Hospital missions and the education of our future health care workforce

Today's U.S. health care industry is facing unprecedented shortages of health personnel in a great variety of disciplines and locations. An adequate supply of well-educated and trained health professionals is imperative to ensure sufficient access to health care for our citizenry. Hospital mission statements reflect the character, strategic direction, and priorities of the organization; thus, we might expect these statements to address the position and strategy of the organizations in regard to education of future health professionals. To investigate hospitals' publicly stated attention and commitment to the education of health professionals, we analyzed publicly available mission statements from a random stratified sample of 402 hospitals. The hospitals were stratified on the basis of teaching status, rural or urban, and profit status. The percentage of hospitals mentioning an education-related keyword was estimated using a 95% confidence interval with a finite population correction factor on the proportion within each stratum. As expected, teaching hospitals were significantly more likely to include language about education in their mission statements than nonteaching hospitals, with 74% of teaching hospitals mentioning education at least once. We found no significant difference in the use of education language among the mission statements of nonteaching hospitals, where 20% mentioned education at least once. From these findings, we conclude that despite the key importance of health professionals, strategies and policy regarding the education of future health personnel have not yet become "mission level" in importance to hospitals.     

The future shape of health care systems

This month HCSM interviews Paul M. Ellwood, Jr., MD, President of InterStudy in Minneapolis, Minnesota. Dr. Ellwood is also a Clinical Professor of Neurology, Pediatrics, and Physical Medicine and Rehabilitation at the University of Minnesota. InterStudy is a nonprofit health policy research group whose aim is to research and develop cost-effective approaches to health care delivery and financing. In this interview Dr. Ellwood discusses the future of health care systems in the United States.     

How mental health providers see managed care

This paper reports findings from two focus groups on managed care conducted in a large U.S. city in 1989. Questions addressed included how managed care had affected mental health practice, specific experiences with managed care, the mechanisms of managed care, and how managed care could be improved. The practitioners complained of multiple problems, but clearly distinguished between “good” and “bad” firms. Firms seen as more positive struck a balance between quality care and cost containment, built ongoing relationships with providers, and negotiated with providers, rather than prescribing a treatment plan. The authors conclude that some of the poor reception by providers of managed care may have been created unnecessarily by firms which have not attended to those factors, and that attention to such factors might lead to a more ready acceptance of managed care.     

The future of health care in the United States

The U.S. government is involved in health care in various ways that include (1) providing services to veterans, (2) paying for care received by Medicare and Medicaid beneficiaries, (3) assuring quality through regulatory activity, (4) financing the discovery of medical breakthroughs, and (5) training members of the health workforce and assuring that the nation has an adequate supply of them. With the aging of the population, the role of the government in these endeavors will increase. This essay considers ways in which the health care of tomorrow will be affected by the intermingling of factors such as demography, epidemiology, economics, technology, globalization, and individual health behavior.