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Evaluating Structural Barriers to Quality Care in the SHOW Free Clinic

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Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.

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2017-05

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Improving Healthcare in the Phoenix Homeless Population Through Triple Aim-Focused Interprofessional Practice

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Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health

Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health for a defined population, 2) enhance the patient care experience, and 3) reduce per capita cost of care. The World Health Organization has identified interprofessional practice (IPP) and interprofessional education (IPE) as a possible approach to achieve the Triple Aim. The Student Health Outreach for Wellness (SHOW) initiative is an interprofessional free clinic and outreach initiative for individuals experiencing homelessness. The goal of the current study was to evaluate whether interprofessional care delivery through SHOW moved SHOW's practice towards the Triple Aim for SHOW's defined population. Methods and Results. Data assessing adherence to Triple Aim goals of population health and costs of care were collected from voluntary post-visit patient satisfaction surveys, while data assessing patient experience were collected from shift rosters of SHOW versus a similar non-interprofessional clinic. SHOW, on average, provided access to more disciplines than a similar non-interprofessional clinic. Access to care cost savings was assessed by surveying patients on where they would have sought care elsewhere SHOW had not been available ; of the 53 patients surveyed, 14 indicated they would have gone to the emergency department (ED); in all, SHOW diverted a little over $30,000 in patient ED visits. Improved health outcomes were measured by each patient's self-perception of his/her health. 91% of patients agreed or strongly agreed that their health had been improved by coming to the clinic. Conclusion. Preliminary data suggest that SHOW's IPP care delivery results in high patient satisfaction rates and positive self-perception of health outcomes, thus may improve the patient experience and minimize costs of care by deterring ED visits within the population. Further studies are needed to determine how specific aspects of interprofessional care can further move towards Triple Aim objectives.

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2016-05

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Risk Management in the Healthcare Supply Chain: Lessons Learned from Hurricane Maria

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The purpose of this thesis is to gain a more nuanced understanding of what research is currently going on in the academic realm of supply chain management. This thesis is composed of two parts. The first part contains summaries and

The purpose of this thesis is to gain a more nuanced understanding of what research is currently going on in the academic realm of supply chain management. This thesis is composed of two parts. The first part contains summaries and personal takeaways from four different supply chain management seminars that were put on by professors who were visiting the ASU campus. These seminars include general topics such as RFID readability, supply chain cash conversion cycles, risk management within the healthcare supply chain, and building trust and trustworthiness in global business. The second part of the thesis will then use a literature review to expand upon the topic of risk management within the healthcare supply chain, and to explore how previous research ties into the current happenings of the industry, as well as its future implications.

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2018-05

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Prenatal Care 2.0 - Evolving Delivery Models and the Role of Mobile Technology

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Prenatal care is a widely administered preventative care service, and its adequate use has been shown to decrease poor infant and maternal health outcomes. Today however, in the United States, preterm birth rates remain among the highest in the industrialized

Prenatal care is a widely administered preventative care service, and its adequate use has been shown to decrease poor infant and maternal health outcomes. Today however, in the United States, preterm birth rates remain among the highest in the industrialized world, with low socioeconomic women having the highest risk of preterm births. This group of women also face the greatest barriers to access adequate prenatal care in the United States. This paper explores the viability of short message service to help bridge gaps in prenatal care for low socioeconomic women in the United States and provides areas for further research.

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2014-05

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Current Issues Facing the Managed Care Industry and the Effects on Cigna

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Exploration of the history of the managed care industry and the key drivers of profitability using Cigna as a case study. Four key current issues facing the industry are explained and contemplated in different DCF scenario analyses using both fundamental

Exploration of the history of the managed care industry and the key drivers of profitability using Cigna as a case study. Four key current issues facing the industry are explained and contemplated in different DCF scenario analyses using both fundamental projections as well as modifications to the CAPM formula. Lastly, the recent price action of Cigna is compared to forecasted predictions and explained using the discounted cash flow model.

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2020-12