Health Policy Commons^™

Critical Issues For Integrating Srh And Hiv/Aids Services To Provide Dual Protection Against Unintended Pregnancy And Hiv/Sti Acquisition, Population Council

Reproductive Health

This document reports on a one-day symposium that was held by the STEP UP (Strengthening Evidence for Programming on Unintended Pregnancy) Research Program Consortium, coordinated by the Population Council. STEP UP generates policy-relevant research to promote an evidence-based approach for improving access to family planning and safe abortion in Bangladesh, Ghana, India, Kenya, and Senegal. The symposium’s objectives were to review and discuss critical and emerging issues around integrating SRH and HIV and AIDS services to enable dual protection, including new directions in dual protection technology and behaviour change interventions. The meeting also provided an opportunity to discuss the programmatic …

Positive Action For Hiv In Schools In Kenya, Francis Obare, Harriet Birungi, Monica Wanjiru, Sheila Bayley, John Kiunjuri, Mary Omondi, Rob Burnet, Bridget Deacon

Reproductive Health

The objective of this study was to test the feasibility of using comic books, role models, and edutainment to communicate HIV and AIDS messages to in-school young people in Kenya, with a view to improving their knowledge about the epidemic, enhancing communication about it, and promoting positive attitudes and behavior among them. The study was implemented by the Population Council in eight secondary schools in Nairobi, as part of the APHIA II Operations Research Project in collaboration with the AIDS Control Unit in the Ministry of Education, Well Told Story, and the National AIDS/STI Control Programme. The study found that …

Population Level Impact Of Vouchers On Access In Uganda, Benjamin Bellows, Francis Obare, Reproductive Health Vouchers Evaluation Team

Reproductive Health

No abstract provided.

Nutrition Policy, Nonmarket Failure, And The Obesity Epidemic, James Woodward

MPA/MPP/MPFM Capstone Projects

The Dietary Guidelines for Americans, which are based on the Dietary Goals for the United States, represent the federal government’s first attempt to improve the nation’s health by recommending that Americans avoid certain foods. The Guidelines were based on what was perceived, by the government and nutritionists alike, to be solid scientific evidence that consumption of fat and saturated fat in particular, increase the risk of developing heart disease. They also emphasized, and continue to emphasize, the importance of exercise and calorie restriction as the primary means of maintaining a healthy weight. In short, the Guidelines sought to …

Report Of The Voucher And Accreditation Evaluation Project Meeting, Reproductive Health Vouchers Evaluation Team, Population Council

Reproductive Health

This is a report on a technical advisory meeting that brought together 45 participants from the five country programs being evaluated through the Reproductive Health Voucher and Accreditation (V&A) project, which is implemented by the Population Council with financial support from the Bill and Melinda Gates Foundation. This group met for the first time as a newly emerging “voucher community” to learn from the successes and challenges faced in this early growth phase of emerging V&A programs that deliver maternal and reproductive health services. In addition to standardizing the collection of performance and financing metrics, who would use such data …

Personal Experiences With Mainecare Services From People Who Use Elder And Adults With Disabilities Waiver And Private Duty Nursing/Personal Care Services., Julie T. Fralich Mba, Katherine Rosingana, Mark Richards Bs, Louise Olsen, Vanessa Bell, Jennifer Pratt

Disability & Aging

This report provides the results from a survey and personal interviews that were conducted with MaineCare members who use long term services and supports -- specifically those who are on the Elder and Adults with Disabilities Waiver and those using Private Duty Nursing (PDN) Services. People who are eligible for these services generally need nursing care and assistance with a combination of activities of daily living (e.g. eating, toileting, mobility, transfer) and instrumental activities of daily living (e.g. meal preparation, grocery shopping, housework). People on the Waiver are medically eligible to be in a nursing home. The purpose of the …

Affordable Care Act Litigation: The Supreme Court And The Future Of Health Care Reform, Lawrence O. Gostin, Kelli K. Garcia

Georgetown Law Faculty Publications and Other Works

In Florida v. HHS, a lawsuit brought on behalf of 26 states challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA), the Supreme Court will determine the future direction of health care reform in the United States. During the unprecedented 5-1/2 hours of oral arguments, the Court will hear 4 issues: the individual purchase mandate, severability, the Medicaid expansion and the Anti-Injunction Act.

The states challenging the ACA maintain that the purchase mandate uniquely penalizes individuals for failing to purchase insurance. Uninsured individuals, however, rarely do nothing. Instead, they self-insure, rely on family, and cost-shift to …

Marketing Pharmaceuticals: A Constitutional Right To Sell Prescriber-Identified Data?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Pharmaceutical companies have strong economic interests in influencing physician-prescribing behaviors. They advertise direct-to-the-consumer and to the physician. Beyond general marketing, manufacturers promote their drugs to physicians through “detailing”—sales representatives (“detailers”) visiting medical offices to persuade physicians to prescribe their products.

By law, pharmacies receive specific information with every prescription, including the physician’s name, the drug, and the dose. Pharmacies sell these records to Prescription Drug Intermediaries (data miners), who use advanced computing to analyze prescriber-identified information (which physicians prescribe what drugs, in what dose, and with what prescribing patterns). Data miners, in turn, lease sophisticated reports to pharmaceutical companies to …

Influence Of Medical Marijuana Programs On Controlled Substance Utilization, James A. Farley Ii

MPA/MPP/MPFM Capstone Projects

Currently there are no studies examining the impact of medical cannabis programs on controlled substance prescribing. The intent of this study is to conduct a preliminary investigation into whether cannabis substitution for prescription drugs results in lower rates of controlled substance use. The hypothesis is that controlled substance use (in this project, defined by controlled substance supply) will decline in states after the introduction of medical cannabis programs.

State and year–specific per capita retail distributions of the seven most commonly prescribed opioid drugs (fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, and oxycodone) were obtained from the Automation of Reports and Consolidated …

Influence Of Prescription Drug Monitoring Programs On Acetaminophen-Related Liver Toxicity, Aaron Barcelo

MPA/MPP/MPFM Capstone Projects

No executive summary.

Personal Experiences With Long Term Care Services And Supports, Julie Fralich Mba, Mark Richards Ba, Louise Olsen, Vanessa Bell, Jennifer Pratt

Disability & Aging

This report captures, in a direct way, the first hand experiences of older and disabled consumers of long term care services and supports. In addition, it includes the collective experiences of eight Maine communities regarding the long term care service delivery system in our state.

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Book Review Of Heather Mccrea, Diseased Relations: Epidemic, Public Health, And State-Building In Yucatán, Mexico, 1847-1924, Autumn L. Quezada-Grant Dr

Arts & Sciences Faculty Publications

Diseased Relations is an impressive work succinct in its focus on the topic of public health history in the Mexican state of Yucatán. Adding to a growing body of scholarship on the nineteenth and early twentieth centuries, this book offers a new lens through which to consider the mechanics of state formation. In this turn to the study of disease and public health, McCrea pulls in the unfolding story of science’s understanding of the origin and spread of diseases and reflects upon the dialogue between national officials and state or local officials in the Yucatán. By choosing to focus on …

Deinstitutionalization And Its Discontents: American Mental Health Policy Reform, Olga Loraine Kofman

CMC Senior Theses

In 1963, President John F. Kennedy signed the Mental Retardation and Community Mental Health Centers Construction Act, establishing the beginnings of deinstitutionalization in the United States. By some counts, this Act was a stupendous policy success—by others, a dismal failure. 50 years later, no cohesive national mental health care policy has emerged to deal with increased rates of mental illness among the homeless and the incarcerated. However, California has made enormous strides to create a state policy which provides adequate services to the mildly, moderately, and severely mentally ill as well as adequate funding for those services through Proposition 63, …

Measuring Equity In Disability And Healthcare Utilization In Afghanistan, Jean-Francois Trani, Cecile Barbou Des Rosieres

Brown School Faculty Publications

This paper analyses equity in health and healthcare utilization in Afghanistan based on a representative national household survey. Equitable access is a cornerstone of the Afghan health policy. We measured socioeconomic-related equity in access to public health care, using disability– because people with disabilities are poorer and more likely to use health care – and a concentration index (CI) and its decomposition. The socioeconomicrelated equity in healthcare utilization was measured using a probit model and compared with an OLS model providing the horizontal inequity index (HI). We found low rate of healthcare facilities utilization (25%). Disabled persons are using more …

Increase In Caesarean Deliveries After The Australian Private Health Insurance Incentive Policy Reforms, Kristjana Einarsdottir, Anna Kemp, Fatima Haggar, Rachael Moorin, Anthony Gunnell, David Preen, Fiona Stanley, C. D'Arcy Holman

Research outputs 2012

Background: The Australian Private Health Insurance Incentive (PHII) policy reforms implemented in 1997–2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA). Methods and Findings: All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the …

Reclaiming Fat, Emilie Debaie

Health Sciences Student Scholarship

No abstract provided.

Driving Qi With Research: Findings From Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

A New State Plan Option To Integrate Care And Financing For Persons Dually Eligible For Medicare And Medicaid, Jane H. Thorpe, Katherine J. Hayes

Health Policy and Management Faculty Publications

As health care costs continue to escalate, Congress, the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, researchers, and policymakers are focusing on identifying new approaches to care delivery and reimbursement for individuals who are dually eligible for both Medicare and Medicaid. Although relatively few in number (9 million), dual eligible beneficiaries are more likely than others to experience poor health, including multiple chronic conditions, functional and cognitive impairments, and a need for continuous care. Sixty-six percent of dual eligibles have three or more chronic conditions; sixty-one percent are …

Postmortems On The Affordable Care Act (Book Review), Rick Mayes

Political Science Faculty Publications

Nearly two years after the Affordable Care Act became law, books are appearing by Washington insiders who detail how the legislation came about. The two reviewed here discuss and dissect topics related to the health reform law from decidedly different points of view.