Information planning for the 1980's and 1990's

With the shift in reimbursement, new medical technology, and increased competition, hospitals must be managed more effectively. Management information systems are being developed to meet these new challenges. This article provides an overview of the types of information needed and outlines the development of a comprehensive information systems plan.     

Silicosis in the 1980's

At the request of the Mine Safety and Health Administration (MSHA), the National Institute for Occupational Safety and Health (NIOSH) recently investigated the health of workers at two silica flour mills. Both mills have a long history of failure to maintain workplace concentrations of dust containing free silica below the MSHA exposure standard. Thirty-seven percent of sixty-one workers and ex-workers with one or more years of silica dust exposure had chest radiographic evidence of silicosis. Because of the high prevalence of silicosis in workers at these two silica flour producers, MSHA silica dust measurements were reviewed for twenty-five other active U.S. silica flour producers. Eighty-nine percent of the work force in these 27 silica flour producers are employed at workplaces where more than twenty-five percent of the dust samples reviewed were above the exposure standard. Fifty-three percent of all samples were above the MSHA standard. No significant decline in silica dust levels occurred during the period (1974-1979) covered by the data supplied by MSHA. Based on the NIOSH study and MSHA data, it is apparent that the risk of silicosis is very high among workers in this industry. Prevention of this disease will require a concerted effort of government enforcement agencies, workers and management.     

General hospital psychiatry in the 1980's

There has been an increasing amount of attention being given to the role of community hospital based inpatient psychiatric services in the face of changing utilization patterns, state hospital deinstitutionalization and cutbacks in community support programs. These trends have converged over recent years to reshape the nature of psychiatric practice in the general hospital setting. It is likely that these trends will continue throughout the 80's and that general hospital based services will become increasingly pivotal in the care of mental illness at the community level. The challenge facing such programs will be to adapt creatively to the changing demands of the market environment while maintaining the integrity of existing programs and coping with the pressures that these changes place on staff.     

Problems and issues for mental health administration in the 1980's

To determine issues in mental health administration in this decade 314 public sector, community level, mental health administrators and 200 professionals in mental health from across the country were sampled. The 670 responses from 253 respondents were analyzed and placed into 15 categories. Impact of decreased funding and personnel related issues were paramount. Implications of the data for administration in mental health are discussed.     

Occupational Therapy's Work Assessment in the 1980's

This article records the findings of a study into current Australian occupational therapy practice for clients desirous of entering or returning to employment. Sixty-six therapists were surveyed through occupational therapy associations in order to determine their familiarity with current work assessment tests and the areas of work assessment causing them concern. This constitutes a preliminary study, carried out in conjunction with an Institute of Industrial Engineers' Task Force to ultimately determine the educational needs of the occupational therapists practising in the area of work assessment.     

Advances in statistical methodology for diagnostic medicine in the 1980's.

Research on diagnostic medicine has been directed at a number of topics in the past decade. Issues which have received a lot of attention are ROC analysis and the identification and correction of various analytic biases. Other topics of widespread interest include the use of expert systems, the relationship of such systems to statistical data-based systems, and the evaluation of tests using cost-effectiveness analysis. Increasingly there is a sentiment that well-designed, prospective trials are required to provide credible information on the accuracy of diagnostic technologies, and so a consensus on methodological standards is needed, paralleling the earlier development of such standards in clinical trials and epidemiology.     

Health maintenance organization environments in the 1980s and beyond

Throughout the past decade, health maintenance organizations (HMOs) were buffeted by dramatic regulatory and competitive changes. In this article, literature of the 1980s is reviewed to update our knowledge on the HMO industry and to suggest future research. The influence of intensified competition on these organizations and the determinants of market entry, expansion, and exit are examined. These organizations are now beginning to require copayments and deductibles and to offer point-of-service choice, while indemnity plans are developing sophisticated utilization management techniques. Given these significant structural changes, past distinctions among HMO, preferred provider organization and fee-for-service medicine must be replaced with a distinction between degree of provider choice and level of benefits.     

Economic crisis and infant mortality in Latin America since the 1980's

In the present study, based on data from nine Latin American countries, we found evidence of an association between the economic crisis and infant mortality during the last decades. The paper initially review previous studies on this issue and shows the need for a greater research focus on shorter time intervals. We then describe the deterioration and unequal conditions among the countries based on trends in selected social and economic indicators and the evolution of infant mortality rates. According to our statistical analysis, infant mortality bore an inverse association to short-term economic variations. We also found a significant and negative correlation between decreasing infant mortality rates and increasing poverty. The economic crisis displayed effects of varying intensity among the countries we analyzed, with social inequality appearing as the most probable explanatory variable.     

乡镇卫生院的任务、地位与挑战（1）

阐述了乡镇卫生院在农村卫生服务中的任务、地位与挑战，为制定政策提供参考依据。     

Care and education for young Australians: Services available at the close of the 1980's

The paper provides an overview of the major care and education services available in the late 1980s to Australian families with young children. Involvement of governments, community networks and commercial groups in the provision of services is discussed. Difficulties are indicated associated with creating an acceptable balance between government responsibilities for providing services for the young and individual family right of choice and ownership of services. Patterns of usage of services, curriculum emphases in services and trends in teacher education for early childhood services are indicated.     

Specialty hospitals: the challenge of the 1980s

Specialty care institutions will face many concerns during the remainder of this decade. Increased intermediary and community education, establishing reliable benchmarks, understanding and dealing with a competitive marketplace, and establishing improved professional productivity are some of the major challenges.