Journal of Public Health Management and Practice最新文献

{"title":"The Influence of State Restrictions on Opioid Prescribing: 2006-2018.","authors":"Leon E Cosler, Luis Midence, Jacob J Hayes, Justin-Theodore Gondeck, Kaitlin Moy, Mei-Hsiu Chen, John D Hogan","doi":"10.1097/PHH.0000000000002004","DOIUrl":"10.1097/PHH.0000000000002004","url":null,"abstract":"<p><strong>Objective: </strong>To measure the longitudinal effect of opioid restrictions on prescribing patterns at the state and regional levels.</p><p><strong>Design: </strong>Health policy evaluation using a Poisson regression of opioid metrics from federal repositories to model what the estimated opioid counts are for the next fiscal year.</p><p><strong>Setting: </strong>State-specific prescribed opioid counts between 2006 and 2018 from CDC reports; population data were obtained from the U.S. Census Bureau for 2006-2018; and opioid prescribing restrictions were extracted from published reports and state regulatory databases.</p><p><strong>Intervention: </strong>Poisson regression models were fitted to assess the relationship of statewide restrictions on opioid prescribing counts adjusting for states' population.</p><p><strong>Main outcome measure: </strong>Estimated opioid counts provided by the Poisson regression model.</p><p><strong>Results: </strong>Per capita rates of prescribed opioids peaked in 2012 at 86.2 per 100 population. Prescribing restrictions are associated with statistically significant decreases in opioid prescribing. Controlling for population and year, we found for every 100 opioid prescriptions in a state without restrictions, only 98 opioid prescriptions are expected for every additional year in a state with restrictions in place.</p><p><strong>Conclusions: </strong>Contrary to other research conducted over a shorter study period, we found that restrictions do reduce opioid prescribing; however, a statistically significant change in rates may not be detectable in the early years after restrictions are enacted.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"34-42"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doctors Who Attend Policy School: Who Are They and Where Do They Work?, Erratum.","authors":"","doi":"10.1097/PHH.0000000000002072","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002072","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"31 1","pages":"148"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Partnerships Out of Barriers: Lessons Learned From Partnerships Between Centers for Independent Living and Health Departments During the COVID-19 Pandemic.","authors":"Hailey Bednar, LaTasha Callis, Alaina Whitton, Sara Lyons, Kimberly Tissot","doi":"10.1097/PHH.0000000000002029","DOIUrl":"10.1097/PHH.0000000000002029","url":null,"abstract":"<p><strong>Introduction: </strong>People with disabilities were left behind in the beginning of the COVID-19 vaccination rollout. More work needs to be done to connect people with disabilities to public health initiatives. Centers for Independent Living (CILs) are an important and under-utilized community partner for health departments and should be engaged as a trusted source when working to reach people with disabilities and improve access to public health programs and services.</p><p><strong>Methods: </strong>The National Foundation for the Centers for Disease Control and Prevention (CDC Foundation), through funding from the CDC, launched the Leveraging CILs to Increase Vaccine Access for People with Disabilities project. The primary goal was to increase accessibility of the COVID-19 vaccination among people with disabilities through (1) outreach and education, (2) service linkage and barrier removal through increasing accessible, (3) widespread education about the vaccine, and (4) improved partnerships between disability-led organizations and local health care providers.</p><p><strong>Outputs: </strong>A grant program resulted in 39 awards distributed to CILs across the United States totaling $2 955 294.00 between November 2021 and March 2023. The project successfully resulted in reported improvements in partnerships between funded CILs and local health providers and a reported reduction in barriers to accessing vaccinations faced by people with disabilities. A suite of resources was also created to address targeted needs identified throughout partner implementation. Successful outreach to the targeted population resulted in 27 044 consumers being directly reached by CILs and 3 675 655 people reached through communication and outreach activities.</p><p><strong>Discussion: </strong>Catalytic funding to disability-led organizations during public health emergency response and including people with disabilities as subject matter experts in program design can successfully strengthen access to care via trust building, message dissemination, and partnership. Building the capacity of community-based and consumer-led partners to implement evidence-based public health programming can provide a foundation for improved care for people with disabilities, particularly during an emergency response.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E40-E47"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Drug Checking Training Program for Frontline Harm Reduction Workers and Implications for Practice.","authors":"Taylor Teal, Bruce Wallace, Dennis Hore","doi":"10.1097/PHH.0000000000002041","DOIUrl":"10.1097/PHH.0000000000002041","url":null,"abstract":"<p><strong>Context: </strong>Drug checking, defined as the use of instruments (e.g. spectrometers), test strips, and other technologies to provide information on drug composition for harm reduction purposes, has emerged as a promising intervention to reduce harms of illicit drugs linked to overdose deaths. While demonstrating potential, these interventions remain limited in reach amid questions of how to reach the full population of people who use drugs and are at risk of overdose, including those outside urban areas. In response to these limitations, Substance, a drug checking project based in Victoria, Canada, developed a Distributed Model of Drug Checking and a concomitant training program.</p><p><strong>Program: </strong>The Distributed Drug Checking Training program eliminates need for point-of-care spectrometry technicians, instead capacitating harm reduction workers to provide drug checking using software developed by the project, infrared spectrometers, and immunoassay test strips. The training includes 5 hours of group content that can be delivered virtually, and 2 hours of practice time per learner.</p><p><strong>Implementation: </strong>Training and data collection took place between May 2022 and March 2024 with learners from 6 locations across Vancouver Island, Canada. We offered 13 training sessions, with evaluation data collected from 54 learners.</p><p><strong>Evaluation: </strong>The training was evaluated across Kirkpatrick's 4 levels of training evaluation. The training was highly acceptable to learners, attributable to intended changes in knowledge and skill related to drug checking, resulted in competence to deliver drug checking through the project's Distributed Model, and facilitated expansion of drug checking services to 6 geographically distant locations.</p><p><strong>Discussion: </strong>After completing the 7-hour training program, harm reduction workers were able to deliver drug checking without need for on-site drug checking technicians. The short duration of the training and its demonstrated success with the Distributed Model of Drug Checking make this a promising approach for expanding the reach of drug checking services.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"43-50"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Parental Rights and Public Health: The Challenge of Childhood Vaccination in a Changing Landscape.","authors":"Y Tony Yang, Sarah Schaffer DeRoo","doi":"10.1097/PHH.0000000000002066","DOIUrl":"10.1097/PHH.0000000000002066","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Coders' Use of the ICD-10-CM \"Unspecified\" Codes for Head and Brain Injury in Emergency Department Settings.","authors":"Tracy Wharton, Morgan Bailey, Alexis Peterson, Kelly Sarmiento, Julia A Bleser, Emily Hunt Costello","doi":"10.1097/PHH.0000000000002003","DOIUrl":"10.1097/PHH.0000000000002003","url":null,"abstract":"<p><strong>Context: </strong>In the emergency department (ED) setting, prioritizing triage and patient care may lead to challenges in capturing detailed documentation necessary for specific International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding in medical records. Consequently, the prevalent use of the \"unspecified head injury\" code poses concerns about the precision of ED-based administrative billing claims data when analyzed for public health surveillance of nonfatal traumatic brain injuries (TBIs). Understanding the perspective of medical coders can illuminate coding processes and opportunities to enhance coding accuracy for TBI and other head injuries in the ED.</p><p><strong>Objective: </strong>This evaluation explores medical coders' perspectives and challenges when assigning ICD-10-CM codes to head injuries in the ED.</p><p><strong>Design: </strong>This qualitative evaluation utilized a phenomenological approach, which employed semi-structured interviews to understand medical coders' perspectives, processes, and coding determinations for head injuries in the ED.</p><p><strong>Setting: </strong>Interviews were conducted using a HIPAA-compliant video-based platform between July 2022 and January 2023.</p><p><strong>Participants: </strong>Seventeen medical coders with ED coding experience were interviewed. Their backgrounds were diverse, though most had more than 15 years of experience.</p><p><strong>Main outcomes: </strong>Four qualitative themes emerged, which highlighted challenges with lack of detailed documentation, defaulting to unspecified codes, time, and productivity pressure, and additional insights into coders' assumptions and code determination processes.</p><p><strong>Results: </strong>Medical coders expressed challenges assigning ICD-10-CM codes to the highest level of specificity, citing issues including insufficient documentation by ED providers and terminology variations. Workplace time constraints and pressure for expedited claims also led to defaulting to unspecified codes.</p><p><strong>Conclusions: </strong>This evaluation highlights the need for improved documentation consistency and detail in ED records to facilitate accurate ICD-10-CM coding. Alleviating time pressures, improving algorithms, and offering specialized training opportunities to medical coders could be helpful steps to improve coding specificity and data accuracy for head injuries in the ED.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"99-106"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141910142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of County-Level Presidential Election Outcome and COVID-19 Mortality in Colorado, 2020-2022.","authors":"Kelly A DeBie, Margaret J Gutilla, Kayleigh P Keller, Jennifer L Peel, David Rojas-Rueda, Andreas M Neophytou","doi":"10.1097/PHH.0000000000002098","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002098","url":null,"abstract":"<p><strong>Context: </strong>The Coronavirus disease 2019 (COVID-19) pandemic occurred during a time of political tension in the United States. County-level political environment may have been influential in COVID-19 outcomes.</p><p><strong>Objective: </strong>This study examined the association between county-level political environment and age-adjusted COVID-19 mortality rates from 2020 to 2022.</p><p><strong>Design setting: </strong>Political environment was measured by the 2020 Presidential election results and compared with age-adjusted COVID-19 mortality rates by county in Colorado.</p><p><strong>Main outcome measures: </strong>Rate ratios (RR) and 95% confidence intervals (CI) were estimated using negative binomial regression incorporating a population offset term. Models adjusted for populational differences using the demographics percentile from Colorado's EnviroScreen Environmental Justice Tool.</p><p><strong>Results: </strong>Age-adjusted county mortality rates ranged from 14.3 to 446.8.0 per 100 000. 2021 COVID-19 mortality rates were nearly twice as high in counties voting for Donald Trump compared to those voting for Joseph Biden (adjusted RR = 1.98, 95% CI: 1.59, 2.47). Results for 2020 and 2022 mortality models were also in the positive direction, though the confidence intervals crossed null values.</p><p><strong>Conclusion: </strong>These results build on a growing body of evidence that political environment may have been influential for COVID-19 mortality, helping to understand the drivers of health outcomes. Implications for the public health system as we shift into the endemic period of COVID-19 include motivation for collaborative work to restore and rebuild trust among and between stakeholders and the community, as well as increase health education given its' influence on both individual and community behaviors.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for Patients Seeking Asylum: Early Data From the Safety Net System in New York City.","authors":"Remle Newton-Dame, Laura Jacobson, Andrew B Wallach, Erica Silverman, Benard Dreyer, Theodore Long","doi":"10.1097/PHH.0000000000002106","DOIUrl":"10.1097/PHH.0000000000002106","url":null,"abstract":"<p><strong>Context: </strong>Over 200 000 people seeking asylum have arrived in New York City from 2022 to 2024.</p><p><strong>Program: </strong>As the safety net hospital system for our city, New York City (NYC) Health + Hospitals (H + H) has taken the lead in caring for newly arrived asylum seekers. We used electronic medical record data to gain early insights into utilization and needs among these patients.</p><p><strong>Implementation: </strong>We developed a hybrid definition to identify patients who are asylum seekers and examined their demographics, insurance, utilization, primary billing diagnoses, and immunizations from the Epic EMR. We included data on other patients as a point of comparison and analyzed data separately for adult and pediatric patients.</p><p><strong>Evaluation: </strong>In 2023, 15 233 or 1.4% of H + H patients were asylum seekers. Asylum seekers had fewer visits than other patients in 2023, and utilization was particularly driven by pregnancy and childbirth. Children seeking asylum were engaged in primary care at high rates. Documented childhood vaccinations were higher among asylum-seeking children engaged in primary care compared to those who were not. The majority of adults and children were insured. Adult primary care engagement was low, as were visits for those seeking care for behavioral health issues.</p><p><strong>Discussion: </strong>For adult asylum seekers, pregnancy and childbirth are key needs for adults. Increasing vaccination rates among children is critical and promoting engagement in primary care is a promising way to do so. Coordinated efforts are required to meet the varied needs of migrant arrivals, and safety net hospitals can play a key role in addressing their health care needs.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV Vaccination and Awareness Programs at Maryland Colleges and Universities.","authors":"Mehrnoosh Soori, Gypsyamber D'Souza, Brian Mattingly, Norma Kanarek","doi":"10.1097/PHH.0000000000002093","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002093","url":null,"abstract":"<p><strong>Context: </strong>About half of adolescents aged 13 to 17 in United States are not fully vaccinated against human papillomavirus (HPV). As they age into young adulthood, colleges may be an excellent target population nexus for implementing interventions to improve HPV vaccination uptake.</p><p><strong>Objectives: </strong>Our study goal was to generate knowledge about HPV vaccine offerings and awareness programs at colleges to ascertain the extent of campus-facilitated access to HPV immunization and education in 1 state.</p><p><strong>Design: </strong>An electronic survey was designed and emailed to 32 of 47 Maryland colleges for which relevant campus contacts could be identified.</p><p><strong>Settings: </strong>The study took place at Johns Hopkins Bloomberg School of Public Health in consultation with the Maryland Cancer Collaborative and the Maryland Department of Health.</p><p><strong>Participants: </strong>Maryland colleges and universities.</p><p><strong>Main outcome measures: </strong>HPV vaccine and awareness program offerings on college and university campuses.</p><p><strong>Results: </strong>Twenty Maryland colleges responded. Two colleges offer awareness programs only. Ten colleges offer HPV vaccine, covering about 39% of Maryland college students. Of these, 4 colleges schedule \"periodic\" campus health clinics or provide an immunization prescription, which is filled at nearby pharmacies. In all colleges, which offer HPV vaccine, immunization is offered to everyone (both men and women) at no out-of-pocket cost.</p><p><strong>Conclusions: </strong>In cooperation with the Maryland Cancer Collaborative, the implementation arm for the Maryland Cancer Control Plan, we showed that college campuses are an excellent target site for implementation of interventions to improve access of college age students to HPV vaccine and awareness programs. We lay the groundwork for recommendations, programs and policies that can improve HPV vaccine offerings among college students thus raising the HPV vaccination rate in young adults. Simple inexpensive alternatives to offering vaccine at college health centers may be periodic campus health clinics and arrangements with nearby pharmacies.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association and Variation Between the COVID-19 Pandemic and Health Care Quality in the Medicare Shared Savings Program: Insights From a Seven-Year Natural Experiment.","authors":"Xiyuan Hu, Mariétou H Ouayogodé","doi":"10.1097/PHH.0000000000002102","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002102","url":null,"abstract":"<p><p>Potential changes in health care quality resulting from variation in pandemic severity since 2020 have received less attention. This study aims to assess the relationship between the pandemic and health care quality in Medicare Shared Savings Program (MSSP) accountable care organizations and identify possible heterogeneity in the relationship. The year-by-year difference-in-difference event study of MSSPs between 2016 and 2022 (N = 3390) indicated that 1 standard deviation increase in standardized cumulative COVID-19 incidence in 2020 was associated with a decrease in total quality score of 0.83 percentage points (95% CI: -0.21 to 1.44) after controlling for confounders. The reduction in quality score was mostly driven by ACOs with the highest COVID-19 incidence and in the Midwest. We found no evidence for a persisting decline in quality scores in 2021 to 2022. Public health efforts may need to carefully monitor quality performance and mitigate negative effects during future health crises. Continued investment in strengthening health care resilience remains crucial.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}