Research

In collaboration with international partners, GHLI develops and disseminates research to improve health systems. Our research focuses on examining health outcomes and quality of care in diverse settings and identifying their organizational, environmental and socioeconomic determinants. We also look to identify essential components of leadership, how they emerge in different settings and how they lead to flexible, efficient and effective health systems.

Through programs such as Leadership Saves Lives and EMHI, GHLI develops and evaluates interventions to improve outcomes in and across health care and government systems. This work enables GHLI to lead a framework for understanding what works in scaling up evidence-based health interventions in low-income countries (AIDED).  

More recently, GHLI has focused research on integrating social and medical services into a cross-disciplinary system that offers a holistic approach to improve the health and well-being of the population. The failure of health care systems because they do not address social factors such as education, housing and employment required to sustain wellness, is of ongoing concern at GHLI. Social determinants vs. health outcomes has become a greater area of research funded by the Robert Wood Johnson Foundation – including work on links between higher obesity and HIV rates in states that have less spending on social services vs. medical services

Recent Publications 

Risk Factors for and Consequences of Substance Use in Post-Conflict Liberia: A Qualitative Study

This study examines current risk factors for and consequences of substance use in Monrovia, Liberia with important implications for policy-makers and practitioners.

Professionalizing Healthcare Management: A Descriptive Case Study

A number of studies have demonstrated the link between management capacity and health systems performance, and the lack of managerial capacity at all levels has been cited as a key constraint in the achievement of the Millennium Development Goals and other global health targets.

Continuous Home Care Reduces Hospice Disenrollment and Hospitalization after Hospice Enrollment

Among the four levels of hospice care, continuous home care (CHC) is the most expensive care, and infrequently provided in practice.

The Impact of Reported Hospice Preferred Practices on Hospital Utilization at the End of Life 

The Affordable Care Act requires hospices to report quality measures across a range of processes and practices. Yet uncertainties exist regarding the impact of hospice preferred practices on patient outcome.

Hospitals across the United States are pursuing strategies to reduce avoidable readmissions but the evidence on how best to accomplish this goal is mixed, with no specific clinical practice shown to reduce readmissions consistently. 

Variation in Health Outcomes: The Role of Spending on Social Services, Public Health, and Health Care

Although spending rates on health care and social services vary substantially across the states, little is known about the possible association between variation in state-level health outcomes and the allocation of state spending between health care and social services. Our study suggests that broadening the debate beyond what should be spent on health care to include what should be invested in health—not only in health care but also in social services and public health—is warranted.

State Variation in HIV/AIDS Health Outcomes: The Effect of Spending on Social Services and Public Health

Despite considerable advances in the prevention and treatment of HIV/AIDS, the burden of new infections of HIV and AIDS varies substantially across the country. Previous studies have demonstrated associations between increased healthcare spending and better HIV/AIDS outcomes; however, less is known about the association between spending on social services and public health spending and HIV/AIDS outcomes. 

Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO) building blocks of health systems strengthening.