Public Affairs, Public Policy and Public Administration Commons^™

Evaluating Quality Improvement To Improve Hiv Reporting, Nandi A. Marshall, William C. Livingood, Angela Peden, Gulzar H. Shah, Russ Toal, Dayna Alexander, Alesha Wright, Sandra Jump, Shelby Freeman, Kay Davis, Lynn Woodhouse, Kellie Penix

Frontiers in Public Health Services and Systems Research

The incorporation and evaluation of Quality Improvement into Georgia’s public health systems continues to be a focus of the Georgia Public Health Practice Based Research Network. This report describes the process, preliminary results and lessons learned from incorporating Quality Improvement into one of Georgia’s public health districts.

Evidence Use In New York City Public Health Policymaking, Miriam J. Laugesen, Kimberley R. Isett

Frontiers in Public Health Services and Systems Research

New York City Mayor Michael R. Bloomberg has attracted national attention for his public health policy reforms. The policy process behind the reform program has received less scrutiny, especially the use of research by policymakers. We show that the process used to develop, promote, and evaluate polices is heavily based on five types of data and research. New York Department of Health and Mental Hygiene staff conducted in-depth appraisals of existing published research, used local health surveys and private laboratory surveillance data, engaged in “shoe-leather” field research, formed research collaborations within and outside government, and disseminated research to legitimize policy …

Commentary: Moving Beyond The Numbers, Effectively Using Research To Influence Policy, F. Douglas Scutchfield, Marylou Wallace

Frontiers in Public Health Services and Systems Research

This seventh issue of Frontiers reflects the variety of PHSSR. One emerging theme, however, is the notion of public health and its role in policy and policy development. PHSSR focuses on several potential users, researchers, practitioners and policy makers. As it concerns policy makers, PHSSR delivers research that allows them to make decisions about policy change that not only influences public health status, but creates healthy conditions. In this way, PHSSR essentially influences decisions about support for public health services.

The Population Health Revolution, Drew Harris Dpm, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Preliminary Findings From An Interventional Study Using Network Analysis To Support Management In Local Health Departments In Florida, Chin S. Park, Hado Byon, Jonathan W. Keeling, Leslie M. Beitsch, Jacqueline A. Merrill

Frontiers in Public Health Services and Systems Research

Management is the core service that integrates and coordinates essential public health services. Managers of local health departments (LHDs) are experts in practice but may not have expertise in organizational management. We conducted an evidence-based training intervention in 10 LHDs in Florida to support managers’ decision-making on organizational integration and coordination. We deployed a standard survey to collect organizational network measurements pre and post intervention. We presented results as evidence-based performance feedback and interviewed managers to document how they used the results in the context of each organization. Post intervention we found unexpected, significantly higher network centralization in daily work. …

Characteristics Of A Local Health Department Associated With The Use Of The Health Equity Index, Moira A. Lawson, Sharon Mierzwa, Michael Knapp

Frontiers in Public Health Services and Systems Research

Local health departments are tasked with understanding and addressing health inequities in the populations they serve. To meaningfully address health inequities, local health departments have identified the need for credible local data to better understand the relationship between community conditions and health outcomes. Yet, when given access to these data, we observe a very large variation in the level of interest between local health departments.

In this study, we offered Connecticut’s Local health departments access to the Health Equity Index, a web based tool that provides data on health outcomes and community conditions at the state, municipal or neighborhood levels. …

Evaluating Use Of Custom Survey Reports By Local Health Departments, Nadya M. Belenky, Christine A. Bevc, Elizabeth Mahanna, Carol Gunther-Mohr, Mary V. Davis

Frontiers in Public Health Services and Systems Research

This report demonstrates how providing survey feedback, like comparative reports, to survey respondents can result in improvement activities. For each of the past three years (2010-2013), the North Carolina Institute for Public Health (NCIPH) has invited local health departments (LHDs) from 40 states to participate in a preparedness capacities survey. In addition, NCIPH fielded a six-question evaluation survey to a subset of LHDs (n=70) to determine how LHDs use these reports. LHDs that reported using their custom reports compared their preparedness capacities to other LHDs, conducted strategic planning (e.g., benchmarking, setting preparedness goals), planned staff trainings, and disseminated the report …

The Relationship Between Quality Improvement And Health Information Technology Use In Local Health Departments, Kendra Johnson, Kim K. Nguyen, Shimin Zheng, Robin P. Pendley

Frontiers in Public Health Services and Systems Research

This research examined if there is a relationship between engagement in quality improvement (QI) and health information technology (HIT) for local health departments (LHDs) controlling for workforce, finance, population, and governance structure. This was a cross-sectional study that analyzed data obtained from the Core questions and Module 1 in the NACCHO 2010 Profile of LHDs. Descriptive statistics, bivariate analyses, and logistic regression analyses were conducted. Findings suggest that LHD engagement in QI has a relationship with utilization of HIT including electronic health records, practice management systems, and electronic syndromic surveillance systems. This study provides baseline information about the HIT use …

Commentary: The Road To Quality In Public Health, A Long But Important Journey, F. Douglas Scutchfield, Glen Mays, Marylou Wallace

Frontiers in Public Health Services and Systems Research

Quality improvement (QI) in public health departments is a focus in this sixth issue of Frontiers. Data is important to the development of quality improvement efforts. As we see growth of and meaningful use of electronic health records, the health department is in a position to take the lead as a data hub and to use this information wisely to both improve their QI efforts and link that QI to outcomes.

Diffusion Of Innovation Across A National Local Health Department Network: A Simulation Approach To Policy Development Using Agent-Based Modeling, Mark Orr, Jacqueline Merrill

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is possible to untangle complex processes using simulation modeling. The results represent how the world might actually work which may provide useful decision support for policymakers …

Community Health Assessment By Local Health Departments: Presence Of Epidemiologist, Governance, And Federal And State Funds Are Critical, Gulzar H. Shah, Barbara Laymon, Julia Joh Elligers, Carolyn Leep, Christine B. Bhutta

Frontiers in Public Health Services and Systems Research

Using the data from the National Association of County and City Health Officials’ (NACCHO) 2010 Profile of Local Health Departments (LHDs) our study investigates whether or not infrastructural characteristics of LHDs were associated with completion of community health assessment (CHA). Our results show that local and shared LHD governance, greater share of revenue from federal and state sources, smaller population size in LHD jurisdiction, and having an epidemiologist significantly increased the odds of CHA completion in the past, after controlling for community characteristics and other independent variables. These findings have important implications for LHDs, PHAB and its partners.

Jefferson Hosts American Public Health Association Student Assembly's Strategic Planning Meeting, Alex Bryan

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Health Reform Upate: The Road To Implementing State-Run, Partnered, And Federally Facilitated Exchanges, Anne Mainardi Md, Shira Yun Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Model Pengambilan Keputusan Meningkatkan Akseptor Keluarga Berencana Metode Kontrasepsi Jangka Panjang, Suryani Manurung

Kesmas

Pada periode 2002-2012, tren angka fertilitas total mengalami stagnasi sekitar 2,6. Milenium Development Goals (MDGs) menunjukkan kemajuan yang baik, tetapi masih memerlukan kerja keras untuk mencapai target tahun 2015. Khususnya upaya untuk mencapai target 102 per 100.000 kelahiran hidup. Metode keluarga berencana (KB) yang banyak digunakan pasien pascapersalinan saat ini adalah metode kontrasepsi jangka pendek seperti pil dan suntik. Sedang metode kontrasepsi jangka panjang seperti intra uterine device dan implant cenderung turun satu poin dari tahun 2002 hingga 2007. Upaya mengatasi masalah yang sedang dialami masyarakat Indonesia saat ini meningkatkan akseptor KB metode kontrasepsi jangka panjang (MKJP). Model pengambilan keputusan …

From The Frontier: Translating Research To Practice…Qi As The Hinge Point, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

This article is number three in the series From the Frontier: Translating Research to Practice. The narrative describes the work of a practice-academic network in Minnesota which explored the degree to which having a culture of quality at the local health department level influenced the capacity to implement a new statewide initiative. The network conducted a mixed-methods study of grantees funded to develop and implement local policy, systems, and environmental change strategies to promote nutrition, increase activity, and reduce tobacco use and exposure. The results of their study indicated that grantees with higher performance levels in Quality Improvement (QI) …

Addressing Health Inequalities In The United States: Key Data Trends And Policy Action, Sara N. Bleich, Marian P. Jarlenski, Caryn N. Bell, Thomas A. Laveist

Frontiers in Public Health Services and Systems Research

Health inequalities, which have been well documented for decades, have recently become policy targets in the United States. This report summarizes current patterns and trends in health inequalities, commitments to reduce health inequalities, and progress made to eliminate health inequalities. Time trend data indicate improvements in health status and major risk factors but increases in morbidity, with black and lower-education individuals experiencing a disproportionate burden of disease. A common policy response has been priority setting in the form of national objectives or goals to address health inequalities. More research and better methods are needed to precisely measure relationships between stated …

The Role Of Health Care In A Democratic Capitalist Society, Barbi Appelquist

Pepperdine Policy Review

What is the government’s role in health care? On March 23, 2010, President Barack Obama signed into law The Patient Protection and Affordable Care Act, commonly known as “Obamacare.” Did the government’s hand reach too far into the health care economy of our nation? This paper focuses on the Affordable Care Act’s general application to the capitalist tradition as framed by Adam Smith and Milton Friedman, with a limited analysis of the federal mandate to purchase individual health insurance. First, I will provide an overview of our nation’s health care system and the Affordable Care Act. Then, I will analyze …

Regulation Of Hydraulic Fracturing Of Shale Gas Formations In The United States, Fatemeh Bagheri

Pepperdine Policy Review

The practice of hydraulic fracturing has become increasingly common over the years since it has been looked at to replace energy derived from coal. Though hydraulic fracturing may be one of the better forms of obtaining energy, it comes with its own set of problems ranging from environmental problems to health problems if the appropriate safeguards are not implemented when completing the process. Regulations at the local, state, and federal level are assessed to determine which entity should regulate the practice and many technologies are reviewed in order to offer suggestions which allow the process to be completed without significant …

Mobile Health Technology In Developing Countries: The Case Of Tanzania, Shruti Modi

Pepperdine Policy Review

Mobile technology is one of the fastest growing industries. In rural parts of the world, mobile phones are more accessible than sanitation facilities and electricity. Mobile phones can be used to transmit health information, promote health awareness, track the spread of diseases, and ultimately decrease the prevalence of diseases. In particular, this study focuses on how mobile health technology, m-health, can reduce the spread of HIV/AIDS and malaria in Tanzania.

Can Clean Drinking Water And Sanitation Reduce Child Mortality In Senegal?, Catherine Bampoky

Pepperdine Policy Review

The purpose of this paper is to measure the impact of clean drinking water, modern sanitation facilities and hygiene on child mortality rates in Senegal. Diarrhea-related morbidity is still fairly common among young children and this disease is mainly due to poor hygiene and environmental factors. Although extensive research has been done on the determinants of child mortality in Senegal, they were mainly descriptive studies that did not focus on a policy-related variable on which public policies could have a direct intervention. Using dummy dependent variable models, I find that drinking water source and sanitation facility are not individually statistically …

Dampak Biaya Laboratorium Terhadap Kesenjangan Tarif Ina-Cbgs Dan Biaya Riil Diagnosis Leukemia, Diah Indriani, Hari Kusnanto, Ali Ghufron Mukti, Kuntoro Kuntoro

Kesmas

Selama penerapan Diagnosis Related Group di Rumah Sakit Umum Pusat (RSUP) Dr. Sardjito, terjadi kesenjangan tarif biaya riil pelayanan kesehatan dengan tarif Indonesia Case Base Groups (INA-CBGs). Penyebab terbesar kesenjangan tarif tersebut adalah pelayanan obat dan penggunaan sumber daya laboratorium yang tidak efisien. Biaya pelayanan penunjang medis untuk pasien leukemia limfoblastik akut adalah sekitar 23,8% dari total biaya pelayanan kesehatan. Penelitian ini bertujuan untuk mengetahui tingkat efisiensi penggunan sumber daya laboratorium dan pengaruh terhadap kesenjangan tarif. Penelitian ini menganalisis semua rekam medis dan data biaya pelayanan laboratorium pasien leukemia limfoblastik akut tahun 2009-2010 di RSUP Dr. Sardjito Yogyakarta. Pemeriksaan kimia …

Analisis Pembiayaan Kesehatan Keluarga Penderita Talasemia, Arif Kurniawan, Arih Diyaning Intiasari

Kesmas

Pembiayaan kesehatan sekitar 146 (60%) penderita talasemia di Banyumas, tahun 2011 ditanggung rumah tangga dalam bentuk pembayaran langsung (out of pocket payment). Penelitian ini bertujuan untuk menganalisis ability to pay, willingness to pay, dan need assessment pembiayaan kesehatan penderita talasemia di Kabupaten Banyumas. Jenis penelitian ini adalah observasional analitik dengan rancangan studi kasus. Penelitian ini menggunakan desain studi cross sectional dengan teknik pengambilan sampel simple random sampling. Jumlah sampel penelitian 30 responden yang mempunyai anggota keluarga penderita talasemia di Kabupaten Banyumas. Hasil penelitian menunjukkan keluarga penderita talasemia mempunyai ability to pay rata-rata adalah Rp34.448,8/bulan dan rata-rata willingness to pay pengobatan …

Kepuasan Bidan Desa Dalam Pelayanan Persalinan Normal Pada Implementasi Kebijakan Jaminan Persalinan, Arih Diyaning Intiasari, Arif Kurniawan, Endang Triyanto

Kesmas

Klaim persalinan yang rendah mengindikasikan ketidakpuasan bidan pada implementasi kebijakan jaminan persalinan (Jampersal) di Kabupaten Purbalingga. Penelitian ini bertujuan mengeksplorasi menyebabkan ketidakpuasan bidan dan hambatan implementasi kebijakan Jampersal di tingkat pelaksana. Penelitian deskriptif dengan desain studi kasus ini melakukan pengumpulan data kualitatif pada periode Maret- Juli 2012 terhadap informan empat bidan pegawai negeri sipil (PNS) dan empat bidan pegawai tidak tetap (PTT). Ditemukan ketidakpuasan bidan dan hambatan pelaksanaan kebijakan Jampersal tahun 2012, meliputi; besaran, pemotongan, dan lama klaim persalinan, penghapusan klaim persalinan komplikasi yang dirujuk, persaingan tidak sehat, dan proses administrasi. Ketidakpuasan bidan dan hambatan implementasi kebijakan Jampersal memerlukan kerja …

Monitoring Qi Maturity Of Public Health Organizations And Systems In Minnesota: Promising Early Findings And Suggested Next Steps, Kimberly J. Miner Gearin, M. Elizabeth Gyllstrom, Brenda M. Joly, Renee S. Frauendienst, Julie Myhre, William Riley

Frontiers in Public Health Services and Systems Research

Public health departments and systems are increasing investments in quality improvement. This paper presents methods used to identify a select number of items from a previously validated QI Maturity Tool as the basis for calculating organizational and system-level QI maturity scores that could be followed over time. Findings suggest that the abbreviated tool measures variation in QI maturity across LHDs, and differences in scores among divisions within a state health department. Minnesota has incorporated the abbreviated tool into an annual reporting system for the MN Local Public Health Act, thereby enabling stakeholders to monitor a system median score and distribution …

Using The Qi Maturity Tool To Classify Agencies Along A Continuum, Brenda M. Joly, Maureen Booth, Prashant Mittal, Yan Zhang

Frontiers in Public Health Services and Systems Research

Major investments have been made to encourage health departments to implement quality improvement (QI) efforts. Yet, there are few empirically tested tools for public health agencies that assess these efforts and classify health departments along a QI continuum. This paper presents a new classification scheme for measuring QI Maturity in public health agencies based on a validated tool. The findings can be used to establish benchmarks, make comparisons and conduct future research linking QI and population health outcomes.

Rediscovering The Core Of Public Health, Steven Teutsch, Jonathan E. Fielding

Frontiers in Public Health Services and Systems Research

The success of public health has been its ability to understand contemporary health problems, to communicate the needs successfully, to identify solutions, and to implement them through programs and policies. In the past 50 years, those successes can be attributed largely to control of infectious disease, improved maternal and child health, delivery of other personal health care services, and changes in behaviors, particularly smoking. Yet health is primarily a product of our social, cultural, and physical environments. To continue to improve the nation’s health and reduce disparities, public health needs to return to its historical roots and engage with other …

Kajian Praktik Kefarmasian Apoteker Pada Tatanan Rumah Sakit, Max Joseph Herman, Rini Sasanti Handayani, Selma Arsit Siahaan

Kesmas

Undang-undang Republik Indonesia No. 36 tahun 2009 tentang kesehatan dan peraturan pemerintah No. 51 tahun 2009 menyatakan bahwa tenaga kesehatan harus mempunyai kualifikasi minimum yang ditetapkan oleh pemerintah. Studi kualitatif secara potong lintang pada tahun 2010 untuk mengidentifikasi kualifikasi apoteker rumah sakit dalam memenuhi persyaratan tersebut di Bandung, Yogyakarta dan Surabaya. Data dikumpulkan dengan wawancara mendalam terhadap 10 orang apoteker dari enam rumah sakit dan empat orang direktur/wakil direktur rumah sakit, masing-masing satu orang apoteker dari enam perguruan tinggi farmasi, tiga pengurus Ikatan Apoteker Indonesia, tiga dinas kesehatan provinsi dan kabupaten/kota. Observasi praktek kefarmasian dengan menggunakan daftar tilik dilakukan pada …

Aids: An Overview, Loretta Mclaughlin

New England Journal of Public Policy

"We stand nakedly in front of a very serious pandemic, as mortal as any pandemic there ever has been," said Halfdan Mahler, director-general of the World Health Organization (WHO). "I don't know of any greater killer than AIDS, not to speak of its psychological, social and economic maiming. Everything is getting worse and worse with AIDS and all of us have been underestimating it, and I in particular. We're running scared. I cannot imagine a worse health problem in this century." When asked to compare AIDS to other epidemics, such as smallpox, that have infected and killed over the course …

From The Frontier: Translating Research To Practice...A Story Of Economic Survival, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

This article is number two in the series From the Frontier: Translating Research to Practice. The narrative describes the interactions between a local health department director and two academicians in addressing the impact of the 2008 financial crisis. In a first set of activities, practice-academic partners used Financial and Operational Ratio and Trend Analysis to identify periods of a negative total margin and the impact of that on the agency’s declining fund balance. The use of private sector processes of retrenchment, repositioning, and reorganization led to a financial turnaround for the agency. In a second set of activities, practice-academic …

Health Inequalities And The Welfare State In European Families, Simone Sarti, Marco Alberio, Marco Terraneo

The Journal of Sociology & Social Welfare

Using EU-Silc data from 2005, our aim in this article is to estimate how self-assessed health and the gradient between education and health vary among individuals in different European countries, considering their contextual socioeconomic vulnerability. In order to do this, we use a hierarchical model with individuals nested in households at the second level, and in various European countries at the third level. Our main research interest is on the modelling variables associated with better health conditions and their improvement or worsening according not only to micro/ individual and macro/national levels but also to the household: a level on which …