Health Services Research Commons^™

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

"Homelike" Characteristics Of Maine's Residential Services: A Survey Of Maine's Residential Service Settings (2010), Julie T. Fralich Mba, Eileen Griffin Jd, Catherine Mcguire Bs

Disability & Aging

To better understand the nature of the residential facilities serving more than 19 percent of Maine’s Long Term Services and Supports (LTSS) population, the Maine Department of Health and Human Services commissioned the Muskie School to conduct a survey of residential facilities as part of its update to Maine’s LTSS profile. The goal of the Maine Residential Settings Characteristics Survey, conducted between July and September 2010, was to measure the "homelike" characteristics of residential settings.

The survey sample comprised a total of 636 facilities which included all licensed residential care facilities or private non-medical licensed institutions. The survey response rate …

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …

Reinventing The 21st Century Public Health Workforce: Innovation, Evaluation & Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Compelling opportunities exist for incorporating practice-based research to into the design, implementation, and evaluation of public health workforce training and development programs. Public Health Training Centers (PHTCs) can collaborate with practice-based research networks (PBRNs) to discover and disseminate evidence-based strategies for workforce development.

Making The Case For Public Health: Estimating Roi And Value, Glen P. Mays

Health Management and Policy Presentations

This presentation describes recent progress and new directions for estimating the value of public health strategies and infrastructure.

Quantifying The Value Of Public Health Investments, Glen P. Mays

Health Management and Policy Presentations

This session reviews recent findings from a series of studies that estimate the health and economic effects attributable to investments in public health services and delivery systems.

Developing Service Delivery Measures For Studies Of Practice Variation: The Mprove Study, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Consequently, HHS recently used a consensus-based process to develop a framework for improving quality in public health and to identify a set of nine priority areas for improvement. As next steps in operationalizing this framework, measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. This presentation profiles the methodology developed …

Scale And Scope Effects In Public Health Delivery: Estimating Gains From Regionalization, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Current approaches to health system reform under the Affordable Care Act include efforts to enhance the delivery of public health services that promote health and prevent disease and injury on a population-wide basis. The nation’s public health delivery system comprises nearly 3000 local public health agencies that vary widely in size, resources, and capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources and expertise across local jurisdictions to enhance delivery and improve population health. This analysis uses longitudinal observations on a national sample of local public health agencies …

Funding Public Health: A New Iom Report On Investing In A Healthier Future, George Isham, Robert Kaplan, Glen P. Mays

Health Management and Policy Presentations

A new Institute of Medicine report recommends establishing a national target for life expectancy and implementing new mechanisms for financing public health strategies to acheive this target.

Emerging Disparities Among Self-Pay Trauma Patients, Michelle Chino Dr, Deborah A. Kuhls, Mark K. Markarian, Sam Holland, John J. Fildes

Journal of Health Disparities Research and Practice

Preliminary results from a study of trauma patients in Southern Nevada are yielding some unexpected findings with implications for both trauma centers and the growing Hispanic population. Hispanic patients are more likely to be self pay irrespective of income level and employment status when compared to non-Hispanic patient groups. Further, self pay Hispanics, unlike their non-Hispanic, self pay counterparts, tend to be employed, have families, and report stable living conditions. The implication is that the financial and social cost of traumatic injury may place a significant burden on trauma centers, patients, their families and the community.

Expanding The Evidence Base For Accreditation And Qi: Progress In Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Studies that examine the implementation and impact of quality improvement strategies in public health are underway through the Public Health Practice-Based Research Networks.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

BACKGROUND: Policy strategies for reforming the U.S. health care system to control costs and improve health outcomes include the possibility of expanded support for public health activities that are designed to prevent disease and promote health on a population-wide basis. These activities include efforts to monitor and report on community health status, investigate and control disease outbreaks, educate the public about health risks and prevention strategies, develop and enforce laws and regulations to protect health, and inspect and assure the safety and quality of water, food, air and other resources necessary for health. The Patient Protection and Affordable Care Act …

Physicians’ Experiences And Opinions Regarding Strategies To Improve Care For Minority Patients, Jared W. Klein, Lindsay O. Schubiner, Margaret Gadon, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Objective: To assess the views and experiences of a select group of physicians interested in minority health issues regarding promising strategies to improve minority care. Methods: Physicians were asked to respond to a 17-item survey assessing the level of agreement, frequency of implementation of and interest in learning more about 7 promising strategies for alleviating disparities. Results: Most physicians (75-95%) agreed that the 7 proposed strategies could be useful to improve the quality of care provided to minority patients, but only 40-66% of physicians had implemented the strategies sometimes or often in their practices. Between 22 and …

The Science Of Public Health Practice: Using Pbrns For Delivery System Research In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

PBRN research tests strategies for improving the delivery of services that promote health and prevent disease and injury on a population-wide basis.

Revised: An Early Assessment Of The Potential Impact Of Texas’ “Affiliation” Regulation On Access To Care For Low-Income Women, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Investing In A Healthier Future: Iom Dissemination Workshop, Glen P. Mays

Health Management and Policy Presentations

This session discusses strategies for implementing new financing strategies and funding mechanisms for public health services.

Perbandingan Tingkat Kepuasan Kerja Perawat Dan Kepuasan Pasien, Jamilla Upik Noras, Ratu Ayu Dewi Sartika

Kesmas

Perawat adalah ujung tombak pemberi pelayanan langsung pada pasien selama 24 jam. Tujuan penelitian adalah untuk membandingkan tingkat kepuasan kerja perawat dengan kepuasan pasien terhadap pelayanan keperawatan kelas 3 di Rumah Sakit Umum Pusat (RSUP) X Jakarta. Penelitian ini bersifat deskriptif dengan desain studi cross sectional, pendekatan kuantitatif dan kualitatif. Populasi adalah seluruh perawat yang bertugas sebagai pelaksana keperawatan kelas 3 sebanyak 40 orang ser- ta pasien yang dirawat di ruang rawat inap kelas 3 sebanyak 120 orang. Pengambilan sampel dilakukan secara purposive sampling sesuai dengan kriteria inklusi dan ekslusi. Hasil pengukuran kuantitatif menunjukkan bah- wa tingkat kepuasan kerja perawat …

Patterns Of Interaction In Public Health Research Networks: Insight From Network Analysis, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Studies from the past three decades have found evidence of wide variation in public health practices and policies across states and communities despite an expanding evidence base of efficacious public health strategies, suggesting gaps in implementation and translation processes. Practice-based research networks (PBRNs) are expected to accelerate research participation and translation. This study uses social network analysis methods with twelve Public Health PBRNs to study processes influencing the implementation and translation of research within diverse public health settings.

DATA and METHODS: A cross-sectional network analysis survey was validated and fielded with participants in two cohorts of public health PBRNs …

Public Health Governance And Population Health Outcomes, Scott P. Hays, Janine Toth, Matthew J. Poes, Peter F. Mulhall, David M. Remmert, Thomas W. O'Rourke

Frontiers in Public Health Services and Systems Research

Research reviews have identified a gap in understanding the diversity of health department governance structures and in understanding how the variations in governing relates to health outcomes. This report details the categorization of local public health governance and reveals that certain governance types may be better suited to achieve better population health outcomes. State systems achieve the poorest health outcomes, but the best health outcomes are achieved when the political branches have a key role in local public health governance. Public health systems should consider greater local control and involvement in governance; but local governance should include the political branches …

Using State And Local Health Survey Data To Advance Phssr, Glen P. Mays

Health Management and Policy Presentations

State and local health survey data can be used to evaluate the implementation and impact of public health delivery innovations in real-world practice settings.

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Racial Disparities In Cancer Screening Among Women With Chronic Joint Pain, Edith M. Williams, Laurene Tumiel-Berhalter, Christopher Purdy, Adrianne Ransom, Judith Anderson

Journal of Health Disparities Research and Practice

Chronic pain related disorders and breast and cervical cancer are more prevalent among African-American women compared with non-Hispanic White women. However, few studies address how racial differences in the context of comorbidity may compound these disparities. This study used secondary analysis of the National Health Interview Survey (NHIS) to assess racial differences in breast and cervical cancer screening and patient education among adult women with chronic joint pain conditions. Statistical analyses included chi-square and independent samples t-tests. African-American women compared with non-Hispanic White women were less likely to receive a pap smear or mammogram within the last two years and …

Pay-For-Performance In Five State Medicaid Programs: Lessons For The Nursing Home Sector, Edward M. Miller, Julia Doherty

Office of Community Partnerships Posters

This project looks at the pay-for-performance program in five state Medicaid programs and lists the lessons that the Nursing Home Sector can learn from. They are: The federal government has traditionally sought to ensure quality outcomes through nursing home (NH) surveys conducted by state officials; Some states have begun to experiment with pay-for-performance (P4P) incentives, which provider higher Medicaid reimbursement to those facilities achieving desired outcomes; By 2007, there were 9 state P4P programs covering 20% of NHs and 16.7% of residents; Little is known about the use of P4P to promote quality and efficiency in the NH sector.

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

Office of Community Partnerships Posters

This project identified the facts about Nursing Facility Reimbursement by Medicaid in the states of New York and Minnesota. The results of this project are as follows: Medicaid is the main purchaser of nursing home (NH) care in the United States; States design their methods of reimbursing NHs to achieve desired policy objectives; Few consumers or resident advocates have been involved in the development or modification of state methods for reimbursing NHs; Lack of consumer involvement has resulted in payment systems that favor industry and government interests at the expense of issues important to residents and families.

Conflict Situation For Health Care Workers: A Case Study Of The Occupational Challenges In Kasangati Health Centre Iv And Their Implications For Patient Care., Shannon Mcdowell

Independent Study Project (ISP) Collection

Many factors influence a country’s ability to provide quality health services for its people. Particularly, quality health care hinges upon the availability of properly trained and equipped health care workers (HCWs) to deliver effective care. Resource-strained countries committed to the Millennium Development Goals are confronting the reality that shortages and uneven distribution of HCWs threaten their capacities to encourage and establish healthy communities. A scarcity in HCWs is one challenge of public health initiatives and places stress on existing HCWs. Other challenges faced by HCWs severely affect performance, motivation, and overall care-giving ability.

This study aims to examine the particular …

Do No Harm: Perceptions Of Short-Term Health Camps In Nepal, Dena Seabrook

Independent Study Project (ISP) Collection

Short-term health camps are a growing form of delivering health care services to needy populations. Often these camps, usually lasting around 2 weeks, are led by I/NGOs in developing nations like Nepal and are staffed with volunteers from the Global North. These camps are largely ungoverned, and there are no evaluative techniques in place to monitor the effectiveness of the work done, raising concerns about the unintended consequences of short-term health camps camps. Nepal is particularly vulnerable to this issue because of the vast number of I/NGOs currently operating within its boundaries.

This research sought to expand the conversation surrounding …

Access To Healthcare For The Poor: Will The Affordable Care Act Address Income-Related Health Disparities In The United States?, Sonya Fabricant

Independent Study Project (ISP) Collection

Background: Low-income populations live shorter and less healthy lives in the United States due to a complexity of social, environmental and behavioral factors. These populations also face significant barriers in accessing health services. In 2010, the Patient Protection and Affordable Care Act (PPACA) passed, marking the first major reform of the American healthcare system since the 1960s. This paper evaluates its potential to address health disparities through changes to medical care delivery. Methodology: Results were compiled from government documents, reports from research institutes, journal articles, and an expert interview. A section-analysis was also performed, evaluating the strengths and weaknesses of …

Conocimientos Y Conductas Sexuales En Trabajadores Migrantes (Arica, Chile), Anna Conley

Independent Study Project (ISP) Collection

Background: The HIV/AIDS epidemic continues to be prevalent and to expand in Chile, as in many other regions of Latin America and around the world. Furthermore, it continues to concentrate in distinct, vulnerable populations. Migrant workers represent one such vulnerable population. The HIV/AIDS epidemic disproportionately impacts migrant workers because of the social, economic, and psychological factors that are involved in both migratory behaviors and disease construction.

Aim: This study identified sexual health knowledge and sexual health behavior in the migrant laborer population of Arica, Chile. More specifically, it identified risk factors for HIV/AIDS and explored possible strategies for a preventative …

Preventing Hepatitis B-Induced Liver Cancer: Implications For Eliminating Health Disparities, Moon S. Chen Jr.

Journal of Health Disparities Research and Practice

If the definition of eliminating of a health disparity were signified by the absence of any differences in incidence or mortality between a population’s experiences with a health problem, then the only health disparity that has ever been eliminated is smallpox because with zero cases of smallpox in the world, no health disparities exist because of smallpox. The eradication of smallpox is perhaps the only historical example where the elimination of a health disparity has been achieved. Principles and lessons learned, particularly through the intersection of science and policy that could be applied to the elimination of other health disparities …