The development of an adaptation model for emergency departments in urban and suburban health maintenance organizations Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/br86b689w

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  • The major purpose of this study was to develop an Adaptation Model for emergency departments in urban and suburban Health Maintenance Organizations. Questions explored which provided data for the Model were: 1) are there significant differences in the demographic, sociologic, and decision-making characteristics of clients seeking services in emergency rooms and after-hour clinics?, and 2) are there significant differences in perceptions of access-related problems and stated preferences for personal physicians among clients seeking such services? A pilot study was completed, critiqued, and analyzed. Final research instruments were developed for adults and children. Questionnaires were completed by 1,031 clients in an urban and suburban facility of the Kaiser-Permanente Medical Care Program in Portland, Oregon. Data analysis was completed using the Statistical Package for the Social Sciences sub-program FREQUENCIES, CROSSTABULATION, AND DISCRIMINANT. Major findings of this study were: 1) no significant differences existed in the demographic and sociologic characteristics of clients, 2) significant differences were found in perceived problems of access, in decision-making characteristics, and in preferences for personal physicians. Significant items were: 1) convenience of the facility location, 2) immediacy and availability of care, 3) contact prior to arrival, 4) instruction by "nurse" to seek care, 5) clients reporting they did not have a personal physician, and 6) repeated use of the emergency department during the previous year. Different profiles of decision-making characteristics of urban and suburban clients resulted from the analyses. The overall pattern of care for children varied less between urban and suburban settings than did the pattern of care for adults. Findings were discussed in terms of the traditional model of emergency department care. Conflicts arising from system "controls" provided the basis for suggesting changes incorporated into the Adaptation Model. The basic premise for the Adaptation Model advances the point at which triage occurs, eliminates conflicts of control, and thus modifies both consumer behavior and the emergency department system.
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  • description.provenance : Approved for entry into archive by Patricia Black(patricia.black@oregonstate.edu) on 2012-12-11T19:52:07Z (GMT) No. of bitstreams: 1 RobertsonBarbaraJ1982.pdf: 5923970 bytes, checksum: e8f6c737ab1c072b523660be29869906 (MD5)
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