The Impact of the Public Insurance Expansions on Children’s Use of Preventive Dental Care

To determine if children eligible for coverage by the State Children’s Health Insurance Program (SCHIP) and Medicaid Programs were more likely to receive preventive dental visits after implementation of the SCHIP policy, retrospective cross-sectional analysis was done from the 1996–2000 Medical Expenditure Panel Surveys (MEPS) data. We linked the individual level data from the MEPS to state-level information on program eligibility. Using logistic regression models that adjust for the complex survey design, the association between SCHIP implementation and receipt of preventive dental care was examined for children aged 3–18 with family incomes ≤200% of the Federal Poverty Line (FPL). Children who were eligible for SCHIP/Medicaid coverage in their respective states were more likely to have received preventive care three years after SCHIP implementation than children with similar eligibility profiles prior to SCHIP implementation. SCHIP has successfully increased the proportion of eligible children receiving preventive dental care among children in families with incomes less than or equal to 200% FPL. Our findings indicate, however, that SCHIP needed time to mature before detecting significant effects on national level.     

Helpful or Harmful? The Impact of Strategic Change on the Performance of U.S. Urban Hospitals

OBJECTIVE: To contribute to the debate as to whether strategic change helps or harms organizations by empirically examining how strategic change influences performance change in urban hospitals. DATA SOURCES: AHA Annual Survey (1994 and 1996), Health Care Financing Administration's Medicare Cost Reports (1994 and 1996) and Medicare HMO Files (1994), U.S. Bureau of the Census' County Business Patterns Files (1994), and Area Resources File (1994). STUDY DESIGN: This work employed a longitudinal approach using a panel design to study the effect of environmental and organizational characteristics on urban hospital strategic behavior and performance. A path analytic model was used to examine the simultaneous effects of environmental and organizational characteristics (1994) on strategic behavior (change in strategies to enhance HMO business and change in strategies to control costs 1994-96), as well as the effects of all of these variables on change in urban hospital performance (change in market share, change in operational efficiency, change in financial performance 1994-96). PRINCIPAL FINDINGS: (1) Environmental context exerts a greater influence on urban hospitals' HMO business enhancement strategies, whereas organizational characteristics have more influence on cost-control strategies. (2) Between the two strategies, HMO business enhancement and cost control, strategic change to enhance business with HMOs is much more complex. (3) Strategic change observed across the 1994 to 1996 time period can be either helpful or harmful to urban hospitals. A strategic change that contributes positively to one type of performance can negatively impact the other. CONCLUSIONS: Although differences of opinion persist in the strategic change debate, results of this study indicate that strategic change can be helpful or harmful to urban hospitals, and its consequences are far more complex than previously thought. Strategic rationality has its own limitations and cannot always be relied on to yield expected results. Hospital strategic changes require coordination to achieve greater performance results.     

The Impact of Head Start Enrollment Duration on Migrant Children’s Health Outcomes

The purpose of this study is to examine whether family characteristics and the length of children’s enrollment in Migrant Head Start affects children’s health treatment. Children in the Michigan Migrant Head Start were classified depending on years of enrollments: One year (n = 638), two years (n = 293), and three or more years (n = 426). Logistic regression analyses were conducted to examine whether the probability of children receiving health treatment differed depending on years of enrollment. There is a higher health treatment rate among children who attended Head Start for multiple years than for those who attended for one year. Children’s special needs status, of siblings, ethnicity, parental educational level, and marital status were related to preventative dental and physical health treatment outcomes. Although the primary goal of Head Start is school readiness rather than health improvement, migrant and seasonal farmworker children are likely to receive more health treatment if they attend more years of comprehensive intervention, such as Head Start, for positive physical and dental health.     

The Impact of Perinatal Depression on Children’s Social-Emotional Development: A Longitudinal Study

Maternal and Child Health Journal - Objectives This longitudinal population study aimed to investigate if maternal depression at different time points during the perinatal period impacts...     

The Impact of Tobacco Control Policies on Disparities in Children’s Secondhand Smoke Exposure: A Comparison of Methods

To examine the impact of cigarette excise taxes and smoke-free legislation on tobacco use among households with school-age children and adolescents as well as disparities in children’s secondhand smoke exposure. We compare the results from models using causal inference techniques to those from cross-sectional models. We linked families of 6–17-year-olds from the 2003 (N = 67,607) and 2007 (N = 62,768) contacts of the National Survey of Children’s Health with state-level cigarette excise taxes and smoke-free legislation total score (0 [none]–32 [very strong]) in 2001 and 2005. Parents reported whether anyone in the household used tobacco products. In adjusted causal inference models every $1.00 increase in cigarette excise tax between 2001 and 2005 was associated with a 4 percentage point decrease in household tobacco use between 2003 and 2007 (p = 0.008); however, there was no effect of smoke-free legislation on household tobacco use. Significant interactions revealed that cigarette tax increases were only associated with reductions in household tobacco use for parents of white children and, separately, lower income households. In contrast, in adjusted cross-sectional models, a higher smoke-free legislation total score was associated with a lower prevalence of household tobacco use. Stronger cigarette excise taxes decrease tobacco use among households with school-age children and adolescents, but smoke-free legislation at the state level does not change parental smoking. Since cross-sectional models cannot assess the direction of causality, evaluations should employ causal inference methods to help inform policy decisions to reduce disparities in adult smoking and, ultimately, protect children from secondhand smoke.     

The Impact of Medicaid Reform on Children’s Dental Care Utilization in Connecticut,Maryland, and Texas

ObjectiveTo measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children.Data2007 and 2011–2012 National Survey of Children’s Health.ConclusionsIncreasing Medicaid dental fees closer to private insurance fee levels has a significant impact on dental care utilization and unmet dental need among Medicaid-eligible children.     

The Impact of Refugee Mothers’ Trauma,Posttraumatic Stress,and Depression on Their Children’s Adjustment

The mechanisms linking refugee parents’ trauma onto their children’s functioning are not well understood. The current study sought to identify how Somali refugee mothers’ past trauma and current mental health impact their children’s psychosocial adjustment. One hundred and ninety-eight Somali mothers (M age?=?39 years) and their children (M age?=?10 years; 56% male) were studied. On average, mothers spent 7 years in refugee camps, experienced significant trauma, and some had been tortured. Measures of mothers’ posttraumatic stress and depression were analyzed as three symptom clusters: volatility/panic, withdrawn/detached, and depressed mood. Most children were born in the U.S. and their indirect exposure to trauma was statistically controlled. Results from structural equation modeling indicated that there was no direct association between trauma of the mother and their children’s well-being, however, mothers’ posttraumatic stress and depressive symptoms significantly mediated the effects of mothers’ past torture on their children’s adjustment—a pattern indicative of intergenerational traumatization. Findings enhance our understanding of how refugees’ traumatization lingers and possibly affects their and their children’s health and well-being.     

The Impact of Prosocial Television News on Children’s Prosocial Behavior: An Experimental Study in the Netherlands

The aim of this experimental study was to examine whether prosocial behavior in television news affects children’s prosocial intentions and behaviors. In this study, 372 Dutch children (9–13 years old) participated. Children in the experimental condition were exposed to prosocial news showing children organizing a fundraising action for UNICEF. In the control condition, children were exposed to news about UNICEF in which no prosocial behavior was included. Afterwards, children were given the opportunity to donate to UNICEF, which served as an index of prosocial behavior. Prosocial intentions were captured using paper-and-pencil questionnaires. Regression analysis demonstrated that, while controlling for important confounders, children exposed to prosocial news were significantly more willing to help with setting up a project for UNICEF and donated more to UNICEF compared to children who did not watch prosocial news. These findings highlight that prosocial television can function as a tool for positive social change among children.     

公立医院公益性实现形式问题研究

公立医院应该体现公益性已经成为社会各界的共识,但公立医院公益性的内涵和外延如何界定,公立医院如何体现公益性却是社会各界探讨的热点问题。就此,我们进行初步的探索。     

加入WTO对军队医院的影响

为探讨加入WTO以后对军队医院的影响，本阐述了加入WTO后我国的医疗市场的竞争更加激烈，人才保留和引进难度增大，为兵服务面临新的冲击；军队医院要把握入世后的机遇，促进军事医学发展。     

加入WTO对中国职业卫生的影响

世界各国的职业卫生问题在全球经济一体化进程中变得日益突出,由此而造成的经济损失约占全世界GDP的4％,中国加入WTO后将促进中国职业卫生管理与国际接轨,加快职业卫生立法,改善工作条件;但应注意国外有害产业的国内转移和由于引进技术、设备、材料带来新的职业卫生问题。     

如何将全面预算绩效管理融入公立医院绩效考核

随着全面预算绩效管理在医院管理中的地位日益显现,公立医院推进全面预算绩效管理与绩效考核相结合势在必行。文章基于AGIL理论提出绩效考核融合全面预算绩效管理的分析框架,从适应、目标达成、整合、潜在模式维持4个维度总结北京市医院管理中心推进全面预算绩效管理与绩效考核一体化的实施路径,并就强化绩效考核主体协同、提升第三方机构专业水平、加强医院内部运营管理3个方面进行了展望。     

北京市公立医院 “区办市管” 改革的PEST-SWOT分析

目的建立北京市公立医院“区办市管”改革的PEST-SWOT模型,对“区办市管”的改革经验和问题及面临的挑战进行总结归纳。方法通过政策解读、实践分析、文献查询及专家咨询,研究构建PEST-SWOT 分析模型。结果“区办市管”具有内部优势和劣势,面临外部政策环境、经济环境、社会环境、技术环境方面的机会和威胁。结论通过建立“区办市管”新模式,挖掘其管理优势,优化区域医疗体系,调整绩效管理方案,可实现市区医院一体化管理,技术人才同质化发展,本地化分级诊疗和差异化绩效激励,从而更好地实现改革目标。     

公立医院慈善基金会生存与发展之探析

公立医院慈善基金会既彰显医院公益性,又可以弥补基本医疗保障的缺口,但目前多数存在资金来源单一、不专业等问题。应让更多优秀专业人才从业,通过规范、透明的管理树立基金会的公信力,同时还可通过政府购买服务及互联网技术的应用,增加活力,实现医院基金会的可持续发展。     

加入WTO对我国中医医院的影响及对策

我国加入 WTO后 ,既给中医医院带来更加广阔的市场前景等发展机遇 ,又使中医医院面临运营机制、经营管理、技术队伍稳定等多方面的挑战 ,文中提出了中医医院要在竞争激烈的医疗市场中占据一席之地所必须采取的对策 ,诸如 :设法增强医院凝聚力 ;努力练好内功 ;健全竞争有序的用人机制 ,建立灵活的内部经济分配制度 ;了解加入WTO后的“游戏规则”及中外合资医疗机构的经营特点 ,做到知己知彼等等。     

公立医院人力资源改革难点及建议

人才是医院的立院之本。指出目前公立医院人力资源改革主要存在以下问题：缺乏改革的勇气及信心;制度不健全、不合理;优秀人才流失严重;考核机制流于形式;分配制度缺乏激励。结合工作实践,提出了以下建议：（1）分类改革,循序渐进;（2）规范制度,合理发展;（3）栽好梧桐,留引凤凰;（4）科学考评,促进发展;（5）用好激励,增添活力,     

我国公立医院多院区管理研究进展

目的通过分析我国公立医院多院区管理研究的趋势、热点、重点以及存在的问题等,为多院区医院发展提供参考。方法检索中国知网和万方数据库,共获得429篇文献。采用定量方法和可视化知识图谱进行趋势、热点、重点等文献计量分析,采用内容分析法对存在问题进行研究。结果多院区医院文献量逐渐增加,2010年后增速加快;但作者机构耦合度尚不高;研究内容由粗转细,研究广度和深度加大。结论多院区医院可分为广义与狭义两类,各有优劣;一院多院区模式是现阶段的发展趋势;一院多院区管理宏观需加强顶层设计、中观需建章立制、微观需采取“信息化+配套激励”措施。     

加入WTO后我国公立医院发展的SWOT分析

探讨中国加入世界贸易组织（WTO）后公立医院的发展战略和策略。并且提出了相应的对策，供政策制定者和医院管理人员参考。