A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Background: Despite the widespread availability of vaccines, including to the uninsured, significant numbers of both children and adults, remain unvaccinated or undervaccinated. Many reasons, including an increasing financial burden on primary care practices, availability of access to healthcare, and beliefs regarding vaccine safety, have been implicated; however, increasing concern has arisen regarding insurance payments for vaccines to providers [2, 5, 8]. Due to these concerns, we conducted a survey to understand the attitudes, perceptions and practices of Arizona pediatricians regarding vaccines and their reimbursement by insurance companies. Methods: In February 2011, 1407 standardized surveys were emailed, 87 surveys were faxed, and 216 surveys were mailed to AZ pediatricians who were listed in the Arizona Chapter of the American Academy of Pediatrics membership database. Results: From the 138 (9.0% response rate) responses, we identified that about half of all provider respondents refer insured and uninsured 5 patients to public health or other outside clinics for vaccines. The most common reason for outside patient referral for vaccine is inadequate reimbursement by insurance companies, and approximately one-third of providers did not vaccinate a patient due to inadequate reimbursement. Additionally, the vast majority of providers were interested in participating in a buying group run by TAPI. Conclusions: Based on our survey, inadequate reimbursement for vaccines by insurance companies negatively affects Arizona pediatricians’ provision of immunizations. A provider buying group coordinated by a not for profit immunization coalition is one possible solution for this problem.

No description available.

This thesis analyses transformations in pediatrics during its history as an organized medical specialty. Pediatricians emerged in a period of high infant and child mortality and poor public health to fight disease and treat difficult feeding problems. After mortality rates began to decline they turned to prevention, supervising the normal growth and development of healthy children. However, as prevention absorbed an ever larger proportion of their time, they became bored and dissatisfied. During the 1970s, competing groups of child health care providers such as pediatric nurse practitioners and family practitioners exacerbated pediatricians' difficulties. Worried about their possible disappearance as primary care specialists, pediatricians sought a new mission in ministering to children's non-physical problems. The "new pediatrics" focuses on the behavioral and psychosocial problems of children and adolescents. This study contributes to understanding how professions respond to changes and threats in their environment.

No description available.

Over the course of the past three decades, largely due to advances in technology, there has been growth in the fields of early intervention (EI) and pediatrics for infants/toddlers with special health care needs (SHCN). This growth has also brought about a change in the relationship between pediatricians and EI service coordinators, creating an increased need for communication and collaboration between these groups of professionals. In order to address these changes, the American Academy of Pediatrics (AAP) presented recommendations for care coordination and stressed the placement of care coordination practices in the medical and developmental plans of infants/toddlers with SHCN. There have also been recommendations about communication and collaboration strategies from experts in the EI field. The medical home framework and Part C (EI) of the Individuals with Disabilities Education Act (IDEA) seek to establish care coordination systems with a family-centered focus of care. The purpose of this study is to examine care coordination within the context of the pediatric medical home and EI service coordination. Eighty- two pediatricians (n=1746, 4.7%) and 52 service coordinators (n=468, 11.1%) returned The Care Coordination Survey. Responses to the 40-item quantitative survey were analyzed using descriptive statistics and independent sample t-tests. Results indicated that pediatricians and service coordinators are implementing a number of key care coordination practices such as being available to clients/patients at their convenience. However, it was also found that both groups of professionals are not consistently providing a number of recommended care coordination practices such as sharing information between disciplines (e.g., contact information, assessment results). The results also offer implications across disciplines and reveal a need for future research in areas, such as training models across disciplines and developing a care coordination model to fit both disciplines.

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008. 149 p. / Objectives: To investigate the knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, and to determine if any correlation exists between the two. Methods: A posted quantitative questionnaire was used to collect data from Paediatricians in South Africa. Follow up telephonic calls were made to encourage response from participants. After a 12-week period, returned questionnaires were collected and data analysed. Results: The results obtained (25% response rate), indicated that there are relatively low levels of knowledge and poor perceptions amongst Paediatricians, which was supported by the low referral rate from Paediatricians for Chiropractic treatment. With regard to perception, Paediatricians seem to have a better perception of Chiropractic for the general compared to the paediatric population. Paediatricians felt that they do not have enough knowledge to discuss Chiropractic with their patients and would like to be further informed. This was reflected in the statistically significant correlation between knowledge and perception, and it would seem that better knowledge allowed for more positive perceptions. The study also found that Paediatricians agreed that they would like to receive treatment feedback after referring a patient for Chiropractic treatment and they were more likely to refer to a Chiropractor if they had a post-registration paediatric specialisation. Conclusions: A correlation exists between knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, with both being relatively, although better perceptions of Chiropractic for the general than for the paediatric population exist.

While information technology has rapidly changed work in the United States in the past 50 years, some businesses and industries have been slow to adopt new technologies. Healthcare is one industry that has lagged behind in information technology investment for a variety of reasons. Recent federal initiatives to encourage IT adoption in the healthcare industry provide an ideal context to study factors that influence technology acceptance. Data from 261 practicing pediatricians were collected to evaluate an extended Technology Acceptance Model. Results indicated that individual (i.e., perceived usefulness, perceived ease of use), organizational (i.e., subjective norm), and device (i.e., compatibility, reliability) characteristics collectively influence pediatricians' intention to adopt tablet computers in their medical practice. Theoretical and practical implications are discussed. Future research should examine additional variables that influence information technology adoption in organizations.

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008. 149 p. / Objectives: To investigate the knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, and to determine if any correlation exists between the two. Methods: A posted quantitative questionnaire was used to collect data from Paediatricians in South Africa. Follow up telephonic calls were made to encourage response from participants. After a 12-week period, returned questionnaires were collected and data analysed. Results: The results obtained (25% response rate), indicated that there are relatively low levels of knowledge and poor perceptions amongst Paediatricians, which was supported by the low referral rate from Paediatricians for Chiropractic treatment. With regard to perception, Paediatricians seem to have a better perception of Chiropractic for the general compared to the paediatric population. Paediatricians felt that they do not have enough knowledge to discuss Chiropractic with their patients and would like to be further informed. This was reflected in the statistically significant correlation between knowledge and perception, and it would seem that better knowledge allowed for more positive perceptions. The study also found that Paediatricians agreed that they would like to receive treatment feedback after referring a patient for Chiropractic treatment and they were more likely to refer to a Chiropractor if they had a post-registration paediatric specialisation. Conclusions: A correlation exists between knowledge and perceptions of Paediatricians in South Africa with respect to Chiropractic, with both being relatively, although better perceptions of Chiropractic for the general than for the paediatric population exist.

Thesis (Psy. D.)--Indiana University of Pennsylvania. / Includes bibliographical references.

Thesis (Ph. D.)--UCLA, 2009. / Vita. Includes bibliographical references (leaves 341-368).