Search PubMed⌕ Search

Biomedical subjects

R J Blendon

Publications and source records attributed to R J Blendon.

At least 91 records · Page 5Linked to original sources
PubMed1981

The shortage of hospital nurses: a new perspective.

There appears to be a critical shortage of hospital nurses in the United States, despite a 15-year national effort to bring the supply of nurses into balance with increased demand. Careful review of supply and requirement data does not provide an adequate explanation for the persistent shortage, and common misconceptions about the nature of the nurse shortage have clouded the debate. Several popular explanations for the shortage do not appear to be valid. Evidence strongly favors the explanation that the shortage has been caused by the depression of nurses' incomes relative to incomes of other workers. THe present wage structure has both short- and long-term effects on the shortage of nurses; allowing nurses salaries to rise to levels of comparable workers may be the only solution.

Employment↗
PubMed1979

Can China's health care be transplanted without China's economic policies?

China's economic policies of the past 25 years have shaped its present health-care system. China's leadership has decided to have neither a national health-insurance system nor a national health service. Instead, it decided that its health system would mirror the workings of its industrial and agricultural system. Decisions to minimize imports, ban private economic activity, assign university graduates on a compulsory basis, control wages, maintain a large domestic standing army and prevent professions or universities from acquiring independent status led directly to the present system of medical care. Consequently, transplantation of China's striking achievements in health-care delivery to the United States or other countries is unlikely to occur in the absence of transfer of the underlying economic policies.

Agriculture↗
PubMed1979

The contribution of specialists to the delivery of primary care.

Despite increased numbers of medical-school graduates and opportunities for "primary-care" specialty training since the mid-1960's, many believe that the shortage of physicians delivering generalist care will continue through the 1980's. Missing, however, is solid information on the role of physician specialists in providing such care. Two national studies have shown that one of every five Americans now receives continuing general medical care from a specialist physician. Our study suggests that, despite the current shortage of generalist-physician services, continuing specialist participation in primary care will lead to sufficient generalist medical services by the mid-1980's. Whether specialist participation is the most appropriate or cost-effective way to improve access to such care is unclear. However, until this question is resolved, more governmental regulation of graduate medical education may be unwise. Offering all physicains, regardless of specialty, more primary-care experience during residency training might better deal with this aspect of American medical practice.

California↗
PubMed1978

The academic medical center: a stressed American institution.

In recent years, relations between academic medical centers and the government have become increasingly adversarial. Although the centers and the government were formerly partners in a number of health ventures, to the mutual benefit of both, the climate is now too often confrontational. It is a confrontation in which there will be no winners, but the larger society may be the loser. A number of pressures on academic centers have helped to contribute to this situation. The federal sector and academic medical institutions must understand one another better and rediscover effective ways to preserve the special strengths of academic medicine in this country.

Community Health Services↗
PubMed1977

The changing American health scene. Sometimes things get better.

Since the increased efforts to improve medical care for Americans were initiated 15 years ago, it is generally believed they had little impact on the problems addressed. Review of national data suggests otherwise. American medical care and health status are getting better. We have improved the availability of physician services and largely eliminated the gap between visits made by rich and poor, or white and black citizens. We have greatly expanded the number of health professionals who provide medical care. Better organized programs to provide care to groups with special health problems have reduced both mortality and morbidity. Age-adjusted death rates, infant and maternal mortality, and death rates from coronary artery disease have fallen. While there remains an important agenda for the future, there seems room for cautious optimism about the abilities of American society to make forward progress.

Allied Health Personnel↗
PubMed1976

The reform of ambulatory care: a financial paradox.

The purpose of this paper is to examine the financial factors which have effectively constrained the movement toward major reform in the out-of-hospital medical care area within this country. Analysis of the current economic picture in the health field leads inescapably to the conclusion that the major wave of new out-of-hospital programs predicted in the early 1970s is not likely to occur in the immediate future. The financial constraints are so substantial that the expansion of new forms of delivering ambulatory care services (HMOs, restructured OPDs, neighborhood health centers, etc.) into low- and moderate-income communities will proceed more slowly than was originally anticipated. The facts outlined in this paper clearly indicate that many new ambulatory care projects designed to serve low- and moderate-income people will face serious financial difficulties and will place a heavy burden on the resources of sponsoring institutions. In the future, widespread reform in the out-of-hospital area will await major improvements in the way this country finances its ambulatory care services.

Ambulatory Care↗
PubMed1975

The changing role of private philanthropy in health affairs.

Since World War II societal changes have fundamentally altered the very special position held by private philanthropy in the health area. The expanding expenditures for health services by the private and public sectors now dwarf those of philanthropic insitutions. Yet the need for private philanthropy has not diminished. Indeed, given some of the problems that may be created by large-scale public-sector support, private philanthropy may prove to be even more imporant in the future. But to respond to this changing state of affairs, the philanthropic community and the nation's health institutions will have to recognize that private philanthropy has become a relatively scarce national resource. To continue to play a major part in health affairs, philanthropic giving will have to become well targeted on select national and regional priorities, moving away from the more broadly scattered approaches reflecting the needs of the earlier parts of the century.

Charities↗