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PubMedDate not supplied

The health network: an alternative form of care delivery.

The Health Network, a community and social service organization of volunteers and a small staff aims to serve three suburban and rural communities west of Ottawa. In June 1991, the Health Network approached Ontario's Ministry of Health for funding of community-based health services for these municipalities. In light of decreasing resources in hospitals, this article reviews how the Health Network became organized and summarizes a community needs assessment complete in September 1989.

Community Health Services↗
PubMed1993

Japan's experience in long-term home health care of the elderly.

Due to increasing national health expenditure and an aging society, Japan in the 1980s started to reinforce home health care, going beyond her long-time investment in institutional care. Since 1983, a sequence of policies was issued focused mainly on frail elderly care. In support of this governmental approach, a variety of enterprises and charity activities have flourished. Now, however, in the midst of a worldwide recession, rationing as health policy is under reconsideration and has an influence on health care for minorities, including the elderly. In Japan, home health care is under review and a new service system was initiated in April 1992. In this article, the newly inaugurated community-based home visiting nursing scheme is introduced together with a short history of elderly care and related business activities in Japan. Feasibility of the new scheme is discussed and compared with the previous version of home visiting nursing, which had its base in hospitals.

Aged↗
PubMed1994

Improving the financial viability of primary care health centers.

This article presents findings from a national demonstration program to improve the long-term financial viability of small not-for-profit primary care health centers. The program initiatives and their implementation are described in some detail. A standard pre/post study design was used to measure the impact of the initiatives on general outcome measures, financial ratios, and the utilization of management techniques. Overall, demonstration centers showed improvement over the study period. Notable short-term improvements included significant growth in the volume of patient visits and increased profit. Observed changes also revealed an increased use of sophisticated management techniques, expected to positively affect longer-term financial health. The findings suggest that improving the financial viability of health centers need not be expensive.

Community Health Centers↗
PubMed1994

Mexican system a mix of public and private providers.

The following article is one of a series that deal with the provision of health care services around the world. Other countries in the series include Canada, Germany, Italy, Japan, the Netherlands, and the United States. Countries scheduled for coverage in the series include Austria, France, Singapore, Spain, and the United Kingdom. The countries are described using a grid of characteristics so that comparisons may be made more easily. All of the analyses, along with further comparative data, will be gathered into a freestanding book to be published later in the year. Dr. Mendoza serves as the editor for the project.

Community Health Centers↗
PubMed1993

Rural health care.

A critical shortage of primary care physicians exists in many rural areas of the United States. Similarly, rural residents are often far from hospitals. These situations have sparked the development of far-reaching programs designed by the federal government and private foundations, along with medical schools, state and local government, physicians, and local volunteers.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1997

Developing leaders in public health: the role of executive training programs.

The growing complexity of the nation's health care system is creating new challenges and opportunities for public health officials, and a renewed concern for leadership training among these officials. A focus group conducted with public health officials at local, state, and national levels reveals perceptions about the predominant trends effecting public health practice, the leadership skills required for effective public health practice, and the strategies that are needed for providing appropriate leadership training to public health executives. Officials indicate that public health practice is undergoing substantial changes in response to the growth of managed care and integrated delivery systems, changes in public health funding sources and levels, and efforts to privatize the delivery of public health services. The skills identified as critical for effective leadership in this environment include the ability to guide organizational behavior and cultivate interorganizational relationships; apply scientific knowledge to public health problems, and build and sustain community coalitions. In light of these skills, public health officials identify four essential components of an optimally effective executive training program in public health leadership: exposure to the core scientific disciplines within public health; exposure to organization theory and management science; training in community development and empowerment; and training in ethics and social justice. All of the officials agree with the need for distance learning programs for executives in public health leadership, and most officials also support the need for doctoral-level training in public health practice.

Community Participation↗
PubMed1988

Evaluation of the national swing-bed program in rural hospitals.

The Health Care Financing Administration (HCFA) implemented a swing-bed demonstration and evaluation program for rural communities in the 1970's. The demonstration substantiated the cost effectiveness of providing long-term care in small, rural, acute care hospitals. As a result, Section 904 of the Omnibus Reconciliation Act of 1980 (Public Law 96-499) authorized the national swing-bed program, allowing rural hospitals with fewer than 50 beds to provide Medicare- and Medicaid-covered swing-bed care. A congressionally mandated evaluation of the program was conducted and the national swing-bed program was found to be cost effective. In this article, HCFA's report and recommendations to Congress are summarized in the context of the evaluation findings. HCFA recommended that the program be continued and that consideration be given to extending the option to larger hospitals. In this regard, the Omnibus Budget Reconciliation Act of 1987 (Public Law 100-203) extended the program to include rural hospitals with up to 100 beds.

Bed Conversion↗
PubMed1989

Hospitals as donors.

Explore the source record for details and available documents.

Community-Institutional Relations↗