No description available.

This thesis examines the problem of utilitarian ageism in Quality-Adjusted Life Years and contrasts it with the biblical principles of community and honor that are to characterize treatment of the elderly. Chapter 1 provides a general orientation into the issue of health care allocation. Attention is given to the history of modern health care allocation and describes its rapid evolution. Chapter 2 provides a more detailed analysis of health care allocation demonstrating the necessity for some system of allocation in modern American health care. It concludes by presenting the QALY model as a potential basis for modern health care allocation decision making. Chapter 3 examines the problems of QALYs as a basis for health care allocation. After the use of quality of life and health life years is evaluated the relationship between utilitarianism and QALYs is explored, focusing on QALYs' discrimination against elderly. Chapter 4 examines the biblical perspectives of elder care, identifying the principles of honor and community as foundational. The underlining principles of justice and biblical love provide a foundation for biblical elder care. Chapter 5 compares the QALY and biblical models. The comparison is accomplished by noting the contrasts in philosophical foundations, economic strategies and priorities in the distribution of limited health care resources. Chapter 6 concludes by contending that QALY calculations are ageist and therefore an unjust basis on which to base decisions regarding the distribution of limited health care resources. This work contends that a potentially less efficient, but a better moral basis for resource allocation are the biblical principles of honor and community. These two principles enable a more holistic approach to dealing with the needy elderly in health care allocation. / This item is only available to students and faculty of the Southern Baptist Theological Seminary. If you are not associated with SBTS, this dissertation may be purchased from <a href="http://disexpress.umi.com/dxweb">http://disexpress.umi.com/dxweb</a> or downloaded through ProQuest's Dissertation and Theses database if your institution subscribes to that service.

The elderly population is growing in nursing homes (NHs), with an estimated 3 million seniors to be residing in NH facilities by year 2030. Many of these seniors are potentially at risk for falls or infections. NH residents with Alzheimer’s disease or other forms of dementia are also increasing, and they are vulnerable to the adverse effects of medications. Psychotropics are overused in NHs, with approximately half to two thirds of residents receiving one or more psychotropics. Many negative health outcomes, e.g. falls and infections, have been associated with their use. The usage of psychotropic medications among NH residents has been a concern and topic of scrutiny for nearly three decades. In 1986, the Institute of Medicine published a landmark report that identified the overuse of psychotropic medications in NHs. The following year, the federal government passed the Omnibus Budget Reconciliation Act that included reform legislation to address psychotropic drug overuse. Since then, additional policies and initiatives have endeavored to rectify the problem, and scientists have conducted research regarding psychotropics and negative health outcomes. However, newer research within the last decade and at a national level is lacking. Therefore, this dissertation explores the association of psychotropic medications with falls and infections among NH residents using a national dataset, and this document is organized into five chapters. The first chapter discusses the background, significance, and current challenges surrounding psychotropic medication use in NHs. The second chapter delineates the search of the literature and relevant findings. The third chapter describes the methodology upon which this analytics of this dissertation was conducted. The fourth chapter outlines the results from the analyses. Lastly, the fifth chapter provides a synthesis and discussion of the findings and recommendations for health policy, practice, and future research.

Typescript (photocopy) Includes bibliographical references (leaves: 260-304)

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

To better understand Anglophone elderly experience in accessing health care services in a Francophone area, it is important to look beyond availability of healthcare services near their homes. This study explored factors such as language competence, preference, motivation, reaching and waiting times, as contributors to elderly people's choice. / A questionnaire designed for this study was administered to 199 males and females, aged 55 years and older, recruited from the only Anglophone Seniors' Centre in East-End Montreal. It was found that elderly people with limited French proficiency were more likely to travel out of their area for healthcare services, resulting in significantly longer average travel and waiting times. Of those who would have liked an interpreter, very few were actually able to get one. The most frequently expressed need was for more English or bilingual workers and services. / To improve access and enhance elderly people's quality of life, training and intervention programs need to be developed in collaboration with the government.

This study examines the importance of age, education, and the health system reforms in the mid 1990's on the utilization of five health services: specialists' visits, family doctor visits, non-physician health professional visits, hospital use, and home care services. The analysis focuses on the Canadians 45 and over, and uses data from the National Population Health Survey. / Results. Age per se has only a minor effect on utilization; the relative high utilization rates observed among the aged relate to the use of services by people with chronic conditions, whose prevalence is higher among the aged. Education has little impact on use of services among the aged. The reforms had only significant effect for four services. They increased utilization of non-medical health professional consults, and increased probability of consulting a specialist. They reduced length of stay, and decreased the number of visits made to family doctors.

Thesis (M.Sc.(Hons) Health) -- University of Western Sydney, 2006. / A thesis submitted for examination for the degree of Master of Health Science (Hons) to the University of Western Sydney, College of Health and Science, School of Nursing. Includes bibliography.

Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 2004.

Thesis (Ph. D.)--University of Missouri--Columbia, 1998. / Typescript. Vita. Includes bibliographical references (leaves : 67-70). Also available on the Internet.