The Presence Of Hospital-Based Palliative Care Programs: A Resource Dependence Perspective

Background: The presence of hospital-based palliative care programs has risen over time in the United States. Nevertheless, organizational and environmental factors that contribute to the presence of hospital-based palliative care programs are unclear. Purpose: The aim of this study was to examine the role of organizational and environmental factors associated with the presence of hospital-based palliative care programs using resource dependence theory. Methodology: Panel data from 2000 to 2009 American Hospital Association Annual Survey and the Area Resource File were used in this study. A random-effect logistic regression was used to analyze the relationship between organizational and environmental factors and the presence of hospital-based palliative care programs. Findings: Hospitals with higher Medicare inpatient days, located in counties with higher Medicare managed penetration, and larger hospitals had greater odds of having a hospital-based palliative care program. Although hospitals in counties that have a higher percentage of individuals 65 years and older, for-profit and government hospitals were less likely to have a hospital-based palliative care program. Practice Implications: Hospitals will vary in the organizational resources available to them, as such, administrators\u27 awareness of the relationship between resources and palliative care programs can help determine the relevance of a program in their hospital

Incentives for Healthy Behaviors

Objective: Engaging individuals in their own health care proves challenging for policy makers, health plans, and providers. Florida Medicaid introduced the Enhanced Benefits Rewards (EBR) program in 2006, providing financial incentives as rewards to beneficiaries who engage in health care seeking and healthy behaviors. Methods: This study analyzed beneficiary survey data from 2009 to determine predictors associated with awareness of and participation in the EBR program. Results: Non-English speakers, those in a racial and ethnic minority group, those with less than a high school education, and those with limited or no connection to a health care provider were associated with lower awareness of the program. Among those aware of the program, these factors were also associated with reduced likelihood of engaging in the program. Individuals in fair or poor health were also less likely to engage in an approved behavior. Individuals who speak Spanish at home and those without a high school diploma were more likely than other groups to spend their earned program credits. Conclusions: Findings underscore the fact that initial engagement in such a program can prove challenging as different groups are not equally likely to be aware of or participate in an approved activity or redeem a credit. Physicians may play important roles in encouraging participation in programs to incentivize healthy behaviors

Defining Population Health: Leveraging advisory board members’ perspectives to identify health administration curriculum content

Current healthcare reform practices are driving the entire healthcare delivery system toward a population health approach. Health administration programs, both undergraduate and graduate, play an important role in training future leaders of healthcare organizations to engage and thrive in this dynamic environment. The purpose of this research was to engage U.S. healthcare leaders in a dialog on population health and to identify essential concepts appropriate for healthcare administration students\u27 education. As advisory board members represent industry leaders who will employ future graduates, their expertise and suggestions help inform programs on both health management competency and skill-development opportunities. Focus groups comprised of advisory board members from five U.S. health administration programs were conducted. Qualitative analysis of the focus group discussions was performed and themes identified by a consensus process. Results showed convergence on five major population health themes. Study findings provide a practitioner-informed definition for population health and validated recommendations for health management curriculum content via a population health perspective. The identification of key topic areas serves to inform program directors and faculty as they develop knowledge content necessary to best prepare future health administrators in this new population health paradigm