How Could Repealing Key Provisions Of The Affordable Care Act Affect Community Health Centers And Their Patients?, Sara J. Rosenbaum, Jessica Sharac, Thao-Chi Tran, Anne Rossier Markus, David Reynolds, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Analyses of repeal of the Affordable Care Act (ACA) have tended to focus on coverage. This study, which gauges the potential effects of repealing certain ACA provisions, looks at the question of primary health care access itself, with a focus on medically underserved communities. A survey developed and fielded in early 2017 asked community health centers to estimate the impact of ending the Health Centers Fund established under the ACA as well as ending expanded Medicaid coverage and subsidies designed to make private insurance affordable for lower income patients. Forty-one percent of health centers responded; 69 percent were located in …

Cues To Cervical Cancer Screening Among U.S.-Hispanic Women, Arelis Moore De Peralta, Bonnie Holaday, Ida Mikisa Hadoto

Publications

Introduction: Hispanic women’s cervical cancer rates are disproportionately high. Cues to cervical cancer screening (Cues to Action) are strategies to activate the decision-making process to get screened for cervical cancer. This study used the health belief model to examine which cues prompt Hispanic women to undergo cervical cancer screening and how perceptions could be potentiated by cues to cervical cancer screening.

Method: A cross-sectional survey was conducted among Hispanic women 18 to 65 years old (n = 220). Generalized linear modeling was used.

Results: Spanish media and reminders by mother and doctors were relevant cues. Generalized linear modeling showed …

Health Workforce Research Centers (Hwrcs) Key Findings, 2013-2016, Clese Erikson

Health Workforce Research Center Publications

No abstract provided.

The Cost Of Cost-Sharing: The Impact Of Medicaid Benefit Design On Influenza Vaccination Uptake, Charles Stoecker, Alexandra M Stewart, Megan Lindley

Health Policy and Management Faculty Publications

ncome persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting cost-sharing, and copayment amounts) on vaccine uptake in the fee-for-service Medicaid population 19–64 years old. We combined previously published reports to obtain state Medicaid policy information from 2003 and 2012. Data on influenza vaccination uptake were taken from the Behavioral Risk Factor Surveillance System. We used a differences-in-differences framework, controlling for national trends and state differences, to estimate the effect of each benefit design factor on vaccination uptake in different Medicaid-eligible populations. …

Public Company Health Insurers And Medical Loss Ratios: An Event Study Of Dates Associated With The Affordable Care Act, Rachelle Quinn

Doctor of Business Administration (DBA)

The Affordable Care Act (ACA) has proved to be a contentious regulatory and political topic. Although key features were established within the law the complexity of the new provisions and political opposition resulted in a series of federal and state governmental process changes, rule clarifications, and legal challenges. One component of the ACA is the introduction of a federal Medical Loss Ratio (MLR), which requires insurers to spend specified percentages of their premium revenue dollars on medical services and quality improvement actions. If thresholds are not met, insurers must refund premiums to their members, potentially removing millions of dollars from …

Oregon's Medicaid Reform And Transition To Global Budgets Were Associated With Reductions In Expenditures, K. John Mcconnell, Stephanie Renfro, Neal T. Wallace, Deborah J. Cohen, Richard C. Lindrooth, Michael E. Chernew

OHSU-PSU School of Public Health Faculty Publications and Presentations

In 2012 Oregon initiated an ambitious delivery system reform, moving the majority of its Medicaid enrollees into sixteen coordinated care organizations, a type of Medicaid accountable care organization. Using claims data, we assessed measures of access, appropriateness of care, utilization, and expenditures for five service areas (evaluation and management, imaging, procedures, tests, and inpatient facility care), comparing Oregon to the neighboring state of Washington. Overall, the transformation into coordinated care organizations was associated with a 7 percent relative reduction in expenditures across the sum of these services, attributable primarily to reductions in inpatient utilization. The change to coordinated care organizations …

The Impact Of National Health Insurance Policy To The Implementation Of Health Promotion Program On Public Health Center In Indonesia, Mochamad Iqbal Nurmansyah, Bulent Kilic

Kesmas

Jaminan Kesehatan Nasional (JKN) telah diimplementasikan di Indonesia pada 1 Januari 2014. Hal tersebut membawa beberapa perubahan pada aspek manajerial pada pusat kesehatan masyarakat (puskesmas). Penelitian ini bertujuan untuk mengidentifikasi dampak dari kebijakan JKN terhadap implementasi program promosi kesehatan di puskesmas di Kota Tangerang Selatan, Indonesia. Penelitian menggunakan metode kualitatif. Data dikumpulkan pada Februari – Maret 2016. Dampak program dilihat dalam hal kebijakan, pendanaan, fasilitas, sumber daya manusia dan pelaksanaan program promosi kesehatan. Dengan menggunakan metode purposive sampling, enam pengambil kebijakan, delapan pemberi layanan dan delapan penerima layanan diambil sebagai informan dalam penelitian ini. Pada analisis dokumen, 17 dokumen telah …

Effect Of School Community Empowerment Model Towards Handwashing Implementation Among Elementary School Students In Dayeuhkolot Subdistrict, Tetti Solehati, Cecep Eli Kosasih, Sri Susilawati, Mamat Lukman, Sayu Putu Yuni Paryati

Kesmas

Perilaku mencuci tangan dengan sabun di Indonesia masih menjadi masalah. Penyebabnya dikaitkan dengan kurangnya kesadaran dalam mencuci tangan pakai sabun. Penelitian ini bertujuan untuk mengetahui pengaruh pemberdayaan komunitas sekolah terhadap penerapan mencuci tangan di kalangan siswa sekolah dasar di Kecamatan Dayeuhkolot, Kabupaten Bandung. Penelitian ini menggunakan desain quasi eksperimental dengan pretest dan posttest serta melakukan analisis deskriptif dan inferensial. Sampel terdiri dari 24 guru, 377 siswa di kelas 4-6, dan 24 dokter kecil. Metode pendekatan dalam penelitian ini menggunakan usaha kesehatan sekolah terpadu (gabungan model fit for school dan UKS terpilih), yang terdiri dari enam tahap. Instrumen terdiri dari kuesioner …

Acceptance Of Medical Resume Completion At Dr. Radjiman Wediodiningrat Lawang Psychiatric Hospital, Silvia Shinta Devi, Aryo Dewanto, Lukman Hakim

Kesmas

Sistem kesehatan di Indonesia mengalami perubahan besar dengan diberlakukannya program Asuransi Kesehatan Nasional. Resume medis memiliki peran penting dalam klaim asuransi kesehatan, sehingga resume medis yang terlambat dan tidak lengkap akan mengganggu proses klaim asuransi. Penelitian ini bertujuan untuk mengetahui pengaruh persepsi kemudahan penggunaan, persepsi manfaat, dan sikap pada penerimaan dokter dalam menyelesaikan resume medis. di Dr Radjiman Wedyodiningrat Psychiatric Hospital Lawang berdasarkan Technology Acceptance Model. Technology Acceptance Model digunakan sebagai model dalam penelitian ini karena resume medis merupakan salah satu bentuk teknologi informasi yang masih dilakukan secara manual. Pengumpulan data untuk penelitian ini dilakukan pada bulan Maret 2016 dengan …

Risk Factors Of Carpal Tunnel Syndrome In Food-Packing Workers Karanganyar, Haris Setyawan

Kesmas

Carpal tunnel syndrome (CTS) terjadi ketika saraf median, yang membentang dari lengan bawah ke tangan, mengalami tekanan atau terpuntir di pergelangan tangan. Hasilnya mungkin sakit, kelemahan atau mati rasa di tangan dan pergelangan tangan, yang memancar ke lengan tangan. Penelitian ini bertujuan untuk mengkaji faktor risiko usia, jenis kelamin, masa kerja dan gerakan repetitif terhadap keluhan CTS pada pekerja pengepakan makanan di Karanganyar. Penelitian ini dilaksanakan pada bulan Oktober – Desember 2014 menggunakan desain observational analitik dengan penelitian potong lintang. Sampel terdiri dari 50 orang dari total 67 pekerja pengepak makanan di kawasan industri Jaten Karanganyar yang diambil dengan menggunakan …

Psychosocial Determinants Of Risky Sexual Behavior Among Senior High School Students In Merauke District, Fenny Etrawati, Evi Martha, Rita Damayanti

Kesmas

Remaja usia 10-24 tahun merupakan kelompok yang rentan terhadap perilaku seksual pranikah, penyalahgunaan narkoba dan infeksi HIV/AIDS. Papua merupakan penyumbang angka HIV/AIDS terbesar di Indonesia. Untuk menanggulangi permasalahan tersebut Rutgers WPF membentuk suatu program intervensi kesehatan reproduksi remaja di tingkat sekolah menengah atas (SMA) yakni program Dunia Remajaku Seru! (DAKU!). Penelitian ini bertujuan untuk mengetahui determinan psikososial perilaku seksual berisiko pada siswa SMA di Kabupaten Merauke dengan menggunakan pendekatan potong lintang. Sampel berjumlah 1.364 siswa SMA kelas dua yang mendapatkan program DAKU!dan dilakukan proses pencocokan pada sekolah yang tidak mendapat program DAKU!. Analisis data meliputi analisis univariat, bivariat (uji kai …

Risk Factors Of Premature Rupture Of Membrane, Maryuni Maryuni, Dedeh Kurniasih

Kesmas

Angka kematian ibu di Indonesia berdasarkan Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012 sebanyak 359 per 100.000 kelahiran hidup. Penyebab kematian ibu tersebut masih didominasi oleh pendarahan, pre-eklampsia/eklampsia, dan infeksi. Salah satu penyebab infeksi adalah ketuban pecah dini (KPD). KPD dapat meningkatkan morbiditas dan mortalitas pada ibu dan anak. Insiden kejadian KPD sekitar 10,7% dari seluruh persalinan. Penelitian ini bertujuan untuk mengetahui faktor risiko kejadian KPD di Rumah Sakit Ibu dan Anak (RSIA) ANNISA Citeureup, Kabupaten Bogor tahun 2014. Penelitian ini merupakan penelitian analitik dengan rancangan penelitian kasus kontrol. Sampel terdiri dari 114 orang kasus ibu yang mengalami KPD …

Nurses’ Intention And Behavior In Reporting Adverse Event: Application Of Theory Of Planned Behavior, Ni Putu Ekayani, Viera Wardhani, Asih Tri Rachmi

Kesmas

Data menunjukkan bahwa secara global jumlah pelaporan insiden keselamatan pasien masih rendah, begitu juga di Rumah Sakit Baptis Batu, Jawa Timur. Penelitian ini bertujuan untuk mengetahui pengaruh antara sikap, norma subjektif, dan perceived behavioral control (PBC) terhadap niat dan untuk menentukan hubungan antara PBC dan niat terhadap perilaku perawat dalam melaporkan kejadian tidak diharapkan (KTD). Penelitian ini menggunakan pendekatan potong lintang dan dilakukan di Rumah Sakit Baptis Batu pada tanggal 16-31 Maret 2016. Pengambilan data dilakukan dengan menggunakan kuesioner yang dibagikan kepada 82 (dari 85) perawat yang bekerja di Rumah Sakit Baptis Batu. Data dianalisis menggunakan regresi linier berganda dan …

Evaluation Of Momentum Male Sterilization Service Effectiveness As An Attempt To Reach Muri Record, Endah Winarni, Muhammad Dawam

Kesmas

Pencapaian Program KB di Sumatera Utara kurang menggembirakan. Total Fertility Rate Sumatera Utara (3,0) lebih tinggi dibandingkan nasional (2,6); dan prevalensi kontrasepsi (55,9 %) lebih rendah dibandingkan nasional (61,9%). Sebagai salah satu strategi peningkatan kesertaan KB, pelayanan momentum sterilisasi pria dikhawatirkan tidak memenuhi standar pelayanan karena dikaitkan dengan rekor MURI. Evaluasi ini bertujuan untuk menjelaskan kualitas pelaksanaan pelayanan dan kepuasan akseptor sterilisasi pria. Evaluasi bersifat kualitatif dan kuantitatif dilakukan secara potong lintang terhadap petugas KB, calon akseptor dan akseptor yang mendapat tindakan sterilisasi pada pelayanan momentum di 13 fasilitas kesehatan di Kota Medan, Sumatera Utara pada 23-24 Oktober 2012. Data …

The Impact Of Parents Having Health Insurance On Their Children’S Health Care, Andrea Bennett

Graduate Theses, Dissertations, and Capstones

Abstract of the Dissertation

This study examines the impact of parents having health insurance on their children’s health care in Kentucky. Child health insurance status and child a usual source of medical care are the two health care measures analyzed. The author builds on prior research that indicated more children would become insured if parents had access to affordable health insurance options. Through the implementation of the ACA in 2014, Kentucky expanded Medicaid eligibility to low-income adults up to 138% of the federal poverty level (FPL) and offered discounts on private health insurance plans for families in certain income thresholds …

Veterans - Best Practices For Effective Transitions Into The Nursing Profession, Mary Jean Schumann, Gretchen Wiersma

Health Workforce Speaker Series

No abstract provided.

Bridging The Divide White Paper: Pregnant Women And Substance Use: Overview Of Research & Policy In The United States, Darla Bishop, Liz Borkowski, Megan Couillard, Amy Allina, Susanna Baruch, Susan Wood

Jacobs Institute of Women's Health

This paper examines the current literature and policy implications of substance use and substance use disorders among pregnant and parenting women. While this is not meant to serve as an exhaustive literature review on this topic, it seeks to describe: current research on health effects of substance use and substance use disorders on pregnant women1 and their children; policies and programs that help ensure that pregnant women who use substances have access to the highest quality healthcare, including prenatal care; the current barriers to accessing treatment for substance use disorders for pregnant women, including those who are incarcerated; and the …

Overpopulation And The Impact On The Environment, Doris Baus

Dissertations, Theses, and Capstone Projects

In this research paper, the main focus is on the issue of overpopulation and its impact on the environment. The growing size of the global population is not an issue that appeared within the past couple of decades, but its origins come from the prehistoric time and extend to the very present day. Throughout the history, acknowledged scientists introduced the concept of “overpopulation” and predicted the future consequences if the world follows the same behavioral pattern. According to predictions, scientists invented the birth control pill and set population control through eugenics. Despite that, population continued to increase and fight with …

The Economic And Employment Consequences Of Repealing Federal Health Reform: A 50 State Analysis, Leighton Ku, Erika Steinmetz, Erin Brantley, Brian K. Bruen

Health Policy and Management Issue Briefs

Donald Trump and Congressional leaders have stated their intent to repeal the Patient Protection and Affordable Care Act (ACA or Obamacare). This report examines the consequences of repealing two key elements: (1) federal premium tax credits that help low and middle income Americans afford insurance policies bought through the Health Insurance Marketplaces (exchanges) and (2) federal payments to states for expansions of Medicaid eligibility for low-income adults. Congress passed similar legislation (H.R. 3762) in late 2015, which President Obama vetoed.

This report analyzes how the repeal of these policies could affect state-level employment, economies and fiscal conditions. If tax credits …

Health Reform Repeal Could Cause 3 Million People To Lose Jobs And Trigger Broad Economic Disruption, Leighton Ku, Erika Steinmetz, Erin Brantley, Brian K. Bruen

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans.

Goal: To determine the state-by-state effect of repeal on employment and economic activity.

Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal …