Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Ownership”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,351 records · Page 75Linked to original sources
PubMed2001

Ethical issues in the documentary data analysis of Internet posts and archives.

The documentary analysis of e-mail posts and archives for qualitative research has been outlined elsewhere. Although there is an increase in the number of studies being conducted on listserv and newsgroup material in health research, this has not always been accompanied by a careful, in-depth consideration of the concomitant ethical issues. Therefore, this article outlines the ethical considerations surrounding this form of research, including issues of accessing voices, consent, privacy, anonymity, interpretation, and ownership and authorship of research material.

Communication↗
PubMedDate not supplied

Viatical settlements: ethical perspectives.

Viatical settlements are new within the last decade. A settlement contract is a written agreement between a viator (terminally ill person) and an independent viatical settlement company. The company purchases the viator's life insurance policy before the person expires, paying a designated percentage of the policy's worth in exchange for ownership of the policy and beneficiary rights. The viatical settlement company assumes the responsibility for paying the premiums on the policy until the death of the viator. Settlement or proceeds to the viator typically average between 50 and 80 percent of the face value of the policy. This article examines the ethical ramifications of viatical settlements.

Contract Services↗
PubMedDate not supplied

Federal and state nursing facility websites: just what the consumer needs?

Since the introduction of the Medicare Nursing Home Compare website in 1999, some states have begun to develop their own websites to help consumers compare nursing facilities (NFs). This article presents a brief conceptual framework for the type of information needed for an Internet-based information system and analyzes existing federal and state NF websites, using data collected from a survey completed in 2002. Twenty-four states and the District of Columbia have a variety of information on NFs, similar to the information on the Medicare website. Information on characteristics and deficiencies of a facility is the most commonly available, but a few states have data on ownership, staffing indicators, quality indicators, complaints, and enforcement actions. Other types of data, such as resident characteristics, staff turnover rates, and financial indicators, are generally not available. Although many states are making progress toward providing consumers with information, there are gaps that exist, which if filled, could provide consumers with a better tool for facility selection and monitoring the quality of care.

Aged↗
PubMed2001

Impact of HMO penetration and other environmental factors on hospital X-inefficiency.

This study examined the impact of health maintenance organization (HMO) market penetration and other internal and external environmental factors on hospital X-inefficiency in a national sample (N = 1,966) of urban U.S. hospitals in 1997. Stochastic frontier analysis, a frontier regression technique, was used to measure X-inefficiency and estimate parameters of the correlates of X-inefficiency. Log-likelihood restriction tests were used to test a variety of assumptions about the empirical model that guided its selection. Average estimated X-inefficiency in study hospitals was 12.96 percent. Increases in managed care penetration, dependence on Medicare and Medicaid, membership in a multihospital system, and location in areas where competitive pressures and the pool of uncompensated care are greater were associated with less X-inefficiency. Not-for-profit ownership was associated with increased X-inefficiency.

Catchment Area, Health↗
PubMed2001

Selective contracting in managed care: the case of substance abuse treatment.

The authors address two critical questions concerning managed care and outpatient substance abuse treatment organizations. Specifically, they consider (1) to what extent selective contracting occurs between managed care firms and treatment providers and (2) what attributes of treatment providers and their operating environments are associated with selective contracting. Using data from a nationally representative sample of outpatient treatment organizations, the authors find evidence of systematic selection. Several indicators of providers' quality and costs, including accreditation status, private ownership, size, and prior experience with managed care, are positively associated with managed care contracting. By contrast, units providing methadone treatment are less likely to be involved in managed care. To a lesser extent, characteristics of treatment providers' operating environment, including extent of competition based on costs and attributes of the Medicaid managed care program, are also positively associated with managed care contracting.

Accreditation↗
PubMed2002

Charity care: do not-for-profits influence for-profits?

This study further examines whether not-for-profit hospitals exert pressure on for-profit hospitals to provide charity care and whether for-profit hospitals react differently than not-for-profit hospitals to managed care pressures and hospital competition in providing charity care. A two equation model is estimated using 1996 data from California hospitals. The results indicate that in mixed ownership markets, for-profit hospitals provide significantly less charity care as not-for-profit hospitals in the market provide more. Unexpectedly, study for-profit hospitals were not more influenced by price competition than other hospitals with respect to charity care. Having a unique role in providing charity care may justify continuing tax exemption for not-for-profit hospitals and enhance interest in payment and other policies with regard to conversions to ensure that not-for-profit hospitals continue to be represented in market areas.

California↗
PubMed1999

Strategic groups and performance in the nursing home industry: a reexamination.

This study further examines the relationship between strategic group membership and performance in the nursing home industry. The results indicate seven strategic groups in the industry with significant between-group differences in operating margin, average profit per patient day, catheterization rate, health deficiencies, life and safety deficiencies, and efficiency in the provision of services. The authors did not, however, find significant between-group differences in pressure sore rate, the use of restraints, or in the percentage of patients with significant unplanned weight changes. The group with the highest private-pay utilization combined with high Medicare utilization generally performed the best along all indicators. Results also suggest that strategic group membership and rural/urban location have a greater impact on performance than do ownership, chain membership, or possession of a dedicated specialty care unit.

Analysis of Variance↗
PubMed1999

Consequences of organizational change in U.S. hospitals.

Organizational change has become commonplace among U.S. hospitals. Empirical investigations of the consequences of organizational change, however, are relatively scarce, and findings of existing studies are inconsistent. In this article, the authors review the rationale and performance implications of hospital organizational change in three areas: (1) the development of new multi-institutional arrangements, (2) change in traditional ownership and management configurations, and (3) diversification in organizational products/services and consolidation of organizational scale. Empirical research on hospital change published between 1980 and 1999 in the health services research, social science, and business literatures is reviewed to highlight the potential pitfalls that hospitals may encounter in their effort to remain viable. The article also summarizes the strengths and weaknesses of current hospital change research and provides specific suggestions for future research in this area.

Health Services Research↗
PubMed2004

Population receptivity to tobacco advertising/promotions and exposure to anti-tobacco media: effect of Master Settlement Agreement in California: 1992-2002.

Tobacco marketing contributes to adolescent smoking initiation, and the Master Settlement Agreement (MSA), therefore, included relevant restrictions. We analyzed data from large population surveys of Californians, conducted in 1992 (11,905 adults, ages 18 years and older), 1993 (5,531 adolescents, ages 12 to 17 years), and 1996 (6,252 adolescents, 18,616 adults) before the MSA, and in 1999 (6,090 adolescents, 14,729 adults) and 2002 (5,857 adolescents, 20,525 adults) following its implementation. Camel lost favorite-advertisement popularity after 1996, and between 1999 and 2002, there were large increases in the percentages declining to name a favorite advertisement. Ownership of tobacco promotional items declined from its peak in 1996. Furthermore, in 2002, close to 90% of adolescents and young adults reported seeing anti-tobacco messages on television in the past month, significantly higher than 1996. These trends indicate less receptivity to tobacco advertising and promotions following the MSA but leave room for additional restrictions to further reduce receptivity.

Adolescent↗
PubMed2005

Returning a recently adopted companion animal: adopters' reasons for and reactions to the failed adoption experience.

The return of a recently adopted companion animal places the nonhuman animal in jeopardy and may be painful and frustrating to the humans involved. However, if returners learn from the failed adoption experience, future adoptions may be more satisfactory for all concerned. In this study, 78 people who had adopted and returned dogs or cats to an animal shelter in a U.S. Midwestern city were interviewed regarding their reasons for return, reactions to the experience, and plans for future adoptions. Although some returners adjusted their pet ownership plans in potentially beneficial ways, most reacted by counseling greater forethought and planning before adopting. The last, although sound advice, had little to do with reasons for return, which primarily were problems that arose postadoption: pet behavior such as not getting along with other pets or children. Changing expectations about the development of new pet-family relationships and the provision of postadoption services might help adopters tolerate the adjustment period and handle problems without resorting to returning the animal.

Adaptation, Psychological↗
PubMed2006

Animal protection measures in Taiwan: Taiwanese attitudes toward the animal protection law and animal shelters.

This study used a questionnaire, self-administered by 387 Taiwanese citizens, to assess Taiwanese perception and knowledge of the Animal Protection Law and perception and use of animal shelters. Most respondents (87%) knew that Taiwan has legal protection for animals. A -5 to 5 summary score measured knowledge of companion animal dog-related legal requirements. The median score was 3, indicating that almost all respondents had inadequate knowledge about these requirements. Although more dog caregivers had adequate knowledge of the law than did nondog caregivers (prevalence ratio = 1.9, 95% confidence interval: 1.1, 3.2), only 19% had adequate knowledge. Although most respondents (81%) knew Taiwan has animal shelters, only 19 (5%) reported visiting or participating in shelter activities. Only 6 (32%) of shelter visitors or users had a "good or better" impression of services received. Despite low usage of animal shelters, most respondents thought shelters should accept (87%) and relocate (90%) unwanted animals, capture strays (64%), assist in finding lost pets (79%), and educate the public about responsible ownership (85%). More than half (52%) thought shelters should perform euthanasia.

Adult↗
PubMed1987

A threat or a promise: acquisition of teaching hospitals by investor-owned chains.

In the early 1980s, acquisition of a small number of teaching hospitals by investor-owned chains raised the spectre of a for-profit takeover of teaching institutions. Drawing on experience to date, as well as interviews with affected parties, this article assesses the likely scope of such acquisitions and their impact on the education, research, and indigent care that teaching hospitals provide. Our assessment concludes that relatively few teaching hospitals are likely to satisfy the financial criteria chains apply to acquisitions; that hospitals with modest rather than extensive commitments to education and research are most likely to satisfy these criteria; and that terms of sale typically enhance, rather than undermine, these institutions' resources for research, education, and, to a lesser extent, indigent care, at least in the short run. In the long run, continuation of these activities is more likely to be a function of third-party payment policies than of proprietary versus nonprofit hospital ownership.

Education, Medical↗
PubMed1981

State Dental practice acts: implications for competition.

This article analyzes the effects of state dental practice acts on competition in the market for dental services. Three types of practice act provisions are examined: (1) restraints on advertising and soliciting of patients; (2) limits on scope of practice and number of dental hygienists per dentist; and (3) restrictions on the form of organization and ownership of dental practices. The empirical results suggest that limits on number of offices per dentist and absence of reciprocal licensing arrangements are associated with higher fees and net incomes among dentists. Restraints on number of hygienists per dentist are positively associated with dental fees, but not with net income. Restrictions on commercial advertising are related to the higher net income, but not fees. There is no significant intercorrelation among the various practice act provisions. The analysis concludes with a discussion policy implications for competition in dentistry and a suggestion that practice act changes are both a cause and an effect of the general metamorphosis observed in the dental market place. The potential indirect effects of national health insurance and altered reimbursement policy are discussed.

Advertising↗
PubMed2001

Does it matter who owns health facilities?

The rhetoric of governments 'steering not rowing' and of purchaser-provider splits is still part of the language of public sector reform throughout the world, despite some retreat in the National Health Service in the UK. Implementation of separation of purchaser and provider roles has often been associated with suggestions that the private sector is better able to manage hospitals. The evidence for this assertion is mixed, especially when possible quality differences are also considered. This essay suggests that the ownership question is a second-order issue and that policy-makers should ensure that existing public hospitals are funded in a way that encourages efficiency.

Australia↗
PubMed2004

Comparison of private for-profit with private community-governed not-for-profit primary care services in New Zealand.

OBJECTIVE: To compare the characteristics of patients, their disease patterns, and the investigation and referral patterns in private community-governed not-for-profit and private for-profit primary care practices in New Zealand. METHODS: Observational study using a representative survey of visits to general practitioners in New Zealand. Practices were categorised according to their ownership: private for-profit or private community-governed not-for-profit. Patient socio-demographic characteristics, treated prevalence and other characteristics of presenting problems, morbidity burden, numbers of investigations and referral patterns were compared. RESULTS: Compared with for-profit practices, community-governed not-for-profit practices served a younger, largely non-European population, nearly three-quarters of whom had a means-tested benefit card (community services card), 10.5% of whom were not fluent in English, and the majority of whom lived in the 20% of areas ranked as the most deprived (by the NZDep2001 index of socio-economic deprivation). Patients visiting not-for-profit practices were diagnosed with more problems, including higher rates of asthma, diabetes and skin infections, but lower rates of chest infections. The duration of visits was also significantly longer. No differences were observed in the average number of laboratory tests ordered. The odds of specialist referral were higher in for-profit patients when confounding variables were controlled for. CONCLUSIONS: Community-governed not-for-profit practices in New Zealand serve a poor, largely non-European population who present with somewhat different rates of various problems compared with patients at for-profit practices. The study highlights for communities, policy-makers and purchasers the importance of community-governed not-for-profit practices in meeting the needs of low-income and minority population groups.

Adolescent↗
PubMed2004

Lessons from New Zealand for England's NHS Foundation Trusts.

The legislation to devolve responsibility for the management and operation of England's top-performing NHS hospitals to community-owned NHS Foundation Trusts raises several issues relating to the challenges posed to governance structures by private non-profit ownership and control of assets used to provide government-financed services. Building upon the lessons learned from devolution of public hospital governance in New Zealand to boards at arm's-length from central control during the 1990s, this paper analyses the English NHS hospital changes. Whilst local political accountability and competition between hospitals indicate that the English reforms may be more successful in meeting patients' needs more efficiently than the New Zealand reforms, the English proposals may be compromised by the ability of staff to become members of Trusts, boards bearing risks of decisions outside their control whilst simultaneously being insulated from the consequences of their decisions by a 'soft budget constraint', and conflicts of interest as boards simultaneously act as agents of both central regulators and local beneficiaries.

Decision Making, Organizational↗
PubMed1993

Living will legislation, nursing home care, and the rejection of artificial nutrition and hydration: an analysis of bedside decision-making in three states.

Although state living will legislation establishing the boundaries of unwanted medical intervention has become almost universal, many states define artificial nutrition and hydration as a basic comfort measure rather than extraordinary intervention. In addition, several states have legislation prohibiting its withholding or withdrawal under any circumstances. Despite the recent growth in public awareness and controversy concerning artificial nutrition and hydration, there is little known about the actual influence of prohibitive legislation on bedside decisions involving its withdrawal. An analysis is undertaken of nursing home decision-making concerning the withdrawal of artificial nutrition and hydration in three states with typical variation in living will legislation specific to its legality. Data from interviews with 140 nursing home directors of nursing service responding to hypothetical case vignettes suggest that living will laws prohibiting the withdrawal of artificial nutrition and hydration have little influence over bedside decision-making in nursing homes. Factors found to be determinate of the likelihood of the withdrawal of artificial nutrition and hydration include the competency of the nursing home resident and form of nursing home ownership. State context exerts a significant influence over the likelihood of artificial nutrition and hydration withdrawal, but not in a direction consistent with language of living will legislation.

Decision Making, Organizational↗
PubMed1998

Variation in psychotropic drug use in nursing homes.

Numerous studies of health service use reveal considerable variation in the degree of services provided. In this article the variation in psychotropic drug use in nursing homes is examined. First, a descriptive analysis of nursing homes with and without high levels of psychotropic drug use is provided. Second, an analysis of the determinants of high levels of psychotropic drug use in nursing homes is provided. Factors such as ownership, staffing levels, having special care units, case-mix intensity, competitiveness of the nursing home market, and the state Medicaid reimbursement rate structure are examined. The results of these analyses are discussed in terms of their policy issues.

Activities of Daily Living↗