Health and Medical Administration Commons^™

Optimising Decentralisation For The Health Sector By Exploring The Synergy Of Decision Space, Capacity And Accountability: Insights From The Philippines, Harvy Joy Liwanag, Kaspar Wyss

Ateneo School of Medicine and Public Health Publications

Background

Several studies on decentralisation have used the ‘decision space’ approach to assess the breadth of space made available to decision-makers at lower levels of the health system. However, in order to better understand how decentralisation becomes effective for the health sector, analysis should go beyond assessing decision space and include the dimensions of capacity and accountability. Building on Bossert’s earlier work on the synergy of these dimensions, we analysed decision-making in the Philippines where governmental health services have been devolved to local governments since 1992.

Methods

Using a qualitative research design, we interviewed 27 key decision-makers at different levels …

How Informational Imperfections Lead To Sub-Optimal Solutions In Health Savings Plan And Potential Remedies In A Competitive Marketplace, Jacob Gene Dengg

Electronic Theses and Dissertations

In the growing trend of consumer-driven health insurance, more consumers than ever have access to a high-deductible health plan paired with a health savings account, where consumers can save pre-tax income for healthcare but also face higher out-of-pocket prices, in hopes that consumers will become smarter shoppers. The Health Savings Plan is successful at lowering costs, but at the expense of consumers lowering their adherence to healthcare, raising health risk. Even in a competitive market, HSP plan designs require smart shoppers and more active healthcare self-management, but without dealing with the informational imperfections that need to be overcome to encourage …

The Health Care Systems Of The United States And Spain: A Comparison, Tasia Harman

Senior Honors Theses

When it comes to understanding and improving the United States health care system, comparison and analysis with the health care system of another country provides valuable insights. In this thesis, the United States’ health care system was compared to that of Spain, as the health care system of Spain is generally ranked well above the United States in terms of quality, function, and cost. In the comparison, information such as the health of the population, the quality of health care received, accessibility, and health care costs indicate the state of the health care systems and their ability to function well …

Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack

Walden Dissertations and Doctoral Studies

Demand for the emergency medical technician (EMT) is 2 times greater than that of all other occupations. Sustainability of ambulance services (AS) personnel is dependent upon the recruitment of EMTs into the industry. The purpose of this multiple case study was the exploration of the recruiting strategies that AS administrators used to increase the number of EMTs. Herzberg's 2 factor theory of motivation was the conceptual framework for this study. The data collection instrument included semistructured interviews with 6 AS company executives in southeastern New Mexico and southwestern Texas. Secondary data and document from each state's emergency medical services personnel …

Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble

Walden Dissertations and Doctoral Studies

The rising cost of health care in the Philippines is a concern for the Department of Defense and TRICARE beneficiaries. The purpose of this quantitative cross-sectional research study was to determine the efficacy and acceptability of a different method to deliver health care to increase access to health care and decrease out-of-pocket costs while maintaining quality of care for TOP Standard beneficiaries who receive health care under the Philippine Demonstration. Secondary data was used to determine the acceptability of an alternative reimbursement methodology to decrease cost but maintain access to quality care. The Andersen's behavioral health care model and the …

Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy

Walden Dissertations and Doctoral Studies

Workplace bullying in the healthcare field has contributed to decreasing productivity, decreasing employee morale, increasing workplace lawsuits, overall dissatisfaction in the workplace, and potentially compromising care to patients. Little, however, is known about how public policies related to workplace bullying impact the experiences of healthcare workers. Using Cornell and Limber's conceptualization of bullying, the purpose of this general qualitative study was to better understand the experiences of healthcare leaders and workers related to workplace bullying of a single health care facility. Data were principally collected from 9 participants representing three organizational leaders, three nurses, and three ancillary members staff. These …

Social Workers And Early Intervention With Diabetic Clients, Rievu Agiri

Walden Dissertations and Doctoral Studies

Social workers are uniquely positioned to facilitate early intervention services that minimize the impact and burden of Type 2 diabetes. There is little evidence on the specific role that social workers play in addressing the psychosocial factors that exacerbate the condition or impact treatment outcomes. The purpose of the study was to examine the role of social workers in facilitating early interventions for clients with Type 2 diabetes. The theories of role and organizational systems provided the conceptual framework. Data was collected from interviews with eight participants with Master'€™s degrees in Social Work in a large Southwestern state in the …

An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon

Walden Dissertations and Doctoral Studies

A global epidemic of metamorphosed, conglomerated health care systems changed the face of public health care organizations. The problem is, public health care organizations merge into new systems, but the culture for each merged organization has not been formed under the new system. Public administrators, health care workers and the Department of Health and Human Services are affected when there are issues in health care behavioral practices and performance outcomes. Research found that employee motivation is hard to achieve when there are issues within the internal structure of a new system. Using Herzberg's motivation-hygiene and Tajfel and Turner's social identity …

Participant Experiences In Christian-Based Recovery, Joshua Mjolsness

Walden Dissertations and Doctoral Studies

Health care leaders are challenged with addressing addiction and the treatment of addiction. Many studies have been conducted around addiction treatment; however, no studies have been conducted on Christian-based recovery programs that use the same approach regardless of the addiction. The purpose of this phenomenological study was to explore the experiences of participants in a Christian-based recovery program that uses the same approach for all addictions. The social learning theory provided the framework for this study. Data were collected by interviewing participants of the Christian-based recovery program Free Grace Recovery (FGR). Eight participants selected had a variety of reasons for …

Graduate Bulletin: 2019-2020, Minnesota State University Moorhead

Graduate Bulletins (Catalogs)

No abstract provided.

An Analysis And Critique Of Mental Health Treatment In American State Prisons And Proposal For Improved Care, Shelby Hayne

Scripps Senior Theses

Mental health treatment in state prisons is revealed to be highly variable, under-funded, and systematically inadequate. Existing literature exposes this injustice but fails to provide a comprehensive proposal for reform. This paper attempts to fill that gap, outlining a cost-effective, evidence-based treatment proposal, directly addressing the deficits in care revealed through analysis of our current system. In addition, this paper provides historical overviews of the prison system and mental health treatment, utilizing theoretical perspectives to contextualize this proposal in the present state of affairs. Lastly, the evidence is provided to emphasize the potential economic and social benefits of improving mental …

Everybody’S Working (But The Weakened): An Assessment Of Medicaid Work Requirements And Their Administrative Burdens, Samuel Misleh

MPA/MPP/MPFM Capstone Projects

Although Medicaid work requirements are currently halted in both Arkansas and Kentucky, this analysis utilizes the data available to make an assessment and estimate of what Kentucky’s Medicaid enrollment will look like if work requirements similar to those Arkansas had are ever implemented. The relative severity of the administrative burden of such requirements provide a tool for comparison, and a difference-in-differences analysis of the change in Medicaid enrollment between Arkansas and West Virginia, a state that has not implemented and currently has no plans to implement Medicaid work requirements, provide the bases for this estimate. After coding the work requirements …

Mobile Iot Adoption As Antecedent To Care-Service Efficiency And Improvement: Empirical Study In Healthcare-Context, Samyadip Chakraborty, Vaidik Bhatt

Journal of International Technology and Information Management

Internet of things (IoT) is the buzzword and pioneering breakthrough approach highlighted in today’s industry 4.0, where the devices are seamlessly integrated with each other, sharing vital information in real-time sync. With the wearable IoT devices, the diagnostic readings and physical measurements of the patients can be shared with the physician on the go and suitable diagnosis can as well be shared with patient in the real-time on their own mobile devices through IoT applications. This study empirically examines the importance of m-IoT adoption on the information pervasiveness across the network and patient stakeholders and in turn investigating how efficiency …

Certified Nursing Assistant Turnover & Impacts On Rural Skilled Nursing Facilities A Qualitative Study & Recommendations For Practitioners, Marisa E. Hansen

All Graduate Theses, Dissertations, and Other Capstone Projects

The cumulative growth in the aging population in the U.S. calls for a high demand for long-term care (LTC) facilities. Furthermore, the LTC (e.g., nursing homes and assisted living facilities, etc.) consumers have become widely diverse (i.e., not just limited to older groups but now included children and adults with disabilities); demand for wide range of needs and support services. In coping with this changing environment, the LTCs, especially operating in rural settings, are faced with multifaceted challenges related to direct care staffing and turnover. In response to this outlook, the present study explores a research question to understand, how …

Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua

Walden Dissertations and Doctoral Studies

Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …

When Bad Genes Ruin A Perfectly Good Outlook: Psychological Implications Of Hereditary Breast And Ovarian Cancer Via Narrative Inquiry Methodology, Cammi Clark

Antioch University Dissertations & Theses

Scientists debunked the belief that breast cancer is always viral with the mid-90s discovery of the first hereditary genetic mutation linked to a significantly higher-than average chance of breast and ovarian cancer. This genetic condition, called Hereditary Breast and Ovarian Cancer (HBOC), passes the mutation from generation to generation in a family. Thousands of variations of such mutations exist, and carriers account for 10 to 15% of all breast cancer, and up to 20% of ovarian (Childers et al., 2017). In addition, genetic testing uncovered a rapidly rising number of healthy people (never had breast/ovarian cancer) who are also carriers, …

Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera

Walden Dissertations and Doctoral Studies

The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the …

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …

Wellness Paradigms In Predicting Stress And Burnout Among Beginning Expatriate Teachers, Kimala Proctor

Walden Dissertations and Doctoral Studies

Research indicates that the current teacher shortage is in part due to stress and burnout. A topic that has not been examined is beginning expatriate English medium teachers (EMTs) with 5 years or less of teaching experience in the United Arab Emirates and the relationship between using individualized, self-initiated wellness paradigms and stress, job burnout, and intent to leave the teaching profession. The transactional model of stress and coping, Maslach's multidimensional theory of burnout, and the health promotion model were used to evaluate the moderating effects of the EMTs' burnout and stress levels on their wellness and intent to leave. …

Caregivers' Challenges In Accessing Services For Children With Autism, Anita Payne Jones

Walden Dissertations and Doctoral Studies

The perspective of the caregiver is vital to understanding the experiences of raising a child with autism, including the challenges faced in accessing services. The purpose of this qualitative, transcendental phenomenological study was to examine the lived experiences of primary caregivers raising a school-age child with autism and to bring about an understanding of the challenges faced in accessing services. Resiliency theory provided the conceptual framework for the study. Semi-structured, in-depth interviews were conducted with 11 participants raising a child with autism in the Washington, DC metropolitan area. Data were analyzed using Moustakas's descriptive approach. Results yielded 5 themes: overall …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

College of Graduate Studies: Theses & Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Guardians' Experiences With Mental Health Care For Adolescents With Pediatric Bipolar Disorder, Saudia Y. George

Walden Dissertations and Doctoral Studies

Pediatric bipolar disorder (PBD) is a growing public health problem in the United States, especially among adolescent children. Despite awareness of the diagnosis and the effects that it has on the child, little attention has been given to the effects that PBD has on the guardian. The purpose of this qualitative phenomenological study was to explore the factors influencing guardians' experiences related to PBD. Penchansky and Thomas' Theory of Access and Family Systems Theory were used in this study to explore guardians lived experiences of PBD, its effects on the entire family system, and mental health service treatment. This approach …

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …

Root Cause Analysis To Improve Incident Reporting In An Ambulatory Care Setting, Lisa Ann Duncan

Doctor of Nursing Practice (DNP) Projects

Problem: The subject organization (SO) is a Federally Qualified Health Center (FQHC) with an internally developed incident reporting system. The SO wanted to improve patient and employee safety using data from incident reports, but the incident reporting system did not give enough information to recognize patterns and develop countermeasures.

Context: Supervisors welcomed the opportunity to learn more about incident report follow-up and conducting root cause analysis (RCA). Members of the Safety Committee were eager for data to use to develop countermeasures to improve patient and employee safety. Decreases in employee injuries can save the SO from increases in the …

Letter From The Editors, Administrative Issues Journal Editors

Administrative Issues Journal

No abstract provided.

Examining The Relationship Of Textbooks And Labs On Student Achievement In Eighth Grade Science, Don Jones, Marie-Ann Mundy, Lavonne Fedynich, Anacita Sugalan

Administrative Issues Journal

One of the most important objectives of teachers, parents, school administrators, and students is to improve student scores on standardized tests, such as the State of Texas Assessment for Academic Readiness (STAAR) in eighth-grade science. This quasi-experimental study examined the science achievement scores between schools that used different textbooks and labs when delivering instruction. This study utilized a quantitative approach, using archival data and survey design. Analysis of covariance (ANCOVA) and multiple regression were used to analyze the data while controlling STAAR eighth-grade reading scores to reveal significant differences between classes. The sample and population for this study were predominantly …

State Of Practice In Accessible Instructional Material Policy In Public Post-Secondary Settings, Veronica Mcgowan

Administrative Issues Journal

For many students, easy access to instructional materials is an expectation of course enrollment. However, for students with disabilities, obtaining instructional materials may involve hurdles such as transcription, captioning, and requesting a braille or large-print version. In order to explore themes related to accessibility and services for students with disabilities, the goal of this study was to examine the similarities and differences between publicly communicated policies related to accessible instructional materials in public post-secondary educational settings. To that end, this study consists of website-provided accessible instructional materials policy of 60 higher educational institutions, representing five American geographic areas and four …

The Relationship Between Admission Criteria And Pre-Service Teacher Preparedness For A Small Rural Educator Preparation Provider, Gerald Mihelic, Chancey Bosch, Kim Boyd, Mary Lou Miller

Administrative Issues Journal

Pre-service teacher preparedness is a measurement of a teacher candidate’s ability to become an effective teacher (Clark, Byrnes, & Sudweeks, 2015). A growing number of Educator Preparation Providers’ (EPPs’) accrediting agencies are insisting that to improve pre-service teacher preparedness, EPPs must increase the rigor of their admission criteria. However, the research is inconclusive regarding whether a relationship exists between admission criteria and pre-service teacher preparedness. Therefore, the purpose of this study was to investigate the relationship between the Educator Preparation Provider’s (EPP’s) current teacher education program admission criteria and pre-service teacher preparedness measurements to determine if the EPP should increase …

Universities Can Learn Too: Extracting The Value Stram From Small-Dollar Transactions, Richard J. Palmer, Mahendra Gupta, James Brandt

Administrative Issues Journal

Based on survey responses of 350 colleges and universities in North America in 2017, we find that the majority of benefits from purchasing card use are falling to a minority of card-using educational institutions. This study examines the extent to which p-card programs at colleges and universities in North America “fail to launch,” and presents an outline for program selfassessment, identifies common obstacles in implementing a successful p-card program, and provides a roadmap to rehabilitate a languishing p-card program.

Overcoming Employer Perceptions Of Online Accounting Education With Knowledge, Rhonda J. Richards, Robert Stevens, Lawrence Silver, Stephanie Metts

Administrative Issues Journal

Accounting education is moving toward an online learning environment. While many universities teach in the face-to-face environment, or at least offer that option, there are also many universities offering online accounting education. Attitudes and intentions of potential employers of accounting students need to be understood by academics as well as by university students. Accreditation and training can play a key role in effective online accounting education. The purpose of this study was to identify and examine factors that have a significant impact on employer perceptions of online accounting education. A survey was developed from literature review and interviews and then …