This thesis explores a three month period that I spent abroad working in medical clinics and hospitals in Ecuador. My work was conducted in three distinct areas: the urban landscape of Quito, Ecuador’s capital; Puyo, a small town bordering the Amazonian rainforest; and a small community located in the heart...
One in four Ecuadorians do not have access to health services; while more than two-thirds have no health insurance and insufficient resources to pay for the health care services they might require. The following three studies examined utilization of health care services using Andersen’s Health Care Utilization Behavior Theory. Secondary...
Cultural competence is a topic that concerns social scientists and medical anthropologists who pay attention to demographic changes and health disparities. This study demonstrates practical approaches to developing cultural competence in medical education by using factors from the social environment to develop protocols for action. With current concerns in domestic...
Introduction: Management of complex systems is facilitated through effective information systems that provide real-time data to decision makers. For example, instrument panels in airplanes ensure that pilots have well-designed feedback concerning the status of mission-critical variables. Problem: While pilots have dashboards for feedback and communication, healthcare executives may be unaware...
Purpose: The Purpose of this research was to design, implement and evaluate a patient centered asthma intervention pilot program directed by physicians and administered by community pharmacists to a group of Managed Care contracted Oregon Health Plan asthmatics. The evaluation was to determine if the proposed intervention could improve the...
From February to September of 2001, a significant body of qualitive data was collected to investigate barriers for Hispanic participation in Oregon's managed care Medicaid program. As a means to investigate this topic, comments were solicited from physicians, hospital administrators, social service agencies, and low-income Hispanics through semi-structured focus groups...
Surveys of both patients and health care providers have indicated strong interest, up to 95%, in favor of advance directives, which are legal documents that express patients' healthcare treatment decisions. Despite the widespread support for advance directives, actual completion rates are very low, ranging from 4% to 20% for the...
The United States population continues to increase and diversify. The cultural composition within the United States embodies a multitude of people from a variety of belief systems, religious backgrounds, and ethnicities. Within current biomedical practice, many of these differences are often marginalized, leaving populations with unsatisfactory experiences in seeking health...
As researchers, policymakers and employers begin focusing
on consumer driven health plan models and medical savings
accounts (MSAs), a better understanding of the political
viability of such reform initiatives is necessary. The
purpose of this study was to survey state legislators'
knowledge and perceptions of medical savings accounts
(MSAs) and...
The study evaluates the effectiveness of a pregnancy intervention model (PIM) developed to improve first trimester prenatal care utilization in a population of 2,694 low-income Medicaid women. Engagement in prenatal care is critical before prenatal care can occur. Early initiation of prenatal care is important for low income pregnant women...