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The infirmary of the Glasgow Town's Hospital, 1733-1800: A case for voluntarism?

BULLETIN OF THE HISTORY OF MEDICINE 1999年第1期73卷 64-105页

作者： Macdonald, FA Wellcome Institute for the History of Medicine London.

Eighteenth-century Britain experienced a flurry of hospital foundation. Between 1719 and the opening of the infirmary of the Glasgow Town's Hospital in 1740, eight voluntary hospitals were founded countrywide. By the end of the century there were at least forty infirmaries (thirty-three voluntary hospitals), besides a number of clinics and dispensaries, which had evolved into hospitals by the nineteenth century. In all, some 150 British medical foundations sprang into life, originating in the provision of charitable health care for the poor. The infirmary of the Glasgow Town's Hospital has yet to be given a place within this development: in most recent accounts, the Glasgow Royal Infirmary takes precedence as the west of Scotland's first voluntary hospital, while the infirmary of the Town's Hospital is generally relegated to the realm of poorhouse history. I would like to argue that this infirmary can be perceived as part of the voluntary hospital movement. It has not been included among the other infirmaries (except notably in histories written by clinicians) because little attention has been paid to its medical provision, but also because it was a hybrid contribution more difficult to classify. It combined features of the older hospital tradition, in which institutions were supported by both municipal sources and voluntary subscribers and employed salaried physicians, and of the newer voluntary hospitals, which were maintained by voluntary subscription and attended by physicians gratis. Yet it was in precisely those settings where medicine became entwined with poor relief, and where social differentiation was articulated through public charity, as Mary Fissell has demonstrated, that the relationship between healer and patient metamorphosed from one of client/patron to that of professional/working-class poor.

关键词：救济院/历史医院慈善/历史医院慈善/组织和管理苏格兰社会责任历史 18世纪人类

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HOSPITAL OWNERSHIP AND PERFORMANCE

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ECONOMIC INQUIRY 1985年第1期23卷 21-36页

作者： BECKER, ER SLOAN, FA VANDERBILT UNIV DEPT ECONNASHVILLETN 37240 VANDERBILT UNIV INST PUBL POLICY STUDIESCTR HLTH POLICYNASHVILLETN 37240

This study compares the performance of three ownership forms of hospitals: for profit, private nonprofit, and public, further classified according to whether or not the hospital is run by a hospital chain. Data come from a 1979 national survey of U.S. hospitals. The authors find that hospital cost is quite similar among alternative ownership forms as is profitability. The results do not provide much empirical support for standard property rights theory. Several reasons are suggested why this may be so.

关键词：成本及成本分析效率医院管理医院私营/组织和管理医院公立/组织和管理医院慈善/组织和管理所有权回归分析美国

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Using a key function approach to performance improvement: a case study.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1998年第5期20卷 29-35页

作者： Benson, H. NorthCrest Medical Center Springfield TN United States

Assisting organizations with performance improvement planning is among the most important, challenging, and potentially rewarding responsibilities of the quality management professional. NorthCrest Medical Center, a 100-bed not-for-profit community hospital, developed a long-term vision for quality which was then supported through a unique model of performance improvement based on important functions. The resulting key function framework has helped the organization prepare for two successful Joint Commission surveys, relocate to a new facility, and survive in today's rapidly changing environment.

关键词：医院病床数 100至299张医院社区/组织和管理医院社区/标准医院慈善/组织和管理医院慈善/标准卫生保健组织鉴定联合委员会组织状况研究组织目标规划技术田纳西全面质量管理/组织和管理

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The Medicare Critical Access Hospital program: The first year

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JOURNAL OF RURAL HEALTH 1999年第1期15卷 61-66页

作者： Reif, SS Ricketts, TC Univ N Carolina Sheps Ctr Hlth Serv Res Chapel Hill NC 27599 USA

The Medicare Critical Access Hospital (CAH) program, part of the Balanced Budget Act of 1997, is a nationwide limited service hospital program. Structured interviews were conducted in August and September 1998 with key people in state offices of rural health, state hospital associations, departments gf health or departments of facility licensing in all 50 states to assess their progress in the development of the CAH program. The majority of states expressed interest in the CAH program. Twenty-one states were moving formally toward involvement in the program. States that had developed or were in the process of developing a state plan estimated that between 183 to 227 hospitals would convert to CAHs in the next one to two years. States that were the most successful with plan de development appeared to be states that participated in the Essential Access Community Hospital/Rural Primary Care Hospital program, states where there was dialogue about the possibility of a limited service hospital program and states with widespread support in the state. A pressing need for most states is for reliable fiscal consulting or analysis that could be applied to individual hospitals that are considering conversion to CAHs. The CAH program shows promise for successful implementation based on its early results.

关键词：预算/立法和法学卫生服务易得程度/组织和管理卫生服务研究医院公立/经济学医院公立/组织和管理医院乡村/组织和管理医院慈善/经济学医院慈善/组织和管理缺医地区 Medicare/组织和管理需求估价/组织和管理试点项目初级卫生保健/组织和管理规划制订方案评价预期支付系统/组织和管理问卷调查偿还途径/组织和管理美国人类

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The impact of operations competitive priorities on hospital performance

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Health Care Management Science 2000年第3期3卷 227-235页

作者： Butler, Timothy W. Leong, G. Keong School of Business Administration Wayne State University Detroit MI 48202 United States Fisher College of Business Ohio State University Columbus OH 43210 United States

A notable lack of empirical analysis exists on hospital operations strategy in spite of widespread debate on quality, cost, and service delivery - issues which are widely included within the realm of operations competitive priorities. We empirically examine the degree of emphasis placed by administrators on competitive priorities and what impact this might have on performance of not-for-profit, general hospitals. Performance is defined as a composite of financial and operational performance. Our research shows that management's emphasis of cost containment and service delivery consistently results in superior business performance. Quality programs are found to be the most preferred competitive priority initiative, yet show relatively low relation with performance. This suggests that quality programs are a necessary, though not sufficient, component of hospital operations strategy. The competitive dimension of flexibility is being employed, but on a less universal scale. We conclude that administrators are not yet sufficiently skilled in the flexibility priority to make this dimension consistently result in superior business performance. © Baltzer Science Publishers BV.

关键词：医务工作者的态度院长医院/心理学竞争行为费用控制数据收集经济竞争/统计学和数值数据卫生工作重点医院慈善/经济学医院慈善/组织和管理密执安多元分析卫生保健质量人类

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The role and application of the balanced scorecard in healthcare quality management.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1998年第1期20卷 10-13页

作者： Castañeda-Méndez, K. Mangan, K. Lavery, A.M. Ridgefield CT United States

To connect practices, outcomes, quality, value, and costs, healthcare organizations must start using a balanced scorecard. A balanced scorecard is a set of measures that reveals the interdependency of the organization, its employees, and its patients. It thus serves as a balanced perspective on the organization for senior management to use in designing, developing, deploying, and directing the strategic plan, consistent with total quality management principles.

关键词：教育继续医院病床数 100至299张医院记录医院慈善/组织和管理医院慈善/标准信息服务管理质量小组纽约组织目标规划技术过程评价(卫生保健) 全面质量管理/方法

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The marketing audit-a strategic necessity: Marketing management for the mature non-profit

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Health Marketing Quarterly 1985年第2-3期3卷 93-97页

作者： Sweeney, Robert E. California Emergency Physicians San Francisco CA 94121 United States

No abstract available for this article.

关键词：医院管理医院慈善/组织和管理管理审计卫生服务使用研究/组织和管理组织和管理美国

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The valuation of pastoral care by hospital administrators: A survey of selected for-profit and non-profit institutions

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Journal of Health Care Chaplaincy 1990年第1期3卷 5-22页

作者： Manns, Maureen Young Pastoral care and education at brigham’s and women’s hospital Boston MA United States

This paper reports on a study of 600 hospital administrators, half of which were in non-profit institutions and half of which were in hospitals owned or managed by the Hospital Corporation of America. The project was designed to identify what differences, if any, existed between surveyed administrators in both bypes of institutions in their valuation of pastoral care. No significant differneces were found between the two groups of administrators in the valuation of pastoral care. All administrators were found to be concerned about the quality of patient care and to value aspects of care such as pastoral care which are personal and difficult to quantify. © 1990 Taylor & Francis Group, LLC.

关键词：方差分析医务工作者的态度宗教事务科医院/统计学和数值数据评价研究医院管理人员/统计学和数值数据医院科室/统计学和数值数据医院医院私营/组织和管理医院慈善/组织和管理牧师心理治疗/统计学和数值数据问卷调查美国人类

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Hospital diversification: Corporate restructuring as a survival strategy

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Hospital Topics 1988年第1期66卷 16-19页

作者： Snook, Donald Presbyterian–University of Pennsylvania Medical Center in Philadelphia United States

Click to increase image sizeClick to decrease image size

关键词：经济竞争评价研究医院管理医院改组医院慈善/组织和管理模型理论美国

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Hospital mission and cost differences

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Hospital Topics 1989年第3期67卷 22-25页

作者： Sorrentino, Elizabeth A. University of Miami United States

The results show no significant differences on average length of stay, cost per patient day, or cost per admission among non-profit, government, and for-profit hospitals when controlling for bed capacities, occupancy rates, number of Medicare/Medicaid days, and hospitals without nurseries. For-profit hospital manhours per patient day were significantly lower than non-profit and government hospitals. This is an important finding because patient-care delivery is labor-intensive. A majority of for-profit hospitals do not have nurseries, which means that they should have more manhours per patient day. As indicated earlier, the manhours for hospitals with nurseries are higher than those for hospitals without nurseries. This indicates cost-cutting behavior on the part of a majority of for-profit hospitals. This method of limiting expenditures by decreasing labor costs associated with certain services is consistent with profit-maximization. The findings of this study with regard to cost differences among non-profit and for-profit hospitals contradict previous research. However, a recent study by Kralewski, Gifford and Porter (1988) noted that whereas ownership, when considered alone, differentiates hospitals, when evaluated within each community, most of the investor-owned and non-for-profit hospital differences disappear. Similar questions have been raised as to whether non-profit hospitals truly differ from for-profit hospitals (Pauly 1987). Caution needs to be exercised in attempting to extrapolate the findings of this study, because of the dynamic health care environment. Hospital ownership changes over time, reimbursement rules affect behavior, and internal factors in organizational operation affect outcomes. These should be considered in future studies exploring organizational mission and cost differences.

关键词：避孕药口服复合成本及成本分析/统计学和数值数据数据收集佛罗里达医院管理医院病床数 100至299张医院私营/组织和管理医院公立/组织和管理医院慈善/组织和管理住院时间/统计学和数值数据模型统计学组织和管理组织目标所有权回归分析

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