Social and Behavioral Sciences Commons^™

Evaluating The Effectiveness Of Ohio's Certificate Of Relief, Peter Leasure

Theses and Dissertations

Employment has been cited as a factor that can aid one's desistance from criminal activity. However, research has consistently demonstrated that those with criminal history face significant barriers to securing employment. In recognition of this problem, most states have implemented various rights restoration mechanisms aimed to increase employment opportunities for ex-offenders. One of these mechanisms, the certificate of relief, aims to aid ex-offenders in their job search by ensuring employers that certificate holders are not a safety risk, providing employers with negligent hiring immunity, and removing occupational licensing bans. A handful of studies have examined whether this mechanism improved hiring …

The Association Of Rural Hospital Closures With In-Hospital And 30-Day Post Hospital Discharge Mortality From Emergency Care Sensitive Conditions, Melinda A. Merrell

Theses and Dissertations

Purpose

Over 100 rural hospitals have closed in the U.S. since 2010. Continuous pressures on the rural health care delivery system suggest that the trajectory of closures will continue in at least the short-term. While the causes of rural hospital closures have been described in the literature, the effects on the health outcomes of populations that experience these closures are still poorly understood. The purpose of this study was to determine associations between rural hospital closures and in-hospital and 30-day post hospital discharge mortality rates for affected residents experiencing time-sensitive emergencies in two U.S. states.

Methods

Rural hospital closures were …

How Do Health System Employees With Established Musculoskeletal Complaints Decide On Their Treatment Pathway? A Qualitative Approach, Noor Alshareef

Theses and Dissertations

Purpose: Non-pharmacologic treatment such as physical therapy (PT) are advocated for musculoskeletal pain for decreasing opioid use. Early access to PT has been shown to decrease costs and improve outcomes through direct access via self-referral. Although self-referral to PT is permitted in the majority of U.S states, health insurance coverage has been identified as a barrier preventing some patients with musculoskeletal complaints from using it. There are few studies examining patient factors related to early access to physical therapy via self-referral. The purpose of this study was to identify the factors outside of insurance that influence the choice to access …

Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris

Theses and Dissertations

Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …

Introduction Of Innovative Medical Practices In Mayo Clinic: Effect Of The Interventions On Patient Outcomes, Duaa I. Aljabri

Theses and Dissertations

Purpose: Assessment of health technologies in medical practice is an ongoing process to provide clinicians and policymakers with information on the value of those applications. This dissertation aims to add to the existing body of literature and fill the gaps in prior studies by assessing two health technologies in Mayo Clinic Florida (MCF). The first paper provides an assessment of patient portal adoption and activity during hospitalization among cancer patients, and determines whether a portal application is associated with selected indices of patient safety, utilization and satisfaction. The second paper provides an assessment of a new approach in pain …

A Study On Satisfaction Of Dental Implant Patients, Jung Su O

Theses and Dissertations

The implant has been around for half a century. It started in Sweden in the 1960s and is now being actively practiced all over the world. It is important to investigate what constitutes a standard for a consumer of medical services in selecting a dentist to receive implants. A great number of dentists and research organizations have published research papers on theory and techniques of implants as well as their strengths and weaknesses. However, researches on reality and satisfaction rate of patients are still very rare.

The purpose of this study was to identify how to improve satisfaction of patients …

Economic Burden Of Tuberculosis Among Bangladeshi Population And Economic Evaluation Of The Current Approaches Of Tuberculosis Control In Bangladesh, Mohammad Rifat Haider

Theses and Dissertations

Introduction: Tuberculosis (TB) is major scourge for human history and causes profound economic burden. Bangladesh is a high burden TB country with 12% of its annual death is caused and 362 thousand people are infected by TB. DS-TB is the most prominent type of TB found in Bangladesh and a 6 month drug regimen (2 month intensive and 4 month continuation phase) is followed. But the directly observed treatment short-course (DOTS) differ in delivery through community health workers (CHW) and community members (CM). Bangladesh has also experienced surge in the number of MDR-TB cases with a 29% of MDR-TB cases …

Depressive Symptoms Association With Health Outcomes And Treatment In Older Americans With Diabetes, Lashonda Jovon Williams

Theses and Dissertations

Introduction: Diabetes remains the 7th leading cause of death in the United States. Diabetes is a major public health concern of its own, but when you add the comorbidity of depression, diabetes outcomes are amplified. This dissertation examines how depressive symptomatology and treatment for depression are associated with selfreported health (SRH) and diabetes control.

Methods: Chi-square and logistic regression were used to analyze data from the Health and Retirement Study (2012). We assessed the associations between SRH and diabetes control with depressive symptomatology data.

Results: In our sample (n=4374), 19% of respondents reported high depressive symptomatology and …

Association Of Provider Communication And Inpatient Hospital Readmissions, Jeremy Dean Faulkenburg

Theses and Dissertations

Introduction: Inpatient hospital readmission rates represent an important clinical and economic problem. Clinical interventions have shown significant decreases in preventable readmissions, but are costly to implement. Another approach is to better equip patients with the knowledge and resources to manage their care after discharge. Patients receive instruction from both nurses and physicians, as well as information pertaining to post-discharge care and instructions for care while at home. This study examines the association between provider communication and inpatient hospital readmissions.

Methods: This study used survey data from the 2013 and 2014 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The …

Feasibility Of Introducing Investor-Owned Hospitals In Korea, Hongseok Seo

Theses and Dissertations

Since 2002, there has been active debate regarding the introduction of for-profit hospitals in South Korea: the advocates highlight the multiplication of economic value after the introduction of for-profit hospitals, whereas the opponents voice their concern about the possible negative consequences for-profit entities can create within the health care system. Various stakeholders including doctors’ associations, hospital associations, and civic groups have been for or against the introduction of for-profit hospitals, according to their interests. The government has tried to develop the national health and medicine system based on the positive and negative impacts of their introduction. In December, 2015, the …

Association Between Job Satisfaction And Pay: The Case Of The Wage Payment System Of Dental Clinics In Korea, Eui Jeong Kim

Theses and Dissertations

The purpose of this study is to investigate empirical type of the wage structures and the sub-items of wage applied at dental clinics and to analyze the determinants of pay satisfaction of dental employees. The questionnaire used in this study consists of personal characteristics, characteristics of workplace, administration of pay, Pay Satisfaction Questionnaire (PSQ), Job Descriptive Index (JDI). PSQ and JDI were translated, and backward translation into Korean was implemented. A pilot test was conducted with 25 dental employees to complete the questionnaire. Survey was conducted from February to July in 2015, receiving 302 valid responses. ANOVA or t-test was …

Healthcare Utilization And Expenditure Patterns Among Older Adults With Functional And Medical Decline, Ashley Shields Robertson

Theses and Dissertations

Purpose. As the aged population of this country grows, the U.S. healthcare system will face increased pressure to provide long-term care services and supports to increasing numbers of elderly Medicare beneficiaries. Studies have indicated that unmet long-term care need can lead to increased, unnecessary utilization of the healthcare system, thus further taxing the Medicare system. Little is known about how type of long-term care, as well as how long-term care policies—specifically payment policies—affect health care utilization. The objective of this original dissertation research was to examine the effects of place of residence (community versus residential long-term care facility) and …

Examining The Relationship Among Patient-Centered Communication, Patient Engagement, And Patient’S Perception Of Quality Of Care In The General U.S. Adult Population, Jumee Wang

Theses and Dissertations

Introduction: Patient-centered care is a major focus of healthcare organizations, policy makers, and researchers. Patient-centered communication by the provider and patient engagement are important components of patient-centered care. Despite increasing attention to these topics, we do not fully understand how patient-centered communication and patient engagement relate to perceived quality of care as reported by patients. This study takes some initial steps in exploring these relationships. The study also identifies patient-related factors such as sociodemographic, health-related, and health system factors that are associated with patient-centered communication, patient engagement, and perceived quality of care.

Method: This study used survey data …

Demand And Supply Factors Affecting Maternal Healthcare Utilization Pattern In Nigeria, Dumbiri Joy Powell

Theses and Dissertations

Given poor maternal services utilization and associated high maternal mortality risk in Nigeria, we document policy-amenable supply and demand factors impacting women’ use of skilled ANC and institutional delivery services. Using a cross-sectional design, we analyzed data from the Nigeria State Health Investment Project health facility and household surveys on 418 health facilities and 3,726 women with a pregnancy within 24 months prior to survey living in 241 geographic wards of two states. Logistic regression was used to study associations of women’s use of each maternal service with ward facilities’ ANC outpatient satisfaction, healthcare staff job satisfaction, surveyorverified facility infrastructure, …

The Emergence Of U.S. Hospital-Based Doula Programs, Violet Dawn Beets

Theses and Dissertations

Labor and birth related health outcomes remain suboptimal in the US. New initiatives and improvement efforts include peer and social support. Doula support is built on the concept of social support, including emotional support, comfort measures, information, and advocacy. Benefits of doula support include increases in women’s satisfaction with their childbirth experiences, postpartum interaction with infant, breastfeeding initiation, and APGAR scores, and reductions in cesarean deliveries, length of labor, use of analgesia, and healthcare costs to healthcare systems. Doula services based within the hospital are a relatively new phenomenon. How and why hospitals are incorporating doula services has not been …