Medicine and Health Sciences Commons^™

Early Diagnosis Of Pulmonary Embolism: Review And Cost-Effectiveness Analysis, Efstathios Polychronopoulos

Health Services Research Dissertations

Pulmonary embolism (PE) is a serious, life-threatening thrombotic disease, which results in considerable health and economic consequences each year for the United States. These consequences include a toll of 83,000 deaths and an economic impact between 1,5 and 5 billion. Approaches to strategy selection by physicians and other health-care specialists are based mainly upon cost, technology availability, and cultural tolerance regarding radiation exposure. The purpose of this study was to determine the most cost-effective diagnostic strategy with patients suspected of PE among several strategies currently used by examining their detection failure rates. This objective was met by (a) assessing parameter …

Using Modeling And Simulation To Improve Oral Health Services Delivery In Hampton Roads, Virginia, Mohammad J. Alzahrani

Health Services Research Dissertations

The purpose of this study is to examine the system performance in delivering oral health services in a public health district based on the Conceptual Framework to Measure Performance of the Public Health System (PHS). Using modeling and simulation, a predictive model based on the conceptual framework dimensions: mission, structural capacity, processes, and outcomes was developed to predict the performance of public health district in delivering oral health services.

This is a retrospective longitudinal study. The main objective of this study is to use a modeling and simulation approach to predict the performance of public health district dental clinic in …

Prenatal Smoking And Drinking Implications For Subsequent Child Maltreatment, Nicholas Alexander Adams

Sociology & Criminal Justice Theses & Dissertations

Prenatal smoking and drinking are very serious problems that have continued to plague society. They have multiple negative effects on the child both physically and cognitively. This study explored the relationship between prenatal abuse, i.e., prenatal smoking and prenatal drinking, and subsequent child physical abuse and official reports of child maltreatment. It was hypothesized that mothers who smoked or drank prenatally would be more likely to physically abuse their child postnatally and have official reports of child maltreatment. The sample included women participating in Wave III of the National Longitudinal Survey of Adolescent Health. N = 620 women who answered …

Adoption Of Electronic Health Records By Admitting Physicians: A Heuristic Model, John Sharon Hudson

Health Services Research Dissertations

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption.

Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical …

The Relationship Of Financial Performance, Quality Indicators, And The Role Of Nurse Executives In Virginia Nursing Homes, Jeany V. Murphy

Health Services Research Dissertations

Problem statement. The dynamic nature of the healthcare industry has triggered changes in nurse executive functions. The job has expanded into entrepreneurial roles to be able to provide the most cost effective services while maintaining good quality outcomes for the residents. The new responsibility requires a different set of knowledge and competencies that is usually achieved through advanced education. It is not known whether nurse executives in long term care in Virginia possess the skills to influence both the financial and quality outcomes of the facility.

Methods. This descriptive research study examined the relationship of the nurse executives' technical, human, …