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At least 289 records · Page 16Linked to original sources
PubMed2000

The value of a psychodynamic approach in the managed care setting.

The managed care setting presents significant challenges to all psychotherapists. Psychodynamic therapists, however, experience specific difficulties in this environment. Despite managed care's general hostility toward psychodynamic theory and practice, psychodynamic therapists provide unique and significant opportunities for patients. Psychodynamic training, with its emphasis on careful evaluation, exploration of unconscious conflict, transference and countertransference, and other therapeutic phenomena, enables clinicians to provide an invaluable service to managed care organizations. The case of K., a 45-year-old man, is used to illustrate the ways in which psychodynamic elements of a brief treatment contributed to a successful outcome. The importance of including psychodynamic treatment in managed care settings is discussed.

Health Maintenance Organizations↗
PubMed1995

[Health and health services].

The state of health of the world population has costantly improved in recent years. However, quality of life and life expectancy show huge variations in the different demografic regions of the world. To explain such differences three main factors can be considered: 1 - patterns of disease, which are largely determined by geography and climate; 2 - human behaviour; 3 - health services funding, organization and management. The paper develops a discussion on these issues, focusing on correlation between health systems methods of funding and management and state of health of the world population.

Financing, Organized↗
PubMed2000

[Principles of management of All-Russia Disaster Medicine Services].

Experience of liquidation of earthquake consequences in Armenia (1988) has shown that it is extremely necessary to create the system of management in regions of natural disaster, large accident or catastrophe before arrival of main forces in order to provide reconnaissance, to receive the arriving units. It will help to make well-grounded decisions, to set tasks in time, to organize and conduct emergency-and-rescue works. The article contains general material concerning the structure of All-Russia service of disaster medicine (ARSDM), organization of management at all levels and interaction between the components of ARSDM and other subsystems of Russian Service of Extreme Situations. It is recommended how to organize management of ARSDM during liquidation of medical-and-sanitary consequences of large-scale extreme situations.

Disaster Planning↗
PubMed1990

Managed care: the second generation.

The current status of managed health care is described and its impact on hospital and pharmacy operations is summarized. In the 1980s, managed care evolved into a three-segment industry, comprising health maintenance organizations (HMOs), preferred-provider organizations, and fee-for-service plans. Five new trends are emerging as managed care, now an established part of the country's health-care delivery system, enters its second generation: dual- and triple-option plans with financial risk sharing between employers and insurers/HMOs, point-of-service determination of benefits and coverage, consolidation of the number of options offered by employee health plans, creation of exclusive provider organizations, and direct provider contracting. Persons charged with negotiating managed-care contracts will make use of three primary cost-management methods: benefit design, provider reimbursement, and prospective pricing. Employees will take an increasingly active part in purchase decisions. Enrollees will face tradeoffs between their desire for maximum freedom of choice of provider and higher premiums, deductibles, and out-of-pocket expenses. Managed-care plans will continue to have a strong impact on hospitals, especially in the areas of reimbursement and use review. The effect of managed care on pharmacy operations will vary from institution to institution; among the positive results may be increased appreciation of the role of clinical pharmacy services in reducing the incidence of readmissions and the length of hospital stays. The result of these changes in the structure of health-care benefits will be greater price sensitivity, marked by a suppression of unnecessary use of health-care services and an increased tendency to compare and evaluate health-plan costs.

Health Maintenance Organizations↗
PubMed1998

A new approach to managed care: the provider-run organization.

Behavioral managed care has been dominated by for-profit carve-out managed care organizations who deliver mental health and substance abuse services by reducing services and fees to the detriment of patients and providers. We offer a new model of managed care based on a provider-run, hospital-based approach in which provider groups contract directly with HMOs and eliminate the managed care organization intermediaries. This approach allows providers to maintain or regain control of the delivery of behavioral health services. A model is presented of an academically based organization which has achieved utilization patterns compatible with the demands of payors. Innovations in service delivery, network management and fiscal issues are reviewed.

Behavior Therapy↗
PubMed2000

Ambulance service and managed care: the MCO perspective.

EMS and managed care can coexist, but it requires communication and flexibility on both sides. If the managed care organizations whose members you service haven't taken steps to contact you regarding these issues, your management can certainly take the initiative in requesting a meeting. In a typical MCO, transportation is a very small percentage of the overall budget, and day-to-day communications with service providers may be overlooked in dealing with larger financial considerations until there's a problem. After a problem has occurred is not the right time to attempt to establish a relationship. Communication, regardless of who takes the first step, can avoid this scenario. Remember, transportation is your area of expertise, not theirs, and most companies will appreciate your efforts to discuss issues before they become problems.

Ambulances↗
PubMed2006

Understanding organizational culture: the key to successful middle manager strategic involvement in health care delivery?

AIM: The aim of this study was to explore the extent to which organizational culture influenced strategic involvement. BACKGROUND: It is crucial for the strategic management of health care that the cultural dimensions affecting health service organizations are identified and understood. How culture influences middle manager strategic involvement has not been established and therefore an understanding of the power of organizational culture is important to middle managers working in not-for-profit health care organizations. CONCLUSION: It was demonstrated that strong organizational culture predicted strategic involvement, and supported the importance of middle managers remaining strategically involved in the development of new organizational strategic initiatives. Findings have implications for strategic management in health service organizations.

Adult↗
PubMed1998

Community orientation in health services organizations: the concept and its implementation.

The management of community health needs has become a focal point in the drive to contain health care costs, enhance service quality, and improve access to care. This article presents a concept of community orientation that health services organizations can use to provide community-focused care. It also discusses the organizational antecedents and consequences of community orientation in health services organizations and develops research propositions.

Community Health Planning↗
PubMedDate not supplied

Implementation of legislative requirements for emergency medical services in prepaid group practice organizations.

The Health Maintenance Organization Act of 1973, the Emergency Medical Services (EMS) Systems Act of 1973, and other laws are examined for their effects on the organization and management of emergency services in prepaid group practice plans (PPGP). The study was conducted in 1974-75 by the Group Health Association of America. The data were gathered through interviews with administrators and providers of seven PPGPs and with leaders of health planning agencies in the same communities, as well as through reviews of internal documents and a 1-month utilization survey of emergency and urgent care services in each PPGP. Effects of the laws were found to be limited, with the health maintenance legislation appearing to have the greastes effect on the design of emergency servide models. In most localities, two parallel systems may operate in offering round-the-clock emergency care and programs to educate members and the public about the appropriate use of emergency facilities. The EMS legislation has had minimal effects on the design of emergency services in the PPGPs. The emergency services component is the most transitional aspect of the PPGS nad the one most amenable to change. Revisions have come through changes in internal management policy and from demands of subscribers. A regulating inference in the operation of the PGP, in the area of emergency services as well as in the delivery of primary care services, is that the plans must compete, both in costs and benefits, with available indemnity insurance coverage. The market dictates premium levels without regard to associated benefits. Additional costs for broader coverage and administrative regulatory mechanisms must be borne by the subscriber in the form of increased premiums. As a result, the utilization of expensive emergency care must be carefully controlled, and this restraint is often accomplished by requirements specifying which health problems are appropriate for the provision of emergency care, rather than by delaying assistance until the plan's office hours. The furtherance of the PPGP concept, that the entire health care of the individual person is provided and financed by one organization, definancedby one organization, detracts from the viability of a central body charged with the coordination of the delivery of all emergency services in the community. It results not only in duplication of effort but often in the establishment of potentially antagoistic organizations.

Consumer Organizations↗
PubMed2005

A survey of total quality management in Iran.

PURPOSE: The objective of this research is to investigate the success of TQM and barriers to its successful implementation in health care services organizations in Isfahan province, Iran, 2004. DESIGN/METHODOLOGY/APPROACH: This descriptive and cross-sectional research was done via two questionnaires (TQM success and its barriers). The statistical population of this research consists of all managers of health care services organizations who implemented TQM in their organizations (90 managers). FINDINGS: TQM success in Isfahan health care organizations was high. In correlation analyses between the success of TQM and its principles, success, process management and focus on employees had a positive and the greatest effect and focus on material resources and on suppliers had a lower effect. In correlation analysis between the barriers to TQM and the problem dimensions, human resource, strategic and structural problems were the most important obstacles and barriers to TQM successful implementation respectively. RESEARCH LIMITATIONS/IMPLICATIONS: Although conducted in Iran, it is anticipated that the findings may well have relevance on a broader scale. ORIGINALITY/VALUE: By replicating this study in different countries and contexts the results could be very fruitful for developing a model of TQM that can be implemented easily, effectively, efficiently and successfully in a cross-cultural context.

Cross-Sectional Studies↗
PubMed2000

Organization, management and operation of contemporary academic mass spectrometry service facilities.

The rapid evolution of mass spectrometry in the past 15 years has moved mass spectrometry facilities from the traditional model in which instruments were located in and used for a single department's samples to a distributed model servicing entire universities. In this paper we describe two such shared instrument facilities that have evolved from a base in a single department to facilities that service a broad clientele. The Purdue University Campus-wide Mass Spectrometry Center (CWMSC) is a decentralized facility with multiple sites on campus. The CWMSC is a limited-access facility in which samples are run by service facility personnel in close cooperation with investigators. The Vanderbilt University Mass Spectrometry Research Center (VU-MSRC) is a centralized facility in the medical school that provides services to the university at large. The VU-MSRC is an open-access facility in which users are expected to prepare and analyze their own samples under the guidance of a trained operator. Perhaps the most significant benefit achieved by these models has been the minimization of academic barriers and the resultant intellectual cross-fertilization that has greatly enriched research at institutions where this approach has been adopted. The advantages and limitations of both models are discussed in terms of the traditional academic paradigm of service, research and education.

Chemistry, Analytic↗
PubMedDate not supplied

Issues encountered in an attempt to implement a second-generation management information system.

Human service organization are beset by internal and external requests for information. As the scale and complexity of such delivery systems has increased, the use of computer-based information systems has become a necessity. The evolution of a client information system in a large, decentralized mental health center is reviewed in this paper to illustrate several critical issues that can be encountered in the application of computer-based technology to human services. An analysis of the center's existing information system and the development of the data forms and procedures necessary for a second-generation system to meet information needs revealed the unique data structure and analysis problems of human service delivery systems. These problems were complicated by regulatory agencies' imposition of external reporting requirements that frequently were unpredictable and inconsistent. Finally, planning and negotiations with the participation of all involved parties demonstrated that formal and informal administrative constraints and conflicting interests within human service organizations must be accommodated or a system may fail. All of these factors combine to highlight both the problems and the need for highly flexible multipurpose information systems.

Boston↗
PubMed1994

Physicians in health care management: 5. Payment of physicians and organization of medical services.

The financing, payment and organization of medical services are closely related. Canada's health care system is financed publicly, from tax revenue, and administered in each province by a single government payer. Although the chief method of payment to physicians is fee for service (FFS), the need to control costs and organize practice more efficiently has led to increased interest in FFS variants, such as capping payments at a certain level or fixing a budget, and alternative payment methods such as capitation-based payment, salary and combinations of these methods. Although solo practice is reportedly still the chief method of practice organization, it is being steadily replaced by arrangements in which physicians share expenses or calls, and by formal partnerships and group and team practices. As medical practice in Canada continues to shift from solo to group and team practice alternative payment methods that facilitate these models will become more common.

Canada↗