Medical Humanities Commons^™

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

Hospice Performance: Environmental And Organizational Correlates, Mengying He

All ETDs from UAB

The purpose of this dissertation is to explore hospice performance using a three paper format. Based on Structure-Conduct-Performance (SCP) and Structure-Process-Outcome (SPO) models, paper 1 conducts a systematic literature review to identify gaps in hospice performance research. Paper 2 explores the relationship between hospice market structure and inpatient services provision (Structure-Conduct). Market munificence is related to hospice inpatient services offering. Organizational factors such as hospice chain-affiliation, age, and ownership also play roles in predicting hospices’ probability in providing inpatient services. Paper 3 examines the impact of hospice inpatient service provision on service utilization and financial performance (Structure-Process-Outcome). Hospices that not …

Improving The Health Of African Americans In The Usa: An Overdue Opportunity For Social Justice, Allan S. Noonan, Hector Eduardo Velasco-Mondragon, Fernando A. Wagner

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Using a modified social ecological model, we conducted a review of the literature and nationwide statistics on African American health. We discuss the main social determinants of health and main health disparities, risk factors, the leading causes of morbidity and mortality, and access to health services for blacks in the USA. The mechanisms through which social determinants, including racism, exert their deleterious effects on black health are discussed at the macro and individual levels. Incarceration and mental health care issues are highlighted as priorities to be addressed. African Americans remain the least healthy ethnic group in the USA, a somber …

The Physician’S Perspective On The Impact Of Interpretive Services On The Physician- Patient Relationship, Amrita Pandey

Williams Honors College, Honors Research Projects

The basis of the physician-patient relationship relies heavily on communication. It has been known that conversation between physician and patient is important in both diagnosing and providing therapeutic support. However, according to the US Census Bureau twenty percent of the US population does not use English as their first language. These residents face language barriers on a daily basis, including when they are being treated medically. The aim of this study was to research the physician’s perspective on the use of interpretive services and how it impacts the physician- patient relationship. The research consisted of surveying physicians who encounter patients …

Heath And The Homeless Population Of Missoula: “Housing First” As A Solution, Marissa S. Ginnett

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Missoula, Montana has an extremely high rate of homelessness at .75% of the population (compared to other large cities, Seattle, Washington at .23% and Los Angeles, California at .32%). This is due to there not being much done to help chronically inebriated homeless individuals. All are turned away from Missoula's overnight shelters if they are not sober. For an inebriated homeless person, the jail and the hospital are the only two places where they can stay the night. Through comparison to other cities, such as Seattle, Washington, I have identified that Missoula needs a wet housing program. Wet housing provides …

Understanding Cultural Health Beliefs And Practices In Ghana, Africa, Jamie Wossilek, Rachel Patterson

Williams Honors College, Honors Research Projects

Abstract

Purpose. The purpose of this study is to explore the experiences and perceptions of university students and faculty after going on a medical mission trip to Ghana, Africa related to the health and illness beliefs of the Ghanaian people.

Background. Many organizations plan and conduct health mission trips. Although, many organizations are focused on improving health in developing countries, some may not understand cultural values and the health problems in those countries. “Improving health” is a complicated problem in developing countries and is hard to understand how those in the countries recognize health and illness.

Methodology. A purposeful, convenience …

Distributed Cognition In Cancer Treatment Decision Making: An Application Of The Decide Decision-Making Styles Typology, Janice L. Krieger, Jessica L. Krok-Schoen, Phokeng M. Dailey, Angela L. Palmer-Wackerly, Nancy Schoenberg, Electra D. Paskett, Mark Dignan

Department of Communication Studies: Faculty Publications

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript …

Decline In Ethical Concerns About Reproductive Technologies Among A Representative Sample Of Us Women, Arthur L. Greil, Kathleen S. Slauson-Blevins, Karina M. Shreffler, Katherine M. Johnson, Michele Lowry, Andrea R. Burch, Julia Mcquillan

Department of Sociology: Faculty Publications

Public awareness and utilization of assisted reproductive technology has been increasing, but little is known about changes in ethical concerns over time. The National Survey of Fertility Barriers, a national, probability-based sample of US women, asked 2031 women the same set of questions about ethical concerns regarding six reproductive technologies on two separate occasions approximately 3 years apart. At Wave 1 (2004–2007), women had more concerns about treatments entailing the involvement of a third party than about treatments that did not. Ethical concerns declined between Wave 1 and Wave 2, but they declined faster for treatments entailing the involvement of …

The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen

All ETDs from UAB

This study examined the potential relationship between interdepartmental transfers and perceptions of adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publically reported comparative data tool measuring hospital patient experiences. As consumers, patients are more informed about their own health and are challenging the quality and service of care provided by hospitals. The value-based purchasing reimbursement model has become a new challenge for hospitals. Historically, hospitals were reimbursed through a volume driven model. Comparatively, the value-based model focuses on …

Examining The Impact Of Emergency Department (Ed) Registered Nurse (Rn) Staffing On Ed Patient Experience, Deana L. Nelson

All ETDs from UAB

EXAMINING THE IMPACT OF EMERGENCY DEPARTMENT (ED) REGISTERED NURSE (RN) STAFFING ON ED PATIENT EXPERIENCE DEANA NELSON DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT Patient experience ratings are important to healthcare organizations from both a clinical and financial perspective. Studies examining the relationship between patient experience and nurse staffing are prevalent in the inpatient setting, but not as much is known about how staffing affects these ratings in the Emergency Department (ED). This study examined the relationships between ED RN staffing, patient expectations and patient experience ratings, using a conceptual framework adapted from Donabedian’s structure/process/outcome model, and expectancy disconfirmation …

Hospital-Physician Vertical Integration: The Effect Of Integration On Cardiology Compensation And Clinical Productivity, Vance Mcleod Chunn

All ETDs from UAB

HC2.

Cultural Competence Practices Implemented In Hospitals And Health Systems By Minority Executives On The Top Management Team, John H. Cunningham

All ETDs from UAB

The study examined whether hospital implementation of cultural competence practices was influenced by the racial/ethnic composition of top management. With one-third of the U.S. population identifying with a racial or ethnic group other than non-Hispanic White, and that population continuing to grow increasingly diverse, racial and ethnic minorities are increasingly accessing health care services. Yet they represent less than 1% of the top management teams (TMT) of health care organizations. The study sought to determine the extent to which health care organizations with TMTs that are representative of the racial and ethnic compositions of the communities in which they serve …

Pay For Performance In Dentistry: Is It Worth It?, Andreea Voinea-Griffin

All ETDs from UAB

Introduction: The variability of dental care and the slow implementation of evidence-based dentistry point to the need for change. Pay for performance (P4P) programs may foster quality improvement if appropriately designed. This work demonstrates the use of modeling and simulation to evaluate such programs prior to deployment. An example is provided in the form of a P4P program for the treatment of occlusal early caries (EC) in permanent teeth. Research Design: The proposed P4P program evaluation consists of two steps. First step is to determine the optimal treatment. In this example, three non-invasive treatments (NTs), watchful-waiting (WW), sealants, and fluoride …

Hospital Vertical Integration Into Sub-Acute Care Services, Carolyn Tory Harper Hogan

All ETDs from UAB

The purpose of this dissertation was to examine the antecedents and outcomes of hospital vertical integration into Sub-Acute Care (SAC). Using a sequential quanqual mixed methods design, we examined why hospitals adopt a vertical integration strategy and the relationship this strategy has to performance. Findings from this dissertation are important to hospital administrators as they seek to find ways to respond to the changing payment structures established during the Affordable Care Act. The results of this dissertation suggest that not all market and organizational factors are associated with vertical integration strategies toward SAC. They also suggest that vertical integration into …

The Role Of Ppar-Delta In Regulating Cardiomyocyte Proliferation And Angiogenesis In Post-Myocardial Infarction Adult Heart, Yishu Ding

All ETDs from UAB

immediately before, soon after, and one month after intervention. Average daily calcium

The Relationships Between Patient Satisfaction, Market Share, And Hospital Financial Performance, David W. Au

All ETDs from UAB

Quantitative scores enumerating patient experience with care have been introduced to healthcare via the Patient Protection and Affordable Care Act of 2010. Consumers can now compare with relative ease, different healthcare providers on the basis of standardized metrics. As government mandated transparency initiatives become commonplace as a result of the law, hospitals are more cognizant of how patient experience with care (operationalized using Hospital Consumer Assessment of Healthcare Providers and Systems: HCAHPS) has an impact on where patients decide to seek treatment. The proliferation of technological tools now enables patients to make meaningful quality and cost comparisons across providers. HCAHPS …

How Well Do Hospitals Budget Operating Results? The Relationship Between Budget Variances And Operating Margin, Mark F. Slyter

All ETDs from UAB

There is a near-universal assumption in both practice and literature that greater accuracy and management to the budget improves profitability (Libby & Lindsay, 2010; Umapathy, 1987). Prior to this study, this assumption has gone untested and we know little about the wisdom of such an assumption. The results of this study indicate greater accuracy in forecasting and/or tighter management to the budget, or favorably exceeding it, leads to improved profitability. More specifically, smaller unfavorable budget variances are associated with greater operating margins while greater favorable budget variances are associated with greater operating margins. A single standard deviation reduction in unfavorable …

Administrative Challenges In Pediatric Long-Term Care, Holly Elaine Jarek

All ETDs from UAB

ABSTRACT This research used a Delphi methodology to solicit challenges that significantly impact the operational success of pediatric long-term care facilities. Further, this study sought to understand the ability of pediatrics administrators to impact, affect, overcome, or resolve these challenges. Round 1 accomplished the desired goal of eliciting a substantial amount of new qualitative information regarding administrative challenges in pediatric long-term care, which previously had been extant in the literature. In Round 2, data were distilled into categories and unique exemplars which in turn were validated by participants. In Round 3, administrators ranked and rated categories and individual challenges in …

Socioeconomic Factors Associated With Cataract-Related Blindness Treatment In Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur 4198353

Undergraduate Research Posters

Despite efforts of Vision 2020 in India, the Andhra Pradesh Eye Disease Study (APEDS) extrapolated, in 2000, approximately 18.7 million blind people in India and also, projected an increase to 31.6 million blind people by 2020. Within the state Andhra Pradesh itself, preventable corneal blindness increased to 1.84% from 1.5% in the late 1980s.

Numerous public health studies have been conducted to outline factors that cause and preclude treatment of avoidable corneal blindness in the India. Conclusively, the escalation of corneal blindness can be largely attributed to personal, social, and economic barriers in utilizing available eye-care services. However, due to …

Patient Engagement Functionalities Facilitated By Health Information Technology: An Examination Of The Adoption Rate And Financial Performance Among U.S. Hospitals, Oghale Elijah Asagbra

All ETDs from UAB

The Centers for Medicare and Medicaid (CMS) meaningful use requirement, as well as documented evidence suggest that health information technology (HIT) has the potential to promote patient engagement and consequently improve quality and reduce cost. This prompts a better understanding of hospital adoption of HIT for patient engagement. The purpose of the three papers presented in this dissertation is to examine hospital adoption of health information technology (HIT) to facilitate patient engagement. Emphasis is placed on the functionalities (i.e., functions or capabilities) offered by these technologies that have been determined to allow patients be more involved in their care because …