
Stephanie BernellOregon State University | OSU · Department of Public Health (PH)
Stephanie Bernell
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32
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Publications (32)
The objective of this study is to explore the extent to which managed care market penetration in the United States is associated with the presence of chronic disease. Diabetes was selected as the chronic disease of interest due to its increasing prevalence as well as the disease management protocols that can lessen disease complications. We hypothe...
By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary's portfolio of card...
The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state publi...
To control Medicaid costs, improve quality, and drive community engagement, the Oregon Health Authority introduced a new system of coordinated care organizations (CCOs). While CCOs resemble traditional Medicaid managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorpo...
Problem Statement: Diabetes mellitus affects 26 million Americans, and costs the nation an average of $174 billion per year. A previous study (Howard et al, 2014) showed rural Medicare beneficiaries were less likely to have diabetes. However, rural diabetic beneficiaries were three times more likely to have comorbidities. Using Medical Expenditure...
Background: By March 2013, 28% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research has yet to explore the impacts of MA market penetration on individual or population health outcomes. The primary objective is to examine the relationships between MA market penetration and the beneficiary’s portfolio of cardiometabo...
Background: Diabetes mellitus affects more than 1 in 4 Americans over the age of 65, and accounts for 32 percent of total Medicare spending. This study advances our understanding of the relationships between Medicare Advantage (MA) market penetration and: (1) prevalence of diabetes or other diabetes-related cardiometabolic diagnoses, (2) prevalence...
Continuing its path of Medicaid program innovation, Oregon recently embarked on a major reform that gives regional Coordinated Care Organizations (CCOs) global budgets and accountability for the physical, behavioral and dental care of the state's Medicaid beneficiaries (Howard et al. 2014). There are some who maintain that the state's bold reform i...
Abstract In this pilot project we examined factors contributing to maternal nutrition among women of child-bearing age in the Western Region of Nepal. We found that rural women are interested in learning about nutrition regardless of educational attainment, and that level of education is strongly associated with interest in learning about nutrition...
The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physica...
Objective:
To test the degree to which adverse physical health events may subsequently increase the utilization of mental health services.
Methods:
A quasi-experimental pretest-posttest design was employed on a nationally representative sample of adults from the Medical Expenditure Panel Surveys for years 2004 and 2005. We constructed a 2-year b...
Background: The recent economic downturn has affected funding sources for HIV behavioral prevention in the US. We examine how funding reductions impact the ability of public health departments (HD) and community-based organizations (CBO) to translate evidence-based interventions, particularly HIV behavioral prevention programs.
Methods: Two appro...
The purpose of this study is to estimate the environmentally attributable costs associated with diseases and disabilities in Oregon. We utilised actual Oregon data on disease rates and costs whenever available. If state-specific data were not available, we extrapolated from national estimates. We then used environmentally attributable fractions to...
This study investigates the degree to which the racial composition of the school environment may influence the body mass index (BMI) of children aged 10 to 18 years. This research may be viewed as extending prior work that has found that the prevalence of risk behaviors among nonwhite adolescents is influenced by exposure to white adolescents.
This...
Results from the 2003-2004 National Health and Nutrition Examination Survey (NHANES) indicate that an estimated 66 percent of U.S. adults are either overweight or obese (CDC, 2006). In spite of the magnitude of the problem, there remains a critical gap in the knowledge base concerning the public policy contributors to obesity. Specifically, the con...
This paper provides a welfare assessment of the new Taiwan National Health Insurance (NHI) co-payment policy, enacted July 15, 2005. This policy creates a pricing mechanism designed to entice patients to first seek outpatient care at local clinics rather than hospitals. Our empirical findings suggest that while the new policy results in a net welfa...
We empirically examine the relationship between obesity and urban development patterns where individuals reside. Previous analyses treat urban form as exogenous to weight, and find higher body mass indices (BMI) among residents of areas with sprawl patterns of development. Using samples of recent movers, we find that the causality runs in both dire...
An existing measure of food insecurity with hunger in the United States may serve as an effective indicator of quality of
life. State level differences in that measure can reveal important differences in quality of life across places. In this study,
we advocate and demonstrate two simple methods by which analysts can explore state-specific contribu...
This study examines the extent to which household demographics, local economic and social conditions, and federal food security programs explain the likelihood of household food insecurity in Oregon. Between 1999 and 2001, Oregon had the highest average rate of hunger in the nation and ranked in the top five states with respect to food insecurity....
Team level tacit knowledge is related to the collective knowledge of the team members. It is the shared experience that results in the ability to successfully anticipate the reactions of teammates in typical and nontypical situations. This study evaluates how tacit knowledge and related team characteristics influence the performance of cardiothorac...
Lack of inpatient bed availability has been identified as a major contributor to emergency department (ED) crowding. Our objective is to determine the changes in ED length of stay and ambulance diversion occurring in an urban, academic medical center after an increase in adult ICU beds.
This was a secondary analysis of 2 years of hospital administr...
This study jointly analyzes the determinants of the use of highly active antiretroviral therapy (HAART) along with the determinants of employment status for human immunodeficiency virus (HIV)-positive individuals.
Data from the HIV Cost and Services Utilization Study (HCSUS) were analyzed using a bivariate probit model. HSCUS collected data on 2864...
We analyze an urban spatial model to examine the possible link between urban land use and obesity. Households maximize utility defined over housing, weight, and food subject to a fixed time budget allocated to commuting, calorie expenditure, and work. Our model explains the observed correspondence between high obesity rates and low development dens...
The contribution of disability to labor market behavior is a subject of considerable attention. Notwithstanding this tremendous interest, a great deal of variation exists in the use of terms such as health, impairment, and disability. Consequently, comparing results across studies is often difficult, and the impact empirical research can have on po...
In the U.S., urban sprawl and the rise in obesity rates have been two powerful trends during the latter half of the 20th century. Previous empirical work has found that obesity rates are influenced by labor market outcomes that are fundamentally shaped by the spatial pattern of developed land. We examine these potential linkages in an urban spatial...