Public Health Commons^™

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 …

Health Policy & Management News, Georgia Southern University

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

• Public Health Collaboration

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.

A Monitoring And Evaluation Plan For The Core Competencies Of Skilled Birth Attendants In Nepal, Roberta Goldstein

Capstone Collection

The purpose of this capstone is to present a Monitoring and Evaluation (M&E) plan of the core competencies, for Skilled Birth Attendants (SBA) of Nepal. The World Health Organization has laid out 10 specific skills that assess a SBAs competency. Nepal presently lacks any formal process for monitoring quality assurance of its SBAs and therefore has no measurement of their effectiveness. This Capstone proposes a simple M&E plan to begin the process of quality measurement, using a recent follow-up study done by the Nepali government, other articles and the experiences of the author. The tools included in this Capstone are …

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.

Insights From "Creating The Healthcare Workforce For The 21(St) Century" Conference., Amanda R Solis

College of Population Health Faculty Papers

No abstract provided.

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

Health Policy & Management News, Georgia Southern University

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

• Dr. Gulzar Shah at JPHCOPH

National Longitudinal Survey Of Public Health Systems: 2011-2012 Wave, Public Health Practice-Based Research Networks

Health Management and Policy Reports

Since 1998, researchers have followed a nationally representative cohort of U.S. communities to examine the types of public health activities performed within the community, the range of organizations contributing to each activity, and the perceived effectiveness of each activity in addressing community needs. This information, obtained through a validated survey of local public health officials, provides an in-depth view of the structure and function of local public health delivery systems and how these systems evolve over time. Originally conducted with support from the U.S. Centers for Disease Control and Prevention, the National Longitudinal Survey of Public Health Systems (NLSPHS) was …

Patient Engagement: Patients As Partners In Their Own Health Care, Nancy L. Falk, Mary Jean Schumann

Nursing Faculty Posters and Presentations

No abstract provided.

Access To General Practitioner Services Amongst Underserved Australians: A Microsimulation Study, Deborah J. Schofield, Rupendra N. Shrestha, Emily J. Callander

Aboriginal Policy Research Consortium International (APRCi)

Background: One group often identified as having low socioeconomic status, those living in remote or rural areas, are often recognised as bearing an unequal burden of illness in society. This paper aims to examine equity of utilisation of general practitioner services in Australia.

Methods: Using the 2005 National Health Survey undertaken by the Australian Bureau of Statistics, a microsimulation model was developed to determine the distribution of GP services that would occur if all Australians had equal utilisation of health services relative to need.

Results: It was estimated that those who are unemployed would experience a 19% increase in GP …

Developing A Business Plan For Sustaining School Mental Health Services: Three Success Storiess, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Governance In Large Nonprofit Health Systems: Current Profile And Emerging Patterns, Lawrence Prybil, Samuel Levey, Rex Killian, David Fardo, Richard Chait, David R. Bardach, William Roach

Health Management and Policy Faculty Book Gallery

From the foreword:

Nonprofit healthcare organizations are not exempt from good governance. In fact, more today than ever, the hospitals and health care systems of this country must have the discipline and commitment to organize their governance structures and practices to provide forward-thinking leadership and stand up to scrutiny from any type of evaluation and review. As we move from “sick care” organizations to “health care” organizations with accountability for the health of the population of our communities from birth to end-of-life, the role of governance becomes even more critical.

Fourteen of the largest and most notable health care systems …

Understanding Underinsurance In Ohio, Meaghan Ebetino

Master of Public Health Program Student Publications

Objectives: To determine the prevalence, predictors, and consequences of underinsurance in the state of Ohio.

Study Design: The investigators created the dependent variables Underinsured, Financial Stress, and Harder to get Health Care using the 2008 Ohio Family Health Survey (OFHS). The sample used for this study included 29,778 respondents, who were adults less than 65 years old and who were continuously insured for the past 12 months.

Results: The study categorized twenty-two percent of the sample respondents as underinsured because they were not able to obtain or delayed needed medical care because of an inability to pay in …

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 …

Survival Analysis Of Dialysis Patients Under Parametric And Non-Parametric Approaches, Maryam Siddiqa, Mueen -Ud -Din Azad, Muhammad K. Pervaiz, Muhammad Ghias, Gulzar H. Shah, Uzma Hafeez

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

Dialysis is a recommended way of treatment for end stage kidney diseases and it provides a life saving procedure. Transplantation can also be useful source but it is restricted by financial limitations especially in developing countries like Pakistan. Censoring is an important part of the survival data which causes insensitivity to the usual procedures of analysis. A little work has been done in literature regarding the estimated survival time of dialysis patients in Pakistan. So, this study has estimated the median survival time of male/females patients separately by parametric and non-parametric approaches. Moreover, comparison of survival time to patients (50 …

Predictors Of Clinician Tobacco Intervention Counseling In Six North Carolina Free Clinics, Joe G. Spangler, Eun-Young Song, Jessica Richardson Pockey, Erin L. Sutfin, Donald W. Helme, Cindy Jones, Kristie L. Foley

Communication Faculty Publications

While the poor and the uninsured are at increased risk for tobacco use, up to two thirds of these patients express interest in near-term quitting. Nonetheless, tobacco counseling rates remain low in clinics serving these patients. As part of a larger tobacco intervention project in North Carolina free clinics, we gathered baseline data on patient characteristics in six randomly selected facilities affiliated with the North Carolina Association of Free Clinics. An exit interview was completed by 231 patients; 126 (54%) were tobacco users. Among all patients, 71% had been asked by a clinician about tobacco use in the past 3 …

Role And Contribution Of Private Sector In Moving Towards Universal Health Coverage In The Eastern Mediterranean Region, Shehla Zaidi, Atif Riaz, Ali Thaver, Aftab Mukhi, Latif Afzal Khan

Community Health Sciences

No abstract provided.

Adjusting For Under-Identification Of Aboriginal And/Or Torres Strait Islander Births In Time Series Produced From Birth Records: Using Record Linkage Of Survey Data And Administrative Data Sources, D Lawrence, D Christensen, F Mitrou, Glenn Draper, G Davis, S Mckeown, Daniel Mcaullay, G Pearson, S R Zubrick

Research outputs 2012

Background: Statistical time series derived from administrative data sets form key indicators in measuring progress in addressing disadvantage in Aboriginal and Torres Strait Islander populations in Australia. However, inconsistencies in the reporting of Indigenous status can cause difficulties in producing reliable indicators. External data sources, such as survey data, provide a means of assessing the consistency of administrative data and may be used to adjust statistics based on administrative data sources. Methods. We used record linkage between a large-scale survey (the Western Australian Aboriginal Child Health Survey), and two administrative data sources (the Western Australia (WA) Register of Births and …

Political Competition, Relative Deprivation, And Perceived Threat: A Research Note On Anti- Christian Violence In India, Chad Bauman, Tamara Leech

Department of Public Health Scholarship and Creative Works

A preliminary subnational statistical analysis of violence against Christians in contemporary India, this article suggests that whereas the data provide very little support for simple, demographic explanations of this violence, they do more robustly support theories emphasizing the relative status of ethnic and religious minorities (vis-à-vis majorities) and the perception, among Hindus, that Christians (and other minorities) represent a threat to their numerical, political and economic strength.

The Aging Services Network: Serving A Vulnerable And Growing Elderly Population In Tough Economic Times, Carol O'Shaughnessy

National Health Policy Forum

In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of social support programs. The "aging services network," broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services …

Driving Qi With Research: Findings From Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

Health Policy & Management News, Georgia Southern University

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

• Georgia Southern University’s Jiann-Ping Hsu College of Public Health receives grant from the Robert Wood Johnson Foundation

Polishing Treadmills At Midnight: Is Refugee Integration An Elusive Goal?, Woods Nash

Catalyst: A Social Justice Forum

It is often said that justice requires us to treat like cases alike. Accordingly, the U.S. refugee resettlement program provides all refugees—no matter where they are from, no matter their pasts—with very similar funding and services. Refugees, however, are far from alike. In this essay, I invoke Borgmann’s distinction between a “thing” and a “device” and draw on stories from my work with a resettlement agency to argue that our current, employment-driven system is in need of reform. Instead of being restricted to generic programs, refugee resettlement agencies should be funded to help each family achieve social integration in ways …

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

The Science Of Public Health Delivery: Evidence, Uncertainties & Research Needs, Glen P. Mays

Health Management and Policy Presentations

Policy initiatives to reform the nation's health system increasingly recognize the need to incorporate public health and prevention strategies. The nation's delivery system for public health, however, varies widely across states and communities in its structure, authority, and capabilities. This session examines research from the growing field of public health services and systems research to identify directions for improving public health delivery.

Estimating The Value Of Public Health Services & Systems: Evidence, Uncertainties, And Research Needs, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act authorized the largest expansion in federal funding for public health services and delivery systems in decades. These provisions, designed to support programs and services that promote health and prevent disease and injury on a population-wide basis, remain controversial because of uncertainties regarding their effectiveness in improving health and constraining medical cost growth. This session examines a series of recent studies to shed light on the health and economic value of spending on public health.