Health Policy Commons^™

Socioecological Factors Linked With Pharmaceutical Incentive-Driven Prescribing In Pakistan, Muhammad Naveed Noor, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Wafa Aftab, Sadia Shakoor, Rumina Hasan, Mishal Khan

Department of Pathology and Laboratory Medicine

Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakistan. We conducted qualitative interviews with 28 policy actors to seek their views on the health system dynamics, how they sustain pharmaceutical incentivisation and their effect on the quality of care. Our analysis revealed four interlinked factors operating at different …

Covid-Dynamic: A Large-Scale Longitudinal Study Of Socioemotional And Behavioral Change Across The Pandemic, Tessa Rusch, Yanting Han, Dehua Liang, Amber R. Hopkins, Carolyn V. Lawrence, Uri Maoz, Lynn K. Paul, Damian A. Stanley, The Covid-Dynamic Team

Pharmacy Faculty Articles and Research

The COVID-19 pandemic has caused enormous societal upheaval globally. In the US, beyond the devastating toll on life and health, it triggered an economic shock unseen since the great depression and laid bare preexisting societal inequities. The full impacts of these personal, social, economic, and public-health challenges will not be known for years. To minimize societal costs and ensure future preparedness, it is critical to record the psychological and social experiences of individuals during such periods of high societal volatility. Here, we introduce, describe, and assess the COVID-Dynamic dataset, a within-participant longitudinal study conducted from April 2020 through January 2021, …

Effortful Control Moderates The Relation Between Negative Emotionality And Child Anxiety And Depressive Symptom Severity In Children With Anxiety Disorders, Elizabeth M Raines, Andres G Viana, Erika S Trent, Haley E Conroy, Karina Silva, Michael J Zvolensky, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

The present study investigated the interactive effect of reactive (negative emotionality) and regulatory (effortful control) aspects of temperament in the prediction of child anxiety and depressive symptoms. Clinically anxious children and their mothers completed a battery of questionnaires that included self- and mother-ratings of child effortful control, negative emotionality, anxiety, and depressive symptoms. Multiple regression analyses were conducted to examine the moderating effect of effortful control on the relation between negative emotionality and child anxiety and depressive symptom severity. The interaction between negative emotionality and effortful control was statistically significant and simple slopes revealed that as effortful control increased, the …

Marijuana Liberalization And Public Finance: A Capital Market Perspective On The Passage Of Medical Use Laws, Stephanie F. Cheng, Gus De Franco, Pengkai Lin

Research Collection School Of Accountancy

We find that the staggered passage of state-level laws that legalize marijuana for medical use increases states' borrowing costs by 7–9 basis points. Consistent with economic theory on substance use suggesting that marijuana legalization increases local consumption of the drug (by expanding its availability and reducing its perceived risks), we predict and find that increased consumption represents an important mechanism that explains the higher state bond spreads. We also show that following such laws’ passage, states incur higher marijuana-consumption-related expenditures, including for police, corrections, and public welfare.

A Phase Ii Window Of Opportunity Study Of Neoadjuvant Pd-L1 Versus Pd-L1 Plus Ctla-4 Blockade For Patients With Malignant Pleural Mesothelioma, Hyun-Sung Lee, Hee-Jin Jang, Maheshwari Ramineni, Daniel Y Wang, Daniela Ramos, Jong Min Choi, Taylor Splawn, Monica Espinoza, Michelle Almarez, Leandria Hosey, Eunji Jo, Susan Hilsenbeck, Christopher I Amos, R Taylor Ripley, Bryan M Burt

Center for Medical Ethics and Health Policy Staff Publications

Purpose: We report the results of a phase II, randomized, window-of-opportunity trial of neoadjuvant durvalumab versus durvalumab plus tremelimumab followed by surgery in patients with resectable malignant pleural mesothelioma (MPM; NCT02592551).

Patients and methods: The primary objective was alteration of the intratumoral CD8/regulatory T cell (Treg) ratio after combination immune checkpoint blockade (ICB) therapy. Secondary and exploratory objectives included other changes in the tumor microenvironment, survival, safety, tumor pathologic response (PR), and systemic immune responses.

Results: Nine patients received monotherapy and 11 received combination therapy. Seventeen of the 20 patients (85%) receiving ICB underwent planned thoracotomy. Both ICB regimens …

Effect Of Hiv And Antiretroviral Therapy Use On Body Weight Changes In A Cohort Of Us Veterans Living With And Without Hiv, Jose M Garcia, Yongquan Dong, Peter Richardson, Jennifer R Kramer, Christine M Hartman, Kathryn Royse, Donna L White, Elizabeth Y Chiao

Center for Medical Ethics and Health Policy Staff Publications

Objective: People living with HIV have high rates of obesity and obesity-related comorbidities. Our study sought to evaluate weight trajectory in a retrospective cohort of people living with HIV and matched HIV-negative veterans (controls) and to evaluate risk factors for weight gain.

Methods: This was a retrospective database analysis of data extracted from the VA Corporate Data Warehouse that included people living with HIV (n = 22 421) and age-matched HIV-negative controls (n = 63 072). The main outcomes were baseline body weight and weight change from baseline at 1, 2, and 5 years after diagnosis (baseline visit for controls). …

The U.S. Should Increase Access To Medication For Opioid Use Disorder Among Incarcerated Individuals, Cody Nagle

Population Health Research Brief Series

Opioid Use Disorder (OUD) is among the most common medical diagnoses for people in jails and prisons. Those leaving incarceration without substance use treatment are 40 times more likely than the general public to have a fatal overdose, making it the leading cause of death for people recently released. This brief describes the use of Medication for Opioid Use Disorder (MOUD) and Medication Assisted Treatment (MAT) as realistic and legally protected approaches to reducing overdoses upon exiting incarceration. It also calls for federal regulation and guidance on the use of MOUD in prisons, jails, and drug courts to ensure each …

User Perceptions Of The Quality Of The Pedulilindungi Application Based On The Dimensions Of Electronic Service Quality (E-Service Quality) During The Covid-19 Pandemic, Gabriela Bianca, Kurnia Sari, Purnawan Junadi

Journal of Indonesian Health Policy and Administration

The use of a contact tracing application is one of the efforts made to overcome the global COVID-19 pandemic with an increasing number of cases. The contact tracing application used in Indonesia is PeduliLindungi which is one of the requirements for accessing public areas, which was initially applied to the Java-Bali region. However, in its use, there are still challenges that affect the quality of electronic services. This study aims to analyze user perceptions of the service quality of the PeduliLindungi application based on the E-Servqual dimension. The method used is observational with a quantitative approach using a cross-sectional design. …

Dispute Analysis Of Claims For Patients With Covid-19: A Case Study At Hospital X Class B In Bantul Regency, Beby Antika Putri, Firdaus Hafidz, Yulita Hendrartini

Journal of Indonesian Health Policy and Administration

The Indonesian Government established referral hospitals for COVID-19 as an effort in combating the pandemic. Referral hospitals for COVID-19 submit their services’ claims to the Ministry of Health. Hospital X in Bantul experienced challenges in submitting COVID-19 claims and underwent claim disputes which caused delays in payment process. This research aimed to explore the factors that led to the disputes over the COVID-19 claims. This descriptive research was conducted with a qualitative approach, using in-depth interviews and observations. The additional descriptive analysis used secondary data COVID-19 claim dispute file reports from 2020. The results showed that the highest criteria of …

Policy Considerations For The Utilization And Rationalization Of Ppe In Maternal Care During Covid-19 Pandemic – Literature Review, Mas Aditya Soebangil, Ascobat Gani, Puput Oktamianti

Journal of Indonesian Health Policy and Administration

Policies regarding utilizing and rationalizing Personal Protective Equipment (PPE) during the COVID-19 pandemic challenge every healthcare service provider. Within the maternal health sector, it is suspected that the negative perception of patients and the lack of implementation and compliance with infection prevention and control policies disrupt the quality of care provided. This research is a narrative review highlighting all proper considerations for using and rationalizing PPE within the maternal health sector. Articles are gathered and filtered from well-known scientific publishing sites, and ten articles became the main discussion of this research. The utilization of PPE impacts all levels of maternal …

Potrait Of Public Private Partnership Policy Substances In Regional Hospitals In Indonesia, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

Public Private Partnership (PPP) is a strategy of the Indonesian Government to deal with budget constraints and overcome gaps in infrastructure, access, and quality of health services. PPP on the operational cooperation (KSO) model is the oldest and most widely applied practice by regional hospitals in Indonesia. The implementation of KSO must refer to government policies in the form of laws and regulations. Since its initial implementation until today, the Ministry of Home Affairs, as the body that oversees the local government, has not carried out a comprehensive evaluation of the KSO policy. This study was carried out by conducting …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa), Lisa Ariellah Ward, Gulzar H. Shah, Jeffery A. Jones, Linda Kimsey, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association …

Post Total Hip Arthroplasty Pseudo- Tumour – A Rare Case Report., Dr Harisha H L, Dr Vikram Patil, Dr Gurumurthy B

Radiology Teaching Files

A 62-year-old female came with complaints of slow growing mass in the left hip region for 4-5 months, associated with dull aching pain. Range of movements were restricted due to pain and mass. She underwent Total Hip arthroplasty (THA) 11 months ago.

Caffey Disease – A Rare Case Report., Dr Sudha Kiran Das, Vikram Patil Dr

Radiology Teaching Files

8 month old male infant with localized swelling of the thigh, fever and irritability.

Prescription Drug Retail Sales In The Mountain West, Caren Royce Yap, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet synthesizes data on prescription drug retail sales in the Mountain West (Arizona, Colorado, Nevada, New Mexico, and Utah). "Retail Sales for Prescription Drugs Filled at Pharmacies by Payer," a 2019 report by the Kaiser Family Foundation, includes data on the amount of retail sales for prescription drugs made in each state by dollar amount, along with the method of coverage, including commercial, Medicare, Medicaid and cash payment.

Urbanization And Physical Activity In The Global Prospective Urban And Rural Epidemiology Study, Kwadwo Boakye, Marit Bovbjerg, John Schuna Jr, Adam Branscum, Ravi Prasad Varma, Rosnah Ismail, Olga Barbarash, Juan Dominguez, Yuksel Altuntas, Romaina Iqbal

Community Health Sciences

Urbanization may influence physical activity (PA) levels, although little evidence is available for low- and middle- income countries where urbanization is occurring fastest. We evaluated associations between urbanization and total PA, as well as work-, leisure-, home-, and transport-specific PA, for 138,206 adults living in 698 communities across 22 countries within the Prospective Urban and Rural Epidemiology (PURE) study. The 1-week long-form International PA Questionnaire was administered at baseline (2003-2015). We used satellite-derived population density and impervious surface area estimates to quantify baseline urbanization levels for study communities, as well as change measures for 5- and 10-years prior to PA …

Bending The Patient Safety Curve: How Much Can Ai Help?

Faculty, Staff and Student Publications

This paper reviews the current state of patient safety and the application of artificial intelligence (AI) techniques to patient safety. This paper defines patient safety broadly, not just inpatient care but across the continuum of care, including diagnostic errors, misdiagnosis, adverse events, injuries, and measurement issues. It outlines the major current uses of AI in patient safety and the relative adoption of these techniques in hospitals and health systems. It also outlines some of the limitations of these AI systems and the challenges with evaluation of these systems. Finally, it outlines the importance of developing a proactive agenda for AI …

The Factors That Influence Clinicians To Choose Rural Settings To Deliver Health Services, Julia Mattingly

Posters-at-the-Capitol

Years before the COVID-19 pandemic brought on a health care shortage in the United States, its rural areas were already struggling to obtain and attract primary care medical practitioners. The federal government has designed many programs with the intent of exposing clinicians to life in rural areas, but few have been successful at keeping medical practitioners in the long-term. Clinicians who are recruited to rural areas via loan repayment programs or other short-lived incentives often leave after only a few years.

In order to learn more about this long-running health policy problem, we set out to study the factors that …

Drawing On The Strengths Of Community Health Workers To Address Sexually Transmitted Infections: Roles, Medicaid Reimbursement, And Partnerships, Naomi Seiler, Katie Horton, Paige Organick-Lee, Claire Heyison, Alexis Osei, Greg Dwyer, Aaron Karacuschansky, Mekhi Washington, Amanda Spott

Health Policy and Management Informal Communications

Rates of bacterial sexually transmitted infections (STIs) in the United States are high and, largely, still soaring. Though chlamydia cases have decreased slightly since 2017, gonorrhea and syphilis have increased by 25% and 68%, respectively, and congenital syphilis has increased by 184%. Bacterial STI can lead to pain, infertility, and even, in the case of syphilis and congenital syphilis, death. With appropriate detection and treatment, all of these STIs are curable. And yet a range of barriers between communities and the healthcare system perpetuate the STI epidemic.

Community health workers (CHWs) could play a key role in helping bridge the …

Sexually Transmitted Infections And Social Determinants Of Health: Emerging Opportunities In The Medicaid Program, Naomi Seiler, Katie Horton, Paige Organick-Lee, Mekhi Washington, Taylor Turner, Lily Ryan

Health Policy and Management Informal Communications

No abstract provided.

Congenital Syphilis In The Medicaid Program: Assessing Challenges And Opportunities Through The Experiences Of Seven Southern States, Naomi Seiler, Claire Heyison, Paige Organick-Lee, Aaron Karacuschansky, Gregory Dwyer, Alexis Osei, Helen Stoll, Katie Horton

Health Policy and Management Informal Communications

Congenital syphilis (CS) is an infection acquired in utero that can lead to devastating outcomes, including stillbirth, infant death, or long-term health complications. Over the past decade, rising national rates of syphilis, including among women, have led to major increases in congenital syphilis cases and deaths.

CS is tragic and costly, but it is also preventable. With appropriate testing and treatment during prenatal care, syphilis in a pregnant woman can be identified and treated, and transmission to the fetus averted.

The Medicaid program is the payer for nearly half of all births in the U.S., making the program a crucial …

Deep Community Partnerships: The Future Of Community-Based Senior Care In A Value-Driven Era, Diana Wilcox

DSW Capstone Projects

This capstone reviews three scholarly products that examine how chronically ill older adults interact with healthcare systems and senior service delivery systems in the United States. The systematic literature review examines how community-based senior programs that are funded by the Older Americans Act (OAA) positively impact health outcomes and promote health and wellness among the older adult population. The conceptual paper examines how Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), Area Agencies on Aging (AAA) interact with the patient and with one another using the lens of Systems Theory. The practice application paper examines best practices regarding care coordination …

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …

Local Community-Based Workforce To Increase Covid-19 Vaccine Access: Deliverables Summary Binder, Mary Lindsey Smith Phd, Evelyn Ali Bs, Katie Rosingana Ba, Tyler Egeland Ba, Katharine Freund Mph

Substance Use Research & Evaluation

Public health evaluators from the Catherine E. Cutler Institute at the University of Southern Maine worked with Healthy Community Coalition and the Hometowns Partnership to provide evaluation services of the Health and Resources Services Administration (HRSA) grant to address vaccination hesitancy and access for the Western Public Health District. This grant program ran from June 2021 to January 2023. The primary goals of the evaluation were to: (1) document implementation strategies and identify barriers and facilitators to implementation, (2) evaluate the efficacy of the education activities at reducing vaccine hesitancy and improving vaccination rates in Western Maine, and (3) assess …

Using Adult Learning Characteristics And The Humanities To Teach Undergraduate Healthcare Students About Social Determinants Of Health, Elizabeth A. Brown, Hannah Kinder, Garrett Stang, Wendy Shumpert

Community & Environmental Health Faculty Publications

Authors used an andragogy framework to help undergraduate allied health students better understand social determinants of health (SDOH) using a photo essay assignment. The study examined students’ perceptions of SDOH in various communities, description of health outcomes associated with their chosen SDOH, and lessons learned and suggestions to improve the assignment for future cohorts. Data were extracted from photo essays from 2019–2021 and entered in Microsoft Excel and Word for data analysis after course completion. Conventional qualitative content analysis was used to analyze student evaluation data from open-ended questions. Data were extracted from 53 student essays from 2019 to 2021. …

Socioeconomic Status, Cultural Values, And Elderly Care: An Examination Of Elderly Care Preference In Oecd Countries, Fang Fang, Xiao Yang

Psychology Faculty Publications

Background

With the rapid growing of the older population around the world, care for older adults is becoming a pressing public health issue. To find the optimum and sustainable balance of informal and formal involvement in senior care is urgently important. However, it is still unclear how older adults’ preferences for senior care are shaped by a range of factors at individual and country levels. Therefore, the present study aimed to examine the roles of socioeconomic status (SES) and culture values in old adults’ attitude toward senior care.

Methods

The data from the International Social Survey Program 2012: Changing Family …

Abortion Decisions As Humanizing Acts: The Application Of Ambivalent Sexism And Objectification To Women-Centered Anti-Abortion Rhetoric, Rachel L. Dyer, Olivia R. Checkalski, Sarah Gervais

Department of Psychology: Faculty Publications

Women-centered anti-abortion rhetoric, grounded in ostensibly positive beliefs that pregnant people are precious objects who must be protected from having abortions, has proliferated anti-abortion activism and legislation. However, abortion stigma, marked by negative perceptions of people who terminate pregnancies, is the most widely used theoretical tool for understanding the social and psychological implications of abortion. In this article, we first integrate these two seemingly contradictory perspectives on abortion through the lens of ambivalent sexism theory. We then argue that ambivalent sexism paves the way for objectifying perceptions and treatment of pregnant people; specifically, our typology of reproductive objectification provides a …

Experiences With Covid-19 Stress Among Hispanic/Latino Farmworkers, Brenda Berumen-Flucker, Hadiza Galadima, Sylvia Shangani, Michele Kekeh, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

BACKGROUND: Hispanics/Latinos, particularly those that identify as foreign-born, are overrepresented in the agricultural sector in the U.S. Over the course of the COVID-19 pandemic, this subpopulation of farmworkers was recognized as an invaluable group of essential workers unable to implement COVID-19 protections.

METHODS: Previously validated COVID-19 stress scale measures were identified, adapted, and translated to collect COVID-19 stress data from Hispanic/Latino agricultural workers in two heavily agricultural counties in northeastern North Carolina. Participants were recruited using purposive convenience sampling. Data collection took place from June to November of 2021.

RESULTS: The majority of Hispanic/Latino agricultural workers surveyed reported experiencing worries …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

The Expected Risks And Exacerbations Of Poverty, Mental Health Disorders, And Maternal Mortality From Abortion Bans: A Comparative Literature Analysis, Daniel J. Francisco

All Master's Theses

Background. Early termination of a pregnancy (hereinafter referred to as an “abortion”) has been debated in the United States (U.S.) for decades, without much regard to the negative outcomes that forced pregnancies have for those assigned female at birth regarding poverty, mental health and maternal mortality. In 1973, access to safe abortions was protected so long that the procedure was done within the legal gestational period and/or was necessary for the health and safety of the patient (Blackmun, 1972). Unfortunately, in 2022, the Supreme Court took that protection away and made it legal for states to determine the reproductive rights …