First Advisor

Larry A. Steward

Term of Graduation

Fall 1984

Date of Publication

11-30-1984

Document Type

Thesis

Degree Name

Master of Science (M.S.) in Speech Communication

Department

Speech Communication

Language

English

Subjects

Good Samaritan Hospital & Medical Center, Hemodialysis -- Decision making

DOI

10.15760/etd.5317

Physical Description

1 online resource (3, iv, 81 pages)

Abstract

In 1982 the Health Care Finance Administration mandated changes in the mechanism and financing of the End Stage Renal Disease (ESRD) Program by the provisions of the Omnibus Budget Reconciliation Act. These changes in finances and procedures became effective August 1, 1983 and have created a state of crisis for ESRD facilities program wide. This study analyzes a large non-profit dialysis program and how its decision making practices were affected 2 by the change in Medicare laws. Application of decision theory in health care provides a basis for this study on the affects of crisis on decision making.

This study reports on the application of decision theory to 12 members of a dialysis program through the use of a survey and an interview. This application resulted in the determination of five salient issues which contribute to identifying decision making practices. In addition, this application determined the overall decision method, the participant's perception of the process, and the perceived affects of the crisis on patient care. To determine the decision making methods employed prior to and following the "crisis" date two methods were used, a survey and a follow-up interview. These two methods served to address the following:

A. The Decision Making Survey addressed the characteristics of the decision making process. These characteristics were then applied to a participative decision making continuum.

B. The Decision Making Interview determined the validity of the survey responses, acted as a second method for determining decision making characteristics, and addressed the secondary issues of this study, i.e., decision alternatives and patient care.

Rights

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Comments

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Persistent Identifier

http://archives.pdx.edu/ds/psu/19463

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