摘要:

The community health center is a new institution which has been promoted by the Office of Economic Opportunity to provide health services to the poor, to establish an alternate model for medical practice, and to help reintegrate the poor into the mainstream of society. Among the barriers to the success of this innovation has been a lack of political realism on the part of many of the participants. A sociological analysis of the process of project evolution, demonstrating the many opportunities for controversy and conflict to develop, is presented. Inferences from conflict theory are presented to show how a sophisticated approach to controversy can expedite social change. If health professionals are to be involved in the wide range of social and physical ills of their patients they must be familiar with these strategies.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

Long-term care activities of New York City voluntary hospitals in 1967 have been studied through annual reports to the United Hospital Fund. Only 10 per cent of the beds in 39 hospitals were in long-term care; general hospitals had chiefly mental-illness beds and special hospitals, beds for chronic patients. Home care programs represented a substitute for an addition of about 5 per cent of capacity. Physical medicine departments were widely prevalent but size of program (treatment load) was variable. Serious diagnoses were unevenly distributed among hospitals but related to the distribution of general practitioners on hospital staffs. Variability was also found in the ratio of admissions to social workers, and this ratio was lowest where length of stay was greatest. It would appear that expansion of various programs not involving intramural beds is achievable and holds promise of reducing long-term disability.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

The problem of determining the number of beds required in each type of service in a progressive hospital, subject to constraints of operating and investment costs and minimum service levels, is approached through computer simulation and mathematical programming. The simulation of the progressive patient care system is based on patient flow through the service zones in an operating hospital, but the program is capable of accommodating any other hospital's structure of facilities or set of patient paths. The mathematical programming approach to the solution of optimal bed allocation raises basic questions on the formulation of objective function and budgeting constraints which are open to further investigation.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

Most research in the field of scheduling of ambulatory patients has defined outpatient appointment systems along a patient-arrival spacing dimension. Along this dimension, scheduling methods have ranged from pure block systems (in which all patients are asked to arrive before the start of the clinic) to individual appointment-time systems (in which patients are given appointments at intervals which approximate average physician service time). Four factors—type of scheduling system utilized, amount of physician lateness, amount of patient lateness, and patient no-show rate—have been shown to affect patient waiting time strongly. A study performed in the Combined Clinics of the Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary provides two additional findings with regard to the ambulatory scheduling process. First, the assignment at the time of appointment of a patient to a specific physician is another significant element in the design and the effectiveness of appointment systems. Second, with the addition of the assignment variable in system definition, a striking behavior pattern was found. The no-show rate, patient arrival time, physician arrival time, and patient waiting time all changed in concert from one appointment system to another among three major systems studied. All factors were found to favor the expeditious delivery of patient care by systems which treated the patient as an individual, in comparison with those that implicitly regarded him as an anonymous figure seeing an unidentified physician.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

An approach for studying the environment of surgical procedures by epidemiologic analysis is outlined. Benefits to be achieved in refinements of data regarding surgery are demonstrated by a small epidemiologic study of the incidence of three surgical procedures in a variety of hospital settings. The need for this and similar types of refined data as a basis for prediction of future demand for surgery is discussed.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID