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Articles 1 - 30 of 40
Full-Text Articles in Social and Behavioral Sciences
Implementing Universal Health Insurance: Case Study Of Stakeholders' Perspectives In Port Said, Egypt, Rana Hetta
Implementing Universal Health Insurance: Case Study Of Stakeholders' Perspectives In Port Said, Egypt, Rana Hetta
Theses and Dissertations
This research delves into the multifaceted dimensions of healthcare access through the lens of stakeholders in Port Said, Egypt, following the implementation of Universal Health Insurance (UHI) policies. The central research question explores the impact of UHI policies on healthcare access in Port Said. A set of investigative questions guides this exploration, focusing on beneficiary experiences, healthcare staff perspectives, and the alignment of UHI system implementation with beneficiaries’ healthcare needs. This study seeks to comprehend the institutional and policy context of UHI in Egypt, providing insights from policymakers, healthcare workers, and beneficiaries. Port Said serves as a case study, given …
Budget Capping Health Care: Its Impact On Health, Susan Chen
Budget Capping Health Care: Its Impact On Health, Susan Chen
Theses and Dissertations
The goal of a budget cap on healthcare is to constrain total healthcare expenditure without compromising quality. This paper examines the impacts of budget capping on health and behavioral health outcomes, exploiting the completed Maryland All-Payer Model and the ongoing, extensional Maryland Total Cost of Care model, both of which capped healthcare budgets in Maryland. I use data from 2011-2021 surveys of the Behavioral Risk Factor Surveillance system and generalized difference-in-difference regression models to find that budget capping improves health and behavioral health outcomes with a greater favorable effect during the Maryland Total Cost of Care model.
Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau
Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau
Theses and Dissertations
Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …
Historical Trauma: Literary And Testimonial Responses To Hiroshima, Mariam Ghonim
Historical Trauma: Literary And Testimonial Responses To Hiroshima, Mariam Ghonim
Theses and Dissertations
The concept of trauma is controversial in literature. While one may be able to come up with ways to describe trauma in fiction, representing historical trauma is a hard task for writers. Some argue that trauma can not be described through those who did not experience it, while others claim that, provided some elements are added, one can represent trauma to the reader. This thesis focuses on twentieth-century historical traumas related to a nuclear catastrophe and explores the different literary and testimonial responses to the catastrophic man-made event of Hiroshima (1945). In this thesis, Kathleen Burkinshaw’s historical fiction The Last …
Investigating The Feasibility Of Creating A Disease Registry In Egypt: A Case Study Of Dementia, Shimaa Adel Heikal
Investigating The Feasibility Of Creating A Disease Registry In Egypt: A Case Study Of Dementia, Shimaa Adel Heikal
Theses and Dissertations
The increased interest in evidence-based medicine led to the emergence of disease registries worldwide to help tackle the impact of chronic diseases by providing accurate data on several aspects of the disease care process. Age-associated diseases, particularly dementia, are growing worldwide with several implications and increased economic burden, especially in lower-income countries. In Egypt, there is a lack of accurate dementia prevalence and statistics data which hinders the establishment of appropriate disease management and care strategies. A national dementia registry would provide a massive valuable source of patient data that will significantly advance the disease management strategies and quality of …
Impact Of Social Media On Public Perception Of Government Covid-19 Response Efforts, Taher Taher
Impact Of Social Media On Public Perception Of Government Covid-19 Response Efforts, Taher Taher
Theses and Dissertations
This research aims to understand this phenomenon to provide insights into how governments can perform better in times of crisis regarding social media and its impact on public opinion. This research aims to understand how social media impacts public perception of government COVID-19 response efforts by studying Facebook comments, likes, and reactions (emoticons).
The study was based on data gathered from Facebook comments on the daily infographic COVID-19 statistics from the official site of the Ministry of Health and Population. The sampling frame is the 52 weeks of 2020, January to December, through random sampling resulting in 546 comments. The …
Motivations And Conflicts In Prison Medical Contracting, Meagan D. Sok
Motivations And Conflicts In Prison Medical Contracting, Meagan D. Sok
Theses and Dissertations
State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical
State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical program. Literature indicates that many of these contracts experience significant issues that negatively impact state resources, including both personnel and money.
This dissertation explores the relationship between prison administrators' motivations and the structure, outcomes, efficiencies, and partner conflicts that arise in the contractual process. Using a framework developed from Incomplete Contract Theory, Contracts as Reference Points Theory and the concept of “essential tension,” this dissertation hypothesizes …
Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason
Theses and Dissertations
Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …
Do Coverage Expansion And Patient-Centeredness Care Delivery Improve Patient Health Outcomes And Care Quality?, Shiva Salehian
Do Coverage Expansion And Patient-Centeredness Care Delivery Improve Patient Health Outcomes And Care Quality?, Shiva Salehian
Theses and Dissertations
Although correlated, improvement of patient health outcomes and quality of care is a result of health care delivery, performance, and healthcare policies that intend to impact health outcomes (Porter, 2010; AHRQ, 2015). This dissertation focuses on a special model of care delivery (Patient-Centered Medical Homes (PCMH)) and two programs (Addiction and Recovery Treatment Services (ARTS) and Medicaid expansion) to examine the correlation and impact of these programs on cardiovascular-related preventive care, healthcare expenditures, and health behavior hospitalizations as patient outcomes.
Academic Health Science Centers And Health Disparities: A Qualitative Review Of The Intervening Role Of The Electronic Health Record And Social Determinants Of Health, Wies Rafi
Theses and Dissertations
Literature on the magnitude of negative health outcomes from health disparities is voluminous. Defined as the health effects of racism, environmental injustice, forms of discrimination, biases in science, and sociological or socioeconomic predictors across populations, health disparities are part of an ongoing and complicated national problem that health equity programs are specifically designed to address. Academic Health Science Centers (AHC) institutions are a complex and unique educational-healthcare ecosystem that often serves as a safety net for patients in vulnerable and lower-income communities. These institutions are often viewed as one of the most uniquely positioned entities in the U.S. with an …
Tummy Time In Infancy: Real-World Assessments And Associations With Developmental Outcomes In Early Childhood, Ketaki Inamdar
Tummy Time In Infancy: Real-World Assessments And Associations With Developmental Outcomes In Early Childhood, Ketaki Inamdar
Theses and Dissertations
Tummy time or awake, supervised, prone play is an important developmental play position in infancy. Engaging in more than 15 minutes of tummy time per day is associated with a lower risk of plagiocephaly, lower body mass index, and achievement of higher motor scores in full-term and at-risk preterm infants. However, there are significant gaps in the measurement of tummy time in current literature. Conventionally used subjective parent reports have not been validated against gold standard direct observation, and the feasibility and real-world validity of objective solutions such as wearable sensors has not been examined in full-term and at-risk preterm …
Access To Behavioral Health Services: Supply, Coverage, And Health Insurance Literacy, Heather Saunders
Access To Behavioral Health Services: Supply, Coverage, And Health Insurance Literacy, Heather Saunders
Theses and Dissertations
This dissertation examines policy and individual barriers to behavioral health (BH) service utilization. The full reach of federal policies like the Affordable Care Act (ACA) and the Comprehensive Addiction and Recovery Act (CARA) may be limited by state policies and the supply of the workforce available to deliver these services. Further, individual factors, such as low health insurance literacy, may influence patterns of behavioral healthcare utilization. Despite efforts to increase access to behavioral health services, treatment rates remain low, suggesting that barriers remain. To explore the effectiveness of these policies and examine remaining barriers, this dissertation explores three main research …
Preventing Obesity: A Social Ecological Exploration Of Centers For Disease Control Prevention Strategies And Guidance Toward Healthy Eating, Physical Activity, And Communities, Ryan Kelly
Theses and Dissertations
Abstract
Obesity has reached nearly 40% of the adult public in the United States, costing the citizen taxpayer over $200 billion annually in healthcare costs. Those suffering from obesity deal with multiple physical and mental repercussions. Through a content analysis of four Centers for Disease Control (CDC) documents and guided by the conceptual framework of the social ecological model, this research explores the federal approach to preventing obesity. The analysis finds that CDC solutions to obesity involve connecting people to each other and healthier choices, an orientation toward local public administration, and an emphasis on environmental and infrastructure improvements. The …
“Insurance Doesn’T Care About The Patient”: An Institutional Ethnography Of The Influence Of Professional Autonomy On The Provision Care For Medicaid Dental Patients With Disabilities, Stephanie Lau
Theses and Dissertations
In terms of unmet needs for people with disabilities (PWD), dental care is number three behind residential care and employment (Fisher, 2012). Regardless of disability, oral healthcare traverses all disability diagnoses and can be a significant factor in quality of life (Deckler, 2011; Griffin et al., 2007; Norwood & Slayton, 2013). When attempting to secure oral healthcare, people with disabilities face many challenges, including lack of access, lack of provider education on proper care of PWD, and difficulty finding a willing dental provider (Deckler, 2011; Fisher, 2012; Kennedy, 2009).
The purpose of this study was to investigate professional practices and …
Associations Between Social Determinants Of Health And Chlamydia Infections Among Georgia Counties, Bre'auna K. Beasley
Associations Between Social Determinants Of Health And Chlamydia Infections Among Georgia Counties, Bre'auna K. Beasley
Theses and Dissertations
Chlamydia is a growing public health concern that disproportionately impacts southern states. While social determinants of health are not direct causes of chlamydia infections, studies have found that these determinants do influence infections by creating environments that promote or hinder health seeking behaviors, as well as exposure to risk factors. Guided by the Social Ecological Model of Public Health and the Healthy People 2030 Social Determinants of Health Conceptual Framework, this dissertation study aimed to examine the associations between social determinants of health and chlamydia infections among Georgia counties. This study employed a correlational research design. Aggregate-level secondary data for …
Cost-Effectiveness Of Interventions Targeting Hard-To-Reach Populations Living With Hiv In Eastern And Southern Africa, Deo Mujwara
Theses and Dissertations
In Eastern and Southern Africa, hard-to-reach populations (e.g., long distance truck drivers and female sex workers), defined as populations that are difficult to interact or engage with due to their unique behaviors and characteristics, are disproportionately affected by the HIV epidemic and are at high-risk of acquiring and transmitting HIV. Further, these populations have substantially low uptake of HIV testing services, and those that have been diagnosed with HIV and on antiretroviral therapy experience high loss-to-follow-up from treatment programs.
Hard-to-reach populations face unique barriers in accessing and utilizing routine HIV care such as provider stigmatization towards sex workers and highly …
Homeless With Breast Cancer On Skid Row, Los Angeles: A Review Of Services For Women, Eva Dittrich
Homeless With Breast Cancer On Skid Row, Los Angeles: A Review Of Services For Women, Eva Dittrich
Theses and Dissertations
This study reviews the literature on breast cancer in general and narrows to within the context of the homeless population of Skid Row, Los Angeles, positing that the experience of breast cancer while homeless is a compounded traumatic experience with complex and numerous practical challenges. It poses the following question: What services are available to homeless women on Skid Row, Los Angeles, the information about which can be found online? Which and how many services are dedicated to breast cancer screenings and treatment? Are other types of cancer screening and treatment services advertised on the included service organizations' websites? A …
The Effect Of Citi Bike Introduction On Injury Rates In New York City, Masakazu Hiruma
The Effect Of Citi Bike Introduction On Injury Rates In New York City, Masakazu Hiruma
Theses and Dissertations
This paper tests the hypothesis that the introduction of Citi Bike influences bicycle injuries by observing the gradual expansion of the bike share system in NYC. Data is analyzed from 2012-2018 New York Police Department (NYPD) Motor Vehicle Collisions and Citi Bike Station Feeds (NYC Open Data).
The Association Of Rural Hospital Closures With In-Hospital And 30-Day Post Hospital Discharge Mortality From Emergency Care Sensitive Conditions, Melinda A. Merrell
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 …
The Effect Of Change In Medi-Cal Dental Coverage On Dental Care Utilization Among Medi-Cal Beneficiaries, Min H. Zhang
The Effect Of Change In Medi-Cal Dental Coverage On Dental Care Utilization Among Medi-Cal Beneficiaries, Min H. Zhang
Theses and Dissertations
One of the most important factors in accessing dental care is having dental insurance. For people with low incomes, Medicaid is the main source of health insurance. Medi-Cal is California’s Medicaid program. Adult dental services were mostly eliminated in Medi-Cal in 2009 due to the economic downturn and partially restored in 2014. The objective of this study is to evaluate the effect of change in Medi-Cal dental coverage, specifically the partial restoration of adult dental coverage in 2014, on dental care utilization among Medi-Cal beneficiaries. The partial restoration significantly increased the utilization rates in dental clinics from 2014 to 2017 …
Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker
Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker
Theses and Dissertations
Provider incentives are a commonly used policy tool to mold provider behaviors.1 However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.
Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …
How Do Health System Employees With Established Musculoskeletal Complaints Decide On Their Treatment Pathway? A Qualitative Approach, Noor Alshareef
How Do Health System Employees With Established Musculoskeletal Complaints Decide On Their Treatment Pathway? A Qualitative Approach, Noor Alshareef
Theses and Dissertations
Purpose: Non-pharmacologic treatment such as physical therapy (PT) are advocated for musculoskeletal pain for decreasing opioid use. Early access to PT has been shown to decrease costs and improve outcomes through direct access via self-referral. Although self-referral to PT is permitted in the majority of U.S states, health insurance coverage has been identified as a barrier preventing some patients with musculoskeletal complaints from using it. There are few studies examining patient factors related to early access to physical therapy via self-referral. The purpose of this study was to identify the factors outside of insurance that influence the choice to access …
Introduction Of Innovative Medical Practices In Mayo Clinic: Effect Of The Interventions On Patient Outcomes, Duaa I. Aljabri
Introduction Of Innovative Medical Practices In Mayo Clinic: Effect Of The Interventions On Patient Outcomes, Duaa I. Aljabri
Theses and Dissertations
Purpose: Assessment of health technologies in medical practice is an ongoing process to provide clinicians and policymakers with information on the value of those applications. This dissertation aims to add to the existing body of literature and fill the gaps in prior studies by assessing two health technologies in Mayo Clinic Florida (MCF). The first paper provides an assessment of patient portal adoption and activity during hospitalization among cancer patients, and determines whether a portal application is associated with selected indices of patient safety, utilization and satisfaction. The second paper provides an assessment of a new approach in pain …
Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris
Theses and Dissertations
Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …
Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun
Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun
Theses and Dissertations
Objective: To examine spillovers from a federal policy, managed care market, and community perspective.
Data Sources/Study Setting: We studied spillovers from a federal policy and managed care market perspective using the Health Care Utilization Project’s (HCUP) State Inpatient Database (SID). American Hospital Association (AHA) data, Interstudy Commercial Managed Care, and Area Health Resource File (AHRF). Medicare Advantage county-level payment schedules originate from CMS. We examined community uninsurance spillovers using 2011-2015 Medical Expenditure Panel Survey (MEPS), the Area Health Resource File (AHRF), and the Small Area Health Insurance Estimator (SAHIE).
Study Design: Ordinary Least Squares (OLS) and difference-in-difference regression analyses were …
A Study On Satisfaction Of Dental Implant Patients, Jung Su O
A Study On Satisfaction Of Dental Implant Patients, Jung Su O
Theses and Dissertations
The implant has been around for half a century. It started in Sweden in the 1960s and is now being actively practiced all over the world. It is important to investigate what constitutes a standard for a consumer of medical services in selecting a dentist to receive implants. A great number of dentists and research organizations have published research papers on theory and techniques of implants as well as their strengths and weaknesses. However, researches on reality and satisfaction rate of patients are still very rare.
The purpose of this study was to identify how to improve satisfaction of patients …
The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente
The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente
Theses and Dissertations
This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.
Economic Burden Of Tuberculosis Among Bangladeshi Population And Economic Evaluation Of The Current Approaches Of Tuberculosis Control In Bangladesh, Mohammad Rifat Haider
Economic Burden Of Tuberculosis Among Bangladeshi Population And Economic Evaluation Of The Current Approaches Of Tuberculosis Control In Bangladesh, Mohammad Rifat Haider
Theses and Dissertations
Introduction: Tuberculosis (TB) is major scourge for human history and causes profound economic burden. Bangladesh is a high burden TB country with 12% of its annual death is caused and 362 thousand people are infected by TB. DS-TB is the most prominent type of TB found in Bangladesh and a 6 month drug regimen (2 month intensive and 4 month continuation phase) is followed. But the directly observed treatment short-course (DOTS) differ in delivery through community health workers (CHW) and community members (CM). Bangladesh has also experienced surge in the number of MDR-TB cases with a 29% of MDR-TB cases …
Depressive Symptoms Association With Health Outcomes And Treatment In Older Americans With Diabetes, Lashonda Jovon Williams
Depressive Symptoms Association With Health Outcomes And Treatment In Older Americans With Diabetes, Lashonda Jovon Williams
Theses and Dissertations
Introduction: Diabetes remains the 7th leading cause of death in the United States. Diabetes is a major public health concern of its own, but when you add the comorbidity of depression, diabetes outcomes are amplified. This dissertation examines how depressive symptomatology and treatment for depression are associated with selfreported health (SRH) and diabetes control.
Methods: Chi-square and logistic regression were used to analyze data from the Health and Retirement Study (2012). We assessed the associations between SRH and diabetes control with depressive symptomatology data.
Results: In our sample (n=4374), 19% of respondents reported high depressive symptomatology and …
Feasibility Of Introducing Investor-Owned Hospitals In Korea, Hongseok Seo
Feasibility Of Introducing Investor-Owned Hospitals In Korea, Hongseok Seo
Theses and Dissertations
Since 2002, there has been active debate regarding the introduction of for-profit hospitals in South Korea: the advocates highlight the multiplication of economic value after the introduction of for-profit hospitals, whereas the opponents voice their concern about the possible negative consequences for-profit entities can create within the health care system. Various stakeholders including doctors’ associations, hospital associations, and civic groups have been for or against the introduction of for-profit hospitals, according to their interests. The government has tried to develop the national health and medicine system based on the positive and negative impacts of their introduction. In December, 2015, the …