scholarly journals Public Reporting: Illumination or Shadows?

2006 ◽  
Vol 17 (2) ◽  
pp. 97-98
Author(s):  
LE Nicolle
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Health Care Organizations ◽  
State Legislatures ◽  
The United States ◽  
Public Reporting ◽  
Mandatory Reporting ◽  
Infection Rates ◽  
The Us ◽  
Conceptual Shift

The infection control communities in Britain and the United States (US) are experiencing an extraordinary conceptual shift with legislated mandatory reporting of hospital infections. In Britain, this shift began in 2001 with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia episodes (1), which are reported to the National Health Service and are publically available on a Health Protection Agency Web site. In the US, the impetus for public reporting of infection rates has come from consumer groups (2). These organizations have bypassed health care organizations and public health and other practitioners, and have addressed their demands to state legislatures. At least eight states have now passed and several more are considering legislation to mandate reporting. The process has been rancorous and, at least initially, vigorously opposed by health care organizations and infection control practitioners.

Evaluation of Hospitalization for Infections That Are Present on Admission

2011 ◽  
Vol 26 (6) ◽  
pp. 468-473 ◽  
Author(s):  
Donald E. Casey ◽  
Kyung Chang ◽  
Rami T. Bustami
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Clostridium Difficile ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Health Care Organizations ◽  
Public Reporting ◽  
Infection Rates ◽  
Serious Infections ◽  
Hospital Acquired ◽  
Present On Admission

Hospitals have experienced increasing requirements for public reporting of various infection rates using clinical and administrative data. Until recently, such reports have not included analysis of “present on admission” (POA), an indicator designed to assess whether such infections are hospital acquired. The authors evaluated the frequency of the POA coding designation for 167 University HealthSystem Consortium hospitals for sepsis/septicemia (S-S), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile infection (CDI). The authors found that 70% of hospitalizations of patients with S-S, 86% of patients with MRSA, and 67% of patients with CDI had these conditions coded POA. The authors recommend that public reporting of hospital infection rates include POA status and that all health care organizations and providers should work more closely together to identify early and prevent such serious infections.

Transformation of the US Veterans Health Administration

2006 ◽  
Vol 1 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jonathan B. Perlin
Keyword(s):  
United States ◽  
Health Care ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Affairs ◽  
United States Department ◽  
Veterans Health ◽  
Department Of Veterans Affairs ◽  
Health Administration ◽  
The Us

Ten years ago, it would have been hard to imagine the publication of an issue of a scholarly journal dedicated to applying lessons from the transformation of the United States Department of Veterans Affairs Health System to the renewal of other countries' national health systems. Yet, with the recent publication of a dedicated edition of the Canadian journal Healthcare Papers (2005), this actually happened. Veterans Affairs health care also has been similarly lauded this past year in the lay press, being described as ‘the best care anywhere’ in the Washington Monthly, and described as ‘top-notch healthcare’ in US News and World Report's annual health care issue enumerating the ‘Top 100 Hospitals’ in the United States (Longman, 2005; Gearon, 2005).

Remember the Ladies: Competition and Mobilization in the United States

2018 ◽  
pp. 83-132
Author(s):  
Dawn Langan Teele
Keyword(s):  
United States ◽  
Political Geography ◽  
Gilded Age ◽  
Political Competition ◽  
State Legislatures ◽  
The United States ◽  
The Political ◽  
The Us ◽  
Race Ethnicity

This chapter presents a case study of women's enfranchisement in the United States. It argues that the formation of a broad coalition of women, symbolized by growing membership in a large non-partisan suffrage organization, in combination with competitive conditions in state legislatures, was crucial to securing politicians' support for women's suffrage in the states. The chapter first gives a broad overview of the phases of the US suffrage movement, arguing that the salience of political cleavages related to race, ethnicity, nativity, and class influenced the type of movement suffragists sought to build. It then describes the political geography of the Gilded Age, showing how the diversity of political competition and party organization that characterized the several regions mirrors the pattern of women's enfranchisement across the states.

The Democratic Deficit of United States Federalism? Red State, Blue State, Purple?

2018 ◽  
Vol 46 (4) ◽  
pp. 645-667
Author(s):  
Vicki C Jackson
Keyword(s):  
United States ◽  
State Legislatures ◽  
The United States ◽  
State Legislature ◽  
Democratic Deficit ◽  
The Us ◽  
The 1960S ◽  
Us Senate ◽  
The One ◽  
Over Time

Aspects of an entrenched constitution that were essential parts of founding compromises, and justified as necessary when a constitution was first adopted, may become less justifiable over time. Is this the case with respect to the structure of the United States Senate? The US Senate is hardwired in the Constitution to consist of an equal number of Senators from each state—the smallest of which currently has about 585,000 residents, and the largest of which has about 39.29 million. As this essay explains, over time, as population inequalities among states have grown larger, so too has the disproportionate voting power of smaller-population states in the national Senate. As a result of the ‘one-person, one-vote’ decisions of the 1960s that applied to both houses of state legislatures, each state legislature now is arguably more representative of its state population than the US Congress is of the US population. The ‘democratic deficit’ of the Senate, compared to state legislative bodies, also affects presidential (as compared to gubernatorial) elections. When founding compromises deeply entrenched in a constitution develop harder-to-justify consequences, should constitutional interpretation change responsively? Possible implications of the ‘democratic’ difference between the national and the state legislatures for US federalism doctrine are explored, especially with respect to the ‘pre-emption’ doctrine. Finally, the essay briefly considers the possibilities of federalism for addressing longer term issues of representation, polarisation and sustaining a single nation.

Optimizing Health Care Coalitions: Conceptual Frameworks and a Research Agenda

2015 ◽  
Vol 9 (6) ◽  
pp. 717-723 ◽  
Author(s):  
Nathaniel Hupert ◽  
Karen Biala ◽  
Tara Holland ◽  
Avi Baehr ◽  
Aisha Hasan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Response ◽  
Disaster Preparedness ◽  
Research Agenda ◽  
Positive Impact ◽  
High Reliability ◽  
The United States ◽  
Health Care Facilities ◽  
The Us ◽  
Hospital Preparedness

AbstractThe US health care system has maintained an objective of preparedness for natural or manmade catastrophic events as part of its larger charge to deliver health services for the American population. In 2002, support for hospital-based preparedness activities was bolstered by the creation of the National Bioterrorism Hospital Preparedness Program, now called the Hospital Preparedness Program, in the US Department of Health and Human Services. Since 2012, this program has promoted linking health care facilities into health care coalitions that build key preparedness and emergency response capabilities. Recognizing that well-functioning health care coalitions can have a positive impact on the health outcomes of the populations they serve, this article informs efforts to optimize health care coalition activity. We first review the landscape of health care coalitions in the United States. Then, using principles from supply chain management and high-reliability organization theory, we present 2 frameworks extending beyond the Office of the Assistant Secretary for Preparedness and Response’s current guidance in a way that may help health care coalition leaders gain conceptual insight into how different enterprises achieve similar ends relevant to emergency response. We conclude with a proposed research agenda to advance understanding of how coalitions can contribute to the day-to-day functioning of health care systems and disaster preparedness. (Disaster Med Public Health Preparedness.2015;9:717–723)

America's health care dilemma: not a pretty sight

2007 ◽  
Vol 2 (3) ◽  
pp. 341-346
Author(s):  
DAVID WILSFORD
Keyword(s):  
Health Care ◽  
Local Politics ◽  
Max Weber ◽  
The United States ◽  
Policy Debate ◽  
Us Congress ◽  
Critical Junctures ◽  
The Us ◽  
The Uk ◽  
The Right

As the American right wing’s control of national (and local) politics implodes in the United States, there is the inevitable hope wafting in the air as policy specialists and other political activists on the other side of the divide anticipate capturing the US presidency at the end of 2008 to go with the center-left’s majorities won in the US Congress at the end of 2006. And so, health care reform is once again on the march! Alas, if Max Weber was wise to have observed that ideas run upon the tracks of interests, implying clearly that some good ideas die their death because they do not find the right track of interests, while some tracks of interests go nowhere for lack of the right idea, the health policy debate still provides a Technicolor demonstration that the mish and mash of this and that is not yet pointing the country in any particular direction, regardless of election outcomes in 2006 and 2008. Worse yet, in spite of the great sociologist Reinhard Bendix’s demonstration in his masterwork Kings orPeople (1978) that non-incremental transformations often occur at critical junctures of a nation’s history due to the diffusion effects of ideas from abroad, there is no evidence in the current (or past) American debate that the country has ever learned anything at all or thinks it has anything at all to learn from the way these problems are grappled with, and more successfully, elsewhere. (Oh, let’s just take Japan, France, Germany, Spain, Canada, the UK, and a handful of other countries as quick examples.)

What Is the Affordable Care Act a Case of? Understanding the ACA through the Comparative Method

2020 ◽  
Vol 45 (4) ◽  
pp. 677-691
Author(s):  
Holly Jarman ◽  
Scott L. Greer
Keyword(s):  
United States ◽  
Health Care ◽  
Welfare State ◽  
Affordable Care Act ◽  
Strong Support ◽  
The United States ◽  
The Us ◽  
The Affordable Care Act ◽  
Shed Light ◽  
The Welfare State

Abstract International comparisons of US health care are common but mostly focus on comparing its performance to peers or asking why the United States remains so far from universal coverage. Here the authors ask how other comparative research could shed light on the unusual politics and structure of US health care and how the US experience could bring more to international conversations about health care and the welfare state. After introducing the concept of casing—asking what the Affordable Care Act (ACA) might be a case of—the authors discuss different “casings” of the ACA: complex legislation, path dependency, demos-constraining institutions, deep social cleavages, segmentalism, or the persistence of the welfare state. Each of these pictures of the ACA has strong support in the US-focused literature. Each also cases the ACA as part of a different experience shared with other countries, with different implications for how to analyze it and what we can learn from it. The final section discusses the implications for selecting cases that might shed light on the US experience and that make the United States look less exceptional and more tractable as an object of research.

Infection Control Dogma Among Nurses in Iran

2007 ◽  
Vol 28 (2) ◽  
pp. 238-240
Author(s):  
Harrison G. Weed ◽  
Mehrdad Askarian
Keyword(s):  
United States ◽  
Infection Control ◽  
Questionnaire Survey ◽  
The United States ◽  
The Us

Using 33 dogmatic statements about infection control, we assessed the knowledge of infection control nurses at a conference in Iran and compared their responses with those of infection control nurses at a conference in the United States. A majority of those at the Iran conference responded correctly to 11 (33%) of 33 statements, whereas a majority at the US conference responded correctly to 20 (61%) of the statements. The differences in responses were significant (P < .001). Nurses at the Iran conference were more likely to agree with dogma not supported by the literature and to put more faith in general cleanliness to prevent infection than is supported by the literature. A similar questionnaire survey might be useful in countries like Iran that are developing their infection control personnel and infrastructure.

scholarly journals The Implementation and Evaluation of the United States Affordable Care Act

2019 ◽  
Vol 12 (1) ◽  
pp. 17-38
Author(s):  
David Schultz
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Health Care Outcomes ◽  
The Us ◽  
American Health Care

In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.

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