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Full-Text Articles in Public Policy

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow Jan 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …


Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice Jan 2023

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …


Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow Jan 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …


Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer Jan 2022

Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer

Walden Dissertations and Doctoral Studies

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …


Retrospective And Forecasting Analysis Of Increased Long Term Care Demand In Niagara, Breanne Alissa Hines Jan 2021

Retrospective And Forecasting Analysis Of Increased Long Term Care Demand In Niagara, Breanne Alissa Hines

Walden Dissertations and Doctoral Studies

A problem exists within the Canadian healthcare system as many patients experience longer lengths of stay (LOS) in acute care (AC) and complex care (CC) beds within hospitals because of a lack of long term care (LTC) facilities. The purpose of this study was to evaluate the extra days patients wait for placement and assess the benefits of increasing the number of LTC beds. The theoretical framework used was the four-level model of the health care system. Research questions involved 2017-2019 data for the number of LTC beds required to eliminate waits and evaluate beds needed in the future. This …


The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager Jan 2021

The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager

Walden Dissertations and Doctoral Studies

Preventive health care screening plays an essential role in reducing chronic diseases and mortality rates; yet, even as health care access has increased, African American men’s utilization of preventive screenings remains low in rural areas. The purpose of this qualitative case study was to investigate why African American men are not utilizing preventive care services and ascertaining the impact that social determinants may have on their utilization of these services. The theoretical framework of this research study comprised the social-ecological modal and health belief model to investigate the barriers to preventive care utilization in the African American community. Twelve African …


Evidence-Informed Health Care Transition Policy In California’S Title V Programs For Medical Complexity, Anthony Pallitto Jan 2021

Evidence-Informed Health Care Transition Policy In California’S Title V Programs For Medical Complexity, Anthony Pallitto

Walden Dissertations and Doctoral Studies

Inadequate health care transition policy continues to cause interruptions or setbacks in the continuity of medical care and lapses in health insurance coverage for adolescents in California's Title V programs for individuals with medically complex cases. Yet, there is a paucity of empirical health care transition research to develop an effective health care transition policy for children with medical complexity who are enrolled in California’s Title V program. The purpose of this explanatory case study was to explore the potentiality of translating evidence from a quasi-experimental health care transition primary research project into evidence-informed health care transition policy. The research …


Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson Jan 2020

Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson

Walden Dissertations and Doctoral Studies

In response to healthcare payment policy reforms, billions of dollars in healthcare provider charges are challenged annually. Following the implementation of the Virginia workers’ compensation medical fee legislation, healthcare organizations experienced declining worker compensation medical fee schedule reimbursements and lack of profitability. Grounded in the adaptive cycle model, the purpose of this qualitative single case study was to explore strategies 2 urgent care center (UCC) leaders in Virginia used to increase profits after implementing the Virginia workers’ compensation medical fee legislation. Data were collected via in-depth interviews and a review of company documents. Thematic analysis was used to analyze data. …


Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera Jan 2019

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 …


Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy Jan 2019

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 …


Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble Jan 2019

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 …


An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon Jan 2019

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 …


Evaluating The Impact Of Integrated Care On Service Utilization In Serious Mental Illness, Heidi C. Waters Jan 2017

Evaluating The Impact Of Integrated Care On Service Utilization In Serious Mental Illness, Heidi C. Waters

Walden Dissertations and Doctoral Studies

Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality. Use of high-cost healthcare services is common, including hospitalizations and emergency department (ED) visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study addressed the impact of integrated care on physical health and ambulatory care sensitive (ACS) utilization via a program evaluation of an integrated health clinic (IHC) at a community mental health center (CMHC). The research questions assessed whether there was a predictive relationship between …


Researchers', Stakeholders', And Investors' Perceptions Of U.S. Stem Cell Research Policy, Dorothy King-Moore Jan 2017

Researchers', Stakeholders', And Investors' Perceptions Of U.S. Stem Cell Research Policy, Dorothy King-Moore

Walden Dissertations and Doctoral Studies

Federal support and funding for human embryonic stem cell (hESC) research in the United States lags behind stem cell programs in many countries because of the divisive debate over hESC research and the continually evolving federal policies that have hindered research efforts. The purpose of this phenomenological study was to explore the perceptions of stem cell researchers, stakeholders, and investors in the United States about the effects of the current federal stem cell policy on stem cell research in the United States, the moral disagreement with stem cell research, and their recommendations to improve stem cell research policy in the …


Policing The Mentally Ill In Coronado, Ca, Jennifer Susan Ayres Jan 2017

Policing The Mentally Ill In Coronado, Ca, Jennifer Susan Ayres

Walden Dissertations and Doctoral Studies

The growing number of individuals suffering from mental illnesses and their inability to access intervention methods has adverse effects on the criminal justice system. These impairments increase the likelihood that police officers will have negative attitudes about persons with mental illnesses. This study sought to understand whether police officers' empathy, education, experience outside of work as well as on the job, and officers' training in the field of mental health all related to police officers' attitudes relating to persons with mental illness. The purpose of this study was to expand the body of knowledge and determine how factors such as …


Relationship Between Health Care Costs And Type Of Insurance, Macey Buker Jan 2017

Relationship Between Health Care Costs And Type Of Insurance, Macey Buker

Walden Dissertations and Doctoral Studies

Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way …


Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant Jan 2017

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …


Perceived Effects Of The Affordable Care Act On Emergency Preparedness, Tanya Marie Scherr Jan 2016

Perceived Effects Of The Affordable Care Act On Emergency Preparedness, Tanya Marie Scherr

Walden Dissertations and Doctoral Studies

National healthcare as executed through the Patient Protection and Affordable Care Act (ACA) was introduced in 2010, but was discussed for several decades prior to its enactment. Section 5210 of the ACA established funding for a Regular and Ready Reserve Corps (RRRC) to provide support to local healthcare entities with emergency preparedness. It is unknown what impact Section 5210 of the ACA has had on local emergency preparedness, as well as what obstacles are encountered with implementing this piece of legislation at the local level. The purpose of this case study was to understand the obstacles encountered at a local …


Alignment Of Standards, Assessment, And Compliance For A Residential Support Provider Organization, Monique Day Jan 2016

Alignment Of Standards, Assessment, And Compliance For A Residential Support Provider Organization, Monique Day

Walden Dissertations and Doctoral Studies

Although Code of Maryland policy mandates multidisciplinary, integrated teams for residential service provider organizations (RPOs) for an intellectual/developmental disabilities (IDD) population, alignment criteria to identify and evaluate the functional characteristics of such teams do not exist. This ambiguity has resulted in potential conflict in the goals of service delivery, as well as misaligned quality assessment and policy development criteria. The intent of this general qualitative study was to use complex adaptive systems theory and Vitkiene's work on corporate ethos to determine whether the services provided by a single RPO were consistent and aligned with the regulatory mandate set by the …


A Comparison Of Regional Health Care Structures For Emergency Preparedness, Leslie Porth Jan 2015

A Comparison Of Regional Health Care Structures For Emergency Preparedness, Leslie Porth

Walden Dissertations and Doctoral Studies

Since 2001, increased policy attention and federal funding mechanisms have required more effective disaster response by government actors and private sector organizations, including the health care system. However, there is limited scholarly evidence documenting which structural elements have been associated with efficacious regional coalitions. This study addressed the gap by examining whether the number of different participating disciplines (a proxy for coalition roles), community setting, and prior weather-related disaster declaration influenced the number of activities (a proxy for coalition responsibilities) conducted by the health care coalition. Social network theory was the theoretical lens with which the study results were used …


Differences Between For-Profit And Nonprofit Hospitals: Perceived Quality And Access, Michael Ray Eiland Jan 2015

Differences Between For-Profit And Nonprofit Hospitals: Perceived Quality And Access, Michael Ray Eiland

Walden Dissertations and Doctoral Studies

Despite a large body of literature addressing the issue, questions remain about whether nonprofit hospitals provide more community benefit than do for-profit hospitals. This lack of information impacts governments, hospitals, and the healthcare industry, as stakeholders attempt to generate requirements to which hospitals should adhere to maintain nonprofit status, and thus tax exemption. This study addressed this lack of information by examining U.S. hospitals through the lens of stewardship theory to determine whether nonprofits are better stewards of the public good than for-profits, and thus likely to provide higher quality and access. The study applied logistic regression to Centers for …


Retaining Behavioral Healthcare Employees Of The Millennial Generation, David W. Gomel Jan 2015

Retaining Behavioral Healthcare Employees Of The Millennial Generation, David W. Gomel

Walden Dissertations and Doctoral Studies

As a result of the passage of the Affordable Care Act, the behavioral healthcare field is experiencing an increased demand for services. This increase is based on the availability of healthcare coverage to an estimated 13.4 million previously uninsured individuals. To meet this demand for treatment, the workforce of behavioral health therapists must grow. The largest generation entering the workforce, the Millennial Generation - those born after 1980 - is believed to lack commitment to their employers, frequently vacating their positions for the next best offer. The purpose of this case study was to determine factors that both affect retention …


The Center For Total Health: Healthcare Reform In Cook County, Illinois, James Leon Miles Jan 2015

The Center For Total Health: Healthcare Reform In Cook County, Illinois, James Leon Miles

Walden Dissertations and Doctoral Studies

The Patient Protection and Affordable Care Act (PPACA) of 2010 requires hospital systems in the United States to shift the culture of patient care from a focus on sick-care to a focus on prevention and wellness care. Little is known about how hospital systems will make this culture shift while retaining quality patient care. The purpose of this case study of a pioneering hospital-based PPACA-compliant initiative was to answer the research question of how Wallace's revitalization movement theory (RMT) "a rapid culture change model"could serve as a transferable evaluation framework for PPACA prevention and wellness care compliance in hospital-based programs. …


Providers' Knowledge Of The U.S. Health Care System And Their Medical Practice Choices: A Study Of Physicians, Residents, And Non-Physician Practitioners, Cora Case Jan 2015

Providers' Knowledge Of The U.S. Health Care System And Their Medical Practice Choices: A Study Of Physicians, Residents, And Non-Physician Practitioners, Cora Case

Walden Dissertations and Doctoral Studies

The expansion of health insurance through health care reform has reduced the number of uninsured. but access to providers has not been addressed. Understanding the relationship between practice choices and aptitude of health policy and delivery is essential to determine other factors or motivators that contribute to the development of health care access policies. This descriptive study explored the value-laden elements of health care reform, such as social constructions, to learn whether there are implicit ways to address the issue of access to health care in the United States. Schneider and Ingrams's conceptualization of policy making through social construction was …


The Role Of Uae Health Professionals In Maternal And Child Health Policy, Immanuel Azaad Moonesar Jan 2015

The Role Of Uae Health Professionals In Maternal And Child Health Policy, Immanuel Azaad Moonesar

Walden Dissertations and Doctoral Studies

Maternal and child health (MCH) mortality is a formidable challenge for health systems around the world according to the World Health Organization. Health professionals and practitioners within the United Arab Emirates were studied to determine the extent they were involved in the policy-making process, and the potential impact that analysis may have on new or revised MCH policies. Research on MCH policy-making and development processes are limited. The Andersen model of healthcare services utilization provides an appropriate framework for this research, enabling the analysis that influences the policy-making process in the area of MCH. Independent variables included nationality, education, work …


The Influence Of Community Support Services In Reducing Potentially Preventable Readmissions, Camille Rose Bash Jan 2011

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 …


Public Sponsored Health Insurance To Improve Health Outcomes With Implications For Government Health Policy, Design, And Decision Making, Steven M. Wagner Jan 2011

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 …