This archive site currently contains the full text of over 100 policy studies and papers produced/edited/complied by Michael Lapolla, Co-Director of the OU Center for Health Policy Research.

These are relevant publications of The University of Oklahoma Center for Health Policy Research & Development and its predecessor organizations at the Oklahoma Medical Research Foundation (OMRF) Center for Health Policy Research (1987-1992) and Oklahoma State University (1993-2003).

Permissions have been received, and are on file, for the use of copyrighted material produced at the Oklahoma Medical Research Foundation (1989-92); and Oklahoma State University (1993-2003). These analyses are provided in the public domain for general public use with attribution. Many, but not all, published studies have been included in this archive.

Downloading these publications requires that you have Adobe Acrobat Reader installed on your computer and within your web browser.

2007

LSU Health Care Services Division
This link is a supplement for the presentation given by Mike Lapolla, OU College of Public Health, in Baton Rouge on Tuesday, September 18. Presentation slides are accessed here.

NSU College of Optometry
 This link is a supplement a College of Public Health class presentation to be held at 10:00 am, Wednesday, September 12 at the NSU College of Optometry. The guest speakers was Michael Lapolla, OU College of Public Health. Classroom slides are accessed here.

Commonwealth Fund Report
 In mid-June, the Commonwealth Fund released a complete 78 page report ranking all 50 states in terms of health systems performance. Oklahoma was ranked 50th - or last. The report and accompanying chart pack are made available here.

Tulsa County Profile
 The Tulsa City County Health Department produced a Tulsa County Health profile (7 mb). It was released in March 2007. This profile analyzes each of the 38 Zip Code Tabulation Areas (ZCTAs) in Tulsa County using a host of variables describing the following categories: demographic; socioeconomic; maternal and child health; infectious disease; injury and violence; mortality and access to health care.

Tulsa World Feature
 The essential findings of the Tulsa Metro Health Study (see 2006 below) were published in the Sunday, February 18, 2007 edition of the Tulsa World. The front page story is here - and the inside story (page 10) is here. And the supporting graphic is here.

Health System Revenue Flow Model
 This single page graphic demonstrates the flow of the health care dollar as it leaves the American family and eventually is expended with health providers. The "journey of the dollar" is along the four avenues of government, business, insurance companies and individuals. The graphic demonstrates the interactions of each and proportions of dollars.


What Is Public Health?
 This primer on public health places the discipline in the context of health in the U.S.
 

2005 Estimates of the Uninsured in Oklahoma and United States
 The Bureau of the Census Current Population Survey estimates that Oklahoma had a population of 3,505,000 in 2005 and that 647,000 were uninsured, a rate of 18.4% of the total population. The summary of 1987-2005 sources of health insurance for both the nation and Oklahoma is provided here.

Estimates of the Uninsured in Oklahoma Counties
 The Bureau of the Census Current Population Survey estimates that Oklahoma had a population of 3,505,000 in 2005 and that 647,000 were uninsured, a rate of 18.4% of the total population. There are three available estimates of the uninsured at the county level in Oklahoma.

The University of Oklahoma Center for Health Policy Research created a locally developed algorithm based upon economic and demographic variables; the Bureau of the Census has created an experimental dataset using 2000 census data; and the Oklahoma Health Care Authority (OCHA) provided estimates per a HRSA funded grant with work performed by SHADAC at the University of Minnesota.

A summary of the county estimates yielded by each is provided here. The average of the three estimates appears to be the most compatible with the more stable CPS data provided by the Bureau of the Census each year.
 

2006

The Lewin Study:
A Regional Strategic Plan for Tulsa's Health Care Safety Net
This April 2006 Lewin Report was presented to the community by the Lewin Group of Washington, DC. The locally developed Tulsa Metro Health Study and the accompanying seven county database were the predicate report for the Lewin Study which assisted Lewin in concentrating on strategic measures rather than problem identification. A .pdf file of the Lewin slides are here.
 
The Lewin Study focused upon Tulsa's health care safety net. It has become the accepted strategic plan for the greater Tulsa region. Several recommendations are now being implemented with more to follow. The HealthPlex recommendations are being promoted by a HealthPlus OK campaign. A .pdf file of the promotional slides (860k) are here as well as the PowerPoint Slides (23 mb). And a link to the HealthPlus website is also here.
 
The essential findings of the Tulsa Metro Health Study were published in the Sunday, February 18, 2007 edition of the Tulsa World. The front page story is here - and the inside story (page 10) is here. And the supporting graphic is here.
 

Uncompensated Hospital Care in Oklahoma
 This April 2006 report analyzes the cost of uncompensated care absorbed by acute care hospitals in Oklahoma. The study builds upon and updates a similar study using data from 2002 and published by the Oklahoma Hospital Association in 2003. The 2003 report was limited to an analysis of indigent care—the cost of charity care services and the shortfall between the cost of care and payments received for Medicaid and legislated care services. This 2006 study addresses “uncompensated care” by expanding the study of indigent care to include the cost of care absorbed by hospitals resulting from bad debts. As noted in the 2003 study, reporting only indigent care services significantly underreports the cost of uncompensated care absorbed by Oklahoma hospitals. Click here for the 8 page report.
 

NSU College of Optometry
 This text and these links supplement a College of Public Health class presentation to be held at 10:00 am, Wednesday, September 13 at the NSU College of Optometry. The guest speakers will be Michael Lapolla and Peter Budetti, MD, JD for the OU College of Public Health. Dr. Budetti is the department chairman of Health Administration and Policy; Mr. Lapolla is a lecturer and head of the Center for Health Policy. (See department faculty).

 
Dr. Budetti will speak of the national scene re: health care and public health. He wrote the October 2004 cover story for JAMA that was a ten year retrospective post-mortem of the failed Clinton Health Plan. Dr. Budetti was one of five people who actually crafted all 1,300+ pages of the Plan. He will also speak of Public Health national issues and refer to a Health Affairs article written by a colleague, Ken Thorpe, PhD, Emory University. The required class reading are the three following documents:
 
 
Mr. Lapolla will discuss local (Tulsa) considerations of Public Health and Health Care. He is the author of a recent analysis of the Tulsa region. The Executive Summary of that study is here and is required reading for the class. The detailed study is available farther down the page. As an additional class resource - students may choose to voluntarily download and view an analysis of our Health Care From 50,000 Feet (PDF) that is a PowerPoint collection of slides observing the evolution of our health care system over the last 100 years. It was presented as the initial class of university Mini-Medical School series in March 2003.
 
We will spend some time reviewing a single page flow diagram that tracks all health spending in the country. It is an excellent overview of where the money comes from (clue: it's you) and how it travels towards ultimate expenditure. The Financing Flow Chart is here. Print it out (black and white is fine) and bring it to class.
 
As there are required readings  - we will randomly ask for feedback from students presuming that the articles have been read. If you do not read them - it will be impossible to fake an answer.
 

PREMIUM BURDEN OF UNINSURED
 Paying a Premium: The Added Cost of Care for the Uninsured quantifies, for the first time, the dollar impact on private health insurance premiums of care provided to the uninsured. Published by the Families USA Foundation.

OKLAHOMA HEALTH DEPARTMENTS
 This analysis is a joint project of the Oklahoma State Department of Health, Tulsa City-County Health Department and Oklahoma City-County Health Department and the University of Oklahoma College of Public Health. A PDF copy of the complete 77 page report is here.

The study produced a variety of integrated and standardized worksheets allocating and aggregating FY 2005 revenue and expense data. They are in .pdf format and require 11x17 tabloid paper to print. They are available below:

Statewide
Statewide Aggregated Revenue
Statewide Aggregated Expense
Statewide Applications

State Health Department
SHD Sources of Revenue
SHD Categories of Expense

Tulsa City-County Health Department
TCCHD Sources of Revenue
TCCHD Categories of Expense

Oklahoma City-County Health Department
OCCHD Sources of Revenue
OCCHD Categories of Expense

The text below is language from the four-party contract that specifies the intended product.  “The contractor (University of Oklahoma) will provide a written product complete with text, tables and charts. The major components of the product are described below.

STATE RANKINGS-There will be an examination of methodologies and state ranking outcomes to identify those risk factors and outcomes most important to achieving higher state ranks in health. Trends in risk behavior and outcomes will be identified.

NATIONAL SPENDING-Oklahoma will be compared to other states for state government funding for health, public health, and the sub-components of public health.

OKLAHOMA SPENDING-The product will collect individual and aggregate fiscal data for the Oklahoma State Department of Health, Tulsa City-County Health Department; and Oklahoma City-County Health Department. Sources of revenue and applications of funds will be arrayed in a variety of descriptive ways including governmental sources, applications to risk behaviors and outcomes, and geographic distribution.

OKLAHOMA ALLOCATIONS-There will be an analysis aligning resource application, risk factors, outcomes and opportunities to realign resource allocation to optimize outcomes.

In summary, this report will clarify and standardize information about the allocation of public health-related resources throughout the state. The arrays and discussion will support an informed conversation about the levels and allocation of resources needed to improve health outcomes for Oklahomans.  The final part of the analysis addresses the pressing question of what potential interventions might improve health outcomes in Oklahoma.  In particular, the report looks at those public health strategies that might ameliorate risk factors in order to prevent disease and disability in the first place, and outlines the extent to which we are currently investing in such prevention strategies.
 

2005


 CAUSES OF DEATH IN OKLAHOMA
The study below (Tulsa Metropolitan Area) observed alarming trends in Oklahoma's age-adjusted death rates - that is the measure of premature death and the resulting loss of productive life. That study was provided to assist in regional health planning. It observed that the downward death rate trend for Oklahoma began to dramatically diverge from the national trends in the early 1990's. As a result, Oklahoma is the only state in the nation where the death rates are now worse than in 1990.
 
This analysis goes a step further and addresses to informal hypothesis of "what happened in Oklahoma in the 1990's?"
 
This follow-up [Summary is 10 pages; complete study is 41 pages] was initiated as a class project for graduate students enrolled in Health Services Research Methods (OU College of Public Health) in the summer of 2005. These students were Sylvia August, MD; Barbara Volz; Melanie Maxwell; Mallory Van Horn; Terri Salisbury, RN; and Shane Ryan. The study was drafted by Bina Patel; and coordinated and edited by Michael Lapolla.
 
 
GRAND ROUNDS-COLLEGE OF PUBLIC HEALTH
The October 18 College of Public Health Grand Rounds was presented by Michael Lapolla, Kent Olson, PhD and Kelly Damphousse, PhD. The subject was the essential findings of the analysis performed in support of The Governor's and Attorney General's Task Force on Mental Health, Substance Abuse and Domestic Violence. The study identified the direct costs and economic impacts of Mental Health, Substance Abuse and Domestic Violence in Oklahoma for 2003. The identified costs were to be federal, state, local, and private sector. The research team identified $3.4 of direct cost and another $5 billion of economic impacts. The complete report is over 380 pages - and the data worksheets were 38 pages. The complete study is available farther down this page.
 
The research team was Michael Lapolla, University of Oklahoma, Principal Investigator (Health Care); Kent Olson, PhD, Oklahoma State University, Co-Principal Investigator  (Economic Impacts); Kelly Damphousse, PhD, University of Oklahoma (Criminal Justice); Craig Knutson  (Non-Profits and Workplace; Laura-Dempsey-Polan, PhD (Domestic Violence and Social Services); Anthony Lo Sasso, PhD, University of Illinois, Chicago (Economic Impacts); Tabitha Doescher, PhD (Economic Impacts); Mark Snead, PhD, Oklahoma State University (Economic Impacts), and Peter Budetti, MD, JD, University of Oklahoma.
 
The 64 Grand Rounds slides are presented here as a PDF file. Grand Rounds Slides
 

HEALTH INSURANCE 2004
 The 2004 estimates of health insurance status in the United States were released by the Bureau of the Census in late August 2005. Listed below are compiled tables and estimates of health insurance in Oklahoma as created by the Center from the Census data. They are arrayed in a variety of reports and formats and also aggregated into a single PDF file.

National Estimates By State
These tables depicts simply the estimated number of insured and uninsured by state for 2004 as provided by the U.S. Census Bureau. Data is shown in alphabetical and rank order. The rankings show that Oklahoma is estimated to have the third highest state rate of the uninsured. 2004 State Estimates

Oklahoma and U.S. Data
Advocates will use data that enhances arguments. Estimates of the uninsured are reported as having both increased and declined in the same year. Analysts frequently must reconcile conflicting numbers that are derived from the same data source. This is because advocates will use single year data - or multiple year averages - whichever is most advantageous. Each is presented here.

These reports provide estimates for Oklahoma and the Unites States by estimated pay source. These pay sources are employer-based, self-purchased, Medicaid, Medicare and Military. They are sub-totaled by private and government sources. They are both for Oklahoma and the United States; and for all ages, and for children between 0-18.  Annual Estimates | Two-Year Averages | Three-Year Averages

County Estimates for Oklahoma
Estimates for 2000 by the U.S. Bureau of the Census
Estimates for 2003 by the OU Center for Health Policy

National Map by County
This map graphically depicts the "uninsured" by county in the United States. It visually shows the highest rates of the "uninsured" in the western and southern states.

Complete Report
Each of the reports above have been combined into a single 27-page PDF file. Click here for the complete report.

TULSA METROPOLITAN AREA
This analysis was initiated in order to provide baseline health policy and planning research for a Greater Tulsa Strategic Master Plan, and to provide the Oklahoma Secretary of Health a replicable template for regional analysis elsewhere in the state. It emphasizes safety net services, causes of death, hospital utilization and health insurance status.

All of the county and MSA analyses use a geographic measure developed by Bureau of the Census - the Zip Code Tabulation Areas (ZCTA), which generally correspond to areas served by a given Zip code. This new tool makes it possible to combine the familiar geography of the U.S. Postal Service (USPS) Zip Codes with the wealth of data available for the Census Tracts.

A primary purpose of this research is to provide basic information to assist in developing a Tulsa Strategic Health Plan. Such a plan will be required to make choices about which strategic direction to pursue with regard to the provision of health care services for the medically underserved. While there are a host of needs and ideas to match, all options cannot be pursued concurrently—some are mutually exclusive, while others simply cannot be addressed at the local level. Nor is it intended to be an encyclopedia of health research, but rather a starting point to establish common ground.

Summary (18 pages)
Final Report (84 pages)
Database Printout (80 pages)

 
The Tulsa Metro data was also displayed in a comparison table listing each of Oklahoma's 77 counties. And a slide depicting the 1980-2004 county, state and national age-adjusted death rates was created. That table and chart are provided below:
 
County Status (2 pages)
Mortality Rate Chart
 

OKLAHOMA VITAL STATISTICS (1930-03)
 These files offers vital statistics data from the Oklahoma State Health Department for the period of 1930-2001.  Researchers may use the data to study birth and death trends in the state. (June 2004)

Oklahoma Vital Statistics for 1999-03 (Excel):
The data provided is newly formatted compared the the 1930-98 data.

Oklahoma Vital Statistics for 1930-98 (Excel):
The data provided is the "Resident Births, Fetal Deaths (Stillbirths), Deaths and Deaths by 34 Selected Causes. Actual and rates are included.

 

COSTS OF MENTAL HEALTH, SUBSTANCE ABUSE, AND DOMESTIC VIOLENCE (PDF)
 The Governor's and Attorney General's Task Force on Mental Health, Substance Abuse and Domestic Violence was convened in January 2004. The Task Force contracted with the Center for Health Policy Research at the University of Oklahoma College of Public Health for a research agenda. The task was to identify all direct costs and economic impacts of Mental Health, Substance Abuse and Domestic Violence in Oklahoma for 2003. The identified costs were to be federal, state, local, and private sector. The research team identified $3.4 of direct cost and another $5 billion of economic impacts. The complete report is over 380 pages - and the data worksheets were 38 pages.

 
The research team was Michael Lapolla, University of Oklahoma, Principal Investigator (Health Care); Kent Olson, PhD, Oklahoma State University, Co-Principal Investigator  (Economic Impacts); Kelly Damphousse, PhD, University of Oklahoma (Criminal Justice); Craig Knutson  (Non-Profits and Workplace; Laura-Dempsey-Polan, PhD (Domestic Violence and Social Services); Anthony Lo Sasso, PhD, University of Illinois, Chicago (Economic Impacts); Tabitha Doescher, PhD (Economic Impacts); Mark Snead, PhD, Oklahoma State University (Economic Impacts), and Peter Budetti, MD, JD, University of Oklahoma.
 
The final report was presented to Governor Henry and AG Drew Edmondson on February 17, 2005. Access the Executive Summary and Recommendations (1.9 mb) here. The report sections are available via .pdf files below:
 
Data Worksheets (730 kb)
Criminal Justice (2.6 mb)
Health Care Services (2.2 mb)
Social Services (2.0 mb)
Non-Profit and Workplace (1.8 mb)
Special Issues (610 kb)
Economic Impacts (1.6 mb)
 
The complete report is an 11.3 mb .pdf file.
 
This report was featured in the March 21, 2005 issue of Alcoholism & Drug Abuse Weekly. A full copy of that newsletter is below in .PDF format. ADA Weekly
 

2003

THE STUDY BELOW IS THE FIRST TIME SUCH ANALYSIS HAVE EVER BEEN DONE IN OKLAHOMA.

Uncompensated Indigent Care in Oklahoma for 2002 (PDF)
This study is a companion piece to the analysis above. It was performed for the Oklahoma Hospital Association using OHA acquired data. The analysis converts hospital indigent care services to actual expense, applies payments and other offsets to that expense, and yields the amount of uncompensated indigent care provided by Oklahoma hospitals. The data is aggregated by region and size of hospital. Oklahoma provides an estimated $152 million of uncompensated hospital expense to medically needy persons. There were 74 responding hospitals representing 87% of hospital capacity in Oklahoma. May 2003.

Health Care From 50,000 Feet (PDF)
This is a PowerPoint collection of slides observing the evolution of our health care system over the last 100 years. It was presented as the initial class of the OSU Mini-Medical School series. (March 2003)

Coastal Research Group (PDF)
These slides were presented to the Coastal Research group annual meeting in Kauai, Hawaii April 11-14, 2003. It is one of very few studies quantifying the impacts of physicians upon local economies. This is a PowerPoint collection of slides providing the key findings of:

  • PMTC 25 Years Later
  • Economic Impacts of Family Medicine Physicians

2002

THE STUDY BELOW IS THE FIRST TIME SUCH ANALYSIS HAVE EVER BEEN DONE IN OKLAHOMA.

Indigent Care Public Revenue for 2002 (PDF)
This study was requested by the Mayor's Working Group, a committee of business leaders from Tulsa and Oklahoma City. This Group is studying the equity of the allocations of public resources between Tulsa and Oklahoma City. The analysis examined Medicare and Medicaid DSH payments and GME payments; and other public subsidies. The findings include that public revenue distributed by state officials is reasonably equitable and appropriate; but the allocation policies of federal Medicaid DSH revenues cause a noticeable inequity. Released Dec 2002.

RN Hospital Workforce 2000 (PDF)
This analysis examines the workforce trends of registered nursing in Oklahoma, with an emphasis upon nurses employed in hospitals. It examines the "nursing shortage" issues by investigating both supply of nurses and demand for their services. The report also includes tables depicting the numbers of both RNs and LPNs in Oklahoma from 1976-2000 ... by place of employment. (May 2002) The basic materials of the analysis are also available in a PowerPoint format. The linked file (Nursing 2000 slides) has 39 slides (496k) and may be used to create attributed and customized presentations. There are 5 tables and 9 charts included.

2001

THIS ANALYSIS ESTIMATES THE JOB AND PAYROLL IMPACTS OF FAMILY PHYSICIANS.
EXTENSIVE LITERATURE SEARCHES CANNOT LOCATE SIMILAR STUDIES.

This study examines the impacts of the Physician Manpower Training Commission activity from 1975-2001. (October 2001); and it summarizes the retention rates and community economic impacts of the three publicly funded Family Medicine residency programs in the state of Oklahoma. (October 2001).

PMTC 25 Years Later
This study examines the impacts of the Physician Manpower Training Commission activity from 1975-2001. The analysis provides a census and catalog of all PMTC assisted physicians and includes community specific economic impacts of their practice activity. The study concludes that an investment of $19 million public dollars has created over $445 million of economic activity on the state of Oklahoma. A PDF version of the analysis is included here. (October 2001)

Economic Impacts of Family Medicine Physicians
This study uses the same methodology of the "PMTC 25 Years Later, above. It examines the retention rates and community economic impacts of the three publicly funded Family Medicine residency programs in the state of Oklahoma. The study includes all graduates between 1975 - 2001. (October 2001)

Physician Workforce 2000
This series of six analyses comprehensively assesses the breadth and depth of Oklahoma's Physician Workforce in 2000.

All volumes are included in the master document "Oklahoma Physician Workforce 2000" (PDF). This document is 46 pages and the file size is 3.3mb.

50 State Survey: Reuse of Prescription Drugs (PDF)
This 4-page brief summarizes a survey of the Pharmacy Boards in all 50 states. The survey queried the Boards about their policies allowing unused nursing home medications to be reused by the indigent in lieu of being destroyed. The survey indicated four states either allow the practice or are actively considering it. The states are Louisiana, Montana, Alabama, and Oklahoma.

Oklahoma's Working Poor and Health Care
This is a 29 slide presentation to Oklahoma Department of Human Services management on January 31, 2001.


2000

Prescription Drug Waste in OK Nursing Homes (PDF)
This 6-page brief explores the legal, cost and regulatory issues requiring nursing homes to destroy millions of dollars worth of prescription medications. The brief proposes a change in the law to allow for recycling of these medications to Oklahoma nursing homes. The brief is accompanied by an 8-page resource supplement (PDF) that provides full-text of relevant laws, policies, letters and research.

Health Insurance in Oklahoma: 1987-98 (PDF)
This report examines the trends of health insurance in Oklahoma for the period 1987-98. The four-page brief looks at the trends. The additional two pages of tables show the sources for health insurance data and percentages for BOTH the entire population ... and children under age 18. Categories include: (April 2000)

  • Uninsured
  • Private Insurance: Employer-sponsored and Self-purchased
  • Public Insurance: Medicare under 65, Medicaid, Military

Medicare Prescription Drug Benefit (PDF)
This paper is the product of the author's participation at February 2000 meeting of the Institute for Health Policy & Research. The Institute is an osteopathic medicine professional organization that explores health policy issues. This paper does not represent the views of the Institute or it's members.

It is the intent of this paper to clearly and concisely analyze the debate surrounding the Medicare prescription drug benefit issue and to assist Oklahomans in developing meaningful and informed positions. (May 2000)

1999

Mental Health in Oklahoma
The Center released a five-part series of policy briefs addressing mental health policy issues in Oklahoma. This series of issue papers has been developed for Oklahoma's laypersons and policymakers. The intent is to place Oklahoma mental health needs in perspective; help promote responsible debate, and to provide a standard reference for policy discussions.

The series is as follows:

Mental Health: Our Children and Adolescents (PDF)
This paper is the 6th in a series of mental health issues in Oklahoma. It was issued in July 2000. The previous 5 briefs were issued in November 1999 (see below).

Health Insurance in Oklahoma for 1997 (PDF)
The Center recently published an analysis of the sources of health insurance in Oklahoma for 1997. The brief was prepared for the Joint Task Force on Health Insurance organized by the Oklahoma Legislature. The brief shows that Oklahoma has made more recent progress in reducing the uninsured than any state in the nation.

The COMLEX Examination Process (PDF)
The Center's analysis showing the correlation of overall medical school GPA with Comlex scores at all levels. It was internally released in July 1999 and has been submitted to the Journal of the American Osteopathic Association for publication.

1998

Oklahoma Health Professions Education for 1992-96
The Center has collaborated with the Oklahoma State Regents for Higher Education to analyze all health professions education programs operated by Oklahoma's public colleges and universities. The there are two companion reports available.

One is the four page "Health Professions Training in Oklahoma for 1992-96" (PDF) with two pages of accompanying spreadsheets. The two single page inserts describing Health Professional Programs for 1996 by Program Type and Institution. One page covers 1996 Enrollments (PDF); the other covers 1996 Degrees Granted (PDF).

The second report is an 8-page Sourcebook that depicts 1992-96 enrollment and graduation activity for every program sponsored by every college/university in Oklahoma.

Mental Health Parity Legislation (PDF)
The Center recently published an analysis of proposed Oklahoma-specific mental health parity legislation. The analysis provides an overview of state and federal activity along with data tables, full-texts of legislation and the clinical definitions of the related mental illnesses. Also included is a 15 question survey (PDF) of 770 Oklahoma businesses (154 responses; 20% response rate) asking about impacts and opinions of Mental Health Parity legislation.


Substance Abuse
The Center coordinated research for the Governor's Task Force on Substance Abuse. The Center coordinated the efforts of:
  • The Oklahoma Academy
  • University of Oklahoma Health Sciences Center
  • Oklahoma State University Bureau for Social Research

The final report addresses the costs of substance abuse in Oklahoma for 1996. It is titled "Everyone Pays" (PDF), a study of the costs of alcohol abuse and the use of illegal substances". The report was released in a gubernatorial press conference in June 1998.

Telemedicine Legislation
The Center released an 8 page report (March 1998) summarizing relevant state and federal legislation ... including an assessment of the impacts on the state of Oklahoma. It is entitled "Legislation/Regulatory: Telemedicine - State and Federal" (PDF).

Physician Manpower for 1996-97
The Center released two physician manpower reports in January 1998. They were entitled "Oklahoma Physician Needs" (PDF) and its companion piece "Oklahoma Physicians in 1997" (PDF). The first report looks at a variety of "physician need" models and the physician census of each of the states. The second provides a detailed census and description of the Oklahoma physician workforce. Both pieces were prepared in conjunction with Terence Grewe, D.O. Dr. Grewe is the past-president of the Oklahoma Osteopathic Association; and is a graduate of the American Osteopathic Association Certificate Program in Health Policy.

1997

Health Insurance in the US for 1995
The Center released the report "Estimated Sources of Health Insurance, by State and by Region, in 1995" (PDF) in November 1996. This report provides an overview of the sources of health insurance by state and by census region ... with an emphasis on Oklahoma.


Health Insurance in Oklahoma for 1996
The Center released the report "Estimated Sources of Health Insurance for Oklahoma in 1996." This report provides county specific estimates of insurance sources including Medicare, Medicaid, Insurance and the Uninsured. The report also categorizes and aggregates county data by economic and policy consideration, urban/rural status, and in county rank orders. The report updates reports performed 5 and 10 years earlier. The Policy Brief may be obtained at this link: Estimated Sources of Health Insurance for Oklahoma in 1996 (PDF) Additionally available are the County Specific Data (PDF) as well as the County Rank Orders (PDF).

Surgeon General's Report on Mental Health
The Surgeon General of the United State recently released an extraordinarily comprehensive report concerning metal health issues in the country. The report is available on the Internet using Adobe Acrobat Reader. It is available by individual report section. Our Center has combined each chapter into a single Acrobat file. You may download one or more chapters ... or the entire report. The chapters, file sizes and pages are listed below:

Section

Title of Section

Pages

File Size

All Chapters

Surgeon General's Report on Mental Health (PDF)

458 pages

11mb

 

Cover Sheets (PDF)

 

1mb

 

Acknowledgments (PDF)

vii - xvii

130k

Chapter 1

Introduction and Themes (PDF)

3-25

325k

Chapter 2

Fundamentals of Mental Health and Mental Illness (PDF)

32-116

3.7mb

Chapter 3

Children and Mental Health (PDF)

124-220

1mb

Chapter 4

Adults and Mental Health (PDF)

225-329

1.1mb

Chapter 5

Older Adults and Mental Health (PDF)

336-401

2.8mb

Chapter 6

Organization & Financing of Mental Health Services (PDF)

405-433

780k

Chapter 7

Confidentiality of Mental Health Information (PDF)

438-450

195k

Chapter 8

A Vision for the Future (PDF)

453-458

98k

1996

1996 Census of Graduates (PDF)
An 8 page analysis of the 1,220 graduates of OSU-COM (May 1996) (64k). Analysis includes charts and tables.

1995

Medical Education and Geriatric Care (PDF)
An 11 page position paper on the needs, and recommended processes, for emphasizing geriatric care in medical schools (December 1995).

Oklahoma's Caring for Children Program (PDF)
An analysis and position paper concerning the Oklahoma Blue Cross & Blue Shield program that provides health insurance for school children (October 1995) (33k).

Juvenile Institutions in Oklahoma (PDF)
An analysis of the unintended effects of court decisions that have simultaneously eliminated juvenile institutions and replaced them with "virtual institutions" due to lack of community resources (October 1995) (33k).

The OSU Telemedicine Center (PDF)
An overview of a unique Center that is focused upon telemedical skills training (September 1995) (50k).

1994: Trends and Geographic Distribution: (PDF)
Oklahoma Physicians in 1994. An analysis of the 1994 active physician census looking at changes during the 1984-94 period (August 1995) (50k).

1994: Physician Specialties and Distribution: (PDF)
Oklahoma Physicians in 1994. An analysis of the 1994 active physician census examining where physicians are practicing in Oklahoma (July 1995) (50k).

1994

Statistical Reports
These files offer the active physician census for Oklahoma for 1994. Sources are the respective MD and DO licensing agencies. There are three files offered:

FILE 1 (PDF): Active physicians by city. All incorporated cites, by county, are included in the census format. (48k and 16 pages)

FILE 2 (PDF): Active physicians by city. Only cities with physicians are included. (16k and 4 pages)

FILE 3 (PDF): Active physicians by county. Also included are county incomes and "rurality" of each county). (16k and 2 pages)


Medical Education for the 21st Century (PDF)
An analysis of why primary care education will be the foundation for 21st century medical education; and why osteopathic medical education could be a fundamental solution for 21st century needs. (May 1994) (50k)

1992

State Question 647: Medicaid Provider Tax (PDF)
An analysis of the impacts of Yes and NO votes on Oklahoma SQ647. This was a statewide vote on a Medicaid Provider Tax. The tax was soundly defeated by a statewide vote. (August 1992) (66k).

Oklahoma Health Care Policy Preferences (PDF)
An analysis of a non-metropolitan survey conducted by the Oklahoma State University Cooperative Extension Service. Includes distilled policy positions and options (June 1992) (33k).

Survey Results (Oklahoma Health Care Policy Preferences) (PDF)
Tabular and quantitative survey results of the above study (June 1992) (33k).

State Health Insurance Mandates (PDF) (April 1992).

1990 Costs of Teen Childbearing (PDF)
What are the direct public expenses related to teens having children? Only a third of teen mothers require public assistance. But those that do use $45,000 of public funds. (March 1992) (33k)

Health Care Costs, Insurance & Taxes (PDF) (March 1992).

Lessons for Oklahoma from ... (PDF)
This is a series of analyses of the health care systems and reform efforts from 5 nations and 3 states. Lessons learned from these efforts are applied to Oklahoma efforts. A separate study of health care in Oklahoma is also included. (February 1992).

1991

Causes of Infant Death (PDF)
An in-depth treatment of the causes of infant mortality in the state of Oklahoma (August 1991).

Small Hospitals in Oklahoma (PDF)
1989 Hospital financial data for the smaller hospitals in the state of Oklahoma (June 1991).

A Healthcare Financing Primer (PDF) (June 1991).
Where does the money come from and where does it go? A timeless chart of funds flows from individual families ... through insurers and governments ... to providers.

Childhood Immunizations (PDF) (June 1991).

Hospitals in Smaller Oklahoma Towns (PDF) (June 1991).

Vision Care in Oklahoma (PDF)
An analysis performed jointly by the Center and the College of Optometry at Northeastern (OK) State University (May 1991) (66k). Also published as: Walls Lesley L, MD, OD: Lapolla, Michael; March, Julie, OD, "A survey of eye and vision care in Oklahoma." Journal of the American Optometric Association, 1993 November; 64 (11): 799-808.

Fiscal Health of Oklahoma Hospitals (PDF)
1989 Hospital financial data for all hospitals in the the state of Oklahoma (April 1991).

Long Term Care in Oklahoma (PDF)
Nursing home data for the state of Oklahoma (April 1991).

A Layman's Guide to Medicaid Eligibility (PDF) (April 1991).
A twelve page text and chart presentation of the complexities of Medicaid eligibility. These complexities will not be affected by any managed care initiative ... but rather must be understood by managed care providers.

Physician Distribution Myths (PDF) (April 1991).
The conventional wisdom is often wrong. This study dispels some of the myths we believe.

Origins of Hospital Admissions in Oklahoma (PDF)
A study emphasizing the origins of hospital admissions for all hospitals in the state. Data includes migration patterns of patients across county lines (March 1991).

Nurse Midwives in Oklahoma (PDF) (March 1991).

Estimated Births for 1991 (PDF)
An algorithm for estimating the number of births ... and the pay source of the parent(s) ... in Oklahoma for 1991. The analysis reveals almost half of the live births will be fully/partially financed by public programs (February 1991).

State Health Benefit Plans (PDF)
An extensive analysis and comparison of health benefit plans provided to state employees in the United States. There is a special emphasis on comparison figures for Oklahoma (February 1991).

Report Card: Oklahoma's Children (PDF)
Evaluating Oklahoma's kids based upon state ranking data by the Children's Defense Funds. Clue: the overall grade is C+ (January 1991).

1990

Oklahoma Nursing Issues (PDF)
A summary of the OMRF sponsored doctoral dissertation of Laura Dempsey-Polan, Ph.D. for Cornell University (October 1990).

Executive Summary: Physician Manpower in Oklahoma (PDF)
This is an 8 page summary of the most complete and exhaustive analysis of physician resources ever done in Oklahoma. The original study consisted of a 143 page analysis. There are four parts. Each part is summarized in a separate 8 page brief. A seven page narrative of findings and policy recommendations (PDF) is also provided (October 1990).

Medical Education Systems (PDF)
An 8 page summary of physician production by the University of Oklahoma College of Medicine and the Oklahoma State University College of Osteopathic Medicine. Analyzes the physician census impacts of medical student graduates as well as graduate medical education and fellowship programs. A 50 page detailed text is provided. (PDF) is also provided (October 1990).

Critique of Past Projections (PDF)
An 8 page summary of manpower projections made 6 years ago. How accurate were they? A 20 page detailed text is provided is also provided (October 1990).

Analysis of Physician Distribution (PDF)
An 8 page summary of the geographic locations of physicians in Oklahoma by specialty and community. A 36 page detailed text is provided is also provided (October 1990).

Factors Influencing Physician Distribution (PDF)
An 8 page summary of factors determining physician location, by specialty. A 30 page detailed text is provided is also provided (October 1990).

1989

Physicians in "Rural" Counties (PDF)
An examination of Oklahoma physicians in "rural" counties (under 10,000 population). There are 15 such counties in Oklahoma. Also included are comparisons to other states. Oklahoma is better than average. (September 1989).

Fiscal Health of Oklahoma Hospitals
This study is comprised of an introduction, six chapters, and a policy implication summary, as listed below. The data was published in March 1989, but the methodology and principles are valid today. The individual studies are:

Obstetrics in Non-Metropolitan Oklahoma (PDF) (March 1989)

Infant Mortality: Oklahoma; US, & International (PDF) (May 1989)
This document computes infant mortality rates ... and provides a single aggregated rank order list of each county in Oklahoma ... each state in the nation ... and each country in the world.

Abortion Policy Review for Oklahoma (PDF) (November 1989)

Symposium Proceedings
The Center for Health Policy Research sponsored a major health policy symposium in October 1988. The session was hosted by the Oklahoma Medical Research Foundation. The speakers were of national reputation ... the topics are still very relevant. The symposium was introduced by Governor Henry Bellmon. This site offers the following five files:

FILE 1 (PDF): Summary of all presentations (16pp and 64k)

FILE 2 (PDF): Complete transcription of all presentations including Health Policy Considerations for Oklahoma by the Honorable Henry Bellmon, Governor, State of Oklahoma. (66pp and 232k)

FILE 3 (PDF): Group Health Care Plans and Small Business. Mr. John Polk, Vice President and Executive Director of the Council of Smaller Enterprises (COSE), Cleveland, Ohio. (23pp and 88k)

FILE 4 (PDF): Universal Health Insurance in Massachusetts: Its Origins, Practicality, and Meanings for Oklahoma. Alan Sager, Ph.D., Associate Professor, School of Public Health, Boston University, Boston, Massachusetts. (23pp and 88k)

FILE 5 (PDF): Rural Health Care: A Time For Change. J. Patrick Hart, Ph.D. , Center for Rural Health, Univ. of North Dakota and President-elect, National Rural Health Association. (16pp and 64k)