Browsing by Subject "Health care policy"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Editorial Peer Reviewers' Recommendations at a General Medical Journal: Are They Reliable and Do Editors Care?
    (Public Library of Science, 2010-04-08) Kravitz, Richard L.; Franks, Peter; Feldman, Mitchell D.; Gerrity, Martha; Byrne, Cindy; Tierney, William M.; Medicine, School of Medicine
    Background Editorial peer review is universally used but little studied. We examined the relationship between external reviewers' recommendations and the editorial outcome of manuscripts undergoing external peer-review at the Journal of General Internal Medicine (JGIM). Methodology/Principal Findings We examined reviewer recommendations and editors' decisions at JGIM between 2004 and 2008. For manuscripts undergoing peer review, we calculated chance-corrected agreement among reviewers on recommendations to reject versus accept or revise. Using mixed effects logistic regression models, we estimated intra-class correlation coefficients (ICC) at the reviewer and manuscript level. Finally, we examined the probability of rejection in relation to reviewer agreement and disagreement. The 2264 manuscripts sent for external review during the study period received 5881 reviews provided by 2916 reviewers; 28% of reviews recommended rejection. Chance corrected agreement (kappa statistic) on rejection among reviewers was 0.11 (p<.01). In mixed effects models adjusting for study year and manuscript type, the reviewer-level ICC was 0.23 (95% confidence interval [CI], 0.19–0.29) and the manuscript-level ICC was 0.17 (95% CI, 0.12–0.22). The editors' overall rejection rate was 48%: 88% when all reviewers for a manuscript agreed on rejection (7% of manuscripts) and 20% when all reviewers agreed that the manuscript should not be rejected (48% of manuscripts) (p<0.01). Conclusions/Significance Reviewers at JGIM agreed on recommendations to reject vs. accept/revise at levels barely beyond chance, yet editors placed considerable weight on reviewers' recommendations. Efforts are needed to improve the reliability of the peer-review process while helping editors understand the limitations of reviewers' recommendations.
  • Thumbnail Image
    Item
    Philanthropy, policy, and politics : power and influence of health care nonprofit interest groups on the implementation of health care policy
    (2018-03-29) Qaddoura, Fady A.; Burlingame, Dwight F.; Benjamin, Lehn; Menachemi, Nir; Kennedy, Sheila
    Nonprofit organizations that “speak for, act for, and look after the interests of their constituents when they interact with government are, by any definition of political science, interest groups.” Indiana’s recent implementation of the Healthy Indiana Plan 2.0 (HIP 2.0) under the Affordable Care Act (ACA) opened a window of opportunity to closely examine the role of nonprofits in shaping the implementation of health care policy. Existing literature on health and human service nonprofit organizations did not examine in depth the role and influence of nonprofits as interest groups in the implementation of public policy. This study examines a deeper research question that was not given adequate attention under existing studies with a special focus on the health care policy field: whose interest do nonprofit organizations advance when they attempt to influence the implementation of public policy? To answer this question, it is critical to understand why nonprofits engage in the public policy process (motivation and values), the policy actions that nonprofits make during the implementation of the policy (how?), and the method by which nonprofits address or mitigate conflicts and contradictions between organizational interest and constituents’ interest (whose interest do they advance?). The main contribution of this study is that it sheds light on the implementation of the largest extension of domestic social welfare policy since the “War on Poverty” using Robert Alford’s theory of interest groups to examine the role of nonprofit organizations during the implementation of HIP 2.0 in Indiana. Given the complexity of the policy process, this study utilizes a qualitative methods approach to complement existing quantitative findings. Finally, this study provides a deeper examination of the relationships between nonprofits as actors within a policy field, accounts for the complexity of the policy and political environment, analyzes whether or not dominant interest groups truly advance the interest of their constituents, and provides additional insights into how nonprofits mitigate and prioritize competing interests.
  • Thumbnail Image
    Item
    Telehealth Wound Applications: Barriers, Solutions, and Future Use by Nurse Practitioners
    (Healthcare Information and Management Systems Society (HIMSS), 2018-07) Shelton, Alyssa; Reimer, Nila; School of Nursing
    Telehealth applications are an emerging technology in a new era of health care system technologies. Although telehealth technologies, including a number of different applications, are used by various members of the health care team, nurse practitioners (NPs) utilize them for a variety of patient issues across healthcare settings. The Indiana University-Purdue University Fort Wayne Computer Science Department has recently developed a wound scanning application, WoundView for nurse practitioners to utilize in different healthcare settings. Such telehealth mobile applications are used in clinics, home health, rural, and remote settings where a physician may not be readily available. However, there are obstacles with the current practice of using telehealth technologies such as a dire need for evidence-based research that supports attainable solutions for these barriers. Extensive, ongoing research will allow NPs to anticipate an immense mainstream implementation of telehealth applications in the very near future.