Health Policy Commons^™

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Awakening From A Medical Mystery: One Patient’S Experience Of Being Undiagnosed, Dwane Unruh

Patient Experience Journal

This personal narrative pleads for a supportive and comprehensive system or sub-system similar to that which exists for cancer patients, to deal with undiagnosed illnesses. By describing the torment of living with a debilitating illness that medicine could not easily recognize, then by contrasting this experience with my wife’s experience of the cancer care system, and by referring along the way to lessons learned many years ago from reading the works of the inciteful neurologist, Dr. Oliver Sacks, I hope to inspire the medical system to develop a separate, supportive and comprehensive system to deal with the undiagnosed. As it …

The Future Of Patient Experience: Five Thoughts On Where We Must Go From Here, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

In looking to the future, we must never forget it is grounded in today and the steps that brought us to this point. Those efforts and actions that led to where we stand now set the foundation for all we can do and what we will accomplish as we look to the future. This idea of not looking too far ahead without knowing where you stand is fundamental in human nature. Far too often we have let our gaze to the future miss the people right in front of us or overlook the significance of the moment in which we …

Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd

Rural Health Clinics

The Rural Health Clinic (RHC) Program is one of the nation’s oldest rural primary care programs. A key feature of the RHC Program is Medicare and Medicaid volume-appropriate, cost-based reimbursement, which is designed to sustain these vulnerable rural primary care providers. Medicare currently pays RHCs for the lesser of reasonable costs (expressed as an adjusted cost per visit) for a defined package of RHC services or a per-visit reimbursement cap, from which provider-based RHCs owned by hospitals with fewer than 50 beds are exempt. Although the per-visit cap is updated periodically, RHC administrators, policymakers, and stakeholders question whether the updates …

Combatting The Opioid Epidemic In Texas By Holding Big Pharma Manufacturers Liable, Katherine Spiser

St. Mary's Law Journal

Abstract forthcoming

Health Engagement Challenges And Strategic Perspectives For The 2023 Health Financing Transition In The Federated States Of Micronesia And The Republic Of The Marshall Islands, Alex Wheatley, Subroto Banerji

Pacific Journal of Health

The Federated States of Micronesia (FSM) and the Republic of the Marshall Islands (RMI) are small sovereign island nations in the Pacific. These nations maintain a special relationship with the US Government (USG) through the Compacts of Free Association (COFA), first signed into law in 1986. One component of COFA—the more than $60 million in direct USG annual financial assistance to FSM and RMI through Compact Sector grants—will end in 2023. This financing shift brings an opportunity to re-assess FSM-RMI-USG engagement specifically around health systems strengthening moving forward. At present, FSM-RMI are included in HHS’ domestic appropriations and authorizations framework; …

Snap At The Community Scale: How Neighborhood Characteristics Affect Participation And Food Access, Nevin Cohen

Publications and Research

Cities are spatially diverse, with enclaves of particular demo- graphic groups, clusters of businesses, and pockets of low-income individuals living amid affluence.

This essay presents data from New York City to illustrate the importance of measuring and addressing neighborhood characteristics that affect Sup- plemental Nutrition Assistance Program (SNAP) participation and the purchasing power of SNAP benefits: pockets of “eligible-but-not-enrolled” in- dividuals, proximity between SNAP participants and jobs, and variations in food prices across neighborhoods.

It concludes with 5 exam- ples of how addressing these community-scale issues can increase SNAP participation and food access.

Associations Among Knowledge, Attitudes, And Practices Toward Palliative Care Consultation Service In Healthcare Staffs: A Cross-Sectional Study, Li-Chun Huang, Ho-Jui Tung, Pei-Chao Lin

Health Policy & Community Health: Faculty Publications

Background

The palliative care consultation service (PCCS) of the National Health Insurance payments has been promoted in Taiwan since 2011, although few studies have been conducted on healthcare staffs’ knowledge, attitudes, and practices regarding PCCS in Taiwan; consequently, the main objective of this study was to explore any correlations regarding the above by cross-sectional design using convenience sampling.

Methods

A total of 210 healthcare staff members were enrolled from a regional hospital from June 1, 2018, to September 30, 2018. Questionnaire items on the Palliative Care Consultation Service Inventory (KAP-PCCSI) were used to measure healthcare staff’s knowledge, attitudes, and practices …

Boomers And Fraudsters: A Closer Look At The Financial Elder Abuse Cycle In America, Ryan E. Brown

Marriott Student Review

In 2011, a landmark study was published by the Metlife Mature Market Institute claiming that nearly $3 billion disappears from the wallets and bank accounts of senior citizens annually. More surprising is that a similar study reported that figure could be as high as $36 billion. Because so many seniors let incidents of fraud or financial deceit go unreported, there is a huge discrepancy in annual reporting. This contributes to the overall lack of understanding we have of elder financial abuse, or why seniors continue to lose to fraudsters and scam artists. In a brief overview of financial elder abuse …

Sustainable Public-Private Strategies To Improve Population Health In Maine: Annotated Bibliography, Zachariah Croll Mph

Population Health

No abstract provided.

La Comunicación Intercultural Entre Pacientes Bolivianos Y Trabajadores De Salud En Buenos Aires, Argentina / Intercultural Communication Between Bolivian Patients And Health-Care Workers In Buenos Aires, Argentina, Lilly Snellman

Independent Study Project (ISP) Collection

Según la Ley de Migraciones 25.871 de 2004, los inmigrantes en Argentina tienen el mismo derecho a la atención médica que los argentinos nativos. El sistema de salud argentina es uno de los más inclusivos en el mundo, pero todavía hay barreras al acceso para comunidades e individuos marginados. Muchas veces los migrantes bolivianos son discriminados en la sociedad argentina por sus rasgos raciales, bajo nivel socioeconómico y diferencias culturales. Tres clases importantes de barreras para el acceso a la atención médica para los migrantes son las económicas, estructurales y comunicativas. En este estudio, decidí enfocarme en las brechas de …

African American Disparities In Healthcare, Emma E. Bedell

Student Publications

African Americans constantly experience disparities in health care due to various factors. They typically face differences in insurance coverage, quality of care, geographic variation, and stereotyping by providers. These social inequalities are ultimately inevitable, however; changes need to be made to better the care that Black patients receive. The differences Black men and women receive in healthcare can put their life in danger or even give them unnecessary medical treatment. There is no simple solution to fix this problem, but action needs to be taken immediately.

Healthcare: A Universal Human Right Or White Privilege?, Nicole E. Heller

Student Publications

It is an undeniable fact that racism has been present in the United States since the beginning of the European colonization of the nation. Structural racism and implicit biases are the modern reality of the African American experience, reflecting years of direct racial targeting, mistreatment and discrimination. Today, there are many examples of deeply rooted racial discrepancies, de facto segregation, and modern acts of colonization. Perhaps one of the most troubling disparities present between African Americans and white Americans is the alarming difference in their experiences with healthcare. After a long history of medical torture, mistreatment, and a denial of …

Syrian Refugee Mothers In Jordan: Perceived Social Support And Postpartum Depression, Marya Rana

Independent Study Project (ISP) Collection

Many women suffer from postpartum depression; migrant women experience postpartum depression at rates almost triple that of the general population. This study investigated the associations between perceived social support and postpartum depression among Syrian refugee mothers living in Amman, Jordan. Eleven mothers completed a sociodemographic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and the Interpersonal Support Evaluation List (ISEL) - Shortened Version. Four of those mothers also participated in individual interviews, and four others were included in a focus group. Multiple recurring themes were identified from the interviews and focus group, including: perceived differences in child and social support in …

The Hapless State Of Amyotrophic Lateral Sclerosis In India: A Comprehensive Look At Life And Medical Services For Als Patients In Rural Himachal Pradesh, Carson J. Bergström

Independent Study Project (ISP) Collection

Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease is a neurodegenerative disorder that leads to paralysis. The disease requires a high amount of medical intervention and interdisciplinary focus to achieve quality of life for patients. This study looks at ALS patient’s lifestyles, their access to these medical devices, Indian therapeutic approaches and policy that impacts patients in Shimla, Himachal Pradesh. As caretakers have a critical part in the care for this disease, their lives were also considered in the case studies. It was found that ALS patients are not experiencing access to medical devices necessary for life because of physical …

Intersections Between Health And Disability: A Case Study At Disha Centre, Jaipur, Rajasthan, Finnian Brokaw

Independent Study Project (ISP) Collection

This study investigated intersections between health and disability by asking the question: how do community perceptions of disability at Disha: A Resource Centre for the Disabled in Jaipur, India relate to health and quality of life for a person with multiple disabilities? This study utilized a case study methodology. The researcher took qualitative interviews from six respondents in the immediate educational and familial support network of a 27-year-old man with multiple disabilities. An interview based, qualitative methodology was important for investigating the complexity of perceptions of multiple disabilities and health as intersecting identities. The responses were analyzed and reflected upon …

An Analysis Of The Rajasthan Public Health System’S Response To The 2019 Dengue Insurgence, Luke Bryan

Independent Study Project (ISP) Collection

Dengue virus is in a pandemic status and is a major public health issue in the modern world. The mosquito-borne disease is largely prevalent in Asia and specifically India, where more than half of the states are considered to have complete presence of the dengue virus. The intricate infrastructure of the Indian public health system looks for dengue cases at all levels and reports to the integrated disease surveillance programme (IDSP).

Analyses of the IDSP and trends of dengue cases was done in response to dengue outbreaks throughout the state. Geographic information system (GIS) maps were created to evaluate a …

What About The Environment?: Exploring The Neglected Third Dimension Of Antimicrobial Resistance, Paige E. Montfort

Independent Study Project (ISP) Collection

Antimicrobial resistance (AMR) is one of the most urgent and complex health risks of our time, with links to human health, animal health, and the environment. The majority of research and policy related to AMR, however, has been dedicated to human and animal health. The third dimension — the environment — has been relatively neglected. Conversations about this problem have begun, but gaps in understanding remain. This study explores the key barriers that have hindered developments related to the environmental aspect of AMR and some of the solutions that have begun to or could be utilized to overcome these barriers. …

Adicción Como Un Hecho Político Económico: Un Análisis De Servicios De Atención De Abuso De Drogas Y Alcohol En Arica, Chile, Jack Steffy

Independent Study Project (ISP) Collection

Research question – What is the current landscape of drug abuse in Chile and how has the state attempted to address this problem?

Objectives – The objectives of the paper were to characterize drug use patterns in Chile since 1994, revise drug abuse services, and offer possible improvements for the system of drug abuse treatment.

Background – Chile, despite being one of the most well economically-developed countries in South America, has some of the worst mental health indicators, one of these being drug abuse. Since 1994, use of alcohol and marihuana has increased, while use of cocaine products has remained …

Salud Mental Comunitaria: Implementación En Chile Actual, Emma Baker

Independent Study Project (ISP) Collection

This study explores how familiar community mental health organizations in Valparaíso follow an established model of community mental health, derived from a variety of essays, books, and reports on the topic. Additionally, it serves to present the effect of this relationship on the contemporary social revolution in Chile. The present social and political unrest, manifesting itself in massive protests throughout the country, presents a unique moment in which these themes can be examined. Additionally, Chile encounters high rates of psychological disorders among its population, a lack of protection for the mental health of children and adolescents, and a lack of …

La Pertinencia Cultural De Los Proyectos Relacionados A La Planificación Familiar De Las Ongs En El Distrito De Acomayo, Sadie Traylor

Independent Study Project (ISP) Collection

Esta investigación identifica y analiza la pertinencia cultural de los esfuerzos de ayuda ambos de una ONG local (Kallpa) y de una ONG internacional (Plan International), examinando específicamente el proyecto de cada ONG vinculado al aumento del acceso y uso de la planificación familiar en el Distrito de Acomayo en la región de Cusco para evaluar cómo opera (o no opera) cada ONG con una pertinencia cultural. Además, esta investigación explora la forma en que las estrategias de cada ONG mantienen un enfoque intercultural, y también analiza las percepciones de los beneficiarios del proyecto como testimonios de cómo este método …

Using A Role-Driven Race Equity Reform Approach To Mitigate The Effects Of America's History Of Racism On Food Insecurity, Kenya N. Washington, Darryl E. Williams Jr.

Professional Agricultural Workers Journal

Abstract

Food insecurity, or the lack of reliable access to sufficient quantities of nutritious food, affects African Americans and other minorities disproportionately. This paper examines how America’s history of racism created and sustains the Nation’s racially disparate food system. Food insecurity contributes to hunger. This paper contemplates disparities in other American systems, including education and criminal justice, as exemplars of the broader ramifications of hunger. Finally, the paper examines the potential of individual action to address problems in any system. It champions the adoption of a role-driven race equity reform strategy as a tool to confront the current food insecurity. …

A Retrospective Study Of Epa's Record Of Decision Report On The Woolfolk Arsenic And Lead Contamination In Fort Valley, Georgia, Ovigueroye L. Ojarikre, Oreta Samples, Jacques Surrency

Professional Agricultural Workers Journal

Abstract

Heavy metal contamination is a major anthropogenic challenge in communities with heavy presence of chemical industries. Most of the contamination is due to the improper disposal of chemical waste. The study involved the evaluation of the levels of arsenic and lead regarding remediation activities carried out by the Environmental Protection Agency (EPA). It compared the results of the EPA’s 1993 soil analysis of arsenic and lead, and a subsequent soil analysis of the same mapped areas. It also covered the evaluation of the level of arsenic dust in the attics of residential properties and evaluation of the EPA’s record …

A Need For Patient-Friendly Language For Those With Low Health Literacy In Advanced Care Planning, Denisha Allicock, Addison Mickens, Tilicia Mayo-Gamble

Health Policy & Community Health: Faculty Publications

Work published by Georgia Southern University Press.

Leveraging Technology To Address Patient-Centered Outcomes In Sickle Cell Disease, Tilicia Mayo-Gamble, Delores P. Quasie-Woode

Health Policy & Community Health: Faculty Publications

Work published by Georgia Southern University Press.

Characteristics Of The Health Information Technology Workforce In Georgia, Imaobong Ekpo, Emmanuel Akowuah, Bettye Apenteng, Samuel T. Opoku

Health Policy & Community Health: Faculty Publications

Background: Advancement in medical technology, as well as the Health Information Technology for Economic and Clinical Health Act, has in part influenced the demand for health information technology (HIT) workers. While other sectors have experienced a tremendous increase in the information technology workforce, the health sector lags in this regard. The aim of this study was to describe the characteristics of the HIT workforce in Georgia, relative to surrounding states and the United States.

Methods: The supply of the HIT workforce in Georgia, surrounding states, and the United States was estimated using data from the 2014-2016 American Community Survey (ACS). …

Medical Marijuana Policy Reform Reaches Florida: A Scoping Review, Khadesia Howell, Alexandria Washington, Paula M. Williams, Arlesia L. Mathis, John S. Luque

Florida Public Health Review

Background: Florida became the first state in the U.S. South to legalize the use of medical marijuana to treat a variety of health conditions including chronic pain, epilepsy, and spasticity symptoms from multiple sclerosis. While there are over 200,000 medical marijuana patients in Florida, there remain financial, psychological, and insurance coverage barriers which reduce access for many patients. Purpose: This scoping review, with a focus on state health policy, first describes some clinical studies examining the therapeutic benefits of medical marijuana. Next, there is a discussion of the Florida regulatory environment and major legislation. Also, the review describes how the …

Sociodemographic And Health Status Characteristics Of Maine's Newly Eligible Medicaid Beneficiaries [Data Brief], Zachariah T. Croll Mph, Erika C. Ziller Phd, Barbara Leonard Mph

Medicaid

This data brief identifies key characteristics of groups who will gain access through MaineCare expansion. Researchers Croll and Ziller at the University of Southern Maine, along with Leonardson of the Maine Health Access Foundation present a statistical analysis of uninsured non-elderly adults age 18 – 64 with no children and lower incomes, the population newly eligible for MaineCare through expansion. Drawing from five years of data from Maine’s Behavioral Risk Factor Surveillance System, the report addresses sociodemographic characteristics, health status, and access to care. The survey indicates that those who are likely eligible for expanded MaineCare coverage are twice as …

The Potential Of Pay‑For‑Success As A Financing Strategy For Evidence‑Based Practices: An Illustration With Multisystemic Therapy, Alex R. Dopp, Cameron M. Perrine, Samantha Iovan, Paula M. Lantz

Psychological Science Faculty Publications and Presentations

There is a critical need to identify strategies for financing the implementation of evidence-based practices. We illustrate the potential of pay-for-success financing (PFS)—a strategy in which private investors fund implementation and receive a return on investment from a government payer—using multisystemic therapy as an example. We argue that standard multisystemic therapy (for serious juvenile offenders) and several of its adaptations (for other complex behavioral problems in youth) would be good candidates for PFS in the right contexts. Despite some challenges for policymakers and administrators, PFS has significant potential as a financing strategy for evidence-based practices.

Hematological Indices Of Pesticide Exposure Rice Farmers In Southern Thailand, Wiyada Kwanhian, Supabhorn Yimthiang, Siriuma Jawjit, Junjira Mahaboon, Udomratana Vattanasit, Phiman Thirarattanasunthon

Kesmas

The most common pesticides used in rice farming are organophosphates and carbamates. These pesticides inhibit acetylcholinesterase (AChE) activity, resulting in excessive levels of acetylcholine accumulation and disrupted neurotransmission. This study compared AChE activity and hematological parameters between pesticide-using rice farmers, non-pesticide using rice farmers, and non-agricultural occupational groups (non-farmers). Pesticide residues that accumulated in rice and the water and soil of the study area were also determined. AChE activity of all participants showed 10 from 87 samples (11.49%) as borderline depressed, with 50% of these being pesticide-using farmers. Most of the hematological parameters were normal in all samples. However, platelet …