Medicine and Health Sciences Commons^™

Library Impact Statement For Health Services Program

Library Impact Statements

Library Impact Statement submitted in response to new program proposal for Health Services. Additional resources were required to support this new program. Responding faculty member: Joanna M. Burkhardt, CMO. Requesting faculty member: Deb Riebe

What's Happening: October, 2010, Maine Medical Center

What's Happening

No abstract provided.

The Primary Care Safety Net: Strained, Transitioning, Critical, Jessamyn Taylor

National Health Policy Forum

This background paper examines the primary care safety net. It describes key primary care safety net providers, including federally qualified health centers, free clinics, local health departments, and safety net hospital outpatient departments and clinics, among others. The paper also explores the changing role of the primary care safety net in a post–health reform marketplace.

High Hopes: Public Health Approaches To Reducing The Need For Health Care, Michele J. Orza

National Health Policy Forum

Driven in part by a desire to contain health care costs, policymakers are looking beyond medical care for opportunities to reduce the need for expensive services. This paper briefly reviews current public health concepts and strategies for improving health that emphasize nonmedical factors such as behavior, socioeconomic status, and environment. It also provides examples of how these concepts and strategies undergird many of the public health provisions of the Patient Protection and Affordable Care Act, other legislation, and several programs and initiatives. These concepts include prevention, health in all policies, global health, the One Health Initiative, and climate change and …

Renewing Health Services Management Research: Redrawing The Citizen-Client In Irish Health Care Policy, Vivienne Byers

Conference Papers

Ireland has a history of health policy which is not explicit as to its aims and objectives. In light of this fact, this paper examines the position and direction of the Irish Health Services, five years on from the advent of the setting up of the Health Services Executive (HSE) and the restructuring of the health services. The Irish health system policy is guided by the Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client, and also by the Primary Care Strategy (2001:7); in that there should be …

What's Happening: September, 2010, Maine Medical Center

What's Happening

No abstract provided.

Governmental Public Health: An Overview Of State And Local Public Health Agencies, Eileen Salinsky

National Health Policy Forum

The Patient Protection and Affordable Care Act significantly expands federal support for community prevention and public health. This paper describes the governmental public health infrastructure at both the state and local level in terms of organizational structure, activities, financing, workforce, partnerships, and performance improvement efforts.

What's Happening: August, 2010, Maine Medical Center

What's Happening

No abstract provided.

Medicare Physician Fees: The Data Behind The Numbers, Laura A. Dummit

National Health Policy Forum

Medicare’s physician fee schedule distributes nearly $60 billion annually and is a critical determinant of individual physicians’ incomes, beneficiaries' access to health care services, and Medicare spending, as well as the basis for physician fees used by many private payers. The Centers for Medicare & Medicaid Services (CMS) relies on data derived from expert judgment and other sources to update the fee schedule. Although CMS’s methods and data for maintaining the fee schedule have improved over the years, concerns remain about medical specialty society involvement and the lack of an effective ”counterweight” to vested interests in establishing and updating the …

Tapping The Potential Of The Health Care Workforce: Scope-Of-Practice And Payment Policies For Advanced Practice Nurses And Physician Assistants, Robert Cunningham

National Health Policy Forum

Expanding coverage and increasing delivery of team-based care are likely to entail a growing role in the
health system for advanced practice nurses (APNs), physician assistants (PAs), and other nonphysician clinicians. These professions have already grown rapidly and have increased access to primary and specialty care, especially in rural and other underserved areas. This background paper provides an overview of the role of APNs and PAs. It reviews the primary features of the training and credentialing of these health professions, including the impact of public policies and market forces on their growth and deployment. It describes variations in state scope-of-practice …

The Ethical Balancing Act Of Hospice Care, Paul D. Longenecker

Health and Sport Sciences Faculty Scholarship

In providing hospice care, clinicians are confronted with ethical challenges on a daily basis involving their patients and families, their personal values and beliefs, and organizational practices. Being able to objectively understand these ethical challenges and having a plan of action to address is essential in effectively fulfilling the role of being a hospice professional.

What's Happening: July, 2010, Maine Medical Center

What's Happening

No abstract provided.

Keeping Health Insurance After A Job Loss: Cobra Continuation Coverage And Subsidies, Kathryn Linehan

National Health Policy Forum

Many Americans under 65 have health insurance through an employer. Beginning in 1985, a federal law known as COBRA required that eligible workers and their dependents have the option to continue employer-based group health coverage when employment is terminated. Because premiums for COBRA coverage can be very expensive, the 111th Congress included provisions in the American Recovery and Reinvestment Act of 2009 (and subsequent legislation) to temporarily subsidize premiums for those who have lost their jobs since September 2008. This issue brief outlines the eligibility rules for COBRA as well as the current COBRA subsidies. It also discusses the possible …

Health Care Shortage Designations: Hpsa, Mua, And Tbd, Eileen Salinsky

National Health Policy Forum

A wide variety of federal programs designed to improve access to health care services rely on specific criteria to designate areas and populations eligible for funding and other types of aid. Two related yet distinct designations, the Health Professional Shortage Area (HPSA) and the Medically Underserved Area (MUA), are most commonly used to identify underserved people or places. This background paper reviews the methodologies currently utilized in these designations, identifies the federal programs that use these designations to allocate resources, describes proposals that have been advanced to consolidate and improve these designations, and discusses key issues and challenges for future …

Heath Care Spending: Why Is Miami An Outlier?, Laura A. Dummit, Mary Ellen Stahlman

National Health Policy Forum

The National Health Policy Forum’s site visit to Miami focused on the complex factors that drive health care spending and is the latest in a series on the dynamics of health care markets. Miami has long been recognized as having among the highest Medicare per capita spending in the country, along with high rates of uninsured, strong managed care presence, and a history of health care fraud. This colorful health care market brings into stark relief many of the reasons for high and growing health care spending across the country. It also highlights several issues involved in building and maintaining …

What's Happening: June, 2010, Maine Medical Center

What's Happening

No abstract provided.

Physician Assessment: Measuring Competence And Performance, Lisa Sprague

National Health Policy Forum

No abstract provided.

The State Of The University Of Connecticut Health Center, Ankeet S. Bhatt

Honors Scholar Theses

Academic medical centers represent the integration of education, namely schools of medicine and dental medicine, research, often through a biomedical sciences graduate program, and a clinical experience, often supplied with an onsite hospital. These medical centers involve an intricate mix of individuals and personalities, making their operation a difficult and sometimes daunting task. The University of Connecticut Health Center (UCHC) financial struggles have created a new opportunity, an affiliation with Hartford Healthcare, which will equip the UCHC with a major tertiary care University Hospital. This thesis intends to provide an analysis of the challenges and potential benefits of such a …

Hospital Performance Evaluation In Uganda: A Super-Efficiency Data Envelope Analysis Model, Bruno Yawe

Zambia Social Science Journal

Standard Data Envelope Analysis models result in a large fraction of the observations becoming 100 percent efficient. The article measures the technical efficiency of 25 district referral hospitals from three regions of Uganda over the 1999-2003 period. It applies a super-efficiency Data Envelopment Analysis model. The application of a super-efficiency model was occasioned by the failure of standard data envelopment analysis models to rank the efficient set of hospitals which attain an efficiency score of unity. The results of the standard data envelopment analysis models indicate the existence of different degrees of technical and scale inefficiency in Uganda’s district referral …

What's Happening: May, 2010, Maine Medical Center

What's Happening

No abstract provided.

Institutional Policy Changes Aimed At Addressing Obesity Among Mental Health Clients, Linda L. Knol, Kelly Pritchett, Jeri Dunkin

All Faculty Scholarship for the College of the Sciences

Background
People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services.

Context
This intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and …

Information And Incentives: Improving The Health Of New York City's Low-Income Population, Kathryn Linehan, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to New York City (NYC) in April 2010 to explore health care delivery for Medicaid beneficiaries and the uninsured in New York City’s hospital-dominated market. New York offers real-time examples of government policy and provider initiatives in health information technology (IT) and quality improvement being played out on a large, complex, and dynamic stage with multiple stakeholders. Site visit participants heard from providers and others who discussed efforts to improve the quality of care for low-income New Yorkers through a variety of methods, such as the adoption and use of electronic …

Factors Related To Potentially Preventable Readmissions Within New York's Medicare Patient Population, Mariela Salazar

MPA Capstone Projects 2006 - 2015

Hospitalizations are the most expensive type of care within the healthcare system. Yet many patients find themselves frequently returning to the hospital, particularly those in Medicare. Hospital readmission rates for Medicare patient's range between 18 to 20 percent higher than other private insured patients. In an effort to reduce spending within Medicare, federal reimbursements will decrease to penalize hospitals performing below national benchmarks. As an indicator of quality of care, readmission rates may identify areas of weakness within the healthcare continuum, and may occur as a result of a combination of different factors. Some of these factors include but are …

Patient Flows To Improve Hospital Performance, Jacquelyn Parr

Honors Projects in Management

This is a case study focused on Backus Hospital in Norwich, Connecticut. The purpose of this report is to discuss ways for Backus Hospital to improve patient flows, which will increase patient satisfaction and safety, increase revenue, and decrease costs. The focus of the research is how the kaizen blitz and A3 methodologies can be used to develop ways to improve patient flow processes. Literature reviews on flow, process improvement, and innovation strategies, both within and outside of the healthcare industry were conducted. The hospital is dedicated to process improvement, innovation and quality improvement, so methodologies based on the Toyota …

What's Happening: April, 2010, Maine Medical Center

What's Happening

No abstract provided.

Potential Benefits And Perceived Need For Health Promoting Hospitals In Pakistan: A Healthcare Stakeholder's Perspective, Asif Raza Khowaja, Rozina Mistry, Ajmal Agha, Rozina Karmaliani

Community Health Sciences

OBJECTIVES: To explore perceptions of healthcare stakeholders' about health promoting hospitals, potential benefits and need in Pakistan.METHODOLOGY: A qualitative exploratory study was conducted between July-August 2007. The data was collected through key-informant (KI) interviews and focus group discussions (FGD) with purposively selected hospital administrators, healthcare providers, health policy makers, and UN-donor agency representatives. The thematic analysis was done using QSR NVivo 2.0; and nodes representing themes were generated.RESULTS: The study participants perceived health promotion, a concept synonymous to health education. Those participants with public health background were better able to relate their perceptions to a more holistic view of health …

The State Health Insurance Assistance Program (Ship), Carol O'Shaughnessy

National Health Policy Forum

The State Health Insurance Assistance Program (SHIP), created by section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 and administered by the Centers for Medicare & Medicaid Services (CMS), supports grants to states and jurisdictions to provide information, counseling, and assistance to Medicare beneficiaries and their families on Medicare and other health insurance questions. This publication describes the program and presents its funding history.

Oral Health Checkup: Progress In Tough Fiscal Times?, Cynthia Shirk

National Health Policy Forum

Almost ten years after the surgeon general’s report designating dental disease as the “silent epidemic,” the nation continues to struggle with adequate access to and utilization of dental services. This is particularly true for low-income individuals, who experience more than twice the amount of untreated dental disease as their higher-income peers. This issue brief reviews sources of dental coverage for low-income children and adults and the challenges these programs face. It highlights some examples of state Medicaid initiatives to improve access and utilization for children and the progress of these initiatives. Finally, it examines the potential effects of the economy …

Is Uncompensated Care Affecting Quality Assurance Of Rural Hospitals?, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Healthcare disparities in rural areas remain significant in the U.S. healthcare industry. Uncompensated care makes healthcare disparities in rural areas worse and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. As many rural residents experience difficulty accessing high quality care and the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality care barriers and opportunities, suggested strategies to strengthen the position of rural hospitals in response to uncompensated …

Electronic Medical Records: Is It Working In Long Term Health Care?, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse

Management Faculty Research

Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …