Public Health Commons^™

A Test Of The Behavioral Model Of Health Services Use On Non-Emergent Emergency Department Use, Moira Crosby Mcmanus

Health Services Research Dissertations

Even though emergency departments (EDs) were created to treat trauma and emergent cases, there has been an increase in emergency department (ED) utilization for non-emergent reasons over the past half of a century. As non-emergent utilization grows as a result of the ED becoming a prevalent substitute for primary care, overcrowding of the ED and increased wait times will continue. Additionally, unnecessary cost to both the ED and the patient will be incurred. Previous research has examined and determined various reasons and risk factors driving non-emergent ED use, among them the influence of living location and the number of non-emergent …

Health Departments’ Engagement In Emergency Preparedness Activities: The Influence Of Health Informatics Capacity, Gulzar H. Shah, Bobbie J. Newell, Ruth E. Whitworth

Health Policy & Management: Faculty Publications (2006-2018)

Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness.

Methods: We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities.

Results: Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency …

Emergency Medical Services And Public Policy In Durban, Kwazulu-Natal, John Buyske

Independent Study Project (ISP) Collection

This project seeks to explore the realities of the emergency medical system in the Durban area, particularly relative to government policy. It contextualizes its findings within the literature on public policy. Data for the project was collected via nine in-depth interviews with various professionals working in the field of emergency medical services, as well as a survey of fourteen citizens conducted in the peri-urban township of Cato Manor. This data was analyzed using qualitative methods. While every participant had different views and a different perspective on emergency services, some recurring themes and trends became evident, allowing for conclusions to be …

The Effects Of Job Characteristics On Home Care Workers’ Well-Being And Job Performance: Understanding The Psychosocial Effects Of Relational Care, Emily C. Franzosa

Dissertations, Theses, and Capstone Projects

Home care workers are the lowest-paid and most precarious segment of the health care industry. Although these workers provide critical, non-medical support that allows elderly and disabled individuals to remain in their homes, the workforce is highly unstable, due to low wages, a lack of supportive benefits like health coverage, paid leave and retirement support, poor working conditions and a physically and emotionally demanding workload. But a lack of consensus around the nature and value of home care has made “quality”, in terms of both jobs and care provision, difficult to define, measure or improve. While home care is a …

Pharmacy Use By Dual-Eligible Non-Elderly Veterans With Private Healthcare Insurance, Brian C. Lund, Mary E. Charlton, Alan N. West

Dartmouth Scholarship

The Veterans Health Administration (VHA) is the largest nationally integrated healthcare system in the United States, operating 168 medical centers and more than 1000 community based outpatient clinics. However, many veterans seek care outside the VHA system, particularly when they are also covered by state or federal programs such as Medicare or Medicaid, or have access to private health insurance, often through employment. Concerted efforts have been made to facilitate communication and coordinate care between VHA and private sector healthcare, but concurrent use of these systems adds to an already fragmented U.S health care system.

Local Health Departments’ Involvement In Hospitals’ Implementation Plans, Simone Singh, Erik Carlton

Frontiers in Public Health Services and Systems Research

Background: More than half of all local health departments (LHDs) in the U.S. are involved in collaborations with nonprofit hospitals on a community health needs assessment (CHNA), yet little is known about the role that LHDs play in hospitals’ implementation plans.

Purpose: This study aims to explore the current state of hospital–LHD collaborations around the implementation plan using data from a survey of LHDs across the country.

Methods: The study sample included 457 LHDs that completed both the 2015 Forces of Change survey and the 2013 Profile survey conducted by the National Association of County and City Health Officials. Univariate …

Enhancing Sexually Transmitted Infection Notification: A Quality Improvement Collaborative Case Report, William C. Livingood, Lori Bilello, Katryne Lukens-Bull, Ulyee Choe

Frontiers in Public Health Services and Systems Research

This case study illustrates how a quality improvement (QI) Collaborative supports an implementation study of using mobile phone texting technology for notification of sexually transmitted infections (STI) test results. The County Health Departments making up the QI Collaborative meet monthly to discuss their progress in using QI to advance the use of texting for STI test results. The main purpose of QI Collaboratives is to maximize implementation outcomes through sharing of successes and challenges. The case study report describes how implementation research can adapt to the context of each unique CHD and the users of new knowledge rather than emphasizing …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Examines the Impact of State HAI Reporting Laws

Getting Ready For Open Enrollment: Supporting Clients Living With Hiv, Juli Powers, Mira Levinson, Naima Cozier

9th Annual Rural HIV Research & Training Conference (2014-2019) (Archived)

Open Enrollment for 2017 Marketplace plans begins on November 1, 2016. Programs should prepare now to engage unenrolled and newly-eligible clients, and support clients who enrolled in previous years to compare options and find affordable, quality plans for 2017 that meet their needs. This interactive session will include strategies to engage and enroll people living with HIV in health coverage.

Current Practices Of Obesity Pharmacotherapy, Bariatric Surgery Referral And Coding For Counselling By Healthcare Professionals, Christine Petrin, Scott Kahan, Monique Turner, C. Gallagher, William Dietz

Health Policy and Management Faculty Publications

Introduction

Rates of obesity pharmacotherapy use, bariatric surgery and intensive behavioural counselling have been extremely low.

Objectives

The primary objective of this study was to survey healthcare provider beliefs, practice and knowledge regarding obesity management.

Methods

Primary care physicians (PCPs), OB‐GYN physicians and nurse practitioners (NPs) responded to a web‐based survey related to drug therapy practice, bariatric surgery referral and reimbursement coding practice.

Results

Rates of reported use of obesity pharmacotherapy appear to be increasing among PCPs, which is likely related to the approval of four new obesity pharmacotherapy agents since 2012. Rates of pharmacotherapy use among OB‐GYNs and NPs …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Examines Epigenetic Dysregulation of IGF

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Examines Social Network Characteristics

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …

Policy Implementation Of Health Coverage For Indonesian Migrant Workers, Risky Kusuma Hartono, Budi Hidayat, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The purpose of this research is to analyze the policy implementation of health coverage for TKI. This research uses a qualitative method with in-depth interview. The framework of this research consists of the aspect of the advisable policy, the implementation factors, and the schematic representation of the problem by using SWOT. The result of this research is the health insurance owned by TKI comes from TKI insurance, the membership of JKN, and insurance during their employment abroad. TKI insurance policy is the instruction of Law No. 39 of 2004 which regulates the obligation of the ownership of the social security …

Study On Public Health Financing In Pidie Jaya District In 2013, Hanifah Hasnur, Purnawan Junadi

Journal of Indonesian Health Policy and Administration

Albeit high dependency on central government transfer (around 69% of total health expenditure), funding from local PAD has been increasing. The revenue shall support priority health programs. This study aims to analyze local health financing system and as input for health program planning. Health financing portrait how fund being spent, and identfying who the agents are as well as the beneficiaries. The study shows spending on health from local budget is Rp130,000. Expenditures on operational costs for direct activities and community-based health efforts or Upaya Kesehatan Masyarakat (UKM) are still low (41%). Puskesmas needs to do more health-related activities for …

An Analysis Of The Usage Patterns Of Health Services Funded Through Capitation And Noncapitation In Government Owned Primary Healthcare Facilities In The District Of Pandeglang, Arovian Yuliardi, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

The National Health Insurance (JKN) is basically a form of managed care, a technique that integrates health costing and service quality through cost control and quality control. In that concept, the Puskesmas acts as the government’s primary healthcare facility, its vanguard. The aim of this research is to discover and analyze the healthcare usage patterns funded by capitation and non-capitation in government primary healthcare facilities (FKTP). This was an analytical study utilizing a cross-sectional design. 615 patients visiting the government’s FKTP were involved in this research. The results indicated that 47.3% of patients utilizing the government’s FKTP at Pandeglang district …

An Analysis Of The Implementation Of The Policy To Integrate Of National Defense Components In Managing Non-Military Threats In The Health Sector, Sugeng Winarno, Prastuti Soewondo

Journal of Indonesian Health Policy and Administration

This research was based on the Minister of Defense’s Decree No. 16/2012 that stated that all national defense components to integrate into one unit when they encounter military and non-military threats. The Ministry of Health, as the main player, and other governmental and private agencies would also play a role in overcoming complex and multidimensional non-military threats, especially in the health sector. Among those threats are infectious diseases such as HIV/AIDS and Ebola. We aim to discover the implementation process of the law above in the management of those two diseases. This was a qualitative analytical research with in-depth interviews. …

The Effectiveness Of The Posyandu And Its Relation To Leadership And Management, Husnah Maryati, Vetty Yulianty Permanasari

Journal of Indonesian Health Policy and Administration

Data on infant mortality in the city of Bogor has increased from 26 to be 62 cases in 2013. Posyandu is one of the facility in a society that runs the health program where one goal is carrying out activities to accelerate the decline in the death rate of mothers and babies. The problems at posyandu in Bogor is the number of active cadres continue to decline while cadre recruitment insufficient, and less active of the function of The National Working team of posyandu. The report of newborn deaths by 2013 and 2014 stated that more than half (55 and …

An Analysis Of The National Health Insurance Policy Implementation In 2014 (Presidential Regulation No. 12 And 111/2013 On Health Insurance) From The Regulator’S Position, Muhammad Arief Rosyid Hasan, Puput Oktamianti, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

JKN (National Health Insurance) is a government program that aims to provide health assurance for all Indonesian citizens for a healthy, productive, and prosperous life. In the two years after JKN was implemented, various problems occurred. This research used the qualitative approach with the Edward II implementation theory. Results of the research indicated that there were problems in communication, stemming from the lack of socialization and inharmonic regulations, there was also the problem of the lack of healthcare resources. From the disposition side, the policy makers often obstructs the implementation preparation, this is evident from the information on determining the …

Public Health West Virginia 3.0, Danny Scalise, Mba Ii, David Didden, Md

Marshall Journal of Medicine

Public health across West Virginia and the nation faces a time of tremendous change. Health is influenced by individual lifestyle, social networks, living and working conditions, and general environmental conditions. As a result, the West Virginia Bureau for Public Health created the West Virginia Public Health Impact Task Force (PHITF) to develop an innovative, custom fit public health system in West Virginia. With goals of improving health, improving quality, and reducing costs, the PHITF recommended a health in all policies approach which combines innovative patient-centered public health services in every community, and asks that local public health partner with stakeholders …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Student Chosen as Scholar

Families Healing Together: Exploring A Family Recovery Online Course, Samantha Estrada

The Qualitative Report

Family members who are trying to support their loved one are often overburdened with stress, and health issues. Research has shown that families who receive family psychosocial education and support can have a dramatic impact on recovery outcomes and their family’s overall well-being. Family psychoeducation is not common. Families Healing Together (FHT) is an online family mental health recovery program that was developed to address this critical gap in family mental health care services. Using an exploratory case study methodology to understand how the program’s philosophy and practice impacts the program’s participants as well as how the participants perceive the …

United States Health Care Reform Progress To Date And Next Steps, Barack H. Obama

United States Public Health Resources

IMPORTANCE The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care.

OBJECTIVES To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act.

EVIDENCE Analysis of publicly available data, data obtained from government agencies, and published research findings. …

The Carefirst Patient-Centered Medical Home Program: Cost And Utilization Effects In Its First Three Years, Alison Cuellar, Lorens A. Helmchen, Gilbert Gimm, Jay Want, Sriteja Burla, Bradley Kells, Iwona Kicinger, Len M. Nichols

Health Policy and Management Faculty Publications

Background

Enhanced primary care models have diffused slowly and shown uneven results. Because their structural features are costly and challenging for small practices to implement, they offer modest rewards for improved performance, and improvement takes time.

Objective

To test whether a patient-centered medical home (PCMH) model that significantly rewarded cost savings and accommodated small primary care practices was associated with lower spending, fewer hospital admissions, and fewer emergency room visits.

Design

We compared medical care expenditures and utilization among adults who participated in the PCMH program to adults who did not participate. We computed difference-in-difference estimates using two-part multivariate generalized …

Ehr Quality Documentation Research Thesis, Ashley Danielle Holmes

Applied Research Projects

This research proposal contains and introduction to my proposed research, background of the issue at hand, purpose of the research, significance of the research, research questions that I will be asking, definition of terms, limitations that I may be facing, literature review, SWOT Analysis, and Work Flow diagram on literature review. Also discussed are my proposed research methodology, research design, population sample, data collection procedures, as well as a table of survey variables that I propose to include. This proposal will go over why documentation quality and quantity is so important and the history behind why we are facing a …

Nutrition Informatics: Information Technology Transition For Registered Dieticians, Arlanda Bell

Applied Research Projects

The passing of the Health Information Technology for Economic and Clinical Health Act (HITECH) has created a growing push for healthcare organizations to no longer use paper based records and convert to an Electronic Health Record (EHR). Along with the adoption of an EHR comes a necessary change for ancillary services like nutrition and dietetic services because it affects patient care as well. In order to maintain a professional standard in patient healthcare as other health disciplines have done, the development of nutrition informatics model has become necessary. Nutrition informatics will prove to be a necessary addition to the developing …

A Sustainable Approach To Health Systems Strengthening In Developing Countries: Lessons From The Ebola Crisis, Prince Tarnah

Capstone Collection

The research paper started with emphasizing the importance of health security as an issue of global concern under the UNDP theory of human security. The research then proceeded with a focus on the approaches to health systems strengthening and a reflection on lessons learned from the Ebola virus outbreak to answer the question: How do we approach health systems strengthening (HSS) to achieve sustainable impact? Scholarly articles, and literature from other authoritative sources on health systems strengthening, like the World Health Organization (WHO) and the US Agency for International Development (USAID), were reviewed to determine a clear definition of HSS, …

Frequency Of Colonoscopy Surveillance In Average-Risk Adults Relative To Guideline Recommendations, Meng-Han Tsai

Theses and Dissertations

Colorectal cancer (CRC) is the third leading cancer in the United States with an estimated 132,700 new cases and 49,700 deaths in 2015. Well-performed screening colonoscopies prevent cancer by allowing visualization of the entire colon and removal of precancerous polyps (adenomas). Persons with high-risk polyps at screening are therefore advised to undergo periodic surveillance colonoscopy. Screening and surveillance colonoscopy guidelines were updated by the U.S. Multi-society Task Force (USMSTF) in 2006, which emphasized risk stratification by polyp features at screening colonoscopy.

This is a retrospective cohort study of patients with screening colonoscopy at an endoscopy center in South Carolina between …

Job Satisfaction And Intent To Quit Outcomes Among Home Health Aides In Home Health Care Industry Of The United States: A Multilevel Study, Seokwon Yoon

Theses and Dissertations

Backgrounds: Home health aides’ job satisfaction and intent to quit have been attributed to organizational and community level factors. The objective is to determine the effects of individual-, organizational-, and community-level factors on job satisfaction or intent to quit among home health aides.

Methods: This research used data from two subsets of the 2007 National Home and Hospice Care Survey and the 2007 National Home Health Aides Survey, sampling six eligible workers across the agencies in the Unites States. As another data source, the present study uses Area Health Resource File. The author used hierarchical linear modeling technique for handling …