ACRL

Association of College & Research Libraries

Internet resources for health policy

By Lynne M. Stuart and Dena Holiman Hutto

Financial, governmental, and industrial resources

I nterest in health policy exploded on cam- puses as well as the rest of the nation in 1992 when President Clinton made health care reform a priority for his administration. Although his comprehensive health care reform proposal died with the 103rd Congress in 1994, the na- tional debate continues. Current federal bud- get-cutting proposals would limit Medicare, Medicaid, and other health care programs. State governments may have to assume the burden of ensuring access to health care if federal cut- backs occur. Regardless of government action or inaction, health care consumers and provid- ers continue to struggle with the economics of rising health care costs.

Health policy is created by a combination of forces in government, the health care and insurance industries, and the medical profession. Doctors, elected officials, regulators, hospital administrators, and insurance companies determine the cost, availability, and quality of health care. As an academic discipline, health policy includes the study of legislative, regulatory, and statistical information traditionally found in government publications, as well as literature in the fields of economics, politics, medicine, business, sociology, and management. One of the challenges facing those who study health policy is its interdisciplinary nature. The World Wide Web, which has no walls or shelves, allows the user to create virtual interdisciplinary collections containing very current information at a level of detail that until recently was available only at large research libraries.

Best starting points

This core list of gateway sites provides an introduction to health policy resources on the Internet. It can also be used to stay abreast of new and changing sites.

Health Administration Resources. This is a joint venture of Mercer University Atlanta Computer Center and Georgia State University Institute of Health Administration. Links include health administration associations, university programs in health administration, and health administration-related listservs and archives. Access: http://www.mercer.peachnet. edu/ www/health/health ‚html.

Yahoo: Health. Yahoo’s “Health” directory is subdivided into many categories, including “health care,” “health administration,” “health insurance,” and “institutes.” These subdirectories contain homepages for health care players such as companies, universities, and government agencies. Access: http:// www.yahoo.com/Health/.

MedWeb: Health Care Reform. This site from Emory University includes a comprehensive list of health care sites. Full-text documents include the Medicare 1995 Handbook and the Glossary of Health Standards. Access: http:// www.cc.emory.edu/WHSCL/medweb. healthreform.html.

HealthSeek. A directory of more than 240 sites containing industry-related news for the health care community. Sites are grouped into topical categories such as research and organizations. Access: http://www.healthseek. com.

Lynne M. Stuart is humanities librarian/general reference at Pennsylvania State University, e-mail: lms@psulias.psu.edu; Dena Holiman Hutto is documents librarian/cataloger at Penn State, e-mail: dhh@psulias.psu.edu

Government sources

The federal government’s rapidly expanding network of Internet resources now rivals printed government documents in its coverage of proposed or enacted legislation and regulations. Most government agencies at the federal and state levels are replacing public access electronic bulletin boards with World Wide Web hypertext documents. As a result, current bills, laws, and regulations that were formerly available only through expensive commercial online services or through difficult-to-use free services are now available directly to libraries, businesses, or the public in a user-friendly form.

GPO Access. The Government Printing Office introduced GPO Access via a handful of library-sponsored “gateway” sites beginning in late 1994. Now a centralized Superintendent of Documents Home Page provides free public access to each of these library “gateways,” many with Web page interfaces, at one Internet address. Congressional bills, public laws, reports, calendars, the Federal Register, the U.S. Code, the Congressional Record, Economic Indicators, and the Government Accounting Office “blue book” reports are available as separate electronic files that can be searched separately or in any combination. Bibliographic databases for locating printed government documents and information for obtaining paid subscriptions to GPO Access are also available. Access: http:// www.access.gpo. gov/su_docs/.

Department of Health and Human Services–Policy Information. Pending legislation, new laws and regulations pertaining to health care, information about HHS programs, and Congressional testimony by agency officials. See also links to HHS-sponsored research and other HHS agency Web sites. Access: http: //www.os.dhhs.gov/.

HCFA (Health Care Financing Administration). Medicare and Medicaid program information, including regulations, statistics on program usage and cost, physician payment schedules, and demographics of program users. See also HCFA’s parent Web site, the Social Security Administration’s Social Security On Line (http://www.ssa.gov/) for summaries of recent legislation. Access: http://www.ssa.gov/ hcfahp2.html.

FinanceNet. This federally sponsored independent Web site is a popular starting point for anyone seeking government budget information. Especially valuable to health care researchers is an electronic version of the “Green Book,” an annual publication from the U.S. House of Representative’s Committee on Ways and Means that details the cost and usage of federal entitlement programs. Also provides links to the U.S. budget, U.S. Government Manual, the OMB (Office of Management and Budget) Resource Page, and budgets of state and local governments. Access: http:// www.financenet.gov/.

Welcome to the White House: A Citizen’s Interactive Handbook. In addition to the White House tour and first family photos, the White House’s Web site includes texts of presidential speeches, press releases, and major policy documents about the Clinton Administration’s own health care initiatives, as well as its responses to congressional proposals. Links to other federal government sites are provided. Access: http://www.whitehouse.gov.

StateSearch. The National Association of State Information Resource Executives (NASIRE) maintains this subject directory of state government information sources on the Internet. At this writing, 22 states have resources listed in the “Health, Human Services, and Welfare” subject directory. Access: http://www.state.ky. us/nasire/NASIREhome.html.

State and Local Government on the Net. A comprehensive collection of sites by and about state governments. Includes links to individual states and state agencies, as well as to national organizations of state and local governments and federal resources for state and local governments. A “quick search” option allows sitewide keyword searching. Access: http: //www.piperinfo.com/-piper/states/states.html.

World Health Organization (WHO) World Wide Web Server. Information on international programs that aim to improve worldwide access to health care. Electronic versions of World Health Report, newsletters, catalogs of WHO publications, and a link to WHOSIS, the WHO Statistical Information System. Access: http://www.who.ch/Welcome.html.

Demographic and Health Surveys (DHS). Results of national health surveys in developing countries, funded mainly by the U.S. Agency for International Development (USAID). Publications and data are available for Africa, Asia, Latin America, and the Caribbean. Access: http://www.macroint.com/dhs.

Academic/research sites

Urban Institute’s Health Policy Center. The Health Policy Center addresses issues that arise from the inevitable trade-offs among health care costs, access, and quality. The site includes full-text material and bibliographies of books, papers, presentations, and articles. Access: http://www.urban.org/ar94/centers/ hp00.htm.

Intergovernmental Health Policy Project (IHPP). Based at George Washington University, the IHPP is one of the few Internet sites devoted to the study of health care policy at the state and local levels. This site describes research projects, publications, and a subscription legislative tracking service. It also includes table of contents information for State Health Notes, the project’s biweekly newsletter. Access: http://www.gwu.edu/~ihpp/shnold.html.

RAND. Rand is a nonprofit institution that works to improve public policy through research and analysis. Its site contains abstracts of research reports from 1990 to the present that cover health-related topics such as managed care. RAND Research Review, which previews reports three times a year, appears in full text. Access: http://www.rand.org/.

Associations

Professional associations with World Wide Web sites typically provide contact information and statements of purpose. Many sites also contain newsletters, policy documents, and other full- text material related to their missions and activities.

AMA (American Medical Association). Nearly 300,000 physicians and medical students form the membership of the AMA. The site contains the table of contents and abstracts from the Journal of the American Medical Association (JAMA) and other journals. The full text of press releases and AMA News are available as well as other selected material. Access: http:// www.ama-assn.org/.

HFMA (Healthcare Financial Management Association). This is the organization for almost 33,000 financial management professionals employed by integrated delivery systems, long-term and ambulatory care facilities, managed care organizations, medical practice groups, hospitals, public accounting and consulting firms, insurance companies, government agencies, and other organizations. HFMA’s Web site promotes its educational programs and conferences. Access: http://www.hfma.org.

National Association of Insurance Commissioners (NAIC). This is the organization of insurance regulators from the 50 states, the District of Columbia, and the four U.S. territories. The NAIC provides a forum for the development of uniform policy. Its Web site includes abstracts from the Journal of Insurance Regulation. A clickable United States map enables users to retrieve homepages of state insurance commissioners, which provide access to state regulations, information, and products. Access: http://www.naic.org/.

HCLA (Health Care Liability Alliance). This national advocacy coalition supports effective federal health care liability reform to enhance the fairness, timeliness, and cost- effectiveness of the civil justice system in resolving health care injury disputes. Members are individuals and organizations representing physicians, hospitals, liability insurers, health device manufacturers, health care insurers, businesses, producers of medicines, and the biotechnology industry. It contains full-text press releases, fact sheets, opinion poll research, statements, and excepts of Congressional testimony. The Web site is maintained by Fleishman- Hillard, a public relations firm. Access: http:// www.wp.com/hcla/.

EHMA (European Healthcare Management Association). EHMA’s mission is to improve health care within the European Union by raising standards of managerial performance in the health sector. An electronic newsletter, news releases, and policy statements are available. Access: http://www.iol.ie/~ehma/.

Journals

Most health policy journal Internet sites provide abstracts and ordering information rather than full electronic text. To locate full-text newsletters and news release of specific organizations and government agencies, search for the organization or agency’s Internet site.

Health Care Financing Review. The journal of the Health Care Financing Administration contains articles about all aspects of health care administration with particular focus on Medicare and Medicaid. This site includes author’s abstracts for 1994 to date. Access: http://www.ssa.gov/hcfa/ord/absum95. html.

Health Policy Page. This site is a component part of Idea Central, a virtual magazine of the Electronic Policy Network. The magazine is edited by Paul Starr. The Health Policy Page includes articles, reports, and statistics about health care policy in America. Much of the material comes from leading policy research and advocacy organizations. Access: http:// epn.org/idea/health.html.

Health Services Research.This journal is published bimonthly for the Hospital Research and Educational Trust by Health Administration Press in cooperation with the Association for Health Services Research. It is the official journal of the Association for Health Services Research. The site contains ten-year subject and author indexes. Access: http:// www.xnet.com/~hret/hsr.htm.

Journal of Health Politics, Policy and Law.The focus of this journal from Duke University Press is an interdisciplinary approach to health policy research. This site includes cumulative 20-year author and subject indexes. Access: http://www.pitt.edu/~jhppl/jhppl.html.

Health care industry

Individual companies are a growing category of health care Internet sites. Many contain useful information about the business of health care.

• HCIA, INC.The Health Care Information Company develops and markets clinical and financial decision support systems to hospitals, integrated delivery systems, managed care organizations, and pharmaceutical manufacturers. The company develops databases used to benchmark clinical performance and outcomes, management costs, and delivery of health care services. Access: http://157.199.4.32/index.html.

• Group Health Cooperative.This mem- ber-governed managed health care organization serves more than 500,000 members in Washington state and Idaho. Its site illustrates how this type of organization delivers quality care to its members. Access: http://www.ghc. org/.

• Mayo Clinic.The clinic is a team practice that serves 40,000 patients a year in five states. Its Web server includes statistics on business operations at individual facilities and throughout the Mayo health system. A key-word search engine provides topical access. Access: http://www.mayo.edu/.

• Merck & Co., Inc.This pharmaceutical products and services company has created a Web site that includes research reports, product information, and a hypertext version of its 1994 annual report. Access: http://www.merck. com:80/. ■

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