Dissertations / Theses: 'Medical Medical care'

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Higgins, Peter McRorie. "Medical care in English prisons." Thesis, Open University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406489.

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Wright, Hollis G. "Means, ends and medical care /." view abstract or download file of text, 2002. http://wwwlib.umi.com/cr/uoregon/fullcit?p3055725.

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Thesis (Ph. D.)--University of Oregon, 2002.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 272-280). Also available for download via the World Wide Web; free to University of Oregon users. Address: http://wwwlib.umi.com/cr/uoregon/fullcit?p3055725.

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Anderson, Mindi S. "Integrating Emergency Medical Services Into the Patient-Centered Medical Home." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10288192.

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Abstract Emergency medical services (EMS) for nonemergent or low-acuity calls is a new normal. EMS agencies spend a majority of time providing primary care services through the 911 system. They are utilized currently to fill the primary care gap subconsciously. The EMS system is activated as a patient navigator for primary care services. EMS agencies in the state where the research occurred have responded to the gap in care management by creating innovative programs such as community health emergency medical services (CHEMS). Creation of CHEMS programs have become one of the most monumental concepts for change in the field on both a state and national level. EMS has sought ways to meet the goals of the Triple Aim by exploring CHEMS as the state transitions to value-based care. Leaders are searching for innovative ways to close the gap in the primary health care system through a patient-centered medical home (PCMH) model. The action research study stimulated innovative thinking to support coordinated care across the evolving continuum of the health care system. The study captured the current awareness from community health care leaders who have had a recent opportunity to explore the idea of integrating EMS into the PCMH model through semi-structured interview sessions. Major findings in the thematical analysis discovered the current way both EMS and a PCMH function in a silo system that could potentially utilize each other to effectively provide managed care. Joint efforts could offset overutilization of EMS services for calls that have no apparent life threats. EMS would allow for a PCMH to conform to the Patient Protection and Affordable Care Act standards of care management, contributing to the integration of Triple Aim objectives. Collaboratively, EMS and an established PCMH will impact the delivery of preventative, quality and cost-efficient care. The theory of organizational culture change is based on three common characteristics: culture is shared, is intangible, and affects human behavior. The conceptual framework of the research study was based on the chronic care model. Patients with comorbidities potentially utilize the health care system more than a healthy patient to seek reassurance that their health is managed.

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Foran, Jameson D. "Medicaid Expansion Implications on Health Insurance Coverage and Medical Out-Of-Pocket Payments." Miami University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=miami1524669331674427.

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Penfold, Christopher M. "Patient copayments in primary medical care." Thesis, Cardiff University, 2011. http://orca.cf.ac.uk/54411/.

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This research was carried out to assess the feasibility of studying the effects of introducing copayments in primary medical care via studying the effects of copayments in primary dental care. Quantitative methods were used to investigate the impact of primary dental care copayments on patients and to compare predictors of primary medical and dental care uptake. Qualitative methods were used to investigate attitudes towards copayments for NHS primary health services and their extension to include primary medical consultations. Regression models, chi-square analyses and ANOVA were applied to the England and Wales sub-sample of nationally representative self-report data from the 1998 Adult Dental Health Survey (ADHS) (n=3628) to investigate the impact of copayments on primary dental care uptake. Regression models and chi-square analyses were applied to the England and Wales sub-sample of nationally representative self-report data from the 1997/98 British Household Panel Survey (BHPS) (n=8526) and the 1998 ADHS (n=3641) to compare predictors of primary medical and dental consultations. Semi- structured interviews were undertaken in Bristol and Somerset with purposively sampled frequent and infrequent primary medical care users (n=19). Predictors of primary medical and dental care utilisation differed across predisposing, enabling and illness level factors. Private and NHS dental copayments were perceived to be expensive and this perception was associated with lower preventive-led dental consultation rates, but not with treatment-led consultation rates. Copayments for services affected the nature of the patient-practitioner relationship. Findings were inconclusive regarding the effect of copayment exemption status on people's decisions to consult a dentist and on dental treatments received. It was not feasible to study the effects of introducing copayments in primary medical care via studying the effects of copayments in primary dental care.

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Fickel, Jacqueline Jean. "Quality of care assessment : state Medicaid administrators' use of quality information." Full text (PDF) from UMI/Dissertation Abstracts International Access restricted to users with UT Austin EID, 2002. http://wwwlib.umi.com/cr/utexas/fullcit?p3077639.

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Neumann, Khamille. "Medical pluralism in Guatemala." Pullman, Wash. : Washington State University, 2010. http://www.dissertations.wsu.edu/Thesis/Spring2010/k_neumann_020510.pdf.

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Thesis (M.A. in cultural anthropology)--Washington State University, May 2010.
Title from PDF title page (viewed on June 2, 2010). "Department of Anthropology." Includes bibliographical references (p. 76-83).

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Dhillon, Simron. "Oceanside Durable Medical Equipment." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10116155.

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Oceanside Durable Medical Equipment (DME) is an accredited start-up company that will offer a comprehensive line of the latest medical supplies and equipment to patients in Long Beach, California. This company will focus on the distribution of leading medical equipment brands to patients who are in need of support for short-term and chronic health conditions. Durable medical equipment can offer help outside of the hospital environment and aid in a better quality of life.

With more than 2.4 million individuals over 60 years old in Southern California, there appears to be a large market and opportunity for this company. Oceanside DME will contract with leading medical equipment manufacturers and healthcare providers to deliver patients with quality products. A rapidly growing market for medical equipment will allow Oceanside DME to create a presence in this healthcare industry.

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Manuel, Eric R. "Physically active centered medical home." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1599186.

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Under the provision of the United States Department of Health and Human Services, the patient centered medical home is a model of primary care transformation that seeks to meet the variety of healthcare needs of patients and to improve patient and staff experiences, outcomes, safety, and system efficiency. Serving the medically underserved and primary care clinic shortage area of Long Beach, California, the Physically Active Centered Medical Home (PAC MH) will be a safe haven for healthy and physically active individuals who are required to avail of health insurance coverage as mandated by the Patient Protection and Accountable Care Act of 2010 (PPACA). PAC MH will offer comprehensive and integrated services that will keep its members healthy and away from the burden of repeated clinical visits. PAC MH understands that medical coverage is the least of the priorities for healthy adults. Hence, PAC MH’s payment system is made simple. The value-based care provided at PAC MH will reward the healthcare team for achieving and exceeding the pre-established benchmarks for quality care.

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Byrd, Rebekah J. "Culturally competent medical care of LGBTQ patients." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/911.

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Öhman, Mattias. "Essays on Cognitive Development and Medical Care." Doctoral thesis, Uppsala universitet, Nationalekonomiska institutionen, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-305627.

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This thesis consists of four self-contained papers. Essay I (with Linuz Aggeborn): Fluoridation of the drinking water is a public policy whose aim is to improve dental health. Although the evidence is clear that fluoride is good for dental health, concerns have been raised regarding potential negative effects on cognitive development. We study the effects of fluoride exposure through the drinking water in early life on cognitive and non-cognitive ability, education and labor market outcomes in a large-scale setting. We use a rich Swedish register dataset for the cohorts born 1985-1992, together with drinking water fluoride data. To estimate the effects, we exploit intra-municipality variation of fluoride, stemming from an exogenous variation in the bedrock. First, we investigate and confirm the long-established positive relationship between fluoride and dental health. Second, we find precisely estimated zero-effects on cognitive ability, non-cognitive ability and education for fluoride levels below 1.5 mg/l. Third, we find evidence that fluoride improves later labor market outcomes, which indicates that good dental health is a positive factor on the labor market. Essay II: I study the associations between cognitive and non-cognitive abilities and mortality using a population-wide dataset of almost 700,000 Swedish men born between 1950 and 1965. The abilities were measured at the Swedish military enlistment at age 18-20. In addition, I investigate if income and education are good proxies for the abilities. The results suggest that both cognitive and non-cognitive abilities are strongly associated with mortality, but that non-cognitive ability is a stronger predictor. The associations are only partly mediated through income and education. For middle and high income earners and individuals with a college education there are no associations with mortality. However, for low income earners and individuals without a college education, both abilities are strongly associated with mortality. The associations are mainly driven by the bottom of the distributions. Essay III (with Matz Dahlberg, Kevin Mani and Anders Wanhainen): We examine how health information affects individuals' well-being using a regression discontinuity design on data from a screening program for an asymptomatic disease, abdominal aortic aneurysm (AAA). The information provided to the individuals is guided by the measured aorta size and its relation to pre-determined levels. When comparing individuals that receive information that they are healthy with those that receive information that they are in the risk zone for AAA, we find no effects. However, when comparing those that receive information that they have a small AAA, and will be under increased surveillance, with those who receive information that they are in the risk zone, we find a weak positive effect on well-being. This indicates that the positive information about increased surveillance may outweigh the negative information about worse health. Essay IV: I estimate the effect of SSRI antidepressants on the risk of mortality for myocardial infarction (MI) patients using Propensity Score Matching on individual health variables such as pharmaceutical drug prescription, patient history and severity of the MI. The effect of antidepressants on mortality is a heavily debated topic. MI patients have an elevated risk of developing depression, and antidepressants are among the most common treatments for depression and anxiety. However, there are indications that some classes of antidepressants may have drug-induced cardiovascular effects and could be harmful for individuals with heart problems, but there is a lack of large-scale studies using credible identification strategies. My findings indicate no increased risk of two-year mortality for MI patients using SSRI. The results are stable for several specifications and robustness checks.

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Yeung, Yee-hung Stella. "Sustainable healthcare delivery in Hong Kong : organizational initiatives and strategic financing /." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B23295776.

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Chan, Adam Y., Elizabeth Farabee, Grace Wholley, Peter Blosser, Jordan L. Herring, and Richard L. Wallace. "Medical Student Burnout in a Small-Sized Medical School." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/72.

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Introduction: Burnout is an occupational condition characterized by emotional exhaustion, depersonalization, and a low sense of personal accomplishment. While medical students begin schooling with mental health profiles similar to or better than peers who pursue other careers, there is a downward trajectory throughout school suggesting this phenomenon often originates in medical school. For physicians and residents, burnout has been linked to poor outcomes such as patient safety, might contribute to suicidal ideation and substance abuse, and may undermine professional development. Furthermore, there is a lack of surveillance of the prevalence of medical student burnout in a small-sized school setting. Methods: The Maslach Burnout Inventory (MBI), a 22-question survey, is largely accepted as the gold standard for assessment; however, we utilized the 7-question, Well-Being Index (WBI), which has been shown equal efficacy as the full MBI. Eligible participants were currently enrolled in their respective class at the East Tennessee State University Quillen College of Medicine. Each year, a participant was given a WBI survey during the winter season (overall response rate 83%, n = 239). Results: Overall the self-reported burnout rate over the two-year study period was 65.2% and was significantly higher in those reporting as female (71%). There was also variation tracking the class from one year to the next. The second year at this institution showed the highest reported amount of burnout (75%, n=145) while the lowest amount of burnout reported was during the fourth year at 47%. Conclusions: Burnout experienced at this institution was reportedly higher than national average. There are limitations to this study as the periods in which medical students were asked to answer the survey were consistently at the same time in the calendar year, but the host institution’s curriculum had been changed so that it might not match up accordingly. Furthermore, class sizes changed from year to year and might skew the data. This information suggests that burnout prevalence is higher at Quillen College of Medicine and intervention strategies to address burnout should be pursued.

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Harvey, Ian Keith. "Managing the diffusion of medical technologies." Thesis, University of Hull, 1998. http://hydra.hull.ac.uk/resources/hull:3875.

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The aim of the study was to understand how and why medical technologies (devices, pharmaceuticals and surgical procedures) are produced (innovated and developed) and consumed (adopted and utilised).Medical technologies are linked to the expansion of health care provision and costs. Policy makers encourage technology assessment to ensure the value of medical technologies (absolute technological efficacy and relative cost effectiveness). This policy, which is underlain by a model of technological determinism, may be ineffective if other factors influence decision making.Three international (UK and USA) comparative case studies were undertaken, analysing the innovation, development and diffusion of specific medical technologies. Annual statistics were gathered on adoption and utilisation rates of Magnetic Resonance Imaging (a device), Laparoscopic Cholecystectomy (a surgical procedure) and Prozac (a drug). Literature review supported interviews with parties involved in decision making processes.The widespread adoption of Magnetic Resonance Imaging has been motivated by professional and institutional competition, despite its often inappropriate utilisation, uncertain efficacy and extremely high costs.Laparoscopic Cholecystectomy (keyhole surgery for gallbladder stones) has diffused rapidly, being driven by general surgeon's concerns over their control of the gallbladder. The ease of the surgery has enabled total surgical volumes to almost double.The diffusion of Prozac (an expensive antidepressant) was influenced by high profile uncertainties regarding its safety and efficacy. Subsequently its range of applications have grown, but many of these are unproven, whilst its long term safety profile is unknown.The study concludes that the decision making surrounding the innovation and diffusion of medical technologies is only vaguely related to their clinical efficacy or their cost effectiveness. lntra professional competition is central to the production and diffusion of medical technologies. Technology assessments, being largely reactive, and dependent on clinical reports, are unlikely to prove effective in achieving cost effectiveness. This finding has significant implications for future health care policy making.

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Garapati, Pavani Tushara. "Greencare - A Medical Waste Management Facility." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10785091.

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GreenCare is a medical waste management facility, located in Los Angeles, California and aims at effectively treating and managing all kinds of medical wastes. GreenCare’s business plan elaborates on how it is designed to safely and effectively handle the management of medical waste, by minimizing harmful byproducts, and emissions in the process. The aim of GreenCare is to offer disposal techniques including no-burn technologies that do not emit dioxin, mercury and other fatal pollutants, which differentiates GreenCare from other competitors in the market. The unique value proposition of GreenCare is to provide advanced ecological sensitive medical waste processing, and we aim to do this in a cost-competitive manner. It aims to lessen the ecological burden of medical waste in our communities, that is bound to create a positive impact on community health, in the long run. This business proposal gives the reader a thorough insight into the legal, regulatory issues and financial assumptions based upon which this proposal was designed.

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Nair, Dev J. "State Medicaid agencies approaches to quality improvement implications for policy, practice and health outcomes /." unrestricted, 2009. http://etd.gsu.edu/theses/available/etd-04222009-214921/.

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Thesis (M.P.H.)--Georgia State University, 2009.
Title from file title page. Russ Toal, committee chair; Mark Trail, committee member. Description based on contents viewed Sept. 14, 2009. Includes bibliographical references (p. 77-81).

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Damberg, Jonas. "Availability of primary care physicians in nursing homes and home care nursing services and associations with emergency care consumption." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-61585.

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Hong, Wing-yee Veronica. "A comparative study of healthcare financing systems in US, UK and HK." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41709858.

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Chan, Yee-ying Michelle. "The formulation and implementation of healthcare reform in Hong Kong." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B2329470x.

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So, Ping-cham. "Development of medical services in Hong Kong." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43780556.

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Clark, Spencer R. "Health Care Reform's Effect on Private Medical Practices." Scholarship @ Claremont, 2011. http://scholarship.claremont.edu/cmc_theses/209.

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In March of 2010, the 44th President of the United States, Barack Obama, signed into law a health care reform bill that will change the medical and business approach to healthcare that has been witnessed for quite some time. The Patient Protection and Affordable Care Act, aims to eliminate several inefficiencies encountered in our current health care system, as well as extend coverage by providing affordable care for the roughly forty six million Americans currently uninsured. Many of the changes will be implemented over the next several years, but hospitals, businesses, physicians, and insurance companies are no doubt planning ahead for the effects these changes will have on their particular industry. Although there will be many facets of change affecting all of the previously mentioned occupancies, the goal of this paper is to investigate the effect healthcare reform will have on private medical practices in the United States. The following sections will cover ways in which medicine has been practiced in the pre-reform era, historical attempts made to pass health reform legislation, several of the issues our current system faces along with the reform changes implemented to fix them. Then I will investigate the effect these changes will have, if any, and conclude by relating everything back to independent medical practices.

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Rubin, Joshua. "Does SCHIP increase children's access to medical care?" CONNECT TO ONLINE THESIS, 2007. http://dspace.wrlc.org/handle/1961/4126.

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Burns, Samuel Jay. "Non-Medical Home Care: Past, Present, and Future." Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/297517.

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The American non-medical home care industry is exploding. It has a consumer base of senior citizens that is estimated to number 72 million by 2025. This thesis explains how non-medical home care works in America, analyzing the industry on both macro and industry levels. Finally, the thesis discusses how businesses currently operating in the industry can improve their position in their local markets, and how future entrants to the industry should consider a consolidation approach to entry and expansion.

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Shah, Ruby. "Naloxone Utilization in a Tertiary Care Medical Center." Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/281779.

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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.

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Ntau, Christopher Gopolang. "Medical careers and the Botswana health care system." Thesis, Royal Holloway, University of London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.543578.

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This thesis examines, from a sociological perspective, the careers of doctors from a developing country without its own medical school or strongly organised medical profession. It argues that the interplay between the socio-economic and political forces and doctors' experiences internalised over the years at medical school, contribute to medical migration in Botswana from the public sector to private practice, and abroad. First, the thesis examines the influences that come into play when Botswana citizens choose a medical career. Then, the study explores students' medical school socialisation outside Botswana, and how this interfaces with subsequent workplace experience in Botswana. The retention efforts within the public health service and the 'pull' factors to the industrialised nations and international agencies are also studied. Data collection for this study was mainly through in-depth interviews with citizen doctors in the public and private sectors in Botswana. For doctors abroad, computer assisted interviewing was utilised. The data reveal that, in choosing a career in medicine, doctors came under varied and sometimes conflicting influences, at the family, community and institutional levels. While studying abroad, doctors were exposed to the modem technologies and facilities and an environment perceived as being conducive to work and study at the same time. These come to be pull factors when doctors, thus trained and socialised, wish to apply their skills and knowledge in practice on their return home. What obtains in medical practice, and the expectations from the state and the public for the medical profession are different from those the doctors have been socialised to expect. This situation leads to complaints and resignations by doctors. In themselves, such complaints are not peculiar to Botswana, but Batswana doctors are relatively well placed to leave the public sector. The study suggests that the solutions devised to address doctors' concerns should go beyond tinkering with monetary incentives

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Atchison, Robert Bryan 1970. "U.S. health care reform and medical privacy rights." Thesis, Massachusetts Institute of Technology, 1994. http://hdl.handle.net/1721.1/35424.

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Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 1994.
Vita.
Includes bibliographical references (leaves 87-99).
by Robert Bryan Atchison.
M.S.

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Pannick, Samuel. "Improving interdisciplinary care on the general medical ward." Thesis, Imperial College London, 2016. http://hdl.handle.net/10044/1/44373.

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General medical wards deliver the majority of inpatient care. Despite technological and therapeutic advances, these wards expose 10% of patients to preventable adverse events, and disproportionately contribute to preventable hospital deaths. Improving ward team performance is often proposed as a mechanism to improve patient outcomes. The overarching goal of this thesis is to identify effective strategies to improve interdisciplinary team care on the medical ward. Chapter 1 introduces key concepts in healthcare quality, and specific issues in the delivery and measurement of interdisciplinary ward care. The existing literature for ward improvement strategies is then described. A narrative review identifies common targets for ward interventions [chapter 2], and a systematic review evaluates interdisciplinary team care interventions, finding little evidence of significant impact on objective patient outcomes [chapter 3]. The development and evaluation of prospective clinical team surveillance (PCTS) is then reported. PCTS is a novel interdisciplinary team care intervention, engaging staff to identify barriers to care delivery, with facilitation and feedback. A programme theory and mixed methods evaluation are presented, using a stepped wedge, cluster controlled trial [chapter 4]. Mixed-effects models show a significant reduction in excess length of stay with high fidelity PCTS [chapter 5]. Surveys, focus groups and auto-ethnography identify PCTS' mechanisms of action, and its impact on incident reporting, safety and teamwork climates [chapter 6]. Implementation outcomes, facilitators and barriers are described in chapter 7. Other perspectives on improvement are also explored. A model of organisational alignment is developed [chapter 8], and an interview study with patients and carers elicits their priorities [chapter 9]. Finally, chapter 10 summarises the findings, highlighting opportunities to develop medical ward outcome sets and construct a model of interdisciplinary team effectiveness. These can be used to support improvements in interdisciplinary care, through changes in policy and practice.

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Meriwether, Wyatt Edward. "Use of Medical Care and Suicide Among Veterans." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7238.

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Due to rising veteran suicide rates, the veteran population has become a focus of practitioners, research scientists, and policymakers. Although researchers have studied the relationship between suicidality and the environment, more research is required to evaluate how suicidal behavior, suicidal ideation, and suicide risk are associated with a veteran's use of medical care services within the Veterans Health Administration (VHA). Therefore, this study focused on environmental variables (medical care usage and rurality), and their relationship with suicidal behavior (Manuscript 1), suicidal ideation (Manuscript 2), and suicide risk (Manuscript 3). The social ecological model was used to better understand the interaction between the environmental factors discussed and veteran suicidality. Use of primary care services was found to be significantly associated (negative association at all levels in comparison to the reference level of high use) with each dependent variable: suicidal behavior (p < .001, OR = .074 - .529), suicidal ideation (p < .001, OR = .170 - .490), and suicide risk (p < .001, OR = .154 - .656). Finally, rurality was found to be significantly associated with suicidal behavior and suicidal ideation. A positive association was found between suicidal behavior (p < .05, OR = 8.099) and suicidal ideation (p < .05, OR = 1.892) and urban residence (in comparison to the reference level of highly rural). This study can promote social change by providing insights on how environmental factors influence veterans' propensity to suicide and by leading VHA researchers into further exploring the impact of veterans' use of services on the suicidality of the population.

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Ayati, S. B. "A portable EIT system for emergency medical care." Thesis, Loughborough University, 2016. https://dspace.lboro.ac.uk/2134/20770.

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Electrical Impedance Tomography (EIT) is a medical imaging technique in which images of tissue conductivity within a body can be inferred from surface electrode measurements. The main goal of this study is to develop a portable EIT system incorporating an optimized electrode layout to detect intracranial haematomas for use in emergency care. A growing haematoma can cause severe and even permanent damage to the delicate tissue of the brain, morbidity, and eventual death of the patient. No capability is at present available for the diagnosis of haematomas pre-hospitalisation or by first-responders. The lack of this crucial information can lead to bad decisions on patient management, and in particular, where to send the patient. Blood has a high electrical conductivity contrast relative to other cranial tissue and can be detected and monitored using electrical impedance methods. EIT is a non-invasive, low-cost monitoring alternative to other imaging modalities, and has the potential to detect bleeding and to localize the approximate bleeding site. A device of this nature would reduce treatment delays, save on costs and waste, and most significantly, positively impact patient outcomes. The first step was a numerical simulation study on FE models. The full array and the hemi-array electrode layouts were modelled and the anomalies were simulated in different positions with different sizes. The results were obtained using TSVD and WMNM reconstruction methods by COMSOL linked with MATLAB. The simulated anomalies were detected for all the positions using both layouts; however those from the full array were in general superior to the hemi-array. In order to perform realistic experiments, a prototype EIT system was constructed in the laboratory. The constructed EIT has 16 channels and operates in the frequency range of 10 kHz to 100 kHz with a temporal resolution of 100 frames per second and high level of accuracy of 93.5 %. The minimum number of 8 electrodes was chosen in this study for emergency care. Minimizing the number of electrodes speeds up the electrode setup process and avoids the need to move the patient s head in emergency care. In the second part of this study, phantom experiments were performed to find an optimised electrode layout for emergency care. The full array and the hemi-array were investigated using phantom experiments. As expected, the full array layout had the best performance in general; however, the performance of the hemi-array layout was very poor. Thus a novel optimised electrode layout (semi-array) for emergency care was proposed and evaluated in phantom experiments. For the hemi-array and the semi-array layouts, measurement sensitivity depends strongly on the anomaly location since the electrodes are not placed all over the head. The HA layout performed very badly, with the best radial localization error of 0.8100 mm, compared to the SA layout with the worst error of 0.2486 mm. Some reconstructed anomalies located far from the electrodes in the posterior region were almost invisible or erroneous for the hemi-array layout; however, it is enhanced by using the semi-array layout. Finally, in vitro experiments were conducted on ovine models. In most of the experiments carried out by other researchers, since the location of the simulated anomalies was not known and the simulated blood was normally injected into the body or the head, localization of the anomalies was not considered and the quantity of the injected blood was investigated solely. In our new method of experiment, the position of the anomalies was known a priori and thus could be compared accurately to the EIT results. The full array and the semi-array layouts were compared in terms of detection, localisation and size estimation of haematomas. As expected, the full array layout was found to be more robust than the semi-array layout with the best mean value of the localization error of 0.0564 mm and the worst QI error of around 30%. Using a minimum number of electrodes in an optimised layout is always desirable in clinical applications. The semi-array 8-electrode layout prevents unnecessary movements and the electrode connections to the head would be very quick in emergency care. Although the semi-array 8-electrode layout reduced the sensitivity of the measurements, the findings from the experiments indicated its potential to detect and monitor haematomas and probably extend its application for emergency applications where the required accuracy is not critical.

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Lorenc, Louise. "Medical compliance : are the elderly different?" Thesis, Keele University, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.237564.

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Lei, Xiaoyan. "Public and private transfers essays on transfers to children and parents /." Diss., Restricted to subscribing institutions, 2007. http://proquest.umi.com/pqdweb?did=1467890571&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.

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32

Fredin, Rebecca Layton. "Perceptions of quality of medical care among consumers with schizophrenia who have a comorbid medical illness." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1330979750.

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33

Donato, Francis A. "Reforming health care through managed care." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.

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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.
Source: Masters Abstracts International, Volume: 45-06, page: 2939. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 91-92).

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Uhlíř, Tomáš. "Medical leadership compensation framework." Master's thesis, Vysoká škola ekonomická v Praze, 2009. http://www.nusl.cz/ntk/nusl-9322.

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This master thesis deals with outlining the rationale of redesigning medical leadership compensation framework within Interior Health Authority (IH). In particular, reviews IH's organizational structure, analyses job descriptions for medical leaders, recommends improvements of communication flow across the authority and designs medical leader's compensation model.

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35

Mykhalovskiy, Eric. "Knowing health care / governing health care exploring health services research as social practice /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0018/NQ56249.pdf.

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Chouteau, Wendy A. "Use of a Portable Medical Summary to Provide Continuity across Systems of Care as Youth with Medical Complexity Transition to Adult Care." Xavier University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1524321320625958.

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Suen, Yuk-lam Kelvin. "A comparative study of the health care policies in Hong Kong and Singapore." Click to view the E-thesis via HKUTO, 2002. http://sunzi.lib.hku.hk/hkuto/record/B42576350.

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Wu, Chi-pang Sam. "Chinese medical convalescence and research centre." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25949871.

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Fong, Ho-nam. "A comparison of the colonial medical systems in British Hong Kong (1841-1914) and German Qingdao(1897-1914)." Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B35051073.

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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.

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Chan, Hung-yee. "Health care delivery and financing in Hong Kong." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B23294735.

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Wong, Chit-ming. "Risk modelling methods and their application to three health care studies /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13282566.

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43

Smith, Jennifer Hale. "Prevalence of Pain in the Medical Intensive Care Unit." Yale University, 2006. http://ymtdl.med.yale.edu/theses/available/etd-06282006-143554/.

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YANG, CHEN-HSI, and 楊晨曦. "Comparative Study on Medical Care Foundation and Medical Care Corporation." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/89dn4w.

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碩士
長榮大學
高階管理碩士在職專班
99
In 2004,in order to archive sustainable management and to establish clear legal status of the private medical institutions, one of the amendments to Medical Care Act is the introduction of Medical care corporation and medical juristical person legal system is also formed. The distinction in nature results in system difference between medical care corporation and medical care foundation.This study build on the difference. From the legal prospective, distinction in nature is analyzed and relevant regulations on establishment, organization, tax system and investment earnings distribution in Medical Care Act are compared. Through interviews with selected medical personnel, government legislature representatives and financial experts, this study researches on the legislative intent of the legal consultation system,understands the operating results, and suggests solutions to found problems to improve current medical care system. Based on the research on related Acts and the comprehensive view formed from interviews conducted，government should considered public needs and govern different types of medical institutions on their share of overall medical resources , so the resources can be distributed evenly. Reduce establishment requirement, clarify governmental policy on the restructuring of private medical institution declarative, and give tax incentives to the medical care corporation to reduce restructuring cost Recognizing profitability of medical care corporation,governmental administration should cease from intervening its regular business activities and ease restrictions on its operation. Key words: Medical care Foundation；Medical care corporation Public-Welfare ； For-porfit

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Hsu, Chuh-Feng, and 許祝鳳. "Financial Performance on Medical Care Corporation and Medical Care Corporate: A Study of Medical Juridical Persons in Taiwan." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/32634164235090361322.

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碩士
國立臺灣大學
健康政策與管理研究所
101
The new chapter of the revision in year 2004 of Medical Care Act has established clearer legal status of Medical Juridical Persons, which consist of Medical Care Corporate and Medical Care Corporation, in order to establish a well-developed, more organized and higher quality system for implementation in medical care and the related practices. The introduction of Medical Care Corporation, a record breaking to the Medical Care Act, has great and far-reaching influence on the system of medical care. After several years since its promulgation, Medical Care Corporation has become the milestone of medical care to the policy makers and to the central competent authority by accommodating a brand new legal institution among the traditional various types of medical service providers. The implementation of Medical Care Corporation since its inception, not only changing the formality but also the substance of the hospital organizations, has been brought into the attention for further study to evaluate the effectiveness of the medical policies and regulations. To distinguish the nature of the legal characteristics from the Medical Care Corporate, the Medical Care Corporation has its applicable articles and detail rulings despite of the same governance from the Medical Care Act. An example of earning distribution after resolutions is allowed in the Medical Care Corporation. Another example is calling for a general meeting of corporation members to vote and elect directors and supervisors. Some rights and obligations are solely for members of Medical Care Corporation. Will the performance be different as a result of different nature of legal characteristics? As of date, five-year historical financial data of Medical Care Corporation and the contemporaneous data for Medical Care Corporate since year 2007 through year 2011 are collected in this study for an empirical design. Among some important practical issues and managerial topics to be discussed, the spotlight on the study of these financial data is to evaluate the performance via the financial reports and ratio analysis. This study first aims to examine the hypotheses of key indicators between Medical Care Corporation and Medical Care Corporate. Then, a multiple linier regression model is also developed to examine the relationship of the financial performance and some key independent variables including financial ratios and non-financial factors. The empirical results show significantly different margin ratio, debt ratio and cash flow ratio, leverage, returns on asset, payroll related costs and some nonfinancial variables between Medical Care Corporation and Medical Care Corporate. The average debt ratio of Medical Care Corporation is higher with more contribution margin generated from health care services than Medical Care Corporate. It shows that the leverage is utilized to maintain its current operation and future possible renewal in medical equipment and/or expansion in premises. It also implies efficiency exists in Medical Care Corporation. The bottom line, however, is lower due to the larger amount of other income to Medical Care Corporate who holds additional assets. As to medical services provided by the Medical Care Corporation, more than 90% of the fee is reimbursed from National Health Insurance(NHI), the insurer, with only 10% from the patients, while respectively 80% and 20% from NHI and patients by Medical Care Corporate. Further findings from the empirical evidence include: the large scale of hospital has higher Return of Assets (ROA) ration and higher margin ratio than those ratios of medium scale and small scale of hospitals while the medium scale hospital has the highest debt ratio. In terms of ranking, our findings are: local hospital has the higher debt ratios than regional hospital and medical center hospital. With respect to area of hospital, in this study it shows that eastern has the highest ROA ratio than southern, central area is in a lower priority while northern suffers the worst ROA ratio. The Empirical results also confirm a positive relationship between two explanatory variables and their performance with respect to margin ratio and ROA ratio while all other independent variables of the multiple linier regression models remained under control: one is Medical Benefits Claim (also known as medical service fee reimbursed from NHI), another is payroll costs. To conclude, the influence of medical juridical persons including Medical Care Corporation and Medical Care Corporate as a whole has increasingly played an important part to the policy makers. In this study, a regression model is built with significant level for explanations of their ROA ratio and margin ratio. The implications on medical care service providers, with which substantial medical resources are invested and operated, remain a lot of issues for decision makers and some for further study.

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Cheng, Chin-Hung, and 鄭志宏. "Parents Affect Children’s Medical Care." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/34645225443544633623.

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碩士
淡江大學
產業經濟學系
87
Traditionally, the mother plays the major role in caring for the child. An extensive economic literature dealing with children’s medical also explains that in view of mother’s utility. In spite of this, we wonder whether the father and the parent’s factor also have some effect on the medical care for the child. For the purpose of the answer, data processing and empirical analysis are performed with the data obtained both from the National Medical Expenditure Survey 1987 by United States Department of Health and Human Services and from the Area Resource File 1993 by Bureau of Health Professions. Referring to empirical model, I adopt two-stage sample selection model that was presented by Heckman in 1979. The results I obtain are as following：First, Children’s demands of medical treatments will decrease as they gradually grow up. Secondly, Parents’ ages will result in increases of children’s demands of medical treatments relatively. Thirdly, if parents as well as children are in high level of education, it will be easier to judge children''s physical conditions then the demands of medical treatments will increase, too. Fourthly, when fathers with good rates of their wages, they will spend more energy to take care of children. Fifthly, having personal insurance will raise probability of seeing a doctor for the child, whereas CHAMPUS will lower, but as to the frequency of medical treatments, there is not a significant relation between insurance and receiving medical treatments. Sixthly, in view of one of the parents, a father or a mother is willing to take the children to receive medical treatment again, especially in high density of doctors, but if we consider two parents, there is not a significant relation between density of doctors and medical behavior. Besides, the bigger the family is, the more the limitations of the economic resources and concerns children get from parents. Finally, my suggestions of this research are as following, First, as the result indicated that the father also has some effect on the medical care for the child, the father should be taken into consideration of analysis. Secondly, the parents should pay attention to the importance of proper age for pregnancy. Thirdly, one of the governmental policies should include set-up of a sound environment for the growth of the child. The government should intensify integration of education, medical system and insurance system.

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47

Gu, Ning Yan Fournier Gary M. "Medical care variations in Florida." 2004. http://etd.lib.fsu.edu/theses/available/etd-08192004-140344.

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Thesis (M.S.)--Florida State University, 2004.
Advisor: Dr. Gary M. Fournier, Florida State University, College of Social Sciences, Dept. of Economics. Title and description from dissertation home page (Jan. 13, 2005). Includes bibliographical references.

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48

Pei-YuHuang and 黃珮瑀. "Medical treatment considerations, medical care satisfaction, again medical care of aesthetic medicine in association studies- Taiwan Aesthetic Medicine Clinic, for example." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/p5p83c.

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碩士
國立成功大學
企業管理學系專班
101
This study investigated the correlation among the following factors: (a) consideration of medical treatment , (b) satisfaction of cosmetic treatment, and (c) consumer willingness to revisit a physician to purchase additional treatment. The study population comprised consumers who received photoelectric treatment and cosmetic injection treatment in Taiwanese aesthetic medical clinics. We (or nurses from the clinic) issued 248 questionnaires, and 201 questionnaires were returned. The questionnaire return rate was 81.05%. We collected 154 valid questionnaires. The questionnaire response rate was 76.62%. We observed that medical treatment factors had a significant effect on revisit intentions. Specifically, satisfaction with medical cosmetic treatment had an effect on revisit intentions when it was considered as a moderating variable. The interaction between patient expectations and satisfaction of medical cosmetic treatment reduced revisit intentions.

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Chang, Chin-Wen, and 張瀞文. "A Study of Medical Customer Value and Medical Care Seeking Behavior." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/84826760987936320192.

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碩士
淡江大學
國際貿易學系
91
Abstract : After the enforcement of National Health Insurance in March 1995, the Medical Care Market is becoming highly competitive. With more and more options, consumers in Taiwan are facing more choices when making decisions from a variety of medical services. Depending on the perceiving of quality, service, and value, consumers consider choosing the preferable place for the medical care. Therefore, providing the value what patients is becoming the key to maintain hospitals’ competitive edge. In past researches, perceived value can be divided into two categories - perceived benefit and perceived sacrifice. This study aims to explore the dimensions of medical customer value and patient''''s medical care seeking behavior. The use of demographics and medical attributes are tried to investigate the characteristics of medical customer value groups. The data were obtained from a stratified random proportional allocation sampling from the outpatients of physical therapy in Taipei. Several statistical inference methods are used to dissert the datum, such as factor analysis, cluster analysis, analysis of variance, discriminate analysis, canonical correlation analysis, and chi-square test. The results of this research are as follows: 1.Medical customer value groups can be divided into five dimensions- “the doctor- patient relationship,” “treating and counseling,” “treatment out of packet,” “for top outcome,” and “level- oriented” with following three groups. (1) Additional Counsel Group; (2) Total Consideration Group; (3) Middle Course Group. 2. Patient''''s medical care seeking behavior has significant effect on different medical customer value groups. 3. Patient''''s medical care seeking behavior is different because of ''''gender'''', ''''age'''', ''''marital status'''', ''''education attainment'''', ''''occupation '''', ''''monthly average household income'''', ''''administrative division'''', ''''the level of hospital '''' and, ''''specialty''''. 4. The distribution of different medical customer value groups have significant differences in ''''age'''', ''''education attainment'''', ''''occupation '''', ''''monthly average household income'''', ''''administrative division'''', ''''hospital type'''', and ''''medical utilization''''.

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Lin, Yuh-feng, and 林裕峯. "Promotion of Medical Care Quality Through Internet Network and Medical Information." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/17355553007764631231.

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博士
國立臺灣科技大學
管理研究所
102
In this dissertation, we address two health decision making projects, and both are implemented in TMU-SHH. In the first project, we implemented a drug refilling system, drive-through pharmacy service to the patients with a refilling prescription for chronic illnesses. The study is a hospital outpatient drug prescription level analysis that adopts a pretest-posttest control group experiment design. We analyze the changes in patient drug prescription behavior 6 months before and 6 months after the system was deployed to assess the efficacy of this new refilling system. An increase in the overall refilling prescription rate, with an increased use of online reservations (7.9% vs. 4.9%, p < 0.001), an increased proportion of medications picked up (93.0% vs. 88.1%, p < 0.001) were noted. Furthermore, an elevation in the percentage of patients using drive-through pharmacy services (45.4% vs. 28.9%, p < 0.001; second vs. first quarter, respectively) during the 6 months after the implementation period was found. After age-group analysis, we noticed that the middle-aged population group (40-65 years of age) utilizes the drive-through prescription service more than other age groups. Generally, the prescription refilling rate for all population categories at Shuang-Ho Hospital increased significantly after the drive-through service was provided (51.1% vs. 50.2%, p < 0.01). The drive-through pharmacy provides patients with convenient access to pick up refilling prescriptions within a shorter duration than ordinary pharmacy service. During a short-term follow-up, an overall increase in the prescription refilling rate was noted after the drive-through service was implemented. Our survey revealed that among the users, over 90% of the patients were satisfied with the drive-through service. In the second project, we use cloud-based manometers integrated to physician order entry systems to trace the patients’ blood pressure in assisting control renal function deterioration. Then, we investigated whether integrating cloud-based manometers and physician order entry systems benefit in our outpatient CKD patients compared with usual blood pressure tracing systems. A total of 36 participants with chronic kidney disease patients were randomly assigned to use cloud-based manometers integrate to physician order entry systems or usual blood pressure recording sheets to trace their blood pressure. The online blood pressure was seen weekly in the study group by physician and the antihypertensive medications will be adjusted in case of values higher than optimized level that is around 130/80mmHg. The composite outcome was patient’s blood pressure improvement and assessment of renal function deterioration. The patients were followed for 6 months. The systolic and diastolic blood pressure and renal function assessment were done during 0, 3 and 6 months after using,the integrated cloud-based manometers and usual blood pressure monitoring sheets are compared. Both the night time systolic and diastolic blood pressure were reduced significantly in the study group compared with control group. Serum creatinine level reduced significantly at 6th month in the study group. Glomerular filtration rate (eGFR) and proteinuria after using the integrated cloud-based manometers is also improved but did not reach significance statistically compared with the control group. Both systolic and diastolic blood pressures during night time significantly improve in the study group compared with baseline. Serum creatinine change from baseline is also found to be significantly reduced in the study group. In our knowledge, the above two projects were not implemented in Taiwan before. In conclusion, the first drive through prescription model improve the chronic prescription rate, first drive through rate and shorten the time to obtain regular medications. Cloud-based manometers integrated to physician order entry systems improve the blood pressure control and renal function preservation in chronic kidney disease patients. Two projects deserve future use and promote in the health care services, and may help physicians to improve patients’ therapeutic management and prognosis.

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Dissertations / Theses on the topic 'Medical Medical care'

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