You searched for subject:(Health Policy).
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1.
Prakash, Shivaani.
The Relationship between Mental Health Capital and Labor
Market Outcomes: Evidence from the U.S. and Chile.
Degree: PhD, Health Services Research, 2014, Brown University
URL: https://repository.library.brown.edu/studio/item/bdr:386213/ 
► The prevalence of mental illness has been rising rapidly in the United States and abroad in the last two decades. Common mental disorders take a…
(more)
▼ The prevalence of mental illness has been rising
rapidly in the United States and abroad in the last two decades.
Common mental disorders take a heavy toll on sufferers both
directly, in terms of high medical costs; and indirectly, in terms
of reduced labor supply and decreased mental
health status. In
addition, there is a high rate of unmet need for mental
health
services among sufferers of mental disorders. To address these
issues, policymakers require a strong understanding of: 1) the
scope of the societal costs attributable to mental disorders, and
2) the expected benefits of expanding access to mental
health
services through
health policy. In the first two chapters, I use a
quasi-experimental design and nationally representative data to
examine the impact of U.S. state mental
health parity laws on labor
outcomes in the adult population and mental
health service
utilization outcomes in the child population from 1988 and 2008.
Our findings suggest that among privately insured adults, labor
outcomes were largely unaffected by the passage of strong parity
laws, but adults who suffered from likely depression saw a
significant increase in their odds of being employed. Within the
population of privately insured children, the passage of mental
health parity laws led to a significant increase in the odds of
children seeing a mental
health provider and receiving insurance
coverage for the visit. Strikingly, there was also a dramatic
increase in the odds that children took a prescription medication
for a behavioral or mental problem when a strong parity law was
passed. Taken together, these findings suggest that employers did
not pass the costs of complying with mental
health parity laws onto
their employees and these laws were specifically active in
increasing access to certain services. In the third chapter, I
studied the individual, household and societal lost income
associated with mental disorders using a nationally representative
epidemiological dataset from Chile. My results suggest that anxiety
disorders are associated with the greatest disease burden in terms
of lost income, and this “income gap” is particularly pronounced at
both the personal and household level among male
sufferers.
Advisors/Committee Members: Galarraga, Omar (Director), Trivedi, Amal (Reader), Bentkover, Judith (Reader), Kohn, Robert (Reader).
Subjects/Keywords: health policy
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APA (6th Edition):
Prakash, S. (2014). The Relationship between Mental Health Capital and Labor
Market Outcomes: Evidence from the U.S. and Chile. (Doctoral Dissertation). Brown University. Retrieved from https://repository.library.brown.edu/studio/item/bdr:386213/
Chicago Manual of Style (16th Edition):
Prakash, Shivaani. “The Relationship between Mental Health Capital and Labor
Market Outcomes: Evidence from the U.S. and Chile.” 2014. Doctoral Dissertation, Brown University. Accessed February 25, 2020.
https://repository.library.brown.edu/studio/item/bdr:386213/.
MLA Handbook (7th Edition):
Prakash, Shivaani. “The Relationship between Mental Health Capital and Labor
Market Outcomes: Evidence from the U.S. and Chile.” 2014. Web. 25 Feb 2020.
Vancouver:
Prakash S. The Relationship between Mental Health Capital and Labor
Market Outcomes: Evidence from the U.S. and Chile. [Internet] [Doctoral dissertation]. Brown University; 2014. [cited 2020 Feb 25].
Available from: https://repository.library.brown.edu/studio/item/bdr:386213/.
Council of Science Editors:
Prakash S. The Relationship between Mental Health Capital and Labor
Market Outcomes: Evidence from the U.S. and Chile. [Doctoral Dissertation]. Brown University; 2014. Available from: https://repository.library.brown.edu/studio/item/bdr:386213/
University of Central Florida
2.
Lin, Yi-Ling.
The Diffusion and Performance of the Accountable Care Organization Model.
Degree: 2016, University of Central Florida
URL: https://stars.library.ucf.edu/etd/5185
► Background: Unity in pursuit of the Triple Aim: better health, better care, and lower per capita cost, can be achieved through a well-designed health care…
(more)
▼ Background: Unity in pursuit of the Triple Aim: better
health, better care, and lower per capita cost, can be achieved through a well-designed
health care delivery system. The accountable care organizations (ACOs) model is considered a key component of
health care delivery system improvement because the model fosters better coordination of care through clinical integration and financial accountability.
Within the six Centers for Medicaid & Medicare Services (CMS) ACO programs, the Medicare Shared Savings Program (MSSP) ACO has the largest size with a total of 432 ACOs formed; the service subjects of the MSSP ACO are the fee-for-service beneficiaries. Recently, academicians and researchers have been attracted to exploring ACOs' formation and performance. However, most of the early ACO research types are either descriptive or case study. Also, early researchers had limited access to ACO data sets, so they could utilize only regional and demographic factors to identify the predictors of ACO formation.
Purpose: An integrative theoretical framework, Rogers' diffusion of innovation theory and Duncan's POET model, was used to examine ACO formation and performance. The first purpose of this study was to determine the relative influences of contextual variables and ACO characteristic variables on how early an ACO model was adopted. The second purpose was to examine how executives' perceptions of ACO performance and the ACO first-year performance are influenced by the contextual variables, ACO characteristic variables, and timing of the adoption of an ACO model.
Methods: A cross-sectional design was formulated to gather data from a survey supplemented by secondary data with the analysis unit at the organization level. Study participants in the ACO survey included 2012, 2013, 2014, and 2015 ACO cohorts. Logistic regression was performed to examine the effects of POET and Rogers' five core characteristics in the early adoption of an ACO model (dichotomous). Additionally, multiple linear regression analysis was used to examine the effects of POET and the timing of adoption of an ACO model in the perceptions of ACO performance. ACO first-year performance dataset consisted only of ACO cohorts from 2012 through 2014. Finally, confirmatory factor analysis and structural equation modeling were conducted to examine the measurement model of the ACO first-year performance and a full latent variable model, respectively.
Major Findings: A survey of ACO executives/managers between October 2015 and February 2016 was conducted. The 447 MSSP ACOs in my mailing list yielded a response rate of 13.65 % (n=61). Of the 61 MSSP ACOs, 42 (52.5%) were late adopters whose contractual agreement with CMS started in 2014 or 2015, and 36 (59.0%) were with hospital-based composition. Among ACOs that participated in my survey, their current degree of IT adoption in functionalities (62.27 vs. 52.50 points), usage levels (65.19 vs. 49.49 points), and integration levels (62.24 vs. 53.37 points) were better than their initial years. The multiple logistic…
Advisors/Committee Members: Wan, Thomas T. H..
Subjects/Keywords: Health Policy
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APA (6th Edition):
Lin, Y. (2016). The Diffusion and Performance of the Accountable Care Organization Model. (Doctoral Dissertation). University of Central Florida. Retrieved from https://stars.library.ucf.edu/etd/5185
Chicago Manual of Style (16th Edition):
Lin, Yi-Ling. “The Diffusion and Performance of the Accountable Care Organization Model.” 2016. Doctoral Dissertation, University of Central Florida. Accessed February 25, 2020.
https://stars.library.ucf.edu/etd/5185.
MLA Handbook (7th Edition):
Lin, Yi-Ling. “The Diffusion and Performance of the Accountable Care Organization Model.” 2016. Web. 25 Feb 2020.
Vancouver:
Lin Y. The Diffusion and Performance of the Accountable Care Organization Model. [Internet] [Doctoral dissertation]. University of Central Florida; 2016. [cited 2020 Feb 25].
Available from: https://stars.library.ucf.edu/etd/5185.
Council of Science Editors:
Lin Y. The Diffusion and Performance of the Accountable Care Organization Model. [Doctoral Dissertation]. University of Central Florida; 2016. Available from: https://stars.library.ucf.edu/etd/5185
University of Central Florida
3.
Shettian, Madhu.
Determinants of Hospital Efficiency and Patient Safety in the United States.
Degree: 2017, University of Central Florida
URL: https://stars.library.ucf.edu/etd/5585
► Hospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical…
(more)
▼ Hospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical study explored the interdependence of three macro-level structural factors and their independent impact on the hospital performance measures efficiency and patient safety, with standardization as an important mediator. The researcher conducted a cross-sectional analysis of multiple data sets from public user files on the acute care hospital industry. The theoretical underpinnings of the study included the structure-process-outcome theory and institutional isomorphism theory. The statistical analysis comprised confirmatory factor analysis (CFA) and covariance structural equation modeling (SEM). The study comprised data for 2,352 acute care hospitals in the United States, which represented more than half of the hospital population. As expected by the hypotheses, the study demonstrated that IT capability, hospital-physician integration, and innovativeness directly affect the variability in standardization, but they did not directly influence the variation in hospital efficiency and patient safety. This revealed that hospitals should focus on standardization because it is the mediating process between structural variables and performance variables. The results indicated a strong negative influence of standardization on hospital efficiency and a weak positive influence on patient safety. The study confirmed the triadic model that "structure" influences the process, which in turn influences organizational outcomes. As standardization through coercive, mimetic, and normative pressure mechanisms becomes more common through system integration and increased collaborative governance, more research on how the implementation of standards may perpetuate isomorphism or uniformity is imperative. The researcher recommends future studies to employ a longitudinal study design to explore the determinants of a variety of performance and outcome indicators, such as patient satisfaction, timeliness of care, the effectiveness of care, and equity/financial performance in addition to patient safety and hospital efficiency.
Advisors/Committee Members: Wan, Thomas T. H..
Subjects/Keywords: Health Policy
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APA (6th Edition):
Shettian, M. (2017). Determinants of Hospital Efficiency and Patient Safety in the United States. (Doctoral Dissertation). University of Central Florida. Retrieved from https://stars.library.ucf.edu/etd/5585
Chicago Manual of Style (16th Edition):
Shettian, Madhu. “Determinants of Hospital Efficiency and Patient Safety in the United States.” 2017. Doctoral Dissertation, University of Central Florida. Accessed February 25, 2020.
https://stars.library.ucf.edu/etd/5585.
MLA Handbook (7th Edition):
Shettian, Madhu. “Determinants of Hospital Efficiency and Patient Safety in the United States.” 2017. Web. 25 Feb 2020.
Vancouver:
Shettian M. Determinants of Hospital Efficiency and Patient Safety in the United States. [Internet] [Doctoral dissertation]. University of Central Florida; 2017. [cited 2020 Feb 25].
Available from: https://stars.library.ucf.edu/etd/5585.
Council of Science Editors:
Shettian M. Determinants of Hospital Efficiency and Patient Safety in the United States. [Doctoral Dissertation]. University of Central Florida; 2017. Available from: https://stars.library.ucf.edu/etd/5585
University of Central Florida
4.
Mustonen, Rachel.
Social Media as a Healthcare Tool: Case Study Analysis of Factors Influencing Pediatric Clinicians' Behavioral Intent to Adopt Social Media for Patient Communication and Engagement.
Degree: 2018, University of Central Florida
URL: https://stars.library.ucf.edu/etd/5898
► Social media aids communication among users worldwide. However, a notable gap exist among social media users, healthcare professionals utilizing social media in the work place.…
(more)
▼ Social media aids communication among users worldwide. However, a notable gap exist among social media users, healthcare professionals utilizing social media in the work place. While the concept of harnessing social media as a professional tool is not novel, healthcare professionals have yet to embrace the practice as standard workflow. This study identifies factors influencing clinicians' behavioral intent to adopt social media for patient engagement and communication. A new framework, the Healthcare Social Media Adoption Framework (HSMA), guided this mixed-method approach to assess 7 factors identified by theory and literature as adoption influencers. A custom, web-based survey collected data from 60 full-time, pediatric clinicians (47 quantitative) at the case institution (a pediatric hospital). Additionally, individual interviews of 6 participants provided their prospective on using social media for patient communications and engagement. Results: Privacy concerns were the only statically significant factor; with an inverse relationship to positive adoption intent, indicating higher privacy concerns influence lower behavioral intent to adopt social media for patient engagement and communication. The qualitative analysis revealed privacy concerns encompass two themes, personal privacy for patient and providers (boundaries), and cybersecurity. The qualitative inputs also uncovered perceived unprofessionalism as a new factor influencing clinician adoption. The implications for these findings indicate a need for both healthcare organizations and healthcare regulators to establish cyber-security defenses for security and use protocols for privacy to aid the diffusion and adoption acceptance of social media use by pediatric healthcare professionals. This research has contributed in four areas: 1) fill a knowledge gap by identifying new factors that influence the behavioral intent of pediatric clinicians to adopt social media; 2) confirm/reject behavioral intent influences found in the literature; 3) formulated a new HSMA framework that measures functional, cognitive, and social aspects of social media adoption; and 4) prioritizes policies and global standard focus.
Advisors/Committee Members: Hou, Su-I.
Subjects/Keywords: Health Policy
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APA (6th Edition):
Mustonen, R. (2018). Social Media as a Healthcare Tool: Case Study Analysis of Factors Influencing Pediatric Clinicians' Behavioral Intent to Adopt Social Media for Patient Communication and Engagement. (Doctoral Dissertation). University of Central Florida. Retrieved from https://stars.library.ucf.edu/etd/5898
Chicago Manual of Style (16th Edition):
Mustonen, Rachel. “Social Media as a Healthcare Tool: Case Study Analysis of Factors Influencing Pediatric Clinicians' Behavioral Intent to Adopt Social Media for Patient Communication and Engagement.” 2018. Doctoral Dissertation, University of Central Florida. Accessed February 25, 2020.
https://stars.library.ucf.edu/etd/5898.
MLA Handbook (7th Edition):
Mustonen, Rachel. “Social Media as a Healthcare Tool: Case Study Analysis of Factors Influencing Pediatric Clinicians' Behavioral Intent to Adopt Social Media for Patient Communication and Engagement.” 2018. Web. 25 Feb 2020.
Vancouver:
Mustonen R. Social Media as a Healthcare Tool: Case Study Analysis of Factors Influencing Pediatric Clinicians' Behavioral Intent to Adopt Social Media for Patient Communication and Engagement. [Internet] [Doctoral dissertation]. University of Central Florida; 2018. [cited 2020 Feb 25].
Available from: https://stars.library.ucf.edu/etd/5898.
Council of Science Editors:
Mustonen R. Social Media as a Healthcare Tool: Case Study Analysis of Factors Influencing Pediatric Clinicians' Behavioral Intent to Adopt Social Media for Patient Communication and Engagement. [Doctoral Dissertation]. University of Central Florida; 2018. Available from: https://stars.library.ucf.edu/etd/5898
University of Central Lancashire
5.
Mcmahon, Naoimh.
Working 'upstream' to reduce health inequalities : a Foucauldian discourse analysis.
Degree: PhD, 2019, University of Central Lancashire
URL: http://clok.uclan.ac.uk/30815/
;
https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.797892
► There has been a long-standing concern to reduce health inequalities between different social groups. While primarily understood as arising from the inequitable distribution of power,…
(more)
▼ There has been a long-standing concern to reduce health inequalities between different social groups. While primarily understood as arising from the inequitable distribution of power, wealth, and resources, in recent years dominant scientific and political discourses have resulted in health inequalities being understood as a problem of individual behaviour. In response, a number of counter-discourses have emerged which seek to reorient efforts away from tackling these symptoms of the problem, to work once again at the level of root causes. In this thesis, I conduct an in-depth analysis of one of these counter-discourses, the upstream parable, to examine how it operates in research and practice. Employing a form of discourse analysis underpinned by the ideas of Michel Foucault, I examine how the idea of working 'upstream' is articulated in a sample of peer-reviewed articles, and how it is interpreted by a sample of people working to reduce health inequalities in the North West of England. I demonstrate that there are many different ways of constructing the problem of health inequalities, and that the upstream counter-discourse, rather than resulting in a reframing of the problem, is in fact interpreted in light of existing perspectives. This finding illustrates the malleability of the discourse, and serves to challenge the extent to which it can operate to successfully reframe the problem of health inequalities, and reorient efforts to work at root causes. In this thesis, I make an original contribution to knowledge by going beyond a critique of dominant perspectives to provide original insights about how an established counter-discourse, in the field of health inequalities, operates in practice. I identify shortcomings of the discourse, and make recommendations for how ideas which appear in the academic literature, could be employed more fruitfully in practice to reorient efforts to work at the root causes of this intractable problem.
Subjects/Keywords: Health policy
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APA (6th Edition):
Mcmahon, N. (2019). Working 'upstream' to reduce health inequalities : a Foucauldian discourse analysis. (Doctoral Dissertation). University of Central Lancashire. Retrieved from http://clok.uclan.ac.uk/30815/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.797892
Chicago Manual of Style (16th Edition):
Mcmahon, Naoimh. “Working 'upstream' to reduce health inequalities : a Foucauldian discourse analysis.” 2019. Doctoral Dissertation, University of Central Lancashire. Accessed February 25, 2020.
http://clok.uclan.ac.uk/30815/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.797892.
MLA Handbook (7th Edition):
Mcmahon, Naoimh. “Working 'upstream' to reduce health inequalities : a Foucauldian discourse analysis.” 2019. Web. 25 Feb 2020.
Vancouver:
Mcmahon N. Working 'upstream' to reduce health inequalities : a Foucauldian discourse analysis. [Internet] [Doctoral dissertation]. University of Central Lancashire; 2019. [cited 2020 Feb 25].
Available from: http://clok.uclan.ac.uk/30815/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.797892.
Council of Science Editors:
Mcmahon N. Working 'upstream' to reduce health inequalities : a Foucauldian discourse analysis. [Doctoral Dissertation]. University of Central Lancashire; 2019. Available from: http://clok.uclan.ac.uk/30815/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.797892
University of Central Lancashire
6.
Sweity, Samaher.
What influences the rise and fall of health research disciplines? : insights from a mixed-method investigation of occupational epidemiological research in the UK.
Degree: PhD, 2016, University of Central Lancashire
URL: http://clok.uclan.ac.uk/18614/
;
https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.721751
► Introduction Occupational Epidemiology (OE) has played a vital role in producing improvements in the working population’s health. Nonetheless, anecdotal evidence indicates that OE in the…
(more)
▼ Introduction Occupational Epidemiology (OE) has played a vital role in producing improvements in the working population’s health. Nonetheless, anecdotal evidence indicates that OE in the UK is facing many challenges and the research workforce, funding, and output in this area are declining. This study aims to: investigate the nature and evolution of these key contributors to success; identify the external social, political, economic and any other factors which frame and contextualise these challenges and the facilitators; use this contextualisation to explain and evaluate how and why the identified challenges and facilitators influenced the OE field development compared to other similar fields; and explore how far they may explain the ebb and flow of research activity in OE in comparison with other health disciplines. Methods A sequential, mixed-method approach was undertaken in four phases. These included interviews with key UK-based OE researchers; a survey of UK-based OE researchers to test out themes that emerged from the first phase; a bibliometric analysis comparing trends and characteristics of UK-based OE published studies with those in public health epidemiology (PHE); and a documentary review of annual reports of three health research funding bodies including: the Medical Research Council, the Cancer Research Campaign, and the Health and Safety Commission. Results The lack of human and financial resources was found to be of utmost concern to the OE community, which increased over time and negatively affected researchers’ abilities to conduct further and higher quality studies. The bibliometric study revealed that the number of PHE publications and researchers increased substantially while the numbers for OE remained fairly constant. Furthermore, it was found that in PHE much higher levels of collaboration and adoption of newer methods such as the use of molecular and genetic techniques were applied. Widening research collaboration and the adoption of newer methods were encouraged by funding bodies because both are perceived to contribute to research efficiency and commercialisation of research ideas. These have been adopted more widely by other fields, thus helping them to develop and improve their status, which was not the case for OE. Furthermore, fewer influential representatives from the field of OE were found within funding bodies, which had played a major role in directing resources to research within health fields and hence influencing their development. Conclusions Social, economic, and political factors such as the exclusion of occupational health (OH) from the National Health Service, deindustrialisation, and neoliberal government policies within public and higher education institutions particularly that focus on economic contribution of science, and research auditing and efficiency, most likely, have the greatest influence on funding decisions of research in OH and other health disciplines. These issues have significantly instigated obscurity of OH and hence OE within the agendas of both the…
Subjects/Keywords: 362.1; Public policy; Health policy
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APA ·
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MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Sweity, S. (2016). What influences the rise and fall of health research disciplines? : insights from a mixed-method investigation of occupational epidemiological research in the UK. (Doctoral Dissertation). University of Central Lancashire. Retrieved from http://clok.uclan.ac.uk/18614/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.721751
Chicago Manual of Style (16th Edition):
Sweity, Samaher. “What influences the rise and fall of health research disciplines? : insights from a mixed-method investigation of occupational epidemiological research in the UK.” 2016. Doctoral Dissertation, University of Central Lancashire. Accessed February 25, 2020.
http://clok.uclan.ac.uk/18614/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.721751.
MLA Handbook (7th Edition):
Sweity, Samaher. “What influences the rise and fall of health research disciplines? : insights from a mixed-method investigation of occupational epidemiological research in the UK.” 2016. Web. 25 Feb 2020.
Vancouver:
Sweity S. What influences the rise and fall of health research disciplines? : insights from a mixed-method investigation of occupational epidemiological research in the UK. [Internet] [Doctoral dissertation]. University of Central Lancashire; 2016. [cited 2020 Feb 25].
Available from: http://clok.uclan.ac.uk/18614/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.721751.
Council of Science Editors:
Sweity S. What influences the rise and fall of health research disciplines? : insights from a mixed-method investigation of occupational epidemiological research in the UK. [Doctoral Dissertation]. University of Central Lancashire; 2016. Available from: http://clok.uclan.ac.uk/18614/ ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.721751
University of Minnesota
7.
Gonzales, Gilbert.
The Impact of Same-Sex Marriage Laws on Health Insurance Coverage in Same-Sex Households.
Degree: PhD, Health Services Research, Policy and Administration, 2015, University of Minnesota
URL: http://hdl.handle.net/11299/175698
► The purpose of this dissertation is to document the relationship between state-level same-sex marriage laws on health insurance coverage in same-sex households. Using data from…
(more)
▼ The purpose of this dissertation is to document the relationship between state-level same-sex marriage laws on health insurance coverage in same-sex households. Using data from the American Community Survey, this dissertation demonstrates that state policy environments extending legal protections to same-sex couples were associated with narrower disparities in employer-sponsored health insurance for cohabiting adults in same-sex couples and their children.
Subjects/Keywords: Health policy; LGBT health; State policy
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APA (6th Edition):
Gonzales, G. (2015). The Impact of Same-Sex Marriage Laws on Health Insurance Coverage in Same-Sex Households. (Doctoral Dissertation). University of Minnesota. Retrieved from http://hdl.handle.net/11299/175698
Chicago Manual of Style (16th Edition):
Gonzales, Gilbert. “The Impact of Same-Sex Marriage Laws on Health Insurance Coverage in Same-Sex Households.” 2015. Doctoral Dissertation, University of Minnesota. Accessed February 25, 2020.
http://hdl.handle.net/11299/175698.
MLA Handbook (7th Edition):
Gonzales, Gilbert. “The Impact of Same-Sex Marriage Laws on Health Insurance Coverage in Same-Sex Households.” 2015. Web. 25 Feb 2020.
Vancouver:
Gonzales G. The Impact of Same-Sex Marriage Laws on Health Insurance Coverage in Same-Sex Households. [Internet] [Doctoral dissertation]. University of Minnesota; 2015. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/11299/175698.
Council of Science Editors:
Gonzales G. The Impact of Same-Sex Marriage Laws on Health Insurance Coverage in Same-Sex Households. [Doctoral Dissertation]. University of Minnesota; 2015. Available from: http://hdl.handle.net/11299/175698
Cornell University
8.
Choi, Anna.
Three Essays In Health Economics
.
Degree: 2015, Cornell University
URL: http://hdl.handle.net/1813/41059
► This dissertation contains three essays in the field of health economics and health policy. The first essay studies the effects of legalizing medical use of…
(more)
▼ This dissertation contains three essays in the field of
health economics and
health policy. The first essay studies the effects of legalizing medical use of marijuana on marijuana use and other risky
health behaviors. I examine the restricted-use data from the National Survey of Drug Use and
Health (NSDUH), which is a repeated cross sectional data set with state identifiers from 2004 to 2012. During this period, 9 states and Washington D.C. allowed patients with medical conditions to use marijuana. I estimate difference-in-differences (DID) models to examine the impacts of these
policy changes on risky
health behaviors. Allowing medical use of marijuana does not lead to higher marijuana use among the overall population and the youth. However, I find that medical marijuana laws (MMLs) are positively and significantly associated with marijuana use among males and heavy pain reliever users. The second essay is a joint work with John Cawley and tests a novel hypothesis: that these
health disparities across education are to some extent due to differences in reporting error across education. We use data from the pooled National
Health and Nutrition Examination Survey (NHANES) Continuous for 1999-2012, which include both self-reports and objective verification for an extensive set of
health behaviors and conditions, including smoking, obesity, high blood pressure, high cholesterol and diabetes. We find that better educated individuals report their
health behaviors more accurately. This is true for a wide range of behaviors and conditions, even socially stigmatized ones like smoking and obesity. We show that the differential reporting error across education leads to underestimates of the true
health disparities across education that average 19.3%. The third essay is a joint work with Rachel Dunifon and studies how state regulations related to the quality of child care centers-such as teachers' education and degree requirements, staff to child ratios, maximum group size, and unannounced inspection compliance requirement-are predictive of children's
health, developmental and cognitive outcomes. State level policies that are related to improving the productivity of child care center teachers by having a higher staff to child ratios and advanced schooling requirement are predictive of child's weight related outcomes and cognitive outcomes.
Advisors/Committee Members: Dunifon,Rachel E. (committeeMember), Kenkel,Donald S. (committeeMember).
Subjects/Keywords: Health economics;
Health policy;
Policy analysis
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to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Choi, A. (2015). Three Essays In Health Economics
. (Thesis). Cornell University. Retrieved from http://hdl.handle.net/1813/41059
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Choi, Anna. “Three Essays In Health Economics
.” 2015. Thesis, Cornell University. Accessed February 25, 2020.
http://hdl.handle.net/1813/41059.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Choi, Anna. “Three Essays In Health Economics
.” 2015. Web. 25 Feb 2020.
Vancouver:
Choi A. Three Essays In Health Economics
. [Internet] [Thesis]. Cornell University; 2015. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/1813/41059.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Choi A. Three Essays In Health Economics
. [Thesis]. Cornell University; 2015. Available from: http://hdl.handle.net/1813/41059
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
9.
Kim, Daeho.
Essays in Health Economics.
Degree: PhD, Economics, 2012, Brown University
URL: https://repository.library.brown.edu/studio/item/bdr:297624/
► This dissertation examines the effects of health care policy on access to health care and health outcomes, use of medical technology, and educational attainment. The…
(more)
▼ This dissertation examines the effects of
health care
policy on access to
health care and
health outcomes, use of medical
technology, and educational attainment. The first chapter,
co-authored with Kenneth Chay and Shailender Swaminathan, examines
the impact of Medicare’s introduction on hospital insurance,
utilization, and mortality rates. The analysis applies an “age
discontinuity” design to data both before and after Medicare’s
introduction. We find that Medicare: i) increased hospital
utilization and costs among the elderly, but at a lower rate than
previously found; and ii) significantly increased life expectancy
in the eligible population. We estimate that Medicare’s
introduction had a cost-per-life year ratio below $200 (in 1982-84
dollars). In addition, we present evidence that the benefit-cost
ratios of Medicare fell during the 1980s, partly due to changes in
Medicare’s reimbursement formula. The second chapter examines the
impact of Medicare payment reform on hospital costs. Medicare’s
Prospective Payment System (PPS) reform in 1983 tied hospital
payments to the national average cost of each medical technology
with the expectation of reducing
health care costs. I show that an
unintended consequence of PPS was to generate financial incentives
for hospitals to expand treatments that had average costs greater
than marginal costs due to sizable fixed investments. In the
context of cardiac treatments, coronary artery bypass graft (CABG)
surgery has a greater average-to-marginal cost ratio than
angioplasty. Exploiting the discontinuity in Medicare eligibility,
I find a discontinuous change in CABG use at age-65 after the
reform that implies an increase of 50 to 60 percent. Nearly all of
the increase is driven by CABG use expanded to relatively healthier
patients. I also present evidence that the increased CABG use was
not cost effective. The third chapter explores the role of hospital
desegregation on educational attainment. The racial integration of
Southern hospitals during the mid- or late-1960s provided increased
access to hospital care for Southern blacks who previously had
limited access. Using a difference-in-difference-in-differences
approach, I document that the black-white gap in educational
attainment decreased significantly more in the South than in the
North among cohorts born after hospital
desegregation.
Advisors/Committee Members: Chay, Kenneth (Director), Aizer, Anna (Reader), Knight, Brian (Reader).
Subjects/Keywords: Health Care Policy
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APA (6th Edition):
Kim, D. (2012). Essays in Health Economics. (Doctoral Dissertation). Brown University. Retrieved from https://repository.library.brown.edu/studio/item/bdr:297624/
Chicago Manual of Style (16th Edition):
Kim, Daeho. “Essays in Health Economics.” 2012. Doctoral Dissertation, Brown University. Accessed February 25, 2020.
https://repository.library.brown.edu/studio/item/bdr:297624/.
MLA Handbook (7th Edition):
Kim, Daeho. “Essays in Health Economics.” 2012. Web. 25 Feb 2020.
Vancouver:
Kim D. Essays in Health Economics. [Internet] [Doctoral dissertation]. Brown University; 2012. [cited 2020 Feb 25].
Available from: https://repository.library.brown.edu/studio/item/bdr:297624/.
Council of Science Editors:
Kim D. Essays in Health Economics. [Doctoral Dissertation]. Brown University; 2012. Available from: https://repository.library.brown.edu/studio/item/bdr:297624/
Boston University
10.
Abrahams-Gessel, Shafika.
An examination of the ability of community health workers to effectively conduct community-based screening for cardiovascular disease in South Africa, Guatemala, and Mexico.
Degree: Doctor of Public Health, Public Health, 2016, Boston University
URL: http://hdl.handle.net/2144/19526
► BACKGROUND: This study explored training effectiveness for community health workers (CHWs) in a successful intervention in which they conducted primary screening for cardiovascular disease (CVD)…
(more)
▼ BACKGROUND: This study explored training effectiveness for community health workers (CHWs) in a successful intervention in which they conducted primary screening for cardiovascular disease (CVD) in low resource settings. Implementation challenges related to scaling were explored with key informants.
METHODS: A multiple methods assessment was conducted to: (1) quantitatively assess training effectiveness; (2) qualitatively capture the CHWs’ experience of training; (3) gather feedback from key stakeholders about factors anticipated to impact scaling the intervention to the population level. Change in knowledge levels at three different time points was determined through comparison of group means (ANOVA). The Consolidated Framework for Implementation Research (CFIR) guided the qualitative data collection and analyses, using nVIVO® and Atlas.ti® software, combined with manual coding.
RESULTS: Training was effective at increasing content knowledge of CVD and the effect persisted for 3-6 months after completion of field work. CHWs felt empowered by the training and the acquisition of new skills but some expressed their reservations about written tests being used to accurately capture their capabilities. Some supervisors (nurses) perceived CHW training as a threat to their own professional standing while also acknowledging the value CHWs added to health services through their expert community knowledge and connections. CHWs remained frustrated by inadequate and irregular compensation, disrespect from formally trained health professionals, lack of career development pathways, and failure to account for the influence environmental factors – safety, extreme weather, and infrastructure – in workload planning. Key informants raised additional concerns about the negative impact of ineffective government communication regarding CHW programs and policies to communities and key actors in the health care system, including failure to consult key stakeholders, lack of clear role definitions, setting standards for training and performance evaluation, and lack of supervisory mechanisms. The issue of financing for CHW programs was not raised by key informants.
CONCLUSIONS: Scaling strategies for successful interventions using CHWs need to be guided by well-designed implementation plans that include proactive, multi-level engagement with communities and health systems, and appropriate evaluation measures tied to health outcomes. Training effectiveness should be evaluated and linked to well-defined outcome measures in CHW’s programs that involve task-shifting.
Subjects/Keywords: Public health; Policy
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APA (6th Edition):
Abrahams-Gessel, S. (2016). An examination of the ability of community health workers to effectively conduct community-based screening for cardiovascular disease in South Africa, Guatemala, and Mexico. (Doctoral Dissertation). Boston University. Retrieved from http://hdl.handle.net/2144/19526
Chicago Manual of Style (16th Edition):
Abrahams-Gessel, Shafika. “An examination of the ability of community health workers to effectively conduct community-based screening for cardiovascular disease in South Africa, Guatemala, and Mexico.” 2016. Doctoral Dissertation, Boston University. Accessed February 25, 2020.
http://hdl.handle.net/2144/19526.
MLA Handbook (7th Edition):
Abrahams-Gessel, Shafika. “An examination of the ability of community health workers to effectively conduct community-based screening for cardiovascular disease in South Africa, Guatemala, and Mexico.” 2016. Web. 25 Feb 2020.
Vancouver:
Abrahams-Gessel S. An examination of the ability of community health workers to effectively conduct community-based screening for cardiovascular disease in South Africa, Guatemala, and Mexico. [Internet] [Doctoral dissertation]. Boston University; 2016. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/2144/19526.
Council of Science Editors:
Abrahams-Gessel S. An examination of the ability of community health workers to effectively conduct community-based screening for cardiovascular disease in South Africa, Guatemala, and Mexico. [Doctoral Dissertation]. Boston University; 2016. Available from: http://hdl.handle.net/2144/19526
University of Aberdeen
11.
Douglas, Flora.
National public health policy and its local implementation.
Degree: 2010, University of Aberdeen
URL: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165977
;
http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540331
► Translation of national public health policy into local action is poorly understood. This thesis explores this issue using: (a) independent evaluation data of the government-funded…
(more)
▼ Translation of national public health policy into local action is poorly understood. This thesis explores this issue using: (a) independent evaluation data of the government-funded Well Men’s Services Pilots Programme (WMS); and (b) an analytical framework derived from ‘rational’ health planning models; particularly the PRECEDE PROCEED (PP) model. A mixed-methods study was conducted, comprising: (i) a review of the health planning literature; (ii) an interpretative documentary analysis of policy documentation and local intervention plans; and (iii) a secondary analysis of 42 semi-structured interviews with local managers and professionals responsible for developing interventions in response to the policy. The research findings (ii&iii) were considered in light of this review. This thesis concluded that rationalist health planning approaches and frameworks are not sufficient to guide the implementation of public health policy to an effective conclusion, and has argued that there is a need to develop new ways of thinking about public health issues that have become ‘policy problems’ deemed in need of intervention and resolution. This new thinking needs to acknowledge the complex and contested nature of health problems. This include accepting: (1) that a range of different perspectives and interpretations of public health policy problems and associated notions of their solutions will reside amongst those individuals and organisations tasked with transforming policy into practice; (2) the inevitability of imperfect and contested evidence; (3) future uncertainties, and; (4) the existence of bureaucratic barriers that will constrain direct engagement of the intended beneficiaries, by policy implementers, in the process of developing interventions.
Subjects/Keywords: 610.7343; Health Policy : Public health
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APA (6th Edition):
Douglas, F. (2010). National public health policy and its local implementation. (Doctoral Dissertation). University of Aberdeen. Retrieved from http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165977 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540331
Chicago Manual of Style (16th Edition):
Douglas, Flora. “National public health policy and its local implementation.” 2010. Doctoral Dissertation, University of Aberdeen. Accessed February 25, 2020.
http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165977 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540331.
MLA Handbook (7th Edition):
Douglas, Flora. “National public health policy and its local implementation.” 2010. Web. 25 Feb 2020.
Vancouver:
Douglas F. National public health policy and its local implementation. [Internet] [Doctoral dissertation]. University of Aberdeen; 2010. [cited 2020 Feb 25].
Available from: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165977 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540331.
Council of Science Editors:
Douglas F. National public health policy and its local implementation. [Doctoral Dissertation]. University of Aberdeen; 2010. Available from: http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165977 ; http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540331
University of Central Florida
12.
Rutherford, Ashley.
Political, Economic, and Health Determinants of Tuberculosis Incidence.
Degree: 2016, University of Central Florida
URL: https://stars.library.ucf.edu/etd/5645
► The epidemiologic transition has shifted major causes of mortality from infectious disease to chronic disease; however, infectious diseases are again re-emerging as a major global…
(more)
▼ The epidemiologic transition has shifted major causes of mortality from infectious disease to chronic disease; however, infectious diseases are again re-emerging as a major global concern (Diamond, 1997; Karlen, 1995; McNeil, 1976). This research aimed to identify potential areas of infectious disease influence that are not
health-related in order to help governments and policymakers establish new policies, correct current policies, or further address these issues in order to effectively prevent and combat infectious disease. This study employed a retrospective, cross-sectional, non-experimental design via structural equation modeling (SEM) and examined tuberculosis incidence rates at the country-level. Secondary data from open-source, international databases like World Bank's World Development Indicators, World Governance Indicators, and World
Health Organization for the year 2014 was utilized. Results revealed that the latent constructs of political stability,
health system indicators, and detection policies directly affected tuberculosis incidence rates; they also exhibited an indirect effect due to covariation. Economic stability did not direct affect tuberculosis incidence, but it indirectly influenced incidence through the covariation of political stability,
health system indicators, and detection policies. As a country's political stability increased, tuberculosis incidence decreased. As positive
health system indicators increased, tuberculosis incidence decreased. Countries with more Xpert detection policies in place experienced an apparent increase in tuberculosis incidence.
Advisors/Committee Members: Unruh, Lynn.
Subjects/Keywords: Health Policy; Health Services Administration
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APA (6th Edition):
Rutherford, A. (2016). Political, Economic, and Health Determinants of Tuberculosis Incidence. (Doctoral Dissertation). University of Central Florida. Retrieved from https://stars.library.ucf.edu/etd/5645
Chicago Manual of Style (16th Edition):
Rutherford, Ashley. “Political, Economic, and Health Determinants of Tuberculosis Incidence.” 2016. Doctoral Dissertation, University of Central Florida. Accessed February 25, 2020.
https://stars.library.ucf.edu/etd/5645.
MLA Handbook (7th Edition):
Rutherford, Ashley. “Political, Economic, and Health Determinants of Tuberculosis Incidence.” 2016. Web. 25 Feb 2020.
Vancouver:
Rutherford A. Political, Economic, and Health Determinants of Tuberculosis Incidence. [Internet] [Doctoral dissertation]. University of Central Florida; 2016. [cited 2020 Feb 25].
Available from: https://stars.library.ucf.edu/etd/5645.
Council of Science Editors:
Rutherford A. Political, Economic, and Health Determinants of Tuberculosis Incidence. [Doctoral Dissertation]. University of Central Florida; 2016. Available from: https://stars.library.ucf.edu/etd/5645
University of Illinois – Chicago
13.
Thornton, Michele.
The Role of External Support in Health Insurance Decision-Making Under the Affordable Care Act.
Degree: 2018, University of Illinois – Chicago
URL: http://hdl.handle.net/10027/22603
► Health insurance decision-making in the United States is a challenging process plagued by complex eligibility guidelines, unfamiliar product choices, increasing financial burdens, and an ever-changing…
(more)
▼ Health insurance decision-making in the United States is a challenging process plagued by complex eligibility guidelines, unfamiliar product choices, increasing financial burdens, and an ever-changing regulatory environment. The Affordable Care Act (ACA) attempted to increase access to healthcare, in part by alleviating some of the barriers to gaining
health insurance coverage. However, complexities persist in
health insurance decision-making and enrollment and as a result, many Americans remain uninsured. Further, under a new administration in 2017 we can expect to see yet another revised
health insurance landscape for individuals to navigate. This study broadens this growing body of knowledge on the role and mechanisms by which both ACA Navigators and
Health Insurance Brokers provide external decision making support in
health insurance enrollment and offerings. The key contributions include: the development of a large new primary dataset on ACA Navigators in Illinois and the types of Outreach work they conduct; leverages this complete set of multi-year data by combining it with longitudinal census data to determine Navigator's association with declining uninsurance rates at the community zip code level; and, finally adds the usage of a mixed methods approach to better understand these results and the underlying mechanisms by which
health insurance decision support workforces like Navigators and
Health Insurance Brokers harness their social capital to improve the uptake of new
policy decisions intended to expand insurance coverage. This framework examines the links in the relationship between two core theories often used separately to explain phenomenon in
health promotion - Social Capital Theory (Coleman, 1988) and Diffusion of Innovations (Rogers, 1995).
The core aims of this study are:
1. Describe the ACA Navigator program funding (nationally), workforce distribution, and outreach activities (Illinois), measured by a newly constructed Navigator Outreach Activity Index.
2. Evaluate the association of the ACA Navigator program funding, workforce distribution and outreach activities with the rate of uninsurance in Illinois and nationally from 2013-2015.
3. Describe and compare a
health insurance broker's (the historic
health insurance outreach and enrollment workforce) approach to
policy and product innovations to that of ACA Navigators.
We find that navigator programs are associated with related geographic decreases in uninsurance rates, and it is observed at an even greater magnitude among key sub-populations of interest. Further, we find that both navigators and brokers leverage the three core dimensions of social capital (Cognitive, Relational and Structural) but each, in a way that magnifies their own unique strengths. Further, it appears that to some extent, this ability to leverage social capital on behalf of a client, has a potentially positive relationship with the desired end result -
health insurance enrollment by the uninsured in the case of the ACA Navigator; and adoption of employee
health…
Advisors/Committee Members: Powell, Lisa M (advisor), Calhoun, Elizabeth (committee member), Stiehl, Emily (committee member), Hebert-Beirne, Jennifer (committee member), Brosseau, Lisa (committee member), Powell, Lisa M (chair).
Subjects/Keywords: Health Policy; Health Insurance
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APA (6th Edition):
Thornton, M. (2018). The Role of External Support in Health Insurance Decision-Making Under the Affordable Care Act. (Thesis). University of Illinois – Chicago. Retrieved from http://hdl.handle.net/10027/22603
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Thornton, Michele. “The Role of External Support in Health Insurance Decision-Making Under the Affordable Care Act.” 2018. Thesis, University of Illinois – Chicago. Accessed February 25, 2020.
http://hdl.handle.net/10027/22603.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Thornton, Michele. “The Role of External Support in Health Insurance Decision-Making Under the Affordable Care Act.” 2018. Web. 25 Feb 2020.
Vancouver:
Thornton M. The Role of External Support in Health Insurance Decision-Making Under the Affordable Care Act. [Internet] [Thesis]. University of Illinois – Chicago; 2018. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/10027/22603.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Thornton M. The Role of External Support in Health Insurance Decision-Making Under the Affordable Care Act. [Thesis]. University of Illinois – Chicago; 2018. Available from: http://hdl.handle.net/10027/22603
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Central Florida
14.
Ashley West, Atalie.
Interaction Between Income, Health Insurance, and Self-rated Health: A Path Analysis.
Degree: 2018, University of Central Florida
URL: https://stars.library.ucf.edu/etd/6269
► The political focus of equitable health outcomes in the United States have long centered on access to medical care. However, there is compelling evidence that…
(more)
▼ The political focus of equitable
health outcomes in the United States have long centered on access to medical care. However, there is compelling evidence that access to medical care is only the bare minimum necessary to achieve
health, and the true influence of
health insurance on
health is still unclear. Widely accepted models of
health estimate that less than 20% of
health outcomes can be attributed to clinical care, while greater than 50% is related to social and economic determinants of
health, with income being the most consistent predictor.
As a result, this study investigated whether earned income is related to insurance status on the one hand and self-rated
health on the other; whether the association between income and self-rated
health is indirectly influenced by the presence of
health insurance –namely private
health insurance; whether there are differences in self-rated
health between the privately insured, the publicly insured, and the uninsured; and if duration of uninsurance was inversely associated with self-rated
health.
As hypothesized, higher income was associated with having
health insurance, and in particular private insurance. Among all included predictor variables, higher income and private insurance are the strongest predictors of higher self-rated
health, and lower income and Medicaid were the strongest predictors of lower self-rated
health. This study affirms that the
health of persons with Medicaid is more similar to persons who are uninsured, and the
health of persons with private insurance is more similar to those with Medicare. The association between income and self-rated
health is indirectly influenced by
health insurance. Age and education exerted the strongest overall influence on self-rated
health: older respondents had lower self-rated
health, and more educated respondents had higher self-rated
health. And as uninsurance duration increased, self-rated
health decreased. Additional studies are recommended to improve
health insurance
policy.
Advisors/Committee Members: Unruh, Lynn.
Subjects/Keywords: Health Policy; Health Services Administration
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APA (6th Edition):
Ashley West, A. (2018). Interaction Between Income, Health Insurance, and Self-rated Health: A Path Analysis. (Doctoral Dissertation). University of Central Florida. Retrieved from https://stars.library.ucf.edu/etd/6269
Chicago Manual of Style (16th Edition):
Ashley West, Atalie. “Interaction Between Income, Health Insurance, and Self-rated Health: A Path Analysis.” 2018. Doctoral Dissertation, University of Central Florida. Accessed February 25, 2020.
https://stars.library.ucf.edu/etd/6269.
MLA Handbook (7th Edition):
Ashley West, Atalie. “Interaction Between Income, Health Insurance, and Self-rated Health: A Path Analysis.” 2018. Web. 25 Feb 2020.
Vancouver:
Ashley West A. Interaction Between Income, Health Insurance, and Self-rated Health: A Path Analysis. [Internet] [Doctoral dissertation]. University of Central Florida; 2018. [cited 2020 Feb 25].
Available from: https://stars.library.ucf.edu/etd/6269.
Council of Science Editors:
Ashley West A. Interaction Between Income, Health Insurance, and Self-rated Health: A Path Analysis. [Doctoral Dissertation]. University of Central Florida; 2018. Available from: https://stars.library.ucf.edu/etd/6269
McMaster University
15.
Vania, Diana.
Feasibility of the Development and Implementation of an Organ Donor Registry in Mumbai, India.
Degree: MSc, 2014, McMaster University
URL: http://hdl.handle.net/11375/14048
► Background: Organ donation in India is a complex issue due to the country’s large population, diverse religious beliefs and myths surrounding organ donation, varying…
(more)
▼ Background: Organ donation in India is a complex issue due to the country’s large population, diverse religious beliefs and myths surrounding organ donation, varying literacy rates, nation-wide focus on disease control, and the commercialization of organs. India has only made marginal steps to address the significant obstacles in order to ensure adequate supplies of organs are available to meet the demand. Purpose: The purpose of this study is to analyze the feasibility of implementing an organ donor registry in Mumbai, India. This is achieved by reviewing current organ donation policies and processes in Mumbai, exploring perceptions of key informants about Indian government health priorities, and identifying possible reasons why the Indian government has not made efforts to increase the deceased donor rate. Methods: This qualitative policy analysis employs semi-structured interviews with physicians, transplant coordinators, and representatives of organ donation advocacy groups in Mumbai to explore key informants’ perceptions about the feasibility of developing and implementing an organ donor registry. The 3-I framework (ideas, interests, and institutions) is used to analyze the results and frame the discussion and their implications. Results: Key informants cite various barriers to the implementation of an organ donor registry in Mumbai, including public misconceptions about organ donation, competing health priorities on the government agenda, and limited hospital infrastructure. Conclusion: In the absence of a focusing event or a policy entrepreneur who is able to push the issue of organ donation onto the health policy agenda, both central and state governments may have little incentive to aggressively pursue the implementation of a donor registry in more than a superficial way. Moreover, even if the issue reached the government’s policy agenda, current barriers may be too overwhelming to overcome. This suggests that implementing an organ donor registry in Mumbai as a means of enhancing organ availability is not feasible in the current environment. Instead, efforts to enhance the transplant system should focus on alternate strategies, such as public education, until the policy environment becomes more amenable to change.
Master of Science (MSc)
Advisors/Committee Members: Randall, Glen, Dobbins, Maureen, Mulvale, Gillian, Global Health.
Subjects/Keywords: organ donation; India; health policy; Health Policy; Health Policy
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APA (6th Edition):
Vania, D. (2014). Feasibility of the Development and Implementation of an Organ Donor Registry in Mumbai, India. (Masters Thesis). McMaster University. Retrieved from http://hdl.handle.net/11375/14048
Chicago Manual of Style (16th Edition):
Vania, Diana. “Feasibility of the Development and Implementation of an Organ Donor Registry in Mumbai, India.” 2014. Masters Thesis, McMaster University. Accessed February 25, 2020.
http://hdl.handle.net/11375/14048.
MLA Handbook (7th Edition):
Vania, Diana. “Feasibility of the Development and Implementation of an Organ Donor Registry in Mumbai, India.” 2014. Web. 25 Feb 2020.
Vancouver:
Vania D. Feasibility of the Development and Implementation of an Organ Donor Registry in Mumbai, India. [Internet] [Masters thesis]. McMaster University; 2014. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/11375/14048.
Council of Science Editors:
Vania D. Feasibility of the Development and Implementation of an Organ Donor Registry in Mumbai, India. [Masters Thesis]. McMaster University; 2014. Available from: http://hdl.handle.net/11375/14048
University of Arizona
16.
Alsaid, Nimer.
Ex Ante Economic Evaluations of Arg389 Genetic Testing and Bucindolol Treatment Decisions in Heart Failure Stage III/IV
.
Degree: 2017, University of Arizona
URL: http://hdl.handle.net/10150/626340
► Introduction: Beta-Blocker Evaluation Survival Trial (BEST) sub-analyses indicated a likely interaction between bucindolol and race disadvantaging black heart failure (HF) patients (Domanski J Cardiac Fail…
(more)
▼ Introduction: Beta-Blocker Evaluation Survival Trial (BEST) sub-analyses indicated a likely interaction between bucindolol and race disadvantaging black heart failure (HF) patients (Domanski J Cardiac Fail 2003); Arg389 homozygotes having adjusted reductions of 38% in mortality and 34% in mortality/hospitalization over other genotypes (Liggett PNAS 2006). Bucindolol is being evaluated in Arg389 genotype patients in the GENETIC-AF trial (NCT01970501). Objective: To conduct parallel (using Domanski et al and Liggett et al) ex ante economic evaluations of Arg389 genetic testing in stage III/IV HF to support bucindolol treatment decisions (if Arg389-positive) and carvedilol (if Arg389-negative) treatment versus no such testing and empirical bucindolol; using Domanski et al and Liggett et al BEST sub-analyses. Methods: In both Domanski et al and Liggett et al analyses, we used a decision tree model with time horizon of 18 months divided into 3 six-month cycles to estimate the cost-effectiveness and cost-utility of Arg389 genetic testing, considering overall survival (OS) from Domanski et al and Liggett et al BEST sub-analyses. Costs and utilities were retrieved from literature except for assumed cost for bucindolol treatment (1.5x cost of carvedilol) and genetic testing (250). Discount rate was set at 3%/yr. Weibull distributions were fitted to OS data. Life-years (LY) and quality-adjusted life-years (QALY) were used to estimate incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR), and results were validated using probabilistic sensitivity analyses (PSA). Results: In the Domanski et-based analysis, Arg389 genetic testing versus no testing was associated with incremental gains of 0.29LYs and 0.27QALYs at incremental cost of 726; yielding ICER of US2,503/LY and ICUR of US2,688/QALY gained. In the Liggett et al-based analysis, Arg-389 genetic testing versus no testing was associated with incremental gains of 0.35LYs and 0.32QALYs at savings of -1.081; for ICER of -US3,089/LY and ICUR of -US3,378/QALY gained. Both analyses were confirmed in PSAs. Conclusion: Arg389 genetic testing to support bucindolol treatment in stage III/IV HF patients prevails economically over bucindolol treatment without genetic testing due to superior OS. If bucindolol is priced at 1.5x the cost of carvedilol. this economic benefit is likely to disappear if bucindolol and/ or genetic testing are priced higher. The clinical and economic benefits of bucindolol treatment with versus without Arg389 genetic testing versus empiric carvedilol remains to be assessed.
Advisors/Committee Members: Abraham, Ivo (advisor), Abraham, Ivo (committeemember), Slack, Marion (committeemember), Sweitzer, Nancy (committeemember), Ramos, Kenneth (committeemember), Erstad, Brian (committeemember).
Subjects/Keywords: Health economics;
health outcomes;
Health policy
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APA (6th Edition):
Alsaid, N. (2017). Ex Ante Economic Evaluations of Arg389 Genetic Testing and Bucindolol Treatment Decisions in Heart Failure Stage III/IV
. (Masters Thesis). University of Arizona. Retrieved from http://hdl.handle.net/10150/626340
Chicago Manual of Style (16th Edition):
Alsaid, Nimer. “Ex Ante Economic Evaluations of Arg389 Genetic Testing and Bucindolol Treatment Decisions in Heart Failure Stage III/IV
.” 2017. Masters Thesis, University of Arizona. Accessed February 25, 2020.
http://hdl.handle.net/10150/626340.
MLA Handbook (7th Edition):
Alsaid, Nimer. “Ex Ante Economic Evaluations of Arg389 Genetic Testing and Bucindolol Treatment Decisions in Heart Failure Stage III/IV
.” 2017. Web. 25 Feb 2020.
Vancouver:
Alsaid N. Ex Ante Economic Evaluations of Arg389 Genetic Testing and Bucindolol Treatment Decisions in Heart Failure Stage III/IV
. [Internet] [Masters thesis]. University of Arizona; 2017. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/10150/626340.
Council of Science Editors:
Alsaid N. Ex Ante Economic Evaluations of Arg389 Genetic Testing and Bucindolol Treatment Decisions in Heart Failure Stage III/IV
. [Masters Thesis]. University of Arizona; 2017. Available from: http://hdl.handle.net/10150/626340
University of New South Wales
17.
Epp, Joanne Elizabeth.
Trends and access to treatment for mental health in Australia from 1989 to 2004-05.
Degree: Economics, 2010, University of New South Wales
URL: http://handle.unsw.edu.au/1959.4/50271
;
https://unsworks.unsw.edu.au/fapi/datastream/unsworks:9149/SOURCE02?view=true
► Accounting for 24 per cent of total disability in Australia, mental health disorders result in significant social and economic costs. Health care costs alone amounted…
(more)
▼ Accounting for 24 per cent of total disability in Australia, mental
health disorders result in significant social and economic costs.
Health care costs alone amounted to $4.1 billion in 2004-05. Mental
health sufferers are more likely to be in low income groups and they often lack the financial, educational and social resources required to seek appropriate treatment. To date, no economic studies in Australia have investigated income and price issues related to the demand for mental
health care, nor have any previous studies considered the importance of concession prices associated with the Australian
health card for accessing mental
health medication.My first paper establishes the trend in the use of mental
health medication in Australia from 1989 to 2004-05, which has previously not been documented. Using decomposition analysis to investigate the contributing factors to the three-fold increase in the use of mental
health medication over this period, I show that socio-demographic characteristics account for only a small amount of the growth. An examination of trends in the association of income with mental
health risk and with mental
health medication use shows a negative income gradient for both. My second paper examines in greater depth the effect of income on mental
health medication use in 2004-05. Selection methods are used to separate the effect of income on medication use from the effect of income on mental
health risk. By estimating mental
health medication use separately for those with and without the
health card, I determine that having the
health card improves access to mental
health medication use and that a positive income gradient for mental
health medication use exists for those without the
health card.My third paper uses a natural experiment approach to determine the price responsiveness of mid-high income seniors for mental
health medication following income eligibility increases in 1999 for the Commonwealth Seniors
Health Card. The results indicate that after controlling for
health status no significant change in mental
health medication use occurred following the
policy for this group of mid-high income seniors, confirming the greater importance of the
health card for mental
health sufferers with low income.
Advisors/Committee Members: Doiron, Denise, Economics, Australian School of Business, UNSW, Maruyama, Shiko, Economics, Australian School of Business, UNSW.
Subjects/Keywords: Australia; Health economics; Health policy; Policy evaluation; Mental health; Mental health policy
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APA (6th Edition):
Epp, J. E. (2010). Trends and access to treatment for mental health in Australia from 1989 to 2004-05. (Doctoral Dissertation). University of New South Wales. Retrieved from http://handle.unsw.edu.au/1959.4/50271 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:9149/SOURCE02?view=true
Chicago Manual of Style (16th Edition):
Epp, Joanne Elizabeth. “Trends and access to treatment for mental health in Australia from 1989 to 2004-05.” 2010. Doctoral Dissertation, University of New South Wales. Accessed February 25, 2020.
http://handle.unsw.edu.au/1959.4/50271 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:9149/SOURCE02?view=true.
MLA Handbook (7th Edition):
Epp, Joanne Elizabeth. “Trends and access to treatment for mental health in Australia from 1989 to 2004-05.” 2010. Web. 25 Feb 2020.
Vancouver:
Epp JE. Trends and access to treatment for mental health in Australia from 1989 to 2004-05. [Internet] [Doctoral dissertation]. University of New South Wales; 2010. [cited 2020 Feb 25].
Available from: http://handle.unsw.edu.au/1959.4/50271 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:9149/SOURCE02?view=true.
Council of Science Editors:
Epp JE. Trends and access to treatment for mental health in Australia from 1989 to 2004-05. [Doctoral Dissertation]. University of New South Wales; 2010. Available from: http://handle.unsw.edu.au/1959.4/50271 ; https://unsworks.unsw.edu.au/fapi/datastream/unsworks:9149/SOURCE02?view=true
McMaster University
18.
Shearer, Jessica C.
Social Networks, Research Evidence, and Innovation in Health Policymaking in Burkina Faso.
Degree: PhD, 2014, McMaster University
URL: http://hdl.handle.net/11375/14094
► This thesis was successfully defended on January 15, 2014 at McMaster University.
Understanding why policies change is an important pursuit for researchers and…
(more)
▼ This thesis was successfully defended on January 15, 2014 at McMaster University.
Understanding why policies change is an important pursuit for researchers and policy-makers alike. Research evidence is one of many possible factors that encourage or constrain policy change, as is the role of ‘networks’ of policy actors. Despite extensive empirical literature on each of evidence-informed health policy and policy networks, the two have rarely been studied together, particularly in low-income country policy environments. This thesis explores both of these variables in a broader structural context of institutions, interests and ideas. Concepts and approaches from social network analysis are applied to three distinct research questions and chapters with the objective to: 1) develop and test a conceptual framework for the integration of networks, institutions, interests and ideas as major variables explaining policy change; 2) test the relationship between policy network structure (closure and heterogeneity) on the use of research evidence and innovation across the three cases; and 3) model the factors that influence the formation of an evidence exchange relationship between policy actors, and the effect of those exchanges on actor-level use of research evidence. Taken together, the findings of this dissertation present persuasive support for adopting a network lens to study evidence-informed health policy and policy change.
Doctor of Philosophy (PhD)
Advisors/Committee Members: Lavis, John N., Abelson, Julia, Dion, Michelle, Health Policy.
Subjects/Keywords: Health policy; social network analysis; knowledge translation; evidence-informed health policy; low-income country; policy network; Health Policy; Health Policy
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APA ·
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MLA ·
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APA (6th Edition):
Shearer, J. C. (2014). Social Networks, Research Evidence, and Innovation in Health Policymaking in Burkina Faso. (Doctoral Dissertation). McMaster University. Retrieved from http://hdl.handle.net/11375/14094
Chicago Manual of Style (16th Edition):
Shearer, Jessica C. “Social Networks, Research Evidence, and Innovation in Health Policymaking in Burkina Faso.” 2014. Doctoral Dissertation, McMaster University. Accessed February 25, 2020.
http://hdl.handle.net/11375/14094.
MLA Handbook (7th Edition):
Shearer, Jessica C. “Social Networks, Research Evidence, and Innovation in Health Policymaking in Burkina Faso.” 2014. Web. 25 Feb 2020.
Vancouver:
Shearer JC. Social Networks, Research Evidence, and Innovation in Health Policymaking in Burkina Faso. [Internet] [Doctoral dissertation]. McMaster University; 2014. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/11375/14094.
Council of Science Editors:
Shearer JC. Social Networks, Research Evidence, and Innovation in Health Policymaking in Burkina Faso. [Doctoral Dissertation]. McMaster University; 2014. Available from: http://hdl.handle.net/11375/14094
Boise State University
19.
Elliott, Annabeth D.
Sex Education Decision Making at the Independent School District of Boise.
Degree: 2010, Boise State University
URL: https://scholarworks.boisestate.edu/td/147
► A needs assessment was conducted in Boise in 2008 to address pregnancy, abortion. and sexually transmitted diseases in teens. Key informants indicated students lacked knowledge…
(more)
▼ A needs assessment was conducted in Boise in 2008 to address pregnancy, abortion. and sexually transmitted diseases in teens. Key informants indicated students lacked knowledge about sexuality and agreed that comprehensive sex education was the best strategy for improving teen sexual health (Elliott, 2008). Because the Independent School District of Boise (ISDB) had an abstinence-only policy, the strategy could not be implemented until the policy was changed.
The purpose of this case study was to cultivate an in-depth understanding of the influences on sex education policy decisions at the ISDB and to add to the body of knowledge, which may facilitate the adoption of evidence-based sex education programs. A qualitative case study design was used to collect descriptive information about the ISDB comprehensive health education policy implemented in 2010. The Communities Coping with Change Model was used as the theoretical framework to guide data collection and analysis of the case (Kelly & Steed, 2004).
Unstructured, one-on-one interviews were conducted with two Board of Trustees and five ISDB employees. Archival records and documents were also reviewed. The data analysis revealed four primary categories of influence on sex education policy: conflict from the past, adherence to an abstinence-only sex education policy, the values of the Boise community, and communication getting lost in the bureaucracy. Sex education policy development had been contentious in the past, influencing Trustees and staff to avoid conflict and strictly adhere to an abstinence-only philosophy. The Trustees and staff perceived a strong community value of sexual abstinence until marriage and that superseded providing comprehensive sex education. A bureaucratic organizational structure and competing priorities for education prevented a free flow of information between the ISDB Trustees, staff, and the community. The ISDB Trustees and staff were unaware of the current research on the growing problem of poor teen sexual health in Boise, evidence of effectiveness regarding sex education curricula or current research on parental support for comprehensive sex education. The community was unaware of the procedure for bringing sex education policy issues to ISDB Trustees and the vast majority of parents, teachers, and nurses had not participated in the process since 1986.
The findings of the case study suggested strong community support would be essential to persuading the ISDB Trustees to adopt an evidence-based sex education policy. Nurses, teachers, parents, and other community members must collaborate to present the ISDB Trustees with the full array of information they need to make an informed decision regarding sex education.
Keywords: Sex education, school, school board, decision making, influences, evidence-based, comprehensive sex education, abstinence-only, and policy.
Subjects/Keywords: Policy; Sex Education; School; Influences; Health Policy
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APA (6th Edition):
Elliott, A. D. (2010). Sex Education Decision Making at the Independent School District of Boise. (Thesis). Boise State University. Retrieved from https://scholarworks.boisestate.edu/td/147
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Elliott, Annabeth D. “Sex Education Decision Making at the Independent School District of Boise.” 2010. Thesis, Boise State University. Accessed February 25, 2020.
https://scholarworks.boisestate.edu/td/147.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Elliott, Annabeth D. “Sex Education Decision Making at the Independent School District of Boise.” 2010. Web. 25 Feb 2020.
Vancouver:
Elliott AD. Sex Education Decision Making at the Independent School District of Boise. [Internet] [Thesis]. Boise State University; 2010. [cited 2020 Feb 25].
Available from: https://scholarworks.boisestate.edu/td/147.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Elliott AD. Sex Education Decision Making at the Independent School District of Boise. [Thesis]. Boise State University; 2010. Available from: https://scholarworks.boisestate.edu/td/147
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Saskatchewan
20.
Wireko, Ishmael.
Explaining Radical Change in Ghanaian Health Care Policy.
Degree: 2015, University of Saskatchewan
URL: http://hdl.handle.net/10388/ETD-2015-11-2298
► The existing literature about the causes of welfare state change, including health care reform, emphasizes stability, yet there is evidence of remarkable changes taking place…
(more)
▼ The existing literature about the causes of welfare state change, including
health care reform, emphasizes stability, yet there is evidence of remarkable changes taking place in welfare systems in much of the developing world. This study analyzes
health care reform in Ghana, a country which has experienced significant path-departing changes in just four decades (1957-2003). These changes – the establishment of a National
Health Service system with deep (first-dollar) coverage, the introduction of a user-fee system, and the transition to a social
health insurance scheme – have been pursued despite key countervailing factors, especially the high political costs associated with them. The study argues that to adequately account for these changes, the
policy process should be given special consideration, particularly through the examination of how new
policy proposals moved onto the agenda; how they were formulated, adopted, implemented and sustained; and how the reformers managed the entire reform process over time. Based on this analysis, I identified three main interconnected contextual and agential explanatory factors: (a) conjunctural factors, which created windows of opportunity for the changes to occur; (b)
policy entrepreneurs, whose leadership, commitment and strategies helped in taking advantage of these opportunities to propel, sponsor, design, adopt, implement and sustain the
policy changes; and (c) the concentrated institutional configuration of Ghana, which limited the number and scope of the veto points available to interest groups opposed to the proposed changes. While these three factors contributed to why and how the changes occurred, I identified
policy entrepreneurs’ commitment, leadership and strategies, including the feedback effects of those strategies, as the most crucial factors. The study contributes to existing
health policy literature by showing how perspectives such as the window of opportunity thesis, the dynamic political process model, the historical institutionalist approach to radical
policy change and, finally, the ideational scholarship on framing processes can be combined to enrich our understanding of radical
policy change. The study also introduces additional mechanisms of
policy change that involve the use of repressive strategies before suggesting some modifications to a number of widely-shared assumptions within the welfare state literature focusing on path dependency, globalization, partisan ideology and vested interests.
Advisors/Committee Members: Béland, Daniel, Marchildon, Gregory P., Mou, Haizhen, Newenham-Kahindi, Newenham-Kahindi.
Subjects/Keywords: Policy change; health policy; health politics; Ghana health
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Export
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Manager
APA (6th Edition):
Wireko, I. (2015). Explaining Radical Change in Ghanaian Health Care Policy. (Thesis). University of Saskatchewan. Retrieved from http://hdl.handle.net/10388/ETD-2015-11-2298
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Wireko, Ishmael. “Explaining Radical Change in Ghanaian Health Care Policy.” 2015. Thesis, University of Saskatchewan. Accessed February 25, 2020.
http://hdl.handle.net/10388/ETD-2015-11-2298.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Wireko, Ishmael. “Explaining Radical Change in Ghanaian Health Care Policy.” 2015. Web. 25 Feb 2020.
Vancouver:
Wireko I. Explaining Radical Change in Ghanaian Health Care Policy. [Internet] [Thesis]. University of Saskatchewan; 2015. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/10388/ETD-2015-11-2298.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Wireko I. Explaining Radical Change in Ghanaian Health Care Policy. [Thesis]. University of Saskatchewan; 2015. Available from: http://hdl.handle.net/10388/ETD-2015-11-2298
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Vanderbilt University
21.
Ward, Benjamin Charles.
Essays on Prescription Drug Policy and Education as Determinants of Health.
Degree: PhD, Economics, 2018, Vanderbilt University
URL: http://etd.library.vanderbilt.edu/available/etd-06292018-135610/
;
► Education and access to legal drugs are two key issues that are influenced by public policy and that may have effects on population health among…
(more)
▼ Education and access to legal drugs are two key issues that are influenced by public
policy and that may have effects on population
health among all ages. I use a variety of data sources to examine examples of these effects on US residents. Using unique data gathered from twins born in Minnesota between 1936 and 1955, I present evidence that increased schooling has a beneficial effect on mortality among males. On average, each additional year of schooling among male twins results in a 3.1 percentage point drop in probability of death during the 20-year window that began in 1994. Education particularly affects the likelihood of being overweight among men, and the observed mortality effects are concentrated on ages 59 to 78. A comparison of patterns of educational investment between monozygotic versus dizygotic twin pairs shows that families tend to use such investments to compensate for
health endowment gaps between siblings. Using data on legal drug distribution and mortality rates, I examine the effects of a 2008 Louisiana law that required frequent and unanticipated drug testing of pain clinic patients who receive opioid prescriptions for the treatment of chronic pain. Evidence shows that the
policy led to significant decreases in the quantity of opioids used and the rate of death from prescription opioid overdose. I then analyze data on foster care entry and child maltreatment reports and demonstrate that the rate of adverse events among children is positively correlated with measures of drug overdose frequency but negatively correlated with the quantity of legal opioids distributed. This finding suggests that policies to reduce the impact of opioid abuse on children should focus on preventing addiction rather than simply reducing the quantity of legal opioids supplied.
Advisors/Committee Members: Kathryn Anderson (chair), Andrew Goodman-Bacon (committee member), Federico Gutierrez (committee member), Peter Savelyev (committee member).
Subjects/Keywords: opioid policy; health policy; education and health; health economics
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APA (6th Edition):
Ward, B. C. (2018). Essays on Prescription Drug Policy and Education as Determinants of Health. (Doctoral Dissertation). Vanderbilt University. Retrieved from http://etd.library.vanderbilt.edu/available/etd-06292018-135610/ ;
Chicago Manual of Style (16th Edition):
Ward, Benjamin Charles. “Essays on Prescription Drug Policy and Education as Determinants of Health.” 2018. Doctoral Dissertation, Vanderbilt University. Accessed February 25, 2020.
http://etd.library.vanderbilt.edu/available/etd-06292018-135610/ ;.
MLA Handbook (7th Edition):
Ward, Benjamin Charles. “Essays on Prescription Drug Policy and Education as Determinants of Health.” 2018. Web. 25 Feb 2020.
Vancouver:
Ward BC. Essays on Prescription Drug Policy and Education as Determinants of Health. [Internet] [Doctoral dissertation]. Vanderbilt University; 2018. [cited 2020 Feb 25].
Available from: http://etd.library.vanderbilt.edu/available/etd-06292018-135610/ ;.
Council of Science Editors:
Ward BC. Essays on Prescription Drug Policy and Education as Determinants of Health. [Doctoral Dissertation]. Vanderbilt University; 2018. Available from: http://etd.library.vanderbilt.edu/available/etd-06292018-135610/ ;
22.
Lucero, Luisa M.
Obesity Policy Stringency Over Time: A Four State Policy Design.
Degree: PhD, School of Public Service, 2017, Old Dominion University
URL: 9780355409260
;
https://digitalcommons.odu.edu/publicservice_etds/6
► Over the past several decades obesity rates in the United States have increased exponentially, reaching epidemic proportions and placing heavy financial and health-related burdens…
(more)
▼ Over the past several decades obesity rates in the United States have increased exponentially, reaching epidemic proportions and placing heavy financial and
health-related burdens on states. States could reduce their obesity-related spending by billions of dollars, however, if they reduced their obesity prevalence by five percent by 2030, which would reduce medical costs, loss of productivity, and loss of life. Despite the incentive to improve obesity rates, not all states are taking advantage of obesity-related
policy as a means to combat obesity. Using a multiple case study design and
policy design as the theoretical foundation, this study explores whether or not state
policy design stringency, reflecting
policy design prescriptiveness, changes as states experience an increase in obesity prevalence. This study also seeks to identify the factors that contribute to variation in state obesity-related
policy stringency.
The results of this study indicate that states enacting a large number of highly stringent obesity-related policies will experience an improvement in obesity prevalence over time. States making minimal improvements will experience consistent obesity rates over time, while states that take no significant obesity-reducing
policy steps will experience worsening obesity prevalence over time. In terms of the factors that lead to variation in
policy design stringency, party sponsorship of obesity-related
policy plays a key role, as does state affluence, and party in control of the state legislature in some cases. Party of the governor and contributions from
health interest groups were not consistently present in years of high obesity
policy stringency. This dissertation also offers implications of the findings and plans for future research.
Advisors/Committee Members: Meagan M. Jordan, John C. Morris, John C. Morris, Tancy Vandecar-Burdin.
Subjects/Keywords: Obesity policy stringency; Policy design; State-level policy; Health Policy; Public Administration; Public Policy
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APA ·
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Manager
APA (6th Edition):
Lucero, L. M. (2017). Obesity Policy Stringency Over Time: A Four State Policy Design. (Doctoral Dissertation). Old Dominion University. Retrieved from 9780355409260 ; https://digitalcommons.odu.edu/publicservice_etds/6
Chicago Manual of Style (16th Edition):
Lucero, Luisa M. “Obesity Policy Stringency Over Time: A Four State Policy Design.” 2017. Doctoral Dissertation, Old Dominion University. Accessed February 25, 2020.
9780355409260 ; https://digitalcommons.odu.edu/publicservice_etds/6.
MLA Handbook (7th Edition):
Lucero, Luisa M. “Obesity Policy Stringency Over Time: A Four State Policy Design.” 2017. Web. 25 Feb 2020.
Vancouver:
Lucero LM. Obesity Policy Stringency Over Time: A Four State Policy Design. [Internet] [Doctoral dissertation]. Old Dominion University; 2017. [cited 2020 Feb 25].
Available from: 9780355409260 ; https://digitalcommons.odu.edu/publicservice_etds/6.
Council of Science Editors:
Lucero LM. Obesity Policy Stringency Over Time: A Four State Policy Design. [Doctoral Dissertation]. Old Dominion University; 2017. Available from: 9780355409260 ; https://digitalcommons.odu.edu/publicservice_etds/6
McMaster University
23.
Li, Kathy K.
The Use of Public Involvement in Canadian Health Policy Decision-Making.
Degree: PhD, 2013, McMaster University
URL: http://hdl.handle.net/11375/13454
► In this age of accountability, responsiveness, and transparency, governments are increasingly pressured to develop ways to demonstrate the value of public involvement in policy…
(more)
▼ In this age of accountability, responsiveness, and transparency, governments are increasingly pressured to develop ways to demonstrate the value of public involvement in policy decision-making. Yet the extent to which policy decisions actually reflect citizens’ views and input from public involvement processes remains relatively unknown. The main purpose of my dissertation is to examine the internal dynamics of how public involvement is used in the health policy decision-making process. It is guided by two research questions: i) How is public involvement used in the health policy decision-making process; and ii) What factors influence the use of public involvement in the health policy decision-making process? These questions are explored through three independent but complementary studies: i) through a concept analysis, to clarify the concept of public involvement use in health policy decision-making; ii) through a document analysis, to examine the values and assumptions that underpin current and proposed relationships between publics and government, how these have evolved over time, and the meaning of public involvement itself; and iii) through a literature review and key informant interviews, to identify the range of factors influencing the nature of how public involvement is used. The concept of public involvement use, as presented in this thesis, is a complex concept that may be understood, interpreted and operationalized through three interrelated questions: What is the meaning of use in relation to other similar concepts? What is public involvement used for? And, how do we know public involvement was used in health policy decision-making? The results of this dissertation also reveal numerous tensions that characterize the dynamics of how public involvement is used in policy decision-making. Taken together, the three studies provide insights into ways in which public administrators and policy decision-makers could respond to calls for greater accountability and transparency regarding the use of public involvement in policy decision-making.
Doctor of Philosophy (PhD)
Advisors/Committee Members: Abelson, Julia, Mita Giacomini and Damien Contandriopoulos, Health Policy.
Subjects/Keywords: public involvement; use; health policy; decision-making; accountability; Canada; Health Policy; Health Policy
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APA ·
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APA (6th Edition):
Li, K. K. (2013). The Use of Public Involvement in Canadian Health Policy Decision-Making. (Doctoral Dissertation). McMaster University. Retrieved from http://hdl.handle.net/11375/13454
Chicago Manual of Style (16th Edition):
Li, Kathy K. “The Use of Public Involvement in Canadian Health Policy Decision-Making.” 2013. Doctoral Dissertation, McMaster University. Accessed February 25, 2020.
http://hdl.handle.net/11375/13454.
MLA Handbook (7th Edition):
Li, Kathy K. “The Use of Public Involvement in Canadian Health Policy Decision-Making.” 2013. Web. 25 Feb 2020.
Vancouver:
Li KK. The Use of Public Involvement in Canadian Health Policy Decision-Making. [Internet] [Doctoral dissertation]. McMaster University; 2013. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/11375/13454.
Council of Science Editors:
Li KK. The Use of Public Involvement in Canadian Health Policy Decision-Making. [Doctoral Dissertation]. McMaster University; 2013. Available from: http://hdl.handle.net/11375/13454
The George Washington University
24.
Kurtzman, Ellen T.
Delivery of High Quality Primary Care in Community Health Centers| The Role of Nurse Practitioners and State Scope of Practice Restrictions.
Degree: 2016, The George Washington University
URL: http://pqdtopen.proquest.com/#viewpdf?dispub=3746006
► In response to the increased demand for primary care in the United States—a byproduct of a growing elderly population and insurance expansion under the…
(more)
▼ In response to the increased demand for primary care in the United States—a byproduct of a growing elderly population and insurance expansion under the Affordable Care Act (ACA)—the total number and capacities of community health centers (HCs) is expected to grow. While HCs have historically depended on physicians to deliver the majority of their care, more and more, they are shifting to non-physician clinicians, especially nurse practitioners (NPs); yet, little is known about the quality of care delivered by NPs in HCs or about the role state occupational restrictions have on these practitioners or their patients. Using quasi-experimental methods and data from the community health center subsample of the National Ambulatory Medical Care Survey (NAMCS), this dissertation explores three distinct, but related, research questions regarding NP-delivered care in HCs—its effectiveness and comparability to physician care, the extent that tradeoffs in the quantity and quality of care are made, and the real-world risks and benefits of states easing their scope of practice restrictions. Findings, which suggest that NP care is comparable to physician care in most ways and that the quality of NP-delivered care does not significantly vary irrespective of states’ NP independence status, have important implications for policy and practice.
Subjects/Keywords: Nursing; Public health; Public policy
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APA (6th Edition):
Kurtzman, E. T. (2016). Delivery of High Quality Primary Care in Community Health Centers| The Role of Nurse Practitioners and State Scope of Practice Restrictions. (Thesis). The George Washington University. Retrieved from http://pqdtopen.proquest.com/#viewpdf?dispub=3746006
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Kurtzman, Ellen T. “Delivery of High Quality Primary Care in Community Health Centers| The Role of Nurse Practitioners and State Scope of Practice Restrictions.” 2016. Thesis, The George Washington University. Accessed February 25, 2020.
http://pqdtopen.proquest.com/#viewpdf?dispub=3746006.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Kurtzman, Ellen T. “Delivery of High Quality Primary Care in Community Health Centers| The Role of Nurse Practitioners and State Scope of Practice Restrictions.” 2016. Web. 25 Feb 2020.
Vancouver:
Kurtzman ET. Delivery of High Quality Primary Care in Community Health Centers| The Role of Nurse Practitioners and State Scope of Practice Restrictions. [Internet] [Thesis]. The George Washington University; 2016. [cited 2020 Feb 25].
Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=3746006.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Kurtzman ET. Delivery of High Quality Primary Care in Community Health Centers| The Role of Nurse Practitioners and State Scope of Practice Restrictions. [Thesis]. The George Washington University; 2016. Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=3746006
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
The George Washington University
25.
Levant, Shaleah.
Essays on Community Characteristics Associated with Potentially Preventable Hospitalizations.
Degree: 2016, The George Washington University
URL: http://pqdtopen.proquest.com/#viewpdf?dispub=10001626
► Adequate access to primary care is an integral part of any health care system. One indicator for access outcomes is potentially preventable hospitalizations (PPH),…
(more)
▼ Adequate access to primary care is an integral part of any health care system. One indicator for access outcomes is potentially preventable hospitalizations (PPH), i.e., a hospitalization that occurs when a patient is hospitalized for an ambulatory care sensitive condition (ACSC). PPHs are of interest because the additional costs of caring for a patient in a hospital with an ACSC, as opposed to in a primary care setting, are substantial, for patients, payers, and hospitals. Identifying the factors associated with PPH will aid in policymaking, improve access to care, and reduce the burden on the health care system. To address the gaps in the literature, I analyze how community-level access to care resources and state policies are associated with PPH using nationally representative data, while controlling for individual patient characteristics and community-level demographics. Multiple publicly available and restricted use data sources are linked to create a comprehensive data set that is used to investigate the relationship between PPH rates and community access to care factors. The dissertation addresses the following three objectives: (1) To determine the association between state Medicaid policies and the odds of a potentially preventable hospitalization; (2) To assess how primary care capacity and the odds of a potentially preventable hospitalization varies across the urbanization spectrum; and (3) To assess how primary care capacity and the odds of PPH varies for chronic and acute ACSCs. The findings are summarized below: - An analysis of state Medicaid policies does not find any significant associations between the odds of PPH and Medicaid generosity index and managed care penetration. - Primary care physician supply and the presence of a federally qualified health center are associated with a lower odds of PPH across the urbanization spectrum. - Physician supply, primary care and specialist, is associated with a lower odds of PPH for chronic ACSCs, while nurse practitioner and physician assistant supply is associated with a lower odds of PPH for acute ACSCs. The presence of a federally qualified health center is associated with lower odds of PPH for both chronic and acute ACSCs.
Subjects/Keywords: Public health; Public policy
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APA (6th Edition):
Levant, S. (2016). Essays on Community Characteristics Associated with Potentially Preventable Hospitalizations. (Thesis). The George Washington University. Retrieved from http://pqdtopen.proquest.com/#viewpdf?dispub=10001626
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Levant, Shaleah. “Essays on Community Characteristics Associated with Potentially Preventable Hospitalizations.” 2016. Thesis, The George Washington University. Accessed February 25, 2020.
http://pqdtopen.proquest.com/#viewpdf?dispub=10001626.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Levant, Shaleah. “Essays on Community Characteristics Associated with Potentially Preventable Hospitalizations.” 2016. Web. 25 Feb 2020.
Vancouver:
Levant S. Essays on Community Characteristics Associated with Potentially Preventable Hospitalizations. [Internet] [Thesis]. The George Washington University; 2016. [cited 2020 Feb 25].
Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=10001626.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Levant S. Essays on Community Characteristics Associated with Potentially Preventable Hospitalizations. [Thesis]. The George Washington University; 2016. Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=10001626
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
26.
Buker, Macey.
Relationship Between Health Care Costs and Type of Insurance.
Degree: 2017, Walden University
URL: http://pqdtopen.proquest.com/#viewpdf?dispub=10634995
► Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have…
(more)
▼ Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way ANOVAs indicated that between 2% and 9% of health care costs could be attributed to type of health insurance, a statistically significant finding. Results also supported the effectiveness of the ACA in stabilizing health care costs. The average annual rate of health care cost increase was 38.6% from 2007 until 2010, decreasing to an average annual increase of 4.3% from 2011 until 2014. Results provide important information to generate positive social change for consumers, providers, and policymakers. This includes improving decisions related to health care costs, improved understanding of the costs of health care services, increased transparency, increased patient engagement, maximizing consumer utility, facilitation of reduction of waste within the industry, and increased understanding of the impact of health policy on health care costs and efficiencies within newly created health policies. Results may also improve transparency of health care costs, which allows consumers, providers, and policymakers to take specific action to reduce health care costs, resulting in a more just and sustainable health care model.
Subjects/Keywords: Public policy; Health care management
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APA (6th Edition):
Buker, M. (2017). Relationship Between Health Care Costs and Type of Insurance. (Thesis). Walden University. Retrieved from http://pqdtopen.proquest.com/#viewpdf?dispub=10634995
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Buker, Macey. “Relationship Between Health Care Costs and Type of Insurance.” 2017. Thesis, Walden University. Accessed February 25, 2020.
http://pqdtopen.proquest.com/#viewpdf?dispub=10634995.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Buker, Macey. “Relationship Between Health Care Costs and Type of Insurance.” 2017. Web. 25 Feb 2020.
Vancouver:
Buker M. Relationship Between Health Care Costs and Type of Insurance. [Internet] [Thesis]. Walden University; 2017. [cited 2020 Feb 25].
Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=10634995.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Buker M. Relationship Between Health Care Costs and Type of Insurance. [Thesis]. Walden University; 2017. Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=10634995
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Edinburgh
27.
Plotnikova, Evgeniya.
Recruiting foreign nurses for the UK : the role of bilateral labour agreements.
Degree: PhD, 2012, University of Edinburgh
URL: http://hdl.handle.net/1842/6445
► This thesis is about policy instruments for the regulation of international labour mobility. It focuses on the use of government-to-government agreements on the cross-border movement…
(more)
▼ This thesis is about policy instruments for the regulation of international labour mobility. It focuses on the use of government-to-government agreements on the cross-border movement of nurses, negotiated between source and destination countries. This research is a qualitative case study of agreements signed in the early 2000s between the UK and Spain, South Africa, the Philippines and India. It aims to understand the role of these agreements in British policy as perceived by actors in the destination country. It addresses three questions: 1) What types of agreements did the British government negotiate? 2) Why did the British government negotiate these agreements? and 3) What functions did these agreements perform? Employing the notion of ‘policy tools’ as an organising concept, this thesis’s analytical framework draws on political sociology and the conception of policy instruments as being composed and brought into existence by actors and their power relations in multilevel policy contexts. This study is based on documentary analysis and elite interviews with experts in international organisations, officials in the Department of Health (England), recruitment officers in the source countries, and professional nursing organisations and trade unions in the UK. This thesis argues that government-to-government agreements between the UK and supply countries emerged from a discourse on the ethical recruitment of health workers which was framed in the language of human rights. One of the roles of these agreements was to contain contradictory and conflicting interests between and within institutional actors involved in the international recruitment of nurses on both sides of the migration process. More broadly, the research addresses and advances the discussion of the policy instrumentation approach, and contributes to the understanding of the choice of policy tools and their performance in an ambivalent policy context.
Subjects/Keywords: health worker migration; policy tools
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APA ·
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Export
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APA (6th Edition):
Plotnikova, E. (2012). Recruiting foreign nurses for the UK : the role of bilateral labour agreements. (Doctoral Dissertation). University of Edinburgh. Retrieved from http://hdl.handle.net/1842/6445
Chicago Manual of Style (16th Edition):
Plotnikova, Evgeniya. “Recruiting foreign nurses for the UK : the role of bilateral labour agreements.” 2012. Doctoral Dissertation, University of Edinburgh. Accessed February 25, 2020.
http://hdl.handle.net/1842/6445.
MLA Handbook (7th Edition):
Plotnikova, Evgeniya. “Recruiting foreign nurses for the UK : the role of bilateral labour agreements.” 2012. Web. 25 Feb 2020.
Vancouver:
Plotnikova E. Recruiting foreign nurses for the UK : the role of bilateral labour agreements. [Internet] [Doctoral dissertation]. University of Edinburgh; 2012. [cited 2020 Feb 25].
Available from: http://hdl.handle.net/1842/6445.
Council of Science Editors:
Plotnikova E. Recruiting foreign nurses for the UK : the role of bilateral labour agreements. [Doctoral Dissertation]. University of Edinburgh; 2012. Available from: http://hdl.handle.net/1842/6445
University of Rochester
28.
Goldstein, Nicolas P. N.
Disproportionate Premature Birth in Women of Low Socioeconomic Status| A Psychological and Physiological Stress Explanation of Financial Risk Removal.
Degree: 2018, University of Rochester
URL: http://pqdtopen.proquest.com/#viewpdf?dispub=10824350
► <b>Objectives:</b> Mothers of low socioeconomic status (SES) and of non-Hispanic black race deliver prematurely more often. The goal of my dissertation was to improve…
(more)
▼ <b>Objectives:</b> Mothers of low socioeconomic status (SES) and of non-Hispanic black race deliver prematurely more often. The goal of my dissertation was to improve understanding of the mechanism of disproportionate premature birth in low SES women. I tested a psychological and physiological stress explanation of prematurity risk, estimated the effect of the Affordable Care Act (ACA) Medicaid expansion on gestational age (GA), and estimated how the ACA Medicaid expansion effect was influenced by race. <i><b>Data and Methods:</b></i> I developed a conceptual framework of how psychological and physiological stress increase premature birth risk utilizing Appraisal and pathophysiology theory. I generated hypotheses about how financial risk removal would impact GA and tested them utilizing variation in expansions in Medicaid eligibility for pregnant women in three matched state pairs and distribution of the Earned Income Tax Credit (EITC). I utilized data from the Pregnancy Risk Assessment Monitoring System and performed multivariate ordinal regressions. I also used national birth record data and exploited state variation in ACA Medicaid expansion status to estimate the impact on GA in non-Hispanic black and all other mothers using multivariate linear regressions and linear probability models. <b>Results:</b> Hypothesis testing based on two of the three Medicaid expansion for pregnant women state pairs and the EITC analyses resulted in significant evidence (one-sided p-values < 0.05) for a direct pathway between psychological stress concerning financial risk, physiological stress, and GA. The ACA Medicaid expansion was associated with an increase in GA for non-Hispanic black mothers (+34 hours), a decrease for all other mothers (–6 hours), and a 3% decrease (95% CI = –5% to –2%) in the incidence of early term or shorter gestation births for non-Hispanic black mothers. <b>Conclusions:</b> Decreasing financial risk for low SES women with Medicaid or the EITC is associated with increased GA. The higher premature birth risk in this population is likely the result of a direct pathway involving psychological and physiological stress. Other financial risk removal strategies should be investigated. The ACA Medicaid expansion did not meaningfully influence GA on a weekly scale but did moderately decrease overall preterm birth risk in non-Hispanic black mothers.
Subjects/Keywords: Obstetrics; Public health; Public policy
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APA ·
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Export
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APA (6th Edition):
Goldstein, N. P. N. (2018). Disproportionate Premature Birth in Women of Low Socioeconomic Status| A Psychological and Physiological Stress Explanation of Financial Risk Removal. (Thesis). University of Rochester. Retrieved from http://pqdtopen.proquest.com/#viewpdf?dispub=10824350
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Goldstein, Nicolas P N. “Disproportionate Premature Birth in Women of Low Socioeconomic Status| A Psychological and Physiological Stress Explanation of Financial Risk Removal.” 2018. Thesis, University of Rochester. Accessed February 25, 2020.
http://pqdtopen.proquest.com/#viewpdf?dispub=10824350.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Goldstein, Nicolas P N. “Disproportionate Premature Birth in Women of Low Socioeconomic Status| A Psychological and Physiological Stress Explanation of Financial Risk Removal.” 2018. Web. 25 Feb 2020.
Vancouver:
Goldstein NPN. Disproportionate Premature Birth in Women of Low Socioeconomic Status| A Psychological and Physiological Stress Explanation of Financial Risk Removal. [Internet] [Thesis]. University of Rochester; 2018. [cited 2020 Feb 25].
Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=10824350.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Goldstein NPN. Disproportionate Premature Birth in Women of Low Socioeconomic Status| A Psychological and Physiological Stress Explanation of Financial Risk Removal. [Thesis]. University of Rochester; 2018. Available from: http://pqdtopen.proquest.com/#viewpdf?dispub=10824350
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Nairobi
29.
Wesangula, Nelima E.
Translating health policy into practice:Successes and challenges at implementation in Bungoma south district, western Kenya
.
Degree: 2009, University of Nairobi
URL: http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32012
► Background: Malaria is one of the most common infectious diseases in the world with more than 40 percent of the world's population at risk and…
(more)
▼ Background: Malaria is one of the most common infectious diseases in the world with more than 40 percent of the world's population at risk and one of the greatest public health concerns especially in sub Saharan Africa. In Bungoma South district, malaria is the leading cause of morbidity, accounting for 49 percent of the top ten diseases in the district. In 2006, Kenya implemented a new malaria treatment policy recommending the use of Artemether-Lumefantrine (AL) as the first line of treatment. National guidelines on the diagnosis, treatment and prevention and job aids were developed and disseminated to health workers alongside in-service training. The survey investigated whether the treatment of uncomplicated malaria conformed to the national treatment guidelines on diagnosis, treatment and prevention of malaria in Kenya.
Methods: In September 2009, 17 in face to face interviews were conducted in 17 health
facilities in Bungoma South, with 31 health workers who routinely performed consultations at the out patient departments in their facilities as well as with 3 representatives of the District Health Management Team. Data on health facility inventory control practices and stock status was retrospectively collected from the records available. The main outcome measures were: availability of antimalarial drugs on the survey day, stock-outs in past six months, presence of AL wall charts, and health worker's exposure to in-service training on AL and access to new national malaria treatment guidelines
Results: Only 35 percent of the health facilities had access to job aids and current treatment guidelines and that 76 percent of the health workers had been trained on malaria case management. AL was almost universally available in all the health facilities on the day of survey, all facilities had recorded stock outs of AL six months prior to the survey and the duration of the stock outs was substantial lasting two months on average. Amodiaquine was not readily available in the health facilities.
Conclusion: These results offered evidence that treatment practices in uncomplicated malaria after policy change, do not fully conform to the national treatment guidelines on diagnosis, treatment and prevention of malaria in Kenya. The targets set for key implementation indicators by the division of malaria control, in terms of availability of recommended drug and training of health workers, have not been fully achieved. If the government does not ensure uninterrupted supply of recommended treatment, high quality focused training and appropriate patient education enhanced, and if provider prescription practices do not fully conform to the recommended treatment guidelines, the major potential public health benefits of AL may not be realized. These findings are important in providing evidence for decision making in future policy review.
Subjects/Keywords: Health policy;
Bungoma south district
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APA ·
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Export
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APA (6th Edition):
Wesangula, N. E. (2009). Translating health policy into practice:Successes and challenges at implementation in Bungoma south district, western Kenya
. (Thesis). University of Nairobi. Retrieved from http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32012
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Wesangula, Nelima E. “Translating health policy into practice:Successes and challenges at implementation in Bungoma south district, western Kenya
.” 2009. Thesis, University of Nairobi. Accessed February 25, 2020.
http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32012.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Wesangula, Nelima E. “Translating health policy into practice:Successes and challenges at implementation in Bungoma south district, western Kenya
.” 2009. Web. 25 Feb 2020.
Vancouver:
Wesangula NE. Translating health policy into practice:Successes and challenges at implementation in Bungoma south district, western Kenya
. [Internet] [Thesis]. University of Nairobi; 2009. [cited 2020 Feb 25].
Available from: http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32012.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Wesangula NE. Translating health policy into practice:Successes and challenges at implementation in Bungoma south district, western Kenya
. [Thesis]. University of Nairobi; 2009. Available from: http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32012
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Universiteit Utrecht
30.
Cairoli, E.
Medicalisation of childbirth in maternity health policies: Ethical evaluation of the use of medicalisation in the Dutch and British maternity policies.
Degree: 2010, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/40306
► This thesis explores the ethical justifiability of medicalisation of childbirth in maternity health policies. This is done by setting a case study on the Dutch…
(more)
▼ This thesis explores the ethical justifiability of medicalisation of childbirth in maternity
health policies. This is done by setting a case study on the Dutch and British approaches to childbirth. The former takes the avoidance of medicalisation in low-risk births as a priority, while in the latter the priority goes to enhancing and respecting women's choice. I address the question of which of these approaches leads to more justifiable
policy decisions from an ethical point of view. In order to answer this question, I structure a specific ethical framework and I apply it to the policies analysed. At the end of my ethical evaluation I find that the Dutch system is more justifiable from a utilitarian point of view, as it successfully maintains the balance between avoiding risks for high-risk pregnancies and limiting the burdens of medicalisation for low-risk ones. On the other hand the British official
policy takes a non-utilitarian approach to maternity care, where the consideration of choice in childbirth is a central concern. In conclusion I suggest that this thesis can contribute to the discourse on maternity reform by clarifying the ethical assumptions of
policy decisions.
Advisors/Committee Members: Bolt, L.L.E..
Subjects/Keywords: Wijsbegeerte; Medicalisation, childbirth, health policy
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APA ·
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MLA ·
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CSE |
Export
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APA (6th Edition):
Cairoli, E. (2010). Medicalisation of childbirth in maternity health policies: Ethical evaluation of the use of medicalisation in the Dutch and British maternity policies. (Masters Thesis). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/40306
Chicago Manual of Style (16th Edition):
Cairoli, E. “Medicalisation of childbirth in maternity health policies: Ethical evaluation of the use of medicalisation in the Dutch and British maternity policies.” 2010. Masters Thesis, Universiteit Utrecht. Accessed February 25, 2020.
http://dspace.library.uu.nl:8080/handle/1874/40306.
MLA Handbook (7th Edition):
Cairoli, E. “Medicalisation of childbirth in maternity health policies: Ethical evaluation of the use of medicalisation in the Dutch and British maternity policies.” 2010. Web. 25 Feb 2020.
Vancouver:
Cairoli E. Medicalisation of childbirth in maternity health policies: Ethical evaluation of the use of medicalisation in the Dutch and British maternity policies. [Internet] [Masters thesis]. Universiteit Utrecht; 2010. [cited 2020 Feb 25].
Available from: http://dspace.library.uu.nl:8080/handle/1874/40306.
Council of Science Editors:
Cairoli E. Medicalisation of childbirth in maternity health policies: Ethical evaluation of the use of medicalisation in the Dutch and British maternity policies. [Masters Thesis]. Universiteit Utrecht; 2010. Available from: http://dspace.library.uu.nl:8080/handle/1874/40306
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Open Access Theses and Dissertations