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CHAS e-newsletter provides policy briefs, service innovations, upcoming events and opportunities for health policy and services researchers at the University of Chicago.
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The Center for Health Administration Studies (CHAS) at the University of Chicago, School of Social Service Administration

CHAS eNews: July 2018

School of Social Service Administration


POLICY BRIEFS

Trends in Post-Acute Care Use Among Medicare Beneficiaries: 2000 to 2015

Since Medicare’s adoption of the inpatient prospective payment system in 1983, hospitals have sought ways to reduce costs by decreasing in-hospital lengths-of-stay and increasing use of institutional post–acute care.. Medicaid Working Group (MWG) member and Department of Public Health Sciences faculty member R. Tamara Konetzka, PhD and her research document trends in use of institutional post–acute care as well as lengths-of stay in hospital and post–acute care settings.  Using Medicare beneficiaries data, they demonstrate that use of institutional post–acute care increased between 2000 and 2015 as did length of post–acute care stays through 2014. Additionally, they found pressure to reduce costs by reducing unnecessary readmissions may encourage the use of post-acute care.. These trends did not appear to change when payment reform was implemented under the Affordable Care Act. Further, it is uncertain whether the use of post–acute care benefits patients. Despite its proliferation, there is little evidence that post–acute care improves key patient outcomes—preventing rehospitalizations or improving functional recovery. Further investigation of how post–acute care affects patient outcomes is needed.
 
 

A Study of Low Incidence Reporting Associated With Sexual Victimization of Female Inmates by Prison Staff

Available data suggest that more than 80,000 prisoners each year are sexually victimized during incarceration, but only about 8% report victimization to correctional authorities. Barriers to  reporting exist when the perpetrators are staff members. Given the restrictive and highly regulated prison environment, studies that examine reporting behaviors are difficult to conduct.  To date, they have relied on information from those who have reported or hypothetical victimization studies. CHAS Seed Grant awardee and School of Social Service Administration (SSA) faculty member, Gina Fedock, PhD, MSW, designed a study that used an ecological framework and archival data from a class action lawsuit of sexual misconduct to determine predictors of reporting. The final study model revealed that that 6 predictors (age at time of assault, physical injury, multiple incidents, perpetrator with multiple victims, the year the abuse began, and the number of years women have left on their sentence) account for 58% of the variance in reporting. Disclosure to inmate peers and/or family and friends was significant mode of reporting.. These findings indicate the need for stronger and more systematic implementation of Prison Rape Elimination Act guidelines and remedies that create and enforce sanctions, including termination, for staff violating policy and state law. 
SERVICE DELIVERY INNOVATIONS

The Importance of Obtaining Father Involvement Reports Directly From Fathers

To better understand the role of fathers in child development and the effects of programs targeting fathers and parenting, measures and measurement models capturing relevant elements of father involvement are needed.  CHAS Committee Member and School of Social Service Administration (SSA) Interim Dean, Deborah Gorman-Smith, PhD, and her research team, have sought to better understand the extent and qualities of father involvement among increasingly diverse family configurations and its impact on child development. The nature and quality of father–child interactions has received relatively little attention and has focused on limited aspects of father involvement such as extent of contact and child support..  In addition, many studies have relied only on mothers’ reports of father involvement.  Dr. Gorman-Smith confirmed with this study that when a mother rates her relationship with the father more highly, she expresses more consistency in her ratings his responsibility toward their children, and his engagement with them. Mothers’ reports on relationship quality do not predict differences in ratings of fathers’ accessibility. The results reinforce an important consideration when measuring father involvement: A mother’s perception of the relationship may matter in her assessment of father involvement. Conversely, it is possible that if mothers perceive that fathers are not doing as much with the children, they may hold more negative views of the relationship. Therefore, it is important that future research examine the mother’s expectations for the father’s involvement and whether she perceives low levels of involvement as problematic.  
 
ANNOUNCEMENTS



CHAS Hosts 2nd Health Policy Workshop in Paris, France

The second University of Chicago-Sciences Po Health Policy and Innovation Reform Workshop was held June 14-15, 2018 at the University of Chicago Paris Center.  The workshop series was organized to bring together leading health policy researchers and scholars from the U.S. and France to share their most recent work in a deliberately comparative and collaborative context toward the goal of knowledge growth and policy innovation. Topics addressed in this year’s Workshop included science-based policy innovation and reform; improving access through health insurance innovation; improving access through service innovation; improving quality through prevention; improving quality through social investment; improving quality through regulation. Participants included health policy researchers from French universities and from the University of Chicago.  Chicago faculty included Mark Courtney, Deborah Gorman-Smith, Colleen Grogan, Jeanne C. Marsh, and Harold Pollack.  The Workshop was sponsored by CHAS and the University of Chicago France Center. To view photos from the workshop and find details on participants and their research, please refer to the CHAS website.
UPCOMING EVENTS

MICHAEL M. DAVIS LECTURE SERIES

The Michael M. Davis Lecture Series will resume for Autumn Quarter on October 9, 2018.
CONFERENCE REMINDERS
APPAM Fall Research Conference
Washington, DC, 2018
November 

American Public Health Association
San Diego, CA
November 10-14, 2018

Association for Research on Nonprofit Organizations and Voluntary Action*
Austin, TX
November 15-17, 2018

Annual Conference on the Science of Dissemination and Implementation in Health
Washington, DC
December 3-5, 2018

SSWR 23rd Annual Conference 
San Francisco, CA 
January 16-20, 2019

Unite for Sight's Global Health & Innovation Conference*
New Haven, CT
April 13-14, 2019

* currently accepting abstracts or applications for involvement
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