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Biomedical subjects

C S Weissert

Publications and source records attributed to C S Weissert.

9 recordsLinked to original sources
PubMed2000

State legislative staff influence in health policy making.

State legislative staff may influence health policy by gathering intelligence, setting the agenda, and shaping the legislative proposals. But they may also be stymied in their roles by such institutional constraints as hiring practices and by turnover in committee leadership in the legislature. The intervening variable of trust between legislators and their support staff is also key to understanding influence and helps explain how staff-legislator relationships play an important role in designing state health policy. This study of legislative fiscal and health policy committee staff uses data from interviews with key actors in five states to model the factors important in explaining variation in the influence of committee staff on health policy.

Decision Making, Organizational↗
PubMed1999

When (not if) evaluation flexibility is desirable. Examples from the CPHPE initiative.

The evaluation literature often debates whether evaluators should be flexible in evaluation design and activities in order to collaborate with program directors and be responsive to programming needs. Two conditions are specified under which evaluation flexibility is not only desirable but essential. Two examples from the cluster evaluation of the W. K. Kellogg Foundation's Community Partnerships for Health Professions Education initiative are provided to illustrate why flexibility under these conditions proved to be essential. One of the examples, related to the "community" involvement in the initiative, illustrates the need for flexibility as programs experience goals clarification. The other example, related to the coincidental national health care reform efforts, illustrates the need for flexibility both to capture programs' efforts to protect their integrity and to ensure against spurious conclusions as a result of external turbulence in policy environments. How the cluster evaluation team addressed these issues is also described.

Allied Health Personnel↗
PubMed1999

Evaluating the impact on public policy of foundation-sponsored programs in the health professions.

The leaders of national philanthropic foundations have long been active in informing public policy makers about their organizations' accomplishments and lessons learned in health care and other issues. The public policy context also is seen increasingly as an important factor influencing changes in the health care market. This article outlines how public policy was monitored and evaluated in a recent initiative in health care by a prominent national foundation. The markers of policy change in the evaluation of this initiative represented a mixture of the initiative's efforts to inform policy makers, the success the participant projects had in making policy makers aware of the initiative's goals, and actual changes in policy outcomes.

Allied Health Personnel↗
PubMed1998

Sending a policy signal: state legislatures, medical schools, and primary care mandates.

In the past few years, eleven states have directed medical schools in their states to produce more primary care practitioners or to change the training of physicians to make careers in primary care more attractive to medical students. This article outlines the progress and politics of the states' desire to hold medical schools accountable for producing more primary care practitioners. It analyzes the coerciveness and scope of the laws, including the provisions for implementation and accountability. Interviews with legislative staff, legislators, and university and medical school lobbyists provide information on the measures' political rationale and expectations. Most striking was the signaling nature of the provisions. The laws were not strident or especially onerous; they contained many loopholes and no real sanctions. They were important, however, in the message they conveyed. In state after state, legislatures sent a message to the medical schools that they were part of the solution to distributional problems of health care delivery and must be responsive to legislative desires for action. State legislators sent a policy signal, and most medical schools apparently understood its significance.

Career Choice↗
PubMed1994

Education and the health professions: explaining policy choices among the states.

Recent calls for restructuring of the nation's health care system have highlighted the deficiencies in the current system of education for the health professions. Of particular concern are the dominance of specialization and hospital-based training and the tendency of new health care providers to settle in communities without substantial health needs. The states are the key actors in reforming health professions education, serving as a primary funding source for health professions schools, chief licensors and regulators of health professions, regulators of private health insurance, key providers of Medicaid, and architects of a variety of subsidy and regulatory programs providing incentives for health professionals to choose specialties and locations for practice. This article provides a taxonomy of state policies affecting health professions education reform and classifies the states according to the choices they have made. Findings show that few states take advantage of their policy options across the four policy types and that most tend to concentrate their efforts on a few policies--ignoring potential means of encouraging more primary care providers in underserved areas. Results from regression models explaining state choice of policy adoption highlight the political nature of policy choice and the highly variable nature of state response in health professions education reform.

Education, Medical↗