Objectives: Few research studies have analyzed college students' attitudes of health reform caused by the Affordable Care Act (ACA). Specifically, no studies exist looking at undergraduate and graduate social work students' views on current health reform. The study will ask two questions: (1) What do Social Work students know about the components and potential impacts of the ACA, and (2) Are there any characteristics of students associated with their level of knowledge or attitudes about the Act? Methods: A 53-item survey questionnaire inquiring knowledge, attitudes, and perceptions related to health reform and the Affordable Care Act was dispersed to a convenience sample of 105 undergraduate and graduate social work students from the University of Central Florida School of Social Work in January-February 2014. Results: Students had favorable views on how the health reform will be funded and how health reform could support specific social issues such as acknowledging the need for reform and believing health care should be a basic right. There were fewer clear trends in students' attitudes about reform implementation and knowledge of specific ACA provisions. There were no significant associations between student's knowledge of the ACA and their insurance status or political affiliation. Conclusions: Students' beliefs on health reform are inconsistent. Ethnicity was the only demographic characteristic that affected students' views. This study advocates the need for more in-depth health policy education within the social work program curriculum.

The aim of this study was to examine the extent to which U.S. newspapers covered the chatter surrounding the 2009/10 healthcare reform debate at the expense of the substance. Also of importance was how the political leanings of newspapers influenced the coverage they gave the issue in terms of tone and page or story prominence. Newspaper endorsement data from Editor & Publisher magazine were used to determine the political leanings of U.S. newspapers based on the candidate they endorsed in the 2008 U.S. presidential election. Newspaper articles related to the topic were retrieved from the Lexis-Nexis database and analyzed. The results showed that overall the healthcare reform debate received substantial coverage in U.S. newspapers; but the major part of the coverage was dedicated to the arguments, protests, and thoughts of people concerning the issue (90.3%) rather than the substance of the issue (9.7%). Implications of the results for media practitioners, communication scholars, and researchers were discussed.

The Patient Protection and Affordable Care Act (PPACA) of 2010 requires hospital systems in the United States to shift the culture of patient care from a focus on sick-care to a focus on prevention and wellness care. Little is known about how hospital systems will make this culture shift while retaining quality patient care. The purpose of this case study of a pioneering hospital-based PPACA-compliant initiative was to answer the research question of how Wallace's revitalization movement theory (RMT) "a rapid culture change model"could serve as a transferable evaluation framework for PPACA prevention and wellness care compliance in hospital-based programs. Kingdon's policy streams theory provided a conceptual framework. Data analysis included iterative, thematic coding of interviews with 3 primary stakeholders responsible for developing the policy, planning, and program implementation strategies of the Center for Total Health (CTH). Nineteen extensive primary source documents were included in the analysis as well. Findings supported the utility of the RMT structure and definitions in the identification of culture change dynamics in CTH. Additionally, this structure served as a scaffolding for grouping individual and institutional rapid culture change dynamics into stages that could be evaluated in terms of PPACA compliance. These stages effectively identified a Kingdon policy window in which PPACA mandates could be expected to result in culture change in multiple streams of public policy development, not only in wellness and sickness prevention, but also in local, state, and national health cost-saving initiatives in food-as-medicine, community identity, public health support networks. It could also reduce chronic disease and the rising institutional care delivery costs.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / O trabalho parte da hipótese de que os movimentos sociais potencializam sua capacidade de pautar agendas e normatizar suas demandas quando conseguem convergir para uma agenda única. Busca-se exemplificar essa tese por meio de uma análise do Movimento Sanitário e a subsequente Reforma Sanitária. A partir da atuação deste movimento foi possível incluir uma nova forma de entender a saúde na Constituição de 1988 e sua regulamentação via Lei Orgânica da Saúde LOS , responsável pela criação do Sistema Único de Saúde SUS. O objetivo norteador do trabalho é a compreensão do motivo pelo qual algumas políticas públicas de saúde foram implementadas com sucesso enquanto outras permaneceram no papel. Argumenta-se que o fato de muitas das premissas instituídas na Lei Orgânica ainda não terem sido efetivadas tem relação, entre outros fatores, com a crescente fragmentação e institucionalização dos movimentos pela saúde, ocorrida ao longo da década de 1990. Hoje o que se observa é uma grande heterogeneidade dos atores ligados ao setor, com os novos movimentos sociais pela saúde apresentando-se de forma cada vez mais difusa. No ano em que o Sistema Único completa 25 anos, é necessário repensar suas estratégias, falhas e sucessos. Destarte, o trabalho leva à reflexão de que ao se buscar a efetivação do SUS legal é premente que doravante se retomem os princípios fundantes da Reforma Sanitária. / The study departs from the hypothesis that social movements improve their ability to bring specific themes to the forefront and to introduce new regulations when they converge around a single agenda. It illustrates this thesis through an analysis of the Sanitary Movement and the subsequent Health Reform. Their actions allowed for a new way of understanding health in the 1988 Constitution and its regulation via Health Law - LOS - , responsible for the creation of the Unified Health System - SUS. The guiding purpose of this thesis is to explain why some public policies related to healthcare were successfully implemented while others were not. In other words, the study examines the factors behind the non-effectiveness of the premises established by the LOS, indicating that this occurred in part due to the increasing fragmentation and institutionalization of the healthcare movement throughout the 1990s. Today one can observe an expressive heterogeneity in the healthcare movement with new actors presenting themselves in an ever more diffuse way. In the year that SUS turns 25, we need to rethink its strategies, successes and failures. This thesis leads to the final reflection that in order for SUS to actually work it is pressing that all actors involved in the healthcare movements return to and reclaim the Sanitary Reform founding principles.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / O trabalho parte da hipótese de que os movimentos sociais potencializam sua capacidade de pautar agendas e normatizar suas demandas quando conseguem convergir para uma agenda única. Busca-se exemplificar essa tese por meio de uma análise do Movimento Sanitário e a subsequente Reforma Sanitária. A partir da atuação deste movimento foi possível incluir uma nova forma de entender a saúde na Constituição de 1988 e sua regulamentação via Lei Orgânica da Saúde LOS , responsável pela criação do Sistema Único de Saúde SUS. O objetivo norteador do trabalho é a compreensão do motivo pelo qual algumas políticas públicas de saúde foram implementadas com sucesso enquanto outras permaneceram no papel. Argumenta-se que o fato de muitas das premissas instituídas na Lei Orgânica ainda não terem sido efetivadas tem relação, entre outros fatores, com a crescente fragmentação e institucionalização dos movimentos pela saúde, ocorrida ao longo da década de 1990. Hoje o que se observa é uma grande heterogeneidade dos atores ligados ao setor, com os novos movimentos sociais pela saúde apresentando-se de forma cada vez mais difusa. No ano em que o Sistema Único completa 25 anos, é necessário repensar suas estratégias, falhas e sucessos. Destarte, o trabalho leva à reflexão de que ao se buscar a efetivação do SUS legal é premente que doravante se retomem os princípios fundantes da Reforma Sanitária. / The study departs from the hypothesis that social movements improve their ability to bring specific themes to the forefront and to introduce new regulations when they converge around a single agenda. It illustrates this thesis through an analysis of the Sanitary Movement and the subsequent Health Reform. Their actions allowed for a new way of understanding health in the 1988 Constitution and its regulation via Health Law - LOS - , responsible for the creation of the Unified Health System - SUS. The guiding purpose of this thesis is to explain why some public policies related to healthcare were successfully implemented while others were not. In other words, the study examines the factors behind the non-effectiveness of the premises established by the LOS, indicating that this occurred in part due to the increasing fragmentation and institutionalization of the healthcare movement throughout the 1990s. Today one can observe an expressive heterogeneity in the healthcare movement with new actors presenting themselves in an ever more diffuse way. In the year that SUS turns 25, we need to rethink its strategies, successes and failures. This thesis leads to the final reflection that in order for SUS to actually work it is pressing that all actors involved in the healthcare movements return to and reclaim the Sanitary Reform founding principles.

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Using data for every elective procedure in 2007 in the English National Health Service, we found evidence of socioeconomic inequality in the probability of having a procedure cancelled after admission while controlling for a range of patient and provider characteristics. Whether this disparity is inequitable is inconclusive.; Using data for every elective procedure in 2007 in the English National Health Service, we found evidence of socioeconomic inequality in the probability of having a procedure cancelled after admission while controlling for a range of patient and provider characteristics. Whether this disparity is inequitable is inconclusive. Copyright A[c] 2012 John Wiley & Sons, Ltd.; � Using data for every elective procedure in 2007 in the English National Health Service, we found evidence of socioeconomic inequality in the probability of having a procedure cancelled after admission while controlling for a range of patient and provider characteristics. Whether this disparity is inequitable is inconclusive.

Bibliography: leaves 268-317 / The challenge of accessing affordable healthcare services in the developing countries prompted the promotion of community-based health insurance (CBHI) as an effective alternative. CBHI has been implemented in many countries of the South over the last three decades for the purpose of improving access and attaining universal health coverage. However, the sudden stoppage of a CBHI programme in rural Nigeria raised a lot of concerns about the suitability of the health financing scheme. Thus, this thesis examines the stoppage of the CBHI programme in rural Kwara, Nigeria. Premised on the health policy triangle as a conceptual framework, mixed methods approach was adopted for data collection. This involved 12 focus group discussions, 22 in-depth interviews, 32 key informant interviews and 1,583 questionaires. The study participants were community members, community leaders, healthcare providers, policymakers, international partner, health maintenance organisation officials and a researcher. Findings revealed that transnational actors relied on various resources (e.g. fund and ‘expertise’) and formed alliances with local actors to drive the introduction of the programme. As such, the design and implementation of the policy were dominated by international actors. Despite the sustainability challenges faced by the programme, the study found that it benefitted some of the enrolled community members. Though, even at the subsidised amount, enrolment premium was still a challenge for many. The main reasons for the stoppage of the programme are a paucity of fund and poor management. The stoppage of the programme, however, signified a point of reversal in the relative achievements recorded by the CBHI scheme because community members have deserted the healthcare facilities due to high costs of care. In view of these, the thesis notes that short-term policies often lead to temporary outcomes and suggests the need to repurpose the role of the state by introducing a long-term comprehensive healthcare policy – based on the reality of the nation – to provide equitable healthcare services for the citizenry irrespective of their capacity to pay. / Sociology / D. Phil. (Sociology)