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PubMed1996

Strategies for materiel management executives.

With a more centralist political philosophy emulating on Capital Hill, this article focuses on potential effects on materiel management executives of a half-competitive (managed care) and a half-regulatory (Medicare and Medicaid) environment in organizing and financing health services. It predicts a far more contentious field; further cutbacks in nonpatient care personnel, including senior positions for material management executives; the centralization of tertiary services; and the possibility of additional regulatory approaches to protect the public.

Canada↗
PubMed2005

Teaching healthcare marketing via community research: the LifeFlight project.

Undergraduate students in Healthcare Administration programs may benefit from cooperative learning strategies such as participation in community research. Collaborating with local healthcare facilities on class projects also encourages more active engagement between the academic and practice communities. This purpose of this paper is to briefly describe one collaborative venture undertakenby undergraduates in a Marketing for Healthcare Organizations class and a LifeFlight program at a local hospital. The students carried out a survey of members in the program, conducted a SWOT analysis, and made relevant recommendations. Student evaluations of this experience were positive, as was the hospital's assessment.

Air Ambulances↗
PubMed1993

On the importance of helping families: policy implications from a national study.

This study is a companion to our 4-year study (Birenbaum, Guyot, & Cohen, 1990) on financing health care for individuals with autism or severe mental retardation. We reported on nonmedical expenditures and opportunity costs pertaining to maintaining a child or young adult with serious developmental disabilities in the home or in residential care and discussed policy implications for assisting their families. We proposed that (a) personal care and family support should be included in health care requirements, (b) family-centered care should be promoted, (c) appropriate programs and care should be provided for young adults no longer in school, (d) financing and organizing of family supports and subsidies should be administratively simple, (e) Medicaid should be expanded to increase use of home- and community-based services, and (f) financial support should be provided to families.

Adolescent↗
PubMed2005

Acknowledged funding sources in pressure ulcer literature: a systematic review.

OBJECTIVE: To identify pressure ulcer research funding sources. DESIGN: A systematic review of the acknowledgment sections of pressure ulcer literature published between 2000 and 2002. RESULTS: Sixty-four papers were identified that acknowledged funding sources. Governmental funding sources were acknowledged in 53% (n = 34) of these papers, followed by manufacturers (30%, n = 19), consumer/professional organizations (17%, n = 11), provider organizations (11%, n = 7), philanthropic organizations (11%, n = 7), and academic institutions (9%, n = 6). CONCLUSION: Although various governmental organizations fund most pressure ulcer-related projects, this systematic review found that many other sources of funding are available. Researchers are encouraged to explore multiple sources for funding clinical research.

Academic Medical Centers↗
PubMed2004

A national evaluation of school breakfast clubs: evidence from a cluster randomized controlled trial and an observational analysis.

STUDY OBJECTIVE: To measure the health, educational and social impacts of breakfast club provision in schools serving deprived areas across England. DESIGN: A cluster randomized controlled trial and an observational analysis. SETTING: England, the UK. INTERVENTION: funding to establish a school-based breakfast club vs. control (no funding). MAIN RESULTS: Intention to treat analysis showed improved concentration (Trail Making Test Part A) amongst the intervention group at 3 months. Fewer pupils within the intervention group reported having skipped classes within the last month and fewer pupils within the intervention group reported having skipped 1 or more days of school within the last month at 1 year. Observational analysis at 1 year showed a higher proportion of primary-aged breakfast club attendees reported eating fruit for breakfast in comparison to non-attendees. A higher proportion of breakfast club attendees had borderline or abnormal conduct and total difficulties scores (primary-aged pupils) and prosocial score (secondary-aged pupils). CONCLUSIONS: Analyses revealed a mixed picture of benefit and apparent disbenefit. This study illustrated the challenges of evaluating a complex intervention in which the evaluators had less control than is usual in randomized trials over recruitment, eligibility checking and implementation. If the impact of new policy initiatives is to be assessed using the most robust forms of evaluation, social policy needs to be organized so that evaluations can be constructed as experiments. This is likely to prove most difficult where the perceived value of implementing an intervention rapidly is high.

Absenteeism↗
PubMed1997

How HMOs assess medical groups and IPAs.

California health maintenance organizations (HMOs) frequently capitate physician organizations--independent practice associations (IPAs) and multispecialty medical groups--to export their risk for professional and outpatient ancillary services. Physician organizations benefit when successful in managing the risk, and from having greater control over medical management decisions. HMOs carefully assess the physician organization's ability to manage capitated risk and provide high-quality care. HMOs gather information on the physician organization's finances, business relationships, physician compensation arrangements, credentialing, hospital relationships, ancillary contracts, procedures for 24-hour care, claims administration, member services, information systems for reporting and tracking utilization, and procedures for utilization/quality management. These data are analyzed to determine whether capitation contract negotiation should proceed.

California↗
PubMed2005

Funding, technical assistance, and other resources for school-based health centers.

To facilitate the successful implementation of school-based health centers (SBHCs), funding streams and technical assistance are needed from various resources. The core funding models for service delivery include federal grants, state grants, local funding, community partnerships, foundations, and patient revenue. Technical assistance opportunities are available through professional organizations, SBHC associations, state health departments, and primary care associations at the national and state levels. This article explores the various federal, state, and local funding sources, and the technical assistance resources and opportunities available to SBHCs and their staff.

Adolescent↗
PubMed2006

The influence of partnership centrality on organizational perceptions of support: a case study of the AHLN structure.

BACKGROUND: Knowledge of the structure and character of inter-organizational relationships found among health promotion organizations is a prerequisite for the development of evidence-based network-level intervention activities. The Alberta Healthy Living Network (AHLN) mapped the inter-organizational structure of its members to examine the effects of the network environment on organizational-level perceptions. This exploratory analysis examines whether network structure, specifically partnership ties among AHLN members, influences organizational perceptions of support after controlling for organizational-level attributes. METHODS: Organizational surveys were conducted with representatives from AHLN organizations as of February 2004 (n = 54). Organizational attribute and inter-organizational data on various network dimensions were collected. Organizations were classified into traditional and non-traditional categories. We examined the partnership network dimension. In- and out-degree centrality scores on partnership ties were calculated for each organization and tested against organizational perceptions of available financial support. RESULTS: Non-traditional organizations are more likely to view financial support as more readily available for their HEALTR programs and activities than traditional organizations (1.57, 95% CI: .34, 2.79). After controlling for organizational characteristics, organizations that have been frequently identified by other organizations as valuable partners in the AHLN network were found significantly more likely to perceive a higher sense of funding availability (In-degree partnership value) (.03, 95% CI: .01, .05). CONCLUSION: Organizational perceptions of a supportive environment are framed not only by organizational characteristics but also by an organization's position in an inter-organizational network. Network contexts can influence the way that organizations perceive their environment and potentially the actions that organizations may take in light of such perceptions. By developing evidence-based understandings on the influence of network contexts, the AHLN can better target the particularities of its specific health promotion network.

Alberta↗
PubMedDate not supplied

Virtuous capital: what foundations can learn from venture capitalists.

U.S. foundations and nonprofits work diligently on behalf of society's most needy and yet report that progress is slow and social problems persist. How can they learn to be more effective with their limited resources? Foundations should consider expanding their mission from investing only in program innovation to investing in the organizational needs of nonprofit organizations as well. Their overemphasis on program design has meant deteriorating organizational capacity at many nonprofits. If foundations are to help nonprofits be assured of making payroll, paying the rent, or buying a much-needed computer, they must develop hands-on partnering skills. Venture capital firms offer a helpful benchmark. In addition to putting up capital, they closely monitor the companies in which they have invested, provide management support and stay involved long enough to see the company become strong. If foundation officers familiarize themselves with such practices, they can begin to build organizational capacity in the nonprofit sector. Foundations can hire organizational experts to assist grantees; they can lengthen grant terms to allow nonprofits to build up organization strengths; and they can create new classes of grants that allow for organizational effectiveness. Nonprofits in turn should articulate their organizational needs when applying for grants; they should apply to foundations known for longer-term grants; and they should create plans that justify long-term support from foundations.

Capital Financing↗
PubMed1990

Dracunculiasis eradication: target 1995.

Substantial progress has been achieved over the past 3 years by the campaign to eradicate dracunculiasis. The target of eradication by 1995 has been set by the African Regional Office of the World Health Organization and accepted by the United Nations Children's Fund (UNICEF) and the United Nations Development Program. India and Pakistan continue to reduce their cases of the disease dramatically. In Africa, Ghana and Nigeria conducted national village-by-village searches in 1988-1990 and, between them, found greater than 800,000 cases of the disease. Most African countries have now prepared national plans of action, appointed national coordinators, and intend to use UNICEF's assistance to conduct national searches by the end of 1990. An international donors' conference held in 1989 facilitated major new assistance for the initiative by UNICEF, the United Nations Development Program, the United States Agency for International Development, the Japanese International Cooperation Agency, the Peace Corps, the American Cyanamid Company, and DuPont. The World Health Organization held a meeting early in 1990 to draft criteria and recommend the process for certifying achievement of elimination of dracunculiasis in formerly endemic countries. The major remaining obstacles to eradication of dracunculiasis by 1995 are civil wars in northeastern Africa and the apathy of some national and international officials.

Africa↗
PubMed1999

Message content of alcohol moderation TV commercials: impact of corporate versus nonprofit sponsorship.

This content analysis examines a sample of 203 alcohol-related North American TV commercials dealing with alcohol moderation and driving under the influence (DUI), in order to determine whether the type of ad sponsor has an impact on the message content. Corporate sponsors, such as breweries and distillers, are compared to nonprofit sponsors such as governments and nonprofit organizations. Findings show that ads from corporate sponsors are less likely to make mention of threats or negative consequences, and are also less likely to use fear arousal. However, DUI/alcohol moderation ads from corporate sponsors and nonprofit sponsors do not differ in the degree to which they use humor or positive approaches.

Advertising↗
PubMed2005

The World Health Organization and the transition from "international" to "global" public health.

The term "global health" is rapidly replacing the older terminology of "international health." We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term "global health" emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context.

Communicable Disease Control↗
PubMed1999

The changing landscape for clinical research.

The authors review the history of U.S. clinical research and identify the profound changes stemming from advancements in the biomedical sciences, the recent transformation in the organization and financing of health care delivery, and the increasing application of information technologies. They observe that the enterprise must reorganize to account for the changed landscape, but there is a lack of the data necessary to monitor change and determine the extent to which clinical research is successfully realigning and sustaining itself. The authors discuss the evolving definition, scope, and venues for clinical research, and review previous analyses of clinical research's difficulties and remedies proposed: shared responsibility in the financing of academic medicine, support by federal and private health insurers for routine costs of patient care in clinical trials, and strengthened collaboration between and among industry, academia, insurers, and government. The authors conclude by describing two major initiatives to foster clinical investigation in the new landscape. The first is the Clinical Research Summit Project, a convocation of representative stakeholders from the health care system with an interest in clinical research, whose charge will be to formulate a national agenda for clinical research that has the broad-based support of the stakeholders. Among the challenges of this undertaking are the needs to identify new and stable sources of support for clinical research infrastructure, assess the future workforce needs for clinical investigation, and devise new methods to ensure the continued vitality and account-ability of clinical research. The second is the Clinical Research Task Force, an initiative of the Association of American Medical Colleges (AAMC), which is already exploring and advising on how AAMC member organizations can best strengthen their capacity to support clinical research programs in the current scientific, health care delivery, and financial environment.

Academic Medical Centers↗
PubMed1993

The use of data monitoring committees in Canadian trial groups.

Following a brief overview of the funding and structure of clinical trials research in Canada, experience with data monitoring committees (DMCs) in four clinical trials organizations is reviewed. Whether committees are required, their mode of selection, composition, degree of independence, mandate and reporting relationships have varied substantially among the groups. Overall the Canadian experience with DMCs has been representative, although formalization of the role of these committees has not proceeded as far as it has in some US agencies.

Canada↗
PubMed1982

Private and public initiatives in health maintenance organizations.

Public policy controversies about the cost-containing potential of HMOs and the failures of many plans should not overshadow the fact that HMOs will be forces in the health care sector in the 1980s, largely as the result of increasing private investment. There is a large, stable segment of the prepaid industry that developed as a result of private sector and community concern long before the federal HMO Act of 1973, and it is their initiatives along with increasing investment activity by insurance companies and management companies in particular, that will serve as a base for consolidation and growth of HMO plans. HMOs have not proved to be the miraculous cost-containing mechanism of the future, but their impact will be felt even more for the changes they stimulate in the customary organizational forms, in financing, and in the role of business in health care.

Capital Financing↗
PubMed2003

Academic health leadership: looking to the future. Proceedings of a workshop held at the Canadian Institute of Academic Medicine meeting Québec, Que., Canada, Apr. 25 and 26, 2003.

The academic health sector will face major changes in governance, health care delivery, educational requirements and research programs over the next decade. Increased emphasis on disease prevention and health outcomes, the need for evidence to support both clinical and policy decisions, educational changes both in content and delivery, and the importance of working in teams will challenge the academic health care community. Large research teams may require new ways of training and nurturing young investigators, including improved grant writing and knowledge translation, human resource management skills and the ability to interact with disciplines that have different research methodologies. MD/PhD and Clinician Investigator Programs may help to fill these gaps in medicine, but nursing is faced with a serious shortage of doctoral-trained educators and researchers and may need targeted programs to achieve a critical mass of academics able to accept leadership roles. The success of the Quebec model of support for health research networks and researchers is encouraging. There is a leadership gap within health care institutions that spans jurisdictions and affects both institutional performance and individual careers. Young investigators need good mentors and adequate protected time to acquire the skills necessary for leadership roles. Policy changes within health care institutions and academic organizations will be necessary to adapt to the coming decade. The Canadian Institute of Academic Medicine is committed to developing better mentoring strategies for the next generation of academic leaders and to creating formal assessments of major Canadian health issues that can be used by health care advocacy groups when talking with policy-makers.

Biomedical Research↗