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首页> 外文学位 >Investigating Strategies To Improve Health Care Labor Market, Health Outcomes, Health Care Quality, And To Reduce Emergency Department Utilization And Costs: A Study Of The Effectiveness Of Family Friendly Policies, Patient-Centered Communication, And Enhanced Access To Care
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Investigating Strategies To Improve Health Care Labor Market, Health Outcomes, Health Care Quality, And To Reduce Emergency Department Utilization And Costs: A Study Of The Effectiveness Of Family Friendly Policies, Patient-Centered Communication, And Enhanced Access To Care

机译：调查策略，以改善卫生保健劳动力市场，卫生成果，卫生保健质量并减少急诊部门的使用和成本：家庭友好政策，以患者为中心的沟通和增强的就医机会的有效性研究

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摘要

This dissertation investigates three important issues in the US health care system: the low utilization of family-friendly policies by health care professionals, the sub-optimal quality of medical services, and the high level of emergency department (ED) expenditures. Chapter 2 uses a unique dataset from a choice experiment to address the first issue by exploring the impact of supervision support on the economic value of family-friendly policies. My results suggest that supervisors' support for the use of family-friendly services significantly increase the economic value of the family-friendly benefits provided. Chapter 3 and 4 investigate the effectiveness of patient-centered care models in improving health outcomes, health care quality and reduce emergency department expenditures. Using six panels of the Medical Expenditure Panel Survey, I construct a multidimensional measure of patient-centered communication that integrates items related to cultural competency, coordinated care, shared decision-making, and patient-centeredness. The results reveal that patient-centered communication significantly increases patients' likelihood to report a better physical or mental health, as well as health care quality. Furthermore, being foreign born, non-English proficient, with mental, social, or physical disability, all significantly decrease the risk of having enhanced access to care and patient-centered communication with medical provider. Finally, having an enhanced access to primary care and a patient-centered communication with primary care provider significantly reduces both ED use and expenditures. Estimated average reduction in ED expenditures attributed to a better access to primary care and a patient centered-communication varies from $1.180,53 to $1.191,89 per year per individual.
机译：本文研究了美国医疗保健体系中的三个重要问题：医疗保健专业人员对家庭友好政策的利用率低，医疗服务质量欠佳以及急诊科（ED）支出高。第2章使用来自选择实验的独特数据集，通过探讨监管支持对家庭友好型政策的经济价值的影响来解决第一个问题。我的结果表明，主管人员对使用家庭友好型服务的支持大大提高了所提供的家庭友好型福利的经济价值。第3章和第4章研究以患者为中心的护理模式在改善健康结果，医疗质量和减少急诊部门支出方面的有效性。我使用“医疗支出面板调查”的六个面板，构建了以患者为中心的多维交流测度，其中整合了与文化能力，协调护理，共同决策和以患者为中心有关的项目。结果表明，以患者为中心的交流显着提高了患者报告身体或精神健康状况以及医疗质量的可能性。此外，由于是外国出生的，非英语熟练的，具有精神，社会或身体残疾的人，都大大降低了增加就医机会以及与医疗服务提供者以患者为中心的沟通的风险。最后，获得更多的初级保健机会以及与初级保健提供者进行以患者为中心的沟通可以显着减少ED的使用和支出。由于更好地获得初级保健和以患者为中心的交流，估计急诊支出的平均减少量为每人每年1.180.53美元至1.191.89美元。

著录项

  • 作者

    Tayou, Juliette Guemmegne.;

  • 作者单位

    The University of New Mexico.;

  • 授予单位 The University of New Mexico.;
  • 学科 Economics.
  • 学位 Ph.D.
  • 年度 2017
  • 页码 168 p.
  • 总页数 168
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

  • 入库时间 2022-08-17 11:38:46

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