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on Health Economics |
| By: | Pía Riggirozzi |
| Abstract: | Since the creation of the Union of South American Nations (UNASUR), health became a strategic driver in regional politics in South America in two ways: by redefining trans-border practices through health policies and institutions within the region; and by projecting (regional) health policies through global interventions. The paper explores these dynamics in relation to UNASUR’s policies towards access to medicine, inclusion, and demands for better governance at the World Health Organisation. It argues that regional organisations like UANSUR are significant actors in on-going attempts to address and mitigate trans-border social harms, contributing with innovative regulatory frameworks and different mechanisms of socialisation and engagement that can significant impact national policy making and management in health. But it is also argued that the significance of regional health governance as promoted by UNASUR has to be seen not only as a framework for the promotion of ‘regulatory regionalism’ (Hameiri and Jayasuriya 2009) in public health, but also for ‘regional health diplomacy’ brokering new norms and revising the terms of global health governance. This analysis hopes to contribute directly to the literature in IPE and regionalism by offering a more nuanced discussion about the links between regionalism and social policy, and new forms of regional diplomacy beyond traditional goals of trade and financial markets expansion. |
| Keywords: | Regionalism , regional health diplomacy, right to health, advocacy, UNASUR |
| Date: | 2014–07 |
| URL: | http://d.repec.org/n?u=RePEc:rsc:rsceui:2014/83&r=hea |
| By: | Nicholas Rohde; Kam Ki Tang; Lars Osberg; D.S. Prasada Rao |
| Keywords: | Economic Insecurity, Instrumental Variables, Mental Health, Panel Data. |
| JEL: | D63 |
| Date: | 2014–06 |
| URL: | http://d.repec.org/n?u=RePEc:gri:epaper:economics:201406&r=hea |
| By: | Elisabetta De Cao |
| Abstract: | Height is the result of a complex process of growth that begins at birth and reaches the end in early adulthood. This paper studies the determinants of height from birth to maturity. A height production function is specified whose structure allows height to be the result of the accumulation of inputs (i.e., nutrition and diseases) over time. The empirical specification allows the causal identification of the age specific effects of both nutrition and diseases on height. Rich longitudinal data on Filipino children followed for more than 20 years are used. Considering the differences in growth patterns between boys and girls, the results show the existence of two critical periods for the formation of height: infancy and pre-puberty. In particular, diseases experienced during infancy, specially in the second year of life, and nutrition during pre-puberty play a major role. |
| Keywords: | height; health; early-life events; production function; Philippines |
| JEL: | I10 I12 O15 C13 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:csa:wpaper:2014-31&r=hea |
| By: | David Bardey; Philippe De Donder; César Mantilla |
| Abstract: | We develop a theoretical analysis of two widely used regulations of genetic tests, disclosure duty and consent law, and we run several experiments in order to shed light on both the take-up rate of genetic testing and on the comparison of policy-holders’ welfare under the two regulations. Disclosure Duty forces individuals to reveal their test results to their insurers, exposing them to the risk of having to pay a large premium in case they are discovered to have a high probability of developing a disease (a discrimination risk). Differently, Consent Law allows them to hide this detrimental information, creating asymmetric information and adverse selection. We obtain that the take-up rate of the genetic test is low under Disclosure Duty, larger and increasing with adverse selection under Consent Law. Also, the fraction of individuals who are prefer Disclosure Duty to Consent Law increases with the amount of adverse selection under the latter. These results are obtained for exogenous values of adverse selection under Consent Law, and the repeated interactions experiment devised has not resulted in convergence towards an equilibrium level of adverse selection. |
| Keywords: | disclosure duty, consent law, discrimination risk, informational value of test, personalized medicine, experiment. |
| JEL: | D82 I18 C91 |
| Date: | 2014–11–13 |
| URL: | http://d.repec.org/n?u=RePEc:col:000089:012341&r=hea |
| By: | Tobias C. Vogt; Fanny A. Kluge |
| Abstract: | Background: After the reunification of Germany, mortality among older eastern Germans converged quickly with western German levels. Simultaneously, the pension benefits of eastern Germans rose tenfold. Objective: We make use of German reunification as a natural experiment to show that, first, increasing financial transfers from the elderly to their children led to increasing reverse transfers in the form of care; and, second, this rise in the number of hours spent on care led to a reduction in old-age mortality. Method: As a first step, we calculated intergenerational transfer profiles by age for eastern and western Germany to determine whether any changes in downward and in upward transfers in the form of time and money occurred since reunification. We use generalized linear regression to test whether rising pensions led to an increase in the number of hours spent on care, and whether this increase led to a reduction in old-age mortality. We use different macro level data sources to test our hypothesis, including mortality rates and time use surveys for East and West Germany and information on private intergenerational transfers from the National Transfer Accounts project for Germany. Results: We show that since German reunification, intergenerational downward transfers more than doubled in percentage terms in the east. This was predominantly caused by the sharp increase in pension benefits since the fall of the Berlin Wall. At the same time, mortality among pensioners dropped markedly, and converged 1 to western German levels. We further show that the rise in pension income was strongly correlated with the increase in social support and the decline in mortality among older eastern Germans. Discussion: Our result suggest that there was an interfamilial monetary transfer from the elderly to the young in exchange for social support. This mutual beneficial exchange may have helped to improve the survival of older East Germans after the reunification. |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp721&r=hea |
| By: | Gerard J. van den Berg; Pia R. Pinger; Johannes Schoch |
| Abstract: | We estimate average causal effects of early-life hunger on late-life health by applying instrumental variable estimation, using data with self-reported periods of hunger earlier in life, with famines as instruments. The data contain samples from European countries and include birth cohorts exposed to various famines in the 20th century. We use two-sample IV estimation to deal with imperfect recollection of conditions at very early stages of life. The estimated average causal effects may exceed famine effects by at least a factor three. |
| Keywords: | Nutrition, famine, ageing, developmental origins, height, two-sample IV |
| JEL: | I12 J11 C21 C26 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp710&r=hea |
| By: | Steffen Otterbach; Alfonso Sousa-Poza |
| Abstract: | In this paper, we use 12 waves of the German Socio-Economic Panel to examine the relationship between job insecurity, employability and health-related well-being. Our results indicate that being unemployed has a strong negative effect on life satisfaction and health. They also, however, highlight the fact that this effect is most prominent among individuals over the age of 40. A second observation is that job insecurity is also associated with lower levels of life satisfaction and health, and this association is quite strong. This negative effect of job insecurity is, in many cases, exacerbated by poor employability. |
| Keywords: | Job insecurity, employment, employability, well-being, health, Germany |
| JEL: | J21 J22 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp720&r=hea |
| By: | Gerard J. van den Berg; Pia R. Pinger |
| Abstract: | This paper examines the extent to which pre-puberty nutritional conditions in one generation affect productivity-related outcomes in later generations. Recent findings from the biological literature suggest that age 8-12 is a critical period for male germ cell development. We build on this evidence and investigate whether undernutrition at that age biologically transmits to children and grandchildren. Our findings indicate that third generation males (females) tend to have higher mental health scores if their paternal grandfather (maternal grandmother) was exposed to a famine during preadolescence. These effects seem to result from a biological shock and are not driven by social processes. |
| Keywords: | Famine, transgenerational transmission, epigenetics, mental health, education, long-run effects, nutrition, intergenerational effects, slow-growth period |
| JEL: | I12 J11 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp709&r=hea |
| By: | Jan Kleibrink |
| Abstract: | In an empirical study based on data from the German Socio-Economic Panel, the effect of job quality on individual health is analyzed. Extending previous studies methodologically to estimate unbiased effects of job satisfaction on individual health, it can be shown that low job satisfaction affects individual health negatively. In a second step, the underlying forces of this broad effect are disentangled. The analysis shows that the effects of job satisfaction on health run over the channels of job security and working hours above the individual limit. Job quality not only has a strong impact on mental health but physical health is affected as well. At the same time, health-damaging behavior including smoking and being overweight is not affected. |
| Keywords: | Individual Health; Job Satisfaction |
| JEL: | I14 J24 J28 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp718&r=hea |
| By: | Sabia, Joseph J. (San Diego State University); Pitts, M. Melinda (Federal Reserve Bank of Atlanta); Argys, Laura (University of Colorado-Denver) |
| Abstract: | Adams, Blackburn, and Cotti (ABC) found that increases in minimum wages were positively related to drunk driving–related traffic fatalities for those ages 16 to 20. The hypothesized mechanism for this relationship—increased alcohol consumption caused by minimum wage–induced income gains—remains empirically unexplored. Using data from two national behavioral surveys and an identification strategy identical to ABC, we find little evidence that an increase in the minimum wage leads to increases in alcohol consumption or drunk driving among teenagers. These results suggest a much smaller set of plausible causal channels to explain ABC's findings. |
| Keywords: | minimum wage; teen drunk driving; alcohol consumption |
| JEL: | J38 K42 |
| Date: | 2014–11–01 |
| URL: | http://d.repec.org/n?u=RePEc:fip:fedawp:2014-20&r=hea |
| By: | Isabel Correia (Universidade do Minho, NIMA); Patricia Norwood (HERU- Aberdeen University); Paula Veiga (Universidade do Minho, NIMA); Verity Watson (HERU- Aberdeen University) |
| Abstract: | This study aims to identify Portuguese patients’ views and preferences on Primary Care (PC) services by exploring patients' experiences of receiving primary care. |
| Keywords: | Primary Health Care, Patient’s preferences, Health Care attributes, Portugal |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nim:nimawp:58/2014&r=hea |
| By: | Carpenter, Christopher S. (Vanderbilt University); Dobkin, Carlos (University of California, Santa Cruz); Warman, Casey (Dalhousie University) |
| Abstract: | A substantial economics literature documents that tighter alcohol controls reduce alcohol related harms, but far less is known about mechanisms. We use the universe of Canadian mortality records to document that Canada's Minimum Legal Drinking Age (MLDA) significantly reduces mortality rates of young men but has much smaller effects on women. Using drinking data that are far more detailed than in prior work, we document that the MLDA substantially reduces 'extreme' drinking among men but not women. Our results suggest that alcohol control efforts targeting young adults should focus on reducing extreme drinking behavior. |
| Keywords: | alcohol control, MLDA, mechanisms |
| JEL: | I18 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp8720&r=hea |
| By: | Drydakis, Nick (Anglia Ruskin University) |
| Abstract: | The current study uses six annual waves of the Longitudinal Labor Market Study (LLMS) covering the 2008-2013 period to obtain longitudinal estimations suggesting statistically significant negative effects from unemployment on self-reported health and mental health in Greece. The specifications suggest that unemployment results in lower health and the deterioration of mental health during the 2008-2009 period compared with the 2010-2013 period, i.e., a period in which the country's unemployment doubled as a consequence of the financial crisis. Unemployment seems to be more detrimental to health/mental health in periods of high unemployment, suggesting that the unemployment crisis in Greece is more devastating as it concerns more people. Importantly, in all specifications, comparable qualitative patterns are found by controlling for unemployment due to firm closure, which allows us to minimize potential bias due to unemployment-health related reverse causality. Moreover, in all cases, women are more negatively affected by unemployment in relation to their health and mental health statuses than are men. Greece has been more deeply affected by the financial crisis than any other EU country, and this study contributes by offering estimates for before and during the financial crisis and considering causality issues. Because health and mental health indicators increase more rapidly in a context of higher surrounding unemployment, policy action must place greater emphasis on unemployment reduction and supporting women's employment. |
| Keywords: | self-reported health, self-reported mental health, unemployment, financial crisis |
| JEL: | C23 C33 E24 I12 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp8742&r=hea |
| By: | Mosca, Irene (Trinity College Dublin); Barrett, Alan (ESRI, Dublin) |
| Abstract: | The few studies that have attempted to identify the causal effects of retirement on mental health and well-being have provided conflicting evidence. Hence, whether retirement affects mental health positively or negatively is still unclear. Our primary objective is to investigate the impact of retirement on mental health as measured by the 20-item Center for Epidemiological Studies Depression Scale (CES-D). We use data from the first two waves of The Irish Longitudinal Study on Ageing (TILDA). This is a nationally representative sample of individuals aged 50 and over and living in Ireland. To deal with possible endogeneity problems, we use first-differenced estimation models and control for a broad range of life events occurring between the two waves. These include transition to retirement but also demographic, social, economic and physical health events. As part of the TILDA survey, reasons for retirement are asked. We exploit this information and distinguish between individuals who retired voluntarily, involuntarily or because of own ill health. We find that involuntary, or forced, retirement has a negative and statistically significant effect on mental health. In contrast, we find no effects for voluntary retirement. We also find that retirement due to ill health is negatively associated with mental health. |
| Keywords: | mental health, retirement |
| JEL: | J26 J14 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp8723&r=hea |
| By: | Nyantara Wickramasekera (Leeds Institute of Health Sciences, University of Leeds); Sandy Tubeuf (Leeds Institute of Health Sciences, University of Leeds); Thomas Veale (Leeds Institute of Health Sciences, University of Leeds); Judy Wright (Leeds Institute of Health Sciences, University of Leeds); Helen Elsey (Leeds Institute of Health Sciences, University of Leeds); Jenni Murray (Leeds Institute of Health Sciences, University of Leeds) |
| Abstract: | Background: Care farms are increasingly commissioned by public sector and health sector organizations to provide support to vulnerable people. It is a complex intervention that provides farming activities for therapeutic purposes. The evidence base assessing the effectiveness of care farms is relatively recent and to date no systematic review has been conducted to assess the impact of care farms using health-related-quality-of-life measures. Aim: This systematic review aims to identify any existing literature evaluating the impact of care farms and green care interventions in adult populations, with a specific focus on health-relatedquality- of-life measures that could be used for a cost-effectiveness or cost-utility analysis. Methods: 19 general health and social science databases were searched systematically in November 2013. Care farm and green care interventions, for adults measuring HRQOL outcome were included and assessed for methodological quality using the Cochrane’s six item risk of bias checklist. Results: Five studies with four hundred and eighty-four participants were included in this review. Two studies favoured the interventions, whereas three studies did not find strong evidence that the intervention had an effect on participants’ health-related-quality-of-life at post-intervention follow-up. These results indicated that care farms and green care may benefit certain populations such as breast and lung cancer patients, the elderly, and people with affective disorders. Conclusions: Given the small number of available studies and their methodological limitations we cannot make unequivocal conclusions about the impact of care farms on health-relatedquality- of-life. With this caveat, some evidence suggests that care farms and green care interventions can improve quality of life for some participants. However, this review highlights the need to conduct more high quality trials with larger sample sizes and longer term follow-up. |
| Keywords: | health-related quality-of-life, care farms, green care, cost-effectiveness, cost-utility |
| JEL: | I31 I38 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:lee:wpaper:1410&r=hea |
| By: | Nikhil Agarwal |
| Abstract: | This paper develops a framework for estimating preferences in two-sided matching markets with non-transferable utility using only data on observed matches. Unlike single-agent choices, matches depend on the preferences of other agents in the market. I use pairwise stability together with a vertical preference restriction on one side of the market to identify preference parameters for both sides of the market. Recovering the distribution of preferences is only possible in an environment with many-to-one matching. These methods allow me to investigate two issues concerning the centralized market for medical residents. First, I examine the antitrust allegation that the clearinghouse restrains competition, resulting in salaries below the marginal product of labor. Counterfactual simulations of a competitive wage equilibrium show that residents’ willingness to pay for desirable programs results in estimated salary markdowns ranging from $23,000 to $43,000 below the marginal product of labor, with larger markdowns at more desirable programs. Therefore, a limited number of positions at high quality programs, not the design of the match, is the likely cause of low salaries. Second, I analyze wage and supply policies aimed at increasing the number of residents training in rural areas while accounting for general equilibrium effects from the matching market. I find that financial incentives increase the quality, but not the number of rural residents. Quantity regulations increase the number of rural trainees, but the impact on resident quality depends on the design of the intervention. |
| JEL: | C51 C78 J41 J44 L44 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20767&r=hea |
| By: | Richard Akresh; German Daniel Caruso; Harsha Thirumurthy |
| Abstract: | This paper estimates the impact of armed conflict on subsequent health outcomes using detailed geographic information on households’ distance from conflict sites—a more accurate measure of conflict exposure— and compares the impact on children exposed in utero versus after birth. The identification strategy relies on exogenous variation in the conflict’s geographic extent and timing as well as the exposure of different birth cohorts while in utero or after birth. Results show that war-exposed children subsequently have lower height-for-age Z-scores, and impacts using GPS information are 87-188% larger than if exposure is measured at the imprecise regional level. Effects of in utero and after birth exposure are comparable in magnitude, and children in the war instigating and losing country (Eritrea) suffer more than the winning nation (Ethiopia). Results are robust to including region-specific time trends, alternative conflict exposure measures, and addressing potential bias due to selective migration. |
| JEL: | I12 J13 O12 O15 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20763&r=hea |
| By: | Amy Finkelstein; Matthew Gentzkow; Heidi Williams |
| Abstract: | We study the drivers of geographic variation in US health care utilization, using an empirical strategy that exploits migration of Medicare patients to separate the role of demand and supply factors. Our approach allows us to account for demand differences driven by both observable and unobservable patient characteristics. We find that 40-50 percent of geographic variation in utilization is attributable to patient demand, with the remainder due to place-specific supply factors. Demand variation does not appear to result from differences in past experiences, and is explained to a significant degree by differences in patient health. |
| JEL: | H51 I1 I11 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:20789&r=hea |
| By: | Hugh Gravelle (Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, UK); Giuseppe Moscelli (Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, UK. PhD Student, University of Tor Vegata.); Rita Santos (Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, UK); Luigi Siciliani (Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, UK. Department of Economics and Related Studies, University of York, UK) |
| Abstract: | We examine (a) the effect of market structure on the level of mortality for AMI, hip fracture, and stroke between 2002/3 and 2010/11 and (b) whether this effect changed after the introduction of Choice policy in 2006 which gave patients the right to a wider choice of hospital. For AMI and hip fracture, hospitals with more rivals had higher mortality at the beginning of the period but this effect became smaller over the period. We find that the decline in the detrimental effect of market structure predated the introduction of Choice. Market structure had no effect on stroke mortality. |
| Keywords: | competition, quality, hospital, choice |
| JEL: | H51 I11 I18 L32 L33 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:chy:respap:106cherp&r=hea |
| By: | John V.C. Nye (National Research University Higher School of Economics); Maria M. Yudkevich (National Research University Higher School of Economics); Ekaterina A. Orel (National Research University Higher School of Economics); Ekaterina V. Kochergina (National Research University Higher School of Economics) |
| Abstract: | There is now a large literature on the correlates of prenatal androgen exposure and various individual measures of performance in sports, business, or schooling. However, there is still relatively limited evidence of the impact of prenatal androgens on life achievement. Using data from the Russian longitudinal survey and measured digit ratios, we found that age-corrected market wages are nonlinearly correlated with low measured 2D:4D ratios signifying higher prenatal testosterone. Unlike earlier work on noncognitive correlates of labor market wages, our findings indicate a clear-cut optimum 2D:4D ratio for women’s wages with higher and lower 2D:4D being associated with lowered wages. However, the size of these effects is small, especially compared to the influence of education on income. |
| Keywords: | Adult wages, Prenatal Testosterone, Female earnings |
| JEL: | J24 J31 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:hig:wpaper:71/ec/2014&r=hea |
| By: | John V.C. Nye (National Research University Higher School of Economics); Maxim V. Bryukhanov (National Research University Higher School of Economics); Sergiy S. Polyachenko (National Research University Higher School of Economics) |
| Abstract: | Using a large sample drawn from families in the Moscow and Moscow region which are part of the Russian RMLS longitudinal survey we observe clear links between measured 2D:4D digit ratios and a variety of life outcome measures, even with the inclusion of multiple controls. Contributing to existing empirical ndings, we found statistically signicant empirical associations of 2D:4D with higher educational attainment, occupational outcomes, knowledge of foreign language, smoking, engaging in sport activities and with some aspects of respondent's self-esteem. In general, the character of detected empirical associations are dierent for women and men, as it was documented in our previous studies. |
| Keywords: | Prenatal testosterone, 2D:4D, level of education, occupations, lifetime outcomes |
| JEL: | D03 I12 J24 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:hig:wpaper:78/ec/2014&r=hea |
| By: | Alexander Karpov (National Research University Higher School of Economics) |
| Abstract: | This paper justifies unequal health care quality in a model with two regions and patients differentiated by location and quality perception. Efficient distribution with unequal healthcare quality arises when there are low travel and/or quality provision costs. If costs are sufficiently low, then both regions win from inequality. Lump-sum transfers and price regulatory policies restore an efficient solution. |
| Keywords: | horizontal and vertical differentiation, health care quality, health care inequality |
| JEL: | L1 I1 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:hig:wpaper:64/ec/2014&r=hea |
| By: | Lutfunnahar Begum; Philip J. Grossman; Asadul Islam |
| Abstract: | This paper investigates whether parents’ inherent gender bias is associated with intrahousehold human capital investment among boys and girls. We conduct an artifactual field experiment to identify parents’ inherent gender bias and then attempt to examine how this attitude correlates with the actual decisions regarding schooling and health of their own children. We focus on five indicators for education, viz., years of schooling, grade for age, enrolment status, education expenditure, and test scores; and three indicators for health, viz., incidence of illness, and access to formal treatment and treatment cost, in case of illness. Although the game outcome suggests that on average, there is no systematic inherent bias among parents, yet inherently biased parents allocate resources in a discriminatory manner. The results suggest that boy-biased parents are more likely to have their boys enrolled in school and to spend more on their boys’ education; and also, less likely to enrol their girls in school and spend less on girls’ education. The boy-biased parents are also less likely to seek formal treatment and tend to spend less when a girl is sick. |
| Keywords: | Household behavior, Gender, Children, Field experiment, Bangladesh |
| JEL: | D10 J16 J13 C93 D13 |
| Date: | 2014–09 |
| URL: | http://d.repec.org/n?u=RePEc:mos:moswps:2014-30&r=hea |
| By: | Miriam Schneidman; Russell J. Dacombe; Jane Carter |
| Abstract: | Laboratories have historically been under supported in developing country health systems resulting in poor quality diagnosis and inadequate disease surveillance. Laboratory professionals are predominantly male with relatively limited female labor participation, with potential gender based barriers to advancement. The focus on communicable diseases has meant that funding for broader public health laboratory services has been relatively neglected. In this paper the authors present a number of strategies to address these problems based on the outcomes from a literature review and case studies conducted in four African countries. Improved registration and human resource planning are required to establish the scale of the problem and to develop country specific strategies to address skills shortages. More high quality pre-service training is needed to supply the service with suitably skilled professional staff to address the current deficit. Innovative in-service training is essential to maintain competence and collaboration is required with the private sector to utilize their expertise. A clear career structure with transparent promotional opportunities is required to recruit and retain staff in the public sector. The establishment of suitable work environments and regulatory and representative bodies will also support recruitment and retention as well as enhance quality. It is also clear that this cadre has been underrepresented in human resources for health research and more activity in this area will lead to greater understanding of the problems and provide more potential solutions. |
| Keywords: | Accreditation, accreditation bodies, Acquired Immune Deficiency Syndrome, AIDS Patient, AIDS Relief, anemia, Avian Influenza, career, career development, career opportunities ... See More + Chikungunya, clinical practices, clinics, communicable disease, communicable diseases, competitive salaries, cost of training, counselors, curriculum, curriculum development, degree programs, degrees, developing countries, development efforts, diagnoses, diagnosis, DIAGNOSTICS, disease, Disease Control, disease outbreaks, disease surveillance, disease transmission, drug resistance, Ebola, economic growth, effective use, Emergency Plan, employment, employment opportunities, endemic diseases, epidemic, epidemics, epidemiologists, Epidemiology, females, fever, financial constraints, focus group discussions, geographic distribution, Government policies, Gross Domestic Product, health care, health care system, health centers, health facilities, Health Interventions, health ministries, Health Outcomes, health policy, Health Regulations, health research, health sector, health system, health systems, health workers, health workforce, hematology, higher education, higher learning, HIV, HIV testing, HIV/AIDS, hospital, hospitals, human resource management, human resource planning, Human Resources, Hygiene, illnesses, Immune Deficiency, immunology, infection, Infectious Diseases, Influenza, informant, informants, job satisfaction, Lab, labor force, labor market, Laboratories, LABORATORY, laboratory facilities, laboratory services, laboratory workers, learning, learning outcomes, literature, Low-income Countries, Lung Diseases, malaria, malaria diagnosis, medical equipment, medical laboratories, Medical Research, midwives, migration, Ministers of Health, Ministries of Health, Ministry of Education, Ministry of Health, minority, National Accreditation, national health systems, National laboratory, national level, national strategies, needs assessment, number of workers, nurse, nurses, Nutrition, on the job training, papers, Pathology, patient, patients, pharmacists, pharmacy, physicians, physiotherapists, policy decisions, policy discussions, policy level, practitioners, preventive medicine, private sector training, private training, private training institutions, Professional Associations, professional development, professional training, progress, public health, public policy, push factors, qualified personnel, qualified professionals, quality assurance, quality control, Quality Improvement, quality of services, reagents, regional networks, Research Institute, respect, risk of exposure, rural areas, schools, Scientist, Scientists, secondary school, service delivery, Service Providers, service provision, skilled human resources, skilled personnel, skilled staff, smaller number, Social Welfare, spillover, STDs, Strengthening human resources, student intake, syphilis, TB, teaching, teaching materials, technical expertise, threats, training facilities, training institutions, training opportunities, training programs, treatment, Tropical Medicine, Tuberculosis, urban areas, Vicious Cycle, Virus, weight loss, work environment, work force, workers, workforce, working conditions, World Health Organization |
| Date: | 2014–11 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:hnpdps:92728&r=hea |
| By: | Maciej Lis; Iga Magda |
| Abstract: | We provide a comparative cross-country analysis of individual age-wage proles for different health statuses. Using semi-parametric regressions run on EU-SILC data we aim at answering the question on the relationship b etween individual health and pro ductivity and its changes in the life cycle, separating the impact of health from traditional wage determinants. We nd that although the agepro ductivity proles vary much among countries, these dierences are not inuenced by the self-p erceived health status. |
| Keywords: | Health, Ageing, Productivity |
| JEL: | I19 J24 |
| Date: | 2014–05 |
| URL: | http://d.repec.org/n?u=RePEc:ibt:wpaper:wp022014&r=hea |
| By: | McGovern, Mark E.; Bärnighausen, Till; Joshua A. Salomon; Canning, David |
| Abstract: | Selection bias in HIV prevalence estimates occurs if non-participation in testing is correlated with HIV status. Longitudinal data suggests that individuals who know or suspect they are HIV positive are less likely to participate in testing in HIV surveys, in which case methods to correct for missing data which are based on imputation and observed characteristics will produce biased results. Interviewer identity is associated with testing participation, but is plausibly uncorrelated with HIV status, allowing a Heckman-type correction that produces asymptotically unbiased HIV prevalence estimates, even when non-response is correlated with unobserved characteristics, such as knowledge of HIV status. We introduce a new random effects method which overcomes non-convergence caused by collinearity, small sample bias, and incorrect inference in existing approaches. It is easy to implement in standard statistical software, and allows the construction of bootstrapped standard errors which adjust for the fact that the relationship between testing and HIV status is uncertain and needs to be estimated. Using nationally representative data from the Demographic and Health Surveys, we illustrate our approach with new point estimates and confidence intervals (CI) for HIV prevalence among men in Ghana and Zambia. In Ghana, we find little evidence of selection bias as our selection model gives a HIV prevalence estimate of 1.4% (95% CI 1.2% ? 1.6%), compared to 1.6% among those with a valid HIV test. In Zambia, our selection model gives a HIV prevalence estimate of 16.3% (95% CI 11% - 18.4%), compared to 12.1% among those with a valid HIV test. Therefore, those who decline to test in Zambia are found to be more likely to be HIV positive, however our new bootstrap confidence intervals are wide. Our approach corrects for selection bias in HIV prevalence estimates, is possible to implement even when HIV prevalence or non-response is very high or low, and provides a practical solution to account for both sampling and parameter uncertainty in the estimation of confidence intervals. These wide confidence intervals reflect that it is difficult to correct statistically for the bias that may occur when many people refuse to test. |
| Date: | 2014–01 |
| URL: | http://d.repec.org/n?u=RePEc:qsh:wpaper:85431&r=hea |
| By: | S. Balia; R. Brau; E. Marrocu |
| Abstract: | Patient mobility is a crucial phenomenon in contexts of hospital competition based on quality and driven by patient choice. This study examines inter-regional patient mobility in the Italian National Health Service, a regionally decentralised tax-funded system in which in-patient hospital services are provided free at any point of use in the whole country, using administrative data on hospital discharges from 2001 to 2010 in all public and private accredited hospitals. The aim is to understand whether mobility patterns might have consequences for the efficiency and effectiveness of the healthcare provided at the regional level, as well as universalism and equity in healthcare. We specify a gravity model for Origin-Destination (OD) flow data that distinguishes between emissiveness (at Origin) and attractiveness (at Destination) factors affecting bilateral flows. We exploit the longitudinal dimension of the data and estimate a negative binomial conditionally correlated random effects (CCRE) dynamic model that allows for region-pair-specific unobservable heterogeneity. Total and specific types of flow (surgical, medical, acute and cancer-related admissions) are modelled, accounting for the correlation between unobserved region-pair effects and time-variant covariates and their spatial lags. Our main findings indicate that RHSs in the richest regions attract more patients from other regions and that the most effective pull factors are the number of beds and diversification of the organisational structure. We also find that the ability of a RHS to attract patients who reside in other regions decreases with the concentration of the organizational structure. Finally, we have detected a mildly explosive dynamics in inter-regional patient mobility over time, which could have implications for the long-run sustainability of the overall national-regional health system. |
| Keywords: | hospital admission, gravity model, decentralised health systems, spatial dependence, negative binomial regression, nonlinear panel data methods |
| JEL: | I18 I1 H77 H75 C23 |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:cns:cnscwp:201409&r=hea |
| By: | Adam Pilny; Roman Mennicken |
| Abstract: | A number of recent empirical studies document significant effects of in-patient care quality indicators on the choice of hospital. These studies use either objective quality indicators based on quantitative figures, or if subjective reputation scores are used, scores based on the opinion of hospital market insiders. We contribute to the current debate by using a subjective reputation score resorting to patient perceptions and examine its impact on the choice of hospital of patients undergoing a coronary artery bypass graft (CABG) in Germany. Our results show that 76% of the patients value hospital reputation positively when choosing a hospital. Moreover, we find evidence for a trade-off between hospital reputation and travel time, i.e. a significant share of patients is willing to accept additional travel time to get a treatment in a hospital with better reputation. The average marginal effect for hospital reputation confirms this finding, since the magnitude of the effect strengthens for higher thresholds of travel time. The results are robust for different degrees of co-morbidities and admission status. |
| Keywords: | Hospital choice; hospital reputation; mixed logit model |
| JEL: | C25 D12 I11 |
| Date: | 2014–11 |
| URL: | http://d.repec.org/n?u=RePEc:rwi:repape:0516&r=hea |
| By: | Jeannette Brosig-Koch; Nadja Kairies-Schwarz; Johanna Kokot |
| Abstract: | Most common physician payment schemes include some form of traditional capitation or fee-for-service payment. While health economics research often focuses on direct incentive effects of these payments, we demonstrate that the opportunity to sort into one’s preferred payment scheme may also significantly affect medical treatment. Our study is based on an experiment testing individual sorting into fee-for-service and capitation payment under controlled laboratory conditions. A sequential design allows differentiating between sorting and incentive effects. We find a strong preference for fee-for-service payment, independent of subjects’ prior experience with one of the two payment schemes. Our behavioral classification reveals that subjects who select into capitation deviate less from patient-optimal treatment than those who prefer fee-for-service payment. Moreover, comparing subjects’ behavior before and after introducing the choice option, we find that subjects preferring fee-for-service become even less patient-oriented after this introduction. As a result, the opportunity to choose a payment scheme does not improve, but - if at all - worsens patient treatment in our experiment. Our findings stress the importance of acknowledging potential sorting and incentive effects in the analysis of physician payment schemes. |
| Keywords: | Physician incentives; fee-for-service; capitation; payment choice; sorting effects; laboratory experiment |
| JEL: | C91 D84 |
| Date: | 2014–12 |
| URL: | http://d.repec.org/n?u=RePEc:rwi:repape:0529&r=hea |
| By: | Adam Pilny |
| Abstract: | German hospitals receive subsidies for investment costs by federal states. Theoretically, these subsidies have to cover the whole investment volume, but in fact only 50%-60% are covered. Balance sheet data show that public hospitals exhibit higher levels of subsidies compared to for-profit hospitals. In this study, I examine the sources of this disparity by decomposing the differential in a so-called facilitation ratio, i.e. the ratio of subsidies to tangible fixed assets, revealing to which extent assets are funded by subsidies. The question of interest is, whether the differential can be attributed to observable hospital-specific and federal state-specific characteristics or unobservable factors. |
| Keywords: | Hospitals; subsidies; ownership; Blinder-Oaxaca decomposition |
| JEL: | H25 I11 L33 |
| Date: | 2014–11 |
| URL: | http://d.repec.org/n?u=RePEc:rwi:repape:0517&r=hea |
| By: | Adam Pilny |
| Abstract: | Since the introduction of the DRG system in 2004, the German hospital market experienced a stream of consolidations in terms of mergers and acquisitions, resulting in a decreasing number of hospital owners. In this study, I examine the ex-ante characteristics of hospitals prior to a merger or an acquisition occurring between 2005 and 2010 in Germany, predominantly focusing on the financial conditions of hospitals. The results reveal that hospitals with a higher probability of default and less liquid resources are more often the targets of acquisitions. On the other hand, hospitals with a lower equity-to-assets ratio exhibit a higher probability of merger. This pattern can be explained by different motives and rationales of hospital chains and potential investors. |
| Keywords: | Hospital market; mergers; acquisitions; consolidation |
| JEL: | I11 L33 |
| Date: | 2014–11 |
| URL: | http://d.repec.org/n?u=RePEc:rwi:repape:0518&r=hea |
| By: | Jelena Zurovac; Randy Brown; Bob Schmitz |
| Keywords: | Care Coordination Medicare Dual Eligibles Special Needs Plans |
| JEL: | I J |
| Date: | 2013–03–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:57a6715d8b914f4ca2b45fc911ede157&r=hea |
| By: | Brenda Natzke; Maggie Colby; Erin Taylor |
| Abstract: | This brief presents an analysis of the Database of Publicly Available Medicaid and CHIP Performance Measure Reports. It provides background on the database; highlights the types of documents and reports available; and discusses which measure domains are typically represented, including examples of reported measures in each domain. The brief also discusses the types of stratification used by states in their analyses, such as beneficiary, provider, or health plan, and the frequency with which measures are reported. |
| Keywords: | Medicaid, CHIP Performance Measures, Publicly Available Reports, Health |
| JEL: | I |
| Date: | 2013–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:bf4707bb7e88425f88d7aed41d4ec6ba&r=hea |
| By: | Eugene C. Rich |
| Abstract: | This “Methods to Policy†piece discusses opportunities and challenges in reconciling increased demands for evidence to be “patient-centered†with the realities of highly diverse patient circumstances, preferences, and clinical situations. |
| Keywords: | Comparative Effectiveness Patient Centered Outcomes Evidence Based Care |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:91776a29992d48f99daf94418465d17e&r=hea |
| By: | Jane Fortson |
| Keywords: | Playworks Student, Healthy Behaviors, Randomized Controlled Trial, Education |
| JEL: | I |
| Date: | 2013–11–08 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b9317037a4ba4a7dabb1b8fee12b4ae9&r=hea |
| By: | Kristin Andrews |
| Keywords: | Ticket to Work, people with disabilities, employment of people with disabilities, State Medicaid , Disability, Labor |
| JEL: | I J |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:72fe7f3bbbdc43758cf46b0ea12e2845&r=hea |
| By: | Sheila Hoag; Debra Lipson; Michaella Morzuch; Victoria Peebles |
| Abstract: | KidsWell's premise is that the Affordable Care Act is the most viable near term policy option to cover all children. |
| Keywords: | KidsWell, Coverage for Children, ACA, Health |
| JEL: | I |
| Date: | 2014–06–03 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e40ef4319fae4a5baec24443399b8992&r=hea |
| By: | Lawrence S. Wissow; Jonathan Brown; Kate E. Fothergill; Anne Gadomski; Karen Hacker; Peter Salmon; Rachel Zelkowitz |
| Abstract: | A systematic review examined universal mental health screening in pediatric primary care, and found little research has addressed patients' engagement in the process or how clinicians can best use screening results. |
| Keywords: | Mental Health Patient Engagement Pediatrics Primary Care, Screening |
| JEL: | I J |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:3f0bf7f6f498418fb2583bf38bd1eaae&r=hea |
| By: | Julie Sykes Shinu Verghese |
| Abstract: | This report describes the creation of the MAX DOD 2009 update file and the MAX DOD 1999–2009 master file. It provides a brief synopsis of the data sources used in this process and presents quality control statistics about both files. The appendices include the file layout, data dictionary, data processing steps, and some frequently asked questions about the DOD information. |
| Keywords: | MAX DOD, Medicaid Analytic Extract Data of Death , Master File 2009 |
| JEL: | I |
| Date: | 2013–06–14 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:f420664ae95d4d88828b97eb2af7d56e&r=hea |
| By: | Maggie Colby Jim Verdier |
| Keywords: | Dual Eligible, Special Needs Plans, Fee-for-Service, Arizona |
| JEL: | I |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:fb07e59006b745ba969e56967338f8d5&r=hea |
| By: | Julia Paradise; Marsha Gold; Winnie Wang |
| Abstract: | This brief, the last of three case studies examining key operational aspects of coordinated care initiatives in Medicaid, focuses on Rhode Island's Chronic Care Sustainability Initiative. This multi-payer, patient-centered medical home initiative includes the one Medicaid health plan in the state and commercial health plans. |
| Keywords: | Medical Home Rhode Island Chronic Care Sustainability Initiative Medicaid |
| JEL: | I |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d40e4911b1614774bd393abe9244feaf&r=hea |
| By: | Rosemary Borck; Ashley Zlatinov; Susan Williams |
| Keywords: | MAX 2008 Medicaid Analytic eXtract Encounter Data Chartbook |
| JEL: | I |
| Date: | 2013–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:876475770047458e8188b7101512578a&r=hea |
| By: | Carol V. Irvin; Rosemary Borck; Wilfredo Lim |
| Keywords: | Medicare Medicaid Enrollees Medicaid Coverage Medicare Beneficiaries |
| JEL: | I J |
| Date: | 2013–03–11 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e2da7a1ce2014c14875f45227ed7a4b6&r=hea |
| By: | Rosemary Borck; Carol V. Irvin; Wilfredo Lim |
| Abstract: | We assessed transitions from Medicare-only to Medicare-Medicaid enrollment (MME) in 2009, examining variations in transition rates by age group, in use of long-term care (LTC) services, and across states. |
| Keywords: | Medicare, dual eligible, Medicare-Medicaid enrollment, long-term care, nursing home, state variations |
| JEL: | I |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e1238ad481cd4bcd837c0f2ae308a009&r=hea |
| By: | Marsha R. Gold |
| Abstract: | Testimony for the U.S. House of Representatives, Committee on Energy and Commerce, Health Subcommittee. |
| Keywords: | Medicare Advantage Medicare + Choice Health Testimony |
| JEL: | I |
| Date: | 2013–12–04 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:862dbaaf44124ff69c9a8a49dd55c374&r=hea |
| By: | Wilfredo Lim Carol V. Irvin |
| Abstract: | This report looks at short-term outcomes for people in the Money Follows the Person (MFP) demonstration. It found nursing home residents who had low care needs and transitioned to community living, through MFP or by other means, were slightly more likely to remain in the community and avoid reinstitutionalization than those with higher care needs. |
| Keywords: | Level of Care, reinstitutionalization, former nursing home residents, Money Follows the Person , Health |
| JEL: | I |
| Date: | 2013–09–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6b784b9c9fa44b76aadcd6f5a7d35e9f&r=hea |
| By: | James D. Reschovsky Chapin White |
| Abstract: | Average hospital outpatient department prices for common imaging, colonoscopy and laboratory services can be double the price for identical services provided in a physician’s office or other community-based setting. |
| Keywords: | Hospital Outpatient Prices, Community Settings, Health |
| JEL: | I |
| Date: | 2014–06–26 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6d78bfd26a6f418290dadb6d1771b93c&r=hea |
| By: | Arkadipta Ghosh; Cara Orfield; Robert Schmitz |
| Abstract: | Conducted as part of the Center of Excellence in Research on Disability Services and Care Coordination and Integration project, this study examined the effects of the Program of All-Inclusive Care for the Elderly (PACE) on Medicare and Medicaid expenditures, use of nursing home services, and mortality. PACE plans provide coordinated acute and long-term care services to nursing home–eligible older adults in the community. The study included two separate components: (1) a comprehensive review of existing evaluations of PACE, and (2) an empirical analysis of costs and outcomes for PACE enrollees relative to a matched comparison group. This report presents findings from the literature review. |
| Keywords: | PACE, Medicare costs, Medicaid costs, hospitalizations, nursing home admissions, quality of care, mortality |
| JEL: | I |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:286857291884466ebe23ba2526b86282&r=hea |
| By: | Karen Llanos; Jason Williams; Katie Adamek; Bailey Orshan |
| Keywords: | Medicaid, Adult Core Set, Adult Health Care Outcomes, Technical Assistance, Medicaid Health Care Quality, CARTS, Adult CARTS |
| JEL: | I |
| Date: | 2013–11–21 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:430d6d9e9fb940c3ad52680677b45d17&r=hea |
| By: | Deborah J. Chollet |
| Keywords: | Health Care Information Portal California Children Service Providers Functions, Models |
| JEL: | I |
| Date: | 2013–12–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1b904615efb8435ea9821994dcd5ebf8&r=hea |
| By: | Laura Ruttner; Irina Cheban; So O'Neil |
| Abstract: | This report describes the knowledge gain among participants of the Massachusetts Department of Public Health Helping You Take Care of Yourself prostate health workshops. Using scores on pre- and post-tests administered immediately before and after the workshops, findings indicated that knowledge increased among workshop participants on average and that they were generally satisfied with the workshops. |
| Keywords: | African Americans Prostate Cancer Massachusetts Health |
| JEL: | I |
| Date: | 2013–03–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e3d7174b1b1541a2b84d0b9eb2f5b765&r=hea |
| By: | Dana Petersen; Henry Ireys; Grace Ferry; Leslie Foster |
| Abstract: | This evaluation highlight illustrates how six grantees use multistate partnerships to improve the quality of children's health care. It describes the strategies that states use to create and maintain cross-state relationships, as well as the benefits and challenges of partnering. |
| Keywords: | CHIPRA , Quality of Health Care , Children's Health Quality Demonstration |
| JEL: | I |
| Date: | 2014–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b76439a2843749b2a0eea89d0f2308de&r=hea |
| By: | Hollis Day; Elizabeth Eckstrom; Sei Lee; Heidi Wald; Steven Counsell; Eugene Rich |
| Abstract: | This perspectives piece sets forth a research agenda in the area of implementation science at the intersection of geriatrics and general internal medicine. It notes how, as the population ages and patients with multiple complex conditions consume more care, the need for research on new approaches to this type of medicine will continue to grow. |
| Keywords: | implementation research geriatrics primary care |
| JEL: | I |
| Date: | 2014–03–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:35415ff0bae5400997a9b246c5eaf07a&r=hea |
| By: | Laura Damschroder; Deborah Peikes; Dana Petersen |
| Keywords: | PCMH Patient-Centered Medical Home Models Implementation Research Adaptation, Dissemination |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:08d14bcc49ee436ba76beec296b3c75e&r=hea |
| By: | Wilfredo Lim; Carol V. Irvin; Rosemary Borck |
| Abstract: | This is one volume of a two-part study to understand the rates and patterns of enrollment in Medicaid among individuals already enrolled in Medicare, the factors that predict this transition to dual coverage, and factors that predict nursing home entry. This volume provides estimated econometric models that predict beneficiaries’ enrollment in Medicaid and their entry into long-term nursing home stays. |
| Keywords: | Medicare, Medicaid, Enrollee Status, Disability, dual eligibility |
| JEL: | I J |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:ca28627bafb141c995ed4e54ba0d2773&r=hea |
| By: | Grace Anglin; Adam Swinburn; Leslie Foster; Cindy Brach; Linda Bergofsky |
| Abstract: | This implementation guide helps states implement or improve care management entities (CMEs), which are designed to coordinate services provided by the many state agencies that serve youth with complex behavioral health needs. |
| Keywords: | CHIPRA quality demonstration, behavioral health, mental health, cross-agency coordination, care management entity, Maryland, Georgia, Wyoming, pediatric |
| JEL: | I |
| Date: | 2014–09–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:8b26e5381126442589b3a4e7f0a701a3&r=hea |
| By: | Marsha Gold Giselle Casillas |
| Keywords: | Medicare Advantage, Traditional Medicare, Quality, Health Care Access |
| JEL: | I |
| Date: | 2014–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e640dda97d0c440bbbe1082ec1a3c5fb&r=hea |
| By: | Julia Adler-Milstein; Catherine M. DesRoches; Michael F. Furukawa; Chantal Worzala; Dustin Charles; Peter Kralvec; Samantha Stalley; Ashish K. Jha |
| Abstract: | The national effort to promote the adoption and meaningful use of electronic health records (EHRs) is well under way. However, 2014 marks an important transition: For many hospitals, penalties will be assessed in fiscal year 2015 for failing to meet federal meaningful-use criteria by the end of fiscal year 2014. |
| Keywords: | Information Technology, Hospitals, EHR |
| JEL: | I |
| Date: | 2014–09–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:ff23228b8d5547ccb749a1a586ddaf31&r=hea |
| By: | Randy Brown |
| Keywords: | Care Coordination, Long-Term Care Beneficiaries, High-Need beneficiaries, Health |
| JEL: | I |
| Date: | 2013–07–17 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c223533fb2a446c7b7300f7d6e9aaf1a&r=hea |
| By: | Sarah A. Avellar Lauren H. Supplee |
| Abstract: | This article found existing rigorous research indicates that home visiting programs serving at-risk pregnant women and children from birth to age 5 have the potential for positive results on these families, particularly on health care usage and child development. |
| Keywords: | Home Visiting, Child Health, Child Development, Child Maltreatment |
| JEL: | I |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2d00cdb4b2eb4fee8087572fc098dfcd&r=hea |
| By: | Allison Hedley Dodd Philip M. Gleason |
| Abstract: | This brief presents the results of the first study conducted using the newly merged Medicaid Analytic eXtract (MAX) and National Health and Nutrition Examination Survey (NHANES) data. The study evaluated the association between Medicaid costs and obesity among adults in 1999–2004. Although the estimated costs were higher for obese adults than for non-obese adults, the combination of a small sample size for NHANES data, wide variation in costs among Medicaid enrollees, and the necessity of controlling for state variation yielded an unstable model with imprecisely estimated relationships. The results demonstrate the hazard of using a small national survey (NHANES) with a state-based data system (MAX) to perform cost analyses, particularly when the range of realistic costs is large. |
| Keywords: | Medicaid Analytic eXtract (MAX) Medicaid enrollment The National Health and Nutrition Examination Survey (NHANES) data to evaluate the association of Medicaid costs and obesity |
| JEL: | I |
| Date: | 2013–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c7372d9ed25c445f9c683edde070a299&r=hea |
| By: | Joseph S. Zickafoose; Lisa R. DeCamp; Dana J. Sambuco; Lisa A. Prosser |
| Abstract: | In this study 20 parents were interviewed about experiences accessing primary care for their children, priorities for enhanced access, and willingness to make trade-offs. Parents had strong preferences for certain services, such as same-day sick care appointments, and were willing to make trade-offs for high-priority services. The authors concluded that primary care practices and medical home programs should educate families about trade-offs needed to implement new services and engage families in setting priorities for medical home implementation. |
| Keywords: | Pediatric Medlical Home Enhanced Access Qualitative Study Health |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:dda4270e65584ee680b55caf1c19ccaa&r=hea |
| By: | John Gettens Alexis D. Henry |
| Abstract: | To address the unmet need for employment-related health care services among persons with disabilities, an alternative and potentially viable policy solution is the development of a new type of subsidized coverage to ‘wrap-around’ the new ACA coverage or other private and public coverage. Additional information on the employment-related health care needs of persons with disabilities is needed to inform the potential development of these plans. |
| Keywords: | Employment, Health Insurance, Service Delivery, Disabilities |
| JEL: | I J |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b65f73905e53403e8aaa4bda1c5efa9f&r=hea |
| By: | Dana Petersen; Lisa Schottenfeld; Caroline Massad Francis; Henry Ireys; Joseph Zickafoose |
| Abstract: | The purpose of this study, sponsored by the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services as part of the Center on Excellence in Disabilities Research, is to describe parents’ perspectives on the care received at medical homes and offer suggestions for ensuring that PCMH models benefit CSHCN and their families. The study is based on key informant discussions with a convenience sample of nine parents of CSHCN receiving primary care at practices recognized as medical homes and six parents who have become leaders in consumer organizations. |
| Keywords: | Patient-Centered Medical Homes, Children , Disability |
| JEL: | I J |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:5fc653e8cfa645d9afe4f159cf8382ab&r=hea |
| By: | Margaret Hargreaves; Vanessa Oddo; Lindsey Stillman; Jonathan Sherwood; Steven Sullivan |
| Abstract: | In a project for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Mathematica and our partners at Cloudburst analyzed current federal (Health Resources and Services Administration and Housing and Urban Development) HIV housing assistance services data and best practices integrating HIV housing and health care services. This report includes a quantitative study of the costs, utilization, and outcomes of current federal HIV housing assistance services and a qualitative study of innovative programs integrating housing assistance with HIV care. It also suggests opportunities for improvement. |
| Keywords: | HIV Care, Housing, Ryan White Program, HOPWA Program |
| JEL: | I |
| Date: | 2014–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2313e87b865c45c49a5de408f35af028&r=hea |
| By: | John L. Czajka |
| Abstract: | This brief examines the practical coverage continuity issues raised by determining Medicaid eligibility on a monthly basis while determining subsidy eligibility on an annual basis. |
| Keywords: | SHARE, Income Eligibility, Affordable Care Act, Annual Income , Assistance, Health |
| JEL: | I |
| Date: | 2013–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e9aac2772b794ba4978f710382a96712&r=hea |
| By: | David K. Baugh Shinu Verghese |
| Abstract: | This study used unduplicated Medicaid enrollment records from 2005 to 2007 to examine enrollees' migration across states. Over the study period, only 3.7 percent moved to another state at least once. This provides a benchmark for adjusting national Medicaid statistics to reduce over-counting. Most moves were not associated with enrollment gaps, but 8.2 percent of moves were associated with short-term gaps. These gaps could indicate a lack of health insurance coverage, leading to concerns about patients' outcomes and higher systemwide costs. |
| Keywords: | MAX Medicaid Eligibility Enrollment, Migration, Moving |
| JEL: | I |
| Date: | 2013–12–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:bab4d15104294803acfedc44f15f6a35&r=hea |
| By: | Angela M. Gerolamo; Amy Overcash; Jennifer McGovern; Grace Roemer; Susan Bakewell-Sachs |
| Abstract: | As a strategy to address the nursing faculty shortage in the state, the Robert Wood Johnson Foundation implemented the New Jersey Nursing Initiative Faculty Preparation Program to prepare nurses for the faculty role. This article highlights program implementation successes and challenges and scholars' and faculty's perceptions of the program, and it provides recommendations for others interested in preparing nurse faculty. |
| Keywords: | Nurse faculty shortage, Faculty preparation |
| JEL: | I |
| Date: | 2014–07–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2f74a85981a64b17970ed40b0424fd8a&r=hea |
| By: | Julia Paradise; Marsha Gold; Winnie Wang |
| Abstract: | This issue brief focuses on Colorado's Medicaid reform initiative, the Accountable Care Collaborative, and one of its three core components, the Statewide Data Analytics Contractor. This component supports primary care providers networked to seven regional care collaboratives and provides data to support care management and improvement. Mathematica health experts collaborated with staff at the Kaiser Commission for Medicaid and the Uninsured to author the brief, the first of three planned studies. |
| Keywords: | Data Analytics, Medicaid, Colorado, Accountable Care Collaborative |
| JEL: | I |
| Date: | 2013–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:104d53a482024a06a85d5242e44f2c27&r=hea |
| By: | Angela M. Gerolamo; Jung Y. Kim; Jonathan D. Brown; James Schuster; Jane Kogan |
| Abstract: | This qualitative study examined the implementation of a reverse colocation pilot program that sought to integrate medical care in two community behavioral health agencies. |
| Keywords: | Reverse Colocation Model, Behavioral Health, Pennsylvania |
| JEL: | I C |
| Date: | 2014–07–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2ec88a0516f64a7fa60a0d03ac0d6cd8&r=hea |
| By: | Deo Bencio |
| Abstract: | This report describes the motivation for creating the MAXPC file and its design and content. It also examines the quality and completeness of each of the six types of provider IDs (inpatient billing provider, long-term care billing provider, other services billing and servicing provider, and prescription drug billing and prescribing providers). The analysis focuses on the 45 states that had the requisite Medicaid Statistical Information System files available for calendar year 2010 services (Idaho, Kansas, Maine, New Jersey, North Dakota, and Utah are excluded). The quality and completeness vary substantially by state and type of provider ID. |
| Keywords: | Medicaid, Medicaid Analytic Extract, MAX, Provider Characteristics, MAXPC, 2010 |
| JEL: | I |
| Date: | 2013–07–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:04ccf7ab6e4040d5a277be732f8c3fd0&r=hea |
| By: | Eugene C. Rich |
| Abstract: | This article discusses the implications of diagnostic errors for comparative effectiveness research (CER). It notes the potential role of CER studies for improving diagnosis and treatment decisions and the value of expanding the CER agenda to address misdiagnosis. |
| Keywords: | Comparative Effectiveness Research Misdiagnosis Mdthods Research Health |
| JEL: | I |
| Date: | 2013–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:f256f01a9640400aa167afbf046974c6&r=hea |
| By: | Marsha Gold Mynti Hossain |
| Abstract: | This paper summarizes information learned from interviews with six hospital-based systems that are in the forefront of health information exchange efforts with external providers. Information learned includes how systems are engaging with exchange, their views on the business case for this exchange, and what policies might advance their collective progress. |
| Keywords: | electronic health information exchange, electronic health records, HITECH |
| JEL: | I |
| Date: | 2014–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:99636ff1a26341f5ad8f1a1bcd53ac85&r=hea |
| By: | Margaret S. Colby; Dominick Esposito; Seth Goldfarb; Daniel E. Ball; Vivian Herrera; Leslie J. Conwell; Susan B. Garavaglia; Eric S. Meadows; Martin D. Marciniak |
| Abstract: | This study looked at the impact of Medicare Part D coverage gaps by examining drug discontinuation and reinitiation among Medicare beneficiaries using medications for cancer or rheumatoid arthritis. The study found that patients in the arthritis or cancer groups—28 and 21 percent, respectively—discontinued medications for these conditions in 2006; about three-fourths reinitiated therapy in the first 90 days of 2007. Although medication discontinuation is often temporary, the effect is complex. Some patients might discontinue before reaching the coverage gap to avoid out-of-pocket costs. For those who spend into or through the coverage gap before discontinuing, cumulative out-of-pocket expenditures might be too high to resume treatment the following year. |
| Keywords: | Medication Discontinuation, Medicare Part D Beneficiaries, Health, Costly Medications |
| JEL: | I |
| Date: | 2013–05–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b9130b96109c4466a513c3f6e4da288c&r=hea |
| By: | Arkadipta Ghosh; Robert Schmitz; Randall Brown |
| Abstract: | This study—examining the effects of the Program of All-Inclusive Care for the Elderly (PACE) on Medicare and Medicaid expenditures, use of nursing home services, and mortality—was conducted as part of the Center of Excellence on Disability Research project. PACE plans provide coordinated acute and long-term care services to nursing home–eligible older adults in the community. Two separate components constituted the study: (1) a comprehensive review of existing evaluations of PACE, and (2) an empirical analysis of costs and outcomes for PACE enrollees relative to a matched comparison group. This report presents findings from the empirical evaluation. |
| Keywords: | PACE, Program of All-Inclusive Care for the Elderly, Medicare costs, Medicaid costs, Nursing Home admissions, mortality, Mortality |
| JEL: | I |
| Date: | 2014–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a15671e45a6c4ec49d72ce26e5b3b89d&r=hea |
| By: | Matthew Kehn Jody Schimmel |
| Abstract: | This report, prepared for CMS, is part of a series of annual reports on participation in the Medicaid Buy-In program. It provides updates on both national- and state-level trends in enrollment, employment, and earnings among the 38 reporting Medicaid Infrastructure Grant (MIG) states with a Buy-In program in 2010. Additionally, this annual report presents findings from a geographical analysis that used participant zip code data to determine where Buy-In participants live, the level of program penetration, which areas have the most successful Buy-In participants, and whether local economic factors are associated with both program penetration and participant success. |
| Keywords: | Medicaid, disability, employment, Medicaid Buy-In |
| JEL: | I |
| Date: | 2013–05–14 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7026802f558b401ea3c5e8f17a79f200&r=hea |
| By: | Gretchen Jacobson; Anthony Damico; Tricia Neuman; Marsha Gold |
| Abstract: | In 2014, more than 16 million Medicare beneficiaries (30%) were enrolled in Medicare Advantage plans – private plans, such as HMOs or preferred provider organization (PPOs) that receive funds from the federal government (Medicare) to provide Medicare-covered benefits to enrollees. |
| Keywords: | Medicare Advantage, Data Spotlight, Plan Changes, Medicare Beneficiaries, HMOs, PPOs |
| JEL: | I |
| Date: | 2014–12–10 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:5321106981d4410ca6d8f9061ccddcbb&r=hea |
| By: | Jonathan D. Brown; Allison Barrett; Emily Caffery; Kerianne Hourihan; Henry T. Ireys |
| Abstract: | This study found the use of injectable antipsychotics varied substantially among state Medicaid programs. African Americans received a disproportionate share in many states. |
| Keywords: | Medicaid schizophrenia antipsychotic depot injections demography |
| JEL: | I J |
| Date: | 2014–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:acc97ce3619a4ceca0d6955db535ab88&r=hea |
| By: | Ha Tu Rebecca Gourevitch |
| Abstract: | This report examines efforts by New Hampshire state government over the past decade to use health care price transparency—notably through the creation of HealthCost, a public website comparing costs of median health care bundled prices—to encourage cost-conscious behavior by consumers and increase competition and efficiency among health care providers. The study found that although state transparency initiatives did not directly alter consumers' behavior, they have helped change health care market dynamics in important ways. By highlighting wide provider price gaps within the state, New Hampshire's transparency initiatives increased pressure on high-price hospitals to lower their rate demands and accelerated a statewide trend toward new insurance products that reward consumers for choosing efficient providers. |
| Keywords: | New Hampshire, Health Care Price Transparency Experiment, Health |
| JEL: | I |
| Date: | 2014–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:13b6fa615b534a58bbce87f293a73cf9&r=hea |
| By: | Joy M. Grossman; Rebecca Gourevitch; Dori A. Cross |
| Abstract: | Hospitals face increasing pressure to implement medication reconciliation—-a systematic way to ensure accurate patient medication lists at admission, during a hospitalization and at discharge—to reduce errors and improve patient outcomes. Electronic health records (EHRs) can help standardize medication reconciliation, but data quality and technical and workflow issues continue to pose challenges to effective medication reconciliation in hospitals. |
| Keywords: | EHR, Electronic Health Records, Hospital Experiences, Medication Reconciliation, Health |
| JEL: | I |
| Date: | 2014–07–29 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a327bb44a1bd4e199284c6c1c2ba83be&r=hea |
| By: | Kate Stewart; Dana Petersen; Joe Zickafoose; Beny Wu; Mynti Hossain; Lisa Schottenfeld; Caroline Massad Francis; Randall Brown; Henry Ireys |
| Abstract: | The studies summarized in this document were sponsored by the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services as part of the Center on Excellence in Disabilities Research, and had the following goals: (1) test the relationship between NCQA recognition and patterns of health service use for Medicaid-enrolled CSHCN; (2) document changes made by practices to obtain NCQA recognition and the perceived impact of recognition on quality of care; and (3) identify provider and practice characteristics that are most important to parents of CSHCN. |
| Keywords: | Children, Disability, Special Health Care Needs, NCQA, Patient-Centered Medical Homes, Health Care Utilization |
| JEL: | I J |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:558db0c957c4447d8fec831d100a6052&r=hea |
| By: | Marsha Gold; Winnie Wang; Gretchen Jacobson |
| Abstract: | With federal and state governments pursuing efforts to better coordinate care and reduce costs for people dually eligible for both Medicare and Medicaid, this brief examines how insurers serving these markets view the opportunities and challenges. Based on interviews with senior executives at 13 large firms that contract with the Medicare and Medicaid programs, the brief finds almost all of the insurers expect dually eligible beneficiaries will become more important to their business over time. |
| Keywords: | Medicare Dual Eligibiles Health Plans Health |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:859769acf35d4c8d855f4de2aba96e97&r=hea |
| By: | James M. Verdier |
| Abstract: | This technical assistance brief, prepared for the Integrated Care Resource Center, provides basic information for states participating in the Centers for Medicare & Medicaid Services’ capitated Financial Alignment Demonstration covering Medicare-Medicaid enrollees. Although not a comprehensive overview of the Medicare Part D prescription drug benefit, it covers beneficiary enrollment, drug payment, drug coverage, and drug utilization. It also reviews how the Medication Therapy Management Program works. |
| Keywords: | Medicare , Medicaid, Part D , Prescription Drugs, Drug Utilization |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:aff6de5c25fe456ca559dc972e5f026f&r=hea |
| By: | Richard J. Manski; John F. Moeller; Haiyan Chen; Jody Schimmel; Patricia A. St. Clair; John V. Pepper |
| Abstract: | This article considers differences in dental use by wealth levels across households. |
| Keywords: | dental, utilization, dentistry insurance, coverage wealth income, retirement |
| JEL: | I |
| Date: | 2014–12–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7744cc6c8995486e91ca8198ed93072c&r=hea |
| By: | Timothy F. Christian; Thomas W. Croghan; Myles Maxfield |
| Abstract: | Explores a unique approach to performance measurement based on the Bayes theorem. |
| Keywords: | Performance Measures , Evidence-Based Care , Bayesian Approach , Health Care Effectiveness , Health |
| JEL: | I |
| Date: | 2013–06–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:78ba0e698cb44d748810e5b650f8f444&r=hea |
| By: | Lorenzo Moreno; Suzanne Felt-Lisk; Stacy Dale |
| Abstract: | This working paper reviews impacts of the Electronic Health Records Demonstration implemented by the Centers for Medicare & Medicaid Services, finding that moderate incentive payments did not lead to universal electronic health record (EHR) adoption and use in a two-year time frame. However, the demonstration showed that incentives can influence physician use of EHRs. |
| Keywords: | Health, Financial, Electronic Records Experiment |
| Date: | 2013–09–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:22eef23eafe040969c53a9454343180f&r=hea |
| By: | Sunyna S. Williams; Dominick Esposito; Eugene C. Rich |
| Abstract: | To improve health outcomes, clinicians and patients must have evidence-based information available to help them make informed decisions, the knowledge and skills to use this information, and positive attitudes about the value of using comparative effectiveness research (CER) in decision making. As a part of the midstream evaluation of the American Recovery and Reinvestment Act CER portfolio, we collected information from a variety of sources regarding perspectives on CER and engagement of clinicians and patients in CER. |
| Keywords: | attitudes, clinician engagement, healthcare decision-making, knowledge, patient engagement, skills, stakeholder engagement |
| JEL: | I |
| Date: | 2014–12–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:4761dcf1a9af49fb8977e92be76de545&r=hea |
| By: | Deirdre McCaughey; Samantha Stalley; Eric Williams |
| Abstract: | This article examines environmental services (EVS) expenses and HCAHPS ratings on hospital cleanliness and overall patient experience ratings to determine how these variables are related.Insurance (SSDI) beneficiaries. Using multivariate models based on agency order of selection characteristics and a measure of the usual wait time for VR services, the study found that longer wait times are associated with lower employment outcomes at VR closure and throughout SSA administrative data. |
| Keywords: | HCAHPS Hospital, Consumer Assessment of Healthcare Providers and Systems, Survey Hospital Management, Expense Management |
| JEL: | I |
| Date: | 2013–10–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2c3686f2fde044cb992c914db2cd63ae&r=hea |
| By: | Derekh Cornwell; Mindy Hu; Dominick Esposito |
| Keywords: | activation, active, comparative effectiveness research, consumers, focus groups, passive , Public |
| JEL: | I |
| Date: | 2014–12–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:88beaa93c4424bd18399b746100dffe2&r=hea |
| By: | Sheila Hoag Adam Swinburn |
| Keywords: | CHIPRA Express Lane Eligibility Evaluation, Oklahoma SoonerCare, Online Enrollment System , Health |
| JEL: | I |
| Date: | 2013–05–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e9853dd7560940e09239b9e7886a25cf&r=hea |
| By: | Marsha Gold |
| Abstract: | As populations age, most industrialized nations are seeking to review their long-term care programs and better allocate better limited public resources to meet expanding needs. This commentary piece examines critical questions that define the way individual nations provide for the long-term care needs of their aging populations. |
| Keywords: | Long-Term Care Aging Population International Health; commentary |
| JEL: | I |
| Date: | 2013–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:45df4180f2954ff0a0a2bb9a30372916&r=hea |
| By: | Susan Sprachman; Emily Moiduddin; Sally Atkins- Burnett |
| Abstract: | Childhood obesity is a growing health problem in the United States that has captured the attention of researchers, policymakers, and practitioners. Over the past four decades, rates of obesity doubled among children age 2 to 5 and quadrupled among children ages 6 to 11 (Ogden and Carroll 2010). |
| Keywords: | Children's Healthy Activity, LAUP, First 5 LA, Early Childhood |
| JEL: | I |
| Date: | 2013–09–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7af2c6493a58403fa690ca8af319d92e&r=hea |
| By: | John Heintzman; Rachel Gold; Alexander Krist; Jay Crosson; Sonja Likumahuwa; Jennifer E. DeVoe |
| Abstract: | Practice-based research networks (PBRNs) have a long history of conducting research in community clinical settings, demonstrating a possible approach to executing multiple research projects over time in broad and varied settings. PBRNs also are uniquely structured and increasingly involved in pragmatic trials, a research design central to dissemination and implementation science. We argue that PBRNs and dissemination and implementation scientists are ideally suited to work together and that the collaboration of these two groups will yield great value for the future of primary care and the delivery of evidence-based health care. |
| Keywords: | Dissemination and Implementation Science, Evidence-Based Medicine, Practice-Based Research, Pragmatic Trials, Primary Health Care |
| JEL: | I |
| Date: | 2014–12–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0fe5bb77c23143e5b22a63c4ee2d8fbe&r=hea |
| By: | Erin Fries Taylor; Rachel M. Machta; David S. Meyers; Janice Genevro; Deborah N. Peikes |
| Abstract: | This article co-authored with the Agency for Healthcare Research and Quality, examines the distinct and complementary roles practice facilitators and care managers play in redesigning and improving primary care delivery. Practice facilitators coordinate practice quality improvement and redesign efforts, helping build capacity for activities that improve quality and safety and the implementation of evidence-based practices. Care managers coordinate patient care and help patients navigate the system, improving access and communicating across the care team. |
| Keywords: | Primary Care Practice Facilitators Care Managers Health |
| JEL: | I |
| Date: | 2013–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b2897e3202c548999e765c7f97bb658b&r=hea |
| By: | Marsha Gold Maria Cupples Hudson |
| Abstract: | The Affordable Care Act has altered payment policy for private Medicare Advantage (MA) plans, with the goal of lowering costs to bring them closer to the costs of traditional Medicare. Using new information on 2009 MA costs, an issue brief compares plans’ estimates of per capita costs for providing Parts A and B benefits to their enrollees, on a risk-adjusted basis, against government data on the same costs for traditional Medicare program beneficiaries in the same county. On average, risk-adjusted MA plan costs were 4 percent higher than traditional Medicare costs (104 percent). Among plan types, only HMOs had lower average costs than traditional Medicare. The wide variation in costs for MA plans relative to those for traditional Medicare suggests room for greater efficiency in care delivery. |
| Keywords: | Medicare Advantage Efficiency Variation Health |
| JEL: | I |
| Date: | 2013–04–24 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:708d7edfabd94a23822450b2010b701a&r=hea |
| By: | Jody Schimmel Gina Livermore |
| Keywords: | Health Care Access, Workers, Disabilities, Disability |
| JEL: | I J |
| Date: | 2013–11–08 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:8bd0b7620cf74cd292941b82ad71a78b&r=hea |
| By: | Sheila Hoag; Debra Lipson; Michaella Morzuch; Victoria Peebles |
| Keywords: | Coverage for Children, ACA, KidsWell Grantees, New Mexico, New York, Health |
| JEL: | I |
| Date: | 2014–06–03 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1e0666d167dc4bc5a7cfea2c38e4f19c&r=hea |
| By: | James M. Verdier |
| Keywords: | Dual Eligibles Coordinated Care Health |
| JEL: | I |
| Date: | 2014–02–25 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:2dbb456993bf4d35b14f680223865152&r=hea |
| By: | Michaela Vine; Margaret B. Hargreaves; Ronette R. Briefel; Cara Orfield |
| Abstract: | This article describes a literature review of articles published from 2005 to 2012 to (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings, and (2) synthesize the evidence on important characteristics, factors, and strategies in successful community-based models. Providers can promote the prevention and treatment of childhood obesity through the following efforts: (1) weight status assessment and monitoring, (2) healthy lifestyle promotion, (3) treatment, (4) clinician skill development, (5) clinic infrastructure development, (6) community program referrals, (7) community health education, (8) multisector community initiatives, and (9) policy advocacy. |
| Keywords: | Childhood Obesity , Primary Care , Prevention , Health |
| JEL: | I0 I1 |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c8048db5ff8f4e2e8c89f6468cb823eb&r=hea |
| By: | Rachel Shapiro Ellen Kisker |
| Abstract: | This report presents findings from a study of the implementation of an enhanced version of HealthTeacher, an online health education curriculum, in Chicago Public Schools in 2011. Teachers of 7th-grade students implemented the family health and sexuality module of HealthTeacher in nine schools. The study found that, despite some challenges, the curriculum was a good fit for Chicago Public Schools and was implemented with high fidelity. |
| Keywords: | Sex Education Pregnancy Prevention Family Support |
| JEL: | I |
| Date: | 2013–08–15 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0e0273b479c74c51a6eefe6d7a4c0873&r=hea |
| By: | James M. Verdier |
| Keywords: | Dual Eligible Health |
| JEL: | I |
| Date: | 2013–12–03 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:eeddc9e12e774047a56682551d6ee9c6&r=hea |
| By: | Jenna Libersky; Allison Hedley Dodd; Shinu Verghese |
| Abstract: | This article uses 2005 and 2008 Medicaid Analytic eXtract (MAX) data to present spending and enrollment trends for adults with disabilities who are dually eligible for Medicare and Medicaid. Nationwide, the proportion of adult duals in managed care increased from 2005 to 2008, with the expansion of prepaid health plans (PHPs), particularly behavioral health PHPs, driving the increase. Although overall use of managed care has increased, there has been little expansion in the use of comprehensive managed care among adult dual eligible beneficiaries, particularly when compared with their Medicaid-only disabled adult peers. This imbalance suggests room to remove barriers preventing dually eligible adults, from enrolling in comprehensive, integrated managed care. |
| Keywords: | Medicaid Dual Eligibles Managed Care Disability |
| JEL: | I J |
| Date: | 2013–04–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6f14ab1dff1c46d0b1639a4fa30e1733&r=hea |
| By: | Deborah N. Peikes; Robert J. Reid; Timothy J. Day; Derekh D.F. Cornwell; Stacy B. Dale; Richard J. Baron; Randall S. Brown; Rachel J. Shapiro |
| Abstract: | This article describes staffing patterns for nearly 500 primary care practices in the Centers for Medicare & Medicaid Services Comprehensive Primary Care initiative before the initiative began. |
| Keywords: | Medical Homes, Primary Care Practices, Staffing Patterns, Primary Care Initiative |
| JEL: | I |
| Date: | 2014–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:91489c0d8f714d7d8f30ed7e77d1b6f0&r=hea |
| By: | Julie Klebonis; Michelle Herman Soper; Jim Verdier |
| Keywords: | Medicare, State Programs, Medicaid Enrollees, Health |
| JEL: | I |
| Date: | 2014–03–13 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:8f372e4405504edba52b069e30b99a74&r=hea |
| By: | Elizabeth O. Babalola; Rosa R. Bair; Stefan Gravenstein; Lauren Capizzo; Amy Zimmerman; Rebekah Gardner |
| Abstract: | There is increasing interest in the potential of health information technology (HIT) to improve quality of care, prevent medical errors, and increase administrative efficiencies in the nursing home setting. The purpose of this study was to identify characteristics of nursing homes that were predictors of high versus low levels of technology adoption. |
| Keywords: | Health information technology, health information exchange, nursing homes, patient safety, care transitions, electronic health records |
| JEL: | I |
| Date: | 2014–06–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:db1319f6b2974df38033a15807a6566d&r=hea |
| By: | Ellen Albritton; Margo Edmunds; Veronica Thomas; Dana Petersen; Grace Ferry; Cindy Brach; Linda Bergofsky |
| Abstract: | This Implementation Guide focuses on the stakeholder engagement efforts in Georgia, Idaho, and Massachusetts, and is designed to help State officials and other program administrators engage and partner with stakeholders in their own child health care quality improvement initiatives. |
| Keywords: | CHIPRA Quality Demonstration, Children's Health Care Quality, Stakeholder Engagement, Quality Improvement |
| JEL: | I |
| Date: | 2014–07–17 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:d006f33ba7fc49ae85d8be70ffa4c0ee&r=hea |
| By: | Michelle Herman Soper; Jenna Libersky; Rudy Villarreal |
| Keywords: | State Monitoring, Managed Long-Term care, Health |
| JEL: | I |
| Date: | 2014–09–23 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:37ab91bd05a74a3e98cd19ee5876a5da&r=hea |
| By: | Nan L. Maxwell Nathan Wozny |
| Abstract: | This study uses a previously untapped database—administrative data on claims filed under the Federal Employees' Compensation Act—to show how risk factors underlying disability following a work-related injury differ across groups defined by demographics, employment characteristics, and injury type (that is, injury or illness). |
| Keywords: | Risk Factors, Disability, Work-Related Injuries, Employment and Training |
| JEL: | I J |
| Date: | 2014–06–16 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:3cd8cee9c4814af5a406f839c2ff92cb&r=hea |
| By: | Jelena Zurovac; Randy Brown; Bob Schmitz; Richard Chapman |
| Abstract: | The study findings suggest that only one of the interventions tested (more frequent routine contacts and medication review) appeared to have led to improved outcomes, but the lack of consistency of favorable findings across outcomes for this intervention, and the anomalous finding for the teachback method, make even this finding suspect. |
| Keywords: | Care Management, Medicare, D-SNP, Wisconsin, Disability |
| JEL: | I J |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:78cf37e4e7c44dc8a82eb6230c8a6dc9&r=hea |
| By: | Bradley M. Gray; Jonathan L. Vandergrift; Mary M. Johnston; James D. Reschovsky; Lorna A. Lynn; Eric S. Holmboe; Jeffrey S. McCullough; Rebecca S. Lipner |
| Abstract: | In 1990, the American Board of Internal Medicine (ABIM) ended lifelong certification by initiating a 10-year Maintenance of Certification (MOC) program that first took effect in 2000. Despite the importance of this change, there has been limited research examining associations between the MOC requirement and patient outcomes. |
| Keywords: | Maintenance of Certification Requirement, Ambulatory Care-Sensitive Hospitalizations, Health Care Costs |
| JEL: | I |
| Date: | 2014–12–10 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c5dbfe946d7440838d9cc80a8c2ec59a&r=hea |
| By: | Kristin Geonnotti; Deborah Peikes; Winnie Wang; Jeffrey Smith |
| Keywords: | Patient-Centered Medical Home Interventions Adaptations, Refinements PCMH |
| JEL: | I |
| Date: | 2013–03–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:5414bd99aa174ea2a8e8637181191058&r=hea |
| By: | Erin Fries Taylor; Deborah Peikes; Kristin Geonnotti; Robert McNellis; Janice Genevro; David Meyers |
| Abstract: | A new brief from the Agency for Healthcare Research and Quality describes the importance of quality improvement in primary care and outlines external supports—which can be used alone or in combination—to assist primary care practices in improving quality. |
| Keywords: | Quality Improvement, Primary Care, External Supports, Health, CHCE |
| JEL: | I |
| Date: | 2014–06–26 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b137222f176d43e8b912950abc562723&r=hea |
| By: | Dana Petersen; Joseph Zickafoose; Mynti Hossain; Henry Ireys |
| Abstract: | The objective of this study was to examine the perspectives of primary care physicians who serve CSHCN on changes they and their practices made in order to achieve the highest level of NCQA PCMH-recognition. Specifically, the study used information from physicians in pediatric and family practices that obtained Level 3 NCQA PCMH-recognition prior to 2011 to address two questions: (1) Did physicians and practices undergo any explicit changes in order to achieve PCMH-recognition? and (2) Did any of the changes lead to higher quality care for CSHCN? |
| Keywords: | Patient-centered medical home, children with special health care needs, primary care, practice transformation, medical home recognition |
| JEL: | I J |
| Date: | 2014–01–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6c606f0707a24ce8a95feb32180c565d&r=hea |
| By: | James Reschovsky |
| Abstract: | This opinion piece critiques the large body of geographic variations research, finding much of it flawed or uninformative for policy. The author posits that wide geographic variation in fee-for-service Medicare spending and care delivery could be mitigated by reforming the payment system to promote better outcomes and greater value, rather than fees for service; fighting fraud and abuse; better defining and communicating best clinical practices; and encouraging physicians to enter integrated systems of care that provide greater care coordination and management. |
| Keywords: | Medical Practice Patterns, Health Care Spending , Medicare |
| JEL: | I |
| Date: | 2014–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:cf263b5099b741128b44b1ab7bb03c88&r=hea |
| By: | Badi H. Baltagi (Center for Policy Research, Maxwell School, Syracuse University, 426 Eggers Hall, Syracuse, NY 13244); Yin-Fang Yen (Southwestern University in Finance and Economics, A319 Tongbo Building, Chengdu, Sichuan, China) |
| Abstract: | This study investigates the effect of the Temporary Aid to Needy Families (TANF) program on children’s health outcomes using data from the Survey of Income and Program Participation (SIPP) over the period 1994 to 2005. The TANF policies have been credited with increased employment for single mothers and a dramatic drop in welfare caseload. Our results show that these policies also had a significant effect on various measures of children’s medical utilization among low-income families. These health measures include a rating of the child’s health status reported by the parents; the number of times that parents consulted a doctor; and the number of nights that the child stayed in a hospital. We compare the overall changes of health status and medical utilization for children with working and nonworking mothers. We find that the child’s health status as reported by the parents is affected by the maternal employment status. |
| Keywords: | Maternal Employment, Children's Health, Welfare, Fixed Effects |
| JEL: | C11 |
| Date: | 2014–11 |
| URL: | http://d.repec.org/n?u=RePEc:max:cprwps:172&r=hea |