Recent Changes In Public Policy Research Articles

Association of Opioid and Concurrent Benzodiazepine, Skeletal Muscle Relaxant, and Gabapentinoid Usage on Healthcare Expenditure and Resource Utilization: A Serial Cross-Sectional Study, 2009 to 2019.

Healthcare providers may be utilizing central nervous system (CNS) depressants to reduce opioid use due to recent changes in public policy. Combination use of these agents with opioids increases the risk of respiratory depression and death. Healthcare expenditures by individuals using these drug combinations have not been previously quantified. We sought to characterize healthcare costs and expenditures associated with a population reporting concurrent CNS depressants and opioid use compared with nonopioid analgesics in the United States from 2009 to 2019. A serial cross-sectional design was used to compare the healthcare expenditures of adult Medical Expenditure Panel Survey respondents who were prescribed nonopioid analgesics, opioids only, opioids/benzodiazepines (BZD), opioids/BZD/skeletal muscle relaxants (SMR), or opioids/gabapentin (gaba) using pooled data from 2009 to 2019. Expenditure (cost and resource utilization) categories included inpatient, outpatient, office-based, and prescription medicine. Average marginal effects were used to compare survey-weighted annual costs and resource utilizations across the groups as compared to nonopioid analgesic respondents, adjusted for covariates. A weighted total of 34 241 838 individuals were identified. Most were opioid-only respondents (46.5%), followed by nonopioid analgesic (43.4%), opioid/BZD (5.3%), opioid-gaba (3.5%), and opioid/BZD/SMR respondents (1.3%). In comparison to the study groups with nonopioid analgesics, opioid-gaba users had the highest significant incremental cost difference among the different pairings (+$11 684, P < .001). Opioid-gaba, opioid/BZD, and opioid/BZD/SMR respondents had significantly higher inpatient, emergency department, and prescription drug costs and use compared to nonopioid analgesic respondents. Opioid-only respondents had higher outpatient and office-based costs and visits compared to nonopioid analgesic respondents. As healthcare providers seek to utilize fewer opioids for pain management, attention must be paid to ensuring safe and effective use of concurrent CNS depressants to mitigate high healthcare costs and burden.

After the Tax Breaks Fade: What Executives Need to Know About Transfer Pricing

Transfer pricing policies have traditionally been driven by a desire to limit taxes by shifting profits from high‐ to low‐tax jurisdictions. Though such practices will no doubt continue, recent changes in public policy, most notably the influence of the OECD's Base Erosion and Profit Shifting initiative, have rendered tax savings more difficult to achieve. But also working in this direction is the tax treaty agreed to by 136 countries in October 2021 mandating a minimum 15% corporate tax rate. The treaty was pushed largely as a reaction against abusive transfer pricing practices.But another economic consequence of transfer pricing, one that is often ignored in practice, appears to be as important than ever—namely, the agency costs associated with conflicts of interests and incentives between corporate managers and owners. Apart from tax effects, when companies get transfer pricing wrong—that is, when the prices are too high or too low relative to opportunity cost—value‐maximizing cooperation across business units tends to be discouraged, resulting in excessive reliance on outsourcing. This article discusses the steps companies can take to limit such agency conflicts and the associated costs.

Refugees, Discrimination, and Barriers to Health

ABSTRACT Using an interpretive phenomenological analysis, we explored refugees’ experiences with discrimination and social determinants of health in a southern city of Texas, within the context of recent public policy changes and anti-refugee rhetoric. To create a separate, yet coextending, exploration of this phenomena, we interviewed both refugees and staff members who work with this population. Five main themes emerged: (a) economic instability, (b) unequal educational starting points, (c) refugee enclaves, (d) negative community and political messages towards refugees, and (e) connection to health and healthcare systems. Implications for counselors are also discussed.

Lesbian, Gay, Bisexual, and Transgender Aging Concerns

Lesbian, gay, bisexual, and transgender (LGBT) elders and long-term couples have become more visible and their special concerns about aging are being recognized by gerontologists. LGBT elders are a diverse group with regard to all characteristics. This article focuses on the characteristics, research needs and barriers, service needs and barriers, clinical implications, and suggestions for appropriate treatment to increase awareness of clinical gerontologists who may not be familiar with LGBT seniors or who wish to improve their services to this population. Gerontologists working in long-term care facilities and those working in social and home care services may be especially interested in the special concerns of transgender elders and the recent changes in public policy regarding all LGBT elders.

Legal Issues Surrounding Single-Sex Schools in the U.S.: Trends, Court Cases, and Conflicting Laws

The No Child Left Behind Act of 2001, followed by the 2006 U.S. Department of Education regulations, represented a drastic change in American public policy by allowing for sex segregation in public schools—as long as it is voluntary, students are provided a substantially equal co-educational option, and the segregation substantially furthers an important governmental objective. Although existing federal and state laws explicitly ban sex segregation, the Courts have historically allowed single-sex schooling within higher education if it does not perpetuate gender stereotypes. Because of the recent public policy changes, there has been a rapid increase in single-sex education within the U.S. public elementary and secondary school system. Many of the now single-sex public schools, however, began segregating because they believe that boys and girls should be taught differently due to innate differences in learning styles and interests. The result is that many of these schools base their educational practices on gender stereotypes. This contradiction of existing laws and precedents has resulted in ongoing lawsuits. This paper offers a review of the legal issues and court cases surrounding single-sex education in the public school system.

New Developments in Technology Management Education: Background Issues, Program Initiatives, and a Research Agenda.

We provide background information on key developments and trends in technology management education, including the managerial implications of recent public policy changes designed to stimulate investment in technology and entrepreneurship. We then consider the educational implications of these trends, drawing on lessons learned from papers in the special issue and our own research. Finally, we outline an agenda for future research on technology management education.

New Developments in Technology Management Education: Background Issues, Program Initiatives, and a Research Agenda

We provide background information on key developments and trends in technology management education, including the managerial implications of recent public policy changes designed to stimulate investment in technology and entrepreneurship. We then consider the educational implications of these trends, drawing on lessons learned from papers in the special issue and our own research. Finally, we outline an agenda for future research on technology management education.

U.S. Patent Policy: Crafting a 21st Century National Blueprint for Global Competitiveness

The paper begins with an overview of the legal, institutional, and public policy bases of the U.S. patent granting system and subsequently examines major deficiencies acknowledged in the existing U.S. patent system. The paper then catalogs the essence of four patent reform proposals of the Federal Trade Commission, the National Research Council, and academic economists (Jaffe/Lerner and Maskus), all of which focus on ameliorating alleged major weaknesses in the U.S. patent system. The paper concludes with an analysis of the above cited patent reform proposals, arguing for a proposed set of workable policy recommendations (reflecting recent changes in public policy) focused on patent cost controls, patent quality, patent uncertainty, and patent reform legislation, all designed to contribute to a globally competitive 21st century patent policy for the U.S. economy.

University patenting and the pace of industrial innovation

Universities, traditionally sources of basic science and research knowledge for industrial researchers, have responded to recent public policy changes by increasingly patenting research results produced by academic researchers. While proponents of strong intellectual property protection argue the benefits of strong rights to promote innovation and facilitate markets for knowledge exchange, critics express concerns over restrictions on diffusion and use of upstream knowledge. Results of an analysis of industrial innovation suggest that increasing university patenting is associated with a slowing pace of knowledge exploitation, especially in technology areas that rely more heavily on science as an input to innovation. This new evidence suggests that university patenting may indeed be hindering or at least slowing industrial innovation. Copyright 2007 , Oxford University Press.

Using policy to drive organizational change

AbstractThis chapter addresses recent changes in public policy and organizational practices that affect LGBTQ individuals and the role that organizational policy can play in establishing and maintaining respectful and inclusive workplaces.

New Responsibilities of Faith‐Related Agencies

Nonprofit agencies with a religious base may be strongly affected by recent public policy changes; they tend to deliver services in areas where federal resources are further declining and are eligible for the special government purchase of service contracts that now may be provided to religious entities. Religious agencies also are now widely expected to deliver uniquely beneficial services and to mobilize social capital to compensate for increasing restrictions of some governmental programs. The current article reports on a qualitative, longitudinal, interview‐based investigation of program changes and their relation to policy changes in a two‐city sample of what are called “faith‐related” agencies. In so doing, it investigates the implications of relying on religious agencies for service delivery. Making use of an extensive framework concerning how agencies are organized, the work finds that faith‐related agencies mildly contribute to increased variety of service delivery styles in the examined cities, but that they rarely expand services significantly to meet increased need or otherwise provide dramatically unique service content in response to recent public policy changes. The patterns in part reflect trade‐offs between fully emphasizing the unique aspects of religion and entering the public arena, and they thus question the likely role of religion in reforming social service systems.

Child Care Use and Parental Desire to Switch Care Type Among a Low-Income Population

This study investigates the use of and satisfaction with child care among low-income families, who are those likely to be affected by recent changes in public policy that emphasize increased work effort. Data from the Survey of Wisconsin Works Families portray differences in the use of center-based care depending on whether or not the family received a child care subsidy. A multivariate analysis of a measure of parental satisfaction, whether a parent would switch child care sources if all care were available at no charge, suggests that parents tend to be more satisfied with center-based care than with alternative forms of care. The analysis also suggests that mothers who received a child care subsidy were significantly more likely to have their children in center-based care.

Community health centers: promise and performance.

This article provides a critical review of the literature on the quality and effectiveness of care provided by community health centers (CHCs) compared with other health care delivery models. Since the mid-1960s, CHCs have played a large role in providing comprehensive primary care to our nation's medically underserved. Recent changes in public policy and the health care marketplace have threatened the viability of the CHC delivery model. This review of structure, process, and outcome indicators suggests that CHCs have effectively reduced many barriers to access, promoted high-quality ambulatory care use among underserved populations, and reduced costly hospitalizations. While CHCs have been shown to save money for Medicaid, little research has addressed the health-related outcomes of care. This article recommends specific areas of research essential to understanding the future performance of CHCs.

The employment effects of social security tax changes and minimum wage regulations: A case study of the American restaurant industry

Several recent changes in public policy in the United States have significantly affected labor market conditions in the restaurant industry. First, at the close of 1987, Congress passed legislation requiring employers to pay, for the first time, Social Security taxes (hereinafter FICA) on the tip incomes of restaurant employees. Second, after a long hiatus, there were two successive increases in the federal minimum wage law — one on April 1, 1990, and the second exactly one year later. This study attempts to measure the employment effects of these policy changes and, in the process, to illuminate how seemingly minor changes in public policy may have very substantial effects on markets.

Meeting the child care needs of low-income families

Recent public policy changes have focused attention on the child care needs of families who are struggling to become or remain economically self-sufficient. This review essay describes public policies designed to assist low-income families, and it examines the ways in which the child care problems those families face differ from those of more advantaged families. Studies of child care choices show that low-income families value the same child-oriented characteristics of child care arrangements as do more advantaged families, but their choices are limited by pressing adult needs for care of acceptable quality that is affordable, available at odd hours, and offered at accessible locations. Steps that child care professionals can take to work with public agencies and low-income parents to address the child care needs of this vulnerable group are discussed.

Prespectives on Ocean Ranching of Pacific Salmon

ABSTRACTThe outlook for private salmon farms engaged in ocean ranching of Pacific salmon is examined from four perspectives‐biologic, methodic, sociologic, and economic. Ecological, physiological, behavioral, and genetic questions which relate to growth and survival of juvenile salmon released from husbandry systems are considered under biologic perspective. Recent innovations in technology to produce at low cost juvenile salmon which retain a capacity for rapid growth and high survival while at sea are described under methodic perspective. Recent changes in public policy that permit private ownership of Pacific salmon on the west coast of the United States are reviewed under sociologic perspective. Finally, questions which must be resolved before the feasibility of ocean ranching can be evaluated are identified under economic perspective.