Thesis (M.S.)--Missouri State University, 2008. / "December 2008." Includes bibliographical references (leaves 84-90). Also available online.

Thesis (M. Phil.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 132-140).

Thesis (Ph. D.)--Rutgers University, 2008. / "Graduate Program in Economics." Includes bibliographical references (p. 81-89).

Thesis (Ph. D.)--Texas State University-San Marcos, 2006. / Vita. Appendices: leaves 99-106. Includes bibliographical references (leaves 107-115).

Thesis (Ph. D.) University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on August 7, 2007) Vita. Includes bibliographical references.

Thesis (Ph. D.)--Texas State University-San Marcos, 2006. / Vita. Appendices: leaves 99-106. Includes bibliographical references (leaves 107-115).

This thesis explores the relevance of international law in the multilateral protection and promotion of public health in a world sharply divided by poverty and underdevelopment. In this endeavour, the thesis predominantly uses the concept of "mutual vulnerability" to discuss the globalisation of diseases and health hazards in the emergent global neighbourhood. Because pathogens do not respect geo-political boundaries, this thesis argues that the world has become one single germ pool where there is no health sanctuary. The concept of mutual vulnerability postulates that the irrelevance or obsolescence of national boundaries to microbial threats has created the capability to immerse all of humanity in a single microbial sea. It follows, therefore, that neither protectionism nor isolationism offers any effective defences against advancing microbial forces. As a result, the thesis argues that contemporary multilateral health initiatives should be driven primarily by enlightened self-interest as opposed to parochial protectionist policy. This study is primarily situated within the discipline of international law. Nonetheless, it draws on the social sciences in its analysis of traditional medicine in Africa. It also makes overtures to medical historians in its discussion of the attitudes of societies to diseases and to the evolution of public health diplomacy, to international relations in its analysis of international regime theories, and to a number of other disciplines interested in the phenomenon of globalisation. This interdisciplinary framework for analysis offers a holistic approach to public health policy-making and scholarship to counter the segmented approaches of the present era. Thus, this thesis is concerned with four related projects. First, it explores the relevance of legal interventions in the promotion and protection of public health. If health is a public good, legal interventions are indispensable intermediate strategies to deliver the final dividends of good health to the vulnerable and the poor in all societies. Second, it explores multicultural approaches to health promotion and protection and argues for a humane health order based on multicultural inclusiveness and multi-stakeholder participation in health-policy making. Using African traditional malaria therapies as a case study, the thesis urges an animation of transnational civil society networks to evolve a humane health order, one that fulfils the desired vision of harmony and fairness. Third, it makes an argument for increased collaboration among lawyers, epidemiologists and scholars of other disciplines related to public health. Using the tenets of health promotion and primary health care, the thesis urges an inter-disciplinary dialogue to facilitate the needed "epidemiological transition" across societies, especially in the developing world. Fourth, the thesis makes modest proposals towards the reduction of unequal disease burdens within and among nation-states. The thesis articulates these proposals genetically under the rubric of communitarian globalism, a paradigm that strives to meet the lofty ideals of the "law of humanity". In sum, it projects a humane world where all of humanity is inexorably tied in a global compact, where the health of one person rises and falls with the health of every other person, and where every country sees the health problems of other countries as its own. Arduous as these tasks may be, they are achievable only if damaged trust of past decades is rebuilt. Because the Westphalian sovereign states lack the full capacity to exhaustively pursue all the dynamics of communitarian globalism, multilateral governance structures must necessarily extend to both state and non-state actors. In this quest, the thesis concludes, international law - with its bold claims to universal protection of human rights and the enhancement of human dignity - is indispensable as a mechanism for reconstructing the public health trust in the relations of nations and of peoples. / Law, Peter A. Allard School of / Graduate

In 1981/82 there was renewed interest in the concept of a regionalized form of health service delivery in British Columbia. A discussion paper which outlined a proposal for regionalizing those services funded directly by the Ministry of Health was circulated to the senior managers in the Ministry in August of that year. In this paper it was suggested that regionalization would encourage the integration and co-ordination of health services at a regional level, thereby increasing the efficiency and effectiveness of the health delivery system. This study considers strategies for planning health service delivery at this regional level, with the model of regionalization outlined in the 1981 proposal used as a basis for discussion. Every effort has been made to develop an approach to planning that is feasible, given the context within which health policy decisions are made in British Columbia in 1982. To do this the changing trends in health care management in B.C. have been considered, and relevant planning and organization theory reviewed. Evaluations of regional planning systems in three other jurisdictions are also described. The potential difficulties a Regional Manager might face in developing an integrated approach to regional planning are identified, and strategies to deal with these possible conflicts outlined. It would seem from this analysis that the degree to which authority is decentralized to the region is central to any decision about planning at the regional level. A model based on normative centralization, and operational decentralization is suggested, with needs assessments, and prioritization of needs taking place at the region. Support for integrated regional health planning by both the government and the provider groups seems to be necessary if good regional plans are to be developed, and if implementation of the plans and policies that evolve from the process are to be successful. It is suggested that introducing the structures and processes for planning at the regional level should involve two stages. During the first, the administrative functions for direct services would be decentralized, and a general review of health services and health care in the region undertaken. The development of a regional identity and liaison among the many subgroups operating in the region would be an important aspect of this first stage. The second stage, which would be implemented after one year, would see the development of a Regional Advisory Council and multidisciplinary, multiagency, Service Development Committees formed along service or functional lines. More authority would be transferred to the Regional Manager during this time in the areas of hospital budget review, and physician manpower planning. This is the most important stage as it has the potential to make the health care system more efficient and effective. In this model support is built into the structure for planning and there are regional wide coordinating and integrating mechanisms. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

No description available.

In recent years, increasing availability of data and advances in predictive analytics present new opportunities and challenges to healthcare management. Predictive models are developed to evaluate various aspects of healthcare systems, such as patient demand, patient pathways, and patient outcomes. While these predictions potentially provide valuable information to improve healthcare delivery, there are still many open questions considering how to integrate these forecasts into operational decisions. In this context, this dissertation develops methodologies to combine predictive analytics with the design of healthcare delivery systems. The first part of dissertation considers how to schedule proactive care in the presence of patient deterioration. Healthcare systems are typically limited resource environments where scarce capacity is reserved for the most urgent patients. However, there has been a growing interest in the use of proactive care when a less urgent patient is predicted to become urgent while waiting. On one hand, providing care for patients when they are less critical could mean that fewer resources are needed to fulfill their treatment requirement. On the other hand, due to prediction errors, the moderate patients who are predicted to deteriorate in the future may self cure on their own and never need the treatment. Hence, allocating limited resource for these patients takes the capacity away from other more urgent ones who need it now. To understand this tension, we propose a multi-server queueing model with two patient classes: moderate and urgent. We allow patients to transition classes while waiting. In this setting, we characterize how moderate and urgent patients should be prioritized for treatment when proactive care for moderate patients is an option. The second part of the dissertation focuses on the nurse staffing decisions in the emergency departments (ED). Optimizing ED nurse staffing decisions to balance the quality of service and staffing cost can be extremely challenging, especially when there is a high level of uncertainty in patient demand. Increasing data availability and continuing advancements in predictive analytics provide an opportunity to mitigate demand uncertainty by utilizing demand forecasts. In the second part of the dissertation, we study a two-stage prediction-driven staffing framework where the prediction models are integrated with the base (made weeks in advance) and surge (made nearly real-time) staffing decisions in the ED. We quantify the benefit of having the ability to use the more expensive surge staffing. We also propose a near-optimal two-stage staffing policy that is straightforward to interpret and implement. Lastly, we develop a unified framework that combines parameter estimation, real-time demand forecasts, and capacity sizing in the ED. High-fidelity simulation experiments for the ED demonstrate that the proposed framework can reduce annual staffing costs by 11%-16% ($2 M-$3 M) while guaranteeing timely access to care.