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At least 163 records · Page 9Linked to original sources
PubMed1990

National health line.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed2004

The case and opportunity for public-supported financial incentives to implement integrated pest management.

Food, water, and worker protection regulations have driven availability, and loss, of pesticides for use in pest management programs. In response, public-supported research and extension projects have targeted investigation and demonstration of reduced-risk integrated pest management (IPM) techniques. But these new techniques often result in higher financial burden to the grower, which is counter to the IPM principle that economic competitiveness is critical to have IPM adopted. As authorized by the 2002 Farm Bill and administered by the U.S. Department of Agriculture (USDA) Natural Resources Conservation Service (NRCS), conservation programs exist for delivering public-supported financial incentives to growers to increase environmental stewardship on lands in production. NRCS conservation programs are described, and the case for providing financial incentives to growers for implementing IPM is presented. We also explored the opportunity and challenge to use one key program, the Environmental Quality Incentives Program (EQIP), to aid grower adoption of IPM. The EQIP fund distribution to growers from 1997 to 2002 during the last Farm Bill cycle totaled approximately 1.05 billion dollars with a portion of funds supporting an NRCS-designed pest management practice. The average percentage of allocation of EQIP funds to this pest management practice among states was 0.77 +/- 0.009% (mean +/- SD). Using Michigan as an example, vegetable and fruit grower recognition of the program's use to implement IPM was modest (25% of growers surveyed), and their recognition of its use in aiding implementation of IPM was improved after educational efforts (74%). Proposals designed to enhance program usefulness in implementing IPM were delivered through the NRCS advisory process in Michigan. Modifications for using the NRCS pest management practice to address resource concerns were adopted, incentive rates for pest management were adjusted, and an expanded incentive structure for IPM technique adoption was tabled for future consideration. The case is strong for using public-supported financial incentives offered by the EQIP to aid grower adoption of IPM as a means to address resource concerns, but current use of the EQIP for this purpose is modest to meager. With appropriate program adjustments and increased grower awareness, USDA NRCS conservation programs, and the EQIP in particular, may provide an important opportunity for growers to increase their use of IPM as a resource conservation and farm management tool.

Agriculture↗
PubMed1987

The profit motive in medicine.

The ethical implications of the growth of for-profit health care institutions are complex. Two major moral criticisms of for-profit medicine are analyzed. The first claim is that for-profit health care institutions fail to fulfill their obligations to do their fair share in providing health care to the poor and so exacerbate the problem of access to health care. The second claim is that profit seeking in medicine will damage the physician-patient relationship, creating conflicts of interest that will diminish the quality of care and erode patients' trust in their physicians and the public's trust in the medical profession. The authors conclude that while the continued expansion of for-profit health care may exacerbate in some respects problems of access, trust and conflicts of interest, it is a mistake to consider these problems as unique to for-profit health care; they are problems for not for-profit health care as well. Though these issues justify continuing moral concern, they do not at this time provide decisive grounds for substantially curbing or eliminating for-profit enterprise in health care.

Economic Competition↗
PubMed1985

Implications of hospital cost control for administrators.

By examining a group of hospitals in California, one can see the effects of cost control legislation on hospital administrators. Problems can be studied and decisions analyzed for their appropriateness, both to the California hospitals and to hospitals in general.

California↗
PubMed1990

Interorganizational linkages in the health sector.

A key element in the success of organizations in the health sector is the maintenance of effective interorganizational linkages with interdependent organizations. A conceptual framework is posited of three general classes of mechanisms through which these linkages are managed.

Cooperative Behavior↗
PubMed1995

Physician responses to a managed environment: a perceptual paradox.

Increased management of physicians is inevitable in today's economically competitive environment. Health maintenance organizations (HMOs) and other managed care settings are challenged by and often confronted with negative perceptions of physicians relating to management and organized practice. Paradoxically, reported experiences of physicians show these negative perceptions to be misconceptions. Managers need to eliminate this perceptual bias through physician education and dialogue.

Adult↗
PubMed1996

Economics of multispecialty group practice.

The number of physicians organized in multispecialty group practices is growing. Research does not suggest that such practices will achieve economies of scope. Rather, the primary economic advantage to multispecialty group practice may be its ability to coordinate the process of care in a managed care setting, a process for which relatively large practices may be necessary.

Costs and Cost Analysis↗
PubMed1993

On defining small areas.

This study explores the relationship between small area and economic approaches to defining hospital markets. Both approaches attempt to link populations receiving care with providers who deliver it. The approaches differ fundamentally, however, in their view of the role of alternative sources of inpatient services. The small area approach attempts to minimize the number of hospitals in a market. Economic approaches attempt to include substitute sources of care. The economic literature also suggests that the availability of substitutes influences the use of health services. This literature is briefly reviewed, and the implications for the analysis of physician practice patterns are discussed. The study concludes that economic approaches to market definition are likely to be more fruitful in explaining variations in the use of services.

Economic Competition↗
PubMed1996

Differentiation and specialization in the California hospital industry 1983 to 1988.

This article examines changes in the service mix of California hospitals as part of their response to shifts in the system of reimbursement between 1983 and 1988. The Hospital Discharge Data Set and the Annual Hospital Disclosure Report produced by California Office of Statewide Health Planning and Development were used in this study. Characteristics of inpatient hospital services in California before and after the introduction of new reimbursement mechanisms (including the Medicare Prospective Payment System [PPS] and the growth of selective contracting plans) were compared. The factors that influence two measures of hospital service mix, one focusing on specialization and the other on differentiation, were studied. The factors included hospital characteristics and changes in hospital reimbursement. Variables describing a hospital's service mix and the level in its market were constructed from data in the annual discharge abstracts. Data pertaining to average hospital costs and reimbursements under the Medicare PPS were drawn from a file containing a 20% sample of hospital stay records for the year of PPS. Other hospital data, such as ownership and bed size, were taken from the California Annual Disclosure Report data set. The results indicate that completion among hospitals tended to increase differentiation whereas higher financial PPS pressure is associated with increased specialization. Hospitals tend to adopt some high visibility services offered by their competitors while filling market niches selectively overall. It also appears that the cost savings expected for specialization may prevail only for narrowly defined services. Study of subsequent data sets should show whether the cost containment strategies used by the hospitals to achieve these results have been maintained over a period of sustained financial pressure.

California↗