摘要:

There has been little focus on improving hospital governance as an approach to controlling costs and improving the quality of care in community hospitals. The author examines assumptions underlying such an approach, describes various proposals, and presents criteria to be used in evaluating them. The author recommends governing board involvement in goal setting and monitoring activities. This requires the development of standards on hospital performance and governing board performance, as well as methodology for external monitoring and external impact on the boards in these respects.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Distortions in market processes for pharmaceuticals raise the important policy problem of devising measures to improve industry performance. This paper first reviews the basic issues involved in formulating economic policy regarding the pharmaceutical industry. Methods for reducing structural market power and undesirable promotional expenditures are examined, and the impacts of four oft-suggested policy “reforms”—removal of trade names, removal of patents, relaxation of requirements for certification of new drug products, and increased enforcement of antitrust laws—are then analyzed. Finally, problems requiring additional research are identified.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Restrictions on advertising about services performed by professional groups have recently been questioned by the government and consumerists. The purpose of this study was to determine physicians' attitudes about the use of advertising in their profession and also to compare these results with responses from dentists, attorneys, and accountants. While a survey of these groups in three metropolitan areas indicate mild support for advertising in general, there was a definite negative reaction to advertising in the respective professions. Participants also reported their attitudes about the effects of advertising on prices and fees, quality of services, and public expectation and governmental regulations. The concepts of social marketing and informative advertising are suggested as approaches that may meet the requirements of both the government and the professions.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Much research on utilization of hospital emergency departments has been published over the past 10 to 15 years. It has failed to yield a coherent view of why the volume of use has increased, however, because most of it has focused on users of one or more ERs, ignoring the nonusers, and has provided insufficient detail about the local context in which the ER operates. The result has been large quantities of data which, when compared, produce inconsistencies which cannot be resolved without additional data from different studies. Yet, a tentative explanation of ER growth can be presented if the question of why people use ERs, which is usually thought of as being similar to the question of why people use medical care services, is restated as, why do people who want to use medical care choose the ER as the site of care? That question can best be answered by paying greater attention to enabling and illness factors than to the predisposing demographic factors upon which much research has focused. A tentative explanation of the growth of ER utilization is offered. Then, the support from the literature for it is presented and the remaining questions are identified for future research.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The impact of the introduction of Medicare in Quebec on hospital emergency room services was examined in Metropolitan Montreal. After Medicare, the emergency room visit rate increased 14 per cent per year compared to a 7 per cent per year increase in the five years preceding Medicare. The outpatient clinic visit rate continued an upward trend (4 per cent per year). In six of the hospitals selected for more detailed studies, patient interviews revealed that before Medicare 33 per cent of emergency room attenders attempted to contact a physician before reporting to the emergency room and 63 per cent were successful in speaking to the physician. After Medicare, 39 per cent attempted but only 38 per cent were successful. Before Medicare, 47 per cent of patients said that their usual source of care was a private physician, and only 17 per cent usually sought care in the emergency room. After Medicare 58 per cent reported a private physician and 31 per cent the emergency room. These findings together with the increased population density of physicians and increased annual number of physician visits per person suggest that there has been a substantial rise in demand from the public for medical care of which one important early manifestation is an increased reliance on emergency rooms.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The impact of the Illinois Trauma System is assessed in the Southernmost region of the state. A sample of vehicular injuries and deaths are compared for a four year study period: two years prior to system implementation (FY 1970–1971) and two years after system initiation (FY 1972–1973). Decreases in mortality rates are experienced at trauma hospitals in FY 1972–1973 while mortality rates at those hospitals which did not become trauma centers remained constant. Trauma hospitals also exhibit significant declines in mortality rates during weekends and for the age group 45 to 64. When examined on a statewide basis the Illinois Trauma System appears to have little impact on urban mortality rates but a substantial effect upon rural mortality rates.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

To determine the characteristics of physicians who move into and out of rural areas, as well as their reasons for establishing or leaving such practices, we sent questionnaires to 67 physicians who began practice in selected rural counties in upstate New York and 88 physicians who left practices in roughly the same area. From the 52 physicians (77.6 per cent) who responded to the former survey we found that 1) good professional support is mandatory for maintaining a satisfying small community practice, 2) a predisposition to small community living is essential for physicians to be recruited for rural practice, and 3) there are substantial differences with respect to demographic characteristics among persons who share similar reasons for practicing medicine in this region. For the 68 physicians (72.0 per cent) who responded to the latter survey, the reasons for leaving could be grouped in the following categories; economic, social, and professional, logistic. Although all of these factors contribute to the decision to leave, physician geographical mobility seems to stem chiefly from an unsatisfactory professional situation. These findings suggest several strategies for improving the situations in which rural physicians practice, and thus altering the massive imbalance in physician: patient ratios in urban and rural areas.

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1978

数据来源: OVID