Managerial process improvement: a lean approach to eliminating medication delivery.

Purpose: Statistical evidence shows that medication errors are a major cause of injuries that concerns all health care oganizations. Despite all the efforts to improve the quality of care, the lack of understanding and inability of management to design a robust system that will strategically target those factors is a major cause of distress. The paper aims to discuss these issues.

Health information technology capacity at federally qualified health centers: a mechanism for improving quality of care.

Background: The adoption of health information technology has been recommended as a viable mechanism for improving quality of care and patient health outcomes. However, the capacity of health information technology (i.e.

Strategies for dealing with future shortages in the nursing workforce: a review.

The well-anticipated and well-documented demographic shift attributed to ageing of the baby boomer generation will place significant demands upon the health-care industry in the future. Significant resources such as the nurse workforce, will be needed to provide health-care services to this cohort. There is a looming shortage of professional and paraprofessional nurses.

Strategic groups in health care: a literature review.

The purpose of this study is to review the literature that discusses the relationship between strategic group membership and performance in the nursing home industry. This literature review examines the relationship between organizational structure and performance in the nursing home industry. Results from these studies suggest industry stability of segmentation; limitation of strategic choice due to high mobility barriers (as represented by facility, staffing and location variables); quality is controlled by the existing combinations of industry regulation and market competition; and the existence of performance differences among strategic groups.

The empowerment and quality health value propositions of e-health.

E-health, as well as its value and benefits, has been characterized as a concept defined in various ways depending on intended audience and use. Attempts to define, characterize and appreciate e-health inadvertently portray it as something out of main stream academia; thus, undermining the relevance and importance of the transformation capabilities of e-health on the practice of health care from the individual and organizational perspectives. In order to contribute towards an understanding and appreciation of e-health as a main stream concept, we propose the use of existing models, theories and principles in support of e-health.

The importance of examining movements within the US health care system: sequential logit modeling.

Background: Utilization of specialty care may not be a discrete, isolated behavior but rather, a behavior of sequential movements within the health care system. Although patients may often visit their primary care physician and receive a referral before utilizing specialty care, prior studies have underestimated the importance of accounting for these sequential movements.

Methods: The sample included 6,772 adults aged 18 years and older who participated in the 2001 Survey on Disparities in Quality of Care, sponsored by the Commonwealth Fund.

Specialty care use in US patients with chronic diseases.

Despite efforts to eliminate health disparities, racial, ethnic, and geographic groups continue lag behind their counterparts in health outcomes in the United States. The purpose of this study is to determine variation in specialty care utilization by chronic disease status. Data were extracted from the Commonwealth Fund 2006 Health Care Quality Survey (n = 2475).

Treatment disparities in medication prescribing for Alzheimer's: disease among ethnic groups.

Objectives: The purpose of this explanatory study was to determine whether medication prescribing for Alzheimer's disease (AD) differs by racial and ethnic group membership. The following research question was examined in this study: Are there prescribing pattern differences for AD among racial and ethnic groups? Additional beneficiary characteristic variables examined included: diabetes, memory loss, psychological disorder, age category, and gender.

Methods: This research project employed a time series study design to analyze three years of a national secondary dataset to examine Medicare beneficiaries with Alzheimer's disease (AD).

Risk factor and cost accounting analysis for dialysis patients in Taiwan.

According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations.

Policy challenges in US health care system reform.

Once again, efforts are being made to overhaul the US health care system. Democrats and Republicans have conflicting views on how to repair this ailing system. However, this is not a new phenomenon.

Data mining for health executive decision support: an imperative with a daunting future!

Data mining is highly profiled. It has the potential to enhance executive information systems. Such enhancement would mean better decision-making by management, which in turn would mean better services for customers.

Strategic information technology alliances for effective health-care supply chain management.

To gain and sustain competitive advantage, health-care providers have to continuously review and renovate their operational and information technology (IT) strategies through collaborative and cooperative endeavour with their supply chain channel members. This paper explores new ways of enhancing a health-care organization's responsiveness to changes and increasing its competitiveness through implementing strategic information technology alliances among channel members in a health-care supply chain network. An overview of issues and problems (e.

A strategic approach of E-health initiatives.

The Internet is transforming the US economy. Though it continues to lag behind other industries, healthcare has begun to incorporate this technology on a wider scale to reduce costs and more effectively address quality and patient-choice issues. This article presents the background of the US healthcare system, examines the application of e-health, advocates for the integration of e-health components and discusses the roles of major stakeholders in e-health as the basis for the strategic planning, initiation and implementation of integrated e-health systems.

Confronting the challenges of long-term health care crisis in the United States.

This article examines the factors that comprise long-term health care and the impact that the aging population will have in dramatically increasing the costs of long-term health care in the United States if current health policies are not amended. It further analyzes the reasons that will cause the health care expenditures to expand. It also discusses the economic challenges and the impact that absent reform can have on state and federal budgets, ultimately affecting the national economy.

The economic value of investing in regenerative medicine.

This article discusses the science of regenerative medicine and presents evidence that investments towards the development of this technology will reduce total health care output. Use of regenerative medicine will also be an important factor in eliminating chronic diseases such as diabetes, heart disease, and Parkinson's disease. Investment in regenerative medicine is a sound strategy for several reasons: human suffering will be reduced, if not eliminated; and the economy will be stimulated by creating employment opportunities, generating additional income and tax revenues, increasing worker productivity, creating new conglomerates, and reducing insurance costs.

Prescription drug spending: contribution to health care spending and cost containment strategies.

Prescription drug costs have been the focus of much research in the health care economy, within managed care organizations, and hospital systems. Pharmacy costs are drivers of general health care spending, premium increases, and to a lesser extent, hospital spending. Factors contributing to increased prescription spending include increased prescription use, replacement of older, cheaper drugs with new and more expensive ones, and the costly prices of retail prescription drugs.

The impact of HMO and hospital competition on hospital costs.

This study examines the impact of HMO penetration and competition on health system performance, as measured by hospital cost per adjusted admissions. The study population consisted of acute-care hospitals in the United States. The findings of this study suggest that there is no relationship between HMO competition and hospital cost per adjusted admission.

Does increasing cigarette excise tax improve people's health? The cases of heart attacks and stroke.

Introduction: Recently, public health advocates have fervently supported an increase in the cigarette excise tax as a means of reducing smoking. Likewise, political leaders have heavily relied on the cigarette excise tax as a means of encouraging a reduction in the overall rates of cigarette use. However, little is known about whether the cigarette excise tax is a valid tool for reducing the negative effects of smoking on public health.

Health care competition, strategic mission, and patient satisfaction: research model and propositions.

Purpose: In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers This paper aims to develop a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the health care industry.

Design/methodology/approach: A literature review was conducted.

Racial and ethnic disparities in the use of mental health services.

The authors used data from the 1998-1999 Community Tracking Study (CTS) household survey to examine variations in predictors of use of mental health services among different racial and ethnic groups (white, African American, Hispanic, and other). African Americans and Hispanics were less likely to have visited a mental health professional (MHP) in the prior year than were whites. Independent of health insurance and health status, low- to middle-income African Americans may be at particular risk for inadequate use of an MHP compared to higher-income African Americans.

A research model of health-care competition and customer satisfaction.

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for customers. In other words, competition ensures the provision of better products and services to satisfy the needs of customers. Various perspectives of competition, the nature of service quality, health-care system costs and customer satisfaction in health care are examined.

The effects of location and race on the performance of cardiac procedures.

This study assessed the impact of patient and facility characteristics on patient outcomes for coronary artery disease. The sample data studied and analyzed (i.e.

Comparison of health behaviors among single- and multiple-member households.

Objective: To assess the differences in health behavior between multiple-member and single-member households by gender.

Methods: Face-to-face household survey interviews were conducted. The relationship between health behaviors and living arrangement was assessed by adjusting for SES.

Managing and analysing a large health-care system database for predicting in-hospital mortality among acute myocardial infarction patients.

There is increasing interest in the identification of predictors of risk for in-hospital mortality due to acute myocardial infarction (AMI). This study identified significant predictors of in-hospital mortality among AMI patients using a patient level clinical database. The study population consisted of 4167 cases admitted between October 1999 and April 2001 with a principal diagnosis of AMI to 36 hospitals in three US states.

Effects of maternal and provider characteristics on up-to-date immunization status of children aged 19 to 35 months.

Objectives: We examined the effects of maternal and provider characteristics on the up-to-date immunization status of children.

Methods: We used data from the 2003 National Immunization Survey to determine variations in children's up-to-date status in the 4:3:1:3 immunization series.

Results: Low maternal educational levels and low socioeconomic status were associated with high 4:3:1:3 series completion rates.