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1
Wilkie, Martin. "Mixed herbivore grazing on a lowland heath system : quantifying the collective impacts for conservation management." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/355885/.
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Degradation of terrestrial habitats with high conservation value has resulted in strategic efforts to cease or reverse their declines. Broad habitat management can restore ecological processes and large herbivores can provide ecological function in some terrestrial systems. Following years of decline and fragmentation, owing to factors such as cessation of traditional practices, lowland heathland has become an internationally important habitat with strategic protection. Free-ranging grazing aims to assist in mitigating such losses to habitat and vegetation communities, but quantifying the grazing regime and its associated impacts is necessary to ensure protection of these vulnerable systems. Reviews of herbivore impacts on lowland heath provide detailed evaluations and recognise the absence of experimental assessments and baseline monitoring. This research aimed to assess ecological activity and impacts (herbage removal, trampling and dunging) of horses and cattle on a lowland heath system to determine their influence on changing vegetation and to inform grazing management. This mixed regime is commonly adopted for restoration of semi-natural habitats but a failure to understand the separate vegetation impacts can be detrimental for the system as a whole. Behavioural activity was quantified using scan-sampling assessing spatial and temporal variation in behaviour, habitat selection and niche overlap, spatial occupancy and diet. A factorial design was set up to quantify the impacts of herbage removal, trampling and dunging to vegetation separately. Assessments vegetation community composition and architecture in treatment and control areas were undertaken. Analyses incorporated non-parametric and general linear models. Animals utilised their environments in different ways, varying for feeding and showed high habitat selectivity, based on physiology and foraging strategy primarily. Herbage removal strongly influenced vegetation architecture and heterogeneity owing to selection for graminoids and the plants’ competitive traits; effects on other plants were not as well defined due to minimal abundance. Trampling modified the vegetation structure due to reduced canopy density maintaining colonising gaps, but increased graminaceous cover and showed a capacity for lateral expansion. Dunging regime was highly influential for enhancing plant architecture and modified vegetation composition based on nutrient availability and competition. Worming regime was influential on architectural parameters and may be due to retarded dung degradation; further research is required. The findings contributed knowledge to lowland heath grazing management, validating the use of mixed regimes at low densities, for generating vegetation heterogeneity, for the control of dominating plants and for understanding the impacts of different animal-management practices. Expanding the reach of this research to comparable systems is necessary to develop the knowledge of grazing-management impacts. The work addressed an absence of experimental evaluation on these systems and also illustrated the importance of separately quantifying the impacts of large herbivores.
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Nduru, Polite Munyaradzi. "Investigating biases in census questions on mortality using Agincourt heath and demographic surveillance system data." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/5891.
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Includes abstract.Includes bibliographical references.
An understanding of the errors found in census questions is important in order to assess the level of confidence in the census data and to get an appreciation of the impact of using these data in estimating mortality derived from census data. While demographic methods are often used to determine the direction of bias in the data, direct evaluation studies are required to determine the nature and extent of biases with more accuracy. Equally important is an understanding of the characteristics of the respondents who produce better responses in censuses. This can be used to inform selection of better respondents in order to improve the quality of the collected data. This research uses census data from a survey, which is matched to the longitudinal Health Demographic Surveillance System site (HDSS) data from Agincourt, Limpopo Province, South Africa, in order to assess the biases found in data used in child and adult mortality estimation that uses indirect techniques.
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Shvets, Anna. "Program kontinuálního zvyšování kvality péče v soukromém zdravotnickém zařízení na Ukrajině." Master's thesis, Vysoká škola ekonomická v Praze, 2017. http://www.nusl.cz/ntk/nusl-359957.
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The aim of this master s thesis is to establish continual program of health care quality improvement in a private multi-specialty medical facility Nebolejka based in Ukrainian city Kharkov. Thesis is divided into several parts. Theoretical part is focused on quality examination from the healthcare system point of view, deals with the analyses of Ukrainian healthcare system actual state. Practical part is focused on health care quali-ty evaluation in a private clinic Nebolejka. With a use of patient satisfaction survey a program of health care quality improvement was established. Its effectiveness was also verified via repeated patient satisfaction survey in short- term time period. This thesis is primarily useful for medical facility Nebolejka, because improvement of health care quality not surprisingly constitute to better competitive market position.
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Kurpė, Vilija. "Korupcijos kontrolė Lietuvos sveikatos apsaugos sistemoje." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140603_133421-32058.
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Kurpė V. Korupcijos kontrolė Lietuvos sveikatos apsaugos sistemoje / magistro baigiamasis darbas. Vadovė Dr. N. Černiauskienė – Vilnius: Mykolo Romerio universitetas, politikos ir vadybos fakultetas, 2014. – 76 p. Magistro baigiamajame darbe išanalizuota ir įvertinta korupcijos kontrolė Lietuvos sveikatos apsaugos sistemoje, iškeltos korupcijos sveikatos apsaugos sistemoje problemos. Pirmoje dalyje remiantis mokslinės bei teisinės literatūros šaltiniais nagrinėjama teorinė dalis: korupcijos sąvoka, formos, korupciją įtakojantys veiksniai. Antroje dalyje analizuojamas korupcijos lygis bei korupcijos kontrolė sveikatos apsaugos sistemoje. Trečioje dalyje pagrindžiama tyrimo problema, pateikiamas instrumentarijus, aptariama atliekamo tyrimo eiga. Ketvirtoje dalyje analizuojamas visuomenės bei gydytojų požiūris į korupciją sveikatos apsaugos sistemoje. Pagrindiniai žodžiai: korupcija, korupcijos kontrolė, sveikatos apsauga, sveikatos apsaugos sistema.Kurpe V.. Corruption control in Lithuania health care system / Master’s Work in. Supervisor assoc. N. Cerniauskiene – Vilnius: Fakulcity of Fakulcity Policy and Management, Mykolas Romeris University, 2014. – 76 p. Master's thesis analyzed and evaluated corruption control Lithuanian health system, bringing health care system corruption problems. In the first part of the scientific and legal literature examines the theoretical part: Corruption concept, shape, corruption influencing factors. The second part analyzes the level of corruption and corruption control health care system. The third section justifies the problem, the instrumentation, discusses the progress of the investigation. The fourth part analyzes public perceptionsand doctors position of corruption in the health care system.
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Daza, Aramayo Lourdes Gabriela. "Sociální zabezpečení v některých státech Latinské ameriky." Master's thesis, Vysoká škola ekonomická v Praze, 2008. http://www.nusl.cz/ntk/nusl-4472.
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This thesis has aims to acquaint the reader with Latin American Social Security systems. For this end, 7 Latin American countries have been chosen. Henceforth, the different Social Security systems operating in these countries are described. It is a comparative analysis, describing the similarities and differences among them. Is necessary to emphasize that this paper does not only provide current information of the different Social Security systems, but also statistical information, which is considered as essential to the context of the economic, demographic and social environments in which are these Social Security systems function. The systems described are: the Pension System, Heath Insurance, Sickness Benefits, Unemployment Insurance, Family Entitlements and last Maternity Benefits. The countries that have been chosen are the following: Argentina, Bolivia, Chile, Colombia, Ecuador, Peru, and Uruguay. In addition to the comparative analysis in this paper, the level of development in the chosen Latin American countries as well as the latest trends concerning the Social Security systems are determined and explained.
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Ferreira, Ana Rita dos Santos. "Mulher negra e saúde pública: o discurso feminino nos movimentos negros." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/100/100134/tde-06122013-091624/.
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Os movimentos negros brasileiros aparecem como principais protagonistas intelectuais e militantes do antirracismo no Brasil e por intermédio das múltiplas modalidades de protesto mobilizam a implantação de políticas públicas para a população negra. O não acesso aos bens comuns da sociedade e aos direitos fundamentais, como no caso da saúde, demanda a criação de medidas para superação das dificuldades de acesso a estes serviços por grande parte da população brasileira. Entre os determinantes sociais encontra-se o racismo e o machismo que expõe as mulheres negras a fatores de risco em saúde e determina suas condições de vida, saúde e adoecimento. O presente estudo traz uma reflexão sobre os sentidos atribuídos ao acesso da mulher negra à saúde pública por mulheres negras militantes em movimentos negros da cidade de São Paulo. Tratam-se de movimentos importantes na luta pela inclusão da mulher negra e atenção as suas especificidades em saúde, bem como na elaboração, implantação e implementação da Política Nacional de Saúde Integral da População Negra. As ações políticas dos movimentos negros foram abordadas também em sua dimensão simbólica cujo campo discursivo se move em contraposição à naturalização das desigualdades raciais, mas em favor do acesso aos direitos, denunciando as injustiças sociais intensificadas para a população negra pelo racismo. Abordamos também seu movimento no sentido de dar à negras e negros o direito de contarem sua própria história , a construir uma memória e identidade coletivas que se contrapunha à imagem marginalizada e inferiorizada instituída historicamente no imaginário social brasileiroThe Brazilian black movements have emerged as the principle intellectual and activist protagonist against racism in Brazil. Through multiple points of protests they have been initiating the implementation of public polices for the black population. The inaccessibility to the common goods of society and the limited access to fundamental rights, as in the case of health, has requires the creation of polices to overcome the difficulties that a huge part of the Brazilian population has in accessing health services. Among other social determinants, racism and sexism significantly impacts the quality of life, health and illnesses facing black women. This study is an analysis of what black militants from black movements in São Paulo City believe limits black women\'s access to the public health system. This is important as central to black movements struggles for the inclusion of black women into Brazilian society is their focus on black women\'s health, as well as, the elaborations and implementation of the Política Nacional de Saúde Integral da População Negra (National Policy of the Black Population\'s Integrated Health). The black movement\'s political actions are also analyzed on its symbolic dimension in which the discursive field moves against the naturalization of racial inequalities and in favor of accessing rights, and denouncing the social injustice which is intensified for black population by racism. These women also focus on the right to tell their history in order to build a memory and collective identity in contrast to the marginalizes one historically constituted in the Brazilian social imaginary
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Scatena, João Henrique Gurtler. "Avaliação da descentralização da assistência à saúde no Estado de Mato Grosso." Universidade de São Paulo, 2001. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-13112001-141924/.
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Instituído pela Constituição de 1988, o Sistema Único de Saúde (SUS) tem na descentralização um de seus princípios, o qual, através das Normas Operacionais Básicas (NOB) tem sido, junto com o controle social, um dos elementos de sustentação deste Sistema. Objetivando avaliar a descentralização da assistência à saúde e suas repercussões nos Sistemas Municipais de Saúde, foi estudada uma amostra de 16 municípios mato-grossenses, selecionados segundo porte, nível sócio sanitário e habilitação às NOB. Numa primeira etapa, a descentralização foi avaliada a partir dos dados quantitativos de financiamento, estrutura, produção e resolutividade dos serviços. Na segunda etapa, numa abordagem qualitativa, foram conduzidos 4 estudos de caso, que com base em análise documental e entrevistas, buscaram avaliar a descentralização sob o ponto de vista dos Conselhos Municipais de Saúde e dos conselheiros. Os dados quantitativos mostraram que a descentralização teve impactos positivos, expressos em: maior aporte de recursos financeiros, melhor organização das secretarias e aumento da produção e da resolutividade de vários serviços, os quais resultaram em melhoria da situação sanitária dos municípios estudados. Os dados qualitativos apontaram o fortalecimento dos Conselhos Municipais de Saúde como instância co-gestora e de controle social do SUS em nível local. Observou-se também que em Cuiabá e nos municípios maiores, está se desenvolvendo um modelo de atenção que prioriza a assistência médica, individualizada, com grande uso e dependência de tecnologia, que começa a comprometer a provisão e o financiamento da atenção primária. A reprodução desse modelo pode significar a inviabilidade financeira do SUS.The Brazilian Health System (SUS), created by the Constitution of 1988, established decentralization as one of its principles. This has been, through the Basic Operational Norms (NOB), one of the sustentation elements of this System, along with social control. With the objective of evaluating health care decentralization and its impact on the Municipal Health System, a sample of 16 of Mato Grosso States municipalities was studied, selected according to their population, socio-sanitary level and habilitation according to the NOB. Initially, the decentralization process was evaluated through the quantitative data of health services funding, production, structure and resolutivity. Second, utilizing a qualitive approach, four case studies were carried out, based on documents and interviews, seeking to evaluate the decentralization from the perspective of the Municipal Health Council and its councilors. The quantitative data demonstrated positive impacts of decentralization, such as the increase in financial health resouces, the improvement in departmental organization, and the rise in health services production and resolutivity, all of which resulted in the improvement of those municipalities health situation. The qualitative data showed the strengthening of the Municipal Health Council as the institution of co-administration and social control of the SUS at the local level. In Cuiabá and in other large cities, there was evidence of the development of a health care model that prioritizes medical care, individually, with great use of and dependence on technology, which begins to compromise primary health care supply and funding. The reproduction of this model may have important implications in SUS financial feasibility.
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Faria, Fernanda Barbosa Pinto de [UNIFESP]. "Medicina Tradicional Chinesa em unidades de saúde da Supervisão Técnica da Sé da cidade de São Paulo." Universidade Federal de São Paulo (UNIFESP), 2010. http://repositorio.unifesp.br/handle/11600/9807.
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Publico-12535.pdf: 742021 bytes, checksum: 9518cc7caeeb58090e95e52453539267 (MD5)A Medicina Tradicional Chinesa (MTC), com bases fundamentadas no estímulo à prevenção, visão holística e ênfase no autocuidado adequa-se às atuais Diretrizes Curriculares dos cursos da área da saúde e aos princípios do SUS, portanto vem sendo utilizada no sistema público de saúde no Brasil. Porém, a inserção de uma Medicina com bases filosóficas e culturais orientais em um contexto ocidental enfrenta numerosos desafios. Esta pesquisa tem como objetivo caracterizar o perfil profissional, as concepções, práticas e o processo de formação em MTC de profissionais que atuam em unidades do serviço público de saúde na cidade de São Paulo. Esta pesquisa descritiva exploratória foi realizada com abordagem qualitativa. A coleta de dados compreendeu a aplicação de formulários e entrevistas semiestruturadas a 12 profissionais que exercem MTC em duas unidades de saúde da região centro-oeste de São Paulo. A análise de conteúdo foi orientada pelos seguintes núcleos: perfil profissional, concepções e práticas, formação em MTC. Os resultados indicaram a configuração de dois grupos de profissionais que atuam com MTC, os médicos que praticam acupuntura e possuem formação mais normatizada e os não médicos que realizam práticas corporais e meditativas, com formação em diversas instituições que oferecem cursos com escassa normatização em relação à carga horária, aos conteúdos e requisitos de admissão. Os entraves na formação para ambos os grupos mencionados referem-se também à escassez de textos didáticos, docentes com insuficiente formação didático-pedagógica e ausência de apoio institucional para aprimoramento profissional em MTC. Os profissionais entrevistados expressam concepções condizentes com os princípios da MTC, contudo, o exercício da prática no cotidiano da unidade se vê prejudicado pela resistência da equipe multiprofissional, pelo escasso número de profissionais, carência de recursos materiais e falta de informação e divulgação da oferta e benefícios da MTC para usuários e profissionais da saúde. Os princípios da MTC e o perfil dos profissionais têm muito a contribuir com o atual modelo biopsicossocial de saúde no Brasil, embora medidas efetivas que incluam a aproximação das Instituições de Ensino Superior aos serviços de saúde devam ser estabelecidas para utilização e ampliação da MTC no serviço público, garantindo sua aplicação com segurança e qualidade visando à melhoria da saúde da população.
The Traditional Chinese Medicine, founded in the principles of stimulating prevention, holistic view and emphasis in self care, is appropriated in the current Curriculum Directive and to the Brazilian Unified Heath System, however, it has been used in the Brazil public health system. Nevertheless, the insertion of a Medicine with oriental philosophical and cultural approach in a western context has a number of challenges. The purpose of this search is to identify the professionals’ profile, the concepts, the practises and the education process of those professionals exercising Traditional Chinese Medicine in public centers in the city of São Paulo. This descriptive exploratory search was conducted with a qualitative approach. The data collection was through forms and semi-structured interviews with 12 professionals that exercise Traditional Chinese Medicine in two health public centers in the central west region of São Paulo. The content analysis was directed by: professional profile, concepts, practises and Traditional Chinese Medicine education. The results indicated the configuration of two professional groups that exercise Traditional Chinese Medicine: the doctors that practise acupuncture and have a formal academic education and the other professionals that give corporal and meditation practises and have a technical education acquired through several institutions that offer courses with limited regulation on minimum lecture and study hours, content and admission requirements. The issues regarding the education of both groups are also with respect to the limited availability of teaching material, teachers with insufficient teaching education and lack of institutional support for the professional improvement in Traditional Chinese Medicine. The traditional Chinese Medicine principles and the profile of the professionals have a lot to contribute with the current bio phiso social model of health in Brazil; nevertheless effective measures, which include the closer interaction between the universities and the health services, must be established in order for the Traditional Chinese Medicine to be used and amplified in the public service, safeguarding its qualified and secure application and aiming at the improvement of the heath standard of the population.
TEDE
BV UNIFESP: Teses e dissertações
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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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Martins, Márcia Maria de Medeiros Travassos Saeger. "A política do cartão nacional de saúde sob a ótica dos usuários do SUS na região metropolitana de João Pessoa e Recife." Universidade Federal da Paraíba, 2009. http://tede.biblioteca.ufpb.br:8080/handle/tede/3871.
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Previous issue date: 2009-09-18Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Throughout its history, Brazil has been finding many difficulties in education, economy, security, politics and health. The poor sections of the population - which is a large majority of people in relation to the ones who have more conditions - depend on governmental actions to make use of education and good health care among other services. One of the ways used to find solution to improve public health care services in the country was to create the Unique Health Care System (Sistema Único de Saúde - SUS), which aims at altering inequality in health care assistance to the population, imposing public attendance to any citizen, being prohibited the charge of money under any circumstances. With the increase in advances in technology around the world, public administration has been inserting in its practice devices that information technology (IT) disposes. In the public health care field, besides the Information systems in health, the national health card -or SUS card - represents one of the biggest projects developed by the government, using information systems that integrate all governmental spheres, providing a bigger financial control of the Ministry of health. The SUS card makes the access of registered patients to the SUS services possible, but at the same time it should not obstacle the access of the ones who do not have the card yet. According to the Health Ministry, one of the objectives of SUS card is to raise quality and efficiency in access to public health services. Ahead of the investments carried through in technology, an increase productivity is waited, that reflects in benefits to the population. This research aims at bringing to the reader the way as the users of SUS perceives the politics of SUS Card. Therefore public hospital patients in the metropolitans regions of João Pessoa and Recife were interviewed and the evaluation results proceeded from content analysis, proposed by Gläser and Laudel, with variables and dimensions established from the SERVQUAL model, scientifically validated. It was verified, to the end of the analysis, that the users of SUS do not feel themselves benefited with the implantation of SUS Card, what it makes possible the conclusion of that the high expenses of the Government with SUS Card had not been reverted in benefits to the population.
O Brasil tem encontrado grandes dificuldades, ao longo de sua história, na educação, economia, segurança, política e saúde. A população carente, que ocupa uma fatia enorme em relação àqueles que têm mais recursos depende das ações do Governo para que possa usufruir de educação e saúde de qualidade, além de outros serviços. Uma das formas adotadas na busca de soluções de otimização dos serviços de saúde pública no país foi a criação do Sistema Único de Saúde (SUS), que tem a finalidade de alterar a situação de desigualdade na assistência à saúde da população, tornando obrigatório o atendimento público a qualquer cidadão. Com os crescentes avanços tecnológicos por que vem passando o mundo, a administração pública vem inserindo em suas práticas ferramentas que a Tecnologia da Informação (TI) disponibiliza. No campo da saúde pública, além dos Sistemas de Informação em Saúde, o Cartão Nacional de Saúde, ou Cartão SUS representa um dos maiores projetos criados pelo governo, utilizando sistemas de informação que integram todas as esferas de Governo, propiciando assim maior controle financeiro do Ministério da Saúde. O Cartão SUS possibilita o acesso de pacientes cadastrados aos serviços prestados pelo SUS. De acordo com o Ministério da Saúde, um dos objetivos do Cartão SUS é aumentar a eficiência e a qualidade do acesso aos serviços públicos de saúde. Diante dos investimentos realizados em tecnologia é esperado um aumento de produtividade, que reflete em benefícios à população. Esta pesquisa objetiva trazer ao leitor, o modo como os usuários do SUS percebem a política do Cartão SUS. Para tanto, foram entrevistados pacientes de hospitais públicos das regiões metropolitanas de João Pessoa e Recife e os resultados da avaliação foram provenientes de uma análise de conteúdo, proposta por Gläser e Laudel, com dimensões e variáveis estabelecidas a partir do modelo SERVQUAL, validado cientificamente. Verificou-se, ao final da análise, que os usuários do SUS não se sentem beneficiados com a implantação do Cartão SUS, o que possibilita a conclusão de que os altos gastos do Governo com o Cartão SUS não foram revertidos em benefícios à população.
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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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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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Fosmoe, Kristofer D. "A systems perspective on army health and discipline." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/100371.
Full textAbstract:
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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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.
Full textAbstract:
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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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.
Full textAbstract:
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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Chen, Chia-Chi (Chia-Chi Jacky). "Improving energy efficiency : (turning wasted heat into cash flow)." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/105306.
Full textAbstract:
Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references (page 62).
The following gaps in critical goals are derived through a direct comparison of the Needs to Goals transformation versus the current waste heat recovery solutions and their stated goals. 1. Critical: Implementation of a sustainable financial plan which can help to initiate an increase in waste heat recovery 2. Critical: Deployment of waste heat recovery strategies for reducing greenhouse emissions A proposed solution to achieve these two goals would be: 1. Purchasing waste heat from industries. 2. Storing this energy with our proprietary thermal storage materials. 3. Selling the stored energy at either industrial sites or to pricier markets. New thermal-storage materials and a mini-sized combined heat and power (CHP) system have been further developed. This system will be the first to involve the arbitrage of waste heat energy by using cheap thermal storage material (made with zero greenhouse emissions) and a mini generator. This system could play an important role in providing economic incentives for industries that wish to recover waste heat.
by Chia-Chi (Jacky) Chen.
S.M. in Engineering and Management
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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.
Full textAbstract:
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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Wang, Chunguang S. M. Massachusetts Institute of Technology. "Enterprise architecture processes : comparing EA and CLIOS in the Veterans Health Administration." Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/76512.
Full textAbstract:
Thesis (S.M. in Engineering and Management)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2012.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 92-94).
There are numerous frameworks for abstracting an enterprise complex system into a model for purposes of analysis and design. Examples of such frameworks include the Complex Large-scale Interconnected Open Social-technical System (CLIOS) process for handling enterprise system architecture, the Enterprise Architecture eight views (EA) for diagnosing and improving overall enterprise performance, and the Enterprise Strategic Analysis for Transformation (ESAT). In addition to helping identify and manage complexity, emergent behavior and the requirements of many stakeholders, all of these frameworks help identify enterprise-wide processes, bringing value-added flow between enterprises and their stakeholders. This thesis evaluates the applicability of integrating these frameworks into a hybrid process in ongoing programs and to determine if a standard process can be generated through an integrative, interdisciplinary approach using the above models and frameworks. Enterprise Architecture eight views framework as developed at MIT is designed to create enterprise-level transformations in large, complex socio-technical enterprises. In the past 15 years of research at LAI, these enterprise developments have been applied and validated in the government and in other industries including aerospace, transportation, healthcare case, defense acquisition and logistics. The CLIOS process, also developed at MIT, is designed to work with Complex, Largescale, Integrated, Open, Socio-technical systems, creating strategies for stakeholders to reach goals through enterprise development. This process has been used heavily in transportation systems, energy distribution, and regional strategic transportation planning. This thesis will apply both of these frameworks to the case of Veterans Affairs health care enterprise to evaluate its effectiveness. Based on insights from self-assessments and the organization's strategy, a transformation plan will be generated for the Veterans Affairs organization's current state and preferred future state. These outcomes will help to identify the strengths of the merged methodology.
by Chunguang Wang.
S.M.in Engineering and Management
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Liew, Shirlene Nepacina. "Digital health in Singapore : building an ecosystem conducive for innovation-driven enterprises." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/105313.
Full textAbstract:
Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references (pages 106-115).
Healthcare is undergoing a digital revolution. In Singapore, business-friendly policies, strong information technology capabilities, and a world-class healthcare system seem to provide the necessary ingredients for digital health businesses to thrive. However, the depth of digital health start-up activities still pales in comparison with more mature ecosystems like Boston. Some challenges of the digital health sector include requiring an understanding of a wide set of stakeholders, facilitating cross-disciplinary innovation across patient care and digital technologies, and propagating innovation in hospital environments. The digital health innovation-driven enterprises ecosystem in Singapore is explored through an in-depth analysis of Singapore hospitals as a key stakeholder and an assessment of healthcare hackathons' suitability in addressing the present gaps. A set of recommendations are presented that could help to promote activities conducive to digital healthcare innovation and entrepreneurship in Singapore, which include extending key stakeholders' networks as well as enhancing access to key human resources and mentoring during the early stages of start-up formation.
by Shirlene Nepacina Liew.
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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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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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.
Full text
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Perumal, Palani. "Business model and strategy analysis for radiologists to use electronic health records (EHR)." Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/76928.
Full textAbstract:
Thesis (S.M. in Engineering and Management)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2012.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 90-94).
Radiology is a medical specialty that employs imaging to diagnose and treat disease. It has long been an advance user of technology to capture, store, share, and use images electronically. In 2009, President Obama signed into law a measure, the HITECH Act (part of the stimulus package), that incentivizes healthcare providers to use electronic health records (EHR) in care delivery to improve quality, efficiency, safety, and reduce cost. The meaningful use (MU) program's Stage 1 requirements (part of HITECH Act) did not include imaging requirements, leading to confusion among radiologists and other specialties with regard to what MU offers to and requires of them. This thesis attempts to clarify the contribution radiology can make to MU by understanding radiology as a system, including its surrounding issues and its drivers, using Stage 1 MU requirements, data from qualitative research, and results from analysis. It answers the following question: Should Radiologists be considered part of the care team, leveraging EHR for meaningful use and hence eligible for incentive payments? It does so via the following methods: a) Discussing in detail current issues surrounding radiology systems from quality, safety, efficiency, and cost perspectives; b) Discussing MU in the context of radiology and reviewing what is missing in it for radiologists; c) Providing deeper systems analysis of current behaviors and why they have this form at this time; and d) Explaining how MU objectives can help to overcome many current issues and ultimately help to improve health outcomes. Specific changes to MU criteria to achieve these benefits are recommended. This thesis employs systems concepts and tools including system architecture and system dynamics for research and analysis to understand the system and derive hypotheses. A system dynamics model is used to analyze current drivers in imaging and to clarify the impact MU can have on these drivers. Thesis conclusions are supported by the analysis performed using the model as well as information gathered through industry interviews, online articles, academic and industry journals, and blogs.
by Palani Perumal.
S.M.in Engineering and Management
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Yang, Joseph H. (Joseph Hansuk). "The curious case of urban heat island : a systems analysis." Thesis, Massachusetts Institute of Technology, 2016. http://hdl.handle.net/1721.1/107347.
Full textAbstract:
Thesis: S.M. in Engineering, Massachusetts Institute of Technology, School of Engineering, Institute for Data, Systems, and Society, System Design and Management Program, 2016.Cataloged from PDF version of thesis.
Includes bibliographical references (pages 59-60).
This thesis provides insights into the urban heat island (UHI) effect using a model of the urban microclimate that integrates the urban geometry, anthropogenic heat emission and the rural weather condition. The study builds upon the Urban Weather Generator (UWG), a numerical simulation program previously developed at MIT, incorporating such improvements as monthly disaggregation of ground sink temperature, Depart of Energy (DOE) commercial reference building templates, hourly schedule of building and non-building anthropogenic heat loads, and the development of an Excel user interface. Simulation generated from the updated model offers an explanation of the underlying mechanisms driving the UHI impact and the interactions between elements of the urban weather system. Based on the sensible energy flux transferred to the urban air mass, an UHI indicator to express the severity of UHI effect by the urban landscape is also developed to help urban planners estimate and mitigate the impact.
by Joseph H. Yang
S.M. in Engineering
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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.
Full textAbstract:
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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Shefali, Shweta. "Disruption of the group health insurance in light of the Affordable Care Act - system approach." Thesis, Massachusetts Institute of Technology, 2014. http://hdl.handle.net/1721.1/90725.
Full textAbstract:
Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2014.Cataloged from PDF version of thesis.
Includes bibliographical references (page 127) and index.
Our current Healthcare system has multiple problems and it is widely perceived that it is not able to provide quality affordable healthcare to all Americans; millions of Americans are without Health Insurance. The Affordable Care Act (ACA) was signed into law to achieve goal of 'quality affordable care for all American'. The ACA has focus on Individual Health Insurance and the provision of Health Exchange Marketplaces to find and purchase Health Insurance. Disruptive Innovation is a phenomenon in which a new entrant company disrupts the existing established company. As ACA and Health Exchanges have provided level playing field for all companies - new entrants and established - will this lead to disruption of Healthcare? Disruptive Innovations is analyzed from System Approach point of view. Disruption is not limited to two companies; Disruptor System disrupts the existing system including incumbent company. Disruption will be spearheaded by new entrant Disruptor Company and disruption will take place at system level. The existing Healthcare System and Possible Disruptor Systems are defined and investigated. Relative advantage and disadvantages to these two systems with regard to ACA regulations are analyzed. Elements of the healthcare disruptor system are analyzed and information present in the public domain about Health Exchange enrolment after the end of first enrollment seasons is studied to find out who could be possible disruptor and whether disruptor system formation has started.
by Shweta Shefali.
S.M. in Engineering and Management
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Sapol, Stephen J. (Stephen John). "A systems approach to leadership and soldier health and discipline in the United States Army." Thesis, Massachusetts Institute of Technology, 2013. http://hdl.handle.net/1721.1/111288.
Full textAbstract:
Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, 2013.Cataloged from PDF version of thesis.
Includes bibliographical references (pages 118-121).
The United States Army is entering a period of strategic reset after more than a decade of intense combat operations. One of the most critical areas of this reset is ensuring the health and discipline of the force remains intact. There are factors, both health and discipline, which drive high-risk behaviors by soldiers. Therefore it is critical to understand if the system is adequately structured in order adequately prepare leaders to not only ensure soldiers complete their work functions, but also maintain a healthy personal life. Leadership and solder welfare systems are the primary drivers of this research. The research explores how leaders ensure soldier well-being in a garrison environment and identifies some of the structural causes for the difficulties in achieving this. It attempts to holistically analyze both how the system is designed, but also its implementation and the properties which emerge from it. The research first outlines Army doctrine to establish the baseline for how the Army operates. Next, it identifies a series of policies and processes which relate directly to soldier welfare to identify the structure in which leaders operate. At the same time this develops the framework to identify how the system operates through a series of interviews with leaders at the company level in order identify the perspective of leaders at the company level and some of the emergent behaviors which evolve from the design of the system. In conclusion, this research determines that a multi-leveled approach must be taken. Senior leaders must ensure the system is designed to foster the development of leaders and provides flexibility to these leaders. Leaders at the company level must not only prioritize short-term operational goals, but also invest in people for the long-term viability of the Army.
by Stephen J. Sapol.
S.M. in Engineering and Management
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Fiedel, Ethan R. "Identifying and analyzing the hiring process for the Department of Veterans Affairs, Veterans Health Administration." Thesis, Massachusetts Institute of Technology, 2010. http://hdl.handle.net/1721.1/67552.
Full textAbstract:
Thesis (S.M. in Engineering and Management)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, June 2011.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 93-94).
This thesis utilizes ideas taken from different Systems Engineering modeling tools to model the hiring process for the U.S. Department of Veterans Affairs (VA), Veterans Health Administration (VHA). This model is a guide for understanding the current state of the process and shows that inadequate Position Descriptions (PD) are not the primary reason why the VA cannot meet the 80 day window set forth by U.S. Office of Personnel Management (OPM). Additionally, the model can assist in identifying potential areas for reducing the overall process timeline and be used as a training tool to illustrate how the hiring process progresses. Existing models only show major steps in the process which can mask sources of delay, communication issues, and confusion. The developed model delves deeper into those major steps, showing individual sub-steps, accountability, timelines, and data flows. Data for the model was obtained by direct observations, interviews, analysis from data collected by the VHA, and documents released by the VA and OPM. When fully developed, the model allowed for the conduction of case studies on three different positions within VHA; these case studies illustrate that the inability to meet the hiring process timeline is only partially due to issues with the PD and that other factors (namely internal reviews and classification delays) have a significantly greater effect in the resulting timeline. The model itself and recommendations provided, such as establishing priorities, targeting specific areas of time delays, improving communication, and generating and providing access to knowledge can help the VHA to achieve a streamlined and compressed timeline.
by Ethan R. Fiedel.
S.M.in Engineering and Management
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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.
Full textAbstract:
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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Shrinath, Arjun. "The evolution of and trends in mobile health : a case study of its application to diabetes." Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/76509.
Full textAbstract:
Thesis (S.M. in Engineering and Management)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2012.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 101-106).
The escalating costs of healthcare have created an urgent need to develop innovative solutions that can improve the quality of healthcare delivered and quality of health outcomes. This thesis explores the role that smartphones can play in creating innovative solutions to help meet these goals. The thesis begins with an analysis of the structure of the healthcare industry and emerging trends. The next section introduces to the reader to the concept of dominant architecture and the analysis of glucose monitors using this framework. The latter part of this section highlights the industry landscape of the mobile health industry in general. This is followed by an analysis of mobile health solutions specific to diabetes based on which recommendations for future solutions are drawn. The final sections of this work provides the reader with some insights on emerging trends with some emphasis on potential solutions that can be developed to address existing gaps in the market.
by Arjun Shrinath.
S.M.in Engineering and Management
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Moore, Michael David. "Problems of tort litigation as a means of patient and consumer protection in health care systems." Thesis, Massachusetts Institute of Technology, 2009. http://hdl.handle.net/1721.1/58522.
Full textAbstract:
Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2009.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 53-57).
The U.S. health care system relies on tort litigation as a means of protecting patients and consumers from medical malpractice. The system of tort litigation has contributed to the U.S. having the highest health care spending per capita of any nation, but it has not resulted in superior quality of care. This work argues that tort litigation in health care is actually detrimental to patient safety and that the deterrent effect that it is meant to provide is circumvented by elements inherent in tort law. The possibility of settlement without admission of guilt creates a mechanism by which litigation is encouraged by economic incentives, but actual malpractice is not effectively discouraged. Furthermore, the system limits the operational knowledge gained through adverse events by removing these events and the actions that created them from the public discourse. Various proposed and enacted reforms to medical tort litigation are considered and it is found that dysfunctional interactions between professionals of different disciplines constitute a major obstacle to effective system reform. Finally, a modular view of the health care system is presented as a step toward identifying and reforming these interactions.
by Michael David Moore.
S.M.
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Zhang, Yiping, Xinyi Yu, and Sintset Gilles. "Enterprise System Post-Implementation: A Practice of System Evaluation Issues in Health Care Organization : A case study of Jönköping County Council." Thesis, Internationella Handelshögskolan, Högskolan i Jönköping, IHH, Informatik, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-16459.
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Introduction: As Information Technology (IT) becomes more and more advanced, the Enterprise System (ES) starts to attract researcher’s attention. While with the high rate of failure IT projects, it is important to evaluate the IT project properly. This paper conducts a case study in the Health Care area and chooses Jönköping County Council’s ROS system to be the target system. According to the established linkage between theory and real world organization, a practice of Enterprise System Evaluation is conducted by using an existing Uwizeyemungu et al.’s Enterprise System Effects Evaluation Model (ESEM). The research questions are as follows: What are the Enterprise Systems Effects which impact on business processes? To what extend do the ES effects impact on the business processes? Purpose: the study is an exploratory study that aims at identifying what are the ES Effects which impact on the business processes and assessing the importance and the actual degree of these effects. The answers of the first goal are explored by analyzing the documents and the record of interview, and the results are the basis of the second question. Method: This research has adopted a combined approach because of the nature of the research questions. Data has been collected through face-to-face interview, survey and the organizational documents. Secondary data are also be used for analyzing. Both qualitative and quantitative data are used for getting a reliable conclusion. Conclusions: The Enterprise System effects can be categorized into automaional effects, informational effects and transformational effects. The relationship between such effects and Performance indicators are very important. By determining the importance and impacts degree of such relationships, the evaluation results can be explicitly calculated and understood.
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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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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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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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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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Mohammad, Yara Mahmoud. "Information security strategy in telemedicine and e-health systems : a case study of England’s shared electronic health record system." Thesis, Brunel University, 2010. http://bura.brunel.ac.uk/handle/2438/4669.
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Shared electronic health record (EHR) systems constitute an important Telemedicine and e-Health application. Successful implementation of shared health records calls for a satisfactory level of security. This is invariably achieved through applying and enforcing strict, and often quite complicated, rules and procedures in the access process. For this reason, information security strategy for EHR systems is needed to be in place. This research reviewed the definition of different terms that related to electronically stored and shared health records and delineated related information security terms leading to a definition of an information security strategy. This research also made a contribution to understanding information security strategy as a significant need in EHR systems. A major case study of the National Programme for IT (NPfIT) in England is used to be the container of other two sub-case studies in two different Acute Trusts. Different research methods used: participant observation and networking, semi-structured interviews, and documentary analysis. This research aimed to provide a comprehensive understanding to the information security strategy of England’s EHR system by presenting its different information security issues such as consent mechanisms, access control, sharing level, and related legal and regulatory documents. Six factors that influence the building of an information security strategy in EHR systems, were identified in this research, political, social, financial, technical, clinical and legal. Those factors are considered to be driving the strategy directly or indirectly. EHR systems are technical-clinical systems, but having other factors (than technical and clinical) that drive this technical-clinical system is a big concern. This research makes a significant contribution by identifying these factors, and in addition, this research shows not only how these factors can influence building the information security strategy, but also how they can influence each other. The study of the mutual influence among the six factors led to the argument that the most powerful factor is the political factor, as it directly or indirectly influences the remaining five factors. Finally, this research proposes guidelines for building an information security strategy in EHR systems. These guidelines are presented and discussed in the form of a framework. This framework was designed after literature analysis and after completing the whole research journey. It provides a tool to help putting the strategy in line by minimising the influence of various factors that may steer the strategy to undesirable directions.
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Poppi, Stefano. "Solar heat pump systems for heating applications : Analysis of system performance and possible solutions for improving system performance." Doctoral thesis, KTH, Energiteknik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-214552.
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Solar heat pump systems (SHPs) are systems that combine solar energy and heat pumps. SHPs have been investigated for several decades and have been proven to increase the share of renewable energy and reduce electric energy demand in residential heating applications. Many solar thermal heat pump systems have become market-available in recent years; however these systems are still not widely employed in the residential sector. This is due mainly to the high initial costs (investment and installation costs) of solar thermal heat pump systems, which limits their cost-effectiveness. Enhancing cost-effectiveness of solar thermal heat pump systems is necessary for a more effective and broader market penetration. In this thesis, solar thermal and photovoltaic systems combined with heat pumps for heating applications are treated. The overall aims of the thesis are to: 1) investigate techno-economics of SHPs and 2) investigate possible solutions for improving system performance of a reference solar thermal and heat pump system for residential heating applications. In the first part of the thesis, the influence of climatic boundary conditions on economic performance of SHPs has been investigated by means of: a) an economic comparison of SHPs found in the relevant literature and b) system simulations of the reference solar thermal heat pump system. In the second part of the thesis, potential solutions for improving system performance of the reference solar thermal heat pump system with limited change in system’ costs are investigated. A systematic approach was used for investigating cost-effectiveness of the system improvements in the reference system. Based on results of the cost-effectiveness analysis, some of the investigated system improvements were chosen for being included in the design of a novel solar thermal and air source heat pump system concept. The novel system was designed for a house standard with relatively high operating temperatures (55°C/45°C) in the space heating distribution system and for high space heating demand (123 kWh/m2·year). Finally, the thesis ends with a cost-effectiveness analysis of the novel system.QC 20170918
MacSheep
iNSPiRe
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BELGA, ILZA MARIA FRANCO. "PROCESS OF INTEGRATION AND IMPLEMENTATION OF QUALITY MANAGEMENT SYSTEM, ENVIRONMENTAL MANAGEMENT SYSTEMS AND SECURITY AND OCCUPATIONAL HEALTH SYSTEMS." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2007. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=10666@1.
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Esta dissertação propõe um processo de integração e
implantação dos
sistemas de gestão da qualidade, meio-ambiente e segurança
e saúde ocupacional,
os quais, atualmente, operam de forma isolada numa
empresa. O negócio da
empresa em questão é a produção de gases industriais e
pretende que o processo
de integração considere a cultura da organização e os
esforços movidos nesta
direção. A metodologia utilizada para a integração da
gestão dos sistemas já é de
uso e conhecimento das organizações e da academia e foi
selecionada conforme
equipe experiente e designada para este propósito,
partindo do princípio que não
se optaria pela reestruturação e sim pela adequação dos
sistemas já existentes. São
ainda comentados os pontos fracos identificados no
programa de implantação dos
sistemas isolados e que deveriam ser considerados quando
da integração dos
mesmos, assim como as necessidades que direcionam a
integração e a expectativa
com relação a responsividade, abrangência, resultados
coletados, além da
mudança cultural promovida. A estratégia é considerada
diferencial na decisão da
integração dos sistemas e a metodologia Seis Sigma a
ferramenta que possibilita a
mensuração de custos e a implantação da filosofia da
melhoria contínua na busca
em exceder as expectativas do cliente.This dissertation proposes an integration process and the implementation of quality management systems, environmental and safety policies, and occupational health. These systems are presently operating separately in the company. The company´s core business is the production of industrial gases and its internal policies establish that the integration process should take into consideration the culture of the organization and also the efforts already taken to move in this direction. The methodology applied for the systems integration management is under knowledge domain and it is being used by organizations and by the academy. It was selected and adopted by a skilled team assigned for this purpose, and it was defined that, instead of restructuring, adjustments would be made to existing systems. There are also comments about weak points identified in the program of implementation of isolated systems that should be considered for the integration process, as well as the needs that drive the integration and expectations related to responsiveness, scope of work, collected results and also the outcome in terms of cultural change. The strategy is considered relevant when deciding for systems integration and for the methodology Six Sigma, which is the tool that allows costs measurement and the implementation of the philosophy of continuous improvement to exceed customer´s expectations.
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Sondheim, Mike. "Applying Systems Engineering and Lean Healthcare Tactics to the Veterans Health Administration Enrollment System." Digital Commons at Loyola Marymount University and Loyola Law School, 2015. https://digitalcommons.lmu.edu/etd/443.
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The Veterans Health Administration of the United States Department of Veteran Affairs has been reported to have a large backlog of patients waiting for healthcare services. The root cause of the issue has been pinpointed to flaws in the VHA's Healthcare Eligibility Center process and software systems. But moreover, the issues within the VHA stem from a lack of management oversight and lack of ownership of the products and services. It is suggested in the following document that the VHA apply Systems Engineering and Lean Healthcare initiatives in order to: baseline the current process and system, generate new process and system requirements aimed at meeting patient's expectations, and use Measures of Effectiveness to validate that the positive impact of the changes.
The goal of this report is to provide solutions for the VHA fix the patient enrollment process and software systems. The VHA already has a group of Systems Engineers (called the Veterans Administration - Center for Applied Systems Engineering) that is currently working to promote Systems and ·Lean Engineering within the VHA, however they are focusing on general training as opposed to fixing the immediate issue presented in this report.
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Uys, Walter F. "Vitalistic information systems in the South African public health system : a transactional analysis perspective." Master's thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/5653.
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Padilla, Rodriguez Ingrid. "Avaliação das taxas de doses de radiação gama e modelagem cartografica das estatisticas de obitos por neoplasias na região central de Cuba." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287293.
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Orientador: Elisabete Maria PascholatiTese (doutorado) - Universidade Estadual de Campinas, Instituto de Geociencias
Made available in DSpace on 2018-08-05T05:12:34Z (GMT). No. of bitstreams: 1 PadillaRodriguez_Ingrid_D.pdf: 8041053 bytes, checksum: 09d5970b48a5198700990c2513a29e66 (MD5) Previous issue date: 2005
Resumo: O estudo desenvolvido visa avaliar as taxas de doses de radiação gama, na região central de Cuba, explorando as possibilidades do levantamento aerogeofisico na caracterização radiogeoquímica e mapeamento geólogo - estrutural do meio ambiente numa área de aproximadamente 16.500 km2. Adicionalmente, é propósito dispor de resultados que contribuam ao estabelecimento de uma linha base ambiental, baseado no background a radiação gama terrestre, de grande interesse para o sistema de vigilância radiológica acional. As estatísticas sobre óbitos por neoplasias do tipo tumores sólidos na região central de Cuba, a qual apresenta o segundo lugar nas ocorrências de casos no país, induz à seguinte hipótese para a pesquisa: "a radiogeoquímica desses ambientes geológicos poderia gerar taxas de doses de radiação gama correlacionáveis aos resultados estatísticos obtidos para a população dos vinte e sete municípios envolvidos?" Com este fim, foram modeladas, analisadas estatisticamente e interpretadas, as variáveis geólogo-geofisicas independentes, de relevo, epidemiológicas e censitárias num ambiente SIG sobre as populações envolvidas, para estabelecer uma possível relação com a taxa de dose estimada para a região central de Cuba. Este procedimento revelou uma razoável representatividade da diversidade geológica do meio ambiente, vinculando-a aos casos registrados e probabilisticamente esperados na população. A geologia na região é representada por vários ambientes: as unidades da margem continental da plataforma das Bahamas (Jurássico Superior - Cretáceo Superior), os ofiolitos Mesozóicos com imbricações das rochas do arco de ilha Vulcânico do Cretáceo (AVC), a cobertura neo-plataformal Cenozóica, as metavulcânicas da fácies xisto verde e os anfibolitos na divisa com as várias unidades lito-tectônicas (Jurássico Inferior - Cretáceo Superior) do Terreno metamórfico Escambray. As principais análises basearam-se rio processamento e na interpretação dos dados gamaespectrométricos aéreos. Embora os contrastes dos teores obtidos sobre os litotipos e as estruturas, sejam sutis as diversidades do ambiente geológico é mapeada com clareza. Através da cartografia como um todo, e das componentes principais, em particular, pode-se reconhecer a, correlação das concentrações Th-U, com relativa predominância do primeiro no platô litorâneo e parcialmente, nas bacias frontais e superpostas ao AVC e nos sedimentos recentes. Observam-se mudanças nos teores de potássio proporcionalmente ao conteúdo de sílica nas rochas ácidas e intermediárias - ácidas, ultrapassando levemente 3,0 %, nos plagiogranitos na divisa do AVC com o complexo Mabujina e, muito localmente, nos sedimentos do Terciário: Os teores Th - U atingem níveis relativamente maiores e anômalos nos sedimentos continentais da plataforma das Bahamas, setor que contém biodetríticos com fosfatos, baixas concentrações residuais de zircônio, monazita e/ou elementos componentes das terras raras, os quais ficaram possivelmente retidos, apesar da movimentação nos processos exógenos, mas sem interesse para a mineração. Embora misturado com as rochas dó AVC, a extensa faixa de ofiolitos é reconhecida pelos baixos níveis dos radioelementos.Também foram mapeadas a faixa de acrescência e sutura entre as rochas' metamórficas do Terreno Escambray e o Complexo . Mabujina, no limite norte, com as rochas do AVc. Existem evidências também de algumas diferenças geomorfológicas na formação de solos e sua relativa movimentação nos córregos e rios da região. ... Observação: O resumo, na íntegra, poderá ser visualizado no texto completo da tese digital
Abstract: This study developed in the central part of Cuba, attempted to evaluate a gamma radiation dose rate, exploring the airbome geophysical survey possibilities in order to obtain a radiogeochemical characterization and the geological - structural mapping of environment for an area of about 16.500 km2. Besides, to dispose through this research, of results that contribute to the establishment of the environmental base tine, based on the background of the gamma terrestrial radiation and its possible relationships in the context, is interest fqr the system of surveillance national radiological. The statistical data about deaths for neoplasies of the type solid tumors in the region, the one which presents the second one place of occurrences of cases in the country, it induces the followirig hypothesis: "could be those environment be able to generate gamma radiation dose rates correlated with the statistics facts, that reach the population of the twenty-seven involved municipal districts?" . With this intent, several independent landscape variables (geological, geophysical, physiographic, epidemiologic ones and related to the population's census), Were modeled and analyzed using GIS, in order to establish a possible relationship with the mean value about the dose'rate estimated in the central region. This procedure provided a reasonable representation of the environmental geological diversity, linking it to current cases incidences and expected probabilistic, in the population. The geological diversity m the area is composed by the units of the margm of the Bahamas contmental platform (Upper Jurassic - Upper Cretaceous), for the Mesozoic ophiolites, partially blended and superimposed for the volcanic rocks of the arch of islands Cretaceous (CVA), for the Cenozoic Neo-platform cover, for the meta - vo1canicrocks of green schist facies and amphibolites m the limits with the litho-tectonic units (Lower Jurassic - Upper Cretaceous) of the metamorphic Escambray Terram.... Note: The complete abstract is available with the full electronic digital thesis or dissertations
Doutorado
Metalogenese
Doutor em Ciências
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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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Mulovhedzi, Patience Tlangelani. "Towards a heat-watch warning system for South Africa for the benefit of the health sector." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/65921.
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Heat waves are, amongst other weather hazards, projected to increase in frequency and intensity due to climate change. This increase has already been evident in parts of South Africa in the recent years. Their negative impacts are felt in many areas, including human health. This study aims to identify the most appropriate meteorological index for forecasting heat waves over South Africa and use it to develop an operational, numerical weather forecast based prediction system that will issue alerts whenever heat waves are expected. Data from temperature and relative humidity subsets from National Centers for Environmental Prediction (NCEP) Ensemble Forecast System (EFS), and observational temperature and dew-point temperature data from the South African Weather Service are used to evaluate and identify the most appropriate meteorological heat index, and to evaluate the model’s skill in heat wave forecasting. A number of evaluation matrices, including bias, symmetric external dependence index and Clayton skill scores, are used for evaluation. Recent heat wave events are also used to identify the synoptic patterns that cause heat waves. This is achieved by plotting the mean sea-level pressure heights and 850hPa and 500hPa geopotential heights from NCEP reanalysis data for these cases. Since there is no evidence that the impacts of heat waves on human health have to date been conducted in South Africa, this study uses international literature to identify the best practices that can be used to prevent or mitigate the negative impacts of heat waves on human health. The Humidex index is identified as the most suitable index for forecasting heat waves over South Africa and has benefit in the skill of up to five days ahead. This implies that heat wave warnings can be issued with confidence 1-5 days ahead of the phenomenon. Eight heat wave cases were identified between 2011 and 2015, and most of them occurred over the eastern interior of the country. These heat waves are caused by the presence of a broad surface trough over the interior that extends from the tropics, with no moisture influx from the Indian Ocean (IO), along with an upper-air high-pressure system over the central interior. Heat waves over the east coast are caused by the presence of a ridging high or continental high that are located in such a way that the east coast is on an off-shore flow. A ridging high that would normally cause berg winds and veld fires over the Western Cape is also the cause of heat waves. The heat-health watch-warning systems in other parts of the world are effective due to the involvement of different stakeholders. The same approach is recommended for adoption over South Africa. With the involvement of different sectors, and with the health sector taking the lead, the system is expected to accomplish the desired outcome.Dissertation (MSc)--University of Pretoria, 2017.
Geography, Geoinformatics and Meteorology
MSc
Unrestricted
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Al-Hajerri, Maha. "An exploratory study of factors affecting the successful implementation of health information systems in the Kuwaiti health care delivery system." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2006. http://researchonline.lshtm.ac.uk/682358/.
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Health care delivery systems face different obstacles when engaged in health information systems implementation. The success of such systems is dependent upon many factors. These factors must be identified and carefully considered to ensure successful system implementation. This study investigates possible factors affecting successful information systems implementation in the Kuwaiti health care delivery system within the public and private sectors. The research was designed as an exploratory study in which qualitative and quantitative approaches were used. In the first stage (qualitative) a focus group was formed and then a semi-structured interview was administered. Themes that emerged from the interviews were used to develop a questionnaire that was used in the second (quantitative) stage of the study. The study covered stakeholders from the public and private sectors in Kuwait. The qualitative part investigated the impact of certain factors on system implementation successfulness. Based on interviewees' responses, three major themes emerged. Those were used to develop the questionnaire which was used in the quantitative part of the study. The questionnaire was aimed at describing the perception of the stakeholders to the preset factors with regard to their effects on the success of implementation in their respective organisations. From both sectors, a sample of 493 respondents was randomly 2 selected. The response rate for the questionnaire from the two sectors ranged from 59% to 72% depending on the stakeholders' group of respondents. When examining the findings of the questionnaire, the perceptions of the top management in the public sector at MOH and Al-Amin hospital were similar toward most of the factors studied. However, they were different from those of the end users. On the other hand, the perceptions of the top management and the end users were similar in the private sector. . The top management in the public sector (MOH and Al-Amin hospital) ranked the following factors in this order as the most important factors that affected successful health information systems implementation in the public sector: Accountability; Resistance to change; Organisational diversity; Organisational stability; and Incentives. The end users in the public sector ranked the following factors as the most important factors that affected successful health information systems implementation in the public sector: Lack of end user involvement; Insufficient planning; Training; Incentives; and Uncertainty of benefits. Both the top management and end users of the public sector ranked "Incentives" as one of the most important factors that affected successful health information system implementation, but this was the only point of agreement between them. In the private sector, the top management ranked the following factors as the most important factors that affected successful health information systems implementation: Resistance to change; Ease of usage; Competition; Incentives; and Compatibility. The end users in the private sector ranked the following factors: Ease of usage; Timeliness; Incentives; Relative advantage; and Competition. The top management and end users in the private sector concurred over the importance of the following factors: Ease of usage; and Competition. In conclusion, both the public and private sector participants (top management and end users) ranked `Incentives' as one of the most important factors that affected successful health information system implementation, while the top management in both sectors (MOH, Al-Amiri and Al-Mowasat hospitals) ranked `Resistance to change' as one of the most important factors that affected successful health information system implementation. In all, the results show that the primary factor affecting successful implementation of health information system regardless of the sector and the employment category is `Incentives', followed by `Resistance to change'. The information produced in the current study was used to produce recommendations on the successful future implementation of health information systems in Kuwait. The recommendations are based on empirical findings, and are to be respectfully commended to strategists concerned with improving health care delivery system in Kuwait. 4 The first and most obvious recommendation regarding future research would be a replication of the same study, but with the inclusion of more comprehensive attributes such as: 1) Vendor services (e. g. hardware performance, expansion and growth potential, ease of modification, interface capabilities, ease of installation, and upgrading capabilities. 2) Vendor selection factors (e. g. vendor reputation and company philosophy, system pricing, and vendor resources. 3) Patient satisfaction with the system benefits. The second recommendation is to use the same organisational, cultural and user satisfaction factors to examine health information systems implementation in a specific facility such as an Army or Police hospital versus a public hospital.
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Shoopala, Anna-Liisa. "Design of a backend system to integrate health information systems – case study: ministry of health and social services (MoHSS)-Namibia." Master's thesis, Faculty of Engineering and the Built Environment, 2021. http://hdl.handle.net/11427/34011.
Full textAbstract:
Information systems are the key to institution organization and decision making. In the health care field, there is a lot of data flow, from the patient demographic information (through the electronic medical records), the patient's medication dispersal methods called pharmaceutical data, laboratory data to hospital organization information such bed allocation. Healthcare information system is a system that manages, store, transmit and display healthcare data. Most of the healthcare data in Namibia are unstructured, there is a heterogeneous environment in which different health information systems are distributed in different departments [1][2]. A lot of data is generated but never used in decision-making due to the fragmentation. The integration of these systems would create a flood of big data into a centralized database. With information technology and new generation networks becoming a called for innovations in every day's operations, the adaptations of accessing big data through information applications and systems in an integrated way will facilitate the performances of practical work in health care. The aim of this dissertation is to find a way in which these vertical Health Information System can be integrated into a unified system. A prototype of a back-end system is used to illustrate how the present healthcare systems that are in place with the Ministry of Health and Social Service facilities in Namibia, can be integrated to promote a more unified system usage. The system uses other prototypes of subsystems that represent the current systems to illustrate how they operate and, in the end, how the integration can improve service delivery in the ministry. The proposed system is expected to benefit the ministry in its daily operations as it enables instant authorized access to data without passing through middlemen. It will improve and preserve data integrity by eliminating multiple handling of data through a single data admission point. With one entry point to the systems, manual work will be reduced hence also reducing cost. Generally, it will ensure efficiency and then increase the quality of service provided.
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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.
Full textAbstract:
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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Pantelopoulos, Alexandros A. "¿¿¿¿¿¿¿¿¿¿¿¿PROGNOSIS: A WEARABLE SYSTEM FOR HEALTH MONITORING OF PEOPLE AT RISK." Wright State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=wright1284754643.
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