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PubMed1987

Patterns of physicians' use of medical resources in ambulatory settings.

We studied British general practitioners' use of ambulatory resources to determine whether the quantities of different resources used were related to each other, and whether these quantities were associated with their personal characteristics. Rates of laboratory requests, referrals for specialty opinion, prescriptions, and visits per patient per year were examined for 21 physicians in seven practices over one year. Physicians who more frequently saw their patients referred and prescribed for them more often and ordered more tests, once the number of years they had practiced was taken into account. Doctors who ordered more tests referred their patients more frequently, regardless of how often they saw them. Doctors longer in practice saw and prescribed for their patients more frequently. Resource use was not related to other personal characteristics we studied. Greater frequency of patient-physician contact appears to increase costs not only through use of more professional time but also through greater use of other ambulatory resources. Attention to the use of only one type of resource may result in a distorted picture of how physicians care for their patients and the costs that such care incurs.

Clinical Laboratory Techniques↗
PubMed1996

Internal resourcefulness, task demands, coping, and dysphoric affect among caregivers of the frail elderly.

Internal resourcefulness is defined as the repertoire of skills and behaviors individuals employ to deal with negative affective states. The relationships among caregivers' internal resourcefulness, demands of the caregiving situation, and caregivers' self-reported coping behaviors were examined relative to changes in dysphoric affect over time. Primary caregivers of the frail elderly (N = 143) completed the following measures, at two time periods, approximately four months apart: Rosenbaum's Self Control Schedule, assessing internal resourcefulness; Poulshock and Deimling's list of tasks carried out for the frail elder; Zarit et al.'s Memory and Behavior Problem Check List assessing caregiver burden; Moos et al.'s Indices of Coping; and Beck et al.'s Depression Inventory as a means of assessing dysphoric affect. Although caregivers' reactions to the care recipients' annoying behaviors predicted negative affect at time 1 and avoidant coping behavior predicted negative affect at times 1 and 2, internal resourcefulness was the only significant predictor of changes in dysphoric affect over time. Decreased dysphoric affect among caregivers was linked to possession of a larger initial set of internal resources to deal with negative internal experiences.

Adaptation, Psychological↗
PubMed1998

Algorithms for resource allocation of substance abuse prevention funds based on the estimated need: a case study on state of Florida--Part 1.

The purposes of Parts 1-3 of this article is to develop a framework for county-based prevention resource allocation algorithms based on the aggregated need for substance abuse prevention services estimated at the county level. The development of these algorithms is founded upon two databases: statewide student drug survey and a set of social indicators routinely collected and published by various agencies of the state of Florida. The resource allocation models are devised by developing several indices of prevention needs that are conceptualized in terms of: 1) county-based composite drug use index (COMDRUG), 2) the definitions of prevention target populations as envisioned by the Institute of Medicine (IOM), 3) composite risk-factor index score, and 4) a set of social indicators that are empirically related to COMDRUG observed at the county level. The first three models are based on the prevention needs estimated from the statewide student survey on substance abuse. The social indicator model, however, is presented as an alternative resource allocation model which may be used in lieu of or in the absence of statewide survey. The resource allocation algorithms found on these four conceptualizations are thought to be more equitable and appropriate to the prevention needs of various communities than may be contrived otherwise. Due to a significant amount of information leading to the development of these models, Part 1 of this series is devoted to the following three topics: 1) sampling method used, 2) poststratification weighting methods used to estimate county-based COMDRUG, and 3) the development of resource allocation models based on COMDRUG and the IOM definitions of prevention target populations.

Alcoholism↗
PubMedDate not supplied

Learned resourcefulness: a conceptual analysis.

Resourcefulness is an important phenomenon in promoting adaptive functioning in individuals experiencing depressive illness. A review of nursing and related literature reveals increasing interest in the usefulness of learned resourcefulness. However, the theoretical and empirical literature also addresses several other phenomena of concern to nurses that seem similar or related to learned resourcefulness. The process of concept analysis provides a useful approach for examining important phenomena and clarifying similarities and differences from related concepts. The purpose of this paper is to explicate the concept of learned resourcefulness through the examination of its uses and consideration of model, borderline, related, contrary, and illegitimate cases. As a result, the defining attributes, antecedents, consequences, and empirical referents are identified. Theoretical, methodological, and clinical implications related to the concept of learned resourcefulness are also discussed.

Aged↗
PubMed1989

Perceived need for interpersonal resources by Israeli drug abusers.

Following Foa's classification of interpersonal resources and Peele's theoretical proposition which describes addiction as an alternative but unappropriate experience, it was hypothesized that drug abusers would express greater need for interpersonal resources than their controls, especially on general wish level, and that they would prefer universalistic--"socially valued" resources like status and money rather than affection and love. Although not conclusively, on the general wish level, drug abusers tended to express higher expectations for interpersonal resources than their controls, but in realistic relationships (e.g., marital relationships and employment) they showed smaller need for resources.

Adult↗
PubMed1990

Learning resources in a medical school--the evolution of an innovation.

Resources to support self-study have been provided in the Medical School of the University of Aberdeen for the past 15 years. The initial impetus to this provision was given when a project--the Postgraduate Teaching Project--was set up in 1974 to develop programmes for medical postgraduates studying the Membership Examinations of the Royal College of Physicians. The success of the project resulted in a widening of its remit to undergraduate medical education. This led, in turn, to the formation, in 1978, of the Medical Learning Resources Group and the construction of a designated Learning Resources Area in the Medical School Library. Use of resources is continuously monitored and the resources themselves are regularly revised and updated.

Education, Medical, Undergraduate↗
PubMedDate not supplied

Nursing faculty development during a time of declining resources.

During a time of declining resources, a school of nursing faculty development committee and their Dean devised a way to provide need-specific scholarly development programs using principles of human potential development. The process yielded information useful for faculty development, regardless of economic resources. Faculty were invited to participate in a non-confidential survey that assessed their needs for scholarly productivity, resources they would offer to others, and goals for their own development. The list of resources and needs generated was shared with faculty. Based upon the needs and resources identified, specific development activities were initiated. Six workshops were planned and implemented with high (89%) participation. The dean hired a part-time statistician, a faculty member developed and distributed a handout on "Tips for Time Management," and a writers' support group was formed. This approach to faculty development merits consideration by other groups since it focuses upon the synergistic development of human potential.

Cost Control↗
PubMed2000

[Making Decisions on the Resources for Cancer Control]

We aim at modelling the strategic decision making process in case of devoting resources to a governmental cancer control program. We use a model based on the theory of Analytic Hierarchy Process. In this article we describe the characteristic features of such a decision making process and reveal the complexity of the problem underlying the decisions. A second article will present and discuss the results from the application of the AHP model. Interventions which are capable of decreasing the burden of cancer in a society need strategic approach. Decisions on interventions seem inevitable to be based on and balance between the priorities and the available resources. There is not much doubt about it that the reason for setting the priorities arises on the one hand from the scarcity of resources. On the other hand, priorities evolve on other bases, and are supposed to "guide" health policy makers devoting the scarce resources. In general, a strategic mode of thought has been based on assumptions, which, in case of cancer control enhance the necessity to assess information on cancer and cancer patients, and to understand the factors contributing towards better health. The capabilities of the NCCP achieving its aims by preventing the development of cancer diseases (primary prevention), by making use of the means of early detection and appropriate therapy (secondary prevention), and by providing modern (comprehensive) tertiary prevention are inevitably affected by the priorities. Health policy should assume a responsibility for enforcing certain priorities and should be aware of the long-term interest of the population. To solve the problem we restrict the model to a simple three level one, representing the goals, the criteria, and the alternatives of the resource allocation. We determine "decreasing the burden of cancer" as the overall goal. "Distributive justice" "cost-effectiveness", "human rights", "evidences", and "standpoints of a community" serve as criteria, while "primary prevention", "early detection and therapy, both belonging to the secondary prevention", "tertiary prevention", "research", and "education" form the alternatives.

Journal Article↗
PubMed1991

Putting your human resource department to work for you.

As a staff function, human resources is organized as a service activity. Service activities render no patient care; they do not advance the work of the organization. However, they support the performance of the organization's work and in a practical sense become necessary. For example, if a pure service, such as building maintenance, did not exist, the facility's physical plant would gradually self-destruct. Similarly, without human resources to see to the maintenance of the work force, the overall suitability and capability of that work force will steadily erode. Recognize human resources for what it is--an essential service function required to help the organization run as efficiently as possible. Learn what the HR department does, and especially learn why the department does what it does. Provide input to the human resource department. Forge a continuing working relationship with the HR department, making it clear that you expect service from this essential service department. Challenge the HR department to do more, to do better, and to continually improve service--and put the human resource department to work for you and your employees.

Decision Making, Organizational↗
PubMed1992

Regionalization of human resources. SCHCS healthcare facilities collaborate to head off labor shortages.

Shortages of healthcare personnel become more pronounced each year. Effective human resource strategies are therefore important to facilities' success. The Sisters of Charity Health Care Systems (SCHCS), Cincinnati, is meeting the labor shortage head-on through collaborative regionalization among its facilities. Regionalization develops an integrated continuum of care on local and regional bases, helps SCHCS members avoid duplication of services, and ensures communities' future access to care by spreading financial risk among partners. SCHCS human resource personnel encourage employees to stay within the organization if they must relocate or are looking for career advancement. Members use a systemswide brochure to recruit nurses and allied health professionals. To attract employees from outside SCHCS, human resource personnel join forces at trade association conferences, job fairs, and school career days. SCHCS human resource personnel recruit and select values-oriented employees. Values-based human resource guidelines provide a framework for SCHCS members to assess how effectively the core values and mission are demonstrated in policies, programs, procedures, behaviors, and culture.

Allied Health Personnel↗
PubMed1997

Dialogue. Resource allocation: to those in the greatest need or those who will benefit most?

The behavioral healthcare community seeks universal coverage for mental health and addiction treatment services at parity with coverage for other medical conditions. To achieve this goal, our field must accept and work within realistic financial limits. The time has come to establish a framework for "rational rationing" of behavioral healthcare resources. What are the priorities? How should resources be equitably shared? Should we sacrifice people with mild and moderate disabilities and illness in order to spend most of our dollars on people who are severely impaired? Our first writer, Dr. Daniels, warns us that there are no moral tenets upon which we can easily or comfortably hang our hats, as he shares the current perspective of medical bio-ethics. Dr. Sabin is a practicing psychiatrist at Harvard Pilgrim Health Care. He highlights the Oregon health Plan as one example of political fortitude and wisdom in resolving healthcare resource allocation challenges. Mac Crawford, chairman of the board and chief operating officer of Magellan Health Services, is in one of the most influential positions in private sector integrated behavioral services delivery. He stresses the importance of managed care and clinical process standardization as fundamental requirements for the rational allocation of resources. One additional note: The lack of a consumer voice in this Dialogue is an unfortunate consequence of the mismatch between submissions received and our publication deadlines. It was our intention to present the perspective of a prominent individual from the growing field of consumer and family advocacy. We apologize for the lack of this perspective, which may have extended this discussion to the practical implications of this abstract question of resource allocation.

Cost-Benefit Analysis↗
PubMed1984

Information resources management: management focus on the value of information and information work.

Progressive management views information resources--all forms of stored data; people as information sources, processors and communicators; information tools--as major assets of companies in the information age. They treat and manage information resources as other valuable resources, e.g. personnel, finances, energy. The unique characteristics of managing information resources are introduced. Approaches toward the introduction of information resources management are outlined.

Information Systems↗
PubMed1984

A taste of nutrition--a nutrition resource for leaders working with mentally handicapped adults.

The trend towards deinstitutionalization for mentally handicapped adults has precipitated a need to provide these individuals with nutrition education and food preparation skills. Food, nutrition, and eating are important components of training programs for life skills, which lead to greater independence for the mentally handicapped. The types of nutrition information and learning activities needed for the mentally handicapped were determined through a literature review and a series of interviews with those working with this target group. The nutritional concerns of mentally handicapped adults include food selection to meet their nutritional needs, menu planning, food preparation, weight control, and nutrient-drug interactions. A Nutrition Resource Kit for Leaders Working with Mentally Handicapped Adults has been developed in The Regional Municipality of York in response to local demand for nutrition education programs and resources for mentally handicapped adults. The kit provides those working with mentally handicapped adults with background nutrition information, learning activities, resource materials, and references to additional resources. The topic areas covered include basic nutrition, nutritional concerns of mentally handicapped adults, nutrient-drug interactions, menu planning, shopping strategies, and food preparation. Dietitian-nutritionists can assist leaders who work with mentally handicapped adults by providing them with up-to-date nutrition information and motivating the to use available nutrition education resources.

Humans↗
PubMedDate not supplied

Meshing human resources planning with strategic business planning: a model approach.

Many people are touting the need to take a strategic approach to human resources management--but this is more easily said than done, point out authors Lloyd Baird, associate professor of management at the School of Management and the Human Resources Policy Institute at Boston University; Ilan Meshoulam, personnel executive at Digital Equipment Corporation; and Ghislaine DeGive, Boston University. Obviously, people cannot be moved around as easily or as speedily as can other resources to help move a company to a strategically identified future position. Thus a great deal of planning is required. The authors present an integrative human resources strategic planning model that focuses on four elements: the environment, the organization's culture, the corporate mission statement, and overall corporate strategy. Each part of the model is thoroughly discussed, and checklist questions are included to help the individual manager develop and implement human resources management plans for his or her own organization.

Models, Theoretical↗
PubMedDate not supplied

Provider resource planning. A study of methods in multispecialty groups and systems.

This article profiles the state of the art in provider resource planning based on a sample of large multispeciality group practices. Senior administrative representatives from a geographically dispersed sample of 12 practices, each employing over 100 physicians, participated in telephone interviews to discuss their respective organization's provider resource planning practices. There was significant variation with regard to the structural and process components and evaluation criteria used to plan provider resources. Variability was most pronounced by the lack of consensus and experience within and across organizations regarding the number and type of criteria deemed useful in evaluating new position requests. This research suggests that there is an opportunity to develop more objective provider resource planning methods that recognize differences across organizations and their respective markets. The authors recommend a series of research steps to develop methods that would identify needs prospectively, minimize the complexities of provider resource planning and maximize the alignment of strategic plans and operations.

Benchmarking↗
PubMedDate not supplied

Resource allocation. The cost of care: two troublesome cases in health care ethics.

With the cost of health care rising rapidly, both physicians and administrators regularly face resource allocation decisions. Under these conditions of relative scarcity, the equitable and appropriate distribution of limited resources becomes an ethical as well as a financial issue. Through ethical analysis, physician executives can assist their physician colleagues and fellow administrators to find rationally defensible answers to questions regarding the distribution of limited resources. Six criteria are frequently "weighted in the balance" by ethicists when analyzing whether justice is served in the distribution of a limited resource: need, equality, contribution, ability to pay, effort, and merit. The authors argue that, from an ethical standpoint, the best single criterion upon which one can base an allocation decision is that of merit, defined as the potential to benefit from the investment of additional resources.

Decision Making↗
PubMed1999

The mutual effects between job resources and mental health: a prospective study among Dutch youth.

The current study construes the relation between job resources (such as job autonomy, skill utilization, and variety) and mental health as a reciprocal process. Following conservation of resources theory (S. E. Hobfoll, 1989), the author expected job resources to have a positive effect on mental health. Poor mental health was assumed to impede workers' attempts to maintain or enhance their job resources either by changing the content of their jobs or attempting to find another (less distressing) job. Longitudinal data from a representative sample of 699 Dutch youth were analyzed with analysis of variance and covariance structure modeling. The results provided good support for the proposition that job resources and mental health mutually influence each other. Limitations and implications of the study are discussed.

Adult↗
PubMed2000

Consequences of phenotypic plasticity vs. interspecific differences in leaf and root traits for acquisition of aboveground and belowground resources.

Trade-offs between acquisition capacities for aboveground and belowground resources were investigated by studying the phenotypic plasticity of leaf and root traits in response to different irradiance levels at low nutrient supply. Two congeneric grasses with contrasting light requirements, Dactylis glomerata and D. polygama, were used. The aim was to analyze phenotypic covariation in components of leaf area and root length in response to above- and belowground resource limitation and the consequences of this variation for resource acquisition and plant growth. At intermediate shading (30 and 20% of full sunlight) the plants were able to maintain their total root length, despite a strongly increased total leaf area and a reduced biomass allocation to roots. This was associated with an unaltered or slightly increased nutrient uptake and growth. At 5.5% relative irradiance, growth was severely reduced, especially in the shade-tolerant D. polygama. The results show that constraints on acquisition capacities for aboveground and belowground resources, caused by biomass allocation, may be alleviated by plasticity in other traits such as tissue-mass density and thickness of roots and leaves. The results also suggest different adaptive constraints for phenotypic plasticity and for genetically determined interspecific variation. Phenotypic plasticity tends to maximize resource acquisition and growth rate in the short term, whereas the higher tissue-mass density and the longer leaf life-span of shade-tolerant species indicate reduced loss rates as a more advantageous species-specific adaptation to shade in the long term.

Journal Article↗