Domestic violence (DV) is a major social and public health issue in countries such as India and Pakistan where patriarchy is the way of life and cultural norms, and beliefs hold a greater say in community decision-making. Women in these countries are discriminated against from birth and face hurdles in...
Unmet healthcare needs and/or delays in needed care are widespread among patients with serious mental illness (SMI). Mental healthcare delivery has changed dramatically over the last two decades. Although access to mental health specialists remains challenging, mental healthcare is now increasingly provided in primary care settings. However, it is unclear...
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death in the United States. Patients with cirrhosis are more likely to develop HCC. More than 80% of HCC patients are found have preexisting cirrhosis. The prevalence of cirrhosis increased from 0.26% to 0.3.% between 1999 to 2010 and...
Background: Prenatal care (PNC) is an important preventive health service that can influence the health of the four million women who give birth annually in the United States, and the health their infants. Despite efforts to increase women’s access to PNC services, significant disparities in PNC utilization and maternal/child health...
Research Objective: Nearly 60 million people in the United States reside in a rural area. Residents in rural areas have higher rates of chronic disease, risky health behaviors, disability, infant mortality, and age-adjusted mortality than their urban counterparts. Health insurance and access to care mitigate those risks, in part because...
Health disparity scholars and researchers call to expand the conceptualization of health disparities research beyond the predominant and long-standing race-based analyses. The call requests the inclusion of frameworks and theories that reflect the complex, multi-level and multifactorial social processes that yield health disparities. Intersectionality is a theoretical framework that is...
Background. Total knee arthroplasty, or replacement, is a common, generally successful, and expensive procedure. Tools to predict outcomes following orthopedic procedures are abundant, yet no commonly used assessment accounts for an individual’s propensity to engage in adaptive health behavior. The 13-item Patient Activation Measure (PAM) questionnaire is a tool that...
The enactment of the Patient Protection and Affordable Care Act (ACA) can be considered an important policy intervention in the context of the U.S. health care. The ACA supported non-elderly adults to obtain health insurance coverage. While Medicare provided health insurance to almost all elderly-adults (persons over 65), the ACA...
In August 2012, Oregon began enrolling Medicaid beneficiaries in coordinated care organizations (CCOs), a unique mandatory-enrollment accountable care organization (ACO) model with payment methods strongly tied to preventive care; care coordination; and integration of physical, mental and dental health care through patient-centered medical homes. This dissertation, consisting of two studies,...
In 2012, Oregon began it enrolling its Medicaid beneficiaries in an accountable care model called Coordinated Care Organizations (CCOs). As one of the of the earliest state-wide efforts to implement this type of healthcare reform among Medicaid enrollees, and thus one of the most mature, Oregon’s CCO implementation provided a...