Health Policy Commons^™

Current Research Projects Of The Public Health Pbrn Program, Glen P. Mays

Glen Mays

The Robert Wood Johnson Foundation’s Public Health Practice-Based Research Networks Program supports research on the organization, financing, and delivery of public health services using the infrastructure of practice-based networks (PBRNs). A Public Health PBRN brings multiple public health agencies into collaboration with an academic research partner to design and conduct studies in real-world practice settings. The program supports research through several different mechanisms, including (1) large-scale Research Implementation Awards (RIAs) conducted by established networks; (2) Quick-Strike Research Fund (QSRF) awards that support short-term, time-sensitive studies on emerging issues; and (3) supplemental Research Acceleration and Capacity Expansion (RACE) awards designed to …

Driving Qi With Research: Findings From Public Health Pbrns, Glen Mays

Glen Mays

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

Overview Of The Public Health Pbrn Program, Glen Mays

Glen Mays

The Public Health Practice-Based Research Networks Program is a national program of the Robert Wood Johnson Foundation that supports the development of research networks for studying the comparative effectiveness, efficiency and equity of public health strategies deployed in real-world practice settings. A practice-based research network (PBRN) brings multiple public health agencies together with research partners to design and implement studies of population-based strategies that prevent disease and injury and promote health. Participating practitioners and researchers collaborate to identify pressing research questions of interest, design rigorous and relevant studies, execute research effectively, and translate findings rapidly into practice. As such, PBRNs …

Pepfar’S Declining Investment In Treatment, Matthew Kavanagh, Marguerite Thorp

Matthew M. Kavanagh

Since its inception in 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) has saved millions of lives through providing anti-retroviral (ARV) treatment to people living with HIV/AIDS. However, our analysis of publicly available PEPFAR operational plans shows that funding to AIDS treatment has actually fallen significantly since 2008 in both absolute dollars and as a portion of total budgets—just at a pivotal moment when investment could change the course of the epidemic.

The Science Of Public Health Delivery: Evidence, Uncertainties & Research Needs, Glen Mays

Glen Mays

Policy initiatives to reform the nation's health system increasingly recognize the need to incorporate public health and prevention strategies. The nation's delivery system for public health, however, varies widely across states and communities in its structure, authority, and capabilities. This session examines research from the growing field of public health services and systems research to identify directions for improving public health delivery.

Estimating The Value Of Public Health Services & Systems: Evidence, Uncertainties, And Research Needs, Glen Mays

Glen Mays

The Affordable Care Act authorized the largest expansion in federal funding for public health services and delivery systems in decades. These provisions, designed to support programs and services that promote health and prevent disease and injury on a population-wide basis, remain controversial because of uncertainties regarding their effectiveness in improving health and constraining medical cost growth. This session examines a series of recent studies to shed light on the health and economic value of spending on public health.

‘Primary Care' Presentations At Emergency Departments - Rates And Reasons By Age And Sex, Peter M. Siminski, Andrew J. Bezzina, L. P. Lago, Kathy Eagar

Kathy Eagar

'Primary care' presentations at Emergency Departments (EDs) have been the subject of much attention in recent years. This paper is a demographic analysis of such presentations in New South Wales EDs and of self-reported reasons for presentation.

Trends In Primary Care Presentations At Emergency Departments In New South Wales (1999-2006), Peter M. Siminski, Andrew J. Bezzina, L. P. Lago, Kathy Eagar

Kathy Eagar

This paper examines trends in potential ‘primary care’ presentations at EDs, comparing these with other ED presentations and to primary care attendances in the community.MethodsThe study draws on EDIS data (Emergency Department Information System), which at December 2005 covered 76 per cent of attendances in New South Wales, and MBS data from Medicare Australia. Annual counts of potential ‘primary care’ presentations to EDs are compared with those of other ED presentations and to primary care presentations in the community. Changes in the percentage of ED presentations that are potentially for primary care are examined, as are changes in the percentage …

Getting Started In Evaluation Consulting: Questions To Ask And Answer Along The Way, Judah J. Viola,

Judah J. Viola, Ph.D.

This PowerPoint presentation includes a four phase approach to considering the main questions you'll need to ask and answer before taking the leap needed to begin working as an independent evaluation consultant.

Disparities Research In Public Health Pbrns, Glen Mays

Glen Mays

Public health agencies are well positioned within the health system to play key roles in addressing oral health issues on a population-wide basis, However, current evidence reveals wide geographic variation in the delivery of public health interventions for oral health promotion. This session explores the factors contributing to this variation, and it highlights studies underway through the Public Health Practice-Based Research Networks (PBRNs) to produce more and better evidence about public health delivery and impact.

Differences In Pandemic Influenza Vaccination Policies For Pregnant Women In Europe, Gordon Marnoch, Michiel Luteijn, Helen Dolk

Gordon Marnoch

Background: An important component of the policy to deal with the H1N1 pandemic in 2009 was to develop and implement vaccination. Since pregnant women were found to be at particular risk of severe morbidity and mortality, the World Health Organization and the European Centre for Disease Prevention and Control advised vaccinating pregnant women, regardless of trimester of pregnancy. This study reports a survey of vaccination policies for pregnant women in European countries. Methods: Questionnaires were sent to European competent authorities of 27 countries via the European Medicines Agency and to leaders of registries of European Surveillance of Congenital Anomalies in …

Key Findings From A Council On Linkages Survey Of Public Health Workers, Vincent Francisco, Jeffery A. Jones, Robin Pendley

Jeffery A Jones

The US governmental public health workforce is dwindling while the need for additional workers is increasing. In an historic effort to address this issue, in March 2010 the Council on Linkages Between Academia and Public Health Practice (Council on Linkages) surveyed over 70,000 public health workers across the US to determine how, when, and why they entered the governmental public health workforce and reasons they have remained in the workforce. Key survey findings were released in the spring of 2011 and have informed the development by the Council on Linkages of evidence-assisted recruitment and retention strategies for the US public …

Leading Improvement Through Inquiry: Practice-Based Research Networks In Public Health, Glen Mays

Glen Mays

The field of public health has surged in public visibility and attention in recent years due to its potential to mitigate leading risks to human health and wellbeing. Advances in prevention research provide an expanding toolbox of programs, policies, and interventions to reduce health risks. As these advances occur, uncertainties loom large regarding how best to deliver efficacious public health strategies to the populations at greatest risk. The nation's local, state, and federal public health agencies—together with their peers and partners in the private and public sectors—represent a vast yet diffuse delivery system of actors charged, to greater or lesser …

Marginal Effects In Multivariate Probit And Kindred Discrete And Count Outcome Models, John Mullahy

John Mullahy

Estimation of marginal or partial effects of covariates x on various conditional parameters or functionals is often the main target of applied microeconometric analysis. In the specific context of probit models, estimation of partial effects involving outcome probabilities will often be of interest. Such estimation is straightforward in univariate models, and Greene, 1996, 1998, has extended these results to cover the case of quadrant probability marginal effects in bivariate probit models. The first purpose of this paper is to extend these results to encompass the general multivariate probit (MVP) context for arbitrary orthant probabilities. It is suggested that such partial …

Using Pbrn Research To Inform Policy And Practice, Glen Mays

Glen Mays

This brief provides examples of how findings from RWJF-supported research projects underway through the public health PBRNs and the larger field of PHSSR are being used to inform public health practice and policy.

Public Health Pbrn Network Analysis Survey Instrument, Glen Mays

Glen Mays

This survey instrument was used to collect data on research activities patterns of interaction within public health practice-based research networks (PBRNs).

Unanswered Questions Of A Minority People In International Law: A Comparative Study Between Southern Cameroons & South Sudan, Bernard Sama Mr

Bernard Sama

The month July of 2011 marked the birth of another nation in the World. The distressful journey of a minority people under the watchful eyes of the international community finally paid off with a new nation called the South Sudan . As I watched the South Sudanese celebrate independence on 9 July 2011, I was filled with joy as though they have finally landed. On a promising note, I read the UN Secretary General Ban Ki-moon saying “[t]ogether, we welcome the Republic of South Sudan to the community of nations. Together, we affirm our commitment to helping it meet its …

Building A Sustainable Pbrn: Securing Ongoing Funding, Glen Mays

Glen Mays

Practice-based research networks require a diversified mix of funding to sustain their activities in research production and translation.

Ownership Unbundling In European Energy Market & Legal Problems Under Eu Law, Michael Diathesopoulos

Michael Diathesopoulos

In this paper we will examine the issue of ownership unbundling and forced divestiture remedies imposed in a series of recent competition law cases of the energy market - examined in other papers - in relation to the possible existence of a series of legal obstacles. These energy market decisions belong to a group of antitrust cases in which a structural divestiture remedy has been imposed under the provisions of Article 9 of Regulation 1/2003. This divestiture refers to transmission networks and to generation capacity and is meant to lead to severe structural changes, which are compatible with the findings …

The Role Of Social Support In Multiple Morbidity Self-Management Among Rural Residents, Shoshana Bardach, Yelena N. Tarasenko, Nancy E. Schoenberg

Yelena N. Tarasenko

Social support generally is considered a valuable asset that may compensate for health service deficiencies among rural populations. Employing a mixed methods approach, we explored how vulnerable rural residents described social support in the context of self-management for multiple chronic conditions. Participants generally felt support was available, though emotional/ informational support was perceived as less available than other types of support. Participants did not rely heavily on informal support to help them manage their multiple morbidities, preferring to call on their doctor and their own resources. We discuss implications of these findings for meeting this vulnerable population’s self-management needs.

In The Face Of Crisis: The Treatment Action Campaign Fights Government Inertia With Budget Advocacy And Litigation, Neil Overy, International Budget Partnership

International Budget Partnership

At the turn of the millennium the South African government allocated a total of R214 million (US$28.5 million) to the fight against HIV/AIDS, an epidemic that had reached crisis proportions. Less than 10 years later this figure has risen, in inflation-adjusted terms, to R3.96 billion (US$528 million), a real increase of over 1,850 percent. This study looks at how a civil society organization’s ongoing campaigns for treatment access that combined negotiations with the government, mass mobilization of its members (including civil disobedience campaigns), and litigation contributed to this increase.

The full version, short summary, and one page summary of this …

Changing The World With One Cell: The Story Of Hela, Allison Roberts

Allison Roberts

Poster Created for the Diversity Committee Fall 2011 Culture Corner featuring The Immortal Life of Henrietta Lacks. Henrietta Lacks’ cell culture spawned changes in medicine, science, ethics, society and the world. This Semester’s Culture Corner features selections from UT Libraries collection that highlight the areas effected by this one human and her immortal cell.

Comparative Effectiveness, Regulation, And The Evidence Base Of Evidence-Based Healthcare, John Mullahy

John Mullahy

There is some consensus that comparative effectiveness (CE) research holds potential to effect improvements in health outcomes and patient and societal well-being as it contributes to the evidence base of evidence-based healthcare (even in the absence of comparative cost-effectiveness research). For this to occur, the evidence base -- which itself is costly to amass -- must affect treatment decisions in ways that are likely ex ante to be health and welfare enhancing. This in turns place some onus on the producers of the data and data summaries that are the foundation of the evidence base to provide results that are …

State-Level Influences On Buprenorphine Utilization: Variations In Opioid Addiction Treatment, Lisa M. Lines Mph, Robin E. Clark Phd

Lisa M. Lines

Research Objective: Buprenorphine is a medication used to treat opioid addiction. Physicians are required to have special Drug Enforcement Agency certification to prescribe buprenorphine. Although it is more accessible and potentially safer than methadone, the leading opioid addiction treatment modality, there appear to be state-to-state variations in rates of buprenorphine adoption and use. The purpose of this study was to identify state-level influences on the volume of buprenorphine prescribed, using a limited set of supply and demand measures. Study Design: We developed a database using data on buprenorphine prescribing and factors hypothesized to influence variations in prescribing obtained from the …

Progress Delayed: State Of Tobacco Control Policymaking In Oklahoma From 2005-2011, Michael Givel, Ami Stearns, Andrew Spivak

Michael S. Givel

EXECUTIVE SUMMARY • Oklahoma’s 1987 Smoking In Public Places Act required the inclusion of smoking sections in restaurants and pre-empted more stringent local anti-tobacco laws with state regulations. • With the 2001 arrival of an aggressive new Commissioner of Health, Dr. Leslie Beitsch, the tide turned with new legislation (Senate Joint Resolution 21 in 2003) that prohibited smoking inside public places and restaurants were allowed to build separately-ventilated “smoking rooms.” • In 2004, State Question 713 increased the cigarette tax by 80 cents per package. • Dr. Beitsch resigned in 2003 and since that time, efforts toward clean air have …

Progress Delayed: State Of Tobacco Control Policymaking In Oklahoma From 2005-2011, Michael S. Givel, Ami E. Stearns, Andrew L. Spivak

Michael S. Givel

• Oklahoma’s 1987 Smoking In Public Places Act required the inclusion of smoking sections in restaurants and pre-empted more stringent local anti-tobacco laws with state regulations. • With the 2001 arrival of an aggressive new Commissioner of Health, Dr. Leslie Beitsch, the tide turned with new legislation (Senate Joint Resolution 21 in 2003) that prohibited smoking inside public places and required restaurants to build separately-ventilated “smoking rooms.” • In 2004, State Question 713 increased the cigarette tax by 55 cents per package. • Dr. Beitsch resigned in 2003 and since that time, efforts toward clean air have stalled. Although restaurants …

Behavioral Responses To Programmatic Features Of States' Children's Health Insurance Programs, Carole Gresenz, S. Edgington, M. Laugesen, Jose Escarce

Carole Roan Gresenz

No abstract provided.

Tradeoffs Between Public And Private Insurance Under Recent Chip Expansions To Higher Income Children, Carole Gresenz, S. Edgington, M. Laugesen, Jose Escarce

Carole Roan Gresenz

No abstract provided.

Competition Law And Sector Regulation In The European Energy Market After The Third Energy Package: Hierarchy And Efficiency, Michael Diathesopoulos

Michael Diathesopoulos

The aim of this research is to provide the basic parameters for a model for the definition of the relation between the general competition and sector specific frameworks and rules regarding the regulation of the Internal Energy Market, especially after the Third Energy Package. The research considers the recent sector specific framework in relation to a series of recent competition law cases of the Energy Market where structural remedies were applied under the commitments procedure. Essential facilities doctrine and generally competition law tools do not seem to provide a suitable framework for effectively addressing the dynamic competition concept, treating the …

Medical Expenditure Measures In The Health And Retirement Study, Dana Goldman, Julie Zissimopoulos, Yang Lu

Yang Lu

This paper reviews out-of-pocket (OOP) medical expenditure measures collected in the Health and Retirement Study (HRS). Medical expenditures are an important cost of poor health. Medical expenditure measures are important for understanding retirement decisions, financial preparation for retirement, and predicting the consequences of health care reform, particularly Medicare reform. Despite the comprehensiveness of the HRS, there are always limitations to what can be learned from population interviews. To assess the quality of current HRS measures of OOP spending, we compare various measures of OOP spending across survey waves to the Medical Expenditure Panel Survey (MEPS) and Medicare Current Beneficiary Survey …