Health and Medical Administration Commons^™

What's Happening: April, 2006, Maine Medical Center

What's Happening

No abstract provided.

Medicaid In 2006: A Trip Down The Yellow Brick Road?, Jennifer Ryan

National Health Policy Forum

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act of 2005 (DRA) and examines the implications of these provisions for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use of waivers as a vehicle for restructuring Medicaid financing systems and for testing completely new approaches to health care delivery. The role of section 1115 waivers in the context of the DRA and as a mechanism for continued state innovation is …

Rebalancing Long-Term Care: The Role Of The Medicaid Hcbs Waiver Program, Cynthia Shirk

National Health Policy Forum

This paper reviews the history and background of the Medicaid home and community-based services (HCBS) waiver program. It describes the eligibility, benefits, and financing structure, as well as the trends in program expenditures over time. The paper considers the contribution of the HCBS waiver program toward improving access to community-based care for Medicaid beneficiaries who are elderly and disabled and discusses the barriers that remain. This paper also summarizes the provisions included in the recently enacted Deficit Reduction Act of 2005 that may further expand Medicaid HCBS and considers how it may continue the process of redefining the concept of …

What's Happening: March, 2006, Maine Medical Center

What's Happening

No abstract provided.

Fitness, Knowledge, Progress: Assessing Physician Qualification, Lisa Sprague

National Health Policy Forum

The informed and empowered consumer is an ideal invoked by many would-be health care reformers. An actual consumer wishing to don the mantle of power may be hindered by the scarcity of information available, particularly with respect to choosing among physicians. How is one to know who is best qualified? This issue brief looks at the basics of physician qualification and the processes by which physicians are licensed, credentialed, and board-certified. It examines how the evolution of these processes (for example, the move from lifetime certification to ongoing maintenance of certification) affects clinicians and their patients. The rise of quality …

Health Benefits In Retirement: Set For Extinction?, Mark Merlis

National Health Policy Forum

Nearly 18 million people rely on employer-provided retiree health benefits to fill gaps in Medicare’s coverage or to provide basic insurance until they reach Medicare age. Rising costs have led many employers to limit benefits, require participants to pay a larger share of the costs, or stop offering coverage at all for workers who have not yet retired. This background paper describes recent developments in retiree health benefits, possible future trends, and policy options for slowing the erosion of coverage or providing alternative ways for retirees to meet their expected medical expenses.

What's Happening: February, 2006, Maine Medical Center

What's Happening

No abstract provided.

The Vaccine Industry: Does It Need A Shot In The Arm?, Eileen Salinsky, Cole Werble

National Health Policy Forum

This paper broadly examines the scientific, regulatory, and economic factors that contribute to constrained vaccine production capacity, periodic vaccine shortages, and perceptions of inadequate investment in new vaccine product development. It describes the vaccine development and production processes and summarizes how regulatory requirements influence these activities. Market dynamics related to vaccine supply and demand are also explored, including an examination of the industry’s cost structure, potential market size, and purchaser price sensitivity. A broad range of policy interventions designed to address shortcomings of the vaccine market are considered.

Children's Mercy Hospital Annual Report 2005, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

What's Happening: January, 2006, Maine Medical Center

What's Happening

No abstract provided.

A National Estimate Of The Cost Of Illness In Parkinson's Disease Using Retrospective Data Analysis, Katherine Anderson

Theses and Dissertations (ETD)

No abstract provided.

Factors Associated With The Provision Of Coronary Heart Disease Preventive Careservices, Patricia Carcaise-Edinboro

Theses and Dissertations

The Anderson and Aday access framework (1974) is utilized to investigate the association of individual and community level, predisposing, socio-demographic, and enabling factors, on potential and realized access to coronary heart disease (CHD) preventive care. The cross-sectional study is based on a sample of adults age 18-85 from the Medical Expenditure Panel Survey (MEPS) who were identified with CHD risk or who had a CHD diagnosis.Variables from the MEPS and the Area Resource File (ARF) are used to test logistic regression models for dependent variables measuring primary and secondary CHD preventive care services. The primary preventive care measures include blood …

Factors Associated With Hospital Commitment To Provide Child/Adolescent Psychiatric Services, Lea Anne Gardner

Theses and Dissertations

General acute care hospitals play a particularly important role in the delivery of children's mental health given the extant lack of alternatives to long term hospitals for patients requiring a restrictive treatment environment (Glied and Cuellar, 2003). This cross-sectional study identifies environmental and organizational factors associated with general acute care and children's hospitals in the United States that provide hospital-based child/adolescent psychiatric services and the number of services. Two macro-level theories, Resource Dependence Theory and Institutional Theory were used to identify environmental and organizational factors. A nationwide sample of hospitals was drawn from the 2003 AHA annual survey. Data from …

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 …

An Evaluation Of Hospital Capital Investment After The Balanced Budget Act, Tae Hyun Kim

Theses and Dissertations

Capital investments in the latest medical equipment and the replacement of aging facilities are important hospital decisions because they may have a significant influence on operating efficiencies and quality of care. However, hospitals experienced a minimal growth rate in capital expenditures which contributed to the aging of the hospital industry's asset base during the late 1990's and early 2000's. One of the underlying reasons behind this lack of growth might be the financial stresses that hospitals were facing after the Balanced Budget Act (BBA) of 1997, which significantly reducedMedicare reimbursement and had an adverse impact on the financial viability of …

The Criminal Justice Response To Elder Abuse In Nursing Homes: A Routine Activities Perspective, Brian K. Payne, Randy R. Gainey

Sociology & Criminal Justice Faculty Publications

Politicians and researchers have begun to pay more attention to elder abuse in recent times. Most of the research on elder abuse has focused on cases of abuse perpetrated by family members, treating the phenomenon as a social problem, but it is increasingly being conceptualized as a crime problem. The current study examines elder abuse in nursing homes from a criminological perspective. Using routine activities theory as a guide, particular attention is given to the criminal justice system's response to abusive activities committed by nursing home employees. In all, 801 cases of abuse investigated by Medicaid Fraud Control Units are …

Identification Of Seventh-Day Adventist Health Core Convictions : Alignment With Current Healthcare Practice, Randall L. Haffner

Dissertations

Purpose. The prevailing literature suggests that organizations can sustain their vitality and longevity by preserving their core ideology. The purpose of this study is to define and articulate the core convictions of Seventh-day Adventist healthcare and then investigate how the leaders' and employees' cognitive understandings, behaviors, and affective attachments align at Florida Hospital in Orlando, Florida.

Method. This two-phased sequential exploratory study utilizes qualitative research to define the core convictions of Seventh-day Adventist healthcare through historical literature review, analysis of official Church publications, four commissioned scholarly papers, and one-on-one interviews with seasoned healthcare administrators. These findings are then used to …

Determinants Of Care Seeking For Persons With Low Back And Neck Pain Treated By Physicians, Chiropractors Or Physical Therapists, Julia Chevan

Theses and Dissertations

Low back and neck pain are frequent reasons for adults to seek healthcare. Three types of practitioners are commonly used in the United States: physicians, chiropractors and physical therapists. In this study, Andersen's "Behavioral Model of Health Services Utilization" is used to examine care seeking and provider selection. Estimates of back and neck pain prevalence in the United States are presented as well as care seeking rates and care consumption estimates for patients who used the three providers of interest. Multivariate regression analyses are presented that model the variables that most influence care seeking and provider selection.Cases with the conditions …

Electronic Medical Records In Acute Care Hospitals: Correlates, Efficiency, And Quality, Abby Jo Swanson

Theses and Dissertations

The purpose of this dissertation is to examine the organizational and environmental correlates of hospital EMR use and to examine the relationship between hospital EMR use and performance. Using a theoretical framework that combines resource dependence theory with Donabedian's structure, process, outcome model, a conceptual model is created. To test the hypotheses of this model, logistic regression and Data Envelopment Analysis (DEA) are used. The data included in this analysis come from the AHA, HIMSS, CMS, ARF, and HQA. In the analysis of hospitals correlates of EMR use, three hypotheses were supported, and one was partially supported. Hospital system affiliation, …

The Determinants Of Hospital Adoption And Expansion Of Bariatric Procedures: A Resource Dependence Perspective, Wenquiang Tian

Theses and Dissertations

New medical technologies have been viewed as the primary cause of rising health are expenditures by health policy researchers in the United States. Since the mid 1990s, with the prevalence of obesity among Americans, the utilization of bariatric surgery, a medical innovation, has increased rapidly among U.S. hospitals. Generally, current literature only states that the volume of bariatric procedures is increasing dramatically.Very limited studies have been conducted to investigate the growth of bariatric procedures.The objective of this study is (1) to provide a detailed description about the adoption and utilization of bariatric procedure in hospitals in 11 states, and (2) …

Information Technology Outsourcing In U.S. Hospital Systems, Mark L. Diana

Theses and Dissertations

The purpose of this study was to determine the factors associated with outsourcing of information systems (IS), and if there is a difference in IS sourcing based on the strategic value of the outsourced functions. The theoretical framework is based upon a synthesis of strategic management theory (SMT) and transaction cost economics (TCE) as they apply to vertical integration in the health care sector; therefore, IS sourcing behavior was conceptualized as a case of vertical integration. The conceptual model proposed that sourcing behavior would be determined by asset specificity, uncertainty, the interaction of asset specificity and uncertainty, bargaining power, corporate …

A Determination Of The Association Of Competition And Regulation With Hospital Strategic Orientation, Kathleen B. Heatwole

Theses and Dissertations

This research study examines the influence of two major forces, competition and regulation, on the strategic orientation of hospitals. This is a particularly relevant subject, as the effectiveness of competition versus the effectiveness of regulation in the health care market has been called one of the Bellwether issues in health care policy, and the most controversial and far reaching philosophical battle facing the health care industry. Even after three decades of research and debate, there is still no consensus on how the hospital industry responds to either a competitive environment or a regulated environment. There continues to be significant variation …

What Cost Hospital Quality: Performance Uncertainty Under Market Reform, Ronald L. Fisher

Theses and Dissertations

Healthcare is an organizational field that has undergone profound change in the last few decades, an era characterized by market reform. Healthcare production has revealed both economic and quality problems in past eras, and reporting on these problems can be seen to have contributed to pressures for social reform. Yet, the move toward more market-oriented governance structures and design solutions also reflects a wider isomorphic institutional tendency for organizing social order.The conceptual frame work of this study takes a pessimistic stance on whether the market reform has achieved the intended goals with respect to advancing organizational quality performance. The framework …

Hospitals' Decision To Vertically Integrate Skilled Nursing Units Before And After The Balanced Budget Act, Betty C. Lucente

Theses and Dissertations

The decision to vertically integrate services and deliver care has both management and policy concerns for healthcare in the United States. The change in reimbursement, which was enacted with the Balanced Budget Act of 1997, influenced the availability of post acute services for acute hospital inpatients. Prior to this change, post acute services were reimbursed based on cost similar to the pre DRG era of Medicare reimbursement. The change in payment had the potential to make discharging patients more difficult resulting in a prolonged length of stay without additional payment and at increased costs for hospitals. As a result of …

Influence Of Organizational, Operational, Financial Andenvironmental Factors On Hospitals' Adoption Of Computerized Physician Order Entry Systems For Improving Patient Safety: A Resource Dependence Approach, Imre Solti

Theses and Dissertations

This study examines specific organizational, operational, financial and environmental characteristics to identify factors that are associated with increased likelihood of hospitals' CPOE adoption decision in six rollout regions of the Leapfrog initiatives.Resource dependence theory provides theoretical basis for the study. The study is retrospective observational in design. Individual hospitals are the unit of analysis. The Leapfrog Group's 2002-survey collection serves the primary data source. Univariate statistical methods along with bivariate and ordinal logistic regression models are used to analyze the data. The models provided support for multiple hypotheses for both the adoption and early adoption decisions of study hospitals. The …