scholarly journals The impact of stakeholder engagement on local policy decision making

2019 ◽  
Vol 52 (4) ◽  
pp. 549-571 ◽  
Author(s):  
Le Anh Nguyen Long ◽  
Megan Foster ◽  
Gwen Arnold
Keyword(s):  
Decision Making ◽  
New York ◽  
Stakeholder Engagement ◽  
New York State ◽  
Policy Decision ◽  
High Volume ◽  
Local Policy ◽  
Government Responsiveness ◽  
The Impact ◽  
Political Actions

Abstract We investigate how grassroots stakeholder engagement in municipal meetings shapes the decision making of local elected officials (LEOs) by examining the choices LEOs in New York State made on how to regulate high-volume hydraulic fracturing (HVHF) or fracking. We analyzed the content of 216 meeting minutes and 18 policy documents for 13 municipalities in New York. Our observations suggest that government responsiveness to local activism is shaped by the level of contestation between grassroots stakeholders. They reveal that contestation among grassroots stakeholders encourages LEOs to try to deflect responsibility for regulating fracking. When this contestation is high, LEOs tend to pursue actions which may limit but not prohibit HVHF within their jurisdiction. In contrast, when there is no contestation, LEOs more actively pursue substantive policy actions that prohibit HVHF. Generally, we find that that the level of contestation among grassroots stakeholders about HVHF impacts the political actions LEOs take.

Understanding User Decision Making and the Value of Improved Precipitation Forecasts: Lessons From a Case Study

2004 ◽  
Vol 85 (2) ◽  
pp. 223-236 ◽  
Author(s):  
Thomas R. Stewart ◽  
Roger Pielke ◽  
Radhika Nath
Keyword(s):  
Decision Making ◽  
New York ◽  
New York State ◽  
Holistic Approach ◽  
Optimal Decision ◽  
Weather Information ◽  
Optimal Decision Making ◽  
Decision Making Model ◽  
The Impact

A case study of the impact of improved precipitation forecasts on the snow-fighting operations of the New York State Thruway is reported. The goal was to use currently available data and literature on forecast process, communication, and use in conjunction with observations and interviews with key decision makers to derive a model that yields estimates of value to users based on a model of their decision processes rather than an optimal decision-making model. That goal proved too ambitious due to limitations in available data. A major lesson learned from this research is the importance of improved, ongoing data collection to support studies of use and value of weather information. A more holistic approach to understanding and realizing forecast value is needed, that is, one in which information (both of forecast skill and usage) centered on the decision process is collected in a much more intensive manner than is presently the case.

Impact of marital status on colorectal cancer (CRC) disease-specific survival in New York state.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18084-e18084 ◽  
Author(s):  
Carla Francesca Justiniano ◽  
Zhaomin Xu ◽  
Adan Z Becerra ◽  
Christopher Thomas Aquina ◽  
Francis P. Boscoe ◽  
...  
Keyword(s):  
New York ◽  
Marital Status ◽  
New York State ◽  
High Volume ◽  
Smoking History ◽  
York State ◽  
Never Married ◽  
Risk Of Death ◽  
Additional Support ◽  
The Impact

e18084 Background: CRC is the second leading cause of cancer death in the US. Social support and financial resources vary by marital status. This study analyzes the impact of marital status by sex on survival after resection for CRC. Methods: The New York State Cancer Registry and Statewide Planning and Research Cooperative System were queried for 2004-2013 colectomy or proctectomy Stage I-III CRC patients and categorized by marital status: single/never married (single), married/domestic partner (married), and widowed/separated/divorced (previously married). Competing risk analysis of 5-year mortality was executed adjusting for patient (age at diagnosis, sex, race, Medicaid, income, marital status, smoking history, comorbidities, year of diagnosis, and stage), treatment (scheduled surgery and complications, chemotherapy, radiation), surgeon (colorectal board, volume), and hospital factors (volume, academic, rural). Results: 38,020 (colon 32,451, rectal 5,569) met inclusion criteria, of which 28% died within 5 years. Single patients were more likely than married to be current smokers (17 vs 12%), be on Medicaid (42 vs 27%) and present emergently (38 vs 25%), and less likely to be treated by high volume surgeons (32 vs 40%). Married patients had decreased risk of 5-year CRC-specific mortality (hazard ratio [HR] 0.86, confidence interval [CI] 0.80-0.94) vs single. When stratified by sex, married males had a decreased risk of death but married females did not and this persists if stratified by colon vs rectum (Table). Income was not significantly associated with survival and previously married patients did not significantly differ from single. Conclusions: Marital status impacts CRC-specific survival in males and females differently. Married men have a protective effect from marriage, whereas married females do not and may benefit from additional support throughout their cancer care. [Table: see text]

Relationship of hospital volume on outcomes in patients with acute pulmonary embolism: Analysis of a 70,000 patient database

2020 ◽  
pp. 1358863X2097026
Author(s):  
Mark Finkelstein ◽  
Mario A Cedillo ◽  
David C Kestenbaum ◽  
Obaib S Shoaib ◽  
Aaron M Fischman ◽  
...  
Keyword(s):  
New York ◽  
Pulmonary Embolism ◽  
Length Of Stay ◽  
New York State ◽  
Multivariable Analysis ◽  
High Volume ◽  
Categorical Variables ◽  
Patient Database ◽  
Very High ◽  
Total Charges

Positive relationships between volume and outcome have been seen in several surgical and medical conditions, resulting in more centralized and specialized care structures. Currently, there is a scarcity of literature involving the volume–outcome relationship in pulmonary embolism (PE). Using a state-wide dataset that encapsulates all non-federal admissions in New York State, we performed a retrospective cohort study on admitted patients with a diagnosis of PE. A total of 70,443 cases were separated into volume groups stratified by hospital quartile. Continuous and categorical variables were compared between cohorts. Multivariable regression analysis was conducted to assess predictors of 1-year mortality, 30-day all-cause readmission, 30-day PE-related readmission, length of stay, and total charges. Of the 205 facilities that were included, 128 (62%) were labeled low volume, 39 (19%) medium volume, 23 (11%) high volume, and 15 (7%) very high volume. Multivariable analysis showed that very high volume was associated with decreased 30-day PE-related readmission (OR 0.64; 95% CI, 0.55 to 0.73), decreased 30-day all-cause readmission (OR 0.84; 95% CI, 0.79 to 0.89), decreased 1-year mortality (OR 0.85; 95% CI, 0.80 to 0.91), decreased total charges (OR 0.96; 95% CI, 0.94 to 0.98), and decreased length of stay (OR 0.94; 95% CI, 0.92 to 0.96). In summary, facilities with higher volumes of acute PE were found to have less 30-day PE-related readmissions, less all-cause readmissions, shorter length of stay, decreased 1-year mortality, and decreased total charges.

Service decision-making processes at three New York state cooperative public library systems

2014 ◽  
Vol 35 (6/7) ◽  
pp. 418-432
Author(s):  
Xiaoai Ren
Keyword(s):  
Decision Making ◽  
New York ◽  
New York State ◽  
Public Library ◽  
Organizational Structures ◽  
Annual Reports ◽  
Content Type ◽  
York State ◽  
Decision Making Processes ◽  
And Cluster Analysis

Purpose – The purpose of this paper is to look at the organizational structure and service provisions of cooperative public library systems in New York State. The study also seeks to ask questions of how cooperative public library systems decide what services to provide. Design/methodology/approach – Descriptive statistics, factor analysis and cluster analysis were applied on New York State public library systems’ 2008 annual reports to generate quantitative profiles of public library systems and their service transactions. Three cooperative public library systems displaying different service features were purposefully selected for further study of their service decision-making processes. The face-to-face and phone interviews were adopted in the study. Findings – Research findings from this study provide information on specific service variations across cooperative public library systems. The findings also provide differences of service decision-making processes in addition to the factors that might cause these differences. Originality/value – This study adds knowledge of public library systems’ management and organizational structures, therefore fills a knowledge gap on public library systems. It can also serve as the baseline for future studies using newer annual report data and therefore to study the changing roles and services of cooperative public library systems in New York State.

scholarly journals The impact of the 2006 Massachusetts health care reform law on spine surgery patient payer-mix status and age

2017 ◽  
Vol 27 (6) ◽  
pp. 694-699 ◽  
Author(s):  
Nicolas W. Villelli ◽  
Hong Yan ◽  
Jian Zou ◽  
Nicholas M. Barbaro
Keyword(s):  
Health Care ◽  
New York ◽  
Health Care Reform ◽  
Health Care System ◽  
Spine Surgery ◽  
Private Insurance ◽  
New York State ◽  
Before And After ◽  
The Impact ◽  
Care System

OBJECTIVESeveral similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors’ prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US.METHODSUsing the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012. Payer-mix status was assigned as Medicare, Medicaid, private insurance, uninsured, or other, which included government-funded programs and workers’ compensation. A comparison of the payer-mix status and patient age, both before and after the policy, was performed. The New York State data were used as a control.RESULTSThe authors analyzed 81,821 spine surgeries performed in Massachusetts and 248,757 in New York. After 2008, there was a decrease in uninsured and private insurance spine surgeries, with a subsequent increase in the Medicare and “other” categories for Massachusetts. Medicaid case numbers did not change. This correlated to an increase in surgeries performed in the age group of patients 65–84 years old, with a decrease in surgeries for those 18–44 years old. New York showed an increase in all insurance categories and all adult age groups.CONCLUSIONSAfter the Massachusetts reform, spine surgery decreased in private insurance and uninsured categories, with the majority of these surgeries transitioning to Medicare. Moreover, individuals who were younger than 65 years did not show an increase in spine surgeries, despite having greater access to health insurance. In a health care system that requires insurance, the decrease in private insurance is primarily due to an increasing elderly population. The Massachusetts model continues to show that this type of policy is not causing extreme shifts in the payer mix, and suggests that spine surgery will continue to thrive in the current US health care system.

340 Trends and Disparities in Cervical Spine Fusion Procedure Utilization in the New York State

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 276-276
Author(s):  
Rui Feng ◽  
Mark Finkelstein ◽  
Eric Karl Oermann ◽  
Michael Palese ◽  
John M Caridi
Keyword(s):  
New York ◽  
African American ◽  
Cervical Spine ◽  
New York State ◽  
High Volume ◽  
Spine Fusion ◽  
York State ◽  
High Volume Hospital ◽  
Low Volume ◽  
Cervical Spine Fusion

Abstract INTRODUCTION There has been a steady increase in spinal fusion procedures performed each year in the US, especially cervical and lumbar fusion. Our study aims to analyze the rate of increase at low-, medium-, and high-volume hospitals, and socioeconomic characteristics of the patient populations at these three volume categories. METHODS We searched the New York State, Statewide Planning and Research Cooperative System (SPARCS) database from 2005 to 2014 for the ICD-9-CM Procedure Codes 81.01 (Fusion, atlas-axis), 81.02 (Fusion, anterior column, other cervical, anterior technique), and 81.03 (Fusion, posterior column, other cervical, posterior technique). Patients' primary diagnosis (ICD-9-CM), age, race/ethnicity, primary payment method, severity of illness, length of stay, hospital of operation were included. We categorized all 122 hospitals high-, medium-, and low-volume. We then described the trends in annual number of cervical spine fusion surgeries in each of the three hospital volume groups using descriptive statistics. RESULTS >African American patients were significantly greater portion of patients receiving care at low-volume hospitals, 15.1% versus 11.6% at high-volume hospital. Medicaid and self-pay patients were also overrepresented at low-volume centers, 6.7% and 3.9% versus 2.6% and 1.7% respectively at high-volume centers. In addition, Compared with Caucasian patients, African American patients had higher rates of post-operative infection (P = 0.0020) and post-operative bleeding (P = 0.0044). Compared with privately insured patients, Medicaid patients had a higher rate of post-operative bleeding (P = 0.0266) and in-hospital mortality (P = 0.0031). CONCLUSION Our results showed significant differences in racial distribution and primary payments methods between the low- and high-volume categories, and suggests that accessibility to care at high-volume centers remains problematic for these disadvantaged populations.

Evaluating the impact of three incentive programs on the economics of cofiring willow biomass with coal in New York State

Energy Policy ◽  
2005 ◽  
Vol 33 (3) ◽  
pp. 337-347 ◽  
Author(s):  
Pradeep J Tharakan ◽  
Timothy A Volk ◽  
Christopher A Lindsey ◽  
Lawrence P Abrahamson ◽  
Edwin H White
Keyword(s):  
New York ◽  
New York State ◽  
York State ◽  
Incentive Programs ◽  
The Impact
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