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Biomedical subjects

J W Begun

Publications and source records attributed to J W Begun.

35 records · Page 2Linked to original sources
PubMed1987

Industry distinctiveness: implications for strategic management in health care organizations.

The health care industry is characterized at its core by the requirement that the organization and financing of services recognize the concept of need for health care. This requirement is reflected in industry characteristics of market failure, professional dominance of physicians, and public concern with equal access to care. While market failure is decreasing as a result of the emergence of insurance companies as the "new consumers" of health services, physician dominance and concerns for access continue to be strong. These characteristics mean that successful health care organizations will be local-market focused, decentralized, and tied to community cultures. With regard to training of health services administrators, education should be strengthened in the area of strategy development, with appropriate recognition given to the distinctiveness of the health care industry.

Commerce↗
PubMed1982

Competition in the health sector: a historical perspective.

Viewed from a historical (and a theoretical) perspective, current "pro-competition" policy proposals are unbalanced in their emphasis on promoting "free market" behavior by consumers rather than by suppliers in the health services market. A comprehensive competition policy would require removal of supply-side restraints on health providers. Based on evidence about the evolution of restraints on physicians, dentists, and optometrists in one state, this article speculates on the political feasibility of removing supply-side restraints and thereby implementing a true "competition policy". Historically, the political environment and the alignment of interest groups have favored the promulgation of stringent restraints on health services providers. While the political environment is more receptive to challenges to those restraints today, there is little evidence that such challenges will succeed at either the state or federal level.

Advertising↗
PubMed1982

A case study in the politics of free-market health care.

Historically, most health occupations have developed legal and ethical restrictions on price advertising and other characteristics of "commercial" practice. Many of these regulations recently have come under critical scrutiny, on the grounds that they inhibit free-market health care delivery, thus keeping prices high, and productivity and innovation low. To help inform current health policy deliberations, we analyze the political history of anticompetitive regulations in one health occupation, optometry. Restrictions on commercial practice arose as a result of professional optometry's purge of commercial elements in the 1930s. Optometry's success in achieving commercial-practice restrictions at the state level was determined by the economic structure of the ophthalmic goods and services industry in each state in the 1930s, and by the political resources and organization of the competing interest groups. Efforts to deregulate health occupations will precipate political conflict to the extent that economic interests are threatened. Opposition to deregulation will be based overtly on the grounds that quality of care will deteriorate, and a significant political investment by proponents of free-market health care will be required to overcome such opposition.

Economic Competition↗
PubMed1980

Social science in medicine: the question of 'relevance'.

Social science differs from the other basic medical sciences in that its perspective for understanding illness is not centered on processes within the individual. For this reason the relevance of social science knowledge to clinical practice is not obvious to many medical educators and students. Initial efforts at the University of North Carolina to develop a social science curriculum that is obviously relevant are described. Strategies include the use of small-group seminars taught by social-scientist/clinician teams and an organizing framework which links social science knowledge to clinical practice. Response to the curriculum from faculty and students has been encouraging.

Curriculum↗
PubMed1978

The effects of advertising--lessons from optometry.

We examine the effect of advertising bans on the price of optometric examinations. Advertising is viewed as an information medium which enables consumers to search for lower prices, to the relative disadvantage of high-cost, low-volume sellers. Self-interest leads these sellers to support bans on advertising. An empirical section shows that price is 16 percent higher in states that ban optometric and optician price advertising, when examination length, procedures, and office equipment are held constant. The two advertising bans work by interaction--both must be present to raise significantly the price of eye examinations.

Advertising↗
PubMed1977

Refining physician manpower data.

Many conclusions about trends in physician manpower are based on the physician data set of the American Medical Association. Comparisons of specialty and activity status of physicians over time are hampered by changes in the AMA classification procedure in 1968 and growth in the "not classified" category since 1970. A method of adjusting data on physician manpower, taking into account these changes, is presented. The adjustments suggest that movements in the total physician supply away from patient care and primary care practice are overstated by use of unadjusted AMA data, and the percentage of physicians engaged in patient care has increased rather than decreased over the past decade.

American Medical Association↗
PubMedDate not supplied

How does Catholic hospital sponsorship affect services provided?

Catholic hospitals maintain a significant presence in delivering hospital services in the United States, but little is known about the ways they differ from other ownership forms in similar market environments. This paper analyzes characteristics of Catholic, other private nonprofit, and investor-owned hospitals in metropolitan areas of the United States to identify the extent to which Catholic hospitals differ from other ownership types on three dimensions of mission-driven identity--access, stigmatized, and compassionate care services. Based on 1993 data, Catholic hospitals offered more compassionate care services than other private nonprofit hospitals, and more compassionate care and stigmatized services than investor-owned hospitals, controlling for four market and six organizational characteristics. The results may help Catholic hospitals differentiate their services and help justify their tax-exempt status.

Catholicism↗
PubMedDate not supplied

Hospital-physician relationships in the integrated delivery system: an ethical analysis.

The need to compete for managed care contracts is causing hospitals and physicians to dramatically change how they do business with each other. Most significant is the formation of integrated delivery health-care systems. The emergence of these systems creates an enhanced need for physicians and administrators to better understand what the other actually does. This article examines the new health-care marketplace from both perspectives and how integrated delivery systems affect individual and community patient care, and it offers guidelines for effective hospital-physician relationships within integrated delivery systems.

Cost Control↗