Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Community Financing”

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 1,495 records · Page 83Linked to original sources
PubMed1993

General practitioners in partnership with management: an organisational model for debate.

The role of general practitioners is changing and expanding. Doctors have more control over the treatment received by their patients but remain largely unaccountable to the public and management. This article proposes an organisational model for integrating primary and secondary care which retains the advantages of fund-holding while giving management control over overall strategy. It proposes that general practitioners control funds for all primary and secondary care. Secondary care will be contracted through a joint team of managers and an elected general practice executive committee. A new health care purchasing authority will contract for primary services with individual practices or primary care provider units. General practitioners will have local contracts reflecting their desire to provide an expanded range of services and the needs of the community.

Capital Financing↗
PubMed1997

Trends in, and transitions to, institutional residence among older people in England and Wales, 1971-91.

OBJECTIVES: To compare transitions from private households to institutions between 1971-81 and 1981-91 among elderly people and see whether (1) differentials in the risk of institutionalisation changed and (2) whether the risk was higher in the second period. DESIGN: Cross sequential analysis of data from the Office of National Statistics longitudinal study, a record linkage study which included individual level data from three national censuses, (1971, 1981, and 1991) and linked vital registration data. SUBJECTS: Altogether 26,400 people aged 65 and over in 1971-81 and 32,500 persons aged 65 and over in 1981-91. These samples represent 1% of the population of England and Wales. RESULTS: In both periods models including age, housing tenure, and marital status or household/family type terms fitted the data reasonably well. The effect of age was stronger in the second decade, while that of marital status was reduced. The risk of transition to an institution was nearly 33-52% higher in the second decade after controlling for these factors. CONCLUSIONS: During the 1980s the availability of state financed institutional care increased substantially; a growth which the 1990 NHS and Community Care Act was designed to reverse. Increased access to institutional care undoubtedly is one factor underlying the higher transition rate to institutions observed in 1981-91 than for the previous decade. During 1981-91, transitions to live with relatives also declined substantially. It is not clear whether this simply represents the continuation of a previous trend or whether the increased availability of institutional care led to some substitution for family care. Either interpretation has worrying implications for policy makers keen to promote care in the community.

Age Factors↗
PubMed1975

History strikes again: two 20th-century reform ventures.

There are striking parallels between the rise and decline of the health center movement of the early decades of this century and the community mental health center movement of the sixties. Four ideas that dominated the early health center movement--district location, preventive care, community participation, and bureaucratic organization--were also important in the development of community mental health centers. Both movements initially were expressions of the reform spirit of the times and later were undermined by the shift to conservative domestic politics.

Community Health Services↗
PubMed1983

Staff training through collaboration: the training resources center.

As fiscal resources for mental health programs dwindle, it is becoming increasingly important to preserve non-direct-service priorities such as staff development. The West Virginia Training Resources Center, a collaborative program operated by the West Virginia Department of Health and the West Virginia University department of behavioral medicine and psychiatry, addresses problems of staff training in the state mental health service system. The authors discuss the development of the center and its functions as provider of training programs, sponsor of statewide training conferences, and clearinghouse of information and expertise. They also discuss problems stemming from the increased need for continuing education for paraprofessionals, the use of outside consultants, and the relationship between academia and the health service sector.

Community Mental Health Centers↗
PubMed1985

Whatever happened to community mental health: portents for corporate medicine.

An assessment of what happened to community mental health is presented through recent comments from psychiatrists who were deeply involved in the movement in the 1960s and 1970s and through an analysis of its current status in relation to corporate medicine. Respondents' views range from beliefs that significant accomplishments were made to opinions that achievements were limited because of the lack of financial, psychiatric, and other commitments. The author believes many of the concepts of the movement, such as team care, prevention, and early detection, will be revitalized in preferred provider organizations, health maintenance organizations, employee assistance programs, and other aspects of corporate medicine.

Community Mental Health Services↗
PubMed1988

CMHCs: muted impact.

Explore the source record for details and available documents.

Community Mental Health Centers↗
PubMed1992

Determinants of equality and equity for special populations served by public mental health systems.

Within the publicly funded mental health service delivery system, debate continues over what constitutes a fair and just system for special populations. To determine a system's fairness, the author proposes a conceptual framework in which two standards of fairness--equality and equity--are applied to three dimensions of a mental health system: utilization of services, funding for services, and access to services. An equal system assumes that rates of mental illness and needs for treatment are the same for all subgroups of the general population; funds are allocated and services are offered accordingly. An equitable system assumes that special populations have different rates of mental illness and different treatment needs; funds are allocated and programs are designed based on the recognition of these differences. The author argues that the publicly funded mental health service system must establish equitable, rather than equal, services for special populations.

Community Mental Health Services↗
PubMed1993

Ensuring services for persons with chronic mental illness under national health care reform.

People with chronic mental illness present complex challenges for the design of health care financing reforms. In this position statement from the committee on psychiatry and community of the Group for the Advancement of Psychiatry, the authors describe chronic and severe mental illnesses as psychiatric illnesses that require acute and ongoing psychiatric assessment and treatment, as chronic medical diseases that require ongoing rehabilitative services, and as persistent disabilities that need ongoing supportive care and social services. Any proposal for health care reform must ensure parity of chronic psychiatric illnesses with other psychiatric conditions. It must also reimburse psychiatric rehabilitation at parity with other medical rehabilitation and provide equal access to and reimbursement for broad ancillary health services that reduce costs and improve quality of life.

Chronic Disease↗