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- All Subjects: Optometry
- Creators: Gaughan, Monica
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
Description
Healthcare systems and health insurance are both concepts implemented in every country to provide access to the general population. Countries undergo healthcare reforms in order to increase the performance of the system. In 2010, the Affordable Care Act (ACA) was introduced in the United States to increase coverage and create a more inclusive health insurance market. For comparison, the recent reforms in Chile and Singapore were observed as points to determine what concepts work well and what can be implemented in the U.S. system. Unlike the United States, Chile and Singapore completely altered the system that was previously in use. In Chile, the reforms began in the 1970s and made two more major changes in 1973 and early 2000s. Singapore began its reform in the 1960s and created the medical savings account system that is still in use today. To analyze the system further, the medical professions of neurology, physician assistants and optometry were compared in each country. In regards to neurology, the coverage of services in Chile and Singapore are similar in that select medical procedures are covered. In contrast, the United States offers coverage on a case-by-case basis. For physician assistants, such a profession does not exist in Chile or Singapore. In the United States, the profession is rapidly expanding, and coverage is offered for most services provided. Optometry is a stand-alone profession in both the U.S. and Singapore. The services provided by the optometrists are selectively covered by insurance, depending on whether it is considered a medical problem. Chile covers the services often provided by optometrists, however, the ophthalmologist is the provider, as optometry does not exist. This study concluded that the U.S. should continue to provide a more inclusive healthcare system that includes vision and dental care. The U.S., like Singapore, should also adopt a more integrative system. Under this system, patient care would be provided in a way that professionals specializing in the care are included in every step of the process.
ContributorsLa, Jenny (Co-author) / Feruj, Farihah (Co-author) / Morrison, Sarah (Co-author) / Gaughan, Monica (Thesis director) / Essary, Alison (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Description
Optometry is a field in the United States dedicated to analyzing the health of eyes and offering corrective lenses and/or treatments to improve a patient’s ocular health and vision. Since its origin in the U.S. in the late 19th century, the field of optometry has been met with strong opposition from the medical community, ophthalmologists in particular. This ongoing feud between optometrists and ophthalmologists, medical doctors who also specialize in eye health and perform eye surgeries, continues today as ophthalmologists push back against optometrists’ attempts to expand their scope of practice. With this expansion to include certain eye surgeries, it would save patients both time and money. This is just one factor impacting patients, with another being the widely varied state laws surrounding eye health. Procedures optometrists are able to perform is decided by state laws, which leads to vast discrepancies. Optometrists in one state can perform laser eye surgeries, while optometrists in a nearby state cannot even provide simple treatments for ocular diseases they diagnosis. In this study, three states were analyzed to showcase these variations in possible treatment and demonstrate both the positive and negative impacts they are having on patients. First was Massachusetts which has one of the best medical care systems in the U.S., but one of the worst vision care. As the only state to not allow optometrists to treat glaucoma and one of two states to not allow optometrists to prescribe medications for patients, these limitations have caused patients the inconvenience of having to then visit an ophthalmologist for treatment which adds additional costs and delay in treatment which can cause the conditions to possibly worsen. Second was Oklahoma which was the first U.S. state to allow optometrists to perform laser eye surgeries in 1998. This legislation expanded Oklahoma residents access to treatment as before patients would have to travel to other cities or counties to visit one of the few ophthalmologists in the state. Lastly was Maine which in 2015 passed legislation to allow optometrists to regain control of their field from vision insurance companies who can no longer dictate fees patients are charged if the insurance companies will not cover it. This study concluded that there needs to be a universal vision care system across the U.S. that includes expansion of practice for optometrists and allow them to be in control of their own field, not the state government or vision insurance companies.
ContributorsFoskit, Nevada Anaid (Author) / Gaughan, Monica (Thesis director) / Chung, Sonia (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
More than 40% of all U.S. opioid overdose deaths in 2016 involved a prescription opioid, with more than 46 people dying every day from overdoses involving prescription opioids, (CDC, 2017). Over the years, lawmakers have implemented policies and laws to address the opioid epidemic, and many of these vary from state to state. This study will lay out the basic guidelines of common pieces of legislation. It also examines relationships between 6 state-specific prescribing or preventative laws and associated changes in opioid-related deaths using a longitudinal cross-state study design (2007-2015). Specifically, it uses a linear regression to examine changes in state-specific rates of opioid-related deaths after implementation of specific policies, and whether states implementing these policies saw smaller increases than states without these policies. Initial key findings of this study show that three policies have a statistically significant association with opioid related overdose deaths are—Good Samaritan Laws, Standing Order Laws, and Naloxone Liability Laws. Paradoxically, all three policies correlated with an increase in opioid overdose deaths between 2007 and 2016. However, after correcting for the potential spurious relationship between state-specific timing of policy implementation and death rates, two policies have a statistically significant association (alpha <0.05) with opioid overdose death rates. First, the Naloxone Liability Laws were significantly associated with changes in opioid-related deaths and was correlated with a 0.33 log increase in opioid overdose death rates, or a 29% increase. This equates to about 1.39 more deaths per year per 100,000 people. Second, the legislation that allows for 3rd Party Naloxone prescriptions correlated with a 0.33 log decrease in opioid overdose death rates, or a 29% decrease. This equates to 1.39 fewer deaths per year per 100,000 people.
ContributorsDavis, Joshua Alan (Author) / Hruschka, Daniel (Thesis director) / Gaughan, Monica (Committee member) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05