Florida Public Health Association 2009 Survey of Academic Public Health Programs in Florida

Preparing the public health workforce is essential to the protection ofthe health and wellbeing ofthe state and the nation. Yet, a workforce shortage is looming. It is anticipated that by 2020, the nation will be facing a shortfall ofmore than a quarter of a million public health workers. To address this impeding shortage, the Association ofSchools ofPublic Health (ASPH) has stressed the need to build public health education capacity, with emphasis on competencies and curriculum in emerging diseases, with joint degrees, and with diverse approaches to education, including certificates and distance learning. To assess Florida’s available public health professional preparation programs in meeting workforce needs, the Academic Committee ofthe Florida Public Health Association (FPHA) undertook a survey of the nine public and private universities offering the MPH degree in the state

Florida Public Health Association 2009 Survey of Academic Public Health Programs in Florida

ABSTRAC

The relationships among service delivery factors, community characteristics, and immunization completion by two-year-old children using county health departments.

This study examined factors influencing health department utilization, early initial immunizations, and immunization completion in Georgia's 159 county health departments. The impact of community characteristics (income, race, education, and health care options) and health department factors (resources, availability and convenience of immunization services, and proactivity) were examined. Major hypotheses were that (1) utilization was highest in counties where families had fewer options for care; (2) the portion of two-year-olds using the health department was unrelated to immunization initiation or completion among health department users and (3) health department factors (budgets, staff resources, sites, hours, sick child care, fees, recall systems, reminder methods, and missed opportunities) influenced immunization behavior. Statistical analyses partially confirmed these hypotheses. The study found that the percent of two-year-olds who used the health department was unrelated to initiation or completion of immunizations. Utilization was lowest in counties where families had alternative sources of health care and highest in counties with high proportions of families who fit the profile of the underimmunized. The earlier children started the immunization series, the greater the immunization completion rate. However, race (proportionately more Blacks in the county) was associated with earlier average age of first immunization completion and with lower immunization completion rates. Immunization completion rates were highest in counties with greater budgets, more sites, no immunization fees, computerized systems, telephone reminders, and fewer missed opportunities. Rural and urban health departments had comparable immunization completion rates. Simulations based on the regression models were used to test policy options. Key policy recommendations included: (1) Efforts to improve immunizations should target health departments in counties with higher proportions of those more likely to be underimmunized: Blacks, low income families, and parents with less than a high school education; (2) Adequate funding is needed for local health departments to achieve public health objectives; (3) Fees should not be charged for immunizations; (4) Immunization services should be provided at multiple sites; (5) Computers should be used to support immunization activities; (6) Practices which minimize missed opportunities should be encouraged; and (7) Early initiation of immunizations should be encouraged.Dr.P.H.Health PolicyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/103532/1/9330807.pdfDescription of 9330807.pdf : Restricted to UM users only

Will Carrots Or Sticks Raise Influenza Immunization Rates Of Health Care Personnel?

New Joint Commission on the Accreditation of Healthcare Organizations standards require health care organizations to implement staff influenza immunization programs and track employee immunization rates. Although the Centers for Disease Control and Prevention have recommended influenza immunizations for health care workers since 1981, employee vaccination rates have stagnated at 30% to 40% for several years. With the recent attention on these low rates, some institutions have increased employee rates significantly with robust, multifaceted immunization programs. Others have attempted to require immunizations as a condition of employment. Declinations signed by those who refuse immunizations also have been proposed. This article examines recommendations for employee influenza immunizations and the evidence for effective strategies that increase coverage rates. With so much misunderstanding about the influenza immunization, robust interactive education, and onsite, easily accessible vaccination at no cost to employees-the carrots-may be more successful in increasing rates than are declinations and work exclusion-the sticks. Strong immunization programs may create the tipping point for making influenza immunizations as routine in health care as gloves. More robust staff immunization programs, evaluations of their effectiveness, surveillance of health care employee immunization rates, as well as further evidence of effectiveness of declinations and work exclusions should guide further policy formation and implementation. © 2007 Association for Professionals in Infection Control and Epidemiology, Inc

Managed Care And Patient Safety: Risks And Opportunities

Objective: Patient safety practices have primarily focused on providers, such as hospitals and ambulatory or long-term care. Based on the premise that most medical errors and patient safety problems arise from system issues, and that managed care constitutes the largest, most integrated system in health care, the authors examine the role of managed care in making patient care safer. Study design: Review of the literature and analysis of the role of managed care in patient safety. Results: Authors find that although much has been written regarding managed care and quality, there is little research on managed care’s relationship to patient safety. Research shows that managed care is not significantly different from indemnity insurance in terms of quality of care. However, managed care contracting, reimbursement, and management practices result in health care utilization changes that could pose potential risks for patient safety. Although managed care may pose possible risks to patient safety, practices can be monitored and adjusted to maintain quality and safety. At the same time, managed care provides opportunities for promoting patient safety at an integrated system level. Managed care organizations are in a unique position to influence patient safety by using safety strategies in selective contracting, financial incentives for performance, quality improvement programs, consumer education, and management and integration of care delivery. Our literature review reveals that health plans are starting to implement some of these strategies, but the practice is not widespread. Conclusions: Authors conclude with a framework and recommendations for patient safety. © 2005 Lippincott Williams & Wilkins, Inc