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State health policy making determinants, theory, and methods: a synthesis
1A.Alfred Taubman Center for Public Policy and American Institutions, Brown University, RI 02912, USA. edward_a_miller@brown.edu
Social Science & Medicine (1982)
|December 13, 2005
Summary
American states show significant health policy variations. Key factors like income, demographics, and public opinion consistently predict multiple health policy outcomes across states.
Area of Science:
- Health Policy Research
- Comparative State Policy Analysis
- Health Economics
Background:
- American states exhibit substantial variation in healthcare spending, cost control strategies, access, and quality of care.
- Significant differences exist in health policy and market characteristics among U.S. states.
Purpose of the Study:
- To synthesize studies using 50-state statistical techniques to model health policy adoption.
- To assess the strengths and weaknesses of existing literature on state-level health policy.
- To identify factors that predict health policy outcomes at the state level.
Main Methods:
- Assembled a database of 245 equations from 63 studies published between 1975 and 2002.
- Utilized 50-state statistical techniques to model policy adoption in the health sector.
- Examined predictors such as income, population demographics, public opinion, and healthcare infrastructure.
Main Results:
- 43 of 87 examined policy determinants consistently predicted two or more state-level outcomes.
- Factors like non-white population percentage, urbanization, income, and unemployment predicted five outcomes.
- Tax capacity/effort and hospital beds predicted six outcomes, while nursing home beds and liberal public opinion predicted seven outcomes.
Conclusions:
- Identified key predictors of state-level health policy outcomes, highlighting the influence of socioeconomic and demographic factors.
- Revealed gaps in understanding the impact of political systems and intergovernmental relations on health policy.
- Emphasized the need for further research into the determinants of state health policy adoption and variation.
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