Health Services Administration Commons^™

The Federal Employees Health Benefits Program: What Lessons Can It Offer Policymakers?, Karl Polzer

National Health Policy Forum

This paper provides an historical overview of the Federal Employees Health Benefits (FEHB) program and its marketplace dynamics. It also reviews key program features and issues, including payments to health plans, strategies used to mitigate the opportunities for risk selection, and costs.

Interprofessional Working And Continuing Medical Education., Linda Headrick, Peter Wilcock, Paul Batalden

Dartmouth Scholarship

No abstract provided.

Site Visit To Philadelphia — Providing Community-Based Primary Care: Nursing Centers, Chcs, And Other Initiatives, Karen Matherlee

National Health Policy Forum

This site visit provided federal congressional and agency health staff opportunities to visit facilities and engage in discussions on essential community health services. Focused on community-based primary care in a managed care environment, it featured delivery and financing concerns relating to nursing centers, community health centers, public-mission hospitals, and homeless services. In examining the impact of managed care in a rapidly changing health marketplace, it explored the implementation of the Medicaid HealthChoices program in the city as well as access to and delivery of care to persons with neither public nor private insurance. It also looked at the role of …

Site Visit To Northern California — Risk, Accountability, And Staying Power In Next-Generation Managed Care, Lisa Sprague, Sandra Foote

National Health Policy Forum

This three-day site visit looked at private health insurance and delivery of care in a market notable for high managed care penetration, relatively low premium costs, and sophisticated provider groups. Federal congressional and regulatory staff heard from health insurance purchasers (both public and private), health plans, hospital systems, and physician groups about the changing relationships and accountabilities in this market and the ways various organizations were positioning themselves to survive the turmoil and emerge the stronger for it. Participants also heard from two county health programs about how competition and realignment in the private market were impacting safety-net services for …

Health Care Quality: From Data To Accountability, Mary Darby

National Health Policy Forum

This paper discussed the evolution of quality measurement and reporting activities as well as efforts to develop accountability for delivering high-quality care. It examined (a) initiatives in the professional arena, such as accreditation and performance measurement by independent accrediting bodies; (b) activities of market proponents, who have preferred to concentrate on making data available to purchasers and consumers that would enable them to choose high- quality plans and providers; and (c) attempts by the public sector to secure quality through regulation and oversight. An exploration of the successes, limitations, overlaps, and gaps in quality assurance initiatives, the paper was published …

Improving Patient Satisfaction With A Major Healthcare Organization, Mary Carolyn Tornero

Theses Digitization Project

No abstract provided.

Indicators Of Leadership Characteristics Of Health Care Administrators: Executive Tenure, Behavioral Attributes, And Self-Professed Values, Kenneth Dale Kassinger

Theses Digitization Project

No abstract provided.

Evaluation De La Prise En Charge De La Maternité Sans Risque Et De La Survie De L'Enfant Au Niveau Communautaire De Bazéga, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council

Reproductive Health

No abstract provided.

The Structural Response And Performance Of General Hospitals In A Managed Care Environment, Denise M. Mccollum

Theses and Dissertations

The study purpose is to link hospital structure, represented by each hospital’s professional contingent, service mix, and inpatient capacity; and its environment, characterized by the penetration of managed care enrollees. The secondary purpose is to test the relationship between hospital structural change and subsequent hospital performance.

The study employs a non-experimental panel design, with a sample of 1882 community hospitals (service type: general medical and surgical). Environmental variables are measured for the base year 1989. Hospital structural variables are measured for 1989 and 1994, with change variables computed. Performance variables are measured for 1989 and 1995, with change computed for …

Managed Care Accreditation: Decoding The Acronyms, Randall K. Abbott, Joanne Gatti-Petito

Nursing Faculty Publications

While their health care plan's accreditation status is of increasing importance to employers, they are faced with a bewildering array of accreditation groups and standards. No accreditation organization can assure quality of care, but careful evaluation of accreditation standards, processes and results can help steer decision making in the right direction.

A Comparison Of The Levels Of Patient Staffing Ratios And Staffing Mix To The Number Of Patient Falls In An Acute Care Setting, Candice Marie Peters

Theses Digitization Project

No abstract provided.

Information About Primary Care Physicians Considered Most Useful By Managed Health Care Consumers, Janet Marie Webb

Theses Digitization Project

No abstract provided.

Pay-Per-Visit For Home Health Agency Nurses, Paula Beth Peoples

Theses Digitization Project

No abstract provided.

Assessment Of The Health Needs Of The Communities Served By Kaiser Permanente Of Riverside, Jennifer Van Arsdall

Theses Digitization Project

The purpose of this community needs assessment was to explore the unmet health needs in some of the communities of Riverside County, to discover which populations are most adversely affected by these unmet needs, and to determine what barriers hinder individuals from getting their needs met. United Way of the Inland Valleys, in cooperation with Kaiser Permanente of Riverside conducted this study as part of their community based needs assessment.

An Examination Of The Effect Of Substance Abuse On Prison Populations And Related Policy Issues Of The California Department Of Corrections, Frank Siaca

Theses Digitization Project

No abstract provided.

Determinants Of The New Entry Of Hmos Into A Medicare Risk Contract: A Resource Dependence-Diversification Model, Chih-Wen Pai

Theses and Dissertations

The purpose of this study is to examine the determinants of the new entry of an HMO into a Medicare risk contract using a resource dependence—diversification model. This study is conducted through a non-experimental, panel design With one year time lag. An HMO’s market is defined as the service area. The primary sample for this study is composed of 440 HMOS that do not have a Medicare risk contract as of January 1994.

Data for the variables are extracted from the 1994 and 1995 InterStudy and Group Health Association of America (GHAA) directories, the 1996 Area Resource File, the 1994 …

Patient Satisfaction Among Users Of The After Hours Program, Helen L. Larocco

Community & Environmental Health Theses & Dissertations

The problem of increasing health care costs and decreasing access to health care services is a major crisis in the U.S. today. One factor contributing to the rising cost of health care is the inappropriate use of emergency rooms, (ERs). In response to escalating costs a local health care corporation implemented a telephone triage program called the After Hours Program, (AHP). The goal of the program was to reduce inappropriate utilization of emergency rooms, and to educate patients to recognize and treat specific health problems independently, i.e., home treatment.

A program evaluation was completed in which different dimensions of patient …

A Comparison Of The Utilization Of Health Services In The Presence Or Absence Of Prescriptive Drug Insurance In A Managed Care Environment, Martha Groblewski

Health Services Research Dissertations

This study tested if the availability of third party payment for prescriptive drugs as part of employer sponsored health insurance was associated with a change in the utilization of four types of health services in an independent practice association (IPA). The study employed the individual determinants component of the Andersen-Newman theoretical framework for health services utilization. Groups of employees in companies that offered health insurance identical in all ways except for the presence or absence of the prescriptive rider were included in the study which resulted in a population of 122 companies (89 with prescriptive rider insurance and 33 without …

Skilled Nursing Facility Based Rehabilitation Outcomes Of The Geriatric Stroke Patient, Sheila Bernadette Andrews

Theses Digitization Project

No abstract provided.

Exercise And Dietary Habits Of High School, Health Science Students, Lorri Castro Aguilera

Theses Digitization Project

No abstract provided.

Women’S-Perceived Quality In Postpartum Care, Maryland A. Hunter

Theses and Dissertations (ETD)

Increased competition among healthcare organizations for the obstetric consumer market has led to increased interest in women’s perceptions of their obstetric experience. This study explored women’s perceptions of quality and women’s perceptions of benefits for women who received family-centered postpartum care (FCPPC) and women who received traditional postpartum care (TPPC). The study also assessed the relationship between women’s-perceived quality (WPQ) and women’s-perceived benefit (WPB) for those receiving FCPPC and those receiving TPPC. Quality and beneficence are the two concepts of Larrabee’s (1992) model of quality operationalized in this study. The sample consisted of 60 postpartum women, 30 receiving care on …

Small Group Market Health Insurance Purchasing Cooperatives Revisited, Karl Polzer

National Health Policy Forum

As Congress was in the final stages of considering the Clinton administration's proposal for comprehensive health reform and various derivatives of it, this Forum session examined the progress of several purchasing cooperatives in helping employees of small firms find affordable insurance coverage. The first half of the meeting focused on California's purchasing alliance, especially its impact on prices in the small-group insurance market. Varying models of cooperatives (or alliances) being set up in Florida, Iowa, and Kentucky also were discussed, with special attention being paid to their potential for addressing fundamental problems such as rising costs and access to insurance.

Patient Perceptions Of Quality: The Influence Of Value And Beneficence, Rebecca H. Waldon

Theses and Dissertations (ETD)

The influence of patient values and patient perception of benefits on patient perceptions of quality have not been extensively investigated, even though patient and provider perceptions of quality have been widely studied. Refocusing quality assessment and improvement to include factors that influence patient perceptions of quality is necessary for humanitarian and economic reasons. The health care patient has certain expectations of health care. These expectations are based on the value the patient places on the services. Value is a predictor of patient-perception of quality. The relative worth of patient goals may also be related to patient perceptions of quality. If …

Federal Support For Medical Education: Framing The Issues For The Systems Reform Debate, Karen Matherlee

National Health Policy Forum

Designed primarily for federal legislative and regulatory health staff involved in systems reform efforts, the session provided a primer on current medical education policies (with emphasis on federal strategies) and a prospectus on policies to change them.

The Effects Of Organizational Culture On Quality Of Life For Older Veterans, Michelle Diane Stone

Dissertations

The organizational culture in a Veteran's Administration Medical Center (VAMC) was described using triangulated methods which included both secondary quantitative survey data, and internal documentary data sources. The initial survey data collected, from staff and elder veterans revealed an overall positive perception from both samples regarding the quality of life for elder veterans living on extended care wards. The study investigated the extent to which the VAMC's organizational culture affected these perceptions of quality of life.

Documentary data were collected from a variety of VAMC sources regarding behaviors, ideologies, leadership trends, mechanisms of control, and the formal organizational structure. A …

A Financial Analysis Of A Southern California Coalition Of Visiting Nurse Associations, Diane Sutton Burns

Theses Digitization Project

No abstract provided.

Certified Nursing Assistants' Satisfaction With Education And Training Programs In Long-Term Care Facilities: A Massachusetts Study, Sheila Kenny Morin

Theses Digitization Project

No abstract provided.

Pain And Hospital Patients Perception Of Quality, Kathy L. Beck

Theses and Dissertations (ETD)

Each year pain disables approximately 50 million Americans. These patients seekhealth care for the relief of pain and its underlying cause. Many of those seeking relief from pain are hospitalized and others experience pain during their hospitalization. All of these patients have the right to relief of their pain and none should suffer pain needlessly. Yet, often nurses fail to accurately assess and adequately manage patients' pain.

Adequate pain management may increase patient perception of nursing care quality. The purpose of this study is to determine the relationships between pain relief and patients' and nurses' perceptions of quality. The relationship …

A Cipp Evaluation Of The Administrative Associate Training Program Through Sentara, Patricia A. Criswell

Community & Environmental Health Theses & Dissertations

Hospitals are facing change in today's environment. In order to meet these growing challenges, they are responding by providing value added services. Value added services have been defined as reducing inefficiencies and improving quality and service. Operational restructuring in the form of a new concept called patient-focused care has become the paradigm shift and structural revamping at several hospitals across the nation. Sentara Hospitals have adopted this program to improve the clinical and service quality delivered to the patient. An integral component of this new approach is the multiskilling of staff to reduce duplication, inefficiencies, and improve the quality provided …

Evaluation Of The Provision For A University Health Service As Part Of The Quality Assurance Process, Rob Chandler, Barry Sheridan

Research outputs pre 2011

Universities within Australia are facing increasing demands to demonstrate quality in both product and process by ensuing that their aims are met efficiently and effectively. As part of the quality assurance process for Edith Cowan University, a multi-campus institution, an evaluation was undertaken to monitor the effectiveness of the University health service and its significance within the University community. Responses from both staff and students to a survey conducted during August 1993 on behalf of the Department of Medical and Health Services indicate a high level of support for this service. This Report provides an overview of the evaluation study …