Public Policy Commons^™

National Quality Awards In Healthcare And Actual Quality In U.S. Hospitals, Beth M. Beaudin-Seiler

Dissertations

This study examined performance outcome data from the Medicare Compare Hospital database for differences in performance between national award-winning hospitals and non-national award-winning hospitals. Specific variables examined were related to clinical care and were identified in literature as well as professional medical associations and societies as being quality indicators. National award-winning hospitals were defined as those having received the Malcolm Baldrige Quality Award in Healthcare or the Healthgrades Distinguished Hospital for Clinical Excellence. The characteristics of highly reliable organizations were also used to align the indicators of excellence for Malcolm Baldrige and Healthgrades recipients. Finally, a closer examination of data …

A Study On Generic Prescription Substitution Policy As A Cost Containment Approach For Michigan’S Medicaid System, Khandaker Nayeemul Islam

Dissertations

Increasing health care costs have made management of Medicaid services to provide low-income families through Medicaid programs critical in the recent times. The number of Medicaid beneficiaries in Michigan has increased over the years mainly due to the downsizing of auto sectors. Currently, states spend almost 16% of their budget for Medicaid, making it the second largest item in the budget for most (Kaiser Foundation, 2010). Prescription drugs are a significant part of Michigan’s Medicaid costs. Higher costs caused a tremendous fiscal burden on Michigan in administering the program and providing prescription drugs for its patients. Michigan has implemented several …

Mass Shootings And Mental Health Policy, Jessica Rosenberg

The Journal of Sociology & Social Welfare

Research suggests that mass shootings can increase mental health stigma, reinforce stereotypes that people with mental illness are violent, and influence public policy. This article examines mental health policy initiatives resulting from the mass shootings in Sandy Hook, Connecticut and Aurora, Colorado within the context of existing research about mental illness, suicide, substance abuse and gun violence. Previous legislation that restricts access to firearms among persons with mental illness is reviewed. The article suggests that gun control legislation that focuses on persons with mental illness is not supported by research, may create barriers to treatment, and may have limited efficacy …

Nongovernmental Program Replication And Implementation: What Can Community-Based Programs To Support The Uninsured Learn From Other Communities?, Raymond J. Higbea

Dissertations

This research study evaluated the replication and implementation of Project Access (a nongovernmental, structured program providing physician and health care services to the working-poor) in Grand Rapids, Michigan. A mixed methodological approach was used and included quantitative and qualitative methodologies. The qualitative method used was a self-administered mailed survey of all Project Access enrollees. This survey evaluated the enrollee's perceived health and lifestyle function, access to physician services, access and adherence to prescribed medication regimen, and barriers to physician services during the year pre- and post-enrollment in Project Access. The survey also evaluated the amount enrollees were able or willing …

Unintended Consequences In Public Policy: Formulation And Implementation Of Michigan’S Safe Delivery Of Newborns Law, Anne Julie Hacker

Dissertations

It is generally believed that social policy is the result of careful research and planning on the part of officials. Yet there often exists a gap between theformulation and implementation of many social policies. This gap brings with it conflict, which in turn may result in unintended consequences. Theseconsequences may be so antithetical to the formulators' original intent as to make the policy implementation paradoxical.

This qualitative research study examines the ambiguities, challenges, or boundaries that policy formulators placed on practitioners responsible for implementing Michigan's Safe Delivery of Newborns Act and that ultimately created unintended consequences indicative of a public …

Providing Uninsured Adults With Free Or Low-Cost Primary Care: Does It Influence Their Use Of Hospital Emergency Departments?, Anne G. Zahradnik

Dissertations

This study analyzes one component of the health care safety net to determine whether or not being enrolled in a free or low-cost primary care physician access program subsequently affects emergency room utilization by uninsured adults ages 18 through 64. Those individual decisions are analyzed from both public goods and rational choice schemas. Additionally, physician access programs of different formats (a low-cost physician referral program and a freewalk-in clinic) are analyzed and compared for relative effectiveness. The study is a quantitative analysis of more than 40,000 individual patient records rather than relying on qualitative patient recall or on analyzing broad …

Crises In The Regulation Of Long-Term Care, Randall Earl Phillips

Dissertations

This study reviews the history of the legislative process that led to the passage of the Nursing Home Reform Act of 1987 and the implementation of the regulations. The analysis uses the model of Masmanian and Sabatier to identify the variables and assess their impact on the implementation process. The content of the regulations in terms of various statutory and nonstatutory variables is assessed, and an estimate is made of their effect on the program.

Three aspects of the regulations are examined. First, the relative importance of how compliance is to be determined--subjectively, objectively, or clinically. Second, the design and …