<p> The purpose of this project was to fund a mobile wellness program for the homeless in Los Angeles County, California. This program will collaborate with service providers in the selected planning areas to promote and support the services of the program to the homeless. The host agency of this proposed project is the John Wesley Community Health Institute, located in Los Angeles County, California. </p><p> After conducting a review of the literature, the grant writer designed a program to provide primary care, behavioral health, and case management services to the homeless population. Specifically, this project will fund a mobile health clinic to offer services to four Service Planning Areas (SPAs) in Los Angeles County. The Annenberg Foundation was determined to be the most appropriate match for funding of the project. </p><p> The actual submission or funding of this grant was not required for the successful completion of the project.</p><p>

The Balanced Budget Act of 1997 introduced the new payment methodology for Medicare managed care plans. However, many managed care organizations started to withdraw from the Medicare market after the implementation of the Act, adversely affecting the accessibility to managed care plans for Medicare beneficiaries. The objective of the study is to examine the determinants of Medicare plus Choice Coordinated Care Plan withdrawal in the post-BBA era. Data on HMO plans for the years 1999 to 2002 were obtained from various sources for the pooled cross section and time series analyses. Samples were organized as per county, per contract, and per county-contract units. Several factors, including organizational attributes, geographic characteristics, performance measures, plan attributes, the degree of market competition, and time, were used for this study. Binomial logit model, multinomial logit model, and negative binomial regression model were employed for data analysis The results demonstrated that factors such as a higher level of M+C payment rate, higher out-of-pocket premiums, the provision of drug coverage, for-profit MCOs, contracts serving large amounts of counties, and a higher number of competitors in the service areas, would increase the probability of contract withdrawal. On the other hand, a higher number of M+C CCP enrollment, higher inpatient care capacity in counties, and more preventive care for enrollees offered by MCOs would reduce the probability of contract withdrawal. The selection effect of MCOs in choosing the service areas based on the demographic factors was detected. In addition, counties experiencing lower payment growth after the BBA tended to have lower numbers of M+C CCP contracts. Though contracts whose service areas had a smaller variance of payment growth after the BBA were found to be less likely to experience termination, they were more likely to experience partial withdrawal. This study advised policymakers to devise a more flexible reimbursement system, to develop a monitoring system to investigate weak contracts, and to develop policies for helping MCOs alleviate the problem of contract withdrawal while controlling the quantity and quality of care for beneficiaries / acase@tulane.edu

No description available.

No description available.

Thesis (Ph.D.)--University of California, San Francisco, 2009. / Source: Dissertation Abstracts International, Volume: 70-04, Section: B, page: 2206. Advisers: Mary A. Blegen; Charlene A. Harrington. Includes supplementary digital materials.

Thesis (Ph.D.)--University of California, San Francisco, 2009. / Source: Dissertation Abstracts International, Volume: 70-04, Section: B, page: 2211. Adviser: Robert Newcomer.

Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2009. / Source: Dissertation Abstracts International, Volume: 70-06, Section: A, page: . Adviser: K. Peter Kuchinke. Includes bibliographical references (leaves 241-252) Available on microfilm from Pro Quest Information and Learning.

<p> <b>Background:</b> Social and health supports provided during young adulthood can have long lasting health implications. Racial and ethnic minorities will soon comprise the majority of this population in the US and are more likely to experience poverty with poor access to health services. Oral health has been identified as a health disparity for young adults in the general population as well as those living with HIV (YALWH). Identifying and addressing barriers to oral healthcare are important for the long-term improvement of overall health outcomes for YALWH.</p><p> <b>Methods:</b> This mixed methods cross-sectional study includes: 1) an in-person quantitative survey and a semi-structured qualitative interview of YALWH between the ages of 17 and 25 years of age, 2) an online and in person survey of general and pediatric dentists and clinical dental hygienists and 3) a focus group with dental clinic support staff of a hospital based dental clinic.</p><p> <b>Results:</b> YALWH expressed the importance of oral health in their lives; a clean mouth and straight white teeth impacts how they judge others and, they assume, how others judge them. Barriers to care identified across all study groups included dental insurance, HIV disclosure and dental fear.</p><p> <b>Conclusions:</b> Oral healthcare for YALWH can be affected by individual and systemic factors including provider communication skills, provider knowledge of HIV, limitations of healthcare delivery systems and the expectations of the individual patient. These factors are important considerations for health policy makers and oral health professionals in their efforts to address oral health disparities for YALWH.</p>

<p> Heart failure patients who visit the Emergency Department often because of chronic nature of their illness require a specific plan of care. Successful engagement requires that nurses identify and act on factors to facilitate transition across the care continuum. This study was undertaken to examine the relationship of three major quality care indicators: social support, perception of nurse caring, and patient satisfaction among patients with heart failure admitted to the emergency department. The study further explored the association of these indicators with demographic and illness variables of the study participants.</p><p> The Quality Caring nursing framework was used as the theoretical framework for the study. A total of 115 adult participants, 71 males and 44 females who were admitted in the emergency department of two public hospitals in the mid-Atlantic region of the United States were recruited. Data were collected using a survey package consisting of four instruments: the Medical Outcomes Study (MOS) Social Support Survey measuring perceived social support, the Caring Assessment Tool (CAT) measuring nurse caring, and the Consumer Emergency Care Satisfaction Scale (CESS) measuring satisfaction with care in the emergency department.</p><p> Although the major study hypotheses that high levels of social support would be associated with caring and with patient satisfaction were not supported, there were significant associations found between aspects of social support, caring measure and the demographic and illness measures such as marital status and the number the number of household members. Also, those who were employed perceived more social support than those who were unemployed and those who were retired had a significantly higher perception of caring.</p><p> These findings challenge nurse clinicians, educators, and administrators to further investigate the roles of social support, caring and patient satisfaction in multiple aspects of chronic illness.</p>

The purpose of this study was to examine the decision-making process of individuals who use the energy healing modalities of homeopathy, reflexology, acupuncture, and Jin Shin Jyutsu. A qualitative design was selected because the personal nature of decision-making was best accessed through self account. Content analysis was used to examine the data because it both describes and quantifies phenomena. The study sample comprised nine volunteers who met study requirements. Data provided limited initial support of the motivating factors suggested in Astin's (1998) study. However, after consideration of all qualitative data, the original categorical definitions of dissatisfaction with conventional medicine, desire for personal control, and philosophical congruence were amplified or clarified. Additional motivating factors were also described and defined in this study. Therefore, this study identified healing system attributes, outcome, pleasure, timing, and recommendation as factors influencing the decision to use alternatives.