Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 21
Filtrar
1.
J Healthc Manag ; 66(6): 433-448, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34757333

RESUMO

EXECUTIVE SUMMARY: Little work has been done comparing the performance of hospitals with physician CEOs versus nonphysician CEOs, despite the ease of identifying this characteristic and extant leadership theories suggesting a relationship between technical expertise and success in leading highly technical organizations. We performed a detailed analysis of several widely accepted measures of clinical and financial performance across a randomly selected group of U.S. acute care hospitals with more than 40 beds and found no statistically significant differences between the two groups. The 30-day acute myocardial infarction mortality rate showed a positive statistically significant difference in the bivariate analysis (p < .001), but the effect was nullified in the multivariable regression analysis.

2.
Am J Health Promot ; 35(7): 988-990, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33792355

RESUMO

PURPOSE: Compare the effectiveness of two educational teaching methods for diabetic patients. DESIGN: Quasi-experimental study comparing two interventions using a pretest/post-test design. SETTING: Three clinics within a western U.S. regional health system. SUBJECTS: 818 adult diabetic participants (60.5 mean age, 52% female) attended one to four sessions between 2013-2017, and had A1c tests within 180 days of first attended session and 30 to 365 days after last attended session. INTERVENTION: A group-based, highly interactive learning experience (n = 561) and a traditional, lecture-style class (n = 257). MEASURES: Pre and post measures of A1c. ANALYSIS: Paired t-tests measured change within each group pre-post intervention. Two-sample t-tests measured mean change pre-post intervention between the two groups. Multivariable linear regression measured mean change in A1c between groups, adjusted for pre-test scores and controlling for demographic variables. RESULTS: Both interactive and traditional teaching interventions were effective at significantly reducing patient A1c levels by 1.3 (p < 0.001) and 1.0 (p < 0.001) points respectively. The between groups difference in A1c was not significant, t(512) = 1.66, p = 0.0985, but when controlling for age, pre-A1c and days post-A1c, the interactive intervention was significantly (p < 0.05) more effective reducing patient A1c levels by 0.19 points than the traditional intervention. CONCLUSION: Group-based, interactive diabetes self-management education programs may be an effective model for reducing patient A1c levels.


Assuntos
Diabetes Mellitus Tipo 2 , Autogestão , Adulto , Diabetes Mellitus Tipo 2/terapia , Feminino , Hemoglobina A Glicada/análise , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade
3.
Artigo em Inglês | MEDLINE | ID: mdl-33660666

RESUMO

BACKGROUND: Advances in natural language processing and text mining provide a powerful approach to understanding trending themes in the health care management literature. PURPOSE: The aim of this study was to introduce machine learning, particularly text mining and natural language processing, as a viable approach to summarizing a subset of health care management research. The secondary aim of the study was to display the major foci of health care management research and to summarize the literature's evolution trends over a 20-year period. METHODOLOGY/APPROACH: Article abstracts (N = 2,813), from six health care management journals published from 1998 through 2018 were evaluated through latent semantic analysis, topic analysis, and multiple correspondence analysis. RESULTS: Using latent semantic analysis and topic analysis on 2,813 abstracts revealed eight distinct topics. Of the eight, three leadership and transformation, workforce well-being, and delivery of care issues were up-trending, whereas organizational performance, patient-centeredness, technology and innovation, and managerial issues and gender concerns exhibited downward trending. Finance exhibited peaks and troughs throughout the study period. Four journals, Frontiers of Health Services Management, Journal of Healthcare Management, Health Care Management Review, and Advances in Health Care Management, exhibited strong associations with finance, organizational performance, technology and innovation, managerial issues and gender concerns, and workforce well-being. The Journal of Health Management and the Journal of Health Organization and Management were more distant from the other journals and topics, except for delivery of care, and leadership and transformation. CONCLUSION: There was a close association of journals and research topics, and research topics evolved with changes in the health care environment. PRACTICE IMPLICATIONS: As scholars develop research agendas, focus should be on topics important to health care management practitioners for better informed decision-making.

4.
Health Care Manage Rev ; 46(2): 162-171, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33630508

RESUMO

BACKGROUND: Most research of chief executive officer (CEO) compensation in the health care industry has been limited to hospitals. This study expands our knowledge of CEO compensation into the nonhospital areas of the industry, specifically community health centers (CHCs). CHCs are safety-net providers that are an integral part of the U.S. health delivery system for medically underserved populations. Since the passage of the Patient Protection and Affordable Care Act, the federal government has created financial incentives for CHCs to improve care through access and quality performance criteria. To promote quality improvement, CEOs need to set their organization's priorities. One method used to achieve this goal is to tie the CEO's compensation to the organization's quality performance. However, there is a gap in our knowledge if CHCs' CEOs compensation is associated with quality performance outcomes. PURPOSE: The primary aim of this study was to examine the relationship between clinical performance and CEO compensation in CHCs. METHODS/APPROACH: Agency, social comparison, and managerial power theories guided this research, which examines the relationship of clinical performance and CEO compensation. Secondary data on Uniform Data System's CHC clinical performance combined with CEO compensation from Internal Revenue Service Form 990 were analyzed using generalized estimating equations with state and year fixed effects on a national sample of section 330 grant-funded CHCs (N = 984) for the period 2011-2016. RESULTS: We found no evidence that clinical performance was associated with CHCs' CEO compensation. Except for race, all other CEO characteristics were positively associated with CEO compensation and in line with previous research. We found that non-White CEOs were compensated more than White CEOs. In addition, further subanalyses revealed that an increase in the highest paid employees' compensation was associated with an increase in CEO compensation. PRACTICE IMPLICATIONS: The findings of this study can assist Health Resources and Services Administration improve its assessment policies in funding allocation to CHCs, as well as help board members make informed decisions regarding tying CEO compensation to predetermined performance metrics.


Assuntos
Diretores de Hospitais , Patient Protection and Affordable Care Act , Benchmarking , Centros Comunitários de Saúde , Humanos , Salários e Benefícios , Estados Unidos
5.
J Healthc Manag ; 66(1): 48-61, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33411486

RESUMO

EXECUTIVE SUMMARY: Financial distress is a persistent problem in U.S. hospitals, leading them to close at an alarming rate over the past two decades. Given the potential adverse effects of hospital closures on healthcare access and public health, interest is growing in understanding more about the financial health of U.S. hospitals. In this study, we set out to explore the extent to which relevant organizational and environmental factors potentially buffer financially distressed hospitals from closure, and even at the brink of closure, enable some to merge with other hospitals. We tested our hypotheses by first examining how factors such as slack resources, environmental munificence, and environmental complexity affect the likelihood of survival versus closing or merging with other organizations. We then tested how the same factors affect the likelihood of merging relative to closing for financially distressed hospitals that undergo one of these two events. We found that different types of slack resources and environmental forces impact different outcomes. In this article, we discuss the implications of our findings for hospital stakeholders.


Assuntos
Fechamento de Instituições de Saúde , Hospitais , American Hospital Association , Estados Unidos
6.
J Healthc Manag ; 65(5): 366-377, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925536

RESUMO

EXECUTIVE SUMMARY: An increasing number of lesbian, gay, bisexual, and transgender (LGBT) individuals openly acknowledge their identity; however, the fear of discrimination prevents many from seeking healthcare-an issue challenged by a lack of culturally competent LGBT healthcare providers. With more than 4% of American adults identifying as LGBT individuals, greater attention to their needs is imperative to improve care and access for this population. This study examined organizational and market factors associated with hospitals achieving the "Leader in LGBT Healthcare Equality" (Healthcare Equality Index, HEI; HEI Leader) designation and reported patient experience scores. We found that system-affiliated hospitals have 4.16 greater odds and teaching hospitals have 2.86 greater odds of earning the HEI Leader designation compared to nonsystem and nonteaching hospitals, respectively. Governmental hospitals have 2.47 greater odds of achieving HEI Leader status, while for-profit hospitals have 86% lower odds of having HEI Leader status compared to not-for-profit hospitals. Hospitals located in a metropolitan area have 3.19 greater odds of being an HEI Leader. The percentage of minorities and per capita income in a county also demonstrated a positive association with being an HEI Leader, with odds ratios of 1.00 and 1.02, respectively, while lower education was associated with 4% lower odds of being an HEI Leader. The main finding of this study was that HEI Leader-designated hospitals reported significantly higher overall hospital rating patient experience scores (B = 1.785; p ≤ .001) as compared to non-HEI Leader hospitals. As such, participation in the HEI may be viewed as a motivation for hospitals attaining HEI Leader designation.


Assuntos
Pessoal de Saúde/psicologia , Disparidades em Assistência à Saúde/organização & administração , Liderança , Satisfação do Paciente/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
7.
J Patient Exp ; 7(2): 263-269, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32851150

RESUMO

This study examined the association between interdepartmental transfers and the perceptions of care received by adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. Transfers of patient care are daily and frequent hospital processes. However, limited attention has focused on the effect that intrahospital transfers of care have on the patient experience. Understanding this relationship is important, since value-based purchasing models directly tie patient experience measures into hospital reimbursements. The key finding of this study indicates that as patients' transfers increase, their perceptions of care decrease. Therefore, by reducing the frequency of interdepartmental transfers, patient satisfaction may increase. This research provides clinicians and administrators a better understanding of the relationship between a frequent and a daily hospital process (ie, interdepartmental transfers) and its influence on patients' perceptions of their experience.

8.
J Healthc Qual ; 42(5): 287-293, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31703021

RESUMO

A national sample (N = 982) of federally qualified health centers (FQHCs) for the period 2011-2016 was examined regarding the relationship between the age and extent of health information technology (HIT) use and clinical performance. We found that each additional year of HIT use was associated with an approximate 4 percent increase in both process and outcome measures of clinical performance. Furthermore, FQHCs that fully adopted HIT had 7 percent higher clinical performance on hypertension control than those that did not adopt HIT. This study's findings can assist stakeholders to make informed decisions for improving care and sustaining a competitive advantage.


Assuntos
Centros Comunitários de Saúde/organização & administração , Centros Comunitários de Saúde/estatística & dados numéricos , Eficiência Organizacional , Informática Médica/organização & administração , Informática Médica/estatística & dados numéricos , Financiamento Governamental , Humanos , Resultado do Tratamento , Estados Unidos
9.
Artigo em Inglês | MEDLINE | ID: mdl-31219912

RESUMO

BACKGROUND: Most research of chief executive officer (CEO) compensation in the health care industry has been limited to hospitals. This study expands our knowledge of CEO compensation into the nonhospital areas of the industry, specifically community health centers (CHCs). CHCs are safety-net providers that are an integral part of the U.S. health delivery system for medically underserved populations. Since the passage of the Patient Protection and Affordable Care Act, the federal government has created financial incentives for CHCs to improve care through access and quality performance criteria. To promote quality improvement, CEOs need to set their organization's priorities. One method used to achieve this goal is to tie the CEO's compensation to the organization's quality performance. However, there is a gap in our knowledge if CHCs' CEOs compensation is associated with quality performance outcomes. PURPOSE: The primary aim of this study was to examine the relationship between clinical performance and CEO compensation in CHCs. METHODS/APPROACH: Agency, social comparison, and managerial power theories guided this research, which examines the relationship of clinical performance and CEO compensation. Secondary data on Uniform Data System's CHC clinical performance combined with CEO compensation from Internal Revenue Service Form 990 were analyzed using generalized estimating equations with state and year fixed effects on a national sample of section 330 grant-funded CHCs (N = 984) for the period 2011-2016. RESULTS: We found no evidence that clinical performance was associated with CHCs' CEO compensation. Except for race, all other CEO characteristics were positively associated with CEO compensation and in line with previous research. We found that non-White CEOs were compensated more than White CEOs. In addition, further subanalyses revealed that an increase in the highest paid employees' compensation was associated with an increase in CEO compensation. PRACTICE IMPLICATIONS: The findings of this study can assist Health Resources and Services Administration improve its assessment policies in funding allocation to CHCs, as well as help board members make informed decisions regarding tying CEO compensation to predetermined performance metrics.

10.
J Healthc Manag ; 63(1): 50-61, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29303825

RESUMO

EXECUTIVE SUMMARY: Efforts by hospitals to improve patient experience continue as changes in policy such as the Affordable Care Act of 2010 have made patient experience a cornerstone of promoting greater value in the United States. Hospital CEOs play an important role in promoting positive patient experiences as they set the organizational vision and strategic goals and can execute change to support positive experiences.This study assessed whether three CEO characteristics-education, tenure with the organization, and gender-were associated with patient experience scores of California hospitals in 2013 and 2014. Using a pooled, cross-sectional design with ordinary least squares regression to account for other hospital and market characteristics, the analysis indicated that hospitals with female CEOs and longer-tenured CEOs were associated with more positive patient experience scores. Higher levels of education were not significantly associated with patient experience scores. Overall, the model covariates accounted for approximately 14.0% of the variance in patient experience scores between hospitals, with CEO characteristics accounting for approximately 2.4% of this variation. Such findings highlight the important yet emerging role of CEO characteristics when accounting for patient experience.


Assuntos
Diretores de Hospitais/estatística & dados numéricos , Diretores de Hospitais/normas , Escolaridade , Liderança , Satisfação do Paciente/estatística & dados numéricos , Competência Profissional , Fatores Sexuais , Adulto , California , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
11.
Anesth Analg ; 125(6): 1840-1842, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29189362
12.
Health Serv Manage Res ; 30(2): 129-137, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28539085

RESUMO

Despite the increasingly global nature of health care, much of the research about journal rankings and directions for future research in health care management is from a United States based viewpoint. There is a lack of information about influential journals and trends for health care management research from a global perspective. This exploratory study gathered the opinions of health care management researchers from 17 countries regarding which journals are considered most influential, popular research topics and areas needing more attention from the research community. An online survey was sent to individuals in high-income Organisation for Economic Co-operation and Development countries who were identified through author relationships, academic institution websites, editorial boards of international journals, and academic and practitioner associations in the countries of interest. Results indicate that journal rankings vary substantially from prior published studies evaluating health care management journals and international ranking lists, and the list of influential journals includes a much more diverse array of publications. Respondents also indicated a diverse number of topics for current and future research, highlighting the global complexity of the field. The implications of this study are valuable to scholars evaluating outlets for disseminating research, and highlighting areas for collaborative research in health care management globally.


Assuntos
Bibliometria , Administração de Serviços de Saúde , Publicações Periódicas como Assunto , Humanos , Fator de Impacto de Revistas , Organização para a Cooperação e Desenvolvimento Econômico , Publicações , Pesquisadores , Estados Unidos
15.
J Ambul Care Manage ; 36(2): 129-39, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23448919

RESUMO

Change interventions in one form or another are viewed as important tools to reduce variation in medical services, reduce costs, and improve quality of care. With the current focus on efficient resource use, the successful design and implementation of change strategies are of utmost importance for health care managers. We present a case study in which macro and micro level change strategies were used to modify primary care physicians' practice patterns of prescribing diagnostic services in a safety-net's ambulatory clinics. The findings suggest that health care managers using evidence-based strategies can create a practice environment that reduces barriers and facilitates change.


Assuntos
Instituições de Assistência Ambulatorial/economia , Comportamento Cooperativo , Eficiência Organizacional/economia , Medicina Geral/organização & administração , Pobreza , Padrões de Prática Médica/organização & administração , Análise Custo-Benefício , Humanos , Inovação Organizacional , Estados Unidos
16.
J Health Hum Serv Adm ; 34(1): 42-63, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21847875

RESUMO

PURPOSE: This article explores the participation of healthcare managers in professional development (PD) activities, the reasons for seeking PD and the perceived support of their organizations in terms of reward and recognition. METHODOLOGY: An exploratory survey was emailed to current and past members of three professional associations who share similar missions "to provide educational and networking opportunities" for their members in the southern region of Florida. FINDINGS: Findings suggest that healthcare managers and healthcare organizations both support and value personal and professional development. Certification by professional organizations appears to be a key credential for upward mobility. RESEARCH LIMITATIONS: This study serves as an initial attempt to account for the factors that explain differences in pursuing professional development activities. Given the exploratory nature of the study and low response rates, the findings provide direction for further research rather than conclusive judgments. PRACTICAL IMPLICATIONS: Continuous learning by managers and organizations should allow the healthcare industry to position itself for future challenges. ORIGINALITY: Across all settings, positions, age groups, and perceived organizational support, individuals seek professional certification suggesting recognition of the professional value associated with these certifications. The value attributed to certification and PD by healthcare managers is further demonstrated by our finding that individuals engage in these activities even in the absence of employer reimbursement.


Assuntos
Atitude , Administradores de Instituições de Saúde/psicologia , Desenvolvimento de Pessoal , Adulto , Educação Continuada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
J Ambul Care Manage ; 33(2): 124-30, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20228635

RESUMO

Designated primary care clinics largely serve low-income and uninsured patients who present a disproportionate number of chronic illnesses and face great difficulty in obtaining the medical care they need, particularly the access to specialty physicians. With limited capacity for providing specialty care, these primary care clinics generally refer patients to safety net hospitals' specialty ambulatory care clinics. A large public safety net health system successfully improved the effectiveness and efficiency of the specialty clinic referral process through application of Lean Six Sigma, an advanced process-improvement methodology and set of tools driven by statistics and engineering concepts.


Assuntos
Instituições de Assistência Ambulatorial , Eficiência Organizacional , Encaminhamento e Consulta/organização & administração , Gestão da Qualidade Total/métodos , Serviço Hospitalar de Emergência , Acesso aos Serviços de Saúde , Pobreza
18.
Health Care Manage Rev ; 32(2): 160-7, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17438399

RESUMO

BACKGROUND: The increase in demand for registered nurses will exceed supply by 29% by 2020, which is due in part to difficulties in retaining the existing nursing workforce. The researchers postulated that nursing professionals are experiencing a higher level of job dissatisfiers than motivators, and this is causing a high percentage of nurses to consider leaving the profession. Prior research has found that nurses' dissatisfaction with their working environments is a predictor of their intent to leave their professions; however, few have addressed the demographic characteristics of the population as predictors of this intent. PURPOSE: The purpose of this study was to explore issues relating to the retention of the existing nursing workforce. This article describes the results of a research study that was designed to identify and evaluate the variables that contribute to nurses' intent to leave their profession and the relationships of gender, ethnicity, and educational levels to this intent. METHODOLOGY: Data were collected from 284 nurses, of which 46% indicated that they were considering leaving their profession. Using multiple regression analysis, the researchers were able to test whether certain groups (according to gender, ethnicity, and education levels) had a greater intent to leave the profession and what factors were related to each subgroups' intent to leave. FINDINGS: The results of this study revealed that (a) nurses who are male, are White-non-Hispanic, or have less than a master's degree are more inclined to consider leaving the nursing profession, and (b) benefits were a more important consideration to male and White-non-Hispanic nurses regarding their intent to leave the nursing profession. PRACTICE IMPLICATIONS: In today's environment of low reimbursement and high cost containment, health care managers need to focus on those items that will have the greatest impact on retaining high-quality nurses because nurses "make the critical, cost-effective difference in providing safe, high-quality patient care."


Assuntos
Escolaridade , Grupos Étnicos , Intenção , Enfermeiras e Enfermeiros , Lealdade ao Trabalho , Mobilidade Ocupacional , Coleta de Dados , Feminino , Florida , Humanos , Masculino , Fatores Sexuais
19.
J Health Hum Serv Adm ; 28(4): 531-49, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16583850

RESUMO

Using DiMaggio and Powell's concept of institutional isomorphism, the authors explain why healthcare lags behind other industries in innovating new production functions that address quality. Healthcare finns can "learn" to be entrepreneurial organizations within Stevenson's 'entrepreneurial versus administrative behavior' framework and Covin and Slevin's model of an entrepreneurial organization's required culture and behavioral support structure.


Assuntos
Empreendedorismo , Setor de Assistência à Saúde/organização & administração , Garantia da Qualidade dos Cuidados de Saúde , Estados Unidos
20.
J Health Adm Educ ; 22(4): 365-79, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16485783

RESUMO

This paper describes the development and implementation of an undergraduate health administration program for nontraditional students at a Hispanic serving institution. The program had to meet the needs of a diverse, adult student population, the local community, and the future leadership requirements of the healthcare industry. As such, the program was designed as a "bridge" for full-time employed healthcare licensed professionals seeking to complete a baccalaureate degree and obtain positions in the healthcare management field. It answered the call of the local community to strengthen partnerships between business and education by offering the program at healthcare employer worksites. Furthermore, the program addressed three needs of the healthcare industry: (1) the recognized shortage of future healthcare leaders, (2) the under-representation of minorities in the industry, and (3) proposed changes in health administration programs' curricula to focus on competencies in the areas of communication skills, decision making, ethical leadership, and self-development.


Assuntos
Currículo , Administradores de Instituições de Saúde/educação , Administração de Serviços de Saúde , Hispano-Americanos/educação , Adulto , Relações Comunidade-Instituição , Educação Baseada em Competências , Humanos , Indústrias , Liderança , Estados Unidos , Universidades
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...