Medicine and Health Sciences Commons^™

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

The Effect Of Provider-Patient Racial Concordance On Student Health Services, Sophia B. Gilliam

Senior Theses

Objective: This research aimed to evaluate the effect of provider-patient racial concordance on perceived care received by University of South Carolina students at Student Health Services.

Methods: A total of 173 students at the University of South Carolina Columbia campus who have received care from Student Health Services within the past 2 years participated in the study. Participants were questioned about their experience with Student Health Services using an adaptation of the CAHPS® Clinician & Group Survey Version 3.0. Independent samples t-tests and descriptive analyses were used for comparisons between the 25 non-white respondents and a randomly selected proportionate group …

Determinants Of Hiv Treatment Disparities In The Latino Population Of South Carolina, Elizabeth G. Caulk

Senior Theses

The Latino population in the United States faces a heightened risk in terms of contracting HIV/AIDS and experiencing negative health outcomes from said infection. HIV/AIDS continues to disproportionately impact ethnic/racial minorities, and the Latino population exemplifies this unfortunate trend, with Latino Americans making up around 18.4% of the national population, but nearly 30% of the HIV/AIDS infections (US Office of Minority Health, 2021). More enduring changes to the current resources available to this population will need to be made in order to address this disparity. Thus, the current study examined social determinants, how they increase risk of infection, and how …

Healthcare Safety-Net In The United States: Patient Satisfaction Across Rural And Urban Hospitals, Vivian Ho

Senior Theses

Objective. To examine rurality and other hospital characteristics associated with patient satisfaction across hospitals in the United States.

Data. Nationwide hospital data from the 2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and the 2020 Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file.

Study Design. Hospital ZIP-codes were categorized into urban, rural micropolitan, or small/isolated rural based on Rural-Urban Commuting Area (RUCA) codes. Patient satisfaction measures from the HCAHPS survey were linked to the CMS POS data for hospital characteristics, yielding 2,357 urban, 749 rural micropolitan, and 1,343 small/isolated rural hospitals. ANOVA and …

Correlates Of Maternal Health Service Use And Women’S Experiences Using Antenatal Care In Ghana: A Mixed-Methods Study, Anna Cofie

Theses and Dissertations

The pace of improvements in maternal mortality has been slow in Ghana. While Ghana’s maternal mortality ratio (MMR) decreased from 635 per 100,000 live births to 319 per 100,000 live births between 1990 and 2015, the country failed to meet the 75% reduction target set by Millennium Development Goal (MDG) goal 5A, to reduce maternal mortality ratio by 75% between 1990 and 2015. Antenatal care (ANC) is critical to improving maternal morbidity and mortality and child deaths. In 2003, Ghana introduced the National Health Insurance Scheme to ensure that all pregnant women have access to free maternal care, and in …

Individual- And Community- Level Associations With Healthcare Utilization Among A Health System, Emergency Department Population, Carlene A. Mayfield

Theses and Dissertations

AIM: The primary aim of this study was to examine individual-level and community- level characteristics associated with ambulatory or primary care utilization, emergency department (ED) utilization, and ED charges among a sample of ED patients.

DESIGN AND SAMPLE: Data for this cross-sectional study were obtained from three distinct sources: (i) electronic medical records (EMR); (ii) billing records; and (iii) the 2013-2017 American Community Survey (ACS). The individual-level EMR and billing sample included all adults residing in Mecklenburg County, North Carolina who visited an Atrium Health ED in 2017. The ACS sample included population and demographic estimates from Mecklenburg County’s 27 …

"Transforming Care Through Disruptive Design": Incorporating A Midwifery Model Of Care Into Obstetric Practices, Lauren Marsh

Senior Theses

Maternal and child health outcomes in the United States are far poorer than in other industrialized nations. To improve women’s experiences with the maternity care system, nurse-midwife Sharon Schindler-Rising developed the CenteringPregnancy (CP) group model of prenatal care (PNC). Research comparing CP with ‘traditional’ one-on-one PNC has found that implementing CP results in decreased rates of preterm birth and low birth weight, increased rates of breastfeeding, and improved outcomes for women who typically experience health disparities, including African Americans. Documented success of the model in the Greenville Health System convinced the South Carolina Department of Health and Human Services of …

Relationship Between The Experience Of Perceived And Physician Diagnosed Arthritis And The Presence Of Dsm-Iv Criteria-Based Major Depression (Mdd) Among Older, Ryan Neil Schmidt

Theses and Dissertations

BACKGROUND: The purpose of this study was to explore both positive screened MDD and the perception of being depressed (P) and the likelihood of either increasing if the patient suffered from arthritis (P/E), either perceived or evaluated by a physician. The study explored the univariate, bivariate, and multivariate relationships between MDD and depression (P) to better describe influencing characteristics and their prevalence, as related to MDD and depression (P).

METHODS: The study examined a cross section of patients 65 years and older (n=8,205) within the National Epidemiologic Survey on Alcohol Abuse and Alcoholism (NESARC) [2001-02] sponsored by the National Institute …