Browsing by Subject "Health Services Administration"
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Item A Comparison of Medicare Prospective Payment Systems on P.T.C.A. and Stent Outcomes in an Urban Hospital(2001-05-01) Compton, Ben H.; Mains, Doug A.; Hilsenrath, P. E.Compton, Ben H., A Comparison of Medicare Prospective Systems on P.T.C.A. and STENT Outcomes in an Urban Hospital. Master of Public Health (Health Services Administration), May 2001, 57 pp., 10 tables, 1 graph, bibliography, 51 titles. To determine if differences in outcomes exist between Medicare prospective payment systems when doing percutaneous transluminal coronary angioplasty (PTCA) or STENT surgeries. From January 1999 and December 2000, 146 Medicare patients were identified with 35 being outpatient and 111 inpatient. A separate group of 1-day inpatients was used as a comparison for the outpatient group. Results from the comparison reveal that in the three groups, the majority of patients were white, non-Hispanic males who were about 70 years of age. The 1-day inpatient group had the highest profit of all three with about $3,000 while the inpatient group broke even. The outpatient group had no in-hospital deaths or complications while all three had equal amounts of comorbidities. The conclusion is that losses will probably occur if PTCA and STENTs are done outpatient. Possible solutions are moving to an inpatient setting or determining which costs can be reduced in the outpatient setting.Item A Health Assessment of Refugee Children From Former Yugoslovia in Tarrant County(2001-12-01) Podgore, John K.; Marshall, Murial; Rene, Antonio; Sandhu, RaghbirThis study was conducted to provide an assessment of the health status and health care utilization of children from former Yugoslavia living in Tarrant County. Additionally an assessment of barriers and problems encountered by these families in obtaining health care for their children was presented. One hundred thirteen households of refugee families arriving in Tarrant County from 1998 through 2000 participated by answering a 79 item health information questionnaire. The results revealed that most of the refugee families had no regular health care provider to assure continuity of medical care. Lack of access to dental care and inappropriate utilization of hospital emergency facilities were also identified as problems. Insufficient understanding of health insurance issues and inability to access health information were additional problems. Addressing these problems by local and state health care agencies may help to improve health care delivery for these and future refugee children.Item A Review of Dendritic Cell Vaccines in Cancer Treatment and a Managerial Focus on Issues Related to Subject Recruitment(2006-12-01) McFarlin, Tory; Arredondo, LaChelle; Gwirtz, Patricia A.; Oglesby, MichaelMcFarlin, Tory. A Review of Dendritic Cell Vaccines in Cancer Treatment and a Managerial Focus on Issues Related to Subject Recruitment. Master of Science (Clinical Research Management), December 2006, 97 pp., 5 tables, bibliography, 24 titles. Melanoma is form of skin cancer that can become deadly if the cancer progresses to a stage of metastasis. Five year survival rates as low as 10% may be noted in such patients. Decarbazine and Proleukin have been approved by the FDA for the treatment of metastatic melanoma; however both have response rates of approximately 20% or less. New treatment modalities including dendritic cell (DC) vaccines are currently being tested for treating metastatic melanoma with greater safety and efficacy profiles. DC vaccines are made by obtaining a subject’s DCs, priming them with melanoma antigen ex vivo and then injecting them into the patient to initiate an immune response against melanoma tumor cells in vivo. Investigational new treatments such has the DC vaccine must first be tested in clinical trials on research subjects. Subject enrollment issues regarding such a trial can cause delays in advances of the treatment. As an intern with a DC vaccine clinical trial, the author assisted in screening 45 patients and observed many hindrances involving enrollment of subjects. Such hindrances include: low rates of study personnel retention, small patient pools, and competing trials. Recommendations to improve enrollment include: more effective advertisement strategies and increased patient education.Item A Review of the Literature on Faith-Based Organization's HIV/AIDs Care and Prevention Efforts in Sub-Saharan Africa(2005-05-01) Rojas, Zeida G.; Lurie, Sue; Urrutia-Rojas, XimenaRojas, Zeida G., A Review of the Literature on Faith-Based Organization’s HIV/AIDS Care and Prevention in Sub-Saharan Africa. Master of Public Health (Community Health), May 2005, 83 pp., 20 diagrams, bibliography, 10 titles. The thesis assesses the role of faith-based organizations (FBOs) involved in HIV/AIDS related care and prevention activities in Sub-Saharan Africa. Do FBOs have the ability to address the multi-faceted syndrome that HIV/AIDS brings to an individual, their family and community? Can FBOs be effective partners to carry out prevention and care initiatives? Faith-based organizations are generally overlooked as potential partners and leaders in the fight against HIV/AIDS. FBOs are often the only genuine nongovernmental organizations in many rural parts of poor countries, or at a minimum, they are the strongest and most influential. Due to their organizational networks, FBOs are able to mobilize people and resources, and to reach rural or isolated areas. Evidence of current FBO efforts demonstrates that FBOs have the ability to address the multifaceted effects of HIV/AIDS and can become indispensable partners for government health agencies and NGOs.Item A Study of Disparities in the Receipt of Anti-Retroviral Drugs, Health Status, and Insurance Coverage Among a Sample of HIV-Positive Adults(2006-12-01) Wittenmyer, Brian F.; Lykens, Kristine; Talbert, Jeffrey; Strawderman, TimWittenmyer, Brian F., A Study of Disparities in the Receipt of Anti-Retroviral Drugs, Health Status, and Insurance Coverage among a Sample of HIV-Positive Adults. Master of Public Health (Health Management and Policy), December 2006, 88 pp., 8 tables, references, 32 titles. Anti-retroviral medications (ARV) are effective at treating HIV/AIDS. Medicare, Medicaid, and ADAP are public programs that supply ARVs to needy patients in the U.S. Studies have documented dispartities in AIDS incidence/prevalence, insurance, and ARV-use. The study described demographic, clinical, and insurance characteristics of a sample of HIV+ persons. The study explored relationships between AIDS diagnosis, health status, and ARV-receipt and demographic, insurance, and clinical variables. Disparities in ARV-receipt, AIDS diagnosis, and health-status were found for gender, age, race, geographic region, and SES. Policy recommendations included: shortening the disability waiting-period for Medicare-eligibility, and relaxing Medicaid’s income-eligibility requirements.Item Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas(2005-08-01) Chaudhary, Prateek; Lykens, Kristine; Borejdo, Julian; Rene, Antonio A.Chaudhary, Prateek. Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas. Master of Public Health, August 2005, 52 pp, 6 tables, bibliography. The mismanagement of diabetes care, due to disparities in access, deficiencies in health insurance, or poor quality of primary care, can lead to preventable microvascular complications which force diabetics to utilize hospital emergency departments (ED). This study uses 2002 hospital discharge data from the Texas Health Care Information Collection to determine whether diabetic and elderly (65+) African Americans and Hispanics from Texas counties with a low ratio of physicians per, 1,000 population (PPR) are more likely to be admitted through the ED with complications from diabetes. Findings indicate that while Hispanic ethnicity is significantly associated with ED use as a source of admission, diabetics from counties with higher PPR are more likely to be admitted through the ED for diabetes complications than diabetics from counties with a lower PPR.Item Accountable Care in Texas: A Case Study of Scott & White Healthcare(2010-05-01) Yaeger, Arynn N.; Dr. Kristine LykensScott & White Healthcare of Temple is Texas’s only example of an “Accountable Care Organization” (ACO), as described in the national health reform of March 2010. This case study seeks to identify how Scott & White is able to contain costs while maintaining patient health and satisfaction and why they were able to create their unique system. Conclusions were drawn from personal interviews with Scott & White administrators, physicians, and staff, whose responses were analyzed for recurring themes addressing the research questions. This case study concludes that Scott & White promotes accountability by achieving an alignment of incentives: namely, a physician led governance structure and electronic health record, integration with their health plan, and being open to other payers.Item Acculturation and Psychological Distress in Mexican-American Health Fair Participants(2004-12-01) Bereolos, Nicole M.; Coggin, Claudia; Franks, Susan; Simpkins, JamesBereolos, Nicole M., Acculturation and psychological distress in Mexican-American health fair participants. Master in Public Health (Health Behaviors), December 2004, 20 pp., 3 tables, 23 titles. Immigrants who have integrated into their host culture along with maintaining their cultural identity have better psychological well-being. Greater degrees of psychological distress in less acculturated immigrants may occur due to stressors associated with the transition. This isolation has prevented providers from addressing their mental health needs. This project studied psychological well-being as its relates to acculturation. Self-report questionnaires were offered at the Hispanic Health Fair in Fort Worth, Texas. Psychological distress was significantly higher for the low acculturated (LA) than the moderately acculturated (MA). Specifically, a higher degree of anxiety for the LA group was found compared to the MA. The difference in depression was not significant, however results suggest that mild psychological distress is likely prevalent in the LA. Results underscore the importance of gaining knowledge about the needs of Mexican-Americans that are rarely seen within traditional health service.Item An Analysis of Osteoporosis-Related Hip Fractures, Using Hospital Discharge Data(2001-12-01) Rubin, Bernard; Rene, Antonio A.; Mains, Doug A.; Marshall, MurielThe purpose of this study is to assess whether a current physician practice may inadequately diagnose osteoporosis in a high risk population of postmenopausal women who have sustained a hip fracture. A review of all patients discharged from Texas hospitals during calendar year 1999 was analyzed, using the Public Use Data File provided through the Texas Health Care Information Council. A total of 13,628 women over the age of 55 were admitted to hospital with a fractured hip. Only 2,233, or 16.3%, of women were also coded with the diagnosis of osteoporosis (P [less than] 0.001). Forty to fifty percent of postmenopausal women have osteoporosis. Therefore, women presenting with a fragility fracture form an even more at-risk subset of the population, such that one would expect a majority of these women to carry a diagnosis of osteoporosis. Percentages of Caucasian, non-Hispanic women in each group were comparable. The age distribution in each group was comparable, implying that the coded diagnosis of osteoporosis was not related to the age of the women when admitted to the hospital. In conclusion, physicians practicing in Texas during calendar year 1999 inadequately diagnosed osteoporosis in a high risk population of postmenopausal women who were admitted to hospital with fractured hip. Future analysis of subsequent analysis databases will be able to identify whether or not continuing medical education efforts will cause physicians to diagnose osteoporosis in this high risk population more frequently.Item An Analysis of Texas Hospitals: Assessing the Association between Charity Care, Uncompensated Care, & Community Benefits(2007-05-01) Mitias, Marcus J.; Lackan, Nuha; Talbert, Jeff; Mains, Doug A.Mitias, Marcus J. An Analysis of Texas Hospitals: Assessing the Association between Charity Care, Uncompensated Care, & Community Benefits. Master of Public Health (Health Management & Policy), May 2007, 47 pp., 5 tables, 11 illustrations, references, 45 titles. The question of whether not-for-profit hospitals are meeting their charitable obligations is once again starting to intensify. Congress is calling for increased scrutiny of not-for-profit hospitals. Similarly, pressure is mounting in Texas where the not-for-profit hospital sector struggles to justify the contributions they make to the community. This cross-sectional study examines the county level association between charity care, uncompensated care expenditures, and community benefits, and hospital structure, and the number of uninsured. Descriptive and multi-linear regression analyses are used to compare hospital charity care and uncompensated care expenditures in Texas. Results indicate the number of uninsured is significantly associated with charity care expenditures and uncompensated care expenditures.Item An Evaluation of an Interdisciplinary House Calls Program For the Frail Homebound Elderly(1999-05-01) Johs, Jennifer L.Johs, Jennifer L. An Evaluation of an Interdisciplinary House Calls Program For the Frail Homebound Elderly. Master of Public Health (Biomedical Sciences), May, 1999, 57 pp., 4 tables, references, 66 titles. The current study compared utilization markers of 87 frail elderly homebound patients prior to and subsequent to enrollment in an interdisciplinary, physician-led house calls program, as well as measured efforts to increase documentation of advance directives. After enrollment in the program the number of hospital admissions (p=0.047) and emergency department visits (p=0.030) were significantly decreased. The number of admissions to skilled nursing facilities (p=0.023) was also reduced, as was length of stay in skilled nursing facilities (p=0.018). The prevalence of advance directives increased from 26% to 74% (p [less than] 0.001) subsequent to enrollment. Patients who died were more likely to die at home (19) than in the hospital (6). All patients who died at home had documented advance directives.Item An Evaluation of the Impact of Continuity of Care on Cost of Services in New and Renewing CHIP Enrollees(2001-01-01) Montague, Brian; Lykens, Kristine; Marshall, Muriel; Singh, KaranObjective. To assess the impact of continuity of care as measured by enrollment history on the cost of services in Colorado’s state insurance program for children in low-income families, the Child Health Plan Plus. Design. A retrospective cohort study using data extracted from the eligibility/enrollment system and the claims payment system for inpatient and specialty services. All children enrolled in the program for at least 90 days and managed under the state managed-care network from its inception to April 1st of 2000 were included in the analysis (n-11841). Enrollees were separated into three enrollment groups: new members, renewing members, and members transition from a prior outpatient services group. The odds by enrollment groups: new members, renewing members, and members transition from a prior outpatient services program. The odds by enrollment group an average monthly claims greater than the 75th percentile amongst those with claims (n-2661) and the odds of presence of any claim in the full data set were compared means of a logistic regression model. In order to permit inferences regarding the total cost of care, all models included age group as a cofactor. Presence of chronic or congenital disease, ethnicity, primary language, urban residence, and the presence of multiple parents or caretakers were tested using univariate chi-square analysis and significant factors (p [less than] 0.1) were included as effects in the models. Results. All cofactors with the exception of ethnicity were significant in both models. Chronic disease status was associated with an increased risk of all claims. (OR=4.961, p [less than] 0.0001) and high claims (OR=9.639, p [less than] 0.0001). Renewal status was associated with a decreased risk of any claim (OR=0.921, p [less than] 0.0936) while rollover status was associated with both an increased risk of any claim (OR=1.157, p=0.0034) and a decreased risk of high claims (OR=0.731, p=0.0033). Residence in rural counties increased the risk of any claim (OR=0.0428, p [less than] 0.0001) and an increased risk of high claims (OR=1.472, p=0.0376). Conclusions. Enrollment history had a modest, though significant, effect on the presence of any claim and the specific presence of high claims. Rollover status was protective increasing utilization of the system overall but reducing the risk of high claims whereas renewal status only reduced the risk of utilization overall. The absence of multiple adults in the household showed a pattern consistent with episodic use of the system. Relative to urban residents, residents of rural counties were more likely to have used any service and less likely to have incurred high claims. This effect may be attributable to the transition of patients to HMO networks in urban counties. Linguistic or cultural barriers as reflected in primary language strongly decreased utilization, suggesting that these may be important barriers to address in outreach and member education.Item An Exploratory Study of the Influence of Language and Ethnic Concordance on Hispanic Patients' Trust in their Healthcare Providers in Tarrant County(2007-08-01) Macias, Isela; Holly E. Jacobson; Francisco Soto-Mas; Daisha CipherMacias, Isela. An Exploratory Study of the Influence of Language and Ethnic Concordance on Hispanic Patients’ Trust in Their Healthcare Providers in Tarrant County. Master of Public Health (Health Interpreting & Health Applied Linguistics), August 2007, 76 pp., 8 tables, references, 57 titles. There is a scare number of Spanish-speaking, Hispanic physicians to serve a growing Spanish-speaking Hispanic population. A survey and interview were conducted in a primary health clinic with fifty-two Spanish-speaking Hispanic patients. The Introduction (Chapter 1), included the problem and purpose; Literature Review (Chapter 2), analyzed supporting literature; Methodology (Chapter 3), described data process; Results (Chapter 4), reported the findings; and Conclusions and Recommendations (Chapter 5), included the decision. Spanish-speaking Hispanics in the study had more trust in Spanish-speaking Hispanic physicians than in non-Hispanic physicians who did not speak Spanish. More studies should include Spanish-speaking Hispanics and focus on differences in acculturation and the patient-physician relationship.Item Are Patients Satisfied with Care in the Veterans Health Administration System?(2007-10-01) Budzi, Dorothy F.; Lurie, Sue; Singh, Karan; Stimpson, JimBudzi, Dorothy F., Are Patients Satisfied with Care in the Veterans Health Administration System? Doctor or Public Health (Social and Behavioral Sciences), October 2007, 152 pp, 9 tables, 66 figures, 107 reference, 45 titles. Over 5 million men and women of the U.S. armed forces receive care from the Veterans Affairs healthcare system. The Veterans Health Administration (VHA) is the largest healthcare system and the single largest employer of physician assistants (PAs) and nurse practitioners (NPs) in the United States. Research question: This study asks the question whether the utilization of PAs and NPs in the VHA is a satisfying experience for the patients. Methods: The study analyzed outpatient Survey of Healthcare Experiences of Patients (SHEP), a monthly survey that measures patient satisfaction with the VA healthcare system. Returned surveys of patients who completed their visits at VHA outpatient clinics, acute care centers, and primary care centers across the nation in 2002-2006 were analyzed to explain patients’ satisfaction with PAs, NPs, and physicians. Samplings: Of the 2,164,559 questionnaires that were mailed to patients, 1,601,828 were returned (response rate= 64%, P-value=.05, confidence interval=95%, margin of error +/-2.2). A difference of four or more points is statistically greater than could be caused by sampling error. Secondary data on primary care patient satisfaction scores per Veterans Integrated Network Service (VISN) and facility was analyzed, and compared with provider type ratio per VISN and per facility. Results: the study found that the utilization of non-physician clinicians such as PAs and NPs in the VHA system was a satisfying experience for patients. In certain VISNs, patient satisfaction scores increased by 5% when the number of non-physician clinicians (NPC) was increased compared to 1.8% when the number of physicians was increased. Physician to PA/NP ratio was 7:3, and majority of the primary care providers were male while most of the NPs were female. The dominant age group of the providers was 45-54 years of age. Considering veteran status, PA veteran and non-veteran were 50:50, NP veterans approximately 65%, NP non-veterans 45%, and physician veterans 20% to 80% non-veterans. The information gained from this research may permit the administrators to develop plans and adjustments that foster quality healthcare services.Item Are the Disaster Preparedness Plans in the Largest Cities in the States Adequate for Disabled & Elderly Populations?(2007-05-01) Hall, Stephanie K.Hall, Stephanie K, Are the Disaster Preparedness Plans in the Largest Cities in the Unites States Adequate for Disabled & Elderly Populations? Master of Public Health (Community Health), May 2007, 36 pp., 10 tables, 1 map, reference, 15 titles. This study seeks to compare urban disaster plans in the 25 largest U.S. cities. The focus of this study involves two populations that are often neglected or dealt with last: elderly and disabled. Therefore, the largest US cities should have a comprehensive disaster preparedness plan that includes evacuation & transportation; sheltering and health services; and legal considerations for both the disabled & elderly populations. The data reported in this study was gathered from each city Office of Emergency Management website. The data was analyzed to determine which cities have disaster preparedness plans that consider the disabled and again populations. Results indicate many cities are not prepared.Item Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community - A Six Month Follow-Up(1999-12-01) Coustasse, Alberto; Rene, Antonio; Mains, Doug A.; Ramirez, GilbertCoustasse, Alberto, Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community – A Six Month Follow-up. Master of Public Health Track, Public Health Administration, December 1999, 22 pp., 9 tables, 9 illustrations, bibliography, 7 titles. The health fair approach was used as a method to establish individual and population health status baselines and to provide a mechanism to follow-up with an elderly population in a rural Texas community. A controlled trial sample of forty-four seniors was initially screened in a primary care clinic in August 1998. Patients were reevaluated at six months and results demonstrated a 46% increase in BMI [Body Mass Index]; 62% remained obese; 62% maintained elevated cholesterol or increased cholesterol values to abnormal values; 61% maintained or increased their BP [blood pressure] to abnormal values. A significant finding was that a change of one unit in the BMI correlated with a change of 19.88 mmHg [millimeter mercury] of SBP [systolic blood pressure] and 18.59 mmHg of DBP [diastolic blood pressure]. The societal economic impact of mortality and morbidity (without the benefit of target interventions) for the initial forty-four seniors was projected at & 74,949. Keywords: Health fairs; obesity; cardiovascular; cost; case management.Item Assisting the Implementation of a Centralized IRB in Multiple Categories of Research at Medical City of Fort Worth(2017-05-01) Randhawa, Pawanpreet; Patricia A. Gwirtz; Caroline A. Rickards; Stephen O. MathewIntroduction: As a collection of ethical principles and guidelines regarding biomedical research on humans, the Common Rule has remained largely unchanged since its inception while the clinical research landscape has grown dramatically in size and complexity. Now with the Common Rule being modernized, one of the proposed changes being executed is the requirement of a centralized Institutional Review Board (IRB) for multi-site research studies. This transition of a research site operating under a local IRB to a centralized IRB is expected to greatly improve collaborative studies. Objective: The main goal of this practicum project is to assist in the implementation of a centralized IRB for multi-site research at Medical City of Fort Worth in order to comply with the changes to the Common Rule. Methods/Results: To achieve the goal of this practicum project, the operational rules and regulatory processes at Medical City of Fort Worth were updated. This included revising the institutional IRB and FWA, adverse event and serious adverse event reporting, and audit policies, establishing a local database for active studies, converting study-related materials to an e-records system, and revising the institutional exemption status policy. Conclusion: These activities led to the completion of the transition of Medical City of Fort Worth from a local IRB to a centralized IRB. Additionally, documentation of the process yielded a procedural guide for other institutions undergoing the same transition.Item Association Between Emergency Hospital Admissions of the Adult Population with Preexisting Respiratory Conditions and Ozone Air Quality Index(2006-12-01) Muzina, Miranda; Gratton, Terry; Mains, Doug A.; Sandhu, RaghbirMuzina, Miranda, Association Between Emergency Hospital Admissions of the Adult Population with Preexisting Respiratory Conditions and Ozone Air Quality Index. Master of Public Health (Environmental Health), December 2006, 117 pp., 23 tables, 18 figures, references, 128 titles. This study examined if an association exists between seasonal ozone air pollution in the Fort Worth area and patients admitted to local area hospitals with existing asthma, pneumonia, bronchitis and COPD. Ozone is secondary pollutant formed in a complex reaction between oxides of nitrogen and volatile organic compounds, in the presence of sunlight and heat. The EPA has classified the Dallas-Fort Worth area as a non-attainment area by for ozone. The study did not find any apparent association between seasonal ozone AQI and the emergency respiration admissions. The available hospital data significantly limited analyzing the connection between emergency hospitalization and daily fluctuations of ozone. Further studies are needed to address this complex relationship in a broader perspective.Item Barriers to Medicaid Enrollment: A Study of the Texas Healthy Kids Corporation(2000-12-01) Barlow, Daphne J.; Mains, Doug A.; Blakley, SallyBarlow, Daphne J., Barriers to Medicaid Enrollment: A Study of the Texas Healthy Kids Corporation. Masters of Public Health (Health Administration), December, 2000, 38 pp., 18 tables, References, 13 titles. Recently Medicaid eligibility was expanded to include more children than ever before in Texas. However, many Medicaid eligible families have not obtained benefits. This study concerns potentially Medicaid eligible families who applied to the Texas Health Kids Corporation. A random telephone survey of these applicants examined the outcome of Medicaid eligibility notification. Data was analyzed to determine the predictors of attempting or completing an application. No significant sensitivity to profilers such as primary language, race/ethnicity, education level or age was detected. Instead, having prior knowledge of Medicaid eligibility and being female were predictive factors to consider when engineering outreach programs. While these results indicated a statistical significance, further study of repeat notification and gender in order to conclusively recommend policy change. These results have implicated for the Texas CHIP program.Item Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care Centers(2004-07-01) Ambavaram, Sukanya; Cipher, Daisha J.; Bayona, Manuel; Coggin, ClaudiaAmbavaram, Sukanya. Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care. Master of Public Health, July 2004, 45 pp., 8 tables, references. Background- There is increasing interest in finding the relationship between pain, depression, behavioral disturbances and cognitive impairment in patients living in long-term care centers and predicting behavioral disturbances using chronic pain, depression and cognitive impairment as predictors. To date this is the first study identifying the relationship between pain and behavioral problems. Methods- The study population consisted of 412 residents living in 16 long-term care centers in Dallas, TX. Pearson product-moment Correlation was done to find the association between behavioral disturbances and pain, depression and cognitive factors. Multiple regression analysis was performed to obtain best predictors of behavioral disturbances and forward selection procedure to find out best fit model. Conclusion- Statistically significant correlation was achieved between behavioral excess and overall pain. The correlation was statistically significant between behavioral deficit and overall pain, activity interference and depression. Overall pain, activity interference and depression are significantly inter-correlated with each other. Over all pain and activity interference were found to be statistically significant predictors of behavioral excess. Overall pain was found to be statistically significant predictor of behavioral deficit.