Health and Medical Administration Commons^™

The Influence Of Community Support Services In Reducing Potentially Preventable Readmissions, Camille Rose Bash

Walden Dissertations and Doctoral Studies

Recently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George's County in the 4th quartile. The purpose of this quantitative research study was to investigate the relationship between community support services and the reduction of PPRs in Prince George's County. The Evans and Stoddart field model of health and well-being guided this …

Effect Of Clinical Laboratory Practitioner Licensing On Wages, Mary Hotaling

Walden Dissertations and Doctoral Studies

Professional licensing directly affects about 29% of U.S. workers and is considered a primary means to establish and maintain health care practitioner competence. Clinical laboratory practitioner licensing was largely ignored in the literature with only 2 studies 30 years apart that provided conflicting conclusions regarding wage effects. This research provided the first study of clinical laboratory practitioner licensing effects on wages after controlling for human capital and individual characteristics wage determinants. This nonexperimental correlational study extended the literature on licensing effects on wages, including women's wages and professions not uniformly licensed across 50 states. The theoretical foundation relied on the …

Improving Communication And Team Cohesion In A Long Term Care Facility, Jen Watson

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this Capstone project was to provide a staff development training that was researched based and educational. The training focused primarily on communication with a secondary emphasis on team cohesion. Training aimed to equip staff with skills and knowledge useful for working within various systems

Sector-Switching In Transition Economies: A Case Study Of Kazakhstan's Health Care Sector, Dariga Chukmaitova

CGU Theses & Dissertations

The dissertation examines the economic and behavioral factors influencing 'sector-switching' in Kazakhstan's health care industry. Sector-switching involves doctors moving from the national to the private system, which is not well established, thereby raising questions about why the switch occurs. It addresses the question: why health care professionals in Kazakhstan switch from the public sector to similar jobs in the private or nonprofit sectors? This study addresses a key issue in public management (sector switching) and also offers insights into the dynamics of the transition from a centralized economy to a market economy. As such, its findings have `real-world' applications beyond …

Evaluation Of Bureau Practice For Illegal Drugs Use Among Teens, Sharon D. Heard

Walden Dissertations and Doctoral Studies

The Bureau of Substance Abuse Treatment Recovery and Prevention, which oversees drug intervention services for Detroit residents, has found the city's illegal drug use among teens to mirror national rates. Illegal drug use is associated with addiction, major health problems, and stigma. Incorporating evidence-based screening during all teen health care visits would decrease missed opportunities to identify at-risk behaviors, the number of teens that do not receive intervention, and the stigma associated with screening. The purpose of this project was to develop evidence-based policy and practice guidelines for teen screening services for illegal drug use. The Plan-Do-Study-Act (PDSA) model was …

The Incidence Of Hip Fracture Associated With Proton Pump Inhibitor (Ppi) And/Or H2 Receptor Antagonist (H2ra) Use In The Kentucky Medicaid Population, Timothy C. Umeh

MPA/MPP/MPFM Capstone Projects

No executive summary.

Perspectives Of Close Relatives In Pediatric Palliative Care: A Grounded Theory Approach, Janelle Marie Feyh

Walden Dissertations and Doctoral Studies

Pediatric palliative care has recently become a priority in the healthcare field and is implemented at the time of diagnosis rather than days or weeks before the child's death. Social constructivism theory in which humans generate meaning from their experiences was utilized as a general framework to determine the impact of pediatric palliative care on close relatives. The purpose of this grounded theory study was to generate a substantive theory that explains how close relatives such as grandparents, aunts, and uncles of a child with cancer experience palliative care. The participants of the study included close relatives of children in …

An Examination Of Awareness Of Over-The-Counter Nonsteroidal Anti-Inflammatory Drugs And Adverse Events, Michelle Popa

Walden Dissertations and Doctoral Studies

The elderly population is among the fastest growing populations in the United States. Finding and consuming medications safely and effectively are challenging endeavors for this population. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a widely consumed class of medications among the elderly population, with 70% of individuals consuming over-the-counter (OTC) NSAIDs once a week and 34% using them daily. The purpose of this quantitative study was to determine whether (a) patients are aware of the risks associated with the consumption of NSAIDs, and (b) there are differences in awareness based upon specific demographic characteristics and levels of patient-physician communication. The health belief …

The Role Of Medical Training Background In Patient Satisfaction, Mariam Zia Qureshi

All Graduate Theses, Dissertations, and Other Capstone Projects

The number of international medical graduates (IMG) is increasing and their ability to satisfy patients has never been studied. The purpose of this study is to examine if there is a difference between the patient satisfaction scores of US medical graduates (USMGs) and IMGs. This is a retrospective study in which 2627 returned patient experience surveys of 55 physicians working in Medical Practice in South Western Mayo Health System were evaluated. These surveys were returned from August 2009 to August 2010. An independent t-test and t-inverse test was conducted with significance level of 0.05. The results of t-test lead to …

Recommendations For The Provision Of Patient Activities, Jean Schlichting

All Graduate Theses, Dissertations, and Other Capstone Projects

Federal Code § 485.645 is entitled “Special requirements for CAH (Critical Access Hospital) providers of long-term care services (“swing beds”).” It states that a CAH must be in substantial compliance with the skilled nursing facility requirements found in § 483. § 483.15 states that the facility must provide a comprehensive activities program that is designed to meet the physical, mental and psychosocial interests and needs of each patient. To ensure the program is meeting the interests and needs of patients, it also states that a comprehensive activities assessment should be completed with each patient. A wealth of research finds that …

Public Sponsored Health Insurance To Improve Health Outcomes With Implications For Government Health Policy, Design, And Decision Making, Steven M. Wagner

Walden Dissertations and Doctoral Studies

This research sought to ascertain the extent to which providing public sponsored health insurance (PSHI) to previously uninsured Mexican-American Hispanics improves health outcomes among those requiring ongoing treatment to control diabetes. Prior research utilizing insurance access theory; access, equity, and health outcome interrelationship theory; health affordability theory; and financial and resource burden theory suggests the uninsured receive less care than the insured, with delayed treatment, leading to chronic conditions. This research tested each of those major theoretical constructs into a blended conceptual framework based on the notion that providing health insurance helps alleviate the disabling effects of diabetes among this …

A Case Study Of Primary Healthcare Services In Isu, Nigeria, Raymond Ogu. Chimezie

Walden Dissertations and Doctoral Studies

Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents' access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi's 7-step method for qualitative data analysis. Key findings included …

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, …

Chhs November E-Newsletter, Wku College Of Health & Human Services, Vashon S. Wells, Editor

College of Health & Human Services Publications

No abstract provided.

Library Impact Statement For Health Services Program

Library Impact Statements

Library Impact Statement submitted in response to new program proposal for Health Services. Additional resources were required to support this new program. Responding faculty member: Joanna M. Burkhardt, CMO. Requesting faculty member: Deb Riebe

Renewing Health Services Management Research: Redrawing The Citizen-Client In Irish Health Care Policy, Vivienne Byers

Conference Papers

Ireland has a history of health policy which is not explicit as to its aims and objectives. In light of this fact, this paper examines the position and direction of the Irish Health Services, five years on from the advent of the setting up of the Health Services Executive (HSE) and the restructuring of the health services. The Irish health system policy is guided by the Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client, and also by the Primary Care Strategy (2001:7); in that there should be …

Hospital Performance Evaluation In Uganda: A Super-Efficiency Data Envelope Analysis Model, Bruno Yawe

Zambia Social Science Journal

Standard Data Envelope Analysis models result in a large fraction of the observations becoming 100 percent efficient. The article measures the technical efficiency of 25 district referral hospitals from three regions of Uganda over the 1999-2003 period. It applies a super-efficiency Data Envelopment Analysis model. The application of a super-efficiency model was occasioned by the failure of standard data envelopment analysis models to rank the efficient set of hospitals which attain an efficiency score of unity. The results of the standard data envelopment analysis models indicate the existence of different degrees of technical and scale inefficiency in Uganda’s district referral …

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

Forming Bodies And Reforming Healthcare: The Co-Construction Of Information Technologies And Bodies Through The Imperative For Self Care, Scout Calvert

University of Nebraska-Lincoln Libraries: Faculty Publications

Care work and technological work are markedly striated by sex; the sites where they overlap are few. What happens when the labor of care meets up with information technologies? It makes good methodological sense to look at largely feminized environments that are also increasingly technological. Gender, Health, and Information Technology in Context, edited and with contributions by Ellen Balka, Eileen Green, and Flis Henwood, is a welcome contribution to the body of evidence about the socio-technical co-construction of technology, health, and gender. The volume houses nine studies, bookended by an astute introduction and conclusion by the editors. Each study …

Uncompensated Care And Quality Assurance Among Rural Hospitals, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Health care disparities in rural areas remain significant in the U.S. health care industry. Uncompensated care makes health care disparities in rural areas worse, and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic-downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. Given that many rural residents experience difficulty accessing high quality care and given the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality-care barriers and opportunities and suggested strategies to strengthen the position of rural hospitals …

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

The Impact Of Stakeholder Collaboration On Effectiveness Of Health Program Implementation In Ghana, Samuel Kwami Agbanu

Walden Dissertations and Doctoral Studies

Healthcare providers increasingly recognize the importance of collaboration among stakeholders in cost-effective healthcare delivery. While collaborative relationships offer great advantages, little research has addressed their relevance in an international development aid context, particularly in sub-Saharan Africa. The region is a major recipient of international development support, yet health indicators on HIV/AIDS, malaria, tuberculosis, and child and maternal mortality indicate the health of the region is among the weakest worldwide. This sequential mixed method, descriptive study of a USAID-funded community health program in Ghana examined the nature of collaboration among six stakeholders and impact of this collaboration on effectiveness of program …

The Effect Of Encounters Between Medical Gatekeepers And Patients On The Doctor-Patient Relationship, Linda Pilzer Erlich

Walden Dissertations and Doctoral Studies

Research currently indicates patient perceptions of the doctor-patient relationship are central to health outcomes. Theoretically, the current study is grounded in two literatures: the placebo effect and the broader literature examining empirically tested predictors of the doctor-patient relationship. Two factors not yet studied relative to patient perceptions of the doctor-patient relationship include the direct effect of medical gatekeeper characteristics along with the interaction between gatekeeper characteristics and existing healthcare attitudes/behaviors. This quantitative archival study utilized a MultiCare Survey dataset of 10, 579 participants who were general practitioner patients in northwestern United States. This study first examined the individual impact of …

A Community Benefit Reporting Toolkit For Critical Access Hospitals, John A. Gale Ms, Melanie Race Ms

Rural Hospitals (Flex Program)

No abstract provided.

Revitalisation, Rigour And Relevance: The Citizen-Client And Planning In The Health Services., Vivienne Byers

Conference Papers

Whereas, in many OECD countries strategic planning in health care has been in evidence since the 1970s, in Ireland the emergence of strategic management processes in health care planning didn’t occur until the 1990s.

This paper reports on part of a comparative study of health services planning in Ireland and in Canada. How can the strategic management of the Irish health services in the form of service planning be implemented? The focus of this paper is the identification of two key stumbling blocks to success in this endeavour. These include the limitations of the control mechanism, the legislation, underpinning service …

Opportunities For Comparative Research In Public Health Pbrns : A Baseline Analysis Of Local Practice Settings, Glen P. Mays, Sharla A. Smith, Elaine B. Wootten, Sylvia J. Porchia

Health Management and Policy Presentations

This analysis describes the organizational and operational characteristics of local public health agencies participating in an initial cohort of five (5) public health PBRNs in the U.S. We examine variation in practice settings within and between PBRNs; compare practice settings to state and national norms; and identify opportunities for comparative research that can be conducted through PBRNs.

Over-Utilization Of Advanced Imaging In The Hospital Setting: An Educational Approach To Reduce Unnecessary Inpatient Studies, Guillermo Madero, J. Platnick, L. Voutsinas, R. Wetz, S. Buchbinder

Internal Medicine

By several measures, health care spending continues to rise, forcing businesses and families to cut back on operations and household expenses. In 2008, health care spending in the United States reached $2.4 trillion dollars, and is projected to reach $3.1 trillion in 2012.During the past decades, there has been a steady increase in the utilization of expensive inpatient imaging studies, with an overall increase in health care costs. In particular, advanced imaging includes CT, MRI and Nuclear Medicine, used for the diagnosis and management of hospitalized patients. The reasons for unnecessary imaging examinations include indirect financial benefit to physicians, medico-legal …

Kawasaki Syndrome In Texas, Alberto Coustasse, Julius J. Larry, Witold Migala, Cody Arvidson, Karan P. Singh

Management Faculty Research

The authors examined hospitalization rates of Kawasaki Syndrome (KS) among Texas children to isolate clusters, identify demographic disparities, and suggest possible causative factors. Using a retrospective cross-sectional study design, they studied 330 KS cases from 2,818,460 hospital discharges. The majority of the cases (61.5%) occurred within the 1-4-years-old category, representing the highest hospitalization rate (14.3 per 100,000 children). Almost 75% of the KS population was less than 5 years old, with hospitalization rates approximately 8 times higher than that of all other children (p < .05). KS diagnosis occurred for only 49.4% of all KS cases upon admission. Along with high-density clusters identified in major metropolitan areas, the authors found the highest rates of KS among Asian and Pacific Islander and non-Hispanic black children. Genetic predispositions and access to healthcare issues may explain the results. The authors recommend improving educational initiatives with healthcare providers and establishing KS as a reportable condition.

A Participant Model: Predictive Medical And Behavioral Factors Of Prostate Cancer Screening Attendees At Markey, Shana L. Steinbach

MPA/MPP/MPFM Capstone Projects

Problem Statement

The Prostate Cancer Screening Program at the Markey Cancer Center co-sponsors prostate cancer screenings with the Prostate Cancer Education Council. All participation, including African-American attendance, has decreased 38% from years 2006 to 2008 and program managers are seeking insight to improve program participation by acquiring knowledge of behavioral and medical characteristics that may influence screening attendance. Because of the higher incidence of prostate cancer in African-American men (ACS, 2008), a specific program goal is also to increase screening attendance for this minority population.

Research Strategy

Questions that assess participant behavior, personal, and family medical history are analyzed to …

Physician Recruitment At Highlands Regional Medical Center: What Works?, Sarabeth Blankenship

MPA/MPP/MPFM Capstone Projects

There is a physician shortage in eastern Kentucky because older physicians are retiring, and younger physicians are choosing to practice in more urban, affluent areas. Eastern Kentucky is plagued with persistent poverty and lacks cultural amenities. These facts put together myths regarding rural practice create a shortage.

My research consisted of interviewing twenty physicians currently practicing at Highlands Regional Medical Center in Prestonsburg, Kentucky. I created a survey instrument that asked questions of physicians regarding demographics characteristics, medical school attended, and what motivated them to practice at Highlands. I chose Highlands because I was able to get interviews scheduled with …