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Ownership, public policy, and market conditions| Their effect on the provision of support services in outpatient substance abuse treatmentYou, Young Ah 21 January 2016 (has links)
<p> This study examines in two ways the provision of support services in outpatient substance abuse treatment (OSAT): (1) the extent to which ownership makes a difference; (2) how public policy and market conditions influence the ownership effect. Two types of support services are investigated: free treatment provision and the total number of ancillary services helping underserved populations recover from drug and alcohol abuse. Regression results suggest that nonprofit OSATs are more likely to offer free treatment and provide a wider range of ancillary services than for-profit OSATs controlling other OSAT characteristics and external conditions. Free treatment provision by nonprofits is twice as high as it is by for-profits. The number of ancillary services is 33% higher in nonprofit facilities than in for-profit facilities. Nonprofit organizations in the outpatient substance abuse treatment area perform their fundamental role serving medically, socially, and economically disadvantaged populations. At the same time, findings of the study show that public policy and market conditions moderate the ownership effect. Government funding, characteristics of states’ parity legislations, market competition with for-profit organizations, and demand for public services impact nonprofit OSATs’ support service provision. Each ownership responses to given policy and market conditions in different ways. This study contributes to the field by showing that ownership difference is evident in types of services offered and the level of support for disadvantaged patients. It is also a valuable addition to the literature about ownership difference in health care research. Ownership difference can better be explained by understanding interactions between ownership and external conditions such as policy and market factors. Given rising interest in comprehensive care and a wraparound approach coordinating behavioral health services with housing, employment, education, and other supports. The findings of this study provide policy makers and practitioners with valuable information about factors related to OSAT provision of support services. Future research will be directed toward the dynamics of ownership and policy interactions and the impact of the recent health care reforms on OSAT support provision.</p>
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The impact of student loans on homeownershipClick, Matthew Eric 17 December 2015 (has links)
<p>This thesis examines the relationship between student loan debt and homeownership. I hypothesize that a negative relationship exists, and control for a respondent?s age, household income, household size, race, gender, marital status, and level of education. Using a binary logistic regression model to examine data from the 2012 National Financial Capability Study (NFCS) and the 2014 Survey of Household Economic Decisions (SHED), I model the odds-ratios and predicted probabilities of homeownership for respondents with and without student loans. I find a decrease in the predicted probability of homeownership by 8.4% and 9.3% in the NFCS and SHED datasets, respectively. While I find that a negative relationship does exist, predicted probabilities show that other factors may exert a greater influence on homeownership, which produces recommendations for future research.
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Fostering Collaboration through IT Tools: An Experimental Study of Public Deliberation on Water SustainabilityJanuary 2011 (has links)
abstract: Most of challenges facing today's government cannot be resolved without collaborative efforts from multiple non-state stakeholders, organizations, and active participation from citizens. Collaborative governance has become an important form of management practice. Yet the success of this inclusive management approach depends on whether government agencies and all other involved parties can collectively deliberate and work toward the shared goals. This dissertation examines whether information technology (IT) tools and prior cooperative interactions can be used to facilitate the collaboration process, and how IT tools and prior cooperative interactions can, if at all, get citizens and communities more engaged in collaborative governance. It focuses on the individual and small groups engaged in deliberating on a local community problem, which is water sustainability in the Phoenix metropolitan area. Experiments were conducted to compare how people deliberate and interact with each other under different IT-facilitated deliberation environments and with different prehistory of interactions. The unique experimental site for this research is a designed deliberation space that can seat up to 25 participants surrounded by the immersive 260-degree seven-screen communal display. In total, 126 students from Arizona State University participated in the experiment. The experiment results show that the deliberation spaces can influence participants' engagement in the collaborative efforts toward collective goals. This dissertation demonstrates the great potential of well-designed IT-facilitated deliberation spaces for supporting policy deliberation and advancing collaborative governance. This dissertation provides practical suggestions for public managers and community leaders on how to design and develop the desired features of IT-facilitated interaction environments for face-to-face and computer-mediated online public deliberation activities. This dissertation also discusses lessons and strategies on how to build a stronger sense of community for promoting community-based efforts to achieve collective goals. / Dissertation/Thesis / Ph.D. Public Administration 2011
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A Comparative Analysis of the Health Status of Hispanic Children: The Cases of Washington State and ArizonaJanuary 2016 (has links)
abstract: ABSTRACT
For the last quarter century, Washington State has been ranked in the top third of the United States in health status while Arizona has been consistently around the bottom third. This gap can be partly explained by data related to traditional determinants of health like education, income, insurance rates and income. Moreover, Washington State invests three times more resources in the public health sector than Arizona. Surprisingly, however, Hispanic children in Washington State have poorer health status than Hispanic children in Arizona. This dissertation explores possible explanations for this unexpected situation, using as a conceptual framework the cultural competency continuum developed by Cross.
The study consisted of analysis of health-related data from Washington State and Arizona, and interviews with state health administrators, local health departments, community-based organizations and university administrators in both states. This research makes a modest contribution to the role that cultural competence plays in the development and implementation of health policy and programs, and the potential impact of this approach on health status. The dissertation ends with recommendations for health policy-makers and program planners, particularly in states with a significant proportion of minority groups. / Dissertation/Thesis / Doctoral Dissertation Public Administration 2016
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Accomplishments and Challenges of the Round Three Federal Empowerment Zone Program: The Case of TucsonJanuary 2013 (has links)
abstract: The Empowerment Zones were created in 1993 under Clinton's administration, demonstrating a commitment to solving tough socio-economic problems in distressed communities. The main objective associated with this program was economic recovery of distressed communities by creating jobs and providing various services to the indigenous populations. The designation of the Empowerment Zones went in three rounds (1994, 1998, and 2001), and although the types and amounts of federal incentives varied across rounds, the four principles around which the program originated remain unchanged: strategic vision for change, community based partnerships, economic opportunity, and sustainable community development. Since its inception, the Empowerment Zones program has been implemented in 30 urban and 10 rural communities in 27 states across the U.S. Two central questions lead the research of this dissertation project: 1) What have been the main accomplishments of the round three federal Empowerment Zones program in Tucson? 2) What have been the main challenges of the round three federal Empowerment Zones program in Tucson? By using a case study research design and various techniques for data collection and analysis (including the program package Atlas.ti), this study examined the accomplishments and the challenges associated with the round three designated Empowerment Zone in Tucson. Evidence was collected from multiple sources, including 24 interviews, over 60 local newspaper articles, relevant documentation, annual performance reports, and other sources. The analysis reveals that the program's implementation in Tucson was strong in the beginning, but after two years, the earlier success started to fade quickly. The shortcomings of program design became evident during the implementation phase and further in the inability of the administration to collect relevant data to demonstrate the program's success. The consequences of the inability to provide data for program evaluation influenced the enthusiasm of the administrators and program partners, and weakened the political support. The reduction in the grant component contributed to overemphasis of the business development component thereby ignoring most community development aspects essential for the success of the program in Tucson. This study did not find evidence for the claim that round three of the empowerment zones program based on federal tax incentives contributes to the creation of new jobs and the attraction of new business in economically deprived communities in Tucson. / Dissertation/Thesis / Ph.D. Public Administration 2013
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Adjusting Holt-Winters Exponential Smoothing for External Intervention: A Mathematical Technique for Making Quasi-Judgmental Adjustments For Anticipated ChangesWilliams, Daniel Wayne 01 January 1994 (has links)
Public administration data is sometimes extrapolated through exponential smoothing. Sometimes such data may undergo a level shift because of a policy decision. The slope of the curve formed by connecting the periodic observations increases or decreases significantly for a brief period, thereafter returning to a slope similar to the slope preceding the policy change. This discontinuity might be called a ramp or a step. Forecasts made with exponential smoothing immediately before, during, or immediately after the ramp or step may be considerably inaccurate unless adjusted. A technique called adjusted exponential smoothing is proposed to reduce or eliminate the inaccuracy of forecasts made under such circumstances when the ramp or step arises from a planned policy decision. An empirical study is conducted to determine whether the proposed technique constitutes an improvement over other exponential smoothing techniques. The empirical study shows that the proposed technique improves the accuracy of forecasts when planned level shifts subsequently actually occur. Guidelines are provided for using the technique.
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Factors and Interactions Contributing to the Risk of Fire following Earthquake for Urban Southern CaliforniaSchellhous, William T. 02 March 2018 (has links)
<p> Earthquakes pose both primary and secondary threats to human life, health, and property. Primary threats include building collapse, landslide, and falling objects. Secondary threats may include tsunamis or fires. Fire following earthquake is a secondary earthquake risk that threatens urban populations in seismically active areas, such as Southern California. The damage from previous post-earthquake fires has far exceeded the damage from the earthquakes themselves. </p><p> Qualitative meta-analysis of many previous studies related to fire following earthquake is applied in this study to identify and describe the factors and interactions that contribute to the risk of fire following earthquake for urban Southern California. A simple risk assessment method is proposed that may inform decision makers of the degree of fire danger that exists following a significant earthquake. Application of the mitigation opportunities discussed in this study, hold the potential to save tens of thousands of lives in future earthquake events.</p><p>
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Community Driven Improvement| A Case Study of the Hillside Neighborhood AssociationVillagomez-Christensen, Mario 16 May 2018 (has links)
<p> This research was undertaken to understand how an organically arisen, neighborhood driven initiative operated. Research attempted to understand what such an initiative could accomplish and change in their neighborhood. This study also attempted to discern longitudinal effects which the organization may have had throughout the neighborhood where they operated. This study attempted to delineate these objectives through researching the Hillside Neighborhood Association, located in the Hillside neighborhood of Colorado Springs, Colorado. The methodology for this case study, was a sequential mixed methods model. Which began with a quantitative phase, that utilized both statistical analysis and data triangulation, to deduce what the organization achieved as indicated through utilized data. The qualitative phase of this case study employed a purposeful sample, participants were contacted by the researcher separately and then interviewed. Participants had to have reside in the neighborhood for at minimum to years from data of contact. Neighborhood longevity ensured that participants would have the most knowledge about the organization and potentially accompanying neighborhood changes. Findings indicated that neighborhood participants held steadfast to past neighborhood achievements which the HNA was conduit for. This long-term neighborhood pride among older residents was salient to them. Additionally, past success appeared to have laid a foundation for future improvement efforts to capitalize on. The social capital of participants highlighted a need to focus on a small-scale street level point of entry for neighborhood improvement endeavors.</p><p>
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A planning model for needs analysis for subacute careBroderick, Pauline Martha 21 June 1995 (has links)
The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand.
Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century.
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Property rights and hospital behavior under DRGs : an examination of nonprofit, government, and forprofit sectorsAndal Sorrentino, Elizabeth M. 01 December 1987 (has links)
This study compares nonprofit, government, and forprofit hospitals in South Florida. Property rights arrangement is defined as rights to residual profits in the forprofit hospitals, and the tax-exemption status on the part of nonprofit and government hospitals with obligations to serve charitable purposes in the public interest. This dissertation derives and tests implications about differences in behavior in the context of efficiency, equity, and quality of care delivered in nonprofit, government, and forprofit hospitals.
Fifty-six hospitals with Joint Commission on Accreditation of Hospitals (JCAH) accreditation were compared on institutional variables (bed size, location>; efficiency variables (occupancy rates, ancillary expenses, bad debts, manhours per patient day, salaries per FTE, length of stay/DRG, charges/DRG, reimbursement/ORB (on twenty DRGs); equity variables (Medicare days, Medicaid days, and uncompensated care); and finally, the quality variable (death rates/DRS on twenty DRGs).
The immediate effects of profit maximization is considered as an incentive for managers in the forprofit hospitals. The social obligations attached to the tax-exemption status can be argued as the underlying rationale far output maximization, i. e. maximizing benefits to society by serving more patients in the nonprofit and government hospitals.
Using analysis of variance, nonprofit, government, and forprofit hospitals were compared to determine if statistically significant differences were present at the .05 level of significance. Pairs of hospital types were tested for significant differences using ANOVA, Mann-Whitney, and multiple regression analysis.
The results provided mixed support for the property rights theory. Significant differences were found on institutional variables, bed size and location; efficiency variables, bad debts, manhours per patient day, and charges per DRG; equity variables Medicare days, Medicaid days, and uncompensated care. In terms of the quality variable, the death rates per DRG showed no statistical significance.
Unexpectedly, nonprofit hospitals were very similar to forprofit hospitals on the variables bad debts and Medicaid days. The relevance of this finding to health policy issues today, particularly tax-exemption privileges, warrant a suggestion for further evaluation of the performance of the nonprofit sector.
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