<p> This study was conducted to identify the driving factors that affect primary care utilization. It hypothesizes that the cost of treatment is the driving factor that affects a patient's decision to seek medical care from their primary care physician. Furthermore, it also hypothesizes that the uncomfortable conversation with the physician, the concern of someone else finding out about the patient's personal health problems, and the trouble of making an appointment are three independent factors that do not affect primary care utilization. In order to test these hypotheses, secondary data from the CHIS 2009 was collected and analyzed. Unfortunately, the data sets concerning these three independents variables were not released as they were classified to contain confidential data. As a result, healthcare coverage and emergency care utilization were served as proxy variables and were used instead to determine the factors associated with primary care utilization. Statistical analysis of these proxy variables indicates that primary care utilization is associated with health insurance coverage and emergency care utilization.</p>

<p> The purpose of this study was to examine the relationship between a faith-based initiative and hospital readmissions. The main data source used was the inpatient data-base of Methodist LeBonheur Healthcare System (MLH) in Memphis, TN. Data were collected from admissions that occurred during years 2008 through 2012 at four of MLH's five adult acute-care hospitals. Data from the U.S. Census Bureau's American Community Survey were also used in the study.</p><p> This study uses theoretical tenets from the Social Justice and Equity Theory and the Chronic Care Model as its conceptual framework. The study consisted of an aggregated cross-section data analysis. Univariate, bivariate, and multivariate statistics were calculated using PASW/SPSS statistical software, version 20. The dependent variable was hospital readmission within 30 days of an index admission. The independent variable was CHN member or non-CHN member. Due to the dependent variable being dichotomous, logistic regression was determined to be the most appropriate analysis.</p><p> Key findings in the study indicated that among inpatients admitted for chronic conditions, the likelihood of readmission for CHN members was not significantly different than that of non-CHN members. Secondly, among inpatients admitted for chronic conditions and residing in low socioeconomic neighborhoods, the likelihood of readmis-sion was not significantly different between CHN and non-CHN members. Additional findings indicated that among patients with chronic illnesses, an increase in level of severity of illness contributes significantly to higher odds of readmission. Finally, the study indicated that among the four chronic illnesses identified in the study, CHF has significantly higher odds of being readmitted within 30 days.</p>

The notion of informed consent to medical treatment is a fundamental precept in law. It recognizes autonomy and the right to personal inviolability, irrespective of nationality, socio-economic situation and ideological orientation. A full realization of autonomy in the Nigerian legal system is severely constricted by sociological and cultural factors. Of particular concern is the impact of oppression which may arise from socialization, arbitrary disclosure practice by physicians, or as a result of legislative enactment. To remedy the elemental defects in the Nigerian Code of Medical Ethics, without addressing the impediments posed by the social environment from which a patient operates, will nuance informed consent in Nigerian health care but may not fully realize patient autonomy. A serious commitment to respecting patient autonomy may be realized through a collective effort of the State, the medical profession, the community, and patients in order to remove the impediments to full exercise of autonomy. / The thesis is the first part of a two part plan for operationalizing patient right in Nigeria

No description available.

No description available.

Many western societies place great emphasis on doctor-patient communication as an integral part of health care for patients. However, no substantial research has hitherto been done on doctor-patient communication in Jamaica. Such research is invaluable as cultural expectations may influence medical care and communication, and paradigms of doctor-patient communication in western, industrialized countries may not be generalizable to less industrialized countries like Jamaica. My research therefore sought to ascertain what factors affect the quality of doctor-patient communication in government hospitals in Jamaica, why, and how. / A quantitative survey was done to gather the required data to ascertain what patients and some health care professionals think of doctors' communication and what factors affect this communication. The data was subjected to qualitative analysis, and my discussion addressed the ethical implications of the findings and conceptualized a practical model for doctor-patient communication in government hospitals in Jamaica. I concluded that, perhaps due to the effects of cultural penetration, some Jamaicans have concerns regarding doctor-patient communication in Jamaican government hospitals that are similar to North-American expectations, but propose that, with proportionally far fewer doctors available and different cultural norms, a different model of doctor-patient communication should exist in Jamaica.

<p>HIV/AIDS is a major problem in South Africa with more than 25 percent of the adult population infected with HIV. Oral lesions and various opportunistic infections characterize the progression of HIV making it imperative for people living with HIV to have access to good quality oral care. There is a need to examine accessibility and use of dental services in South Africans living with HIV as very little research in this regard, has been undertaken. Aim: To investigate the barriers to oral health care for people living with HIV in the KZN and the WC. Research Design and Methodology: A cross-sectional study utilising a self-administered questionnaire and semi-structured interviews has been employed. Participants were people living with HIV older than 18 years attending HIV clinics located throughout Kwa-Zulu Natal and WC. Binary logistic regression was performed to determine the variables associated with not obtaining care.</p>

The central aim of this study is to identify and describe the experiences of first time mothers who are underusers of child care clinics. An attempt is made to counterbalance the tendency of researchers in this area to be judgmental of underusers who "neglect" their children, and their own health care needs, -by reporting the mothers' views of the child health services in their own terms. Underusers within a certain Health Authority area were identified using a purposely developed Index of Uptake. The achieved sample of predominantly working class mothers constituted a group of people who are particularly difficult to research. It is believed that success in locating and eliciting evidence from this group was in itself an important contribution to the research literature. In depth interviews were undertaken, and the data analysed in two ways; (1) A Subsample, made up of those having made least use of the services available to them, was analysed interpretively to provide detailed material of an idiographic kind on the lifeworld of the person and the place of medical care within it; (2) All interviews were subjected to content analysis to provide a more general picture of mothers' experiences of health care provision. The main findings include the following; (1) The particular population studied had a generally low level of visage as assessed by the index, but use of specifically medical provision was greater. A process of rational decision making is implicated. (2) Accounts of underusers' experiences highlight as a central theme the mothers' vulnerability to personal undermining by many aspects of health care provision. The thesis concludes with a discussion of the approach which health care providers adopt towards'underusers, and argues that there must be an explicit recognition of the point of view of the clients if the services are to reach this deprived segment of the community. Such recognition is rarely found in research or comment on the problem of underusage. In fact apparently irrational and blameworthy behaviour by underusers can be. rendered explicable when considered in the light of the individuals' perceptions and experiences, and this leads to a serious questioning of the utility and appropriateness of the negative judgements made of them.

<p> Communication is an essential aspect of health care that influences compliance and health outcome. Unfortunately, effective communication between patients and their healthcare providers is not easily obtained, especially for the older population. </p><p> This study is a secondary data analysis seeking to look at the communication between the healthcare provider and their elderly patients and determine what potential difficulties exist. It was predicted that older participants are more likely to have a hard time understanding their physician and are less likely to feel carefully listened to their health care provider than younger participants. The hypotheses were tested using data collected from the CHIS 2011-2012 Questionnaire. </p><p> The statistical tests did not find an association between old age and the patient's ability to understand their physician, as initially hypothesized. However, the analysis found a significant relationship between age and the participant's likeliness to feel carefully listened by their physician or medical provider.</p>

<p> Obesity has taken a front row seat as one of the major health concerns in the United States. The literature shows that genetics, socio-economics, and advancement in technology are factors that contribute to what has become an epidemic in the country. If left treated or controlled, obesity can lead to other health problems such as diabetes and high blood pressures. Obese American adults, who have developed comorbidities, look to different therapies such as weight loss programs as a solution to improve their quality of life. The aim of the present study was to examine the effectiveness of an adult weight loss program in lowering medications and increasing physical activities. Data from a restrospective cohort of 440 adults who participated throughout eighteen sessions of a weight loss program were collected from a community hospital in Southern California. It was hypothesized that the medication intake for health problems such as diabetes and high blood pressure decrease as a result of the weight loss program. It was also hypothesized that physical activities increase as another result of the weight loss program. It was noted that the second association was supported, but not the first. </p>