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EXCHANGE OF VETERANS AFFAIRS MEDICAL DATA USING NATIONAL AND LOCAL NETWORKS

ANNALS OF THE NEW YORK ACADEMY OF SCIENCES-SERIES 1992年第1期670卷 50-66页

作者： DAYHOFF, RE MALONEY, DL Washington Information Systems Center Department of Veterans Affairs 8403 Colesville Road Suite 200 Silver Spring Maryland 20910

Remote data exchange is extremely useful to a number of medical applications. It requires an infrastructure including systems, network and software tools. With such an infrastructure, existing local applications can be extended to serve national needs. There are many approaches to providing remote data exchange. Selection of an approach for an application requires balancing of various factors, including the need for rapid interactive access to data and ad hoc queries, the adequacy of access to predefined data sets, the need for an integrated view of the data, the ability to provide adequate security protection, the amount of data required, and the time frame in which data is required. The applications described here demonstrate new ways that the VA is reaping benefits from its infrastructure and its compatible integrated hospital information systems located at its facilities. The needs that have been met are also needs of private hospitals. However, in many cases the infrastructure to allow data exchange is not present. The VA's experiences may serve to establish the benefits that can be obtained by all hospitals.

关键词： CD-ROM 临床药学信息系统/组织和管理计算机通信网络/组织和管理诊断显像卫生服务需求医院信息系统/组织和管理医院退伍军人/组织和管理机构间关系病案连锁病案系统计算机化多机构系统/组织和管理办公室自动化病人转诊人群监测转诊和会诊登记软件远程医学美国

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STAFF COMMUNICATIONS AND CREDENTIALING IN A MULTISITE INSTITUTION

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES 1992年第1期670卷 211-214页

作者： BOOTH, FVM HASSETT, JM Department of Surgery School of Medicine and Biomedical Sciences State University of New York at Buffalo 100 High Street Buffalo New York 14203-1154

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Consequences of organizational change in US hospitals

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MEDICAL CARE RESEARCH AND REVIEW 1999年第3期56卷 227-276页

作者： Lee, SYD Alexander, JA Univ Illinois Dept Sociol MC 312 Chicago IL 60607 USA Univ Michigan Ann Arbor MI 48109 USA

Organizational change has become commonplace among U.S. hospitals. Empirical investigations of the consequences of organizational change, however, are relatively scarce, and findings of existing studies are inconsistent. In this article, the authors review the rationale and performance implications of hospital organizational change in three areas: (1) the development of new multi-institutional arrangements, (2) change in traditional ownership and management configurations, and (3) diversification in organizational products/services and consolidation of organizational scale. Empirical research on hospital change published between 1980 and 1999 in the health services research, social science, and business literatures is reviewed to highlight the potential pitfalls that hospitals may encounter in their effort to remain viable. The article also summarizes the strengths and weaknesses of current hospital change research and provides specific suggestions for future research in this area.

关键词：卫生服务研究医院管理医院改组多机构系统/组织和管理组织改革组织目标所有权美国人类

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An Expert Panel Approach to Assessing the Rural Implications of Health Care Reform: The Case of the Health Security Act

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The Journal of Rural Health 1994年第1期10卷 6-15页

作者： Coburn, Andrew F. Cordes, Sam M. Crittenden, Robert A. Hart, J. Patrick Mueller, Keith J. Myers, Wayne W. Ricketts, Thomas R.

The policy arena is hungry for objective information regarding the potential effects of comprehensive national and state health care reform. Such information reduces the dependence of policy-makers on information generated solely by advocacy groups and serves as a checkpoint for such information. Unfortunately, the academic community is often unable to mobilize its resources quickly enough to help meet this information need. This article describes one model for overcoming this difficulty. When the time frame is especially short, academic expertise can be brought together in the form of an expert panel. However, for such an approach to be effective, it must be carefully configured and orchestrated. Critical ingredients include much preparatory groundwork, a well-defined framework and methodology for conducting the policy analysis, and a professional facilitator. The Rural Policy Research Institute used such an approach to analyze President Clinton's Health Security Act shortly after the initial blueprint was released (but before the legislative language was released). The consensus of the expert panel was that the Health Security Act would, on balance, represent an improvement over today's rural reality. However, a number of troubling aspects were noted. First, the Act's emphasis on primary care and nonphysician providers is a double-edged sword. While these are precisely the types of providers needed in rural areas, the short-run effect may be to create increased competition for such providers from urban areas.(ABSTRACT TRUNCATED AT 250 WORDS)

关键词：综合保健/组织和管理综合保健/发展趋势集中研讨小组卫生保健费用/立法和法学卫生保健费用/发展趋势卫生保健改革/经济学卫生保健改革/立法和法学卫生保健改革/发展趋势卫生人力/发展趋势卫生服务研究/方法医院乡村/经济学医院乡村/立法和法学医院乡村/发展趋势多机构系统/组织和管理多机构系统/发展趋势医师家庭/供应和分配农村卫生/发展趋势美国

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THE COMPETITIVE EFFECTS OF HORIZONTAL MERGERS IN THE HOSPITAL INDUSTRY - A CLOSER LOOK

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JOURNAL OF HEALTH ECONOMICS 1991年第3期10卷 359-372页

作者： VITA, MG SCHUMANN, L FED TRADE COMMISS BUR ECONWASHINGTONDC 20580 USA

Woolley (1989) attempted to analyze the competitive impact of horizontal hospital mergers using the 'event study' method. Woolley characterized his results as consistent with traditional 'oligopoly' theories of market behavior. We scrutinize in detail a large number of his events, however, and find that most either generated concentration increases too small to plausibly produce market power, or could not have conferred monopoly returns on firms improperly characterized as rivals. Accordingly, any observed abnormal returns are likely attributable to some other cause; we suggest some alternative interpretations of his results. Our paper highlights the need for care in the selection of events and the identification of rivals when applying the event study method to the analysis of mergers.

关键词：反垄断法经济竞争/统计学和数值数据卫生设施合并/经济学卫生服务研究/方法医院私营/组织和管理多机构系统/组织和管理研究设计/标准抽样研究选择偏倚美国美国联邦贸易委员会

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The multi-hospital emergency medicine group: Catalyst for effective contracting

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Journal of Ambulatory Care Marketing 1987年第2期1卷 85-94页

作者： Sweeney, Robert E. Donovan, Raymond Weeker, Ellis California Emergency Physicians United States Samaritan Healthcare Medical Group United States Samarian Healthcare Medical Group United States

No abstract available for this article.

关键词：加利福尼亚合同业务/组织和管理急救医学急诊室医院/组织和管理财务管理/组织和管理管理医疗规划/组织和管理多机构系统/组织和管理组织隶属关系

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Developing a marketing function in a multi-hospital system: How to define your job

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Health Marketing Quarterly 1985年第2-3期3卷 37-45页

作者： Larkin, Del Manager of Marketing and Research Evangelical Health Systems Oak Brook IL 60521 United States

No abstract available for this article.

关键词：伊利诺伊职务说明卫生服务使用研究/组织和管理多机构系统/组织和管理人员管理规划技术

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Organizational issues for the teaching hospital

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Journal of Hospital Marketing 1991年第2期5卷 61-72页

作者： Vogel, Lucie L. Woodrow Wilson Rehabilitation Center Fishersville VA United States

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Description of a multihospital process to develop a care path for the child with acute lymphoblastic leukemia.

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Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses 2000年第1期17卷 33-44页

作者： McMahonLW SealingPA MahoneyDHJr BowmanWP SandlerE NationalAssociationofChildren'sHospitalsandRelatedInstitutions PalmHarborFL34685USA.

This article describes the National Association of Children's Hospitals and Related Institutions (NACHRI) collaborative group process used to create a multihospital care path for the child with acute lymphoblastic leukemia (ALL), and presents strategies for implementation and future direction. Although most children in the United States with cancer are treated according to National Cancer Institute-sponsored comprehensive protocols, there is a wide variation in the implementation of protocols by physicians and hospitals. The development of this care path was based on evidence from the literature, review of practice patterns, expert opinion, and group participant consensus building. The resulting 4-day care path was organized into six categories of care (e.g., assessment practices, diagnostic tests, teaching, and discharge planning). Discharge criteria are stated at the beginning of the care path to emphasize the planning process immediately on admission. Clinical outcomes, skill and knowledge outcomes for the parent and child, and home assessment considerations are also included. Strategies to create change and gain support of various stakeholders toward implementation of the care path are presented. The strength of the resulting care path is possible in large part because the multihospital group process brought professionals from around the country together to discuss, analyze, and reach consensus on the practices related to the child with ALL. The group process enabled the development of a care path that goes beyond a traditional care path developed by a single institution.

关键词：合作行为临床路径/组织和管理医院儿科/组织和管理多机构系统/组织和管理肿瘤护理/组织和管理病人医疗小组/组织和管理儿科护理学/组织和管理规划制订/方法美国儿童人类

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Health care clusters in hospitals: The market audit and frameworks for planning

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Journal of Hospital Marketing 1993年第2期7卷 61-76页

作者： Gruca, Thomas S. Kaltenbach, Katherine M. Nath, Deepika University of Iowa Iowa City IA 52242 United States Alexian Brothers Medical Center Elk Grove Village IL United States York University Toronto Canada

Many hospitals are turning to cluster relationships to gain the benefits of diversification without the troubles of increased capital costs and management conflicts. The goal of healthcare clusters is to provide a continuum of care to a defined geographic region through integration of referral and payment systems. To aid in successful planning for healthcare clusters, a market audit and frameworks for examining the current healthcare market are presented. © 1993 Taylor & Francis Group, LLC.

关键词：卫生服务范围综合保健/组织和管理综合保健/标准病人医护连续性/组织和管理病人医护连续性/标准评价研究医院计划卫生服务使用研究模型组织管理多机构系统/组织和管理美国

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