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Author ORCID Identifier
N/A
AccessType
Campus-Only Access for Five (5) Years
Document Type
dissertation
Degree Name
Doctor of Philosophy (PhD)
Degree Program
Public Health
Year Degree Awarded
2018
Month Degree Awarded
September
First Advisor
Lisa Wexler
Second Advisor
Aline Gubrium
Third Advisor
Laurel Smith-Doerr
Fourth Advisor
Penelope Pekow
Subject Categories
Health Services Research | Medicine and Health
Abstract
The research conducted for this dissertation broadly explored the relationship between characteristics of healthcare organizations and quality and equity in pediatric healthcare. The first of the three studies identified characteristics of pediatric practices with high scores on measures of quality and patient experience using qualitative methods. The second study assessed whether the candidate characteristics identified in the first study were quantitatively associated with performance on quality measures using a statewide survey and publicly available quality data. This study found several potentially modifiable factors associated with performance, including an organizational culture characterized by good communication and interpersonal relationships amongst providers and staff, having a designated quality champion, and offering co-located ancillary services, such as behavioral health. The third study used ethnographic-style methods to explore implementation of community health workers in a pediatric practice in a new Medicaid accountable care organization. Observations and interviews identified a number of potential barriers to effective planning for integration of the community health workers, which could in turn limit the capacity of the community health worker program to improve quality and address inequities in healthcare for low-income children.
DOI
https://doi.org/10.7275/12627498
Recommended Citation
Goff, Sarah L., "ORGANIZATIONAL FACTORS INFLUENCING QUALITY AND EQUITY IN PEDIATRIC PRIMARY CARE: A MIXED METHODS STUDY" (2018). Doctoral Dissertations. 1438.
https://doi.org/10.7275/12627498
https://scholarworks.umass.edu/dissertations_2/1438