BACKGROUND Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challeng...

WHY HEALTHCARE REFORM IS REAL Heal thcare reform is being driven by four economic and social forces, the most potent of which is the rapidly rising cost of healthcare. At current rates of growth, it is predicted that in six years the annual healthcare costs for a family of four will be $30,000—more than the family will spend on food, housing, transportat ion, and clothing combined. These costs ...

The authors in this paper describe the process and findings of a participatory action research project between a college of nursing and a for-profit acute healthcare organization as practice environment transformation occurred, grounded in caring theory. The participatory action research process and findings emphasize the importance of the intention to know what matters and the required time, c...

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For many stand-alone hospitals, a merger, partnership, or affiliation may be the only option to access scale and remain viable in the nation's emerging new healthcare delivery system. These organizations can consider many options for affiliation, including traditional options such as affiliation with regional academic medical centers, a merger or takeover to become the corporate member of a lar...

In this study we examine the effects of transferring physicians from a compensation system based on salary to a profit-sharing system. Consistent with theory, we find that the change has a large and significant effect on the quantity of services provided. In addition, we find a selection effect, where the least productive doctors leave the company and more productive doctors join. We want to th...

P4P is the reimbursement incentive that is based on quality improvement, efficiency, which is dominating the healthcare landscape and CMS. A literature review was conducted to search for and review significant information regarding P4P and how it pertains to chronic conditions and reimbursement methods. This literature review displayed while some programs were able to display a benefit/ profit ...

Long-term healthcare organisations significantly benefit from Knowledge Management (KM). However, the extant literature has little empirical support for this statement. Using the KM instrument developed by Bontis and Fitz-enz (2002), this paper extends prior studies by evaluating behaviours within a not-for-profit context over several years. As such, it tests a comprehensive causal model that i...

On July 21, 1998, the nonprofit Allegheny Health, Education, and Research Foundation (AHERF) filed for bankruptcy, with $1.3 billion in debt and 65,000 creditors. The Pittsburgh-based organization had pursued an aggressive strategy of acquiring physicians and hospitals in the Philadelphia area. Its dramatic collapse prompted the entry of a for-profit hospital chain into the Philadelphia market,...

183. Evaluating Multidrug Resistance Prevalence and Antimicrobial Stewardship Preparedness in the Largest Not-For-Profit Healthcare System in the United States: Taking the First Step to Optimize Antimicrobial Use Roy Guharoy, PharmD, MBAS; Mohamad G. Fakih, MD, MPH; Gail Fraine, RN; Michelle Heavens, BSN, MHA; Ann Hendrich, RN, PhD; Medicine, University of Massachusetts Medical School, Worceste...