Context: Despite early skepticism about Medicaid's ability to withstand retrenchment as a program of "welfare medicine," it has proved remarkably durable. Existing analyses explain durability with a policy feedbacks perspective - how program provisions affect the subsequent political environment and policymaking options. This article updates earlier feedback accounts to the ACA era.
View Article and Find Full Text PDFObjective: The care of critically ill neonatal and pediatric patients requiring transport is optimized by using specialty transport teams. Research demonstrates that training is best accomplished through routine simulation. At the project site, no simulation-based learning is provided to critical care transport team members.
View Article and Find Full Text PDFTraumatic brain injury (TBI) presents a significant public health challenge, necessitating innovative interventions for effective treatment. Recent studies have challenged conventional perspectives on neurogenesis, unveiling endogenous repair mechanisms within the adult brain following injury. However, the intricate mechanisms governing post-TBI neurogenesis remain unclear.
View Article and Find Full Text PDFObjective: As the health care setting has become more centralized, there has been an increased need for critically ill neonatal and pediatric patients to be transported to facilities for a higher level of care. These interfacility transports are possible through the utilization of highly specialized teams of health care providers. Unfortunately, there is currently a lack of consistency in training these teams to provide safe care.
View Article and Find Full Text PDFContext: The COVID-19 pandemic has caused enormous damage to physiological health and economic security, especially among racial and ethnic minorities. We examined downstream effects on mental health, how effects vary by race and ethnicity, and the role of existing state-level social policies in softening the pandemic's impact.
Methods: We analyze an online, multi-wave Census Bureau survey fielded to nearly a million respondents between late April and July 2020.
The Affordable Care Act (ACA) has allowed researchers to examine mass policy feedback effects-how public policies affect individuals' attitudes and political behaviors-in real time while using causal models. These efforts help address criticisms of the extant feedbacks literature and have revealed new policy feedback effects and new information on the conditions under which policy feedbacks occur. The ACA case also raises empirical and theoretical questions about the types of data needed to assess feedback effects, the magnitude of policy effects required for detection, the time frame in which feedbacks occur, and the suitability of various empirical approaches for assessing policy feedback effects.
View Article and Find Full Text PDFContext: The opioid epidemic is a major US public health crisis. Its scope prompted significant public outreach, but this response triggered a series of journalistic articles comparing the opioid epidemic to the crack cocaine epidemic. Some authors claimed that the political response to the crack cocaine epidemic was criminal justice rather than medical in nature, motivated by divergent racial demographics.
View Article and Find Full Text PDFTo assess potential barriers and facilitators to participation in bio-behavioural surveillance surveys of men who have sex with men and transgender women (trans women) in Jamaica, we recruited participants for individual interviews and focus group discussions. Respondents included 3 trans women; 46 gay, bisexual and other men who have sex with men; and 3 cis gender women. Data from 46 men and 3 trans women were analysed to describe barriers and facilitators to participation in research.
View Article and Find Full Text PDFFor decades, public satisfaction with the health care system has been lower in the United States than in other high-income countries. To better understand the distinctive nature of US health system satisfaction, we compared the determinants of satisfaction with the health system in the United States to those in seventeen other high-income countries by applying regression decomposition methods to survey data collected in the period 2011-13. We found that concerns related to "accessing most-preferred care" (the extent to which people feel that they can access their top preferences at a time of need) were more important to satisfaction in the United States than in other high-income countries, while the reverse was true for satisfaction with recent interactions with the health system.
View Article and Find Full Text PDFJ Health Polit Policy Law
August 2013
At a November 2012 workshop, state health policy officials, other Medicaid and insurance exchange practitioners, and health policy researchers discussed issues surrounding the implementation and sustainability of Medicaid expansion and insurance exchange coordination under the Patient Protection and Affordable Care Act (PPACA). Foremost were concerns about (1) intergovernmental relations (states experiencing uncertain information, lack of coordination among federal agencies, and limited resources to take on new responsibilities under the PPACA), and (2) policy design (new issues such as Medicaid exchange coordination on top of preexisting Medicaid challenges). JHPPL has proposed the creation of a research network to develop policy options and share strategies and best practices.
View Article and Find Full Text PDFThis article explores how the intersections of gendered, racialized and neoliberal dynamics reproduce social inequality and shape the violence that nurses face. Grounded in the interviews and focus groups conducted with a purposeful sample of 17 registered nurses (RNs) and registered practical nurses (RPNs) currently working in Ontario's mental health sector, our analysis underscores the need to move beyond reductionist notions of violence as simply individual physical or psychological events. While acknowledging that violence is a very real and disturbing experience for individual nurses, our article casts light on the importance of a broader, power structure analysis of violence experienced by nurses in this sector, arguing that effective redress lies beyond blame shifting between clients/patients and nurses.
View Article and Find Full Text PDFJ Health Polit Policy Law
December 2011
A recently developed analytic approach--policy feedback effects--provides health policy analysts with a crucial new tool for understanding the politics of health policy. Three cases--senior citizens' opposition to the Obama health care reform, tax breaks for employer-provided health insurance, and the Medicare Part D prescription drug program--demonstrate how policy designs affect subsequent policy outcomes. To differing degrees, the three cases show how public policies can create constituencies with particular understandings of their benefits who attempt to thwart reform; can highlight or reduce the visibility of the government role in health care, shaping attitudes about the worth of government action; and can provide half solutions that fail to maximize beneficiary welfare but that deflate momentum for policy improvements.
View Article and Find Full Text PDFPast research on peace and conflict in Northern Ireland has focused on politically-motivated violence. However, other types of crime (i.e.
View Article and Find Full Text PDFThe partisan split in Congress over health reform may reflect a broader divide among the public in attitudes toward the uninsured. Despite expert consensus over the harms suffered by the uninsured as a group, Americans disagree over whether the uninsured get the care they need and whether reform legislation providing universal coverage is necessary. We examined public perceptions of health care access and quality for the uninsured over time, and we found that Democrats are far more likely than Republicans to believe that the uninsured have difficulty gaining access to care.
View Article and Find Full Text PDFAn individual mandate is an important feature of many recent plans to achieve universal health insurance coverage in the United States, without radically changing the way most Americans get health care and coverage. Using national public opinion data, we find that on its own, an individual mandate does not have broad support across partisan and sociodemographic groups. Policymakers who choose to pursue an individual mandate for policy reasons may expand the base of supporters by incorporating it into a "shared-responsibility" plan that includes requirements for employers, government, and insurers.
View Article and Find Full Text PDFWe conducted secondary analyses of data from two random samples of the population of Northern Ireland, involving 1046 participants in 2000, and 1000 participants in 200 1, to explore the role of in-group identity and religious group membership in moderating the relationship between in-group and out-group affect. In both surveys the results indicated a general in-group bias - feeling thermometer ratings (affect) for the in-group exceeded those for the out-group. This effect was moderated by participants' in-group identification and religious group (Catholic or Protestant), but these moderations also varied as a function of differential sectarian tension between 2000 and 2001.
View Article and Find Full Text PDFHealth Soc Care Community
November 1999
The introduction of total purchasing pilots (TPPs) into the National Health Service (NHS) gave general practitioners (GPs) significant new opportunities to take responsibility for the development of community and continuing care (CCC) services. Based on five case studies of TPPs involved in developing CCC this paper asks three questions: (1) to what extent were the TPP's involvement in CCC informed by an awareness of CCC policy?; (2) were TPPs involved in joint commissioning to develop integrated purchasing or provision which was informed by population based needs assessment?; (3) were TPPs seeking to involve users, carers and voluntary agencies in their plans? The findings indicate that TPPs showed little awareness of national or local policy for CCC, although their project initiatives did address some of the policy issues (in particular a recognition of the need for joint working at the practice level). At the time of fieldwork, four of the case study TPPs had begun to investigate the potential for integrated purchasing, and three of them had relatively sophisticated models of both horizontally and vertically integrated provision of care.
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