<p> Perfect economic conditions in the national unemployment rate, healthcare crisis in the medical management of acute and chronic conditions, aging population, and the promotion of an active lifestyle culminate in the need of services for physical therapy to address the medical necessity in the healthcare management of musculoskeletal disorders. A private practice in the City of Redondo Beach is primed to provide the needed services patients are seeking to help address all their musculoskeletal needs and goals. The combination of specialized training, advance education, and excellent patient satisfaction is placing Ascend Physical Therapy at the forefront as the first and best choice for physical therapy. Patient outcomes will exceed expectations and will form a relationship with both patients, provider and referral source that will foster a healthy active lifestyle.</p><p>

<p> The current study focused is on the underrepresentation of registered nurses in hospital CEO positions. There are several existential gaps in chief executive officer (CEO) leadership in the United States. The gender gap in CEO positions across all sectors demonstrates that females represent 31% of CEO positions in the United States. However, females represented only 12% of hospital CEOs in 2007 (Plant, 2008). In 2016, females represented 36% of hospital CEOs. Nevertheless, a far greater gap exists as registered nurses represented 2.5% of hospital CEOs in 2007 (Plant, 2008), and 3.0% of hospital CEOs in 2016. The chronic underrepresentation of registered nurses (RNs) is irrespective of education, experience preparation, knowledge, attitude, skills, and habits as RN executives aspiring to become hospital CEOs often have more education and experience than their non-registered nurse counterparts have. The sample for the current qualitative grounded theory study had 30 participants including 10 RN executives currently employed and holding the title of hospital CEO, 10 non-RN executives currently employed holding the title of hospital CEO, and 10 decision-makers who have authority over the hospital CEO candidate selection process. The current study employed grounded theory method to develop a substantive grounded theory of why the phenomenon of the underrepresentation of registered nurses in hospital CEO positions exists. The substantive grounded theory developed in the study might help decision-makers involved in the hospital CEO selection process adjust their selection strategies so they evaluate hospital CEO candidates equitably. Registered nurses aspiring to become hospital CEOs might also benefit from the study by altering their career development strategies so the decision-makers perceive them as qualified candidates for the position of hospital CEO.</p><p>

<p> The Healthcare System in the United States is in dire need of improvement and reform for preventive healthcare. Diseases that can be prevented compose a significant problem due to the high costs they impose on our system. Beyond the Stroke is an organization which caters to past stroke victims who seek prevention form a future stroke by making lifestyle changes. Beyond the Stroke offers their health services with the main goal of educating and raising awareness to facilitate better decision making to its patients. Patients with recurrent stroke have a markedly higher mortality than patients with a first-ever stroke, but those who survive recover as well and as fast as patients with a first-ever stroke. The business plan for this organization is divided into 4 main parts. Chapter 1 will provide a complete market analysis with an overview of a full company and market analysis. It will also summarize the target population, services provided and main purpose. Chapter 2 provides a full feasibility analysis by the SWOT analysis, shedding light on potential success and problems this organization may face as it develops. Chapter 3 will focus on legal and regulatory issue enforcement along with litigation and medical compliance laws that Beyond the Stroke will to abide to. Chapter 4 explains a clear financial analysis to ensure business probability.</p><p>

Consumers value health and a sense of well-being. The health care system cannot supply these values, but only "products" such as hospitalization, ambulatory care, medications, procedures, and preventative care. These components of health care represent neither the value within the system nor the desired final output. Nonetheless, the health care system has focused inordinately on the products, to the point of suggesting that they have intrinsic value. We link this situation to the concept of goods-dominant logic, which has dominated business and managerial thinking since the Industrial Revolution. We then explain why and how moving to service-dominant logic is essential for consumers and providers to better cocreate value from products which are not intrinsically valuable. The challenge of cocreating value is confounded by information asymmetry, and by the myriad factors in the health care ecosystem that contribute to or detract from health and well-being. A new lexicon, emanating from service-dominant logic, is suggested to facilitate the move away from a goods-dominant mindset.

Magister Chirurgiae Dentium - MChD / HIV/AIDS is a major problem in South Africa with more than 25 percent of the adult population infected with HIV. Oral lesions and various opportunistic infections characterize the progression of HIV making it imperative for people living with HIV to have access to good quality oral care. There is a need to examine accessibility and use of dental services in South Africans living with HIV as very little research in this regard, has been undertaken. Aim: To investigate the barriers to oral health care for people living with HIV in the KZN and the WC. Research Design and Methodology: A cross-sectional study utilising a self-administered questionnaire and semi-structured interviews has been employed. Participants were people living with HIV older than 18 years attending HIV clinics located throughout Kwa-Zulu Natal and WC. Binary logistic regression was performed to determine the variables associated with not obtaining care. / South Africa

Philosophiae Doctor - PhD / Decentralisation has been considered by many as one of the most important strategies in public sector reform in several of the developing countries. Both donors and governments have regarded decentralisation as a tool for national development through the realisation of the objectives of enhancing popular participation in development and the management of development at the regional or local level. Countries are expected to reap the benefits of decentralisation through improved service delivery, namely, through bringing service delivery closer to the consumers, improving the responsiveness of the central government to public demands and,thereby,reducing poverty and inequalities, improving the efficiency and quality of the public services and empowering lower levels of government to feel more involved and in control. However, decentralisation also has the potential to widen the gap in fiscal resources at the sub-national leveland this may, in turn, result in inequities in service delivery tocitizens of the same countryanddepending on where they live. Over the years Ghana has experimented with amix of decentralisation reforms with the current policy integrating elements of political, administrative and economic decentralisation. The current system of local government in Ghana is based on a decentralisation programme that was launched in 1988 with the introduction of district assemblies (DAs) by the Provisional National Defence Council (PNDC) government. Nevertheless, years after the launch of the decentralisation process there are still significant disparities and inequities between districts and regions in Ghana as regards health variables. This study set out to investigate the link between decentralisation and health inequities by exploring the spatial dimensions of health equities in Ghana. The thesis used a concurrent mixed method approach by combining a quantitative inequality indices analysis and a qualitative analysis of interviews with policy makers in both the health sector and the decentralised system. The analysis used household level data from the Ghana Demographic and Health Survey 2003 and 2008 to construct inequality curves and indices in order to illustrate the existing inequities across and within regions in Ghana after an increase in the intensity of decentralisation. The study then decomposed the indices to determine the extent to which these inequities were accounted for by variations both within the regions and between the regions. The thesis also used available data from the common fund records of district assemblies to assess the level of inequities in selected health resources across districts. The thesis then investigated the micro-foundations of health decentralisation using the qualitative and quantitative descriptive analyses. The analysis conducted revealed that inequities in maternal health utilisation decreased between 2003 and 2008‒the two data points used based on theresearch design. However,these inequities were attributed primarily to within region inequities as the level of between regions inequities was significantly lower for both the concentration index and the Theil’s index. However, although, at the regional level the general trend revealed that inequities had also decreasedbetween 2003 and 2008, some individual region s had recorded increases. The concentration index, which provided information on the gradient of the inequities, revealed that the health inequities in Ghana‒the total health inequities and also for both years between and within regions‒were pro rich. In the instances of the regional inequities these inequities generally manifested a pro rich nature, with the exception of the Upper East region which had showed pro poor inequities in 2008. The analysis of the district level inequities in selected health resources and as regards health facilities, doctors and nurses indicated that the distribution of these facilities favoured the richer districts as the inequities revealed a pro rich gradient. The inequities in the health facilities at the district level were highest in respect of the nurses, followed by doctors and health facilities with scores of 0.32, 0.29 and 0.084 respectively. The analysis of the qualitative data corroborated the results of the quantitative analysis as it emerged that policy makers at all levels believed that, over the years since the decentralisation, inequities had reduced, albeit marginally. The policy makers highlighted the high levels of the inequities in health resources,especially human resources,as a major area of concern. However, they also raised major concerns regarding inequities within regions, arguing that a number of factors, includingthe nature of the decentralisation regime in Ghana, the variations in the economic strength of districts and certain political factors,continued to cause inequities within the decentralised system. They argued that these factors impacted on the ability of both districts and regions to address inequities at a local level. In addition, they also pointed to the need to re-examine the definition of inequities in the Ghana health sector, inequities which result from focusing the attention on a number of regions and areas to the detriment of others.

<p>The Juvenile Diabetes Empowerment Center is a business located in the city of Los Angeles, Ca that focuses on educating children diagnosed with diabetes mellitus about their condition. The company offers a place where children can spend an entire day learning and connecting with other children who share the same condition. Education is offered by means of formal lecture, small group discussion involving therapeutic communication, and educational video games developed using BrainPoP software. The goal of the company is to empower children living with diabetes through teaching them how to independently manage their condition effectively. The business plan gives an in-depth description of how the Juvenile Diabetes Empowerment Center operates and discusses the company?s strengths, weaknesses, opportunities, threats, and regulatory issues. Furthermore, financial assumptions are explained in detail and an excel spreadsheet is attached displaying the company?s increasing cash valuation trend during the first three years of operation. The financial development of the Juvenile Diabetes Empowerment Center will allow the company to help empower children with diabetes both physically and emotionally while continuing to grow and offer a valuable service to the community.

This dissertation investigates how patient-perceived integrated care and manager commitment influence the improvement and integration of health care delivery. Using survey instruments, across three studies I examine potential mechanisms for improving health care delivery: patient perceptions of integrated care, a physician organization care management program, and manager commitment to a quality improvement program. In Chapter Two, I examine how patient-perceived integrated care relates to utilization of health services. I assess relationships between provider performance on 11 domains of patient-reported integrated care and rates of emergency department (ED) visits, hospital admissions, and outpatient visits. I find better performance on two of the surveyed dimensions of integrated care are significantly associated with lower ED visit rates: information flow to other providers in doctor’s office and responsiveness independent of visits. Better performance on three dimensions of integrated care is associated with lower outpatient visit rates: information flow to specialist, post-visit information flow to the patient, and continuous familiarity with patient over time. No dimension of integration is associated with hospital admission rates. In Chapter Three, I use the same patient sample to evaluate the achievement of integrated care by a care management program (CMP) from the perspective of older patients with multiple chronic conditions. Survey results suggest that patient perceptions of integrated care vary substantially among survey items and domains. CMP enrollment is significantly associated with greater patient perceptions of care integration in two domains: connecting patients to home services and being responsive independent of visits, domains that were targeted for improvement by the CMP. Enrollment in the CMP is not significantly associated with other domains of integration. In Chapter Four, I assess whether and how senior and middle manager commitment to a falls reduction quality improvement (QI) program is associated with the successful implementation of the program. Survey results suggest managers’ affective commitment to the program is positively associated with program implementation success across all manager levels surveyed (senior managers, middle managers, and assistant middle managers). Stronger frontline worker support for the falls QI program partially mediates the relationship between manager affective commitment and falls program implementation success for middle managers and assistant middle managers, but not for senior managers. Manager affective commitment to the falls program mediates the relationship between organizational support for the falls program and program implementation success across all manager levels. Together, these studies advance our understanding of how patient-perceived integrated care, care management programs, and manager commitment to a quality improvement program influence the integration and improvement of health care delivery. Findings demonstrate how patient reports of integration can be useful guides to improving health systems. Dissertation results also provide empirical evidence of a relationship between manager commitment—at both the middle and senior manager levels—and successful QI program implementation. In addition, these studies provide practical implications for physicians and hospital managers seeking ways to improve the quality and integration of health care delivery. / Health Policy

<p> Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way ANOVAs indicated that between 2% and 9% of health care costs could be attributed to type of health insurance, a statistically significant finding. Results also supported the effectiveness of the ACA in stabilizing health care costs. The average annual rate of health care cost increase was 38.6% from 2007 until 2010, decreasing to an average annual increase of 4.3% from 2011 until 2014. Results provide important information to generate positive social change for consumers, providers, and policymakers. This includes improving decisions related to health care costs, improved understanding of the costs of health care services, increased transparency, increased patient engagement, maximizing consumer utility, facilitation of reduction of waste within the industry, and increased understanding of the impact of health policy on health care costs and efficiencies within newly created health policies. Results may also improve transparency of health care costs, which allows consumers, providers, and policymakers to take specific action to reduce health care costs, resulting in a more just and sustainable health care model.</p><p>

<p> Objective. To systematically evaluate and compare healthcare innovations in three geographically small nations, Ireland, Israel, and Switzerland, and to explore the factors that contribute to both innovations and diffusions of innovations. </p><p> Design. Systematic review of published articles. </p><p> Data Survey. CINAHL, ProQuest, PubMed Central, Google Scholar and Citation Lists. All articles published 2017 and earlier will be included in the search. </p><p> Review Method. Articles describing innovation in healthcare, diffusion in innovation, and/or innovation indicators in Israel, Switzerland, and Ireland were selected for review. Only scholarly journals were accepted. </p><p> Results. The data analysis for this systematic review followed the PRISMA guidelines that encapsulated the basic eight steps for systematic review process. Academic search engines were used to identify studies relevant to the topic under study. The CASP checklist was used to evaluate the quality of the study, along with determining whether the study met the eligibility criteria for this systematic review. Eighty-nine full text sources were included in the final assessment, and 57 of these were excluded from the final review because, while some appeared in scholarly journals, these were either webpages, conference papers, commentaries, interviews, or news related. The 32 remaining full text articles were included in the review. </p><p> In addition to the systematic literature review, six Subject Matter Experts were interviewed. Participants&rsquo; responses showed clear perspectives on the critical success factors v necessary for healthcare innovation to thrive within a country and an organization. Their responses overlapped in answering each of the research questions. The principal areas of concern included committed leadership, collaborative cultures, cost effectiveness, planning, and futureoriented thinking. These areas were the top critical success factors for healthcare innovation. However, these also represented concerns about and barriers to it. The absence of these factors potentially stalled innovation in a country. This stall occurred if that country lacked openness to new ideas or was extremely risk adverse. These various factors required further study to understand the overall effect on healthcare innovation in different contexts. </p><p> Conclusion. Small nations that innovate in healthcare benefit the most from government subsidies of research and development. Additionally, benefits accrue exponentially with strong global partnerships. The development of national and international partnerships occurred when existing internal information was shared at the beginning of the innovation process. Connecting healthcare stakeholders is necessary for improving innovation experts. Developing new methods of measuring innovation will significantly aid in understanding the influence of adaption and diffusion of innovations in healthcare systems. The implications of this study suggest that our understanding of innovation and innovation diffusions have the potential to lead to adaptations. However, we don&rsquo;t yet fully understand the most efficacious way to measure innovation and its impact on society.</p><p>