutic wafers. Outcomes of inpatient mortality and charges were assessed via multivariate regression analysis, controlling for patient characteristics, hospital structure, comorbidities, and clinical complications. Main Results: The average age of patients with brain neoplasms was 56.6 (±16.5) years, and of those patients, 42.9% were female. The odds ratio for inpatient mortality of patients treated with implantable chemotherapeutic wafers was OR=0.380 (P<0.001), and patients that received wafer treatment had increased charges exp(b)=2.147 (P<0.001). Conclusions: Multiple factors were associated with inpatient mortality and charges among the 247,829 patients that were diagnosed with malignant brain neoplasms from 2005-2009. With regards to these patients, implantable chemotherapeutic wafers were associated with increased inpatient survival and increased charges.
Rejzer, Courtney Brynne. "The influence of the acute care nurse practitioner on healthcare delivery outcomes : a systematic review /." Full-text of dissertation on the Internet (211 KB), 2009. http://www.lib.jmu.edu/general/etd/2009/Honors/Rejzer_CourtneyB/rejzercb_honors_11-11-2009.pdf.
Full textGipson, Linda Stephens. "The Impact of Managed Care on the Utilization and Distribution of Inpatient Surgical Procedures with Demonstrated Volume and Outcome Endogeneity." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3118.
Full textHerman, Patricia, Sally Dodds, Melanie Logue, Ivo Abraham, Rick Rehfeld, Amy Grizzle, Terry Urbine, Randy Horwitz, Robert Crocker, and Victoria Maizes. "IMPACT - Integrative Medicine PrimAry Care Trial: protocol for a comparative effectiveness study of the clinical and cost outcomes of an integrative primary care clinic model." BioMed Central, 2014. http://hdl.handle.net/10150/610366.
Full textMurasko, Jason Elliot. "Determinants of health outcomes and healthcare utilization." Thesis, 2004. http://hdl.handle.net/1911/18673.
Full textHsu, Pei-Hsuan, and 許珮萱. "Healthcare Utilization and Outcomes among Home-care Patients in Different Care Settings." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/k7n2wr.
Full text國立臺灣大學
健康政策與管理研究所
107
Background: Home care is an essential part of the long-term care system, and it also plays an important role in the medical system in an aging society. An aging society may cause changes in population and family structure, and increase the demand for care in the hospital and community. Patients may choose to receive care at home, nursing home or residential care home. This study aims to explore the expenditure and outcome of care delivered at different sites. Method: This study is a secondary data analysis of retrospective cohort studies. We used data for the year of 2010 from the National Health Insurance Research Database and collected data from patients receiving home care service in 2012. In this study, data from1,556 patients was collected and the patients were categorized into 3 groups: patients receiving care at home (HC), at nursing home (NH) and at residential care homes (RCH). Two-part model was used in this study. The first-stage multiple logistic regression analysis and second-stage generalized linear model analysis were conducted to verify the patients’ usages of outpatient department, emergency department, hospitalization, home care, and physician visits within one year after receiving home care, and make comparison between medical utilization and avoidable hospitalization. Results: Concerning medical utilization, in terms of (1) out-patient departments: patients utilizing nursing homes and residential care homes led to more outpatient visits than those utilizing home care by 44% and 13% (p<.001); and the outpatient expenses were higher among patients at nursing homes (14%, p<.01), and lower among patients at residential care homes (14%, p<.001) than among patients at home. (2) emergency room: patients utilizing nursing homes and residential care homes led to less emergency utilization than patients utilizing home care by 0.72 times (p<.05) and 0.63 times (p<.001); emergency visit: patients utilizing nursing homes and residential care homes led to less emergency visits than patients utilizing home care by 0.35 times and 0.43 times (p<.001) ; and the difference in emergency department expenses among different sites was not significant. (3) hospitalization: the difference in admission at different sites was not significant; patients utilizing nursing homes and residential care homes made fewer days of stay than those utilizing home care by 14% and 24% (p<.001); patients utilizing nursing homes and residential care homes made fewer expense than those utilizing home care by 17% (p<.05). (4) home care: patients utilizing nursing homes and residential care homes utilized more home care services than those utilizing home care by 5% (p<.05); patents utilizing residential care homes got more expense of home care services than those utilizing home care by 12% (p<.01). (5) utilization of physician visit: patients utilizing nursing homes and residential care homes made more utilization of physician visits than those utilizing home care by 1.95 times and 1.99 times (p<.01); physician visit: patients utilizing nursing homes and residential care homes made more physician visits than those utilizing home care by 28% and 21% (p<.01); and the expense for patients utilizing nursing home was higher than those utilizing home care by 17% (p<.001). Concerning care outcomes, no significant difference was found in visits of avoidable hospitalization; patients utilizing nursing homes and residential care homes made fewer days of avoidable hospitalization than those utilizing home care by 29% and 32% (p<.001); patients utilizing nursing homes and residential care homes made fewer expense of avoidable hospitalization than those utilizing home care by 35% and 33% (p<.001). While the total expense of home care services is lower for patients receiving home care at home, the total expense of medical use for them is much higher than those who received their home care service in residential care homes. Conclusions: Overall, among home care recipients, those who received home care at home made more emergency visits; but those who received home care at nursing home made most outpatient visits, outpatient expenses, home care utilization and physician visits, followed by those who received home care at residential care homes. Parameters of residential care homes are usually between nursing homes and homes, except patients utilizing residential care homes made least emergency visits. There was no difference among hospitalization visits among the three groups, but those who received home care at home made most days of stay and emergency department expenses. Concerning the care outcome, those who received home care at home made most days of stay and expenses of avoidable hospitalization, which is mainly caused by infection in urinary tract, bacterial pneumonia, and chronic obstructive pulmonary disease. It is obvious that nursing needs of the patients receiving home care at home cannot be satisfied owing to the lack of regular nursing staff, which demands more emergency use. The outcome demonstrated that patients utilizing nursing home made more outpatient and home care utilization but less emergency use. Despite the outcome may indicate decent collaborations among institutes and hospitals, further examination may still be needed to verify if there are adequate home care applied in institutes.
Pan, Chih-Hsi, and 潘芷昕. "The Effect of Family Physician Integrated Care Program on Healthcare Utilization and Outcomes." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/90389048537140727816.
Full text國立臺灣大學
健康政策與管理研究所
102
Background The Family Physician Integrated Care Program has been implemented for many years. The National Health Insurance Administration wants to establish the foundation plans to reach a Family Physician System by this program. However, in recent years, there have been few studies on the long-term effect of the program on healthcare utilization and outcomes. Purpose The purpose of this study was to evaluate the effect of the Family Physician Integrated Care Program on healthcare utilization and outcomes. Methods This study used the Nation Health Insurance data from 2004 to 2011. Patients were classified into two groups. Beneficiaries who did not join the program from 2004 to 2006 but joined the program from 2007 to 2011 were classified as an intervention group. Others who did not join the program from 2004 to 2011 were classified as a comparison group. We used the Difference in Difference method, Propensity Score method and multivariate regression models to examine the effect of the program on healthcare utilization and outcomes. Results There was an increase in adult preventive services utilization. Discussion This study shows that Family Physician Integrated Care Program can increase the prevention services utilization, meaning that family physicians may provide more preventive services to prevent their members from morbidity. However, the effect of the program other healthcare services utilization and outcomes is limited.
Tsai, Ya-An, and 蔡雅安. "The impact of dental scaling and subgingival curettage on outcomes and healthcare utilization among patients with diabetes." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/nwtuhn.
Full text國立臺灣大學
健康政策與管理研究所
107
Background: Hemoglobin A1c(HbA1c) is associated with severe periodontal ailment among patients with type 2 diabetes, and can be lowered by non-surgical periodontal treatment. However, data from empirical studies on diabetes and periodontal treatment interventions are not robust, as Taiwan lacks population-based data. Objective: To evaluate the effect of dental scaling and subgingival curettage on outcomes and healthcare utilization among patients with diabetes. Methods: The retrospective cohort study was designed using the database of National Health Insurance for secondary analysis. Patients diagnosed with type 2 diabetes and periodontal disease in 2017 were selected, and we have used propensity score matching to reduce bias between treatment and control groups on a large number of covariates. If the difference between the results of 2017 and 2018 diabetes outcomes and utilization is due to periodontal treatment intervention is to be ascertained. Results: After dental scaling or subgingival curettage, compared with those who did not receive the treatment, the ratio of odds of subsequent HbA1c below 7% was 1.065, and the risk of renal ailment was lower by 13%, and of hospitalization by 27%. The data analysis shows that there was an increase in the number of medical outpatient visits, of dental visits, and total dental expenses, but there was decrease in the average length of hospital stays, total hospitalization expenses, and overall medical expenses. Conclusions: Patients with type 2 diabetes and periodontal disease who have received periodontal treatment have better subsequent diabetes outcomes, and lower hospitalization need and overall medical care. Hence, we recommend that health policymakers consider the inclusion of dentists in Diabetes Shared Care team and institute relevant referral systems.
Huang, Chung-Bin, and 黃崇濱. "The Healthcare Resource Utilization and Outcome of Very Low Birth Weight Infants in the First 2 Years after Initial Neonatal Hospitalization—A Comparison with Non-Followup Group." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/29479326616899012089.
Full text高雄醫學大學
公共衛生學研究所碩士在職專班
92
The Healthcare Resource Utilization and Outcome of Very Low Birth Weight Infants in the First 2 Years after Initial Neonatal Hospitalization —A Comparison with Non-Followup Group Objective : This study was undertaken to evaluate the difference of cost and outcome between VLBW-follow up and VLBW-non follow up infants during the first two years after NICU-discharge. Study design: This was a retrospective review of prospectively collected data on neurodevelopmental outcome and medical cost in the first two years after initial neonatal hospitalization for all infants born in 2000 with birth weight < 1500g in the area of Tainan-Chiayi-Yuling ( N=156). A comparison VLBW-infants and full term newborn, and comparison of two groups of VLBW infants divided into follow-up (N=120) and non follow-up infants (N=36). Standard statistical methods for continuous and non-continuous data and regression procedures were performed. Results : 1. The medical care cost of VLBW infants in the first two years after neonatal initial hospitalization was higher than full term newborn (30:1) 2. The medical care cost of VLBM-follow up infants was higher than non-follow up group (3:1) 3. The medical care cost between follow-up and non-follow up of VLBW infants become no difference after 2 years. 4. The outcome and mortality of follow-up group was much better compared with the non follow-up infants. Conclusion : Neonatal intensive care and its sequelae are certainly very expensive, especially the very-low-birth-weight infants. How to avoid premature labor and prematurity is essential. Early educational intervention relying on a intensive schedule of home-visiting and center-based approaches resulted in substantial gains in cognitive and behavioral development even among those very-low-birth-weight infants.
"Spatial variation in the utilization of public healthcare services among the Hong Kong elderly in the last three years of life in relation to the service provision and their health outcome." 2010. http://library.cuhk.edu.hk/record=b5894480.
Full text"August 2010."
Thesis (M.Phil.)--Chinese University of Hong Kong, 2010.
Includes bibliographical references (leaves 158-172).
Abstracts in English and Chinese.
Chapter Chapter One: --- Introduction --- p.1
Chapter 1.1 --- Background --- p.1
Chapter 1.2 --- Research objectives --- p.5
Chapter 1.3 --- Research hypothesis --- p.7
Chapter 1.4 --- Research questions --- p.7
Chapter 1.5 --- Research structure --- p.9
Chapter Chapter Two: --- Literature Review --- p.10
Chapter 2.1 --- "Health geography: knowledge of population, people, places and health" --- p.10
Chapter 2.2 --- Understanding geographies of diseases: mapping and modeling diseases and health --- p.17
Chapter 2.3 --- Healthcare services provision and utilization --- p.22
Chapter 2.4 --- Hong Kong: facts and context --- p.31
Chapter 2.4.1 --- Demographics --- p.32
Chapter 2.4.2 --- Key challenges arising from population ageing --- p.37
Chapter 2.4.2.1 --- Implications to medico-social agenda --- p.38
Chapter 2.4.2.2 --- Implications to health status --- p.38
Chapter 2.4.2.3 --- Implications to disease pattern --- p.39
Chapter 2.4.3 --- Healthcare service delivery system in Hong Kong --- p.41
Chapter 2.4.3.1 --- Financing and expenditure --- p.42
Chapter 2.4.3.2 --- Organizational framework and healthcare policy --- p.44
Chapter 2.4.3.3 --- Healthcare resources --- p.49
Chapter 2.4.3.4 --- Utilization and provision of public healthcare services --- p.50
Chapter Chapter Three: --- Material & Methods --- p.55
Chapter 3.1 --- Background of main source of data --- p.55
Chapter 3.2 --- Sources of data --- p.57
Chapter 3.2.1 --- Hospital services utilization data --- p.57
Chapter 3.2.2 --- Healthcare resources data --- p.61
Chapter 3.2.3 --- Population data --- p.62
Chapter 3.3 --- Spatial scale of analysis --- p.62
Chapter 3.4 --- Statistical analyses --- p.63
Chapter 3.4.1 --- Service utilization ratios --- p.63
Chapter 3.4.2 --- Provision of healthcare resources to population --- p.65
Chapter 3.4.3 --- Adequacy of healthcare services provision --- p.65
Chapter 3.4.4 --- Mortality analysis --- p.67
Chapter 3.4.5 --- Multi-level analysis --- p.69
Chapter 3.4.6 --- Mapping of health services utilization ratio and mortality ratio --- p.70
Chapter 3.5 --- Statistical packages used --- p.73
Chapter 3.6 --- Cautions on interpretation --- p.74
Chapter 3.6.1 --- Confounding and ecological fallacy --- p.74
Chapter 3.6.2 --- Problem with the use of Standardized Mortality Ratio --- p.75
Chapter 3.6.3 --- Problem with mapping and visualization --- p.76
Chapter Chapter Four: --- Results --- p.78
Chapter 4.1 --- Socio-spatial variation in mortality --- p.78
Chapter 4.2 --- Statistical analysis and mapping of health services utilization ratio --- p.80
Chapter 4.3 --- Statistical and cartographic analysis in Standardized Mortality Ratio --- p.88
Chapter 4.4 --- Provision of healthcare resources to population --- p.91
Chapter 4.5 --- "Multi-level analysis of hospital services utilization, provision and mortality" --- p.92
Chapter 4.6 --- Further analysis --- p.95
Chapter Chapter Five: --- Discussion --- p.100
Chapter 5.1 --- Geographic variations in health services utilization ratios --- p.101
Chapter 5.2 --- Geographic variation in Standardized Mortality Ratio --- p.107
Chapter 5.3 --- "Multi-level models on health services utilization, provision and mortality" --- p.121
Chapter 5.3.1 --- Socio-demographic characteristics of health services utilization --- p.121
Chapter 5.3.1.1 --- Age --- p.121
Chapter 5.3.1.2 --- Gender --- p.124
Chapter 5.3.2 --- Health services utilization in relation to services provision --- p.129
Chapter 5.3.3 --- Health services utilization in relation to mortality --- p.132
Chapter 5.3.4 --- Adequacy of healthcare services provision --- p.134
Chapter 5.3.4.1 --- Adequacy of hospital care provision --- p.134
Chapter 5.3.4.2 --- Adequacy of primary care provision --- p.139
Chapter 5.4 --- Implications --- p.143
Chapter 5.5 --- Strengths of study --- p.146
Chapter 5.6 --- Limitations of study --- p.148
Chapter 5.7 --- Recommendations for future research --- p.151
Chapter Chapter Six: --- Conclusion --- p.154
References --- p.158