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Добірка наукової літератури з теми "Health Care Administration"

Автор: Grafiati

Опубліковано: 4 червня 2021

Оновлено: 27 липня 2024

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Статті в журналах з теми "Health Care Administration"

MacMillan, Carllene B. "Health Care Administration." AORN Journal 63, no. 3 (March 1996): 636. http://dx.doi.org/10.1016/s0001-2092(06)63407-8.

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Wolper, Lawrence F. "Health Care Administration." Journal For Healthcare Quality 19, no. 4 (July 1997): 34. http://dx.doi.org/10.1097/01445442-199707000-00009.

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Levey, Samuel, and N. Paul Loomba. "Health Care Administration." Health Care Management Review 10, no. 3 (January 1985): 92. http://dx.doi.org/10.1097/00004010-198501030-00018.

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Editorial Submission, Haworth. "HEALTH CARE FINANCING ADMINISTRATION." Health Care on the Internet 4, no. 1 (January 1, 2000): 88–89. http://dx.doi.org/10.1300/j138v04n01_15.

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Stacey, J. "The Health Care Financing Administration." JAMA: The Journal of the American Medical Association 258, no. 6 (August 14, 1987): 822. http://dx.doi.org/10.1001/jama.258.6.822.

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Stacey, James. "The Health Care Financing Administration." JAMA: The Journal of the American Medical Association 258, no. 6 (August 14, 1987): 822. http://dx.doi.org/10.1001/jama.1987.03400060098038.

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Prystaya, M. "Public administration in the field of health care peculiarities." Uzhhorod National University Herald. Series: Law 1, no. 80 (January 22, 2024): 557–62. http://dx.doi.org/10.24144/2307-3322.2023.80.1.85.

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Анотація:

The article examines the peculiarities of administration in the field of health care through the definition of the concept of public administration in the field of health care, its object(s), subject(s), and goals. It was determined that public administration should be understood as the activity of subjects of public administration, which consists in establishing, changing or terminating the rights and obligations of private individuals for the purpose of ordering and organizing social relations to implement the decisions of the legislative body. Public administration can be expressed through the adoption of normative acts, administrative acts, as well as the execution of legally significant actions. It has been established that in scientific works of legal direction and public administration, health care and the medical field are often considered as an object of public management (administration). However, for the purposes of legal research, the object of public administration is defined as the sphere or branch of health care in which various subjects interact: public authorities, health care institutions, patients, legal entities, medical workers, administration of institutions, etc. And the goal of public administration is to achieve the appropriate level of organization of activities of subjects in the field of health care. At the same time, the subjects of legal relations in the field of health care can simultaneously act as objects of administration, if the legal relations are considered from the standpoint of administrative and legal regulation. Accordingly, a health care institution is a separate object of public administration, which is directed to the goal-setting, organizing, as well as regulatory activities and influence of administration subjects (state bodies, local self-government bodies, administrations of the institutions themselves). Therefore, in the future research, the terms “administration (management) in the field of health care”, “administration (management) of a health care institution” will be used.

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Shumaker, Mary, John Holahan, Marilyn Moon, W. Pete Welch, Stephen Zuckerman, Jack Hadley, and Marilyn Moon. "Health Care Reform and Public Administration." Public Administration Review 55, no. 4 (July 1995): 389. http://dx.doi.org/10.2307/977134.

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Cutler, David M., and Gail R. Wilensky. "Health Care in the Next Administration." New England Journal of Medicine 359, no. 15 (October 9, 2008): e17. http://dx.doi.org/10.1056/nejmp0807567.

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Alexander, Rinda. "Handbook of Home Health Care Administration." Journal of Gerontological Nursing 21, no. 5 (May 1, 1995): 45–46. http://dx.doi.org/10.3928/0098-9134-19950501-11.

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Дисертації з теми "Health Care Administration"

Donato, Francis A. "Reforming health care through managed care." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.

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Анотація:

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.
Source: Masters Abstracts International, Volume: 45-06, page: 2939. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 91-92).

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Holmberg, Leif. "Health-care processes a study of medical problem-solving in the Swedish health-care organization /." Lund : Lund University Press, 1997. http://books.google.com/books?id=1jNrAAAAMAAJ.

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Annear, Peter Leslie, and mikewood@deakin edu au. "Healthy markets - Heathly people? Reforming health care in Cambodia." Deakin University. School of Health Sciences, 2001. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050825.134836.

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Анотація:

Health care reform has been described as a global epidemic. This thesis deals with nature and experience of health care reform in developing countries. Increasing privatisation, economic transition, and structural adjustment have provided the context for health system changes. Different approaches to reform have been developed by international organisations such as the World Bank, WHO and UNICEF. What has driven national health care reforms? Are such policies really appropriate to developing countries? Has a consensus now emerged in relation to international health policy? Has a new health care model appeared? The study of health care reform in Cambodia is a timely opportunity to investigate the implementation of health care reform under extreme conditions. These conditions include a legacy of genocide, long-term conflict, political isolation, and economic transition. This case study uses both qualitative and quantitative methods and multiple sources of data to analyse the reform program. The study reinforces the conclusion that, under conditions of extreme poverty, market based reforms are likely to have limited positive impact. Rather, understanding the cultural conditions that determine demand, delivering health care of a satisfactory quality, providing appropriate incentives for health practitioners, and supporting services with adequate public funding are the prerequisites for improved service delivery and utilisation. Cambodia's strategy of integrated district health service development and universal population coverage may provide an instructive example of reform. Emerging policy issues identified by this case study include the fundamental role of equity in service provision, the influence of the social determinants of health and illness and interest in the appropriate use of evidence in international health policy-making.

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Catena, Rodolfo. "Essays on health care operations management." Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:3c2035a6-b5d0-43b7-9b12-4883e5db4526.

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The aim of operations management in health care is to enhance the provision of services to patients and to decrease costs. Overall worldwide health care expenditures represent around 10.5% of the global GDP and are projected to increase at an annual rate of 5.3% from 2015 to 2017 [74]. In order to investigate how to curb health care costs, I study the English NHS, a health care system that provided universal care to around 54 million people in 2014 [243]. The NHS has launched many initiatives to improve the performance of hospital operations such as the "QIPP" program, which has the objective to save £20 billion of costs by 2015 [98]. Given this framework, this research aims to contribute to the theory that is guiding these operational changes, using data on all admissions to hospitals and focussing on the inguinal hernia, one of the most common surgical procedures [86]. In the next chapters, this research describes inguinal hernia care delivery in the English NHS, examines the impact of spillovers and complementarities on costs, and investigates the effects of length of stay reduction on risk of re-admission and risk of death. The findings of this thesis indicate that one of the possible problems in the delivery of inguinal hernia care in the NHS is the decrease in the number of elective operations performed and the increase in readmission rates. They also clarify how decisions on allocation of resources can affect hospital expenditures by showing that loss in focus can increase health care costs and by pointing out that there is little evidence to support the theory of spillovers and complementarities in the surgical context. Finally, the results of this research can be used to suggest the logic of a policy to decrease length of stay that can inform hospital decisions and can decrease hospital costs.

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Phelps, John Clayton. "Health Care Leaders' Strategies to Reduce Nursing Turnover." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7326.

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Анотація:

Health care leaders who lack effective nurse turnover strategies can negatively affect patient quality of care, productivity, and profitability. The purpose of this single case study was to explore strategies health care leaders used to reduce nursing turnover in a health care organization. The conceptual framework for this study was Herzberg's 2-factor theory. Data were collected from semistructured interviews with 4 health care leaders in the West Texas region who had a history of reducing nurse turnover for a minimum of 5 years from the date of hire, and from review of organizational documents related to the strategies to reduce nurse turnover, including policy handbooks and annual reports. Data were analyzed using word frequency and coding to distinguish patterns. Three key themes emerged: leadership support, job satisfaction, and compensation. The results of this study might contribute to social change through an increased understanding of nurse turnover strategies that would improve productivity and the overall quality of patient care to yield organizational success, decreased mortality rates, and improved community health.

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Haque, Rezwan. "Organizational Innovation in Health Care." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:17463146.

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Анотація:

This dissertation investigates whether differences in organizational innovation amongst health care providers can explain the huge variation in costs and outcomes. I specifically consider two facets of organizational innovation: the deployment of information technology and the relationships between hospitals and physicians. In the first chapter, I investigate IT adoption in a service setting by considering the impact of electronic medical records (EMRs) on the length of stay and clinical outcomes of patients in US hospitals. To uncover the distinct impacts of EMRs on operational efficiency and care coordination, I present evidence of heterogeneous effects by patient complexity. I find that EMRs have the largest impact for relatively less complex patients. Admission to a hospital with an EMR is associated with a 2\% reduction in length of stay and a 9\% reduction in thirty-day mortality for such patients. In contrast, there is no statistically significant benefit for more complex patients. However, I present three additional results for complex cases. First, patients returning to the same hospital benefit relative to those who previously went to a different hospital, which could be due to easier access to past electronic records. Second, computerized order entry is associated with higher billed charges. Finally, hospitals that have a high share of publicly insured patients, and hence a bigger incentive to curb resource use, achieve a greater reduction in length of stay for complex patients after EMR adoption. In the second chapter, co-authored with Robert Huckman, I investigate the role of process specialists in guiding customers through such complex service transactions by considering the management of patients admitted to U.S hospitals. Traditionally, a patient's primary care physician has been in charge of his or her hospital admission. Over the past decade, however, there has been a steady rise in the use of hospitalists - physicians who spend all their professional time at the hospital - in managing inpatient care. Using data from the American Hospital Association and the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample (NIS) database, we find that hospitals with hospitalist programs achieve reductions in the risk-adjusted length of stay of inpatients over the time period 2003 to 2010. The effect is strongest for complex patients who have a higher number of comorbidities. Our findings support the view that process specialists such as hospitalists are particularly beneficial for complex transactions that entail a greater degree of coordination. In the final chapter, I document the positive relationship between consolidation in the health care industry and technology adoption. I propose several mechanisms that could explain the association between the adoption of electronic medical records and greater hospital-physician integration. I show that the positive correlation between technology adoption and hospital consolidation has been increasing over time. I show that hospitals located in concentrated markets are more likely to adopt electronic medical records and to use hospitalists. Moreover, for a limited set of hospitals, the quality of management is positively associated with the adoption of electronic medical records and the use of hospitalists.
Business Economics

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Gaikwad, Neha Kiran. "Easy care home health agency -- Business plan." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10118894.

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Анотація:

Home health care has become a popular long term care option as most seniors prefer to age and heal in the comfort of their homes and among their loved ones. With the advent of the Affordable Care Act (ACA) and a rise in baby boomers, home health care has become an integral part of the health care delivery system. Additionally, these have led to an increased demand for Home Health Agencies - HHA’s, and created a good market for the home health business. The following business plan is developed for the establishment of a Home Health Agency, in Long Beach, California. Chapter 1 Market analysis discusses the market structure and potential for the Home health business and analysis of the company, customers, and competitors. It also presents the marketing strategies, goals and objectives. Chapter 2 Feasibility and SWOT Analysis explains the operational feasibility and financial viability of the business plan. This chapter also explores the strengths and weaknesses of the business, opportunities for the business and threats to the business. Chapter 3 Legal and Regulatory issues, describes various legal aspects and regulatory requirements in a home health agency business. Chapter 4 Financial Analysis, gives detailed explanation of the financial plan and structure for the business like costs, expenses, budget and compensation.

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Kirk, Malee. "Strategies for Health Care Administration Leaders to Reduce Hospital Employee Turnover." Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10283032.

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Staff turnover is high in the hospital industry, influencing health care administration leaders to implement successful strategies to decrease staff turnover. The purpose of this case study was to explore successful strategies to reduce hospital employee turnover. Five health care leaders from Raleigh, North Carolina hospitals were in the sample drawn from the population of medical professionals with successful employee retention in their hospital settings. The conceptual framework for this study was the Herzberg dual-factor theory with the supporting theory, Maslow’s hierarchy of needs theory, and the opposing theory, Vroom’s expectancy theory. Semistructured interviews occurred with 5 leaders. The review of hospital human resource documents, website pages, and training program information combined with interview data for methodological triangulation using the Yin 5-step process, leading to 5 themes. Participants emphasized selective recruitment and hiring with a focus on hiring employees for a good organizational fit. Participants discussed different ways of engaging, supporting, and motivating hospital employees. Strategies included valuing employees, effective communication, recognition, and respect. Participants identified a fair, flexible, collaborative, and safe organizational culture as ideal for the retention of hospital employees who fit with the hospital environment. Reducing employee turnover may improve customer relations and quality of care in hospitals, leading to lower health care costs, representing positive social change for hospital employees and the patients served.

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Marti-Morales, Madeline. "Care coordination, family-centered care and functional ability in children with special health care needs in the United States." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/870.

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Анотація:

Children with special health care needs (CSHCN) generally have physical, mental, or emotional conditions that require a broader range and greater quantity of health and related services compared to typical children. Care coordination (CC) and family-centered care (FCC) are necessary in the quality of health care for CSHCN. A gap exists in the literature regarding the impact of CC and FCC on children's functional ability (FA). Previous researchers have focused on met and unmet health care needs, but not on health outcomes or functionality. The purpose of this study was to determine if there was an association between CC, FCC, and FA in CSHCN. The design of this study was a secondary analysis of data from the 2005--2006 National Survey of CSHCN. The study was guided by an adapted socioecological multilevel conceptual framework. Statistical methods included univariate, bivariate, and multiple logistic regression analysis. Results indicated that CC was associated with FA in CSHCN. CSHCN that did not receive CC had a 53% increased risk (OR =1.53, 95%CI 1.21--1.94, p < 0.001) for a limitation in FA compared to CSHCN that received CC, controlling for age, gender, number of conditions, household poverty level, parental educational level, and health insurance. FCC was not associated with a limitation in FA in CSHCN ( p = 0.61). Findings from this study were consistent with the socioecological multilevel framework and the literature on care coordination. This study contributed to positive social change by providing information that can be used by public health officials, health care providers and policy makers in developing policies to assure that care coordination is provided to CSHCN and their families in order to improve their health outcomes and functionality.

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Hale-Hanes, Heidi A. "Hand In Hand Home Health Care." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10164122.

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The need for home health care is a growing need in the United States due to the shift of the “baby-boomers” into the post retirement years. However, there is a growing niche market within this aging population: the lesbian, gay, bisexual and transgendered (LGBT) elders who have lived their adult lives “out of the closet” and who are facing difficulty receiving care which is compassionate and culturally sensitive at the same time. The mission of Hand-In-Hand Home Health Care is to provide exceptional home health care with a team of professionals that provide patient-centered care which is culturally sensitive and compassionate, achieved with employee training developed by SAGE (Services & Advocacy for GLBT Elders). Hand-In-Hand Home Health Care will achieve economic viability within the first year through optimal cash flow management with Axxess client software and the initial capital assistance with a 7a Small Business Loan.

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Книги з теми "Health Care Administration"

Health care management. New York: Ferguson, 2009.

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Horowitz, Marcia. Health care management. New York: Ferguson, 2010.

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J, Riordan Timothy, and Davis Stephanie Taylor, eds. Home health care administration. Albany, N.Y: Delmar Publishers, 1996.

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M, Cascio Dorothy, ed. Modern health care administration. 2nd ed. Madison, Wis: Brown & Benchmark, 1993.

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Horowitz, Marcia. Health care management. New York: Ferguson Pub., 2010.

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Accountability, Florida Office of Program Policy Analysis and Government. Health Care Regulation Program, Agency for Health Care Administration. Tallahassee, FL: Office of Program Policy Analysis and Government Accountability, 2001.

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R, Schermerhorn John, and Kramer Brian 1974-, eds. Health care management. Hoboken, NJ: Wiley, 2007.

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1935-, Nicholson Janice E., ed. Comparative health administration. North York, Ont: Captus Press, 1992.

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D, Harris Marilyn, ed. Home health administration. [Washington, D.C.?]: National Health Pub., 1988.

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Davis, Winborn E. Introduction to health care administration. 3rd ed. Bossier City, LA: Publicare Press ; La Grange, Tex. (P.O. Box 268, La Grange 78945-0268) : Distributed by M. & H. Pub. Co., 1991.

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Частини книг з теми "Health Care Administration"

McCullough, Ann. "Contexts and Health Care." In Management and Administration for the OTA, 1–14. New York: Routledge, 2024. http://dx.doi.org/10.4324/9781003524939-1.

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Balogun, Joseph A. "Administration of health care education departments." In Health Care Education in Nigeria, 74–86. Abingdon, Oxon ; New York, NY : Routledge, 2021.: Routledge, 2020. http://dx.doi.org/10.4324/9781003127529-4.

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Sharma, Shashikant, and Saurabh Singh. "Administration Unit." In Planning & Designing Health Care Facilities in Developing Countries, 186–90. Boca Raton: CRC Press, 2024. http://dx.doi.org/10.1201/9780367460884-32.

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Grieves, Marion. "Drug Usage: Legislation and Administration." In Foundations of Health and Social Care, 174–83. London: Macmillan Education UK, 2007. http://dx.doi.org/10.1007/978-0-230-22933-4_18.

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Powell, Jason. "Narrative, Health, Care and Family." In International Perspectives on Social Policy, Administration, and Practice, 91–101. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-25432-1_8.

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Moini, Jahangir, and Morvarid Moini. "Occupational Safety and Health Administration (OSHA) standards." In Fundamentals of U.S. Health Care, 303–34. Abingdon, Oxon; New York, NY: Routledge, 2017.: Routledge, 2017. http://dx.doi.org/10.4324/9781315620374-13.

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Chen, Ke. "Health-Care Policy in America." In Global Encyclopedia of Public Administration, Public Policy, and Governance, 3034–41. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-20928-9_2850.

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Chen, Ke. "Health-Care Policy in America." In Global Encyclopedia of Public Administration, Public Policy, and Governance, 1–8. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-31816-5_2850-1.

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Chen, Ke. "Health-Care Policy in America." In Global Encyclopedia of Public Administration, Public Policy, and Governance, 6147–54. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-66252-3_2850.

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Chan, Linda, William Greeley, Don Klingen, Brian Machado, Michael Padula, John Sum, and Angela Vacca. "Barcode Medication Administration Implementation in the FIAT Health System." In Transforming Health Care Through Information: Case Studies, 85–96. New York, NY: Springer New York, 2009. http://dx.doi.org/10.1007/978-1-4419-0269-6_8.

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Тези доповідей конференцій з теми "Health Care Administration"

Lv, Q., Y. Jiang, J. Qi, Y. Zhang, X. Zhang, Z. Liao, Z. Lin, and J. Gu. "AB1278 Mobile device-aided health care: administration of new health care in china." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.3499.

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Lu, C., and R. Fenske. "274. Salivary Excretion of the Herbicide, Atrazine, After Oral Administration in Rats." In AIHce 1996 - Health Care Industries Papers. AIHA, 1999. http://dx.doi.org/10.3320/1.2764944.

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Roh, J., Y. Ahn, H. Kim, and C. Kim. "400. Urinary Excretion of Benzedine and Its Metabolites in Rats after Oral Administration of Direct Black 38 and Benzidine." In AIHce 1996 - Health Care Industries Papers. AIHA, 1999. http://dx.doi.org/10.3320/1.2765081.

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Campbell, Catherine, Avi Parush, Thomas Ellis, Jacqueline Garvey, Régis Vaillancourt, and Daniel Lebreux. "Addressing Risk Factors in Morphine Administration: A Collaborative Prototyping Approach." In 2012 Symposium on Human Factors and Ergonomics in Health Care. Human Factors and Ergonomics Society, 2012. http://dx.doi.org/10.1518/hcs-2012.945289401.010.

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Collins, A. C., M. Lemma Woldehanna, G. Sese, O. A. Shlobin, C. S. King, K. Ahmad, S. D. Nathan, and A. W. Brown. "Administration of COVID-19 Convalescent Plasma in a Metropolitan Health Care System." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2509.

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Alshami, Noura, Amerah NAl Saleh, Amjed Abu Alburak, Regina Manlulu, Saif Al Saif, Mark Anthony Castro, Eden Grace Abainza, et al. "7 Reduce medication administration delay in neonatal intensive care unit." In Patient Safety Forum 2019, Conference Proceedings, Kingdom of Saudi Arabia, Ministry of National Guard Health Affairs. British Medical Journal Publishing Group, 2019. http://dx.doi.org/10.1136/bmjoq-2019-psf.7.

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Tkachenko, V. I. "The quality of primary health care is a priority area of public administration." In INFLUENCE OF EUROPEANIZATION ON PUBLIC MANAGEMENT AND ADMINISTRATION IN UKRAINE. Baltija Publishing, 2022. http://dx.doi.org/10.30525/978-9934-26-249-4-17.

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Altalib, Hamada, Rizwana Rehman, and Zulfi Haneef. "Access and Equity of Epilepsy Care in the Veterans Health Administration (P6-9.006)." In 2023 Annual Meeting Abstracts. Lippincott Williams & Wilkins, 2023. http://dx.doi.org/10.1212/wnl.0000000000203714.

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Taylor, Lesley, Scott D. Wood, and Roger J. Chapman. "Analysis and Mitigation of Reported Informatics Patient Safety Adverse Events at the Veterans Health Administration." In 2012 Symposium on Human Factors and Ergonomics in Health Care. Human Factors and Ergonomics Society, 2012. http://dx.doi.org/10.1518/hcs-2012.945289401.001.

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Zyma, O. T. "Legislation on liability for administrative offenses in the field of health care: directions for improvement." In DIGITAL TRENDS AND ANTI-CORRUPTION REFORMS IN PUBLIC ADMINISTRATION. Baltija Publishing, 2023. http://dx.doi.org/10.30525/978-9934-26-369-9-21.

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Звіти організацій з теми "Health Care Administration"

Watson, Monte R. Factors Associated with Student Stress in the U.S. Army - Baylor University Graduate Program in Health Care Administration. Fort Belvoir, VA: Defense Technical Information Center, July 1986. http://dx.doi.org/10.21236/ada209758.

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Skuster, Patty, Elizabeth A. Sully, and Amy Friedrich-Karnik. Evidence for Ending the Global Gag Rule: A Multiyear Study in Two Countries. Guttmacher Institute, April 2024. http://dx.doi.org/10.1363/2024.300502.

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As a leading funder of global health programs, the United States has the power to make a tremendous impact on people’s sexual and reproductive health and rights. But restrictions on funding that target abortion care internationally have had broad, detrimental impacts on reproductive health care systems, advocacy and outcomes. Such is the case with the so-called global gag rule, a policy that conditions US global health assistance on nongovernmental organizations’ agreement not to provide or promote abortion. Our multiyear research study in Uganda and Ethiopia examines the impact of this policy in two countries that rely on US assistance for their family planning programs but where the legal context around abortion differs—highly restrictive in Uganda and liberal in Ethiopia. Until now, no research has fully captured the effects of the most recent implementation of the global gag rule, which, during the four-year Trump administration, was the greatest expansion of the policy in its history. The research shows how, in both countries, the gag rule stalled and even reversed progress toward expanded access to modern contraception, impacting the countries’ reproductive health outcomes, the ability of people to decide whether and when to have children, and overall bodily autonomy. Abortion care cannot be separated from reproductive health care; evidence clearly demonstrates that the US government’s attempts to limit abortion care through the gag rule also limit access to other essential sexual and reproductive health services. Although the gag rule is currently not in effect, the risk of an anti-abortion president reinstating and expanding the gag rule and causing significant harm to reproductive health progress globally remains. And even after the gag rule is rescinded, its effects persist. The time for a permanent end to the global gag rule is now.

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Svynarenko, Radion, Theresa L. Profant, and Lisa C. Lindley. Effectiveness of concurrent care to improve pediatric and family outcomes at the end of life: An analytic codebook. Pediatric End-of-Life (PedEOL) Care Research Group, College of Nursing, University of Tennessee, Knoxville, 2022. http://dx.doi.org/10.7290/m5fbbq.

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Implementation of the section 2302 of the 2010 Patient Protection and Affordable Care Act (ACA) enabled children enrolled in Medicaid/Children's Health Insurance Program with a prognosis of 6 months to live to use hospice care while continuing treatment for their terminal illness. Although concurrent hospice care became available more than a decade ago, little is known about the socio-demographic and health characteristics of children who received concurrent care; health care services they received while enrolled in concurrent care, their continuity, management, intensity, fragmentation; and the costs of care. The purpose of this study was to answer these questions using national data from the Centers of Medicare and Medicaid Services (CMS), which covered the first three years of ACA – from January 1, 2011, to December 31, 2013.The database included records of 18,152 children younger than the age of 20, who were enrolled in Medicaid hospice care in the sampling time frame. Children in the database also had a total number of 42,764 hospice episodes. Observations were excluded if the date of birth or death was missing or participants were older than 21 years. To create this database CMS data were merged with three other complementary databases: the National Death Index (NDI) that provided information on death certificates of children; the U.S. Census Bureau American Community Survey that provided information on characteristics of communities where children resided; CMS Hospice Provider of Services files and CMS Hospice Utilization and Payment files were used for data on hospice providers, and with a database of rural areas created by the Health Resources and Services Administration (HRSA). In total, 130 variables were created, measuring demographics and health characteristics of children, characteristics of health providers, community characteristics, clinical characteristics, costs of care, and other variables.

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Stall, Nathan M., Kevin A. Brown, Antonina Maltsev, Aaron Jones, Andrew P. Costa, Vanessa Allen, Adalsteinn D. Brown, et al. COVID-19 and Ontario’s Long-Term Care Homes. Ontario COVID-19 Science Advisory Table, January 2021. http://dx.doi.org/10.47326/ocsat.2021.02.07.1.0.

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Key Message Ontario long-term care (LTC) home residents have experienced disproportionately high morbidity and mortality, both from COVID-19 and from the conditions associated with the COVID-19 pandemic. There are several measures that could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes, if implemented. First, temporary staffing could be minimized by improving staff working conditions. Second, homes could be further decrowded by a continued disallowance of three- and four-resident rooms and additional temporary housing for the most crowded homes. Third, the risk of SARS-CoV-2 infection in staff could be minimized by approaches that reduce the risk of transmission in communities with a high burden of COVID-19. Summary Background The Province of Ontario has 626 licensed LTC homes and 77,257 long-stay beds; 58% of homes are privately owned, 24% are non-profit/charitable, 16% are municipal. LTC homes were strongly affected during Ontario’s first and second waves of the COVID-19 pandemic. Questions What do we know about the first and second waves of COVID-19 in Ontario LTC homes? Which risk factors are associated with COVID-19 outbreaks in Ontario LTC homes and the extent and death rates associated with outbreaks? What has been the impact of the COVID-19 pandemic on the general health and wellbeing of LTC residents? How has the existing Ontario evidence on COVID-19 in LTC settings been used to support public health interventions and policy changes in these settings? What are the further measures that could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes? Findings As of January 14, 2021, a total of 3,211 Ontario LTC home residents have died of COVID-19, totaling 60.7% of all 5,289 COVID-19 deaths in Ontario to date. There have now been more cumulative LTC home outbreaks during the second wave as compared with the first wave. The infection and death rates among LTC residents have been lower during the second wave, as compared with the first wave, and a greater number of LTC outbreaks have involved only staff infections. The growth rate of SARS-CoV-2 infections among LTC residents was slower during the first two months of the second wave in September and October 2020, as compared with the first wave. However, the growth rate after the two-month mark is comparatively faster during the second wave. The majority of second wave infections and deaths in LTC homes have occurred between December 1, 2020, and January 14, 2021 (most recent date of data extraction prior to publication). This highlights the recent intensification of the COVID-19 pandemic in LTC homes that has mirrored the recent increase in community transmission of SARS-CoV-2 across Ontario. Evidence from Ontario demonstrates that the risk factors for SARS-CoV-2 outbreaks and subsequent deaths in LTC are distinct from the risk factors for outbreaks and deaths in the community (Figure 1). The most important risk factors for whether a LTC home will experience an outbreak is the daily incidence of SARS-CoV-2 infections in the communities surrounding the home and the occurrence of staff infections. The most important risk factors for the magnitude of an outbreak and the number of resulting resident deaths are older design, chain ownership, and crowding. Figure 1. Anatomy of Outbreaks and Spread of COVID-19 in LTC Homes and Among Residents Figure from Peter Hamilton, personal communication. Many Ontario LTC home residents have experienced severe and potentially irreversible physical, cognitive, psychological, and functional declines as a result of precautionary public health interventions imposed on homes, such as limiting access to general visitors and essential caregivers, resident absences, and group activities. There has also been an increase in the prescribing of psychoactive drugs to Ontario LTC residents. The accumulating evidence on COVID-19 in Ontario’s LTC homes has been leveraged in several ways to support public health interventions and policy during the pandemic. Ontario evidence showed that SARS-CoV-2 infections among LTC staff was associated with subsequent COVID-19 deaths among LTC residents, which motivated a public order to restrict LTC staff from working in more than one LTC home in the first wave. Emerging Ontario evidence on risk factors for LTC home outbreaks and deaths has been incorporated into provincial pandemic surveillance tools. Public health directives now attempt to limit crowding in LTC homes by restricting occupancy to two residents per room. The LTC visitor policy was also revised to designate a maximum of two essential caregivers who can visit residents without time limits, including when a home is experiencing an outbreak. Several further measures could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes. First, temporary staffing could be minimized by improving staff working conditions. Second, the risk of SARS-CoV-2 infection in staff could be minimized by measures that reduce the risk of transmission in communities with a high burden of COVID-19. Third, LTC homes could be further decrowded by a continued disallowance of three- and four-resident rooms and additional temporary housing for the most crowded homes. Other important issues include improved prevention and detection of SARS-CoV-2 infection in LTC staff, enhanced infection prevention and control (IPAC) capacity within the LTC homes, a more balanced and nuanced approach to public health measures and IPAC strategies in LTC homes, strategies to promote vaccine acceptance amongst residents and staff, and further improving data collection on LTC homes, residents, staff, visitors and essential caregivers for the duration of the COVID-19 pandemic. Interpretation Comparisons of the first and second waves of the COVID-19 pandemic in the LTC setting reveal improvement in some but not all epidemiological indicators. Despite this, the second wave is now intensifying within LTC homes and without action we will likely experience a substantial additional loss of life before the widespread administration and time-dependent maximal effectiveness of COVID-19 vaccines. The predictors of outbreaks, the spread of infection, and deaths in Ontario’s LTC homes are well documented and have remained unchanged between the first and the second wave. Some of the evidence on COVID-19 in Ontario’s LTC homes has been effectively leveraged to support public health interventions and policies. Several further measures, if implemented, have the potential to prevent additional LTC home COVID-19 outbreaks and deaths.

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McCurdy, Rodney K. A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing Administration, The Texas Department of Insurance, and The National Committee on Quality Assurance: The Cost of Multi-Agency Oversight on Medicare+Choice Plans in Texas. Fort Belvoir, VA: Defense Technical Information Center, April 2001. http://dx.doi.org/10.21236/ada420956.

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Ciapponi, Agustín. Do interventions reduce health care fraud and abuse? SUPPORT, 2013. http://dx.doi.org/10.30846/131212.

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Health care fraud is a serious problem for health systems considering the enormous volume of money spent on health care. There are increasing national, regional and international fraud control initiatives. Political, legislative, and administrative interventions are being intendend to combat it.

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Krhutová, Lenka, Petr Šaloun, Kamila Vondroušová, Marcela Dabrowská, Zdeněk Velart, David Andrešič, and Miroslav Paulíček. Výzkum a vývoj podpůrných sítí a informačních systémů pro neformální pečující o osoby po cévních mozkových příhodách. Ostravská univerzita, 2021. http://dx.doi.org/10.15452/vsouhrntacr.2021.

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The summary research report describes and summarizes the goals, course and results of the TAČR–VISNEP project. The aim of the experimental development project was to create an information system (IS) for informal carers (ICs) for a person after stroke using modern information technologies in the technical and non-technical spheres of research. IS will allow users to obtain relevant, timely and interconnected information on support networks to prevent their possible social isolation and exclusion, physical and psychological exhaustion, health disorders and other risk factors in their difficult life situation. The purpose of IS is to contribute to improved awareness of ICs support systems across other long-term care providers, in particular public administration, general practitioners etc. The intent of the project was to create and verify a pilot model of IS in Moravian-Silesian Region, which can subsequently be applied in other regions and / or other target ICs groups. The presented results of the project are based on data obtained by research procedures of qualitative and quantitative methodology in the process of agile software development.

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Cohen, Deborah J., Annette M. Totten, Robert L. Phillips, Jr., Yalda Jabbarpour, Anuradha Jetty, Jennifer DeVoe, Miranda Pappas, Jordan Byers, and Erica Hart. Measuring Primary Healthcare Spending. Agency for Healthcare Research and Quality (AHRQ), May 2024. http://dx.doi.org/10.23970/ahrqepctb44.

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Background. Policy leaders and researchers have identified a range of primary care spending conceptualizations, developed frameworks and methods for measuring primary care spending, and documented the pros and cons of different approaches. However, these efforts have not been comprehensive, particularly as the number of estimates has grown. We continue this work by identifying the definitions, data sources, and approaches used to estimate primary care spending in the United States. Our objective was to identify where there is and is not consensus across methods, and how initial steps toward a standardized approach to estimating primary care spending might be achieved. We approached this comparison from a societal economic perspective. Methods. Searches were conducted in Ovid MEDLINE® and Cochrane CENTRAL databases (inception to May 2, 2023), and were supplemented by manual reviews of reference lists, Scopus searches of key articles, gray literature searches of State and organization websites, and responses to a Federal Register Notice, as well as recommendations from Key Informants. Websites of States and organizations that produced reports were reviewed in November 2023 to identify updates. Publicly available estimates and reports of methods were supplemented by discussions with experts who have supported States’ estimates. Findings. We identified 67 primary care spending estimates for 2010 to 2021: 42 of these were produced by 11 State Governments for their State, 2 were published by the Veterans Health Administration, and 23 were published by researchers or other organizations, which include foundations and policy organizations. Forty-four estimates reported on primary care spending for a single State, one estimate reported spending for the New England States, and 22 reported national spending. To date, 13 State Governments have developed and/or are implementing measurements of primary care spending. When State Governments measure primary care spending, they produce regular, often yearly, estimates. States have produced one to eight estimates, demonstrating some States have more experience with this task than others. Primary care spending estimates in our sample ranged from 3.1 to 10.3 percent. These estimates started with definitions of primary care, which are often labeled narrow or broad. Estimates may use these same labels to mean different things. Narrow definitions of primary care usually include fewer providers, locations, or service types, while broad definitions include more. State, regional, or national estimates are either reported as two estimates, one using a narrow and one using a broad definition of primary care, or as a single estimate labeled neither narrow nor broad. Variations in what providers, services, and locations are included in definitions of primary care are significant and likely contribute to variation in primary care spending estimates. However, it is difficult to distinguish differences in definitions and measurement from differences in actual primary care spending. Conclusions. While there are some core similarities in how primary care spending is measured across State, regional, and national estimates, there are more differences. While there may be rationale behind some of these variations, this variation limits comparisons and what could be understood about the impact of policies. Furthermore, lack of clear, detailed reporting of methods can obscure precisely how and why estimates differ. Research is needed that quantifies the impact different decisions and measurement methods have on spending estimates. To assure the validity and reliability of estimates of primary care spending, and facilitate comparisons and links to health outcomes, Federal, State, and policy leaders need to: (1) collaborate to create a primary care clinician database that can function as a public utility for States to allow for more precise identification of primary care clinics and clinicians, and reduce reliance on Current Procedural Terminology/Healthcare Common Procedure Coding System codes; (2) develop a template for transparent reporting of methods used to estimate primary care spending; (3) foster collaboration among Federal agencies and State leaders to develop a consensus definition of primary care and process for estimating primary care spending, with consideration of methods that are easy to understand and transparent; and (4) support the development and ongoing maintenance of State All-Payer Claims Databases, expand to include nonclaims payments, and supply Medicare and Medicaid estimates for every State.

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Arora, Sanjana, and Olena Koval. Norway Country Report. University of Stavanger, 2022. http://dx.doi.org/10.31265/usps.232.

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This report is part of a larger cross-country comparative project and constitutes an account and analysis of the measures comprising the Norwegian national response to the COVID-19 pandemic during the year of 2020. This time period is interesting in that mitigation efforts were predominantly of a non-medical nature. Mass vaccinations were in Norway conducted in early 2021. With one of the lowest mortality rates in Europe and relatively lower economic repercussions compared to its Nordic neighbours, the Norwegian case stands unique (OECD, 2021: Eurostat 2021; Statista, 2022). This report presents a summary of Norwegian response to the COVID-19 pandemic by taking into account its governance, political administration and societal context. In doing so, it highlights the key features of the Nordic governance model and the mitigation measures that attributed to its success, as well as some facets of Norway’s under-preparedness. Norway’s relative isolation in Northern Europe coupled with low population density gave it a geographical advantage in ensuring a slower spread of the virus. However, the spread of infection was also uneven, which meant that infection rates were concentrated more in some areas than in others. On the fiscal front, the affluence of Norway is linked to its petroleum industry and the related Norwegian Sovereign Wealth Fund. Both were affected by the pandemic, reflected through a reduction in the country’s annual GDP (SSB, 2022). The Nordic model of extensive welfare services, economic measures, a strong healthcare system with goals of equity and a high trust society, indeed ensured a strong shield against the impact of the COVID-19 pandemic. Yet, the consequences of the pandemic were uneven with unemployment especially high among those with low education and/or in low-income professions, as well as among immigrants (NOU, 2022:5). The social and psychological effects were also uneven, with children and elderly being left particularly vulnerable (Christensen, 2021). Further, the pandemic also at times led to unprecedented pressure on some intensive care units (OECD, 2021). Central to handling the COVID-19 pandemic in Norway were the three national executive authorities: the Ministry of Health and Care services, the National directorate of health and the Norwegian Institute of Public Health. With regard to political-administrative functions, the principle of subsidiarity (decentralisation) and responsibility meant that local governments had a high degree of autonomy in implementing infection control measures. Risk communication was thus also relatively decentralised, depending on the local outbreak situations. While decentralisation likely gave flexibility, ability to improvise in a crisis and utilise the municipalities’ knowledge of local contexts, it also brought forward challenges of coordination between the national and municipal level. Lack of training, infection control and protection equipment thereby prevailed in several municipalities. Although in effect for limited periods of time, the Corona Act, which allowed for fairly severe restrictions, received mixed responses in the public sphere. Critical perceptions towards the Corona Act were not seen as a surprise, considering that Norwegian society has traditionally relied on its ‘dugnadskultur’ – a culture of voluntary contributions in the spirit of solidarity. Government representatives at the frontline of communication were also open about the degree of uncertainty coupled with considerable potential for great societal damage. Overall, the mitigation policy in Norway was successful in keeping the overall infection rates and mortality low, albeit with a few societal and political-administrative challenges. The case of Norway is thus indeed exemplary with regard to its effective mitigation measures and strong government support to mitigate the impact of those measures. However, it also goes to show how a country with good crisis preparedness systems, governance and a comprehensive welfare system was also left somewhat underprepared by the devastating consequences of the pandemic.

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Dilly, George A. The Failure of the Clinton Administration's Health Care Reform: A Matter of Substance or Process? Fort Belvoir, VA: Defense Technical Information Center, January 2003. http://dx.doi.org/10.21236/ada442073.

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