ISSN:0749-6753    

DOI:10.1002/hpm.4740090302

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThe development of any health care system towards setting goals and targets and intended outcomes—with national guidelines, a legislative framework, limited resources, consumer influence and competitive forces—makes great demands on the control mechanisms required. The Swedish health care system has no tradition of goal formulation of this type. Hence, the purpose of this article is to clarify the goal‐setting process of performance standards, and to examine whether goal setting is a relevant method within the organization of a Swedish county council. Goal setting can be seen partly as a control method and partly as an administrative processThe approach used is a combination of qualitative and quantitative methods. Data have been collected from interviews, observations, notes taken in the field and available performance statistics. The analysis shows that working towards a goal is made easier through a common and simple concept. It ‘stands and falls’ with the management of the work and its manager. Good communications and information are important prerequisites if goal formulation, through dialogue, is to succeed, This process takes time and can be described as an iterative process, in which a common behaviour pattern develops a ‘we‐feeling’ which spreads among the staff. It is important that the goal is relevant and directly related to the basic objects of the work. It is also crucial that the goal is realistic and reflects a priority. Goal formulation relating to performance standards can be a contributing factor to staff's experience of job satisfaction through increased engagement and motivation, and to the satisfaction of patients/relatives with the care givenIt is difficult to formulate performance standards; there are many problems and obstacles. If goal formulation as a control method within the health care system in Sweden is to work, clearer manifestations of political will are necessary and also better measuring methods in order to gu

ISSN:0749-6753    

DOI:10.1002/hpm.4740090303

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractDeterminants of care‐seeking and patterns of referral for acute respiratory infections (ARIs) in children were studied in two communities in Ismailia, Egypt. A video was used to assess mothers' recognition and interpretation of clinical signs of serious illness. Mothers were questioned about which of the locally available provider options they would choose for four different locally‐defined ARI illnesses; they were also read brief descriptions of hypothetical cases, and asked how they would recommend treating children in those situations. These results were compared with reported care‐seeking practices during past ARI episodes that occurred in their own childrenThe results indicate that mothers generally recognize rapid or difficult breathing, but do not use the recognition to take appropriate actions. The data suggest that a substantial proportion of children in the study area, who are perceived to have severe respiratory illnesses, may not be brought to the government health facilities for treatment. Implications of the findings for the training policies and strategies of the Egyptian national ARI program are consi

ISSN:0749-6753    

DOI:10.1002/hpm.4740090304

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThe demand for home care in the Netherlands is growing and changing. A decreasing rate of institutionalization, combined with an increasing number of elderly people with special age‐related, often complex health problems, has led to new groups of patients, to be cared for in their home settings. This requires a strong coordination of services between suppliers from the primary and secondary health care sectorsIn order to promote coordinated care, Dutch health care providers are building inter‐organizational networks. The development of such arrangements was the target of 12 demonstration projects, selected by the Ministry of Health for the National Home Care Programme. This article presents some of the results of an evaluation study of the Programme, with special attention given to the question of the extent to which such inter‐organizational networks contribute to the balance between quality and

ISSN:0749-6753    

DOI:10.1002/hpm.4740090305

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThe aim of this study was to investigate whether the differences in waiting‐list lengths between hospitals can result from differences in demand for surgery. We compared waiting‐list lengths for seven surgical procedures to the rates of these procedures. The numbers of procedures were obtained from the 1987 Finnish Hospital Discharge Register, and the numbers of patients on the waiting lists were obtained from an inquiry made to Finnish hospitals in 1987. Correlation coefficients were calculated between population‐based waiting‐list lengths and procedure ratesSignificant, positive correlations were found between population‐based waiting‐list lengths and rates for operations on hallux valgus, for herniorrhaphy and for hysterectomy. Rates for cholecystectomy and haemorrhoidectomy were also positively correlated with waiting‐list lengths, but these correlations were not statistically significant. There was no correlation for varicose‐vein operations, and a negative correlation for cataract extraction. These results suggest that insufficient resources are not theonlyreason for long waiting lists; but, both long waiting lists and a high rate of surgery can result from a high demand for surgery, influenced by physicians' decisions. If the waiting list is long because surgical treatment is preferred, the answer is not necessarily to increase resources, but to examine critically the indicati

ISSN:0749-6753    

DOI:10.1002/hpm.4740090306

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740090308

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740090309

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740090310

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740090311

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:0749-6753    

DOI:10.1002/hpm.4740090312

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY