<p> Health care disparities have been well document to exist in various demographics. Specifically, there are differences in the access to and quality of healthcare between ethnic and racial groups. Congestive Heart Failure (CHF) is a debilitating chronic condition that affects the underinsured population more often than the insured. The present study sought to identify associations with the diagnosis of CHF between race, ethnicity, and insurance type.</p><p> Data sets retrieved from the 2010 National Ambulatory Medical Care Survey were utilized to run statistical analysis and identify correlations between the dependent variable and independent variables. A chi-square test was performed to determine the significance of the results. The sample population selected was cross tabulated to identify associations between the variables. The findings suggest that significant differences exist in the diagnosis of CHF between race, ethnicity, and insurance type. The results support past research, which found that racial, ethnic, and socioeconomic disparities exist in health care. </p>

<p> Two key issues in healthcare today are the over-utilization of emergency departments (ED) and the lack of preventative care participation. Successful preventative care can help to reduce ED utilization and harmful behaviors such as drinking and smoking.</p><p> Exposing patients to the benefits of preventative or primary care benefits could start in the ED. This report sought relationships between ED utilization for personal health and smoking cigarettes or drinking alcohol in a 12 month period. This study utilized the CHIS 2011-2012 data set to find such a relationship. A relationship was found between smoking and drinking during a 12 month period and visiting the ED for personal health.</p><p> This report identifies an opportunity for improvement within health benefit utilization. Smokers and drinkers can be exposed to cessation programs in the ED, while also helping to encourage patients to better utilize primary and preventative services.</p>

<p> This study analyzes the effect of payor mix in the adoption of Electronic Health Records (EHR) among physicians in the United States and whether or not this adoption has been incentivized by the Medicare and Medicaid incentive programs. The study predicted that payor mix influenced adoption and that practices with higher percentage of patient care revenue coming from Medicare and Medicaid would present higher levels of adoption. It also predicted that physicians planning to apply for Medicare and Medicaid incentive programs are more likely to adopt this technology. The Statistical Package for Social Services was utilized to analyze the 2010 National Ambulatory Medical Care Survey data using Chi Square statistics. The results of this study showed a significant relationship between payor mix and EHR adoption and incentive payments and EHR adoption. The findings of this study are valuable for medical practices, EHR vendors, hospitals and government entities to strategize on additional incentives and financial assistance programs that foster meaningful adoption and improve healthcare outcomes.</p>

<p> The purpose of this study is to review how much time and resources were spent on having pharmacy missing doses and analyze the pharmacy process of filling a missing dose request. Data is extracted from the VistA and Omnicell program at the Veterans Affairs Long Beach Healthcare System (VALBHS). One hypothesis is that waste exists in the system and the other hypothesis is that time on hand (waiting) was the biggest waste. The first hypothesis is supported, while the second hypothesis lacked evidence and, therefore, is not supported. Potential solutions and issues surrounding the usage of Lean and Six Sigma are discussed.</p>

<p> Every day, India sees the addition of 5,000 new cases of diabetes to its current diabetic population of 65 million people. This number is projected to cross the 100 million mark in 15 years. The emerging pandemic scale of diabetes growth is straining India's already-overburdened public healthcare resources. India is home to several well-established native and adapted foreign traditions of medicine that are widely practiced. These traditions include Ayurveda, yoga and naturopathy, unani, siddha, and homeopathy. The modern and traditional medicine approaches are extensively used as independent systems. The purpose of this qualitative research case study was to evaluate the use of an integrative approach to address the multiple challenges posed by diabetes in India. The research design for the case study was based on the theoretical framework of participatory action research. The research questions evaluated how the modern and traditional medicine systems can be jointly used to contain the spread, scale, and immensity of diabetes in India and examined the barriers and challenges in combining various systems of medicine. Data were collected from interviews with 30 modern and traditional medical practitioners and 6 policy makers identified through a stratified purposeful sampling process. The transcribed data were coded thematically and objectively analyzed. The trustworthiness of interpretations was bolstered with triangulation through records from notes and observations. In evaluating the feasibility of a synergistic and integrative approach, the study filled a gap in scholarly literature. The study contributes to social change by adding to the existing body of knowledge available to physicians and patients in preventing and containing the diabetes pandemic.</p>

Thèse (M.Sc.)--Université de Sherbrooke (Canada), 2008. / Titre de l'écran-titre (visionné le 1 février 2007). In ProQuest dissertations and theses. Publié aussi en version papier.

Thesis (Educat.D.)--Fairleigh Dickinson University, 1983. / Source: Dissertation Abstracts International, Volume: 43-11, Section: B, page: 3529.

<p> The purpose of this qualitative exploratory case study was to explore the perceptions held by physicians, nurses, and other allied clinicians regarding hand-hygiene practices in order to understand what causes non-compliance with those practices. The conceptual framework guiding the research study was based on the social behavioral theories Rosenstocks Health Belief Model, The theory of reasoned action (TRA), introduced by Ajzen and Fishbein (1975) and The social cognitive theory which suggests that an individual&rsquo;s behavior is determined by his or her own personal intention and that this intention is a function that also determines the individual&rsquo;s attitude toward the subjective norm or behavior. This research study employed a telephone interview with open-ended questions to explore physician, nurse, and allied clinician perceptions about the hand washing and the factors for non-compliance. The content of the transcribed interviews were analyzed using NVivo 10 software to explore the hand hygiene perspective of a purposeful sample of 3 nurse, 3 physicians and 4 allied clinicians with at least two years of direct patient care experience. Interview data collected from the study resulted in 5 major themes encompassing the need for healthcare institutions to consider when developing hand hygiene initiatives. The descriptive patterns that emerged were: (a) lack of reoccurring formal education/training, (b) staff shortages, (c) sink placement, (d) skin breakdown and sensitivity to hand hygiene products, (e) educational differences among the three groups (physician, nurse, and allied clinician staff). Specifically the results of the case study showed demographic and generational variability with participants of different ages, educational backgrounds, and patient care experience. Results from the study led to recommendations for healthcare leaders that may strengthen hand hygiene compliance enforcement. Study results were also used to make suggestions for future research.</p>

Context. There has been increasing attention concerning the use of DNA-based genetic tests in health care. Many have argued that the use of genetic technologies should be subject to public debate and scrutiny. However, few in the general population can offer views informed by actual experience with genetic services. Prenatal and newborn screening programs are examples of genetic services that are routinely offered to the general population. Objectives. To determine if conjoint analysis is a useful tool for eliciting user preferences for newborn screening services. Methods. Discrete choice conjoint analysis (CA). Results. Counterintuitive results identified issues concerning the validity of the CA instrument that was developed. As a result limitations to the usefulness of aggregate logit regression for the analysis of CA data were identified. Other analytical approaches, such as latent class analysis, merit further examination to determine their validity and the value of the information they may provide.

<p> Medical errors have been detrimental in the field of medicine. They have impacted both patients and doctors. While physicians recognized that error disclosure was an ethical and professional obligation, most remained silent when mistakes happened for different reasons. Guided by the theory of planned behavior and Kant's deontological theory, the purpose of this quantitative study was to investigate the perceived barriers affecting physicians' willingness to report major medical errors. An association was tested between the independent variables physician fear of disclosure of errors, organizational culture toward patient safety, physician apology, professional ethics and transparency, physician education, and the dependent variable physician willingness to disclose major medical errors. Using a cross-sectional method, 122 doctors out of 483 surveyed, completed the online and paper-based survey. Multiple linear regression and descriptive statistics models were used to analyze and summarize the data. The results showed there was a statistically significant relationship between the independent variables organizational culture toward patient safety, physician apology, professional ethics and transparency, and physician education and the dependent variable physician willingness to disclose major medical errors. There was no relationship between the independent variable fear of disclosure of errors and the dependent variable. The findings added to the knowledge base regarding barriers to physicians' medical errors disclosure. The results and recommendations could provide positive social change by helping hospitals raising doctors' awareness regarding major medical errors disclosure. </p><p>