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At least 19 recordsLinked to original sources
PubMed1983

Plundering the poor: the role of the World Bank in the Third World.

The World Bank, the most important so-called development assistance agency, annually dispenses billions of dollars to Third World governments, ostensibly to "develop" their economics through a variety of loan projects. But even a superficial analysis reveals that the Bank is the perfect mechanism to help (i.e., subsidize) the large transnational corporations from the industrial countries to expand their industrial, commercial, and financial activities in the Third World, at the expense of the latter and particularly at the expense of the rural and urban proletariat. This article discusses Cheryl Payer's recent book, The World Bank: A Critical Analysis, in which she analyzes the Bank's role in the Third World and sets forth the major reasons why poverty, hunger, and malnutrition, as well as unemployment, and all the adverse social phenomena associated with them, are on the increase.

Developing Countries↗
PubMed1975

The use of an information system for community health services planning and management.

The challenge of delivering health care on a more cost-effective and equitable basis has led to the formation of new kinds of organizations, which in turn require new kinds of management information systems. The system described in this article is used for planning resource allocation and monitoring the overall performance of Livingston Community Health Services, Inc., a rural community-owned health service designed to provide comprehensive care to a geographically defined target population. The Health Services Data System processes information on performance and productivity, effectiveness with respect to the target population, and billing and financial activities. Input consists of the results of a community census and two household surveys, patient registrations and patient services operating data, and financial data. Besides billing patients automatically, the system integrates financial, demographic, and health services utilization data to generate monthly summaries for the administrators, medical director, and community board. The article discusses several examples of these summaries, stratifying utilization by geographic location of residence, age, income, and race.

Accounting↗
PubMedDate not supplied

Occupational medicine. The essentials of finance.

Finance is concerned with the generation and use of funds to support organizational objectives whereas accounting records transactions and summarizes how funds are expended. Money has costs associated with its procurement and use. There are costs associated with maintaining equipment and inventory. Financial analysts have developed methods to evaluate a company's efficiency in using money. While the occupational physician may not be directly involved in financial activities, knowledge of the techniques used should improve an understanding of organizational limitations.

Accounts Payable and Receivable↗
PubMed1994

Stability of functional outcomes following transitional living programme participation: 3-year follow-up.

The functional status and perceived problems of 21 persons with severe brain injury were reported at admission, and at 1 and 3 years post-discharge from a community-based post-acute rehabilitation programme. Functional status was measured by participation in productive activity, financial support, place of residence and level of supervision required. Improvements observed at 1-year follow-up remained stable or had improved at 3-year follow-up. Loneliness and depression, while not reported at admission, increased over time to become the two problems reported most frequently at 3-year follow-up.

Activities of Daily Living↗
PubMed1986

The cost implications of academic group practice. A randomized controlled trial.

We evaluated the reorganization of a general medical clinic into several group practices, using equivalent groups of patients and physicians in a randomized controlled trial. The group practice, unlike the traditional clinic, provided decentralized registration, clinic coverage five days a week, and telephone coverage at night and on weekends. Residents worked in small groups with an attending physician, nurse practitioner, and receptionist. All financial activity involving a sample of 2299 patients was followed during the 11-month intervention. The total hospital charges per patient were 26 percent lower for the patients seen in the group practice than for those seen in the traditional clinic (P = 0.003). This difference was primarily attributable to inpatient charges, which were 27 percent lower per patient hospitalized (P = 0.004). The mean length of stay was 8.3 days among group-practice patients and 10.5 days among traditional-clinic patients (P = 0.011). We conclude that organizational changes to improve outpatient access and to integrate inpatient and outpatient services can decrease medical charges.

Academic Medical Centers↗
PubMed1992

Retirement intentions among black professionals: implications for practice with older black adults.

This study examined the preretirement intentions of black professionals. The sample consisted of 234 blacks and was stratified by gender, age, and professional status. Based on a model developed for predicting the retirement intentions and attitudes of a sample of white professionals, six categories of independent variables (sociocultural, work history, alienation, leisure and social activities, financial planning, and plans for retirement life) were included in the analysis. Professionals who were highly committed to their work, had few financial investments, and socialized primarily with co-workers tended to avoid planning for retirement. These results have important implications for practitioners concerned with more effectively meeting the preretirement and retirement needs of older black adults.

Adult↗
PubMed1994

Improvement of quality-of-life following resective surgery for temporal lobe epilepsy: results of patient and family assessments.

In order to evaluate the quality-of-life (QOL) of epilepsy surgery patients, we surveyed patients' degree of life satisfaction and their families' degree of satisfaction with patient's status in a range of domains both pre- and post-operatively. Of 100 patient-family sets of surveys that were mailed out, 93 were completed and returned from patients and 91 from their families. All patients surveyed had temporal lobe epilepsy and had been followed for longer than 2 years after resective surgery. Patients and their families rated overall QOL as having markedly improved following surgery. However, they rated social domains of QOL, including role activities, financial status, and social and family relationships as having improved relatively little. Despite freedom from seizures, a few patients' families were dissatisfied with the patients' post-operative status, primarily for psychosocial reasons. Patients operated on at a later age reported little gains in life satisfaction following surgery. This study supports the conclusion that surgical intervention should occur before patients are subjected to the psychological conflicts and social handicaps associated with chronic intractable epilepsy.

Adaptation, Psychological↗
PubMed1990

Maternal and child oral health issues: research.

There is currently little oral research directed toward the maternal and child health population, especially outside of the National Institute of Dental Research funded programs. Although many agencies are involved with research in this area, there is no central national coordination, policy, or research agenda. Not all segments of the population are benefiting from existing knowledge. To improve oral health for all segments of the population, leadership in the establishment of research priorities is needed to direct activities that will benefit the population groups most affected by oral disease. New directions and perspectives are needed in the type of research conducted. The populations and conditions studied and the depth of the analyses performed must be extended. Additional emphasis should be placed on behavioral, evaluation, and health services research and collaborative research with other health fields. The population groups studied need to be expanded from the historical focus on relatively healthy elementary schoolchildren. As discussed by Waldman, information is particularly needed pertaining to children under age five, all women, and special population groups. As Frazier and Horowitz indicated, research on health promotion and health education within these target populations, as well as among other family members and care givers is needed. Data collected from surveys need to be analyzed more thoroughly. As new diagnostic systems and oral health care technologies are developed, they need to be evaluated adequately for safety, effectiveness, and efficiency. To accomplish all these activities, financial and human resources are needed--funding from appropriate sources in the public and private sector and qualified dental researchers interested in public health and clinical issues of concern to the maternal and child population.

Adolescent↗
PubMed1991

Organisation of veterinary public health in the western Pacific region.

Information on veterinary public health organisation and activities was obtained from government sources in countries located in the Western Pacific region. This region has a wide range of geographical features, population densities, farming practices, social structures and disease prevalences. In spite of this variation, there is common agreement on the importance of veterinary public health both for the provision of safe food and for the control of zoonotic diseases. Not all countries, however, are able to put all the resources they would wish into these activities; financial, social and personnel constraints are recognised.

Animals↗
PubMed1991

Medicare reimbursement deficits: are nursing costs to blame?

Nursing costs were found to be only 11% of the total operating costs. This finding dispels the myth that nursing service is an expensive expenditure for hospitals. The range of facility cost compared with DRG reimbursement was wide, which points to the need to scrutinize costs other than nursing as the sources of hospital deficits. Nursing costs were found to be lower than facility or OR costs. Nurse managers need to emphasize this cost effectiveness to decrease the chance of staffing cuts and requests for concessions in wages or benefits for nurses. Nurse managers need to plan their financial activities to ensure their hospital cost is less than, or at most equal to, the DRG payment.

Costs and Cost Analysis↗
PubMed1982

Role of the director of pharmacy: the first four months.

Specific goals and tasks that should be addressed during a pharmacy director's first four months of employment are reviewed. Individuals must prepare themselves for the director's role, find the right job, and negotiate an acceptable benefits package. During the first two months as director of pharmacy, an individual should primarily work on gathering facts and assessing the department's operations without making many changes. Interrelationships within the hospital should be studied, and many pharmacy and hospital documents should be reviewed so that the director has an understanding of past history. The director should interview all employees of the department and work as a staff pharmacist for one to two days in each area. During the third and fourth months, the new director will need to determine the extent of authority, develop working relationships with key individuals, assess the pharmacy-management team, develop a data-collection system, learn the processes for making changes, and consolidate authority. A major document, containing a departmental-operations analysis, statement of philosophy, goals, and approach to goal completion, should be the culmination of the four months. The director of pharmacy must meld professional, administrative, and financial activities; the final determinant of success will be the director's ability to implement and follow through with proposed changes.

Administrative Personnel↗
PubMed1980

Chronic gastric ulcer and life events.

The purpose of this study was to define the frequency of stress preceding or during the course of chronic gastric ulcer (CGU). Stress was measured by the occurrence of 62 selected life events over 2 yr in two groups of CGU patients. One group (A) was studied for events during the 2 yr before their diagnosis (147 patients) and the second group (B) was studied for events occurring after diagnosis (73 patients). The ulcer groups were compared with community controls matched for age, sex, and social grade. Groups A and B did not differ in any significant way in their reported life events, indicating no temporal relationship between stressful life events and CGU. The combined ulcer groups, when compared with controls showed no differences in the number of events experienced or the associated scores for change and distress caused by the events. There was no difference in the order of the three most frequent events. Only the event "minor illness" was more frequent in controls on matched pairs analysis (P less than 0.05). The other 61 events showed no differences. When events were grouped into areas of activity, financial and legal events were reported by 38 patients and 23 controls (P less than 0.05). Significantly, few of these 38 patients were in the 60+ age range (P less than 0.02). Twenty-four patients reported no events, compared to 12 controls (P less than 0.05). Although there is no difference in the life events experienced by CGU patients and their controls, this assessment of stress has not taken account of the significance of the event as perceived by a particular individual, the ulcer patient perhaps reacting differently to stress and the ulcer being one result of this abnormal reaction. Consequently, the role of emotional stress remains open.

Adult↗
PubMed1995

The carrot, the stick and the general practitioner: how have changes in financial incentives affected health promotion activity in general practice?

BACKGROUND: Financial incentives for increasing health promotion activity in primary care, introduced with the 1990 contract for general practitioners, were amended in 1993 and are now focused on cardiovascular disease. Payments for health promotion clinics were abolished and target payments were introduced. AIM: The study aimed to evaluate the effect of the change, in June 1993, in financial incentives for health promotion activity in primary care on the distribution of health promotion payments in two family health services authorities. METHOD: A retrospective study was undertaken in which data from two family health services authorities were used to determine the annual level of health promotion payments per 1000 practice population before and after the contractual amendment. Health promotion clinic payment data were analysed for 78 practices in Bedfordshire Family Health Services Authority and 85 practices in Kensington, Chelsea and Westminster Family Health Services Authority. Changes in health promotion payments were calculated and related to two measures of relative need: all cause standardized mortality ratios, for patients aged 74 years or less, of the electoral ward in which the practice is located; and the Jarman underprivileged area score. High relative need was defined as a standardized mortality ratio of over 100 or more than 25% of the practice population living in electoral wards with a Jarman score of over 30. RESULTS: Health promotion payments were more evenly distributed after the change in June 1993 than before between the two family health services authorities and between general practices. Single-handed practices were carrying out more clinics in 1992 than multi-partner practices and consequently were one of the greatest financial losers as a result of the change. In addition, practices located in electoral wards with high relative needs lost proportionally more than those in electoral wards with lower needs. CONCLUSION: Changes in the general practitioner health promotion contract have created new financial winners and losers. It now appears that health promotion payments are more evenly distributed but that the distribution is unrelated to need or treatment given. More evidence on the effectiveness of health promotion interventions is required before policies aimed at promoting better health through primary care can be fully evaluated.

England↗