This thesis analyzes the health care that is provided to the communities of Blount County, Tennessee, and Shangri-La, China. This particular study was in part an observational study, with some of the data coming from first-hand interpretation by the researcher. The goal of this research is provide an accurate and detailed description of the type of health care that residents of Blount County and Shangri-La are currently experiencing. The study focuses on four major areas of health care that were felt to be the most pertinent to modern health within the given communities: demand for health care, supply of health care services, quality of health care, accessibility of health care. Similarities and differences between the two communities' respective health care systems are revealed through comparing and contrasting the two locations.
The demand factors of health care were the first area of focus that this study covered. The factors of demand were injuries and illnesses that were common within the given communities. These particular factors were chosen because these ailments stimulate the patient demand for health care services. Next, the study compared the two areas in terms of the determinants of demand.
The health care services that are provided by their respective health care facilities are the next area of evaluation. The health care services are those that the health care facilities provide in order to meet the demands of community members. Health care facilities provide these services either internally or externally. Again, a comparison of the two communities exposes similarities and differences regarding supply of health care services.
The quality of health care that is provided by medical facilities is the next point of emphasis covered in this study. The quality of health care is determined by the medical professionals, facilities, equipment, and the management of finances by the health care facility. This section concludes by comparing the quality of health care in Blount County and Shangri-La.
Then, the study describes accessibility to health care services. The two main contributors to health care accessibility are travel-time and affordability. This section ends with the comparison of Blount County and Shangri-La's accessibility issues.
The final chapter of this study proposes potential solutions that could improve the health care that is provided to each location's respective community members. In this chapter, it is the goal to effectively and critically analyze the previously covered areas of focus so that solutions to the problems of health care in the community can be improved.
Hometown: Maryville, Tenn.
Thesis Title: Health Care Analysis: Blount County, Tennessee, and Shangri-La, China
Advisor: Dr. Sherry Kasper
Cory Everett's 85-page Senior Study is proof positive that learning at Maryville College doesn't only happen in classrooms, the library and the laboratory. It isn't contained to the 320-acre campus, even.
Everett, a senior economics major from Maryville, Tenn., chose his topic because of two off-campus experiences he took advantage of as a Maryville College student: an internship in hospital administration at Blount Memorial Hospital (BMH) in Maryville and a travel-study trip to China.
The internship at BMH during the summer of 2007 helped solidify his vocational plans to pursue health care administration.
“The internship gave me a good overview of hospital administration and what all is encompassed in the delivery of health care,” Everett explained. “After that summer, I knew that I wanted my Senior Study to be health-care related.”
Discussing his Senior Study topic with his advisor, Professor of Economics Dr. Sherry Kasper, during the fall of 2007, Everett originally intended to study economic factors at specialty health care facilities like orthopedic clinics. But then he was recruited to join a travel-study trip led by Dr. Scott Henson, assistant professor of political science. Henson had been awarded a grant to study rural populations of China during the summer of 2008 and was taking a few students to participate in the research.
A major earthquake had just rocked the Sichuan province, and Everett and Kasper discussed the possibility of his Senior Study comparing how the Chinese region responded to the disaster and how similar disasters are handled in the United States. However, because of the severity of the earthquake, the Chinese government announced that spring that it was closing the Sichuan borders to all tourists.
“When we learned that they had closed the borders, I was disappointed,” Everett said. “We then made a group decision to travel to the Yunnan province and the city of Shangri-La.
“It's the biggest tourist development in Western China,” Everett continued, explaining that until about five years ago, the town was known by another name. Capitalizing on the West's positive association with the name “Shangri-La” (in James Hilton's 1933 novel Lost Horizon, Shangri-La is a mythical Himalayan utopia), the Chinese government renamed it, invested lots of money in its infrastructure and began marketing it as a tourist destination for Western Europeans and wealthy Chinese.
Visiting with Shangri-La residents and collecting data as a part of the group research project, Everett began to see geographic and demographic similarities between the Chinese city and Blount County, Tenn., where he has spent all of his life.
“It has a population of approximately 30,000 residents,” Everett said of Shangri-La. “This area of China relies heavily upon the tourism industry for economic prosperity. Much as Maryville is the so-called ‘gateway to the Smoky Mountains,' Shangri-La is a gateway to the Himalayan Mountains.”
Entertaining the thought that his Senior Study back home could focus on the similarities and differences in health care in the two non-metropolitan communities located in opposite hemispheres, Everett spent his time gathering information on the demand for health care, the supply of health care services, the quality of care, and citizens' accessibility to health care services in the city.
He was fortunate to be introduced to Dr. Douglas Briggs early in the Shangri-La stay. An American-trained doctor practicing medicine in a private hospital in the city, Briggs “provided tremendous insight into the Chinese health care system that would have been quite inaccessible for most foreign researchers,” Everett said.
In addition to sharing information from his practice and his hospital, Briggs introduced Everett to an administrator at the local Tibetan hospital, where more traditional medicine was practiced. (A third hospital in the city, operated by the Chinese government, was not accessible to Everett.) From those interviews and visits, the MC student gathered data on subjects such as: the types of injuries and illnesses that impacted health care demand, the number of hospitals and clinics available to residents, the education and training required of medical professionals, and citizens' abilities to afford quality health care.
Everett's completed study includes numerous tables and graphs that visually explain information like top diagnoses, salaries and wages of medical professionals, emergency room waiting times and supply-and-demand projections for registered nurses.
Because both communities are offering health care within larger cultural and governmental frameworks, some of Everett's data compares the two countries and not just regions or provinces.
One dramatic difference between the United States and China can be seen when looking at percentages of the gross domestic product spent on health care. The U.S. spends more than 15 percent of its gross domestic product on health care whereas China spends less than five percent.
And considering the way that the majority of health care services paid for in the United States (government and private insurance) as compared to China (out-of-pocket), Everett and Kasper said it was interesting to realize that the U.S.' system is far more socialistic in reality than China's, which many would argue follows a more capitalistic model.
In the last chapter of his study, Everett shares some thoughts about how each community could learn from the other in trying to improve health care for its citizens. The most promising lessons are cultural, Everett said. For example, U.S. citizens could adopt a diet similar to the Chinese diet, which acts as a form of preventative medicine. The Chinese would do well to adopt the U.S.' standards for sanitation.
Everett has been awarded a scholarship to attend the University of Alabama-Birmingham's master of health administration program and will enroll during the fall of 2009. In interviewing for the position, Everett said 95 percent of the conversation he had between UAB admissions officials was about his Senior Study and the trip to China.
Kasper couldn't be more proud. Not only is her advisee enrolling in a program that's considered one of the 10 best in the country, he has the passion, education and sensitivity to influence health care in the United States for the better.
“Here's a wonderful opportunity to enter this field on the ground floor,” she said of Everett's graduate-school plans. “There's now a demand from society to fix health care because it's not working. Cory is motivated to understand the complexities of the system, to use the tools of economics analysis and to think about the trade-offs.”