Health Services Research Commons^™

Developing Service Delivery Measures For Studies Of Practice Variation: The Mprove Study, Glen P. Mays

Health Management and Policy Presentations

The Multi-Network Practice and Outcome Variation (MPROVE) Study supports investigations of the causes and consequences of variation in public health service delivery through collecting a standardized set of delivery measures across more than 300 local practice settings in 6 states. The measures characterize volume, intensity, quality, efficiency, and equity of service delivery in three core domains of chronic disease prevention, communicable disease control, and environmental health protection.

Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Practice-based research networks (PBRNs) provide powerful mechanisms for implementing research studies that evaluate the health and economic effects of delivery system innovations. This presentation reviews strategies, emerging findings, and lessons learned from PBRNs and related studies conducted in U.S. public health settings. We give special focus to studies that examine multi-organizational and cross-sectoral strategies for population health improvement.

Electronic Health Record Documentation: Is It An Accurate Indicator Of Quality Of Care For Mechanically Ventilated Patients?, Joetta Powell

Applied Research Projects

Background: Ventilator associated pneumonia is one of the leading hospital acquired infections associated with increased mortality and lengths of stay in mechanically ventilated patients.

Hypothesis: It is hypothesized that the introduction of chlorhexidine gluconate will show reduction in the incidences of ventilator associated pneumonia and a greater reduction with tooth brushing vs oral swabbing. It is also hypothesized that the electronic health record will provide more evidence of quality of care than an external EHR sources.

Methods: The non-randomized, non-sampled population included 98 patient records that met the inclusion criteria. The external tool, Automated Vent Bundle tool provided information as …

Summary Of Pediatric Quality Measures For Children Enrolled In Mainecare Ffy 2009-Ffy 2013, Mary Lindsey Smith Phd, Msw

Population Health & Health Policy

In Maine, a key objective of the IHOC CHIPRA demonstration grant is to collect and report on the Initial Core Set of Children’s Health Care Quality Measures (referred to as the “CHIPRA Core Measures”), a set of 24 standardized, evidence-based measures identified by CMS for use by State Medicaid and CHIP programs. This report presents the results of the 18 CHIPRA Core Measures that were collected using MaineCare claims, Vital Statistics or survey data and reported to the Centers for Medicare and Medicaid Services (CMS) for FFY 2013. Also included in this report are an additional three measures from the …

Annual Report 2013, Forum Staff

National Health Policy Forum

This annual report describes the activities of the Forum during the 2013 calendar year, and provides a snapshot of our participants and resources.

Adolescent Perceptions Of Health Through Photovoice In Cato Manor, South Africa, Renee Lamoreau

Independent Study Project (ISP) Collection

This study will investigate how youth in Cato Manor perceive health in their community using photovoice as the primary methodology. Photovoice is a participatory action research method that gives participants the power to answer research questions through imagery. Participants take pictures in response to a question or prompt, and then describe a self-­‐selected number of pictures using the SHOWED process. This study will employ this methodology to answer the following questions: What objects, people, and events do youth associate with health? How do youth in Cato Manor define health and sickness? The following report will summarize the social and physical …

A Metaevaluation Of Evaluations Of Health Care Programs That Employ The Chronic Care Model, Jan Fields

Dissertations

Background: The purpose of this dissertation is to explore the use of metaevaluation to evaluate the quality of healthcare studies conducted on programs that employ the Chronic Care Model (CCM) to provide chronic illness care. In this study, healthcare studies of CCM programs are regarded as program evaluations. Method: Using a non-experimental cross-sectional design, 28 healthcare studies of CCM programs were evaluated using the accuracy standards portion of the Program Evaluations Metaevaluation Checklist (Stufflebeam, 2011). The results of the metaevaluations were analyzed and compared to the HEAL grade of the same healthcare studies as determined by the Hierarchy of Evidence …

Citizenship Documentation Requirement For Medical Eligibility: Effects On Oregon Children, Brigit A. Hatch, Jennifer E. Devoe, Jodi A. Lapidus, Matthew J. Carlson, Bill J. Wright

Sociology Faculty Publications and Presentations

BACKGROUND AND OBJECTIVES: The Deficit Reduction Act (DRA) of 2005 mandated Medicaid beneficiaries to document citizenship. Using a prospective cohort (n=104,375), we aimed to (1) determine characteristics of affected children, (2) describe effects on health insurance coverage and access to needed health care, and (3) model the causal relationship between this new policy, known determinants of health care access, and receipt of needed health care.

METHODS: We identified a stratified random sample of children shortly after the DRA was implemented and used state records and surveys to compare three groups: children denied Medicaid for inability to document citizenship, children denied …

Grappling With Gatekeepers: Addressing Gender Hindrances To Mhealth, Jack O’Rourke

Independent Study Project (ISP) Collection

This study was conducted in order to understand the social and economic problems associated with Ugandan women’s usage of mobile phones and the ways in which different mHealth groups are approaching these problems. Seeing how these different groups approach this issue added new information and analysis to a relatively unexplored topic

The qualitative methodology undertaken was two pronged. First, single sex focus groups in rural Mukono District were assembled. Men, women without phones and women and with phones were all talked to in Luganda with the use of a translator. In addition to these focus groups in rural Mukono District, …

Quality Of Emergency Departments In Amman Evaluated By The Availability Of Essential Emergency Equipment, Seif Laeth Sari Nasir

Independent Study Project (ISP) Collection

The present study aims to determine the quality of emergency health care in Jordan by assessing the availability of essential emergency equipment in emergency departments in Amman. This study uses a cross-­‐sectional questionnaire assessing the accessibility of equipment and medication in emergency departments, as well as eliciting the opinions of the participants regarding the future development of the emergency medical sector in Jordan. The questionnaires were distributed to the physician directors of every participating hospital emergency department in Amman, and completed by the physician director excepting two cases, one of which was completed by the head staff nurse, and the …

Cleft Lip And Palate In India: Determining The Socioeconomic Factors That Influence Quality Of Life And Treatment Received, With A Focus In Rural Nainital District, Uttarakhand State, Ellery Ward

Independent Study Project (ISP) Collection

Cleft lip and cleft palate are birth defects that range in severity, and may cause serious physical and social challenges to those who are born with them. This project sought to determine the socioeconomic factors that influence the lives of people with cleft lip and or cleft palate in India, and the treatment, or lack thereof, which they receive. Specific focus was given to the rural and mountainous area of Nainital district in Uttarakhand state. This study was carried out with the assistance of the Aarohi organization located in the Satoli village in Nainital district. Interviews with one plastic surgeon …

National Spending For Long-Term Services And Supports (Ltss), 2012, Carol O'Shaughnessy

National Health Policy Forum

Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2012, spending for these services was $219.9 billion (9.3 percent of all U.S. personal health care spending), almost two-thirds of which was paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.

Strengthening The Science Of Public Health Delivery: Complexities In Implementation, Inference & Translation, Glen P. Mays

Health Management and Policy Presentations

Delivery systems for public health programs and policies are diffuse and heterogeneous across the U.S., reflecting wide variation in the capacity to implement population-level health improvement strategies. This lecture examines strategies for evaluating the causes and consequences of variation in public health delivery across the U.S., with a focus on identifying pathways for improving the health and economic effects of policy and practice.

Telehealth: Into The Mainstream?, Lisa Sprague

National Health Policy Forum

Teleheath, and its subset telemedicine, extend across a range of technologies allowing patients to seek diagnosis, treatment, and other services from clinicians by electronic means. Telephone, videoconferencing, iPads, and apps are all employed. In its most established form, hospitals and medical centers use telehealth to reach patients in underserved rural areas. Proponents of telehealth suggest it can relieve medical workforce shortages; save patients time, money, and travel; reduce unnecessary hospital visits; improve the management of chronic conditions; and improve continuing medical education. But telehealth also faces ongoing challenges. States require physicians to be licensed in each state where they treat …

Understanding Racial Hiv/Sti Disparities In Black And White Men Who Have Sex With Men: A Multilevel Approach, Patrick S. Sullivan, John Peterson, Eli S. Rosenberg, Colleen F. Kelley, Hannah Cooper, Adam Vaughan, Laura F. Salazar, Paula M. Frew, Gina Wingood, Ralph Diclemente, Carlos Del Rio, Mark Mulligan, Travis H. Sanchez

Environmental & Global Health Faculty Research

Background The reasons for black/white disparities in HIV epidemics among men who have sex with men have puzzled researchers for decades. Understanding reasons for these disparities requires looking beyond individual-level behavioral risk to a more comprehensive framework. Methods and Findings

Exploring The Association Between Long-Term Hpsa Designation And County Population-To-Physician Ratio, Christopher Duffrin, Natalie A. Jackson

Frontiers in Public Health Services and Systems Research

Federal, state, local and public health officials utilize Health Professional Shortage Area (HPSA) designations to manage health and physician workforce development in underserved regions. HPSA designation length by county was examined to determine if there is significant association with population-to-primary care physician ratio since the inception of HPSA designations in 1978. Counties were grouped in 5 categories based on consecutive designation length and analyzed with demographic variables. This report examines the relationship of long-term HPSA status and changes in primary care physician workforce.

The Effects Of The State Of Tennessee Immunization Policy Change Of 2011 - 2012 On Vaccination Uptake In East Tennessee, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds allocated from the American Recovery and Reinvestment Act required action by states to ensure appropriate use of remaining funds. In Tennessee, the response was a …

Diffusion Theory And Knowledge Dissemination, Utilization And Integration, Lawrence W. Green, Judith M. Ottoson, César García, Robert A. Hiatt, Maria L. Roditis

Frontiers in Public Health Services and Systems Research

Part of the Community Health and Preventive Medicine Commons, Health and Medical Administration Commons, Health Policy Commons, Health Services Administration Commons, Health Services Research Commons, and the Public Health Education and Promotion Commons

Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners …

Public Health Services Most Commonly Provided By Local Health Departments In The United States, Gulzar H. Shah, Huabin Luo, Sergey Sotnikov

Frontiers in Public Health Services and Systems Research

The primary purpose of this research is to identify the most commonly performed public health services by local health departments (LHDs) and highlight variation by LHD characteristics. Data were drawn from the 2008 and 2010 National Profile of LHDs, conducted by the National Association of County and City Health Officials (NACCHO). The descriptive analysis aims to further the essential dialogue triggered by a recent Institute of Medicine (IOM) report about the standard minimum set of services that all LHDs should provide. This study identified a set of 22 activities performed by LHDs that are common in jurisdictions of all sizes. …

Community Health Assessment By Local Health Departments: Future Questions, Kay Lovelace

Frontiers in Public Health Services and Systems Research

This "Letter to the Editor" is a response to the article "Community Health Assessment by Local Health Departments: Presence of Epidemiologist, Governance, and Federal and State Funds are Critical" published in volume 2, issue 6 of this journal. It considers how LHDs develop CHAs in complex jurisdictions, the roles of other professionals in the development of CHAs, and the conduct, quality, and use of CHAs.