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Title: Wealth Over Health? An Analysis of Macro-Level Factors That Influence Public Opinion on Health Care Policy.
Creator: Reiss, Jacquelyn, Hinojosa, Ramon, Hinojosa, Melanie, Huff-Corzine, Lin, University of Central Florida
Abstract / Description: Currently, the U.S. reports some of the worst health outcomes while spending the most money on health care when compared to other developed countries in the Organization for Economic Co-operation and Development (OECD). In 2018, Americans took out $88 billion in debt to cover the cost of medical care and approximately 28.5 million individuals remained uninsured. Despite poor health outcomes across the country, health care reform is a highly controversial issue and has been for the last...
Show moreCurrently, the U.S. reports some of the worst health outcomes while spending the most money on health care when compared to other developed countries in the Organization for Economic Co-operation and Development (OECD). In 2018, Americans took out $88 billion in debt to cover the cost of medical care and approximately 28.5 million individuals remained uninsured. Despite poor health outcomes across the country, health care reform is a highly controversial issue and has been for the last century. Historically, elites in the Republican party have aligned themselves with New Right political philosophies, which stand for a privatized health care system with minimal government involvement. Elites in the Democratic party have aligned with Pluralist political philosophies, which is an orientation that encourages government oversight to protect the health of its citizens. Recently there has been a rise in political polarization that has stemmed from the asymmetric movement of the Republican Party further to the right escalating the controversy around health care reform. In addition to growing polarization, recent studies have found that politicians are more responsive to the affluent classes while concurrently accumulating an influx of wealth. When neglecting to vote with the majority of their constituents, politicians have tried to change public opinion rather than address it. These short-term manipulation strategies have been found to confuse constituents more than mobilize them, contributing to the controversy around health care reform today. This project aims to understand how macro level structures affect public opinion on government funding of health care utilizing the thermostatic model and the works of Nicos Poulantzas and Michel Foucault as theoretical frameworks to understand how political structures influence public opinion and how political structures are shaped within Capitalistic societies. Specifically, the current study examines how the political leaning of Congress and the Presidency, total lobbying dollars contributed by the top five medical industries, and the number of health care bills passed per year affects public opinion on government funding of health care between 1986 and 2018. The data were accumulated from multiple sources including the General Social Survey, OpenSecrets.org, GovTrack.us, and the Senate, House, and White House websites. After completing bi-variate and multi-variate autoregressive integrated moving average (ARIMA) models the only variable that was found to impact public opinion was the political party of the Presidency.
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Date Issued: 2019
Identifier: CFE0007713, ucf:52453
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007713

Title: LGBT AFFIRMING ENVIRONMENTS IN HOSPICE CARE SETTINGS.
Creator: Gore, Maria, Gammonley , Denise, University of Central Florida
Abstract / Description: Abstract The documented experiences and perceptions of lesbian, gay, bisexual, and transgender (LGBT) patients receiving hospice or palliative care gives merit to the need for the implementation of LGBT affirming environments in hospice care settings. The guidelines for creating these affirming environments are described in this paper. Applying the Donabedian (1988) model of structure, process, and outcome this thesis project analyzes identified interventions relevant to the implementation of...
Show moreAbstract The documented experiences and perceptions of lesbian, gay, bisexual, and transgender (LGBT) patients receiving hospice or palliative care gives merit to the need for the implementation of LGBT affirming environments in hospice care settings. The guidelines for creating these affirming environments are described in this paper. Applying the Donabedian (1988) model of structure, process, and outcome this thesis project analyzes identified interventions relevant to the implementation of LGBT affirming environments in hospice care settings. Utilizing a formal PICO questioning method, a search strategy was devised and studies were identified based on established criteria. The results suggest that there is a paucity of data in relation to the implementation of LGBT affirming environments in hospice care settings. In an effort to assist in identifying existing interventions that have not been studied this project also includes a recommended survey tool to measure the active efforts of hospice organizations to implement LGBT affirming environments.
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Date Issued: 2013
Identifier: CFH0004353, ucf:44986
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004353

Title: THE LASTING EFFECTS AND ANALYSIS OF THE SUPREME COURT'S DECISION IN: THE NATIONAL FEDERATION OF INDEPENDENT BUSINESS V. SEBELIUS.
Creator: Esposito, Devin, Wood, Robert, University of Central Florida
Abstract / Description: The purpose of this thesis is to examine the Affordable Care Act through an analysis of the United States Supreme Court's holding in The National Federation of Independent Business v. Sebelius. In order to better understand the Supreme Court's reasoning in that case, this paper will first examine the history and the function of the Supreme Court, which will demonstrate the Court's power to either augment or diminish the power of the states in relation to the federal government. This paper...
Show moreThe purpose of this thesis is to examine the Affordable Care Act through an analysis of the United States Supreme Court's holding in The National Federation of Independent Business v. Sebelius. In order to better understand the Supreme Court's reasoning in that case, this paper will first examine the history and the function of the Supreme Court, which will demonstrate the Court's power to either augment or diminish the power of the states in relation to the federal government. This paper will then discuss the background of the Affordable Care Act, the procedural history of the case, and the majority's analysis supporting its decision. The concurring and dissenting opinions of the other justices will be discussed to present the various viewpoints regarding the proper role of the federal government and the implications this case may have on federal/state conflict. The Supreme Court ruled in favor of the Department of Health and Human Services. The 5-4 decision was extremely close and the opinions given by each Justice highlighted the various flaws and benefits of the Act it was looking to uphold. Further research of Supreme Court cases in our country's history reveal the trend of augmenting and diminishing state's rights. This thesis will examine the constitutionality of the aforementioned decision, the effects it will have on each of the states within the United States, and the impact the citizens will experience.
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Date Issued: 2013
Identifier: CFH0004372, ucf:45012
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004372

Title: BARRIERS AND FACILITATORS TO ACCESSING AND UTILIZING MENTAL HEALTH SERVICES FOR HOMELESS YOUTH: A SYSTEMATIC REVIEW.
Creator: Lapinski, Abbygail P, Dever, Kimberly, University of Central Florida
Abstract / Description: Homelessness in the youth population is associated with elevated rates of mental illness, substance abuse, and suicidality compared to the housed population in the United States (Berdahl, Hoyt, and Whitbeck, 2005; Hodgson, Shelton, Van den Bree, 2014; Hughes et al., 2010). With a survival-focused perspective, exacerbating issues, stigmatization, and transience housing; homeless youth require special consideration to meet their diverse health needs. When barriers impede homeless youth's access...
Show moreHomelessness in the youth population is associated with elevated rates of mental illness, substance abuse, and suicidality compared to the housed population in the United States (Berdahl, Hoyt, and Whitbeck, 2005; Hodgson, Shelton, Van den Bree, 2014; Hughes et al., 2010). With a survival-focused perspective, exacerbating issues, stigmatization, and transience housing; homeless youth require special consideration to meet their diverse health needs. When barriers impede homeless youth's access to necessary health resources, their health concerns are left untreated and impound until emergency services are required. This review of literature is focused on identifying and synthesizing barriers and facilitators for homeless youth to access and utilize mental health care services. When untreated mental illness reaches a crisis point, it becomes more expensive to treat (Taylor, Stuttaford, and Vostanis, 2006). For youth experiencing homelessness, various factors influence their decisions to wait until a crisis to reach out to emergency services. Within the literature, barriers and facilitators were bracketed into personal, social, and structural factors. These factors ranged from financial concerns, communication with health care providers and between health care service locations, stigmatization, lack of awareness, and administrative requirements. While further research is required, evidence from the literature shows promise in developing and altering interventions and communication to meet homeless youth's mental health and substance abuse needs.
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Date Issued: 2019
Identifier: CFH2000468, ucf:45860
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000468

Title: HEALTH CARE PROVIDERS' PERSPECTIVES ON MALE INVOLVEMENT IN THEIR SEXUAL AND REPRODUCTIVE HEALTH CARE NEEDS.
Creator: Milanes, Lilian, Mishtal, Joanna, University of Central Florida
Abstract / Description: Young men are at the greatest risk of contracting sexually transmitted infections (STIs) within the U.S. male populations, yet are the least likely to make a sexual and reproductive health (SRH) care visit. Clinical approaches in these areas that include the outreach to and the involvement of male partners of female patients can prove particularly useful in expanding SRH care to men and can also improve health outcomes for women who have sex with men. In this study I examined UCF's healthcare...
Show moreYoung men are at the greatest risk of contracting sexually transmitted infections (STIs) within the U.S. male populations, yet are the least likely to make a sexual and reproductive health (SRH) care visit. Clinical approaches in these areas that include the outreach to and the involvement of male partners of female patients can prove particularly useful in expanding SRH care to men and can also improve health outcomes for women who have sex with men. In this study I examined UCF's healthcare provider's approaches to educate and involve men (between the ages of 18 and 30) and male partners of female patients in their SRH needs. I conducted qualitative semi-structured interviews with 18 health care providers at the Student Health Center; including physicians, physician assistants, and registered nurses. This study found that there were significant differences in perception of men's SRH risk behaviors among the providers. In addition, this study revealed issues that might deter male students from accessing care, specifically how patients are required to state to the operator (who is also an undergraduate student) their name, PID and exactly why they are scheduling a visit to the clinic, thus many men say they have cold symptoms instead of issues with SRH. This study is significant because it can contribute to improvements in the delivery of SRH care to male students on campus.
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Date Issued: 2012
Identifier: CFH0004225, ucf:44954
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004225

Title: Constructing and Validating an Integrative Economic Model of Health Care Systems and Health Care Markets: A Comparative Analysis of OECD Countries.
Creator: Helligso, Jesse, Wan, Thomas, Liu, Albert Xinliang, King, Christian, Hamann, Kerstin, University of Central Florida
Abstract / Description: This dissertation argues that there are three basic types of health care systems used in industrial nations: free market (private insurance and provision), universal (public insurance and private provision), and socialized (public insurance and provision). It examines the role of market forces (supply and demand) within the health care systems and their effects on health outcomes by constructing an integrative model of health care markets and policies that is lacking within the scientific and...
Show moreThis dissertation argues that there are three basic types of health care systems used in industrial nations: free market (private insurance and provision), universal (public insurance and private provision), and socialized (public insurance and provision). It examines the role of market forces (supply and demand) within the health care systems and their effects on health outcomes by constructing an integrative model of health care markets and policies that is lacking within the scientific and academic literature. The results show that, free market systems have decreased access to care, good quality of care, and are economically inefficient resulting in 2.7 years of life expectancy lost and wasted expenditures (expenditures that do not increase life expectancy) of $3474 per capita ($1.12 trillion per year in the U.S.). Socialized systems are the most economically efficient systems but have decreased access to care compared to universal systems, increased access to care compared to free market systems and have the lowest quality of care of all three systems resulting in 3 months of life expectancy lost per capita and a saving of $335 per capita. Universal systems perform better than either of the other 2 systems based on quality and access to care. The models show that health insurance is a Giffen Good; a good that defies the law of demand. This study is the first fully demonstrated case of a Giffen good. This investigation shows how the theoretically informed integrative model behaves as predicted and influences health outcomes contingent upon the system type. To test and substantiate this integrative model, regression analysis, Time-Series-Cross-Section analysis, and structural equation modeling were performed using longitudinal data provided and standardized by the Organization for Economic Cooperation and Development (OECD). The results demonstrate that universal health care systems are superior to the other two systems.
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Date Issued: 2018
Identifier: CFE0007335, ucf:52114
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007335

Title: FAMILY SUPPORT AND MENTAL HEALTH CARE QUALITY IN NURSING HOMES SERVING RESIDENTS WITH A MENTAL HEALTH HISTORY.
Creator: Frahm, Kathryn, Gammonley, Denise, University of Central Florida
Abstract / Description: The prevalence of mental health disorders among the nursing home population is well recognized. However, providing adequate mental health services for nursing home residents who need them remains a challenging endeavor. The social support of family has long been recognized as a key resource for older adults with a mental health history and older adults residing in nursing homes. The purpose of this study is to examine the quality of mental health care provided for nursing home residents with...
Show moreThe prevalence of mental health disorders among the nursing home population is well recognized. However, providing adequate mental health services for nursing home residents who need them remains a challenging endeavor. The social support of family has long been recognized as a key resource for older adults with a mental health history and older adults residing in nursing homes. The purpose of this study is to examine the quality of mental health care provided for nursing home residents with a mental health history and to determine if family support influences the quality of their mental health care accounting for other facility resident and facility organizational characteristics. The study utilized a retrospective, cross-sectional design with 2003 national Online Survey Certification and Reporting (OSCAR) facility data merged with the resident-level Minimum Data Set (MDS) resulting in N=2,499 nursing homes. Guided by the convoy model of social support and socioemotional selectivity theory, descriptive statistics and exploratory factor analysis were used to create a profile of facility level data of nursing home residents with a mental health history, explore the role of family support, and determine if items within the OSCAR and MDS databases could respectively be used to measure mental health care quality and family support. Overall, it was found that families have a positive relationship with their relatives and are involved in their lives. Additionally, items within the OSCAR and MDS databases could be used to measure mental health care quality and family support. Finally, facility organizational characteristics explained more variation in the quality of mental health care than did facility resident, family support, or market characteristics. In sum, to enhance the quality of mental health care in nursing homes, partnering with families may be an important tool to meet resident needs.
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Date Issued: 2009
Identifier: CFE0002529, ucf:47670
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002529

Title: IS THE DOCTOR IN? THE EFFECTS OF EMIGRATION ON THE HEALTH CARE SYSTEMS IN POLAND AND ROMANIA.
Creator: Wolk, Gabriela B, Turcu, Anca, University of Central Florida
Abstract / Description: The �brain drain� phenomenon encompasses the mass movement of highly educated individuals. Highly-skilled and well-educated migrants are moving to more developed and urban settings, often in search of a higher standard of living and better wages. Since joining the European Union and the Schengen Agreement, Poland and Romania have experienced significant emigration which has subsequently affected their health care systems. Motivations for emigrating from these two countries and the effects...
Show moreThe �brain drain� phenomenon encompasses the mass movement of highly educated individuals. Highly-skilled and well-educated migrants are moving to more developed and urban settings, often in search of a higher standard of living and better wages. Since joining the European Union and the Schengen Agreement, Poland and Romania have experienced significant emigration which has subsequently affected their health care systems. Motivations for emigrating from these two countries and the effects emigration has had on patients and other doctors will be considered. The paper also seeks to compare policy responses to the mass medical emigration phenomenon in both countries, as well as the outcomes of such policies. The main methodology of study throughout this project entails a comparative assessment of the governmental policy responses to brain drain. An analysis of Poland�s and Romania�s health care systems will be performed initially. The analysis includes details on the causes and factors that bring about migration, the impact that emigration has had on patients, how doctors remaining in the sending country are affected, and what social upheavals and unrest result from such emigration. Following, the levels and flows of migration are considered for each country, looking at the type of people leaving, whether educated or not, and the range of professions, with a focus on health professionals that are migrating from both countries. After an analysis has been performed for both countries, the results will be compared to one another, paying special attention to any differences and potential reasons for these differences.
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Date Issued: 2016
Identifier: CFH2000062, ucf:52903
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000062

Title: Three Studies Examining Auditors' Use of Data Analytics.
Creator: Koreff, Jared, Sutton, Steven, Arnold, Vicky, Baudot, Lisa, Brazel, Joe, University of Central Florida
Abstract / Description: This dissertation comprises three studies, one qualitative and two experimental, that center on auditor's use of data analytics. Data analytics hold the potential for auditors to reallocate time spent on labor intensive tasks to judgment intensive tasks (Brown-Liburd et al. 2015), ultimately improving audit quality (Raphael 2017). Yet the availability of these tools does not guarantee that auditors will incorporate the data analytics into their judgments (Davis et al. 1989; Venkatesh et al....
Show moreThis dissertation comprises three studies, one qualitative and two experimental, that center on auditor's use of data analytics. Data analytics hold the potential for auditors to reallocate time spent on labor intensive tasks to judgment intensive tasks (Brown-Liburd et al. 2015), ultimately improving audit quality (Raphael 2017). Yet the availability of these tools does not guarantee that auditors will incorporate the data analytics into their judgments (Davis et al. 1989; Venkatesh et al. 2003). The first study investigates implications of using data analytics to structure the audit process for nonprofessionalized auditors. As the public accounting profession continues down a path of de-professionalization (Dirsmith et al. 2015), data analytics may increasingly be used as a control mechanism for guiding nonprofessionalized auditors' work tasks. Results of this study highlight negative ramifications of using nonprofessionalized auditors in a critical audit setting. The second study examines how different types of data analytics impact auditors' judgments. This study demonstrates the joint impact that the type of data analytical model and type of data analyzed have on auditors' judgments. This study contributes to the literature and practice by demonstrating that data analytics do not uniformly impact auditors' judgments. The third study examines how auditors' reliance on data analytics is impacted by the presentation source and level of risk identified. This study provide insights into the effectiveness of public accounting firms' development of data scientist groups to incorporate the data analytic skillset into audit teams.Collectively, these studies contribute to the literature by providing evidence on auditors' use of data analytics. Currently, the literature is limited to demonstrating that auditors are not effective at identifying patterns in data analytics visualizations when viewed before traditional audit evidence (Rose et al. 2017). The three studies in this dissertation highlight that not all data analytics influence judgments equally.
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Date Issued: 2018
Identifier: CFE0007210, ucf:52289
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007210

Title: Utilization of Ambulatory Services by the Health Maintenance Organization of Florida.
Creator: Hansen, Thomas Harold, Mendenhall, Thomas S., Health
Abstract / Description: University of Central Florida College of Health Thesis; The utilization of ambulatory services by the health maintenance organization of Florida (HMO), independent practice association (IPA) model, was compared to a fee-for-service population. Each randomly selected group 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...
Show moreUniversity of Central Florida College of Health Thesis; The utilization of ambulatory services by the health maintenance organization of Florida (HMO), independent practice association (IPA) model, was compared to a fee-for-service population. Each randomly selected group 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 evaluations are needed.
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Date Issued: 1988
Identifier: CFR0008167, ucf:53069
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFR0008167

Title: HEALTH-CARE SEEKING BEHAVIORS OF PUERTO RICANS WITH DIABETES MELLITUS WHO LIVE IN SOUTH FLORIDA: AN EXPLORATORY STUDY.
Creator: Gonzalez, Laura, Bushy, Angeline, University of Central Florida
Abstract / Description: ABSTRACT Latinos are the fastest growing minority population in the United States (U.S.) and have the worst access to health care of any ethnic group. The chronic disease of diabetes is twice as common in adult Latinos as in non-Latino whites, and the risk of death related to diabetes is twofold. Reasons for this disparity have yet to be clearly identified. This study had two purposes: 1) to explore cultural beliefs regarding health-care seeking behaviors in Puerto Ricans with diabetes who...
Show moreABSTRACT Latinos are the fastest growing minority population in the United States (U.S.) and have the worst access to health care of any ethnic group. The chronic disease of diabetes is twice as common in adult Latinos as in non-Latino whites, and the risk of death related to diabetes is twofold. Reasons for this disparity have yet to be clearly identified. This study had two purposes: 1) to explore cultural beliefs regarding health-care seeking behaviors in Puerto Ricans with diabetes who live in South Florida; and 2) to examine Puerto Ricans' perceptions about their health-care providers. The cultural phenomena of interest were familism, religiosity, spirituality, use of ethnomedicine, and perception of ethnic concordance of health-care provider. Numerous studies have examined these phenomena with other Latino groups, but none have specifically focused on Puerto Ricans. An overarching goal of the study was to contribute to the knowledge base on a particular health disparity--diabetes. Using a narrative inquiry approach, a purposive sample of self-identified Puerto Ricans with diabetes (N = 12) were recruited from six sites in a South Florida city. Data were obtained using a pencil-and-paper demographic instrument, the Short Acculturation Scale to determine language preference of Spanish or English, and a personal interview using a semi-structured, ten-item interview guide. Subjects gave written informed consent for participation, and all data were coded to ensure confidentiality. The personal interviews were tape recorded and transcribed verbatim. Interviews completed in Spanish were translated to English and transcribed. Using content analyses techniques, transcribed narratives were analyzed for content and thematic emergence. iii The findings revealed that familism was an important consideration in health-care seeking behaviors. Traditional gender role expectations, coupled with caregiver burdens, deterred some participants from seeking care even when care was needed. Religiosity and spirituality did not influence decision-making but did have a role in coping with the chronic disease. While participants were aware of culturally based ethnomedicine, they preferred Western medicine for the treatment of their diabetes. They also had a preference for a health-care provider who was ethnically concordant. Serendipitous findings that emerged in the analyses included the casual attitude of several participants about their diabetic status and reports of depressive-like symptoms among most of the women. Health-care providers need to take into consideration the cultural and linguistic preferences of Puerto Ricans to develop an appropriate and effective treatment plan. Discrepancies between the health-care providers and the clients' systems must be reconciled to improve adherence to evidence-based treatment.
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Date Issued: 2008
Identifier: CFE0002018, ucf:47631
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002018

Title: EFFECTS OF HEALTH INFORMATION TECHNOLOGY ADOPTION ON QUALITY OF CARE AND PATIENT SAFETY IN US ACUTE CARE HOSPITALS.
Creator: Seblega, Binyam, Zhang, Ning, University of Central Florida
Abstract / Description: The adoption of healthcare information technology (HIT) has been advocated by various groups as critical in addressing the growing crisis in the healthcare industry. Despite the plethora of evidence on the benefits of HIT, however, the healthcare industry lags behind many other economic sectors in the adoption of information technology. A significant number of healthcare providers still keep patient information on paper. With the recent trends of reimbursement reduction and rapid...
Show moreThe adoption of healthcare information technology (HIT) has been advocated by various groups as critical in addressing the growing crisis in the healthcare industry. Despite the plethora of evidence on the benefits of HIT, however, the healthcare industry lags behind many other economic sectors in the adoption of information technology. A significant number of healthcare providers still keep patient information on paper. With the recent trends of reimbursement reduction and rapid technological advances, therefore, it would be critical to understand differences in structural characteristics and healthcare performance between providers that do and that do not adopt HIT. This is accomplished in this research, first by identifying organizational and contextual factors associated with the adoption of HIT in US acute care hospitals and second by examining the relationships between the adoption of HIT and two important healthcare outcomes: patient safety and quality of care. After conducting literature a review, the structure-process-outcome model and diffusion of innovations theory were used to develop a conceptual framework. Hypotheses were developed and variables were selected based on the conceptual framework. Publicly available secondary data were obtained from the American Hospital Association (AHA), the Health Information and Management Systems Society (HIMSS), and the Healthcare Cost and Utilization Project (HCUP) databases. The information technologies were grouped into three clusters: clinical, administrative, and strategic decision making ITs. After the data from the three sources were cleaned and merged, regression models were built to identify organizational and contextual factors that affect HIT adoption and to determine the effects of HIT adoption on patient safety and quality of care. Most prior studies on HIT were restricted in scope as they primarily focused on a limited number of technologies, single healthcare outcomes, individual healthcare institutions, limited geographic locations, and/or small market segments. This limits the generalizability of the findings and makes it difficult to draw definitive conclusions. The new contribution of the present study lies in the fact that it uses nationally representative latest available data and it incorporates a large number of technologies and two risk adjusted healthcare outcomes. Large size and urban location were found to be the most influential hospital characteristics that positively affect information technology adoption. However, the adoption of HIT was not found to significantly affect hospitalsÃ‚Â' performance in terms of patient safety and quality of care measures. Perhaps a remarkable finding of this study is the better quality of care performance of hospitals in the Midwest, South, and West compared to hospitals in the Northeast despite the fact that the latter reported higher HIT adoption rates. In terms of theoretical implications, this study confirms that organizational and contextual factors (structure) affect adoption of information technology (process) which in turn affects healthcare outcomes (outcome), though not consistently, validating Avedis DonabedianÃ‚Â's structure-process-outcome model. In addition, diffusion of innovations theory links factors associated with resource abundance, access to information, and prestige with adoption of information technology. The present findings also confirm that hospitals with these attributes adopted more technologies. The methodological implication of this study is that the lack of a single common variable and uniformity of data among the data sources imply the need for standardization in data collection and preparation. In terms of policy implication, the findings in this study indicate that a significant number of hospitals are still reluctant to use clinical HIT. Thus, even though the passage of the American Recovery and Reinvestment Act (ARRA) of 2009 was a good stimulus, a more aggressive policy intervention from the government is warranted in order to direct the healthcare industry towards a better adoption of clinical HIT.
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Date Issued: 2010
Identifier: CFE0003327, ucf:48445
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003327

Title: SPIRITUALITY AND EXPECTATIONS OF CARE PROVIDERS OF OLDER PATIENTS WITH CHRONIC ILLNES IN NORTH CENTRAL FLORIDA.
Creator: Sherman, Myra, Wink, Diane, University of Central Florida
Abstract / Description: A qualitative design was used to explore the use of spirituality and prayer by older adults who have chronic illness and reside in a rural community. Thirteen individuals responded to a flyer soliciting participation in a study of the use of spirituality as part of health care. Participants were at least 60 years of age, had at least one chronic illness and resided in North Central Florida. Twelve participants then responded to six open-ended questions based on an adaption of an instrument...
Show moreA qualitative design was used to explore the use of spirituality and prayer by older adults who have chronic illness and reside in a rural community. Thirteen individuals responded to a flyer soliciting participation in a study of the use of spirituality as part of health care. Participants were at least 60 years of age, had at least one chronic illness and resided in North Central Florida. Twelve participants then responded to six open-ended questions based on an adaption of an instrument used by Dr. Shevon Harvey in her doctoral dissertation. The data was analyzed to identify themes and answer four research questions. The four research questions were 1) how do older adults living with chronic illness describe spirituality? 2) how do older adults use spirituality while living with chronic illness? 3) how can health care providers assist older individuals with chronic illness to meet their spiritual needs?, and 4) do patients feel that their spiritual needs are being addressed during their outpatient health care? The interview responses demonstrated that several different practices, including prayer and scripture readings as well as adherence to medication, diet, and exercise recommendations were used as coping mechanisms by study participants. The majority of participants want their health care providers to address spirituality and/or refer them to spiritual advisors for counseling. The study showed that some participants stated that their spiritual needs were met, but there were some who did not want spirituality addressed in the outpatient setting. Four themes were identified, which suggest that 1) spiritual practices were frequently used coping measure for these individual with chronic illness, 2) health care providers are supportive of their patients' spirituality, 3) participants with chronic illness consider adherence to medication, diet, and exercise a coping measure, and 4) participants with chronic illness want their health care providers to recognize their spiritual needs. The findings indicated that individuals who self identify as individuals from whom spiritual life is important and who have chronic illnesses and have spiritual needs that can be addressed in the outpatient setting. The findings also demonstrated use of non spiritual coping measures and the importance of health care provider's acceptance of spirituality in this specific population. Recommendations for further research are made.
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Date Issued: 2011
Identifier: CFE0003740, ucf:48794
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003740

Title: An Examination of the Florida Linking Individuals Needing Care Coordination Program for Racial and Ethnic Minority Females.
Creator: Vance, Michelle, Gryglewicz, Kimberley, Chapple, Reshawna, Lawrence, Shawn, Fisher, Kristina Childs, University of Central Florida
Abstract / Description: Suicide accounts for close to 800,000 deaths each year, making it one of the leading causes of death in the United States. In the state of Florida, suicide is the 10th leading cause of death. Currently, it is the 2nd leading cause of death among young people ages 15-29, claiming more lives than homicide. Among Black and Hispanic youth (10 to 24), it is the 2nd and 3rd leading causes of death. This study aimed to examine the extent to which depression and suicidality outcomes change among...
Show moreSuicide accounts for close to 800,000 deaths each year, making it one of the leading causes of death in the United States. In the state of Florida, suicide is the 10th leading cause of death. Currently, it is the 2nd leading cause of death among young people ages 15-29, claiming more lives than homicide. Among Black and Hispanic youth (10 to 24), it is the 2nd and 3rd leading causes of death. This study aimed to examine the extent to which depression and suicidality outcomes change among racial and ethnic minority females (i.e., Black and African American, Hispanic) who participated in a care coordination intervention. These subpopulations were chosen due to limited suicide prevention research on at-risk racial and ethnic minority females and to address health disparities. To examine these outcomes, the study employed a one-group pretest-posttest design utilizing secondary data from 76 youth participants enrolled in the care coordination program from three crisis stabilization units (CSU) in Florida. Key findings included significant decreases in depression symptomology (54%) and suicidality (82%). Among participants enrolled in the program, 84% did not have a readmission to the CSU. Length of stay was a predictor or readmission in that a one unit (one day) increase lead to a 3% increase in odds of readmission to the CSU. Results of this study can help guide social work and mental health practitioners in designing and implementing community-based suicide prevention programs for racial and ethnic minority females.
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Date Issued: 2019
Identifier: CFE0007548, ucf:52594
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007548

Title: Down in the Mouth: Homelessness and Oral Health.
Creator: Kleinberger, Jessica, Wright, James, Rivera, Fernando, Donley, Amy, University of Central Florida
Abstract / Description: The burden of dental disease in American has been termed a (")silent epidemic,(") affecting the most vulnerable populations in society. Poor oral health has been linked with general health issues, such as diabetes and cardiovascular disease, as well as decreased mental health and impairments in social functioning. This burden weighs particularly heavy on the homeless, who are not only denied access to private systems of care, but are further rejected by an inadequately supported public safety...
Show moreThe burden of dental disease in American has been termed a (")silent epidemic,(") affecting the most vulnerable populations in society. Poor oral health has been linked with general health issues, such as diabetes and cardiovascular disease, as well as decreased mental health and impairments in social functioning. This burden weighs particularly heavy on the homeless, who are not only denied access to private systems of care, but are further rejected by an inadequately supported public safety net. Despite the recognition of social inequalities and the call for further scientific research, oral health care has not been extensively recognized within sociology. The aim of this research was to uncover how Central Florida's homeless adults cope with oral health issues in the face of barriers. This study intends to begin closing the gap by exploring the ways in which structural inequalities are embodied in the teeth of the homeless. Twenty-five semi-structured interviews were conducted with homeless individuals in the Central Florida area in regards to their oral health and coping mechanisms. Results indicate that without conventional access to dental care, homeless are forced to rely on emergency departments, alcohol, illegal drugs, home remedies, and over-the-counter medications. When treatment was received, only emergency services were provided. This led to an extraction-denture treatment model which left many homeless individuals edentulous, with continued complications in their ability to eat, work, and talk.
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Date Issued: 2014
Identifier: CFE0005192, ucf:50640
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005192

Title: PERCEPTIONS OF SENIOR CITIZENS IN CENTRAL FLORIDA REGARDING QUALITY OF CARE UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA).
Creator: Nieves , Rafael, Sumner, Jennifer, University of Central Florida
Abstract / Description: On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their...
Show moreOn March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their perceived effects on the healthcare quality provided to them under this law. Four sections of PPACA bill, thought to specifically pertain to the elderly, were selected for this study; respondents were asked their opinions regarding PPACA's aspects of: (1) the reform on preventive healthcare services; (2) Medicare Part D [prescription drugs]; (3) Medicare; and (4) Medicaid. This thesis employed both qualitative and quantitative methodologies; data were collected and analyzed with findings presented and discussed.
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Date Issued: 2013
Identifier: CFH0004468, ucf:45112
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004468

Title: LOW-INCOME HEALTH CARE NETWORKS: INITIAL CONDITIONS, EXTENT, AND INTENSITY RELEVANT TO COUNTY GOVERNMENT PARTICIPATION.
Creator: Knepper, Hillary, Feldheim, Mary Ann, University of Central Florida
Abstract / Description: Contemporary health care systems in the United States are not equitable. Indeed, as the literature indicates, there are substantial differences in the variety and scope of service delivery based on age, income, and other socio-economic indicators. The recent passage of health care reform in the United States illustrates that Americans are seeking to bring balance and equity to health care. However, as learned in this study, county governments across the country have been working in their...
Show moreContemporary health care systems in the United States are not equitable. Indeed, as the literature indicates, there are substantial differences in the variety and scope of service delivery based on age, income, and other socio-economic indicators. The recent passage of health care reform in the United States illustrates that Americans are seeking to bring balance and equity to health care. However, as learned in this study, county governments across the country have been working in their communities to ensure some balance and equity, by making a safety net available for those citizens who are unable to access health care. Perhaps this is because health care quickly becomes a local government problem. In this current economic climate, county governments are being pinched between declining revenues and rising demands for services (Eaton, 2009; Phaup, 2009). The Orange County Primary Care Access Network is one example studied here that provides clear evidence of how organizations can work together to develop and maintain a sustainable health care safety net for the underinsured and uninsured. This study is the first of its kind to examine county government influences, environmental pressures, and community resources in the context of health care network performance. The methodological research question for this study is what determinants (exogenous constructs) contribute to a health care network and its performance (endogenous construct) within the framework of county government participation? Further, is the model supported by the data and can prediction, direction, and strength of relationships among the variables be identified? The simple answer is yes. For this study, the responses from 123 counties were analyzed with a variety of statistical techniques, culminating in structural equation modeling. The outcome of these analyses provided a reasonable explanation for the variation among the variables leading to network performance improvement in meeting the health care needs of uninsured and underinsured people. These quantitative data were also supported in their results with the inclusion of a case study analysis of a particular health care safety-net, the Orange County Primary Care Access Network in Orange County, Florida. Ultimately, this study learned three valuable lessons that can be used by county government decision-makers and health care providers alike. First, county involvement in community based health care networks results in a benefit that reverberates during economic stress- the leveraging of resources. Second, public-private initiatives are fundamental to reducing disparities in health care access. Third, health care networks improve access to health care for uninsured and underinsured people. Ultimately, county government participation is the largest predictor of network performance in this study.
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Date Issued: 2010
Identifier: CFE0003341, ucf:48475
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003341

Title: Factors Influencing Hypoglycemia Care Utilization and Outcomes Among Adult Diabetic Patients Admitted to Hospitals: A Predictive Model.
Creator: Kattan, Waleed, Wan, Thomas, Ramirez, Bernardo, Gurupur, Varadraj, Stevenson, Robyne, Pratley, Richard, University of Central Florida
Abstract / Description: Diabetes Miletus (DM) is one of the major health problems in the United States. Despite all efforts made to combat this disease, its incidence and prevalence are steadily increasing. One of the common and serious side effects of treatment among people with diabetes is hypoglycemia (HG), where the level of blood glucose falls below the optimum level. Episodes of HG vary in their severity. Nevertheless, many require medical assistance and are usually associated with higher utilization of...
Show moreDiabetes Miletus (DM) is one of the major health problems in the United States. Despite all efforts made to combat this disease, its incidence and prevalence are steadily increasing. One of the common and serious side effects of treatment among people with diabetes is hypoglycemia (HG), where the level of blood glucose falls below the optimum level. Episodes of HG vary in their severity. Nevertheless, many require medical assistance and are usually associated with higher utilization of healthcare resources such as frequent emergency department visits and physician visits. Additionally, patients who experience HG frequently have poor outcomes such as higher rates for morbidities and mortality.Although many studies have been conducted to explore the risk factors associated with HG as well as others that looked into the level of healthcare utilization and outcomes among patients with HG, most of these studies failed to establish a theoretical foundation and integrate a comprehensive list of personal risk factors. Therefore, this study aimed to employ Andersen's health Behavior Model of health care utilization (BM) as a framework to examine the problems of HG. This holistic approach facilitates enumerating predictors and examining differential risks of the predisposing (P), enabling (E) and need-for-care (N) factors influencing HG and their effects on utilization (U) and outcomes (O). The population derived from the national inpatient sample of the Healthcare Cost and Utilization Project (HCUP) database and included all non-pregnant adult diabetic patients admitted to hospitals' Emergency Departments (EDs) with a diagnosis of HG from 2012-2014. Based on the BM framework, different factors influencing HG utilization and outcome were grouped under the P, E, or N component. Utilization was measured by patients' length of stay (LoS) in the hospital and the total charges incurred for the stay. Outcome was assessed based on the severity ranging from mortality (the worst), severe complications, mild complications, to no complications (the best). Structural Equation Modeling (SEM) followed by Decision Tree Regression (DTREG) were performed. SEM helped in testing multiple hypotheses developed in the study as well as exploring the direct and indirect impact of different risk factors on utilization and outcome. The results of the analysis show that N is the most influential component of predictors of U and O. This is parallel to what was repeatedly found in different studies that employed the BM. Regarding the other two components, P was found to have some effect on O, while E influences the total charge. Interaction effects of predictors were noted between some components, which indicate the indirect effect of these components on U and O. Subsequently, DTREG analysis was conducted to further explore the probability of the different predictor variables on LoS, total charge, and outcome. Results of this study revealed that the presence of renal disease and DM complications among HG patients play a key role in predicting U and O. Furthermore, age, socio-economic status (SES), and the geographical location of the patients were also found to be vital factors in determining the variability in U and O among HG patients.In conclusion, findings of this study lend support to the use of the BM approach to health services use and outcomes and provide some practical applications for healthcare providers in terms of using the predictive model for targeting patient subgroups (HG patients) for interventions among diabetic patients. Moreover, policy implications, particularly related to the Central Florida area, for decision makers regarding how to approach the growing problem of DM can be drawn from the study results.
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Date Issued: 2017
Identifier: CFE0006611, ucf:51304
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006611

Title: THE EFFECT OF JOB STRAIN IN THE HOSPITAL ENVIRONMENT: APPLYING OREM'S THEORY OF SELF CARE.
Creator: Andrews, Diane, Wan, Thomas, University of Central Florida
Abstract / Description: The purpose of this research was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover. It was conducted at the level of the individual nurse employee in order to better understand the health consequences associated with job strain, the factors in the professional practice environment which may contribute to the propensity to leave and the influence of...
Show moreThe purpose of this research was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover. It was conducted at the level of the individual nurse employee in order to better understand the health consequences associated with job strain, the factors in the professional practice environment which may contribute to the propensity to leave and the influence of coping behaviors in response to workplace stressors. It was undertaken with the intention of identifying intervention strategies which will promote a healthy workforce and the retention of nurses in the workplace. An exploratory cross-sectional survey of 1235 staff nurses employed on the intensive, progressive and general medical-surgical nursing units of seven hospitals associated with a major Central Florida healthcare network tested a client-centered model in an effort to identify nurses vulnerable to the health consequences of job strain using structural equation modeling. Human subject protection was assured. An 82 item questionnaire was used to collect demographic data and measure responses to items associated with the constructs of health status, autonomy, collaboration, decentralization, coping, satisfaction, absenteeism and intent to leave. A variety instruments that were previously demonstrated as valid and reliable were used in the construction of the instrument. Subjects were also given the option of including additional written comments. A total of 325 surveys were returned, of which 308 met inclusion criteria, for a response rate of 25%. Data analysis determined that the measurement of job strain as a function of self-assessed generic health status was predictive of propensity to leave (ã = -.21). The experience of job strain shared a strong association with indicators of mental health status. Job strain was significantly influenced by coping behavior (ã = .56) which targeted activities associated with sustaining and balancing. Anecdotal remarks suggested that the need for balance influenced perceptions regarding stressors in the workplace. The professional practice environment was associated negatively with the propensity to leave (ã = -.58). Those staff nurses who experienced higher levels of autonomy expressed a greater degree of satisfaction and lower intent to leave. The variables of collaboration and decentralization contributed minimally to the construct of professional practice. Anecdotal remarks suggested that the low contribution of collaboration and decentralization contributed to a sense of powerlessness and frustration with work related circumstances. The influence of job strain, coping and the professional practice environment upon staff nurses suggests that health promotion strategies, efforts to enhance coping behavior and promotion of a professional practice environment will increase employee satisfaction and reduce intent to leave. Adoption of policies and procedures which support the health and well-being of individual staff members will benefit employees, strengthen the organizations in which they practice and promote the overall retention of nurses in the face of looming nurse shortages.
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Date Issued: 2006
Identifier: CFE0000935, ucf:46742
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0000935

Title: RISK OF MEDICATION ERRORS IN THE HOME: AN INTEGRATIVE LITERATURE REVIEW.
Creator: Crescenzi, Maria M, Bushy, Angeline, University of Central Florida
Abstract / Description: Regardless of the setting, medication errors are of great concern when associated with an individual's health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative...
Show moreRegardless of the setting, medication errors are of great concern when associated with an individual's health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant articles in the English language between 2006 to 2017, including CINAHL, MEDLINE, PubMed, and PsycINFO. Search terms included 'medication errors', 'home care', 'post-discharge', 'hospital readmission', and 'medication error risks in the home'. Exclusion criteria included medication errors in acute and extended care settings. The integrative review involved reading, analyzing and selecting articles, and summarizing on a matrix. Findings on occurrences of medication errors in the home included impaired client mental status, confusion related to medication names, limited understanding of medication purpose in the care plan and its side effects, level of health literacy, and client-provider miscommunication in discharge planning. Consistent and conflicting findings are discussed along with gaps in the literature. Limitations and implications for nursing practice, policy, research, and education are also noted.
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Date Issued: 2017
Identifier: CFH0000223, ucf:44678
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0000223

health care (4)	+ -
health (2)	+ -
health care providers (2)	+ -
nursing (2)	+ -
quality of care (2)	+ -

ACA (1)	+ -
Adolescent (1)	+ -
Ambulatory medical care -- Florida (1)	+ -
Andersen’s health Behavior Model of health care utilization (1)	+ -
Barriers (1)	+ -
Behavioral Health (1)	+ -
Caregiver (1)	+ -
Central Florida (1)	+ -
Child (1)	+ -
Comfort (1)	+ -
Coping (1)	+ -
Data analytics (1)	+ -
Decision Tree Regression (1)	+ -
Diabetes (1)	+ -
Diabetes Mellitus (1)	+ -
End of Life (1)	+ -
Facilitators (1)	+ -
Giffen good (1)	+ -
HIT (1)	+ -
Health Care (1)	+ -
Health Care Funding (1)	+ -
Health Care Providers (1)	+ -
Health Status (1)	+ -
Health care (1)	+ -
Health care associated infections (1)	+ -

ETD Collection (17)	+ -
Honors Collection (8)	+ -

University of Central Florida (24)	+ -
Wan, Thomas (3)	+ -
Bushy, Angeline (2)	+ -
Donley, Amy (2)	+ -
Hinojosa, Melanie (2)	+ -

Lawrence, Shawn (2)	+ -
Andrews, Diane (1)	+ -
Arnold, Vicky (1)	+ -
Baker, Herma (1)	+ -
Baudot, Lisa (1)	+ -
Blackwell, Christopher (1)	+ -
Brazel, Joe (1)	+ -
Chapple, Reshawna (1)	+ -
Covelli, Maureen (1)	+ -
Crescenzi, Maria M (1)	+ -
Daniel, Lauren (1)	+ -
Dever, Kimberly (1)	+ -
Esposito, Devin (1)	+ -
Feldheim, Mary Ann (1)	+ -
Fisher, Kristina Childs (1)	+ -
Frahm, Kathryn (1)	+ -
Gammonley , Denise (1)	+ -
Gammonley, Denise (1)	+ -
Gonzalez, Laura (1)	+ -
Gore, Maria (1)	+ -
Gryglewicz, Kimberley (1)	+ -
Gurupur, Varadraj (1)	+ -
Hamann, Kerstin (1)	+ -
Hansen, Thomas Harold (1)	+ -
Health (1)	+ -

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