Doctoral Dissertation Research: Short-Term Health Care Providers and Network Structure

University Of Florida, Gainesville FL

Investigators

Abstract

University of Florida doctoral student Jessica-Jean Casler, supervised by Dr. Clarence C. Gravlee, will explore how networks of health care access and delivery are shaped by programs designed to improve the relationship between patient and provider. The research will focus on the role of short-term health care providers (STHPs). Short-term health care providers (such as medical school student brigades) supplement local and state health care services in many lower-income countries. Even with these additional providers however; the inability to access adequate health care largely continues to affect the poor. Annual influxes of short-term health care providers in lower-income countries suggest that health care systems may be changing structurally and with them the ways that patients and providers use health care services. This study will provide a timely contribution to this global issue by examining: (1) how patients and providers use short-term health care providers (STHPs), (2) whether the informal structure of providers? networks resemble patient networks, and (3) the role of STHPs in patients? health care networks. To meet these goals, the Co-PI will recruit 30 households in Matagalpa, Nicaragua representative of the socioeconomic, familial, and geographic diversity in the city to participate in the study. The site itself is chosen because of the high concentration of American medical students that visit it during an STHP trip. Households will be visited bi-monthly over a period of eight months as Ms. Casler the researcher conducts in-depth ethnographic interviews with her participants and also records their most recent usage of health care services. The Co-PI will map and interview all local health care providers (as identified by the community), collecting information about how they refer patients to different health care providers within the system. Using this information the Co-PI will be able to create network usage patterns for both patients and providers, determining any similarities between the networks and identifying the role of STHPs in one of Nicaragua?s urban health care systems. This research is important because it will contribute to the development of theory in both medical anthropology and the anthropology of development by mapping patients' and providers' use of health care providers within larger health care networks in a local setting. This study specifically explores the relatively recent addition of STHPs to health care systems of the poor and will also contribute to interdisciplinary social science research on health care systems. Findings will also suggest how urban health care systems could more efficiently use and organize the providers that typically comprise them. The project also supports the training of a graduate student.