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PubMed1989

[Job satisfaction of physicians in academic and general hospitals].

Based on a study of 20 medical departments (general surgery, internal medicine, radiology) an analysis is presented of variables which may account for differences in work satisfaction. The results show: (a) (experienced) work load correlates negatively with work satisfaction; (b) satisfied physicians define their medical domain more broadly than dissatisfied physicians. Besides, they do not regard their salary as an important aspect of their work. In general, radiologists are most satisfied with their work, internists least; medical specialists are more satisfied than residents. In the discussion it is argued that hospital physicians prefer regularity in their work, combined with a professional work climate. In terms of the growing bureaucratization of the physician's work it is concluded that satisfaction is positively influenced by standardization of work processes and negatively by external pressures which limit professional autonomy.

Academic Medical Centers↗
PubMed1987

The impact of DRG payment on New Jersey hospitals.

Debate persists about the most effective way to pay hospitals to limit health care cost inflation. New Jersey, the first state to adopt the DRG payment system, has accumulated sufficient experience to allow a comparison of the relative efficacy of two reimbursement methods. Regression results, using a time trend specification, indicate that per case payment based on diagnosis related groups was no more successful in controlling hospital costs per capita than a previous per diem payment system. There were, however, significant changes in costs per case and length of stay. But the increase in admission rates neutralized the reduction in costs per case. There were no significant overall cost savings.

Diagnosis-Related Groups↗
PubMed1988

[The Berlin psychotherapy study (decision on indications and the therapeutic reality in various fields of psychotherapy practice].

This article presents concepts, problems, and approaches used in a completed observational study carried out by 47 therapists in analytical/psychotherapeutic private practices and institutions. The diagnostic situation (of 739 patients) and the initial phase of therapy (involving 381 patients) were studied with the help of a comprehensive system of documentation. What is documented here is the patient perspective on the one hand and the perspective of the therapists on the other with regard to numerous self-evaluations and evaluations by others, evaluations that throw light on the diagnostic-therapeutic process from different observational levels. Most of the scales used were developed in the study group. Given the complex structure of the data, new methods of storing and evaluating data had to be found. In addition to the description of the therapeutic reality of a large city, the main goal of the study was to examine the patient-therapist relationship and the prognostic elements it contains since these elements influence the indication for psychotherapy and the possibility of its successful realization and thus have the character of predictors for the course of psychotherapy. A number of other results of the study are presented in the succeeding contributions to this issue.

Berlin↗