Social and Behavioral Sciences Commons^™

How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays

Health Management and Policy Presentations

Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.

Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Health Management and Policy Presentations

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.

Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays

Health Management and Policy Presentations

Research on the organization and financing of public health strategies offers valuable insight for governmental public health agencies seeking to adapt to a population health improvement perspective under health system reform.

Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

Public health laboratories are the information engines for public health agencies and delivery systems. Measuring the value stream that flows from this information can support objective assessments of the health and economic benefits attributable to laboratory infrastructure and information.

Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: Twenty-six states are expanding Medicaid eligibility under the Affordable Care Act (ACA) in 2014, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who newly enroll in Medicaid in response to ACA’s expanded outreach and enrollment incentives. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to …

Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays

Health Management and Policy Presentations

This session reviews progress in the field of public health services & systems research (PHSSR), with a specific focus on findings that can inform the implementation and impact of health reform strategies on the U.S. public health system.

Playing To Our Strengths: An Academic/Health Department Collaboration To Facilitate Public Protections Against Tuberculosis, Thaddeus L. Miller, Erin K. Carlson, Nuha A. Lackan

Frontiers in Public Health Services and Systems Research

Background:

Economic modeling and analysis can facilitate evidence-based policy and practice. Such analyses may exceed the technical capacity and mission of public health agencies, yet may be critical to sustain health protections such as tuberculosis (TB) control. The net effect of TB prevention is incompletely understood, hampering objective value judgments of national TB elimination policies. This may promote inefficiencies and threaten individual and public health protections.

We describe how a HRSA-funded Texas Public Health Training Center (TPHTC) coordinated specialized analytical skills with the needs of a state public health department to create a user-friendly tool to inform planning and resource …

Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Practice-based research networks (PBRNs) provide powerful mechanisms for implementing research studies that evaluate the health and economic effects of delivery system innovations. This presentation reviews strategies, emerging findings, and lessons learned from PBRNs and related studies conducted in U.S. public health settings. We give special focus to studies that examine multi-organizational and cross-sectoral strategies for population health improvement.

Strengthening The Science Of Public Health Delivery: Complexities In Implementation, Inference & Translation, Glen P. Mays

Health Management and Policy Presentations

Delivery systems for public health programs and policies are diffuse and heterogeneous across the U.S., reflecting wide variation in the capacity to implement population-level health improvement strategies. This lecture examines strategies for evaluating the causes and consequences of variation in public health delivery across the U.S., with a focus on identifying pathways for improving the health and economic effects of policy and practice.

Academic Predictors And Characteristics Of Self-Reported Juvenile Firesetting, Carrie Howell Bowling, Hatim A. Omar

Pediatrics Faculty Publications

The main purpose of this study was to address gaps in existing research by examining the relationship between academic performance and attention problems with juvenile firesetting. Two datasets from the Achenbach System for Empirically Based Assessment (ASEBA) were used. The Factor Analysis Dataset (N = 975) was utilized and results indicated that adolescents who report lower academic performance are more likely to set fires. Additionally, adolescents who report a poor attitude toward school are even more likely to set fires. Logistic regressions were run to determine if attention problems predicted firesetting and the findings indicated that attention problems are predictive …

Estimating The Costs Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

Hospital Contributions To Public Health Activities Before And After Aca: Incentives, Constraints & Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created enhanced IRS requirements for not-for-profit hospitals regarding the provision of community benefits, potentially stimulating new approaches to community health needs assessment, priority setting, and engagement with public health agencies and other community stakeholders. Yet the economic downturn has constrained hospital earnings and increased demand for uncompensated care, potentially crowding out hospital contributions to public health activities. This study uses data from 1998-2012 on a national cohort of communities to examine: (1) the extent and nature of change in hospital contributions to public health activities; and (2) the economic, institutional, and policy-related factors that …

Analyzing Return On Investment In Public Health: Implications And Future Directions, Glen P. Mays

Health Management and Policy Presentations

Return on investment (ROI) analyses of public health programs, policies, and services are being undertaken with increasing frequency to provide assessments of the value of these activities. This presentation reviews current initiatives and future directions for improving the quality of ROI studies and their application to real-world public health policy and administrative decisions.

Public Health Delivery Systems And Population Health, Glen P. Mays

Health Management and Policy Presentations

Despite high overall health expenditures, the U.S. continues to fall behind other high-income countries on many measures of population health. While health care delivery systems are now studied intensively for solutions to U.S. cost and quality problems, the nation's delivery systems for public health programs and policies are only now becoming the subject of rigorous empirical study. This presentation examines recent studies of public health delivery systems and important directions for future inquiry.

Estimating Return On Investment: Approaches And Methods, Glen P. Mays

Health Management and Policy Presentations

Continuing fiscal constraints in the public sector and large-scale policy changes associated with health reform implementation in the U.S. are giving heightened attention to questions about the health and economic value of public health programs, services, and policies -- strategies designed to protect health and prevent disease and injury on a population-wide basis. This session provides an overview of approaches for conducting return-on-investment (ROI) analyses and related economic evaluation studies in public health settings in order to inform policy and administrative decision-making. New opportunities and resources created through CDC's National Public Health Improvement Initiative (NPHII) and RWJF's Public Health Practice-based …

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.

Patterns Of Interaction Among Local Public Health Officials And The Adoption Of Recommended Practices, Jacqueline A. Merrill, Kathleen M. Carley, Mark G. Orr, Christie Y. Jeon, Jonathon Storrick

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues contains two groups of LHDs that are influential for either their ability to spread information or to innovate. Both groups are more likely to conduct community health assessments and develop health improvement plans. Since these activities are fundamental aspects of accreditation and health reform, the findings may present an early indication that these initiatives are having an effect on the public health system.

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 …

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.

Influence Of Prescription Drug Monitoring Programs On Acetaminophen-Related Liver Toxicity, Aaron Barcelo

MPA/MPP/MPFM Capstone Projects

No executive summary.

Impact Of Poor Quality Of Life On Adolescents In Rural Kentucky: A Brief Report, Hatim A. Omar, Søren Ventegodt, Joav Merrick

Pediatrics Faculty Publications

In many rural areas in Kentucky, adolescents lack the basic assets for a good quality of life, such as having caring adults, a safe place and useful activities after school. Methods: Analysis of data from middle and high school students referred to a comprehensive school based health promotion center (SBHPC). Results: From august 2006 to February 2008, a total of 382 students (200 female, 182 male, aged 12-18 years) were referred to the SBHPC for help. Only two (0.5%) students had two parents living with them and 12 (3.1%) had safe, organized after school activities. 19.9% of the total were …

Evaluating The Healthy States Initiative Policy Forums, Jessica Harmon

MPA/MPP/MPFM Capstone Projects

Since 2005, The Council of State Governments (CSG) has participated in a cooperative agreement funded by the Centers for Disease Control and Prevention (CDC) called the Healthy States Initiative. The initiative promotes public health by providing information resources to state legislators through publications and public health forums. CSG is interested in information about the impact of the public health forums on state legislators. More specifically, they would like to know if the forums have encouraged the participants to produce public health legislation, to support funding for public health projects, and to work closely with colleagues and various groups to improve …

The Influence Of Veterinary Schools On The Veterinary Labor Market, Kyle Bosh

MPA/MPP/MPFM Capstone Projects

Problem Statement:

Does the presence of a veterinary school in a state influence the supply of veterinarians practicing in that state? Citizens and animals in states without a veterinary school are at a disadvantage if the presence of a veterinary school significantly improves public health and access to medical services in those states that have a veterinary school.

Research Strategy:

The unit of analysis in this study is 50 states and the District of Columbia. The study is designed as a cross-sectional analysis of 2006 pet, 2002 livestock, 2006 human, labor, and economic data. The study uses simultaneous equations to …