The New Language of Hospital Management

Alper, Philip R.

doi:10.1056/nejm198411083111910

Cited by 14 publications

(2 citation statements)

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“…Likely restrictions to these activities would be the standards of care as set by policy-makers, and the ethical code of professionals and health care institutions. Neither could be regarded as being always in place or effective, which may explain the reservations felt about for-profit hospitals (Relman, 1980;Ginzberg, 1984;Alper, 1984). The answer could lie in the establishment of the equivalent of a fair trade regulation concerning the effectiveness of health services.…”

Section: Remaining Prob Fernmentioning

confidence: 95%

The concept of gemeinschaft in health planning and management: A Japanese perspective

Ikegami

1985

Health Planning & Management

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The rationale for public involvement in the health sector lies mainly in realizing equity values. As the Gesellschaft relationship of utility maximization cannot be relied upon to arrive at a level of health care regarded as equitable in geographic and other terms, this article argues that there is need to focus on the Gemeinschaft relationship of humanitarian concern. Policy-makers would, firstly, have to define explicitly the objectives at each policy level; and, secondly, to convince and educate the public and the health providers that such is the way forward. At the operational level, the Japanese-style management with its emphasis on the mutual commitment of the management and the workers to the organization, would seem to offer a way to unify the fragmented interests within the hospital setting. A comparative study of the health systems of the UK, Japan and the US is made to evaluate the constraints and opportunities each country faces, or would face, in realizing the Gemeinschaft concept at the policy and operational levels. The conclusion reached is that, despite the difficulties, this concept appears to offer a viable alternative to the intensified conflict for resources in the health sector.

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Section: Remaining Prob Fernmentioning

confidence: 95%

The concept of gemeinschaft in health planning and management: A Japanese perspective

Ikegami

1985

Health Planning & Management

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“…These lower rates were offered to patients who subscribed to these services and who agreed to be treated exclusively by the contracted physician. However, expensive services were controlled and referrals to specialists were restricted (6).…”

Section: Introduction Of Managed Carementioning

confidence: 99%

Part IV: Reformers in medical education and practice: Effect of managed care organization in the United States

Entin

2003

Canadian Journal of Plastic Surgery

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qui avaient innové dans le domaine de la philosophie médicale ou des connaissances médicales. Quant à la 4 e partie, elle porte sur une période où la pratique de la médecine est soumise à de nouvelles conditions. Aux États-Unis, l'enseignement et la pratique de la médecine ont subi les répercussions de la participation des institutions financières à la gestion des soins de santé. MODÈLE D'ÉTUDE : Les réformateurs étaient des scientifiques qui correspondaient à notre définition de « réformateur », c'est-à-dire une personne dont l'intervention a rétabli, réorganisé ou amélioré la structure ou l'idéologie de la pratique de la médecine. RÉSULTATS : L'étude a montré que les réformes ont été apportées par des scientifiques qui possédaient le jugement critique et les capacités analytiques nécessaires pour influer sur l'orientation de l'enseignement et de la pratique de la médecine. Au cours des vingt dernières années, les institutions financières ont imposé divers critères qui nécessiteront probablement l'intervention de futurs réformateurs pour rétablir les objectifs oubliés. CONCLUSION : Les réformes se sont réalisées de différentes façons : par l'intuition, la modification des pratiques usuelles, les recherches laborieuses et les restructurations administratives. Aux États-Unis, la gestion actuelle des soins de santé a grand besoin de solutions nouvelles.

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Primary Care in Transition

Alper¹

1994

JAMA

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It is generally agreed that too few physicians have chosen careers in primary care. The advent of managed care as a popular method of health care provision is now affecting primary care physicians in ways that may further discourage enthusiasm for the practice of primary care and have an unintended negative effect on the primary care physician supply. In addition, the early implementation of the resource-based relative value scale by Medicare and some insurance carriers has been less beneficial to primary care physicians than expected and may even have been harmful to general internists. Efforts to improve the position of primary care physicians in relation to payers and among peers are hindered by the fact that, as a group, primary care physicians are less affluent, less influential, and greatly outnumbered by their more specialized colleagues. Consequently, some of the support currently directed toward primary care may be more apparent than real. My proposals, which aim both to protect and to enhance primary care practice, are the creation of separate primary care fee schedules and separate primary care budgets within health plans, changes in consumer protection rules that intrude on primary care practice, and the development of statewide primary care associations for mutual support and greater bargaining power. Some aspects of contracting and gatekeeping require further study.

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The New Language of Hospital Management

Cited by 14 publications

References 0 publications

The concept of gemeinschaft in health planning and management: A Japanese perspective

The concept of gemeinschaft in health planning and management: A Japanese perspective

Part IV: Reformers in medical education and practice: Effect of managed care organization in the United States

Primary Care in Transition

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