Thesis (Ph.D.)--University of Minnesota, 1998. / Includes bibliographical references (leaves 115-119). Also available on the World Wide Web as a PDF file.

This study was undertaken to determine where adolescents obtain their health care. A survey form was sent to four high schools in this state which reported urban, suburban, and rural populations. This questionnaire contained 18 items designed to determine demographic statistics about the study population as well as to identify their source of health care. Results from the 569 respondents were tabulated and analyzed. Most of this 15-16 year old adolescent group considered their doctor to be a family doctor. It was to a family doctor that most adolescents turned to for medical care. Other physicians and health care providers delivered some of the care but usually the family physician was the most frequent care giver. Adolescents are felt to be an underserved group of patients and the results of this study could be used to channel more efforts toward delivery of their health care. Conclusions drawn here reveal that family physicians do provide most of an adolescent's care.Ball State UniversityMuncie, IN 47306

This research builds further on the existing conceptual framework of the relationship between decentralization and service delivery and provides a cross-country empirical examination of the core dimensions of decentralization reform on access to two key services: health care and improved drinking water sources. The regression results provide evidence supporting positive and significant effects of fiscal, administrative, and political decentralization, individually, on the variables used to measure access to health care, and improved water provision; although the size and robustness of such effects varies for each dimension of decentralization in relation to each service examined. The results obtained in this study suggest that there is an additional (or "extra") positive effect coming from the interaction of two decentralization dimensions on access to health care and water services (that is, a mutually-reinforcing effect additional to the individual effect of each dimension of decentralization). The results obtained also support the expectation that developing countries could benefit significantly more from decentralization reforms compared to developed countries. These findings underscore the importance of considering all dimensions of the decentralization process when investigating the effects of this reform on any economic, institutional, or social variable. The policy implications are highly relevant, particularly for developing countries: decentralization implemented only through one dimension may render fewer positive fruits in terms of access to services than a multi-dimensional approach. Moreover, learning more about the most beneficial mutually-reinforcing effects across dimensions of decentralization may also help strategically in how the overall decentralization reform is designed.

The establishment of medical institutions in Kaohsiung municipal is mainly to cooperate with the Kaohsiung City government in promoting health policy, equally allocating medical resources, enhancing the health of the citizens, looking after mid- or low-income citizens, and taking charge of the medical care services of special patients. However, many institutions encounter various internal constraints and environmental challenges, such as bureaucratic personnel management, inflexible accounting system, faulty implementation of national healthy insurance and competition between hospitals, the Taiwanese medical system has become ¡§high competition, low profitability¡¨. More institutions follow the trend to modify their medical care operation. Outsourcing is one of the methods to strength their medical services. The medical industry currently is highly competitive. By increasing awareness of health concern, patients are more cautious in searching for appropriate and reliable medical care. Therefore, the hospital management regards patient satisfaction, confidence, and loyalty as the core values to improve its medical care services. In this research paper, we discuss the relationship between the quality of medical care services in Kaoshiung municipal hospitals and their operating performance. We also compare the operating differences between public hospitals and outsourcing hospitals to provide authoritative reference. In our research, we selected samples of patients from the Kaoshiung Municipal Minsheng Hospital, United Hospital (Kaohsiung Museum of Fine Art Branch), Hsiaokang Hospital, and Cijin Hospital. We sent out 310 surveys and collected 287 responses by Apr 15 2010. Data analysis and hypothesis testing was based on SPSS for Windows12.0. Based on this research, we concluded that: 1.There is a significant correlation between quality of medical care services and hospital operating performance. Also, process of medical care services was highly correlated with operating performance. In addition, hospital operating performance could be effectively evaluated by quality of medical care services. 2.With regards to the evaluation of medical care services and operating performance for the four municipal hospitals, United Hospital received the highest scores, followed by Minsheng Hospital, Hsiaokang Hospital, and Cijin Hospital. However, the performance of these hospitals is average, indicating that their medical care services need improvement. 3.Finally, outsourcing hospitals have a competitive advantage, which could help the improvement of medical care services. Due to the different operating systems for each hospital, the regulatory authority should be cautious in supervising the performance of the hospital.

The medical care is one of the service encounters. Patients evaluate the service quality based on the interaction with the physician. This research integrates the babyface and gender stereotypes into the model of service encounter. The research examines how these stereotypes affect people¡¦s perceptions and judgments, especially after a negative event occurs. The present study uses an experimental design to investigate the effects of the level of babyface (high vs. low), gender of physician (male vs. female) and the type of specialty (the surgical department vs. the internal medical department). A 2x2x2 factorial design is conducted. Eight different scenarios are established and the effects are measured by satisfaction and loyalty(the attitude toward the medical care). In addition, health consciousness is incorporated into this research to observe the responses under those scenarios. The results indicate that the babyfaced physicians are more effective than the maturefaced physicians in terms of patient¡¦s satisfaction and loyalty. More importantly, the results demonstrate that in the babyfaced group, the male physicians are more effective than the female ones, but no such difference is found in the maturefaced physicians. After the negative even happened, due to the Teddy-bear effect arise, the female babyfaced physicians in the surgical department earned higher loyalty than male ones. On the other hand, the female maturefaced physicians in the internal medical department earn stronger loyalty from patients than male ones. Regarding the aspect of attribution in this study, the results show that the female maturefaced physicians are more likely to be perceived as frauds, and the female babyfaced physicians are more likely to be deemed to be responsible for such the negative event. When considering perceived severity of the negative event, people are more likely to attribute it to the male babyfaced physicians within the surgical department, and the female babyfaced physicians within the internal medical department. Overall speaking, the results suggest that stereotypes of babyface and gender exist in the service encounter with physicians.

Following the prosperity and economic growth of society, the people in Taiwan start to pay attention to the quality of hospitalization and personal health care. There are numerous new types of medical care business start to grow to meet these demands; hence the pressure of the competition in the medical care market becomes more serious ever. An immediate and important task is to utilize the knowledge and experience of the medical care workers to improve the quality of medical care service hence to create a long-term competitiveness. However, to enhance the quality of medical service, it needs to satisfy its internal customers (employees) to provide a high quality products and service. Then with high quality products and service, it will produce the satisfactory outside customers. This study focuses on the relationship between medical care industry knowledge employee¡¦s work values, motivation equality and resignation inclination. The actual survey objects are the employees of the hospitals, the pharmaceutical manufacturing and biotech related industry. This research adopts the random selection methodology for questionnaire. A total of 338 questionnaires were collected to perform the statistic analysis. The results are emphasizing the individual attributes of medical care knowledge worker to his work values, motivation equality, and resignation inclination. In summary: 1. Different individual attributes of medical care knowledge worker have significant difference in work values. 2. Different individual attributes of medical care knowledge worker have significant difference in resignation inclination. 3. Medical care knowledge workers¡¦ work values in different level have significant impact on resignation inclination. 4. Interaction between medical care knowledge workers¡¦ individual attributes and motivation equality has significant impact on resignation inclination. 5. Interaction between medical care knowledge workers¡¦ work values and motivation equality has significant impact on resignation inclination. Based on the results mentioned above, this study recommends the following suggestions to the medical care industry: (1) establish an equal and justice decision process and a transparent employee salary system, (2) enhance the mutual trust between the medical care industry and medical care workers, (3) pay attention to workers¡¦ career and development, and increase the human capital, (4) create an excellent working environment, and to allow the growth for both business and workers, (5) remove any blocks in the communication channels to create a win-win situation between medical care employer and workers. To future researchers on this topic, the author suggests that the research objectives should be expanded to the whole medical care industry. The statistical methodology should adopt the Stratified Random Sampling method. Data collection uses questionnaire mainly but complements with other observation method and in-depth interview method. There are many factors to affect the employee¡¦s resignation inclination, but only the worker¡¦s work values, motivation equality, and individual attributes to be selected as the variables. Other variables, such as organization climate, behavior of leadership, and etc.., are not included in this research. The author recommends that the future study can concentrate on the actual case study for the resignation inclination problems by using multi-variable analysis method.

This research builds further on the existing conceptual framework of the relationship between decentralization and service delivery and provides a cross-country empirical examination of the core dimensions of decentralization reform on access to two key services: health care and improved drinking water sources. The regression results provide evidence supporting positive and significant effects of fiscal, administrative, and political decentralization, individually, on the variables used to measure access to health care, and improved water provision; although the size and robustness of such effects varies for each dimension of decentralization in relation to each service examined. The results obtained in this study suggest that there is an additional (or "extra") positive effect coming from the interaction of two decentralization dimensions on access to health care and water services (that is, a mutually-reinforcing effect additional to the individual effect of each dimension of decentralization). The results obtained also support the expectation that developing countries could benefit significantly more from decentralization reforms compared to developed countries. These findings underscore the importance of considering all dimensions of the decentralization process when investigating the effects of this reform on any economic, institutional, or social variable. The policy implications are highly relevant, particularly for developing countries: decentralization implemented only through one dimension may render fewer positive fruits in terms of access to services than a multi-dimensional approach. Moreover, learning more about the most beneficial mutually-reinforcing effects across dimensions of decentralization may also help strategically in how the overall decentralization reform is designed.

Thesis (MA)--University of Montana, 2009. / Contents viewed on November 25, 2009. Title from author supplied metadata. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 148-150). Also available on the Internet.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 579-596). Available also in a digital version from Dissertation Abstracts.