PubMed · 1894086
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E Macdonald, M H Nusbaum. 1991. New bar coding tools for clinical managers.. https://pubmed.ncbi.nlm.nih.gov/1894086/
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Are there differences among the nursing practice dimensions of the three major nursing practice models--team nursing, case management, and total patient care? The author, whose study found few differences, discusses reasons for the similarity among models and suggests approaches to designing future nursing practice models.
The continued rise of health care costs, despite private and governmental control efforts, has sustained cost containment as a central issue for health care researchers and policy makers. In keeping with these concerns, the Florida Health Care Cost Containment Board conducted a study of neonatal intensive care units (NICUs) in Florida to ascertain the costs, charges, and net revenues associated with NICU services in individual hospitals, to document cost shifting and cross-subsidization as a means of financing NICU care for indigent populations, and to assess the fiscal impact of NICUs in state-sponsored vs non-state-sponsored Regional Perinatal Intensive Care Center hospitals providing NICU care. Hospitals in the state-sponsored program reported a loss of approximately $16.5 million in contrast to the non-state-sponsored hospitals, which reported a gain of $1 million. Payment being generated by private-pay patients amounted to almost 60% of total revenues but constituted less than one third of the costs in state-sponsored hospitals, indicating a high level of cost shifting. Government support of state-sponsored NICUs, while substantial, has been insufficient; increasing constraints on this funding source would likely worsen the deficit and increase the necessity of cost shifting.
The purpose of this study was to examine the degree of concordance between experts and practitioners as to the importance of quality assessment measures (elements and indicators) in therapeutic recreation (TR) services. Results from a survey of TR practitioners as to actual uses of these quality assessment measures within Veterans Affairs Recreation Services nationwide were compared to expert opinions used in a previous study that identified quality assessment measures for TR. Agreement between expert ratings of importance and frequency of use by practitioners were greatest for the experts' most important elements and indicators and least for the least important. Findings suggest that a select few "important" elements and indicators might be universally required of all quality assessment programs; others might be optional or can be modified to meet the needs of individual settings. Results also demonstrate the need for further study of optimal quality assessment approaches using both expert knowledge and practitioner experience.