Medicine and Health Sciences Commons^™

The Effect Of Dental Insurance Coverage And Economic Fluctuations On Oral Health Outcomes In The United States, Laura Singletary

Senior Theses

Proper oral health is imperative to overall health, but obstacles often persist in

receiving proper oral health care. Lack of dental insurance coverage and economic recessions are two main factors contributing to oral health outcomes. Extended time without cleanings or addressing current oral health concerns exacerbates oral health problems into more costly procedures for the patient that are conveniently not covered by many insurance plans. This thesis investigates the oral health outcomes associated with periods following economic downturns, specifically citing the time of the Great Recession from 2007-2009.

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 Intersectionality Of Race And Rurality In Polysubstance Use During Pregnancy In The United States: A Study Of National Survey On Drug Use And Health, Sophia Tavakol

Senior Theses

Importance: Though detrimental consequences, many pregnant individuals are still binging alcohol, smoking, and/or using illicit drug. Yet, little is known regarding variations in such behaviors across pregnant people in the United States.

Objective: To examine alcohol, tobacco, and drug use during pregnancy in 2015-2020 and assess their racial, ethnic, and rural disparities.

Design: This cross-sectional descriptive study derived maternal characteristics and self-reported prenatal substance use data from 2015 and 2020 National Survey on Drug Use and Health, considering the complex sampling weight per participant per year produced by NSDUH.

Setting: United States.

Participants: A scientific random sample of non-institutionalized residents …

The Utilization And Effectiveness Of Telemedicine In The Wake Of Covid-19, Maxwell Sharawy

Senior Theses

The COVID-19 pandemic devastated the world, in every industry. Almost none were hit as hard as the healthcare system. Through the use of telemedicine, healthcare providers were able to care for their patients without rise of infection. Through a review of published literature and interviews conducted with three practicing physicians of various specialties, a diagnosis was developed to determine if the care provided through telemedicine was as effective as in-person care. It was hypothesized that when used properly, telemedicine can be used as an effective replacement for in-person care across a wide range of specialties. After review of the literature …

Are Adverse Childhood Experiences Associated With Health Behaviors Among College Students: Emotion Regulation As A Potential Moderator, Margaret Winters

Senior Theses

In this study, we sought to examine the relations among adverse childhood experiences (ACEs), physical activity (PA), sleep quality, and emotion regulation in college students. ACEs have been proven to have a dose-response relation with adverse health outcomes in adulthood, including heart disease, cancer, lung disease, liver disease, poor mental health, and risky health behaviors (Felitti et al., 1998; Merrick et al., 2016; Zhang et al., 2020). ACEs have also been previously associated with poor sleep quality and emotion dysregulation (Kajeepeta, Gelaye, Jackson, & Williams, 2015[WL1] ; Kim & Cicchetti, 2010). Given these findings, we sought to examine how …

Did Medicaid Expansion Under The Affordable Care Act Reduce The Likelihood That People Report Employment Status Changes Due To Health, U.S., 2009-2017, Songyuan Deng

Theses and Dissertations

Medicaid expansion of Affordable Care Act (ACA) extended coverage to low-income working adults. While Medicaid expansion led to increased healthcare use and national healthcare expenditures, current studies do not examine the effects of Medicaid expansion on health status from the perspective of social roles, for example, changes in employment status. This study use data from the Current Population Survey to examine the association between Medicaid expansion and the probability to attribute part-time work or not-in-labor- force to health issues among people with family annual income no more than 138 of Federal Poverty Level, with a difference-in-differences study design. We found …

The Association Of Health Insurance And Prescription Drug Coverage On Cost-Related Non-Adherence And Hospitalization Across Age-Related Groups Of Individuals With Copd, Shamika Martin Walls

Theses and Dissertations

Background: COPD patients have poor adherence to prescribed treatment. Individuals with COPD have higher out-of-pocket treatment cost than individuals without COPD. The significant out of pocket COPD related treatment cost can lead to prescription drug non-adherence especially for individuals without health insurance or prescription drug coverage.

Significance: Since the implementation of Medicare Part D on January 1, 2006, there are no studies that have used national data to evaluate the association of health insurance and prescription drug coverage on cost related non-adherence and hospitalization among individuals 50-64 years old with COPD compared to individuals 65 years and older …

The Relationship Between The Electronic Health Record Patient Portal And Shared Decision Making, Gloria Esoimeme

Theses and Dissertations

Shared decision making (SDM) is a collaborative decision-making style where the patient and the physician are involved in the clinical decision-making process. The goal of this dissertation project was to examine the relationship between the patient portal of an electronic health record (EHR) and SDM.

The SDM process has three main components: information sharing, deliberation and decision making. Patients participate in SDM at varying levels: some patients may prefer to share information and deliberate but leave the final decision making to the provider while others prefer to participate in all the three components of SDM. The patient portal of an …

Hiv Care Location: An Evaluation Of Single Versus Multi Facility Utilization Of Hiv/Aids Care Services And Patient Health Outcomes And Clinical Indicators In South Carolina, Melanie Gwynn

Theses and Dissertations

Background: On the HIV/AIDS care continuum, the “retention in care” metric does not distinguish between single-facility (SF) or multi-clinic utilization (MC), also described as HIV care location (or type). SF utilization is vital as it has been linked optimal clinical outcomes among People Living with HIV/AIDS (PLWH). Published research detailing the prevalence of HIV care type and its association with health outcomes/clinical indicators, has been studied only in limited urban settings. Additionally, coinfections such as sexually transmitted infections (STIs), have yet to be evaluated as potential predictive factors for HIV care type.

Methods: A cross-sectional design was used …

A Policy Analysis Of South Carolina Drug Court Legislation: H. 3322 § 302: Drug Court Program Act (2019), Mae Chinnes

Senior Theses

The purpose of this thesis is to examine a piece of drug court legislation currently being considered by the South Carolina Legislature, H. 3322 § 302. An overview of drug criminalization in the United States, its impact, and drug courts are provided. This is followed by a review of the literature on the key programmatic components of drug court best practices, including: target population, incentives and sanctions, management team, and duration. An example analysis of Florida’s Thirteenth Judicial Circuit Drug Court Program policies proceeds the analysis of H. 3322. Parameters of successful drug court legislation and program outcomes are defined …

Examining Women’S Perceptions Of Maternity Care In Public And Private Sectors Of National Guard Hospitals In Saudi Arabia: A Qualitative Study, Hanin M. Almahmoud

Theses and Dissertations

Every second, a baby is born. The process of birth is a complex one – biologically, medically, and emotionally. In particular, women in labor need both physical and emotional care. They need to be heard, to be comforted, and to be safe.

Women’s satisfaction can be used as a legitimate way to measure the quality of maternity care. Moreover, when health systems practice patient-centered care and listen to women’s concerns and what they want out of their care, it can lead to improvements in their satisfaction. Hospitals in Saudi Arabia are considered to be among the best and most technologically …

The Association Of Reimbursement Methods With The Tendency Of Primary Care Physicians To Apply The American Diabetic Association’S Recommendations And Make Referrals To Specialists Among Ambulatory Care Patients In Us Outpatient Settings., Abdullah Alharbi

Theses and Dissertations

We report on a study of the comparison of two reimbursement methods, capitation (CAP) and fee for service (FFS), as well as mixed payment, with respect to the implementation of the ADA recommendations for Diabetes Type 2 (DM2) management and referral rates for specialist health care in the outpatient setting of the United States.

Our purpose in examining these specific topics is to determine whether there is any difference in the implementation of the ADA recommendations or the frequency of referral between visits paid under CAP vs under FFS because both quality and cost of healthcare is affected by these …

The Intergenerational Effects Of Adverse Childhood Experiences On Children’S Emergency Department Utilization And Depression And Anxiety In South Carolina, Eboni E. Haynes

Theses and Dissertations

Adult exposure to adverse childhood experiences (ACEs) is common in the U.S., with over half of adults reporting exposure to at least one ACE. Childhood trauma is associated with risk factors for premature death, disability, poor physical and mental health, and lower quality of life in adults. Traumatic experiences also influence parenting behaviors later in life, placing offspring at an increased risk of ACE exposure. Few studies have explored the intergenerational effects of ACEs on the health and well-being of offspring. This study sought to identify whether associations existed between caregiver ACE exposures and emergency department (ED) utilization for sick …

Clinically Integrated Networks: The ‘Magic Pill’ For Improving The Quality Of Health Care?, Kaitlyn Ann Crosby

Theses and Dissertations

The Patient Protection and Affordable Care Act (ACA) served as a paradigm shift to reimburse physicians based on health outcomes or quality of care patients receive in relation to and conscious of the cost to provide care, rather than the traditional fee-for- service (FFS) system. To implement value-based care under the ACA, value-based care models (VBCM), such as patient-centered medical homes (PCMH) and accountable care organizations (ACO), were formed with the ultimate goal to advance quality of care. Among commercially insured populations, clinically integrated networks (CIN) have emerged as another type of VBCM.

Since CINs are the newest type of …

Health Insurance Program For The Poor, Out-Of-Pocket Costs, And Catastrophic Health Expenditures In India, Shyamkumar Sriram

Theses and Dissertations

Background

India is currently taking steps to provide Universal Health Coverage (UHC) as envisaged in its National Health Policy 2017. Financial protection is considered the backbone of UHC. In India, OOP expenses accounts for about 62.6% of total health expenditure - one of the highest in the world. Out of 1.324 billion people in India, around 12.4% of the population is below the poverty line. Lack of health insurance coverage and inadequate coverage are important reasons for high OOP health expenditures. High OOP health expenditures push many households into poverty. The objective of this research is to examine the effect …

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 …

Behavioral And Neural Correlates Of Aging Effects On Temporal Predictive Mechanisms During Speech Production And Limb Movement, Karim Joharikhatoonabad

Theses and Dissertations

Existing evidence suggests that the brain facilitates motor responses to temporally predictable sensory inputs by generating more robust predictions about the timing of incoming stimuli to better estimate the next state of movement. In this context, previous studies have shown that motor responses are generated with faster reaction time in response to sensory stimuli with predictable compared to those with unpredictable temporal dynamics. However, our understanding of the underlying behavioral and neural mechanisms of temporal predictive mechanisms during movement production has remained limited by several factors. First, studies regarding temporal predictive mechanisms have mainly examined limb movement as a target …

An Investigation Into The Relationship Between Academic Pressure And Non-Medical Prescription Stimulant Use Among University Of South Carolina Undergraduate Students, Arslan Valimohamed

Senior Theses

One hundred and six undergraduate students of the University of South Carolina were surveyed to understand misuse of prescription stimulants and how perceived academic pressure may play a role in this behavior. Overall, the survey revealed that 33.0% of participants reported illicit use of prescription stimulants in the last 30 days, and 52.8% reported illicitly using prescription stimulants at least once during their time in college. Data from the survey responses indicated that students perceiving academic pressure were more likely to have misused prescription stimulants at least once during their time in college, but only if these students also reported …

The Importance Of Interdisciplinarity: Redefining The Health Belief Model, Ross F. Lordo

Senior Theses

Throughout academia, there lacks an existence of a commonly utilized multicomponent and interdisciplinary approach in understanding our outside world. This thesis provides an analysis of the current state of interdisciplinarity and the need to develop interdisciplinary theory. Through this effort, the researcher utilizes the health belief model as a framework that is severely limited in applicable scope due to its constructs. Contrastingly, systems theory and game theory are validated as examples of theories with an interdisciplinary nature. Through the coding of the literature pertaining to the qualitative characteristics of the health belief model, game theory and systems theory, guidelines in …

Bayesian Semiparametric Quantile Regression For Clustered Data, Xin Tong

Theses and Dissertations

Traditional frequentist quantile regression makes few assumptions on the form of the error distribution and thus is able to accommodate non-normal errors. However, inference on the quantile regression models could be challenging for the unknown error distribution, though asymptotic or resampling methods were developed. Bayesian literature on quantile regression with random effects is relatively limited. The quantile regression approach proposed in this dissertation is founded on Bayesian probabilistic modeling for the underlying unknown distributions. By adopting the error density with a nonparametric scale mixture models, we developed Bayesian semiparametric models to make an inference on any quantile of interest and …