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2012

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Full-Text Articles in Social and Behavioral Sciences

National Longitudinal Survey Of Public Health Systems: Comparative Report Of 2012 Results, Glen Mays Dec 2012

National Longitudinal Survey Of Public Health Systems: Comparative Report Of 2012 Results, Glen Mays

Glen Mays

The third wave of the National Longitudinal Survey of Public Health Systems was fielded in 2012 in a nationally-representative cohort of local communities. The survey measures the availability of 20 recommended public health activities in the community, the range of organizations that participate in performing each activity, and the perceived effectiveness of each activity. Prior waves of the survey were fielded in 1998 and 2006. Local health officials report data for this survey and receive a customized report of results that compare data for their community with national norms and with "peer groups" of similar communities. This document provides an ...


Public Health Return On Investment: Making The Case, Glen P. Mays Dec 2012

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.


Public Health Return On Investment: Making The Case, Glen Mays Dec 2012

Public Health Return On Investment: Making The Case, Glen Mays

Glen Mays

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.


Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays Dec 2012

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).


Comparative Effectiveness Research And Patient-Centered Outcomes Research In Public Health Settings: Design, Analysis And Funding Considerations, Glen Mays Dec 2012

Comparative Effectiveness Research And Patient-Centered Outcomes Research In Public Health Settings: Design, Analysis And Funding Considerations, Glen Mays

Glen Mays

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).


The Impact Of Health Care Reform On Hospital And Preventive Care: Evidence From Massachusetts, Jonathan T. Kolstad, Amanda E. Kowalski Dec 2012

The Impact Of Health Care Reform On Hospital And Preventive Care: Evidence From Massachusetts, Jonathan T. Kolstad, Amanda E. Kowalski

Health Care Management Papers

In April 2006, Massachusetts passed legislation aimed at achieving near-universal health insurance coverage. The key features of this legislation were a model for national health reform, passed in March 2010. The reform gives us a novel opportunity to examine the impact of expansion to near-universal coverage state-wide. Among hospital discharges in Massachusetts, we find that the reform decreased uninsurance by 36% relative to its initial level and to other states. Reform affected utilization by decreasing length of stay, and the number of inpatient admissions originating from the emergency room. When we control for patient severity, we find evidence that preventable ...


Price Elasticity Of Expenditure Across Health Care Services, Fabian Duarte Nov 2012

Price Elasticity Of Expenditure Across Health Care Services, Fabian Duarte

Fabian Duarte

Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures. Estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Using unique individual-level data compiled from administrative records from the Chilean private health insurance market, I estimate the price elasticity of expenditures across a variety of health care services. I find elasticities that range between zero for the most acute service (appendectomy) and −2.08 for the most elective (psychologist visit). Moreover, the results show that at least one third ...


Data Acquisition Plan For The Public Health Multi-Network Practice And Outcome Variation (Mprove) Study, Glen Mays Nov 2012

Data Acquisition Plan For The Public Health Multi-Network Practice And Outcome Variation (Mprove) Study, Glen Mays

Glen Mays

This brief details the steps to be followed in obtaining and compiling data on the core (and optional) measures of public health service delivery for the MPROVE study. MPROVE data will need to be obtained from several different sources. Data for some measures already exist in administrative records, surveillance systems, or other sources maintained by the local and state public health agencies that participate in your PBRN. For other measures, it may be necessary to obtain data from other agencies that collaborate with the public health agencies in your PBRN. In still other cases, it may be necessary to undertake ...


Essays On Health Insurer And Provider Interactions, Daniel Montanera Nov 2012

Essays On Health Insurer And Provider Interactions, Daniel Montanera

Electronic Thesis and Dissertation Repository

This thesis consists of three chapters on insurer and provider interactions. Despite widespread reports of defensive medicine in surveys of physicians, empirical investigations have produced conflicting evidence that defensive medicine is practiced on a significant scale. Findings imply that the relationships between malpractice pressure and health care spending and quality are non-monotonic. These predictions provide an explanation for the apparent conflicts and inconsistencies in the existing empirical literature, as well as policy guidance for future empirical investigations in separating observations and populations in different equilibrium types.

The next chapter expands the model by making physicians mobile, and includes a location ...


Final Set Of Public Health Delivery Measures Selected For The Multi-Network Practice And Outcome Variation Examination (Mprove) Study, Glen Mays Nov 2012

Final Set Of Public Health Delivery Measures Selected For The Multi-Network Practice And Outcome Variation Examination (Mprove) Study, Glen Mays

Glen Mays

The Multi-Network Practice and Outcome Variation Examination Study (MPROVE) engages public health practice-based research networks (PBRNs) in the collection and analysis of measures of public health delivery across a large number of local practice settings in order to examine the causes and consequences of practice variation in public health. This document summarizes the final set of measures selected for the MPROVE study, including measures of the reach, volume, intensity, and quality of public health delivery in three domains of activity: chronic disease prevention, communicable disease control, and environmental health protection.


Management And Employee Agreement On Reports Of Organizational Policies And Practices Important In Return To Work Following Carpal Tunnel Surgery, Benjamin Amick, H. Hunt, Jeffrey Katz, Rochelle Habeck, Janet Ossmann, Gopika Ramamurthy, Valerie Soucie Nov 2012

Management And Employee Agreement On Reports Of Organizational Policies And Practices Important In Return To Work Following Carpal Tunnel Surgery, Benjamin Amick, H. Hunt, Jeffrey Katz, Rochelle Habeck, Janet Ossmann, Gopika Ramamurthy, Valerie Soucie

H. Allan Hunt

No abstract provided.


Online Appendix: Spatial Mobility And Environmental Effects On Obesity, Zhenxiang Zhao Nov 2012

Online Appendix: Spatial Mobility And Environmental Effects On Obesity, Zhenxiang Zhao

Zhenxiang Zhao

No abstract provided.


Estimating Dynamic Discrete Choice Models Of Product Differentiation: An Application To Medicare Part D With Switching Costs, Daniel P. Miller, Jungwon Yeo Nov 2012

Estimating Dynamic Discrete Choice Models Of Product Differentiation: An Application To Medicare Part D With Switching Costs, Daniel P. Miller, Jungwon Yeo

Research Collection School Of Economics

This paper proposes an algorithm to estimate dynamic discrete choice models using aggregate market share data. The algorithm achieves a computational advantage by decomposing the complicated mapping between market shares and utility flows into two simpler ones. The first maps observed market shares to mean choice specific values, and the second then maps to mean utility flows. In the application, we estimate switching costs in the Medicare Part D market. Our results indicate a large switching cost of around $1,700, which implies an average welfare loss of $480 as enrollees choose to remain in sub-optimal plans to avoid switching ...


The Likely Impact Of Mandated Paid Sick And Family-Care Leave On The Economy And Economic Development Prospects Of The State Of Ohio, Edward W. Hill, Spence Christopher, Daila Shimek, Ziona Austrian Oct 2012

The Likely Impact Of Mandated Paid Sick And Family-Care Leave On The Economy And Economic Development Prospects Of The State Of Ohio, Edward W. Hill, Spence Christopher, Daila Shimek, Ziona Austrian

Ziona Austrian

This report analyzes the potential impact of a proposed paid sick and family care leave legislation on the economy of the state of Ohio, the economic development prospects of the state and on the management of production processes that depend on highly integrate teams. The report also reviews the literature on the effect of mandated paid sick and family care leave on the industrial relations system—workplace performance and worker retention. Our analysis concludes that there would have been a net cost associated with the paid sick leave and family-care initiative proposed in Ohio with a lower bound estimate of ...


Public Health Return-On-Investment Template - Demonstration Version, Glen Mays Oct 2012

Public Health Return-On-Investment Template - Demonstration Version, Glen Mays

Glen Mays

The Public Health Return on Investment (ROI) Template is designed to help public health organizations estimate the economic returns from investments made in strategies that enhance public health service delivery, including quality improvement (QI) interventions. Depending on data availability, the template can be used to support retrospective analyses of actual investments as well as prospective analyses of potential future investments. The tool is designed to analyze economic returns realized through one ore more of the following pathways: (1) Reductions in routine operating costs; (2) Increases in revenue streams; (3) Increases in the outputs produced through agency services/functions; (4) Reductions ...


Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison Oct 2012

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the ...


The Cost-Effectiveness Of Combination Treatment Consisting Of Either Cetuximab Or Panitumumab Plus Folfiri Versus Treatment With Bevacizumab Plus Folfiri As First-Line Treatment For Kras Wild-Type Metastatic Colorectal Cancer Patients In Ontario, Emmanuel M.G. Ewara Oct 2012

The Cost-Effectiveness Of Combination Treatment Consisting Of Either Cetuximab Or Panitumumab Plus Folfiri Versus Treatment With Bevacizumab Plus Folfiri As First-Line Treatment For Kras Wild-Type Metastatic Colorectal Cancer Patients In Ontario, Emmanuel M.G. Ewara

Electronic Thesis and Dissertation Repository

I conducted a cost-effectiveness analysis of combination cetuximbab or panitumumab plus FOLFIRI as first-line treatment for patients with metastatic colorectal cancer (MCRC) from the perspective of the Ontario healthcare payer. I developed a Markov decision analytical model to simulate the lifetime costs and benefits of each treatment option. The model was parameterized using data collected from administrative databases in the province of Ontario and from published clinical trials. In the base case scenario, treatment consisting of bevacizumab plus FOLFIRI was found to dominate other treatment options. The ICER values were found to be sensitive to the efficacy of first-line treatment ...


Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison Oct 2012

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Rachel Hogg-Graham

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health. METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the ...


Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison Oct 2012

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Glen Mays

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health. METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the ...


The Dynamics Of State University Participation In State Medicaid Administration, Ronald Preston, Marc A. Thibodeau, David Polakoff Oct 2012

The Dynamics Of State University Participation In State Medicaid Administration, Ronald Preston, Marc A. Thibodeau, David Polakoff

Commonwealth Medicine Publications

It is not uncommon for state university faculty to participate as part-time consultants in the administration of state Medicaid programs. However, rarely do state universities participate institutionally as public agencies in the administration of state Medicaid programs since the propriety, value and parameters of these engagements are usually not recognized.

Even in states where they flourish, collaborations between state universities and state Medicaid agencies are not well understood and suggest to some people an unlikely confluence of two worlds. The missions of state universities and state Medicaid programs differ, their institutional cultures differ, and their protocols differ. In all states ...


Unlocking The Complexity Of The Health Care System: Kentucky’S Health Navigators, Michael T. Childress Oct 2012

Unlocking The Complexity Of The Health Care System: Kentucky’S Health Navigators, Michael T. Childress

CBER Research Report

From the preface:

Health navigation comes in many forms. Sometimes it takes the form of helping an individual find the treatment, medication, or health services they need. Other times navigation takes the form of helping a patient overcome barriers of child care, finances, or transportation so they can see a doctor. In other cases navigation means working with patients to enhance health literacy so they comply with medical instructions and are not readmitted to a hospital. And sometimes health navigation entails lending an empathetic hand to patients under‐ going the rigors of cancer treatment.

Here we adopt a fairly broad ...


Selecting Measures Of Public Health Service Delivery: Results From A Delphi Survey For The Mprove Study, Glen Mays Sep 2012

Selecting Measures Of Public Health Service Delivery: Results From A Delphi Survey For The Mprove Study, Glen Mays

Glen Mays

This database contains detailed, sortable results from the expert panel Delphi survey used to rate candidate measures of public health service delivery to be used in the Multi-Network Practice and Outcome Variation Examination Study (MPROVE), conducted by the Public Health Practice-Based Research Networks (PBRN) Program.


Selecting Measures Of Public Health Delivery: Results Of A Delphi Survey For The Mprove Study, Glen Mays Sep 2012

Selecting Measures Of Public Health Delivery: Results Of A Delphi Survey For The Mprove Study, Glen Mays

Glen Mays

The Multi-Network Practice and Outcomes Variation Examination Study (MPROVE) supports six participating public health practice-based research networks (PBRNs) in selecting a common set of service delivery measures for use in analyzing geographic variation in delivery across local communities. This report presents results from an expert panel Delphi survey used to rate candidate measures on a set of selection criteria, in order to select the final set of measures for study.


Inventory Of Public Health Service Delivery Measures: The Mprove Study, Glen Mays Sep 2012

Inventory Of Public Health Service Delivery Measures: The Mprove Study, Glen Mays

Glen Mays

This database contains a searchable inventory of measures of public health service delivery that have been recommended as candidates for use in the MPROVE study of geographic variation in local public health service delivery.


A Profile Of Kentucky Medicaid Mental Health Diagnoses, 2000‐2010, Michael T. Childress Sep 2012

A Profile Of Kentucky Medicaid Mental Health Diagnoses, 2000‐2010, Michael T. Childress

CBER Research Report

Good policy is dependent upon good data. This is especially true in health policy. Here we provide data on the number of Kentucky Medicaid beneficiaries who have received a mental or behavioral health diagnosis from 2000 to 2010. A Profile of Kentucky Medicaid Mental Health Diagnoses, 2000‐2010 provides information on the total number of individuals who have been diagnosed with a mental health disorder as well as a year‐by‐year count of the 15 broad categories used to classify these diagnoses. Presented for children (age 18 and younger) and adults (19 and older), these data are organized at ...


Children’S Consumption Of Fruits And Vegetables: Do School Environment And Policies Affect Choice At School And Away From School?, Ariun Ishdorj, Helen H. Jensen, Mary Kay Crepinsek Sep 2012

Children’S Consumption Of Fruits And Vegetables: Do School Environment And Policies Affect Choice At School And Away From School?, Ariun Ishdorj, Helen H. Jensen, Mary Kay Crepinsek

CARD Working Papers

School environment and policies affect children’s healthy eating choices both at and away from school. We estimate their effect on fruit and vegetable intakes and control for the endogenous decision to participate in the National School Lunch Program. School meal participants consume more total fruits and vegetables, with relatively more at school and less away from school compared to nonparticipants. The policies had little effect on participation itself. Policies to restrict high fat milks or desserts for school lunch and selling competitive foods are associated with greater fruit and/or vegetable intake at school; some policies affected consumption of ...


Technology Growth And Expenditure Growth In Health Care, Amitabh Chandra, Jonathan Skinner Sep 2012

Technology Growth And Expenditure Growth In Health Care, Amitabh Chandra, Jonathan Skinner

Open Dartmouth: Faculty Open Access Scholarship

In the United States, health care technology has contributed to rising survival rates, yet health care spending relative to GDP has also grown more rapidly than in any other country. We develop a model of patient demand and supplier behavior to explain these parallel trends in technology growth and cost growth. We show that health care productivity depends on the heterogeneity of treatment effects across patients, the shape of the health production function, and the cost structure of procedures such as MRIs with high fixed costs and low marginal costs. The model implies a typology of medical technology productivity: (I ...


Reinventing The 21st Century Public Health Workforce: Innovation, Evaluation & Practice-Based Research, Glen P. Mays Aug 2012

Reinventing The 21st Century Public Health Workforce: Innovation, Evaluation & Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Compelling opportunities exist for incorporating practice-based research to into the design, implementation, and evaluation of public health workforce training and development programs. Public Health Training Centers (PHTCs) can collaborate with practice-based research networks (PBRNs) to discover and disseminate evidence-based strategies for workforce development.


Reinventing The 21st Century Public Health Workforce: Directions From Practice-Based Research, Glen P. Mays Aug 2012

Reinventing The 21st Century Public Health Workforce: Directions From Practice-Based Research, Glen P. Mays

Glen Mays

Compelling opportunities exist for incorporating practice-based research to into the design, implementation, and evaluation of public health workforce training and development programs. Public Health Training Centers (PHTCs) can collaborate with practice-based research networks (PBRNs) to discover and disseminate evidence-based strategies for workforce development.


Valuing Improvements To Coastal Waters Using Choice Experiments: An Application To Revisions Of The Eu Bathing Waters Directive, Stephen Hynes, Dugald Tinch, Nick Hanley Aug 2012

Valuing Improvements To Coastal Waters Using Choice Experiments: An Application To Revisions Of The Eu Bathing Waters Directive, Stephen Hynes, Dugald Tinch, Nick Hanley

Working Papers

Planned changes to the European Union’s Bathing Waters Directive (2006/7 EC) will force member states to produce improvements in a number of parameters of coastal water quality. This study uses the choice experiment method to estimate the economic benefits attached to such improvements, based on a sample of recreationalists on beaches in Ireland. The analysis indicates that improvements in all of the bathing water related attributes studied result in positive willingness to pay, and also show evidence of scope effects. Using random parameters and latent class modelling techniques, potential heterogeneity in preferences is then investigated and shown to ...