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Full-Text Articles in Health Services Research

Geographic Variation In The Implementation Of Public Health Services: Organizational, Economic, And Network Determinants, Glen P. Mays Dec 2015

Geographic Variation In The Implementation Of Public Health Services: Organizational, Economic, And Network Determinants, Glen P. Mays

Glen Mays

An expanding body of research-tested public health interventions exist to prevent disease and injury and promote health on a population-wide basis, such as those profiled in the CDC’s Guide to Community Prevention Services, but adoption and implementation of these strategies vary widely across states and communities. Public health services are delivered through diffuse constellations of governmental agencies and their private-sector and community-based counterparts using implementation mechanisms that are poorly understood. The studies in this panel examine how organizational, economic, and inter-organizational network characteristics influence the implementation of public health services across states and communities.


Inter-Organizational Network Effects On Public Health Service Implementation, Outcomes, And Disparities Across U.S. Communities, Glen P. Mays Dec 2015

Inter-Organizational Network Effects On Public Health Service Implementation, Outcomes, And Disparities Across U.S. Communities, Glen P. Mays

Glen Mays

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.Methods: We follow a longitudinal cohort of 360 …


Estimating Health And Economic Gains From Public Health Delivery System Transformation, Glen Mays Nov 2015

Estimating Health And Economic Gains From Public Health Delivery System Transformation, Glen Mays

Glen Mays

Objectives: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health system change; and (2) the effects of these changes on preventable mortality and resource use. Methods: …


Understanding The Value Of Multi-Sector Health System Interactions, Glen P. Mays Oct 2015

Understanding The Value Of Multi-Sector Health System Interactions, Glen P. Mays

Glen Mays

Recent research examines the health and economic value of multi-organizational and multi-sectoral approaches for the delivery of public health services. This presentation examines how data on these multi-organizational delivery systems and their impact can be used to solve collective action problems and stimulate collaborative solutions in public health.


Kentucky's Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays Oct 2015

Kentucky's Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays

Glen Mays

This session examines recent progress toward the 2012 Institute of Medicine recommendation to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be available across the U.S. Research about the health and economic benefits of Foundational Public Health Services has begun to shape Kentucky's strategic plan for transforming the public health system.


Analytic Approaches For Causal Inferences With Complex Multi-Component Interventions: Project Achieve's Study Of Managing Care Transitions, Glen P. Mays Oct 2015

Analytic Approaches For Causal Inferences With Complex Multi-Component Interventions: Project Achieve's Study Of Managing Care Transitions, Glen P. Mays

Glen Mays

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.


Trends In Health Care Delivery Systems: Implications For Cancer Prevention And Control, Glen P. Mays Sep 2015

Trends In Health Care Delivery Systems: Implications For Cancer Prevention And Control, Glen P. Mays

Glen Mays

The Affordable Care Act and larger economic forces are leading both health care providers and public health agencies to renegotiate their roles and responsibilities within the U.S. health system. This session reviews major changes occurring in both health care and public health delivery systems, with a focus on the implications for cancer prevention and control. The information infrastructure created by cancer registries and other health information systems are increasingly important for enabling greater coordination, alignment and accountability within the nation's changing delivery systems.


The National Health Security Preparedness Index: Proposed Updates For 2015-16, Glen P. Mays Sep 2015

The National Health Security Preparedness Index: Proposed Updates For 2015-16, Glen P. Mays

Glen Mays

The U.S. Centers for Disease Control and Prevention (CDC) initiated development of the National Health Security Preparedness Index in 2012 to create a platform for measuring the nation’s progress in preparing for, responding to, and recovering from disasters and other large-scale emergencies that pose risks to health and well-being in the United States. As a measurement tool, the Index is designed to summarize levels of preparedness achieved within individual states and for the nation as a whole. This session summarizes proposed updates to the Index for 2015-16 that are designed to improve the validity and reliability of Index measures and …


Improving The National Health Security Preparedness Index: Recommended Updates For 2015-16, Glen P. Mays Aug 2015

Improving The National Health Security Preparedness Index: Recommended Updates For 2015-16, Glen P. Mays

Glen Mays

This report describes proposed updates in methodology and measures for the 2015-16 release of the National Health Security Preparedness Index


Using Research And Roi To Drive Partnerships In Public Health Delivery Systems, Glen P. Mays Aug 2015

Using Research And Roi To Drive Partnerships In Public Health Delivery Systems, Glen P. Mays

Glen Mays

Stimulating public-private partnerships (PPP) for health and economic development initiatives requires research that can answer key questions: (1) what are the health and economic returns likely to be realized; (2) over what time frames and with what certainty; (3) what investments are required to achieve results; and (4) what are the implementation strategies most likely to succeed. This presentation reviews ongoing research on the PPPs used to deliver public health services in the U.S., and explores the lessons this research offers PPPs in low and middle income countries. We examine how scientific evidence on public health delivery systems and their …


Estimating Patient-Centered And Community-Centered Treatment Effects: Examples From Medical Care And Public Health, Glen P. Mays Aug 2015

Estimating Patient-Centered And Community-Centered Treatment Effects: Examples From Medical Care And Public Health, Glen P. Mays

Glen Mays

Health services researchers face growing clinical and policy imperatives for estimating how the effectiveness of medical and public health interventions vary across patients, population groups, and community settings. Recent advances in local instrumental variables estimation techniques allow for the estimation of person-specific and community-specific treatment effects in the presence of unobserved heterogeneity. This presentation explores examples from both medicine and public health following the local IV methods developed by Basu et al. (2013).


Foundational Public Health Services And Health System Reform: Evidence, Economics, And Implementation, Glen P. Mays Aug 2015

Foundational Public Health Services And Health System Reform: Evidence, Economics, And Implementation, Glen P. Mays

Glen Mays

The Institute of Medicine's 2012 report on public health financing recommended a national initiative to identify the components and costs of a "minimum package" of public health programs and infrastructure that should be available in every U.S. community. In response, efforts are now underway to reach consensus on a set of "Foundational Public Health Services" for the nation, and to identify resource requirements for implementing these services. This presentation reviews existing research on the current availability of Foundational Public Health Services across the U.S. and the health and economic effects attributable to these services. We also review progress on ongoing …


Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays Aug 2015

Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays

Glen Mays

This workshop provides an overview of the design and implementation of economic evaluation studies of public health programs and policies. Strategies for integrating economic evaluation principles, measurement strategies, analytic approaches, and results into the routine operations of public health agencies are examined.


Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic And Health Effects, Glen P. Mays Jul 2015

Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic And Health Effects, Glen P. Mays

Glen Mays

MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other …


Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays Jun 2015

Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays

Glen Mays

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This session highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This methods workshop examines the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures. This paper profiles examples of using SNA principles and methods to study the implementation …


Learning From Network Analysis: Care Transitions, Market Competition, And Community Interventions, Glen P. Mays Jun 2015

Learning From Network Analysis: Care Transitions, Market Competition, And Community Interventions, Glen P. Mays

Glen Mays

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This methods workshop highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This session will examine the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures.


Learning From Delivery System Behavior, Dynamics, And Interactions To Advance A Culture Of Health, Glen P. Mays Jun 2015

Learning From Delivery System Behavior, Dynamics, And Interactions To Advance A Culture Of Health, Glen P. Mays

Glen Mays

A new "Systems for Action" national research program flows directly from the Robert Wood Johnson Foundation's Culture of Health action framework. This program will build evidence on how best to align the delivery and financing systems for medical care, public health, and community services & supports so as to promote wellbeing and resiliency, realize efficiencies in resource use, and reduce inequities in health.


Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril Jun 2015

Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril

Glen Mays

Research Objective: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health “system capital”; and (2) the effects of these changes on preventable mortality and resource use. …


National Health Security Preparedness Index: Recommendations From The National Advisory Committee, Glen P. Mays, Michael Childress, Anna Goodman Hoover, Chris Bollinger Jun 2015

National Health Security Preparedness Index: Recommendations From The National Advisory Committee, Glen P. Mays, Michael Childress, Anna Goodman Hoover, Chris Bollinger

Glen Mays

This meeting of the National Advisory Committee for the National Health Security Preparedness Index program discussed strategies for improving the theoretical framework, measures, and analytic methodologies used in assessing and comparing preparedness levels across U.S. states and the nation as a whole.


Cost Estimation In Public Health Services & Systems Research, Glen P. Mays Jun 2015

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Glen Mays

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.


Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays Apr 2015

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Glen Mays

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.


The National Health Security Preparedness Index: Harnessing Evidence & Experience To Drive Improvement, Glen P. Mays Mar 2015

The National Health Security Preparedness Index: Harnessing Evidence & Experience To Drive Improvement, Glen P. Mays

Glen Mays

This presentation profiles the National Health Security Preparedness Index as a mechanism for measuring preparedness and resiliency levels across the U.S. Forthcoming enhancements in measurement and analytic methodologies will allow the Index to play heightened roles in informing policies and practices that protect the U.S. population from a broad range of hazards.


Connecting Preparedness Science With The National Health Security Preparedness Index: Research Translation Opportunities, Glen P. Mays Mar 2015

Connecting Preparedness Science With The National Health Security Preparedness Index: Research Translation Opportunities, Glen P. Mays

Glen Mays

The National Health Security Preparedness Index is a mechanism for applying advances in preparedness measurement and analysis from Hurricane Sandy research projects to advance policies and practices in preparing for, responding to, and recovering from disasters and other health emergencies


Using Practice-Based Research Networks For Next-Generation Public Health, Glen P. Mays Mar 2015

Using Practice-Based Research Networks For Next-Generation Public Health, Glen P. Mays

Glen Mays

U.S. public health agencies face an existential imperative to transform their work from a collection of discrete programs and policies into a coherent enterprise for population-wide health improvement. Practice-based research networks (PBRNs) and the advancing science of public health delivery systems can help to achieve this transformation.


Refining And Improving The Methodology For The National Health Security Preparedness Index, Glen P. Mays, Michael Childress, Dominique Zephyr Mar 2015

Refining And Improving The Methodology For The National Health Security Preparedness Index, Glen P. Mays, Michael Childress, Dominique Zephyr

Glen Mays

This first meeting of two newly reconstituted Working Groups for the National Health Security Preparedness Index Program examined opportunities for improving and refining the Index's measurement, scaling, weighting, and aggregation methodologies. Methodological improvements will enhance the Index's utility for education, planning, policy development, and quality improvement efforts focused on improving national preparedness and resiliency for large-scale health threats.


Estimating The Costs Of Foundational Public Health Services, Glen P. Mays Feb 2015

Estimating The Costs Of Foundational Public Health Services, Glen P. Mays

Glen Mays

The Institute of Medicine’s 2012 report on public health financing called for the convening of expert panels to identify the components of a “minimum package” of public health services and cross-cutting capabilities that should be available in every U.S. community to protect and improve population health. This report also called for studies to identify the resources required to make these services universally available across the country. This research brief describes the research methodology in use to generate first-generation estimates of current resource use and estimated resource needs for implementing foundational public health services and capabilities.


Defining Comprehensive Public Health Delivery Systems, Glen P. Mays Feb 2015

Defining Comprehensive Public Health Delivery Systems, Glen P. Mays

Glen Mays

This brief describes the methodology for defining Comprehensive Public Health Delivery Systems using data from the National Longitudinal Survey of Public Health Systems. The systems meeting this definition have been shown to deliver a broader range of recommended public health services, using fewer resources, than the more prevalent types of U.S. public health systems that do not meet this definition. Over time, comprehensive systems are associated with larger gains in population health status than are their counterparts.


Orientation To The National Health Security Preparedness Index, Glen P. Mays, Anna Goodman Hoover, Michael Childress Feb 2015

Orientation To The National Health Security Preparedness Index, Glen P. Mays, Anna Goodman Hoover, Michael Childress

Glen Mays

Refining the measures and methodologies used within the National Health Security Preparedness Index will allow users to make more meaningful comparisons of preparedness levels across U.S. geographic areas and to assess changes in preparedness over time.


Improving Measures Of Public Health Activity At Local And State Levels: The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays Feb 2015

Improving Measures Of Public Health Activity At Local And State Levels: The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays

Glen Mays

Implementation of high-value public health strategies for chronic disease prevention, communicable disease control, and environmental health protection vary widely across U.S. states and communities. The Multi-Network Practice and Outcome Variation Examination Study (MPROVE) supported by the Robert Wood Johnson Foundation creates the measurement and analytic foundation for investigating the causes and consequences of practice variation in public health.


Aca Implementation In The South: The Political Economy Of Full Participation In Kentucky, Glen P. Mays Jan 2015

Aca Implementation In The South: The Political Economy Of Full Participation In Kentucky, Glen P. Mays

Glen Mays

This analysis, conducted as part of the ACA Implementation Research Network, examines economic and political forces shaping Kentucky's early experience with implementation of the Patient Protection and Affordable Care Act.