Social and Behavioral Sciences Commons^™

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

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

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

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

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).

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

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

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.

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

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 costs.

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 $63.84 …

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 availability of 20 …

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 availability of 20 …

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, …

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 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.

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 the state, regional, …

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

Dartmouth 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

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

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

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 be present …

Patterns Of Interaction In Public Health Pbrns: Insights From Network Analysis, Rachel Hogg, Glen P. Mays

Glen Mays

This report presents data from a network analysis survey conducted with public health practice-based research networks (PBRNs) to examine patterns of interaction among researchers and public health practitioners who participate in the networks. These data provide a baseline for tracking the types and frequencies of interaction that occur within networks, and reveal opportunities for promoting more productive patterns of engagement in applied public health research. Over time, these types of data can reveal how and under what circumstances PBRNs facilitate the production and application of research about public health services and delivery systems. The analysis includes data on more than …

Adhd Medication: Wide Variation Across Kentucky Raises Questions, Michael T. Childress

Issue Brief on Topics Affecting Kentucky’s Economy

No abstract provided.

Analgesic Narcotics: Effects Beyond Pain Relief, Michael T. Childress

Issue Brief on Topics Affecting Kentucky’s Economy

No abstract provided.

Antipsychotics: Broadened Use Brings Concerns, Michael T. Childress

Issue Brief on Topics Affecting Kentucky’s Economy

No abstract provided.

Kentucky Medicaid Pharmaceutical Utilization Guide, 2000‐2010, Michael T. Childress

CBER Research Report

From the preface:

Understanding Medicaid pharmaceutical utilization in Kentucky is important: over $6.6 billion was expended in the state from 2000 to 2010 on outpatient medication; it has the potential to fundamentally transform the health and well‐being individuals, and by extension wider communities; and there is a continuing trend in the nonmedical use (and abuse) of prescription drugs, exacting a heavy toll on individuals, their families, and the wider community. The Kentucky Medicaid Pharmaceutical Utilization Guide, 2000‐2010 provides information on the 50 most utilized pharmaceuticals in Kentucky with respect to prescriptions, costs, and total grams—and presents this information for children …

Socio-Economic Determinants Of Out-Of-Pocket Payments On Healthcare In Pakistan, Ashar Muhammad Malik, Syed Iqbal Azam Shah

Community Health Sciences

BACKGROUND:

Out-of-pocket (OOP) payment on healthcare is dominant mode of financing in developing countries. In Pakistan it is 67% of total expenditure on healthcare. Analysis of determinants of OOP health expenditure is a key aspect of equity in healthcare financing. It helps to formulate an effective health policy. Evidence on OOP in Pakistan is sparse. This paper attempts to fill this research gap.

METHODS:

We estimated determinants of OOP payments on healthcare in Pakistan. We used data sets of Pakistan Household Integrated Economic Survey (HIES) and Pakistan Standard of Living Measurement (PSLM) Survey for the year 2004-05. We developed a …

Making The Case For Public Health: Estimating Roi And Value, Glen P. Mays

Health Management and Policy Presentations

This presentation describes recent progress and new directions for estimating the value of public health strategies and infrastructure.

Making The Case For Public Health: Estimating Roi And Value, Glen P. Mays

Glen Mays

This presentation describes recent prograss and new directions for estimating the value of public health strategies and infrastructure.

Preliminary Economic Evaluation Of Brentuximab Vedotin In Relapsed And Refractory Hodgkin Lymphoma: An "Early Look" Model Based On Phase Ii Results, Vusal Babashov

Electronic Thesis and Dissertation Repository

We conducted a cost-effectiveness analysis of brentuximab vedotin for the treatment of relapsed and refractory Hodgkin Lymphoma (HL) from health care system perspective in Canada. We developed a Markov decision analytical model to simulate lifetime costs and benefits and parameterized the model using brentuximab phase II clinical trial and cd-link data which is a linked datasets of cancer registry with administrative databases of Ontario, Canada. In the base case scenario, brentuximab treatment led to an increase of 0.352 Quality Adjusted Life Years (QALYs) per person and $108,500 per person, which resulted in incremental cost effectiveness ratio (ICER) of $308,532 per …