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Results for “Hospitals, Voluntary”

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At least 19 recordsLinked to original sources
PubMed1987

Competition or conscience? Mixed-mission dilemmas of the voluntary hospital.

Voluntary hospitals must develop increasingly businesslike strategies to survive in today's market-driven health care system. While challenging and necessary, this behavior is stirring fears that the time-honored mission of these hospitals will be seriously undermined. Noting that the voluntary tradition leavens the competitive marketplace, the authors suggest that we have much to lose if voluntary not-for-profit hospitals no longer play a leading role in the health care system, including: needed services to all classes of patients, paying and nonpaying; an important locus of community expressions of compassion and charity; and the settings that have inspired the vision of what medicine and health care can accomplish for mankind.

Attitude↗
PubMed1990

Keeping up with the Joneses: the influence of public and proprietary neighbours on voluntary hospitals.

Individual hospitals often share their markets with other nearby hospitals. In this paper we examine how a hospital's ownership and the ownership of its hospital neighbours influence the availability of selected services. The presence of a CT scanner and a newborn nursery were found to be associated with both hospital ownership (voluntary, proprietary, or public) and with the ownership of hospital neighbours. Voluntary hospitals with a proprietary neighbour were more likely to have a CT scanner. These findings suggest that the ownership configuration of local hospital markets is an important influence on patterns of service availability.

Catchment Area, Health↗
PubMedDate not supplied

Adapting to the age of competition: a paradigm for voluntary hospitals.

The difference between voluntary hospitals that successfully change themselves from charitable into competitive institutions and those that don't is the way the hospitals' leaders view their institutions. The concept of the hospital as an institution that provides services to those in need differs from the concept of the hospital as an institution that offers services to customers. This fundamental conflict may be why many voluntary hospitals find it difficult to benefit from modern management methods that work well in commercial enterprises. For hospitals wanting to make themselves more competitive, the author recommends introducing the customer/client concept at middle management levels of the organization.

Economic Competition↗
PubMed1985

The financial condition of New York City voluntary hospitals: the first year of NYPHRM (New York Prospective Hospital Reimbursement Methodology).

HIGHLIGHTS OF THE STUDY. In 1983, for the first time since 1977, the average voluntary hospital in New York City did not incur a deficit. Nevertheless, voluntary hospitals in New York City continued to have a lower return on their assets than voluntary hospitals in the rest of the state, in the Mid-Atlantic region, and in the nation. New York City voluntary hospitals would need 85 percent of their total assets to repay their debt, while the comparison groups would use less than 60 percent. The annual rate of growth in hospital expenses among New York City voluntary hospitals declined from almost 12 percent between 1981 and 1982 to less than 9.5 percent between 1982 and 1983, which also was almost a full percentage point below the national rate of increase. Between 1982 and 1983, the value of uncompensated care provided by New York City voluntary hospitals increased from 3.4 percent to 3.7 percent of total operating expenses. Fourteen of the 49 New York City voluntary hospitals studied were financially stressed in 1983, compared to 18 in 1982. Without the additional revenues received from the NYPHRM pools, 10 more New York City voluntary hospitals would have had bottom-line deficits. More details on the financial condition of New York City voluntary hospitals in 1983, and first year of NYPHRM, follow. Definitions, data sources, and methods are described in an appendix to the report, which also includes a glossary of financial terms.

Costs and Cost Analysis↗
PubMed1982

Neighborhood characteristics and hospital closures. A comparison of the public private and voluntary hospital systems.

This paper analyzes the neighborhood distribution of hospital closures in New York City between 1970 and 1981. Discriminant analysis procedures are used to compare the social, economic and health status characteristics of neighborhoods in which hospitals have closed with those of neighborhoods in which facilities have remained open. The results show that overall hospital closures have had a substantial distributional impact, with facilities in low-income, high infant mortality neighborhoods having the highest rates of failure. Closures of voluntary hospitals occurred most frequently in disadvantaged neighborhoods; whereas municipal and proprietary hospital closures showed no differential neighborhood impact. Implications for the geographical accessibility to various groups to health care and for the efficiency and cost of hospital services are discussed.

Catchment Area, Health↗
PubMed1985

Analysis of length-of-stay differences between investor-owned and voluntary hospitals.

In contrast to assertions that investor-owned (I-O) hospitals are more efficient than voluntary hospitals, this study finds no significant difference between I-Os and voluntaries where the efficiency measure is length of hospitalization (LOH). The data base used is a national probability sample of hospitals and patients. The analysis accounts for variation in LOH by controlling for hospital characteristics other than ownership, and in particular it utilizes a new case-mix index to control for the case-mix portion of heretofore suggested differences.

Bed Occupancy↗
PubMed1994

Differences in treatment of ischemic heart disease at a public and a voluntary hospital: sources and consequences.

A study of hospital patients with ischemic heart disease reports that patients in a public hospital received fewer needed diagnostic tests, surgeries, and follow-up visits for their conditions than their private hospital counterparts. Factors in the hospitals' organizational environments and the patients' social backgrounds were observed to have an impact on content of treatment and to affect patient as well as provider perspectives on the quality of care. To facilitate the analysis, data were collected from four sources: direct observation of the care of each patient on rounds and at the bedside; interviews with physicians concerning the rationale for their decisions; a process-oriented chart audit assessing the appropriateness of care; and an extensive home interview with each patient three months following hospital discharge to establish further use of health services, health status, and satisfaction with care.

Ambulances↗
PubMed1993

Mortality differences between New York City municipal and voluntary hospitals, for selected conditions.

To determine if mortality differences between municipal and voluntary hospitals in New York City persist after adjustment for computerized administrative data (age, sex, principal diagnosis, and secondary diagnosis), six conditions in those hospitals from 1984 through 1987 were studied. Unadjusted mortality was significantly higher in municipal hospitals for myocardial infarction, stroke, and head trauma, and lower for congestive heart failure and pneumonia. Adjustment using administrative data eliminated differences for myocardial infarction, congestive heart failure, and pneumonia, but not for stroke and head trauma. We conclude that adjustment using administrative data eliminates some but not all mortality differences between municipal and voluntary hospitals. Medical record review is needed to determine why these differences persist.

Diagnosis-Related Groups↗