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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.
Search results
Showing 311 to 318 of 318 (0.055 seconds)| 311 |
Adherence to antidepressants in psychiatry: a descriptive survey of outpatients in Johannesburg, GautengTaljaard, Lian 02 1900 (has links)
Text in English / Pharmacological treatment is often required in the management of psychiatric disorders. Non-adherence to medication represents a significant health concern that prevents patients from fully benefitting from their treatment, and can lead to negative consequences for individuals, their families and the healthcare system. The adherence rates to antidepressant medications in a sample of psychiatric outpatients in the Johannesburg Metropolitan district of Gauteng Province were examined. A descriptive survey method was employed to systematically collect data from n=377 patients using a structured, non-clinical questionnaire and the 8-item Morisky Medication Adherence Questionnaire. Variables were analysed using descriptive and correlational statistical methods. Antidepressant adherence rates were reported as 47.7% (low), 31.3% (medium) and 21% (high). These high rates represent a concern in antidepressant treatment, and health care practitioners and health systems must take this into consideration when planning and developing interventions to improve adherence in this area. The current study found significant correlations between
antidepressant adherence rates and some medication-, health system- and moderating variables. Based on these findings, interventions that provide appropriate health-related education about treatment and improved social support systems may be effective in addressing antidepressant non-adherence in psychiatric outpatients in this region. / Psychology / M. Soc.Sc. (Psychology)
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Klinisch-empirische Querschnittsstudie zur Mundgesundheit, mundgesundheitsbezogenen Lebensqualität und zum Ernährungszustand von ambulanten und stationären pflegebedürftigen Senioren im Landkreis Schwäbisch Hall / Clinical-empirical cross-sectional study of the oral health, the oral health-related quality of life and the nutritional status of senior citizens in need of care (outpatient and stationary care) in the county of Schwaebisch HallDenkler, Clara Rosa 19 March 2018 (has links)
No description available.
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Féminisation, activité libérale et lieu d'installation : quels enjeux en médecine générale ? : Analyses micro-économétriques de l'offre de soins / Feminisation, services provision and practice location : what issues in general medicine? : Micro-econometric analyses of outpatient care supply.Dumontet, Magali 29 June 2015 (has links)
Dans un contexte de grandes transformations de la médecine générale, cette thèse s’intéresse aux déterminants de l’offre de soins des médecins généralistes. Nous avons développé différentes stratégies micro-économétriques pour dans premier temps comprendre l’effet de la féminisation sur les revenus des médecins généralistes et plus particulièrement sur leurs comportements d’activité en termes de volume de soins fournis mais également de composition de l’activité. Dans un deuxième temps, nous cherchons à étudier les déterminants du choix du lieu d’installation des jeunes médecins généralistes, au sein d’une région et à identifier les leviers qui pourraient améliorer leur répartition sur le territoire. Nos résultats confirment que les femmes ont d’une part une offre de soins quantitativement plus faible que celle des hommes et que le contenu de leur offre est également différent. Toutefois, ils adoptent des comportements d’installation similaires. Les facteurs qui influencent le choix du lieu d’installation sont plutôt des caractéristiques du lieu, comme les caractéristiques associées à l’offre de soins, à la demande de soins, ou aux équipements. L’objectif de ce projet de recherche est, à travers une approche micro-économétrique, de mieux appréhender les préférences des médecins. Nous souhaitons comprendre ces préférences à travers les arbitrages travail/loisir du médecin et donc l’intensité de l’offre de travail (arbitrage entre nombre d’actes et durée de consultation), mais aussi selon les choix d’installation du médecin tant par le choix du lieu que par les modalités de cette installation, à savoir une activité libérale et ou salariée tout en sachant que ces décisions dépendent fortement des revenus espérés et donc de contextes différenciés de demande de soins. / In the context of changes of general practice (uneven distribution of young general practitioners (GPs) across the country, strong feminisation), this thesis focuses on the determinants of the outpatient care supply of general practitioners. Using different micro-econometric analyses, firstly we want to understand the impact of feminization on the incomes of general practitioners and specifically on their private practice behaviours in terms of volume of care provided but also composition of the activity (consultations, home visits). Secondly, we study the determinants of the practice location choice within the region and we identify the levers that could improve the distribution of GPs in the area. Our results confirm that female GPs provide fewer services than male GPs and they also have a different composition of private practice activity. However, we show that male and female GPs adopt a similar practice location choice. Factors characterizing the place of installation as the characteristics associated with the supply of care, the demand for care, or equipment influence the practice location choice.
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The influence of cross-sectoral treatment models on patients with mental disorders in Germany: study protocol of a nationwide long-term evaluation study (EVA64)Neumann, Anne, Swart, Enno, Häckl, Dennis, Kliemt, Roman, March, Stefanie, Küster, Denise, Arnold, Katrin, Petzold, Thomas, Baum, Fabian, Seifert, Martin, Weiß, Jessica, Pfennig, Andrea, Schmitt, Jochen 25 April 2019 (has links)
Background
Close, continuous and efficient collaboration between different professions and sectors of care is necessary to provide patient-centered care for individuals with mental disorders. The lack of structured collaboration between in- and outpatient care constitutes a limitation of the German health care system. Since 2012, a new law in Germany (§64b Social code book (SGB) V) has enabled the establishment of cross-sectoral and patient-centered treatment models in psychiatry. Such model projects follow a capitation budget, i.e. a total per patient budget of inpatient and outpatient care in psychiatric clinics. Providers are able to choose the treatment form and adapt the treatment to the needs of the patients. The present study (EVA64) will investigate the effectiveness, costs and efficiency of almost all model projects established in Germany between 2013 and 2016.
Methods/design
A health insurance data-based controlled cohort study is used. Data from up to 89 statutory health insurance (SHI) funds, i.e. 79% of all SHI funds in Germany (May 2017), on inpatient and outpatient care, pharmaceutical and non-pharmaceutical treatments and sick leave for a period of 7 years will be analyzed. All patients insured by any of the participating SHI funds and treated in one of the model hospitals for any of 16 pre-defined mental disorders will be compared with patients in routine care. Sick leave (primary outcome), utilization of inpatient care (primary outcome), utilization of outpatient care, continuity of contacts in (psychiatric) care, physician and hospital hopping, re-admission rate, comorbidity, mortality, disease progression, and guideline adherence will be analyzed. Cost and effectivity of model and routine care will be estimated using cost-effectiveness analyses. Up to 10 control hospitals for each of the 18 model hospitals will be selected according to a pre-defined algorithm.
Discussion
The evaluation of complex interventions is an important main task of health services research and constitutes the basis of evidence-guided advancement in health care. The study will yield important new evidence to guide the future provision of routine care for mentally ill patients in Germany and possibly beyond.
Trial registration
This study was registered in the database “Health Services Research Germany” (trial number: VVfD_EVA64_15_003713).
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Improving health care delivery in rural communities through the use of mobile phones : a case study in WindhoekIyawa, Gloria Ejehiohen 11 1900 (has links)
Poor health care delivery in rural communities is a major problem facing the health sector in Namibia.
Patients who visit rural communities often wait on queues for several hours every day before they can
be examined by a medical practitioner. This is detrimental to the health care process and impacts
negatively on the efficiency and effectiveness of the sector. Mobile phones can however be employed
as tools to improve work processes in such hospitals and as a result improve health care delivery in
rural communities.
The purpose of this study was to investigate the health care services provided to patients at Outpatient
Departments (OPDs) in rural hospitals through the use of data collection instruments such as
interviews, questionnaires, document analysis, expert validation and photographs in order to compile a
Mobile Health Service Framework (MHSF) to improve healthcare delivery processes in OPDs. From
an interpretive paradigm perspective, the qualitative design was used together with a case study
approach. Three hospitals in rural communities were used as case studies. These were Okuryangava
Hospital, Katutura Hospital and Khomasdal Hospital. Interviews were conducted and questionnaires
distributed to the participants. The findings revealed that there is a high concentration of mobile phone
usage in rural communities and there is a high usage of the SMS feature on such mobile phones. / Computing / M. Sc. (Computing)
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Vergleich von Anästhesieverfahren bei chirurgischen Eingriffen an der oberen Extremität / Regional anesthesia compared to general anesthesia for outpatient surgery on the upper limbGeibel, Stephan 09 August 2017 (has links)
No description available.
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Therapieprozess- und Ergebnisforschung in der Ambulanten Langzeit-Intensivtherapie für Alkoholkranke (ALITA) / Therapy process and outcome research on the Outpatient Longterm Intensive Therapy for Alcoholics (OLITA)Stawicki, Sabina 02 May 2007 (has links)
No description available.
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Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General HospitalLucas, D. Pulane 24 April 2013 (has links)
Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs.
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