Borrow or Serve? An Economic Analysis of Options for Financing a Medical School Education.

Purpose: To understand the long-term economic implications of key pathways for financing a medical school education.

Method: The authors calculated the net present value (NPV) of cash flow over a 30-year career for a 2013 matriculant associated with (1) self-financing, (2) federally guaranteed loans, (3) the Public Service Loan Forgiveness program, (4) the National Health Service Corps, (5) the Armed Forces Health Professions Scholarship Program, and (6) matriculation at the Uniformed Services University of the Health Sciences. They calculated the NPV for students pursuing one of four specialties in two cities with divergent tax policies.

Assessing the impact of an integrated care system on the healthcare expenditures of children with special healthcare needs.

Objectives: The Children's Medical Services Network, a carved-out fee-for-service healthcare system for Florida's children with special healthcare needs (CSHCN), chose to develop an integrated care system (ICS) for its enrollees. The goals of this study were to analyze the effects of a managed care program on the Medicaid expenditures of CSHCN and to evaluate the performance of econometric models used to analyze healthcare expenditures.

Study Design: We used administrative data from 3947 CSHCN enrolled in Florida's Medicaid program between 2006 and 2008 for 2 treatment and 2 control counties.

Effect of an integrated care system on utilization for CSHCN in Florida.

In 2006, Florida began a pilot program under a federal Medicaid waiver to reform its Medicaid program in Broward and Duval counties. The Children's Medical Services Network, a subcontracted health care delivery system for Florida's children with special health care needs (CSHCN) enrolled in public insurance programs, participated in Medicaid reform through an Integrated Care System (ICS) for its enrollees. The ICS constitutes a significant departure from the subcontracted fee-for-service system used to deliver care to CSHCN in the non-reform counties, and limited information exists about its impact.

Information seeking behaviors of parents whose children have life-threatening illnesses.

Objectives: For children with life-threatening illnesses we sought to (1) understand the associations between parental characteristics and preferred health information sources, and (2) assess the e-health literacy of Internet-users.

Study Design: Cross-sectional, telephone survey of 129 parents whose children are in a pediatric palliative care program in Florida.

Results: Four out of five parents report that they use the Internet, and 64% of Internet-users use it daily.

Parents' experiences in choosing a health plan for their children with special health care needs.

To investigate the information sources, and the perceived helpfulness of each source, that parents used when choosing a health plan for their children with special health care needs (CSHCN) and to determine how parents' perceptions varied by their sociodemographic characteristics and their children's enrollment status (newly versus previously enrolled). In Florida, a cross sectional study was carried out using 2007 telephone survey data from 500 parents. Sixty-three percent of parents used at least one information source to choose a health plan for their CSHCN.

Factors that affect parent perceptions of provider-family partnership for children with special health care needs.

Partnering between families and their children's providers is a cornerstone of family-centered care. This study aimed to identify factors associated with family-provider partnership and determine the association between partnership and other outcome measures for children with special health care needs (CSHCN). Descriptive, bivariate, and multivariate analyses were conducted using data from the 2005-2006 National Survey of Children with Special Health Care Needs.

Pediatric palliative care: describing hospice users and identifying factors that affect hospice expenditures.

Objective: Each year approximately 50,000 children die. These children could benefit from pediatric palliative care, and hospice is one important provider of palliative care. However, little information exists to understand pediatric hospice care.