Management

Substance Use Treatment Barriers for Patients with Frequent Hospital Admissions

Substance Use Treatment Barriers for Patients with Frequent Hospital Admissions
Journal of Substance Abuse Treatment

Billings, J., Raven, M., Carrier, E. et al.
01/01/2010

Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identified by a validated statistical algorithm as being at high-risk for frequent hospitalizations were interviewed at an urban public hospital. Patient drug/alcohol history, experiences with medical, psychiatric and addiction treatment, and social factors contributing to readmission were evaluated. Three themes related to SU and frequent hospitalizations emerged: (a) barriers during hospitalization to planning long-term treatment and follow-up, (b) use of the hospital as a temporary solution to housing/family problems, and (c) unsuccessful SU aftercare following discharge. These data indicate that homelessness, brief lengths of stay complicating discharge planning, patient ambivalence regarding long-term treatment, and inadequate detox-to-rehab transfer resources compromise substance-using patients' likelihood of avoiding repeat hospitalization. Intervention targets included supportive housing, detox-to-rehab transportation, and postdischarge patient support.

The Behavioral Dimension of Governing Inter-Organizational Goal Directed Networks: Managing the Unity/Diversity Tension

The Behavioral Dimension of Governing Inter-Organizational Goal Directed Networks: Managing the Unity/Diversity Tension
Journal of Public Administration Research and Theory Second Author with A. Saz-Carranza

Ospina, S.
01/01/2010

Network management research documents how network members engage in activities to advance their own goals. However, this literature offers little insight into the nature of work that aims to advance the goals of the network as a “whole.” By examining the behavioral dimension of network governance, this article identifies a specific tension that network leaders address to effectively govern networks: although unity and diversity are essential to network performance, each makes contradictory demands which require attention. Findings from four case studies of immigrant networks in the United States point to three activities representing mechanisms that staff of network administrative organizations use to address this (network level) managerial tension. The study proposes that unity versus diversity represents a distinct challenge to the governance of networks that requires strategic action at the whole-network level and merits further study.

Tous les systèmes de santé coûtent de plus en plus cher

Tous les systèmes de santé coûtent de plus en plus cher
Propos recueillis par Marc Rambuzet le 10 décembre 2009, Objectif méditerranée, n'lOB, Décembre-Janvier 2010, pg 4.

Rambuzet, M. & Rodwin, V.G.
12/10/2009

Victor G. Rodwin, qui tiendra une conférence à Marseille le 22 janvier prochain, explique en quoi la réforme
du système de santé est si difficile à mettre en oeuvre aux États-Unis. Si le Président Obama a surmonté
les premières difficultés, la course d'obstacles n'est pas pour autant terminée. Rodwin reconnaît l'excellence
du système médical français tout en contestant la première place attribuée par l'OMS à notre pays.

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative
Journal of Health Care for the Poor and Underserved. Vol. 20.4

Kaplan, S.A.
11/01/2009

The paper provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation.

Achieving Horizontal Equity: Must We Have A Single-Payer Health System?

Achieving Horizontal Equity: Must We Have A Single-Payer Health System?
Journal of Health Politics, Policy and Law, Vol. 34, No. 4, August 2009 © 2009 by Duke University Press

Gusmano, M.K., Weisz, D. & Rodwin, V.G.
08/01/2009

The question posed in this paper is whether single-payer health care systems

are more likely to provide equal treatment for equal need (horizontal equity) than are multipayer systems. To address this question, we compare access to primary and specialty health care services across selected neighborhoods, grouped by average

household income, in a single-payer system (the English NHS), a multiple-payer system with universal coverage (French National Health Insurance), and the U.S. multiple-payer system characterized by large gaps in health insurance coverage. We find that Paris residents, including those with low incomes, have better access to health care than their counterparts in Inner London and Manhattan. This finding casts doubt on the notion that the number of payers influences the capacity of a health care system to provide equitable access to its residents. The lesson is to worry less about the number of payers and more about the system’s ability to assure access to primary and specialty care services.

Pages

Subscribe to Management