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Implementation strategies of patient-focused care. 以病人为中心的护理实施策略。
Hospital & health services administration Pub Date : 1995-01-01
A L Mang
{"title":"Implementation strategies of patient-focused care.","authors":"A L Mang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 3","pages":"426-35"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21016083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Access implications of rural hospital closures and conversions. 农村医院关闭和改建对获取的影响。
Hospital & health services administration Pub Date : 1995-01-01
N L McKay, J A Coventry
{"title":"Access implications of rural hospital closures and conversions.","authors":"N L McKay,&nbsp;J A Coventry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines the effects of rural hospital closures and conversions on various structural dimensions of access. Based on a data set of rural hospitals in Texas during the period 1985-1990, the results indicate that closure or conversion typically had relatively little detrimental effect on hospital services and distance to alternative sources of care, but hospital bed and physician availability may have been adversely affected in certain cases. Rural hospital conversions to alternative types of health care facilities, such as ambulatory care clinics, do appear to have maintained the availability of a restricted set of medical services in some rural areas.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 2","pages":"227-46"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21015080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A model of voluntary turnover among hospital CEOs. 医院首席执行官自愿离职模型研究。
Hospital & health services administration Pub Date : 1995-01-01
P A Weil, P A Kimball
{"title":"A model of voluntary turnover among hospital CEOs.","authors":"P A Weil,&nbsp;P A Kimball","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study examines factors contributing to hospital CEOs' voluntary decisions to leave their positions in 1990. Using a longitudinal design, we contrast 49 leavers with 1,362 stayers. We view turnover as influenced by both \"push\" factors that promote leaving (dissatisfaction with the position) and \"hump\" factors that need to be overcome (the cost of job change). Push factors giving rise to dissatisfaction include lower compensation, the predecessor's termination, and value incongruity between the CEO and the hospital. Testing the impact of key variables from Fiedler's contingency theory of leadership, we show that task-oriented leaders are relatively less satisfied when compared with relationship-oriented leaders. CEOs also express less satisfaction in low-situational control settings, a measure heavily influenced by perceived inadequate support from medical staff and subordinates. \"Hump\" factors that deterred leaving included family-related obstacles such as spouse's work or children's school, features mentioned most often by younger CEOs. The study suggests that boards should structure competitively paid positions with opportunities to generate support from the medical staff and subordinates. Recruiters for CEO positions are apprised of the importance of nonwork features in CEOs' willingness to consider new positions.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 3","pages":"362-85"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21016079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The hospital as provider and employer: the case of AIDS. 医院既是提供者又是雇主:艾滋病病例。
Hospital & health services administration Pub Date : 1995-01-01
D R Longo
{"title":"The hospital as provider and employer: the case of AIDS.","authors":"D R Longo","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 4","pages":"437-8"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21024029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving hospital performance: issues in assessing the impact of TQM activities. 提高医院绩效:评估TQM活动影响的问题。
Hospital & health services administration Pub Date : 1995-01-01
M A Counte, G L Glandon, D M Oleske, J P Hill
{"title":"Improving hospital performance: issues in assessing the impact of TQM activities.","authors":"M A Counte,&nbsp;G L Glandon,&nbsp;D M Oleske,&nbsp;J P Hill","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite numerous published reports of the need for TQM activities in health care organizations and their widespread diffusion within the health care industry, whether they make a difference remains an unresolved issue. In this article, we discuss the major reasons why the impacts of TQM should be assessed, what needs to be measured during assessment activities, and significant methodological issues that can confound the evaluation of TQM effects. An audit framework is described that can be used to depict the types of effects that TQM may have on the performance of health care organizations. Assessment guidelines are offered that will hopefully benefit the future efforts of institutional managers and health services researchers in their attempts to determine whether TQM activities do in fact make a significant difference.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 1","pages":"80-94"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21012747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continually improving governance. 持续改进治理。
Hospital & health services administration Pub Date : 1995-01-01
B Arrington, K Gautam, W J McCabe
{"title":"Continually improving governance.","authors":"B Arrington,&nbsp;K Gautam,&nbsp;W J McCabe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>What can governance do to ensure the continual improvement of organizational performance? This article explores this question, with particular emphasis on two central considerations. First, what constitutes good governance? Second, what are the sources of and opportunities for leveraging performance available to governance? We argue that focusing on strategy, evaluating performance, and developing the means to learn are the key venues available to governance for leveraging its own and organizational performance.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 1","pages":"95-110"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21012748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The total costs of illness: a metric for health care reform. 疾病总成本:医疗改革的衡量标准。
Hospital & health services administration Pub Date : 1995-01-01
D H Gustafson, C P Helstad, C F Hung, G Nelson, P Batalden
{"title":"The total costs of illness: a metric for health care reform.","authors":"D H Gustafson,&nbsp;C P Helstad,&nbsp;C F Hung,&nbsp;G Nelson,&nbsp;P Batalden","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Systems thinking is a fundamental element of quality management and should be a fundamental element of health care reform. An implication of systems thinking is that one aim of health care should be to minimize the total costs of illness, not simply the direct medical expenditures. If we are to continue to improve health care over time, we should measure its impact on the total costs of illness to the patient, family, employer, and society. Thus a system of measurement is needed that quantifies total costs of illness and also suggests how these constituencies can collaborate to improve processes and reduce total costs. This article introduces the total costs of illness concept, contrasts it with societal costs of illness, describes a measurement system we developed to quantify it, and describes a case study examining the total costs of back injury illness to employers. We found that medical expenditures accounted for less than half of the total costs of illness, the average total costs of illness varied by over 350 percent among employers, and a simple metric (days off work) explained 62.5 percent of the variance in total costs of illness.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 1","pages":"154-71"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Techniques for managing quality. 管理质量的技术。
Hospital & health services administration Pub Date : 1995-01-01
P E Plsek
{"title":"Techniques for managing quality.","authors":"P E Plsek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The science of quality management is an eclectic collection of concepts and methods primarily borrowed from other fields. Techniques roughly fall into three categories involving quality improvement, planning, and measurement. Improvement techniques include models to guide team-based efforts, tools for process description, and tools for data analysis. These methods are the most visible artifacts of CQI efforts in health care organizations today. Less widely known, but equally powerful, are the techniques of quality planning. There are models to guide both process design and strategic planning, methods for identifying customer needs, and tools to support these efforts. Finally, while measurement is a traditionally well-developed area in health care, industrial quality management science broadens our outlook about what is important to measure. It also provides the technique of benchmarking, which suggests that we look beyond our own organization when we measure performance.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 1","pages":"50-79"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21012746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Admission severity of illness and resource utilization: comparing Medicaid and privately insured patients. 入院疾病严重程度和资源利用:比较医疗补助和私人保险患者。
Hospital & health services administration Pub Date : 1995-01-01
M Arndt, R C Bradbury
{"title":"Admission severity of illness and resource utilization: comparing Medicaid and privately insured patients.","authors":"M Arndt,&nbsp;R C Bradbury","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study compares Medicaid patients and privately insured patients. Regression analyses examine the effect of Medicaid status on hospital admission severity, length of stay, and ancillary charges for 14,557 patients in ten medical DRGs and ten surgical procedures. The results show that Medicaid patients were significantly sicker on admission, especially the medical patients. After adjustments for patient age and sex, admission severity of illness, case mix, and hospital, Medicaid patients still had significantly longer lengths of stay and higher ancillary charges, although the effect was not as strong for ancillary charges. We suggest that this association between Medicaid status and length of stay and ancillary charges may be due to greater difficulty in discharge planning for Medicaid patients, health status differences not captured adequately in severity classification, and utilization review practices. The implications of these findings for hospital management, health care policy, and future research are discussed.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 2","pages":"210-26"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21015079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rural hospital closures and access to services. 关闭农村医院和提供服务。
Hospital & health services administration Pub Date : 1995-01-01
S T Fleming, H A Williamson, L L Hicks, I Rife
{"title":"Rural hospital closures and access to services.","authors":"S T Fleming,&nbsp;H A Williamson,&nbsp;L L Hicks,&nbsp;I Rife","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines the implications resulting from the closure of 25 rural hospitals during 1990. The implications are evaluated by estimating travel distance and time to the nearest open hospitals. In addition, the types of services offered in the hospitals studied were measured to provide a view of potential change in access to services. The average travel distance and time to the nearest hospital after closure was 25.7 miles and 30.2 minutes, respectively. In most cases, the remaining hospitals offered a broader scope of services than did the hospitals that closed. A possible interpretation is that the hospital closures resulted in a tradeoff between breadth of services and rapid access for emergency conditions.</p>","PeriodicalId":77163,"journal":{"name":"Hospital & health services administration","volume":"40 2","pages":"247-62"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21015081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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