Faced with shrinking patient rolls and reduced federal support, hospitals across the country are offering a wide variety of new and--for them--unconventional services to bolster their finances. Although the services themselves aren't always profitable, hospital administrators hope the programs will give their facilities a positive image and persuade customers to return when they need medical care.

istorically, a “we versus them” relationship among many hospital administrators and physicians has bred mistrust and poor communication. Relationships became even more strained in the 1990s, after hospitals bought physicians’ practices and then sold hundreds of them. In many cases, physicians responded by opening delivery centers of their own — competing outpatient surgery and imaging centers a...

In 1996, Duke Children's Hospital was in serious trouble. Its $11 million annual operating loss had forced administrators to make cutbacks. As a result, some caregivers felt that the quality of care had deteriorated. Parents' complaints were on the rise. Frustrated staff members were quitting. In this article, Jon Meliones, DCH's chief medical director, candidly describes how his debt-ridden ho...

BACKGROUND The influenza vaccination rate in hospitals among health care workers in Europe remains low. As there is a lack of research about management factors we assessed factors reported by administrators of general hospitals that are associated with the influenza vaccine uptake among health care workers. METHODS All 81 general hospitals in the Netherlands were approached to participate in ...

OBJECTIVES To describe the concerns and priorities of key stakeholders in a developing country regarding ethical obligations held by researchers and perceptions of equity or "what is fair" for study participants in an HIV/AIDS clinical drug trial. DESIGN Qualitative study with focus groups. SETTING Teaching and referral hospital and rural health centre in Western Kenya. PARTICIPANTS Poten...

In 2008, Medicare implemented a policy limiting reimbursement to hospitals for treating avoidable hospital-acquired conditions (HACs). Although the policy will expand nationally to Medicaid programs in 2011, little is known about the impact on safety net hospitals. The authors conducted interviews with 60 chief quality officers and 55 chief financial officers from safety net hospitals to explor...