Mark Schlesinger
Datos Biográficos
| ID | 187675 |
|---|---|
| NOMBRE | Mark Schlesinger |
| NOMBRES | Mark |
| APELLIDO | Schlesinger |
| FIRMA | SCHLESINGER M |
| AFILIACIONES | Yale University |
| ORCID | 0000-0002-7142-8667 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 37 |
| TOTAL DE CITAS | 572 |
| TOTAL COMO AUTOR | 37 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1986 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 9 |
Anti-Latine bias and drug-induced homicide law support
BACKGROUND: Drug-induced homicide laws, which hold people criminally responsible for overdose deaths linked to drugs they distribute, are a prominent feature of modern United States drug policy. Some are concerned that support for these laws is bolstered by racialized assumptions about people who sell drugs. The current study examines whether and how the perceived race-ethnicity of a suspected "drug dealer" affects support for drug induced homici…
Improving Diagnosis
BACKGROUND: Understanding patients' experiences with diagnosis is crucial for improving care. Clarifying how best to ask about these experiences is an essential step in doing so. OBJECTIVE: To elicit and then categorize diagnostic problems and mistakes in a national, population-based survey. METHODS: Drawing from a nationally representative panel, respondents were asked whether they had experienced (directly or as a care partner) a diagnostic pro…
Exploring sociodemographic disparities in diagnostic problems and mistakes in the quest for diagnostic equity
Introduction: As part of building a platform for epidemiological research on diagnostic errors and problems that centers on patients and equity, this paper summarizes the development and analysis of data collected from fielding a survey in a nationally representative U.S. population to explore the prevalence and harm consequences of diagnostic problems or mistakes (referred to here as "diagnostic P&Ms") by respondent-reported sociodemographic cha…
Cross country analysis of qualitative interviews
ZORA (Zurich Open Repository and Archive) provides open and worldwide access to the research and scholarly output of the University of Zurich, Switzerland. A focus is on qualified scientific publications. ZORA is operated by the University Library together with the Central IT of the University of Zurich
The familial canopy as thought space for meaning making, emotional calibration and planful action around inherited cancer risk
The identification of genetic cancer risk often induces a reconsideration of self-concept. • Familial context is salient to individuals' engagement with elevated risk and subsequent action. • Familial generations offer distinct resources for meaning-making that are not temporally bound. • Generational peers can be salient for integration of hereditary cancer into individual identity
When Mistakes Multiply
In this essay, we explore consequences of the systemic failure to track and to publicize the prevalence of patient‐safety threats in American medicine. Tens of millions of Americans lose trust in medical care every year due to safety shortfalls. Because this loss of trust is long‐lasting, the corrosive effects build up over time, yielding a collective maelstrom of mistrust among the American public. Yet no one seems to notice that patient safety …
Envisioning Complex Futures
The development of technologies for gene editing in the wild has the potential to generate tremendous benefit, but also raises important concerns. Using some form of public deliberation to inform decisions about the use of these technologies is appealing, but public deliberation about them will tend to fall back on various forms of heuristics to account for limited personal experience with these technologies. Deliberations are likely to involve n…
Broadening Medical Students’ Exposure to the Range of Illness Experiences
PROBLEM: Exposing medical students to a broad range of illness experiences is crucial for teaching them to practice patient-centered care, but students often have limited interaction with patients with diverse illness presentations. APPROACH: The authors developed, implemented, and evaluated a self-directed online curriculum followed by a small-group discussion focused on depression education. The curriculum was based on a module created using th…
Stumbling Into Adulthood
Depression manifests in distinct ways across the life course. Recent research emphasizes how depression impedes development during emerging adulthood. However, our study-based on 40 interviews with emerging adults from multiple regions in the United States, analyzed following grounded theory-suggests a more complex narrative. Increasing experience with cycles of depression can also catalyze (a) mature perspectives and coping mechanisms that prote…
Peer effects of obesity on child body composition
How Patient Comments Affect Consumers’ Use of Physician Performance Measures
BACKGROUND: Patients' comments about doctors are increasingly available on the internet. The effects of these anecdotal accounts on consumers' engagement with reports on doctor quality, use of more statistically reliable performance measures, and ability to choose doctors wisely are unknown. OBJECTIVE: To examine the effects of providing patient comments along with standardized performance information in a web-based public report. DESIGN: Partici…
Explaining Racial/Ethnic Disparities in Use of High-Volume Hospitals
Racial/ethnic minorities are less likely to use higher-quality hospitals than whites. We propose that a higher level of information-related complexity in their local hospital environments compounds the effects of discrimination and more limited access to services, contributing to racial/ethnic disparities in hospital use. While minorities live closer than whites to high-volume hospitals, minorities also face greater choice complexity and live in …
The Insecure American
Even before the sharp downturn that began in 2007, many Americans were concerned about economic risks. Yet this widespread public concern has not been matched by attention from political scientists regarding how citizens experience and understand the economic risks they face or how those experiences and understandings shape their views of public policy. We develop here an argument about the role of personal economic experiences in the formation o…
Caring for Grieving Family Members
BACKGROUND: A founding principle of hospice is that the patient and family is the unit of care; however, we lack national information on services to family members. Although Medicare certification requires bereavement services be provided, reimbursement rates are not tied to the level or quality of care; therefore, limited financial incentives exist for hospice to provide more than a minimal benefit. OBJECTIVES: To assess the scope and intensity …
Consumer Response to Patient Experience Measures in Complex Information Environments
BACKGROUND: As indicators of clinician quality proliferate, public reports increasingly include multiple metrics. This approach provides more complete performance information than did earlier reports but may challenge consumers' ability to understand and use complicated reports. OBJECTIVES: To assess the effects of report complexity on consumers' understanding and use of patient experience measures derived from the Consumer Assessment of Healthca…
Insecure Alliances
Popular support for the welfare state varies greatly across nations and policy domains. We argue that these variations-vital to understanding the politics of the welfare state-reflect in part the degree to which economic disadvantage (low income) and economic insecurity (high risk) are correlated. When the disadvantaged and insecure are mostly one and the same, the base of popular support for the welfare state is narrow. When the disadvantaged an…
Quality of Palliative Care at US Hospices
BACKGROUND: The National Quality Forum (NQF) identified hospice services as a national priority area for health care quality improvement and endorsed a set of preferred practices for quality palliative and hospice care. This study reports the first national data regarding hospices' self-reported implementation of the NQF preferred practices and identifies hospice characteristics associated with more comprehensive implementation. METHODS: We condu…
Obesity Metaphors
Context: Relatively little is known about the factors shaping public attitudes toward obesity as a policy concern. This study examines whether individuals' beliefs about the causes of obesity affect their support for policies aimed at stemming obesity rates. This article identifies a unique role of metaphor‐based beliefs, as distinct from conventional political attitudes, in explaining support for obesity policies. Methods: This article used the …
Racial and Ethnic Disparities in the Use of High-Volume Hospitals
Differences in the source of care could contribute to racial and ethnic disparities in health status. This study looks at a major metropolitan area and examines racial and ethnic differences in the use of high-volume hospitals for 17 services for which there is a documented positive volume-outcome relationship. Focusing on the hospitalizations of New York City area residents in the periods 1995-1996 and 2001-2002, we found, after controlling for …
The Accountability of Nonprofit Hospitals
Under Internal Revenue Service requirements, nonprofit hospitals will begin filing new community benefit reports in 2010. Maryland has had similar requirements since 2004. This paper, based on interviews at 20 hospitals, describes how Maryland's requirements affected hospitals and their activities. Increases in reported community benefit expenditures since the program began are due to both changes in activities and better data capture. Charity ca…
The flip-side of social capital
Nonprofit Health Care Organizations and the Public Trust
Sources of stigma for means-tested government programs
Policy Frames, Metaphorical Reasoning, and Support for Public Policies
This article evaluates the predictive value of a new theory for understanding public support for alternative solutions to policy problems, which we call policy metaphors. A policy metaphor represents a particular form of cognitive framing that makes use of commonly understood social institutions and judgments about their effectiveness to form "archetypes" against which proposed solutions to new policy problems are compared. We test the extent to …
Policy Feedback and Public Opinion
This study extends the literature on policy feedback and explores the extent to which public attitudes reflect learning from past government initiatives. We analyze the ways in which feedback mechanisms affecting public attitudes may differ from those earlier identified in the literature. We apply this general analytic framework to help explain variation in public attitudes toward private employer involvement in health care, explore possible caus…
Insecure Alliances
Popular support for the welfare state varies greatly across nations and policy domains. We argue that these variations-vital to understanding the politics of the welfare state-reflect in part the degree to which economic disadvantage (low income) and economic insecurity (high risk) are correlated. When the disadvantaged and insecure are mostly one and the same, the base of popular support for the welfare state is narrow. When the disadvantaged an…
Sources of stigma for means-tested government programs
The Insecure American
Even before the sharp downturn that began in 2007, many Americans were concerned about economic risks. Yet this widespread public concern has not been matched by attention from political scientists regarding how citizens experience and understand the economic risks they face or how those experiences and understandings shape their views of public policy. We develop here an argument about the role of personal economic experiences in the formation o…
Gender Gap or Gender Gaps? New Perspectives on Support for Government Action and Policies
This paper clarifies the theoretical bases for expecting women to be more supportive of government programs than are men. We identify several factors not developed in past literature: (1) differences in emotional responses to social problems, (2) gendered differences in the awareness of those problems among one's own kin, (3) differences in the perceived fairness of existing social institutions, (4) differences in the perceived efficacy of govern…
Policy Frames, Metaphorical Reasoning, and Support for Public Policies
This article evaluates the predictive value of a new theory for understanding public support for alternative solutions to policy problems, which we call policy metaphors. A policy metaphor represents a particular form of cognitive framing that makes use of commonly understood social institutions and judgments about their effectiveness to form "archetypes" against which proposed solutions to new policy problems are compared. We test the extent to …
The Meaning and Measure of Policy Metaphors
The apparent ability of the American public to form coherent assessments of policy options-while being largely ignorant of political institutions, actors, and ideology-remains a persistent puzzle for political science. We develop a theory of political decision making that helps resolve this puzzle. We postulate that both the public and political elites comprehend complex policies in part through "reasoning by policy metaphor," which involves comp…
The flip-side of social capital
Trust, repute and the role of non-profit enterprise
This article examines the trust hypothesis: the claim that asymmetric information can explain the existence of non-profit enterprise in certain markets. We argue that this hypothesis, in order to be viable, has to meet three challenges: ‘reputational ubiquity’, ‘incentive compatibility’ and ‘adulteration’. Drawing on modern agency theory, we conclude that the trust hypothesis stands on shaky ground. It can be sustained only under particular condi…
Competitive Bidding and States' Purchase of Services
Competitive bidding and states' purchase of services
Over the past two decades states have significantly increased their use of competitive bidding to purchase health and social services from private agencies. Competitive contracting is thought to facilitate program administration, to reduce costs, and to increase the quality of delivered services. We evaluate these claims in light of Massachusetts' experience with competitive contracting for mental health care. We find that few of the expected ben…
Stumbling Into Adulthood
Depression manifests in distinct ways across the life course. Recent research emphasizes how depression impedes development during emerging adulthood. However, our study-based on 40 interviews with emerging adults from multiple regions in the United States, analyzed following grounded theory-suggests a more complex narrative. Increasing experience with cycles of depression can also catalyze (a) mature perspectives and coping mechanisms that prote…
Containing mental health treatment costs through program design
A single site pre-post study of seriously mentally ill patients treated in a public mental health system shows that annual treatment costs can be substantially reduced with the use of day hospital treatment. Two cohorts of psychiatric patients--282 consecutive admissions to a traditional public inpatient unit in 1980, and 340 consecutive admissions to a combination of inpatient and day hospital care in 1984--were followed 12 months after admissio…
Competitive Bidding and States' Purchase of Services
Competitive bidding and states' purchase of services
Over the past two decades states have significantly increased their use of competitive bidding to purchase health and social services from private agencies. Competitive contracting is thought to facilitate program administration, to reduce costs, and to increase the quality of delivered services. We evaluate these claims in light of Massachusetts' experience with competitive contracting for mental health care. We find that few of the expected ben…
Profits Under Pressure
This study assesses the economic performance of investor-owned and private nonprofit health maintenance organizations by comparing their costs and revenues, controlling for other characteristics of the plans and the areas in which they are located. Data are drawn from a sample of 173 HMOs operating in 1983, one quarter under proprietary auspices. For-profit plans have average costs 10% higher than their nonprofit counterparts, primarily due to hi…
The perfectibility of public programs
The perfectibility of public programs: real lessons from large-scale demonstration projects. M SchlesingerCopyRight https://doi.org/10.2105/AJPH.78.8.899 Published Online: October 07, 2011
Containing mental health treatment costs through program design
A single site pre-post study of seriously mentally ill patients treated in a public mental health system shows that annual treatment costs can be substantially reduced with the use of day hospital treatment. Two cohorts of psychiatric patients--282 consecutive admissions to a traditional public inpatient unit in 1980, and 340 consecutive admissions to a combination of inpatient and day hospital care in 1984--were followed 12 months after admissio…
The Ownership of Health Facilities and Clinical Decisionmaking
The growth of investor-owned health care facilities raises questions about the relationship between profit seeking and medical decisionmaking. The authors compared the treatment received by patients with end-stage renal disease in private nonprofit, for-profit, and public facilities. Using data collected by the Health Care Financing Administration in 1981, they found that facility ownership had a significant independent effect on treatment of ren…
Contracting Between Public Agencies and Private Psychiatric Inpatient Facilities
Purchasing human services through contracts with private providers has become an increasingly common practice over the past 20 years. Using data from a national survey of psychiatric inpatient facilities, this paper examines the extent to which psychiatric units in privately controlled general hospitals and private psychiatric specialty hospitals (N = 611) participate in contractual arrangements to provide services to governmental bodies. It also…
Trust, repute and the role of non-profit enterprise
This article examines the trust hypothesis: the claim that asymmetric information can explain the existence of non-profit enterprise in certain markets. We argue that this hypothesis, in order to be viable, has to meet three challenges: ‘reputational ubiquity’, ‘incentive compatibility’ and ‘adulteration’. Drawing on modern agency theory, we conclude that the trust hypothesis stands on shaky ground. It can be sustained only under particular condi…
Competition, Ownership, and Access to Hospital Services
OBJECTIVES: This article examines the impact of increasing competition among hospitals on access to inpatient services and preexisting differences in access between nonprofit and for-profit facilities. It tests theoretical propositions that suggest that nonprofit and for-profit hospitals will respond in different ways and to differing degrees to changing competitive pressures. METHODS: Drawing data from a 1987-88 national survey of psychiatric ho…
Risk, motives, and styles of utilization review
The Meaning and Measure of Policy Metaphors
The apparent ability of the American public to form coherent assessments of policy options-while being largely ignorant of political institutions, actors, and ideology-remains a persistent puzzle for political science. We develop a theory of political decision making that helps resolve this puzzle. We postulate that both the public and political elites comprehend complex policies in part through "reasoning by policy metaphor," which involves comp…
Gender Gap or Gender Gaps? New Perspectives on Support for Government Action and Policies
This paper clarifies the theoretical bases for expecting women to be more supportive of government programs than are men. We identify several factors not developed in past literature: (1) differences in emotional responses to social problems, (2) gendered differences in the awareness of those problems among one's own kin, (3) differences in the perceived fairness of existing social institutions, (4) differences in the perceived efficacy of govern…
Policy Feedback and Public Opinion
This study extends the literature on policy feedback and explores the extent to which public attitudes reflect learning from past government initiatives. We analyze the ways in which feedback mechanisms affecting public attitudes may differ from those earlier identified in the literature. We apply this general analytic framework to help explain variation in public attitudes toward private employer involvement in health care, explore possible caus…
Policy Frames, Metaphorical Reasoning, and Support for Public Policies
This article evaluates the predictive value of a new theory for understanding public support for alternative solutions to policy problems, which we call policy metaphors. A policy metaphor represents a particular form of cognitive framing that makes use of commonly understood social institutions and judgments about their effectiveness to form "archetypes" against which proposed solutions to new policy problems are compared. We test the extent to …
Nonprofit Health Care Organizations and the Public Trust
Sources of stigma for means-tested government programs
Obesity Metaphors
Context: Relatively little is known about the factors shaping public attitudes toward obesity as a policy concern. This study examines whether individuals' beliefs about the causes of obesity affect their support for policies aimed at stemming obesity rates. This article identifies a unique role of metaphor‐based beliefs, as distinct from conventional political attitudes, in explaining support for obesity policies. Methods: This article used the …
Racial and Ethnic Disparities in the Use of High-Volume Hospitals
Differences in the source of care could contribute to racial and ethnic disparities in health status. This study looks at a major metropolitan area and examines racial and ethnic differences in the use of high-volume hospitals for 17 services for which there is a documented positive volume-outcome relationship. Focusing on the hospitalizations of New York City area residents in the periods 1995-1996 and 2001-2002, we found, after controlling for …
The Accountability of Nonprofit Hospitals
Under Internal Revenue Service requirements, nonprofit hospitals will begin filing new community benefit reports in 2010. Maryland has had similar requirements since 2004. This paper, based on interviews at 20 hospitals, describes how Maryland's requirements affected hospitals and their activities. Increases in reported community benefit expenditures since the program began are due to both changes in activities and better data capture. Charity ca…
The flip-side of social capital
Quality of Palliative Care at US Hospices
BACKGROUND: The National Quality Forum (NQF) identified hospice services as a national priority area for health care quality improvement and endorsed a set of preferred practices for quality palliative and hospice care. This study reports the first national data regarding hospices' self-reported implementation of the NQF preferred practices and identifies hospice characteristics associated with more comprehensive implementation. METHODS: We condu…
Caring for Grieving Family Members
BACKGROUND: A founding principle of hospice is that the patient and family is the unit of care; however, we lack national information on services to family members. Although Medicare certification requires bereavement services be provided, reimbursement rates are not tied to the level or quality of care; therefore, limited financial incentives exist for hospice to provide more than a minimal benefit. OBJECTIVES: To assess the scope and intensity …
Consumer Response to Patient Experience Measures in Complex Information Environments
BACKGROUND: As indicators of clinician quality proliferate, public reports increasingly include multiple metrics. This approach provides more complete performance information than did earlier reports but may challenge consumers' ability to understand and use complicated reports. OBJECTIVES: To assess the effects of report complexity on consumers' understanding and use of patient experience measures derived from the Consumer Assessment of Healthca…
Insecure Alliances
Popular support for the welfare state varies greatly across nations and policy domains. We argue that these variations-vital to understanding the politics of the welfare state-reflect in part the degree to which economic disadvantage (low income) and economic insecurity (high risk) are correlated. When the disadvantaged and insecure are mostly one and the same, the base of popular support for the welfare state is narrow. When the disadvantaged an…
The Insecure American
Even before the sharp downturn that began in 2007, many Americans were concerned about economic risks. Yet this widespread public concern has not been matched by attention from political scientists regarding how citizens experience and understand the economic risks they face or how those experiences and understandings shape their views of public policy. We develop here an argument about the role of personal economic experiences in the formation o…
Political science (22 obras) · Medicine (18 obras) · Economics (17 obras) · Health care (15 obras) · Psychology (15 obras) · Business (13 obras) · Economic growth (10 obras) · Nursing (9 obras) · Social Psychology (9 obras) · Healthcare Policy and Management (8 obras)