Digital Commons Network^™

Nongovernmental Program Replication And Implementation: What Can Community-Based Programs To Support The Uninsured Learn From Other Communities?, Raymond J. Higbea

Dissertations

This research study evaluated the replication and implementation of Project Access (a nongovernmental, structured program providing physician and health care services to the working-poor) in Grand Rapids, Michigan. A mixed methodological approach was used and included quantitative and qualitative methodologies. The qualitative method used was a self-administered mailed survey of all Project Access enrollees. This survey evaluated the enrollee's perceived health and lifestyle function, access to physician services, access and adherence to prescribed medication regimen, and barriers to physician services during the year pre- and post-enrollment in Project Access. The survey also evaluated the amount enrollees were able or willing …

Unintended Consequences In Public Policy: Formulation And Implementation Of Michigan’S Safe Delivery Of Newborns Law, Anne Julie Hacker

Dissertations

It is generally believed that social policy is the result of careful research and planning on the part of officials. Yet there often exists a gap between theformulation and implementation of many social policies. This gap brings with it conflict, which in turn may result in unintended consequences. Theseconsequences may be so antithetical to the formulators' original intent as to make the policy implementation paradoxical.

This qualitative research study examines the ambiguities, challenges, or boundaries that policy formulators placed on practitioners responsible for implementing Michigan's Safe Delivery of Newborns Act and that ultimately created unintended consequences indicative of a public …

Providing Uninsured Adults With Free Or Low-Cost Primary Care: Does It Influence Their Use Of Hospital Emergency Departments?, Anne G. Zahradnik

Dissertations

This study analyzes one component of the health care safety net to determine whether or not being enrolled in a free or low-cost primary care physician access program subsequently affects emergency room utilization by uninsured adults ages 18 through 64. Those individual decisions are analyzed from both public goods and rational choice schemas. Additionally, physician access programs of different formats (a low-cost physician referral program and a freewalk-in clinic) are analyzed and compared for relative effectiveness. The study is a quantitative analysis of more than 40,000 individual patient records rather than relying on qualitative patient recall or on analyzing broad …

The War On Drugs V. The War On Pain: Do Controlled Prescribing Laws Have A Role?, Susanne F. Homant

Dissertations

The illegal use of prescription drugs and the under-treatment of chronic pain are both considered serious public health issues in this country. Strong medicines classified as controlled substances by the DEA are often used to treat chronic pain conditions and are also known to be diverted to non-medical uses, thus a solution to one problem may happen at the expense o f the other. Prescription Monitoring Programs (PMPs) are public policies that are felt by many to address diversion of controlled substances, and are generally welcomed by law enforcement as an excellent tool in the war against drugs. A number …