Biomedical subjects
Publications and source records attributed to M Wagner.
Telemedicine is advancing rapidly, and with it the diagnostic and treatment possibilities. X-ray and MRI images, tissue specimens and medical record data are being transmitted between distant cities even now. For rural hospitals, this means having around-the-clock access to radiology expertise--without having to compensate a full-time radiologist. And for off-site clinics, it means fewer trips out to have an image interpreted.
Hospitals spent almost $9 billion on capital equipment in 1989. Many factors enter in the decisionmaking on technology acquisition, some having more to do with hospital politics or competitive demands than with a facility's true clinical requirements. But administrators are learning lessons from past acquisition mistakes and are placing more of the burden on vendors and physicians to prove that new technology is a prudent purchase.
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Preliminary results of a study on stockless inventory emphasize that potential savings aren't built into the distribution method. Rather, the groundwork done by hospitals before starting a stockless program may determine its success.
In many developing organisms the establishment of axial polarity and the patterning of cells depend on local signals that derive from restricted regions of the embryo. In vertebrate embryos, the origins of tissue polarity have been examined extensively in the developing limb. The anteroposterior pattern of the chick limb seems to be controlled by a morphogen, possibly retinoic acid, that is enriched in a region of the limb known as the zone of polarizing activity (ZPA). Certain tissues other than the ZPA have also shown polarizing activity experimentally in the chick limb, raising the possibility that signalling molecules involved in pattern formation in different embryonic tissues are conserved. Here we provide evidence that a similar polarizing activity is also present in a restricted region of the developing central nervous system (CNS). We show that a specialized group of neural cells termed the floor plate, but not other regions of the CNS, mimics the ZPA in respecifying the digit pattern in the developing chick limb. In addition, using an in vitro biochemical assay, we show that the floor plate can synthesize retinoic acid and 3,4-didehydroretinol, the precursor of a second morphogenetically active retinoid, 3,4-didehydroretinoic acid. These results show that the floor plate is a local source of a ZPA-like polarizing signal, possibly a retinoid, which may regulate the pattern of cell differentiation in the developing CNS.
To gain a competitive edge, group purchasing organizations and alliances realigned themselves and jockeyed for position in the market. They also emphasized member compliance with purchase volume commitments to gain or maintain leverage with vendors. And they responded to demand for more service contract agreements in addition to the traditional discounted-goods contracts.
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Needlestick injuries are getting attention now that hospital liability for blood-borne diseases is a hot topic. But safer needle devices and alternatives to needles have yet to catch on, held down by high price and uncertain demand.
Rosemary Stevens decided to study healthcare's history as a way of understanding what it had become. The one-time hospital administrator gradually became an academic expert and author, whose work earned the 1990 Baxter Health Services Research Award.
Despite recent scandals at generic drug companies that raised questions about quality and supply, few hospitals have shunned the off-brand products altogether. With stepped-up scrutiny of the industry by the Food and Drug Administration and purchasing groups, hospitals continue to show confidence in generics as a prescription for savings.
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Explore the source record for details and available documents.
Home infusion therapy growth doubled in 1989, but the revenue picture for providers of home-care services was a flat landscape. The durable medical equipment business showed little improvement.
Disposable linens have blanketed the hospital market since the 1970s, but reusable products are attracting renewed interest. Sparking the reassessment are elevated costs of medical-waste disposal, innovations in recycled linens and blossoming environmental concerns.
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Explore the source record for details and available documents.
Some hospitals are turning plant operations over to companies that design systems to reduce costs in return for a share of the savings. Some companies also pay for or finance capital improvements as part of the deal.