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Eygelaar, Johanna Elizabeth. "An investigation into factors influencing the quality of nursing care in district hospitals in the West Coast Winelands region of the Western Cape." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/4042.
Повний текст джерелаENGLISH ABSTRACT: Every patient comes to a hospital with the expectation of getting quality care. It is not always within the ability of nursing personnel to give quality care in the work situation. Guided by the research question “What are the factors influencing the quality of nursing care in district hospitals in the West Coast Winelands Region of the Western Cape?” a scientific investigation was undertaken. The goal of this study was to identify the factors which influence the quality of nursing care in the eight (8) district hospitals of the West Coast Winelands Region of the Western Cape. The objectives set for the study were: to determine whether staffing is adequate for all activities; to evaluate what the perceptions of the nursing staff is about their current working situation; to determine what the effect of the absence of full time doctors are on the management of patient care; to evaluate whether adequate equipment is available for the execution of nursing care and to evaluate whether adequate provisions for the execution of nursing care is done. A descriptive non-experimental design with a quantitative approach was applied. The population for this study was all the nursing staff available at the time of data collection, working in the eight district hospitals of the West Coast Winelands Region. A structured questionnaire was used to collect the data. The final sample of nursing staff was N= 280 of a total population of 340 – all the members were invited to participate. Reliability and validity were assured by means of a pilot study and the use of experts in nursing research, methodology and statistics. Data were collected personally by the researcher. Ethical approval was obtained from Stellenbosch University and various health authorities. Informed written consent was obtained from the participants. The data was analyzed with the support of the statistician; it was expressed in frequencies, tables and histograms. Comparisons between variables were made using either ANOVA (Analysis of variance) techniques or cross-tabulations with the Chi-square test. The 95% confidence interval was applied to determine whether there was an association between the various variables. The analysis shows that participants of the separate wards hospitals N=142 (90%) and the mixed wards type hospitals N=113 (95%) disagree that staff provision (numbers) is adequate. From the analysis it is clear that the patient documentation is not up to standard. A statistical significant correlation between hospital type and adequate time for the completion of written records (Chisquare Test p=0.00) was shown. Management N=13 (100%), registered nurses N=80 (86%), enrolled nurses N=63 (86%) and nursing assistants N= 81 (83%) disagree that it is not necessary to act beyond their scope of practice. The following recommendations were made: Safe staffing levels have to be determined; qualify staff with the necessary skills; where unit managers are still lacking, they have to be appointed; to make personnel development possible for staff; continuous auditing of patient documentation. It is necessary that there is always adequate equipment and consumables. More training is necessary for the effective and efficient implementation of the Batho Pele principles.
AFRIKAANSE OPSOMMING: Elke pasiënt kom na ‘n hospitaal met die verwagting om kwaliteit verpleegsorg te ontvang. Dit is nie altyd binne die vermoë van die verpleegpersoneel om sodanige diens te kan lewer nie. “Watter faktore het ‘n invloed op die lewering van gehalteverpleegsorg in die distrikhospitale van die Weskus Wynlandstreek in die Wes Kaap? het die wetenskaplike ondersoek gelei. Die doel van die studie is om die faktore te identifiseer wat ‘n invloed het op die lewering van gehalteverpleegsorg in die ag (8) distrikhospitale van die Weskus Wynlandstreek in die Wes Kaap. Die doelwitte van die studie is: om te bepaal of personeelvoorsiening voldoende is vir al die aktiwiteite; om te evalueer wat die persepsies is van die verpleegpersoneel betreffende hulle huidige werksituasie, om te bepaal watter effek die afwesigheid van voltydse geneeshere het op pasiënte sorg; om te evalueer of toerusting voldoende is vir pasiënte sorg; om te evalueer of daar voldoende voorsiening gemaak is vir die lewering van pasiënte sorg. ‘n Beskrywende, nie-eksperimentele ontwerp as metodologie is gebruik met ‘n kwantitatiewe benadering. Die bevolking betreffende die studie was alle verpleegpersoneel, werksaam tydens die insameling van die data in die ag distrikhospitale van die Weskus Wynlandstreek. ‘n Gestruktureerde vraelys was gebruik om die data te versamel. Die finale steekproef van die verpleegpersoneel was 280 uit die totale bevolking van 340. Betroubaarheid en geldigheid is verseker deur middel van ‘n loodstudie, en deur gebruik te maak van kenners betreffende verpleegnavorsing, metodologie en statistieke. Data is persoonlik deur die navorser ingesamel. Etiese goedkeuring was verkry vanaf die Universiteit van Stellenbosch en die verskeie gesondheidsowerhede. Ingeligde, skriftelike toestemming is van elke deelnemer verkry. Data is ontleed met die ondersteuning van die statistikus en is uitgedruk in die vorm van frekwensies, tabelle en histogramme. Vergelykings tussen die veranderlikes was gedoen deur gebruik te maak van ANOVA (analise met betrekking tot variansie) en kruis-tabulerings met die Chi-kwadraat toets. 95% Betroubaarheidsinterval is toegepas om te bepaal of daar ‘n assosiasie was tussen die onderskeie veranderlikes. Die analise het getoon dat deelnemers betreffende die hospitale met aparte afdelings N=142 (90%) en die gemengde sale hospitale N=113 (95%) verskil, betreffende die stelling dat daar voldoende personeelgetalle is. Dokumentasie is volgens die analise nie op standaard nie. ‘n Statistiese betekenisvolle korrelasie is verkry met betrekking tot die hospitaal tipe en voldoende tyd betreffende volledige geskrewe dokumentasie (Chi-kwadraat Toets p=0.00). Verpleegbestuur N=13 (100%), geregistreerde verpleegkundiges N=80 (86%), stafverpleegsters N=63 (86%) en verpleegassistente N=81 (83%) het verskil met die stelling dat dit nie nodig is om buite bestek van hul praktyk te werk nie. Die volgende aanbevelings is gemaak: die bepaling van veilige personeel vlakke moet gedoen word; voldoende personeel moet gekwalifiseer word met die nodige vaardighede. Eenheidsbestuurders moet aangestel word waar dit ontbreek; personeelontwikkeling moet moontlik wees en deurlopende oudits van dokumentasie moet plaasvind. Voldoende toerusting en voorraad is nodig om kwaliteit verpleegsorg moontlik te maak. Verdere opleiding in die beginsels van Batho Pele is nodig ten einde effektiewe en doeltreffende implementering daarvan moontlik te maak.
Eygelaar, Johanna Elizabeth. "A programme to facilitate quality client-centred care in Primary Health Care clinics of the rural West Coast District." University of the Western Cape, 2018. http://hdl.handle.net/11394/6884.
Повний текст джерелаIntroduction: The overall aim of this study was to develop a programme to facilitate quality client-centred care in Primary Health Care clinics of the rural West Coast District. Research design and -method: Both quantitative and qualitative methods were applied for this study . Phase 1, a situational analysis collected and analysed quantitative data from the perspective of clients and clinical nurse practitioners via structured questionnaires. The population included all clients 18 years and older (N=137 991) of the fixed clinics (N=25) in the five subdistricts of the West Coast District. According to the Cochran formula a sample of (n=383) should be adequate to represent the population. Non-proportional sampling was applied to estimate the number of participants per clinic. An all-inclusive sample of (n=64) clinical nurse practitioners participated in the study. Phase 2, the qualitative part of the situational analysis, applied five focus group discussions to explore and describe the managers and allied health professionals’ perceptions about quality client-centred care. A semi-structured interview schedule was compiled to guide the focus group discussions. An all-inclusive sample was utilised to include all the managers and allied health professionals of the five subdistricts (N=43). Phase 3 included the development of the programme based on the study findings and literature. Quantitative results: The analysis revealed the following quality client-centred care challenges, namely: Patient Rights (Domain 1) were not always respected and adhered to as these were characterised by: language (statistical p<0.001 and practical significant with a large effect size d=0.74); Satisfaction and Safety (statistical p<0.001 and practical significant with a medium effect size d=0.55); Referral Procedures (statistical significant p<0.001); Waiting Times (statistical p<0.001 and practical significant with a medium effect size d=0.47) and Confidentiality difficulties (statistical p<0.001 and practical significant with a medium effect size d=0.68). The Domain 2, Clinical Governance, Care and Safety showed shortcomings as highlighted by the Client and his/her Family (statistical p<0.001 and practical significant with a large effect size d=0.77). Clinical Support Services, Domain 3, revealed inadequacies regarding the continuous availability of medication (statistical significant p<0.008) and the reporting of side-effects (statistical significant p<0.001). Furthermore, Public Health Domain 4, showed that clients identified community health promotion and disease prevention events (statistical p<0.01 and practical significant with a large effect size d=0.79), and home visits by the community healthcare workers (statistical p<0.001 and practical significant with a large effect size d=1.09) as both a “problem” and a “gap”. Leadership and Corporate Governance, Domain 5 was characterised by the lack of: visible organograms (clients mean 2.40), community communication (clients mean 2.12 & clinical nurse practitioners mean 2.36), visibility of goals, values and future plans of the Western Cape Department of Health (statistical p<0.001 and practical significant with a medium effect size d=0.59) and role and function of the clinic committees (statistical significant p<0.008). Moreover, Domain 6, Operational Management was challenged by inadequate staffing levels (statistical significant p<0.003). Lastly, Domain 7: Infrastructure was characterised by the lack of drinking water in the waiting areas (clients mean 2.08 & clinical nurse practitioners mean 2.02), inadequate clinic space (clients mean 2.10 & clinical nurse practitioners 2.23); maintenance not up-to-date (statistical significant p<0.002); physical appearance of the clinic (statistically significant p<0.001) did not have a positive effect on staff morale and evacuation plans (statistical p<0.001 and practical significant with a medium effect size d=0.54) were not visible. In addition, correlations between the domains showed that the domains are not in silos, but are interdependent on another. Qualitative results The qualitative, thematic data analysis revealed various inadequacies regarding quality client-centred care. Theme One about the Patient Rights revealed that patients were not always treated with the necessary respect and dignity. Theme Two concerning Patient Care, revealed that focus group participants were well-informed on what the concept client-centred care entailed. However, patients and or clients did not always experience their care as client-centred. Theme Three about the Clinical Support Services, indicated shortages of medication and medical equipment; long waiting time for specialists and rehabilitation referral appointments. Theme Four, referring to the Public Health confirmed that health promotion and prevention activities are limited, due to various organizational factors and community healthcare workers’ activities which are limited to home-based care activities. Theme Five, Corporate Governance and Leadership matters were characterised by too many processes or “red tape” resulting in inefficient procurement processes, inadequate staffing and inactive health committees. Theme Six, Operational Management highlighted the severe pressure under which the operational managers have to work, resulting from their twofold role of being the clinic manager and at the same time operate as a clinical nurse practitioner. Theme Seven refers to Infrastructure and Facilities and is characterised by inadequate maintenance and lack of space according to the number of clients and package of care. To summarise: The situational analysis revealed 81 problems. These problems form the evidence base for the development of the programme to facilitate quality client-centred care in primary helth care clinics of the rural West Coast District.
Van, Heerden Petro. "The perception of patients regarding comprehensive care rendered by Clinical Nurse Practitioners in the West Coast rural district in the Western Cape." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20233.
Повний текст джерелаENGLISH ABSTRACT: Primary Health Care (PHC) provide a quality, comprehensive health service to the community, based on the principles of equity, affordability, accessibility and community participation. It is a nurse driven service with the Clinical Nurse Practitioner (CNP), a registered nurse specialising in the clinical elements of primary, secondary and tertiary prevention at the forefront. It is against this background that this study was endeavored to investigate the community’s perceptions and lived experiences of the quality of care being rendered by CNPs in the West Coast rural district of the Western Cape. The objectives of this study included the following: - To explore and describe the perceptions of patients in the West Coast rural community regarding the attitudes, knowledge and skills of CNPs. - To provide policy makers with feedback and possible recommendations with regards to the implementation of this nurse driven PHC service. - To provide recommendations for improvement of the existing curricula at nursing education institutions based on whether the current training meets patients’ needs and thereby possibly influence curricular change. A qualitative, descriptive, research design was used. The guideline by Colaizzi (as cited in Streubert & Carpenter, 1999:14) was used for data collection and analysis. Twenty-six participants took part in five different group interviews. Semi-structured, open ended questions were used to encourage the participants to actively partake. Each interview was audio taped and field notes were taken. Thematic analyses was performed to highlight three main themes, i.e. the attitudes of the CNPs, the knowledge and skills of CNPs, and the impact of the current training programmes on the quality of care being rendered by these CNPs. Written approval from the Ethics Research Committee, University of Stellenbosch, as well as from the Research unit of the Western Cape Department of Health was obtained. Prior informed consent was further obtained from each participant, after being assured of voluntary participation, confidentiality and anonymity. Credibility, dependability and transferability were ensured by returning to two participants who validated that the transcripts were a true reflection of their experiencesand opinions. This study concluded that patients perceived CNPs as being unfriendly, uncompassionate and unprofessional. Dissatisfaction with the prevalence of unjust practices due to family members and certain race groups being attended to first by CNPs, were expressed. Participants found the competency levels of CNPs more than adequate when assessing, examining and providing health information and medicine. However, they expressed the need that CNPs should be able to prescribe a greater variety of medicines and perform more diagnostic tests than currently permitted by the scope of practice as set out by the South African Nursing Council. Therefore, these views of the participants indicated that the current postgraduate training programme do fulfill their health needs, although the need for expansion of the role and function of the CNP were expressed. Recommendations made included: - An in-depth investigation into the alleged rude attitudes of CNPs should be undertaken, soas to improve the professional behavior of CNPs towards patients. - Applicable policy makers should consider expanding the roles and functions of the CNP. - Enforcing continuous, professional competency through adequate and productive in-service training programmes. In conclusion, this study showed that CNPs need to be constantly aware that they work with human beings, with feelings and with health needs. The need for a therapeutic environment is thus crucial to the rendering of a quality, comprehensive service to the community they serve.
AFRIKAANSE OPSOMMING: Primêre Gesondheidsorg (PGS) voorsien ’n kwaliteit, omvattende gesondheidsdiens aan die gemeenskap, gebaseer op die beginsels van gelykheid, bekostigbaarheid, toeganklikheid en gemeenskaps-betrokkenheid.Dit is `n verpleegaangedrewe diens met die Kliniese Verpleegspraktisyn (KVP) wat gespesialiseerd is in die kliniese elemente van primêre, sekondêre en tersiêre voorkoming, aan die voortou. Dit is teen hierdie agtergrond wat hierdie studie aangepak is, ten einde ondersoek in te stel aangaande die gemeenskap se persepsies en geleefde ervarings van die kwaliteit van sorg wat deur KVPs in die plattelandse Weskusdistrik van die Wes-Kaap gelewer word. Die doelwitte van hierdie studie het die volgende ingesluit: - Om die persepsies van pasiënte, rakende die ingesteldhede (gedrag), kennis en vaardighede van KVPs te ondersoek. - Om toepaslike beleidsmakers metterugvoer en moontlike aanbevelings te voorsien aangaande die implimentering van verpleegaangedrewe, PGS. - Om aanbevelings te maak vir die verbetering van bestaande kurrikula aan verpleegopleidingsinstellings op grond van óf die huidige opleiding in pasiëntbehoeftes voorsien, en sodoende kurrikulumverandering moontlik te beïnvloed. ’n Kwalitatiewe, beskrywende navorsingsontwerp is gebruik. Die raamwerk van Colaizzi (soos beskryf in Streubert & Carpenter, 1999:14) is tydens datainsameling en analiese gebruik. Ses-en-twintig deelnemers het aan die vyf verskillende groepsonderhoude deelgeneem. Semi-gestruktureerde, oop-einde vrae was gebruik om die deelnemers aan te moedig om aktief aan die besprekings deel te neem. Elke onderhoud is op oudio band opgeneem en veldnotas is gemaak. Tydens analiese is drie hooftemas geïdentifiseer, nl die houdings van KVPs, die kennis en vaardighede van die KVPs sowel as die impak van die opleidingsprogram op die kwaliteit van sorg wat deur KVPs gelewer word. Skriftelike toestemming vir die studie is by die Etiese Navorsingkommittee, Universiteit van Stellenbosch, asook die Navorsingseenheid van die Wes- Kaapse Departement van Gesondheid verkry. Voorafgaande toestemming is voorts vanaf elke deelnemer verkry, nadat hulle verseker is van vrywillige deelname, konfidensialiteit en anonimiteit. Geloofwaardigheid, afhanklikheid en oordraagbaarheid is verseker, deur na twee van die deelnemers terug te gaan wat die transkripsies geverifieër het as juis en korrek. In hierdie studie is tot die slotsom gekom dat pasiënte KVPs as onvriendelik enongevoeligervaar het. Onbillike praktyke kom steeds voor, deurdat familielede en sekere rassegroepe voorkeur behandeling kry. Deelnemers se ervarings aangaande die bevoegdheid van KVPs was as toereikend beskryf aangaande die assessering, ondersoek en voorsiening van gesondheidsinligting en medisyne. Hulle het egter ook die behoefte uitgespreek dat die KVP’s `n groter verskeidenheid medisyne behoort voor te skryf en meer diagnostiese toetse behoort te kan uitvoer as wat tans binne die bestek van praktyk, soos neergelê deur die Suid-Afrikaanse Raad op Verpleging, moontlik is. Hierdie persepsie van die deelnemers impliseer dat die huidige nagraadse opleidingsprogram voldoende is en hul gesondheidsbehoeftes aanspreek. Die behoefte vir die uitbreiding van die rol en funksie van die KVP is egter uitgespreek. Die aanbevelings wat gemaak is sluit in: - ’n In-diepte ondersoek oor die onbeskofte ingesteldhede van KVPs behoort uitgevoer te word, ten einde die professionele gedrag van KVPs teenoor pasiënte te verbeter. - Beleidmakers behoort die uitbreiding van die rolle en funksies van die KVP te oorweeg. - Benadruk voortgesette, professionele bevoegdheid deur toepaslike en produktiewe indiensopleidingsprogramme. Ter aflsuiting: hierdie studie het aangetoon dat KVPs voortdurend bewus moetbly dat hulle met mense werk wat gevoelens het en wat gesondheidshulp benodig. Dit is uiters belangrik om aan die behoeftesvan ’n terapeutiese omgewing te voorsien, ten einde ’n kwaliteit, omvattende diens aan die gemeenskap te lewer.
Kristiansen, Marthe. "The Quality of Life of Children living in Residential Child Care Facilities : A comparative study of three Children’s Homes in Accra and Cape Coast, Ghana." Thesis, Norwegian University of Science and Technology, Department of Geography, 2009. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-5319.
Повний текст джерелаThis study is concerned with aspects of the quality of life of children in three residential child care facilities (Children's Homes) in Accra and Cape Coast Municipality. It is comparative in its nature and aims to investigate how the material and social structures and supplies of the Children’s Homes contribute to similarities and dissimilarities in aspects of the children’s quality of life, both between and within the homes. The theoretical framework of the study is based on a quality of life approach, where quality of life is seen as an all-embracing conception, which includes a basic needs approach (BNA) and is supplemented by a subjective well-being approach (SWB). The theory of structuration is used to understand how material and social structures and supplies at the Children's Homes affect aspects of the children’s quality of life. The theory of structuration is a framework to investigate to what degree the children are able to act as competent social actors. The study was carried out in two different regions; the Greater Accra Region and in the Central Region at three Children's Homes. Osu Children’s Home (governmental) is located in Accra, the capital of Ghana, Ahotokurom (private) in a peri-urban area outside the city of Cape Coast and Lighthouse Children’s Home (private) is located just outside the Cape Coast city centre. Methodologically this study applies a qualitative approach and includes the triangulation of a variety of qualitative instruments of data collection. The data has been collected through 14 interviews with children from the ages of twelve to nineteen and eight key-informant interviews with the staff at the Children's Homes, two interviews with additional informants, as well as observations and some quantitative data. The thesis concludes that the material and social structures and supplies available at the Children’s Homes have strong bearings on the children’s lives and aspects of their quality of life. The Children’s Homes represents sets of structures that both enable and restrict the children to act as competent social actors. Even though the material and social structures and supplies at the homes determine much of the children’s lives, the children have some degree of freedom to act within these structures and are able to influence their own lives. The degree of freedom to act as competent social actors varies between the homes. At Osu there exists a stronger accumulation of conditions creating poorer aspects of quality of life, such as poor food, shelter, clothing, education, safety, leisure, love and belonging and social networks. The children at Ahotokurom and Lighthouse generally enjoy conditions creating better aspects of quality of life, the only exception being perhaps healthcare. This difference seems to be connected to the type of ownership, gatekeeping, finances, location and contact with the local community.
D'Arrietta, Louisa, and n/a. "An investigation of the information needs and information-seeking behaviour of general practitioners in their delivery of patient care to the elderly on the Gold Coast." University of Canberra. Information, Language & Culture, 1994. http://erl.canberra.edu.au./public/adt-AUC20060426.164122.
Повний текст джерелаLiebenberg, Linda. "Low-income women and mental health care : an exploratory study of non-governmental mental health services in the west coast/winelands region of South Africa." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51821.
Повний текст джерелаENGLISH ABSTRACT: This study is aimed at exploring mental health services for low-income women in the West Coast I Winelands Region of South Africa. In order to understand the extent to which such services are empowering, the accessibility and theoretical underpinnings of these services are investigated. It was found that although services appear to be available, they are often not very accessible. They also often lack a specific gender focus. In certain instances, services need to increase their accessibility in order to accommodate the restrictive environments of women in this region. As such, it is believed that services require greater integration in their approach to intervention concerning both gender and the origins of mental health problems. Results of this study also highlight areas on which future research could focus. These areas include language of service provision, how organizations understand available theories surrounding service provision, and the service needs of women in this region themselves.
AFRIKAANSE OPSOMMING: Hierdie studie is gemik op die ondersoek van geestesgesondheidsdienste vir vroue van lae-inkomste groepe in die Weskus I wynverbouingstreek van Suid Afrika. Die toeganklikheid en teoretiese onderstuttngs van hierdie dienste word ondersoek in In poging om die graad waarin delke dienste bemagtigend is, te verstaan. Bevindinge toon dat dienste, albeit beskikbaar voorkom, dikwels nie baie toeganklik is nie. Dienste toon ook meestal 'n gebrekkige fokus ten opsigte van 'n spesifieke geslag. In sekere gevalle behoort die toeganklikheid van dienste verbeter te word in 'n poging om die beperkende omstandighede van vroue in hierdie streek tegemoet te kom. As sulks benodig dienste 'n hoër mate van integrasie in hul benadering tot intervensie, beide wat geslag en die oorsprong van geestesgesondheidsprobleme betref. Bevindinge lig ook areas uit waarop toekomstige navorsing kan fokus. Hierdie areas sluit die volgende in: die taal van diensvoorsiening, hoe organisasies beskikbare teorieë ten opsigte van diensvoorsiening verstaan, en die behoefts van die vroue in hierdie streek self ten opsigte van dienste.
Maart, Lana Catherine. "Knowledge, attitudes and practices related to lifestyle factors among childbearing women in the West Coast/Winelands health district." Thesis, University of the Western Cape, 1990. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5520_1207815219.
Повний текст джерелаMany of the known risk factors associated with low birth weight, such as socio-economic status, ethnicity, genetic makeup, and obstetric history, are not within a women's immediate control. However, there are many things that a woman can do to improve her chances of having a normal healthy child. Lifestyle behaviours, such as cigarette smoking, nutrition and the use of alcohol, play an important role in determining the growth of the fetus. The aim of this study was to establish the knowledge, attitudes and practices related to lifestyle factors such as alcohol use, smoking and nutrition among childbearing women and health care workers on the farms in Stellenbosch and Vredendal.
Vanhook, Patricia M. "Cost-Utility Analysis/Cost Effectiveness of Nursing Care." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7432.
Повний текст джерелаNoble, Marilynn. "Integrating Health Care Systems to Maintain Quality Care and to Manage Cost." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6851.
Повний текст джерелаCasely-Hayford, Augustus Lavinus. "A genealogical history of Cape Coast stool families." Thesis, Online version, 1992. http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.325493.
Повний текст джерелаLehman, Kay Frances 1953. "The effect of nurse care management on cost and health care resource utilization." Thesis, The University of Arizona, 1997. http://hdl.handle.net/10150/291880.
Повний текст джерелаValtonen, Hannu Juhani. "Application of cost-benefit thinking in health care." Thesis, University of York, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316208.
Повний текст джерелаLiengme, Christine Anne. "West Coast strandveld : its utilization and management." Thesis, University of Cape Town, 1987. http://hdl.handle.net/11427/26136.
Повний текст джерелаBriggs, Andrew H. "Uncertainty in the cost-effectiveness of health care interventions." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299755.
Повний текст джерелаRichardson, Gerald Anthony. "The cost-effectiveness of interventions to support self care." Thesis, University of York, 2007. http://etheses.whiterose.ac.uk/9918/.
Повний текст джерелаLorden, Andrea L. "An estimation of uncompensated care cost for preventable hospitalizations." online resource, 2008. http://digitalcommons.hsc.unt.edu/theses/5/.
Повний текст джерелаHo, 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.
Повний текст джерелаMuofhe, Mmboneni Leonard. "Lichens as air pollution assays on the Western Cape coast." Bachelor's thesis, University of Cape Town, 1994. http://hdl.handle.net/11427/26102.
Повний текст джерелаRaikou, Maria. "Estimating medical care costs : an examination under conditions of censoring." Thesis, City University London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269356.
Повний текст джерелаLiu, Lin. "Estimation of net present value of total health care costs." Diss., Connect to online resource - MSU authorized users, 2006.
Знайти повний текст джерелаTitle from PDF t.p. (viewed on June 19, 2009) Includes bibliographical references (p. 92-98). Also issued in print.
Marivate, Dennis. "Cost containment strategies and their relationship to quality of care within the South African private healthcare industry." Diss., University of Pretoria, 2010. http://hdl.handle.net/2263/24693.
Повний текст джерелаDissertation (MBA)--University of Pretoria, 2010.
Gordon Institute of Business Science (GIBS)
unrestricted
Ostreicher, Linda. "A patient-oriented review of health care under cost containment." Thesis, Massachusetts Institute of Technology, 1985. http://hdl.handle.net/1721.1/76393.
Повний текст джерелаMICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH.
Bibliography: leaves 141-149.
by Linda Ostreicher.
M.C.P.
Willis, Susan Beth. "Cost-benefit and cost-effectiveness of case management for a teen pregnancy and parenting program." CSUSB ScholarWorks, 1993. https://scholarworks.lib.csusb.edu/etd-project/630.
Повний текст джерелаMugford, Miranda. "How does the method of cost estimation affect the assessment of cost-effectiveness in health care?" Thesis, University of Oxford, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.318922.
Повний текст джерелаСміянова, Ольга Іванівна, Ольга Ивановна Смиянова, Olha Ivanivna Smiianova, J. M. Usaiyd, and F. H. Ayman. "Health care situation and the human coats of war in Iraq." Thesis, Сумський державний університет, 2013. http://essuir.sumdu.edu.ua/handle/123456789/32146.
Повний текст джерелаHon, Wai-ping Tiki. "An analysis of policy options to tackle the problem of expanding expenditure in public healthcare in Hong Kong." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21036640.
Повний текст джерелаHooshmand, Mary A. "Comparison of Telemedicine to Traditional Face-to-Face Care for Children with Special Health Care Needs: Analysis of Cost, Caring, and Family- Centered Care, Family Cost Survey, Caring Professional Scale, Measure of Processes of Care 20-Item Scale." Scholarly Repository, 2010. http://scholarlyrepository.miami.edu/oa_dissertations/408.
Повний текст джерелаVichare, Anushree M. "Affordability, Utilization and Satisfaction with Care: A Policy Context for Improving Health Care Experiences." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4978.
Повний текст джерелаVasiliadis, Helen-Maria. "A cost-effectiveness and cost-utility study of lung transplants /." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=84852.
Повний текст джерелаObjectives. To determine the incremental cost-effectiveness (C/E) and cost-utility (C/U) of lung transplantation (L-Tx) according to the health system perspective.
Methods. A C/E and C/U analysis of L-Tx was carried out on 124 patients accepted unto the Quebec L-Tx waiting list (1997--2001). Survival was presented in mean life years (LY). HRQOL and utility were assessed using the SF-36 and standard gamble; they were studied cross-sectionally and longitudinally on a group of patients. Utility was used in the computation of the QALY. The economic impact of L-Tx was based on direct medical costs for 3 time periods: the waiting list, the transplant procedure and post-transplant phase. In the incremental C/E and C/U ratio, the costs for the procedure and follow-up care were compared to those during the waiting list, which served as an estimate for costs without transplantation. Estimates were modeled beyond the study period based on registry data. Simulating different person-time experiences during the waiting time (1 to 6 years) and post-transplant phase (1 to 8 years) tested key assumptions. Costs were based on provincial and national data and were discounted at a rate of 5%.
Results. The estimates were based on the 1,090.0 and 1,421.5 person-months contributed by the cohort (N = 124) to the waiting list and post-transplant phase (N = 91), respectively. The mean LYs and QALYs gained were 0.57 (95% CI: 0.36--0.78) and 0.62 (95% CI: 0.36--0.78), respectively. HRQOL was higher on average for all domains in lung recipients versus candidates. Utility scores were also higher in recipients as compared to candidates: 0.76 (95% CI: 0.69, 0.83) versus 0.17 (95% CI: 0.12, 0.22). The estimated total average cost per patient without Tx was $15,015 or $1,708 (95% CI: $1,327--$2,090) per month. The L-Tx program induced an additional screening cost of $9,622 per patient. The average cost of a transplant procedure was $49,314 (95% CI: $39,216--$69,465). The average post-Tx follow-up cost per patient per month in the first, second, third and fourth year was $2,804 ($1,840--$3,792), $1,643 ($1,090--$2,291), $1,749 ($804--$2,690) and $971 ($768--$1,175), respectively.
Glover, Gloria. "Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, and Quality of Care." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7142.
Повний текст джерелаMumuni, Thompson. "Teachers' practices in kindergarten classrooms within the Cape Coast metropolis, Ghana." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/62153.
Повний текст джерелаEducation, Faculty of
Curriculum and Pedagogy (EDCP), Department of
Graduate
Hunter, I. T. "The Weather of the Agulhas bank and the Cape South Coast." Master's thesis, University of Cape Town, 1987. http://hdl.handle.net/11427/21858.
Повний текст джерелаHagen, Leanne. "The Economics of Genetic Disease in a Level IV Neonatal Intensive Care Unit: Diagnostic Approaches and the Cost of Care." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592136819078415.
Повний текст джерелаAndersson, Agneta. "Health economic studies on advanced home care." Doctoral thesis, Linköping : Univ, 2002. http://www.ep.liu.se/diss/health_society/2002/002/index.html.
Повний текст джерелаChou, Ping-Hung. "Essays on Vietnamese hospital cost functions /." Thesis, Connect to this title online; UW restricted, 2004. http://hdl.handle.net/1773/7419.
Повний текст джерелаSennfält, Karin. "Economic studies of health technology changes in prostate cancer care /." Linköping : Center for Medical Technology Assessment, Department of Healt and Society, Linköping University, 2005. http://www.bibl.liu.se/liupubl/disp/disp2005/med889s.pdf.
Повний текст джерелаDale, Jeremy. "Primary care in accident and emergency departments : the cost effectiveness and applicability of a new model of care." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1998. http://researchonline.lshtm.ac.uk/682264/.
Повний текст джерелаHagberg, Lars. "Cost-effectiveness of the promotion of physical activity in health care." Doctoral thesis, Umeå : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-999.
Повний текст джерелаFernández, Carballo Blanca Leticia. "Low-cost point-of-care diagnostic devices for low resource settings." Doctoral thesis, Universitat Ramon Llull, 2017. http://hdl.handle.net/10803/401780.
Повний текст джерелаLos test de tipo ‘point-of-care’ (POC) presentan un gran potencial para el manejo y el diagnóstico de enfermedades. Los dispositivos POC permiten la realización de pruebas clínicas cerca del paciente, permitiendo así un diagnóstico rápido, una pronta iniciación de tratamientos, y en caso necesario, una derivación rápida a otros centros médicos. Estos dispositivos tienen además el potencial de ser más económicos, más robustos, y más fáciles de usar que los dispositivos médicos tradicionales. Por estos motivos, los dispositivos médicos de tipo POC se consideran prometedores para los países en vías de desarrollo, los cuales son también los que necesitan de forma más urgente nuevas tecnologías médicas. En este contexto, esta tesis se centra en el desarrollo de dispositivos médicos de diagnóstico in vitro de tipo POC para salud global. Teniendo en cuenta que los recursos para el desarrollo de dispositivos POC para países con bajos recursos son limitados, el Capítulo 2 se enfoca en el desarrollo de prioridades de investigación en salud. Mediante el establecimiento de estas prioridades se pretende facilitar la selección de objetivos a fabricantes de dispositivos médicos, así como incrementar el impacto de las nuevas tecnologías desarrolladas. Los criterios de priorización considerados son muy amplios e incluyen el impacto de un nuevo test en la incidencia de una enfermedad, la disponibilidad y precio de los tratamientos de las enfermedades, la inversión tecnológica para el desarrollo de un nuevo dispositivo, y los principios bioéticos. El segundo Capítulo 3 describe el desarrollo de un dispositivo médico sencillo que puede ser fabricado fácilmente en laboratorios con escasos recursos: tiras reactivas de diagnóstico de papel para la detección de biomarcadores presentes en fluidos biológicos fabricados con impresoras de chorro de tinta domésticas y con recetas sencillas para la preparación de las tintas. Esta técnica de fabricación de tiras reactivas de diagnóstico fue probada para la detección de deficiencia de yodo, un problema severo de salud global en el mundo. En este capítulo se presentan experimentos de preparación de tintas químicas, impresión en papel, detección de yodo en las concentraciones presentes en la orina, y directrices para el desarrollo de nuevas tintas para la detección de otros biomarcadores de enfermedades. Este simple y versátil proceso de fabricación de tests de diagnóstico permitiría a hospitales y laboratorios con pocos recursos diseñar sus propios diagnósticos para enfermedades relevantes, en una forma y cantidad adaptada a las necesidades de cada comunidad. Desafortunadamente, no todas las enfermedades pueden diagnosticarse usando sencillas tiras reactivas de diagnóstico, y frecuentemente se necesitan dispositivos más complejos. El Capítulo 4 está enfocado en el desarrollo de dispositivos de PCR y RT-PCR de bajo coste, de tiempo-real, y de tipo POC que permiten detectar cuantitativamente patógenos basados en DNA y RNA respectivamente. Nuestro sistema se basa en PCR de flujo continuo, el cual mantiene zonas de temperatura fijas y empuja la solución de PCR entre las áreas calefactadas, permitiendo así una transferencia de calor más rápida y consecuentemente, PCR más veloces. Ambos sistemas de PCR y RT-PCR fueron fabricados en base a un chip microfluídico desechable diseñado para ser producido a bajo coste industrialmente mediante métodos de ‘roll-to-roll’. El sistema óptico permite la detección de patógenos en tiempo real mediante medidas de fluorescencia. Para demostrar la función del chip, dos bacterias infecciosas y un virus fueron seleccionados: Chlamydia trachomatis, Escherichia coli O157:H7, y Ebola virus. Para los tres patógenos, se probaron diferentes velocidades de flujo, se determinó el límite de detección del sistema, y se calcularon las eficiencias de las PCRs. El éxito de los resultados obtenidos y la versatilidad del sistema, hace que estos dispositivos se consideren prometedores para el diagnóstico de otros patógenos como Zika o chikungunya, que constituyen amenazas mundiales a la salud pública. Ambos dispositivos de diagnóstico in vitro presentados en esta tesis son buenos ejemplos de dispositivos de diagnóstico apropiados para salud global.
Point-of-care (POC) testing has great potential for the management and diagnosis of disease. POC devices allow for testing close to the patient permitting rapid diagnosis, prompt treatment initiation, and when needed, quick referral to other health-care units. They have the potential to be lower-cost, more robust, and more user-friendly than traditional medical devices. For these reasons, POC diagnostic tests are a promising approach for the developing world, where there is also the most urgent need for new health technologies. In this context, this thesis is focused in the development of POC in vitro diagnostic tests for global health. Considering that the resources for developing POC devices for low-resource settings are limited, during Chapter 2 we focused on setting health research priorities to aid test developers setting their targets to increase the impact of the technology. The criteria for prioritization considered were very broad and took into account the impact of a new test on the burden of disease, the availability and expense of disease treatments, the technological investment to develop a new device, and the bioethical principles. Chapter 3 describes the development of a medical device that can be easily manufactured in limited resources laboratories: paper diagnostic chemical dipsticks to detect biomarkers present in biological fluids produced with domestic inkjet printers and simple ink preparation recipes. This fabrication technique for diagnostic strips was tested for the detection of iodine deficiency, a severe global health problem worldwide. In this chapter we present successful experiments for chemical inks preparation, printing on paper, detection of iodine in the concentrations present in the urine, and guidelines for new ink development to target other disease biomarkers. This simple and versatile manufacturing process for diagnostic tests would allow hospitals and laboratories with limited infrastructure to design diagnostics for relevant diseases in a format and quantity adapted to each community needs. Unfortunately, not all diseases can be diagnosed using simple chemical dipstick assays and more complex diagnostic devices are required. Chapter 4 is focused on the development of a low-cost, real-time, point-of-care PCR and RT-PCR systems for quantitative detection of DNA and RNA-based pathogens. Our systems are based on continuous-flow PCR which maintains fixed temperatures zones and pushes the PCR solution between heated areas allowing for faster heat transfer and as a result, faster PCRs. Both PCR and RT-PCR systems were built around disposable microfluidic chips designed to be economically produced industrially by roll-to-roll embossing methods. The optical system allows for pathogen detection via real-time fluorescence measurements. To demonstrate the function of the chips, two infectious bacteria and one viral target were selected: Chlamydia trachomatis, Escherichia coli O157:H7, and Ebola virus. For the three pathogens, different flow velocities were tested, the limit of detection of the system was determined, and PCR efficiencies were calculated. Our successful results, and the versatility of our system, make it promising for the detection of other DNA and RNA-based pathogens such as Zika or chikungunya, which constitute global health threats worldwide. The two in vitro diagnostic tests presented in this thesis are good examples of promising POC diagnostic devices appropriate for global health.
O'Shea, Eamon. "Care of the elderly : an analysis of placement, process and cost." Thesis, University of Leicester, 1994. http://hdl.handle.net/2381/35514.
Повний текст джерелаSchroeder, Elizabeth-Ann. "The cost-effectiveness and efficiency of intrapartum maternity care in England." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:f9cf3e25-34ae-49a3-ab50-5721e81a7458.
Повний текст джерелаHomer, Emily. "Insurance Status and Obesity as Predictors of Cost in Trauma Care." Scholarly Commons, 2020. https://scholarlycommons.pacific.edu/uop_etds/3692.
Повний текст джерелаRuschenbaum, Paul Alfred. "The determination of cost drivers of three public district hospitals in the Western Cape." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/8503.
Повний текст джерелаThe aim of this research report is to identify and quantify the cost drivers of three district hospitals in the Western Cape, namely Knysna Hospital, Oudtshoorn Hospital and Mossel Bay Hospital, and to simultaneously measure value-driven performance indicators. An environmental scan identified various driving forces that would significantly affect change in the healthcare industry such as the brain drain of health professionals, consumerism and cost containment and efficiency initiatives. The Department of Health’s understanding of the eighth Batho Pele principle of value for money is generally understood as providing quality health care within prescribed cost limits. An attempt is made to establish the effect of the quadruple burden of disease (the HIV/AIDS pandemic, persistent infectious diseases, injury arising from violence and road traffic collisions and emerging chronic conditions) on hospital expenditure in the Eden District. Research identified Mossel Bay as a high TB burden area known as a TB “hotspot” and it is a recognized immigration transit point en route to Cape Town. The population analyses revealed that Mossel Bay is the growth point of the Eden District, showing extraordinary growth of 25% between 2007 and 2009. Personnel costs: This study revealed that personnel costs are responsible for the overwhelming majority of the total expenditure of the district hospitals.Staff numbers, occupation specific dispensation (OSD) implementation and annual wage negotiations are the cost drivers of personnel costs. This study also found a clear correlation between an over-expenditure in personnel expenses and over-expenditure in the total expenditure of all three hospitals. Health care costs: Expenditure on blood products is considered a major cost driver of clinical expenses. Laboratory expenditure is clearly the largest cost driver for clinical expenses at all three hospitals. Together with laboratory expenses, medicine and medical supplies are the cost drivers for clinical expenses. Costs not related to health care: The three most significant administrative expenses are communication, stationery and printing as well as travel and subsistence allowances. The cost driver for subsistence and travel expenses is the number of vehicles followed by the preference of vehicle, which in turn determines the daily tariff and the kilometre tariff. This study revealed that Knysna Municipality has the cheapest electricity cost of the three towns. It is clear that cost and consumption of electricity and water are the two variables that affect municipal service expenditure the most. Equity: When the district hospital expenditure is combined with the primary health care expenditure in the three sub-districts, the figures show that Oudtshoorn is spending 3% more than its equitable share of the total budget at a higher cost of R978 per capita, in excess of R100 above the district average. Efficiency: The cost per patient day equivalent (PDE) per economic classification for all three hospitals is less than the average cost per PDE of the district hospitals in the Western Cape. The cost/PDE of Oudtshoorn Hospital is considerably higher than that of Knysna and Mossel Bay in all economic classifications, with the single exception of the agency cost of Mossel Bay Hospital. The cost of health care always reflects a combination of price, quantity and value, and it is impossible to consider individual cost drivers in isolation. Several cost-saving initiatives and managerial control measures are recommended.
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.
Повний текст джерелаFan, Yun-sun Susan. "Medical insurance : the solution to health care financing in Hong Kong? /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13236404.
Повний текст джерелаRohdin, Jeanette, and Åsa Nylander. "Vård- och omsorgspersonals erfarenheter av att använda COAT : Carers Outcome Agreement Tool." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20237.
Повний текст джерелаProgram: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska
Nakabe, Takayo. "The personal cost of dementia care in Japan: A comparative analysis of residence types." Kyoto University, 2020. http://hdl.handle.net/2433/253218.
Повний текст джерелаPascual, Argente Natàlia 1988. "Essays on economic evaluation of efficiency in health care interventions." Doctoral thesis, TDX (Tesis Doctorals en Xarxa), 2021. http://hdl.handle.net/10803/672767.
Повний текст джерелаL’objectiu d’aquest treball és l’avaluació de l’impacte de nous antivirals d’acció directa per a l’hepatitis C com a innovació sanitària disruptiva que va desafiar els sistemes sanitaris. Dues revisions sistemàtiques analitzen els estudis de cost-utilitat de les noves teràpies i els costos de productivitat de l’hepatitis C. A continuació s’avalua l’actualització de les recomanacions clíniques a nivell europeu entre el 2016 i el 2018 i el mètode inclou qüestions metodològiques que s’han identificat com a mancances en treballs anteriors. En concret, el model Markov incorpora els costos de productivitat i els costos reals d’adquisició dels medicaments. Els resultats confirmen que l’actualització europea sobre les recomanacions de tractament contra l’hepatitis C va ser eficaç, ja que va generar guanys en salut i estalvis en costos. L’avaluació econòmica pot ser útil no només per avaluar les innovacions sanitàries, sinó també com a test d’eficiència de les decisions clíniques.
Jeun, Ki Jin. "Frequency and Magnitude of Co-payments Exceeding Prescription Drug Cost." University of Toledo Health Science Campus / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=mco1564786558787039.
Повний текст джерела何知行 and Chi-hang Bruce Ho. "Health care financing options for Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31966822.
Повний текст джерела