What is your topic? Or what are your key words thus far?
Universal Health Care
UHC
Private Insurance
policy
I start a lot of my initial research either on the UNR KC website of the AJPH. As noted above in the picture, I need to really start thinking about inclusion/exclusion factors because when I simply look up policy + _something___ a lot of variety comes up. Maybe I can include only current studies.... 1990 and greater. I can exclude non American results to focus on solely our information and funnel my question down again.
What is your research question? Have you decided to change it at all? And, if you have, how do I know that the way in which this question is formulated is appropriate to conduct a literature review with a systematic approach?
Original Question: With a new leader in power, how will the structure of American Healthcare change? Is it possible or even plausible for the US to shift to Universal Healthcare as most countries have?
Revised: What changes or adaptations can policymakers create to ensure universal coverage for all American citizens?
This shifts my question away from possible bias, away from current government issues, but still focuses on the issue of the system itself. This narrows down my search significantly while opening up more literature instead of things published in relation to election (I mean this as saying there probably isn't enough research right now since Trump JUST took office)
And what are the definitions on which it depends?
My question depends on a few terms...
policymakers --> anyone in the healthcare field that can create a change within policy and law
universal coverage --> riding the system of private insurers -or- creating universal coverage backbone while allowing others to opt into private care... having a basic plan insuring ALL and private for MORE benefits
ALL AMERICAN CITIZENS --> no loopholes, no non insured citizens, EVERYONE
What is your hierarchy of evidence? And how do I know you going about finding the most appropriate evidence/method for your research question?
My question mainly relies on policy literature, but through researching, I was greatly interested in practice literature to see how certain models of structure were working in current times. This allowed me to compare and contrast different systems and answer my question fully. I also came across quite a few random clinical trials testing patients reactions to different types of health care and the qualities of their care. This will also help my research overall to be able to decide IF the system should change.
Policy
Practice
RCT
How do I know that the remit of the method itself is selecting the research, rather than just you on a whim? + 1 thing you found interesting + how you imagine using the source
Article #1
Martin, D. P., Diehr, P., Price, K. F., & Richardson, W. C. (1989). Effect of a gatekeeper plan on health services use and charges: a randomized trial. American Journal of Public Health, 79(12), 1628–1632.
This is a random clinical trial, and though lower on my hierarchy of evidence chain, it still has extremely relevant information. This method is rather different for my policy analysis approach but will greatly influence my paper's argument. It demonstrates just how certain people feel on certain plans and how they feel their treatment is. It also analyzes costs of different structures and many other important aspects when deciding to change policy. I found most interesting that many Americans didn't want change... even though we know the system is failing.
Article #2
Akhter, M. N. (2003). APHA Policies on Universal Health Care: Health for a Few or Health for All? American Journal of Public Health, 93(1), 99–101.
This source is directly relevant to my research question, as it is actually analyzing healthcare policy. It discussed the risk vs rewards of changing the current system and discusses thoroughly what would need to change and how we can make certain laws adapt to fit growing needs. It matches directly with my questions and I can see myself really diving deep into this article because of the quality of in-depth analysis and actual results. The most interesting thing to me was definitely realizing just how much is spent on a failing system.
Article #3
Tooker, J. (2003). Affordable health insurance for all is possible by means of a pragmatic approach. American Journal of Public Health, 93(1), 106–109. doi:10.2105/ajph.93.1.106
This is my "dream article" as it directly states just how America can make UHC work and why its beneficial. It discusses the fact that the American HealthCare system could flourish if they switched to universal coverage. It also discussed major benefits to citizens if the switch were to happen and how exactly the government can make these happen. It spoke on lessons we can learn from past policy and current issues. This specifically relates to my article because it shows the steps to make UHC successful and the benefits in doing so, which is what my article will overall be about. I can see myself using this as the main argument and even supporting facts from other articles. The most interesting thing to me was just the strong language used and the call to action.
Article #4
Ottersen, T., & Schmidt, H. (2017). Universal health coverage and public health: Ensuring parity and Complementarity. American Journal of Public Health, 107(2), 248–250. doi:10.2105/ajph.2016.303590
This is another policy review that fits well with my current research question. It discusses how we can keep equality within the healthcare system even when it is changing and after. It will be great evidence supporting the backbone to my argument and provides clear insight to the "ensuring the coverage of all Americans" that my question really focuses on. The most interesting thing to me while also being the most important part of this article is how well it defined many health terms relating to coverage that I fear many Americans and those not well educated do not know. I can also seeing myself defining these in my paper to ensure the reader understand just what I am talking about.
Article #5
Leavell, H. R. (1953). The basic unity of private practice and public health. American Journal of Public Health and the Nations Health, 43(12), 1501–1506. doi:10.2105/ajph.43.12.1501
I went back and forth on deciding if the information in this article was important enough to include. I am going to include it at this moment because I feel like I chose a rather hard concept to write my paper on and that my audience might need some background information and defining of key terms that I will use throughout my entire paper. It discusses the meaning behind private practice within public health and how it evolved over time. I am also hoping that this helps me relate to our current system needing a "face-lift" per say and hopefully convince the audience that our system needs to evolve again to match competing countries and ensure the health of again, ALL CITIZENS.
Anything else interesting happen?
My research question keeps changing to fit my needs and better fit my actual research. I am learning so much in how to shape a question and how to structure a systematic review of a ton of different, related sources. Also, really looking in depth into every source helps me funnel down information I see needed for my paper and helps me decide what is most important in my research and in my overall discussion.
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