Browsing by Subject "quality indicators"
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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 The development of an instrument to assess student opinions of the quality of distance education(2009-05-15) Chaney, Elizabeth HensleighIn the past decade, there has been an enormous growth of distance education courses and programs in higher education. However, the potential of distance education is tempered by one overriding question: How do you ensure that distance education coursework and degrees are of high quality? The purpose of this study is threefold: (1) to identify quality indicators of distance education; (2) to provide implications of the identified quality indicators for health education researchers and practitioners; and, (3) to develop an instrument to assess student opinions of the quality of distance education. Dillman's (2000) steps of pretesting and the instrument development framework in the Standards (1999) were used, and data were collected from students enrolled in four health education on-line courses during the Spring 2006 semester at Texas A&M University. MPlus (Muthen & Muthen, 2002) was used to conduct reliability and validity analyses of the instrument. The results of the study revealed common benchmarks and quality indicators that all parties deem important in designing, implementing and evaluating distance education courses and programs. Additionally, an instrument was produced that resulted in both valid and reliable scores.