Research needs in investor-owned psychiatric facilities.
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Biomedical subjects
Publications and source records attributed to A Checker.
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Data on capital projects funding in nonfederal U.S. hospitals in the years 1972, 1977, 1978, and 1981 were analyzed to identify changes in the number, cost, and funding sources of capital projects in public and private psychiatric hospitals and to compare them with changes in public and private general hospitals. The study identified three major trends over the ten-year period: a larger decrease in the number of capital projects and a larger increase in the average cost per project in public psychiatric hospitals compared with other types of hospitals, and a greater dependence by all types of hospitals on borrowed money to fund capital projects. The author suggests that the decreased number and higher cost of capital projects in public psychiatric hospitals may be related to the hospitals' increasing reliance over the ten-year period on debt financing rather than on government funding. Because of the high costs involved in debt financing--costs unrelated to the size of the debt--these hospitals may have consolidated their building projects.
There has been national concern regarding the decreasing number of U.S. medical students entering psychiatric residency training programs in the 1970s at the same time that the Graduate Medical Education National Advisory Committee (GMENAC) report designated psychiatry as one of only three medical specialties with a manpower shortage. The authors document the decline in psychiatric residents in state mental hospitals from 1975 to 1980 and analyze five possible explanations for this absolute and relative decrease. They discuss approaches to altering the situation as well as the emerging role of the state mental hospital in the future training of psychiatric residents.
The community mental health movement of the mid-1960s included a novel belief that psychiatric hospitals should be located near population centers. The author studied the extent to which recent site configurations of state psychiatric hospitals have reflected that conceptual change. In the period 1960-1980, a large number of rural state hospitals closed; at the same time a smaller number of state hospitals were opened. Although one set of states moved in the direction of an urbanized setting concept, another set of states held firm in its devotion to the rural hospital tradition.
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In summary, there are several changes influencing the NIRMP. The changes noted are: (a) the number of graduates from foreign medical colleges has been increasing rapidly since 1970 and now represents 21 percent of the applicants; (b) the proportion of U.S. medical school graduates in the program has decreased to a low of 84 percent; (c) there is a better balance of numbers between the positions available and matched in 1975.
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