Journal of health and human services administration (J Health Hum Serv Admin )

Publisher: Southern Public Administration Education Foundation (U.S.)


The Journal of Health and Human Services Administration (JHHSA) began publication in 1978 as the Journal of Health and Human Resources Administration. It is, and has remained, a blind-refereed journal dedicated to publishing articles, symposia and book reviews in all areas of health, hospital and welfare administration and management.

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    Journal of Health and Human Services Administration website
  • Other titles
    Journal of health and human services administration, JHHSA
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  • Material type
    Conference publication, Periodical
  • Document type
    Journal / Magazine / Newspaper

Publications in this journal

  • [show abstract] [hide abstract]
    ABSTRACT: Home-based caregiving in Africa was examined in the context of the work of the Home-Based Care Alliance, first launched in 2005 to provide support and advocacy for approximately 30,000 caregivers. A review of ten countries in Africa shows that caregivers were either not included, or only selectively included in government programs. With respect to caregiver advocacy, additional resources, recognition and increased involvement in decision-making were the primary identified concerns. Increased health systems capacity for AIDS management, new regulation, innovative collaborations, decentralization, task-shifting, and caregiver burnout are among the trends identified in the broader policy environment impacting caregivers.
    Journal of health and human services administration 01/2014; 36(3):367-91.
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    ABSTRACT: The purpose of this study is to determine the relationship across race/ethnicity relative to reported subjective physical symptoms and clinically assessed medical conditions among the aging minority population using the Health and Retirement Study data for years 1998-2000. Poisson and negative binomial regressions were used to estimate three count dependent variables: physical symptom, chronic, and life-threatening medical conditions. Results indicate that while Black respondents were 18% more likely to report physical symptoms when compared to White respondents (B = .171, p < .01, e(.171) = 1.18) and 1.06 times more likely to report life-threatening medical conditions (B = .058, p < .01, e(.058) = 1.06), when SES variables were added being Black was no longer significantly associated with physical symptoms and chronic conditions. However, being Black did remain statistically significant and positively associated with life-threatening conditions, even after controlling for SES. Results bear statistical and clinical significance, given that we are examining racial and ethnic groups. First, Blacks are at higher risk for premature death for a variety of reasons; this has implications on financial expenditures and on the quality of life. Second, growth among the Hispanic population is outpacing both White and Black populations. Policy initiatives, including geriatric health education, partnerships with community and grass-roots leaders will promote awareness.
    Journal of health and human services administration 01/2014; 36(3):323-66.
  • Journal of health and human services administration 01/2014;
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    ABSTRACT: The study introduces the "Conflict-Choice model" (C-C) as an analytic framework for studying consumer demand for health and healthcare. The proposed approach integrates the Theory of Consumer Behavior (TCB), the Investment Theory of Demand (ITD), and the Health Belief Model (HBM) into a single model that might be applied to a wide spectrum of health behavior and use of health services. Separating the episode of care into the two phases (patient initiated and physician dominated), the C-C model is limited to the individual's decision to seek service. This phase is dominated by two conflicting and undesirable outcomes that the patient seeks to avoid. The first is discomfort or disutility that accompanies the use of care. The second is the discomfort of illness and a reduced ability to perform social and economic roles, an outcome that may result in a potential decline in income. In this conflict-choice situation, the interrelation between two undesirable conditions and related avoidance gradients result in a behavioral equilibrium. The study applied this framework to the use or non-use of HIV tests. The analysis used the responses of 196,081 individuals in the Behavioral Risk Factor Surveillance System (BRFSS) of 2003. The analyses supported the expectations based on the newly developed conflict-choice theoretical framework and support the adoption of policies that reduce the tendency to avoid care while increasing the avoidance of undesirable health outcomes.
    Journal of health and human services administration 01/2014; 36(3):274-96.
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    ABSTRACT: Understanding practice behaviors of solo/dual physician ownership and associated factors at the national level is important information for policymakers and clinicians in response to the Affordable Care Act (ACA) of 2010, but poorly understood in the literature. We analyzed nationally representative data (n = 4,720). The study results reveal nearly 33% of the sample reported solo/two-physician practices. Male/minority/older physicians, psychiatrists, favor small practices. Greater market competition was perceived and less charity care was given among solo/two-physician practitioners. The South region was favored by small physician practitioners. Physicians in solo or two-person practices provided fewer services to chronic patients and were dissatisfied with their overall career in medicine. Small practices were favored by international medical graduates (IMGs) and primary care physicians (PCPs). Overall our data suggest that the role of solo/dual physician practices is fading away in the delivery of medicine. Our findings shed light on varied characteristics and practice behaviors of solo/two-physician practitioners, but more research may be needed to reevaluate the potential role of small physician practitioners and find a way to foster a private physician practice model in the context of the newly passed ACA of 2010.
    Journal of health and human services administration 01/2014; 36(3):297-322.
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    ABSTRACT: The purpose of this research was to obtain information about general and pandemic preparedness efforts of residents within San Patricio County in South Texas, as well as to identify the most effective means of communicating the risks posed by pandemic influenza. The population of San Patricio County is socially vulnerable to a variety of disasters, including influenza pandemics due to the unique demographic profile of the county as well as its location on the Gulf Coast. The goals of this study were to help with pandemic planning efforts and to provide recommendations that could serve as a foundation for building more resilient communities within San Patricio County. Clearly the various governmental levels must work together to assist communities prepare for pandemic preparedness but broad, inclusive community participation is also necessary to strengthen community resilience.
    Journal of health and human services administration 01/2013; 36(2):164-207.
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    ABSTRACT: Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain mechanism to ensure availability of the right materials at the right time at a reasonable cost. Thus innovations like HRF will prove robust in rendering quality healthcare at an affordable cost.
    Journal of health and human services administration 01/2013; 36(1):3-23.
  • Journal of health and human services administration 01/2013; 36(2):252-69.
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    ABSTRACT: Persistent toxic pollutants such as polychlorinated biphenyls and mercury accumulate in tissues of fish that are caught and consumed by sport anglers and their families. Unlike commercially-sold fish, the U.S. Food and Drug Administration (FDA) does not regulate sport-caught fish that are contaminated with these and other pollutants. Instead, nearly every state in the U.S. develops and issues consumption advice for contaminated sport-caught fish. We examined fish consumption advice issued by states that border and share waters of the Mississippi River. Our examination identified numerous jurisdictional inconsistencies that threaten the receptivity and credibility of consumption advice and, more important, threaten the health of individuals who consume contaminated sport-caught fish.
    Journal of health and human services administration 01/2013; 36(2):208-27.
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    ABSTRACT: This paper describes how grounded theory was used to investigate the "black box" of network leadership in the creation of the National Quality Forum. Scholars are beginning to recognize the importance of network organizations and are in the embryonic stages of collecting and analyzing data about network leadership processes. Grounded theory, with its focus on deriving theory from empirical data, offers researchers a distinctive way of studying little-known phenomena and is therefore well suited to exploring network leadership processes. Specifically, this paper provides an overview of grounded theory, a discussion of the appropriateness of grounded theory to investigating network phenomena, a description of how the research was conducted, and a discussion of the limitations and lessons learned from using this approach.
    Journal of health and human services administration 01/2013; 35(4):469-504.
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    ABSTRACT: Charitable contributions are becoming increasingly important to nonprofit hospitals, yet fundraising can sometimes be one of the more troublesome aspects of management for nonprofit organizations. This study utilizes an organizational effectiveness and performance framework to identify groups of nonprofit organizations as a method of classifying organizations for performance evaluation and benchmarking that may be more informative than commonly used characteristics such as organizational age and size. Cluster analysis, ANOVA and chi-square analysis are used to study 401 organizations, which includes hospital foundations as well as nonprofit hospitals directly engaged in fundraising. Three distinct clusters of organizations are identified based on performance measures of productivity, efficiency, and complexity. A general profile is developed for each cluster based upon the cluster analysis variables and subsequent analysis of variance on measures of structure, maturity, and legitimacy as well as selected institutional characteristics. This is one of only a few studies to examine fundraising performance in hospitals and hospital foundations, and is the first to utilize data from an industry survey conducted by the leading general professional association for healthcare philanthropy. It has methodological implications for the study of fundraising as well as practical implications for the strategic management of fundraising for nonprofit hospital and hospital foundations.
    Journal of health and human services administration 01/2013; 36(1):24-60.
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    ABSTRACT: Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has particularly been the case in issue areas like public health policy where diseases are detected and treated at the local level. While past studies on collaborative federalism and health care policy have focused on federal systems that are largely democratic, little research has been conducted to examine the extent of collaboration in authoritarian structures. This article applies the collaborative federalism approach to the Islamic Republic of Pakistan and the Bolivarian Republic of Venezuela. Evidence suggests that while both nations have exhibited authoritarian governing structures, there have been discernible policy areas where collaborative federalism is embraced to facilitate the implementation process. Further, while not an innate aspect of their federal structures, Pakistan and Venezuela can potentially expand their use of the collaborative approach to successfully implement health care policy and the epidemiological surveillance and intervention functions. Yet, as argued, this would necessitate further development of their structures on a sustained basis to create an environment conducive for collaborative federalism to flourish, and possibly expand to other policy areas as well.
    Journal of health and human services administration 01/2013; 36(2):124-63.
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    ABSTRACT: This study aimed to better understand the varied factors that contribute to social worker subjective well-being (SWB) (the social science concept for happiness). Using qualitative methods of inquiry 19 social workers who reported having low to medium levels of workplace and profession satisfaction were interviewed to assess those factors within their lives that they perceived as impacting their well-being. One thematic category from the analysis was aspects of the intraorganizational context of workplaces that can impact social worker SWB. Respondents identified interpersonal workplace relationships, decision-making processes, management/supervisory dynamics, workload and workplace expectations, access to resources and infrastructure support, and inter-organizational relationships as key intra-organizational factors contributing to their overall wellbeing. In conclusion, these findings have practical application within organizations for structured policies and unstructured practices to improve social worker subjective well-being.
    Journal of health and human services administration 01/2013; 36(1):61-105.
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    ABSTRACT: Throughout the last several decades, there has been a chronic shortage of foster and adoptive families in the United States. Recruiting families to begin the licensure process to become foster and adoptive parents is already a difficult undertaking. But research shows that a very large proportion of families drop out of the licensure process early on due to frustration or a lack of support. This paper studies two faith-based partnerships that have arisen to create new capacity in the child welfare system. These programs recruit prospective families from churches and then provide training and ongoing support to those families throughout the licensure process. Using survey data collected from program participants, respondent perceptions of the licensure process are compared to a nationally representative sample of foster parents from the National Foster Care Adoptions Attitude Survey. Statistical results demonstrate that participants with the faith-based programs reported much higher levels of satisfaction with the process than the national sample. These findings provide evidence that these faith-based partnerships may provide an important additional source of capacity for an overburdened child welfare system.
    Journal of health and human services administration 01/2013; 36(2):228-51.
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    ABSTRACT: State, county, and local governments are currently facing a myriad of economic issues, based on shrinking tax revenues combined with increased expenditures. Of these, the costs related to defined benefit pension plans are one of the most serious issues facing many public employers. Through a comprehensive review of the existing literature, this article examines how the shift from the defined benefit (DB) to defined contribution (DC) pension plan has the potential to enhance levels of labor unrest due to changes in union militancy, bargaining skills deficits, intra-organizational conflict, and issues related to economic trade-offs. Besides the capacity for immediate and deleterious ramifications in the collective bargaining process, the transition to the DC pension also presents some potentially negative consequences related to human resource management, including changes in the psychological contract, recruitment strategies, employee turnover, and changes in retirement patterns. Recommendations to improve labor relations and human resource management practices in the DC pension environment are also explored.
    Journal of health and human services administration 01/2013; 35(4):414-68.
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    ABSTRACT: Though still a relatively nascent public function, emergency medical services (EMS) agencies have come to constitute a core local government service. The potentially life-saving interventional and palliative treatments provided by EMS personnel are inarguably vital for positive short- and long-term patient outcomes, yet our understanding of the behavior of these individuals during service interactions is limited. This exploratory research begins to narrow this gap in our understanding of street-level bureaucrats in EMS organizations by analyzing semi-structured interviews of paramedics recounting uncertain and complex accounts of street-level patient processing. Results indicate that factors such as paramedic communication skills, influential bystanders with key incident information, and patient identity serve to shape street-level interactions with patients.
    Journal of health and human services administration 01/2013; 35(4):505-42.
  • Journal of health and human services administration 01/2013; 36(2):109-23.
  • Journal of health and human services administration 01/2012; 34(4).
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    ABSTRACT: Vaccines are valuable, cost-effective tools for preventing disease and improving community health. Despite the importance and ubiquity of vaccinations, childhood immunization coverage rates vary widely by geography, race, and ethnicity. These differences have been documented for nearly two decades, but their sources are poorly understood. Between 2005 and 2008, immunization staff of the National Association of County & City Health Officials (NACCHO) visited 17 local health department (LHD) immunization programs in 10 states to assess their immunization service delivery (ISD) practices and their impact on community childhood immunization coverage rates. To qualitatively characterize LHD immunization programs and specific organizational factors underlying ISD performance challenges and successes related to community childhood immunization coverage rates. Case studies were conducted in a convenience sample of 17 geographically and demographically diverse LHDs, predicated on each LHD's childhood immunization coverage rates per data from the National Immunization Survey and/or Kindergarten Retrospective Survey. NACCHO staff selected LHDs with high (> or = 80% up to date [UTD]), moderate (> or = 75% UTD but < 80% UTD), and low (< 75% UTD) coverage rates. All immunization staff members interviewed (n = 112) were included in focus group interviews at each LHD per a standard semi-structured interview script developed by NACCHO staff. Supporting documents from each LHD immunization program were also collected for inclusion in the analysis. Content and thematic analyses of interview transcripts and supporting documents were conducted. Two thematic dimensions and six key factors emerged from the data. The dimensions of the themes were success and challenge elements. The organizational factors that were associated with success and/or challenges with regard to improving childhood immunization coverage rates included 1) leadership: organizational leadership and management related to aligning ISD with other child-focused services within the LHD; 2) resources: organizational efforts focused on aligning federal and state ISD financing with local ISD needs; 3) politics: political advocacy and partnering with local community stakeholders, including local political entities and boards of health to better organize ISD; 4) community engagement/coalitions and partnerships: partnerships, coalitions, and community engagement to support local immunization-related decision-making and prioritization; 5) credibility: agency credibility and its ability to influence community attitudes and perspectives on the health department's value in terms of child health; and 6) cultural competency of LHD staff: LHD staff members' perceptions and understandings of its community's cultural, economic, and demographic attributes shaped their responses to and understandings of the community and how they interacted with it in terms of service delivery. Public health researchers are in a nascent stage of understanding how health department organizational factors may contribute to specific community health outcomes, such as childhood immunization coverage rates. An implicit challenge to LHD immunization programs is to implement strategies that lead to equitable and high vaccination coverage among children, despite shrinking resources and community demographic differences. Community-specific attributes (e.g., poverty, lack of health insurance, or geographic isolation) affect childhood immunization coverage rates, but internal LHD aspects such as leadership and organizational culture also likely have a significant impact.
    Journal of health and human services administration 01/2012; 34(4):418-55.
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    ABSTRACT: Unlike scientists, politicians and the public rarely remain sharply focused on any domestic issue for very long. Without a front page story, a chief executive at the bully pulpit, or an outraged minority, public attitudes and behaviors about most key domestic problems are short-lived. Anthony Downs has suggested that public policies follow an issue-attention cycle. Our research on the ups and downs of the stem cell debate confirms that public attention wanes when the issue moves off the front page. Public opinion surveys linked with content analysis of national newspapers over a 10 year period confirm that while the scientific community continues to look for a cure, the public no longer expects an instant fix. As public interest in the issue has declined, media coverage is now more about science and less about controversy.
    Journal of health and human services administration 01/2012; 35(3):331-51.

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