To see the other types of publications on this topic, follow the link: Medical care – Utilization – Benin.
Dissertations / Theses on the topic 'Medical care – Utilization – Benin'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Medical care – Utilization – Benin.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Belanger, Marc Andrew. "Determinants of health care seeking behaviour in the Pahou PHC project in the People's Republic of Benin : an exploratory study." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68072.
Full textAbstract:
The goal of this study is to identify factors which may be preventing use of an experimental health care program in the People's Republic of Benin. While previous surveys have focused more specifically on the impact of fees on use and demand, our aim to identify a wider range of factors.There are two principle methods by which this can be done. One is to extract possible factors from a review of the relevant literature. The other is to carry out an exploratory, qualitative study in the field. We have used both these methods.
A qualitative study is a necessary prelude to a survey, since we initially have no specific idea about which factors to measure and investigate. The aim is to identify factors which may be relevant so that a subsequent survey, with a larger number of cases, could quantify and measure their influence and statistical significance.
2
Shah, Ruby. "Naloxone Utilization in a Tertiary Care Medical Center." Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/281779.
Full textAbstract:
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.The purpose of this research project was to review the use of naloxone for oversedation events from 2008-2011 at the Mayo Clinic Hospital in Phoenix, Arizona. Opiates are generally an accepted form of acute and chronic pain management. Opiate analgesic use has increased in past decades due to several factors including cultural and healthcare ideas on the importance of pain management, as well as the availability, cost, and marketing of the drugs. Concomitant with the increased use of opiates has been a rise in addiction, diversion, and abuse. In addition, opiate overdose is a potentially lethal consequence. Balancing the use of opiates for effective pain control and the possible risks of opiates is a constant effort for healthcare professionals. Monitoring the use of naloxone has arisen as an effective metric to examine the safety and outcomes of opiate utilization in a hospital setting. Reviewing every dose of naloxone delivered over the years 2008-2011 has allowed us to recognize trends that have led to improvements in patient safety. 154 cases of naloxone use for sedation events were reviewed in a retrospective case controlled unmatched chart review. We were able to determine that patient risk for oversedation is greatest within our surgical practices, especially general and orthopedic, and that the overall risk is greatest within the first 24 hours in all surgical patients. In addition, we were able to determine statistically significant increase in risk with elevated creatinine level, American Society of Anesthesiology (ASA) Class, and patient controlled analgesia (PCA) use compared to our unmatched control group. The significance of these findings is that it identifies certain risk groups and factors that carry increased risk for sedation events, and therefore can lead to improvements in quality and education across the institution.
3
Blanchard, Janice C. "Discrimination and health care utilization." Santa Monica, CA : RAND, 2006. http://www.rand.org/pubs/rgs_dissertations/RGSD198/.
Full text
4
Basu, Rashmita. "Healthy lifestyle, disease prevention and health care utilization." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Dissertations/Fall2009/r_basu_112309.pdf.
Full text
5
Cheng, P. Y. Rachel. "Gender differences in health service utilization among Hong Kong adults." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38479278.
Full text
6
Li, Nan. "Study of patterns of medical care utilization using computer algorithms." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0016/MQ54931.pdf.
Full text
7
Sonico, Eric A. "Implementation and utilization of electronic medical records| An analysis." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1522655.
Full textAbstract:
This master's thesis will present a literature review and analysis ofthe implementation and use of Electronic Medical Records (EMR). The literature review will discuss reasons that support implementation of EMRs, factors that are necessary for successful implementation and barriers that impede implementation. Also, real-world examples of implementation for medical billing in healthcare organizations will be discussed, as well as the disparity in implementation rates between larger and smaller healthcare organizations.
The analysis portion of this thesis will include data from the 2009 National Ambulatory Medical Survey (NAMCS) EMR Supplement and, through the application of the Chi-Square statistical test using SPSS, will assess whether size of the medical practice in terms of number of physicians is significantly associated with EMR implementation and functionality, the latter of which includes clinical reminders and prescription ordering. It will be shown that physician size is indeed significantly associated with implementation and functionality.
8
Robisnon, Brenda Joyce. "Is there an Association between Non-VA Medical Care Coordination and Utilization of Care?" ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2376.
Full textAbstract:
The Non-Veteran Administration Care (NVC) is a program in which the Veterans Health Administration purchases health care when it cannot provide the health services needed for eligible Veterans. The rising cost of this program led to audits by the Office of the Inspector General and other entities. The scholarly problem for this DNP Project was the lack of oversight, accountability, and management, found throughout the audits of NVC, as well as a lack of evaluation of NVC. The purpose of this project was to ascertain if there was a relationship between the Non-VA Care Coordination program (NVCC) and utilization of care. The NVCC was implemented to eliminate the deficiencies cited by audits. Sleep study and chiropractic consults for FY 2013 (pre-NVCC) and FY 2014 (post-NVCC) were examined. Sleep apnea service was available at the local Veteran Administration Medical Center and chiropractic service was not. Utilization of care was determined by emergency room (ER) visits and admissions related to the consult. A logic model was used to conceptualize the project and the longer-term implementation and evaluation of NVCC, and descriptive statistics were used to analyze trends in the chiropractic data (sleep study consults were excluded from the analysis due to the minute number). There were a total of 859 chiropractic consults and 2,184 approved visits analyzed. The results revealed that Veterans who utilized the consults had no ER visits or admissions related to referrals for chiropractic consults. Completed chiropractic consults remained proportionality the same both years. NVCC had no association with the utilization of care. This scholarly project contributes to social change by empowering consumers and providing transparency in the government through audits that facilitate quality improvement and evaluation of the NVCC program.
9
Boles, Brian Nelson. "An examination of relationships among indicators of socioeconomic status, health status, and selected health care utilization for fund allocation /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq21255.pdf.
Full text
10
Wong, Oi-ling Irene. "Medical ecology of inpatient service utilization in Hong Kong a population survey /." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31971337.
Full text
11
Lindrooth, Richard C. "Selective contracting, cost sharing, and utilization management : a theoretical and empirical analysis of the market for health care /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/7463.
Full text
12
Newman, Edward 1957. "An analysis of utilization of health services by the elderly in Canada /." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=42108.
Full textAbstract:
Population aging in Canada is expected to result in a sharp increase in the use of health services by the aged. The purpose of this thesis, is to enhance the knowledge of the utilization of the health system by the elderly. For this, an analysis of the utilization of three health services was pursued, using data from two health surveys, and two general social surveys in a statistical examination; to describe age-use; identify the major determinants of utilization; and to discover the sources of change in use. The results show that the aged were the highest users of health services among all age groups. Use increased for some services, and decreased for others. Changes in how people were managed by the health system, and to a lesser extent a rise in disease prevalence, were the primary sources of variations in utilization. There was no conclusive evidence of the presence of supplier induced demand. Population aging was not a significant determinant of changes in health service use, but rather factors associated with the management of the elderly by the health system; this includes technological changes in medicine, and changes in treatment patterns.
13
McKnight, Madalyn. "Utilization of Preventative Care Services by African Americans Post-Affordable Care Act." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7700.
Full textAbstract:
Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and health education. The health belief model was used to determine how belief and modifying factors influence health decisions. The quantitative study required use of a secondary dataset to determine utilization of preventative care services, insurance affordability, future access to care and understanding of the health care law. The study included testing the statistical significance of these factors among African Americans, White Americans, and Hispanic Americans who participated in the Healthy Americas Survey. Using the program SPSS to process data analyzation and organize output, results reveal that African American participants are concerned about the future ability to access and afford care. With a history of distrust amongst African Americans and the health industry, social implications are for administrators and providers to bridge the gap by offering health education to those in their immediate communities and requesting and implementing feedback from those same individuals.
14
Rein, David Bruce. "Modeling the health care utilization of children in Medicaid." Diss., Available online, Georgia Institute of Technology, 2004:, 2003. http://etd.gatech.edu/theses/available/etd-06072004-131339/unrestricted/rein%5Fdavid%5Fb%5F200405%5Fphd.pdf.
Full text
15
Wong, Oi-ling Irene, and 黃愛玲. "Medical ecology of inpatient service utilization in Hong Kong: a population survey." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31971337.
Full text
16
Sakyi-Addo, Isaac. "Inequality in Access to, and Utilization of, Health Care - The Case of African American and Non-Hispanic White Males." Thesis, University of North Texas, 2001. https://digital.library.unt.edu/ark:/67531/metadc2747/.
Full textAbstract:
Using data from the Household Component of the 1996 Medical Expenditure Panel Survey, the study compares (1) the accessibility, and (2) the predictors of health care services utilization among African American and non-Hispanic White males, 18 to 65 years old in the United States. Using ANOVA procedure in comparing the means for use of physicians, hospitals, doctors, and difficulty obtaining care, seven hypotheses were tested in the study. First, it was hypothesized that African American men of working age will have less access to health care services (physicians, hospitals, and dentists), and be more likely to report having experienced delay or difficulty obtaining care, compared to non-Hispanic white males of working age. Second, it was hypothesized that, controlling for health status, African American men of working age will have less access to health care services (physicians, hospitals, and dentists), and will also be more likely to experience delay or difficulty obtaining care, than non-Hispanic white males. This was followed by the third hypothesis which compared utilization of physicians, hospitals, dentists, and difficulty obtaining care among African American and non-Hispanic white males, controlling for health status and insurance coverage (any insurance, private insurance, any public insurance, and Medicaid). Hypotheses four through six compared the utilization of physicians, hospitals, and dentists, as well as difficulty obtaining care among African American and non-Hispanic white males, controlling for the following variables sequentially: health status and poverty status; health status and having a usual source of care; and health status and employment status, in that order. Finally, it was hypothesized that, controlling for health status, any insurance, poverty status, and employment status, African American men of working age will have less access to physicians, hospitals, and dentists, and experience more difficulty and delay obtaining care, compared to non-Hispanic white males of working age. Results from the study indicated that Hypothesis 1 was supported for use of physicians and dentists. Hypotheses 2, 3a and 3c were supported for use of physicians, hospitals, and dentists. Hypotheses 3b, 3d, and 4 received support for use of physicians, hospitals, dentists, and difficulty obtaining care. Additionally, both Hypotheses 5 and 6 were supported for use of physicians, hospitals, and dentists, with the last hypothesis being confirmed for use of physicians, hospitals, dentists, and difficulty obtaining care. The study calls for a closure of the gap in access to health care between African American and non-Hispanic white adult males in the US. A reform-oriented government-sponsored single-payer plan modeled after the Canadian health care system is recommended for the United States. A national health insurance plan is most likely to ensure equity of access, compared to others, in the sense that it is founded on the premise that everyone will be covered in a similar fashion. Considering the role of Community Health Centers in serving Medicaid and Medicare recipients, low-income uninsured and insured, the underinsured, as well as high-risk populations and the elderly, in the interim, they should be extended to every community in the United States.
17
Field, Kenneth Spencer. "Modelling health care utilization : an applied Geographical Information Systems approach." Thesis, University of Northampton, 1998. http://nectar.northampton.ac.uk/2708/.
Full textAbstract:
This research has emanated from the geographical concerns raised by organisational change in the British National Health Service (NHS), namely the ongoing debate relating to health and health care inequalities. This thesis develops a flexible, portable and predictive model of health care utilization capable of assisting improved health care planning and analysis. In so doing it contributes to the current resurgence in medical geography. An applied approach to this research is identified which builds upon methods of modelling spatial patterns and processes in geography and the upsurge of interest in Geographical Information Systems (GIS) technology. In these terms, the use of GIS is central to the research; it supports construction and application of the model; facilitates a wide range of analyses; and provides a basis for visualisation and interpretation of model results. The value of modelling in analysing relationships between health inequalities and the location and allocation of health care is identified through a discussion of previous NHS policy initiatives and previous research. From this, a conceptual model of utilization is developed which incorporates components of need, accessibility and provision. A patient survey of asthmatics and diabetics informs the development of the model and validates the choice of indicators used to measure utilization. Indicators of need, accessibility and utilization are thus defined and subsequently measured using a signed chi-square scoring method. The model was developed and tested for primary care General Practitioner services in the Northampton District Health Authority area and outcome measures are proposed and evaluated. Rigorous testing of the model’s sensitivity and robustness is undertaken and potential for its simplification explored. Components are critically evaluated through a comparison with alternative methods of determining spatial inequalities in disadvantage. The potential of the model of utilization for health care planning and analysis is extensively demonstrated through the application of a variety of modelled scenarios. Emergent issues from the research are considered and potential for future geographical research in this area of study, and the impact upon research agendas more generally, is explored
18
Johnston, Janice Mary. "Ambulatory care: a comparison of event and episode utilisation patterns." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31237125.
Full text
19
Soud, Fatma Ali. "Medical pluralism and utilization of maternity health care by Muslim women in Mombasa, Kenya." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010181.
Full text
20
Jones, French Allan. "The Analysis of Patient Status Following Substance Abuse Treatment and Utilization of Medical Care." Thesis, University of North Texas, 1988. https://digital.library.unt.edu/ark:/67531/metadc331514/.
Full textAbstract:
Subjects were 2,950 patients who had previously received inpatient treatment for substance abuse at 40 treatment centers in 13 states and were followed up by the Chemical Abuse/Addiction Treatment Outcome Registry (CATOR) via telephone during the 2 years immediately following their treatment. All subjects were contacted every 6 months and asked a series of questions regarding their relapse status, medical utilization, illnesses, injuries, and arrests. Patient status was based on 3 categories: (1) abstinence from any abuse of a chemical, (2) brief relapse of less than 3 months abuse of any chemical, or (3) total relapse of longer than 3 months of any chemical. Findings showed that abstainers had fewer days in the hospital for emotional problems and detoxification. Abstainers also had fewer visits to the hospital for emergency reasons. Males in the brief relapse category had a greater number of injuries than abstainers or total relapsers. Regarding arrests and automobile accidents, no difference was discovered. However, regarding Drunk While Driving (DWI) arrests, abstainers had fewer arrests.
21
Seligman, Laura D. "The Effects Of Anxiety and Depression on Children's Utilization of Medical Health Care Services." Thesis, Virginia Tech, 1996. http://hdl.handle.net/10919/36820.
Full textAbstract:
The current study was designed to examine the relationship between childhood anxiety and depression and
children's rate of medical care utilization. Additionally, the model examined
considered family and parental factors (family conflict, parental anxiety,
parental depression, and parental somatization) as well as children's level of
negative affectivity and demographic variables (ageand sex). A hierarchical
regression analysis was used to examine the effects of each of these variables
on rate of physician utilization and to control for the effects of demographic
factors, parent/family variables and negative affectivity while examining
childhood anxiety and depression. Results revealed that parental anxiety and
depression and family conflict contribute significantly to the explanation of
children's health care utilization. Additionally, child anxiety also explained
number of physician visits but only when considered in the absence of child depression.Master of Science
22
Bell, Sue Ellen. "Ethical issues for nurses in performance of utilization review /." Diss., ON-CAMPUS Access For University of Minnesota, Twin Cities Click on "Connect to Digital Dissertations", 1998. http://www.lib.umn.edu/articles/proquest.phtml.
Full text
23
Grammer, Kyndal, and Julia Dodd. "Perceived Need for Medical Care and Patient Satisfaction: Does Rurality Matter?" Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/asrf/2021/presentations/46.
Full textAbstract:
Many individuals, especially those in rural areas, experience barriers to accessing medical care. Some barriers are attitudinal and represent perceived quality of care, such as patient satisfaction; however, some rural residents report elevated patient satisfaction scores, regardless of limited access to these services. Identifying how perceived need for medical care is related to patient satisfaction has not been previously explored. Using an online survey to collect data from a national sample (n=535), the current study used the Patient Satisfaction Questionnaire-Short Form (PSQ-18) and a single-item measure of perceived need to examine the association between these two variables, and further, whether rural status, measured by a single-item measure, moderated this association. Results indicated a significant negative correlation between patient satisfaction and perceived need, r(423)=-.12, p=.012. Although the overall moderation model was significant, F(5, 388)=7.10, p<.001, perceived need was not significantly associated with patient satisfaction, b=-.14, p=.20, and rurality status did not significantly moderate the relationship, F(1, 388)=.44, p=.51, ��R2=0.01. However, the covariates of income, b=.11, p<.001, and sexual orientation, b=.23, p=.01, significantly predicted patient satisfaction. This study identified an association between patient satisfaction with perceived need for medical care that has not been previously explored, although this relationship was no longer significant in a larger model, indicating other important factors likely influence this relationship and contribute to the elevated satisfaction scores identified in some rural areas. The lack of moderation by rurality may be due to consistently high barriers to accessing care across all regions of the United States; while rural areas certainly experience unique barriers to care, the barriers present in urban environments may be significant enough that level of rurality in itself does not significantly affect the relationship between perceived need and patient satisfaction. Furthermore, this study highlights the importance of social determinants of health in patients’ perceptions of quality of care. Sexual orientation and income emerged as significant predictors of patient satisfaction, in that higher satisfaction was associated with those who identified as heterosexual and had higher income, consistent with previous literature. Further investigation is necessary to determine the reasons why these relationships exist; however, it is important to acknowledge that individuals with low-income and who identify as sexual minorities experience stigma and discrimination in healthcare settings. These negative experiences with healthcare likely influence perceptions and health disparities that exist within these individuals and may directly impact patient satisfaction levels, which may be influential to these findings.
24
Lanoye, Autumn. "The Impact of a Primary Care Psychology Training Program on Medical Utilization in a Community Sample." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3508.
Full textAbstract:
Mental illness and psychological distress is associated with higher rates of medical service usage and treatment of these issues results in more appropriate medical utilization rates. Little research has been conducted in an integrated care clinic, wherein health psychologists or behavioral health specialists work together with physicians to provide patient care. The current study examines the effects of brief behavioral and mental health interventions on patient medical utilization in this setting with care delivered by medical residents and doctoral psychology trainees. Access to the health system’s electronic billing records allowed for objective measures of annual healthcare utilization in terms of inpatient, outpatient, and emergency department use. A quasi-control group was constructed using propensity score matching in order to compare patients who had received a primary care psychology intervention to those who had not. Rates of inpatient utilization decreased significantly among treated patients overall as well as among treated patients identified as frequent attenders; there was no change in inpatient utilization among patients in the control group overall nor among frequent attenders in the control group, indicating that there is likely an effect of behavioral and mental health treatment on rates of inpatient visits. Rates of emergency department use and specialty outpatient visits were comparable between treated and control group patients, suggesting the lack of a treatment effect in these areas. Strengths, limitations, possible mechanisms, and implications for future research are discussed.
25
Cheng, P. Y. Rachel, and 鄭佩欣. "Gender differences in health service utilization among Hong Kong adults." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B39724372.
Full text
26
Rochon, Sophie. "Age and presence of chronic conditions, education and the health system reform : impact on utilization of health care services by the Canadian elderly." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=79806.
Full textAbstract:
This study examines the importance of age, education, and the health system reforms in the mid 1990's on the utilization of five health services: specialists' visits, family doctor visits, non-physician health professional visits, hospital use, and home care services. The analysis focuses on the Canadians 45 and over, and uses data from the National Population Health Survey.Results. Age per se has only a minor effect on utilization; the relative high utilization rates observed among the aged relate to the use of services by people with chronic conditions, whose prevalence is higher among the aged. Education has little impact on use of services among the aged. The reforms had only significant effect for four services. They increased utilization of non-medical health professional consults, and increased probability of consulting a specialist. They reduced length of stay, and decreased the number of visits made to family doctors.
27
Al-sultan, Muhammed S. "Using the medical expenditure panel survey (MEPS) to assess antibiotic utilization in acute respiratory tract infections /." View online ; access limited to URI, 2003. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3112112.
Full text
28
Li, Chenghui. "Reexamination of the disparity in utilization of medical care services between the insured and uninsured." [Bloomington, Ind.] : Indiana University, 2005. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3167798.
Full textAbstract:
Thesis (Ph.D.)--Indiana University, Dept. of Economics, 2005.Source: Dissertation Abstracts International, Volume: 66-04, Section: A, page: 1435. Adviser: Pravin K. Trivedi. "Title from dissertation home page (viewed Nov. 9, 2006)."
29
Hansen, Thomas Harold. "Utilization of Ambulatory Services by the Health Maintenance Organization of Florida." Master's thesis, University of Central Florida, 1988. http://digital.library.ucf.edu/cdm/ref/collection/RTD/id/16172.
Full textAbstract:
University of Central Florida College of Health ThesisThe utilization of ambulatory services by the health maintenance oranization of Florida (HMO), independent practice association (IPA) model, was compared to a fee-for-service population. Each randomly selected froup consisted of 250 patients being cared for by the same providers, at the same clinic, during the calendar year 1986. Demographic and clinical data was gathered from the office charts. Frequencies were evaluated by the Statistical Package for the Social Sciences and t-tests were run to substantiate variance at the 0.05 level of confidence. The HMO group is a younger population (t=0.017), and the males are responsible for the increased utilization of ambulatory services (t-0.001). Trends of increased utilization are noted across the age groups and the variables. The rate of hospitalization is insignificantly higher for the HMO population and covers a broader range of age groups. Consequently, this HMO IPA model increases the rate of ambulatory service utilization in a younger population without reducing the rate of hospitalization. Cost effectiveness studies and organizational management evalutions are needed.
M.S.;
Health
Health Sciences
51 p.
iii, 51 leaves, bound : ill. ; 28 cm.
30
Estrada, Antonio L. "Beyond Access to Health Care: Institutional and Cultural Barriers Experienced by Mexican Americans in a Southwestern Community." University of Arizona, Mexican American Studies and Research Center, 1996. http://hdl.handle.net/10150/219192.
Full text
31
Moutafis, Roxanne Alexis. "Symptomatology and life quality as predictors of emergent use." Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/277089.
Full textAbstract:
A nursing concern for patients with chronic obstructive airway disease (COAD) is to assist the patient/family in improving adaptation strategies and self-care abilities. Identification of emotional and behavioral characteristics impacting on symptoms and life quality may predict individuals at risk for greater utilization of health care resources. The purpose of this descriptive study was to apply Traver's Prediction Formula for Emergent Use to a more general COAD population to determine if the formula would accurately predict those subjects who have high versus low emergent use of institutional health care resources. Fifty subjects with a range of COAD severity were studied. Subjects completed instruments which measured symptoms and life quality: the Bronchitis-Emphysema Symptom Checklist and the Sickness-Impact Profile. Findings demonstrated Traver's Formula predicted low emergent subjects with 76 percent accuracy, high emergent subjects with 53 percent accuracy and predicted the overall emergent status of subjects with 67 percent accuracy.
32
Piterman, Hannah, and Hannah Piterman@med monash edu au. "Tensions around introducing co-ordinated care a case study of co-ordinated care trial." Swinburne University of Technology, 2000. http://adt.lib.swin.edu.au./public/adt-VSWT20050418.092951.
Full textAbstract:
The aim of the research was to analyse the organisational dynamics surrounding a health care reform implementation process associated with the introduction of coordinated care, which is an Australian Government initiative to introduce structural changes to the funding and delivery of health-care in response to rising health care costs. A longitudinal case study of an implementation team was studied. This included the perceptions and experiences of individuals and institutions within hospitals, the general practice community and Divisions of General Practice. Furthermore, the case study explored organisational structures, decision-making processes and management systems of the Project and included an examination of the difficulties and conflicts that ensued. The broader context of health care reform was also considered.
The study found that an effective change management strategy requires clarity around the definition of primary task in health care delivery, particularly when the task is complex and the environment uncertain. This requires a management and support structure able to accommodate the tensions that exists between providing care and managing cost, in a changing and complex system. The case study indicated that where tensions were not managed the functions of providing care and managing costs became disconnected, undermining the integrity of the task and impacting on the effective facilitation of the change process and hence, the capacity of stakeholders to embrace the model of co-ordinated care. Moreover, the micro dynamics of the project team seemed to parallel the macro dynamics of the broader system where economic and health care provision imperatives clash. Through its close analysis of change dynamics, the study provides suggestions for the improved engagement of stakeholders in health care change.
33
Chang, Wen-Chiung, and 張文瓊. "Long-term Care Arrangement, Continuity of Care, and Medical Care Utilization." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/93185354148295733166.
Full textAbstract:
博士國立臺灣大學
健康政策與管理研究所
102
Background and Objectives: With the trend of population aging, the society faces the challenge of increasing needs on long-term care and medical care. People with long-term care needs also have high demand on medical care. In addition to the factors of sociodemographic characteristics and health status, long-term care arrangement, which is shaped by policy design, could also exert influences on medical care utilization. Long-term care users usually have multiple and complex health care needs; therefore, the continuity of care could influence their health-care outcomes and subsequent medical care uses. At the present time, Taiwan is developing the formal long-term care system. It is needed to analyze experimental data to clarify the relationship between long-term care arrangement and medical care utilization, and provide this base information for system planning. The aims of this study include: 1) describing the medical care utilization of the middle-aged and older adults with long-term care needs, 2) exploring the relationship between long-term care arrangement and medical care utilization, 3) analyzing the association between continuity of care and medical care utilization, 4) examining the joint effects of long-term care arrangement and continuity of care on medical care utilization, and 5) comparing the effects of realted factors of medical care utilization among different long-term care arrangements. Methods: The data analyzed in this study was from the 2002 interview data of the Assessment of National Long-Term Care Need in Taiwan (ANLTCNT) and 2002-2003 claims data of the National Health Insurance (NHI). To estimate the long-term care needs in Taiwan, the ANLTCNT, a two-stage nationwide survey, was first launched in 2001. Subjects who met one of the following four criteria were defined as with long-term care needs and entered the second-stage survey: 1) one or more ADLs disability; 2) five or more IADLs disabilities; 3) cognitive impairment as measured with the Short Portable Mental Status Questionnaire (SPMSQ); or 4) unable to response SPMSQ due to dementia. A total of 13,110 individuals were analyzed in this study. Dependent variables were medical care utilization of outpatient visit, emergency department (ED) visit, hospitalization, and potentially avoidable hospitalization (PAH). For each type of medical care, whether used, number of episodes, length of stay (LOS) in one year (for hospitalization and PAH), and expenditures in one year were analyzed, In addition, the total medical expenditure in one year was also included in analyses. Independent variables were long-term care arrangement and continuity of care. Long-term care arrangement was categorized as 1) family caregiver or home- and community based services (HCBS), 2) without caregiver, 3) full-time, in-home care assistant, and 4) long-term care institution. Continuity of care index was computed by applying the method proposed by Bice &; Boxerman. Control variables included 1) predisposing factors: sex, age, and educational level, 2) enabling factors: copayment exemption, level of urbanization, and marital status, and 3) need factors: morbidity burden, depressive symptom, cognitive impairment, disability level, and unmet need. Descriptive statistics, χ2 test、ANOVA、t-test、multiple logistic regression, and generalized linear models (GLM) were used in statistical analyses. Results: Of the study samples, 60.7% were cared by family caregiver or HCBS, 14.3% had no caregiver, 16.0% hired care assistant, and 8.9% resided in institutions. The rates and numbers of using were 94.1% and 26.1 visits/year(yr) for outpatient visit, 32.6% and 0.7 visits/yr for ED visit, 36.3% and 0.8 episodes/yr for hospitalization, and 17.5% and 0.3 episodes/yr for PAH. Comparing with the family caregiver/ HCBS group, the individuals without caregiver had less hospitalization utilization and medical expenditures in all types of medical care. The care assistant group had higher utilization in outpatient and ED visits, hospitalization, and PAH, and total medical expenditure. The institution residents used more in outpatient visit, hospitalization, PAH, and total medical expenditure, but less in ED visit. Higher continuity of care was associated with lower risk and numbers of using outpatient and ED visits, hospitalization, and PAH. After controlling for continuity of care, the effects of long-term care arrangement on medical care utilization were still significant, but the magnitude of influence weakened, in particular for hospitalization and PAH. In the analyses stratified by long-term care arrangements, the effect of continuity of care on outpatient visit utilization was most significant in the care assistant group; however, the effects on ED visit, hospitalization, PAH, and total medical expenditure were more significant in the institutionalized group. The effects of morbidity burden on increased medical utilization were more relevant for those without caregiver. Higher disability was associated with lower outpatient visit and higher hospitalization utilization for the community-dwellers, but for the institution residents, the direction of effects was reverse. Conclusions: Long-term care arrangement could affect medical care utilization, and this association is partly mediated by continuity of care. Under different long-term care arrangements, the effects of the related factors of medical care utilization might be different. The findings of this study indicate the linkage between long-term care and medical care systems. Long-term care arrangement, which is directed by long-term care policy, could greatly influence the amount of medical care utilization in medical system. To improve the quality and efficiency of health care, policy makers shoud reinforce developing diverse HCBSs to support family caregiving, and modify the trend of over-dependency on foreign care assistants and institutionalization.
34
Lin, Yi-Hsuan, and 林衣瑄. "Unemployment, Medical Care Utilization and Health in Taiwan." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/40384699332957854462.
Full textAbstract:
碩士國立高雄大學
應用經濟學系碩士班
99
As the world was hit by the global financial crisis and the resulting economic recession, Taiwan also experienced stagnations of economic growth, wanes of export, and risings of unemployment in this crisis. Because of the continuing distressed economy, workers in Taiwan were dismayed by plant closure, layoff, and unpaid leave. As economic structure changed, the problem of unemployment became more severe in Taiwan. Unemployment rate are usually high in many developed countries. Unemployment made workers lose their main economic sources, which have enormous effects over a long period of time on individuals, families, and societies. In this study, we use National Health Interview Survey and National Health Insurance Research Database to examine the effect of unemployment on total medical care utilizations and health. The empirical results show that, the effect of unemployment on medical care utilization and health are varied by pre-health conditions. Unemployment made those who had mental diseases, cardiovascular diseases, or respiratory diseases need more clinical medical care utilization and were hospitalized more frequently; those who had diabetes need more hospital services and less clinical medical care utilization; considering those four diseases discussed above in the meantime, we find that clinic and hospital medical care utilization increase, and the probability of taking medical treatment rises after being unemployed.
35
Wang, Hsin-Hui, and 王新慧. "The Demand of Vitamin and Medical Care Utilization." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/64599547549187132097.
Full textAbstract:
碩士國立臺北大學
經濟學系
101
The purpose of the study is to examine the demand of vitamin and medical care utilization. Since health professionals have more health knowledge, the study first explores whether health professionals have more demand of vitamin than the general population. In order to understand the effect of vitamin, the study further analyzes the medical care utilization between vitamin users and non-vitamin users. Data are taken from the 2005 National Health Insurance Survey and the 2005-2007 National Health Database. It includes 20,434 people who were twelve years of age or older. A Two-Stage method is adopted in the research. Probit model is first used to examine the demand of vitamin and then OLS model is used to analyze the medical care utilization. The results show that health professionals don’t prefer eating vitamin than the general population. Although health professionals have more health knowledge, they don’t show higher demand for vitamin. Furthermore, the results also show that eating vitamin can’t reduce the numbers of outpatient visits significantly, but can reduce the outpatient expenditures and the total medical expenses significantly. In other words, eating vitamin probably can’t prevent illness, but vitamin can mitigate the severity.
36
Wang, Chao-Mei, and 王昭玫. "The Effects of Insomnia on Health Care Utilization and Medical Care Outcome." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/97754817248005177307.
Full textAbstract:
碩士國立中山大學
企業管理學系醫務管理碩士班
104
Objective: This research were to discuss the relationship between the outcome of health care utilization in medical car and patients with or without insomnia. In order to analyze the influence of health care utilization and medical care outcome from insomniac. Method: This research is a retrospective secondary analysis, mainly use the data from the National Health Insurance Database. To reduce the difference of each separate group, choose the Propensity Score Match as a main method. Then, control the gender , age and Charlson Comorbidity Index score based on the 1:1 proportion to set the newly diagnosis insomniac as a case group, and recipients without insomnia as a control group for discussing the impact of health care utilization and medical care outcome between case and control group by analyzing the statistics of t test, chi-square test and regression test. Result: This study results showed that high prevalence insomniacs are female adults, whose ages are between 45–64, and have higher clinic visit rate and emergency rate. In Charles Comorbidity Index, their score are basically 0. In addition, the research results revealed that the risk of patients visiting Psychiatric due to insomnia is (OR=5.56); the risk of visiting emergency in reason of insomnia is (OR=73.42), and the rate of visiting emergency in any reason is (OR=1.61). Conclusion: Patients with insomnia actually have higher utilization rate of health care and lower quality of medical care outcome.
37
Chung, Li-Ying, and 鍾麗英. "Medical Care Utilization of Children in Low-income Families." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/28137247516810541044.
Full text
38
Chang, Kai-Shiang, and 張凱翔. "The Relationship Between Living Environments And Medical Care Utilization." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/29037920429593202578.
Full textAbstract:
碩士國立臺北大學
經濟學系
101
This paper explores the relationship between living environments and medical care utilizations. Land price instead of housing price was used to measure living environments, due to the availability of the housing price data. On the other hand, medical expenditure was used to measure medical care utilization. The Data set comes from the 2001 National Health Insurance Survey and the 2001 Taiwan Land Price Index of Residential areas. The study uses Two-Stage Least Square to analyze the relationship. The result shows that the density of population, the average salary, and the numbers of medical staffs in each town have positively significant impacts on the land price. The residents living in the higher land-price area have more medical expenditures than those living in the lower land-price area. Since land price is a proxy of living environments and medical expenditure is a proxy of medical care utilization, we could infer that residents living in better living environments have more medical care utilization. However, even though residents living in better environments enjoy convenience and fast information, they also have to face polluted and crowed environments and have more pressure than the others which might lead to more medical care utilization.
39
Tsai, Shu-ling, and 蔡淑鈴. "Medical Care Utilization, Mortality and Unemployment in Economic Recession." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/67713826146252885334.
Full textAbstract:
博士國立陽明大學
公共衛生研究所
92
Part 1: Unemployment and Medical Care Utilization Previous research has shown that exposure to unemployment could have either health effect or income effect on medical care utilization. Objective: This study examines to distinguish health effect from income effect by studying total and five disease-specific medical care utilizations before and after exposure to involuntary unemployment under the National Health Insurance Program in Taiwan. Methods: A experimental study design with control group and fixed effect model were used. Two groups of people were observed from 1999 to 2002: (1) the involuntary unemployment group (n=92,562), and (2) the control group (n=92,443). The unit of observation was person-year. In order to obtain more precise estimates and control for possible confounders, the difference-in-difference (DD) method and generalized estimation equation (GEE) approach were conducted. Results: Decreases in both ambulatory and inpatient services utilizations were observed after unemployment. In terms of disease-specific utilization, 3 important findings are identified: (1) a decrease in utilization for common cold detected after unemployment exhibits a strong income effect of unemployment on minor diseases; (2) has no significant change in utilization for three cardiovascular diseases found after unemployment; (3) an increase in utilization identified for mental diseases after unemployment implies a significant health effect from exposure to unemployment. Conclusion: Income and health effects of unemployment on medical care utilization vary among types of diseases. One study limitation is that we only examines the short-term(one year) effects of unemployment on medical care utilization, so it is important for future study to further investigate possible long-term effects of unemployment on utilization. Part II: Unemployment and Mortality in Taiwan Background: Unemployment, and its consequences, is always of great concern during economic downturns. However, no empirical study has investigated the effect of unemployment on mortality in Taiwan. Objective: The aim of this study was to investigate the effect of unemployment on mortality in Taiwan - an environment with a high unemployment rate in 2001. Method: The study design was a cohort study with a control group. Each unit of observation was a subject, within the study population. The unemployed group included 92,563 involuntarily unemployed individuals in 2001. Those in the control group (n=92,599) were randomly selected from 1,230,000 employees, and matched with those in the unemployed group, by age, sex, income, firm size and urbanization, using a frequency matching mechanism. All subjects were followed during the period from January 2001 to December 2002. The adjusted hazard ratio was estimated using the Cox Proportional Hazards Model. Result: After adjusting for other factors, it was found that those who were unemployed (HR=1.99, 95%CI: 1.60, 2.48), had a higher risk of mortality than those who were employed. The gender specific adjusted hazard ratios for the unemployment of men and women were 2.07 (95%CI: 1.59-2.70) and 1.82(95%CI: 1.22-2.69), respectively. Unemployed men had a significantly higher mortality risk for cardiovascular disease, digestive system diseases, all other diseases (except for cancer, digestive system and cardiovascular diseases) and other external causes (not including suicide) than men who were employed. Unemployed women had a significantly higher mortality risk, only for other diseases, than women who were employed. Conclusion: Unemployment is one important risk factor for mortality in Taiwan. However, since the study population was followed only within two years of becoming unemployed, the long-term impact of unemployment on mortality still remains to be explored. Part III: Firm Size, Unemployment and Mortality It is well documented that job security is higher in larger firms. However, many speculate that as employees of larger firms tend to have a better job security, once they are laid off, they may face a more dramatic change in life and suffer worse health consequences than those of smaller firms. However, none has empirically studied how the relationship between unemployment and health vary by level of job security. Objectives: This study aimed to examine the relationship between job security, unemployment, and mortality using firm size as a proxy of job security. Methods: We performed a cohort study among 185,162 men and women, 15-64 years old, in Taiwan in 2001. This sample was followed from January 2001 to December 2002 on mortality. The mortality in relation to firm size and unemployment was analyzed using the multivariate Cox hazard model. Results: After adjusting for possible confounding factors, the laid off employees of larger and small firms had 2.64 times (95%CI: 1.94-3.59) and 1.43 times (95%CI: 1.04-1.96) higher mortality rates than those who are still employed, respectively. The mortality risk of unemployment on previous large firm employees was significantly higher than small firm employees (RR=1.87, 95%CI: 1.21-2.91). Conclusion: The study not only confirms previous finding of significant relationship between unemployment and health, but also shows that the relationship between unemployment and health was particularly strong among employees who are laid off by larger firms. The results warrant more public attentions on the unemployed, especially those who are laid off by larger firms.
40
LIN, SZU-CHEN, and 林思辰. "A Study on Emergency Medical Care Utilization of Elderly." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/29622604358725097365.
Full textAbstract:
碩士國立臺北護理健康大學
健康事業管理研究所
104
Background: Aging societies are a worldwide trend. In Taiwan, the ratio of population aged 65 or older reached 7.10% in 1993, suggesting that Taiwan had become an aged society. The rapid growth of aging population causes considerable impact on healthcare system, including emergency care. Frequent utilization of emergency care for degeneration-related conditions is not only a burden on medical resources, but it is also a sign of incorrect perspective on the purpose of medical services and can lead to diminished quality of medical practice. Unfortunately, domestic research on emergency care utilization remains scarce, especially on a nationwide basis. Objectives: To explore the 2012 emergency care utilization of elderly population in Taiwan and frequent access of emergency care and correlation factors. Methods: In this study, LHID 2010 released by National Health Research Institute was processed and analyzed with SAS 9.4 Package. Descriptive statistics was used to explore the 2012 emergency care utilization data of Taiwanese elderly population. Chi square (χ2 test), complex logistic regression was used to explore the correlation factors of elderly population emergency care utilization and frequent access of emergency care, respectively. Results: In 2012, 128,228 Taiwanese people were elderly aged 65 or older, where 31,957 (24.92%) have accessed emergency care with 62,605 person-time, on an average of 1.96 time each individual. Men aged 85 or older of low income that have their insurance locations in typical village/town/city/district and cities/towns with more aged population, had more than 30 outpatient visits and/or hospital stay in the previous year, and with CCI classification of 3 or higher are associated with higher utilization of emergency care. Of the emergency care users, 3,484 (10.90%) were frequent users and 141 (0.44%) were very frequent users. Men aged 85 or older of lower income that have their insurance locations in typical village/town/city/district and cities/towns with more aged population, had more than 30 outpatient visits and/or hospital stay in the previous year. With CCI classification of 3 or higher are associated with higher utilization of emergency care. Men aged 85 or older of low income that have their insurance locations in typical village/town/city/district and cities/towns with more aged population, had more than 30 outpatient visits and/or hospital stay in the previous year, and with CCI classification of 3 or higher are associated with higher utilization of emergency care and become frequent emergency care users. Conclusions: The emergency care utilization rate of elderly population is 24.92%, with 1.96 times annually on average. The factors contributing to very frequent utilization of emergency care include gender, age group, economic status (low income or not), degree of urbanization at insurance location, and the medical utilization and health status of patients in the previous year. Elderly populations tend to frequently access emergency care due to degenerated body function and co-morbidities, medical authority, and health policy makers are recommended to provide elderly population with activities for health promotion to improve overall health status and lessen the stress on emergency care practitioners.
41
Chuang, Yu-Ching, and 莊育菁. "Metabolic Syndrome, Morbidity Outcome, and Medical Care Utilization in Taiwan." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/38547806131754850544.
Full textAbstract:
碩士國立陽明大學
衛生福利研究所
96
Objectives: The aim of this study is to explore the correlations of metabolic syndrome and cardiovascular disease and diabetes morbidity outcome. The research also analyzes the relationship between metabolic syndrome and its major risk factors on medical care utilization in Taiwan. Materials and Methods: This study is a long-term follow-up cohort study. The data came from Taiwanese Survey on Prevalence of Hyperglycemia, Hyperlipidemia and Hypertension (TwSHHH). A total of 4,710 individuals were used in the analysis after excluding those who lacked information and had diagnosis of cardiovascular disease and diabetes at baseline. Subjects were followed up for cardiovascular disease and diabetes morbidity and mortality from 2002 to 2006 by linking their data to the National Health Insurance Research database and National Death Register, and their medical care utilizations were analyzed. In this study, classification of metabolic syndrome is based on the modified NCEP ATP III criteria for Asians. The statistical design includes description statistics, multiple logistic regression analyses, Cox proportional hazard model and multiple regression analyses. Results: After adjustment for age, sex, race, education, income, life style and cormobidity, the hazard ratio of developing cardiovascular disease, coronary heart disease（CHD） and diabetes for those with metabolic syndromes are 1.67（95%CI: 1.44-1.94, p<0.001), 1.52（95%CI:1.26-1.85, p<0.001）and 2.69（95%CI: 2.23-3.25, p<0.001）respectively, compared with those without such syndromes. The result also revealed that subjects with metabolic syndrome are at significant greater risk of cardiovascular disease mortality（adjusted HR=5.02, 95%CI:1.38-18.25，p=0.014）and diabetes mortality（adjusted HR=7.88, 95%CI:1.49-41.76，p=0.015）than those without metabolic syndrome. As numbers of risk factors from metabolic syndrome increased, the risk of cardiovascular disease and diabetes morbidity also increased. Under different disease severities, frequency of outpatient visits and total medical expenditure are significantly higher among subjects with metabolic syndrome than those without. As numbers of risk factors from metabolic syndrome increased, the cost of outpatient visit and admission also increased. Hypertension and elevated triglyceride are two significant predictors for outpatient visit and medical expenditure among the metabolic syndromes. Conclusion: People with metabolic syndrome are at increased risk of cardiovascular disease and diabetes morbidity and mortality than those without. Metabolic syndrome can be used as a multiple dimension risk factor assessment tool for clinicians to identify people with high risk of developing cardiovascular disease and diabetes at an early stage. Policymakers should encourage preventive screening strategy to detect major risk factors of metabolic syndrome in order to lower morbidity and mortality rates in the future, as well as reduce medical resources utilization and social cost, so that the burden of the health care system can be reduced.
42
Huang, Yu-Ching, and 黃玉卿. "Utilization Pattern of Medical Care on Low Back Pain Patients." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/43386494538550039003.
Full textAbstract:
碩士國立陽明大學
醫務管理研究所
94
Objectives: The purpose of this study is to explore the utilization pattern of medical care on low back pain patients and the related factors. Methods: This study applied secondary data analysis to NHI research database in 2004 provided by the National Health Research Institute. ICD-9-CM with initial three codes as 721, 722, 724, and 729.1 was selected from the database. Cases with the illness located at cervix or thorax were excluded. A total of 3,732,567 patients on low back pain in 2004 were retrieved as the study subjects. Logistic regression model and multinomial logit model were used to analyze the factors affecting the utilization pattern and tendency of medical care. Results: 1) Approximately two-third (67.18%) of patients on low back pain are the pattern of western medicine; follow by the pattern of Chinese medicine (22.89%), and the pattern of plural medicine (9.93%). 2) Logistic regression model shows that the patients retaining the following characteristic were more likely to be the tendency towards Chinese medicine: female, younger, better health status, and living at areas with more sufficient manpower in Chinese medicine or less sufficient manpower in western medicine. 3) Multinomial logit model shows that the patients retaining the following characteristic were more likely to be the pattern of plural medicine: poorer health status, and living at areas with higher urbanization degree. Conclusions: The results show that low back pain patients’ utilization pattern were western medicine resource. The patients characteristics, socio-economic level, health status, local resources were significant impact on low back pain patients’ utilization pattern of medical care.
43
Cheng, Wan Hsin, and 鄭琬馨. "Medical Care Utilization of Institutional Adult Inpatients with Intellectual Disabilities." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/44540894154761542278.
Full textAbstract:
碩士高雄醫學大學
醫務管理學研究所碩士在職專班
95
Objective This study investigated the disease category of hospitalization, the comorbidity of inpatient, the predictors of inpatient utilization of medical resources, and the predictors of hospitalization in institutional adults with intellectual disabilities. A structural equation modeling (SEM) was performed to test the validity of the causal structure of this research. Methods This study was a secondary data analysis. The sample included 161 adults of a handicapped institution, who have been hospitalized during 2003~2006. The information of demographic characteristics and handicapped characteristics was collected from the institution, and the information related to medical record and expenditure of hospitalization was obtained from the community hospitals, area hospitals and Bureau of National Health Insurance. Results This study found that the most common disease-categories were “respiratory disease”, digestive disease”, and “skin disease”. The disease-categories with the highest medical utilization were “tumor”, “endocrine related disease”, “respiratory disease”, and “injury and poisoning”. The stepwise multiple regression analysis showed that the significant predictors of inpatient medical utilization in adults with mental retardation were comorbidity, active level, and self-care ability. The logistic regression analysis showed that the self-care ability was a significant predictor of hospitalization in adults with mental retardation. Conclussion and Suggestion Improving the self-care ability, disease management and decreasing the comorbidity in those institutional handicapped adults, would be an important goal in the future.
44
Nyambi, Rachel N. "Health care in Cameroon a rural hospital utilization /." 1996. http://catalog.hathitrust.org/api/volumes/oclc/47661858.html.
Full text
45
Yang, Shunyu, and 楊順宇. "Relative Deprivation and Medical Care Utilization–an Application of Yitzhaki Index." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/26977919000900301341.
Full textAbstract:
碩士國立臺北大學
財政學系
99
The trend of income distribution in Taiwan has been deteriorating during the past two decades. According to statistics, the Gini coefficient and the difference in household income between top 20% to lowest 20% were both found increased. The magnitude was 11% and 22%, respectively. Based on social comparison mechanism, people with lower income or life quality may feel upset or oppressive and then could cause the feeling of “relative deprivation”. Under the relative deprivation, they may be more likely to get sick and result in more medical expenditures. The objective of this paper was to examine whether there is an association between relative deprivation and medical expenditures. The use of tobacco, wine and betel nut were also included in the analysis to control their impacts on relative deprivation, i.e. examining the impact of the mediator. The Yitzhaki’s index was applied to quantify the relative deprivation. Medical expenditures were grouped into two parts: NHI (National Health Insurance) coverage and out-of-pocket. Data were selected from 1999-2006 Survey of Family Income and Expenditure, which is a pooled cross-section data. To avoid the potential endogenous bias, the two stage least squares and Wu–Hausman test were adopted. The result showed that relative deprivation has a positive significant effect on both types of medical expenditures. This indicated that people who have higher relative deprivation tended to have more expenditures no matter whether it is out-of–pocket or not. Besides, the impacts of tobacco, wine and betel nut use were shown to be significant. But we do not have strong evidence for a dominant mediator. Due to the significant impact of relative deprivation, the authority needs to pay more attention on income redistribution policy to reduce the gap of income level and relative deprivation. By doing this, NHI financial crisis may be also improved.
46
Hsu, Chia-Ming, and 許家銘. "The effect of private health insurance on the medical care utilization." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/688mj3.
Full textAbstract:
碩士國立中央大學
產業經濟研究所在職專班
105
This research investigates the effect of private health insurance on the medical care utilization. This data source is 12 ~ 64 years old personal questionnaire of 2005 National Health Interview Survey (NHIS) in Taiwan. We use the ordinary least squares to analyze the effect of private insurance on the medical care utilization. Due to the endogeneity problem arising from the potential correlation between the unobserved factors affecting individual’s purchase of private insurance and the medical care utilization, the instrumental variable (i.e., “physical examination” and “safety consciousness”) was employed to overcome the estimation bias associated with the endogeneity. This research also explored the likelihood of medical service utilization by the Probit model. The research results indicated that private insurance and private health insurance both have a significantly positive influence on the medical care utilization; but the latter is reversely related to the self-pay hospitalization expenditure, though the estimate is statistically insignificant. The individuals with private insurance and private health insurance tend to use less outpatient and emergency visits. In addition, the elderly and the female use more outpatient care.
47
Peng, Yu-Chi, and 彭育棋. "Cloud Systems on the Utilization of Medical Care and Service Innovation." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/11099872630977761957.
Full textAbstract:
碩士中臺科技大學
長期整合照護與福祉服務產業碩士專班
101
With the advent of an aging society and health consciousness, government promotes preventive medicine, expected by early detection and early treatment to improve the cure rate of the disease, it also can retrench medical expenses, achieve win-win situation, therefore, is bound to need to import high added-value services, and health care cloud services is to "Service innovation" to think about the future of medical technology in Taiwan. However, the current domestic and international research on health cloud, mostly focuses on system development, system design, technical build, platform design and other four categories, few discuss medical issues related to cloud services innovation. Therefore, this study aims to explore innovative medical cloud technology service impact analysis of the value of service innovation, expected contributions for medical institutions for medical cloud into the future of intelligent life planning direction and innovative service model to enhance customer experiences.
48
LEE, PING-CHANG, and 李秉璋. "The Relationship between the Preventive Care Service and the Medical Care Utilization among the Elderly." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/84019336410248923974.
Full textAbstract:
碩士國立臺北大學
經濟學系
98
Since the inception of the National Health Insurance System in 1996, the bureau has been providing adult preventive care services, hoping to increase and maintain an individual’s health. Nevertheless, the usage rate was only around 40 percent. Furthermore, there are no other studies concerning subsequent medical utilization. Therefore, this research uses 「2001 National Health Interview Survey」and 「2001 & 2002 National Health Insurance Database」 which include 2,156 elderly aged beyond 65, to analyze the utilization of preventive care services in 2001 and medical utilization in 2002. The research uses logistic regression model to analyze the usage rate of preventive care services, and uses two-part model to analyze subsequent medical utilization. Logistic regression model is used in the analysis of whether or not an individual had received outpatient and inpatient care services. Negative binomial regression model is used to estimate the number of outpatient visits and length of stay in the hospital. Ordinary least squares regression model is used to analyze the medical expenditure. The study also uses instrumental variables in the regression in order to solve the endogeneity problem of medical utilization.The results show that the proportion utilizing preventive care services was only 31.03% which was quite low. There is a significantly positive likelihood of receiving preventive care services among those lived in the central and southern region. We also find that individuals aged 75 or more, have healthy status, have limitations in activities of daily living, do not exercise regularly, and smoked, there will tend to be a significantly lower likelihood of them using preventive care services. Moreover, individuals who use preventive care services tend to have higher probability of receiving outpatient service but lower length of stay during inpatient service. This indicates that serious illness can be detected and avoided in advance through preventive care services for the elderly.
49
Peng, Li-Ning, and 彭莉甯. "Association between Pain and Medical Care Utilization among Older People in a Veterans Care Home." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/40228500862267664606.
Full textAbstract:
碩士國立陽明大學
醫務管理研究所
99
Objectives：To explore the prevalence of pain and its association with medical utilization among residents in a veterans care home Materials and Methods：Residents aged over 65years in a veterans care home who participated in the Longitudinal Older VEterans (LOVE) study were enrolled. Measurements of pain were derived from the Minimum Data Set (MDS), and physical function of participants was determined by MDS ADL Hierarchy Scale. Cognitive function was evaluated by Mini-Mental Status Examination (MMSE). Depression was evaluated by Geriatric Depression Scale-Short Form (GDS-SF). Comorbidity was evaluated by Charlson’s comorbidity index (CCI), and care complexity was evaluated by MDS Resident Assessment Protocol (RAP) Triggers. Quality of life (QoL) was surrogated by MDS social engagement scale. Medical utilization was evaluated by the frequency of emergency department visit and hospital admissions according to the records in the veteran care home. Results：In total, 605 people (mean age:81.0±5.1years, all males) participated in the study. Among them, 92.9% were physical independent and 18.2% of all participants had mild-to-moderate cognitive impairment. Overall, 159 (26.3%) participants reported presence of pain, and117 (73.6%) of them had mild pain and the remaining 42(26.4%) participants had moderated pain. No severe pain had been reported. The most common site of pain was low back pain (54.1%, 86/159), followed by joint pain (29.6%, 47/159). Subjects with pain were more prone to have higher scores of GDS (2.3±2.4 vs 1.9±2.2, p<0.030) and higher sum of RAP triggers (4.7±1.9 vs 3.9±1.9, p<0.001) after adjustment of age, cognitive function and physical function. Triggers of psychosocial well-being, activities, ADL function/rehabilitation, falls and mood state were significantly associated with the presence of pain. Compared with pain-free subjects, subjects with pain were more likely to be hospitalized in the following year (0.7±1.2 vs 0.5±1.0, p<0.004) . Conclusion：In conclusion, the prevalence of pain among veteran care home residents in Taiwan was 26.3%. Subjects with pain had more depressive mood, higher care needs and were more prone to be hospitalized during the following year.
50
Cheng, Chi-hui, and 鄭啓慧. "The Influencing Factors of National Health Insurance Medical Expenses on Medical Care Utilization and Quality." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/25940828639271946835.
Full textAbstract:
碩士東吳大學
EMBA高階經營碩士在職專班
100
In recent years, due to population aging and medical introduction of new technology, it made the medical resources utilization to increase, the NHI medical expenses grow year by year. Therefore the National Health Insurance Bureau implement global budget payment system policy to control the growth of medical expenses, but controls the medical expenses disbursement easy to neglect to the medical quality value. How causes the control medical expenses growth and between the promotion medical service quality obtains the balance, is worth paying attention. This paper mainly discusses the influence factors of hospital outpatient medical expenses and drug expenses, using from 2005 to 2010 year statistical data. This paper use descriptive statistics and Panel Data model analysis method, to discuss medical care utilization and the quality to the outpatient medical expenses and drug expenses influence. The findings discovered that, the “ declare the number of outpatient cases” , “beneficiaries”, “consecutive drug prescription for chronic disease”, “outpatient injection drug usage rate” and “outpatient oral blood pressure lowering medicine different prescription repeat rate for drug use period” are influential to the outpatient service medical expense and the drugs expense. The “every 100,000 population mortality rate”, “contracted hospital institutions” and “outpatient anti-melancholia medicine different prescription repeat rate for drug use period” are influential to the outpatient service drugs expense.