Health and Medical Administration Commons^™

Developing Service Delivery Measures For Studies Of Practice Variation: The Mprove Study, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Consequently, HHS recently used a consensus-based process to develop a framework for improving quality in public health and to identify a set of nine priority areas for improvement. As next steps in operationalizing this framework, measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. This presentation profiles the methodology developed …

Scale And Scope Effects In Public Health Delivery: Estimating Gains From Regionalization, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Current approaches to health system reform under the Affordable Care Act include efforts to enhance the delivery of public health services that promote health and prevent disease and injury on a population-wide basis. The nation’s public health delivery system comprises nearly 3000 local public health agencies that vary widely in size, resources, and capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources and expertise across local jurisdictions to enhance delivery and improve population health. This analysis uses longitudinal observations on a national sample of local public health agencies …

Funding Public Health: A New Iom Report On Investing In A Healthier Future, George Isham, Robert Kaplan, Glen P. Mays

Health Management and Policy Presentations

A new Institute of Medicine report recommends establishing a national target for life expectancy and implementing new mechanisms for financing public health strategies to acheive this target.

Expanding The Evidence Base For Accreditation And Qi: Progress In Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Studies that examine the implementation and impact of quality improvement strategies in public health are underway through the Public Health Practice-Based Research Networks.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

BACKGROUND: Policy strategies for reforming the U.S. health care system to control costs and improve health outcomes include the possibility of expanded support for public health activities that are designed to prevent disease and promote health on a population-wide basis. These activities include efforts to monitor and report on community health status, investigate and control disease outbreaks, educate the public about health risks and prevention strategies, develop and enforce laws and regulations to protect health, and inspect and assure the safety and quality of water, food, air and other resources necessary for health. The Patient Protection and Affordable Care Act …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

The Science Of Public Health Practice: Using Pbrns For Delivery System Research In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

PBRN research tests strategies for improving the delivery of services that promote health and prevent disease and injury on a population-wide basis.

Book Review: Dream Of Ding Village By Yan Lianke, Mike Frick

China Beat Blog: Archive 2008-2012

Unsurprisingly, the Chinese government levied a “three nos” ban—no sales, no distribution, and no promotion—against Dream of Ding Village after its publication in 2005. Though the storytelling relies heavily on dream sequences, Yan takes little poetic license when exposing the depth of the state’s culpability in spreading HIV among poor, medically-naïve farmers. He is just as uncompromising when detailing how officials denied responsibility for the ensuing AIDS epidemic, even as they profited from its human tragedy. No one in Ding Village receives medical care, mental health counseling, food assistance, or a chance to hold the blood heads legally accountable. Cast …

Health Professions Education And Professional Obligations, Lisa Sprague

National Health Policy Forum

While there are differences in academic degree and length of time spent preparing to practice, all health professionals must meet certain requirements to commence and remain in practice in the United States. This Basic outlines the educational requirements of the various professions and the processes designed to demonstrate continuing competence in practice.

Investing In A Healthier Future: Iom Dissemination Workshop, Glen P. Mays

Health Management and Policy Presentations

This session discusses strategies for implementing new financing strategies and funding mechanisms for public health services.

Patterns Of Interaction In Public Health Research Networks: Insight From Network Analysis, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Studies from the past three decades have found evidence of wide variation in public health practices and policies across states and communities despite an expanding evidence base of efficacious public health strategies, suggesting gaps in implementation and translation processes. Practice-based research networks (PBRNs) are expected to accelerate research participation and translation. This study uses social network analysis methods with twelve Public Health PBRNs to study processes influencing the implementation and translation of research within diverse public health settings.

DATA and METHODS: A cross-sectional network analysis survey was validated and fielded with participants in two cohorts of public health PBRNs …

Using State And Local Health Survey Data To Advance Phssr, Glen P. Mays

Health Management and Policy Presentations

State and local health survey data can be used to evaluate the implementation and impact of public health delivery innovations in real-world practice settings.

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Long-Term Services And Supports (Ltss): Arlington County's Integrated Approach, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a local site visit looking at community-based aging programs and long-term services and supports (LTSS) in Arlington County, Virginia. Arlington County human services are integrated under an umbrella agency in the Department of Human Services (DHS) which administers multiple programs for the elderly and people with disabilities. These include the Older Americans Act services, Medicaid LTSS, transportation services, a nursing case management program, and mental health services for those living in nursing homes and assisted living facilities. Arlington County integrates its aging and disability programs under the auspices of an Administration on Aging-funded Aging …

Do No Harm: Perceptions Of Short-Term Health Camps In Nepal, Dena Seabrook

Independent Study Project (ISP) Collection

Short-term health camps are a growing form of delivering health care services to needy populations. Often these camps, usually lasting around 2 weeks, are led by I/NGOs in developing nations like Nepal and are staffed with volunteers from the Global North. These camps are largely ungoverned, and there are no evaluative techniques in place to monitor the effectiveness of the work done, raising concerns about the unintended consequences of short-term health camps camps. Nepal is particularly vulnerable to this issue because of the vast number of I/NGOs currently operating within its boundaries.

This research sought to expand the conversation surrounding …

Post-Acute Care Payment Reform Demonstration: Final Report Volume 4 Of 4, Barbara Gage, Melvin Ingber, Laura Smith, Anne Deutsch, Tracy Kline, Jill Dever, Judith Abbate, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Kelleher, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Post-Acute Care Payment Reform Demonstration: Final Report Volume 3 Of 4, Barbara Gage, Melissa Morley, Laura Smith, Melvin Ingber, Anne Deutsch, Tracy Kline, Jill Dever, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Mckeller, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Post-Acute Care Payment Reform Demonstration: Final Report Volume 1 Of 4, Barbara Gage, Melissa Morley, Laura Smith, Melvin Ingber, Anne Deutsch, Tracy Kline, Jill Dever, Judith Abbate, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Kelleher, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Post-Acute Care Payment Reform Demonstration: Final Report Volume 2 Of 4, Barbara Gage, Melissa Morley, Laura Smith, Melvin Ingber, Anne Deutsch, Tracy Kline, Jill Dever, Judith Abbate, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Kelleher, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Uncertainty about the magnitude and timing of economic returns associated with spending on public health services has contributed to policy debates about the optimal role of the federal government in financing these services.

Recent Proposals To Limit Medigap Coverage And Modify Medicare Cost Sharing, Kathryn Linehan

National Health Policy Forum

As policymakers look for savings from the Medicare program, some have proposed eliminating or discouraging “first-dollar coverage” available through privately purchased Medigap policies. Medigap coverage, which beneficiaries obtain to protect themselves from Medicare’s cost-sharing requirements and its lack of a cap on out-of-pocket spending, may discourage the judicious use of medical services by reducing or eliminating beneficiary cost sharing. It is estimated that eliminating such coverage, which has been shown to be associated with higher Medicare spending, and requiring some cost sharing would encourage beneficiaries to reduce their service use and thus reduce program spending. However, eliminating first-dollar coverage could …

Older Americans Act Of 1965: Programs And Funding, Carol O'Shaughnessy

National Health Policy Forum

This document offers a basic description of the Older Americans Act of 1965. The Act is considered the major vehicle for promoting the delivery of social services to the aging population. The Act's seven titles and multiple programs are described, along with a chart showing fiscal year 2012 federal appropriations.

Public Health Spending, Preventable Outcomes, And Medical Cost Offsets: Questions For Health Reform, Glen P. Mays

Health Management and Policy Presentations

Uncertainty continues to surround the health and economic effects that can be expected from increased federal spending on public health and prevention strategies. Recent research provides some insight into the question of whether spending on public health strategies can offset the need for future spending on medical care.

The Geographic Value Of Patient-Carried Medical Records In Improving Healthcare In The Us, Lauren Edmundson

The Macalester Review

American medical records have typically been maintained in a single location. However, patient-carried medical records (PCMRs) present an opportunity to alter the space in which health records and information operate. While past research has evaluated PCMRs from a largely economic perspective, this research examines potential benefits of PCMRs through a geographic framework. In total, while further work is needed to perfect the PCMR system, they can ultimately serve as a tool to alleviate four specific complaints made by American patients: lack of communication between provider and patient, lack of communication between providers, medical error, and high costs.

Utilization Of Ct Scans And Mris In An Insured Population With Migraine, Neil I. Goldfarb, Valerie Pracilio, Mph, Daisy Ng-Mak, Phd, Joe Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Stephen Silberstein, Md

College of Population Health Lectures, Presentations, Workshops

Background:

• Neuroimaging is a diagnostic tool that may be used to rule out a serious condition when a patient presents with head pain. It is not typically warranted for patients who have a normal neurologic exam, and may be over utilized despite established practice parameters set by the American Academy of Neurology.

•A decision to use neuroimaging should consider the type of headache and presence of any clinical features that suggest a serious condition.

Over-utilization of neuroimaging has cost and safety implications.

The United States Headache Consortium, a panel of experts on migraine, set the guidelines for diagnosis and …

Association Between Triptanuse And Cardiac Contraindications In An Insured Migraine Population, Daisy Ng-Mak, Phd, Valerie P. Pracilio, Mph, Stephen Silberstein, Md, Joseph Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Neil I. Goldfarb

College of Population Health Lectures, Presentations, Workshops

Background

Safety concerns exist when using triptansto treat patients with cardiac contraindications.

–Triptans cause vasoconstriction, a safety concern for migraineurswith cardiovascular (CV) disease or other cardiac risk factors.

–All triptans contain contraindications in their package inserts to avoid use in patients with cardiac conditions.

•Previous research indicates that clinicians are less likely to prescribe triptansin patients with CV disease or CV risk factors.

Limited research has examined the proportion of migraine patients with cardiovascular disease or those individuals who were concurrently treated with triptans.

Trust In Government And Support For Governmental Regulation: The Case Of Electronic Health Records, Mitchel Herian, Nancy C. Shank, Tarik Abdel-Monem

University of Nebraska Public Policy Center: Publications

Background — This paper presents results from a public engagement effort in Nebraska, USA, which measured public opinions about governmental involvement in encouraging the use of electronic health records (EHRs).

Objective — We examine the role of trust in government in contributing to public support for government involvement in the development of EHR technologies. We hypothesize that trust in government will lead to support for federal and state governmental encouragement of the use of EHRs among doctors and insurance companies. Further, because individual experiences with health-care professionals will reduce perceptions of risk, we expect that support for governmental involvement will …

Teaching Cultural Humility And Competence: A Multi-Disciplinary Course For Public Health And Health Services Students, Rob Simmons Drph,Mph,Ches, Nancy L. Chernett, Mph, Elaine Yuen, Phd, Susan Toth-Cohen, Phd, Otr/L

College of Population Health Lectures, Presentations, Workshops

Poster on the interdisciplinary Cultural Humility and Competence course taught at the Jefferson School of Population Health for the past several years.

Overall Course Aim:

Why a multi-disciplinary cultural humility competence course?

An in-depth and advanced understanding of cultural diversity, health inequities and cultural competence in inter-professional health and human service delivery and administration. Facilitate development of cultural competence and humility in one's self, colleagues and the work environment and its application to practice.

Characterization Of Pasteurella Multocida Strains Isolated From Geese, Zsuzsanna Varga, Dmitriy V. Volokhov, Laszlo Stipkovits, Akos Thuma, Boglarka Sellyei, Tibor Magyar

United States Food and Drug Administration: Publications

Phenotypic and genotypic diversity of forty-two Pasteurella multocida isolates from geese were characterized by analysis of their capsular type, Heddleston serotype, biotype, fimbrial gene allele type, comparative outer membrane protein (OMP) electrophoresis patterns, and were analyzed using PCR for the presence of virulence-associated genes (toxA, tbpA, pfhA, hgbA, hgbB, nanH, nanB, fimA, hsf-1, and pmHAS). A sequence comparison of the thdF and rpoB housekeeping genes of twenty representative P. multocida strains from three different OMP groups demonstrated that seventeen strains were closely related phylogenetically to previously published strains of P. multocida subsp. multocida and P. multocida subsp. gallicida, and only …

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …