Health Services Research Commons^™

Annual Report 2014, Forum Staff

National Health Policy Forum

This annual report describes the activities of the Forum during the 2014 calendar year, and provides a snapshot of our audience and resources.

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Health Management and Policy Presentations

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.

Providence Ed Guide Program - Analysis Of Program Impacts; The Center For Outcomes Research & Education (Core); Providence Health & Services, Bill J. Wright

Articles, Abstracts, and Reports

No abstract provided.

Innovating At Jefferson: Developing The Patient-Centered Medical Home (Pcmh) Cost Tool, Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented at Jefferson School of Population Health Faculty Research Seminar.

Objectives:

Describe the cost-collection tool we created for the PCMH Model

Propose improvements to our tool in order to enhance the response rate

Determine our next steps in terms of research and innovation for PCMH at Jefferson

21 slides

When Nurses Are Also Patients: Intimate Partner Violence And The Health System As An Enabler Of Women's Health And Agency In Johannesburg, Courtenay Sprague, Nataly Woollett, Jane Parpart, Abigail M. Hatcher, Theresa Sommers, Shelley Brown, Vivian Black

Conflict Resolution, Human Security, and Global Governance Faculty Publication Series

While violence against women is a recognised global health problem, women’s agency in marginalised settings is poorly understood, particularly in relation to health systems. We explored agency as a practical and theoretical construct through qualitative research among 20 nurses with direct or indirect experiences of intimate partner violence (IPV) in Johannesburg. Interviews conducted from August 2013 to March 2014 generated rich descriptions from respondents in five health facilities. Nurses’ self-reported IPV matched national prevalence of 24–31%. Findings revealed the way in which agency is enacted by nurses, allowing them the economic means to leave abusive partnerships, yet disabling them from …

Deconstructing Unmade Examining The Capacity Of Ayurveda To Address India’S Mental Health Crisis, Cassie Sutten Coats

Independent Study Project (ISP) Collection

Though India does not have a credible, widespread system in place to recognize and focus on issues of mental health, especially in allopathic treatments, it is imperative to evaluate the existing practices and approaches in regards to mental health alongside the impact that these approaches may have on Indian society. In contrast to Westernized systems of medicine, the traditional Indian system of Ayurveda inherently addresses issues in mental health due to the holistic approach through mind-body medicine. This study evaluates the enormous potential that exists within Ayurvedic philosophy to provide adequate, culturally congruent, treatments and care in mental health, and …

Investigating Barriers To Early Cancer Detection For Rural Indian Women: A Qualitative Analysis Of Cancer Outreach In Dehradun, Uttarakhand, Blair Burnett

Independent Study Project (ISP) Collection

This study examines barriers to early detection for women’s specific cancers in rural India in and around Dehradun, Uttarakhand, within the framework of existing health outreach programs from tertiary hospitals in the state. The burden of cancer mortality within India is disproportionately affecting women living in rural populations considering the current health education and health care infrastructure in place. Barriers of knowledge, access to knowledge, economic condition, geography, and cultural norms are all examined within this study in the context of early cancer detection. National Indian health policy is currently framed to address the burden of cancer within India; however, …

Effect Of Females In Leadership Roles On Menstrual Sanitation In Rural Jamkhed, India, Kirsten Hughes

Independent Study Project (ISP) Collection

Introduction: Menstruation is integral to puberty and maturation of adolescent girls. Education about menstruation and menstrual hygiene effects a woman’s physical and psychosocial health through the majority of her life.

Purpose: This study seeks to answer the following questions: Who is providing information to girls before or after their first menstruation? Is this information timely, appropriate and accurate? Is the information effective enough to see changes in menstrual practices through a family and community? In answering these questions, the study attempts to determine the pathways of communications regarding menstruation and menstrual health in the Jamkhed area of the Ahmednagar district …

Babies First: Ensuring Proper Infant Nutrition During Emergencies, Abigail M. Alonso

Independent Study Project (ISP) Collection

Background: Breastfeeding is the best source of nutrition for an infant, living in all regions and cultures. Recommendations apply across the board, from developed nations to refugee camps, from women with HIV to those with time constraints regarding feeding. There also exists a complex relationship between corporations that provide BMS and the NGOs working to promote breastfeeding in emergency situations amongst vulnerable populations.

Objective: The objective of this paper is to expose breastfeeding promotion, using the Dadaab camps in Northeastern Kenya as a case study of IYCF programs and support of breastfeeding among low-literacy populations with an emphasis on women …

Processes, Practices And Politics In The Treatment Centers For Addictions And Problematic Consumptions: An Analysis Of The Perspectives And Practices Of The Professionals In A Treatment Center In The Autonomous City Of Buenos Aires, Chiara Lawrence

Independent Study Project (ISP) Collection

Contextual Information: Historically in Argentina, as well as globally, the politics regarding the use of “drugs” have been prohibitionist and treatment centers have implemented these politics with models of abstinence. More recently, the need for both the politics and the treatment to prioritize the rights and health of the drug uses has become more widely recognized in both social and political contexts, as much as among professionals in treatment centers. New laws have been passed proposing the implementation of harm reduction strategies in the treatment of addictions and problematic drug use. In the Autonomous City of Buenos Aires there are …

El Rol Del Parto Mapuche En El Mundo De La Medicina Moderna / The Role Of Mapuche Birth In A World Of Modern Medicine, Nita Chai

Independent Study Project (ISP) Collection

Research Question: Is there existing demand for Mapuche birth practices and what are the barriers to incorporating them in the Chilean healthcare system? Objective: Analyze the current role of Mapuche birth practicesby determining what is the demand from the Mapuche for their use, describing the quality of communication between Mapuche women andmodern professionals, and identifying the perspectives of modern professionals on Mapuche birth practices. Background: Childbirth is an integral process for the human race. For many indigenous communities, the arrival of a new life holds cultural significance that is recognized through ceremonies during or after childbirth. Chile has implemented health …

Effect Of Massachusetts Healthcare Reform On Racial And Ethnic Disparities In Admissions To Hospital For Ambulatory Care Sensitive Conditions: Retrospective Analysis Of Hospital Episode Statistics, Danny Mccormick, Amresh D. Hanchate, Karen E. Lasser, Meredith G. Manze, Mengyun Lin, Chieh Chu, Nancy R. Kressin

Publications and Research

Objectives To examine the impact of Massachusetts healthcare reform on changes in rates of admission to hospital for ambulatory care sensitive conditions (ACSCs), which are potentially preventable with good access to outpatient medical care, and racial and ethnic disparities in such rates, using complete inpatient discharge data (hospital episode statistics) from Massachusetts and three control states.

Design Difference in differences analysis to identify the change, overall and according to race/ethnicity, adjusted for secular changes unrelated to reform.

Setting Hospitals in Massachusetts, New York, New Jersey, and Pennsylvania, United States.

Participants Adults aged 18-64 (those most likely to have been affected …

Evaluating The Effectiveness Of Current Types Of Patient Portal Education Efforts, Jennifer L. Cooper

Applied Research Projects

Hospitals and providers participating in Meaningful Use are required to show 5% enrollment rate in their patient portals in order to receive incentive payments. The challenge with this is determining how to effectively market the portal in order to educate patients that the portal exists that also results in patients enrolling in the portal. A survey of patients was conducted at Hunt Regional Medical Center in Greenville Texas to identify how they are hearing about the patient portal and if they are signing-up as a result. While the response rate was low, the survey results did indicate what form of …

The Impact Of The Veterans Health Administration's Home Based Primary Care On Health Services Use, Expenditures, And Mortality, Melissa Castora-Binkley

USF Tampa Graduate Theses and Dissertations

Background: Among patients with multiple chronic conditions, care coordination and integration remains one of the major challenges facing the U.S. health care system. A home-based, patient-centered primary care program has been offered through the Veterans Health Administration (VHA) since the 1970s for frail veterans who have difficulty accessing VHA clinics. The VHA Home Based Primary Care (VHA HBPC) aims to integrate primary care, rehabilitation, disease management, palliative care, and coordination of care for frail individuals with complex, chronic diseases within their homes. Early research suggested that VHA HBPC was associated with positive outcomes (e.g., reduced resource use and patient satisfaction). …

Developing Integrate: A Fast And Frugal Patient-Reported Measure Of Integration In Health Care Delivery, Glyn Elwyn, Rachel Thompson, Roshen John, Stuart W. Grande

Dartmouth Scholarship

Efforts have been made to measure integration in health care delivery, but few existing instruments have adopted a patient perspective, and none is sufficiently generic and brief for administration at scale. We sought to develop a brief and generic patient-reported measure of integration in health care delivery. Drawing on both existing conceptualisations of integrated care and research on patients’ perspectives, we chose to focus on four distinct domains of integration: information sharing, consistent advice, mutual respect and role clarity. We formulated candidate items and conducted cognitive interviews with end users to further develop and refine the items. …

Connecting Preparedness Science With The National Health Security Preparedness Index: Research Translation Opportunities, Glen P. Mays

Health Management and Policy Presentations

The National Health Security Preparedness Index is a mechanism for applying advances in preparedness measurement and analysis from Hurricane Sandy research projects to advance policies and practices in preparing for, responding to, and recovering from disasters and other health emergencies

The National Health Security Preparedness Index: Harnessing Evidence & Experience To Drive Improvement, Glen P. Mays

Health Management and Policy Presentations

This presentation profiles the National Health Security Preparedness Index as a mechanism for measuring preparedness and resiliency levels across the U.S. Forthcoming enhancements in measurement and analytic methodologies will allow the Index to play heightened roles in informing policies and practices that protect the U.S. population from a broad range of hazards.

Answering The Call To Integrate: Simple Strategies From Public Health And Healthcare Executives In One Urban County, Erik L. Carlton, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Background: As the Affordable Care Act transforms the practice of both public health and health care, it also provides opportunity for both to become more closely linked through improved integration and collaboration. Yet, while public health agencies are increasingly called to work with healthcare partners to address population health needs, both public health leaders and their healthcare counterparts may not be well equipped to answer that call. Although recent studies have begun exploring the collaborative strategies and capacity of public health system partners, there is still much to learn. The purpose of this study was to identify, through the perspective …

Accreditation Intent, Community Health Assessments, And Local Health Department–Hospital Collaboration, Erik L. Carlton, Simone Singh

Frontiers in Public Health Services and Systems Research

Background: Community health assessments (CHAs) are among the most core of activities conducted by local health departments (LHDs), and many LHDs have been conducting CHAs on a regular basis for years. More recently, completing a CHA has also become a prerequisite for LHDs seeking accreditation by the Public Health Accreditation Board (PHAB). Similarly, under the Affordable Care Act, tax-exempt hospitals are required to conduct periodic community health needs assessments. Opportunities thus exist for LHDs and tax-exempt hospitals to engage in collaborations related to CHAs. Yet, it remains unclear whether interest in PHAB accreditation provides incentive to LHDs to engage in …

Alternate Payment Models For Ryan White Hiv/Aids Program Funded Services: Strategies Used By Nine Grantees, Naomi Seiler, Scott Dafflitto, Rosalind Fennell, Julia Hidalgo, Katie Horton, Mary-Beth Malcarney

Health Policy and Management Faculty Publications

The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) offers Ryan White HIV/AIDS Program (RWHAP) Part A and Part B grantees some flexibility in determining the method used for paying subgrantees for core medical and support services. Many Part A and Part B grantees use a traditional “cost-based reimbursement” approach, in which subgrantees submit budgets that include personnel costs, other direct costs related to the provision of funded services, and capped indirect costs (IDCs). Some grantees, however, have developed alternative reimbursement models for core medical and/or support services. This report summarizes the reimbursement approaches taken by nine RWHAP grantees. …