Medicine and Health Sciences Commons^™

Impact Of Levalbuterol Versus Albuterol In Kentucky Medicaid Patients, Velma Henry

MPA/MPP/MPFM Capstone Projects

Problem:

Asthma is a chronic pulmonary disease that occurs in approximately 10 percent of the population worldwide and is associated with a significant increase in direct medical expenditures. Levalbuterol and racemic albuterol are two short-acting β2-agonists (SABA) prescribed for the treatment of asthma. Racemic albuterol has been used for more than 40 years but is associated with several side effects including tremor. When levalbuterol was approved in 2005 its manufacturer and several studies suggested that using levalbuterol results in better respiratory parameters, fewer hospitalizations, less adverse effects and therefore, lower overall treatment costs and hence less need for β-adrenergic agonist …

Foothills Academy: A Program Ranking And Comparative Analysis Of Residential Treatment Programs, William Aaron

MPA/MPP/MPFM Capstone Projects

The Foothills Academy is an all male adolescent residential treatment facility in Albany, Kentucky. As more states turn toward alternative treatment options to address the growing needs of youth suffering from mental and emotional disorders and substance abuse issues, demand for more efficient treatment programs is on the rise. To remain competitive and to administer the best treatment services for their clients, residential treatment programs must utilize industry best practices that allow efficient use of public funds. By identifying high performing programs, those programs may then be studied to identify factors key to individual program success.

My findings were consistently …

Community Needs Assessment Of Mayasandra Village, Karnataka, India, Alexander Hernandez Holl

MPA/MPP/MPFM Capstone Projects

No executive summary.

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

A Participant Model: Predictive Medical And Behavioral Factors Of Prostate Cancer Screening Attendees At Markey, Shana L. Steinbach

MPA/MPP/MPFM Capstone Projects

Problem Statement

The Prostate Cancer Screening Program at the Markey Cancer Center co-sponsors prostate cancer screenings with the Prostate Cancer Education Council. All participation, including African-American attendance, has decreased 38% from years 2006 to 2008 and program managers are seeking insight to improve program participation by acquiring knowledge of behavioral and medical characteristics that may influence screening attendance. Because of the higher incidence of prostate cancer in African-American men (ACS, 2008), a specific program goal is also to increase screening attendance for this minority population.

Research Strategy

Questions that assess participant behavior, personal, and family medical history are analyzed to …

The Implementation Of The Kentucky Transitions: A Money Follows The Person Demonstration Grant Program, Amie Goodin

MPA/MPP/MPFM Capstone Projects

Kentucky Transitions is a Kentucky Medicaid program that is funded primarily by a grant from the Centers for Medicare and Medicaid Services. The purpose of this program is to transition individuals residing in long-term care facilities back into the community, where they will continue to receive health, social, and other benefits but do so in an approved residential setting. Individuals living in the community may experience higher quality of life and the increased ability to choose how and when they receive services, while Medicaid reaps the projected financial benefit of providing less-expensive community alternatives for care.

Though Kentucky Transitions operates …

Medication Therapy Management: Is It Worth Medicare’S Time?, Jennifer White

MPA/MPP/MPFM Capstone Projects

Problem:

Medication Therapy Management (MTM) is a service that a pharmacist can provide to any of their patients, but mostly to those who are either high risk patients for adverse events or those who are new to chronic medication therapy. As Medicare Part D has begun to cover MTM services, more and more pharmacists and other clinicians are becoming providers of MTM.

The intent of MTM is to decrease adverse events and healthcare costs to both the patient and the third party payer. In realizing the benefits of MTM, it is important to assess these outcomes to see if clinical, …

Physician Recruitment At Highlands Regional Medical Center: What Works?, Sarabeth Blankenship

MPA/MPP/MPFM Capstone Projects

There is a physician shortage in eastern Kentucky because older physicians are retiring, and younger physicians are choosing to practice in more urban, affluent areas. Eastern Kentucky is plagued with persistent poverty and lacks cultural amenities. These facts put together myths regarding rural practice create a shortage.

My research consisted of interviewing twenty physicians currently practicing at Highlands Regional Medical Center in Prestonsburg, Kentucky. I created a survey instrument that asked questions of physicians regarding demographics characteristics, medical school attended, and what motivated them to practice at Highlands. I chose Highlands because I was able to get interviews scheduled with …

Employability After Substance Abuse Treatment In Kentucky: An Analysis Of The Kentucky Treatment Outcome Study, Steven Scrivner

MPA/MPP/MPFM Capstone Projects

Public funding of substance abuse treatment (SAT) in Kentucky dates back to the 1950s when legislators sought to curb the problem of alcoholism through legislative acts. The definition of substance abuse expanded through the years to include other substances such as cocaine, marijuana and opiates.

Employment after SAT is a critically important outcome for policymakers to consider when allocating funds because it assists in social re-integration, helps to prevent relapse and promotes economic self-sufficiency. Because of this, employment is an important factor to consider when assessing the impact SAT has on its clients (participants).

The Kentucky Alcohol and Other Drug …

Evaluating The Healthy States Initiative Policy Forums, Jessica Harmon

MPA/MPP/MPFM Capstone Projects

Since 2005, The Council of State Governments (CSG) has participated in a cooperative agreement funded by the Centers for Disease Control and Prevention (CDC) called the Healthy States Initiative. The initiative promotes public health by providing information resources to state legislators through publications and public health forums. CSG is interested in information about the impact of the public health forums on state legislators. More specifically, they would like to know if the forums have encouraged the participants to produce public health legislation, to support funding for public health projects, and to work closely with colleagues and various groups to improve …

The Influence Of Veterinary Schools On The Veterinary Labor Market, Kyle Bosh

MPA/MPP/MPFM Capstone Projects

Problem Statement:

Does the presence of a veterinary school in a state influence the supply of veterinarians practicing in that state? Citizens and animals in states without a veterinary school are at a disadvantage if the presence of a veterinary school significantly improves public health and access to medical services in those states that have a veterinary school.

Research Strategy:

The unit of analysis in this study is 50 states and the District of Columbia. The study is designed as a cross-sectional analysis of 2006 pet, 2002 livestock, 2006 human, labor, and economic data. The study uses simultaneous equations to …

Preparing For The Future: An Evaluation Of Alternative Methods For Estimating The Needed Capacity Of Nursing Home Beds In Kentucky, Michelle D. Woods

MPA/MPP/MPFM Capstone Projects

Due to the aging of the generation known as “Baby Boomers”, the nation is expected to witness extraordinary growth in the total population ages 65 and over. Population projections provided by the United States Bureau of the Census suggest that this segment of the population will double in size to 72 million by the year 2030. In order to prepare for the anticipated increase elderly Americans, policy officials have been analyzing the potential effects on the nation’s long-term care system. Although Baby Boomers can expect to live longer than their predecessors, as they age, it is predicted that this generation …

Senate Bill (Sb) 172: Governance Of Nutrition In Kentucky Public Schools: Implementation Analysis Final Report, Bill Brumbach

MPA/MPP/MPFM Capstone Projects

This report is intended to evaluate the implementation of Senate Bill (SB) 172 in Kentucky's public schools. This law requires that all schools in Kentucky implement strict nutrition standards that apply to all foods sold during the school day. This report highlights the different methods used by selected schools in implementing the requirements in SB 172. In performing my analysis, I traveled to different schools in central and southeastern Kentucky to assess how these select schools were meeting the requirements of the law. Site visits allowed me to discuss implementation strategies with school administrators and aided in my understanding of …

Expanding A General Surgery Practice: Privileges, Ambulatory Care Centers And Hospital Interactions, Julia Snow

MPA/MPP/MPFM Capstone Projects

The objective of this case study is to document the interactions between a general surgery practice group and a university medical center as the physician group establishes and seeks to expand its revenue base. The group proposes to lease or purchase a practice location where they can consult with patients and perform procedures. The practice location is near a competitive hospital, Saint Jose East. The surgeons currently have privileges at Saint Jose Hospital and request to continue the privileges.

The case study's design and methods include benchmarking and financial analysis. The results of the study are :

• Benchmarking of operating …

Evaluating If The Built Environment Has A Substantial Effect On Obesity In Fayette County, Kentucky, Will Warren

MPA/MPP/MPFM Capstone Projects

Background:

Obesity is a major health issue in the United States and Fayette County. As Fayette County has become increasingly obese, it too has had an issue of sprawl within its urban service area and beyond. Relationships between obesity and aspects of the built environment are continuing to be studied.

Objective:

To evaluate the impact certain factors may have on the body mass index of Fayette County residents, in particular whether urban sprawl has an overriding impact on the weight of residents.

Methods:

The study area used was Fayette County, which was broken down into its fourteen zip code areas …

Mental Illness And Barriers To Health Care Access, Charlene Powell

MPA/MPP/MPFM Capstone Projects

Statement of Problem

Access to health care in the United States is major concern, despite the fact that the country spends more per capita on health care than any other country. Individuals with mental illness may face greater access problems than the general population.

Research Question

• Does mental illness predict greater difficulties with access to health care?

Methodology

The 2004 National Health Interview Survey (NHIS) was used to examine the barriers to health care among individuals reporting a mental illness diagnosis. Nine questions relating to health access problems were drawn from the survey and combined into an access index. Multivariate …

Ky Pharmacists’ Perceptions On Medication Errors (Me): A Tool For Legitimate Discussions With The Kentucky Board Of Pharmacy?, J. D. Hammond

MPA/MPP/MPFM Capstone Projects

No executive summary.

The Effects Of A University-Based Academic Detailing Program For Primary Care Providers On Hemoglobin A1c Assessment Frequency In Type Ii Diabetics, Christopher Maloy

MPA/MPP/MPFM Capstone Projects

Diabetes is a serious illness affecting millions of people in the United States today. The disease is characterized by the chronic and acute complications of poorly regulated blood glucose concentrations. These complications lead to significant morbidity and mortality in the diabetic population. It is estimated that diabetes accounts for over $1.9 billion in Kentucky healthcare expenditure annually, a figure that continues to grow each year. In order to address this serious public health problem, many states have adopted healthcare initiatives to target increased diabetes awareness and care. The Commonwealth of Kentucky has implemented numerous such initiatives, including an innovative program …

Evaluating Awareness Of Community Health And Human Services By The Hispanic Population In Lexington, Kentucky, Pilar Corbellini

MPA/MPP/MPFM Capstone Projects

Over the past 10 years, Hispanics, predominately Mexicans, have become a notable component of immigration in Kentucky. At the same time, the city of Lexington has striven to increase and stimulate community efforts to help and support people in need. Over 2000 non-profit organizations exist in the city and surrounding areas that unite community support to assist people seeking help.

Among non-profit agencies, particularly the United Way of the Bluegrass, there is a perceived idea that people in need and seeking help are overwhelmed with information about available community human and health services. Notwithstanding this perception, a different reality seems …

Childhood And Adolescent Obesity: Nationwide Pediatric Healthcare Provider Practices And Their Role In Treatment And Prevention Of The Obesity Epidemic, Alison Farley

MPA/MPP/MPFM Capstone Projects

The purpose of this research is to explore screening and treatment patterns as well as the underlying provider confidence in their decision-making related to the overweight and obese child and adolescent patient. The screening and treatment of obesity in the child and adolescent population are affected by complex social implications and physical side effects. Without a clear consensus on screening, diagnosis and alternative treatment plans, healthcare providers will not maximize the opportunity to provide primary and secondary prevention to the growing epidemic.

Statistical analysis of secondary survey data was conducted to explore screening and treatment patterns as well as the …

When The Safety Net Fails: An Analysis Of Alternative Long-Term Care Services In Kentucky, Suzanne Dale

MPA/MPP/MPFM Capstone Projects

The Problem

In early 2003, the Kentucky Cabinet for Health Services, faced with a $450 million Medicaid shortfall, implemented several cost-cutting measures to the Medicaid program. The most visible measure included new stricter medical eligibility requirements for long-term care programs. As a result of these new requirements, approximately 2,813 elderly and disabled Kentuckians were denied services in Kentucky’s Aged/Disabled Home and Community-Based Waiver Program, a Medicaid program that provides long-term care services in people’s homes and in community-settings. The Cabinet for Health Services claimed that those who lost home and community-based Medicaid services could receive care through alternative state programs. …