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Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana 2017 University of Calgary

Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana

Patient Experience Journal

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed ...


A Trip To Healthcare, david e. matz 2017 UMass/Boston

A Trip To Healthcare, David E. Matz

Patient Experience Journal

This narrative shares how my experience with two colonoscopies and three surgeries in one year taught me that I am not so good at engaging in treatment decisions. I thought I was. This essay sets out where I made my mistakes, why I believe I made those mistakes, and how the hospitals, intentionally or not, made good decision-making harder. I offer two suggestions for enhancing the role of the patient in decision-making including 1) Every doctor in a diagnostic-decision-making interview should use the sentence “You have some choices here.” The doctor will have preferences, of course, but the patient needs ...


The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave deBronkart 2017 Chair Emeritus, Society for Participatory Medicine

The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave Debronkart

Patient Experience Journal

This essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we ...


Pushing The Boundaries Of Patient Experience, Jason A. Wolf PhD 2017 The Beryl Institute / Patient Experience Journal

Pushing The Boundaries Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

This special issue is designed to push the boundaries of patient experience a little farther. Beyond just examples of applying the critical principles of patient and family centered care or even practices of patient engagement, we have been pushed to move further down the perspective of partnership, to the era of “doing with” in which healthcare now finds itself. The idea of involvement as the descriptor selected to frame this issue, was due to its broad and representative nature. It reflects all the words on involving patients mentioned above, but gets further along to participation and ownership (or activation as ...


Reflecting Back On The Ebola Outbreak And The Future Of Bioterrorism, Christian Pedersen 2017 Pepperdine University

Reflecting Back On The Ebola Outbreak And The Future Of Bioterrorism, Christian Pedersen

Pepperdine Policy Review

In the wake of the 2014 Ebola outbreak, policy makers have focused on the public health components which led to the outbreak, the efforts to control it, and mitigate the impact of the outbreak. Some of the most enlightening aspects of the outbreak, pertain to National Security. The crisis demonstrated some crucial challenges the United States would have to plan for to effectively respond to a bioterrorist attack.


Supporting And Retaining Village Health Teams: An Assessment Of A Community Health Worker Program In Two Ugandan Districts., Daniel C Mays, Edward J O'Neil, Edison A Mworozi, Benjamin J Lough, Zachary J Tabb, Ashlyn E Whitlock, Edward M Mutimba, Zohray M Talib 2017 George Washington University

Supporting And Retaining Village Health Teams: An Assessment Of A Community Health Worker Program In Two Ugandan Districts., Daniel C Mays, Edward J O'Neil, Edison A Mworozi, Benjamin J Lough, Zachary J Tabb, Ashlyn E Whitlock, Edward M Mutimba, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Uganda’s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts ...


Exploring The Contributions Of Local Health Departments In Land Use And Transportation Policy: Implications For Cross-Sector Collaboration, Meera Sreedhara, Karin V. Goins, Semra Aytur, Katie Heinrich, Jay Maddock, Stephenie C. Lemon 2017 University of Massachusetts Medical School

Exploring The Contributions Of Local Health Departments In Land Use And Transportation Policy: Implications For Cross-Sector Collaboration, Meera Sreedhara, Karin V. Goins, Semra Aytur, Katie Heinrich, Jay Maddock, Stephenie C. Lemon

Stephenie C. Lemon

Introduction: Transportation and land use policies can impact physical activity. Local health departments (LHDs) are encouraged to participate in land use and transportation policy processes, which are outside their traditional expertise. Cross-sector collaborations are needed, yet stakeholders’ perceptions of LHD involvement are not well-understood. This paper explores (1) the perceived value of LHD participation in transportation and land use decision-making and (2) potential contributions of LHDs to these processes among relevant stakeholders.

Methods: Qualitative data were analysed from 49 semi-structured interviews conducted in 2015 and 2016. Participants were professionals representing land use planning (n=13), transportation/public works (n=11 ...


Determination Of Massachusetts’ Respite Policies And The Potential Impact Of Unpaid Family Care Giver Support On Home And Community Based Services, Leanne Winchester, Kate Russell, Kelly Love 2017 University of Massachusetts Medical School

Determination Of Massachusetts’ Respite Policies And The Potential Impact Of Unpaid Family Care Giver Support On Home And Community Based Services, Leanne Winchester, Kate Russell, Kelly Love

Commonwealth Medicine Publications

Direct care workforce shortages, increasing health care costs, and limited access to services force many families to make life-changing decisions to care for family members with long term disabilities or who are chronically ill at home. For this project, the authors conducted an environmental scan of current policies and programs for state and federally funded respite services across Massachusetts’ state agencies.

The results of this project demonstrate the variability in Massachusetts’ state policies and program practices in four primary areas:

  • The types of respite services offered by state agencies

  • The agencies definition of respite services

  • Variability in the ability of ...


The Effects Of Insurance Status On Pediatric Traumatic Brain Injury Outcomes: A Literature Review, Anthony Fabio, Austin Murray, Michelle Mellers, Stephen Wisniewski, Michael Bell 2017 University of Pittsburgh

The Effects Of Insurance Status On Pediatric Traumatic Brain Injury Outcomes: A Literature Review, Anthony Fabio, Austin Murray, Michelle Mellers, Stephen Wisniewski, Michael Bell

Journal of Health Disparities Research and Practice

Objective: To review the literature that describes the effects of insurance status on traumatic brain injury (TBI) outcomes among pediatric patients to understand how policies related to access to health insurance changes TBI outcomes. Method: This review was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA). A search of OVID Medline was conducted in May of 2016 for all years for peer-reviewed articles that included keywords related to “brain injuries” and “insurance status”. Articles were included if authors conducted a separate analysis of children aged 0 to 18. Articles were excluded if the TBI was the ...


Utilizing Title Vi As A Means To Eradicate Health Discrimination, Adrian D. Samuels, Mariah L. Cole 2017 Meharry Medical College

Utilizing Title Vi As A Means To Eradicate Health Discrimination, Adrian D. Samuels, Mariah L. Cole

Journal of Health Disparities Research and Practice

Health disparities among people of color are persistent and detrimental to the overall wellness of these groups. Discrimination in the provision of health care services is one of the primary causes of health disparities. Title VI of the Civil Rights Act of 1964’s availability as a tool to prevent discrimination and, in turn, disparities among these groups is underdocumented. The legislative intent of Title VI and the historical context of the law have been helpful in its use outside of the health care arena to prevent discrimination. This sheds light on the ways that the law can influence the ...


Income, Life Expectancy & The Strength Of Public Health Activities In American Communities, Glen P. Mays 2017 University of Kentucky

Income, Life Expectancy & The Strength Of Public Health Activities In American Communities, Glen P. Mays

Glen Mays

Objectives: Landmark research by Raj Chetty and colleagues finds wide geographic and intertemporal variation in the relationship between income and life expectancy in the U.S., using 1.4 billion administrative tax records from the IRS linked to nearly 7 million federal death records. Many questions remain about the underlying causes of these findings and their implications for policy.  This study links Chetty’s income and life expectancy data with the 1998-2014 National Longitudinal Survey of Public Health Systems to examine whether the existence and strength of multi-sector public health activities influence income-related disparities in life expectancy over time. 
 
Study ...


State Differences In The Application Of Medical Frailty Under The Affordable Care Act: 2017 Update, Peter Mosbach, Sherry J. Campanelli 2017 University of Massachusetts Medical School

State Differences In The Application Of Medical Frailty Under The Affordable Care Act: 2017 Update, Peter Mosbach, Sherry J. Campanelli

Commonwealth Medicine Publications

This poster details the effects of Medicaid coverage expansion since the Affordable Care Act began the inclusion of childless adults below the poverty level. This change has created a divide in how different states handle Medicaid coverage and this study examines how states undergoing Medicaid expansion differ in their treatment of individuals who may need the extra benefits offered by traditional Medicaid.

Researchers studied 14 different states and found substantial differences in how each state assessed eligibility for Medicaid coverage. In states like Massachusetts, individuals who were applying for disability-based Medicaid could self-declare that they had special medical needs, while ...


The First Special Issue Of Dignity, Donna M. Hughes 2017 University of Rhode Island

The First Special Issue Of Dignity, Donna M. Hughes

Dignity: A Journal on Sexual Exploitation and Violence

No abstract provided.


Knowledge Of Health Insurance Concepts And The Affordable Care Act Among Rural Residents, Erika Ziller PhD, Jennifer Lenardson MHS, Amanda Burgess MPPM 2017 University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center

Knowledge Of Health Insurance Concepts And The Affordable Care Act Among Rural Residents, Erika Ziller Phd, Jennifer Lenardson Mhs, Amanda Burgess Mppm

Access / Insurance

Health insurance literacy is central to identifying eligibility for coverage and subsidies, choosing a plan, and using optimal healthcare services under the Affordable Care Act (ACA) or other insurance reform initiatives. To fully benefit from policy efforts to improve health insurance access, rural residents must have the ability to select the plan that best meets their healthcare needs. However, a higher proportion of rural residents possess characteristics that may put them at risk of lower health insurance literacy, including lower incomes and educational attainment, less experience with private insurance, and historically higher uninsured rates. Using Health Reform Monitoring Survey data ...


Obesity Policy Stringency Over Time: A Four State Policy Design, Luisa M. Lucero 2017 Old Dominion University

Obesity Policy Stringency Over Time: A Four State Policy Design, Luisa M. Lucero

Public Service Theses & Dissertations

Over the past several decades obesity rates in the United States have increased exponentially, reaching epidemic proportions and placing heavy financial and health-related burdens on states. States could reduce their obesity-related spending by billions of dollars, however, if they reduced their obesity prevalence by five percent by 2030, which would reduce medical costs, loss of productivity, and loss of life. Despite the incentive to improve obesity rates, not all states are taking advantage of obesity-related policy as a means to combat obesity. Using a multiple case study design and policy design as the theoretical foundation, this study explores whether or ...


Pharmaceutical Federalism, Patricia J. Zettler 2017 Georgia State University College of Law

Pharmaceutical Federalism, Patricia J. Zettler

Faculty Publications By Year

There is growing interest in states regulating pharmaceuticals in ways that challenge the U.S. Food and Drug Administration’s (FDA) federal oversight. For example, in 2013 Maine enacted a law to permit the importation of unapproved drugs, reflecting concerns that federal requirements are too restrictive, while in 2014 Massachusetts banned an FDA-approved painkiller, reflecting concerns that federal requirements are too lax. This Article provides an account of this recent state interest in regulating drugs and considers its consequences. It argues that these state regulatory efforts, and the nascent litigation about them, demonstrate that the preemptive reach of the FDA ...


Use Of Prostate-Specific Antigen Testing In Medicare Beneficiaries: Association With Previous Evaluation, G S. Cooper, T D. Kou, M D. Schluchter, A Dor, S M. Koroukian, S P. Kim 2017 George Washington University

Use Of Prostate-Specific Antigen Testing In Medicare Beneficiaries: Association With Previous Evaluation, G S. Cooper, T D. Kou, M D. Schluchter, A Dor, S M. Koroukian, S P. Kim

Health Policy and Management Faculty Publications

Objective: Determine uptake of prostate-specific antigen (PSA) testing in Medicare beneficiaries according to previous receipt of PSA testing. Methods: A 5% random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims. We measured the annualized frequency of PSA screening among men due for PSA testing, stratified by PSA testing use in the previous 2 years, and clustered by ordering provider. Results: Throughout the study period, PSA testing use was consistently higher for men with previous screening than for men without previous screening. For men without previous screening, there ...


Public Health System Capital And Its Health & Economic Returns, Glen P. Mays 2017 University of Kentucky

Public Health System Capital And Its Health & Economic Returns, Glen P. Mays

Glen Mays

This session summarizes emerging research on the health and economic value of multi-sector networks that support public health improvement strategies.


An Ethical Evaluation Of The Modern Pharmaceutical Industry, Kaitlyn Drennan 2017 Abilene Christian University

An Ethical Evaluation Of The Modern Pharmaceutical Industry, Kaitlyn Drennan

Dialogue & Nexus

Lack of transparency, wrongdoings, and unlawful promotion characterize the healthcare industry; these are especially prevalent within the pharmaceutical industry. Consequently, an investigation into the evidence of the corruption and the ethical infringement is needed. In this paper, I will evaluate the pharmaceutical industry’s adherence to the three major branches of ethics. The ever-increasing prices of pharmaceutical products, especially medications used for the combating of anaphylaxis and cancer, coupled with the compensatory-based medication promotion and research points to a major crisis in the realm of social justice. These examples, among many other current issues, lead to difficulties in individuals receiving ...


Multi-Sector Population Health Activities Reduce Income-Related Disparities In Life Expectancy, Glen P. Mays 2017 University of Kentucky

Multi-Sector Population Health Activities Reduce Income-Related Disparities In Life Expectancy, Glen P. Mays

Glen Mays

Research Objective: Landmark research by Raj Chetty and colleagues finds wide geographic and intertemporal variation in the relationship between income and life expectancy in the U.S., using 1.4 billion administrative tax records from the IRS linked to nearly 7 million federal death records. Many questions remain about the underlying causes of these findings and their implications for policy.  This study links Chetty’s income and life expectancy data with the 1998-2014 National Longitudinal Survey of Public Health Systems to examine whether the existence and strength of multi-sector population health improvement activities influence income-related disparities in life expectancy over ...


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