Health Services Research Commons^™

A Gathering Place For Patient Experience Research: The Power Of Community, Jason A. Wolf Phd

Patient Experience Journal

In introducing Issue 2, we explore the power of community and its implications in shaping not only the purpose and intent of Patient Experience Journal, but of the patient experience movement itself. Community defined in this moment is simple, yet significant, the key being unity around common interest and its focus on ownership and participation. The idea of community bears great weight and has provided strong guidance and purpose for the work of experience excellence. It supports the goal of elevating the conversation, helps align the voices engaged and provides the space for listening, learning and impact.

Experience Framework …

The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays

Health Management and Policy Presentations

We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Wordless Intervention For Epilepsy In Learning Disabilities (Wield): Study Protocol For A Randomized Controlled Feasibility Trial, Marie-Anne Durand, Bob Gates, Georgina Parkes, Asif Zia

Dartmouth Scholarship

Epilepsy is the most common neurological problem that affects people with learning disabilities. The high seizure frequency, resistance to treatments, associated skills deficit and co-morbidities make the management of epilepsy particularly challenging for people with learning disabilities. The Books Beyond Words booklet for epilepsy uses images to help people with learning disabilities manage their condition and improve quality of life. Our aim is to conduct a randomized controlled feasibility trial exploring key methodological, design and acceptability issues, in order to subsequently undertake a large-scale randomized controlled trial of the Books Beyond Words booklet for epilepsy.

Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …

Cost Estimates Of Foundational Public Health Services: Results From Piloting An Expert Consensus Methodology, C. B. Mamaril, Glen P. Mays

Health Management and Policy Presentations

We review preliminary estimates from pilot testing a cost estimation methodology developed to identify the resources required to implement a set of Foundational Public Health Services as recommended by the Institute of Medicine and defined by the Public Health Leadership Forum.

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays

Health Management and Policy Presentations

Kentucky's implementation of the Affordable Care Act has included early successes with insurance coverage expansion through Medicaid and a state-operated health insurance exchange. Signals of improvements in health care accessibility and delivery of preventive services are evident in the first year after coverage expansions. Challenges associated with political opposition, delivery system transformation, and public health financing remain on the state's policy agenda.

Cost Estimates Of Foundational Public Health Services: Results From Piloting The Expert Consensus Methodology In Kentucky, C. B. Mamaril, Glen P. Mays

Health Management and Policy Presentations

We developed a methodology for estimating the resources required to deliver a set of foundational public health capabilities as recommended in the 2012 Institute of Medicine report on public health financing. The capabilities are based on IOM recommendations and defined by a national expert panel convened as part of the Public Health Leadership Forum. This paper presents preliminary estimates from a pilot test of the cost estimation methodology in Kentucky, and outlines plans for the national estimation strategy.

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Health Management and Policy Presentations

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .

The Future Of Population-Based Reimbursement, David Chin, Md, Mba

College of Population Health Forum

David C. Chin, MD, MBA is a Distinguished Scholar at the Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Medicine, where he focuses on novel industry/academic research partnerships and preparing health systems and academic medical centers for success under accountable care.

Dr. Chin will describe the Maryland-All payer system as a model of innovative population-based reimbursement. He will discuss early adaptive strategies, including ways in which health care systems will need to change. Dr. Chin will also provide a comparison of the new incentives in the model vs. fee-for-service.

Prior to joining Hopkins Dr. Chin has …

Frontiers In Phssr Is On The Move, F. Douglas Scutchfield

Frontiers in Public Health Services and Systems Research

Recently, Dr. Jenine Harris and her colleagues examined the use of journals by state chronic disease prevention staff to stay up-to-date on public health evidence. We, at Frontiers in PHSSR, are pleased to be included among the journals listed in the survey. Online open-access journals are shifting the paradigm of scientific publication, allowing free and rapid exchange of information. Another illustration of Frontier’s increasing utility is a forthcoming issue of the American Journal of Public Health (AJPH). We are pleased that AJPH has agreed to publish selected abstracts from Frontiers in PHSSR in their regular issue with links to …

Policymakers Identify Priorities For Phssr, Katherine Froeb Papa

Frontiers in Public Health Services and Systems Research

A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund.

In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes the evidence gaps identified, and provides strategies for communicating with decision makers.

Editorial Comment: Understanding Cost Variation In Std Service Delivery As State And Federal Agencies Reduce Funding, Michael A. Preston, William W. Greenfield, Sharla A. Smith

Frontiers in Public Health Services and Systems Research

As health reform gains momentum, many changes have been seen in the way health services are delivered and financed. In an attempt to address the uncertainties and understand the costs of delivering STD prevention services, the authors examined the cost of STDs in a highly centralized public health agency system (PHAS). This commentary covers several implications that arise from this study.

Understanding Cost Variations In Std Service Delivery As State And Federal Agencies Reduce Funding, William C. Livingood, Lori Bilello, Bonita Sorensen

Frontiers in Public Health Services and Systems Research

Sexually transmitted diseases (STD) continue to be a major health problem in the U.S. Despite the persistence of STDs and the critical role of the public health sector in controlling these diseases, STD services continue to be reduced. A linear regression was performed using county demographic and cost variables. Many of these variables in county public health agencies and the populations they serve were not significantly correlated with cost of service. However, the availability of local tax funding for county health departments (CHDs), which varies extensively across counties within the state, is statistically linked to higher STD expenditure per case. …

Chhs November 2014 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Improving Community Health Through Hospital-Public Health Collaboration: Insights And Lessons Learned From Successful Partnerships, Lawrence Prybil, F. Douglas Scutchfield, Rex Killian, Ann Kelly, Glen P. Mays, Angela Carman, Samuel Levey, Anne Mcgeorge, David W. Fardo

Health Management and Policy Faculty Book Gallery

From the introduction:

Health care expenditures in the United States currently consume over 17 percent of the nation’s gross domestic product, a much larger share than other developed nations. Yet, despite this large investment, studies by Commonwealth Fund, the Institute of Medicine, and other organizations show the USA lags behind other developed nations on multiple metrics of population health such as infant mortality and life expectancy. Moreover, there is extensive evidence of disparities in access, cost, and quality of health care services.

Thus, we are confronted by a striking paradox: the USA spends a large and growing proportion of our …

Quality Of Cancer Registry Data, Alicia Noel Richardson

Applied Research Projects

Cancer registry is a growing field and with data being collected year round the data needs to be of good quality standing. Quality of cancer care is measurable per standards when met within the time frame allotted per care regimen. Cancer programs are evaluating and implementing new process to make their data valid and complete through information technology and connection among hospital-based and community-based practices. The aim of this study is to review the available validity, barriers and utilization related to quality of cancer care data. The studies were consistent among each other in that a concurrent review of data, …

Provider Cost Analysis Supports Results-Based Contracting Out Of Maternal And Newborn Health Services: An Evidence-Based Policy Perspective, Peter Hatcher, Shiraz Shaikh, Hassan Fazli, Shehla Zaidi, Atif Riaz

Community Health Sciences

Background

There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services.

Methods

This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical …

Integration Of Non-Communicable Diseases Into Primary Health Care: A Snapshot From Eastern Mediterranean Region, Shehla Zaidi, Abdul Latif Khan, Aftab Ali Mukhi, Yousuf Memon, Slim Slama, Samer Jabbour

Community Health Sciences

No abstract provided.

The Role Of Leadership In Creating A Strategic Climate For Evidence-Based Practice Implementation And Sustainment In Systems And Organizations, Gregory A. Aarons, Mark G. Ehrhart, Lauren R. Farahnak, Marisa Sklar

Frontiers in Public Health Services and Systems Research

There is a growing impetus to effectively implement evidence-based practices (EBPs) in health and allied health settings in order to improve the public health impact of such practices. To support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups (3). This article identifies two relevant types of leadership for implementation and recommends steps that leaders can take in developing a strategic climate for EBP implementation and sustainment within the outer and inner contexts of health …