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Articles 2851 - 2880 of 8960

Full-Text Articles in Medicine and Health Sciences

Patient Centered Communication, Aelius Khan, Zhe Liu, Thomas Krajewski, Sean Gibbs Jan 2022

Patient Centered Communication, Aelius Khan, Zhe Liu, Thomas Krajewski, Sean Gibbs

South Atlantic Division GME Research Day 2022

No abstract provided.

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Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb Jan 2022

Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb

Walden Dissertations and Doctoral Studies

Dysautonomia dysfunction (DD) is a disorder of the autonomic nervous system. Over 70 million people suffer from some type of DD, and the average length of time from symptoms to diagnosis is 6 years. Most facilities and providers choose not to treat DD due to the number of symptoms and the difficulty of being able to diagnose correctly. The purpose of this project study was to create guidelines for the diagnosis, treatment, and management of DD. The research question addressed the effectiveness of these guidelines to help nurses and providers caring for patients with DD provide better care. Watson’s theory …

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The Relationship Between Length Of Stay, Hospital Characteristics, And Cost Of Care In Acute Care Hospitals In The U.S., Maria Mikhataykina Jan 2022

The Relationship Between Length Of Stay, Hospital Characteristics, And Cost Of Care In Acute Care Hospitals In The U.S., Maria Mikhataykina

Walden Dissertations and Doctoral Studies

Rising healthcare costs make access to healthcare less accessible for many individuals. Hospital administrators, payer stakeholders, and patients are concerned with rising healthcare costs, as many patients may be hindered from receiving quality health care. Grounded in complex adaptive systems theory, the purpose of this quantitative correlation study was to examine the relationship between inpatient hospital (a) LOS, (b) bed size, (c) location, (d) region, (e) control/ownership, and cost of care. The participants were community hospitals participating in the Nationwide Inpatient Sample (NIS) data collection tool of the Healthcare Cost and Utilization Project. The results of the multiple linear regression …

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The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson Jan 2022

The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson

Walden Dissertations and Doctoral Studies

Home dialysis is a cost-effective and efficient means of treating end-stage renal disease. Under-utilization of home dialysis results in higher than necessary Medicare spending and loss of quality of life for patients. The purpose of this study was to understand the relationship between a nephrologist's length of time in practice, a nephrologist's belonging to a Joint Venture (JV) financial arrangement with a home modality program, and the use of home dialysis and home modality education using a quantitative, correlational design. Roger's diffusion of innovation theory explains the varying willingness of individuals to accept innovation. Secondary data were collected from Medicare …

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Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia Jan 2022

Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia

Walden Dissertations and Doctoral Studies

Healthcare costs have continued to increase in the United States. The Centers for Medicare and Medicaid Services (CMS) have proposed policy changes to reduce inequities between hospital outpatient centers and independent freestanding facilities when reimbursing for the same service. The purpose of this quantitative study was to explore if there was a difference in the payments to the Outpatient Prospective Payment System between the years 2017 and 2018 to assist hospital administrators in preparing for Medicare reimbursement cuts. The study was grounded in the agency theory and aimed to determine the relationship among the provider, payer, and patient. The research …

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The Impact Of Telemedicine Availability On Fatal Opioid Overdose Rates In Texas, 2020, Cara W. Hall Jan 2022

The Impact Of Telemedicine Availability On Fatal Opioid Overdose Rates In Texas, 2020, Cara W. Hall

Walden Dissertations and Doctoral Studies

AbstractSubstance use disorders (SUDs) and fatal overdoses are a significant problem in the United States. A viable and effective method for treating SUDs is through telemedicine (tele-SUD) visits. Tele-SUD visits are an effective means of meeting with patients virtually, especially in the post-COVID-19 environment; however, a problem in health care exists concerning the availability of tele-SUD services in middle America. The purpose of this study was to investigate the impact of tele-SUD availability on rates of opioid overdose deaths in the state of Texas. Donabedian’s model of health care quality evaluation was used as the theoretical framework. A quantitative, independent …

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Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin Jan 2022

Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin

Walden Dissertations and Doctoral Studies

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …

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Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli Jan 2022

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

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Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies Jan 2022

Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies

Walden Dissertations and Doctoral Studies

Performance related to patient satisfaction is becoming a significant factor in determining reimbursement for hospital-based services. Furthermore, consumers are increasingly accessing publicly available quality and patient experience information to make decisions about where to receive care. Understanding which hospital characteristics influence patient satisfaction is critical to the healthcare administrator to ensure the financial viability of the organization and to meet the needs and expectations of the community. Many studies have examined the relationship between a single performance characteristic and patient satisfaction. This secondary data quantitative study used regression analysis to analyze the relationship between three hospital performance characteristics (i.e., the …

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Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro Jan 2022

Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …

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Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore Jan 2022

Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore

Walden Dissertations and Doctoral Studies

Fraudulent business activities have the potential for adverse business outcomes. Speech pathology business owners who lack a robust fraud prevention strategy may subject their practices to severe civil and criminal penalties. Grounded in Wilhelm’s eight-stage fraud management lifecycle theory, the purpose of this qualitative multiple case study was to explore strategies speech pathologist business owners used to prevent Medicare claims fraud. The participants were five speech pathologist business owners from three practices in a western U.S. state who successfully implemented fraud prevention strategies. Data were collected using semistructured interviews and reviewing organization policies and procedures manuals. Three themes emerged using …

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Strategies For Retaining Nurses In Rural Healthcare Settings, Michelle Lee Pratt Yeater Jan 2022

Strategies For Retaining Nurses In Rural Healthcare Settings, Michelle Lee Pratt Yeater

Walden Dissertations and Doctoral Studies

Rural healthcare leader deficiency in implementing successful strategies to retain nurses can deleteriously impact the quality of patient care and impede the organization's financial performance. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore successful nurse retention strategies used by rural healthcare leaders. Data were collected from semistructured interviews with eight pastoral healthcare leaders in the eastern region of the United States who improved nurse retention and a review of relevant supporting documentation from company websites. Coding was used for data analysis and theme determination. Three themes emerged: effective nurse retention incentives, meaningful relationships …

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The Relationship Between Allied Health Therapy Leaders In Hospitals And Patient Satisfaction, Dickson Rodriguez Jan 2022

The Relationship Between Allied Health Therapy Leaders In Hospitals And Patient Satisfaction, Dickson Rodriguez

Walden Dissertations and Doctoral Studies

AbstractAlthough allied health professions account for 60% of the health care workforce, funding to support training and leadership in the allied health fields remains nominal. The purpose of this quantitative study was to investigate whether there is a relationship between allied health therapy leaders in hospitals and patient satisfaction. The Donabedian model was used as the theoretical framework, as it made it possible to conceptualize the underlying parts and processes that may contribute to poor quality of care for patients receiving healthcare. A quantitative methodology with a cross-sectional design was used to provide quantifiable information to ascertain whether the results …

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Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig Jan 2022

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

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Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen Jan 2022

Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen

Walden Dissertations and Doctoral Studies

AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …

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Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi Jan 2022

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …

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Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe Jan 2022

Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe

Walden Dissertations and Doctoral Studies

AbstractFood insecurity is not having enough food or resources or not being able to procure nutritious foods. An observation that nurses in one oncology clinic rarely assessed their patients for food insecurity as part of their regular assessment led to the development and testing of an educational intervention for nurses which was to create awareness on the importance of assessing food insecurity among oncology patients and to learn to use the Household Food Insecurity Assess Scale (HFIAS) in assessing patients. Summative evaluation was done using a pre/and posttest. The Maslow’s hierarchy of needs and the Virginia Henderson nursing need theories …

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Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun Jan 2022

Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun

Walden Dissertations and Doctoral Studies

AbstractLike other individuals from diverse backgrounds, nurses who work in nursing homes are susceptible to becoming overweight. The way that others see and respond to the overweight person also may vary and even result in some level of discrimination. The purpose of this study was to explore the perspective of nurse managers about obese staff in the workplace. A qualitative phenomenological descriptive study design was used, guided by the theory of interpersonal relations and the relational leadership framework, to examine the lived experiences of managers working with obese nurses in nursing home settings in a large metropolitan region in the …

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Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike Jan 2022

Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike

Walden Dissertations and Doctoral Studies

Nurses play a significant role in mobility management, an essential element of care for critically ill adults. However, the current practice of mobility management comes from patient orders without the adoption of an evidence-based physiologic assessment guide to support safe patient mobility resulting in unreliable outcomes. Physiologic stability may change during mobility and unsafe patient mobilization can result in negative patient outcomes that increase patient recovery time. The purpose of this systematic review was to look at the current practice of physiologic assessment measures and then use the findings to influence safe patient mobility practices in intensive care units. The …

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Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan Jan 2022

Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan

Walden Dissertations and Doctoral Studies

Ineffective strategies to contain the costs of medical supply inventory can result in financial loss and are a significant challenge for hospital leaders. Grounded in complex adaptive systems theory, the purpose of this qualitative single case study was to explore the cost-containment strategies that private hospital business leaders use to reduce the expense of pharmaceutical inventory. The participants comprised six private hospital business leaders in one healthcare organization in Myanmar. Data were collected from semistructured interviews, internal company documents, and publicly available annual reports. Four themes emerged from Yin’s five-step data analysis method: (a) management controls, (b) specialist engagement and …

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Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli Jan 2022

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

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Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt Jan 2022

Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt

Walden Dissertations and Doctoral Studies

Physicians in residency training (PIRTs) in the United States are facing extreme burnout. The prevalence of burnout among physicians in residency training may cause adverse consequences such as medical malfeasance, alcoholism, or suicide due to physical and mental exhaustion. The purpose of this study was to analyze the servant leadership style of physician trainers and burnout among PIRTs in academic medical centers in the United States to ultimately increase wellness and thereby mitigate burnout. Servant leadership was the theoretical foundation for this study. This research investigated whether servant leadership characteristics of physician trainers played a statistically significant role in burnout …

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Nursing Health Care Leadership Strategies To Reduce Homeless Patient 30-Day Readmission Rates, Shavonda L. Greene Jan 2022

Nursing Health Care Leadership Strategies To Reduce Homeless Patient 30-Day Readmission Rates, Shavonda L. Greene

Walden Dissertations and Doctoral Studies

AbstractAdult homeless patient 30-day readmission is a concern for nursing healthcare leaders who still have problems in providing effective strategies for revisit reduction in various acute care settings across the United States. The purpose of this quantitative comparative study was to examine the association between nursing healthcare leadership strategies, 30-day homeless patient readmission rates, and hospital discharge rates at hospitals in California. The theoretical foundation for the research study was Pender’s health promotion model theory, which identifies preventative health measures and describes the critical function of nurses in helping patients to prevent illness by self-care and bold alternatives. Research questions …

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Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky Jan 2022

Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …

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Primary Care Provider Education On Behavioral Interventions For Management Of Adult, Rose Chinasa Kajuru Jan 2022

Primary Care Provider Education On Behavioral Interventions For Management Of Adult, Rose Chinasa Kajuru

Walden Dissertations and Doctoral Studies

The high prevalence of obesity continues to pose significant health challenges globally. According to the U.S. Preventive Service Task Force, obesity affects more than 35% of men and 40% of women in the United States. The national annual cost of medical care related to obesity is estimated at $147 to $210 billion. Intensive behavioral interventions in adults with obesity can lead to clinically sufficient improvements. The project aimed to determine if the current evidence-based clinical guideline of behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults would improve primary care providers’ knowledge of adult obesity management. The …

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Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González Jan 2022

Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González

Walden Dissertations and Doctoral Studies

Business executives risk higher healthcare costs and absenteeism rates without implementing cost-effective strategies to support wellness within the organization. To offset rising healthcare costs and absenteeism, executives should implement wellness programs as a component of the benefits package provided to their employees and families. Grounded in the theory of planned behavior, the purpose of this qualitative multiple case study was to explore the cost-effective strategies that executives in the private and not-for-profit sectors implemented to encourage employees to adopt healthy habits for increasing productivity and decreasing organizations’ healthcare costs. Six executives from the healthcare sector within the southern region of …

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Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler Jan 2022

Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler

Walden Dissertations and Doctoral Studies

AbstractThe Centers for Medicare and Medicaid Services implemented the Hospital Readmission Reduction Program in 2012. Ten years later, hospitals across the United States have had negligible improvement in reducing preventable 30-day hospital readmissions for COPD patients. Healthcare, specifically the hospital setting, consists of complex processes and procedures. Not one process or procedure is the sole cause of correcting excessive preventable 30-day readmissions of patients with COPD. The essential elements of provider communication were studied using the Complex Adaptive Systems theory in this quantitative study. Each fundamental element of provider communication was the independent variable, and the preventable 30-day COPD excessive …

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Successful Allocation Of Funds In Managed Health Care Programs Revenue, Sherri Jean Loveall Jan 2022

Successful Allocation Of Funds In Managed Health Care Programs Revenue, Sherri Jean Loveall

Walden Dissertations and Doctoral Studies

Managed care leaders of independent physician associations (IPAs) lack strategies for allocating existing funds to avoid business closure. Medical providers are concerned with the quality of care for patients if the allocation of funding is not executed correctly. Grounded in the competing values framework (CVF), the purpose of this qualitative single case study was to explore strategies managed care leaders of IPAs use to allocate funds to avoid business closure. Participants were six executive leaders of an IPA in Los Angeles, the United States, who successfully managed the allocation of funds in a managed healthcare system. Data were collected from …

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Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs, Stella Obiageli Maduka Jan 2022

Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs, Stella Obiageli Maduka

Walden Dissertations and Doctoral Studies

Low health literacy can adversely affect individuals and groups without access to health information. Health insurance leaders who lack strategies to decrease low health literacy may lose their ability to provide quality health services and control care costs. Grounded in the health belief model and the Andersen health service model, the purpose of this qualitative multiple case study was to identify the strategies private health insurance leaders use to increase medical utilization to reduce healthcare costs. The three participants were from two private insurance companies in Las Vegas, Nevada. Data were gathered through semistructured, open-ended interviews via videoconferencing, a review …

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Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell Jan 2022

Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell

Walden Dissertations and Doctoral Studies

Readmissions for chronic obstructive pulmonary disease (COPD) are a major contributor to healthcare costs and patient outcomes. The Hospital Readmissions Reduction Program (HRRP) by the Centers of Medicare and Medicaid was implemented to decrease high rates of readmissions for serious medical problems, including COPD. The purpose of this study was to determine whether HRRP resulted in reductions in readmissions and costs for COPD patients. The Donabedian model was used as the theoretical framework to investigate three research questions concerning whether there are statistically significant differences in terms of readmission rates, total charges, and primary type of insurance payment before and …

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