ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The purpose of this paper is to describe how the work associated with psychosocial and physical caregiving is structured within nursing facilities. Arguing from a contingency perspective, our central hypothesis is that because the technology underlying physical care is less variable and more interpretable and the process-outcome relationships underlying care processes are better understood than for psychosocial care, work in the physical care domain will be comparatively more mechanistically structured even though work in both domains is performed by the same paraprofessional nurse aide staff. Data for this analysis derive from a survey of unit charge nurses (n = 739) in 308 nursing homes in eight states undertaken as part of a large NIA-funded study of the relationship between nursing home organization and resident outcomes. With the exception of centralization, contingency theory correctly predicts how the work associated with physical and psychosocial care is differentiated.

ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This study examines the determinants of divestiture in health systems. Financial performance is a common indicator of a hospital's value. However, health systems may consider other factors that influence a hospital's value to the system. To enhance our understanding of hospital divestiture, we identify factors that enhance a hospital's value to the system and thus its likelihood of being retained. Our findings support previous studies that financial performance influences divestiture decisions. At the same time, our results identify three other factors influencing divestiture decisions relative resource configuration, legitimacy, and integration.

ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

It is becoming increasingly apparent that some disparities in health outcomes for vulnerable populations relate to performance of providers. Based on analysis of Medicaid claims records, large differences in performance among primary care providers are documented for New York City patients, suggesting the need for better evidence in making management decisions.

ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This article identifies areas of management research that should be pursued to develop a better understanding of barriers and facilitators to improve quality in health care organizations. Five major structural barriers to improvement of quality are discussed. Research priorities are presented with suggestions on how to encourage more meaningful research that will accelerate quality improvement in health care.

ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This article explores the current state of the creation and use of evidence by managers for cost containment in hospitals. We assert that hospitals do not know enough about what things cost, and until they get evidence on costs, it is not likely that much can be done to narrow the chasm between common practice and best practice. Part of the problem is that managers do not seek out available evidence that exists, and part of the problem is a lack of sufficient research efforts to generate evidence for managers to use. The article strives to help direct future efforts by researchers and managers in the area of evidence-based cost containment research by presenting a framework for priorities that managers and researchers can use to increase the amount of research done to generate evidence and to increase the use of evidence by health care managers.

ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0361-6274    

出版商:OVID    

年代:2003

数据来源: OVID