{"title":"A literature review of the problems of delayed presentation for treatment and non-completion of treatment for tuberculosis in less developed countries and ways of addressing these problems using particular implementations of the DOTS strategy.","authors":"Cassie Thomas","doi":"10.1108/02689230210446544","DOIUrl":"https://doi.org/10.1108/02689230210446544","url":null,"abstract":"<p><p>Tuberculosis is the cause of a large burden of disease in less developed countries. With the development of drug resistance and the co-epidemic of HIV, tuberculosis has already started to make a comeback in wealthier countries. The WHO's solution to this global tuberculosis epidemic is the DOTS strategy, the implementation of which presents many problems. The two issues most common to the majority of locations are delay in presentation for treatment and non-completion of treatment. This review looks at the reasons for these problems in the less developed world, and addresses some solutions. The main reasons for delayed presentation are: a lack of understanding about TB; the stigma associated with the disease; the inaccessibility of treatment; and a preference for private practitioners. The main reasons for non-completion of treatment are: the stigma of the disease; a lack of information; dissatisfaction with the treatment and its delivery; and inaccessibility of treatment. Successful implementations of the DOTS strategy need to address all these issues. There is little evidence that DOT enhances treatment completion unless combined with other strategies. Community-based, patient-orientated DOTS appears to be an appropriate way of addressing many of these issues. The involvement of volunteers in community-based strategies is common, but needs more research in order for this strategy to realise its full potential.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 4-5","pages":"371-400"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210446544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138793","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}
{"title":"Variation in coding influence across the USA. Risk and reward in reimbursement optimization.","authors":"Daniel P Lorence, Michael Richards","doi":"10.1108/02689230210450981","DOIUrl":"https://doi.org/10.1108/02689230210450981","url":null,"abstract":"<p><p>Recent anti-fraud enforcement policies across the US health-care system have led to widespread speculation about the effectiveness of increased penalties for overcharging practices adopted by health-care service organizations. Severe penalties, including imprisonment, suggest that fraudulent billing, and related misclassification of services provided to patients, would be greatly reduced or eliminated as a result of increased government investigation and reprisal. This study sought to measure the extent to which health information managers reported being influenced by superiors to manipulate coding and classification of patient data. Findings from a nationwide survey of managers suggest that such practices are still pervasive, despite recent counter-fraud legislation and highly visible prosecution of fraudulent behaviors. Examining variation in influences exerted from both within and external to specific service delivery settings, results suggest that pressure to alter classification codes occurred both within and external to the provider setting. We also examine how optimization influences vary across demographic, practice setting, and market characteristics, and find significant variation in influence across practice settings and market types. Implications for reimbursement programs and evidence-based health care are discussed.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 6","pages":"422-35"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210450981","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22201645","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}
{"title":"Enhancing clinical and management discourse in ICT (information and communication technology) implementation.","authors":"Teresa Waring, David Wainwright","doi":"10.1108/02689230210434880","DOIUrl":"https://doi.org/10.1108/02689230210434880","url":null,"abstract":"<p><p>Modern NHS organisations are seen to be increasingly reliant, in terms of achieving improvements and service targets, on the efficient provision of information to enable clinical, administrative and managerial decision making A key barrier to effective ICT introduction in NHS trust hospitals has been identified as the complex social, organisational and political issues endemic within the organisation, preventing true discourse amongst key stakeholders. This paper describes how the adaptation of critical social theoretical thinking may be used to develop an innovative approach to participative process and information flow modeling. This approach is used within a hospital trust to investigate its potential as a precursor to ICT procurement and development. Empirical results of the research are described with suggestions for a more informed approach to ICT introduction, leading to a re-examination of issues concerning: historical context, emancipatory practice and the role of the systems analyst.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 2-3","pages":"133-49"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210434880","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21972980","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}
P. Allen, B. Croxson, Jennifer A. Roberts, S. Crawshaw, K. Archibald, L. Taylor
{"title":"Health professionals' views of contracting for infection control in the NHS internal market.","authors":"P. Allen, B. Croxson, Jennifer A. Roberts, S. Crawshaw, K. Archibald, L. Taylor","doi":"10.1108/02689230210428607","DOIUrl":"https://doi.org/10.1108/02689230210428607","url":null,"abstract":"This paper reports a national study which investigated the involvement of infection control professionals in (and their views about) the formal processes of contracting for health care in the NHS internal market. Health care professionals needed to be involved contracting, if it was to be effective. The study found that many infection control professionals were not, in fact, involved in contracting, while the importance of both contracts and informal professional networks were recognised But respondents did not think that their professional networks entirely compensated for their lack of involvement in contracting. As formal agreements continue to be central to achieving quality of care in the post-internal market NHS, infection control professionals need to be involved in specification and implementation of these arrangements.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 1 1","pages":"20-33"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210428607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62517538","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}
{"title":"Managing managed care: the enabling role of IS/IT.","authors":"Nilmini Wickramasinghe, Roberta Lamb","doi":"10.1108/02689230210434961","DOIUrl":"https://doi.org/10.1108/02689230210434961","url":null,"abstract":"<p><p>In their conceptualization of the principal/agent relationship, Jensen and Meckling were not referring to a knowledge worker (KM) agent. Agency theory is extended to the context of a KW agent to identify a key role for IS/IT in facilitating the monitoring function. To test this, the dynamics of a critical principal-KW agent relationship in the health-care industry are investigated It is demonstrated that IS/IT goes beyond just alleviating the agency problem to enabling the KW agent to perform \"self-monitoring\". The results are significant for health care, agency relationships and the use of IS/IT with knowledge workers.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 2-3","pages":"238-50"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210434961","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21972897","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}
{"title":"The deferrable elective patient: a means of reducing waiting-lists in orthopaedics.","authors":"John Bowers, Gillian Mould","doi":"10.1108/02689230210434899","DOIUrl":"https://doi.org/10.1108/02689230210434899","url":null,"abstract":"<p><p>The orthopaedic trauma session is almost universally adopted as a means of coping with non-elective orthopaedic demand Here patients who can be stabilised are treated in a weekday planned theatre session. It allows for greater consultant involvement and a reduction in out-of-hours operating. The utilisation of trauma theatre time is typically low. However, there is an opportunity to make better use of this time by including some \"deferrable elective patients\" in the session. These are elective patients who have been offered earlier treatment in return for accepting the possibility of postponement, if the trauma demand on the day of the appointment is high Simulation of patient demand was used to explore the balance between maximising the utilisation of the theatre sessions, avoiding too many overruns and ensuring a reasonable quality of care in a typical hospital in the UK.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 2-3","pages":"150-8"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210434899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21972981","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}
{"title":"Management retention in the NHS.","authors":"Janet Scott","doi":"10.1108/02689230210445103","DOIUrl":"https://doi.org/10.1108/02689230210445103","url":null,"abstract":"<p><p>High turnover amongst middle managers in organisations can lead to strategic instability as well as operational issues. Since the advent of the NHS internal market flatter management structures have led to middle managers being given more responsibilities along with larger spans of control. This has exacerbated the consequences of the high turnover found amongst service managers. This study examines the relationship between the length of time service managers wish to stay with their organisation, their participation in decision making in directorates, the feedback they receive and their perception of feeling valued it outlines the findings from a small study and discusses the implications for health trusts.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 4-5","pages":"292-302"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210445103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138787","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}
{"title":"Clinical ICT systems: augmenting case management.","authors":"Lynne P Baldwin, Malcolm Clarke, Russell Jones","doi":"10.1108/02689230210434925","DOIUrl":"https://doi.org/10.1108/02689230210434925","url":null,"abstract":"<p><p>In order to improve the diagnosis and subsequent care given to patients, health-care workers involved in the management of their care, as well as the treatment itself, are increasingly looking at the role that information and communication technologies (ICTs) can play in supporting the complex interactions between patient, doctor or nurse, consultant and medical equipment. Effective communication both amongst health-care workers and between health-care workers and their patients in both primary and secondary care is vital; ICTs can play an important role in this. In this paper possible interpretations given to the term \"telemedicine\" are discussed, and then attention is turned to the challenges involved in human interaction and the role of ICTs. An example of a clinical ICT system (AIDMAN) is used to illustrate how face-to-face interaction has usefully been supported by way of a \"virtual\" consultation, which facilitates remote medical diagnosis and can provide improved case management.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 2-3","pages":"188-98"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210434925","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21972893","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}
{"title":"Non-profit multi-hospital organizations: challenges and prospects.","authors":"Natalia Trogen, Ugur Yavas","doi":"10.1108/02689230210450007","DOIUrl":"https://doi.org/10.1108/02689230210450007","url":null,"abstract":"<p><p>This study seeks to determine the relative importance of factors non-profit hospital administrators rely on in their decisions to join a non-profit multihospital organization (MO) and their assessments of an MO in satisfying these motives. A related objective of the study is to determine whether or not the administrators of different types of hospitals (i.e. general vs specialty, member of a national vs non-national MO and church-affiliated vs non-church affiliated) differ in their judgements. The analytical framework of the importance-performance technique is used in analyzing the data gathered from the top administrators of a nation-wide sample of hospitals in the USA. Results and implications of the study are discussed.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 6","pages":"451-62"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210450007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22201647","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}
{"title":"Implementation of intelligent decision support systems in health care.","authors":"A E Smith, C D Nugent, S I McClean","doi":"10.1108/02689230210434943","DOIUrl":"https://doi.org/10.1108/02689230210434943","url":null,"abstract":"<p><p>The full implementation of any intelligent system in health care, which is designed for decision support, has several stages, from initial problem identification through development and, finally, cost-benefit analysis. Central to this is formal objectivist evaluation with its core component of inherent performance of the outputs from these systems. A Medline survey of one type of intelligent system is presented, which demonstrates that this issue is not being addressed adequately. Lack of criteria for dealing with the outputs from these \"black box\" systems to prescribe adequate levels of inherent performance may be preventing their being accepted by those in the health-care domain and, thus, their being applied widely in the field.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"16 2-3","pages":"206-18"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230210434943","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21972895","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}