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> 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>

<p> In the United States the high rate of adolescent pregnancy is a cause for a concern. Previous research indicates that infants born to adolescent parents have negative social outcomes and are prone to repeat the cycle. For this reason, it is necessary and important to lower the adolescent pregnancy rates. The study examines factors that influence adolescent pregnancy and respondents' age when the first child was born (i.e., teenage pregnancy), consumption of alcohol, and sexually transmitted disease (STD) testing. The 2005 CHIS adult data set was used for the analysis; the sample used included only women less than 20 years of age at the time of interview (<i>N</i> = 390). There were no statistically significant findings, probably due to the small sample size.</p>

<p> This project analyses data from the California Health Interview Survey (CHIS) to compare the healthcare needs of veterans with those who never served in the military. This project will attempt to elucidate if military service creates poorer outcomes and subsequently a greater need for healthcare services for those who enlist. The project will test eleven hypotheses which are indicators of health status for both veteran and non-veteran respondents. For all hypotheses, the independent variable will be if the respondent has ever served in the United States Military. The eleven dependent variables are as follows: respondent self-reported health status, current and former tobacco use, likelihood of alcohol abuse, likelihood the respondent is overweight or obese, prevalence of heart disease, prevalence of diabetes, prevalence of hypertension, state of emotional health, state of work, family, and social relationships, marital status, and income status. All eleven hypotheses state that veterans' are more likely to experience poorer health outcomes than their civilian counterparts. </p><p> Analysis of all eleven outcomes had diversified results. Veterans were more likely to self-report poorer states of health, be former tobacco users, abuse alcohol, be overweight or obese, and have diagnoses of heart disease, diabetes or hypertension. This could be due to rigors of military service. It may also be increased access to healthcare services, enabling veterans to receive medical diagnoses. Conversely, veterans were less likely to be current tobacco users, self-report better emotional health, self-report better relationships, more likely to be married, and have higher incomes. This could be because the military in some facets acts as a health protector. It could also be due to the highly stigmatized perceptions of mental illness or dysfunction. This project finds several reasons veterans may need more healthcare services, but also finds further research on this topic is necessary.</p>

<p> Consumer-directed health plans (CDHPs) are insurance options for employers offering benefits, and for individuals wanting more responsibility in their healthcare decision-making. These plans seek to control costs by shifting financial accountability from insurers to consumers. Consisting of a high-deductible health plan, a health savings account, and information tools, consumer-directed health plans attempt to promote greater value in health care spending. Data from the 2011-2012 California Health Interview Survey was used to identify the demographic and socioeconomic characteristics associated with individuals choosing a CDHP. As hypothesized, a Chi-square analysis determined that educational attainment was associated with choosing a CDHP (&chi;²(9, <i>N</i>=1240) = 33.296, <i> p</i>=. 000). Statistical support was not found for annual income, self-reported health, and number of doctor visits. Limitations surrounding the sample size and working definition of a high deductible may have prohibited a more complete investigation; educational attainment is a key indicator of a more cost-conscious consumer.</p>

<p> The purpose of this study was to analyze the factors associated with higher Emergency Department (ED) visits in the United States. Higher ED utilization contributes in a major way to costs in the healthcare industry. Unnecessary utilization of emergency department causes medication errors, poor patient satisfaction, lower quality and higher cost. This study analyzed the data from National Hospital Ambulatory Medical Care Survey (NHAMCS) collected in 2010, which involved a sample size of 34,936 ED visits nationwide. The variables in this study included age, ethnicity, type of coverage and gender differences. The result showed that Medicaid population has a higher number of ED visits than other types of insurance coverage; white population shows maximum ED visits than other race types; males visits ED more than females and infants has higher ED rate than other age groups. More research is needed to develop health policies to limit the non-urgent ED visits.</p>

<p> The overall purpose of this study was to determine causal associations and factors between the health of children and the neighborhoods, environments, and level of social economic status from which they live and mature. This study looked at the environment of the children inside and outside of the home and the place that social capital has within a child's health. It also looked at how family and social economic status are vital to the wellbeing of children. Findings in this study prove that an environment of poverty is correlated significantly with ill health in children. The loss of social capital and the physical environment of the home showed a significant correlation to the health of the child. The main limitation to the study is the bias of publications. Also, additional research and study of the topic are recommended. </p>

<p> Research has shown that patients with limited-English proficiency experience lower quality health care, have more difficulty communicating with their physician and more likely to need a translator which potentially lead to significant adverse health outcomes. The objective of this study was to demonstrate that patients with limited-English proficiency face more barriers which create equity and disparity in understanding their physician as compared to their English-speaking counterparts.</p><p> Secondary data analysis was performed using the California Health Interview Survey (CHIS) 2011-2012. The CHIS is a population-based random-digit dial telephone survey conducted every two years of California's population. The survey consists of extensive questions in a variety of health related topics. For purposes of this study, specific questions were selected for statistical analysis.</p><p> All the literature and data analyses strongly supported that patients with limited-English proficiency are more likely to face barriers in obtaining quality care throughout the health continuum.</p>

<p> The purpose of this study was to determine what factors in clinical performance can negatively impact Medicare reimbursement for acute-care hospitals. Secondary data from Medicare.gov Hospital Compare website was used, specifically using results from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medications, cleanliness of hospital, and quietness at night of hospital. The goal is to receive a response of "Always" to receive Medicare reimbursement.</p><p> A comparative analysis was used to compare the survey results from 194 acute-care hospitals among nine California counties. San Diego County had a consistent "Always" response in all 10 HCAHPS categories. One limitation was the inability to correlate total population with high or low HCAHPS scores. For further study, selecting specific demographics of each county to determine who is more likely to complete an HCAHPS survey.</p>