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Cultural Competence Practices Implemented In Hospitals And Health Systems By Minority Executives On The Top Management Team, John H. Cunningham Jan 2016

Cultural Competence Practices Implemented In Hospitals And Health Systems By Minority Executives On The Top Management Team, John H. Cunningham

All ETDs from UAB

The study examined whether hospital implementation of cultural competence practices was influenced by the racial/ethnic composition of top management. With one-third of the U.S. population identifying with a racial or ethnic group other than non-Hispanic White, and that population continuing to grow increasingly diverse, racial and ethnic minorities are increasingly accessing health care services. Yet they represent less than 1% of the top management teams (TMT) of health care organizations. The study sought to determine the extent to which health care organizations with TMTs that are representative of the racial and ethnic compositions of the communities in which they serve …


Hospice Performance: Environmental And Organizational Correlates, Mengying He Jan 2016

Hospice Performance: Environmental And Organizational Correlates, Mengying He

All ETDs from UAB

The purpose of this dissertation is to explore hospice performance using a three paper format. Based on Structure-Conduct-Performance (SCP) and Structure-Process-Outcome (SPO) models, paper 1 conducts a systematic literature review to identify gaps in hospice performance research. Paper 2 explores the relationship between hospice market structure and inpatient services provision (Structure-Conduct). Market munificence is related to hospice inpatient services offering. Organizational factors such as hospice chain-affiliation, age, and ownership also play roles in predicting hospices’ probability in providing inpatient services. Paper 3 examines the impact of hospice inpatient service provision on service utilization and financial performance (Structure-Process-Outcome). Hospices that not …


The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen Jan 2016

The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen

All ETDs from UAB

This study examined the potential relationship between interdepartmental transfers and perceptions of adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publically reported comparative data tool measuring hospital patient experiences. As consumers, patients are more informed about their own health and are challenging the quality and service of care provided by hospitals. The value-based purchasing reimbursement model has become a new challenge for hospitals. Historically, hospitals were reimbursed through a volume driven model. Comparatively, the value-based model focuses on …


Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson Jan 2016

Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson

All ETDs from UAB

As life expectancy continues to increase and the number of elderly Americans rises, public health initiatives are seeking to identify modifiable risk factors to preserve cognitive function and increase quality of life in advanced ages. The primary objective of this dissertation was to investigate dietary patterns, carbohydrate consumption, and insulin resistance as modifiable risk factors that may contribute to the development of cognitive impairment and cognitive decline. Three separate studies were performed in the REasons for Geographic And Racial Differences in Stroke study, a prospective cohort containing 30,239 black and white participants. Cognitive impairment was defined using the Six-Item Screener. …


Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste Jan 2016

Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste

All ETDs from UAB

Reimbursement for chemotherapy could account for two thirds of the income for oncologists in private practice. The Medicare prescription drug improvement and modernization act of 2003 (MMA) brought about a dramatic change in the way physicians were reimbursed for delivering chemotherapy in an attempt to slow the skyrocketing costs of drugs and Medicare costs for covering these drugs . The MMA reduced Medicare reimbursements for covered outpatient prescription drugs from 95% to 85% of the average wholesale price. In 2005, a new payment system was instituted that reimbursed fee-for-service providers for drugs at the national average sales price plus 6%. …