Health Policy Commons^™

Nh Delivery System Reform Incentive Payment Program (Dsrip): Key Findings From The Summative Evaluation Report, Mary Lindsey Smith Phd, Deborah Thayer Mba, Katie Rosingana Ba, Rachel M. Gallo Mph, Catherine Mcguire Bs, Evelyn Ali Mph, Katharine Knight Mph, Chinonye Anumaka, Tyler Egeland Ba, Mark Richards Bs, Karen Pearson Mlis

Substance Use Research & Evaluation

Delivery System Reform Incentive Payment (DSRIP) programs are part of the broader Center for Medicare & Medicaid Services (CMS) Section 1115 Waiver programs and provide states with significant funding to support system transformation efforts. CMS approved New Hampshire’s five-year Building Capacity for Transformation Section 1115(a) Medicaid Demonstration Waiver in 2015. The overall goal of the DSRIP Demonstration is to improve the care for New Hampshire’s Medicaid Beneficiaries with behavioral health disorders by addressing workforce and infrastructure shortages, improving care transitions, and integrating physical and behavioral health. This condensed report highlights key findings from the NH DSRIP summative evaluation report. For …

Summative Evaluation Report By The Independent Evaluator For The New Hampshire Delivery System Reform Incentive Payment (Dsrip) Program, Mary Lindsey Smith Phd, Deborah Thayer Mba, Katie Rosingano Ba, Rachel M. Gallo Mph, Catherine Mcguire Bs, Evelyn Ali Mph, Katharine Knight Mph, Chinonye Anumaka Od, Mph, Tyler Egelund Ba, Mark Richards Bs, Karen Pearson Mlis, Ma

Substance Use Research & Evaluation

Delivery System Reform Incentive Payment (DSRIP) programs are part of the broader Center for Medicare & Medicaid Services (CMS) Section 1115 Waiver programs and provide states with significant funding to support system transformation efforts. CMS approved New Hampshire’s five-year Building Capacity for Transformation Section 1115(a) Medicaid Demonstration Waiver in 2015. The overall goal of the DSRIP Demonstration is to improve the care for New Hampshire’s Medicaid Beneficiaries with behavioral health disorders by addressing workforce and infrastructure shortages, improving care transitions, and integrating physical and behavioral health. This report is the final summative evaluation report on New Hampshire's DSRIP program. For …

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Yes, The Mda Stands For Something, Michael G. Maihofer Dds

The Journal of the Michigan Dental Association

In the President's address, Dr. Maihofer responds to concerns about the MDA's relevance, outlining four key points that emphasize its commitment to ethical dentistry, continuous education, advocacy, and adapting to changing professional needs. He highlights the MDA's role in opposing dental therapy, advocating for tax repeals, and promoting diversity, equity, and inclusion. Dr. Maihofer encourages member participation, emphasizing the collective strength of the MDA community. The address expresses gratitude to various contributors, including predecessor Dr. Steve Meraw, President-elect Dr. Vince Benivegna, the Board of Trustees, MDA staff, volunteers, and his wife, Denise.

Headquarters Report: Without Mda Advocacy, Michigan Dentistry Would Look Very Different, Karen Burgess Cae

The Journal of the Michigan Dental Association

This Headquarters Report reflects on the impactful advocacy efforts of the Michigan Dental Association (MDA) over the past three years. Highlighting various scenarios, the report envisions a different landscape for dentistry in Michigan without MDA advocacy. The article emphasizes the critical role played by MDA in addressing issues related to COVID-19, regulations, funding, public protection, and dental policies. The advocacy initiatives have not only protected dental professionals but have also ensured the best interests of the public, contributing to a resilient and thriving dental community in Michigan.

Factors Associated With The Nutritional Status Of Infants And Young Children From Rural Honduras, Ana M. Palacios, Mario Keko, Aishat Adewoye, Haresh Rochani, Asli Aslan, Dziyana Nazaruk, Ana Gisela Ramos, Weston L. Oliver, Laura Manship

Health Policy & Community Health: Faculty Publications

Objectives

Malnutrition is a major public health problem in children. Undernutrition and excessive weight at young ages are associated with life-long consequences. The main objective of this study was to characterize the sociodemographic and food insecurity factors associated with the nutritional status of rural children ages 6 to 24 months living in 27 rural communities in Intibucá, Honduras.

Methods

This secondary analysis of baseline data included a total of 402 children ages 6 to 24 months who were recruited to participate in a cluster-non-randomized trial of a community-based nutrition intervention. Data were collected in January 2021 through a survey that …

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

Benign Prostatic Hyperplasia (Bph): A Comprehensive Analysis Of The Malaise And Summarizing Possible Management Options Through Phytotherapeutic Agents, Shan Sasidharan, Kumarapillai Parameswaran Srinivasakumar, Sandeep Poddar, Amiya Bhaumik, Sreemoy Kanti Das, Hareendran Nair J

Kesmas

Benign prostatic hyperplasia (BPH) is a severe illness affecting middle-aged and geriatric male patients. This disease normally occurs at the age of 40 or above and is also associated with sexual dysfunction. Alpha-blockers and 5α-reductase inhibitors are the preferred drugs practiced to treat BPH. However, invasive surgical therapy remains the gold standard for managing the condition in the case of refractory and intricate BPH conditions. Due to the fear of sexual dysfunction and the detrimental influence on their quality of life, most patients seek to avoid synthetic drugs and surgery. For this reason, several patients turn to phytotherapy and other …

Treatment Adherence And Incidence Of Coronary Heart Disease In Type 2 Diabetes Mellitus Patients, Ahmad Sahlan Baniu, Rani Sauriasari, Woro Riyadina, Pradana Soewondo

Kesmas

Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed …

Local Wisdom Enriching Complementary Feeding Practices During Disaster Situations In Indonesia, Astuti Astuti, Happy Hayati, Fajar Tri Waluyanti, Dessie Wanda

Kesmas

This study aimed to analyze complementary food fulfillment during disaster situations in Indonesia since it frequently experiences natural disasters and young children face unique challenges related to their feeding needs in disaster situations. This qualitative case study based on the Mount Merapi eruption and Sumedang landslide in 2021 collected data using observations, forum group discussions, and in-depth interviews; then, a thematic analysis was conducted. This study involved 17 participants, including Non-governmental Organizations (NGO) activists, health workers, residents involved in making complementary foods, and primary caregivers of children aged 6–24 months. This study found that there were five themes generated from …

Muscle Dysmorphia In Fitness Center Members: Its Affecting Factors And Impacts, Deny Yudi Fitranti, Nurmasari Widyastuti, Etika Ratna Noer, Ayu Rahadiyanti, Fillah Fithra Dieny, Rachma Purwanti, Dewi Kurnia Sandi, Widya Destikasari

Kesmas

Muscle dysmorphia (MD) has several impacts on the decline in social and health functions. This study aimed to determine the correlation between MD with eating behaviors and exercise loading among fitness center members and analyze the factors affecting it. This study used a cross-sectional design with 100 subjects chosen by a consecutive sampling method at three fitness centers in Semarang City. The subjects were all male members of an active fitness center between 17 and 45 years. The data of MD were obtained using the Drive Muscular Scale (DMS), while eating behavior data were obtained using the Eating Attitude Test-40 …

Determinants Of The Coexistence Dual Form Of Malnutrition In Pairs Of Mother And Child Aged 6 – 59 Months In Bogor District 2019, Maulina Dwi Krismanita, Triyanti Triyanti, Ahmad Syafiq, Trini Sudiarti

Kesmas

The dual form of malnutrition (DFM) is defined as multiple nutritional problems in the same household and time. This study aimed to determine the related factor to DFM incidence in pairs of mothers and children aged 6–59 months in Bogor District in 2019. This cross-sectional study used secondary data on the Nutrition and Health of Babakan Madang Subdistrict Toddlers in 2019 and Nutrition Intake and Stunting of Children Under-Five in Bogor District, West Java Province, involving a total sample of 274 households. The dependent variable in this study was DFM, while the independent variables were maternal age during pregnancy, maternal …

The Influence Of Intrapersonal Constraints On Travel Intention Of People At High Risk From Covid-19 During The New Normal, Dyah Widiyastuti, Ikasari Kusuma Wardhani

Kesmas

Due to the COVID-19 pandemic, tourism constraints have created a challenge for inclusive tourism, especially for older people and people with comorbidities. This study examined intrapersonal constraints’ effect on the travel intentions of people facing fewer opportunities for tourism due to the COVID-19 pandemic, which could disrupt their well-being fulfillment. The data were collected through an online survey of Jakarta citizens aged 46 years and older from the end of June to September 2021, and a total of 337 responses were accumulated. This study applied partial least square structural equation modeling to test the moderating effect of intrapersonal constraints toward …

Zoom Fatigue During The Covid-19 Pandemic: Is It Real?, Putri Winda Lestari, Adhila Fayasari

Kesmas

The coronavirus disease 2019 (COVID-19) pandemic has caused drastic changes to social lives moreover the activities done outside, such as work and school. The policy of large-scale social restrictions (LSRR)/Pembatasan Sosial Berskala Besar (PSBB), which makes people stay at home, also plays an important role in changing the face-to-face activity online. As a solution to the major change, people use video conferencing to keep in touch and still feel like doing "offline" activities. The increasing use of video conferencing has raised concerns about the resulting fatigue, termed "Zoom fatigue." This study aimed to describe Zoom fatigue during the COVID-19 pandemic …

Diabetes Mellitus And Mortality Among Covid-19 Patients In Jakarta, March-August 2020, Endang Widuri Wulandari, Sudarto Rotnoatmodjo, Ngabila Salama

Kesmas

Diabetes mellitus (DM) comorbidity is one of the risk factors for coronavirus disease 2019 (COVID-19) mortality. This study aimed to determine the association of comorbid DM and mortality among COVID-19 confirmed cases in DKI Jakarta Province, controlled with confounding variables from March to August 2020. The study design was a retrospective cohort using cox proportional hazard regression, with a total sample of 1,480. The data consisted of 740 COVID-19 cases with and 740 without comorbid DM. The inclusion criteria were COVID-19 confirmed cases with polymerase chain reaction (PCR) laboratory testing reported to the DKI Jakarta Provincial Department of Health, and …

Knowledge, Attitudes, And Covid-19 Prevention Practices Of Healthcare Workers In Indonesia: A Mobile-Based Cross-Sectional Survey, Besral Besral, Zulvi Wiyanti, Dion Zein Nurizin, Milla Herdayati, R Sutiawan, Martya Rahmaniati, Popy Yuniar

Kesmas

Knowledge of disease can affect attitudes and prevention practices, and wrong attitudes and practices can directly increase the risk of disease infection. This study aimed to describe the knowledge, attitudes, and COVID-19 prevention practice of healthcare workers in Indonesia and factors associated with prevention practices. A mobile-based cross-sectional survey was conducted in August 2020 with 254 healthcare workers in Indonesia. The self-administered questionnaire consisted of four parts: 1) sociodemographic information, 2) knowledge of COVID-19, 3) attitudes and anxiety toward COVID-19, and 4) COVID-19 prevention practices. The results indicated that healthcare workers in Indonesia had excellent knowledge and positive attitudes about …

Infarct Diameter For Predicting Cognitive Dysfunction In Ischemic Stroke Survivors In West Nusa Tenggara, Indonesia, Herpan Syafii Harahap, Setyawati Asih Putri, Yanna Indrayana, Hasan Amin, Fransisca Ika Mahardika

Kesmas

Cognitive dysfunction is an important consequence of ischemic stroke, which can progress in the first few years and is primarily determined by clinical factors. This study aimed to investigate the clinical determinants of cognitive dysfunction in stroke survivors in West Nusa Tenggara Province, Indonesia. This cross-sectional study assessed 255 ischemic stroke survivors with a mean age of 57.1±9.3 years old and 29–79 years old, recruited consecutively in three main hospitals in West Nusa Tenggara Province between March 2019 and October 2021. Categorical data collected included age, sex, education level, clinical determinants of ischemic stroke, and cognitive status of the patients. …

Interprofessional Collaborative Practice And Health Workers Retention At Remote Primary Health Care: Case Study From Nusantara Sehat Team-Based Program, Prastuti Soewondo, Retno Pujisubekti, Ade Widyati Prastyani, Nurul Maretia Rahmayanti

Kesmas

The Nusantara Sehat Team (NST), established in 2015 and consist of multi-professional health workers, implemented to provide comprehensive services at remote primary health cares (PHCs) for two years. This study aimed to explore how the NST leverages the Interprofessional Collaboration (IPC) and its impact on the future career prospects of health workers. Using a qualitative approach, the information was gathered from 48 informants drawn from the current 30 NST recruits and 18 alumni through semi-structured interviews. Of these 48, 20 were clinical practitioners, while the rest were non-clinical health workers. The findings revealed several challenges in promoting collaborative practice, including …

Telemedicine And Electronic Health Record Implementation In Rural Area: A Literature Review, Arifah Alfiyyah, Dumilah Ayuningtyas, Agus Rahmanto

Journal of Indonesian Health Policy and Administration

The Indonesian Minister of Health 2019 issued regulations regarding the implementation of telemedicine services between health service facilities. Telemedicine is aimed primarily at rural areas. This research aims to look at the quality of telemedicine-based services, which are documented in an electronic health record (EHR) with complete information. This research uses the narrative literature review method: Garuda journal channels, Google Scholar, IEEE Explorer, ProQuest, PubMed, Science Direct, and Scopus. With the input-output process approach, eight scientific articles were published on countries with telemedicine/telehealth policies in rural areas. The implementation of telemedicine has advantages and disadvantages depending on the things supported …

Policy Implementation Of Halal Product Assurance For Pharmaceutical Products In Indonesia, Hilyatul Fadliyah, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

After the implementation of halal product assurance (HPA) became a public policy, the assurance for halal pharmaceutical products is a must. However, the implementation has been relaxed for several years. This shows that the policy implementation is complicated. This study aimed to analyze and evaluate the implementation process of the HPA policy for pharmaceutical products in Indonesia. We applied Van Meter Van Horn’s theory using the qualitative method through in-depth interviews with eight informants and a review ten documents. The result shows that the implementation is going well but is still not optimal, especially from the point of view regarding …