Dissertations / Theses on the topic 'Quality of health performance'
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Smith, Ronny Terrell. "Home Health Aides' Performance and Home Health Clients' Quality of Life." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6676.
Full textJung, Helen. "Physical performance and health-related quality of life post-stroke." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33788.
Full textForty-three community-living persons with stroke were recruited to participate in a six-week intervention preceded and followed by a performance- and interview-based evaluation assessing different levels of disability and functioning. HRQL was measured by the VAS of the EQ-5D.
Regression models generated cross-sectionally demonstrated that physical performance, social, and psychological functioning explained up to 90% of the variation in HRQL. A GEE model revealed that, over time, only upper extremity functioning had a significant relationship with HRQL.
Much attention has already been focused on increasing physical performance in rehabilitation. However, clinicians should consider other components that affect HRQL directly or indirectly through physical performance. Only by treating the different components of functioning at various levels can HRQL be ultimately increased.
Fisher, Ronald L. "What Cost Hospital Quality: Performance Uncertainty Under Market Reform." VCU Scholars Compass, 2006. https://scholarscompass.vcu.edu/etd/705.
Full textRichardson, Samuel Starr. "Quality-based payment in health care: Theory and practice." Thesis, Harvard University, 2013. http://dissertations.umi.com/gsas.harvard:11142.
Full textNair, Dev. "State Medicaid Agencies Approaches to Quality Improvement: Implications for Policy, Practice and Health Outcomes." Digital Archive @ GSU, 2009. http://digitalarchive.gsu.edu/iph_theses/59.
Full textRhodes, Harry B. "Factors influencing the quality of EHR performance| An exploratory qualitative study." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10252643.
Full textA significant amount of evidence existed in support of the positive effect on the quality of healthcare that resulted from transitioning to electronic health information systems, equally compelling evidence suggests that the development process for electronic health information systems falls short of achieving its potential. The objective of this research was to assess the existing HIT standards and health information management (HIM) principles to determine if they are robust enough to inform the development of national and international interoperability standards. The research question asked; How do HIT standards and HIM principles and practices influence the quality of EHR performance? This study’s goal was to maintain focus on the collaborative challenges revealed by the lack of understanding and shared vision that commonly exists between HIM professionals, HIT developers, and HIT vendors that obstruct synergy and enfolding of health information standards-based capabilities and HIM practice (business) standards. The complex electronic health record (EHR) universe proved well suited for testing by a combination of complexity science and the unified theory of acceptance and use of technology (UTAUT) information management theories. Through analysis of research literature and qualitative interviews, the research identified nine factors defined into drivers and barriers that influenced the actions of healthcare organizations; leadership, patient focus, planning, communication, alignment with lifecycle models people, processes, dynamics, training and user input, change management standard adoption, and recognition of the power of technology. Analysis of the data obtained from exploratory qualitative interviews of health information technology professionals selected from a professional healthcare management organization supported conclusions that leadership, collaboration, planning, and training limiters, have a direct impact on EHR system success or failure.
DeLellis, Nailya. "Determinants of Nursing Home Performance: Examining the Relationship Between Quality and Efficiency." VCU Scholars Compass, 2009. https://scholarscompass.vcu.edu/etd/2050.
Full textJoseph, Woodside M. "BUSINESS INTELLIGENCE AND LEARNING, DRIVERS OF QUALITY AND COMPETITIVE PERFORMANCE." Cleveland State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=csu1304981512.
Full textHunter, Marc W. "CRT anti-glare treatments, image quality, and human performance." Diss., Virginia Polytechnic Institute and State University, 1988. http://hdl.handle.net/10919/52323.
Full textPh. D.
Gilyard, Ameer. "Implementation Strategies for Quality Assurance Performance Improvements in Nursing Homes." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5466.
Full textSalazar, Ligia de. "Assessment of health students performance by the community using perceived quality of care model." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=40337.
Full textThe main purpose of this partnership is to encourage efforts to promote, oversee, and apply the actions in each one of the instances in order to improve training of human resource, strengthen local health systems, and empower the communities. Human resource competence and performance, the capacity to provide services, and the degree of community participation and commitement to health, are key elements in improving service quality.
The philosophy of current curricula reform at the Valle University stresses the partnership relationship between academic institutions, services centers, and the community, in the training of health professionals. The proposed investigation focuses on the community-based training aspect of student performance assessment and its relation to the health care system and academia. Specifically, the study will focus on designing valid and reliable instruments for community assessment of student performance, using both qualitative and quantitative aspects of data collection and analysis to assess "patient satisfaction" as an indicator of quality of care.
The results of this study demonstrate that the proposed assessment activity will allow the educational and health services institutions to have relevant and dynamic information as feedback for planning and adjustment of their programs. At the same time, it will allow the community to participate in an effective way in aspects related to their health care. The results of this study will be used as a basis for producing guidelines for involving communities (users) in the health care students evaluation process.
Kollberg, Beata. "Performance Measurement Systems in Swedish Health Care Services." Doctoral thesis, Linköping : Department of Management and Engineering, Linköpings universitet, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9302.
Full textKarki, S. (Saujanya). "Oral health status, oral health-related quality of life and associated factors among Nepalese schoolchildren." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526223384.
Full textTiivistelmä Tämän poikkileikkaustutkimuksen tavoitteena oli tutkia nepalilaisten koululaisten suunterveyttä ja siihen liittyvää elämänlaatua (OHRQoL). Toiseksi tavoitteena oli tutkia karieksen ja sen seurausten mm. oireet ja tulehdus, yhteyttä suunterveyteen liittyvään elämänlaatuun, sosiodemografisiin ja antropometrisiin tekijöihin, suunterveyskäyttäytymiseen, koulupoissaoloihin sekä -menestykseen. Tutkimus toteutettiin 18/75 satunnaisesti valitussa Nepalin piirikunnassa, jotka edustivat sekä viittä kehitysaluetta että kolmea ekologista aluetta. Mukaan kutsutuista 1157 koululaisesta (27 koulua, mukavuusotos), 1137 osallistui sekä kysely- että kliiniseen tutkimukseen. Sosiodemografiset taustatiedot sekä tiedot suunterveyskäyttäytymisestä kerättiin strukturoidulla kyselylomakkeella. Suunterveyteen liittyvää elämänlaatua arvioitiin käyttäen validoitua nepalin kielistä Child-OIDP –lomaketta. Kliinisessä tutkimuksessa tutkittiin kariestilanne, sen kliiniset seuraukset (pufa/PUFA) sekä kiinnityskudosten tila WHOn ohjeiden mukaan. BMI, vyötärön ja lantion ympärysmitan suhde sekä vyötärön ympärysmitan ja pituuden suhde laskettiin mittaustulosten perusteella. Kouluista saatiin tiedot poissaoloista viimeisen kouluvuoden aikana sekä koulumenestys kolmessa keskeisimmässä oppiaineessa viimeisimmässä todistuksessa. Lähes kaikilla todettiin ienverenvuotoa. Nuorimmassa ikäryhmässä oli muita useammin korjaavan karieshoidon tarvetta (79% vs. 64%). Kariesta sekä sen seurauksia esiintyi eniten niiden keskuudessa, jotka asuivat Kathmandun laaksossa tai vuoristossa. Karieksen esiintyvyys oli myös yhteydessä mm. sokerin, makeisten ja sokeriteen kulutukseen sekä epäsäännölliseen hampaiden harjaukseen. Karies seurauksineen oli yhteydessä huonoon suunterveyteen liittyvään elämänlaatuun (OHRQoL), erityisesti syömiseen, suun puhdistamiseen sekä nukkumiseen. Sillä oli myös yhteys sekä matalaan että korkeaan BMIhin, lisääntyneisiin koulupoissaoloihin sekä huonoon koulumenestykseen. Matala ja korkea BMI, huono suunterveyteen liittyvä elämänlaatu sekä poissaolot olivat käänteisesti yhteydessä koulumenestykseen. Karies ja ienverenvuoto ovat yleisiä nepalilaisten koululaisten keskuudessa. Karies seurauksineen on yhteydessä huonoon suunterveyteen liittyvään elämänlaatuun (OHRQoL), haitalliseen suunterveyskäyttäytymiseen, sosiodemografisiin ja antropometrisiin tekijöihin (BMI, keskivartalolihavuus) sekä lisääntyneisiin koulupoissaoloihin ja huonoon koulumenestykseen
Munson, Robert D. "Effects of delayed steroid implanting on health, performance, and carcass quality in high health risk, auction market sourced feedlot steers." Thesis, Kansas State University, 2015. http://hdl.handle.net/2097/19707.
Full textDiagnostic Medicine/Pathobiology
Daniel U. Thomson
Auction derived feeder calves (n=1,601; initial BW = 273.5 ± 4.7 kg) were used to examine the effects of delayed administration of the initial steroid implant on health, performance, and carcass characteristics of feedlot cattle. Steers were procured from multiple-source auction markets in the southeastern United States and shipped to a central Kansas feedyard over a 6 week period from December 2009 to January 2010. Steers were rested overnight prior to processing, then were randomly assigned, within arrival block, to 1 of 2 treatments: 1) implanted with Revalor-XS (40 mg estradiol and 200 mg trenbolone acetate) immediately upon arrival (ARRIVAL); or 2) implanted with the same implant after 45 d (DELAYED). Cattle were weighed on a group scale immediately following processing of each block. Feed deliveries were measured using load cells on feed trucks and recorded daily. Cattle were evaluated daily for morbidity and mortality by trained feedyard health personnel. Sick or injured cattle were removed from the home pen for further diagnosis and treatment. Individual animal health data were obtained and recorded daily. Final BW was calculated by dividing HCW by the average dressing percent of the pen. Carcass data (quality grade and yield grade) were obtained by USDA personnel; presence of lung lesions, pleural adhesions, and liver abscesses was evaluated by trained university personnel. Delaying the initial implant tended to reduce morbidity (24.7 vs. 28.5%; P = 0.13) and reduced railer rates (1.8 vs. 3.3%; P = 0.02); however, there were no effects of timing of implant administration (P ≥ 0.31) on rates of retreatment, mortality, lung lesions, or pleural adhesions. Implanting immediately upon feedlot arrival resulted in numerical improvements in ADG and feed conversion, but these differences were not statistical (P ≥ 0.56). Cattle implanted upon arrival had numerically greater HCW and yield grade vs. cattle implanted on d 45; however, these differences were not statistical (P ≥ 0.16). Delaying the initial implant 45 d did not influence animal health, performance parameters or carcass characteristics in high risk feeder calves.
Burley, Claire Victoria. "A multimodal investigation of brain health : cerebral blood flow, cognitive performance and quality of life." Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8485/.
Full textHirsch, Annemarie G. "Examination of the Use of Electronic Health Record Data for Measuring Performance in Diabetes Care." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1337189274.
Full textBruhn, Hanne. "Factors affecting performance on a respondent-generated quality of life measure an evaluation of the SEIQoL-DW /." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2008. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=25036.
Full textFarquhar, MaryBeth Anne. "Actor Networks in Health Care: Translating Values into Measures of Hospital Performance." Diss., Virginia Tech, 2008. http://hdl.handle.net/10919/28312.
Full textPh. D.
Swanson, Abby Jo. "Electronic Medical Records in Acute Care Hospitals: Correlates, Efficiency, and Quality." VCU Scholars Compass, 2006. https://scholarscompass.vcu.edu/etd/871.
Full textChukmaitov, Askar S. "Variations in Quality Outcomes Among Hospitals in Different Types of Health Systems." VCU Scholars Compass, 2005. https://scholarscompass.vcu.edu/etd/1414.
Full textFerrante, Livio. "Decentralization and health performance in Italy: theoretical and empirical issues." Doctoral thesis, Università di Catania, 2017. http://hdl.handle.net/10761/3630.
Full textDavid, Beverley Mari. "Sleep quality and daytime functioning in primary insomnia : a prospective study." Thesis, Loughborough University, 2008. https://dspace.lboro.ac.uk/2134/15745.
Full textMorrow, Heather E. M. "Corporate social performance, psychologically healthy workplaces and applicant attraction /." Halifax, N.S. : Saint Mary's University, 2009.
Find full textRunning head: Factors affecting applicant attraction Includes abstract. Supervisor: Victor Catano. Includes bibliographical references (leaves 41-46).
Mallur, Kavya. "A Quality Assurance Framework for Business Process Management." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32273.
Full textNarotam, Pradeep K. "The Utility of Health Care Performance Indicators in Evaluating Low Back Surgery." Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10109127.
Full textLow back syndrome affects 20% of people, and it is estimated that 30% of patients are unable to return to work after surgery. The monitoring of health care outcomes could improve the delivery of health services. The health performance conceptual framework, derived from the Donabedian model, was used to evaluate the functional outcome, clinical recovery, response to surgery, and physician performance of the surgical management of lumbar spine degeneration. A quantitative study (n=685) was undertaken using an administrative database in a repeated-measures design. The clinical and functional outcome improvements were analyzed using t tests. Surgical complexity on health outcome was examined with ANOVA. Predictors of patient satisfaction was explored using Pearson's correlation and regression analyses. The results demonstrated highly significant improvements in functional (mean change 30%; ODI=16.79 ± SD 19.92) and clinical recovery (mean change 50%; modified-JOA=6.983 ± SD 2.613) with surgery at 3 months; a >50% positive response to surgery; and a > 90% patient satisfaction, sustained over a 2 year period. Complexity of surgery did not impact health performance. Strong correlations between the health performance metrics were detected up to 6-months from surgery. Poor clinical recovery and persistent functional disability were predictive of patient dissatisfaction. The social change implications for health policy are that a constellation of health performance metrics could predict the potential for functional and clinical recovery based on presurgery disability while avoiding medical expenditures for procedures with no health benefit; aid in health quality monitoring, peer comparisons, revision of practice guidelines, and cost benefit analysis by payers.
Kucharczyk, Erica. "The occupational impact of sleep quality." Thesis, Loughborough University, 2013. https://dspace.lboro.ac.uk/2134/11336.
Full textUnger, Kevin L. "An investigation into the effects of winning the Malcolm Baldrige National Quality Award on the performance of hospitals/healthcare systems." Thesis, Colorado State University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3593456.
Full textThe efficiency and efficacy of the U.S. healthcare system has been in question for decades. We spend more per capita than any other industrialized nation while consistently realizing inferior health outcomes for our population as a whole when compared with many industrialized nations. In 1965, the proportion of U.S. gross domestic product (GDP) attributed to healthcare was approximately 6%. Today, the share of GDP spent on healthcare by the United States is almost 18%. This number is 5% higher than the next two countries, the Netherlands and France (spending 12.0% and 11.8% of their GDP on healthcare respectively) according to the Organization for Economic Co-operation and Development (OECD). The proportion of GDP spent on healthcare in 2020 is estimated to reach 20%, with the nation's increasing healthcare expeditors reducing resources available for other worthy government programs, eroding wages, and undermining the competitiveness of U.S. industry.
This dissertation explores longitudinal outcome data for Malcolm Baldrige National Quality Award recipients in healthcare in the dimensions of patient outcomes (mortality, complications and patient safety), as well as hospital financial and efficiency measures (average length of stay, expense per discharge and profitability). Source data from Truven Health Analytics (formerly Thomson Reuters) are used to evaluate changes in level, immediacy/latency and trend in the years prior to versus the years after becoming a Malcolm Baldrige National Quality Award recipient. In support of the hypothesis, being a recipient of the Malcolm Baldrige National Quality Award in healthcare explains slight enhancements in clinical outcomes, while hospital financial and efficiency measures all showed overwhelmingly positive operating results.
Vartak, Smruti Chandrakant. "Association between organizational factors and quality of care: an examination of hospital performance indicators." Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/2784.
Full textHands, Marisa Lynn. "Season of arrival and geographic region of origin affect feedlot performance, health, and carcass traits of Angus steers." Thesis, Kansas State University, 2011. http://hdl.handle.net/2097/8165.
Full textDepartment of Animal Sciences and Industry
Christopher D. Reinhardt
Angus steers (n = 17,919) fed at a single feedlot in southwestern Kansas between 1997 and 2007 were used to evaluate the effects of various demographic and phenotypic characteristics (season of arrival, geographic origin, health status, rate of gain, quality grade, and yield grade) on feedlot health, performance, and carcass traits. Cattle were not commingled and were predominantly preconditioned and backgrounded prior to shipment to the feedlot. Season of arrival was categorized as winter (December, January, and February), spring (March, April, and May), summer (June, July, and August), or fall (September, October, and November). Regions were: SC = Texas, Oklahoma, and New Mexico; C = Colorado and Kansas; NC = Montana, Nebraska, and Wyoming; and SE = Georgia, Mississippi, South Carolina, Tennessee, Virginia, and West Virginia. Steers that originated in SC had the poorest ADG (P < 0.01) and those originating in C had the greatest ADG, HCW, and quality grade (P < 0.01). Steers that arrived during fall had the lowest ADG and those arriving during the summer had the greatest morbidity (P < 0.01). Morbidity decreased and performance increased with increasing initial BW; quality grade was only minimally related to arrival BW in steers which were not treated for disease. After accounting for yield grade differences, the association between morbidity and carcass quality and between quality grade and heavier final BW and HCW were diminished, although ungraded cattle had lower ADG, final BW, and HCW (P < 0.01). Increasing yield grade from 1 and 2 to yield grade 3 increased percentage Choice by 12.1 points (P < 0.01); there was no additional gain in quality grade moving to yield grade 4 and 5. More rapidly gaining steers were heavier and fatter at marketing; this translated to greater quality grade in all but steers with initial BW > 375 kg. Performance was very similar among cattle which graded Prime, Choice, and Select, suggesting that producers do not need to choose between performance and quality grade; instead, much of the difference in quality grade can be explained by differences in yield grade.
Bentley, Tabitha Anne. "Performance Improvement Data and Staff Responsibility." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3485.
Full textDüsseldorf, Simon [Verfasser]. "Concept of key performance indicators controlling consumer oriented quality and herd health management in a Bavarian pork chain / Simon Düsseldorf." Bonn : Universitäts- und Landesbibliothek Bonn, 2013. http://d-nb.info/1043065717/34.
Full textSomers, Rosemarie. "The Effects of Feeding Seaweed Extract in the Diet of Swine on Gut Health, Performance, Carcass Characteristics, and Pork Quality." Thesis, North Dakota State University, 2017. https://hdl.handle.net/10365/28386.
Full textRousseau, Marie-Christine. "Caractérisation du polyhandicap : déterminants de santé, performance du système de soins et impact sur les aidants." Thesis, Aix-Marseille, 2018. http://www.theses.fr/2018AIXM0724.
Full textPolyhandicap (PLH) is a chronic affliction occurring in an immature brain, leading to the combination of profound mental retardation and serious motor deficit. The French health system allows care management in specialized rehabilitation centers (SRC), residential facilities (RF), and home care. The aims of this study were i) To describe PLH patients ‘health status and to estimate the adequacy of care management ii) To assess the QoL of parents and health-care workers.Method: inclusions: PLH patients, parents and institutional HCWs of each included patients. Data collection: socio demographic, clinical, modalities of care management, caregivers' QOL. Results: 875 PLH patients were included: main comorbidities were pulmonary infections, orthopedic and epilepsy. Global objective adequacy was higher for patients cared for in SRC.The QoL scores of all dimensions were significantly lower for parents and health care workers than for controls
Alfaiate, Carmen Sofia Pardelha. "A qualidade e o desempenho nos cuidados de saúde primários do Agrupamento de Centros de Saúde do Alentejo Central." Master's thesis, Universidade de Évora, 2020. http://hdl.handle.net/10174/29183.
Full textSchmitt, Mathias. "Leadership and Healthcare Performance." Diss., Virginia Tech, 2012. http://hdl.handle.net/10919/77975.
Full textPh. D.
Agrawal, Seema. "A Study of Asthma, School Attendance, Academic Performance, and Quality of Life in Predominantly Minority Children in 3rd to 5th Grades." Thesis, The George Washington University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10743569.
Full textAsthma is an inflammatory disorder (Koterba & Saltoun, 2012) and a common chronic condition of childhood (McCowan, Bryce, Neville, Crombie, & Clark, 1996) that can cause children to experience poorer academic outcomes (Stingone & Claudio, 2006), a lower quality of life (Everhart & Fiese, 2009), hospitalizations, and in some cases death (Center for Disease Control, [CDC], 2017). This mixed methods study explored the relationship of asthma, school attendance, grades in mathematics and reading, and the quality of life in predominantly minority children with asthma and in those without asthma. Data for this study was collected at the Children’s National Health Systems (CNHS) in the District of Columbia. A total of 36 children without asthma and 30 children with asthma enrolled in the study at the hospital’s Emergency Department (ED) and the Improving Pediatric Asthma Care in the District of Columbia (IMPACT DC) clinic. The children were in grades three to five, 8 to 11 years old, and attended schools in the District of Columbia Public Schools (DCPS) during the 2015–2016 school year. Descriptive statistics, t-tests, ANCOVA, ANOVA, Spearman ranked order correlations, and hierarchical multiple linear regression were used to analyze the data.
The quantitative analysis indicated children with asthma visited the ED significantly more frequently than those without asthma (p < .001, d= 0.8). The quality of life scores were lower for children with asthma compared to those without asthma. Further, as asthma severity increased, the quality of life scores decreased. In addition, children without asthma reported more unexcused days and absence from school than those with asthma. Lastly, children without asthma achieved a lower GPA in mathematics and reading than those with asthma. The findings indicate asthma impacts the quality of life scores in children, and that further research is warranted to determine how asthma impacts academic performance in children.
Seidner, Blake. "The Balance Between Financial and Quality Performance in For-Profit Hospitals versus Non-Profit Hospitals." Scholarship @ Claremont, 2018. http://scholarship.claremont.edu/cmc_theses/1950.
Full textSegovia, Villarreal Santiago Eduardo. "Linking worker health and well-being with business performance measures in the maquiladora manufacturing industry in the US-Mexico Border Region." To access this resource online via ProQuest Dissertations and Theses @ UTEP, 2008. http://0-proquest.umi.com.lib.utep.edu/login?COPT=REJTPTU0YmImSU5UPTAmVkVSPTI=&clientId=2515.
Full textChildress, Cynthia. "THE IMPACT OF WAR ON MILITARY HOSPITAL PERFORMANCE: A STUDY OF ORGANIZATIONS’ RESPONSE TO AN ENVIRONMENTAL JOLT." VCU Scholars Compass, 2013. https://scholarscompass.vcu.edu/etd/3171.
Full textBuika, Kyle Joseph. "Essays in Applied Microeconomics." Thesis, Boston College, 2013. http://hdl.handle.net/2345/3317.
Full textEssays on the effects of health policy payment systems in long-term care and end-of-life care institutions are studied. In the arena of long-term care, state Medicaid agencies have recently implemented pay-for-performance (P4P) programs to address poor quality of care in nursing homes. Using facility-quarter level data from 2003 to 2010, we evaluate the effects of Medicaid nursing home P4P programs on clinical quality measures, relying on variation in the timing of P4P implementation across states. Further, we exploit variation in the structure of states' programs to investigate whether programs that reward certain dimensions of quality are associated with larger improvements. We find P4P decreases the incidence of adverse clinical outcomes by as much as 8%, and the improvements are concentrated among the measures that experienced an increase in their relative returns and share strong commonalities in production. In the Hospice industry, changes to the current reimbursement system are mandated by the Patient Protection and Affordable Care Act. The motivation stems from noticeable hospice utilization changes since the Medicare Hospice Benefit (MHB) introduced a per-diem reimbursement in 1983. This research analyzes the abilities of a multi-tiered payment system, and a simpler two-part pricing system, to accurately match Medicare payments with hospice patient costs. Both systems improve on the current payment mechanism, while two-part pricing is the only system to maintain access to care for all MHB eligible patients. In addition, consumer disutility incurred by driving to airports is estimated and used to define air travel markets. Though an accurate definition of an economic market is important for any study of industry, there is no rule governing what exactly constitutes a market. To define a market we must ask the question ``between which products do consumers substitute,'' knowing that the answer to this question will depend on how ``close'' products are to one another in product space, as well as how close they are to one another, and to consumers, in geographic space. We estimate a discrete choice model of air travel demand that uses known information about the locations of products and consumers, which allows us to study substitution patterns among air travel products at different airports. We evaluate the commonly used city-pair and airport-pair definitions of a market for air travel, and conclude that a city-pair is the appropriate definition. We also employ the Hypothetical Monopolist test for antitrust market definition, as defined by the Department of Justice and Federal Trade Commission, and conclude that the relevant geographic market for antitrust analysis is frequently more narrowly defined as an airport-pair
Thesis (PhD) — Boston College, 2013
Submitted to: Boston College. Graduate School of Arts and Sciences
Discipline: Economics
Malhan, Amit Sundeep. "Exploring EHR Adoption and Implementation: The Impact of Resource Advantage Theory on Healthcare Organization's Competitive Position." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1538677/.
Full textCloud-Buckner, Jennifer M. "Managing Patient Test Data in Primary Care: Developing and Evaluating a System for Test Tracking to Enhance Processes, Safety, and Understanding of Performance." Wright State University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=wright1348258363.
Full textVasan, Ashwin. "Improving the quality of primary care delivery and health worker performance in rural Rwanda using the W.H.O. Integrated Management of Adolescent & Adult Illness (IMAI) guidelines." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2016. http://researchonline.lshtm.ac.uk/2548572/.
Full textANGWECH, HARRIETT. "Efficacy of in ovo delivered prebiotic on health, performance and meat quality of Ross 308 broiler and Kuroiler chicken reared under temperate and tropical climatic conditions." Doctoral thesis, Università degli studi del Molise, 2018. http://hdl.handle.net/11695/85317.
Full textIn ovo technology has been developed to enable delivery of sustainable bioactives, such as pre-/probiotics, directly into the egg air chamber at day 12 of embryonic incubation. Thus, improving the effectiveness of these compounds by administering them to the animals under fully controlled conditions and as early as possible. However, research on the efficacy of prebiotics delivered in ovo on gut health, performance and meat quality is still in exhaustive having been concentrated mainly on meat-type chickens. This neglects the richness of chicken biodiversity and climatic variations. The aim of the current thesis (divided in two parts) was to evaluate the efficacy of prebiotics delivered in ovo on egg hatchability, gut health, performance, and meat quality of Ross 308 broiler and Kuroiler chickens reared under temperate and tropical climatic conditions. Study one carried out in Italy used a commercial prebiotic Bi2tos (BI) injected in ovo to assess the effects of prebiotics on performance, quality and oxidative stability of meat from broiler chickens reared under temperate climatic conditions. The eggs used in this experiment were from Ross 308 broiler (meat-type) chickens. On day 12 of incubation, 300 eggs that had viable embryos were randomly divided into three experimental groups: prebiotic group (BI), injected with 200 μL Bi2tos (3.5 mg/embryo); saline group (S), injected with 200 μL of physiological saline solution; and un-injected control (C). Hatched chicks were scored and sexed for each experimental group and 120 males (40 chicks/group) were grown to 42 days of age in floor pens (4 replicates of 10 birds each), with free access to an outdoor area. Birds were fed ad libitum starter and grower-finisher diets with free access to water. Along the rearing period, chickens were weighed and counted within each pen. At 42 d, 20 randomly chosen birds per treatment, of similar estimated body weight, were individually weighed and slaughtered. Hot carcass weight was recorded and carcass yield was calculated. Main commercial cuts were removed from the carcass and weighed and their percentages (yield) calculated. Pectoral muscle pH, colour and water holding capacity (WHC) were measured 24 hours post-mortem. In addition, fatty acid composition and meat oxidative stability were also analyzed. Data were analyzed by one-way ANOVA. The multi-comparison Scheffe’s test was used to separate the differences among the mean for statistical significance (P < 0.05). Results from the study showed a satisfactorily high hatchability (> 90%) though similar among experimental groups. Mortality of the chickens during this study was very low (2%) and not dependent on the substance injected in ovo. Initial body weights were the same among all experimental groups. In the period from week one to three, BI group showed a significantly higher weight gain in comparison to the C (+2.5 %) and S (+1.9 %) groups. While for the entire rearing period (week 1 - 6), both BI and S groups showed higher BWG in comparison to the C group (+7.5% and 6.8%, respectively). Chickens from BI group were significantly heavier at slaughter than those from C group, but similar to those of S group. Similarly, carcass weight was higher in S and BI groups as compared to C. However, no significant differences among experimental groups were found for carcass yield, main commercial cut yields (breast, legs and wings) and back+neck yield. pH24, colour (L*, a*, b*) and WHC were the same among treatments. Intramuscular fat (IMF) content was higher in BI group compared to C group, with intermediate values for S group. The treatment did not affect total amounts of saturated fatty acids (SFA) and individual SFA content of meat. The most concentrated SFA in all experimental groups were palmitic acids (C16:0; 23.45 – 24.95%) followed by stearic acid (C18:0; 9.49 – 10.21%). No effect of treatment was observed in the composition of monounsaturated fatty acids (MUFA) as well as total MUFA contents. Quantitatively, oleic acid (C18:1n 9) was the most abundant MUFA (24.49 – 25.53%). In ovo delivered prebiotic lowered (-2.6%) the total poly unsaturated fatty acid (PUFA) content compared to the S group. Total n-6 and n-3 PUFA contents of meat from BI group birds were also significantly lower than those of the S group. For individual fatty acid, only docosahexanoic acid (C22: 6n 3) was affected by the treatment being lower in the BI group in comparison with the S group (-0.31%) and C group. Regardless of the treatment, the most abundant PUFA were linoleic (C18:2n 6; 25.13– 25.73%) and arachidonic acids (C20:4n 6; 5.22 – 6.44%). Regarding selected fatty acid indices, n-6/n-3 ratio was significantly higher in the prebiotic treated group (+16.2%) than in S group. In addition, P/S tended to be lower in BI group compared to S and C. The treatment did not have any effect on atherogenic and thrombogenic indices. The treatment had no negative effect on lipid peroxidation. In fact, TBARs values were slightly lower in BI compared to the control group after 72 hours of storage. All in all, the results obtained from this study clearly proved that the in ovo prebiotic administration improved production performance in Ross 308 broiler chickens throughout the rearing period without negatively affecting meat quality. In the second study, the efficacy of prebiotics, antibiotic-chick formula and a combination of the two on growth performance, carcass traits and gut health in the face of a natural coccidiosis infection was assessed in Kuroiler chickens reared under field condition in Uganda. At the 12th day of incubation, 150 eggs from Kuroiler (dual purpose) chickens with viable embryos were randomly divided into two equal groups. One group was injected with 0.2 mL of Bi2tos (3.5mg/embryo); and the other was left uninjected as control. Hatched chicks from each of the two experimental groups above where further randomly divided into two groups: one group received antibiotic chick formula (poltricin with oxytetracycline at a dose of 1g/litre of drinking water for 7 days) while the other was left without the antibiotic chick formula. Thus, giving rise to four experimental groups: Control (C), Antibiotic (A), Bi2tos (B) and Bi2tos + Antibiotics (AB). The birds (half males and half females) were reared in a local poultry farm in Gulu District where coccidiosis infection was previously confirmed by field veterinarians. All birds were reared under semi-intensive confined system for a period of 18 weeks. Chickens were fed ad libitum starter, grower and finisher diets and had constant access to water. Body weights were taken per pen on a weekly basis and also faecal samples were collected for parasitological analysis to check for possible infection with Eimeria parasites. At d 12 and at the end of the experiment, 6 birds/group were randomly chosen to assess the severity of coccidial lesions in the intestines. At slaughter, carcass and meat quality traits were evaluated as described in experiment one above. The treatment with Bi2tos (B) significantly increased body weight and body weight gain especially at 6 weeks of age. On the other hand, AB group was the heaviest of all experimental groups at the end of the experiment. The B group had a slightly higher carcass weight compared to the rest of the treatments. Breast yield was generally higher in all treatment groups compared to the C, although significant differences were found only with AB group (+6.0%). Leg weight and yield were not significantly different among experimental groups but tended to be higher in prebiotics treated groups. Wings yield was higher in AB group compared to the C group, intermediate values were observed in A and B groups. Sexual dimorphism was clearly evident with males being heavier at slaughter and displaying better carcass traits. pH and WHC values were similar among experimental groups and between the two sexes. Significant interaction between treatments x sex was observed for breast yield and wings weight. With reference to the effect of the treatment on fatty acid composition, meat from the B group displayed the highest (+ 3.72 %) amount of total PUFA compared to the control group. Conversely, breast muscles of the B group as well as those of the AB group had, in general, lower amounts of total MUFA compared to C and A groups. Total amount of SFA was not affected by the treatments. Total n-3 fatty acids were higher in B compared to the control groups A and AB had intermediate values. Total n-6 fatty acids were the same among treatment groups. The ratio of PUFA to SFA was not significantly different among experimental groups. On the other hand, the n-6/n-3 ratio was lower in B and AB groups compared to C and A groups. A comparison of the two sexes showed only minimal effects on fatty acid profile. Total MUFA was higher in males compared to the females; while PUFA were higher in females than males. The fatty acid ratios were not affected by sex. There were significant treatments x sex interaction effects on total n-3 as well as n-6/n-3 ratio though. Overall, prebiotic (Bi2tos) with or without antibiotics reduced the severity of coccidiosis lesions induced by natural infection with Eimeria spp. as well as oocyst excretion compared with the control and also improved meat quality. In conclusion, the study has demonstrated that use of in ovo delivered prebiotics in broiler production can lessen the depression in growth due to coccidial challenge with positive effects on meat quality. Regardless of the treatment and experimental conditions, Kuroilers had lower n-6/n-3 ratio compared to Ross 308 broiler chickens.
Everhart, Chichi Kate. "Strategies for Measuring Quality Care in Healthcare Organizations in the United States." ScholarWorks, 2018. http://scholarworks.waldenu.edu/dissertations/4851.
Full textMühlhan, Markus, Michael Marxen, Julia Landsiedel, Hagen Malberg, and Sebastian Zaunseder. "The effect of body posture on cognitive performance: a question of sleep quality." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-147476.
Full textPaula, Janice Simpson de 1984. "Determinantes sociais, saúde bucal, rendimento escolar e qualidade de vida em crianças e adolescentes = Social determinants, oral health, school performance and quality of life in children and adolescents." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290865.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O objetivo geral dessa Tese foi avaliar os determinantes sociais da saúde (DSS) associados à saúde bucal, ao rendimento escolar e a qualidade de vida em crianças e adolescentes, além de testar as propriedades psicométricas longitudinais de questionários de Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) e comparar um questionário genérico de qualidade de vida com outro de QVRSB. Para isso, foram usadas duas amostras: uma composta por crianças de 8 a 10 anos, participantes do Programa Sempre Sorrindo (PSS), no município de Piracicaba, São Paulo, e outra composta por escolares de 12 anos provenientes de escolas públicas e privadas do município de Juiz de Fora, Minas Gerais. Foram coletados dados referentes às condições clínicas e aplicados questionários para avaliação da qualidade de vida (Child Perception Questionnaire ¿ CPQ8-10 e CPQ11-14 e AUQUEI ¿ Autoquestionnaire Qualité de Vie Enfant Image), bem como do nível socioeconômico, do ambiente familiar e do rendimento escolar das crianças. Os resultados demonstraram que os DSS apresentaram associações com cárie dentária e que, em particular, os aspectos socioeconômicos possuíram maior associação com a experiência de cárie, quando comparados com variáveis relacionadas ao ambiente familiar. Observou-se, ainda, que tanto aspectos socioeconômicos, do ambiente familiar e a presença de lesões de cárie, mesmo que tratadas, foram indicadores de risco para o pobre rendimento escolar, e a experiência de cárie foi um importante preditor para mudanças na QVRSB de adolescentes ao longo do tempo. Sobre a responsividade dos instrumentos de QVRSB, verificou-se que o questionário CPQ11-14 apresentou-se responsivo às mudanças longitudinais, avaliadas pelo critério de Longitudinal Construct Validity, mas com pequena alteração quando avaliada pela análise de effect size. Os resultados também demonstraram que o CPQ11-14 apresentou correlação com o instrumento genérico de qualidade de vida AUQUEI e que ambos apresentaram associações com variáveis clinicas e socioambientais. Por fim, verificou-se que o tratamento da cárie dentária impactou positivamente na melhora da QVRSB de escolares, e o CPQ8-10 apresentou boas propriedades psicométricas para avaliar estas mudanças ao longo do tempo. Conclui-se, a partir dos resultados dos estudos supracitados, que houve associações entre DSS e a cárie dentária, e que ambos estiveram associados a um pior rendimento escolar. Da mesma forma, verificou-se que a QVRSB esteve correlacionada à qualidade de vida nesta população. Quando os escolares foram avaliados longitudinalmente, constatou-se que a experiência de cárie foi um preditor importante para mudanças da QVRSB ao longo do tempo nesta população, mensurada pelos questionários Child Perception Questionnaire, que apresentaram boas propriedades psicométricas de responsividade às mudanças de qualidade de vida relacionada à saúde bucal. Dentro deste contexto, o acesso ao tratamento odontológico foi um importante fator para a melhoria da qualidade de vida relacionada à saúde bucal de escolares que vivem sob vulnerabilidade social
Abstract: The overall objective of this thesis was to evaluate the social determinants of health (SDH) associated with oral health, school performance and the quality of life in children and adolescents, as well as test the longitudinal psychometric properties of Oral Health realte Quality of Life (OHRQoL) questionnaires and compare a generic questionnaire of quality of life with other of OHRQoL. For this, two samples were used: one consisting of children 8-10 years participating in the Program Always Smiling (PSS), in Piracicaba, São Paulo, and another composed of schoolchildren of 12 years from public and private schools in the city Juiz de Fora, Minas Gerais. Data were collected regarding on clinical conditions and questionnaires to assess quality of life (Child Perception Questionnaire - CPQ8-10 and CPQ11-14 and AUQUEI - Autoquestionnaire Qualité de Vie Enfant Image) and socioeconomic status, home environment and school performance of schoolchildren. The results showed that the SDH were associated with dental caries and, in particular, the socioeconomic aspects contained higher association with caries experience compared to variables related to the home environment. It was observed also that both socioeconomic aspects of the home environment and the presence of caries lesions, even if treated, were risk factors for poor school performance, and caries experience was an important predictor of changes in QVRSB adolescents over time. On the responsiveness of OHRQoL instruments, it has been found that the questionnaire is presented CPQ11-14 responsive to longitudinal changes, as evaluated by Longitudinal Construct Validity, but with little change as determined by the effect size analysis. The results also showed that CPQ11-14 correlated with the generic instrument of quality of life AUQUEI and both were associated with clinical, social and environmental variables. Finally, it was found that treatment of dental caries has impacted positively on improving of OHRQoL, and had good psychometric properties of CPQ8-10 for measuring changes over time. In conclusion, from the results of the aforementioned studies, there were associations between SDH and tooth decay, and both were associated with poorer school performance. Likewise, it was found that the OHRQoL was correlated to quality of life in population. When the students were assessed longitudinally, it was found that caries experience was an important predictor of changes OHRQoL over time in this population, as measured by the Child Perception Questionnaire questionnaires, which showed good psychometric properties of responsiveness to quality of life changes related to oral health. Within this context, access to dental treatment was an important factor in improving the quality of life related to oral health of children living under social vulnerability
Doutorado
Odontologia em Saude Coletiva
Doutora em Odontologia
Ort, Shona B. "The impact of direct-fed microbials and enzymes on the health and performance of Holstein cattle with emphasis on colostrum quality and serum immunoglobulins in the calf." Thesis, University of New Hampshire, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10161772.
Full textResearch has shown that direct-fed microbials (DFM) and enzyme supplementation can impact the dry matter intake (DMI), milk production, and milk composition. However, limited research has evaluated the impact of DFM and enzyme supplementation on colostrum quality and the uptake of the Immunoglobulins A and G (IgA and IgG) by calves. In this study, 36 multiparous Holstein cows were blocked by expected calving date and randomly assigned to 1 of 3 treatments 3 weeks prior to calving and remained on these treatments until week 8 postpartum. These treatments were: 1) 0 g of DFM and enzyme (control), 2) 45.40 g/d of Tri-Lution® (Tri), or 3) 45.40 g/d of Tri-Lution® and 18.16 g/d of Zy-mend® (Tri + Zy). The amount of total mixed ration (TMR) fed and orts refused were measured each day to determine DMI. Blood samples were taken on the cows every Monday, Wednesday, and Friday at 1100 h from the coccygeal veins and arteries to be analyzed for β-hydroxybutyrate (BHBA), glucose, and nonesterified fatty acids (NEFA). Cows were also weighed once a week throughout the course of the study. Colostrum was harvested and weighed at parturition and later analyzed for IgA and IgG concentration via radial immunoassay. Calves were fed 4 L of maternal colostrum within 2 h after calving. Blood samples were also taken from the calves at 0 and 24 h in order to be analyzed for IgA and IgGconcentrations and to determine apparent efficiency of absorption of IgA and IgG. Finally, milk yields were taken daily for 8 wk postpartum and samples were taken once a week and sent to DairyOne (Ithaca, NY) to be analyzed for quality. Prepartum body weight (BW), BW, efficiency of gain, DMI, BHBA, NEFA, and glucose concentrations were not impacted by treatment. There was also no impact of treatment on colostrum yield, IgA and IgG content, and composition with the exception of IgA yield and ash percentage. The ash percentage of colostrum tended (P = 0.07) to increase with the Tri and Tri + Zy treatments while the IgA yield (P = 0.05) decreased with the Tri treatment. Treatments did not impact BW, serum IgA and IgG concentrations or apparent efficiency of absorption of IgA and IgG of the calves. Postpartum BW, DMI, blood metabolites, milk production and composition, with the exception of BW gain and somatic cell score (SCS), of the cows were not impacted by treatment. Cows on the Tri treatment gained more BW (P =0.03) and tended to have a greater efficiency of gain (P = 0.09) in comparison to those on the Tri + Zy treatment, but both treatments did not differ from the control. This suggests that there is a negative effect of applying the Tri-Lution® and Zy-mend® together which might be due to negative interactions among ingredients and microorganisms. An increase in SCS (P = 0.04) was also observed with the Tri treatment. All these results indicate that the supplementation of DFM and enzymes is not beneficial in improving the health and performance of dairy cattle during the transition period and early lactation.
KAO, BIANCA JEAN-AN. "EFFECT OF FAMILY HISTORY OF DEMENTIA AND SELF-REPORT OF SLEEP QUALITY ON COGNITIVE PERFORMANCE IN HEALTHY OLDER ADULTS." Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/613111.
Full textChul, Chang Young. "Experimental, theoretical and computational modelling of airflow to investigate the themalhydraulic performance and ventilation efficiency in a clean room." Thesis, University of Bristol, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.389239.
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