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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Factors That Determine The Outcome of Valvular Disease Among Patients, Based On The Type Of Hospital, Location Of Patient, And Type Of Insurance.

Onakpoma, Francis, Okeke, Francis, Mamudu, Saudikatu, Olomofe, Charles, Mamudu, Hadii, Husari, Ghait, Weierbach, Florence, Asifat, Olamide, Paul, Timir, Ahuja, Manik 25 April 2023 (has links) (PDF)
Valvular disease affects the heart's valves and can lead to complications if left untreated. In 2017, about 2.7% (U. S) of the population had a valvular disease. The Centers for Disease Control and Prevention (CDC) also estimated that about 2500 Americans die yearly due to valvular disease. Several factors, such as the type of valvular disease, can affect the outcome of this disease. However, the hospital type, insurance status, and location of the patients may determine the quality of care and valvular disease outcome. Teaching hospitals are often in urban regions and house various well-grounded specialists as well as tools and equipment that may be a significant contributory factor to the outcome of Valvular heart disease. This study aims at determining the importance of quality of healthcare access in the outcome of valvular disease. At the bivariate analysis level, it was hypothesized that the type of hospital, location of patients, and age at diagnosis are significantly related to the outcome of valvular disease. At the multivariate level, it was hypothesized that after controlling for every other variable, the predictor variables were significantly related to the outcome of valvular disease. Data analysis was conducted on cross-2012 sectional National Inpatient Survey (NIS) data. The Core, severity, and hospital data were used for this analysis. Descriptive statistics and bivariate and multivariate logistic regressions were conducted to assess the association between the outcome of valvular disease and the type of hospital (teaching or non-teaching), patient location, age at diagnosis, insurance, income, and sex. All analysis was performed using the Statistical Analysis System (SAS). The results of the descriptive study showed about 2.9% of patients had comorbidity from valvular disease. Patients attending teaching hospitals had a 0.3% comorbidity present (P =.001). At the multivariate analysis level, patients at the teaching hospital were less likely to have comorbidity compared to individuals at non-teaching (AOR = 0.735; CI = 0.549, 0.970, P = 0.0303). Patients with public or no insurance were less likely to have a comorbidity of valvular disease as compared to patients with private insurance (AOR =0.596, AOR =0.288; CI = 0.393, 0.904 CI= 0.120, 0.692 P= 0.0149 P= 0.0054 respectively). Also, males were less likely to have valvular heart disease comorbidity as compared to females. All other variables not mentioned were not significant in the multivariate analysis. Accreditation programs can ensure that non-teaching hospitals have the necessary resources, equipment, and personnel to manage the valvular disease. Furthermore, providing incentives, such as financial support or performance-based incentives, can encourage non-teaching hospitals to invest in the necessary resources and personnel to manage valvular heart disease. We also recommend awareness campaigns and screening programs for patients in rural regions.

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