Health Economics Commons^™

Book Review: Social Justice: The Moral Foundations Of Public Health And Health Policy, Robin West

Georgetown Law Faculty Publications and Other Works

This essay is a review of Social Justice: The Moral Foundations of Public Health and Health Policy by Madison Powers & Ruth Faden (2006).

In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate? In a world filled with inequalities in health and well-being, which inequalities matter most and are the most morally urgent to address? In order to answer these questions, Powers and Faden develop a unique theory of social justice that, while developed for the specific contexts of public health and health …

Desulfovibrio Desulfuricans G20 Tetraheme Cytochrome Structure At 1.5 A˚ And Cytochrome Interaction With Metal Complexes, Mrunalini Pattarkine, J J. Tanner, C A. Bottoms, Y H. Lee, Judy D. Wall

Faculty Works

The structure of the type I tetraheme cytochrome c3 from Desulfovibrio desulfuricans G20 was determined to 1.5 A˚ by X-ray crystallography. In addition to the oxidized form, the structure of the molybdate-bound form of the protein was determined from oxidized crystals soaked in sodium molybdate. Only small structural shifts were obtained with metal binding, consistent with the remarkable structural stability of this protein. In vitro experiments with pure cytochrome showed that molybdate could oxidize the reduced cytochrome, although not as rapidly as U(VI) present as uranyl acetate. Alterations in the overall conformation and thermostability of the metal-oxidized protein were investigated …

Does Falling Smoking Lead To Rising Obesity?, Jonathan Gruber, Michael D. Frakes

Faculty Scholarship

The strong negative correlation over time between smoking rates and obesity have led some to suggest that reduced smoking is increasing weight gain in the U.S.. This conclusion is supported by the findings of Chou et al. (2004), who conclude that higher cigarette prices lead to increased body weight. We investigate this issue and find no evidence that reduced smoking leads to weight gain. Using the cigarette tax rather than the cigarette price and controlling for non-linear time effects, we find a negative effect of cigarette taxes on body weight, implying that reduced smoking leads to lower body weights. Yet …

Examining Adherence And Sexual Behavior Among Patients On Antiretroviral Therapy In India, Avina Sarna, Indrani Gupta, Sanjay Pujari, A.K. Sengar, Rajiv Garg, Ellen Weiss

HIV and AIDS

With increased availability of ART, HIV-positive individuals are living healthier lives and continuing or resuming sexual activity. However, optimism related to ART’s success in slowing disease progression, reducing viral load, and improving health status may lead to more risky sexual practices and a possible increase in transmission of infections. To determining the sexual behavior of HIV-positive persons on ART, the Horizons program, in collaboration with research partners in Delhi and Pune, conducted a study to assess current levels of adherence to ART among a sample of people living with HIV/AIDS, identify the factors that influence their adherence to treatment, and …

Reducing Child Malnutrition: How Far Does Income Growth Take Us? By Lawrence Haddad, Harold Alderman, Simon Appleton, Lina Song And Yisehac Yohannes: A Review, Sani Bawa

Economic and Financial Review

This is a review of the article “Reducing Child Malnutrition: How Far Does Income Growth Take Us?” By Lawrence Haddad, Harold Alderman, Simon Appleton, Lina Song and Yisehac Yohannes which was published in the World Bank Economic Review, Vol.17, No. 1, 2003.

The Road To Universal Health Coverage In Massachusetts: A Story In Three Parts, John E. Mcdonough

New England Journal of Public Policy

In 1988, the Massachusetts Legislature passed a new law, a “play or pay” employer mandate, requiring all employers with six or more workers to provide health insurance coverage for their employees. A few years later, with Medicaid identified as a “Budget Buster,” the Weld administration sought deregulation as the way to cut costs and expand access by establishing MassHealth, which dropped the employer mandate and expanded Medicaid, and eventually distinguished Massachusetts as the state with the greatest percent of covered citizens. But MassHealth enrollment has declined as premium costs have risen, and the Uncompensated Care Pool is once again faced …

Using Incentives To Encourage Aids Programs And Policies In The Workplace: A Study Of Feasibility And Impact In Thailand, Simon Baker, Srisuman Sartsara, Patchara Rumakom, Philip Guest, Katie D. Schenk, Anthony Pramualratana, Suparat Suksakulwat, Surachai Panakitsuwan, Sikarat Moonmeung

HIV and AIDS

A recently completed Horizons study in Thailand examined the question of how to encourage the private sector to become actively involved in developing and improving workplace HIV/AIDS programs. The study found that the AIDS-response Standard Organization (ASO) initiative mobilized a moderate proportion of different types of companies to develop and improve HIV/AIDS workplace policies and programs. The data also reveal that companies that were eligible for the insurance discount made the greatest improvements. Thus a financial incentive combined with efforts to tap into managers’ willingness to respond to the epidemic can be important motivators for certain companies to improve their …

Identifying Compliance Issues In The Community Health Care Clinic Environment, Faye K. Beery

Graduate Theses

This study explored the high number of failed appointments and follow-up appointments at a community health care children’s clinic. A thirty-seven item questionnaire was randomly given to 112 participants seeking health care at the clinic on a random basis. Based on literature reviews, five hypothesis were generated to examine reasons for failing to keep appointments for children: 1. Communication difficulties between healthcare personnel and parents regarding patient comprehension of instructions and bottle directions were anticipated. 2. Patient/physician/clinic relationships were expected to influence patient compliance. The need for more reminder calls for appointments was anticipated to be a factor in patient …

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Carolyn Barnes, Erica Keogh, Nontokozo Nemarundwe, Loveness Nyikahadzoi, Ellen Weiss

HIV and AIDS

This study, conducted in Zimbabwe, sought to better understand the relationship between a microfinance program, Zambuko Trust, and how microentrepreneurs’ households cope with the impact of HIV/AIDS. The study examined how HIV/AIDS is affecting Zambuko’s operations and what microfinance institutions (MFIs) can do to lessen the impact of HIV/AIDS on their clients and operations. The findings indicate several small yet important ways that MFI programs help microentrepreneurs and their families respond to these impacts through access to credit and business management training. Participation in a microfinance program led to income smoothing and better financial management, which can help households mitigate …

State Regulations Of Smoking In Public Places: Determinants And Implications On The Demand For Smoking And Consumers' Behavior, Ioana Raluca Mazare

Dissertations

No abstract provided.

Studies On The Formation Of Dna-Cationic Lipid Composite Films And Dna Hybridization In The Composites, Murali Sastry, Vidya Ramakrishnan, Mrunalini Pattarkine, Krishna N. Ganesh

Faculty Works

The formation of composite films of double-stranded DNA and cationic lipid molecules (octadecylamine, ODA) and the hybridization of complementary single-stranded DNA molecules in such composite films are demonstrated. The immobilization of DNA is accomplished by simple immersion of a thermally evaporated ODA film in the DNA solution at close to physiological pH. The entrapment of the DNA molecules in the cationic lipid film is dominated by attractive electrostatic interaction between the negatively charged phosphate backbone of the DNA molecules and the protonated amine molecules in the thermally evaporated film and has been quantified using quartz crystal microgravimetry (QCM). Fluorescence studies …

Cationic Surfactant Mediated Hybridization And Hydrophobization Of Dna Molecules At The Liquid/Liquid Interface And Their Phase Transfer, Murali Sastry, Ashavani Kumar, Mrunalini Pattarkine, Vidya Ramakrishnan, Krishna N. Ganesh

Faculty Works

Hybridization of complementary oligonucleotides mediated by a cationic surfactant at the water/hexane interface leads to hydrophobic, double-helical DNA which may be readily phase transferred to the organic phase and cast into thin films on solid substrates.

The Market For Medical Ethics, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

At the core of Kenneth Arrow’s classic 1963 essay on medical uncertainty is a claim that has failed to carry the day among economists. This claim—that physician adherence to an anti-competitive ethic of fidelity to patients and suppression of pecuniary influences on clinical judgment pushes medical markets toward social optimality—has won Arrow near-iconic status among medical ethicists (and many physicians). Yet conventional wisdom among health economists, including several participants in this symposium, holds that this claim is either naïve or outdated. Health economists admire Arrow’s article for its path-breaking analysis of market failures resulting from information asymmetry, uncertainty, and moral …

Hybridization Of Dna By Sequential Immobilization Of Oligonucleotides At The Air-Water Interface, Murali Sastry, Vidya Ramakrishnan, Mrunalini Pattarkine, Anand Gole, K. N. Ganesh

Faculty Works

The hybridization of DNA by sequential electrostatic and hydrogen-bonding immobilization of single-stranded complementary oligonucleotides at the air-water interface with cationic Langmuir monolayers is demonstrated. The complexation of the single-stranded DNA molecules with octadecylamine (ODA) Langmuir monolayers was followed in time by monitoring the pressure-area isotherms. A large (and slow) expansion of the ODA monolayer was observed during each stage of complexation in the following sequence: primary single-stranded DNA followed by complementary single-stranded DNA followed by the intercalator, ethidium bromide. Langmuir-Blodgett (LB) films of the ODA-DNA complex were formed on different substrates and characterized using quartz-crystal microgravimetry (QCM), Fourier transform infrared …

Measurement Of Hospital Performance: Environmental And Organizational Factors Associated With Cost, Debra Kay Dierksmeier Anderson

Health Services Research Dissertations

As U.S. health care expenditures top the $1 trillion mark, there is increased interest in measuring the performance of health care providers. For bottom line oriented payors such as government and business, the focus is on measuring cost. As hospitals account for over one-third of health care expenses, hospital cost per admission is a common measure of performance.

Many environmental and organizational factors come into play in determining hospital cost per admission. This research examines several of these factors, using Raymond Zammuto's model of organizational effectiveness assessment. Using Zammuto's framework, this research looks at the relationship of social, physical, and …

Labor's Response To Hospital And Workplace Transformation, Enid Eckstein

New England Journal of Public Policy

The health care industry and the nation's hospitals are in the throes of revolutionary change. The shift to managed care resulted in fundamental changes in the delivery of care and the structure of health care, For the past ten years, hospitals have actively been merging and creating large-scale integrated delivery systems. Employers, eager to expand market share and reduce costs, are engaged in radical reorganization of the hospital and the structure of work from which no group is immune. Physicians, nurses, technicians, and housekeepers are all affected by these changes. Hospitals are reducing their personnel, shifting work outside the hospital, …

Anion Induced Blue To Purple Transition In Bacteriorhodopsin, Mrunalini Pattarkine, Anil K. Singh

Faculty Works

Purple membrane (PM, λ" role="presentation">λmax" role="presentation">max 570 nm) of H. halobium on treatment with sulphuric acid changes its colour to blue (λ" role="presentation">λmax" role="presentation">max 608 nm). The purple chromophore can be regenerated from the blue chromophore by exogeneous addition of anions such as CI−" role="presentation">− and HPO42−" role="presentation">2−4. Chloride ion is found to be more effective than the dibasic phosphate ion in regenerating the purple chromophore. Nevertheless, one thing common to the anion regeneration is that both CI−" role="presentation">− and HPO42−" role="presentation">2−4 show marked pH effect. At pH 1.0 the efficiency of …

Update - December 1993, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Wages Through the Ages: The Ethics of Physician Income
-- Frontiers in Medicine and Morality - Probed at Second Annual Contributors Convocation

Could Distance Be A Proxy For Severity-Of-Illness? A Comparison Of Hospital Costs In Distant And Local Patients., H G. Welch, E B. Larson, W P. Welch

Dartmouth Scholarship

We test the hypothesis that hospital costs, after adjusting for DRG mix, are higher in distant patients than in local patients. Data were obtained from the Washington State Commission Hospital Abstract Reporting System (CHARS) and included all patients discharged from 15 metropolitan hospitals in the state of Washington during fiscal year 1987 (N = 181,072).

Update - September 1991, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Business and Medicine: Are They Ethically Compatible?

-- [ A Standard Level of Health Care to All: A Moral Obligation? ]

-- Loma Linda University reorganizes the Center for Christian Bioethics

Trends In Hospital And Nursing Home Care Expenditures, Maine, 1982 To 1986, Maine Department Of Human Services

Maine Collection

Trends in Hospital and Nursing Home Care Expenditures, Maine, 1982 to 1986

Maine Department of Human Services - Office of Data, Research, and Vital Statistics

John R. McKernan, Jr., Governor, Rollin Ives, Commissioner, Brenda Smith, Planning and Research Associate, May, 1989.

"This report produced under Appropriation No. 1310-4010."

Contents: Introduction / Hospital Care Expenditures / Nursing Home Care Expenditures / Comparison of Hospital and Nursing Home Care Expenditure Trends / Concluding Remarks / References

Acute Care Bed Need In Maine: General Use Acute Care Facilities In Maine : Utilization, Occupancy Rates, And Bed Need Projected To 1990 And 1995, Stephen Greenberg

Maine Collection

Acute Care Bed Need in Maine: General Use Acute Care Facilities in Maine : Utilization, Occupancy Rates, and Bed Need Projected to 1990 and 1995

by Stephen Greenberg, Planning and Research Associate, Office of Data, Research, and Vital Statistics.

Prepared at the request of the Division of Planning, Bureau of Health, Maine Department of Human Services.

Produced under Appropriations 1310.4, 1305.1065 and 2210.2950 (November, 1988).

Contents: Overview and Discussion of Findings / Using the Data: An Example / List of Detailed Tables / Appendices

Aids And New England Hospitals, Jesse Green, Neil Wintfeld, Madeleine Singer, Kevin Schulman

New England Journal of Public Policy

The Centers for Disease Control projects that nine thousand persons with AIDS will be alive in New England in 1991, representing a sevenfold increase from 1986. Our analysis indicates that more than 2 percent of medical/surgical beds in New England will be used for AIDS care by 1991, representing 766 fully occupied hospital beds. The direct cost of providing hospital care to New England's AIDS patients is projected to be $195.2 million in 1991, reflecting 3 percent of all hospital inpatient costs in the region.

AIDS treatment is very unevenly distributed among hospitals in New England. Just twenty hospitals (8 …

Medical Care Of Aids In New England: Costs And Implications, Stewart J. Landers, George R. Seage Iii

New England Journal of Public Policy

This article presents an overview of cost issues related to AIDS. Data from the Massachusetts Cost of AIDS Study are combined with epidemiological projections to estimate the cost of treating people diagnosed with AIDS in New England. Aggregate inpatient, ambulatory, and home care costs are estimated to be $96.9 million and $524.8 million through 1987 and 1991, respectively. These estimates represent a relatively small percentage of total health care costs for all illnesses over the same time period.

The authors find that the cost of treating AIDS does not affect all health care providers uniformly and therefore argue that appropriate …

Health Care Expenditures In Maine 1978 : A Funds Flow Analysis, Bruce Armstrong

Maine Collection

Health Care Expenditures in Maine 1978 : A Funds Flow Analysis

by Bruce Armstrong, Research Consultant

Maine Department of Human Services, Bureau of Health Planning and Development, Division of Data and Research, Augusta, Maine (August 1981).

Contents: Preface / Highlights / List of Tables and Figures / Introduction / Definitions / Health Expenditures / Sources of Funds / Type of Expenditure / Comparison of Maine and U.S. Per Capita Expenditures

Trends In Health Care Expenditures, Maine 1974-1978, Bruce Armstrong

Maine Collection

Trends in Health Care Expenditures, Maine 1974-1978

by Bruce Armstrong, Research Consultant

Maine Department of Human Services, Bureau of Health Planning and Development, Division of Data and Research, Augusta, Maine (August 1981).

Contents: Preface / Highlights / List of Tables and Figures / Yearly Tables / Trend Illustrations and Tabular Descriptions

The Rate Of Return On The Investment In Registered Nurse Education As Related To The Supply Of Registered Nurses, Barbara Zuern

Dissertations and Theses

The focus of this research is the relationship between the supply of registered nurses and the rate of return on the educational investment to become a registered nurse. Is this rate of return a determining factor in the supply, past, present, and future? Since 98. 8 percent of all registered nurses are women, an integral part of this study is a survey of the data on women in the labor force.

The empirical data, statistical, was obtained from government sources and non-government associations, The American Nurses Association, The American Hospital Association, and the educational institutions. The data indicates the following: …

A Hospital Plan For The Hillsborough-Pinellas Area Florida, James A. Hamilton And Associates

City and Regional Planning -- Florida

A Study of the Area's Hospital Needs and a Proposed Program of Development October, 1950