Memorial Medical Center: new hospital, new name

Memorial Medical Center is a rarity these days--a new hospital opened when others are consolidating or closing. Handling the marketing, public relations and promotion (not to mention five open houses back-to-back) was a real challenge, successfully met. Here's the background on how it was accomplished.     

Forecasting the health care future. Futurescan 2001 and its implications for health care marketing

In his new book, futurist Russell C. Coile Jr. presents predictions about seven aspects of health care for the next five years. Aided by a panel of health care experts, he analyzes likely developments in health care consumerism, technology, managed care, and other areas that raise a number of issues for health care marketers. Even if only a few of these predictions come true, marketers will be forced to rethink some of their techniques to adapt to this rapidly changing environment.     

The Brazilian Association of Workers' Medicine: a space for the constitution of occupational health as a medical specialty in Brazil in the 1940s

This article analyzes the Brazilian Association of Workers' Medicine, created in the end of 1944 as a space for consolidating occupational health as a medical specialty in Brazil. The Association was founded by the first group of specialists in the field of occupational hygiene and medicine with seat at the facilities of the proper Ministry of Work, Industry and Commerce, where the founders were working. Counting on an initial core group of 35 physicians and five engineers, all of them coming from the Ministry, the main objective of the Association was to study, discuss and promote the issues related to workers' medicine. Among the most relevant activities promoted by the Association were the monthly scientific meetings (with lectures held by invited physicians and physicians and engineers of the Ministry itself), the organization of scientific events and the publication of a specialized periodical. In 1945, only one year after its foundation, the Association passed to make part of the International Bureau of Safety at Work, with seat in Montreal, Canada, and the International Bureau of Work of the International Labor Organization. In December 1945, on occasion of the election of the new board of directors, the Association created the Journal of Workers' Medicine, whose first issue was published in 1946.     

Disability profile and health care costs of Medicare beneficiaries under age sixty-five

Medicare has more than five million beneficiaries with disabilities who are under age sixty-five, and enrollment is rising rapidly. This paper presents a profile of nonelderly beneficiaries in fee-for-service Medicare by major disability category, excluding those with end-stage renal disease. The profile is based on Medicare Current Beneficiary Survey (MCBS) Cost and Use data for 1994-1996. We estimate Medicare costs by service type and health care costs by payer type, and we discuss implications for Medicare reform and related federal disability policy issues.     

Worksite health promotion: its evolution and the Johnson & Johnson experience

Worksite health promotion, a rapidly growing form of preventive health service, may include health risk appraisal with communication of findings to the individuals tested. It may also assist in achieving and maintaining physical and mental fitness, controlling alcohol use, avoiding or quitting tobacco and other drugs, and otherwise maintaining health protective habits, while providing opportunities to control high blood pressure, and reduce elevated blood cholesterol, obesity, and other health hazards. This article presents a synopsis of the evolution of that movement and reviews the experience of one industrial firm that has endeavored to document and evaluate its effort. Such a review may be helpful in consolidating the various findings to date and in indicating the complexity of assessing the health and economic consequences of such an endeavor in private companies.     

Reengineering--impact on organizational culture

There is no question that reengineering impacts organizational culture. In the case of a community-based hospital, it becomes more than just changing the culture--a new culture must emerge. However, cultural change does not have to be negative. The empowerment of reengineering causes employees to think beyond their jobs and to begin seeing their roles in the organization. At first, reengineering appeared to be in direct conflict with CQI principles and the organization's culture. However, culture, no matter how positive or strong, cannot threaten organizational survival. Survival demands the emergence of a new culture. The grassroots nature of CQI and reengineering can create an opportunity to improve labor relations, develop more effective work processes, and assure long-term viability in a rapidly consolidating industry.     

Consolidation in the health care market: good or bad for consumers

The health care system has been transforming itself; the big fish are eating the small fish; the small fish are combining to grow big. Providers, including hospitals, physicians, and health plans, are aggressively buying, selling, merging, entering into joint ventures, and otherwise consolidating into larger affiliations. These new enterprises, in turn, form networks that can deliver all the health services a patient may need in a lifetime--acute, home health, and nursing home care, and more--and then compete for insurance contracts to cover the greatest possible number of people. While this market reorganization seems to have a role in tempering spiraling costs, it raises other issues of choice, quality, and access. This issue of States of Health examines how consumer interests are faring in the changing market place.     

复杂性管理方式在科研项目实施中的应用

复杂性科学是研究复杂系统行为与性质的科学。鉴于当前管理模式受到复杂性的影响，把复杂性科学引入科研管理是适应科学技术发展的需要，也有助于在更深层次上和更广范围内洞察管理问题。此文概述了应用复杂性管理方式，对973创伤项目实施中加强组织领导、整合科技队伍、优化资源配置、突出研究重点、强化研究目标、加强科研过程管理与目标管理等措施，进行优势集成与联合协作，并在促进科研群体创新和组织管理创新方面进行了初步探索，取得了一定的成功经验。     

Economy of generic drugs in Latin America]

In terms of economics, implementing generic drug policy is nothing other than consolidating (or even, creating) drug markets that set competitive prices, the result of which favors public access to essential drugs. This article approaches the topic of generic drugs from the economic perspective by examining various regulatory models in order to evaluate and leverage generic drug policy implementation options as a mechanism for battling some of the markets' specific weaknesses. The conclusion is that there is no single unequivocal method for promoting the use of generic drugs, and that the most favorable way to integrate markets may be through a broad combination of alternatives. These alternatives are grouped and analyzed according to the market issues or challenges that must be overcome. Several options are then identified based on the degree of market consolidation to be obtained.     

Medicaid managed care and provider consolidation

In the thrust toward constructing economic value, health care provider firms have been consolidating at a marked rate. Medicaid managed care programs have been rapidly emerging with the objectives of containing health care costs and improving services for beneficiaries. However, there are concerns that the trend toward achieving market efficiency through merger is largely incongruent with the economic and health value objectives of Medicaid managed care programs in the states. Discordance among value objectives arises primarily because of inefficient and market concentrating horizontal merger strategies employed by firms and disruptions in quality of care that occur during the transition to integrated health care systems. By promoting vertical integration strategies and filling in the quality gaps created by an active merger environment, Medicaid offices advance state objectives of cost containment and quality while recognizing that providers operate in a complex and competitive environment that necessitates consolidation for organizational survival.     

论军队医院管理者应具备的基本素质

军队医院管理者要强化自身素质要做到“一个定位”,即对扮演的角色要定好位;“两种意识”,即责任意识和服务意识;“三个基础”,即打牢政治思想基础、业务基础、军事基础;“四种能力”,即领导能力、执行能力、学习能力、创新能力;“五个重点”,即提高内涵质量、维护制度“钢性”、注重学科建设、注重人性化服务、注重人才建设。“一个定位”是关键,“两种意识”是根本,“三个基础”是前提,“四种能力”是保证,“五个重点”是核心。     

Understanding India, globalisation and health care systems: a mapping of research in the social sciences

ABSTRACT: National and transnational health care systems are rapidly evolving with current processes of globalisation. What is the contribution of the social sciences to an understanding of this field? A structured scoping exercise was conducted to identify relevant literature using the lens of India - a 'rising power' with a rapidly expanding healthcare economy. A five step search and analysis method was employed in order to capture as wide a range of material as possible. Documents published in English that met criteria for a social science contribution were included for review. Via electronic bibliographic databases, websites and hand searches conducted in India, 113 relevant articles, books and reports were identified. These were classified according to topic area, publication date, disciplinary perspective, genre, and theoretical and methodological approaches. Topic areas were identified initially through an inductive approach, then rationalised into seven broad themes. Transnational consumption of health services; the transnational healthcare workforce; the production, consumption and trade in specific health-related commodities, and transnational diffusion of ideas and knowledge have all received attention from social scientists in work related to India. Other themes with smaller volumes of work include new global health governance issues and structures; transnational delivery of health services and the transnational movement of capital. Thirteen disciplines were found represented in our review, with social policy being a clear leader, followed by economics and management studies. Overall this survey of India-related work suggests a young and expanding literature, although hampered by inadequacies in global comparative data, and by difficulties in accessing commercially sensitive information. The field would benefit from further cross-fertilisation between disciplines and greater application of explanatory theory. Literatures around stem cell research and health related commodities provide some excellent examples of illuminating social science. Future research agendas on health systems issues need to include innovative empirical work that captures the dynamics of transnational processes and that links macro-level change to fine-grained observations of social life.National and transnational health care systems are rapidly evolving with current processes of globalisation. What is the contribution of the social sciences to an understanding of this field? A structured scoping exercise was conducted to identify relevant literature using the lens of India - a 'rising power' with a rapidly expanding healthcare economy. A five step search and analysis method was employed in order to capture as wide a range of material as possible. Documents published in English that met criteria for a social science contribution were included for review. Via electronic bibliographic databases, websites and hand searches conducted in India, 113 relevant articles, books and reports were identified. These were classified according to topic area, publication date, disciplinary perspective, genre, and theoretical and methodological approaches. Topic areas were identified initially through an inductive approach, then rationalised into seven broad themes. Transnational consumption of health services; the transnational healthcare workforce; the production, consumption and trade in specific health-related commodities, and transnational diffusion of ideas and knowledge have all received attention from social scientists in work related to India. Other themes with smaller volumes of work include new global health governance issues and structures; transnational delivery of health services and the transnational movement of capital. Thirteen disciplines were found represented in our review, with social policy being a clear leader, followed by economics and management studies. Overall this survey of India-related work suggests a young and expanding literature, although hampered by inadequacies in global comparative data, and by difficulties in accessing commercially sensitive information. The field would benefit from further cross-fertilisation between disciplines and greater application of explanatory theory. Literatures around stem cell research and health related commodities provide some excellent examples of illuminating social science. Future research agendas on health systems issues need to include innovative empirical work that captures the dynamics of transnational processes and that links macro-level change to fine-grained observations of social life.     

建立法人治理结构的实践与探索

对东阳市人民医院建立法人治理结构、实施董事会领导下的院长负责制、落实医院独立法人地位的16年改革经历进行了回顾性综述.实践表明,建立和完善法人治理结构是推行政事分开、管办分开、经营权与所有权分离的有效形式,是落实公立医院独立法人地位、推进医院可持续发展的重要保证,是当前推进公立医院改革的一个可以借鉴的模式.     

Biotechnical and other factors affecting orthognathic surgery

Orthognathic surgery is a rapidly growing biotechnologic interaction involving alterations of facial form and dental occlusion. This article describes some of the important and complex psychological, sociological, ethical, and public policy issues involved. Advances in the latter issues are necessary for advancement of the field.     

口腔全瓷修复材料抛光方法研究进展

口腔全瓷材料是目前牙齿修复的主要材料,它具有稳定的色泽、良好的生物相容性以及出色的美观性。全瓷材料的分类目前主要有长石质瓷、玻璃陶瓷和多晶陶瓷。现如今,随着口腔技术不断发展与改进,促使众多研究学者对抛光工具对患者使用效果也引起了高度重视。牙科陶瓷抛光是一种单纯的机械性抛光,亦是一种磨削加工工艺中的精密磨削方式。抛光工具对瓷材料表面的磨削清除是通过磨粒直接完成的,结合剂具有固结磨粒、成形以及较强的支撑作用。抛光是指牙冠经过调磨后,利用工具将表面变成光滑表面的过程。全瓷冠在戴牙时通常需要调磨,该文就口腔全瓷修复体不同抛光工具表面处理方法及其研究进展等相关问题做一综述,希望能够对选择合适的抛光方法带来帮助。     

The Hospitalist Movement: Ten Issues to Consider

The rapidly growing hospitalist model appears to be living up its promise to improve the efficiency and perhaps the quality of hospital care. The important issues no longer relate to its continued existence—even skeptics concede that it is here to stay. Instead, concern surrounds the myriad organizational and clinical issues that inevitably appear whenever there is a major change in the health care system.     

The hospitalist movement: ten issues to consider

The rapidly growing hospitalist model appears to be living up its promise to improve the efficiency and perhaps the quality of hospital care. The important issues no longer relate to its continued existence--even skeptics concede that it is here to stay. Instead, concern surrounds the myriad organizational and clinical issues that inevitably appear whenever there is a major change in the health care system.     

Overlapping topics in advisory reports issued by five well-established European National Immunization Technical Advisory Groups from 2011 to 2014

National Immunization Technical Advisory Groups (NITAGs) are facing increasingly complex vaccination issues together with a lack of human resources for evidence assessment and data analysis. One way to reduce these burdens could be to share some of the preparatory work across NITAGs. We conducted an inventory of all the advisory reports issued by five well-established European NITAGs from 2011 to 2014 to assess overlaps in issues and activities. A total of 104 advisory reports were retrieved. Advisory reports on the same issues were compared to identify overlapping activities and processes.Advisory reports issued by the five NITAGs showed little overlap in issues and processes. A first step towards efficient collaboration would be to establish an independent platform to provide insight into each NITAG’s work and to facilitate the exchange of agendas, assessment frameworks and evidence.     

Reforms in the Portuguese health care sector: Challenges and proposals

Portugal has one of the most complete public systems worldwide. Since 1979, the Portuguese National Health Service (NHS) was developed based on the integration and complementarity between different levels of care (primary, secondary, continued, and palliative care). However, in 2009, the absence of economic growth and the increased foreign debt led the country to a severe economic slowdown, reducing the public funding and weakening the decentralized model of health care administration. During the austerity period, political attention has focused primarily on reducing health care costs and consolidating the efficiency and sustainability with no structural reform. After the postcrisis period (since 2016), the recovery of the public health system begun. Since then, some proposals have required a reform of the health sector's governance structure based on the promotion of access, quality, and efficiency. This study presents several key issues involved in the current postcrisis reform of the Portuguese NHS response structure to citizens' needs. The article also discusses the implications of this Portuguese experience based on current reforms with impact on the future of citizens' health.     

A new era of emergency care: planning and design consideration

Emergency care is one of the most complex, rapidly growing areas of ambulatory care. Providers need to consider new issues related to management of low-acuity patients, capacity for surge events, and the need to integrate patient focused care into the emergency department environment. This article explores these issues and discusses basic organizational topologies for facilities.