Suchergebnisse

AbstractThe nation's governors took strong and decisive action in responding to the 2020 COVID-19 pandemic, often directly affecting their local governments. These actions allow us to examine this question: Will governors' actions in an unprecedented emergency situation centralize the authority of the state or rely on local governments to deal with localized problems? Additionally, what factors affect those decisions? We examine all governors' executive orders affecting local governments in the first five months of the 2020 pandemic. We find that preemption did occur, especially in the early months of the pandemic. States that gave their localities more autonomy were associated with preemption throughout the pandemic; the governor's party affiliation and her ideological match with local officials were associated with greater preemption in some phases of the pandemic but not others.

Cognizant of the disappointing health status effects of home care in past studies, the authors argue that home care (homemaker, chore, day care, and other personal care services) is ill equipped to alter health status but could alter the way in which patients, family, and physicians respond to health status changes. If it does this, it should be effective in preventing some of certain types of hospitalizations: those for death, nursing home placement, and evaluation. This study, which reanalyzes the National Channeling Demonstration Project data set to focus on these three most promising outcome effects of home care found that it did not prevent these types of potentially avoidable hospitalizations. Indeed, there is little evidence that such targeted preventive efforts took place. This may suggest that the objective function of home care should be redefined to focus on altering responses to health status change rather than on altering health status.