Health Policy Commons^™

Disability Rights And Labor: Is This Conflict Really Necessary?, Samuel R. Bagenstos

Indiana Law Journal

In this Essay, I hope to do two things: First, I try to put the current labor-disability controversy into that broader context. Second, and perhaps more important, I take a position on how disability rights advocates should approach both the current contro-versy and labor-disability tensions more broadly. As to the narrow dispute over wage-and-hour protections for personal-assistance workers, I argue both that those workers have a compelling normative claim to full FLSA protection—a claim that disability rights advocates should recognize—and that supporting the claim of those workers is pragmatically in the best interests of the disability rights movement. As to …

The Economics Of Health, Donald J. Meyer Editor

Upjohn Press

Donald J. Meyer leads a group of notable health economists who explore critical issues—and their economic impacts—facing the nation's healthcare system today. These include lifestyle choices and their health impacts, decisions on medical care and self-care, the fee-for-service payment model, disability and workers’ compensation insurance claims, long-term care, and how various aspects of the Patient Protection and Affordable Care Act (ACA) impact the nation’s healthcare system. Contributors include M. Kate Bundorf, Marcus Dillender, John H. Goddeeris, Donald J. Meyer, Edward C. Norton, and Charles E. Phelps.

Examining The Relationship Among Patient-Centered Communication, Patient Engagement, And Patient’S Perception Of Quality Of Care In The General U.S. Adult Population, Jumee Wang

Theses and Dissertations

Introduction: Patient-centered care is a major focus of healthcare organizations, policy makers, and researchers. Patient-centered communication by the provider and patient engagement are important components of patient-centered care. Despite increasing attention to these topics, we do not fully understand how patient-centered communication and patient engagement relate to perceived quality of care as reported by patients. This study takes some initial steps in exploring these relationships. The study also identifies patient-related factors such as sociodemographic, health-related, and health system factors that are associated with patient-centered communication, patient engagement, and perceived quality of care.

Method: This study used survey data …

The Politics Of Mental Health: A Comparative Study Of Policy Adoption And Implementation In Germany And Japan, Luis Diego Campos

Honors Undergraduate Theses

In the aftermath of World War II, the Liberal Democratic Party of Japan followed Germany’s blueprint in fashioning a universal health coverage system. Comparisons to Germany’s welfare state during this same time period reveal markedly different social and mental health policy practices, as Germany’s Christian Democratic Union and Social Democratic Party cooperated toward progressive policies while the Liberal Democratic Party largely neglected social welfare expansion. The effect of these practices is reflected in budgetary provisions, institutionalization practices, and mental health epidemiology. This research finds that a favorable economic climate allowed the Liberal Democratic Party to politically isolate the Social Democratic …

The Diffusion And Performance Of The Accountable Care Organization Model, Yi-Ling Lin

Electronic Theses and Dissertations

Background: Unity in pursuit of the Triple Aim: better health, better care, and lower per capita cost, can be achieved through a well-designed health care delivery system. The accountable care organizations (ACOs) model is considered a key component of health care delivery system improvement because the model fosters better coordination of care through clinical integration and financial accountability. Within the six Centers for Medicaid & Medicare Services (CMS) ACO programs, the Medicare Shared Savings Program (MSSP) ACO has the largest size with a total of 432 ACOs formed; the service subjects of the MSSP ACO are the fee-for-service beneficiaries. Recently, …

Competitive Food Policy Implementation In Kentucky Schools, Paula Gisler

Theses and Dissertations--Nursing

This study was designed to explore the literature on competitive food policy implementation (CFPI); examines demographic and school factors associated with CFPI; and explores the experiences of school leaders and staff in CFPI using a proposed theoretical framework to guide the research. Competitive foods are those sold in vending machines, a la carte settings, fundraisers, class parties and other venues which compete with foods offered through the national school lunch and breakfast programs. Competitive foods have traditionally been of low nutritional value and high energy density. CFPI may be effective in reducing student calorie intake and BMI. However, evaluation of …

The Consumer Perspective: A Consultation With Senior Health Officials From Developing Countries On Standards Of Evidence For Reproductive And Maternal Health Care, The Evidence Project, Step Up Research Programme Consortium

Reproductive Health

The Population Council (through the STEP UP consortium and the Evidence Project) and the High Impact Practices (HIP) Collaboration, together with other partners, held a series of three consultative meetings around the topic of standards of evidence in reproductive and maternal health. This report details the third and final meeting held in Bellagio, Italy in February 2016. The meeting brought together developing-country decisionmakers to vet, from the research “consumer” perspective, the recommendations that emerged from the second consultation and to elicit further recommendations on how to better generate and package evidence to meet the needs of decisionmakers. Also in attendance …

Routine Screening For Intimate Partner Violence: A Guide For Trainers, Odongo Odiyo, Chi-Chi Undie, Margaret Mak'anyengo

Reproductive Health

This the first regional document devoted to building the capacity of providers to respond to intimate partner violence (IPV). The training guide is a follow-on initiative to the 6th Best Practices Forum in Health of the East, Central and Southern Africa (ECSA) Health Community, held in August 2012. This Forum brought to the fore research findings from the region centering on the acceptability and feasibility of IPV screening, and culminated in the passage of a resolution by Health Ministers that prescribes the integration of gender-based violence screening into healthcare settings in the ECSA region. This training guide responds to this …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Technical Brief, Population Council

Reproductive Health

Leader dans le domaine de la Planification Familiale (PF) en Afrique de l’Ouest francophone, le Sénégal a entrepris diverses initiatives pour atteindre ses objectifs, dont l’élaboration du Plan d’Action National de Planification Familiale (PANPF) 2012–15, basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où il arrivait à terme, et que l’élaboration d’un nouveau plan était envisagée, il était nécessaire de documenter l’approche, sa mise en œuvre, et ses réalisations. Le Population Council a mené cette étude en collaboration avec la Direction de la Santé de la Reproduction et de la Survie de l’Enfant du Ministère de la Santé et …

Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

In 2008, the Government of India launched the National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in both urban and rural areas to access a range of private health services. The available evidence suggests several limitations and barriers that may affect the utilization of RSBY services and warrants a more in-depth examination of the contexts of family planning/reproductive health (FP/RH) services. The Population Council, under the Evidence project, conducted a study among the urban poor to: 1) determine RSBY awareness and barriers to enrollment; 2) identify barriers and facilitating factors to …

An Implementation Analysis Of Needle Exchange Programs In Kentucky: Implementation Barriers And Facilitators Identified By Stakeholders, Samantha Jane Harris

MPA/MPP/MPFM Capstone Projects

Kentucky law authorizes county health departments to implement harm reduction needle exchange programs given that the county receives approval from all governing authorities including the local and/or district boards of health, the county government, and the city government in the jurisdiction in which the exchange is intended to operate. As of April 2016, five county health departments operate needle exchange programs and around 20 other county health departments are seeking approval from their governing authorities or beginning to discuss engaging in this process.

I conducted qualitative interviews with key stakeholders in the implementation process to determine the facilitators and barriers …

Across The States: Do Long Term Services & Supports Policies Affect The Number Of Nursing Home Residents With Low-Care Needs?, Mary Otis

MPA/MPP/MPFM Capstone Projects

Long term care for the elderly has been steadily gaining salience in the public policy realm for many years. The federal government has been vigorously studying and exploring solutions, including the Centers for Medicare and Medicaid Services’ (CMS) efforts to expand access to home and community-based services (HCBS) in order to reduce dependence on institutional care. These federal efforts include various incentive programs and policies recently offered under the Affordable Care Act. However, data on the strength of each state’s long term services and supports system has not been easily accessible until recently. The report “Raising Expectations: A State Scorecard …

Is There A Trade-Off? Infant Health Outcomes And Managed Care Competition, Shana L. Moore

Theses and Dissertations--Public Policy and Administration

This study offers insights into the impact of competition among Managed Care organizations (MCOs) on infant birthing charges and birth outcomes. Kentucky provides one of the nation’s first case studies to determine successes and failures of Medicaid MCOs, and by doing so, provides a prediction of the impact of Patient Protection Affordable Care Act (PPACA) competition on healthcare costs and birth outcomes. An analysis of a natural policy experiment in the state of Kentucky reveals that infants insured by a Medicaid MCO stay longer in hospitals, are less healthy, and cost more than those insured under Traditional Medicaid prior to …

American Obesity: Rooted In Uncertainty, Institutions And Public Policy, James Woodward

Theses and Dissertations--Public Policy and Administration

Despite the efforts of policymakers, medical professionals, and other stakeholders, obesity and related health problems show no signs of receding from their record-high rates. Public policy has largely taken the form of consumer advice, (e.g., USDA’s Dietary Guidelines). Since consumers bear most of the costs associated with their obesity, the goal of obesity prevention appears to be incentive-compatible, prima facie. That is, there is no a priori case for much further policy intervention unless existing advice is deficient or consumers’ exhibit systematically poor decision-making.

My review of the literature shows that scholars have long conveyed a consistent narrative regarding …

Influence Of Public Insurance On Healthcare Access And Cancer Care, Wafa W. Tarazi

Theses and Dissertations

Medicaid expansion under the Affordable Care Act (ACA) facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Tennessee’s Medicaid program experienced a dramatic Medicaid contraction when the program disenrolled approximately 170,000 nonelderly adults in 2005. Pre-ACA expansions were associated with better access to and utilization of healthcare services. However, little is known about the effect of these policy changes on improvement in health outcomes for women diagnosed with breast cancer, access to care for cancer survivors, and the effect of generosity and duration of expansion on access to care.

This dissertation has three …

Implementation Of Self-Directed Supports For Individuals With Intellectual And Developmental Disabilities: A Political Economy Analysis, Matthew P. Decarlo

Theses and Dissertations

Self-directed supports, as a method of service delivery, have grown from small pilot programs in a handful of states to at least one program in every state. For individuals with intellectual and developmental disabilities (IDD), self-direction presents unique opportunities to engage in self-determined behavior and shape the services upon which they rely. Although the evidence base for self-direction is relatively robust, there is a significant lack of information on how implementation of self-direction is faring on the national level. The purpose of this study is to understand how the political and economic factors within and across states have impacted the …

Does Evidence Influence Policy? Resource Allocation And The Indigenous Burden Of Disease Study, Christopher Doran, Rod Ling, Andrew M. Searles, Peter S. Hill

Research outputs 2014 to 2021

Objective

The Indigenous Burden of Disease (IBoD) report is the most comprehensive assessment of Indigenous disease burden in Australia. The aim of the present study was to investigate the potential effect of the IBoD report on Australian Indigenous health policy, service expenditure and research funding. Findings have significance for understanding factors that may influence Indigenous health policy.

Methods

The potential effect of the IBoD report was considered by: (1) conducting a text search of pertinent documents published by the federal government, Council of Australian Governments and the National Health and Medical Research Council of Australia (NHMRC) and observing the quantity …

Political, Economic, And Health Determinants Of Tuberculosis Incidence, Ashley Rutherford

Electronic Theses and Dissertations

The epidemiologic transition has shifted major causes of mortality from infectious disease to chronic disease; however, infectious diseases are again re-emerging as a major global concern (Diamond, 1997; Karlen, 1995; McNeil, 1976). This research aimed to identify potential areas of infectious disease influence that are not health-related in order to help governments and policymakers establish new policies, correct current policies, or further address these issues in order to effectively prevent and combat infectious disease. This study employed a retrospective, cross-sectional, non-experimental design via structural equation modeling (SEM) and examined tuberculosis incidence rates at the country-level. Secondary data from open-source, international …

Neoliberalism Redux: The Global Health Policy Agenda And The Politics Of Cooptation In Latin America And Beyond, Anne E Birn, Laura Nervi, Carlos Eduardo Siqueira

Gastón Institute Publications

This article explores the neoliberal cooptation of social justice-oriented global health policies over the last three decades, from primary health care and ‘health for all’ to various contemporary so-called ‘health equity’ initiatives, such as Universal Health Coverage and ‘health convergence’. The authors illustrate and contextualize the different periods and approaches with examples from a range of Latin American countries, drawing on diverse political experiences and social struggles in the health arena. The analysis concludes with reflections about the region’s experiences of resisting and challenging the neoliberal health agenda, in spite of domestic and global environments that have constrained these efforts, …

A Cross-Sectional Study On Patients' Access To Healthcare In A Developing Nation, Pawan Bhandari

All Graduate Theses, Dissertations, and Other Capstone Projects

The objective of this research study was to gauge the current status of patients' access to health care services in a developing nation or least-developed country (as defined by the World Bank and United Nations), Nepal. Many patients are not privileged to have a hospital at a close proximity in Nepal. They are also forced to travel and wait for long hours due to their inability to pay for services offered by private healthcare institutions. A survey questionnaire was developed to get a snapshot of how long patients travel to get to a public hospital for an outpatient service. The …

Depression Intervention Programs In Low-Income High Schools, Gopika Hari

UROP Posters

It is estimated that 2.6 million adolescents suffer from major depressive episodes each year. Research has noted that symptoms in youth have become indicators of mental health complications later in life. Studies reveal that low income is a risk factor for depression and that socioeconomically-disadvantaged teenagers are more than twice as likely to develop mental illnesses. Only roughly 25% of children with mental illnesses receive adequate help and 80% of these resources come from schools. This study focuses on establishing the importance of depression intervention programs in low-income high schools and on designing novel guidelines for effective protocols. A compilation …

Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica, Mark Gordon

Journal of Sustainable Social Impact

Food policy has a unique role for public, nonprofit, private, and academic stakeholders. Growing food in the city is a challenge worldwide. Food systems can be destroyed by external (weather extremes) and internal (zoning regulations) forces. This study explores urban farms as a secondary food source and their common themes across four sectors. A Northeastern U.S. city was the case study to examine how it implemented its formal urban agriculture program. The positive social change implications of urban farms include greater food visibility and food access in low-income areas and more consumer awareness about growing fresh food. This study contributes …

The Word Outside And The Pictures In Our Heads: Contingent Framing Effects Of Labels On Health Policy Preferences By Political Ideology, Sungjong Roh, Jeff Niederdeppe

Research Collection Lee Kong Chian School Of Business

This study uses data from systematic Web image search results and two randomized survey experiments to analyze how frames commonly used in public debates about health issues, oper- ationalized here as alternative word choices, influence public support for health policy reforms. In Study 1, analyses of Bing (N = 1,719), Google (N = 1,872), and Yahoo Images (N = 1,657) search results suggest that the images returned from the search query “sugar-sweetened beverage” are more likely to evoke health-related concepts than images returned from a search query about “soda.” In contrast, “soda” search queries were more likely to incorporate brand-related …

Food Insecurity And Housing Instability In Vulnerable Families, Christian King

Department of Nutrition and Health Sciences: Faculty Publications

Reducing the prevalence of household food insecurity has been a long-standing objective of the federal government. Previous research has found many negative consequences of food insecurity for families and households but has not examined its relationship with housing instability. Using longitudinal data from the Fragile Families and Child Wellbeing Study, difference-in-difference models show that food insecurity is associated with housing instability. The association remains statistically significant after accounting for potential selection and unobserved heterogeneity using propensity score matching and excluding households that experienced prior housing instability from the sample. Examining potential mediating factors, I find that material hardship explains about …

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

Healthcare Utilization And Expenditure Patterns Among Older Adults With Functional And Medical Decline, Ashley Shields Robertson

Theses and Dissertations

Purpose. As the aged population of this country grows, the U.S. healthcare system will face increased pressure to provide long-term care services and supports to increasing numbers of elderly Medicare beneficiaries. Studies have indicated that unmet long-term care need can lead to increased, unnecessary utilization of the healthcare system, thus further taxing the Medicare system. Little is known about how type of long-term care, as well as how long-term care policies—specifically payment policies—affect health care utilization. The objective of this original dissertation research was to examine the effects of place of residence (community versus residential long-term care facility) and …

No More Mind Games: Content Analysis Of In-Game Commentary Of The National Football League’S Concussion Problem, Jeffrey Parker

Theses and Dissertations (Comprehensive)

American (gridiron) football played at the professional level in the National Football League (NFL) is an inherently physical spectator sport, in which players frequently engage in significant contact to the head and upper body. Until recently, the long-term health consequences associated with on the field head trauma were not fully disclosed to players or the public, potentially misrepresenting the dangers involved in gameplay. Crucial to the dissemination of this information to the public are in-game televised commentators of NFL games, regarded as the primary conduits for mediating in-game narratives to the viewing audience. Using a social constructionist theoretical lens, this …

Experiences Of Victimization And Health Care Access Among Non-Metropolitan Lgbtq+ Individuals, Ashley-Ann Marcotte

Theses and Dissertations (Comprehensive)

Lesbian, gay, bisexual, trans, and queer (LGBTQ+) individuals report substantial rates of violence, discrimination, and negative life events due to homophobia and transphobia and these experiences impact access to health care services and programs (Bauer et al, 2009; Grant, Mottet, Tanis, Harrison, & Keisling, 2010) These experiences result in LGBTQ+ communities needing services, programs, and social supports to provide safer spaces. Although it is well recognized that health care services are not a major determinant of health outcomes and yet use more than 60% of health spending (Canadian Institute for Health Information, 2014; Muzyka, Hodgson, & Prada, 2012). As such, …

Policies And Clinical Practices Regarding Candidacy And Auditory Treatment For Hispanic Pediatric Patients In Cochlear Implant Centers In The United States, Matthew Ehrenburg

Senior Independent Study Theses

This research sought to investigate the policies and clinical practices regarding candidacy and auditory treatment for Hispanic pediatric cochlear implant patients at cochlear implant centers in the United States. More specifically, the study investigated treatment services provided to pediatric patients who are raised in monolingual Spanish, English as a second language (ESL), and bilingual English-Spanish speaking homes. The study made use of survey research to examine cochlear implant centers regarding their policies, clinical practices, and their referral processes for this specific group of cochlear implant recipients. The survey was distributed electronically through the online survey software Qualtrics via email to …

Health Care Service Disparity: Factors Associated With The Distribution Of Primary Care Physicians, Robert L. Morgan

Senior Honors Projects, 2010-2019

Primary care physicians operate on the front lines of health care. Although primary care physicians play a critical role in improving health outcomes, workforce trends in the United States show a growing shortage of primary care physicians as demand for primary care rises. In conveying the importance of primary care physicians, the worsening physician shortage, the inequitable distribution of providers, and the lackluster institutional response thus far, this paper calls into question the effectiveness of current indicators used to identify underserved areas and provide appropriate government assistance. Through the use of data from the 2010 census and American Medical Association …