EVIDENCE BASE IN DESIGN
When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.
In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.
RESOURCES
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
· Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
· Review the health policy you identified and reflect on the background and development of this health policy.
BY DAY 3 OF WEEK 7
Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.
BY DAY 6 OF WEEK 7
Respond to at least two of your colleagues * on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.
LEARNING RESOURCES
Required Readings
· Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
· Chapter 5, “Public Policy Design” (pp. 87–95 only)
· Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
· Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
· Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)
· American Nurses Association (ANA). (n.d.). Advocacy Links to an external site. . Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/
· Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementation Links to an external site. . Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf
· Congress.govLinks to an external site. . (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
· Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site. . Academy of Management Review, 21(4), 1055–1080.
· Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site. . Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.
· Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site. . Public Management Review, 16(4), 527–547.
**Description of Health Policy**
The health policy I have selected is the proposed expansion of Medicaid coverage to include dental benefits for adults in the state of Illinois. Currently, Medicaid coverage for dental services in Illinois is limited to children under the age of 18, pregnant women, and individuals with disabilities. However, there is a growing recognition of the importance of oral health in overall well-being, and advocates argue that expanding Medicaid coverage to include dental benefits for adults would address disparities in access to dental care and improve overall health outcomes.
**Background and Problem/Issue**
The problem being addressed by this health policy is the lack of access to dental care among low-income adults, particularly those covered by Medicaid. Dental care is essential for maintaining oral health, preventing dental diseases, and addressing conditions such as periodontal disease and tooth decay. However, many adults, especially those from underserved communities, face barriers to accessing dental services due to cost, lack of insurance coverage, and shortage of dental providers in certain areas.
**Social Determinant Affecting the Policy**
One of the social determinants that most affects this policy is socioeconomic status. Low-income individuals and families often struggle to afford dental care, leading to disparities in oral health outcomes. Lack of access to preventive and routine dental services can result in untreated dental problems, which may progress to more severe conditions requiring costly interventions. Expanding Medicaid coverage to include dental benefits for adults would help alleviate financial barriers and improve access to essential dental care services for vulnerable populations.
**Evidence Base to Support the Policy**
There is a strong evidence base to support the proposed policy of expanding Medicaid coverage to include dental benefits for adults. Numerous studies have demonstrated the link between oral health and overall health, highlighting the importance of preventive dental care in reducing the risk of chronic diseases such as diabetes, cardiovascular disease, and respiratory infections. Additionally, research has shown that individuals with untreated dental problems are more likely to experience pain, discomfort, and impaired quality of life.
Moreover, evidence from states that have already expanded Medicaid dental coverage for adults, such as California and Oregon, suggests positive outcomes, including increased utilization of preventive services, reduced rates of dental emergencies and hospitalizations, and improved oral health status among Medicaid beneficiaries. By providing access to dental care services through Medicaid, states can promote equity in healthcare access, improve health outcomes, and potentially reduce healthcare costs associated with untreated dental conditions.
**Example of Evidence**
A study conducted by the American Dental Association (ADA) found that adults with Medicaid coverage were less likely to have visited a dentist in the past year compared to those with private dental insurance. Furthermore, the study found that Medicaid beneficiaries were more likely to report unmet dental care needs due to cost barriers. This evidence underscores the importance of expanding Medicaid coverage to include dental benefits for adults to address disparities in dental care access and utilization among low-income populations.
(Source: American Dental Association. (2019). Medicaid and dental benefits: An analysis of dental utilization and unmet dental care needs among Medicaid beneficiaries.)
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