Publications by authors named "Jane Nelson Bolin"

9 Publications

  • Page 1 of 1

Rural Healthy People 2010, 2020, and beyond: the need goes on.

Fam Community Health 2011 Apr-Jun;34(2):182-8

Blue Cross and Blue Shield of Florida Center for Rural Health Research and Policy, Florida State University College of Medicine, Tallahassee, FL 32306-4300, USA.

Rural Healthy People 2010 represented the first effort to specifically include small and rural communities in the Healthy People movement to improve the health of Americans. Rural Healthy People 2010 set rural-specific health priority areas, documented what is known about health in rural areas, identified rural best practice programs/interventions, and promoted rural health services research and researchers. Over the last decade Rural Healthy People 2010 has provided policy makers, rural providers, and rural communities with a valuable resource for planning and policy making. Sustaining the Rural Healthy People project in collaboration with the broader Healthy People 2020 effort will provide an important infrastructure for improving rural health.
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http://dx.doi.org/10.1097/FCH.0b013e31820dea1cDOI Listing
July 2011

How well are we doing addressing disability in America? Examining the status of adults with chronic disabling conditions, 1995 and 2005.

J Health Hum Serv Adm 2007 ;30(3):306-26

Texas A&M Health Sciences Center, USA.

Despite laws like the Americans with Disabilities Act (ADA), (1992), and The Ticket to Work Act, (TTWA), (2001), working age adults who develop chronic disabling conditions often find themselves faced with a choice of leaving the labor market in order to qualify for public health insurance or continuing to work, often on a "hit and miss" basis, disqualifying them from employee health benefits. Federal and state policy makers continue to struggle to find solutions addressing the needs of working age adults with disabling conditions and illnesses. In this study we examine the work status of working age adults using two National Health Interview Surveys conducted a decade apart (1995 & 2005) to investigate and compare adults who have chronic, disabling conditions and self-reported rates of work. Specifically, this research investigates whether reported work activity among working age adults who report chronic health conditions has improved in the decade between 1995 and 2005. The effects of racial/ethnic differences, age, and region of residence on one's work status are also examined.
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March 2008

Strategies for incorporating professional ethics education in graduate medical programs.

Am J Bioeth 2006 Jul-Aug;6(4):35-6

Texas A&M University System Health Science Center.

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http://dx.doi.org/10.1080/15265160600755557DOI Listing
September 2006

Differences between newly admitted nursing home residents in rural and nonrural areas in a national sample.

Gerontologist 2006 Feb;46(1):33-41

Department of Health Policy and Management, School of Rural Public Health, The Texas A&M University System Health Sciences Center, College Station, TX 77843-1266, USA.

Purpose: Previous research in specific locales indicates that individuals admitted to rural nursing homes have lower care needs than individuals admitted to nursing homes in urban areas, and that rural nursing homes differ in their mix of short-stay and chronic-care residents. This research investigates whether differences in acuity are a function of differences in resident payer status and occur for both individuals admitted for short stays, with Medicare as payer, and those needing chronic care.

Design And Methods: We used a representative 10% sample of national resident assessments (Minimum Data Set) for calendar year 2000 (N = 197,589). We conducted statistical analyses (means, percentages, and logistic regression) to investigate differences in Medicare and non-Medicare admissions to facilities in metropolitan and nonmetropolitan areas.

Results: Non-Medicare residents admitted to rural nursing facilities have lower acuity scores than non-Medicare residents admitted to metropolitan nursing homes. However, individuals admitted under Medicare were similar in rural and urban areas.

Implications: Differences in resident acuity at admission among facilities in different locales were largely a function of lower acuity levels for individuals admitted to rural nursing homes for long-term or chronic care, although differences in Medicare census also played some role in facility-level differences in acuity. Other factors must be explored to determine why this lower acuity occurs and whether higher use of rural nursing homes by less impaired older persons meets their needs and preferences and represents good public policy.
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http://dx.doi.org/10.1093/geront/46.1.33DOI Listing
February 2006

Urban and rural differences in end-of-life pain and treatment status on admission to a nursing facility.

Am J Hosp Palliat Care 2006 Jan-Feb;23(1):51-7

Department of Health Policy and Management, Texas A & M University School of Rural Public Health, Bryan, Texas, USA.

Individuals receiving end-of-life (EOL) care may have needs that are unrecognized or treated inappropriately. Yet, very little is known about differences in pain and special-care needs of EOL patients admitted to rural nursing facilities compared with urban nursing facilities, and whether the differing payer mix in urban and rural facilities affects the treatment ordered on admission. We examine a nationally representative sample of 6084 EOL patients upon admission to nursing homes to examine differences in diseases, pain assessments, and treatment orders. We found that rural EOL residents have higher rates of congestive heart failure, cancer, renal failure, and emphysema than urban EOL residents and are significantly more likely to report frequent pain, however, they are less likely to receive treatments such as IV medications, dialysis, and wound care.
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http://dx.doi.org/10.1177/104990910602300109DOI Listing
March 2006

Opportunities for administrators to promote disease management.

J Healthc Manag 2005 Sep-Oct;50(5):297-309; discussion 309-10

School of Rural Public Health, Texas A&M University System Health Science Center, College Station, Texas, USA.

Studies of disease management (DM) have shown that patients who participate in such programs achieve better health status and make fewer emergency room visits. Private and government payers have recently increased their efforts to promote DM initiatives through financial incentives to healthcare providers. This article explores opportunities for administrators of health services organizations (HSO) to promote DM in the current political and economic environment. Our survey of professionals (DM leaders, physicians, and DM nurses) in six DM programs reveals these professionals' assessments of the key players and resources that they deem important to their respective DM programs. They view DM programs as heavily dependent on the support of physicians, nurses, and health plan leaders but relatively less so on the support of HSO administrators- a situation that may suggest opportunities for administrators to take on greater leadership in moving the HSO toward developing DM programs. Survey results also indicate a strong need for the integration of resources such as communication systems, electronic medical records, and DM reporting. Taken collectively, these needs suggest a number of strategies for the administrator to play a larger role in supporting the adoption and effective implementation of DM. In the article, we propose that DM programs can benefit substantially from an administrator who can demonstrate a thorough knowledge of DM-related government and private-payer initiatives and who has the ability to provide leadership to develop and implement viable DM programs. Valued contributions that the administrator should bring to the table include support of standardized DM processes, use of practice guidelines, and provision of pertinent information systems.
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December 2005

Organizational technologies of chronic disease management programs in large rural multispecialty group practice systems.

J Ambul Care Manage 2005 Jul-Sep;28(3):210-21

Department of Health Policy and Management, School of Rural Public Health, Health Science Center, Texas A&M University System, College Station, USA.

Four large rural multispecialty group practice systems employ a mix of organizational technologies to provide chronic disease management with measurable impacts on their patient populations and costs. Four technologies-administrative, clinical, information, and social-are proposed as key dimensions for examining disease management programs. The benefits of disease management are recognized by these systems despite marked variability in the organization of the programs. Committees spanning health plans and clinics in the 4 systems and electronic medical records and/or other disease management information systems are important coordinating mechanisms. Increased reliance on nurses for patient education and care coordination in all 4 systems reflects significant extension of clinical and social technologies in the management of patient care. The promise of disease management as offered by these systems and other auspices are considered.
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http://dx.doi.org/10.1097/00004479-200507000-00004DOI Listing
October 2005

Avoiding charges of fraud and abuse: developing and implementing an effective compliance program.

J Nurs Adm 2004 Dec;34(12):546-50

Department of Health Policy and Management, Texas A&M University Health Sciences Center, School of Rural Public Health, College Station 77843-1266, USA.

During the last decade the federal government has made investigation of healthcare fraud and abuse a priority. Increasingly, nurses and skilled nursing organizations have been at the center of fraud and abuse cases. The authors examine data of sanctioned nurses obtained from the Office of the Inspector General. Nurses are most frequently sanctioned for license violations, drug convictions, and patient neglect.
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http://dx.doi.org/10.1097/00005110-200412000-00003DOI Listing
December 2004

State regulation of private health insurance: prescription drug benefits, experimental treatments, and consumer protection.

Am J Manag Care 2002 Nov;8(11):977-85

Department of Health Policy and Management, School of Rural Public Health, The Texas A&M University System Health Sciences Center, College Station, 77843-1266, USA.

This study analyzes the results of 2 surveys sent to state insurance commissioners that focused on policies regulating conventional health insurance and managed care organizations (MCOs) during 2000. Surveys were returned by 49 states and the District of Columbia. Several states have implemented regulations mandating prescription drug coverage. In addition, some states now require health insurers and MCOs to cover the medical care associated with experimental medications and treatments. Some states have also created laws allowing beneficiaries to sue their health insurer or MCO for damages caused by denial of care. These state policies provide a rich source of data for federal policy makers to analyze as they consider new patient protection legislation and amendments to the Employee Retirement Income Security Act.
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November 2002