Management

Virtual District, Real Improvement: A Retrospective Evaluation of the Chancellor's District, 1996-2003

Virtual District, Real Improvement: A Retrospective Evaluation of the Chancellor's District, 1996-2003
New York University, Institute for Education and Social Policy,

Phenix, D., Siegel, D., Zaltsman, A. & Fruchter, N.
01/01/2004

This study is a retrospective analysis of the outcomes of the Chancellor’s District, a virtual district created to improve New York City’s most poorly performing public schools. New York City Schools Chancellor Rudy Crew initiated the district in 1996 to remove state-identified low-performing schools from their sub-district authorities, and to accelerate their improvement by imposing a centralized management structure, a uniform curriculum, and intensive professional development. The initiative was terminated in 2003 when a new, Mayoral-controlled regime restructured the city school system.

Wage inequality, health care, and infant mortality in 19 industrialized countries

Wage inequality, health care, and infant mortality in 19 industrialized countries
Social Science & Medicine Volume 58 Number 2, pages 279-292.

Macinko, J., Shi, L. & Starfield, B.
01/01/2004

This pooled, cross-sectional, time-series study assesses the impact of health system variables on the relationship between wage inequality and infant mortality in 19 OECD countries over the period 1970-1996. Data are derived from the OECD, World Value Surveys, Luxembourg Income Study, and political economy databases. Analyses include Pearson correlation and fixed-effects multivariate regression. In year-specific and time-series analyses, the Theil measure of wage inequality (based on industrial sector wages) is positively and statistically significantly associated with infant mortality rates--even while controlling for GDP per capita. Health system variables--in particular the method of healthcare financing and the supply of physicians--significantly attenuated the effect of wage inequality on infant mortality. In fixed effects multivariate regression models controlling for GDP per capita and wage inequality, variables generally associated with better health include income per capita, the method of healthcare financing, and physicians per 1000 population. Alcohol consumption, the proportion of the population in unions, and government expenditures on health were associated with poorer health outcomes. Ambiguous effects were seen for the consumer price index, unemployment rates, the openness of the economy, and voting rates. This study provides international evidence for the impact of wage inequalities on infant mortality. Results suggest that improving aspects of the healthcare system may be one way to partially compensate for the negative effects of social inequalities on population health.

Water

Water
Chapter 5 in R. Zimmerman, R. and T.A. Horan, eds.Digital Infrastructures: Enabling Civil and Environmental Systems through Information Technology. London, UK: Routledge,

Zimmerman, R.
01/01/2004

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. "Digital Infrastructures" presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions. "Digital Infrastructures" addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security. "Digital Infrastructures" is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

What are Digital Infrastructures?

What are Digital Infrastructures?
Chapter 1 in R. Zimmerman, R. and T.A. Horan, eds. Digital Infrastructures: Enabling Civil and Environmental Systems through Information Technology. London, UK: Routledge,

Zimmerman, R.
01/01/2004

Digital Infrastructures presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crisis conditions. Digital Infrastructures addresses not only the technological dimension but importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems.

What Matters to Low-Income Patients in Ambulatory Care Facilities?

What Matters to Low-Income Patients in Ambulatory Care Facilities?
Medical Care Research and Review. Sep 2004; 61: 352 - 375.

Delia, D., Hall, A. & Billings, J.
01/01/2004

Poor, uninsured, and minority patients depend disproportionately on hospital outpatient departments (OPDs) and freestanding health centers for ambulatory care. These providers confront significant challenges, including limited resources, greater demand for services, and the need to improve quality and patient satisfaction. The authors use a survey of patients in OPDs and health centers in New York City to determine which aspects of the ambulatory care visit have the greatest influence on patients’ overall site evaluation. The personal interaction between patients and physicians, provider continuity, and the general cleanliness/appearance of the facility stand out as high priorities. Access to services and interactions with other facility staff are of significant, although lesser, importance. These findings suggest ways to restructure the delivery of care so that it is more responsive to the concerns of low-income patients.

The Role of Social and Behavioral Science in Public Health Practice: A Study of the New York City Department of Health

The Role of Social and Behavioral Science in Public Health Practice: A Study of the New York City Department of Health
Journal of Urban Health 2003;80(4)625-634.

Van Devanter, N., Shinn, B., Tannert-Naing, K, Bleakley, A., Perl, S. & Cohen, N.
12/01/2003

Studies over the last decade have demonstrated the effectiveness of public health interventions based on social and behavioral science theory for many health problems. Little is known about the extent to which health departments are currently utilizing these theories. This study assesses the application of social and behavioral science to programs in the New York City Department of Health (NYCDOH). Structured open-ended interviews were conducted with executive and program management staff of the health department. Respondents were asked about the application of social and behavioral sciences within their programs, and about the benefits and barriers to increasing the use of such approaches. Themes related to the aims of the study were identified, a detailed coding manual developed, narrative data were coded independently by two investigators (kappa.85), and data analyzed. Interviews were conducted with 61 eligible individuals (response rate 88%). The most common applications of social and behavioral science were individual-level behavior change to prevent HIV transmission and community-level interventions utilizing community organizing models and/or media interventions for health promotion and disease prevention. There are generally positive attitudes about the benefits of utilizing these sciences; however, there are also reservations about expanded use because of resource constraints. While NYCDOH has successfully applied social and behavioral sciences in some areas of practice, many areas use them minimally or not at all. Increasing use will require additional resources. Partnerships with academic institutions can bring additional social and behavioral science resources to health departments and benefit researchers understanding of the health department environment.

Evidence Based Financial Management

Evidence Based Financial Management
Healthcare Financial Management, October

Finkler, S.A., Henley, R.J. & Ward, D.M.
10/01/2003

Focuses on the importance of evidence-based financial management of hospitals in the U.S. Concept behind evidenced-based financial management; Mechanics of an evidence-based financial management; Benefits provided by this type of financial management; Financial implications if this type of financial management is used.

Functional Outcomes of Pediatric Liver Transportation

Functional Outcomes of Pediatric Liver Transportation
Journal of Pediatric Gastroenterology & Nutrition, 37(2), 155-60.

Alonso, E.M. Neighbors, K., Mattson, C., Sweet, E., Ruch-Ross, H., Berry, C. & Sinacore, J.
08/01/2003

The functional status and health-related quality of life (HRQOL) of children who survive liver transplantation (LT) have not been well documented. The purpose of this study was to determine the functional status and HRQOL in this population using a validated measure for children, the Child Health Questionnaire-Parent Form 50 (CHQ-PF50).

Methods: The CHQ-PF50 instrument was completed by the parents of 55 children who agreed to participate in a mailing survey. Subscale scores for the sample were compared with those of a published normal population (n = 391).

Results: Study sample characteristics were: 87% Caucasian, 54.5% female, mean age at survey was 9.6 years (range, 5-17 years). Responding caregivers were 95% biologic parents and 93% female. Compared with the normal population, LT recipients had lower subscale scores for general health perceptions (P < 0.0005), emotional impact on parents (<0.0005) and disruption of family activities (0.0005). The mean physical summary score of the LT recipients was lower than that of the normal population 48.1 /- 12.1 (P = 0.005), but the mean psychosocial summary score was similar 48.8 /- 11.9 (P = 0.156). Within the LT population, the original diagnosis (biliary atresia vs. other), type of LT (living donor vs. cadaveric), age at LT, z score for height, and hospital days did not significantly influence any of the subscale scores.

Conclusions: Children who have survived LT have functional outcomes in the physical domain that are lower than those of normal children. Self-esteem and mental health in this group appeared normal. The parents in this sample experienced more emotional stress and disruption of family activities than did parents in a normal population.

Understanding Cooperative Behavior in Labor Management Cooperation: A Theoy-Building Exercise

Understanding Cooperative Behavior in Labor Management Cooperation: A Theoy-Building Exercise
Public Administration Review, July 2003, vol.63, no.4, pp. 455-471(17) Blackwell Publishing Inc.

Ospina, S.
07/01/2003

This article proposes a theory of how mandated institutional cooperation transforms into individual cooperative behavior. Using qualitative strategies, we draw insights about cooperation in three public-sector efforts of labor-management cooperation (LMC). We report an association between critical shifts in the roles of stakeholders and the change from adversarial to cooperative labor relations. While managers became team players along with their employees, labor representatives assumed managerial responsibilities. These changes were also associated with a service-oriented perspective, better understanding of the other's experiences, and a view of cooperation as partnership. At the heart of these transformations, we found critical changes in communication patterns associated with incrementally growing levels of trust. We propose a model that depicts the links between collective and individual levels of organizational action related to LMC. We conclude that the positive shifts in mental models regarding work and the value of cooperation justify the promotion of LMC efforts.

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