Health and Medical Administration Commons^™

The Prescription Drug Safety Net: Access To Pharmaceuticals For The Uninsured, Jack Hoadley

National Health Policy Forum

This background paper provides an overview of organized programs that provide access to prescription drug products for uninsured persons, with an emphasis on manufacturer-sponsored pharmacy assistance programs (PAPs) and the federal 340B drug pricing program. It summarizes the chief characteristics of these programs and reviews concerns regarding the reach and efficiency of these efforts. The paper begins with a brief examination of the number of people who lack insurance coverage for prescription drugs and discusses the influence of this gap in coverage on health status. The paper also describes informal mechanisms providers frequently use to help uninsured patients fill their …

What's Happening: May, 2007, Maine Medical Center

What's Happening

No abstract provided.

The Fundamentals Of Health Savings Accounts And High-Deductible Health Plans, Beth Fuchs, Lisa Potetz

National Health Policy Forum

This background paper updates and expands on a previous NHPF document that looked at the fundamentals of health savings accounts (HSAs) and high-deductible health plans (HDHPs), their intellectual and legislative origins, and the ways they work. In addition to updating information on the HDHP/HSA marketplace, this paper presents a description of how the HDHP combined with the HSA works for enrollees. Using a question and-answer format, it then addresses some of the more complicated details of these arrangements, looking first at the HDHPs and then the HSAs. This closer examination suggests some potential policy challenges for lawmakers, the focus of …

What Have You Done For Me Lately? Assessing Hospital Community Benefit, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key aspects of the ongoing policy debate related to not-for-profit hospitals, the advantages they derive from tax exemption, and the benefits they provide to communities served. It provides a historical context for how federal standards for assessing hospitals’ tax-exempt status have evolved and describes recent activities to explore additional policy changes. Legislative and regulatory actions at the state and local level are also examined. Evidence on the performance of not-for-profit hospitals in comparison to their for-profit competitors on measures of cost, quality, and access is summarized, and perspectives on the need to preserve a not-for-profit presence …

Review Of Access And Quality Of Care In Schip Using Standardized National Performance Measures, Terence A. Partridge

National Health Policy Forum

The State Children's Health Insurance Program (SCHIP) has proven to be a critical addition to public coverage programs for low-income children since its inception ten years ago. Tracking the number of children enrolled, however, is only part of the story. This technical paper reviews access and quality for children enrolled in SCHIP by examining information on four primary and preventive care health measures submitted to the Centers for Medicare & Medicaid Services by states in their 2005 annual reports. The paper concludes that the data examined for this paper indicate that children enrolled in SCHIP are receiving not only coverage …

Competition And Collaboration: The Spirit Of St. Louis, Laura A. Dummit, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to St. Louis, Missouri, on April 3-5, 2007, to consider the relationships between hospitals and physicians—and the degree of alignment in their financial, organizational, and policy goals—as a foundation for a new round of discussions on how to reform the health care system. St. Louis offered an interesting venue for these investigations because it is home to two major medical schools, three large hospital systems, and a physician community dominated by small practices. Site visit participants were able to converse with community, business, medical school, hospital, and physician leaders to learn …

Mapping The Literature Of Health Care Management, Mary K. Taylor, Meseret D. Gebremichael, Cassie Wagner

Articles

Objectives: The research provides an overview of the health care management literature and the indexing coverage of core journal literature.

Method: Citations from five source journals for the years 2002 through 2004 were studied using the protocols of the Mapping the Literature of Allied Health Project and Mapping the Literature of Nursing Project. The productivity of cited journals was analyzed by applying Bradford's Law of Scattering.

Results: Journals were the most frequently cited format, followed by books. Only 3.2% of the cited journal titles from all 5 source journals generated two-thirds of the cited titles. When only the health care …

A Case Study Of School Age Female Minority Athletes Who Became Pregnant, Floyd Jones Phd, Jennifer Y. Mak, Phyllis A. Jones Ed

Management Faculty Research

The purpose of this study is to provide an in-depth understanding of ''What had happened to the urban minority female athletes who became pregnant while playing high school basketball?'' The study wanted to provide a qualitative analysis of rich narrative data collected from questionnaire interviews of two separate groups (one in Pittsburgh, the other in New York City). The findings of this study suggest that in fact urban female African-Americans athletes still received benefits from sports participation.

Towards E-Health: National Access To Electronic Health Information, Lindsay K. Harris

Lindsay Harris

Health Libraries Australia has made a sustained effort to advance the development of a national approach to the delivery of electronic health information since holding a national forum back in 2003. Lindsay Harris plots the progress to date.

A Two-Hour Basketball Practice Increases Landing Error Scoring System Scores In Female Collegiate Basketball Players, Caroline Wesley

Undergraduate Theses and Capstone Projects

The high rate of knee injuries in women’s athletics has been well documented in recent years. There are multiple factors which contribute to the increased risk of injury in female athletes, including biomechanics when landing. Fatigue has also been examined as a contributing factor to injury, but few studies have utilized actual sport participation as a fatiguing protocol. No study has used the Landing Error Scoring System (LESS) to examine the changes that may result from fatigue. The objective of our study was to use the LESS to examine the effects of a two-hour basketball practice on the landing biomechanics …

What's Happening: April, 2007, Maine Medical Center

What's Happening

No abstract provided.

Health Care Price Transparency And Price Competition, Mark Merlis

National Health Policy Forum

Growing numbers of consumers are in health plans that give them incentives to be more cost-conscious. Yet complex pricing systems and limited information may make it hard to choose among providers and treatment options. This report examines steps that insurers and others have taken to make better price information available, possible government measures to further promote price transparency or to simplify price comparisons, and the likely effects on consumer behavior and provider competition.

Fairfax County's Commitment: A Housing And Health Continuum For Seniors, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-day site visit focused on the range of services made available to seniors by Fairfax County, Virginia, including senior centers, adult day health care, and assisted living and independent housing. Services to low-income residents were emphasized. Participants were introduced to the different agencies and funding streams involved and were able to observe how county officials have acted on a stated commitment to help seniors who wish to age in place, staying in the county and in their own homes rather than in a nursing home or other institution. The day included tours of two Fairfax County multiservice sites, in …

Medical Malpractice Reform: A Societal Crisis Or Fear Marketing?, Phil Rutsohn, Andrew Sikula Sr.

Management Faculty Research

This paper explores the primary issues surrounding the malpractice crisis currently facing the healthcare system and asks the question ‘is it truly a crisis or is it an effective marketing campaign waged by interested parties?’ The authors discuss the primary issues presented by both the supporters of tort reform and the opposition to tort reform. As is true for many issues in healthcare, final analysis suggests that tort reform is needed or not needed depends on the analysts' role in the system. The authors argue that the evidence suggests malpractice reform will produce desired results if the goal is to …

What's Happening: March, 2007, Maine Medical Center

What's Happening

No abstract provided.

Adaptation Of Lean Methodologies For Healthcare Applications, Heather (Woodward) Hagg, Deanna Suskovich, Jamie Workman-Germann, Susan Scachitti, Brian Hudson, Joseph Swartz, Chris Vanni

RCHE Publications

Lean and Six Sigma quality concepts and terminology have been applied in the manufacturing arena since the late 1980’s and early 1990’s. It has only been in recent years that healthcare administrators have identified these methods as being adaptable to their organizations so that they may realize organizational improvements for continuing success and delighting customers. Unfortunately, this is not an application that is widely taught in typical Industrial Engineering curriculum and therefore there are few educated professionals coming right out of college that are able to apply these principles to healthcare. There are however, many experienced professionals knowledgeable in the …

Dietary Fiber Intake And Ovarian Cancer Risk: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

There is some evidence from case–control studies that dietary fiber intake might be inversely associated with ovarian cancer risk, but there are limited prospective data. Therefore, we examined ovarian cancer risk in association with intake of dietary fiber in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS), who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Data from the food frequency questionnaire were used to estimate intake of total dietary …

Inside Unlv, Diane Russell, Shane Bevell, David Ashley, Lori Bachand, Grace Russell, Mamie Peers

Inside UNLV

No abstract provided.

What's Happening: February, 2007, Maine Medical Center

What's Happening

No abstract provided.

Enhancement Of Claims Data To Improve Risk Adjustment Of Hospital Mortality, Michael Pine, Harmon S. Jordan, Anne Elixhauser, Donald E. Fry, David C. Hoaglin, Barbara Jones, Roger Meimban, David Warner, Junius Gonzales

Publications from Provost Junius J. Gonzales

Context Comparisons of risk-adjusted hospital performance often are important components of public reports, pay-for-performance programs, and quality improvement initiatives. Risk-adjustment equations used in these analyses must contain sufficient clinical detail to ensure accurate measurements of hospital quality.

Objective To assess the effect on risk-adjusted hospital mortality rates of adding present on admission codes and numerical laboratory data to administrative claims data.

Design, Setting, and Patients Comparison of risk-adjustment equations for inpatient mortality from July 2000 through June 2003 derived by sequentially adding increasingly difficult-to-obtain clinical data to an administrative database of 188 Pennsylvania hospitals. Patients were hospitalized for acute myocardial …

Rawls And Health Care, Elizabeth H. Coogan

Honors Theses

John Rawls’s A Theory of Justice (1971), his first major work articulating his theory of justice as fairness, was immediately recognized as a fundamental contribution to political philosophy in the twentieth century. Working within the tradition established by previous philosophers such as Kant and Locke, Rawls employed the contract theory approach. Taking it to a higher order of abstraction, he sought to determine not what the structure of social organization would be, but what the principles which governed social institutions would be under a hypothetical contracting situation. Rawls uses this contract theory approach to construct a society in which the …

Quality Models: Selecting The Best Model To Deliver Results, William Martin

Publications – Dreihaus College of Business

No abstract provided.

Annual Report Central Administrative Services 2006/2007

Annual Reports - Education

University of Connecticut Health Center, Central Administrative Services, Annual Report, Fiscal Year 2006-2007; Submitted by Barry Feldman, Vice President & Chief Operation Officer, University of Connecticut, and Susan Whetstone, Chief Administrative Officer, UConn Health Center, August 2007

Integrating Mental Health And Primary Care, Stephen Thielke, Steven D. Vannoy, JüRgen UnüTzer

Steven D Vannoy

No abstract provided.

Children's Mercy Hospital Annual Report 2006, 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, 2007, Maine Medical Center

What's Happening

No abstract provided.

The Effect Of Pediatric Hospital Specialization On Patient Safety And Effectiveness Of Care, James Mitchell Harris Ii

Theses and Dissertations

Provider specialization is an area of interest in health care as patients, payers and policy makers are now demanding better performance and demonstrated proof of the benefits of specialization. While previously ignored in the specialization debate, now even the hospitals focusing on pediatric care (i.e. children's hospitals) are experiencing pressure to demonstrate their value. The current study attempts to answer the questions: do hospitals specializing in pediatric care provide better quality pediatric inpatient care; and do they do so for differing types of patient outcomes and across different levels of care complexity? Contingency Theory is used to develop and assess …

Expanding A General Surgery Practice: Privileges, Ambulatory Care Centers And Hospital Interactions, Julia Snow

MPA/MPP/MPFM Capstone Projects

The objective of this case study is to document the interactions between a general surgery practice group and a university medical center as the physician group establishes and seeks to expand its revenue base. The group proposes to lease or purchase a practice location where they can consult with patients and perform procedures. The practice location is near a competitive hospital, Saint Jose East. The surgeons currently have privileges at Saint Jose Hospital and request to continue the privileges.

The case study's design and methods include benchmarking and financial analysis. The results of the study are :

• Benchmarking of operating …

Serum Gamma-Glutamyltransferase And The Risk Of Type 2 Diabetes In A Population-Based Cohort Study Of Older Mexican Americans, Lynn Blythe

Master's Theses and Doctoral Dissertations

Our objective was to test the hypothesis that increased GGT predicts an increased risk of type 2 diabetes (T2D) in elderly Mexican Americans.

Data from a population-based cohort study of 1789 community-dwelling Mexican American men and women, aged 60-101, in the SALSA study were used. Data for 1,203 participants without diabetes at baseline were evaluated for incident diabetes. Proportional hazard models were used to predict the probability of incident T2D by GGT level.

After adjustment for age, gender, smoking, alcohol use, and BMI, the risk of developing T2D associated with GGT was significant at 1.4 (95% CI 1.2 -1.7). However, …

Approval Of New Drugs By The U. S. Food And Drug Administration: Problems With The Process And Access To Unapproved Drugs, Christine M. Hoeft-Loyer

Master's Theses and Doctoral Dissertations

Today, the vast majority of drugs available for patient use have gone through a rigorous system of human clinical trials supervised by the Food and Drug Administration (FDA), to ensure the drugs are safe and efficacious. There are now citizen advocacy groups that seek use of drugs not yet approved by the FDA, to be administered to terminally ill patients who have exhausted all other available means of therapy. The FDA has programs for terminal patients, under the supervision of their physicians, to use unapproved drugs; however, the advocacy groups seek access to drugs in much earlier phases than is …