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PubMed · 10110871

System nets economic plusses.

E W Presson
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Abstract

How will multi-hospital systems facilitate medical care in the future? How do administrators of such systems integrate the important components and personnel to achieve well-coordinated care for individual patients? In the following article, E. Wynn Presson, president and CEO of Health Midwest, a regional health care system involving 10 counties around metropolitan Kansas City, Kan., discusses the process of building and maintaining a regional care system of 40 health care entities including 11 hospitals and 2,350 licensed acute care beds.

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CommunicationHospital AdministratorsHumansKansasMulti-Institutional SystemsOrganizational ObjectivesOwnershipQuality of Health CareRoleInterview

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E W Presson. 1991. System nets economic plusses.. https://pubmed.ncbi.nlm.nih.gov/10110871/

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Information-sharing among couples considering multifetal pregnancy reduction.

OBJECTIVE: To determine the information-sharing strategies of couples considering fetal reduction, and the impact of these strategies on the chances of encountering hostility in their social networks. DESIGN: Cross-sectional design of semistructured qualitative interviews, coded with respect to sharing strategies and level of personally directed hostility encountered. SETTING: Multiple Pregnancy Management Program, Comprehensive Genetics, New York, New York. PATIENT(S) AND INTERVENTION(S): Fifty women and their partners who were making a first visit to our maternal-fetal management facility, in order to consider the possibility of multifetal reduction as a pregnancy-management strategy. MAIN OUTCOME MEASURE(S): Development of information-sharing strategies, and the chances of encountering personally directed hostility regarding multifetal reduction associated with more and less selective strategies. RESULT(S): Four information-sharing strategies emerged from the analysis. Two of these strategies were relatively open (extended network, and both parents). Two other strategies were relatively selective (qualified family and friends, and defended relationship). The selective strategies were significantly less likely to encounter to encounter personally directed hostility (odds ratio, 3.88; 95% confidence intervals, 0.87-17.30). CONCLUSION(S): Selective sharing of information for couples considering multifetal prgnancy reduction is a potentially useful strategy for moderating potentially stressful relationships in their social networks. Clinics should find a way of integrating the discussion of selective sharing into their clinic's cultural repertoire of patient-support services.

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