Health Policy Commons^™

An Analysis Of The Usage Patterns Of Health Services Funded Through Capitation And Noncapitation In Government Owned Primary Healthcare Facilities In The District Of Pandeglang, Arovian Yuliardi, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

The National Health Insurance (JKN) is basically a form of managed care, a technique that integrates health costing and service quality through cost control and quality control. In that concept, the Puskesmas acts as the government’s primary healthcare facility, its vanguard. The aim of this research is to discover and analyze the healthcare usage patterns funded by capitation and non-capitation in government primary healthcare facilities (FKTP). This was an analytical study utilizing a cross-sectional design. 615 patients visiting the government’s FKTP were involved in this research. The results indicated that 47.3% of patients utilizing the government’s FKTP at Pandeglang district …

An Analysis Of The National Health Insurance Policy Implementation In 2014 (Presidential Regulation No. 12 And 111/2013 On Health Insurance) From The Regulator’S Position, Muhammad Arief Rosyid Hasan, Puput Oktamianti, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

JKN (National Health Insurance) is a government program that aims to provide health assurance for all Indonesian citizens for a healthy, productive, and prosperous life. In the two years after JKN was implemented, various problems occurred. This research used the qualitative approach with the Edward II implementation theory. Results of the research indicated that there were problems in communication, stemming from the lack of socialization and inharmonic regulations, there was also the problem of the lack of healthcare resources. From the disposition side, the policy makers often obstructs the implementation preparation, this is evident from the information on determining the …

The Relationship Between Personal Factors, Work Factors, Ptsd, And Suicide Ideation In Emergency Medical Service Providers, Faith Joy Boldt

Masters Theses & Specialist Projects

EMS providers work in a high-stress environment and are routinely exposed to critical incidents. Many providers are left to deal with the chronic stress on their own, either because of lack of effective employer-based programs or a culture that discourages its use. The extent to which these factors -- as well as personal characteristics such as resilience, PTG, and coping skills -- influence PTSD and suicide ideation among EMS providers has not been well studied among EMS providers. An online survey was administered to a convenience sample of EMS providers. Of the 2,683 respondents, more than one quarter (27.7%) met …

Issue 10: Global Care Chains: Addressing Unpaid Reproductive Labour In The Philippines, Harrison Ellis

International Migration Research Centre

This brief examines policy options to address the gender disparities of unpaid care work created by the global care chain. Examining the Philippine context, potential responses include equalizing maternity and paternity leave, expanding state childcare services, partnering with money transfer businesses (MTBs), and promoting the recruitment men for care positions. This issue has been recognized by the Sustainable Development Goals (SDGs). Target 5.4 of the SDGs calls for the recognition of the value of “unpaid care labour and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of responsibility within the household and …

The Carefirst Patient-Centered Medical Home Program: Cost And Utilization Effects In Its First Three Years, Alison Cuellar, Lorens A. Helmchen, Gilbert Gimm, Jay Want, Sriteja Burla, Bradley Kells, Iwona Kicinger, Len M. Nichols

Health Policy and Management Faculty Publications

Background

Enhanced primary care models have diffused slowly and shown uneven results. Because their structural features are costly and challenging for small practices to implement, they offer modest rewards for improved performance, and improvement takes time.

Objective

To test whether a patient-centered medical home (PCMH) model that significantly rewarded cost savings and accommodated small primary care practices was associated with lower spending, fewer hospital admissions, and fewer emergency room visits.

Design

We compared medical care expenditures and utilization among adults who participated in the PCMH program to adults who did not participate. We computed difference-in-difference estimates using two-part multivariate generalized …

Toward An International Constitution Of Patient Rights, Alison Poklaski

Indiana Journal of Global Legal Studies

In the past decade, medical tourism-the travel of patients across borders to receive medical treatment-has undergone unprecedented growth, fueled by the globalization of health care and related industries. While medical tourism can benefit patients through increased access to treatment and cost-savings, medical travel also raises concerns about ensuring quality of care and legal redress in medical malpractice. Moreover, existing regulations fail to address these unprecedented issues. The multilateral adoption of an International Constitution of Patient Rights (ICPR) is necessary in order to more effectively preserve medical tourism's benefits and guard against its risks.

Increasing Health Care Access In Yemen Through Community-Based Health Insurance, Matthew Fuss

Indiana Journal of Global Legal Studies

This Note addresses the implementation of health insurance reform in Yemen. As a result of a system of user fees and a lack of health insurance, the current regime poses serious barriers to health care access for Yemen's uninsured citizens. When the dust settles from the ongoing conflict with Houthi rebels, the time will be ripe for replacing Yemen's health financing system. In order to rebuild trust and curb abuse in the public health system, legal reforms are required to implement health insurance through decentralized decision-making and accountability measures. The Welfare Regime Framework accommodates these general reforms through policies that …

Economic Windfalls And The Affordable Care Act: A Policy Proposal, Joshua Congdon-Hohman, Victor Matheson

Economics Department Working Papers

This paper identifies a major issue with windfall payments under either possible interpretation of the ACA as it currently stands. Several alternatives are proposed that would eliminate the windfalls. We advocate the establishment of a tort award funded “Federal Stabilization Fund” to improve the economic efficiency of future health care awards in the age of the Affordable Care Act

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

Racial Disparities In Emergency General Surgery: Do Differences In Outcomes Persist Among Universally Insured Military Patients?, Cheryl Zogg, Wei Jiang, Muhammed Ali Chaudhary, John Scott, Adil A. Shah, Stuart R. Lipsitz, Joel S. Weissman, Zara Cooper, Ali Salim, Stephanie L. Nitzschke, Louis L. Nguyen, Lorens A. Helmchen, Linda G. Kimsey, Samuel Olaiya, Peter A. Learn, Adil H. Haider

Health Policy & Management: Faculty Presentations (2008-2022)

Research Objective: Described as one of the most serious health problems affecting the nation, racial disparities are estimated to account for >83,000 deaths, >$57 billion per year. They have been identified in multiple surgical settings, including differences in outcomes by race among emergency general surgery(EGS) patients. As many minority patients are uninsured, increasing access to care is thought to be a viable solution to mitigate inequities. The objectives of this study were to determine whether racial disparities in 30/90/180day outcomes exist within a universally-insured population of military/civilian-dependent EGS patients and whether differences in outcomes differentially persist in care received at …

Georgia’S Rural Hospital Closures: The Common-Good Approach To Ethical Decision-Making, Randi G. Bastain, Marcus Garner, John S. Barron, Emmanuel A. Akowuah, William A. Mase

Health Policy & Management: Faculty Publications (2006-2018)

Background: Critical access hospitals provide several essential services to local communities. Along with the functions associated with providing necessary medical care, they also offer employment opportunities and other economic benefits to the communities they serve. Since 2010, the number of rural hospitals closures has steadily increased. The common-good approach to ethical decision-making provides a framework that aids in evaluation of the effects that hospital closures have on rural residents and communities.

Methods: This analysis includes results of a systematic overview of peer-reviewed literature to address the following research questions: 1) How have state policies and the adoption of Medicaid expansion …

Best Practices For Self-Exclusion Reinstatement And Renewal, Alex Price

International Conference on Gambling & Risk Taking

While many studies have examined self-exclusion few have focused on the processes through which gamblers return at the end of their agreements. In 2014, the RGC Centre for the Advancement of Best Practices examined voluntary self-exclusion reinstatement and renewal in an effort to develop evidence-informed best-practices for both land-based and online gambling operations. The presentation outlines the findings of the study and the recommended best practices for reintegration and ban renewal.

The study examined a range of practices around the world. In the end the study recommended an active reinstatement process in which all participants are required to apply to …

The South African Elderly: Neglect, Social Contribution And The Hiv/Aids Epidemic, Alessia Frisoli

Dissertations, Theses, and Capstone Projects

With a slowing fertility rate and an increasing longevity, the world population is aging. Both developed and developing countries have seen their elderly become more numerous with an increasing burden on their financial, medical and social system. Many scholars have suggested immediate change of policies to contain the predicted crisis that will affect the health care and the pension schemes in the next decades. However, few have investigated the positive role that the seniors play contributing to society, beyond the complications caused to the economy and welfare system. This thesis will support the argument that the elderly, if appropriately cared …

A Clinical Score To Predict Dose Reductions Of Antidiabetes Medications With Intentional Weight Loss: A Retrospective Cohort Study., Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Vimal Ravi, Rohit C Khanna, Scott Kahan, Lawrence J Cheskin

Health Policy and Management Faculty Publications

Abstract

Background

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: “WIG”) to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss.

Methods

Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed.

Results

Mean period of follow-up was 12.5 ± 3.5 months. To derive the “WIG” scoring algorithm, one point each was assigned to “W” (loss of 5% of initial body weight within the first 3 months of attempting weight loss), “I” (triglyceride [TGL]/highdensity lipoprotein ratio >3 …

Book Review: Laugesen & Gauld. Democratic Governance & Health: Hospitals, Politics And Health In New Zealand, Vivienne Byers

Articles

No abstract provided.

Birth Intervals Among Multiparous Women In Indonesia, Dini Kurniawati, Sabarinah Prasetyo

Kesmas

Angka kematian ibu dan angka kematian bayi di Indonesia masih tinggi. Salah satu faktor yang menyebabkan tingginya risiko kematian pada ibu dan bayi adalah kelahiran terlalu dekat. Penelitian ini bertujuan untuk mempelajari determinan jarak antarkelahiran pada perempuan multipara di Indonesia. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012 pada 9.945 perempuan multipara. Analisis data menggunakan uji Mann Whitney, Kruskal Wallis, dan regresi logistik. Median jarak antarkelahiran sebesar 62 bulan dan 22,8% perempuan memiliki jarak antarkelahiran kurang dari tiga tahun. Hasil menunjukkan determinan jarak antarkelahiran pendek meliputi pendidikan ibu, usia terakhir melahirkan, ukuran ideal keluarga, pemakaian kontrasepsi, riwayat kematian …

Impact Of Husband’S Participation In Antenatal Care On The Use Of Skilled Birth Attendant, Febri Wicaksono

Kesmas

Pendekatan alternatif diperlukan untuk mengatasi persoalan kesehatan reproduksi, salah satunya dengan meningkatkan partisipasi laki-laki pada kesehatan reproduksi perempuan. Penelitian ini bertujuan untuk menelusuri dampak partisipasi suami dalam pelayanan antenatal pada penggunaan tenaga persalinan terlatih setelah mengontrol karakteristik sosial demografi. Sampel sebanyak 4.000 perempuan berusia 15 – 49 tahun yang memiliki persalinan terakhir pada tahun lalu sebelum survei diambil dari Survei Demografi dan Kesehatan Indonesia tahun 2012. Penelitian menggunakan model regresi logistik biner untuk mengidentifikasi dampak partisipasi suami dalam pelayanan antenatal pada penggunaan tenaga persalinan terlatih setelah mengontrol karakteristik ibu dan sosial demografi. Peluang setelah mengontrol faktor lainnya mengindikasikan perempuan yang …

Child Health Improvement Through Implementation Of Food Safety Model, Arief Safari, Machfud Machfud, Eriyatno Eriyatno, Heny Kuswanti Daryanto

Kesmas

Pemenuhan akan pangan merupakan komponen dasar untuk mewujudkan sumber daya manusia yang berkualitas. Namun, masih terdapat permasalahan dalam mewujudkannya, di antaranya masalah keamanan pangan dengan persentase kasus keracunan makanan masih tinggi. Penelitian ini bertujuan untuk menganalisis situasi pelaksanaan keamanan Pangan Jajanan Anak Sekolah (PJAS) yang ada saat ini dan memilih alternatif model keamanan pangan yang paling efektif dan efisien diterapkan di usaha mikro kecil (UMK) guna meningkatkan keamanan pangan yang dihasilkannya sehingga terjadi peningkatan kesehatan anak. Penelitian dilakukan pada kuartal II tahun 2015 sampai dengan awal kuartal III tahun 2015 melalui survei lapangan dan survei pakar dengan mengambil studi kasus …

Housewives’ Compliance In Reading Food Labels In Gorontalo City, Imran Tumenggung, Lucky Herawati, Sofyawati Talibo

Kesmas

Di Indonesia, masalah label pada kemasan makanan kurang mendapat perhatian konsumen. Penelitian ini bertujuan untuk mempelajari determinan kepatuhan membaca label pada kemasan makanan oleh ibu rumah tangga di Kota Gorontalo. Penelitian dengan metode survei ini dilakukan dari bulan Juni sampai Agustus 2013. Data dikumpulkan secara potong lintang dengan menggunakan angket. Variabel terikat adalah kepatuhan membaca label pada kemasan makanan yang terdiri dari label informasi nilai gizi, komposisi makanan, masa kedaluwarsa, harga, dan status halal. Variabel bebas adalah usia, tingkat pendidikan, dan keterpaparan dengan media informasi. Besar sampel 262 orang ditentukan secara accidental technique. Analisis data menggunakan uji kai kuadrat. Hasil …

Effect Of Ambient Particulate Matter 2.5 Micrometer (Pm2.5) To Prevalence Of Impaired Lung Function And Asthma In Tangerang And Makassar, Budi Haryanto, Budy Resosoedarmo, Sri Tjahjani Budi Utami, Budi Hartono, Ema Hermawati

Kesmas

Emisi partikel debu 2,5 mikrometer (PM2.5) meningkat dengan bertambahnya jumlah penduduk kota akibat peningkatan angka kendaraan bermotor sebagai transportasi penduduk sehari-hari. Penelitian ini bertujuan untuk mengetahui tingkat gangguan fungsi paru dan asma serta hubungannya dengan kadar ambien PM2.5 pada masyarakat migran di Tangerang dan Makassar dan kondisi sosial ekonomi. Desain potong lintang digunakan dengan melibatkan 4.250 dan 2.900 responden di Tangerang dan Makassar pada bulan April sampai September 2010. Pendekatan cluster sampling diterapkan. Pengukuran ambien PM2.5 di masing-masing kota berdasarkan koordinat 40 lokasi Global Positioning System (GPS). Kadar PM2.5 ditemukan lebih tinggi pada pagi hari dibandingkan siang hari di kedua …