Health and Medical Administration Commons^™

Sector-Switching In Transition Economies: A Case Study Of Kazakhstan's Health Care Sector, Dariga Chukmaitova

CGU Theses & Dissertations

The dissertation examines the economic and behavioral factors influencing 'sector-switching' in Kazakhstan's health care industry. Sector-switching involves doctors moving from the national to the private system, which is not well established, thereby raising questions about why the switch occurs. It addresses the question: why health care professionals in Kazakhstan switch from the public sector to similar jobs in the private or nonprofit sectors? This study addresses a key issue in public management (sector switching) and also offers insights into the dynamics of the transition from a centralized economy to a market economy. As such, its findings have `real-world' applications beyond …

The Incidence Of Hip Fracture Associated With Proton Pump Inhibitor (Ppi) And/Or H2 Receptor Antagonist (H2ra) Use In The Kentucky Medicaid Population, Timothy C. Umeh

MPA/MPP/MPFM Capstone Projects

No executive summary.

The Role Of Medical Training Background In Patient Satisfaction, Mariam Zia Qureshi

All Graduate Theses, Dissertations, and Other Capstone Projects

The number of international medical graduates (IMG) is increasing and their ability to satisfy patients has never been studied. The purpose of this study is to examine if there is a difference between the patient satisfaction scores of US medical graduates (USMGs) and IMGs. This is a retrospective study in which 2627 returned patient experience surveys of 55 physicians working in Medical Practice in South Western Mayo Health System were evaluated. These surveys were returned from August 2009 to August 2010. An independent t-test and t-inverse test was conducted with significance level of 0.05. The results of t-test lead to …

Public Sponsored Health Insurance To Improve Health Outcomes With Implications For Government Health Policy, Design, And Decision Making, Steven M. Wagner

Walden Dissertations and Doctoral Studies

This research sought to ascertain the extent to which providing public sponsored health insurance (PSHI) to previously uninsured Mexican-American Hispanics improves health outcomes among those requiring ongoing treatment to control diabetes. Prior research utilizing insurance access theory; access, equity, and health outcome interrelationship theory; health affordability theory; and financial and resource burden theory suggests the uninsured receive less care than the insured, with delayed treatment, leading to chronic conditions. This research tested each of those major theoretical constructs into a blended conceptual framework based on the notion that providing health insurance helps alleviate the disabling effects of diabetes among this …

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 …

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

Uncompensated Care And Quality Assurance Among Rural Hospitals, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Health care disparities in rural areas remain significant in the U.S. health care industry. Uncompensated care makes health care 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. Given that many rural residents experience difficulty accessing high quality care and given 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 and suggested strategies to strengthen the position of rural hospitals …

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

A Community Benefit Reporting Toolkit For Critical Access Hospitals, John A. Gale Ms, Melanie Race Ms

Rural Hospitals (Flex Program)

No abstract provided.

Revitalisation, Rigour And Relevance: The Citizen-Client And Planning In The Health Services., Vivienne Byers

Conference Papers

Whereas, in many OECD countries strategic planning in health care has been in evidence since the 1970s, in Ireland the emergence of strategic management processes in health care planning didn’t occur until the 1990s.

This paper reports on part of a comparative study of health services planning in Ireland and in Canada. How can the strategic management of the Irish health services in the form of service planning be implemented? The focus of this paper is the identification of two key stumbling blocks to success in this endeavour. These include the limitations of the control mechanism, the legislation, underpinning service …

Opportunities For Comparative Research In Public Health Pbrns : A Baseline Analysis Of Local Practice Settings, Glen P. Mays, Sharla A. Smith, Elaine B. Wootten, Sylvia J. Porchia

Health Management and Policy Presentations

This analysis describes the organizational and operational characteristics of local public health agencies participating in an initial cohort of five (5) public health PBRNs in the U.S. We examine variation in practice settings within and between PBRNs; compare practice settings to state and national norms; and identify opportunities for comparative research that can be conducted through PBRNs.

Over-Utilization Of Advanced Imaging In The Hospital Setting: An Educational Approach To Reduce Unnecessary Inpatient Studies, Guillermo Madero, J. Platnick, L. Voutsinas, R. Wetz, S. Buchbinder

Internal Medicine

By several measures, health care spending continues to rise, forcing businesses and families to cut back on operations and household expenses. In 2008, health care spending in the United States reached $2.4 trillion dollars, and is projected to reach $3.1 trillion in 2012.During the past decades, there has been a steady increase in the utilization of expensive inpatient imaging studies, with an overall increase in health care costs. In particular, advanced imaging includes CT, MRI and Nuclear Medicine, used for the diagnosis and management of hospitalized patients. The reasons for unnecessary imaging examinations include indirect financial benefit to physicians, medico-legal …

A Participant Model: Predictive Medical And Behavioral Factors Of Prostate Cancer Screening Attendees At Markey, Shana L. Steinbach

MPA/MPP/MPFM Capstone Projects

Problem Statement

The Prostate Cancer Screening Program at the Markey Cancer Center co-sponsors prostate cancer screenings with the Prostate Cancer Education Council. All participation, including African-American attendance, has decreased 38% from years 2006 to 2008 and program managers are seeking insight to improve program participation by acquiring knowledge of behavioral and medical characteristics that may influence screening attendance. Because of the higher incidence of prostate cancer in African-American men (ACS, 2008), a specific program goal is also to increase screening attendance for this minority population.

Research Strategy

Questions that assess participant behavior, personal, and family medical history are analyzed to …

Physician Recruitment At Highlands Regional Medical Center: What Works?, Sarabeth Blankenship

MPA/MPP/MPFM Capstone Projects

There is a physician shortage in eastern Kentucky because older physicians are retiring, and younger physicians are choosing to practice in more urban, affluent areas. Eastern Kentucky is plagued with persistent poverty and lacks cultural amenities. These facts put together myths regarding rural practice create a shortage.

My research consisted of interviewing twenty physicians currently practicing at Highlands Regional Medical Center in Prestonsburg, Kentucky. I created a survey instrument that asked questions of physicians regarding demographics characteristics, medical school attended, and what motivated them to practice at Highlands. I chose Highlands because I was able to get interviews scheduled with …

Employability After Substance Abuse Treatment In Kentucky: An Analysis Of The Kentucky Treatment Outcome Study, Steven Scrivner

MPA/MPP/MPFM Capstone Projects

Public funding of substance abuse treatment (SAT) in Kentucky dates back to the 1950s when legislators sought to curb the problem of alcoholism through legislative acts. The definition of substance abuse expanded through the years to include other substances such as cocaine, marijuana and opiates.

Employment after SAT is a critically important outcome for policymakers to consider when allocating funds because it assists in social re-integration, helps to prevent relapse and promotes economic self-sufficiency. Because of this, employment is an important factor to consider when assessing the impact SAT has on its clients (participants).

The Kentucky Alcohol and Other Drug …

Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs

Rural Hospitals (Flex Program)

Legislators and other policymakers will be continually challenged to balance the needs of hospitals for appropriate reimbursement and oversight with supporting their provision of important services to local communities.

Shea/Apic Guideline: Infection Prevention And Control In The Long-Term Care Facility, Philip W. Smith, Gail Bennett, Suzanne Bradley, Paul Drinka, Ebbing Lautenbach, James Marx, Lona Mody, Lindsay Nicolle, Kurt Stevenson

United States Department of Veterans Affairs: Publications

Long-term care facilities (LTCFs) may be defined as institutions that provide health care to people who are unable to manage independently in the community.¹ This care may be chronic care management or short-term rehabilitative services. The term nursing home is defined as a facility licensed with an organized professional staff and inpatient beds that provides continuous nursing and other services to patients who are not in the acute phase of an illness. There is considerable overlap between the 2 terms.

More than 1.5 million residents reside in United States (US) nursing homes. In recent years, the acuity of illness …

The Relationship Of Patient Falls To Prevention Policies In Hospitals: A Case Study, Cornelia Branzan

Master in Public Administration Theses

There have been a lot of studies over the past decade on patient falls, risk factors, and strategies for preventing the falls. However, these studies provide answers for long term care; acute care and community hospitals need more specific interventions. Falls and their consequences are important for patients and families, health care providers, insurance companies, state agencies, hospital accreditation, and others. Furthermore, they are causing psychological and physiological injuries among the patients, take a greater time to recover, prolong hospitalization [15 days in Switzerland, Sweden, USA, Western Australia, Province of British Columbia and Quebec in Canada www.stopfalls.com )] and increase …

Resuscitating A Healthcare Charity, R Akhileswaran, Seet Ai Mee

Social Space

When government funding policies change, voluntary welfare organisations that depend largely on subsidies to run their services can find their survival at stake. Dr R Akhileswaran and Dr Seet Ai Mee present the case study of HCA Hospice Care.

Listening To The Stars: The Constellation Model Of Collaborative Social Change, Tonya Surman, Mark Surman

Social Space

There has been much talk about social sector partnerships and networks. Tonya Surman and Mark Surman explain how the ‘constellation model’, developed for the Canadian Partnership for Children’s Health and the Environment, offers an innovative approach to organising such collaborative efforts.

Creating Progam Logic Models: A Toolkit For State Flex Programs, John A. Gale Ms, Andrew F. Coburn Phd, Stephanie Loux Ms

Population Health & Health Policy

A logic modeling toolkit developed by the Flex Monitoring Team is available for use by state Medicare Rural Hospital Flexibility Programs (Flex Programs) in planning for and managing their Flex programs. The use of the Program Logic Model (PLM) Toolkit will provide states with a tool to assist in:

Planning, managing, reporting on, and assessing their Flex Program goals, activities, and accomplishments;

• Developing buy-in among key Flex Program stakeholders;
• Clarifying the underlying program assumptions;
• Identifying and defining measurable outcomes;
• Linking state-level Flex Program strategies and activities to specific and measurable outcomes; and
• Reporting program results to both internal and external …

Mental Illness And Barriers To Health Care Access, Charlene Powell

MPA/MPP/MPFM Capstone Projects

Statement of Problem

Access to health care in the United States is major concern, despite the fact that the country spends more per capita on health care than any other country. Individuals with mental illness may face greater access problems than the general population.

Research Question

• Does mental illness predict greater difficulties with access to health care?

Methodology

The 2004 National Health Interview Survey (NHIS) was used to examine the barriers to health care among individuals reporting a mental illness diagnosis. Nine questions relating to health access problems were drawn from the survey and combined into an access index. Multivariate …

Update - September 2005, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Just Care: Rationing in a Public Health Crisis
-- Editorial
-- Graduate profiles
-- Jack W. Provonsha Lecture Series: Physician-Assisted Suicide: A Religious Perspective

Scope Of Services Offered By Critical Access Hospitals: Results Of The 2004 National Cah Survey, David Hartley Phd, Mha, Stephenie L. Loux Ms

Rural Hospitals (Flex Program)

No abstract provided.

The Road To Universal Health Coverage In Massachusetts: A Story In Three Parts, John E. Mcdonough

New England Journal of Public Policy

In 1988, the Massachusetts Legislature passed a new law, a “play or pay” employer mandate, requiring all employers with six or more workers to provide health insurance coverage for their employees. A few years later, with Medicaid identified as a “Budget Buster,” the Weld administration sought deregulation as the way to cut costs and expand access by establishing MassHealth, which dropped the employer mandate and expanded Medicaid, and eventually distinguished Massachusetts as the state with the greatest percent of covered citizens. But MassHealth enrollment has declined as premium costs have risen, and the Uncompensated Care Pool is once again faced …

When The Safety Net Fails: An Analysis Of Alternative Long-Term Care Services In Kentucky, Suzanne Dale

MPA/MPP/MPFM Capstone Projects

The Problem

In early 2003, the Kentucky Cabinet for Health Services, faced with a $450 million Medicaid shortfall, implemented several cost-cutting measures to the Medicaid program. The most visible measure included new stricter medical eligibility requirements for long-term care programs. As a result of these new requirements, approximately 2,813 elderly and disabled Kentuckians were denied services in Kentucky’s Aged/Disabled Home and Community-Based Waiver Program, a Medicaid program that provides long-term care services in people’s homes and in community-settings. The Cabinet for Health Services claimed that those who lost home and community-based Medicaid services could receive care through alternative state programs. …

Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess

Theses, Dissertations and Capstones

Medicaid-funded long-term care services are traditionally delivered in nursing homes. States may apply for waivers which allow them to provide home and community based services with Medicaid funds. Because these services are by definition an alternative to nursing home care, waiver services are generally based upon a medical model which emphasizes medical deficits and tends to restrict consumers’ movements to inside the home. Recent developments such as the Olmstead Decision and federal New Freedom Initiatives have caused states to recognize that consumers desire and have a legal right to be part of a community rather than institutionalized or homebound. These …

The Medicaid Buy-In Program: Lessons Learned From Nine "Early Implementer" States, Donna Folkemer, Allen Jensen, Robert Silverstein, Tara Straw

Center for Health Policy Research

For many individual Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) recipients, the risk of losing Medicaid coverage linked to their cash benefits is a powerful work disincentive. Eliminating barriers to health care and creating incentives to work can greatly improve financial independence and well being. To support this goal, Congress included a Medicaid Buy-In option in the Balanced Budget Act of 1997 and enacted the Ticket to Work and Work Incentives Improvement Act (TWWIIA) in 1999. These laws authorized states to create Medicaid Buy-In programs to extend Medicaid coverage to persons with disabilities who go to work. …

Policy Frameworks For Designing Medicaid Buy-In Programs And Related State Work Incentive Initiatives, Allen Jensen, Robert Silverstein, Donna Folkemer, Tara Straw

Center for Health Policy Research

This report provides policy frameworks to assist stakeholders (such as Medicaid directors, state legislators, and cross-disability coalitions) design and implement Medicaid Buy-In programs and related work incentive initiatives to enhance the level of economic self-sufficiency of persons with significant disabilities. Of particular focus of the paper are the design decisions affecting enrollment, costs, and a state's fiscal exposure.

The policy frameworks describe the interrelationships between federal and state cash assistance programs (particularly SSDI, SSI, and state SSI supplementation programs) and health entitlements (particularly the Medicaid program). The policy frameworks are derived from the experiences of the nine early implementation states …

Trends. The Privileged Status Of The Physical In Health Ideology: The Security Consequences Of Aids, Ibpp Editor

International Bulletin of Political Psychology

The author discusses the importance of recognizing both physical and psychological factors of the AIDS (Acquired Immune Deficiency Syndrome) pandemic on security.