Health Policy Commons^™

Contextual Factors Influencing The Association Between The Affordable Care Act’S Medicaid Expansion And Veteran Va-Medicaid Dual Enrollment, Patrick N O'Mahen, Chase S Eck, Cheng Rebecca Jiang, Laura A Petersen

Center for Medical Ethics and Health Policy Staff Publications

Objective: To evaluate changes in dual enrollment after Affordable Care Act Medicaid expansion by VA priority group, (e.g., service connection), sex, and type of state expansion.

Study setting: Our cohort was all Veterans ages 18-64 enrolled in VA and eligible for benefits due to military service-connection or low income from 2011 to 2016; the unit of analysis was person-year.

Study design: Difference-in-difference and event-study analysis. The outcome was dual VA-Medicaid enrollment for at least 1 month annually. Medicaid expansion, VA priority status, whether a state expanded by a Section 1115 waiver, and sex were independent variables. We controlled for race, …

Phase Ii Study Of Ulixertinib In Children And Young Adults With Tumors Harboring Activating Mitogen-Activated Protein Kinase Pathway Alterations: Apec1621j Of The National Cancer Institute-Children's Oncology Group Pediatric Match Trial, Kieuhoa T Vo, Amit J Sabnis, P Mickey Williams, Sinchita Roy-Chowdhuri, David R Patton, Brent Coffey, Joel M Reid, Jin Piao, Lauren Saguilig, Todd A Alonzo, Stacey L Berg, Alok Jaju, Elizabeth Fox, Brenda J Weigel, Douglas S Hawkins, Margaret M Mooney, Naoko Takebe, James V Tricoli, Katherine A Janeway, Nita L Seibel, D Williams Parsons

Center for Medical Ethics and Health Policy Staff Publications

Purpose: The National Cancer Institute-Children's Oncology Group (NCI-COG) Pediatric MATCH trial assigns patients age 1-21 years with refractory malignancies to phase II treatment arms of molecularly targeted therapies on the basis of genetic alterations detected in their tumor. Patients with activating alterations in the mitogen-activated protein kinase pathway were treated with ulixertinib, an extracellular signal-regulated kinase (ERK)1/2 inhibitor.

Methods: As there were no previous pediatric data, ulixertinib was initially tested in a dose escalation cohort to establish the recommended phase II dose (RP2D) before proceeding to the phase II cohort. Ulixertinib was administered at 260 mg/m2/dose orally twice a day …

Performance Of Stunting Reduction Acceleration Team: An Explorative-Qualitative Study In Indonesia-Timor Leste Border Area, Maria Paula Marla Nahak, Veronika Nitsae

Kesmas

Stunting is a complex issue influenced by multiple factors, including specific factors within and outside the health sector. Achieving a significant reduction in stunting needs the involvement of relevant local government offices in the Stunting Reduction Acceleration Team (SRAT). This study aimed to investigate SRAT performance in a specific context of accelerating stunting reduction in Malaka District. This qualitative study, with a phenomenological approach, was conducted in Malaka District, Indonesia, and Timor Leste Border Area from July to September 2023. This study revealed four major themes of SRAT performance to accelerate stunting reduction in Malaka District: activities to accelerate stunting …

The Influences Of Medical Students' Consent To Participate In Thalassemia Research, Raditya Wratsangka, Donna Adriani, Endrico Xavierees Tungka, Aditya Krishna Murthi

Kesmas

An effective way of learning about thalassemia, a complex public health issue with multiple perspectives, is through participating in research. This study used an inductive approach to presume the influencing factors of students' consent to participate in thalassemia research voluntarily. Nested in the preliminary stage of a research series on thalassemia, this study used a consecutive sampling to recruit 140 medical undergraduates. Their knowledge, experience, and attitude to thalassemia and the perception of self-quality life were assessed using self-administered questionnaires. Blood samples were drawn for carrier screening. Students' GPAs were collected from faculty records. Of 140 participants, only 123 had …

Balancing Community And Individual Health Efforts By Utilizing Sub-Primary Health Care At Regions: Analysis For Policy, Rocky Setya Budi, Wiku Bakti Bawono Adisasmito, Adang Bachtiar, Elvi Rosanti

Journal of Indonesian Health Policy and Administration

Public Health Centers (PHCs) are responsible for organizing public health efforts and individual health efforts. PHCs also serve as FKTP, UPTD, sub-district supervisors, and implementers of policies and programs from the Ministry of Health. The workload of PHCs is increasing because people visit PHCs primarily for treatment, rather than seeking preventive measures to stay healthy. The PHCs have Sub-PHCs to lighten the workload of the PHCs, but there is no policy regulating Sub-PHCs to be used as FKTP. This research aims to analyze the policy of Balancing Community and Individual Health Efforts by utilizing Sub-PHCs such as FKTP. The research …

Policy Implementation Analysis Of Antenatal Care Services At Puskesmas Negara Ratu And Puskesmas Cempaka Kabupaten Lampung Utara, Willyana Syafriyanti, Anhari Achadi

Journal of Indonesian Health Policy and Administration

The Ministry of Health has issued Minister of Health Regulation Number 21 of 2021 to strengthen maternal health services, which regulates health services during pregnancy (antenatal). The Minister of Health's regulation states that antenatal care is carried out at least six times, 2 (two) of which are examinations with a doctor using an Ultra Sonography (USG) device. Community health centers as primary services are expected to be able to provide antenatal services according to standards. The North Lampung Health Service has distributed ultrasound equipment to community health centers in the North Lampung Regency to support the implementation of antenatal services. …

Policy Content Analysis In Minister Of Health Regulation Number 15 Of 2016 About Hajj Health Istithaah, Salman Mauluddin Idris, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

Indonesia has the world's largest Muslim population and sends the most pilgrims to Saudi Arabia. The Hajj Health Istithaah Policy in Minister of Health Regulation Number 15 of 2016 is the government's effort to carry out health screening for pilgrims before leaving so that they can perform the Hajj in a healthy and independent condition. This research was conducted using a qualitative approach by collecting data through in-depth interviews and document reviews. In this study, Walt and Gilson's Policy Triangle Model was used as a reference for reviewing the Hajj health istithaah policy, especially in the content section of the …

Island Health Crisis: Bridging Gaps In Indonesia's Healthcare Deserts, Joyce Mangoma, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

This narrative literature review examines critical healthcare challenges in Indonesia's island communities, focusing on workforce shortages, inadequate health infrastructure, and the profound impact of geographical and socioeconomic factors. Drawing from eight studies published between January 2000 and December 2023, the discussion highlights both the strengths and weaknesses of existing research. The studies were selected based on their relevance to healthcare issues in island communities, rigorous methodological approaches, and significant insights into healthcare challenges and solutions. This time frame was chosen to encompass a comprehensive evolution of healthcare challenges and responses, particularly considering the effects of the COVID-19 pandemic. Grounded in …

Management Overview Of The Lung Tuberculosis Control Program At The Dki Jakarta Provincial Health Office In 2023, Mutiara Kiranti, Helen Andriani

Journal of Indonesian Health Policy and Administration

Tuberculosis is one of the infectious diseases that is fatal if not cured immediately. In 2022, the success rate of tuberculosis treatment in DKI Jakarta Province is 81%, while the national target is 90%. In the field, the number of cadres to carry out contact investigations is still insufficient, so that in 2022 the coverage of contact investigations in DKI Jakarta Province will only reach 25%, while the national target is 90%. To increase the scope of successful treatment, the government should try to overcome tuberculosis, which is needed. Proper program management is required to run effectively and efficiently for …

Impact Of The Department Of Defense Maternity Leave Policy Change On Retention And Postpartum Depression And The Air Force Postpartum Physical Fitness Policy Change On Physical Readiness Outcomes, Minette S. R. Herrick

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Understanding the implications of health policy is paramount to support continued execution and further wide-spread distribution. The Department of Defense has made many recent family friendly policy changes in effort to improve the health and morale of the force. Two such policies were analyzed in this study. The first was the change in maternity leave, in 2016, from allotting women six weeks time off to twelve weeks time off in the postpartum period. The second was executed by the Air Force to permit postpartum women a longer duration for their required physical fitness assessment (an increase from six months to …

Buprenorphine Use For Analgesia In Palliative Care, Leanne K Jackson, Ivy O Poon, Mary A Garcia, Syed Imam, Ursula K Braun

Center for Medical Ethics and Health Policy Staff Publications

Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans®), or a buccal film (Belbuca®). Buprenorphine’s unique high receptor binding affinity and slow dissociation at the MOR allow for effective analgesia while offering less adverse effects compared to a full agonist opioid, in particular, less concern for respiratory depression and constipation. It is underused in chronic pain and palliative care due to misconceptions and stigma from its use in opioid use disorder (OUD). This case report discusses the unique pharmacology of buprenorphine, including its advantages, disadvantages, …

Your Money Or Your Life: A Study Of Medical Debt In The Southeastern United States, Grace Barrett

Honors Theses

A major issue has emerged from the U.S. healthcare system: medical debt. Medical debt is a serious problem in the U.S. that often cripples those who received healthcare services, but are unable to pay the bill. The most common scenario is when an unexpected major medical issue occurs, e.g. a heart attack, an automobile accident, cancer or anything requiring an emergency room visit. These hospital visits often result in very large, very unexpected expenses. These expenses are ultimately owed to the healthcare provider by the patient (or the patient's insurance policy) and increasingly, cause lifelong financial stress to those who …

Covid-19 And Global Institutional Shift From National To Subnational Governments, Jonathan Feld-Jacobson, Armaan Rizvi, Bora Sinan

Working Papers Series

The COVID-19 Pandemic saw dramatic global shifts in legislative powers between central and local governments. With changes in the severity and duration of the pandemic, in the federations of Nigeria, Australia, and Canada, policymaking regarding border and school closures and states of emergency saw an increasing involvement of regional governments. We suggest that looking at the national and regional PPI data for our hypotheses could indicate directly the severity of the pandemic in these nations. Federalisms particularly provide a case of institutional change evidencing that COVID-era decision-making saw a change in the rules and expectations of governance in the nations …

The Impact Of Purchasing Power Parity (Ppp), Infrastructure, And Decentralization On Pandemic Restrictions, Liam Hansen, Veronica Taraskina, Jennifer Weng

Working Papers Series

This research compares a country's mandate to shift to remote work between the federal and regional levels in comparison to PPP. We focus on how economic factors determine a country's ability to move to remote work and at what level of government the decision is made. The findings suggest that while there was variation in which level of government issued work-from-home requirements, there were strong trends for most mandates to come from the federal level. Moreover, an overwhelming majority of countries issued such federal mandates regardless of PPP. We then compare PPP per capita and the stringency of public transportation …

Could It Be That Healthcare Systems Are Putting Profits Before Patients?, Majida Naz

Publications and Research

The escalating costs of healthcare in the United States have led to a significant burden on diverse populations, often resulting in diminished access to quality care. As profit-driven motives increasingly influence healthcare providers and insurers, the affordability and accessibility of healthcare services are adversely affected. This research examines the intricate dynamics between profit motives and healthcare provision, employing a mixed-methods approach to investigate the impact on the diverse groups. By conducting a quantitative and some qualitative examination of healthcare spending data, this study demonstrates a pronounced disparity in the quality of healthcare services provided to populations across different income levels. …

Addressing Or Reinforcing Injustice? Artificial Amnion And Placenta Technology, Loss-Sensitive Care And Racial Inequities In Preterm Birth, Sophie L Schott, Faith Fletcher, Alice Story, April Adams

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

The State Of Mental Health In The Mountain West, 2023, Ayda Atici, Freddy Nie, Jesse M. Fager-Larsen, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines the state of mental health for both youth and adults and availability of mental health care in the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The data are retrieved from Mental Health America’s (MHA) 2023 report, The State of Mental Health in America.

Psychosocial Factors Associated With Substance Use Vulnerability In Black Americans, Aanya Mehta

Honors Scholar Theses

In 2010, the World Health Organization developed the Conceptual Framework for the Social Determinants of Health as a response to epidemiologists’ and public health workers’ need to estimate the impact of social inequality. Within this framework, psychosocial factors are intermediary determinants of health that influence an individual’s interactions with their environment. This paper analyzes data and results from ten articles from the Family and Community Health Study (FACHS), which looks at the impacts of psychosocial, contextual, and family effects on health and developmental outcomes in Black American families. The findings across the ten articles provide strong evidence that there are …

A Qualitative Interview Study To Determine Barriers And Facilitators Of Implementing Automated Decision Support Tools For Genomic Data Access, Vasiliki Rahimzadeh, Jinyoung Baek, Jonathan Lawson, Edward S Dove

Center for Medical Ethics and Health Policy Staff Publications

Data access committees (DAC) gatekeep access to secured genomic and related health datasets yet are challenged to keep pace with the rising volume and complexity of data generation. Automated decision support (ADS) systems have been shown to support consistency, compliance, and coordination of data access review decisions. However, we lack understanding of how DAC members perceive the value add of ADS, if any, on the quality and effectiveness of their reviews. In this qualitative study, we report findings from 13 semi-structured interviews with DAC members from around the world to identify relevant barriers and facilitators to implementing ADS for genomic …

Trust In Government And Policies Of The Covid-19 Pandemic: The Before And After Comparison In The European Sample, Julia Match

Undergraduate Honors Theses

This research explores the relationship between COVID-19 policies and mortality rates and the level of trust in government in Europe. This study looks at the stringency of measures, as well as their effectiveness as shown through high or low mortality rates, to see if there is a relationship between those factors and increases or decreases in trust in 2020. The Eurobarometer is the dataset for trust in government, with a focus on the data from Summer 2020, the first Eurobarometer after COVID-19 began. The Johns Hopkins Coronavirus Resource Center was used for cumulative mortality, and Shvetsova et al., 2022 provided …