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 1,459 records · Page 81Linked to original sources

The postmortem fate of Pat Gregory: a disinterred Native American.

In late June 1990, the Mono County Sheriffs Department in Bridgeport, CA contacted the Physical Anthropology Human Identification Laboratory (PAHIL) at California State University, Chico to seek assistance in the identification of a recently discovered skull. To assist with possible identification, the cranium received a classic physical anthropological/morphological analysis to suggest the decedent's sex, age at death, ancestral affiliation, and uniqueness. It was concluded the cranium was that of an older male, and someone with mixed ancestry, probably Native American/White. Suggested uniquenesses were an eroded and greasy texture, with adhering white sand, evidence of healed antemortem nasal fractures, and a bifid left occipital condyle. The cranium was confiscated from a man suspected of vandalizing a Native American cemetery just south of the community of Lee Vining. The cemetery was established in the mid-1800's by local Native American tribes. Although ownership of the land was disputed by the US Forest Service (the Inyo National Forest), and the Los Angeles Department of Water and Power (LADWP), county authorities claimed that because the incident involved the desecration of a cemetery and human remains, it was a legal issue, and therefore, the Sheriff's Department had jurisdiction over the case if not the land. The suspect pled guilty to the possession of Native American remains but claimed not to have desecrated a grave. Over the next year and a half, members of the Native American community representing various tribes sought the return of the cranium, while also seeking assurance that it belonged to the vandalized grave. While county, US Forest Service, and LADWP officials continued to argue over whom had jurisdiction of the remains the superior court judge ordered the county to pay for any analysis necessary to determine if the cranium belonged to the decedent in question. This report addresses the conclusions of that analysis and the disposition of the case. Furthermore, the report addresses the forensic value to Native Americans of the continued study of a wide variety of human skeletal remains.

Anthropology, Physical↗

The National Nursing Home Survey: 1995 summary.

OBJECTIVE: The 1995 National Nursing Home Survey (NNHS) was conducted to collect data on nursing homes and their current residents. This report presents detailed data on the characteristics of the nursing homes including ownership, certification, bed size, location, affiliation, and services provided. Data on current residents are presented by basic demographics, living arrangement prior to admission, functional status, and other health and personal characteristics of the residents. METHODS: The 1995 NNHS is a sample survey consisting of a two-stage design with a probability sample of 1,500 nursing facilities in the first stage and up to six current residents from each facility in the second stage. RESULTS: About 1.5 million residents were receiving care in an estimated 16,700 nursing homes in 1995. Nearly 1.8 million beds were available and facilities operated at about 87 percent of their capacity. Nearly 90 percent of the residents were 65 years and over. They were predominantly female and white with a large portion needing assistance in the activities of daily living (ADL's) and instrumental activities of daily living (IADL's).

Activities of Daily Living↗

Off-balance-sheet financing can generate capital for strategic development.

To manage their real estate portfolios effectively and obtain funding for strategic development, IDSs should consider adopting off-balance-sheet financing strategies, such as sale-and-leaseback transactions, synthetic leases, and joint-venture arrangements. Under these approaches, real estate assets are moved off of the organization's balance sheet via a partial or complete transfer of ownership to a third-party entity. The organization typically retains a satisfactory degree of control over the assets as lessee in sale-and-leaseback and synthetic-lease arrangements, or limited or minority partner in a joint venture, while freeing up cash to use for other strategic purposes.

Accounting↗

Lessons learned from three physician-equity models.

To improve the profitability of group practice ownership, some healthcare organizations have structured arrangements to include a form of physician equity. An equity incentive is designed to encourage physician behavior that supports business operations by tying financial reward to overall organizational performance. Three physician-equity models--third-party integration, joint venture management services organization (MSO), and physician-owned practice management company--have used the physician equity incentive with varying degrees of success. The experiences of three healthcare systems that implemented these models demonstrates that strategies often cannot be executed as planned, growth should not be assumed, and the changing healthcare marketplace is unpredictable.

Connecticut↗

What determines hospital sponsorship of an HMO?

Using a strategic adaptation framework, this study evaluates the underlying institutional, market, organizational, and financial factors leading to hospital sponsorship of a health maintenance organization (HMO) insurance product. Analyzing hospitals in Metropolitan Statistical Areas (MSAs) in 1995 and 1996, the study found that a hospital is more likely to sponsor an HMO in markets that see a combined interaction effect of a large number of competing HMOs and high HMO penetration. HMO sponsorship also is more likely among hospitals with relatively low market share. Only in small MSA markets do hospitals with greater liquidity sponsor an HMO. Finally, hospitals that are affiliated with a multihospital system and under public ownership are more likely to sponsor HMOs.

American Hospital Association↗

Over-the-counter codeine use in Iceland: the impact of increased access.

BACKGROUND: The objective of this study was to test the assumption that liberalizing community pharmacy ownership in Iceland would lead to increased irrational use of over-the-counter pain relievers containing codeine. METHODS: Based on this assumption we built and tested a model using an interrupted time series design that contrasts the monthly sales data for over-the-counter pain relievers containing codeine before and after the legislation took effect. RESULTS: The total use of over-the-counter pain relievers containing codeine as well as those containing paracetamol and codeine has risen steadily throughout the period under study. The interrupted time series did not show a substantial effect from the legislative change on the use of all over-the-counter codeine pain relievers, paracetemol with codeine, and aspirin with codeine combinations. CONCLUSION: The assumption that increased access leads to irrational use of over-the-counter medicines is not substantiated in the case of over-the-counter pain relievers containing codeine.

Analgesics, Opioid↗

How managed care plans contribute to public health practice.

Growth in managed care enrollment potentially creates incentives for health plans to become involved in public health activities, such as health promotion and disease prevention interventions, and care for vulnerable populations. Using cross-sectional data from 60 diverse markets, this study explores the extent to which health maintenance organizations (HMOs) form cooperative alliances with local public health agencies to perform such activities. Results from multivariate models suggest that the incentives for cooperation vary substantially with health plan ownership and market structure. In view of recent HMO industry trends, these findings raise questions about the ability of alliances to integrate the practice of public health and medicine on a broad national scale, as some proponents suggest they do.

Cooperative Behavior↗

Physician group practice turnaround. Focus on physician behavior.

Physician behavior is an important driver in a group practice turnaround. A strong leadership team, giving physicians ownership, governance and proper incentives, creates the necessary behavior changes. It's also critical to have budget discipline, identify and make the hard decisions, provide effective care management, employ a sound business infrastructure and good contracting, and attend to physician morale.

Budgets↗

Merger failure: a five-year journey examined.

In 1994, Catholic Medical Center and Elliot Hospital in Manchester, New Hampshire, merged to form Optima Health, a full-ownership, not-for-profit IDS. Initially, Optima Health was an economic success. A number of strategic miscalculations, however, led to the IDS's demise. First, Optima Health's leaders failed to fully consider the divergent cultures of the two hospitals, particularly with respect to their religious differences. Second, Optima Health's leaders did not anticipate the public's response to the organization's consolidation plan. And third, the consolidation was found to have changed the charitable missions of the two tax-exempt hospitals in violation of Federal laws regarding charitable trusts. The issues combined to undermine the commitment of the organization's leaders to the consolidation strategy, and Optima Health was dissolved.

Community-Institutional Relations↗

Practice transitions--past, present, and future.

Upon their retirement, dentists have gone from simply closing their office doors to seeing the sale of their practice as a means to fund their retirement. Today, other practice transition options are used to the advantage of both the retiring dentist and the dentist just starting out. Options will continue to meet the changing needs of dentists, particularly new dentists who must pay off higher education debts and may not opt for immediate ownership of a practice upon graduation.

Education, Dental↗

Organizational economics and health care markets.

As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership.

Data Collection↗

Establishing an Integrated Catchment Management (ICM) program in East Java, Indonesia.

The Brantas is one of Indonesia's most important catchments. It is the "rice bowl" of Java and nationally important for its industrial activity. Surabaya, Indonesia's second largest city, is located at the mouth of the Brantas River which is pivotal to the city's water supply. The challenges associated with the institutional framework for natural resource management in East Java parallels that of many states and provinces around the globe. It is multi-layered and complex. Integrated Catchment Management (ICM) may be defined as "the co-ordinated and sustainable management of land, water, soil vegetation, fauna and other natural resources on a water catchment basis". Over a period of six months, an ICM Strategy was researched and facilitated for the Brantas River Catchment in East Java via a short term advisor attachment. The aim of the Strategy is to improve coordination, co-operation, communication and consistency of government and community efforts towards sustaining the catchment's environmental, economic and social values. The attachment was part of the Pollution Control Implementation (PCI) Project funded by AusAid and the Indonesian Government. The ICM Strategy developed was broad based and addressed the priority natural resource management issues facing the Brantas Catchment. It was co-ordinated by BAPEDALDA, the Provincial Environmental Protection Agency, and developed by all agencies involved in natural resource management in the catchment. Various Universities and Non Government Organisations (NGOs) were also involved in the ICM process which developed the Strategy. At the conclusion of the attachment, a draft ICM Strategy and a proposed institutional framework had been developed. A working group of key agencies was also established to further enhance local "ownership", finalise timescales and implementation responsibilities within the Strategy and bring the institutional arrangements into being through a Governor's Decree.

Agriculture↗

Fiscal options for America's best hospitals.

A review of America's "best" teaching hospitals shows a huge disparity in their fiscal positions. Among the 15 hospitals studied, roughly half experience some fiscal distress. However, a somewhat similar fiscal analysis of the nation's largest investor-owned hospital chains, HMOs, and physician practice management corporations shows an even more serious weakness in operating margins and debt-equity ratios. Aside from raising possible ethical, quality, and cost issues, this financial analysis suggests that conversion from nonprofit to for-profit ownership of America's top teaching hospitals might not guarantee an improvement in their long-term fiscal outlook.

Accounts Payable and Receivable↗

Income, location, and the demand for health care from public, nonprofit, and for-profit hospitals.

Although, empirically, for-profit hospitals serve few poor and indigent patients, they may be able to shift capital more quickly than hospitals of other ownership types, thereby spatially avoiding poor patients. However, in a market with a relatively high proportion of for-profit hospitals, spatial avoidance of poor patients is not possible because spatial competition will exist in non-poor areas. The study examines hospital choice for maternity care in a market with many for-profits using a gravity model or conditional logit. The analysis shows that poor and Medicaid populations choose for-profit hospitals overall. Income, along with distance, is an important factor in hospital choice.

Catchment Area, Health↗

Managing for value. It's not just about the numbers.

In theory, value-based management programs sound seductively simple. Just adopt an economic profit metric, tie compensation to agreed-upon improvement targets in that metric, and voilà! Managers and employees will start making all kinds of value-creating decisions. If only it were that easy. The reality is, almost half of the companies that have adopted a VBM metric have met with mediocre success. That's because, the authors contend, the successful VBM program is really about introducing fundamental changes to a big company's culture. Results from their major research project into the practice of VBM reveal that putting VBM into practice is far more complicated than many of its proponents make it out to be, requiring a great deal of patience, effort, and money. According to the authors' study, companies that successfully use VBM programs share five main characteristics. First, nearly all made explicit and public their commitment to shareholder value. Second, through training, they created an environment receptive to the changes the program would engender. Third, they reinforced that training with broad-based incentive systems closely tied to the VBM performance measures, which gave employees a sense of ownership in both the company and the program. Fourth, they were willing to craft major organizational changes to allow all their workers to make those value-creating decisions. Finally, the changes they introduced to the company's systems and processes were broad and inclusive rather than focused narrowly on financial reports and compensation. A VBM program is difficult and expensive. Still, the authors argue, properly applied, it will put your company's profitability firmly on track.

Commerce↗

Vulnerability of rural hospitals to Medicare outpatient payment reform.

Because the Balanced Budget Act (BBA) of 1997 requires implementation of a Medicare prospective payment system (PPS) for hospital outpatient services, the authors evaluated the potential impact of outpatient PPS on rural hospitals. Areas examined include: (1) How dependent are rural hospitals on outpatient revenue? (2) Are they more likely than urban hospitals to be vulnerable to payment reform? (3) What types of rural hospitals will be most vulnerable to reform? Using Medicare cost report data, the authors found that small size and government ownership are more common among rural than urban hospitals and are the most important determinants of vulnerability to payment reform.

Aged↗

Phase I Stark II regulations provide some flexibility.

The Centers for Medicare and Medicaid Services (CMS--formerly HCFA) issued Phase I regulations of Stark II in January 2001. The Stark II final rule prohibits physicians from referring Medicare patients for designated health services (DHS) to entities with which the physicians or their immediate family members have a financial relationship. A financial relationship can be either an ownership interest or a compensation arrangement, and can be direct or indirect. The law provides a variety of sanctions, including denial or refund of payment and civil penalties. The final rule generally permits physicians to make referrals to entities with which they have a compensation relationship, as long as the compensation paid to the physician is no more than would be paid to someone who provided the same services but was not in a position to generate business for the entity. The final rule is substantially different from the January 1998 proposed rule. As a result, physicians who refer patients to entities for DHS need to ensure that the referrals do not trigger Stark II prohibitions. To avoid unknowingly violating the law, healthcare providers need to understand what constitutes an entity, how CMS views referrals, and what is and is not a DHS.

Financial Management↗