Can Accreditation Work in Public Health? Lessons From Other Service Industries

Reviews the literature on the experiences and outcomes of existing accreditation programs in health and social service industries in order to derive implications about the potential benefits and costs of accreditation for public health agencies

Kentucky: Round 1 - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.Kentucky's health benefit exchange has thus far been among the nation's leaders in successful implementation, its sustainability will depend on political leadership, the ability of supporters to mount successful public relations and constituent campaigns, and ongoing fiscal support. All these elements will be hotly contested in the next year

Evaluation of the benefits of transnational transportation projects

In this paper an analytical framework has been developed to evaluate the primary beneficiaries of cargo traffic generated by transnational transport projects. In the transportation economics literature, the economic impact of infrastructure projects on cargo traffic has not been developed as fully as for passenger traffic. In much of the previous literature it is often assumed that consumers of the traded goods would receive the full benefits from the reduction in logistics and transportation costs. This paper has shown that whether the goods are traded internationally or regionally is a key factor in the allocation of the economic benefits arising from the reduction in the cost of cargo transportation. The analytical framework developed in the paper is applied to the evaluation of the impacts of the proposed Buenos Aires-Colonia binational bridge project.Argentina, Uruguay, cargo traffic, transnational, transportation benefits

1,2-Dimethyl-4,5-diphenylbenzene determined on a Bruker SMART X2S benchtop crystallographic system

The title compound, C(20)H(18), has two crystallographically independent molecules in the asymmetric unit. The phenyl substituents of molecule A are twisted away from the plane defined by the central benzene ring by 131.8 (2) and -52.7 (3)degrees. The phenyl substituents of molecule B are twisted by -133.3 (2) and 50.9 (3)degrees. Each molecule is stabilized by a pair of intraMolecular C(aryl, sp(2))-H center dot center dot center dot pi interactions, as well as by several interMolecular C(methyl, sp(3))-H center dot center dot center dot pi interactions

2,3-Bis(bromomethyl)-1,4-diphenylbenzene

In the title compound, C(20)H(16)Br(2), the terminal phenyl groups are twisted away from the central ring by approximately 55 and -125 degrees (average of four dihedral angles each), respectively. The crystal structure is stabilized by a combination of interMolecular and intraMolecular interactions including interMolecular pi-pi stacking interactions [C atoms of closest contact = 3.423 ( 5) angstrom]

Measuring Progress to Comprehensive Public Health Systems, National Preparedness, and a Culture of Health

This update describes recent progress on two national health measurement initiatives: The National Health Security Preparedness Index and the National Longitudinal Survey of Public Health Systems. These longitudinal data sources offer valuable perspectives on how health security practices and public health delivery systems are changing across the U.S

Medicaid Crowd-Out of Other Public Health Spending: Modeling Economic & Health Effects

MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other types of public health programs and policies. The ACA may exacerbate Medicaid’s tendency to crowd out other types of public health spending, possibly resulting in unintended, adverse effects on population health. OBJECTIVES: Using a unique longitudinal data series on governmental spending from the 1992-2014, this study: (1) estimates the degree to which state Medicaid spending complements or crowds out other state and local public health spending over time; and (2) uses crowd-out estimates in combination with estimates of service delivery and mortality effects from other studies to simulate the impact of ACA’s Medicaid expansions on public health financing, service delivery, and preventable mortality. DESIGN: A retrospective cohort design follows 50 states and approximately 2500 local public health agencies over the period 1992-2014 using periodic surveys of local agencies conducted by NACCHO combined with data from the U.S. Census of Governments (COG), Area Resource File, and state Medicaid reports. We construct separate measures of annual state Medicaid spending, state and local hospital spending, and state and local public health spending on a per capita scale. Fixed-effects and dynamic structural equation models are used to estimate the effects of Medicaid and hospital spending on public health spending, while controlling for a rich set of fiscal, demographic, socioeconomic, and health resources variables. Instrumental variables techniques are used to control for unobserved characteristics that simultaneously influence Medicaid and public health spending, using information on state Medicaid policy changes, Federal Medical Assistance Percentage (FMAP) changes, and public health governance characteristics as instruments. We estimate separate models at (1) the state level only and (2) both state and local level using hierarchical specifications. Population Studied: A total of 50 states and 2467 local public health agencies are examined over a 22 year period. RESULTS: Medicaid spending produces sizeable crowd-out effects on public health spending at both state and local levels during the study period. A 10% increase in state Medicaid spending was associated with a 4.1% reduction in state public health spending (