Should a Healthcare System Facilitate Racially Concordant Care for Black Patients?

Addressing racial disparities in health outcomes is an urgent priority for many health care organizations, leading health care managers to explore the potential for organization-level interventions to yield substantive health gains. In recent literature, it is suggested that Black patients who are treated by Black physicians may achieve superior health outcomes in some settings. In this case discussion, we consider a case in which a medical director considers implementing a voluntary program to promote racially concordant care for Black patients. Commentators consider the precedent for such a program, both in current informal care networks and 20th century medical history, as well as the burden such a program may place on Black physicians and the risks of reducing patients' intersectional identities to be solely about race. A subset of commentators suggest that these risks are mitigated by the voluntary nature of the program, whereas others offer caution about relying solely on Black physicians to remedy health disparities. Others view multiple paths as morally defensible but emphasize the need for managers to take proactive steps to communicate and evaluate their choices in the face of such a complex social challenge.

El papel de hospitales municipales y provinciales en España desde una perspectiva histórica / The role of municipal and provincial hospitals in Spain from a historical perspective

Los hospitales municipales y provinciales representaron un papel clave en la confi-guración histórica del sistema hospitalario en España hasta la segunda mitad del siglo XX. Su papel estratégico en la beneficencia del siglo XIX para la cobertura de los pobres se modificó con el avance y la configuración del hospital moderno ubicado en nuevos edificios y técnicas de gestión, con una estructura interna jerarquizada y avances en ámbito diagnóstico-terapéutico para la cobertura de cada vez más porcentaje de población. Partiendo de esta idea, este trabajo se centra en el estudio histórico de las infraestructuras hospitalarias públicas vinculadas a los municipios y diputaciones en España con dos objetivos. De un lado, trata de analizar cómo se configuraron, qué servicios prestaron y cómo afrontaron su financiación hasta la dictadura de Franco. De otro, aborda los efectos que tuvo la puesta en marcha del Seguro Obligatorio de Enfermedad (SOE), en 1944, y la construcción de su propia red de hospitales, conocidos como residencias sanitarias, en el funcionamiento y supervivencia de estas viejas infraestructuras municipales y provinciales. Finalmente se analiza su práctica desaparición tras la cesión de las competencias sanitarias en la transición democrática (AU)

Rethinking Private-Public Partnership in the Health Care Sector: The Case of Municipal Hospital affiliation.

By the late 1950s, New York City's public hospital system-more extensive than any in the nation-was falling apart, with dilapidated buildings and personnel shortages. In response, Mayor Robert Wagner authorized an affiliation plan whereby the city paid private academic medical centers to oversee training programs, administrative tasks, and resource procurement. Affiliation sparked vigorous protest from critics, who saw it as both an incursion on the autonomy of community-oriented public hospitals and the steamrolling of private interests over public ones. In the wake of the New York City fiscal crisis of 1975, however, the viability of a purely public hospital system withered, given the new economic climate facing the city. In its place was a new institutional form: affiliation and the public-private provision of public health care.

[The History of the F. Ch. Graal Perm Municipal Clinical Hospital, One of the Oldest Hospitals of the Ural Region].

The article presents the history of becoming and development of F. Ch. Graal Perm municipal clinical hospital, founded on October 17, 1915. In 1928 A. V. Lunacharsky characterized this hospital as "The pearl of Ural". V. N. Derevenko, the surgeon-in-ordinary of the Royal Family, is its first director. Famous national scientists, such as academician E. A. Wagner, professors D. P. Kuznetsky, V. N. Parin, B. V. Parin, I. A. Ivanov, V. F. Simonovich, J. S. Zimmerman and others worked in this hospital. They made a significant input into development of medical science and health care of the Ural Region.

Del Hospital Municipal de Trujillo y del cese de las Hermanas Amantes de Jesús / O Hospital Municipal de Trujillo ea cessação de amantes Irmãs de Jesus / Municipal Hospital of Trujillo and the cessation of Lovers Sisters of Jesus

Los objetivos del estudio fueron realizar una descripción del hospital municipal y de las obras acometidas, exponer las condiciones del convenio entre el Ayuntamiento y las religiosas y describir los cambios que se producen durante 1894. Se ha realizado un estudio histórico-documental durante los años 2014-2015 de los legajos depositados en el Archivo Municipal de Trujillo. El Hospital de la ciudad de Trujillo estaba destinado a la atención de ciudadanos, militares y transeúntes enfermos. La atención a los enfermos fue realizada por las Hermanas Amantes de Jesús y María Inmaculada desde el año 1890. En la labor asistencial, las religiosas fueron ayudadas por una enfermera y un enfermero contratados por el Ayuntamiento. Durante 1894 se produjeron una serie de cambios, promovidos por la Corporación Local de la ciudad, que provocaron que las religiosas cesaran su labor asistencial. Estos cambios se vieron motivados por las quejas recibidas por los enfermos ingresados y por lo costoso que la atención resultaba para el Ayuntamiento. El cese de las hermanas llevaría a que el Ayuntamiento tuviera la necesidad de estudiar una nueva organización a nivel de régimen y administración (AU)

O alvo de este estudo foi a descrição do hospital e das obras de remodelação do mesmo, assim como expor as condições do contrato entre as religiosas e a Câmara. Descrevem-se também as alterações producidas durante 1894. Em 2014 e 2015 realizou-se un trabalho de investigação dos documentos depositados no Arquivo Municipal da cidade de Trujillo. O Hospital Municipal da cidade de Trujillo, estava destinado ao atendimento de cidadãos, militares e transeuntes doentes. O tratamento dos doentes foi realizado pelas Irmãs Amantes de Jesus e Maria Imaculada desde o ano 1890. Para dar assistência às irmãs seriam contratados uma enfermeira e um enfermeiro, pagos pela Câmara Municipal. Durante 1894 a Câmara Municipal efetuou uma série de alterações que produziram a cessação da tarefa assistencial das raligiosas. Esatas alterações foram originadas pelas queixas de alguns dos doentes e pelas elevadas despesas que a Câmara Municipal tinha que pagar pela manutenção do hospital. Com a cessação da atividadde das irmãs a Câmara começou a estudar uma nova organização do regime e da administração da instituição (AU)

The objectives were to make a description of the hospital and the works undertaken, exposing the conditions of the agreement between the city and religious and describe changes that occur during 1894. There has been a historical documentary study during the years 2014-2015 of the files deposited in the Municipal Archives of Trujillo. The Municipal Hospital in the city of Trujillo, was destined to service citizens, sick soldiers and bystanders. The Sisters Lovers of Jesus and Mary Immaculate performed treatment of patients since the year 1890. To assist the sisters would be hired a nurse and a nurse, paid by the city. During 1894 the City Council performed changes that produced the cessation of the assistance service of religious. The changes originated by the complaints of some patients and the high costs that the City Council had to pay for hospital maintenance. With the cessation, the religious began to study a new organization of the regime and the management of the institution (AU)

[In process] / Alimentation et soins des maladies de I'Hotel-Dieu de Paris à l'èpoque moderne.

At the end of the Middle Ages, in 1492, the Hôtel-Dieu de Paris was still and establishment of charity intended to receive thepoor which came there to find a shelter and some food. Three centuries later, just before the French Revolution, it became an establishment of care mainly destined to receive the patients, to feed them, take care of them and if possible cure them. This medicalization of the Hôtel-Dieu de Paris is related to the progressive emergence of the medical function, which resulted in the creation and the development of a doctor's and surgeon's profession, but also in the development of the apothecary and its drugs. In this context, the diet plays a central part, because it happens to supplies. It would not be until the eve of the French Revolution that it would be integrated in the doctor's prescription and became a dietetic item.

[Surviving handwritten signatures of Ignác Semmelweis]. / SEMMELWEIS IGNÁC AUTOGRÁF HAGYATÉKA.

We know only rather few samples of Semmelweis's handwriting and therefore it is important to carefully preserve those we have. The first collection of his manuscripts was published by Antall et al in 1968. During the following 47 years only rather few further samples of his handwriting have been published. Our present collection completes the former list with two previously unknown letters and with an earlier unpublished document signed by Semmelweis. The first document is a certificate written by Semmelweis in 1854 regarding the age of a woman who delivered her child at Szent Rókus Hospital in Pest. The second document includes a request from the Court of Justice towards the Medical Faculty's of the University of Pest regarding the body's opinion in a case of infanticide. The third document is a registration book of a student at the University of Medicine signed by Semmelweis in 1859. Present work attempts to list all of Semmelweis's handwritings known at this moment. The list includes 29 documents written by Semmelweis and further 16 documents signed by him.