Browsing by Subject "health care"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Community correlates of pneumonia hospitalization and mortality among persons 65 years and older in Texas counties(2007-07-13) Frank Christopher Lemus; Jean L. Freeman, PhD; Michael A. Stoto; Karl Eschbach, PhD; James S. Goodwin, MD; Elizabeth T. Anderson, DrPH, RN; Daniel H. Freeman, Jr., PhD; C. Glen Mayhall, MDThis study contributes knowledge to the overarching goals of Healthy People 2010, as it examined an objective aimed at improving population health of a priority population in the United States. The study aims examined the effect of health care quality on pneumonia among persons 65+ in Texas counties, and considered how community (county) characteristics such as prosperity and racial/ethnic homogeneity impact population health and well-being.\r\n The project applied Evans and Stoddart determinants of health model to examine the effect and relationship of contextual factors on two AHRQ quality of health care indicators, and their influence on population health. The project utilized 1999-2001 Texas hospital discharge data to estimate county bacterial pneumonia hospitalization rates and pneumonia inpatient mortality rates. Population counts and contextual factors were derived from Census 2000 Summary Files. Population mortality rates were estimated from 1999-2001 Texas vital statistics files.\r\n Study results showed an association between increasing percent Latinos in a county and lower bacterial pneumonia hospitalization rates, not just for Latinos, but also for non-Hispanic Blacks and non-Hispanic Whites. Results indicate bacterial pneumonia hospitalization rates increase significantly with age, especially in persons 75+, with males experiencing higher rates than females. Persons with high risk of mortality scores experienced significantly higher mortality rates in the hospital setting. Community pneumonia mortality rates were similar to those for bacterial pneumonia hospitalizations, and bacterial pneumonia hospitalizations were associated with community pneumonia mortality.\r\n In summary, this research provides baseline pneumonia morbidity and mortality data for Texas counties by which to evaluate future health studies among the elderly. The methodology demonstrates the application of hospital discharge data in community based health services research and contributes to understanding neighborhood influences on population health. It may contribute to policy considerations for Texas counties by allowing stakeholders to assess population health status for funding and treatment priorities. \r\n Finally, this research represents a stepping stone to research that can guide future community-based interventions to improve care, and provides a model for other states to evaluate community correlates of mortality and morbidity. The model could potentially be applied to many different conditions affecting community health, such as immunizations.Item Survival of nonprofit community health clinics(Texas A&M University, 2006-08-16) Schemmer, Ruth AnnIn the provision of public goods such as health care for the uninsured, nonprofit organizations serve important functions in society. Because they often rely on volunteer labor, and funding is frequently unstable, their survival depends on factors not present in either private enterprise or state agencies. This comparison case study examines three clinics, one surviving clinic and two that did not survive, to find patterns that characterize organizational success and survival. Theories about public goods, volunteering, and organizational coordination and communication provide insight into different aspects of the case study. Data was gathered from 19 in-depth interviews with individuals connected to the three clinics. The analysis employs Ostrom??s characterization of eight principles of longstanding common-pool resource organizations, with slight adjustments for the public goods setting. As expected, the successful clinic reflects more of the characteristics, or possesses them to a greater degree, than the unsuccessful ones. Specifically, the successful clinic reflects a greater degree of congruence between organizational rules and local conditions (as evidenced by community support), and collective-choice arrangements (as indicated by the presence of an actively engaged board of directors). In addition, the successful clinic is loosely nested with other organizations, whereas the nonsurviving clinics were more tightly nested within local organizations; the looser nesting allows for greater autonomy in decision-making. Finally, an unexpected finding drawn from the interviews concerns the manner in which the clinics framed their message and mission. The successful clinic framed its mission in terms of serving the ??working poor,?? whereas the nonsurviving clinics stated their mission as charity for the poor and needy. This variance may have contributed to greater community support for the successful clinic.Item The mediating effect of perceived organizational support on espoused safety attitudes: a field study(2011-02-17) Apodaca, Steven P.; Apodaca, Steven P.; Schell, Kraig L.; Hack, Tay; Davidson, William; Walker, Molly; Gee, Donna; Angelo State University. Department of Psychology, Sociology and Social Work.This research examined a proposed mediated model of safety attitudes and perceived organizational support in affecting safety outcomes in a population of nurses within a West Texas community hospital. Participants completed questionnaires pertaining to the aforementioned measures, and supervisors were solicited to complete a questionnaire pertaining to safety behaviors of subordinates within their respective departments. Data analysis revealed significant correlations among safety attitudes and perceived organizational support but failed to show support for a mediated model. Explanations as to why hypotheses were not supported are discussed, as well as avenues for future research.