The major purpose of this study was to develop an Adaptation
Model for emergency departments in urban and suburban Health
Maintenance Organizations. Questions explored which provided data
for the Model were: 1) are there significant differences in the
demographic, sociologic, and decision-making characteristics of
clients seeking services in emergency rooms and after-hour clinics?,
and 2) are there significant differences in perceptions of access-related
problems and stated preferences for personal physicians
among clients seeking such services? A pilot study was completed,
critiqued, and analyzed. Final research instruments were developed
for adults and children. Questionnaires were completed by 1,031
clients in an urban and suburban facility of the Kaiser-Permanente
Medical Care Program in Portland, Oregon. Data analysis was completed
using the Statistical Package for the Social Sciences sub-program
FREQUENCIES, CROSSTABULATION, AND DISCRIMINANT. Major findings of
this study were: 1) no significant differences existed in the
demographic and sociologic characteristics of clients, 2) significant
differences were found in perceived problems of access, in decision-making
characteristics, and in preferences for personal physicians.
Significant items were: 1) convenience of the facility location,
2) immediacy and availability of care, 3) contact prior to arrival,
4) instruction by "nurse" to seek care, 5) clients reporting they
did not have a personal physician, and 6) repeated use of the emergency
department during the previous year. Different profiles of
decision-making characteristics of urban and suburban clients resulted
from the analyses. The overall pattern of care for children
varied less between urban and suburban settings than did the pattern
of care for adults. Findings were discussed in terms of the traditional
model of emergency department care. Conflicts arising from
system "controls" provided the basis for suggesting changes incorporated
into the Adaptation Model. The basic premise for the Adaptation
Model advances the point at which triage occurs, eliminates
conflicts of control, and thus modifies both consumer behavior and
the emergency department system. / Graduation date: 1982
| Identifer | oai:union.ndltd.org:ORGSU/oai:ir.library.oregonstate.edu:1957/35630 |
| Date | 10 July 1981 |
| Creators | Robertson, Barbara J. |
| Contributors | Ellis, John K. |
| Source Sets | Oregon State University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
Page generated in 0.0022 seconds