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

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

Journal description

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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Website Journal of Health and Human Services Administration website
Other titles Journal of health and human services administration, JHHSA
ISSN 1079-3739
OCLC 31384814
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 U.S. social safety net is formed by governmental and nonprofit organizations, which are trying to respond to record levels of need. This is especially true for local level organizations, such as food pantries. The organizational capacity literature has not covered front-line, local, mostly volunteer and low resource organizations in the same depth as larger ones. This analysis is a consideration of whether grassroots nonprofit organizations have the ability to be a strong component of the social safety net. Based on the literature on organizational capacity, a model is developed to examine how service delivery at the local level is affected by organizational capacity. Surprisingly, we find few of the characteristics previously identified as important are statistically significant in this study. Even when so, the material effect is negligible. Current organizational capacity research may apply to larger nonprofits, but not to the tens of thousands of small community nonprofits, a significant limitation to the research to date.
    Journal of health and human services administration 01/2014; 37(1):111-45.
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    ABSTRACT: This paper examines the organizational adoption of medically assisted treatments (MAT) for substance use disorders (SUDs) in a representative sample of 555 US for-profit and not-for-profit treatment centers. The study examines organizational adoption of these treatments in an institutionally contested environment that traditionally has valued behavioral treatment, using sociological and resource dependence frameworks. The findings indicate that socialization of leadership, measured by formal clinical education, is related to the adoption of MAT. Funding patterns also affect innovation adoption, with greater adoption associated with higher proportions of earned income from third party fees for services, and less adoption associated with funding from criminal justice sources. These findings may generalize to other social mission-oriented organizations where innovation adoption may be linked to private and public benefit values inherent in the type of socialization of leadership and different patterns of funding support.
    Journal of health and human services administration 01/2014; 37(1):37-75.
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    ABSTRACT: Nationwide from 1996 to 2004, the overall proportion of Emergency Department (ED) reimbursement ratios for outpatient ED visits decreased from 57% to 42%. The continued falling of ED reimbursement ratios, which is the share of ED charges that are ultimately paid, is an indicator of the financial pressures facing the ED. Once the healthcare reforms are put in place what will the impact be on reimbursement rates of overburdened and underfunded emergency departments. The purpose of this study is to examine if there is a declining disparity in payment rates for ED care based on payment sources in a safety net ED provider. Findings of this study could indicate how the healthcare reforms might impact these types of ED reimbursement ratios in the upcoming years. This was a retrospective study that examined randomly selected charts of all ED visits charts from May 2002 to May 2008 at a level one adult and pediatric emergency trauma center with 45,000 annual visits. This study was IRB approved. A regression model was used to predict if there was a relationship between amount received and types of insurance payers within the ED. A significant relationship was found between types of insurance (payers) as the independent variable, and the dependent variables of charges (p = .00), payments (p = .00), amount of adjustments (p= .00), and balance remaining after 90 days (p = .00). Who pays for the ED services does impact the ED's bottom line. The privately funded patients will provide an ED with a higher reimbursement ratio per year as compared to those patients who are publicly or self pay. This explains why EDs that provide care for 40% or more publicly or self pay patients have seen a decline in reimbursement ratios. Healthcare reform has the potential to change and possibly improve safety net ED rate of reimbursement depending on how private, public and self pay patients pay for ED services.
    Journal of health and human services administration 01/2014; 36(4):400-16.
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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 study explores organizational restructuring following the occurrence of a crisis. Restructuring activities following an intervention are considered here to be indicators of an organization's loss of legitimacy because they have lost their independent status, a basic characteristic of nonprofit human settings. The study shows that according to the Resource Based View of organization restructuring--experienced as downsizing, neglecting and abandoning of projects--organizations are affected by (a) government intervention in decision making; (b) higher demands for accountability; and (c) higher evaluations of performance gaps. On the basis of the study of a sample of 138 Nonprofit Human Services in Israel, the results show that the higher the level of restructuring, the higher the level of legitimacy. However, organization location in metropolitan areas moderates the link between restructuring and legitimacy loss. We conclude that Israel's nonprofit human services being overly dependent on goverhment funding are more prone to restructuring and losing legitimacy following organizational crisis.
    Journal of health and human services administration 01/2014; 36(4):460-97.
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    ABSTRACT: This study aims at replicating and extending Xiao and Savage's (2008) research to understand the multidimensional aspect of HMOs distinguished by HMOs' consumer-friendliness, and their relationship to consumers' preventive care utilization. This study develops a dynamic model to consider both concurrent and time lagging effects of HMOs' consumer-friendliness. Our data analysis discloses similar relationship patterns as revealed by Xiao and Savage. Additionally, our findings reveal the time-series changes of the influence of HMOs' consumer-friendliness that either the effects of early experienced HMOs' consumer-friendliness wear out totally or HMOs' consumer-friendly characteristics on the concurrent term contain most of the explanatory power.
    Journal of health and human services administration 01/2014; 37(1):76-110.
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    ABSTRACT: Organizations are configurations of variables that support each other to achieve customer satisfaction. Based on Treacy and Wiersema (1995), we predicted the emergence of two configurations, one supporting a product leadership stance and one predicting the customer intimate approach from a set of 73 for profit health care clinics. In addition, we predicted the emergence of a configuration where the scores on most variables were near the mean for each variable. Using cluster analysis and discriminant function analysis, we identified three configurations: one a "master of two" strategy, one "stuck-in-the-middle," and one showing scores well below the mean on most variables. The implications for organization design and manager actions in the health care industry are discussed.
    Journal of health and human services administration 01/2014; 37(1):4-36.
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    ABSTRACT: The delivery of high-quality service, rendered by health service professionals who interact with customers (patients), increases the likelihood that customers will form positive evaluations of the quality of their service encounters as well as high levels of customer satisfaction. Using linkage theory to develop our conceptual framework, we identify four clusters of variables which contribute to a chain of sequential events that connect organization climate to personal and operational work outcomes. We then examine the perceptual differences of service professionals, grouped by intensity of customer contact, with respect to these variables. National data for this project were obtained from multiple sources made available by the Veterans Healthcare Administration (VHA). Cross-group differences were tested using a series of variance analyses. The results indicate that level of customer-contact intensity plays a significant role in explaining variation in perceptions of support staff, clinical practitioners, and nurses at the multivariate and univariate levels of analysis. Contact intensity appears to be a core determinant of the nature of work performed by health service professionals as well as their psychological responses to organizational and customer-related dynamics. Health service professionals are important resources because of their specialized knowledge, labor expense, and scarcity. Based on findings from our research, managers are advised to survey employees' perceptions of their organizational environment and design practices that respond to the unique viewpoints of each of the professional groups identified in this study. Such tailoring should help executives maximize the value of investments in human resources by underwriting patient satisfaction and financial sustainability.
    Journal of health and human services administration 01/2014; 36(4):417-59.
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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.
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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: 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: 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.
  • Journal of health and human services administration 01/2013; 36(2):252-69.
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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.
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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.