<p> This master's thesis will present a literature review and analysis ofthe implementation and use of Electronic Medical Records (EMR). The literature review will discuss reasons that support implementation of EMRs, factors that are necessary for successful implementation and barriers that impede implementation. Also, real-world examples of implementation for medical billing in healthcare organizations will be discussed, as well as the disparity in implementation rates between larger and smaller healthcare organizations. </p><p> The analysis portion of this thesis will include data from the 2009 National Ambulatory Medical Survey (NAMCS) EMR Supplement and, through the application of the Chi-Square statistical test using SPSS, will assess whether size of the medical practice in terms of number of physicians is significantly associated with EMR implementation and functionality, the latter of which includes clinical reminders and prescription ordering. It will be shown that physician size is indeed significantly associated with implementation and functionality. </p>

<p> In the past, most patients received care in the country of their residence, but more recently, medical related travel to other countries has grown from a cottage industry into a worldwide scheme. Travel for medical care today has many forms and is largely driven by cost, lack of access to emerging procedures and wait times. While cosmetic procedures are still popular, today's medical travelers may also journey across the world for cardiac and orthopedic procedures. </p><p> The industry has labeled this phenomenon Medical Tourism and many countries across the globe are positioning themselves to attract international patients. Turkey has positioned itself as a convenient, high-quality and low cost provider of care to health travelers, with a goal to become an international health travel hub. The Internet is a major driver of information on health travel and is also a vehicle for patients to share their experiences. There are few studies that evaluated the experiences of health travelers. </p><p> To date there are few studies in the medical tourism literature that evaluate health travelers' experiences with care in another country. This qualitative research, an analysis of online narratives, identified themes of health travelers' experiences to Turkey. The intent was to describe the experiences written online by health travelers to Turkey. It is expected that this research will assist in decision-making for patients considering health travel in the future. </p><p> The research may strengthen health administration education by providing insights in to the phenomena of health travel. In addition, this study may assist Turkey and other countries with their marketing and positioning to health travelers and serve as a resource for hospitals wanting to recruit and retain staff to serve a global patient base. Finally this study may provide a springboard for further research on health travelers' experiences. The overarching question to be answered with this research is: What can we learn about health travelers to Turkey through analysis of their online narratives? In addition, the goal was to identify the important individual characteristics, outline the push and pull factors to seek healthcare in another country, identify satisfaction with the outcomes and the results of these individuals' treatments, and note some positive and negative factors influencing health travelers' perceptions and overall experiences about their health travel to Turkey. </p><p> Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain as many publicly posted English narratives of health travelers to Turkey via purposeful sampling. The narrative posts of 36 individuals who traveled to Turkey from at least 13 countries for medical care were obtained. Posters' written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding were conducted to identify characteristics and themes using NVivo version 10. </p><p> Results indicated that driven by lower costs, physician's expertise and the desire for care unavailable in their home country, health travelers to Turkey are generally satisfied with the outcomes of their procedures and care provided by their physicians. Communication challenges, food, transportation and gaps in customer service are key areas of opportunity for improvement. </p><p> This analysis provides an understanding of the insights of health travelers though the words of actual health travelers. This methodology may be applied to study other patient experiences. The findings of this research expands the body of knowledge in medical tourism as well as serve as a platform for further qualitative and quantitative research on health travelers' experiences. </p>

<p> The aim of this thesis is to explore racial groups that are affected by gestational diabetes mellitus in the state of California. Hypothesis of the study to be tested are: 1. Women of minority race background are more likely than majority white women to report having gestational diabetes. 2. Women with lower household incomes, irrespective of race are more likely to report having gestational diabetes. Statistical analysis was conducted using SPSS 20 (statistical package for the social sciences). Descriptive analysis was used to examine the relationship between different race groups and their socioeconomic status. A One-Way ANOVA test was conducted to show the significance of low household income and gestational diabetes. The outcomes of this study indicate that gestational diabetes mellitus does exist within the subsamples of women who have lower socioeconomic status and are members of minority race groups.</p>

<p> Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder, and also among the most prevalent chronic health conditions affecting school-aged children. The literature states that Latinos are at a greater risk to have ADHD, yet the studies also show that they are less likely to be diagnosed. The Latino population in the United States is the fastest growing ethnicity. The main purpose of this study is to identify whether being Latino and/or speaking a primary language other than English in the home will decrease the likelihood of being diagnosed with ADHD. California Health Interview Survey 2007 Child questionnaire data were analyzed to discern if either being Latino and/or speaking a language other than English in the home had an effect on ADHD diagnosis for California children 11 years and under. Both hypotheses were found to decrease the likelihood of being diagnosed with ADHD. Results, conclusions and future suggestions were discussed.</p>

<p> Pneumonia is a serious clinical problem with associated high mortality and morbidity. It can be potentially life threatening in the elderly and in patients with other comorbid diseases. Its clinical spectrum ranges from rapid resolution of symptoms to severe medical complications and death.</p><p> At least 1.2 million people are admitted to the hospital with pneumonia each year in the United States, and approximately 10% of these patients will die within 30 days of admission. According to the University of Maryland Medical Center, the majority of pneumonias respond well to treatment, but the infection kills 40,000&ndash;70,000 people each year. Given its public health significance, pneumonia has been the target of quality improvement activities for nearly 2 decades. This began with the publication of clinical practice guidelines in the early 1990s, was followed by a series of statewide and national quality improvement initiatives, and more recently has included public reporting and pay-for-performance programs led by the Joint Commission and the Centers for Medicare &amp; Medicaid Services (CMS) and other payers. The aim of the study was to examine the association of antibiotic timing and reduced mortality. Data from a retrospective cohort of 550 patients hospitalized and discharged with a diagnosis of community acquired pneumonia was collected from a community hospital located in Southern California. It was hypothesized that antibiotics administered within the first six hours of hospital arrival for patients discharged with a principal diagnosis of pneumonia is associated with decreased inpatient mortality. It was noted that this association was not supported.</p>

<p> Patient centered care considers patients' values, personal preferences, cultural traditions and lifestyles when it comes to implementing care and treatments. This study looks at the effect of patient-physician race concordance on patient centered care and focuses on which ethnic backgrounds are more impacted by this concept. When patients feel they can relate to their care providers, they tend to report higher satisfaction rates when it comes to their treatments. Results of this study can be applied to future research revolving around patient centeredness and can be used to determine how to enhance patient centered care for all patients.</p>

<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>

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