Policy Effect of the Public Health Clinic Closure and Consolidation Policies on All the Preventative Practices Following the Affordable Care Implementation in Louisiana

Anita V Feist

doi:10.7176/ppar/10-11-05

Abstract

The purpose of this study is to examine the policy effect of the public health clinic closure and consolidation policies on public health preventive practices in Louisiana. It is observed in the literature that many governments’ efforts towards the healthcare market has being failing across different political administrations. This is because the current health care reform, public health clinics closures and policy consolidations following the implementation of the affordable care act seems to be disappointing in the state of Louisiana. Currently, many parishes, are battling with low health care professional’s availability, and high prevalence of poor health outcomes (i.e. high spread of STDs, high cancer spread, low accessibility to healthcare, and several communicable diseases) making all the public health interventions programs or initiatives look bad in the face of the policy reforms. However, it is not clear whether the policy consolidation and public health clinics closures are the causal factors to the high spread of diseases and health disparities across the parishes. As a result, this particular study used paired t-test and secondary source of data from the Department of Health and Hospitals and Integrated Public Use Microdata Series USA (IPUMS-USA) spanning from 2008 to 2019 to examine the problem. The study finds that the average Gonorrhea infection rate, and P&S Syphilis infection rate between 2014 and 2019 is greater than the average infection rate before the closure of the public health clinics (2008 and 2013). Above all, the study establishes that there is a strong evidence of significant difference in the following: (a) access to healthcare, (b) Sexually-Transmitted Disease (STD) Screening preventative practices, and (c) the participation of Breast Cancer Screening preventative practices resulting from the different periods of policy implementation in relation to public health clinic closures. Therefore, the study recommends that all the closures of the public health clinics needs to be reopen to ensure a greater access to healthcare and healthy population. Keywords: Healthcare, ACA, Clinic, Policy, healthcare, Preventive, Screening, and STDs. DOI: 10.7176/PPAR/10-11-05 Publication date: November 30 th 2020

Highlights

The state of Louisiana has experienced tremendous closures of public health clinics between 2014/2015 and 2016/2017 fiscal years and has continued up to date by following the federal healthcare reforms policies
The study further examines the following hypotheses: (a) There is no statistical difference in the participation of Breast Cancer Screening preventative practices based on the public health clinic closure and consolidation policies in Louisiana state parishes. (b) There is no statistical difference in the Sexually-Transmitted Disease (STD) Screening preventative practices based on the clinic closure and consolidation policies in Louisiana state parishes to inform public health policy
IMPLICATIONS In conclusion, the analysis of the study finds that the average Gonorrhea infection rate, Chlamydia infection rate, and primary and secondary (P&S) Syphilis infection rate between 2014 and 2019 is greater than the average infection rate before the closure of the public health clinics (2008 and 2013)

Summary

Introduction

The state of Louisiana has experienced tremendous closures of public health clinics between 2014/2015 and 2016/2017 fiscal years and has continued up to date by following the federal healthcare reforms policies (or policy consolidations). In addition to the use of Electronic Health Record Systems, DHH proposed that transitioning from the current fee-for-service Medicaid program to a system that more effectively coordinates’ health care will lead to better access, more choices, and improved health for patients (DHH, 2014) Louisiana parishes such as East Baton Rouge, Orleans, and Jefferson had the most Medicaid Enrollees during 2010 and 2014. Kaiser Family Foundation based estimates on the Census Bureau's Current Population Survey (2014) and estimates show that there is one primary care physician for every 1,937 people in Louisiana This number would be adequate to meet the primary health care needs of Louisiana's residents if these providers were evenly distributed throughout the state and accepted all patients regardless of ability to pay. This constitutes a severe shortage in rural areas across the state, and within parishes, some areas are more underserved than others

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Conclusion