Dissertations / Theses: 'Medical care'

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Higgins, Peter McRorie. "Medical care in English prisons." Thesis, Open University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406489.

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Wright, Hollis G. "Means, ends and medical care /." view abstract or download file of text, 2002. http://wwwlib.umi.com/cr/uoregon/fullcit?p3055725.

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Thesis (Ph. D.)--University of Oregon, 2002.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 272-280). Also available for download via the World Wide Web; free to University of Oregon users. Address: http://wwwlib.umi.com/cr/uoregon/fullcit?p3055725.

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Donato, Francis A. "Reforming health care through managed care." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.

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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.
Source: Masters Abstracts International, Volume: 45-06, page: 2939. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 91-92).

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Penfold, Christopher M. "Patient copayments in primary medical care." Thesis, Cardiff University, 2011. http://orca.cf.ac.uk/54411/.

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This research was carried out to assess the feasibility of studying the effects of introducing copayments in primary medical care via studying the effects of copayments in primary dental care. Quantitative methods were used to investigate the impact of primary dental care copayments on patients and to compare predictors of primary medical and dental care uptake. Qualitative methods were used to investigate attitudes towards copayments for NHS primary health services and their extension to include primary medical consultations. Regression models, chi-square analyses and ANOVA were applied to the England and Wales sub-sample of nationally representative self-report data from the 1998 Adult Dental Health Survey (ADHS) (n=3628) to investigate the impact of copayments on primary dental care uptake. Regression models and chi-square analyses were applied to the England and Wales sub-sample of nationally representative self-report data from the 1997/98 British Household Panel Survey (BHPS) (n=8526) and the 1998 ADHS (n=3641) to compare predictors of primary medical and dental consultations. Semi- structured interviews were undertaken in Bristol and Somerset with purposively sampled frequent and infrequent primary medical care users (n=19). Predictors of primary medical and dental care utilisation differed across predisposing, enabling and illness level factors. Private and NHS dental copayments were perceived to be expensive and this perception was associated with lower preventive-led dental consultation rates, but not with treatment-led consultation rates. Copayments for services affected the nature of the patient-practitioner relationship. Findings were inconclusive regarding the effect of copayment exemption status on people's decisions to consult a dentist and on dental treatments received. It was not feasible to study the effects of introducing copayments in primary medical care via studying the effects of copayments in primary dental care.

5

Damberg, Jonas. "Availability of primary care physicians in nursing homes and home care nursing services and associations with emergency care consumption." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-61585.

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Anderson, Mindi S. "Integrating Emergency Medical Services Into the Patient-Centered Medical Home." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10288192.

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Abstract Emergency medical services (EMS) for nonemergent or low-acuity calls is a new normal. EMS agencies spend a majority of time providing primary care services through the 911 system. They are utilized currently to fill the primary care gap subconsciously. The EMS system is activated as a patient navigator for primary care services. EMS agencies in the state where the research occurred have responded to the gap in care management by creating innovative programs such as community health emergency medical services (CHEMS). Creation of CHEMS programs have become one of the most monumental concepts for change in the field on both a state and national level. EMS has sought ways to meet the goals of the Triple Aim by exploring CHEMS as the state transitions to value-based care. Leaders are searching for innovative ways to close the gap in the primary health care system through a patient-centered medical home (PCMH) model. The action research study stimulated innovative thinking to support coordinated care across the evolving continuum of the health care system. The study captured the current awareness from community health care leaders who have had a recent opportunity to explore the idea of integrating EMS into the PCMH model through semi-structured interview sessions. Major findings in the thematical analysis discovered the current way both EMS and a PCMH function in a silo system that could potentially utilize each other to effectively provide managed care. Joint efforts could offset overutilization of EMS services for calls that have no apparent life threats. EMS would allow for a PCMH to conform to the Patient Protection and Affordable Care Act standards of care management, contributing to the integration of Triple Aim objectives. Collaboratively, EMS and an established PCMH will impact the delivery of preventative, quality and cost-efficient care. The theory of organizational culture change is based on three common characteristics: culture is shared, is intangible, and affects human behavior. The conceptual framework of the research study was based on the chronic care model. Patients with comorbidities potentially utilize the health care system more than a healthy patient to seek reassurance that their health is managed.

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Yeung, Yee-hung Stella. "Sustainable healthcare delivery in Hong Kong : organizational initiatives and strategic financing /." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B23295776.

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Fickel, Jacqueline Jean. "Quality of care assessment : state Medicaid administrators' use of quality information." Full text (PDF) from UMI/Dissertation Abstracts International Access restricted to users with UT Austin EID, 2002. http://wwwlib.umi.com/cr/utexas/fullcit?p3077639.

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Jahn, Sandra, and Sandra Wedebrand. "To care or not to care." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24132.

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I sjuksköterskeprofessionen är omsorg en viktig del. Det används av sjuksköterskor varje dag och är en integral del i det bilaterala förhållandet mellan sjuksköterska och patient. Syftet med denna litteraturgranskning är att undersöka omsorg i omvårdnad samt se om omsorg kan orsaka utbrändhet. Författarna har granskat 11 vetenskapliga studier, gjorda till och med tio år tillbaka runt om i världen. Genom analysering av resultaten identifierades fem huvudteman: patientens syn på god omsorg, patientens syn på dålig omsorg, sjuksköterskans syn på god omsorg, sjuksköterskans syn på dålig omsorg, samt processen och konsekvenserna av utbrändhet.
In the nursing profession, caring is the most essential part. It is used by nurses’ everyday and is an integral part in the responsive nurse-patient relationship. The main aim of this study was to investigate caring in nursing. Furthermore, because of Maslach (1998) statement that close contact within the nurse-patient relationship contributes to burnout in nurses, the authors wanted to investigate studies exploring the cause of burnout in nurses.Additionally, the cause of burnout in nurses is explored. The authors reviewed 11 scientific studies, performed in the past ten years around the world. The results showed that five main themes could be identified. These were: patient’s view of good care, patient’s view of bad care, nurse’s view of good care, nurse’s view of bad care, and the process and consequences of burnout.

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Öhman, Mattias. "Essays on Cognitive Development and Medical Care." Doctoral thesis, Uppsala universitet, Nationalekonomiska institutionen, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-305627.

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This thesis consists of four self-contained papers. Essay I (with Linuz Aggeborn): Fluoridation of the drinking water is a public policy whose aim is to improve dental health. Although the evidence is clear that fluoride is good for dental health, concerns have been raised regarding potential negative effects on cognitive development. We study the effects of fluoride exposure through the drinking water in early life on cognitive and non-cognitive ability, education and labor market outcomes in a large-scale setting. We use a rich Swedish register dataset for the cohorts born 1985-1992, together with drinking water fluoride data. To estimate the effects, we exploit intra-municipality variation of fluoride, stemming from an exogenous variation in the bedrock. First, we investigate and confirm the long-established positive relationship between fluoride and dental health. Second, we find precisely estimated zero-effects on cognitive ability, non-cognitive ability and education for fluoride levels below 1.5 mg/l. Third, we find evidence that fluoride improves later labor market outcomes, which indicates that good dental health is a positive factor on the labor market. Essay II: I study the associations between cognitive and non-cognitive abilities and mortality using a population-wide dataset of almost 700,000 Swedish men born between 1950 and 1965. The abilities were measured at the Swedish military enlistment at age 18-20. In addition, I investigate if income and education are good proxies for the abilities. The results suggest that both cognitive and non-cognitive abilities are strongly associated with mortality, but that non-cognitive ability is a stronger predictor. The associations are only partly mediated through income and education. For middle and high income earners and individuals with a college education there are no associations with mortality. However, for low income earners and individuals without a college education, both abilities are strongly associated with mortality. The associations are mainly driven by the bottom of the distributions. Essay III (with Matz Dahlberg, Kevin Mani and Anders Wanhainen): We examine how health information affects individuals' well-being using a regression discontinuity design on data from a screening program for an asymptomatic disease, abdominal aortic aneurysm (AAA). The information provided to the individuals is guided by the measured aorta size and its relation to pre-determined levels. When comparing individuals that receive information that they are healthy with those that receive information that they are in the risk zone for AAA, we find no effects. However, when comparing those that receive information that they have a small AAA, and will be under increased surveillance, with those who receive information that they are in the risk zone, we find a weak positive effect on well-being. This indicates that the positive information about increased surveillance may outweigh the negative information about worse health. Essay IV: I estimate the effect of SSRI antidepressants on the risk of mortality for myocardial infarction (MI) patients using Propensity Score Matching on individual health variables such as pharmaceutical drug prescription, patient history and severity of the MI. The effect of antidepressants on mortality is a heavily debated topic. MI patients have an elevated risk of developing depression, and antidepressants are among the most common treatments for depression and anxiety. However, there are indications that some classes of antidepressants may have drug-induced cardiovascular effects and could be harmful for individuals with heart problems, but there is a lack of large-scale studies using credible identification strategies. My findings indicate no increased risk of two-year mortality for MI patients using SSRI. The results are stable for several specifications and robustness checks.

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Byrd, Rebekah J. "Culturally competent medical care of LGBTQ patients." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/911.

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Hong, Wing-yee Veronica. "A comparative study of healthcare financing systems in US, UK and HK." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41709858.

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Foran, Jameson D. "Medicaid Expansion Implications on Health Insurance Coverage and Medical Out-Of-Pocket Payments." Miami University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=miami1524669331674427.

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Mykhalovskiy, Eric. "Knowing health care / governing health care exploring health services research as social practice /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0018/NQ56249.pdf.

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Chan, Yee-ying Michelle. "The formulation and implementation of healthcare reform in Hong Kong." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B2329470x.

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Neumann, Khamille. "Medical pluralism in Guatemala." Pullman, Wash. : Washington State University, 2010. http://www.dissertations.wsu.edu/Thesis/Spring2010/k_neumann_020510.pdf.

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Thesis (M.A. in cultural anthropology)--Washington State University, May 2010.
Title from PDF title page (viewed on June 2, 2010). "Department of Anthropology." Includes bibliographical references (p. 76-83).

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Dhillon, Simron. "Oceanside Durable Medical Equipment." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10116155.

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Oceanside Durable Medical Equipment (DME) is an accredited start-up company that will offer a comprehensive line of the latest medical supplies and equipment to patients in Long Beach, California. This company will focus on the distribution of leading medical equipment brands to patients who are in need of support for short-term and chronic health conditions. Durable medical equipment can offer help outside of the hospital environment and aid in a better quality of life.

With more than 2.4 million individuals over 60 years old in Southern California, there appears to be a large market and opportunity for this company. Oceanside DME will contract with leading medical equipment manufacturers and healthcare providers to deliver patients with quality products. A rapidly growing market for medical equipment will allow Oceanside DME to create a presence in this healthcare industry.

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Manuel, Eric R. "Physically active centered medical home." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1599186.

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Under the provision of the United States Department of Health and Human Services, the patient centered medical home is a model of primary care transformation that seeks to meet the variety of healthcare needs of patients and to improve patient and staff experiences, outcomes, safety, and system efficiency. Serving the medically underserved and primary care clinic shortage area of Long Beach, California, the Physically Active Centered Medical Home (PAC MH) will be a safe haven for healthy and physically active individuals who are required to avail of health insurance coverage as mandated by the Patient Protection and Accountable Care Act of 2010 (PPACA). PAC MH will offer comprehensive and integrated services that will keep its members healthy and away from the burden of repeated clinical visits. PAC MH understands that medical coverage is the least of the priorities for healthy adults. Hence, PAC MH’s payment system is made simple. The value-based care provided at PAC MH will reward the healthcare team for achieving and exceeding the pre-established benchmarks for quality care.

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Rubin, Joshua. "Does SCHIP increase children's access to medical care?" CONNECT TO ONLINE THESIS, 2007. http://dspace.wrlc.org/handle/1961/4126.

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Clark, Spencer R. "Health Care Reform's Effect on Private Medical Practices." Scholarship @ Claremont, 2011. http://scholarship.claremont.edu/cmc_theses/209.

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In March of 2010, the 44th President of the United States, Barack Obama, signed into law a health care reform bill that will change the medical and business approach to healthcare that has been witnessed for quite some time. The Patient Protection and Affordable Care Act, aims to eliminate several inefficiencies encountered in our current health care system, as well as extend coverage by providing affordable care for the roughly forty six million Americans currently uninsured. Many of the changes will be implemented over the next several years, but hospitals, businesses, physicians, and insurance companies are no doubt planning ahead for the effects these changes will have on their particular industry. Although there will be many facets of change affecting all of the previously mentioned occupancies, the goal of this paper is to investigate the effect healthcare reform will have on private medical practices in the United States. The following sections will cover ways in which medicine has been practiced in the pre-reform era, historical attempts made to pass health reform legislation, several of the issues our current system faces along with the reform changes implemented to fix them. Then I will investigate the effect these changes will have, if any, and conclude by relating everything back to independent medical practices.

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Atchison, Robert Bryan 1970. "U.S. health care reform and medical privacy rights." Thesis, Massachusetts Institute of Technology, 1994. http://hdl.handle.net/1721.1/35424.

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Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 1994.
Vita.
Includes bibliographical references (leaves 87-99).
by Robert Bryan Atchison.
M.S.

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Ntau, Christopher Gopolang. "Medical careers and the Botswana health care system." Thesis, Royal Holloway, University of London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.543578.

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This thesis examines, from a sociological perspective, the careers of doctors from a developing country without its own medical school or strongly organised medical profession. It argues that the interplay between the socio-economic and political forces and doctors' experiences internalised over the years at medical school, contribute to medical migration in Botswana from the public sector to private practice, and abroad. First, the thesis examines the influences that come into play when Botswana citizens choose a medical career. Then, the study explores students' medical school socialisation outside Botswana, and how this interfaces with subsequent workplace experience in Botswana. The retention efforts within the public health service and the 'pull' factors to the industrialised nations and international agencies are also studied. Data collection for this study was mainly through in-depth interviews with citizen doctors in the public and private sectors in Botswana. For doctors abroad, computer assisted interviewing was utilised. The data reveal that, in choosing a career in medicine, doctors came under varied and sometimes conflicting influences, at the family, community and institutional levels. While studying abroad, doctors were exposed to the modem technologies and facilities and an environment perceived as being conducive to work and study at the same time. These come to be pull factors when doctors, thus trained and socialised, wish to apply their skills and knowledge in practice on their return home. What obtains in medical practice, and the expectations from the state and the public for the medical profession are different from those the doctors have been socialised to expect. This situation leads to complaints and resignations by doctors. In themselves, such complaints are not peculiar to Botswana, but Batswana doctors are relatively well placed to leave the public sector. The study suggests that the solutions devised to address doctors' concerns should go beyond tinkering with monetary incentives

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Pannick, Samuel. "Improving interdisciplinary care on the general medical ward." Thesis, Imperial College London, 2016. http://hdl.handle.net/10044/1/44373.

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General medical wards deliver the majority of inpatient care. Despite technological and therapeutic advances, these wards expose 10% of patients to preventable adverse events, and disproportionately contribute to preventable hospital deaths. Improving ward team performance is often proposed as a mechanism to improve patient outcomes. The overarching goal of this thesis is to identify effective strategies to improve interdisciplinary team care on the medical ward. Chapter 1 introduces key concepts in healthcare quality, and specific issues in the delivery and measurement of interdisciplinary ward care. The existing literature for ward improvement strategies is then described. A narrative review identifies common targets for ward interventions [chapter 2], and a systematic review evaluates interdisciplinary team care interventions, finding little evidence of significant impact on objective patient outcomes [chapter 3]. The development and evaluation of prospective clinical team surveillance (PCTS) is then reported. PCTS is a novel interdisciplinary team care intervention, engaging staff to identify barriers to care delivery, with facilitation and feedback. A programme theory and mixed methods evaluation are presented, using a stepped wedge, cluster controlled trial [chapter 4]. Mixed-effects models show a significant reduction in excess length of stay with high fidelity PCTS [chapter 5]. Surveys, focus groups and auto-ethnography identify PCTS' mechanisms of action, and its impact on incident reporting, safety and teamwork climates [chapter 6]. Implementation outcomes, facilitators and barriers are described in chapter 7. Other perspectives on improvement are also explored. A model of organisational alignment is developed [chapter 8], and an interview study with patients and carers elicits their priorities [chapter 9]. Finally, chapter 10 summarises the findings, highlighting opportunities to develop medical ward outcome sets and construct a model of interdisciplinary team effectiveness. These can be used to support improvements in interdisciplinary care, through changes in policy and practice.

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Ayati, S. B. "A portable EIT system for emergency medical care." Thesis, Loughborough University, 2016. https://dspace.lboro.ac.uk/2134/20770.

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Electrical Impedance Tomography (EIT) is a medical imaging technique in which images of tissue conductivity within a body can be inferred from surface electrode measurements. The main goal of this study is to develop a portable EIT system incorporating an optimized electrode layout to detect intracranial haematomas for use in emergency care. A growing haematoma can cause severe and even permanent damage to the delicate tissue of the brain, morbidity, and eventual death of the patient. No capability is at present available for the diagnosis of haematomas pre-hospitalisation or by first-responders. The lack of this crucial information can lead to bad decisions on patient management, and in particular, where to send the patient. Blood has a high electrical conductivity contrast relative to other cranial tissue and can be detected and monitored using electrical impedance methods. EIT is a non-invasive, low-cost monitoring alternative to other imaging modalities, and has the potential to detect bleeding and to localize the approximate bleeding site. A device of this nature would reduce treatment delays, save on costs and waste, and most significantly, positively impact patient outcomes. The first step was a numerical simulation study on FE models. The full array and the hemi-array electrode layouts were modelled and the anomalies were simulated in different positions with different sizes. The results were obtained using TSVD and WMNM reconstruction methods by COMSOL linked with MATLAB. The simulated anomalies were detected for all the positions using both layouts; however those from the full array were in general superior to the hemi-array. In order to perform realistic experiments, a prototype EIT system was constructed in the laboratory. The constructed EIT has 16 channels and operates in the frequency range of 10 kHz to 100 kHz with a temporal resolution of 100 frames per second and high level of accuracy of 93.5 %. The minimum number of 8 electrodes was chosen in this study for emergency care. Minimizing the number of electrodes speeds up the electrode setup process and avoids the need to move the patient s head in emergency care. In the second part of this study, phantom experiments were performed to find an optimised electrode layout for emergency care. The full array and the hemi-array were investigated using phantom experiments. As expected, the full array layout had the best performance in general; however, the performance of the hemi-array layout was very poor. Thus a novel optimised electrode layout (semi-array) for emergency care was proposed and evaluated in phantom experiments. For the hemi-array and the semi-array layouts, measurement sensitivity depends strongly on the anomaly location since the electrodes are not placed all over the head. The HA layout performed very badly, with the best radial localization error of 0.8100 mm, compared to the SA layout with the worst error of 0.2486 mm. Some reconstructed anomalies located far from the electrodes in the posterior region were almost invisible or erroneous for the hemi-array layout; however, it is enhanced by using the semi-array layout. Finally, in vitro experiments were conducted on ovine models. In most of the experiments carried out by other researchers, since the location of the simulated anomalies was not known and the simulated blood was normally injected into the body or the head, localization of the anomalies was not considered and the quantity of the injected blood was investigated solely. In our new method of experiment, the position of the anomalies was known a priori and thus could be compared accurately to the EIT results. The full array and the semi-array layouts were compared in terms of detection, localisation and size estimation of haematomas. As expected, the full array layout was found to be more robust than the semi-array layout with the best mean value of the localization error of 0.0564 mm and the worst QI error of around 30%. Using a minimum number of electrodes in an optimised layout is always desirable in clinical applications. The semi-array 8-electrode layout prevents unnecessary movements and the electrode connections to the head would be very quick in emergency care. Although the semi-array 8-electrode layout reduced the sensitivity of the measurements, the findings from the experiments indicated its potential to detect and monitor haematomas and probably extend its application for emergency applications where the required accuracy is not critical.

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Shah, Ruby. "Naloxone Utilization in a Tertiary Care Medical Center." Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/281779.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
The purpose of this research project was to review the use of naloxone for oversedation events from 2008-2011 at the Mayo Clinic Hospital in Phoenix, Arizona. Opiates are generally an accepted form of acute and chronic pain management. Opiate analgesic use has increased in past decades due to several factors including cultural and healthcare ideas on the importance of pain management, as well as the availability, cost, and marketing of the drugs. Concomitant with the increased use of opiates has been a rise in addiction, diversion, and abuse. In addition, opiate overdose is a potentially lethal consequence. Balancing the use of opiates for effective pain control and the possible risks of opiates is a constant effort for healthcare professionals. Monitoring the use of naloxone has arisen as an effective metric to examine the safety and outcomes of opiate utilization in a hospital setting. Reviewing every dose of naloxone delivered over the years 2008-2011 has allowed us to recognize trends that have led to improvements in patient safety. 154 cases of naloxone use for sedation events were reviewed in a retrospective case controlled unmatched chart review. We were able to determine that patient risk for oversedation is greatest within our surgical practices, especially general and orthopedic, and that the overall risk is greatest within the first 24 hours in all surgical patients. In addition, we were able to determine statistically significant increase in risk with elevated creatinine level, American Society of Anesthesiology (ASA) Class, and patient controlled analgesia (PCA) use compared to our unmatched control group. The significance of these findings is that it identifies certain risk groups and factors that carry increased risk for sedation events, and therefore can lead to improvements in quality and education across the institution.

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Burns, Samuel Jay. "Non-Medical Home Care: Past, Present, and Future." Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/297517.

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The American non-medical home care industry is exploding. It has a consumer base of senior citizens that is estimated to number 72 million by 2025. This thesis explains how non-medical home care works in America, analyzing the industry on both macro and industry levels. Finally, the thesis discusses how businesses currently operating in the industry can improve their position in their local markets, and how future entrants to the industry should consider a consolidation approach to entry and expansion.

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Meriwether, Wyatt Edward. "Use of Medical Care and Suicide Among Veterans." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7238.

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Due to rising veteran suicide rates, the veteran population has become a focus of practitioners, research scientists, and policymakers. Although researchers have studied the relationship between suicidality and the environment, more research is required to evaluate how suicidal behavior, suicidal ideation, and suicide risk are associated with a veteran's use of medical care services within the Veterans Health Administration (VHA). Therefore, this study focused on environmental variables (medical care usage and rurality), and their relationship with suicidal behavior (Manuscript 1), suicidal ideation (Manuscript 2), and suicide risk (Manuscript 3). The social ecological model was used to better understand the interaction between the environmental factors discussed and veteran suicidality. Use of primary care services was found to be significantly associated (negative association at all levels in comparison to the reference level of high use) with each dependent variable: suicidal behavior (p < .001, OR = .074 - .529), suicidal ideation (p < .001, OR = .170 - .490), and suicide risk (p < .001, OR = .154 - .656). Finally, rurality was found to be significantly associated with suicidal behavior and suicidal ideation. A positive association was found between suicidal behavior (p < .05, OR = 8.099) and suicidal ideation (p < .05, OR = 1.892) and urban residence (in comparison to the reference level of highly rural). This study can promote social change by providing insights on how environmental factors influence veterans' propensity to suicide and by leading VHA researchers into further exploring the impact of veterans' use of services on the suicidality of the population.

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Lei, Xiaoyan. "Public and private transfers essays on transfers to children and parents /." Diss., Restricted to subscribing institutions, 2007. http://proquest.umi.com/pqdweb?did=1467890571&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.

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Fong, Ho-nam. "A comparison of the colonial medical systems in British Hong Kong (1841-1914) and German Qingdao(1897-1914)." Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B35051073.

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Boles, Brian Nelson. "An examination of relationships among indicators of socioeconomic status, health status, and selected health care utilization for fund allocation /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq21255.pdf.

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Chan, Hung-yee. "Health care delivery and financing in Hong Kong." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B23294735.

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Wong, Chit-ming. "Risk modelling methods and their application to three health care studies /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13282566.

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So, Ping-cham. "Development of medical services in Hong Kong." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43780556.

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Nair, Dev J. "State Medicaid agencies approaches to quality improvement implications for policy, practice and health outcomes /." unrestricted, 2009. http://etd.gsu.edu/theses/available/etd-04222009-214921/.

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Thesis (M.P.H.)--Georgia State University, 2009.
Title from file title page. Russ Toal, committee chair; Mark Trail, committee member. Description based on contents viewed Sept. 14, 2009. Includes bibliographical references (p. 77-81).

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Harvey, Ian Keith. "Managing the diffusion of medical technologies." Thesis, University of Hull, 1998. http://hydra.hull.ac.uk/resources/hull:3875.

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The aim of the study was to understand how and why medical technologies (devices, pharmaceuticals and surgical procedures) are produced (innovated and developed) and consumed (adopted and utilised).Medical technologies are linked to the expansion of health care provision and costs. Policy makers encourage technology assessment to ensure the value of medical technologies (absolute technological efficacy and relative cost effectiveness). This policy, which is underlain by a model of technological determinism, may be ineffective if other factors influence decision making.Three international (UK and USA) comparative case studies were undertaken, analysing the innovation, development and diffusion of specific medical technologies. Annual statistics were gathered on adoption and utilisation rates of Magnetic Resonance Imaging (a device), Laparoscopic Cholecystectomy (a surgical procedure) and Prozac (a drug). Literature review supported interviews with parties involved in decision making processes.The widespread adoption of Magnetic Resonance Imaging has been motivated by professional and institutional competition, despite its often inappropriate utilisation, uncertain efficacy and extremely high costs.Laparoscopic Cholecystectomy (keyhole surgery for gallbladder stones) has diffused rapidly, being driven by general surgeon's concerns over their control of the gallbladder. The ease of the surgery has enabled total surgical volumes to almost double.The diffusion of Prozac (an expensive antidepressant) was influenced by high profile uncertainties regarding its safety and efficacy. Subsequently its range of applications have grown, but many of these are unproven, whilst its long term safety profile is unknown.The study concludes that the decision making surrounding the innovation and diffusion of medical technologies is only vaguely related to their clinical efficacy or their cost effectiveness. lntra professional competition is central to the production and diffusion of medical technologies. Technology assessments, being largely reactive, and dependent on clinical reports, are unlikely to prove effective in achieving cost effectiveness. This finding has significant implications for future health care policy making.

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Garapati, Pavani Tushara. "Greencare - A Medical Waste Management Facility." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10785091.

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GreenCare is a medical waste management facility, located in Los Angeles, California and aims at effectively treating and managing all kinds of medical wastes. GreenCare’s business plan elaborates on how it is designed to safely and effectively handle the management of medical waste, by minimizing harmful byproducts, and emissions in the process. The aim of GreenCare is to offer disposal techniques including no-burn technologies that do not emit dioxin, mercury and other fatal pollutants, which differentiates GreenCare from other competitors in the market. The unique value proposition of GreenCare is to provide advanced ecological sensitive medical waste processing, and we aim to do this in a cost-competitive manner. It aims to lessen the ecological burden of medical waste in our communities, that is bound to create a positive impact on community health, in the long run. This business proposal gives the reader a thorough insight into the legal, regulatory issues and financial assumptions based upon which this proposal was designed.

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Beaubien, Jason Michael. "Effectiveness of recipient restriction programs in medicaid managed care organizations /." View online ; access limited to URI, 2005. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3206244.

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Suen, Yuk-lam Kelvin. "A comparative study of the health care policies in Hong Kong and Singapore." Click to view the E-thesis via HKUTO, 2002. http://sunzi.lib.hku.hk/hkuto/record/B42576350.

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Singleton, Alsy R. "Patient satisfaction with nursing care : a comparison analysis of critical care and medical units." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1061875.

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Patient satisfaction is an outcome of care that represents the patient's judgment on the quality of care. An important aspect of quality affecting patient's judgment can be attributed to patients' expectations and experiences regarding nursing care according to type of unit. The purpose of this study was to examine differences between patients' perceptions of satisfaction with nursing care in critical care units and medical units in one Midwestern hospital.The conceptual framework was "A Framework of Expectation" developed by Oberst in 1984, which asserted that patients have expectations of hospitals and health care professionals regarding satisfaction and dissatisfaction with care. The instrument used to measure patient satisfaction was Risser's Patient Satisfaction Scale, with three dimensions of patient satisfaction: (a) Technical-Professional, (b) Interpersonal-Educational, (c) Interpersonal-Trusting. The convenience sample included 99 patients50 from critical care units and 49 from medical wards. Participation was voluntary. The study design was comparative descriptive and data was analyzed using a t-test.The demographic data showed that the majority of patients had five or more admission. About one-third of the patients were 45-55, 56-65, 66-75, respectively. Findings related to the research questions were that: (a) 84 percent of the respondents rated overall satisfaction in the satisfactory to excellent range, (b) results of a t-test showed significant differences in overall patient satisfaction with patients being more satisfied with care in critical care units. Significant differences were found in three subscales with critical care being more satisfied. No relationship was found between patient satisfaction and age/and/or type of unit.Conclusions were that in both medical and critical care units patients were more satisfied with Technical-Professional and Interpersonal-Trusting than with Interpersonal-Educational. Also noted was that patients in the units where nurse-to-patient ratio was higher participants perceived that nurses had more time, energy and ability to meet patient expectation. Implications call for analysis of nurse/patient ratio in relation to patient satisfaction and nurses in relation to patient education as well as patient's perceptions of getting their needs met.
School of Nursing

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Killmeyer, Mary. "Communication Between Primary Care Providers and Medical Family Therapists: Reducing Barriers to Collaborative Care." NSUWorks, 2015. http://nsuworks.nova.edu/shss_dft_etd/6.

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A review of the research related to Medical Family Therapy demonstrates that the inclusion of marriage and family therapists as part of the healthcare team offers benefits such as decreased utilization of healthcare, decreased costs, increased positive outcomes for patients and healthcare systems. However, studies demonstrate the difficulty with communication between providers limiting access to marriage and family therapists. Results of this study identified benefits to working with medical family therapists including broadening the understanding and using a collaborative effort to help the patient improve and get better. Participants also identified barriers to collaboration such as the lack of knowledge of and access to MedFTs, their inclusion in the system, MDs finding value in the MedFT profession, and that the communication process is lacking. Further need for improved communication at the referral and follow-up stages in collaborative practices is shown. In order to move more toward collaborative practices, PCPs and MedFTs need to develop and disseminate training on treatment notes, communication, team meetings, and continuance of collaborative work with one another.

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Robisnon, Brenda Joyce. "Is there an Association between Non-VA Medical Care Coordination and Utilization of Care?" ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2376.

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The Non-Veteran Administration Care (NVC) is a program in which the Veterans Health Administration purchases health care when it cannot provide the health services needed for eligible Veterans. The rising cost of this program led to audits by the Office of the Inspector General and other entities. The scholarly problem for this DNP Project was the lack of oversight, accountability, and management, found throughout the audits of NVC, as well as a lack of evaluation of NVC. The purpose of this project was to ascertain if there was a relationship between the Non-VA Care Coordination program (NVCC) and utilization of care. The NVCC was implemented to eliminate the deficiencies cited by audits. Sleep study and chiropractic consults for FY 2013 (pre-NVCC) and FY 2014 (post-NVCC) were examined. Sleep apnea service was available at the local Veteran Administration Medical Center and chiropractic service was not. Utilization of care was determined by emergency room (ER) visits and admissions related to the consult. A logic model was used to conceptualize the project and the longer-term implementation and evaluation of NVCC, and descriptive statistics were used to analyze trends in the chiropractic data (sleep study consults were excluded from the analysis due to the minute number). There were a total of 859 chiropractic consults and 2,184 approved visits analyzed. The results revealed that Veterans who utilized the consults had no ER visits or admissions related to referrals for chiropractic consults. Completed chiropractic consults remained proportionality the same both years. NVCC had no association with the utilization of care. This scholarly project contributes to social change by empowering consumers and providing transparency in the government through audits that facilitate quality improvement and evaluation of the NVCC program.

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Armbruster, Susanne. "Versorgungsnetzwerke im französischen und deutschen Gesundheitswesen : eine vergleichende Studie unter Berücksichtigung rechts- und gesundheitswissenschaftlicher Aspekte /." Stuttgart : Ibidem-Verl, 2004. http://www.gbv.de/dms/sbb-berlin/46191977X.pdf.

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Chouteau, Wendy A. "Use of a Portable Medical Summary to Provide Continuity across Systems of Care as Youth with Medical Complexity Transition to Adult Care." Xavier University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1524321320625958.

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Ho, Chi-hang Bruce. "Health care financing options for Hong Kong." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25139526.

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Levy, Elizabeth Giselle. "Therapeutic process in a managed care type setting : the working alliance, pre-treatment characteristics and outcome /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.

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Wong, Lai-cheung. "A study of hospice care : [factors affecting] communication between the health care professionals and the patients /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13409475.

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Lindrooth, Richard C. "Selective contracting, cost sharing, and utilization management : a theoretical and empirical analysis of the market for health care /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/7463.

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Torssander, Erika. "An Ethical Reflection on Coercion in Dementia-Care." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-66959.

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Smith, Jennifer Hale. "Prevalence of Pain in the Medical Intensive Care Unit." Yale University, 2006. http://ymtdl.med.yale.edu/theses/available/etd-06282006-143554/.

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Cabrera, Katherine Marie. "Florida's health care reimbursement for outpatient medical nutrition therapy." FIU Digital Commons, 2002. http://digitalcommons.fiu.edu/etd/1957.

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The purpose of this study was to describe and inform registered dietitians (RDs) in the State of Florida what insurance companies are providing in terms of medical nutrition therapy (MNT) coverage. A questionnaire was developed to encompass major MNT reimbursement stipulations such as policies, specific diseases coverage, specific Current Procedural Terminology (CPT) codes and descriptors, use of the medical necessity letter and nutrition cost benefits analysis (CBA). The questionnaire, encompassing 27 plans (HMO, PPO, Indemnity, Medicare, Medicaid), also served as a MNT promotional tool for 11 top administrators from insurance companies (10 private, 1 government) around the State of Florida. The results showed that 78% of all plans reimbursed for MNT caseby- case even without specific MNT policies. Sixty-seven percent of the plans would approve for MNT reimbursement with a medical necessity letter. Half of these top administrators showed an optimistic interest in using nutrition CBAs, case studies and practice protocols for creating MNT policies. The top ranked CPT codes were found to be 99204 (1), 99202 (2), 99201 (2), 99203 (3). The most recognized corresponding descriptors with the CPT were MNT, disease management skills and training and nutritional counseling. This questionnaire may be used to create additional MNT reimbursement audits or research. The results given in this study can aid RDs in proper documentation on insurance claim forms, usage of the medical necessity letter, nutrition CBAs, practice guidelines and case studies for successful MNT reimbursement.

Dissertations / Theses on the topic 'Medical care'

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