Health Services Research Commons^™

Measuring Progress To Comprehensive Public Health Systems, National Preparedness, And A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

This update describes recent progress on two national health measurement initiatives: The National Health Security Preparedness Index and the National Longitudinal Survey of Public Health Systems. These longitudinal data sources offer valuable perspectives on how health security practices and public health delivery systems are changing across the U.S.

Adults With Autism: What Happens After 18?, Nicole A. Pacwa

Scholarly and Creative Works Conference (2015 - 2021)

Autism diagnoses have recently been on the rise, which eventually leads to young adults and their families having to figure out what to do for the future. Unfortunately, the services that these children grow up with will no longer are applicable once they turn 18. Families need to think about possible paths that would work best for their child. Some options would be a transitional school that could provide services and learning opportunities, group living communities that offer support while giving the individual a chance to live on his or her own while being supported, or vocational support that offers …

A Comparative Analysis Of Attitudes Towards Women Physicians In Nineteenth Century Articles And Novels, Hannah White

Honors Theses

No abstract provided.

Learning From Variation And Change: The 2016 Release Of The National Health Security Preparedness Index, Glen P. Mays

Health Management and Policy Presentations

The 2016 release of the National Health Security Preparedness Index uses an improved computational methodology and validated set of measures to more accurately track national and state progress in protecting the public from the health effects of disasters, outbreaks and other large-scale emergencies. This presentation provides a preview of the new methodology and results.

Understanding The Value Of Multi-Sector Partnerships To Improve Population Health, Glen P. Mays

Health Management and Policy Presentations

We review recent research concerning multi-sectoral partnerships aimed at improving health status on a population-wide basis, with a particular focus on implementation strategies and on health and economic impact. While still preliminary and emerging, research indicates that large health benefits are possible through collective actions that engage the medical, public health, and social sectors. Mechanisms for aligning incentives, dividing responsibilities equitably, and measuring progress regularly appear critical to success.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays, Rick Ingram

Health Management and Policy Presentations

We review methods for measuring the structure of public health delivery systems using data from the National Longitudinal Survey of Public Health Systems. A growing body of research using these measures demonstrates how multiple sectors contribute to core public health functions, and how these functions influence community health status over time. We end with a summary of how the Comprehensive Public Health System measure will be used in monitoring the impact of the 21st Century Public Health System initiative.

Sex, Milk, And Cookies: Tackling Sexual Health Promotion On A Catholic College Campus, Mary Franz

All College Thesis Program, 2016-2019

A great divide exists among parents, policy makers, educational institutions, and the public at large regarding how to prevent the negative consequences of sexual activity among young adults. Some educators believe that sex education programs should promote abstinence as the best behavioral goal for students; however, a more intense debate surrounds whether this should be the only message that adolescents receive about sex or just one element of a more comprehensive view of sexuality and informed sex choices. Catholic colleges face a particularly difficult challenge in deciding what information to provide to students and more significantly, which topics to avoid …

"Paying For Success": Structuring Reimbursement Of Free Healthcare For Pre-Insured Patients Using The Social Equity Bond Model, Nikkole Turgeon

Senior Honors Projects

Millions of Americans without insurance under the Affordable Care Act expansion fall into two categories: the ‘coverage gap’ and the ‘citizenship gap’. These two groups are disproportionately affected by health disparities due to low-income or legal status. Health disparities affect individuals in many aspects of their lives, including their health, finances, and overall quality of life. To improve the lives of uninsured individuals in Providence, Rhode Island Clínica Esperanza/Hope Clinic (CEHC) proposes to set up a Social Investment Bond Pay for Success program. CEHC has teamed with the Rhode Island Office of Health and Human Services and other RI organizations …

User Acceptance Of Neurology Telemedicine Technology In The Emergency Department, Teresa W. Mcneil

Applied Research Projects

There is currently a significant shortage of trained neurologists in the country. In addition to the shortfall of neurologists, there is an increasing need for this specialty due to an aging population, increase in the incident of neurologic diseases and an increasing demand for healthcare (Freeman, 2013). The development of tele neurology technology has been shown to help address these problems. As with any new technology there are multiple barriers to overcome, one of those being user acceptance of the technology. A survey of users of the telemedicine product VGo was conducted at Hunt Regional Medical Center to access the …

Urgent Care And Emergency Department Visits In The Pediatric Medicaid Population., Amanda Montalbano, Jonathan Rodean, Juhi Kangas, Brian R. Lee, Matt Hall

Manuscripts, Articles, Book Chapters and Other Papers

Background: Urgent care (UC) is one of the fastest growing venues of health care delivery. We compared clinical and cost attributes of pediatric UC and emergency department (ED) visits that did not result in admission.

Methods: Our study examined 5 925 568 ED and UC visits of children under 19 years old in the 2010 through 2012 Marketscan Medicaid Multi-State Database. Basic demographics, diagnoses, severity, and payments were compared. Between ED and UC visits, χ(2) tests were used for proportions and Wilcoxon rank-sum tests were used for continuous variables.

Results: The UC and ED had the same most common diagnoses. …

Capacity Building Of Health Workforce: Investigation Of Training Process For Community Health Volunteers (Chvs) Serving Refugee Populations In Host Communities, As Perceived By Participants And Trainers, Jerusalem Hadush

Independent Study Project (ISP) Collection

The health system in the Hashemite Kingdom of Jordan, which hosts 1.4 million refugees from the Syrian Arab Republic—more than 636,000 of whom are registered with UNHCR—is over-extended (UNHCR, 2016). Non-governmental organizations fill gaps in service delivery by injecting health personnel to deliver care, however, nationals and refugees must be integrated in the response to ensure sustainable health care delivery (UNHCR Handbook for Emergencies, 2007). Leveraging the capacities of lay citizens and refugees by task shifting and training CHVs can alleviate the increased health burden. Research into training programs is significant because the quality of training is directly related to …

Sex Disparities In Access To Acute Stroke Care: Can Telemedicine Mitigate This Effect?, Catherine Wolff, Amelia K. Boehme, Karen Albright, Tzu-Ching Wu, Michael Mullen, Sean Savitz, Charles Branas, James Grotta, Brendan Carr

Journal of Health Disparities Research and Practice

Background: Women have more frequent and severe ischemic strokes than men, and are less likely to receive treatment for acute stroke. Primary stroke centers (PSCs) have been shown to utilize treatment more frequently. Further, as telemedicine (TM) has expanded access to acute stroke care we sought to investigate the association between PSC, TM and access to acute stroke care in the state of Texas.

Methods: Texas hospitals and resources were identified from the 2009 American Hospital Association Annual Survey. Hospitals were categorized as: (1) stand-alone PSCs not using telemedicine for acute stroke care, (2) PSCs using telemedicine for acute stroke …

An Identification Of The Social And Emotional Needs Of People Living With Post-Lingual Hearing Loss, Dianne Briffa, Fiona Davidson, Danielle Ferndale Ms

JADARA

Hearing loss is associated with challenges in achieving effective communication which can constrain an individual’s ability to participate in social and work environments, affecting their social and emotional well-being. Through a thematic analysis of focus groups, interview and survey responses from 41 people experiencing post-lingual hearing loss, we identified an overarching theme of adjusting to impaired communication and three sub-themes in which we were able to identify the unmet social and emotional needs of people who are hard of hearing. In light of our analysis we discuss and offer recommendations specific to meeting the needs of this population.

Factors Influencing The Variation In Gms Prescribing Expenditure In Ireland, Aisling Conway Lenihan, S. Ahern, J. Cronin, N. Woods

Dept. of Management & Enterprise Publications

Background

Pharmaceutical expenditure growth is a familiar feature in many Western health systems and is a real concern for policymakers. A state funded General Medical Services (GMS) scheme in Ireland experienced an increase in prescription expenditure of 414 % between 1998 and 2012. This paper seeks to explore the rationale for this growth by investigating the composition (Anatomical Therapeutic Chemical (ATC) Group level 1 & 5) and drivers of GMS drug expenditure in Ireland in 2012.

Methods

A cross-sectional study was carried out on the Health Service Executive-Primary Care Reimbursement Service (HSE-PCRS) population prescribing database (n = 1,630,775). Three …

Aligning Delivery & Financing Systems To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Systems for Action Research Program supports research on how best to organize, finance, and deliver the constellation of services and supports that promote health and well-being in American communities, including but extending beyond the medical care and public health sectors. This session describes work underway through the S4A program and future research priorities, building on a strong scientific foundation in the fields of health services research (HSR) and public health services & systems research (PHSSR).

Integrating Health Services & Systems: What We Know, Think We Know, And Need To Learn, Glen P. Mays

Health Management and Policy Presentations

The delivery and financing systems for medical care, public health, and social and community services pursue many common goals and serve overlapping groups of families and communities. Unfortunately, in most American communities these systems interact in complex and often poorly understood ways through fragmented funding vehicles, information flows, governance and decision-making structures, institutional relationships, implementation rules and strategies, and professional and interpersonal connections. New research approaches are required to untangle these interactions and expose novel pathways of influence that can support equitable improvements in service delivery, resource use, health impact, and wellbeing. This presentation will summarize evidence from recent studies …

Measuring Multi-Sector Contributions To Public Health Delivery Systems & Population Health, Glen P. Mays

Health Management and Policy Presentations

The National Longitudinal Survey of Public Health Systems has followed a nationally-representative cohort of U.S. communities since 1998 to measure the scope of public health activities implemented in each community and the range of organizations and sectors that contribute to each activity. With 16 years of follow-up observations, this survey allows us to study the effects of demographic, economic, and policy shocks on public health delivery systems, and estimate the health effects attributable to delivery system change.

Maternal Leisure-Time Physical Activity And Risk Of Preterm Birth: A Systematic Review Of The Literature, Mira Kahn, Loretta Dipietro, Kimberly Robien

GW Research Days 2016 - 2020

Background: Preterm birth is a leading cause of infant death and regular physical activity may reduce the risk for preterm birth because of its beneficial effects on pregnancy complications such as preeclampsia, excessive weight gain, and gestational diabetes. On average, however, pregnant women report lower levels of physical activity compared with those who are not pregnant. This systematic review examined low, moderate and vigorous leisure-time physical activity (LTPA) during pregnancy and the outcome of preterm birth.

Methods: Key words related to preterm birth and physical activity were used to search relevant databases (Medline, Cochrane, CINAHL, Sports Discuss and Scopus). Studies …

Racial And Ethnic Disparities In Health Care: An Examination Of State Inpatient Databases In The Utilization Of And Outcomes Following Total Knee Arthroplasty, Alexis W. Lan, Wei Zhang, Yan Ma

GW Research Days 2016 - 2020

Title: Racial and Ethnic Disparities in Health Care: An Examination of State Inpatient Databases in the Utilization of and Outcomes following Total Knee Arthroplasty

Background: The U.S. population is becoming more racially and ethnically diverse yet disparities in health care still exist. One area of medical care in which racial disparities have been identified is total knee arthroplasty (TKA)¬—an efficacious and cost-effective treatment option for individuals with advanced arthritis of the knee. Previous studies have documented that racial and ethnic minorities tend to have higher rates of adverse health outcomes and face more barriers utilizing the procedure. However, these studies …

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Delivery and financing systems for public health services vary widely across U.S. communities, raising questions about the comparative effectiveness and efficiency of alternative structures. We summarize recent approaches for measuring alternative system configurations and estimating their health and economic effects.