All Berkeley professors are expected to perform three functions:
research, teaching, and service. As a professor of health policy,
I find that one of the most rewarding parts of my job is in
service, which involves translating the findings from the
research that my colleagues and I have done into meaningful
public policy. In fact, my research program is grounded in
asking questions that are policy relevant and that will
immediately inform the public policy debate.
There are two research grants that I am conducting at the present that directly feed into California policy. The first is my participation in the Right Care Initiative, a statewide quality improvement initiative led out of the Department of Managed Health Care. Arnold Milstein, MD, MPH ’75, the medical director of the Pacific Business Group on Health and a thought leader at Mercer, Inc., and I are the cochairs of the “get to zero” hospital acquired infections (HAI) campaign.
The harm associated with HAIs— measured in terms of their impact on the public’s health and high costs to the health care system—is staggering. It has been estimated that more than 1.7 million persons or as many as 10 percent of hospital inpatients develop HAIs each year, with an estimated 99,000 attributable deaths, at a cost of $28-33 billion dollars.
California enacted legislation requiring mandatory reporting of HAIs for two years beginning 2009, followed by public reporting beginning in 2011 (SB 1058). At the present time, there are no standardized data on infection rates in California’s hospitals. However, under a million dollar grant from the Blue Shield of California Foundation, we conducted a statewide survey on HAI prevention in California’s hospitals (response rate 78 percent) and made the findings available to state policy makers to inform their programmatic decisions on reducing HAIs. We will be conducting a second survey of the hospitals this spring to examine hospital responses to the mandatory reporting requirement and changes in hospital policies and practices to reduce HAIs.
The other major project I conduct in California that has a significant service component is the California Health Benefits Review Program (CHBRP), which is authorized by the Legislature and directed out of the UC Office of the President. We are conducting a comprehensive analysis of all proposed bills that include mandates for health insurers and health plans to offer specific benefits or services. The analysis has three parts: 1) a review of the medical effectiveness literature for the proposed mandate, 2) an analysis of the impact of the mandate on health care expenditures and premiums, and 3) an analysis of the impact of the mandate on the public’s health. There are three vice chairs responsible for each of these analyses—medical effectiveness at UCSF, cost analysis at UCLA, and public health analysis (myself) at UC Berkeley.
Both the Legislature and the Governor’s Office have found this work to be enormously helpful through the introduction of comprehensive evidence and objective analysis into the legislative process. They frequently cite the CHBRP reports when considering these bills. The project has been a tremendous success in demonstrating the value of involving academics with specific expertise in a multi-campus initiative to inform state policy. In both of these projects, California is leading the way in engaging university faculty in a meaningful way in service to the state and the development of good public policy.