Cross-subsidization in hospital care: some lessons from the law and economics of regulation.
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Economic Competition↗
Biomedical subjects
S E Foreman
Publications and source records attributed to S E Foreman.
Use of health services by Chinese elderly in Beijing.
OBJECTIVES: This article provides an inquiry into use of health services by the elderly. METHODS: The authors operationalize models of use with a survey of 350 elderly Chinese. Because the survey involves native Chinese, the empirical test can isolate functional social support as well as "structural" social supports (marriage, living with children). RESULTS: The principal findings comport with prior work: the strongest determinants of the use of health services by the elderly are those that relate to need. In addition, structural social support impacts use but demonstrates complex patterns. CONCLUSIONS: The availability of family support increases physician visits while diminishing the probability of a hospital stay. Increased Western physician use ties to increased use of Chinese physicians and increased hospitalization. Functional social support plays a role as well. Finally, income effects did not play a large role in determining the use of health services among this population.
Activities of Daily Living↗
Family and cultural correlates of depression among Chinese elderly.
This study hypothesized that depressive experiences of the elderly could be aggravated by universal factors such as low social status, poor health, financial strain, and unhealthy lifestyle, as well as by factors specific to an indigenous socio-cultural environment (stressful family dynamics) of a given population. Three hundred and fifty Chinese subjects aged 65 or older were interviewed either at their homes or in the geriatric out-patient clinic of Beijing Hospital. Hierarchical logistic regression was used to examine significant predictors of depression. Results showed that certain social status, poor physical health, financial strain, unhealthy lifestyle, and stressful family situation explained 47 percent of the variance in depression. However, stressful family situation alone explained 13 percent of the variance in depression, indicating that family factors were important predictors of depression for Chinese elderly. Furthermore, this study demonstrated for the first time that verbal abuse within Chinese families is a significant correlate of depression among the elderly. Cultural implications of these findings are discussed.
Aged↗
The power of health care value-adding partnerships: meeting competition through cooperation.
Given the hypercompetitive health care industry, proposing cooperation as a means to survive and prosper appears radical. This article develops a case for the formation of a health care value-adding partnership as a viable, if not preferred, alternative to the integrated health care system owned and controlled by a single entity. The conceptual and the practical aspects of obtaining voluntary cooperation are addressed, and examples of successful value-adding partnerships are presented.
Continuity of Patient Care↗
Management corporation makes joint hospital project possible.
Through the development of a management corporation, a religious allopathic hospital and a nonsectarian osteopathic hospital are able to enter into cooperative ventures while avoiding problems created by merger or other methods of consolidation.
Contract Services↗
An incentive approach to physician implementation of medical practice guidelines.
We propose a probabilistically based incentive payment system for guideline implementation that provides rewards for physicians who follow practice guidelines and additional remuneration for physician leaders who engage in information sharing. All payments are based on observed outcomes of patient treatment. A fixed base payment forms the core of the system with probabilistic offsets calculated from the chance that a 'good' outcome occurs without optimal treatment or information. The system pays different physician types for different task sets.
Cost Control↗
Mental health benefits in the Clinton plan.
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Continuity of Patient Care↗
Beyond competition.
Hospitals and individuals who form lasting symbiotic relationships that leave both parties intact as viable adversaries will outperform both their non-cooperative and their non-competitive rivals.
Conflict, Psychological↗