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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 109 records · Page 6Linked to original sources
PubMed1993

Integrated delivery networks. A system for the future. Genesys Health System designs and builds a patient-focused care delivery network.

St. Joseph Hospital, Flint, MI, formed Genesys Health System in 1981, affiliating with five area hospitals and a number of other healthcare organizations. In 1983 the system closed one of the hospitals. Genesys Health System's vision is described as a three-legged stool, with the integrated delivery system as the seat. That system balances on three legs: a strong primary and specialty care physician network; a financing, or insuring, mechanism; and a revolutionary hospital and delivery system with a full continuum of services across a range of institutional and home settings. Genesys has two physician joint ventures that will eventually become one as Genesys member hospitals' medical staffs merge. Member physicians are already linked by a common computer system and risk-sharing mechanisms. The physician-Genesys joint ventures have contractual arrangements with various managed care organizations. The system serves more than 50,000 persons enrolled with HealthPlus of Michigan and virtually all the 10,000 enrolled patients of Blue Care Network, the Blue Cross health maintenance organization. After evaluating the community's needs, Genesys Health System decided to build a new hospital; 439-bed Genesys Regional Medical Center at Health Park is scheduled to open in 1997. The new hospital will be the first in the United States to be designed and built using patient-focused care concepts.

Catholicism↗
PubMed1985

Health systems agency and state health planning and development agency reviews; certificate of need programs--PHS.

The Assistant Secretary for Health, with the approval of the Secretary of Health and Human Services, amends the regulations governing certificate of need reviews by State health planning and development agencies (State Agencies) and health systems agencies (HSAs). The amendments accomplish two tasks: (1) To implement amendments to the Public Health Service Act made by the Health Programs Extension Act of 1980 (Pub. L. 96-538) and the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35), and (2) to reduce Federal regulatory burdens. Under the provisions of Title XV of the Public Health Service Act, the planning agencies are required to administer certificate of need programs consistent with the Department's regulations, under which they review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. These regulations change the requirements for satisfactory certificate of need programs.

Certificate of Need↗
PubMed1983

Health systems agency and state health planning and development agency reviews; certificate of need programs--PHS. Notice of proposed rulemaking.

The Assistant Secretary for Health, with the approval of the Secretary of Health and Human Services, proposes to amend the regulations governing certificates of need reviews by State health planning and development agencies (State Agencies) and health systems agencies (HSAs). The proposed amendments would accomplish two tasks: (1) Implement amendments to the Public Health Service Act made by the Health Programs Extension Act of 1980 (Pub. L. 96-538) and the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35) and (2) reduce Federal regulatory burdens. Under the provisions of Title XV of the Public Health Service Act, the planning agencies are required to administer certificate of need programs consistent with the Secretary's regulations, under which they review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. These regulations set forth proposed changes to the requirements for satisfactory certificate of need programs. Interested persons are invited to submit written comments and recommendations concerning these proposed rules as well as suggestions for alternative methods of implementing any of the provisions of the amendments that affect the requirements for certificate of need programs.

Health Planning Organizations↗
PubMed1995

Critical paths at Alliant Health System.

Alliant Health System (Alliant) was an enthusiastic, early user of critical paths in a hospital setting. In spite of its apparent early successes with the approach, Alliant eventually dropped critical paths as an overall corporate strategy and redesigned its approach to those critical paths still in use. This article summarizes the lessons learned and offers suggestions on the use of critical paths.

Clinical Protocols↗
PubMed1995

The management information system and change processes in health systems.

This report describes a management information system (MIS) designed by PAHO's Health Systems and Services Division in collaboration with technical experts from a number of different countries. This MIS, a methodology currently used at the institutional or national level in more than 21 countries of the Americas, is a strategic and practical instrument that is easy to apply, interpret, and use, and whose purpose is to facilitate fundamental changes in health management. Based on the management concept that inputs, processes, and outputs are quantifiable, the MIS places special emphasis on health system productivity, an essential condition for achieving health coverage that is both adequate and equitable.

Community Mental Health Services↗
PubMed1980

Public Health Service--Health systems agency and state health planning and development agency reviews: certificate of need programs. Final regulation.

These rules amend the Public Health Service regulations on health systems agency and State health planning and Development agency (State Agency) certificate of need reviews. These final regulations implement changes to Title XV of the Public Health Service Act made by the Health Planning and Resources Development Amendments of 1979 (Pub L. 96-79). Under the amended provisions of the Public Health Service Act, the planning agencies are required to review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. These regulations set forth the minimum requirements for satisfactory certificate of need programs.

Certificate of Need↗
PubMed2004

[Demanding respect for the subjectivity of public health system clients: towards humanization of health care].

This paper analyzes how clients of the public health system in Natal, Rio Grande do Norte, Brazil, "give meaning" to their situation as "patients", basically focusing on three aspects: (1) evaluation of care, (2) awareness of their rights as citizens and role in improvement of the service, and (3) expectations regarding the encounter with health professionals. The results point to many deficiencies in the health system, besides demonstrating the population's passivity and resignation towards the present situation. The need to consider clients' subjectivity is important, as is the health professional-client relationship, with their encounter considered a prime moment for establishing a humanizing process in health practice, besides fostering the development of a critical awareness among clients concerning their rights and their role as agents of change in the health system.

Adult↗
PubMed1994

Managing a pluralist health system: the case of health care reform in France.

During the last decade increasing health care expenditure led to persistent difficulties in the financing and management of the French health care system. A series of cost-containment measures in the 1980s and early 1990s concentrated on raising patient contributions and establishing global budgets for public hospitals. These initiatives met with limited success and did not address the issue of hospital management. In 1991 new reforms were instigated to strengthen the public sector and achieve a better balance with the private sector. Although these reforms altered management practice within public hospitals, they failed to tackle the underlying problems of the long-term financing and management of the French health system, ensuring continuing attempts at reform. The French experience provides evidence of the difficulties of reforming a pluralist health system that contains few incentives to stem rising expenditure.

Cost Control↗
PubMed1980

Should health systems agencies be involved in environmental health planning?

Public Law 93-641 provides health systems agencies (HSAs) with a broad planning preview which has enabled a number of agencies to address environmental health issues in their health systems plans. Opponents of HSA involvement in environmental health planning charge that these activities overextend agency resources, duplicate efforts of other government agencies and involve HSAs in "issues of public policy." Closer examination of these charges finds them lacking in validity. The planning activities of health systems agencies are cooperative in nature, drawing upon the planning efforts of other institutions and agencies. It is illogical to exclude environmental concerns from general health planning in light of the impact of the environment upon health. Charges that issues of public policy are inappropriate topics for health planning are seen as attempts to avoid scrutiny of inconsistant legislative policies. Cooperative planning between health systems agencies and environmental health agencies is considered both desirable and essential for the development of effective health planning.

Environmental Health↗
PubMed2004

Fend for yourself. Systemic failure in the Dominican health system.

Despite relatively high levels of total spending and enormous growth in the supply of services during five decades, the Dominican health system demonstrates low performance in addressing the health needs of its population, ensuring acceptable quality of care, reducing the financial burden of health care on the poor, or providing adequate insurance coverage for those with the ability to pay. The paper analyzes deficiencies in financing, organization and delivery of health services in both the public and private sectors. The paper argues that government failure has undermined the health system and health care. Despite calls for reforms, attempts to restructure the system have not yet taken shape.

Consumer Behavior↗
PubMed1997

[Algorithm for establishing hospital admittance data based on the hospital information system in the Brazilian Unified Health System]

The authorization form for hospital admittance (AIH), an observation unit under the Hospital Information System of the Unified Health System (SIH/SUS), may represent a short-term hospital admittance or a longer hospital stay. This study presents an algorithm for composing admittance data based on the AIH forms, allowing for a proper assessment of hospital mortality, costs under the Unified Health System (SUS), and longer hospital stays, typical of chronic, terminal, and psychiatric patients.

Journal Article↗
PubMedDate not supplied

The coming age. What's ahead for hospitals and health systems.

The health care delivery system is a reactive instrument: it conforms to the demands of the most powerful drivers. How the system responds to these drivers in terms of design of coverage and delivery of care represents in large part the major challenge of the coming decade. This article presents an overview of some of the major drivers of health care today--cost, customers and technology--and how hospitals and health systems are responding.

Consumer Behavior↗
PubMedDate not supplied

Making health systems more equitable.

Health systems are consistently inequitable, providing more and higher quality services to the well-off, who need them less, than to the poor, who are unable to obtain them. In the absence of a concerted effort to ensure that health systems reach disadvantaged groups more effectively, such inequities are likely to continue. Yet this situation need not be accepted as inevitable, for there are many promising measures that might be pursued: establishment of goals for improved coverage in the poor, rather than in entire populations, and use of those goals to direct planning toward the needs of the disadvantaged; use of one or more of the several techniques that seem to have been effective in at least some of the settings where they have been tried; and empowerment of poor clients to have a more central role in health system design and operation.

Delivery of Health Care↗