Health services administration and health services research.
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Health and social service administrators are increasingly realising the importance of adopting a community or neighbourhood scale for the organisation and delivery of many different services. The concept of neighbourhood is an elusive one, yet it has been used for a number of planning purposes. This paper reviews the nature and utility of neighbourhoods and demonstrates the variety of territorial units used by different statutory agencies. The results of an empirical exercise in North Staffordshire are reported as an example of the practical issues involved. Neighbourhoods are identified with a view to being used for data collection, the delivery of health care services and the possible implementation of health forums.
Health care administrators should recognize that the economic quality and behavioral quality dimensions comprising consumer satisfaction are conceptually independent in nature and may be empirically independent as well.
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The U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT), announce the availability of FY 1999 funds for cooperative agreements for the following activity. This activity is discussed in more detail under section 4 of this notice. This notice is not a complete description of the activity; potential applicants must obtain a copy of the Guidance for Applicants (GFA) before preparing an application. Note: SAMHSA also published notices of available funding opportunities for FY 1999 in previous issues of the Federal Register.
Section 3102 of the Children's Health Act of 2000, Pub. L. 106-310, amends section 501 of the Public Health Service (PHS) Act (42 U.S.C. 290 aa) to add a new subsection (m) entitled "Emergency Response." This newly enacted subsection 501(m) authorizes the Secretary to use up to, but no more than, 2.5% of all amounts appropriated under Title V of the PHS Act, other than those appropriated under Part C, in each fiscal year to make "noncompetitive grants, contracts or cooperative agreements to public entities to enable such entities to address emergency substance abuse or mental health needs in local communities." Because Congress believed the Secretary needed the ability to respond to emergencies, it exempted any grants,contracts, or cooperative agreements authorized under this section from the peer review process otherwise required by section 504 of the PHS Act. See section 501(m)(1) of the PHS Act. Instead, the Secretary is to use an objective review process by establishing objective criteria to review applications for funds under this authority. Pursuant to Public Law 106-310, the Secretary is required to establish, and publish in the Federal Register, criteria for determining when a mental health or substance abuse emergency exists. In this interim final rule, the Secretary sets out these criteria, as well as the intended approach for implementing this new mental health and substance abuse emergency response authority. The Secretary invites public comments on both the criteria and the approach described in this interim final rule.
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The pace of change in the health policy and health administration environments supports the need for linking teaching and research. This article describes a successful effort to tap real-time synergies between faculty research on health care information systems development and teaching in health services administration. It describes the real-time case approach (RTCA), a highly interactive case method employed in teaching a graduate health management information systems course. The approach offers another alternative to the "teach-the-text-and-lecture" model and adds important dimensions to the standard "case discussion" model. The article discusses the mechanics of implementing the RTCA, the instructor's role, and five cases used in the course. Among the benefits of the RTCA is that students place great reliance upon cases in interpreting other reading material, lectures, and discussion points in the course. Students are more likely to make theory connections to elements in one or more of the cases. Potential weaknesses include students' inhibitions to criticize and question key decision makers who they have met, as opposed to those who might appear in a fictional case. Also, some possible concession of comprehensiveness and time-ordered treatment of information systems issues, as might be found in a written case study, is made in favor of the dynamics of information gathering, distillation, and integration by students in the real-time case environment.
Programs in Health Services Administration (HSA) should respond to the mandate to improve patient care as put forth by the Institute of Medicine (IOM) and other reports on the proliferation and consequences of medical errors. This article will identify a framework to base curriculum change, competency areas, and educational methods to impart quality improvement knowledge and skills. The first six competency areas reflect the six redesign imperatives from the IOM report, Crossing the Quality Chasm: A New Health System for the 21st Century (2001): redesign of the care process; use of information technologies; knowledge and skills management; development of effective teams; coordination of care; and use of performance and outcomes measurement. Based on a literature review, five additional areas were identified: strategic quality planning; programs for patient safety and risk management; change management; roles of stakeholders, payers and regulators; and development of a learning environment and blame-free culture. Examples of curriculum content are provided from HSA programs at Georgetown University, University of Washington, and University of California at Berkeley.
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The training of health services administration professionals in Mexico has faced two main challenges. One the one hand, the need to have recognition as professionals, and on the other hand the difficulty to train individuals that are currently working as health care administrators. This article emphasizes a distance education strategy as an alternative to provide training to these type of personnel. A proposal developed as the second phase of the Advance Education Program on Health Administration (PROASA-II) is presented. It has the objective to strengthen local institutions to take responsibility for the future training of their professional administration staff. Once that this is started, we can begin to talk about the creation of a national system of manpower training in health administration and public health, that will support the decentralization and the appropriate training of the different levels of health administration in the country.
The definition and scope of health services administration are important to public policy, educational programs, new entrants to the field, and practitioners. Formal definition of the field of health services administration has not received concerted attention since 1975. Significant changes in the field have occurred since that time, widening opportunities for graduates of educational programs and increasing interdependencies between health services organizations and public policy organizations, supplier organizations, insurers, and other businesses that are not involved directly in health services delivery. Stakeholders in the field of health services administration should consider a broadened definition of the field that would institutionalize and build on those increased opportunities and interdependencies.
Health services administration continues to evolve in response to environmental changes in reimbursement, technology, demographics, and health care reform. These changes encourage further integration of business skills in health services, an emphasis which often conflicts with the perspectives of clinicians. The balance between business and clinical perspectives must be developed such that administrators and clinicians foster the survival and growth of their organizations while assuring comprehensive and quality health services to patients and the community. This paper describes education in health services administration, and uses a survey of one program's graduates to assess the usefulness of the current educational model in balancing business and clinical perspectives.
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This article documents research into the demand for graduate education in health services administration/management with a case study model. Research included background information on the profession, the history of graduate education in health services administration, health care administrator demographics and their perceptions of the demand for graduate-prepared professionals and their own educational needs, most appropriate degree to offer, and curriculum content. The findings support the trend toward a balance between specific and general health care business skills in graduate education. Other schools may benefit from the student profile, program delivery, appropriate degree information, and curriculum content findings as well as the research instrument design and methodology when assessing and planning graduate programs in health services administration/management.