Health Policy Commons^™

Demographic Analysis Of Recovery Act Supported Jobs In Massachusetts, Quarters 1 And 2, 2011: Final Report, Carol Hardy-Fanta, Monica Lamboy, David Merwin, Paige Ransford, Meryl Thomson, Christian Weller

Publications from the Center for Women in Politics and Public Policy

Since 2009, researchers have analyzed the economic and employment impact of ARRA spending and tax policies. The current report is possible due to the efforts of Massachusetts policymakers who went beyond federal reporting requirements to require additional reporting on the number of workers who received ARRA-funded pay. ARRA workers’ demographic characteristics were also collected as part of the Massachusetts’ ARRA reporting requirements to allow for transparency and determine the fiscal policy’s impact on the state and local economy. The Massachusetts Recovery and Reinvestment Office (MassRRO) makes available much of these data on their website (www.mass. gov/recovery), including highlights for each …

Aiding Or Abetting? An Analysis Of Medical Humanitarian Aid In Complex Humanitarian Emergencies, Claire Dunn

Honors Theses

Medical humanitarianism is generally viewed very positively by society. Selfless humanitarians are going to war-torn, disaster-affected, or otherwise undesirable locations to provide medical care to those who are in need. However, when considered more carefully, it becomes clear that there are many problematic aspects of humanitarian aid. That is not to say that humanitarian aid is unnecessary, but rather that humanitarian actions are likely to have some unintended consequences or fail to live up to their potential no matter how well-meaning the intentions. Acknowledging that medical humanitarianism is but a single component of the response to complex humanitarian emergencies and …

Is More Information Always Better? Mandatory Disclosure Regulations In The Prescription Drug Market, Joanna Shepherd

Faculty Articles

This Article proceeds as follows. In Section I, I describe the structure of the PBM industry. I also describe the business model PBMs employ to administer prescription drug coverage and the methods they use to reduce prescription drug spending. In Section II, I discuss mandatory disclosure regulations enacted in several states and at the federal level under the Affordable Care Act. In Section III, I explain why mandatory disclosure regulations are not needed to ensure that health plan sponsors pay a competitive price for PBM services. In Section IV, I discuss the various costs that mandatory disclosure regulations will impose …

A Case Study Of The Effects Of Privatization Of Child Welfare On Services For Children And Families: The Nebraska Experience, Grace S. Hubel, Alayna Schreier, David J. Hansen, Brian Wilcox

Department of Psychology: Faculty Publications

Privatization, or contracting with non-governmental agencies for provision of state or federally funded services, is a strategy that has gained recent attention from policymakers as a potential tool for successful child welfare reform. The Child Welfare Privatization Initiatives Project was created in 2007 as a joint effort between the United States Department of Health and Human Services and the Office of the Assistant Secretary for Planning and Evaluation. The framework identified by this project produced twelve key considerations for states moving towards a privatized system. This case study considers these twelve considerations in a description of the large-scale effort to …

Psychotropic Medication Utilization In Care Home Residents Age 65 Or Older Compared With The Equivalent General Population In Scotland, Tyler P. Stewart

MPA/MPP/MPFM Capstone Projects

Purpose: In Scotland, care homes provide assisted living and medical services. Psychotropic medications (antipsychotics, anxiolytics, and hypnotics) may be over utilized in these facilities. This study compared psychotropic medication utilization in elderly care home residents to the equivalent population of non-care home residents. It is hypothesized that patients in care homes utilize psychotropic medications more than non-care home residents.

Methods: Demographic and prescription information for all patients aged 65 years and older on January 1, 2011 who received at least one prescription for a psychotropic medication during 2011 was retrieved from the national Prescribing Information System (PIS). Patients were grouped …

Influential Determinants On The Time Of Adoption Of State-Based Healthcare Insurance Exchanges, Chris Record

MPA/MPP/MPFM Capstone Projects

The Patient Protection and Affordable Care Act of 2010 consists of several provisions designed to promote the obtainment of affordable health insurance coverage for all Americans. In order to facilitate access to information on available prices and policies for this coverage, the law requires states to decide whether to operate their own healthcare insurance exchange or join a partnership or federal exchange. While many states proceeded with the implementation of state-based exchanges despite a challenge to the law in the Supreme Court, other states did not. This paper explores the influence that certain and health market characteristics may have had …

Could The Money Saved Through Uncompensated Hospital Care Be Enough To Justify Medicaid Expansion In The State Of Kentucky?, Matthew Rudacille

MPA/MPP/MPFM Capstone Projects

This paper examines the proposed Medicaid Expansion detailed under the Patient Protection and Affordable Care Act (ACA) and whether it would be fiscally responsible for the state of Kentucky to move forward with the expansion. While the federal government plans on covering a majority of the expense for the expansion, each state will be responsible for a portion of the costs incrementally increasing from 5% in 2017 to 10% in 2020 and beyond. Analysts and think tanks have examined the healthcare act’s expansion and determined the individual states have a lot to gain financially for accepting the federal government’s proposition. …

Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar

Poverty, Gender, and Youth

This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …

Policy Brief—Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu

Reproductive Health

Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The specific objectives of the initiative were to: increase knowledge, awareness, and use of EC among Kenyan women; increase knowledge and awareness of EC among health providers; and strengthen EC provision in both the private and public sectors. This policy brief describes a toolkit designed for policymakers and service providers which draws on the achievements, lessons learned, and experiences from this project.

Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community

Reproductive Health

The East, Central and Southern Africa (ECSA) Health Community, which prioritizes gender-based violence and child sexual abuse as regional health concerns, partnered with the Population Council to convene a pre-conference Expert Committee meeting of the Research, Information and Advocacy Programme. The conference marked a major milestone in the ECSA Health Community’s commitment to promote and support region-wide sharing and utilization of health research and policy information among its member states. This report summarizes the deliberations of the two-day workshop and the recommendations for implementing an advocacy plan to address this important facet of the region’s development agenda.

Infographic: Vouchers Are Transforming Reproductive Health Access Worldwide, Population Council

Reproductive Health

No abstract provided.

Kentucky Pharmacist Opinions Of The Potential Reclassification Of Pseudophedrine As A Legend Drug, Kathleen E. Monson

MPA/MPP/MPFM Capstone Projects

Methamphetamine is a drug of abuse, which is often produced in clandestine laboratories. Recent efforts to curb methamphetamine abuse are aimed at controlling access to precursors, including pseudoephedrine (PSE), used in illicit methamphetamine production. Currently, access to PSE is controlled in Kentucky by placement behind pharmacy counters, retail quantity limitations and electronic tracking. Recent legislation proposed in Kentucky to change PSE from non-prescription to a legend medication was unsuccessful and highly controversial. The objective of this project is to collect and analyze pharmacists’ opinions on the effectiveness of current precursor controls, proposed legislation to make PSE a legend drug and …

Oral Care & Asian And Pacific Islander Communities In Oregon, Amira Caluya

Center to Advance Racial Equity Publications and Reports

This report attempts to describe the current knowledge of oral health care access within Asian American, Native Hawaiian, and Pacific Islander communities in Oregon based on secondary data from the Oregon Health Authority’s Smile Survey 2007, Smile Survey 2012; and the Coalition of Communities of Color’s 2012 report, The Asian and Pacific Islander Community in Multnomah County: An Unsettling Profile. To be clear, the 2012 survey report draft is cited most, as the 2012 survey reported more data on children of color compared to the 2007 survey. This paper also attempts to highlight the multifaceted aspects of access to care …

Increasing The Relevance Of Research To Underserved Communities: Lessons Learned From A Retreat To Engage Community Health Workers With Researchers, Heather Angier, Noelle Wiggins, Jessica Gregg, Rachel Gold, Jennifer E. Devoe

Community Health Faculty Publications and Presentations

This article presents information on a community retreat developed to seek input from community health workers (CHWs) to increase the relevance of our research to underserved communities in Oregon. Retreats facilitating dialogue between researchers and CHWs could yield important insight to enhance the significance of research for communities.

Managing The Polarities Of Democracy: A Theoretical Framework For Positive Social Change, William J. Benet

Journal of Sustainable Social Impact

People around the globe have embraced democracy to bring about positive social change to address our environmental, economic, and militaristic challenges. Yet, there is no agreement on a definition of democracy that can guide social change efforts. The Polarities of Democracy model is a unifying theory of democracy to guide healthy, sustainable, and just social change efforts. The Polarities of Democracy model consists of ten elements, organized as five polarity pairs: freedom & authority, justice & due process, diversity & equality, human-rights & communal-obligations, and participation & representation. In this model each element has positive aspects and negative aspects and …

Better Health, But Less Justice: Widening Health Disparities After National Federation Of Independent Business V. Sebelius, Emily W. Parento, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

At the time it was enacted in 2010, the Patient Protection and Affordable Care Act (ACA) was widely applauded by health activists, as it meant that the United States would at last join the overwhelming majority of industrialized countries in providing its population with guaranteed access to affordable health care. Roughly half of the increase in access to health insurance was to come from the expansion of Medicaid eligibility to all U.S. citizens and legal residents with income below 138% of the Federal Poverty Level. However, the Supreme Court’s 2012 ruling in National Federation of Independent Business v. Sebelius ( …

Towards A Framework Convention On Global Health: A Transformative Agenda For Global Health Justice, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

International law has responded weakly to the inequities in health care, public health, and the broader determinates of health that collectively cause the greatest loss of lives and human potential every year. Approximately one-third of global deaths can be attributed to enduring and unconscionable inequities. Despite significant progress in improving global health over the past several decades, these inequities persist. Current global governance for health is inadequate to the task of resolving these inequities, from lack of accountability and enforcement to inadequate funding and the absence of leadership required to respond to the threats to health that arise from other …

Bloomberg’S Health Legacy: Urban Innovator Or Meddling Nanny?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Michael Bloomberg leaves the mayoralty of New York City, with his health legacy is bitterly contested. The public health community views him as an urban innovator—a rare political and business leader willing to fight for a built environment conducive to healthier, safer lifestyles. To his distractors, however, Bloomberg epitomizes a meddling nanny—an elitist dictating to largely poor and working class people about how they ought to lead their lives. His policies have sparked intense public, corporate, and political ire—critical of sweeping mayoral power to socially engineer the city and its inhabitants.

Here, I seek to show how Bloomberg has fundamentally …

Motivating Men Who Have Sex With Men To Get Tested For Hiv Through The Internet And Mobile Phones: A Qualitative Study, Magaly M. Blas, Luis A. Menacho, Isaac E. Alva, Robinson Cabello, Edwin Roberto Orellana

School of Social Work Faculty Publications and Presentations

Background: Men who have sex with men (MSM) have the highest HIV prevalence in Peru, yet they are underserved by traditional preventive programs. In Peru, the Internet and mobile phones have emerged as an effective and convenient tool to reach this population.

Methods and Findings: From October 2010 to February 2011, we conducted eight focus groups with gay identified MSM (closeted and out-of-the-closet) and with self-identified heterosexual MSM in order to identify key features and preferences to be used to tailor culturally-appropriate messages that could be delivered through Internet and mobile phones to motivate MSM to get tested …

Short Text Messages To Motivate Hiv Testing Among Men Who Have Sex With Men: A Qualitative Study In Lima, Peru, Luis A. Menacho, Magaly M. Blas, Isaac E. Alva, Edwin Roberto Orellana

School of Social Work Faculty Publications and Presentations

Objective: The objective of this study is to identify features and content that short message service (SMS) should have in order to motivate HIV testing among men who have sex with men (MSM) in Lima, Peru.

Methods: From October, 2010 to February, 2011, we conducted focus groups at two stages; six focus groups were conducted to explore and identify SMS content and features and two additional focus groups were conducted to tailor SMS content. The text messages were elaborated within the theoretical framework of the Information-Motivation-Behavioral Skills model and the Social Support Theory.

Results: A total of …

A Discourse Analysis Of Ontario's Family Health Teams, Rachelle Ashcroft

Theses and Dissertations (Comprehensive)

Inspired by critical social work practice, this study engages in a discourse analysis of Ontario’s Family Health Team (FHT) model. The purpose for this study is threefold; namely, a) to deepen our understanding of health discourses promoted by Ontario’s FHT model; b) to explore how Ontario’s FHT model compares to Haggerty, Burge, Lévesque, Gass, Pineault, Beaulieu, & Santor’s (2007) conceptual model of PHC; and c) to promote critical reflection in order to help inform decisions on how to improve quality of care and enhance health equity in FHTs. This study is guided using the overarching question: What health care practices …

The Demands For Outpatient Care In Private Hospitals, Pujiyanto Pujiyanto

Kesmas

Peningkatan pendapatan per kapita menaikkan permintaan rawat jalan dan harapan mutu pelayanan rumah sakit. Masyarakat memiliki persepsi pelayanan rumah sakit swasta lebih bermutu daripada rumah sakit pemerintah, sehingga terdapat asumsi pelanggan rumah sakit swasta mempunyai karakteristik khusus. Tujuan studi ini adalah menginvestigasi berbagai faktor yang berhubungan dengan utilisasi rawat jalan dan kelompok yang mendapat manfaat. Studi ini menggunakan 42.540 responden rumah sakit swasta IFLS-4 tahun 2007. Semakin tinggi pendapatan semakin tinggi pula permintaan, kelompok jaminan/asuransi mempunyai permintaan yang lebih tinggi daripada non-jaminan. Kenaikan tarif rawat jalan rumah sakit swasta yang dipersepsi masyarakat sebagai barang mewah meningkatkan permintaan. Namun, kenaikan tarif …

Variasi Cakupan Jaminan Persalinan Di Kabupaten Bogor 2011, Ajeng Tias Endarti

Kesmas

Program Jaminan Persalinan (Jampersal) dirancang untuk meningkatkan akses ibu hamil pada fasilitas pelayanan kesehatan yang pada gilirannya berkontribusi terhadap penurunan kematian ibu. Artikel ini bertujuan menilai cakupan Jampersal di Kabupaten Bogor, Provinsi Jawa Barat dengan menggunakan sumber data sekunder yaitu profil kesehatan dan laporan kesehatan ibu dan anak (KIA) Dinas Kesehatan Kabupaten Bogor tahun 2011. Cakupan Program Jaminan Persalinan yang meliputi pelayanan antenatal care (ANC), persalinan, dan pascapersalinan berada pada kisaran 2,67% _ 12,56%, dengan cakupan tertinggi pelayanan persalinan (12,56%). Berdasarkan uji analysis of variance (ANOVA) ditemukan perbedaan yang bermakna antara cakupan di wilayah pembangunan barat (25,05%), tengah (9,43%), dan …

Tingkat Kepuasan Karyawan Perusahaan Swasta Dalam Pelayanan Jaminan Sosial Tenaga Kerja (Jamsostek), Matias Siagian

Kesmas

Penelitian ini berbentuk penelitian deskriptif yang mengkaji masalah pelaksanaan program Jaminan Sosial Tenaga Kerja (Jamsostek) sebagai hak karyawan. Penelitian ini bertujuan mengetahui tingkat kepuasan karyawan yang bermukim di desa Mulyorejo, sebuah desa industri, dalam pelayanan Jamsostek khususnya Jaminan Pemeliharaan Kesehatan, Jaminan Kecelakaan Kerja, dan Jaminan Kematian. Sampel penelitian terdiri dari 70 keluarga karyawan peserta Jamsostek. Data dikumpulkan dengan menggunakan kuesioner dan dianalisis dengan menggunakan statistik deskriptif. Tingkat kepuasan karyawan diukur dengan skala likert. Hasil penelitian menyimpulkan, secara umum pelayanan Jamsostek belum memuaskan. Sosialisasi belum memuaskan karyawan. Dari tiga pelayanan yang diteliti, hanya satu yang memuaskan, yaitu Jaminan Kematian, sedangkan pelayanan …

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Children And Adults With Long Term Services And Support Needs: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010, Stuart Bratesman Mpp, Julie T. Fralich Mba, Tina Gressani, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. An earlier report provided a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008 to 2010. Both reports were prepared as part of the Maine State Profile Tool grant funded by the Centers for Medicare & Medicaid Services. This second report analyzes the characteristics, use and expenditure patterns of sub-populations of long term service users including adults …

Satisfaction Survey Results And Lessons Learned: Maine's Aging & Disability Resource Center (Adrc) Project, Julie T. Fralich Mba, Louise Olsen, Mark Richards Bs, Jennifer Pratt, Taryn Bowe

Disability & Aging

The primary goal of Maine’s Aging and Disability Resource Center (ADRC) Project was to empower consumers to make informed decisions about long-term services and supports and to streamline access to existing services and supports through an integrated system. With funding from the Administration on Aging to strengthen and expand the number of Aging and Disability Resource Centers (ADRCs) in the state, all five of the Area Agencies on Aging were committed to becoming and/or strengthening their capacity to be fully functioning ADRCs.

This report provides a summary of the results of consumer satisfaction surveys that were conducted for three years …

Funding Health-Related Vr Services: The Potential Impact Of The Affordable Care Act On The Use Of Private Health Insurance And Medicaid To Pay For Health-Related Vr Services, Robert Silverstein

All Institute for Community Inclusion Publications

One of the myriad of issues affecting the administration of the vocational rehabilitation (VR) program by State VR agencies under Title I of the Rehabilitation Act is how to maximize access to and use of all available funding sources to pay for VR services and supports for VR applicants and clients. In March 2010, Congress passed and the President signed into law the "Affordable Care Act" (ACA). 1 On June 28, 2012, the United States Supreme Court upheld all of the provisions of the ACA, with the exception of provisions mandating Medicaid expansion. The Supreme Court held that if a …

Town Of Cohasset Senior Center Study, Jan Mutchler, Hayley Gravette, Caitlin Coyle

Gerontology Institute Publications

The Town of Cohasset is considering the construction of a new Senior Center that will provide the opportunity for expanded programming within a dedicated building. In support of planning efforts by the Town of Cohasset, a study was conducted by the Gerontology Institute of the McCormack Graduate School at UMass Boston. The study addresses the need for, and probable utilization of, a new Senior Center, and includes consideration of the recreational, educational and health-related programs that are likely to be offered through the new Center. Results of the study presented in this report respond to three questions: First, what are …