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This book combines a wide-ranging theoretical view of accessibility and utilization with empirical experience from a variety of comparable health-care delivery systems - those of the United Kingdom, the United States, Canada, Australia and New Zealand. The authors focus on primary health-care provision, but also consider secondary and tertiary facilities. Where previous medical geography texts have dealt with disease ecology, this book provides a comprehensive review of recent geographical research into the health service system and its utilization. The book is clearly structured and well written, enabling students to grasp the essentials of the subject. The skilful use of references will permit more advanced students to follow up the topics in greater detail.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
The purpose of this cross-sectional analysis was to determine the importance of spatial accessibility to health care services utilization and to the health status of persons with disabilities. This study utilizes two datasets (Survey of Access to Outpatient Medical Service in the Rural Southeast and Ohio Family Health Survey) to analyze. ArcGIS 9.2 was use to measure spatial accessibility to health care services. Bivariate analysis for health services utilization and health status included t-tests, and Chi-square, as appropriate for the level of measurement. Logistic regression models identified for the three outcomes (health care visit, regular check up visit, and perceived poor health status). The multivariate analyses of "Survey of Access to Outpatient Medical Service in the Rural Southeast" dataset revealed that those residing within an area that had a higher primary physician to population ratio were less likely to have made a health care services visit in the past year. Perceived travel time was significantly associated with poor health status; adults who had to drive longer to access health care services were more likely to perceive themselves to be in poor health compared to adults who were faced with a shorter drive. The analyses of the "Ohio Family Health Survey" dataset indicate that participants of the survey who resided within areas that had a higher primary care physician to population ratio were less likely to perceive themselves to be in poor health. Likewise, those residing in areas that had a hospital located within a 30-minute commute were also less likely to report being in poor health. Further analyses of the Ohio Family Health Survey dataset, which is comprised of data collected from urban and rural areas, revealed that those driving longer to access health care services were more likely to perceive themselves to be in poor health compared to adults who were faced with a shorter drive in urban area. The model of rural areas revealed that those residing within an area that had a higher primary physician to population ratio were less likely to have made a health care services visit in the past year. Adults who had to drive longer time to get health care service were more likely to perceive themselves to be in poor health compared to adults who had a shorter drive. Participants who lived within areas that had a higher primary care physician to population ratio were less likely to perceive themselves to be in poor health. Those having hospital within a 30-minute commute were less likely to report being in poor health. These results show the importance of spatial accessibility in health care utilization and health status for people with disabilities. These also indicate that spatial accessibility must be addressed in public policy.
Technological advances of the past decades have allowed organizations of all sizes to use information technology in all aspects of organizational management. This book presents more than 200 papers that address this growing corporate phenomena.
This study utilized a mixed methods approach to examine the issue of how parents, students, and teachers (stakeholders) perceive accessibility and the utilization of computer and Internet technology within the Selinsgrove, Pennsylvania Area School District. Quantitative data was collected through the use of questionnaires distributed to the stakeholders within the school district. The Qualitative method utilized in the study was grounded theory, as the questionnaires were the basis for interviews to develop a theory on the perceptions of the stakeholders and to hypothesize on what has influenced these perceptions. The primary question focused on identifying the perceptions of the stakeholders about accessibility and utilization of computer and Internet technology in the school district. To provide adequate background on previous research and studies, three streams of research were identified to address the concepts of a digital divide and digital equity to provide a background in how computer and Internet technologies have been utilized in schools to address how computer and Internet access is utilized on a day to day basis in homes and communities, and how the use of these technologies may be influenced by factors that may define the existence of a digital divide. This mixed methods study utilized questionnaires to collect quantitative data and interviews as a means of collecting qualitative data. Through an examination of the data, it was found that all three groups believed computer technology and the Internet have been a benefit to a student's education, but they differed on exactly how these technologies are utilized. The data indicated there were no components of digital equity within the school district based on those who responded to the questionnaires and participated in the interviews. The data also indicated that teachers have been unfamiliar with the extent to which students can access technology in the home. Keywords: Digital Divide, Digital Equity, Computer Technology, Internet, Technology Education