Health Policy Commons^™

Pengaruh Implementasi Quality Management System Iso 9001:2000 Terhadap Kinerja Rumah Sakit Duren Sawit, Dian Ekowati

Kesmas

Upaya organisasi meningkatkan produksi jasa pelayanan kesehatan melalui implementasi Quality Management System ISO 9001:2000 secara sistematis, menyeluruh dan sinambung seharusnya mampu menampilkan kinerja yang efektif dan efisien. Penelitian ini bertujuan untuk memperoleh gambaran mengenai peran implementasi QMS ISO 9001:2000 terhadap kinerja Rumah Sakit Duren Sawit yang akan diukur melalui pendekatan kerangka strategis Balanced Scorecard serta identifikasi kesenjangan dalam organisasi untuk menganalisis kesiapan implementasi manajemen strategis Balanced Scorecard di Rumah Sakit Duren Sawit. Hasil penelitian menggambarkan bahwa melalui pemahaman dan implementasi yang QMS ISO 9001:2000 konsistensi, Rumah Sakit Duren Sawit mampu menghasilkan kinerja organisasi yang efektif dan efisien. serta berhasil menganalisis …

Perlindungan Hak Pasien Di Rs Kanker Dharmais Jakarta, Harvensica Gunnara

Kesmas

Banyaknya kasus “kelalaian atau kesalahan medis” dan pasien yang belum memperoleh haknya dalam pelayanan medis merupakan masalah yang sangat krusial dewasa ini Untuk mengatasi masalah tersebut telah ditetapkan berbagai kebijakan dibidang pelayanan medis dalam rangka memberikan perlindungan pada hak pasien yang antara lain adalah UU Kesehatan dan UU Praktik Kedokteran, dan agar tujuan kebijakan tersebut dapat dicapai perlu adanya peran aktif seluruh pihak. Namun, berbagai kebijakan pelayanan medis dalam rangka perlindungan hak pasien belum sepenuhnya mencapai tujuan yang diharapkan. Tujuan penelitian ini adalah menganalisis kebijakan pelayanan medis dalam rangka perlindungan hak pasien di Rumah Sakit Kanker Dharmais Jakarta. Penelitian ini …

Assessment Of Maine's Long-Term Care Needs Baseline Report: Demographics And Use Of Long Term Care Services In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Karen Mauney, Catherine Mcguire Bs, Louise Olsen, Jasper Ziller

Disability & Aging

In 2006, the Office of Elder Services requested the assistance of the Muskie School in developing an assessment of long term care service use in Maine. This report provides baseline information on the demographic characteristics, participant characteristics and service use trends for people accessing long term care services in this State.

For purposes of this report, we have excluded people with MR/DD. Long term care services do not include community support services for people with mental illness.

In this report, long term care services include:

• Nursing Facility Services
• Private Non-medical Institutions
• Consumer Directed Attendant Services
• Day Health Services
• Elder and …

Barriers To Medicare Hospice Utilization: A Qualitative Study Of Maine's Medicare Hospice Providers, Judith B. Tupper Dhed, Ches, Cpps

Disability & Aging

This report, prepared for the Maine Hospice Council and funded by the Carpenter Foundation, presents findings of a qualitative study of barriers to hospice utilization. This study includes the perspectives of all 26 Medicare certified hospice providers in Maine. Significant findings of the qualitative study include: A continuing need to educate the general public about hospice and the Medicare benefit. Maine health care providers have low referral rates to the hospice programs and often misunderstand the regulations and guidelines of the hospice benefit. The referral process to hospice programs is based on fragile systems of communication, fraught with potential miscues, …

Perceived Organizational Support And Ethical Work Climates As Predictors Of Turnover Intention Of Licensed Nurses In Skilled Nursing Facilities, Anna A. Filipova

Dissertations

The purpose of this study was twofold: (1) to replicate Victor and Cullen's (1987; 1988) studies to confirm whether ethical climates (ECs) arise in skilled nursing facilities (SNFs), and whether organizations and groups within organizations have identifiable ECs; and (2) to test a model that examines the effects of ECs and perceived organizational support (POS) on licensed nurses' turnover intention (TOI) through job satisfaction (JS) and organizational commitment (OC).

A cross-sectional survey design was implemented. Three hundred and fifty nine freestanding SNFs were selected in a midwestern state. While a total of 110 facilities (31%) agreed to participate, responses were …

Addressing Potential Conflicts Of Interest Arising From The Multiple Roles Of Colorado’S Community Centered Boards, Maureen Booth Mrp, Ma, Eileen Griffin Jd

Disability & Aging

This document summarizes the information we gathered, our analysis of potential conflicts of interest, and recommendations for addressing opportunities for improvement. The information we gathered is based on document review, input from stakeholders, and a review of practices in four other states.

Women Of Talent: Gender And Government Appointments In Massachusetts, 2002–2007, Carol Hardy-Fanta, Kacie Kelly

Publications from the Center for Women in Politics and Public Policy

Despite the high educational and occupational attainment—and considerable talent—of women in Massachusetts, the state ranks just 22nd in the nation on women's overall share of top executive, legislative, and judicial posts, compared to their share of the population. The goals of this study were to (1) calculate the percentage of women holding senior-level positions in state government at these four points in time; (2) analyze the distribution of appointments by type of position and executive office; (3) provide possible explanations for the status of women’s representation in these positions; and (4) offer recommendations that will serve to promote the appointment …

Analisis Manajemen Pengawasan Dan Pengendalian Penyalahgunaan Formalin Di Dinas Kesehatan Kabupaten Tangerang, Hendri Hartati

Kesmas

Banyak industri makanan Tangerang ditemukan menggunakan bahan pengawet formalin. Tujuan penelitian ini mengetahui peranan Dinas Kesehatan (Dinkes) Kabuppaten Tangerang mengawasi dan mengendalikan formalin pada makanan. Penelitian ini dilakukan pada Nopember 2006-Pebruari 2007. Dengan metode kualitatif wawancara mendalam dan penelusuran dokumen. Sumber data adalah Dinkes Kabupaten Tangerang dan Puskesmas terpilih. Para responden adalah Kepala Dinkes Kabid Yankes; Kasi Pengawasan makanan dan minuman; Staf pelaksana Dinkes dan Puskesmas. Hasil yang ditemukan meliputi pengawasan dan pengendalian formalin dilakukan oleh dinas kesehatan secara rutin sejak tahun 2004. Namun, program intensif ketika merebak issue kandungan formalin dalam makanan, tahun 2006. Masalah yang dihadapi: peraturan belum …

Low Health Literacy: Implications For National Health Policy, John A. Vernon, Antonio Trujillo, Sara J. Rosenbaum, Barbara Debuono

Health Policy and Management Faculty Publications

Securing appropriate healthcare hinges on having the necessary skills to read and fill out medical and health insurance forms, communicate with healthcare providers, and follow basic instructions and medical advice. At virtually every point along the healthcare services spectrum, the healthcare system behaves in a way that requires patients to read and understand important healthcare information. This information is dense, technical, and has jargon-filled language. Examples include completing health insurance applications, reading signs in hospitals and clinics about where to go and where to sign in, and following written and oral instructions in brochures and pamphlets, as well as prescription …

Barriers To Serving The Vulnerable: Thoughts Of A Former Public Official, Christine Ferguson

Health Policy and Management Faculty Publications

In an environment of limited resources, the question of who is deserving and undeserving of assistance becomes critical. Policymakers’ biases about whether a health condition is self-inflicted, as well as their perceptions about whether treatments are truly effective, play a major role—often unstated—in the allocation of resources.

Assumed Equity: Early Observations From The First Hospital Disparities Collaborative, Bruce Siegel, Jennifer K. Bretsch, Vickie Sears, Marsha Regenstein, Marcia J. Wilson

Health Policy and Management Faculty Publications

Disparities in healthcare represent a failure in the equity domain of quality. Although disparities have been well documented, little has been written about how hospitals might use improved data collection and quality improvement techniques to eliminate disparities. This article describes early findings from the planning phase of the first hospital-based disparities collaborative. The authors also discuss the changes in policy and practice that may speed hospitals in placing disparities and equity on their quality agendas.

An Assessment Of Legal Issues Raised In "High Performing" Health Plan Quality And Efficiency Tiering Arrangements: Can The Patient Be Saved?, Sara J. Rosenbaum, Sarah Kornblet, Phyllis Borzi

Health Policy and Management Faculty Publications

A legal analysis released by The George Washington University School of Public Health and Health Services and the Robert Wood Johnson Foundation affirms the legality under federal and state law of physician ranking systems used by health plan provider networks. This analysis examines seven types of possible legal allegations against physicians tiering, concluding how the approach is undertaken plays a significant role in determining legal backlash.

Sistem Manajemen Crash Program Campak Pasca Tsunami Di Dinas Kesehatan Kota Lhokseumawe, Ismiati Ismiati

Kesmas

Imunisasi campak adalah program prioritas dalam situasi darurat di pengungsian. Namun, sampai akhir masa tanggap darurat cakupan imunisasi campak di Kota Lhokseumawe tidak mencapai target. Penelitian ini bertujuan mendapatkan gambaran fungsi sistem manajemen crash program campak di Dinas Kesehatan Kota Lhokseumawe tahun 2005, mengidentifikasi hal-hal yang menyebabkan tidak tercapainya target imunisasi dan mengetahui umpan balik dalam pengembangan program imunisasi. Penelitian ini dilakukan dengan rancangan penelitian kualitatif untuk memahami latar belakang yang dialami subjek penelitian dalam melaksanakan fungsi manajemen crash program campak meliputi perencanaan sampai evaluasi serta rencana umpan balik berdasarkan hasil cakupan imunisasi. Pengumpulan data dengan cara wawancara mendalam dan …

Analisis Pembiayaan Kesehatan Bersumber Pemerintah Di Kabupaten Bogor, Nia Aryani Rahmaniawati

Kesmas

Pembiayaan kesehatan bidang kesehatan di Kabupaten Bogor yang diperoleh dari berbagai sumber dianggap besar, tetapi derajat kesehatan dari tahun ke tahun tidak beranjak banyak. Padahal pada era desentralisasi peningkatan tersebut seharusnya menyentuh pelayanan langsung kepada masyarakat. Tujuan penelitian ini adalah mengetahui sumber dana pemerintah, besar dana yang telah dianggarkan, realisasi alokasi anggaran kesehatan yang diberikan pemerintah. Penelitian dibatasi pada biaya kesehatan yang dikelola oleh Dinkes, Badan Rumah Sakit Daerah Cibinong dan Ciawi dengan menggunakan sumber data sekunder berbagai dokumen anggaran tahun 2003-2005. Ditemukan bahwa bidang kesehatan merupakan APBD Kabupaten, tetapi proporsi anggaran kesehatan tertinggi tahun 2005 (9,8%) lebih rendah dari …

Diabetes Treatments And Moral Hazard, Jonathan Klick, Thomas Stratmann

All Faculty Scholarship

In the face of rising rates of diabetes, many states have passed laws requiring health insurance plans to cover medical treatments for the disease. Although supporters of the mandates expect them to improve the health of diabetics, the mandates have the potential to generate a moral hazard to the extent that medical treatments might displace individual behavioral improvements. Another possibility is that the mandates do little to improve insurance coverage for most individuals, as previous research on benefit mandates has suggested that mandates often duplicate what plans already cover. To examine the effects of these mandates, we employ a triple-differences …

The Voting Rights Act And The Election Of Nonwhite Officials, Pei-Te Lien, Dianne M. Pinderhughes, Carol Hardy-Fanta, Christine M. Sierra

Publications from the Center for Women in Politics and Public Policy

Voting Rights Act (VRA) is one of the most important—if not the most important—public policies developed over the last half century to increase access to the U.S. political system for people of color. The VRA also provides an important context for understanding the ascension of nonwhite groups into the elected leadership of the nation (Browning, Marshall, and Tabb 1984; Davidson and Grofman 1994; Menifield 2001; Mc-Clain and Stewart 2002; Segura and Bowler 2005; Bositis 2006). This essay assesses the present-day significance of the VRA for the political representation of communities of color by examining the implications of majority-minority districts and …

Achieving Family Health Literacy: The Case For Insuring Children, Sara J. Rosenbaum, Peter Shin, Barbara Debuono

Health Policy and Management Faculty Publications

One aspect of the SCHIP reauthorization debate that has received more limited attention than it deserves is the relationship between children's health insurance coverage and family health literacy. That is, to what extent is children's health insurance associated with higher health literacy, and to what extent is reduced parental health literacy linked to lower rates of health insurance among children? This association is extremely important, since there is strong evidence of a link between health literacy and the appropriate use of health care. Evidence suggests that when previously uninsured children are covered by health insurance, parents at all income levels …

Tracer Study : Melacak Jejak Lulusan Fkm Ui (Hasil Study Kualitatif Tracer Sarjana Kesehatan Masyarakat Fkm Ui 2006), Ahmad Syafiq, Sandra Fikawati

Kesmas

Salah satu indikator penting keberhasilan pendidikan tinggi adalah sumbangsih lulusannya dalam masyarakat dan pembangunan. Tracer study dapat menyediakan informasi mengenai sumbangsih dan keterlibatan alumni di masyarakat termasuk dinamika di dunia kerja. Fakultas Kesehatan Masyarakat UI (FK-MUI) sudah melaksanakan tracer study kuantitatif pada tahun 2003 yang menginformasikan beberapa aspek terkait dengan lulusan dan keberadaannya di dunia kerja. Penelitian ini merupakan tracer study kualitatif untuk melengkapi gambaran yang diperoleh pada tracer study pertama tersebut dan mencoba menggali lebih dalam informasi mengenai pengalaman pembelajaran di FKMUI, pengalaman bekerja, dan kepuasan lulusan dan pengguna lulusan terhadap pendidikan di FKMUI. Wawancara mendalam dilakukan terhadap 24 …

Analisis Utilisasi Resep Antibiotik Pasien Rawat Jalan Tingkat Pertama (Rjtp) Di Puskesmas Tebet Jakarta Selatan, Tahun 2005, Nurlaili Isnaini

Kesmas

Kecenderungan peningkatan penggunaan antibiotika di Pelayanan Kesehatan Dasar merupakan penggunaaan obat yang tidak rasional dan akan menghambat penurunan angka morbiditas dan mortalitas penyakit. Pemberian antibiotika yang berlebihan akan meningkatkan resistensi bakteri dan meningkatkan pembiayaan obat. Tujuan penelitian ini adalah mengetahui gambaran utilisasi obat antibiotika Hasil penelitian menemukan bahwa persentase resep obat pasien RJTP yang berisi antibiotika 37,74 %. Proporsi terbesar pemanfaatan obat antibiotika pada pasien RJTP di Puskesmas Tebet tahun 2005 ditemukan pada kelompok usia dewasa (12-65 tahun) yaitu sebesar 56,5 %, pasien yang bayar sendiri yaitu sebesar 89,8 %, penyakit infeksi lain selain ISPA yaitu sebesar 61,6 % dan …

Kendala Pengawasan Melekat Bahan Habis Pakai Pasien Gakin (Unit Rawat Inap Rs Persahabatan Tahun 2006), Ernawaty Ernawaty

Kesmas

Pelaksanaan pengawasan atasan langsung (waskat) dalam penggunaan bahan habis pakai/obat dan pemberian obat untuk pasien gakin adalah sangat penting. Tujuan penelitian ini adalah mengidentifikasi berbagai komponen unit pengawasan yang lemah dan berbagai faktor yang berhubungan meliputi struktur organisasi, kebijaksanaan pelaksanaan berikut tindakan koreksi terhadap penyimpangan. Metode penelitian yang digunakan adalah metode kualitatif dengan menggunakan sumber data primer dan sekunder, yang meliputi pengamatan pasif, telaah dokumen dan wawancara mendalam terhadap berbagai informan yang terkait. Untuk menilai keabsahan data dilakukan kembali triangulasi sumber, member chek, diskusi dengan teman sejawat dan melakukan analisis kasus negatif. Hasil penelitian menemukan kendala dalam proses pelaksanaan pengawasan …

Session 1 - Rationalizing The Home Front: The Cold War, The Nevada Test Site, And Radiation Exposure, Leisl A. Carr

International Symposium on Technology and Society

Beginning in 1953, radiation exposure and its effects became a hotly contested issue between the government, members of communities surrounding the Nevada Test Site (NTS), and researchers within the national scientific community. The Atomic Energy Commission (AEC), concerned about maintaining a continental testing facility and aware that atomic testing would impact communities surrounding the NTS, sent representatives to areas potentially affected by fallout to instruct and reassure the affected public. How government officials perceived neighboring communities and how these communities perceived these representatives of the government often determined public responses to the atomic testing program. The story of radiation monitors …

Assessing The Effects Of Federal Pediatric Drug Safety Policies, Avi Dor, Taylor Burke, Ramona Whittington, Taylor Clark, Ruth Lopert, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This policy analysis examines the effectiveness of pediatric exclusivity, one of the policy approaches the federal government uses to promote drug safety for children. Federal policy in this area is highly complex, and provisions related to pediatric drug safety, including pediatric exclusivity, are set to expire in 2007. Following a policy overview, this analysis summarizes the impact of pediatric exclusivity and reports on the results of our effort to shed light on the economic value of pediatric exclusivity. The analysis concludes with a discussion of options for further promoting a safe environment for drug use in children.

Payments To Medicare Advantage Plans Exceed Fee-For-Service Costs: Options For Medicare Savings From 2008 Through 2012, Brian Biles, Emily Adrion

Health Policy and Management Faculty Publications

The Medicare Modernization Act of 2003 (MMA) and the Deficit Reduction Act (DRA) of 2005 include provision intended to increase the role of private health plans in Medicare. These provisions set Medicare Advantage plan payment rates at levels higher than average costs would be in tradition free-for-service Medicare in every county in the nation. The total amount of extra payments to Medicare Advantage plans resulting from these provisions is projected to total over $8 billion in 2008 and $70 billion over the five year period, 2008 to 2012.

This briefing paper outlines the specific MMA and DRA provisions that generate …

Parental Health Insurance Coverage As Child Health Policy: Evidence From The Literature, Sara J. Rosenbaum, Ramona Whittington

Health Policy and Management Faculty Publications

One of the policy questions expected to receive considerable attention during the State Children's Health Insurance Program (SCHIP) reauthorization process is whether — and if so, under what circumstances — to permit states to use SCHIP funds to cover parents. In 2006, the average Medicaid income eligibility level for coverage of working parents stood at 65% of the federal poverty level, and 15 states and the District of Columbia set income eligibility levels for this group at 100 percent of the federal poverty level or higher.1 In 2005, 8 states used some portion of their SCHIP allotment funding, in combination …

Maine State Employee Survey On Disability, Commission On Disability And Employment, Department Of Financial And Administrative Services Bureau Of Human Resources, Muskie School Of Public Service University Of Southern Maine

Disability & Aging

The Executive Order regarding Maine State Government as a Model Employer of people with disabilities was signed on February 24, 2006. The order included several action steps, including a survey of State employees to ascertain the prevalence of workers with disabilities in State employment.

Maine’s Bureau of Human Resources and the Commission on Disability and Employment were named to oversee this survey. The University of Southern Maine’s Muskie School of Public Service administered the survey and analyzed results. Each of these three organizations are members of an Executive Order Working Group designed to overall all action steps under the Executive …

A Trade-Off Proposal For Funding Long-Term Care, Yung-Ping Chen

Gerontology Institute Publications

Long-term care can be a depressing subject. Most of us tend not to think about it. However, we cannot long avoid it as the 76 million baby boomers begin reaching older ages in a few short years. According to projections, in 40 years, those aged 65 to 84 (numbering 31.6 million in 2005) will more than double, and those 85 plus (about 5.1 million in 2005), who are more at risk of dependency, will more than triple (U.S. Census Bureau, 2004 and 2006). Heavy reliance on Medicaid, already the second largest budget item in most states, would not appear viable. …

Medical Malpractice Reform And Physicians In High-Risk Specialties, Jonathan Klick, Thomas Stratmann

All Faculty Scholarship

If medical malpractice reform affects the supply of physicians, the effects will be concentrated in specialties facing high liability exposure. Many doctors are likely to be indifferent regarding reform, because their likelihood of being sued is low. This difference can be exploited to isolate the causal effect of medical malpractice reform on the supply of doctors in high-risk specialties, by using doctors in low-risk specialties as a contemporaneous within-state control group. Using this triple-differences design to control for unobserved effects that correlate with the passage of medical malpractice reform, we show that only caps on noneconomic damages have a statistically …

A Seat At The Table? Racial/Ethnic & Gender Diversity On Corporate, Hospital, Education, Cultural & State Boards, Carol Hardy-Fanta Phd, Donna Stewartson

Publications from the Center for Women in Politics and Public Policy

As part of its larger Diversity Initiative, the McCormack Graduate School of Policy Studies at UMass Boston has undertaken a number of projects. The first was a public opinion survey conducted around the time of the November 2006 elections. The report, Transformation and Taking Stock: A Summary of Selected Findings from the McCormack Graduate School Diversity Survey, included a comprehensive look at race relations in the Commonwealth at a time of significant transition—demographically and politically. This report was followed by A Benchmark Report on Diversity in State and Local Government, which focused on the percentage of positions filled …

Mandating Hpv Vaccination--Private Rights, Public Good, Alexandra M. Stewart

Health Policy and Management Informal Communications

New York State's regulations require health care workers who have direct contact with patients or who may expose patients to disease to be vaccinated against seasonal and H1N1 influenza. Courts must take into account constitutional guarantees of personal autonomy, freedom of contract, and freedom of religion when reviewing the current lawsuits. These rights, however, have been constrained when they conflict with government measures that are intended to protect the community's health and safety. Health care workers have a profound effect on patients' health. Although they have the same rights as all private citizens, it is likely that courts will continue …

Oversight Hearings On Science And Environmental Regulatory Decisions, David Michaels

Health Policy and Management Congressional Testimonies

No abstract provided.