Subject(s)
Internship and Residency , Ophthalmology , Adult , Emigration and Immigration/statistics & numerical data , Female , Foreign Medical Graduates/statistics & numerical data , Health Services Needs and Demand/trends , Humans , Internship and Residency/statistics & numerical data , Learning Curve , Male , Middle Aged , National Health Programs/economics , Ophthalmology/education , Personnel Downsizing , Physicians/economics , Physicians/supply & distribution , Private Sector/economics , Spain , Unemployment/statistics & numerical data , WorkforceABSTRACT
Royal College of Midwives general secretary Cathy Warwick is urging the government to act now to save UK maternity services from deteriorating further.
Subject(s)
Maternal Health Services , Midwifery , Patient Safety , Personnel Downsizing , Quality of Health Care , Female , Humans , Pregnancy , United Kingdom , WorkforceSubject(s)
Job Satisfaction , Nursing Administration Research/trends , Nursing Staff, Hospital/supply & distribution , Personnel Downsizing/trends , Quality of Health Care/standards , Adult , Cost Control/trends , Cross-Cultural Comparison , Female , Germany , Health Care Costs/trends , Humans , Male , Middle Aged , National Health Programs/economics , Nursing Staff, Hospital/economics , Personnel Downsizing/economics , Quality of Health Care/economicsSubject(s)
Attitude of Health Personnel , Emigration and Immigration , Mental Health Services/organization & administration , Physicians/psychology , Psychiatry/organization & administration , Cost Control , Health Care Rationing/organization & administration , Humans , London , Motivation , National Health Programs/organization & administration , New Zealand , Personnel Downsizing/organization & administration , Personnel Downsizing/psychology , Physicians/organization & administration , State Medicine/organization & administration , StereotypingABSTRACT
In an attempt to find some remedies within what is already a highly competitive and politically charged environment, this article's purpose is to specify some major steps that the management of integrated delivery systems might heed in the next decade to curtail their expenditures and better position themselves for the future.
Subject(s)
Delivery of Health Care, Integrated/organization & administration , Health Facility Merger/organization & administration , Health Services Administration/trends , Cost Control , Efficiency, Organizational , Humans , Personnel Downsizing , United StatesABSTRACT
Health care in Ontario consumes 35% of provincial government annual revenues. Fiscal constraint mandates restructuring of health services to maintain a fully, publicly-funded universally-accessible health system that is patient-focussed and health-outcome driven. Acute-care hospital restructuring under the authority of the Health Services Restructuring Commission and primary health-care reform characterise present government initiatives. Laboratory medicine services at about Can $1 billion annually account for about 5% of health expenditure. A Laboratory Services Restructuring Secretariat created by the Ministry of Health in 1995 has planned regionally-based integrated laboratory services systems bringing together public and private providers, designed a province-wide laboratory information system, developed a quality management program, reviewed the human resource needs for laboratory physicians, scientists and technologists, and recommended that the legislation be rewritten so as to be enabling - not controlling. Meanwhile both hospital and private laboratories have closed, leaving 296 in 1998 compared to 394 in 1991. Laboratory physician numbers at 39 per million population falls far short of the recommended target of 52 and many are within 10 years of retirement. Renewal of laboratory physicians and scientists to meet the shortfall is not occurring. The numbers of registered laboratory technologists has fallen by 6. 8% over 2 years. Consolidation and downsizing of laboratories with the formation of core laboratories has resulted in multi-discipline and cross discipline tasking of specialist technologists. Senior and middle level management technologists have been declared redundant. As a consequence, quality control practices have been hard hit. Plans to address these deficiencies through regional integration and sharing of resources remain to be implemented.
Subject(s)
Laboratories/organization & administration , Personnel Downsizing , Total Quality Management , Clinical Laboratory Information Systems , Delivery of Health Care/economics , Delivery of Health Care/organization & administration , Facility Regulation and Control , Laboratories/legislation & jurisprudence , Laboratories/standards , Licensure , Medical Laboratory Personnel , National Health Programs/economics , National Health Programs/legislation & jurisprudence , National Health Programs/organization & administration , OntarioSubject(s)
Delivery of Health Care, Integrated/economics , Bed Occupancy/statistics & numerical data , Capitation Fee , Colorado , Delivery of Health Care, Integrated/organization & administration , Economic Competition , Health Maintenance Organizations/economics , Income , Multi-Institutional Systems/economics , Multi-Institutional Systems/organization & administration , Negotiating , Personnel DownsizingABSTRACT
A major downsizing is under way in the hospital industry. Hospitals are laying off thousands of workers and closing down a variety of services. Facilities cite the usual suspects for taking such drastic action: managed care, reimbursement changes in federal healthcare programs, plummeting inpatient loads and consolidation. This is the first in a two-part series on financial turmoil in the industry.