A brief history of hospital administration education in Zaire.
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A survey of health care institution administrators and consumers finds that the former give significantly more positive approval to their advertising than their consumers do. In fact, the latter perceive medical advertising to be rather unprofessional. Among the administrators, more positive attitudes toward their advertising is projected by those who have used advertising in the past and by female administrators.
To be successful in today's competitive market, hospital/medical staff relations must evolve to the point where the two entities work together within the health care institution in a combined effort to help people achieve their life goals by minimizing the effects of illness and maximizing physical and mental health. This article sets forth simple, practical techniques for moving a health care institution toward this goal.
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Of 57 patients referred to the McGuire Veterans Administration Medical Center, Richmond, Va, for evaluation for cardiac transplantation, 18 received allografts. The overall graft survival rate was 67% from two to 24 months after transplantation. In 15 recipients receiving immunosuppression with rabbit anti-human thymocyte globulin, prednisone, and azathioprine, previous transfusion and HLA-DR matching resulted in improved graft survival. In three patients receiving cyclosporin and prednisone, hypertension, nephrotoxicity, and hepatotoxicity were seen. All surviving recipients were in functional New York Heart Association class 1 or 2. The cost to the Medical Center was $23,275 per transplant. The results achieved at the center suggested that a regionalized cardiac transplant program can be established within the VA health care system with acceptable clinical results and significant financial savings.
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Over the past decade a greater number of optometrists can be found practicing in hospitals, health maintenance organizations, health clinics and other multipractitioner group settings. The impetus enabling optometry to practice in such settings is based in part on cost effectivity. Optometrists in Veterans Administration (VA) hospitals have been in the forefront in this movement to provide the full range of primary eye care services, and in becoming an integral part of the hospital/medical community.
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Crime in health care settings is becoming a major concern for health care administrators. An administrator who fails to provide adequate security leaves himself or herself open to liability and lawsuits.
Over the past four decades, the delivery of health care services has seen dramatic changes. Medicare coverage in 1966 expanded the ability of the health care industry to treat a growing segment of the population. Technology improvements have made great strides in the treatment of disease. Public policy decisions expanded health care coverage from an employee benefit to entitlement for large segments of the population. Managed care growth has reorganized the basic health care delivery system. The aggregate effect of all these items was a dramatic increase in the cost of providing health care in the United States. Beginning in the late 1960s, and escalating in the 1970s and 1980s, the increase of the cost of care was the primary issue for the industry. Only in the 1990s has the rate of increase modified through the impact of managed care, and now there is significant competition for the health care dollar among many competing providers.
This article seeks to assist healthcare executives in focusing their thinking on the changing healthcare environment and on related ethical issues. An attempt is made to consider such major concerns as the allocation of resources, the development and use of technology, and the troublesome question of quantity versus quality of life. Also discussed are more specific and practical issues related to the workplace and how an individual executive might be affected by the problems of our time. Attention is directed to those personal choices that individuals must consider when making decisions associated with their professional activities. The conclusion suggests that after reviewing all the implications involved, a decision regarding what is right or wrong in a given situation ultimately rests with the individual administrator. Therefore, our personal background and philosophy on ethics is critical in determining our final decisions.
1. Flexibility, creativity, and consistency are critical characteristics for both frontline staff and administrators in the delivery of treatment and care for complex forensic patients who may be difficult to manage. 2. Through collaborative efforts and ongoing communication, plans can be identified and implemented that enhance patient and staff safety and facilitate positive behavioral and rehabilitation outcomes for patients. 3. Effective partnerships among frontline staff, administration, patients, their families, labor unions, and communities contribute significantly to the effective resolution of conflicts and dilemmas in the provision of holistic care to forensic patients.
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This document summarizes the experience of CAH administrators with contracts offered by Medicare Advantage (MA) plans. Telephone surveys were conducted with CAH administrators across the country to learn about their experiences with MA plans. This brief includes information about the contract terms administrators have been offered, their experiences negotiating with MA plans, and their advice for others dealing with this issue.
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