IU Indianapolis ScholarWorks :: Browsing by Author "Taylor, Heather L."

Browsing by Author "Taylor, Heather L."

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Core Competency Gaps among Governmental Public Health Employees With and Without A Formal Public Health Degree
(Lippincott Williams & Wilkins, 2021) Taylor, Heather L.; Yeager, Valerie A.
Objectives: To examine the role of a formal public health degree as it relates to core competency needs among governmental public health employees. Design: This cross-sectional study utilizes the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). Bivariate relationships were analyzed by conducting χ tests of respondents' supervisory level and reported skill gaps. Multivariate logistic regressions of reported skill gaps were performed holding gender, age, race/ethnicity, highest degree attained, current employer, role type, tenure in current agency, and public health certificate attainment constant. Setting: Nationally representative sample of government public health employees. Participants: A total of 30 276 governmental public health employees. Main outcome measure: Self-reported competency skills gaps. Results: Among nonsupervisors, those with a public health degree had significantly lower odds of reporting a competency gap for 8 of the 21 skills assessed. Among supervisors/managers, those who had a formal public health degree had significantly lower odds of reporting a competency gap in 3 of the 22 skills assessed. Having a degree in public health was not significantly related to an executive's likelihood of reporting a skill gap across any of the 22 skills assessed. Regardless of supervisory level, having a public health degree was not associated with a reduced likelihood of reporting skill gaps in effective communication, budgeting and financial management, or change management competency domains. Conclusions: Possessing a formal public health degree appears to have greater value for skills required at the nonsupervisor and supervisor/manager levels than for skills needed at the executive level. Future work should focus on longitudinal evaluations of skill gaps reported among the public health workforce as changes in public health curricula may shift over time in response to newly revised accreditation standards. In addition, public health education should increase emphasis on communication, budgeting, systems thinking, and other management skills among their graduates.
Does preventive dental care reduce non-preventive dental visits and expenditures among Medicaid-enrolled adults?
(Wiley, 2022) Taylor, Heather L.; Sen, Bisakha; Holmes, Ann M.; Schleyer, Titus; Menachemi, Nir; Blackburn, Justin; Health Policy and Management, School of Public Health
Objective To determine whether preventive dental visits are associated with fewer subsequent non-preventive dental visits and lower dental expenditures. Data Sources Indiana Medicaid enrollment and claims data (2015–2018) and the Area Health Resource File. Study design A repeated measures design with individual and year fixed effects examining the relationship between preventive dental visits (PDVs) and non-preventive dental visits (NPVs) and dental expenditures. Data Collection/Extraction Methods Not applicable. Principal findings Of 28,152 adults (108,349 observation-years) meeting inclusion criteria, 36.0% had any dental visit, 27.8% a PDV, and 22.1% a NPV. Compared to no PDV in the prior year, at least one was associated with fewer NPVs (β = −0.13; 95% CI -0.12, −0.11), lower NPV expenditures (β = −$29.12.53; 95% CI -28.07, −21.05), and lower total dental expenditures (−$70.12; 95% -74.92, −65.31), as well as fewer PDVs (β = −0.24; 95% CI -0.26, −0.23). Conclusions Our findings suggest that prior year PDVs are associated with fewer subsequent NPVs and lower dental expenditures among Medicaid-enrolled adults. Thus, from a public insurance program standpoint, supporting preventive dental care use may translate into improved population oral health outcomes and lower dental costs among certain low-income adult populations, but barriers to consistent utilization of PDV prohibit definitive findings.
Economic Burden Associated With Untreated Mental Illness in Indiana
(American Medical Association, 2023) Taylor, Heather L.; Menachemi, Nir; Gilbert, Amy; Chaudhary, Jay; Blackburn, Justin
Importance There is a paucity of systematically captured data on the costs incurred by society—individuals, families, and communities—from untreated mental illnesses in the US. However, these data are necessary for decision-making on actions and allocation of societal resources and should be considered by policymakers, clinicians, and employers. Objective To estimate the economic burden associated with untreated mental illness at the societal level. Design, Setting, and Participants This cross-sectional study used multiple data sources to tabulate the annual cost of untreated mental illness among residents (≥5 years old) in Indiana in 2019: the US National Survey on Drug Use and Health, the National Survey of Children’s Health, Indiana government sources, and Indiana Medicaid enrollment and claims data. Data analyses were conducted from January to May 2022. Main Outcomes and Measures Direct nonhealth care costs (eg, criminal justice system, homeless shelters), indirect costs (unemployment, workplace productivity losses due to absenteeism and presenteeism, all-cause mortality, suicide, caregiver direct health care, caregiver productivity losses, and missed primary education), and direct health care costs (disease-related health care expenditures). Results The study population consisted of 6 179 105 individuals (median [SD] age, 38.0 [0.2] years; 3 132 806 [50.7%] were women) of whom an estimated 429 407 (95% CI, 349 526-528 171) had untreated mental illness in 2019. The economic burden of untreated mental illness in Indiana was estimated to be $4.2 billion annually (range of uncertainty [RoU], $2.1 billion-$7.0 billion). The cost of untreated mental illness included $3.3 billion (RoU, $1.7 billion-$5.4 billion) in indirect costs, $708.5 million (RoU, $335 million-$1.2 billion) in direct health care costs, and $185.4 million (RoU, $29.9 million-$471.5 million) in nonhealth care costs. Conclusion and Relevance This cross-sectional study found that untreated mental illness may have significant financial consequences for society. These findings put into perspective the case for action and should be considered by policymakers, clinicians, and employers when allocating societal resources and funding. States can replicate this comprehensive framework as they prioritize key areas for action regarding mental health services and treatments.
Evaluation of a Dental Diagnostic Terminology Subset
(IOS, 2019) Taylor, Heather L.; Siddiqui, Zasim; Frazier, Kendall; Thyvalikakath, Thankam; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
The objective of this study was to determine how well a subset of SNODENT, specifically designed for general dentistry, meets the needs of dental practitioners. Participants were asked to locate their written diagnosis for tooth conditions among the SNODENT terminology uploaded into an electronic dental record. Investigators found that 65% of providers’ original written diagnoses were in “agreement” with their selected SNODENT dental diagnostic subset concept(s).
Faculty salaries in health administration: trends and correlates 2015-2021
(2022-06) Balio, Casey P.; Taylor, Heather L.; Robertson, Ashley S.; Menachemi, Nir
In this study, we provide updated information on salaries of academic health administration (HA) faculty members based on data collected in 2015, 2018, and 2021 and examine characteristics associated with earnings. We present mean inflation-adjusted salaries by demographic characteristics, education, experience, productivity, and job activities. We find that salaries of assistant, associate, and full professors have kept up with inflation and there have not been significant changes in salary by any characteristics over time. As in previous iterations of similar survey data, there remain differences in salary by both gender and race. Higher salaries were associated with having a 12-month contract, being tenured or tenure-track, having an administrative position, and being in a department whose focus is not primarily teaching. Findings from our study will be of interest to individuals on the HA job market, hiring committees, and doctoral students preparing for a position after graduation.
How Has the Pandemic Affected Career Satisfaction and Employment Perceptions of Faculty in Health Administration?
(2023) Robertson, Ashley S.; Balio, Casey P.; Taylor, Heather L.; Menachemi, Nir
Employee satisfaction has been shown to affect productivity and turnover among faculty in higher education. The COVID-19 pandemic has required significant organizational changes in higher education, including hiring freezes, furloughs, and a rapid move to online teaching. Little is known about the effects of these changes on health administration faculty. Therefore, the current study utilizes data from a national survey of health administration faculty conducted in 2018 and 2021 to perform three analyses: quantification of the proportion of faculty respondents experiencing furloughs or whose depart ments implemented a hiring freeze brought upon by the pandemic; changes in career satisfaction and employment perceptions between the years 2018 and 2021; and a cross-sectional analysis of the relationship between furloughs and/ or hiring freezes and 2021 career satisfaction and employment perceptions. Overall, 17.9% experienced a furlough and 81.4% indicated their department had a hiring freeze. We observed no significant changes in career satisfaction or employment perceptions from 2018 to 2021. However, receipt of furloughs was negatively associated with multiple indicators of career satisfaction and employment perceptions. The results of this study will be of interest to health administration program administrators and faculty as well as leaders in higher education who would benefit from understanding the impact of the pandemic on faculty more broadly.
Primary Care Case Conferences to Mitigate Social Determinants of Health: A Case Study from One FQHC System
(2021) Yeager, Valerie A.; Taylor, Heather L.; Menachemi, Nir; Haut, Dawn P.; Halverson, Paul K.; Vest, Joshua R.
Objective: Given the increasing difficulty healthcare providers face in addressing patients’ complex social circumstances and underlying health needs, organizations are considering team-based approaches including case conferences. We sought to document various perspectives on the facilitators and challenges of conducting case conferences in primary care settings. Study Design: Qualitative study using semi-structured telephone interviews Methods: We conducted 22 qualitative interviews with members of case conferencing teams, including physicians, nurses, and social workers from a Federally Qualified Health Clinic, as well as local county public health nurses. Interviews were recorded, transcribed, and reviewed using thematic coding to identify key themes/subthemes. Results: Participants reported perceived benefits to patients, providers, and healthcare organizations including better care, increased inter-professional communication, and shared knowledge. Perceived challenges related to underlying organizational processes and priorities. Perceived facilitators for successful case conferences included generating and maintaining a list of patients to discuss during case conference sessions and team members being prepared to actively participate in addressing tasks and patient needs during each session. Participants offered recommendations for further improving case conferences for patients, providers, and organizations. Conclusions: Case conferences may be a feasible approach to understanding patient’s complex social needs. Participants reported that case conferences may help mitigate the effects of these social issues and that they foster better inter-professional communication and care planning in primary care. The case conference model requires administrative support and organizational resources to be successful. Future research should explore how case conferences fit into a larger population health organizational strategy so that they are resourced commensurately.
Student perceptions of a teaching electronic medical record in Health Administration education
(2022) Taylor, Heather L.; Brumitt, Gary; Harle, Christopher A.; Johnston, Ann; Williams, Karmen; Vest, Joshua R.
Given the ubiquity of electronic health records (EHR), health administrators should be formally trained on the use and evaluation of EHR data for common operational tasks and managerial decision-making. A teaching electronic medical record (tEMR) is a fully operational electronic medical record that uses de-identified electronic patient data and provides a framework for students to familiarize themselves with the data, features, and functionality of an EHR. Although purported to be of value in health administration programs, specific benefits of using a tEMR in health administration education is unknown. We sought to examine Master of Health Administration (MHA) students' perceptions of the use, challenges, and benefits of a tEMR. We analyzed qualitative data collected from a focus group session with students who were exposed to the tEMR during a semester MHA course. We also administered pre- and post-survey questions on students' self-efficacy and perceptions of the ease of use, usefulness, and intention to use health care data analysis in their future jobs. We found several MHA students valued their exposure to the tEMR, as this provided them a realistic environment to explore de-identified patient data. Scores for students' perceived ease of using healthcare data analysis in their future job significantly increased following use of the tEMR (pre-test score M=3.31, SD=0.21; post-test score M=3.71, SD=0.18; p=0.01). Student exposure and use of a tEMR may positively affect perceptions of using EHR data for strategic and managerial tasks typical of health administrators.
The impact of narrow and tiered networks on costs, access, quality, and patient steering: A systematic review
(Sage, 2022-10) Mazurenko, Olena; Taylor, Heather L.; Menachemi, Nir
Health insurers use narrow and tiered networks to lower costs by contracting with, or favoring, selected providers. Little is known about the contemporary effects of narrow or tiered networks on key metrics. The purpose of this systematic review was to synthesize the evidence on how narrow and tiered networks impact cost, access, quality, and patient steering. We searched PubMed, MEDLINE, and Cochrane Central Register of Controlled Trials databases for articles published from January 2000 to June 2020. Both narrow and tiered networks are associated with reduced overall health care costs for most cost-related measures. Evidence pertaining to access to care and quality measures were more limited to a narrow set of outcomes or were weak in internal validity, but generally concluded no systematic adverse effects on narrow or tiered networks. Narrow and tiered networks appear to reduce costs without affecting some quality measures. More research on quality outcomes is warranted.
The Relationship Between Dental Provider Density and Receipt of Dental Care Among Medicaid-enrolled Adults
(Johns Hopkins University, 2024) Taylor, Heather L.; Menachemi, Nir; Holmes, Ann; Sen, Bisakha; Schleyer, Titus; Blackburn, Justin; Health Policy and Management, Richard M. Fairbanks School of Public Health
Objective: We sought to measure the association of dental provider density and receipt of dental care among Medicaid-enrolled adults. Methods: We used four years of Indiana Medicaid claims and enrollment data (2015 to 2018) and the Area Health Resources File to examine the relationship between any dental visit (ADV) or any preventive dental visit (PDV) and three county-level measures of dental provider density (the total number of Medicaid-participating dentists, a binary indicator of a federally qualified health center (FQHC) with a Medicaid-participating dentist, and the overall county dentist-to-population ratio). Results: The likelihood of ADV or PDV increased with greater density of Medicaid-participating dentists as well as dentists accepting Medicaid working at an FQHC within the county. The overall dentist-to-population ratio was not associated with dental care use among the adult Medicaid population. Conclusion: Dentist participation in Medicaid program may be a modifiable barrier to Medicaid-enrolled adults' receipt of dental care.

Browsing by Author "Taylor, Heather L."

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