Health Policy Commons^™

Model Spesifikasi Dinamis Permintaan Rokok: Rasionalkah Perokok Indonesia?, Budi Hidayat, Hasbullah Thabrany

Kesmas

Studi ini mengestimasi model spesifikasi dinamis permintaan (demand) rokok di Indonesia. Tujuannya adalah untuk menguji hipotesis kecanduan rasional perokok, dan menghitung elastisitas harga rokok jangka pendek dan jangka panjang. Analisis diaplikasikan pada data agregat individu yang dibentuk dari tiga tahapan survei panel IFLS selama tahun 1993-2000. Studi ini menjajagi sejumlah teknik ekonometrik dan memilih teknik tercocok atas dasar serangkaian uji statistik. Hasilnya menunjukkan bahwa rokok terbukti sebagai produk yang menimbulkan kecanduan (koefisien konsumsi masa lampau positif dan signifikan pada 1%). Sedangkan koefisien negatif dan signifikan untuk konsumsi rokok masa depan menunjukan sifat kecanduan miopik, artinya para perokok bersifat tidak rasional. …

Analisis Implementasi Kebijakan Pkps Bbm Bidang Kesehatan, Adang Bachtiar, Dumilah Ayuningtyas, Riastuti Kusuma Wardani

Kesmas

Tingginya harga minyak dunia mengakibatkan pemerintah Indonesia di bawah pimpinan Susilo Bambang Yudhoyono (SBY) harus mengurangi subsidi Bahan Bakar Minyak (BBM). Hal ini berdampak pada kenaikan harga BBM sebanyak tiga kali yaitu pada Maret 2005 (kenaikan harga berkisar 60 persen), Oktober 2005 (sekitar 108 persen), dan Mei 2008 (sekitar 30 persen). Kebijakan ini dimaksudkan agar dana yang diperoleh dari pengurangan subsidi BBM dapat dipindahkan alokasinya untuk empat program utama bagi penduduk miskin dan tidak mampu. Program-program tersebut adalah Bantuan Langsung Tunai, Bantuan Operasional Sekolah (BOS), pelayanan kesehatan gratis, dan infrastruktur desa. Studi ini bertujuan untuk menilai secara umum pelaksanaan Program …

Analisis Saldo Piutang Pasien Jaminan Di Rumah Sakit Port Medical Center, Dian Kusumawardhani, Prastuti Soewondo

Kesmas

Piutang merupakan harta lancar yang terbesar pada organisasi kesehatan dan berdampak dana investasi. Kegagalan pengelolaan piutang di rumah sakit akan mengganggu cash flow dan kegiatan operasional rumah sakit. Penelitian ini bertujuan mengetahui penyebab saldo piutang pasien jaminan pihak ketiga yang tinggi, meliputi dinas dan langganan di RS Port Medical Center. Penelitian operasional ini melakukan pengamatan langsung dan telaah dokumen pada proses pengelolaan piutang pada tahap penerimaan, pembebanan biaya, penataan rekening, penagihan dan penutupan rekening. Informan adalah para pejabat dan pelaksana yang terlibat. Didapatkan bahwa tidak ada standar atau persyaratan kredit yang berlaku sebelum kerja sama. Potongan harga, jangka waktu pembayaran …

Diagnosing Death: Why Does It Remain "Well Settled And Persistently Unresolved"?, Melissa M. Goldstein

Health Policy and Management Faculty Publications

For ten days after Motl Brody had been declared dead by physicians, the 12-year-old boy lay in an intensive-care unit of Children's National Medical Center, sustained by drugs and a ventilator. His Orthodox Jewish parents insisted that, according to religious law, Motl remained alive because his heart continued to beat. District of Columbia law said he did not.

Although statutes on the books of every U.S. state allow a determination of death when all functions of the brain, including the brain stem, have irreversibly ceased, there is continued debate, especially in religious, philosophical, and bioethics contexts, about how, or even …

Ready Or Not? Protecting The Public's Health From Diseases, Disasters, And Bioterrorism, Jeffrey Levi, Serena Vinter, Rebecca St. Laurent, Laura M. Segal

Health Policy and Management Faculty Publications

While significant progress has been made to better protect the country from health emergencies, funding for essential programs has been cut, putting these improvements in jeopardy. Additionally, a number of critical areas of preparedness still have significant gaps, including surge capacity and biosurveillance systems, and these problems are less likely to be addressed as funding decreases.

Liability Protections For Emergency Volunteer Health Practitioners And Entities, Jennifer Lee, Orriel L. Richardson, Ross Margulies, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Twenty-four states and D.C. have statutes that extend some level of immunity to groups and/or organizations providing charitable, emergency, or disaster relief services, although these laws varied greatly among states.

Communicable Disease And International Security: The Case Of Africa & Hiv/Aids, Amy L Rue

Archived Theses and Dissertations

In this thesis, I will look at how communicable disease fits into the human security discourse particularly with the disease being views as the 'potential threat' and the 'referent object' within the international sphere. The case of Africa will be used to illustrate the impact of HIV/AIDS on international security at country, regional and international levels. Ultimately, I will argue that communicable disease, as a human security issue, is a clear and important international security issue due to its status as a continual "potential threat" within international relations particularly in Africa. The elements that I will use to establish my …

Improving Medicaid: Assessment Of District Of Columbia Agencies' Claims Processes And Recommendations For Improvements In Efficiency And Customer Service, George Washington University, School Of Public Health And Health Services, Department Of Health Policy, Health Management Associates

Health Policy and Management Faculty Publications

The District of Columbia Department of Health Care Finance (DHCF), like other state Medicaid agencies, is constantly challenged to improve service delivery and reimbursement for Medicaid services. In the District, several governmental agencies ("Partner Agencies") play an instrumental role in Medicaid – either as a Medicaid provider or in operating a Medicaid program. Today, each Partner Agency may retain its own system and process for claims submission, provider enrollment, and administrative claiming as it relates to Medicaid. For these reasons, the DHCF initiated an assessment of the Medicaid claims processes for Partner Agencies. The purpose of the assessment is to …

Medicare Advantage's Private Fee-For-Service Plans: Paying For Coordinated Care Without The Coordination, Brian Biles, Emily Adrion, Stuart Guterman

Health Policy and Management Faculty Publications

Like the private managed care plans offered under Medicare Advantage, private fee-for-service (PFFS) plans are paid more per beneficiary than those individuals would be expected to cost if they were enrolled in traditional fee-for-service Medicare. However, PFFS plans are not required to provide the same type of coordinated care required of Medicare Advantage plans. Payments to PFFS plans in 2008 average 16.6 percent more than costs in traditional Medicare, or $1,248 for each of the 2 million enrollees in PFFS plans—a total of nearly $2.5 billion in extra payments. Recently, Congress has made significant revisions to policies that will affect …

Assessing The Effects Of Medicaid Documentation Requirements On Health Centers And Their Patients: Results Of A "Second Wave" Survey, Lee Repasch, Brad Finnegan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This report represents a "second wave" follow-up to a "first wave" study whose purpose was to measure the effects of the Deficit Reduction Act's citizenship documentation requirements on health centers and their patients. The earlier study, conducted six months after implementation, found that the law had a widespread impact, including delayed applications, interrupted enrollment, disruptions in care, and at least anecdotal evidence of a growth in the number of uninsured patients as a result of the denial or loss of Medicaid coverage. This "second wave" survey underscores the existence of serious, ongoing problems more than a year after implementation. Specifically, …

Second-Generation Consumerism: Increasing Consumer Activation To Improve Health Outcomes And Lower Costs For Patients With Chronic Disease, Judith H. Hibbard, Katherine J. Hayes

Health Policy and Management Faculty Publications

With health care costs increasing, some policymakers have sought to make patients better health care consumers through increased cost-sharing linked with greater information on the cost of care. These may be successful cost containment strategies in the short term. But patients are just as likely to forgo necessary as unnecessary care, which ultimately leads to greater demand for more intensive and expensive care in the long term. Patients can, however, play an important role in preventing the onset of chronic conditions or preventing deterioration in health once they have been diagnosed with a chronic condition. In this chapter we discuss …

Slouching Toward Health Reform: Insights From The Battle Over Schip, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

No abstract provided.

For Asians Only? The Perils Of Ancestry-Based Drug Prescribing, Perry W. Payne

Health Policy and Management Faculty Publications

The article discusses various aspects of ancestry-based drug prescribing and contemporary medical ethics in the U.S. Ancestry has been used by researchers to identify a subgroup of people most likely to have a certain allele linked to an adverse drug response. Also discussed are carbamazepine labeling, the U.S. Food and Drug Administration's (FDA) Alert on drug prescribing based on allele testing and the ethics of genetically categorizing people.

The Likely Impact Of Mandated Paid Sick And Family-Care Leave On The Economy And Economic Development Prospects Of The State Of Ohio, Edward W. Hill, Spence Christopher, Daila Shimek, Ziona Austrian

All Maxine Goodman Levin School of Urban Affairs Publications

This report analyzes the potential impact of a proposed paid sick and family care leave legislation on the economy of the state of Ohio, the economic development prospects of the state and on the management of production processes that depend on highly integrate teams. The report also reviews the literature on the effect of mandated paid sick and family care leave on the industrial relations system—workplace performance and worker retention. Our analysis concludes that there would have been a net cost associated with the paid sick leave and family-care initiative proposed in Ohio with a lower bound estimate of $63.84 …

The Continuing Cost Of Privatization: Extra Payments To Medicare Advantage Plans In 2008, Brian Biles, Emily Adrion, Stuart Guterman

Health Policy and Management Faculty Publications

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, every MA plan in the nation is paid more for its enrollees than they would have been expected to cost in traditional fee-for-service Medicare. The authors calculate that payments to MA plans in 2008 will be 12.4 percent greater than the corresponding costs in traditional Medicare—an average increase of $986 per MA plan enrollee, for a total of more than $8.5 billion. Over the five-year period 2004–2008, extra payments to MA plans are estimated to have totaled nearly $33 billion. Although …

Designation Of Medically Underserved And Health Professional Shortage Areas: Analysis Of The Public Comments On The Withdrawn Proposed Regulation, Emily Jones, Leighton C. Ku, Joseph Lippi, Ramona Whittington, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In February 2008, the Health Resources and Services Administration (HRSA) proposed new regulations that would have modified and combined the Health Professional Shortage Area (HPSA) and Medically Underserved Area/Population (MUA/P) designation processes. The comment period was extended twice in response to the large volume of comments, through June 30th. On July 23rd, HRSA effectively withdrew the proposed rule, announcing that in light of its preliminary review of comments, the agency had elected to develop a new proposal. This Research Brief highlights some of the salient issues surrounding the proposed rule, based on an analysis of the public comments by researchers …

Shea/Apic Guideline: Infection Prevention And Control In The Long-Term Care Facility, Philip W. Smith, Gail Bennett, Suzanne Bradley, Paul Drinka, Ebbing Lautenbach, James Marx, Lona Mody, Lindsay Nicolle, Kurt Stevenson

United States Department of Veterans Affairs: Publications

Long-term care facilities (LTCFs) may be defined as institutions that provide health care to people who are unable to manage independently in the community.¹ This care may be chronic care management or short-term rehabilitative services. The term nursing home is defined as a facility licensed with an organized professional staff and inpatient beds that provides continuous nursing and other services to patients who are not in the acute phase of an illness. There is considerable overlap between the 2 terms.

More than 1.5 million residents reside in United States (US) nursing homes. In recent years, the acuity of illness …

Membangun Bangsa Yang Sehat Produktif, Does Sampoerno

Kesmas

Peran kesehatan yang dipahami pihak eksekutif dan legislatif di Indonesia masih terbatas pada pengobatan dan penyembuhan penyakit, bukan membangun sumber daya manusia yang berkualitas. Sejak masa penjajahan, kebijakan kesehatan tersebut didominasi oleh kebijakan kuratif dengan fasilitas kesehatan utama Rumah Sakit, Puskesmas dan Balai Pengobat. Upaya kesehatan tersebut melemahkan argumentasi peran penting kesehatan dalam pembangunan bangsa. Konsep tersebut berpengaruh terhadap tujuan upaya kesehatan mencapai keadaan sehat produktif untuk semua yang dapat mengantarkan penduduk mencapai tingkat sehat produktif. Definisi sehat yang baru tersebut berpengaruh terhadap perubahan paradigma penanganan kesehatan dari “Health Program for Survival” ke “Health Program for Human Development”. Tujuan akhir …

Analisis Potensi Pasar Dan Atribut Pelayanan Rumah Sakit Islam Depok, Dumilah Ayuningtyas, Hidayani Fazriah

Kesmas

Di Kota Depok masyarakat muslim yang menjadi komunitas terbesar (91,94%) merupakan pasar potensial rumah sakit. Tujuan penelitian ini adalah mendapat gambaran potensi pasar dan atribut pelayanan rumah sakit yang diharapkan masyarakat muslim. Penelitian yang menggunakan model SERVQUAL ini dimodifikasi dengan 4 karakteristik syariah marketing dan dikelompokkan dalam people, place, symbols, equipment, dan price. Desain penelitian menggunakan metode survey self administered questionaire. Sampel berjumlah 120 diambil dari pasien yang berobat di rumah sakit di Kota Depok. Selain itu, dilakukan studi kualitatif dengan metode indepth interview kepada pakar terkait. Atribut pelayanan rumah sakit Islam pilihan responden yang bersifat universal berupa bentuk pelayanan …

Uninsured And Medicaid Patients' Access To Preventive Care: Comparison Of Health Centers And Other Primary Care Providers, Avi Dor, Yuriy Pylypchuck, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This issue of Research Briefs examines health centers' role in reducing disparities in preventive health care access by medically vulnerable and high risk populations. The analysis uses information from several national data sources to examine differences in the provision of preventive health care to Medicaid and uninsured patients between health centers and other primary care providers.

Key Findings:

• Compared to those treated by other primary care providers, Medicaid and uninsured patients treated by health centers are significantly poorer, in significantly worse health, and in the case of uninsured patients, more likely to be members of racial and ethnic minority groups. …

Using Spatial Visualization Software To Influence Cancer Control Policy: A Case Study Of Prostate Cancer In South Carolina., Shannon Amelia Shropshire

Electronic Theses and Dissertations

Prostate cancer in the United States shows great disparities among race and socioeconomic status. Disparities in cancer rates in South Carolina are severe. Cancer control policies are lacking in ways to identify reasons for high risk populations and cost-effective ways to do so. An innovative spatial visualization program called the GeoViz Toolkit was used to determine areas of high Prostate Cancer incidence and mortality in South Carolina (rates obtained from the South Carolina Central Cancer Registry) compared with socioeconomic variables (education, income, lack of health insurance, and living in rural areas) and race. From there, recommendations were made using the …

Access Transformed: Building A Primary Care Workforce For The 21st Century, Sara J. Rosenbaum, Peter Shin

Health Policy and Management Faculty Publications

Though access to primary care protects health and cuts costs, this report shows there aren't enough primary care doctors and nurses at health centers to meet the need, with some areas having almost none – a situation that cannot be solved just by expanding health insurance coverage. The report indicates the availability of a primary care workforce depends on where you live, and primary care clinicians are not locating in areas that need them most, especially low-income communities. The study includes state-level projections of growing patient needs expected to stretch the health care system in years ahead. It was conducted …

Positioning Hospice Care Within The Black And Hispanic Communities, Carol Armstrong

Graduate Theses

Nationally, hospice care and the signing of advance directives are underutilized by minority populations. Research on this phenomenon includes cultural differences, access to medical care and language barriers. A retrospective study of 1,817 closed patient charts from a local hospice was conducted to determine significant differences among the White, Black and Hispanic patient populations. The number of White patients admitted to both hospice homecare and to the hospice inpatient was significantly greater than the number of admissions of either the Black or Hispanic patients. There were no significant findings in the total number of services provided to each of the …

The Forgotten Minority: A Cross-Sectional And Time-Series Analysis Of American Indian/Alaska Native Child Abuse And Neglect, 1993-2003, Linda Kaye Ketcher

Graduate Theses and Dissertations

Very little empirical research has been conducted on child abuse among American Indians/Alaska Natives (AI/AN). This dissertation examines the rate of reported AI/AN child abuse from 1993-2003 for the 20 U. S. states with the largest percentages of AI/AN populations. Research on child abuse and neglect from at least two bodies of literature is examined - one on child abuse in the general population and the other on child abuse among American Indians/Alaskan Natives. Based on SAS output from pooled time series analysis, two tables were created, one for the general population and one for the AI/AN population. The results …

Monitoring And Assessing The Use Of External Quality Review Organizations To Improve Services For Young Children: A Toolkit For State Medicaid Agencies, Tara Krissik, Henry T. Ireys, Anne R. Markus, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Federal regulations encourage state Medicaid agencies to use external quality review organizations (EQROs) to help implement strategies for assessing and improving the quality of medical services provided to beneficiaries enrolled in managed care plans. However, many states have not availed themselves of this opportunity and may lack guidance on how to do so. This report provides agencies with specifications for developing a scope of work that will lead to conceptually and methodologically sound studies of the quality of preventive and developmental services for young children enrolled in Medicaid. Among other recommendations, the authors note that states may require EQROs to …

For Love, Money Or Flexibility: Why People Choose To Work In Consumer-Directed Homecare, Candace Howes

Economics Faculty Publications

The purpose of this study was to investigate the impact of wages and benefits (relative to other jobs available to workers), controlling for personal characteristics, on the recruitment and retention of providers working in a consumer-directed home care program.

This article was written as part of a project titled ‘‘Building a High Quality Homecare Workforce: Wages, Benefits and Flexibility Matter,’’ which was supported by a research grant from the Better Jobs Better Care Program and funded by the Robert Wood Johnson Foundation (#049213) and Atlantic Philanthropies (#12099) with direction and technical assistance provided by the Institute for the Future of …

Parenting From Prison: Family Relationships Of Incarcerated Women In Massachusetts, Erika Kates, Sylvia Mignon, Paige Ransford

Publications from the Center for Women in Politics and Public Policy

Historically in the United States, there has been little concern about the needs of incarcerated women and their family members, especially children. This began to change with the tremendous increase in the number of incarcerated women. The rate of women’s incarceration increased dramatically during the 1980s and today the number of female inmates continues to rise faster than the number of male inmates. In 1986, 19,812 women were incarcerated in the United States and this number rose in 1991 to 38,796. Today, over 112,000 women are incarcerated in state or federal facilities (Sabol et al., 2007; Snell 1994). While in …

Peranan Pelatihan Learning Organization Pada Perubahan Individu Dan Institusi: Pengalaman Kabupaten Cianjur, Ede Surya Darmawan

Kesmas

Dalam rangka mendukung peningkatan kapasitas aparat pemerintah daerah dalam melaksanakan peran dan fungsi setelah penerapan kebijakan desentralisasi, Unit Desentralisasi Departemen Kesehatan telah menyusun beberapa rencana strategis yang bertujuan mengantisipasi transisi desentralisasi, diantaranya adalah membangun organisasi pembelajar. Melihat bagaimana peranan pelatihan berpengaruh pada perubahan individu dan institusi pada lingkungan birokrasi yang lebih ketat pada tingkat pemerintah daerah. Penelitian ini adalah sebuah penelitian quasi-eksperimental dengan pre- dan post- intervensi, pengukuran yang berulang kali, dan kontrol yang tidak merata. Kelompok pertama akan menerima pelatihan SLLO (Xa) dan pendampingan (Xb). Kelompok kedua hanya akan berfungsi sebagai kelompok pengontrol. Penelitian ini menemukan: (1) Pelatihan LO …

Medicare Competitive Acquisition: Implications For Persons With Diabetes, Sara J. Rosenbaum, Avi Dor, Brad Finnegan, Emily Jones

Health Policy and Management Faculty Publications

Nearly one in five Medicare beneficiaries has diabetes and these patients face major challenges in managing their health. The high diabetes rate among beneficiaries also means that the Medicare program itself is highly vulnerable to the high costs of uncontrolled diabetes. As a result, great care must be taken when implementing any new cost containment strategy that has the potential to disrupt access to preventive health care. This is particularly in the case of the Medicare Competitive Acquisition Program for Durable Medical Equipment and Supplies (DMEPOS), because of its potential impact on access to products needed for a basic preventive …

Baseline Evaluation Of The Dc Emergency Healthcare Coalition, Melissa A. Higdon, Peter Shin, Michael A. Stoto

Health Policy and Management Faculty Publications

The DC Healthcare Facilities Emergency Care Coalition, funded by a grant by the U.S. Department of Health and Human Services Assistant Secretary for Preparedness and Response (ASPR), was designed to significantly improve the state of emergency preparedness in health care facilities in the District of Columbia (DC), and to create a model for emergency preparedness that can be used by other large cities or regions of care across the nation. Its goal is to provide a comprehensive, uniform, and consistent framework and infrastructure for emergency preparedness across the full continuum of patient care. Devised to address the inconsistencies, shortcomings, fragmentations, …