Health Policy Commons^™

Surveillance Of Infectious Diseases Among American Indians And Alaska Natives, Jeanne Bertolli, Amy Roussel, Jennie Harris, Dan Lentine, Julia Gable, Ron Fichtner, Joann Kauffman, Michael Landen, Ralph T. Bryan

Journal of Health Disparities Research and Practice

We assessed participation in public health surveillance networks among Indian Health Service, tribal, and urban (I/T/U) Indian health facilities for a group of infectious diseases, and barriers to participation. We conducted surveys of I/T/U facilities and key informant interviews with representatives of tribal, urban, and national American Indian/Alaska Native (AI/AN) agencies. For the surveys, frequencies and percentages of responses in each response category were calculated. Qualitative methods were used to analyze interview content. The proportion of facilities participating in case reporting is suboptimal across facility types and diseases. Even when reporting is occurring, there is little feedback to tribal agencies. …

Gay And Lesbian Health Disparities: Evidence And Recommendations For Elimination, M. R. Barker

Journal of Health Disparities Research and Practice

Research suggests that significant health disparities exist among the gay and lesbian population in the United States. These disparities impact both the short- and long-term health outcomes of this population. This study first provides a current literature review of available research on gay and lesbian health disparities and organizes these findings according to health topic. The paper then investigates recommendations for the elimination of racial and ethnic health disparities and examines their applicability in eliminating sexual minority disparities. While many recommendations are valid, this paper analyzes the six thought to have the greatest potential in eliminating gay and lesbian health …

Evaluation Of Lift Up Your Voice! Advocacy Training For Older Adults And Their Caregivers: Executive Summary, Alison Gottlieb, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

The Lift Up Your Voice! (LUYV) training, a component of Community Catalyst’s effort to support the Campaign for Better Care (CBC), is designed to mobilize grassroots advocacy structures of vulnerable older adults by directly engaging and empowering older adults and their caregivers. The goal of the evaluation is to assess the effectiveness LUYV in recruiting potential advocates, educating them about the health care reform, empowering them via advocacy skills training, and engaging them in state-based CBC activities.

Coordinating And Integrating Care For Safety Net Patients: Lessons From Six Communities, Leighton C. Ku, Marsha Regenstein, Peter Shin, Holly Mead, Alice R. Levy, Kate Buchanan, Fraser Rothenberg Byrne

Health Policy and Management Faculty Publications

This report examines efforts to improve the coordination of health care among safety net providers in six communities (Austin, TX; Brooklyn, NY; Indianapolis, IN; Marshfield, WI; San Francisco, CA; and St. Louis, MO), based on case study site visits and a roundtable discussion. Across the communities, we identified three approaches to improving coordination: (1) collaboration of providers using a coordinating organization, (2) coordination facilitated by Medicaid managed care plans, and (3) development of highly integrated care systems. These represent models that could be used by different communities, based on their local circumstances. Successful development of coordination approaches involved shared commitment …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

A Framework Convention On Global Health: Health For All, Justice For All, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Health inequalities represent perhaps the most consequential global health challenge and yet they persist despite increased funding and innovative programs. The United Nations is revising the Millennium Development Goals (MDGs) that will shape the world for many years to come. What would a transformative post-MDG framework for global health justice look like? A global coalition of civil society and academics—the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI)—has formed an international campaign to advocate for a Framework Convention on Global Health (FCGH). Recently endorsed by the UN Secretary-General, the FCGH would reimagine global governance for …

The Science Of Public Health Practice: Using Pbrns For Delivery System Research In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

PBRN research tests strategies for improving the delivery of services that promote health and prevent disease and injury on a population-wide basis.

The Task Force Initiative: Local Interventions At The Department Level—A Key Component Of A Multi-Tiered Approach To Promote Institutional Change, Emily Conant, Patricia Scott, Josef Reum, Alyssa Westring, Susmita Pati, Lucy Tuton, Mary Sammel, Rebecca Speck, Jean Grisso, Stephanie Abbuhl

Health Policy and Management Faculty Posters and Presentations

This NIH Transforming Academic Culture (NIH-TAC) trial is a multi-level coordinated intervention to enhance institutional culture, increase academic productivity, and improve job satisfaction for women faculty. This poster details a task force initiative in which each department and division reviewed their current practices and policies to recommend and implement change. This particular task force resulted in a list of interventions which were disseminated and implemented throughout the institution.

Medicare: What Is In Store For Future Generations?, Karen L. Poon

Honors Scholar Theses

Medicare is the health insurance coverage provided to all senior citizens over the age of 65. It has been around since 1965. This paper takes an in-depth look into the Medicare program. First, the history behind Social Security is introduced. The Medicare program was created as an addition to Social Security, and its history follows. Although the ideas and goals of the Medicare program have good intentions, there are many issues with it. These problems are discussed in detail in the current issues portion of the paper. As a follow up, I have expanded upon and come up with some …

An Early Assessment Of The Potential Impact Of Texas' "Affiliation" Regulation On Access To Care For Low-Income Women, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This analysis provides an initial assessment of the implications for low-income women of Texas' "affiliation regulation," which would bar Planned Parenthood Federation of America (PPFA) clinics from participating in the Texas Women's Health Program (WHP). In 2010, more than 183,000 women were enrolled in the WHP, which provides health screening, family planning and birth control to low-income women, and nearly 106,000 received care through the program. In our analysis of WHP provider data, we find:

• Planned Parenthood (PPFA) clinics are by far the dominant source of care under the WHP. In FY 2010, PPFA clinics accounted for approximately 49 percent …

Revised: An Early Assessment Of The Potential Impact Of Texas’ “Affiliation” Regulation On Access To Care For Low-Income Women, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

What Is The Optimal Subsidy For Exercise? Informing Health Insurance Companies' Fitness Reimbursement Programs, Molly E. Frean

Economics Honors Projects

Health care costs account for 17% of US GDP and many programs and policies seek to reduce these costs. This paper focuses on exercise as preventive care due to its immense physiological benefits. I model the profit-maximizing choice of health insurance companies to subsidize exercise and the utility-maximizing choice of individuals to engage in exercise using a traditional principal-agent framework. I then use principles from behavioral economics and psychology to critique these models and provide further insight into understanding our underconsumption of such preventive services. I end with an evaluation of current programs and suggestions for improvement using empirical findings.

Improving Nursing Home Patient Safety In Maine: A Review Of The Ahrq Patient Safety Culture Survey Implementation Process, Andrea Fenner-Koepp

Muskie School Capstones and Dissertations

An organization’s patient safety culture has a powerful influence on the behaviors, strategies, and clinical outcomes of healthcare organizations. The Agency for Healthcare Research & Quality (AHRQ) Patient Safety Culture Survey has been deemed an effective tool for assessing patient safety culture and driving improvement initiatives. There has been little done to assess the quality of patient safety culture in long-term care facilities and, specifically, Maine has not collectively established baseline measures of patient safety culture in nursing home. This capstone reviews the implementation process of the AHRQ Patient Safety Culture Survey in five rural nursing facility pilot sites.

Challenges To Policy Implementation: An Examination Of An Integrated Health Care Delivery System Demonstration Project, Kaitlin A. Roh

Political Science Honors Projects

US health care costs are among the highest of all industrialized nations. In an effort to reduce costs and improve health outcomes, new delivery models – including accountable care organizations – have been developed. Yet, as revealed through interviews with key participants in Hennepin County's delivery project, significant challenges to implementing them exist. They include obstacles that inherently arise from implementing a means-tested health care policy within a competitive, federalized governing structure. Because these challenges are not unique to Hennepin County, this project can help similar projects and may push policy towards the integration of the health care and social …

Perbandingan Tingkat Kepuasan Kerja Perawat Dan Kepuasan Pasien, Jamilla Upik Noras, Ratu Ayu Dewi Sartika

Kesmas

Perawat adalah ujung tombak pemberi pelayanan langsung pada pasien selama 24 jam. Tujuan penelitian adalah untuk membandingkan tingkat kepuasan kerja perawat dengan kepuasan pasien terhadap pelayanan keperawatan kelas 3 di Rumah Sakit Umum Pusat (RSUP) X Jakarta. Penelitian ini bersifat deskriptif dengan desain studi cross sectional, pendekatan kuantitatif dan kualitatif. Populasi adalah seluruh perawat yang bertugas sebagai pelaksana keperawatan kelas 3 sebanyak 40 orang ser- ta pasien yang dirawat di ruang rawat inap kelas 3 sebanyak 120 orang. Pengambilan sampel dilakukan secara purposive sampling sesuai dengan kriteria inklusi dan ekslusi. Hasil pengukuran kuantitatif menunjukkan bah- wa tingkat kepuasan kerja perawat …

Investing In A Healthier Future: Iom Dissemination Workshop, Glen P. Mays

Health Management and Policy Presentations

This session discusses strategies for implementing new financing strategies and funding mechanisms for public health services.

Extent And Nature Of Resource Sharing Among Local Health Departments, Joshua Vest, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

Objective: Collaborative arrangements between local health departments (LHDs) by which they share services, responsibilities, or staff, is a growing occurrence in the US. This phenomenon is referred to as regionalization, resource sharing, or intra-state resource sharing. Participants of this session will learn about the current state of resource sharing among LHDs in terms of the public health activities, nature of the relationships, and geography. We will also discuss which characteristics of LHDs are associated with resource-sharing.

Data Source: Data for this analysis come from the National Association of City & County Health Official's 2010 Profile of Local Health Departments. The …

Diffusion Of Practice-Based Research In Local Public Health: What Differentiates Adopters From Non-Adopters?, Gulzar H. Shah, Kay Lovelace, Reba Novich

Health Policy & Management: Faculty Presentations (2008-2022)

Objective: To improve session-participants’ understanding of level of local health departments’ (LHDs) involvement in various practice-based research (PBR) activities. Practice-based public health research is gaining increased recognition for improving the efficiency and effectiveness of public health practice.

Data: Data are drawn from NACCHO’s 2010 National Profile of LHDs Study. Questions about LHDs’ participation in PBR were administered to a stratified random sample of 625 LHDs.

Findings: Over the 12 months prior to the study 38 percent of LHDs did not participate in any PBR activity and another five percent of respondents did not know if their health department …

Health Districts As Quality Improvement Collaboratives And Multi-Jurisdictional Entities, William C. Livingood, Nandi A. Marshall, Angela Peden, Ketty Gonzales, Gulzar H. Shah, Dayna S. Alexander, Kellie O. Penix, Russell B. Toal, Lynn D. Woodhouse

Health Policy & Management: Faculty Presentations (2008-2022)

Research Objective: The Georgia Public Health PBRN assessed the utility of the Multi-county Health District as a structured Quality Improvement Collaborative (QIC), and as multi jurisdictional entities for purposes of meeting standards for accreditation by the Public Health Accreditation Board.

Data Sets and Sources: Data were collected from online surveys followed up with phone interviews or paper surveys to maximize participation. A newly developed clinical care QIC instrument (Schouten et al, 2010) was modified to collect data with a revised focus on QICs for public health. We retained QI culture constructs in the instrument while shifting the focus …

The Resilient Local Health Department: Attributes Of Survival During The Economic Crisis, Paul C. Erwin, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

The purpose of this research is to explore the attributes of local health departments (LHDs) which have survived the recent economic crises without loss of staff. A retrospective cohort study is being conducted, using the 2005 and 2010 Profile of Local Health Departments datasets from the National Association of County and City Health Officials. LHDs which responded to both surveys and which provided data on full-time equivalents (FTEs) and expenditures are included for analysis. LHDs are categorized as resilient or non-resilient based on whether the LHD gained or did not lose FTEs between 2005 and 2010 (“resilient LHD”) vs. those …

Patterns Of Interaction In Public Health Research Networks: Insight From Network Analysis, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Studies from the past three decades have found evidence of wide variation in public health practices and policies across states and communities despite an expanding evidence base of efficacious public health strategies, suggesting gaps in implementation and translation processes. Practice-based research networks (PBRNs) are expected to accelerate research participation and translation. This study uses social network analysis methods with twelve Public Health PBRNs to study processes influencing the implementation and translation of research within diverse public health settings.

DATA and METHODS: A cross-sectional network analysis survey was validated and fielded with participants in two cohorts of public health PBRNs …

Public Health Governance And Population Health Outcomes, Scott P. Hays, Janine Toth, Matthew J. Poes, Peter F. Mulhall, David M. Remmert, Thomas W. O'Rourke

Frontiers in Public Health Services and Systems Research

Research reviews have identified a gap in understanding the diversity of health department governance structures and in understanding how the variations in governing relates to health outcomes. This report details the categorization of local public health governance and reveals that certain governance types may be better suited to achieve better population health outcomes. State systems achieve the poorest health outcomes, but the best health outcomes are achieved when the political branches have a key role in local public health governance. Public health systems should consider greater local control and involvement in governance; but local governance should include the political branches …

Using State And Local Health Survey Data To Advance Phssr, Glen P. Mays

Health Management and Policy Presentations

State and local health survey data can be used to evaluate the implementation and impact of public health delivery innovations in real-world practice settings.

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Multi-State Plans Under The Affordable Care Act, Trish Riley, Jane H. Thorpe

Health Policy and Management Faculty Publications

New state health insurance exchanges that are developing under The Patient Protection and Affordable Care Act (ACA) will offer consumers a choice of private health plans known as qualified health plans (QHPs). Under the law, in every state, two of those must be multi-state plans or MSPs. These plans will be administered by the federal Office of Personnel Management (OPM). The MSPs must meet the same requirements as other QHPs. As with other QHPs, people enrolled in the plans will be eligible for premium tax credits and cost sharing assistance if their income is less than 400 percent of poverty …

Minority Rights And Health Care Equity In Turkey, Katherine Logan '12

Honor Scholar Theses

No abstract provided.

Institute For Community Inclusion (Ici) Leadership Education In Neurodevelopmental Disabilities (Lend) Partners With Community-Based Organizations (Cbos), David Helm, Institute For Community Inclusion, University Of Massachusetts Boston

Office of Community Partnerships Posters

This Interdisciplinary Leadership Education in Neurodevelopmental and Related Disabilities (LEND) and Maternal and Child Health Bureau (MCHB) funded-program aims at providing long-term, graduate level interdisciplinary training to health professionals and family members. The purpose of this project is to develop leadership potential to improve the health status of infants, children, and adolescents with or at risk for neurodevelopmental and related disabilities and to enhance the systems of care for these children and their families.

Health Information Privacy In The Correctional Environment, Melissa M. Goldstein

Health Policy and Management Faculty Publications

Information technology is considered a transformative element in health care because it facilitates the transparency and sharing of health information, which have always been central to the practice of medicine and the delivery of high-quality care. The widespread use of electronic health records (EHRs) and electronic health information exchange, among other technologies, is considered essential to improving the quality of care, reducing medical errors, reducing health disparities, and advancing the delivery of patient-centered medical care.

Reaching The Oldest Population: Improving The Coverage Of Service For People Over 85 Years Old In Broome County, Xiaofei Jiang

MPA Capstone Projects 2006 - 2015

From 2000 to 2010, the population of those over 85 years old ( the oldest old) in Broome County has increased by 23.19%. However at the same time, the number of the oldest old who receive service from Broome County Office for Aging (BCOFA) has decreased by 10%. As the only department in Broome County government which provides services specifically targeting senior citizens, BCOFA may differ from the needs of those who do not and what strategies could be used to improve the service coverage for this problem.

Fitness Tax Credits: Costs, Benefits, And Viability, Daniel M. Reach

Northwestern Journal of Law & Social Policy

As the number of overweight and obese Americans rises, it becomes increasingly clear that Americans need further incentives to stimulate lasting lifestyle changes. Tax incentives focused on exercise, which have been largely unexplored to this point, are an effective response to the growing obesity problem in the United States that would largely avoid the political opposition that tax policies focused on diet have encountered. In addition, they would also provide a more palatable solution for the taxpayer beneficiaries with a relatively low impact on government revenues. Viable tax incentives to encourage greater fitness include tax credits and sales tax breaks, …