This article introduces a conceptual model for understanding how young women perceive the current challenges of leadership. Numerous studies and articles claim that women are better educated, more experienced, and better suited for leadership positions than ever before. This news is encouraging, but the number of women in leadership roles in American politics gained less than one percentage point this year, hovering around 22%, while in the private sector many organizations have yet to place a single woman on their board. The proportion of women on corporate boards is 16%, with no evidence that this is likely to grow in the near future. What is even more discouraging is that these low numbers are not significantly higher than those in many developing nations. It is evident that women are underrepresented in top leadership positions and must intensely challenge the status quo. This article presents results of a study based on in-depth interviews with college women who are seeking paths to leadership. The researchers employ qualitative analytical research tools to explore the complexities of the phenomena. The findings bring a greater understanding of the antecedents and consequences that lie beneath the challenges affecting the next generation of women leaders.
To identify differences in groups of children with special healthcare needs (CSHCN) identified as underinsured by two alternate definitions and discuss implications for policy decisions based on using one definition over another. Secondary data from the National Survey of CSHCN 2005/2006 were analyzed. Only CSHCN who were continuously-insured for 12 months were included in analyses. We identified groups of underinsured CSHCN using two general definitions ("economic" and "attitudinal") and three mutually-exclusive groups (identified by both definitions, identified by attitudinal but not economic, and identified by economic but not attitudinal). Key variables included demographics and condition characteristics. Different underinsurance rates were identified [attitudinal = 30.9 % (n = 11,470); economic = 22.7 % (n = 8,447)] with fair agreement by kappa score (κ = 0.3194; Z = 65.91; p > 0.0001). Differences across mutually-exclusive groups included family income ≥400 % FPL (attitudinal only = 34.2 %, economic only = 16.3 %, both = 18.4 %; p < 0.001) and high severity (attitudinal only = 42.5 %, economic only = 68.5 %, both = 69.9 %; p < 0.001). CSHCN who needed equipment/supplies/home health (OR = 1.31, p < 0.001) had increased odds of being identified as underinsured by the economic, but not attitudinal definition. CSHCN with private insurance had increased odds of being identified by attitudinal only or both definitions, but not by economic only (AO: OR = 1.41, p < 0.001; BOTH: OR = 2.36, p < 0.001). Despite overlap between the two definitions, choosing either one excludes some CSHCN, potentially underestimating the extent of underinsurance and masking important findings related to specific conditions characteristics. A definition that comprehensively identifies and describes underinsurance is vital to translating health insurance coverage expansion into benefit packages that meet complex health and service needs.
The rising cost of US health care has precipitated some close examination as to the supply, distribution, and specialty choice of the physician workforce. It is an issue of considerable concern as America struggles to control health-care expenditures by shifting resources away from specialty medicine. Central to this problem are the various programmes and incentives which have encouraged an excess number of residency positions and specialty training. Examines the consequences of an unregulated medical school structure and provides an overview of current policy alternatives designed to increase the number of primary care physicians, correct the problems of physician maldistribution, and limit the overall number of medical school graduates.
With states facing their worst financial crisis since World War II, Medicaid programs across the nation are facing a period of significant stress. Medicaid expenditures are a major part of most states' budgets, which make them an important target when policy makers and legislators are faced with budget deficits. This study compares programs across states and identifies major reform trends being used by state officials as they try to balance the needs of their Medicaid recipients with the realities of budget shortfalls. Our research illustrates that the short-term view prevails: many states have relied heavily on one time funding sources, such as tobacco settlement monies in conjunction with traditional cost controlling mechanisms (e.g., freezing provider reimbursement rates, reducing program eligibility levels, requiring prior authorization for services) as their means of addressing the current crisis.
This paper seeks to contribute to an understanding of how macro health systems work by comparing three possible sets of influences on national health care outcomes: 1) health care facilities and their presumed link to national affluence, 2) social characteristics which are assumed to promote healthy behavior, and 3) political variables in the form of welfare state development. Our findings bear both optimistic and pessimistic connotations. On the one hand, the somewhat limited importance of the first set of factors shows that good health in a country is not simply the function of high spending levels. However, the surprisingly strong role of "social development" in determining health care outcomes that emerges implies that much more than the direct provision of health care must be manipulated to ensure optimal health for a nation's population. Copyright 2000 by The Policy Studies Organization.
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