Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.160
Filtrar
3.
J Am Med Inform Assoc ; 26(3): 188-197, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30597001

RESUMO

Objective: There is global interest in implementing national information systems to support healthcare, and the National Health Service in England (NHS) has a troubled 25-year history in this sphere. Our objective was to chronicle structural reorganizations within the NHS from 1973 to 2017, alongside concurrent national information technology (IT) strategies, as the basis for developing a conceptual model to aid understanding of the organizational factors involved. Materials and Methods: We undertook an exploratory, retrospective longitudinal case study by reviewing strategic plans, legislation, and health policy documents, and constructed schemata for evolving structure and strategy. Literature on multi-organizational forms, complexity, national-level health IT implementations, and mega-projects was reviewed to identify factors that mapped to the schemata. Guided by strong structuration theory, these factors were superimposed on a simplified structural schema to create the conceptual model. Results: Against a background of frequent NHS reorganizations, there has been a logical and emergent NHS IT strategy focusing progressively on technical and data standards, connectivity, applications, and consolidation. The NHS has a complex and hierarchical multi-organization form in which restructuring may impact a range of intra- and inter-organizational factors. Discussion: NHS-wide IT programs have generally failed to meet expectations, though evaluations have usually overlooked longer-term progress. Realizing a long-term health IT strategy may be impeded by volatility of the implementation environment as organizational structures and relationships change. Key factors influencing the strategy-structure dyad can be superimposed on the tiered NHS structure to facilitate analysis of their impact. Conclusion: Alignment between incremental health IT strategy and dynamic structure is an under-researched area. Lessons from organizational studies and the management of mega-projects may help in understanding some of the ongoing challenges.


Assuntos
Informática Médica/história , Medicina Estatal/história , História do Século XX , História do Século XXI , Informática Médica/organização & administração , Modelos Organizacionais , Estudos Retrospectivos , Medicina Estatal/organização & administração , Reino Unido
4.
Health Econ Policy Law ; 14(1): 1-10, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29307315

RESUMO

The paper analyses the achievements and problems stemming from Nye Bevan's model of a tax funded national health care system, on the assumption that only so could equity be achieved. The evidence shows that indeed the National Health Service (NHS) scores highly on equity, so vindicating Bevan's vision. The price paid is that fiscal crises are the norm for the NHS, with ever more centralisation, intensive regulation and performance management. Successive reorganisations represent attempts to square the circle - to combine the strengths of Bevan's model and those of a less hierarchic system - but have so far failed to deliver and can be expected to continue.


Assuntos
Medicina Estatal/história , Medicina Estatal/organização & administração , História do Século XX , História do Século XXI , Reino Unido
5.
Health Econ Policy Law ; 14(1): 29-39, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29655400

RESUMO

The British National Health Service (NHS) celebrates its 70th birthday on 5 July 2018. This paper examines this anniversary through the lens of previous anniversaries, exploring two strands of political debates and NHS documents. It draws on the basic 'multiple streams model' of Kingdon that argues that an issue reaches the agenda when the policy window opens to allow the coupling of three independent streams - policy, problem and politics. It is found that there appears to be some discontinuity in the problem stream; some periods of relative consensus and sharp political differences in the politics stream; and sharp variations over time in the policy stream. While it is clear that there have been both continuities and discontinuities in the problem, politics and policy streams over the past 70 years, they have rarely come together to result in a policy that has taken it off the agenda.


Assuntos
Formulação de Políticas , Política , Medicina Estatal/história , História do Século XX , História do Século XXI , Reino Unido
15.
Asclepio ; 70(1): 0-0, ene.-jun. 2018.
Artigo em Espanhol | IBECS | ID: ibc-173502

RESUMO

Este artículo aporta nuevos datos sobre la médica argentina Telma Reca (1904-1979), particularmente en relación con su inserción en ámbitos académicos y en la gestión estatal a partir de los años treinta del siglo XX. Nos focalizaremos en su trayectoria profesional desde que obtuvo su doctorado en la Universidad de Buenos Aires (1932) hasta que se retiró de la División de Maternidad e Infancia del Departamento Nacional de Higiene en 1948. Durante ese período aplicó en la gestión estatal sus investigaciones sobre el estudio de las condiciones sociales de la delincuencia juvenil y de la educación. Su perspectiva crítica, lejos de implementar medidas punitivas generadoras de una mayor exclusión social, buscó la integración de los menores en la comunidad por medio de políticas educativas y sanitarias


This article will reconstruct the biography of the Argentine physician Telma Reca (1904-1979) who managed to get involved in academic fields and the state administration in the 30's. We will address ourselves to tracking her professional career from her PhD degree in Medicine (1932) until her withdrawal from the División de Maternidad e Infancia del Departamento Nacional de Higiene (Maternity and Childhood Division of the National Hygiene Department) in 1948. During this period, she focused her research on the study of the social conditions of juvenile delinquency on the public administration. With a critical eye, far from social exclusion and punitive measures, she managed to promote social integration through health and education policies


Assuntos
Humanos , Médicas/história , Política Pública/história , Políticas Públicas de Saúde , Planos Governamentais de Saúde/história , Medicina Estatal/história , Argentina , Administração de Serviços de Saúde/história , Educação Médica/história , História da Medicina
16.
Br J Nurs ; 27(9): 493-495, 2018 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-29749790

RESUMO

In celebration of International Nurses Day, Jane Cummings, Jean White, Fiona McQueen and Charlotte McArdle, Chief Nursing Officers (CNOs) for England, Wales, Scotland and Northern Ireland, share their thoughts on this important day in the nursing calendar.


Assuntos
Assistência à Saúde/ética , Assistência à Saúde/história , Direitos Humanos , Cuidados de Enfermagem/ética , Medicina Estatal/ética , Medicina Estatal/história , Inglaterra , História da Enfermagem , História do Século XXI , Humanos , Irlanda do Norte , Escócia , País de Gales
18.
J R Coll Physicians Edinb ; 48(1): 78-84, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29741534

RESUMO

The Deaconess Hospital, Edinburgh, opened in 1894 and was the first establishment of its kind in the UK, maintained and wholly funded as it was by the Reformed Church. Through its 96-year lifetime it changed and evolved to time and circumstance. It was a school: for the training of nurses and deaconesses who took their practical skills all over the world. It was a sanctum: for the sick-poor before the NHS. It was a subsidiary: for the bigger hospitals of Edinburgh after amalgamation into the NHS. It was a specialised centre: as the Urology Department in Edinburgh and the Scottish Lithotripter centre. And now it is currently student accommodation. There is no single source to account for its history. Through the use of original material made available by the Lothian Health Services Archives - including Church of Scotland publications, patient records, a doctor's casebook and annual reports - we review its conception, purpose, development and running; its fate on joining the NHS, its identity in the latter years and finally its closure.


Assuntos
Hospitais Religiosos/história , Escolas de Enfermagem/história , História do Século XIX , História do Século XX , Hospitais Religiosos/organização & administração , Hospitais de Ensino/história , Hospitais de Ensino/organização & administração , Missionários/educação , Missionários/história , Escócia , Medicina Estatal/história
20.
Br J Community Nurs ; 23(5): 225-228, 2018 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-29708789

RESUMO

This article reflects on the history of the NHS in Wales and how this has led to its current structure. How this structure supports integrated working across primary, community and secondary care and how further integration with social care is moving forward and its direct effects on district nursing are explored. This article describes how district nursing is meeting these challenges. Support for district nurses as part of integrated multiprofessional teams is being developed to promote appropriately staffed teams centred on meeting the requirements of people within a designated area and ensuring that home is the best and first place of care.


Assuntos
Enfermagem em Saúde Comunitária/organização & administração , Admissão e Escalonamento de Pessoal/organização & administração , Atenção Primária à Saúde/organização & administração , Especialidades de Enfermagem/organização & administração , Medicina Estatal/história , Medicina Estatal/organização & administração , Recursos Humanos/organização & administração , Adulto , Enfermagem em Saúde Comunitária/história , Feminino , História do Século XX , História do Século XXI , Humanos , Masculino , Pessoa de Meia-Idade , Admissão e Escalonamento de Pessoal/história , Atenção Primária à Saúde/história , Especialidades de Enfermagem/história , Reino Unido , País de Gales , Recursos Humanos/história
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA