Research Methods: Survey Research

Maine Pediatric and Family Practice Survey Chartbook

Abstract: 

In February 2010, Maine and Vermont were awarded a five-year demonstration grant from the Centers for Medicare and Medicaid Services to improve care quality for children who are insured by Medicaid and the Children’s Health Insurance Program (CHIP). In Maine, Improving Health Outcomes for Children (IHOC) is a public/private collaboration of health systems, pediatric and family practices, associations, state programs and consumers that is intended to 1) select and promote a set of child health quality measures; 2) build a health in­formation technology infrastructure to support the reporting and use of quality information; and 3) transform the delivery of health services for children using a patient centered medical home model.

As part of the IHOC initiative, the University of Southern Maine surveyed pediatric and family practices about how they use data, clinical guidelines and office systems to monitor and improve children’s healthcare quality. The purpose of the survey is to provide baseline information about quality improvement activities in primary care practices serving children in Maine. Survey data was used to inform IHOC activities and to monitor changes over time. The web-based survey was conducted in the winter of 2011-2012 and sent to practice man­agers at a sample of 168 practice sites, of which 64% responded. Responding practices represent more than one-quarter of family practices and nearly two thirds of all pediatric practices in the state. Together these prac­tices served more than half (57%) of all children insured by MaineCare, or nearly 68,000 MaineCare children. Respondents represent a broad distribution of practices across regions of the state and practice size and own­ership, and include nearly two-thirds of practices participating in IHOC’s First STEPS learning collaborative.

This report summarizes the results of the initial survey and assesses quality improvement activities in pediatric and family practices at baseline. In 2014, a follow-up survey will be conducted to assess how quality improve­ment has changed in child-serving practices statewide over time and within specific types of practices (e.g. those participating in First STEPS).

Key issues from the baseline survey results include the following:

  • Medical Home Recognition and Practice-Level Quality Improvement
  • Data Systems Used to Track and Monitor Care
  • Use of Electronic Health Records for Quality Improvement
  • Awareness and Use of Financial Incentives and Data for Quality Improvement from Payers

A follow-up survey was fielded during the final year of the initiative in 2014.The practice survey was designed to assess changes in knowledge and awareness of: child health quality measures; evidence-based clinical guidelines; recommended preventive screening tools; office systems and procedures; and the degree to which Maine practices use standardized protocols to monitor and improve children’s healthcare quality. Results of that survey can be viewed or downloaded here: Child Health Quality in Maine: Practice Survey Report 2011-2014

Publication Type: 
Report
Publish Date: 
January 29, 2011
URL: 
http://www.maine.gov/dhhs/oms/pdfs_doc/children_IHOC/Provider%20Survey%20final.pdf

Gender-Responsive Policy Development in Corrections: What We Know and Roadmaps for Change

Abstract: 

Erica King, research staff at the Muskie School, co-authored this policy bulletin for the US Department of Justice National Institute of Corrections with Jillian Foley, a recent Muskie School graduate.

Lack of gender-informed policy creates challenges for correctional practitioners. When there is a gap between training that is evidence-based and gender-informed and what is written in policy, staff may find themselves hindered in their attempts to work toward establishing a gender-responsive environment. This policy bulletin, released in February 2015 and based on survey data and focus groups with women, is an initial step to determine the existence of gender-informed policy within correctional agencies. The findings of this bulletin provide an overview of the current state of gender-responsive policies for women and define a focus for future research, training and technical assistance in the effort to create a more effective, and efficient correctional approach for women offenders.

Suggested Citation: King E, Foley J. Gender-Responsive Policy Development in Corrections: What We Know and Roadmaps for Change. Washington, DC: U.S. Department of Justice, National Institute of Corrections; October, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
October 1, 2014
Author: 
URL: 
https://s3.amazonaws.com/static.nicic.gov/Library/029747.pdf

Rural Health Clinic Readiness for PCMH Recognition

Abstract: 

The patient-centered medical home (PCMH) model reaffirms traditional primary care values including continuity of care, connection with an identified personal clinician, provision of same day- and after-hours access, and positions providers to participate in accountable care and other financing and delivery system models. However, little is known about the readiness of the over 4,000 Rural Health Clinics (RHCs) to meet the PCMH Recognition standards established by the National Council for Quality Assurance (NCQA). Researchers at the Maine Rural Health Research Center (University of Southern Maine) present findings from a survey of RHCs that examined their capacity to meet the NCQA PCMH requirements, and discuss the implications of the findings for efforts to support RHC capacity development.

Key Findings

  • Based on their performance on the “must pass” elements and related key factors, Rural Health Clinics (RHCs) are likely to have difficulties gaining National Center for Quality Assurance’s (NCQA) Patient-Centered Medical Home (PCMH) Recognition.
  • RHCs perform best on standards related to recording demographic information and managing clinical activities, particularly for those using an electronic health record.
  • RHCs perform less well on improving access to and continuity of services, supporting patient self-management skills and shared decision-making, implementing continuous quality improvement systems, and building practice teams.
  • RHCs are likely to need substantial technical assistance targeting clinical and operational performance to gain NCQA PCMH Recognition.

For more information on this study, please contact John Gale.

Suggested Citations:

(Working Paper) Gale JA, Croll Z, Hartley D. Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; January, 2015. Working Paper No. 57.

(Policy Brief) Gale J, Croll Z, Hartley D.Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; January, 2015. Research & Policy Brief PB-57.

 

Publication Type: 
Working Paper
Publish Date: 
January 30, 2015
URL: 
http://muskie.usm.maine.edu/Publications/rural/RHC-Readiness-for-PCMH-Recognition-Working-Paper

Understanding Changes to Physician Practice Arrangements in Maine and New Hampshire

Abstract: 

This report examines trends in the organization and ownership of physician practices in Maine and New Hampshire. The Maine Office of MaineCare Services and the New Hampshire Office of Medicaid Business and Policy observed a trend in the conversion of physicians from private practice to other practice arrangements including Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), hospital-owned practices, and hospital outpatient departments. Faced with increased costs for care provided within these facilities, both Medicaid programs sought to understand more about these changes, including their magnitude, the forces driving them, and their short and longer-term implications.

Suggested Citation:

Lenardson J, McGuire C, Alfreds S, et al.  Understanding Changes to Physician Practice Arrangements in Maine and New Hampshire. Portland, ME: University of Southern Maine, Muskie School of Public Service, Institute for Health Policy; January 2008.

Publication Type: 
Report
Publish Date: 
January 31, 2008
URL: 
http://muskie.usm.maine.edu/Publications/ihp/PhysicanPracticeChanges.pdf

Child Care and Children with Special Needs: Challenges for Low Income Families: Parents' Voices

Abstract: 

This report represents the first, exploratory phase of a larger study to learn about the experiences of low income families of children with special needs in finding and keeping child care and balancing work and family. Our interest in this area focused on a number of policy arenas including the child care system, workplace policies, welfare reform and the system of early intervention and special education for children zero to five. We recognized that all of these programs and policies affected employment decisions and strategies and the ability of parents to balance work with the needs of their families. Given the complexity of our study, we chose to begin by conducting qualitative research with families in order to explore what issues were involved and what methodologies in the larger study would best address those issues. Therefore, during the first year of our three-year study, we conducted focus groups and in-depth,
semi-structured interviews with parents and guardians of children with special needs. These were held between May 20th and November 13th, 2002.We hope that these and the other findings that emerge from our research will help bring the voices of these parents into the debates about child care, welfare reform and special education that are taking place at the state and federal level. Our aim in conducting the research in the manner we did, was to emphasize for policy makers the importance of looking across policies and programs to understand how the system as a whole affects this population of children and families. By focusing on the families’ experiences first, and then looking at all the sectors of the system which serve them, we hope by the end of this project to provide a sense of where inconsistencies in policies, gaps in services and fragmentation of programs may be making the work/family balance for these families more difficult.

Suggested Citation: Ward H, Atkins J, Herrick A, et al.  Child Care and Children With Special Needs: Challenges for Low Income Families: Parents' Voices.   Portland, ME: University of Southern Maine, Muskie School of Public Service; April 2004.

Publication Type: 
Report
Publish Date: 
April 1, 2004
URL: 
http://muskie.usm.maine.edu/Publications/CYF/Children-With-Special-Needs-Parents-Voices.pdf

Child Care and Children With Special Needs: Challenges for Low Income Families.

Abstract: 

Findings from this mixed methods study include:

  • Parents of young children with special needs face significant challenges finding and keeping child care arrangements for their child.
  • Parents report significant problems with the child care arrangements they have used for their child with special needs.
  • There are significant programmatic and financial barriers to supporting parents of children with special needs so they can work, and balance work and family.
  • The combination of all of these problems and the particular demands of caring for a child with special needs often result in employment problems and job instability.
  • Families of children with special needs face more economic difficulties (poverty, food and rent insecurity, lack of health insurance) than do families of children without special needs.
  • Certain types of disabilities have a greater impact on the number of child care and work problems than others.
  • Having a child with multiple special needs or having more than one child with special needs significantly increases the likelihood of employment difficulties and job instability.

Suggested Citation: Ward H, Morris L, Oldham E, et al.  Child Care and Children With Special Needs: Challenges for Low Income Families.  Portland, ME: University of Southern Maine, Muskie School of Public Service, Cutler Institute for Child and Family Policy; December 2006.

Publication Type: 
Report
Publish Date: 
December 1, 2006
URL: 
http://muskie.usm.maine.edu/Publications/CYF/Children-With-Special-Needs-Challenges-for-Low-Income-Families.pdf

Children Served by MaineCare 2012: Survey Findings

Abstract: 

The purpose of the annual Survey of Children Served by MaineCare is to monitor the quality of services delivered by MaineCare, the State's Medicaid and CHIP program.  The 2012 survey examines the experiences of families with children. ages 0-17, who are enrolled in MaineCare using a standardized survey instrument (Consumer Assessment of Healthcare Providers and Systems--CAHPS--4.0H Child Medicaid Health Plan Survey). MaineCare scores very favorably compared with national benchmarks on CAHPS measures of Getting Needed Care, Getting Care Quickly, and How Well the Child's Doctors Community, with ratings at or above the 75th percentile on all the composites and individual items.  Overall ratings of the child's personal doctor, ratings of the child's specialist, and ratings of all the child's health care are also among the highest nationally.  Areas for improvement included MaineCare customer service and care coordination.  Continued administration of the CAHPS 4.0H Child Medicaid Health Plan Survey is recommended for 2013 and beyond to allow for ongoing monitoring of patient experience with and computation of trend results of the MaineCare program as well as ensuring that the MaineCare program complies with federal CHIPRA measure reporting requirements.

Suggested citation: Anderson, N., Fox, K., Thayer, D., & Croll, Z. (2013, January). Children served by MaineCare, 2012: Survey findings. Portland, ME: University of Southern Maine, Muskie School of Public Service.

Publication Type: 
Report
Publish Date: 
January 1, 2013
URL: 
http://www.maine.gov/dhhs/oms/pdfs_doc/ihoc/Maine-2012-MaineCare-Children-Survey.pdf

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