Health Services Research Commons^™

Health Workforce Needs: Projections Complicated By Practice And Technology Changes, Rob Cunningham

National Health Policy Forum

As population growth and the aging of the overall population increase demand for health care, policymakers and analysts posit whether sufficient health care providers will be able to meet that demand. Some argue there are too few providers already; others say our current supply-demand problems lie with efficiency. But suppose both are correct? Perhaps the real challenge is to understand how physician practices are changing in response to market forces such as payment changes, provider distributions, and technology innovations. This issue brief reviews what is known about evolving practice organizations, professional mixes, information technology support, and the implications of these …

Preliminary Findings From An Interventional Study Using Network Analysis To Support Management In Local Health Departments In Florida, Chin S. Park, Hado Byon, Jonathan W. Keeling, Leslie M. Beitsch, Jacqueline A. Merrill

Frontiers in Public Health Services and Systems Research

Management is the core service that integrates and coordinates essential public health services. Managers of local health departments (LHDs) are experts in practice but may not have expertise in organizational management. We conducted an evidence-based training intervention in 10 LHDs in Florida to support managers’ decision-making on organizational integration and coordination. We deployed a standard survey to collect organizational network measurements pre and post intervention. We presented results as evidence-based performance feedback and interviewed managers to document how they used the results in the context of each organization. Post intervention we found unexpected, significantly higher network centralization in daily work. …

Characteristics Of A Local Health Department Associated With The Use Of The Health Equity Index, Moira A. Lawson, Sharon Mierzwa, Michael Knapp

Frontiers in Public Health Services and Systems Research

Local health departments are tasked with understanding and addressing health inequities in the populations they serve. To meaningfully address health inequities, local health departments have identified the need for credible local data to better understand the relationship between community conditions and health outcomes. Yet, when given access to these data, we observe a very large variation in the level of interest between local health departments.

In this study, we offered Connecticut’s Local health departments access to the Health Equity Index, a web based tool that provides data on health outcomes and community conditions at the state, municipal or neighborhood levels. …

Evaluating Use Of Custom Survey Reports By Local Health Departments, Nadya M. Belenky, Christine A. Bevc, Elizabeth Mahanna, Carol Gunther-Mohr, Mary V. Davis

Frontiers in Public Health Services and Systems Research

This report demonstrates how providing survey feedback, like comparative reports, to survey respondents can result in improvement activities. For each of the past three years (2010-2013), the North Carolina Institute for Public Health (NCIPH) has invited local health departments (LHDs) from 40 states to participate in a preparedness capacities survey. In addition, NCIPH fielded a six-question evaluation survey to a subset of LHDs (n=70) to determine how LHDs use these reports. LHDs that reported using their custom reports compared their preparedness capacities to other LHDs, conducted strategic planning (e.g., benchmarking, setting preparedness goals), planned staff trainings, and disseminated the report …

Assessing A Quality Improvement Project In A Georgia County Health Department, Dayna S. Alexander, William C. Livingood, Nandi A. Marshall, Angela Peden, Russ Toal, Gulzar H. Shah, Alesha Wright, Purity Cummings, Ketty Gonzalez, Lynn Woodhouse

Frontiers in Public Health Services and Systems Research

The study and evaluation of quality improvement among Georgia’s public health systems continues to be a major priority for the Georgia Public Health Practice Based Research Network (GAPH-PBRN). This article focuses on the application and evaluation of a Quality Improvement project in a Georgia County Health Department. The QI team sought to reduce the waiting time in the teen clinic; thereby, increasing the Quality Improvement culture one project at a time in this Health Department. The project revealed that Quality Improvement is a continuous process that requires change and adaptation by employees. This initial Quality Improvement project was the first …

The Relationship Between Quality Improvement And Health Information Technology Use In Local Health Departments, Kendra Johnson, Kim K. Nguyen, Shimin Zheng, Robin P. Pendley

Frontiers in Public Health Services and Systems Research

This research examined if there is a relationship between engagement in quality improvement (QI) and health information technology (HIT) for local health departments (LHDs) controlling for workforce, finance, population, and governance structure. This was a cross-sectional study that analyzed data obtained from the Core questions and Module 1 in the NACCHO 2010 Profile of LHDs. Descriptive statistics, bivariate analyses, and logistic regression analyses were conducted. Findings suggest that LHD engagement in QI has a relationship with utilization of HIT including electronic health records, practice management systems, and electronic syndromic surveillance systems. This study provides baseline information about the HIT use …

Commentary: The Road To Quality In Public Health, A Long But Important Journey, F. Douglas Scutchfield, Glen Mays, Marylou Wallace

Frontiers in Public Health Services and Systems Research

Quality improvement (QI) in public health departments is a focus in this sixth issue of Frontiers. Data is important to the development of quality improvement efforts. As we see growth of and meaningful use of electronic health records, the health department is in a position to take the lead as a data hub and to use this information wisely to both improve their QI efforts and link that QI to outcomes.

The Commission On Long-Term Care: Background Behind The Mission, Carol O'Shaughnessy

National Health Policy Forum

The American Taxpayer Relief Act of 2012 (ATRA, P.L. 112-240) created a Commission on Long-Term Care charged with developing a plan for financing of long-term services and supports (LTSS) and issuing a report in September 2013. Significant research and advocacy have been devoted to LTSS financing issues and perceived inadequacies of the delivery system over the past several decades, but the most recent comprehensive review of financing options was in 1990 by the Pepper Commission. This publication presents brief background behind the mission of the Commission, including a time line of selected federal and national activities on LTSS financing and …

The Pertinence Of Maternal Education On Child Immunization In Rural Uttarakhand: More Than Just Increased Rates, Sarah Banerji

Independent Study Project (ISP) Collection

Child immunization rates in India continue to remain low, despite the 1985 implementation of a Universal Immunization Program that provides free basic immunizations to all children. There are numerous logistical factors that contribute to the low rates of immunization, but rates are made further worse by a lack of parental awareness and education about immunization, especially in village communities. This study examines the maternal understanding of immunization in rural Uttarakhand, both in villages in which an NGO has been working to improve maternal immunization education and in villages with no NGO involvement. It finds a positive correlation between increased immunization …

The Perception Of Maternal Anemia And The Effect Of Nutritional Education: A Qualitative Analysis Among Village Mothers In Rural Kumaon, Uk, Kelsey Bash

Independent Study Project (ISP) Collection

Malnutrition is often associated with starving children in developing countries. However, while calorie and protein deficiencies—macronutrient deficiencies—are a cause for concern, micronutrient deficiencies can be equally detrimental and are even more pervasive. The most prevalent micronutrient deficiency is anemia, and the story of anemia in India is particularly grim. India has the largest number of anemic people in the world and severe anemia is the cause of death for an average of 22,000 Indians each year (The Micronutrient Initiative 2006). Anemia rates are exacerbated for women and even more so for pregnant women. According to the most recent National Family …

La Situación De Las Cataratas En La Ciudad De Buenos Aires: Un Estudio De Caso En El Hospital Ramos Mejía / The Situation Of Cataracts In The City Of Buenos Aires: A Case Study In Ramos Mejía Hospital, Katie Elizabeth Kessler

Independent Study Project (ISP) Collection

Background: When a person has cataracts his or her lens becomes clouded by proteins, causing diminished vision. Though cataracts cause poor vision or in more serious cases blindness, what is special about cataracts is that they are treatable. Surgery replaces the clouded lens with a new artificial lens called an intraocular lens. In Argentina in 2006 only 10% of cataract surgeries were realized in the public sector, and the Ministry of Health of the Nation decided to develop a program called Program Eye Health and the Prevention of Blindness to fight these and other inequities in the realm of visual …

Weza Motrin Pichikeche Meu: El Entendimiento Cultural De La Obesidad Infantil En El Pueblo Mapuche, Katherine Shaffer

Independent Study Project (ISP) Collection

Research Question: How do the Mapuche people interpret childhood obesity, and how do they use this interpretation to treat and prevent this disease?

Objective: To describe the Mapuche concept of childhood obesity used by families and community leaders in Makewe, Chile, and how this concept is used to treat and prevent this disease.

Background: Childhood obesity is a growing problem throughout much of the world, including Chile, with grave effects on physical and mental health. There are a plethora of causes of this disease, from individuals with an imbalance in calorie expenditure, to national and international policies in economy and …

Suicide And Suicide Attempts In Kentucky, 2001‐2012, Joshua W. Lambert, Svetla Slavova

Kentucky Injury Prevention and Research Center Special Report

The data sources, methods, and definitions used in this report are based on the State Injury Indicators report: Instructions for Preparing 2011 Data, Atlanta, Georgia, March 2013, a publication of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

La Feminización De La Especialidad De Pediatría En La Ciudad De Buenos Aires, Argentina / The Feminization Of The Specialty Of Pediatrics In The City Of Buenos Aires, Argentina, Jessica Wilder

Independent Study Project (ISP) Collection

Background: In the context of feminization of pediatrics that is occurring rapidly worldwide, this investigation seeks to determine the underlying causes of the phenomenon in Argentina. It focuses on the field of pediatrics because pediatrics is one of the most feminized medical specialties. Through this narrowed focus, the investigation intends to suggest causes for the feminization occurring in all of medicine. It studies the pediatricians of the Autonomous City of Buenos Aires in order to illuminate the social, logistical, and personal motivations that attracted them to pediatrics. It is very important to discover these motivations and causes because they reflect …

Bibliographic Review Of Research Publications On Access To And Use Of Medicines In Low-Income And Middle-Income Countries In The Eastern Mediterranean Region: Identifying The Research Gaps., Arash Rashidian, Nader Jahanmehr, Samer Jabbour, Shehla Zaidi, Fatemeh Soleymani, Maryam Bigdeli

Community Health Sciences

BJECTIVES:

We assessed the situation of academic publications on access to and use of medicines (ATM) in low-income and middle-income countries (LMICs) of the Eastern Mediterranean Region (EMR). We aimed to inform priority setting for research on ATM in the region.

DESIGN:

Bibliographic review of published studies.

SETTING:

LMICs in EMR.

INCLUSION CRITERIA:

Publications on ATM issues originating from or focusing on EMR LMICs covering the period 2000-2011. Publications involving multinational studies were included if at least one eligible country had been included in the study.

INFORMATION SOURCES AND DATA EXTRACTION:

We conducted comprehensive searches of the PubMed, Social Science …

Los Colores De La Edad, Kerry Johnson

Independent Study Project (ISP) Collection

La vejez ecuatoriana está a punto de convertirse en la población más importante del país en las siguientes décadas. El estado está elaborando planes para establecer la infraestructura de apoyo que necesitará la población de ancianos que está creciendo, pero es importante que entendamos cómo ayudarlos de la manera más adecuada. La tradición del cuidado en la casa de los hijos está cambiando, pero no es necesariamente un retraso si es que en otro lugar encuentran la compañía, el amor y las amistades que necesitan. Dentro de un asilo de ancianos es posible crear estas características si uno recrea en …

Los Determinantes De La Diferencia En La Tasa De Fecundidad Adolescente Entre Comunidades Pobres Y Ricas En Buenos Aires, Emily Turner

Independent Study Project (ISP) Collection

The city of Buenos Aires has some of the lowest rates of teenage fertility in Argentina (Gogna, Binstock, Fernández, Ibarlucía, & Zamberlin, 2008). However, this aggregated number obscures the huge variance within the city. In the most current available data (2010/2012) from the government of the city of Buenos Aires (GCBA) broken down by comunas (areas) highest fertility rate for 15-19 year olds was 81.6 births (per 1000) versus the lowest fertility rate which was only 6.2 (D. d. e. d. GCBA). This discrepancy is huge and reflects the incredible economic disparity in Buenos Aires. The comunas with the three …

La Opinión Pública Sobre El Aborto En Chile: Conceptos Públicos De Moralidad Y De Derechos De Las Mujeres En Relación Con Aborto, Sarah Smith

Independent Study Project (ISP) Collection

Background: Abortion legislation in Chile is among the most restrictive in the world, with abortion being illegal without exception. However, while abortion remains completely illegal in Chile, there are an estimated 125,000-175,000 clandestine abortions being carried out each year. Illegal abortions account for about 30% of maternal deaths in Chile. It is important to understand public opinions on abortion in order to understand this discrepancy between legislation and reality.

Research Objectives:What is the public opinion of Chileans on the legal and moral status of abortion in Chile? Do Chileans relate the topic of abortion to the theme of women’s …

Opinions Of Individuals In The Greater Durban Area Concerning Government Healthcare, Alexander Braun

Independent Study Project (ISP) Collection

One important determinant of health in South Africa is how government entities, from the local level to the national level, use their health budgets. A complex system of organizations involving many government employees at the various levels are involved in the process of turning a budget allocation of Rand into healthcare services and goods that make their way to the South African people. What do individuals in the greater Durban area think about that process as it exists currently, and what do they think of the services that are eventually delivered to them? This is an important question, especially in …

A Comparison Of Malnutrition Causes And Treatments: A Case Of Mwanamugimu Nutrition Unit, Mulago National Referral Hospital, Kampala District And Nakifuma Government Health Unit, Mukono District, Berkley Singer

Independent Study Project (ISP) Collection

In beginning of the investigation process, the researcher set out to study malnutrition in Uganda. She wanted to study an urban region in comparison to a rural region and so based her research out of both Kampala and the Mukono region. The researcher set out to learn more about the causes of the condition and why children become malnourished. She also was interested in the differences that exist between the two different locations and why they exist. Finally, the researcher was eager to learn what malnutrition meant to each community and how health care professionals go about treating the condition …