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Investigates the conditions that have led some of the nation2s top teaching hospitals to merge with each other. The three case studies in this book describe mergers among some of the nation's best known hospitals. In addition to citing published articles and books, the author also includes information obtained from numerous personal interviews with more than two hundred faculty members, administrators, trustees, and invested observers who shared their experiences with and knowledge of the mergers. Throughout the book, the author not only presents a picture of the events and conditions that have led to the recent drop in funding for teaching hospitals and why these mergers came about, but he also investigates how the organizations have fared since joining together. The mergers are analyzed and compared in order to identify various methods of merger formation as well as ways in which other newly formed hospitals might accomplish a variety of important goals.
Why would a university renowned for its school of medicine ever sell its teaching hospital? In his newest book, Dr. John A. Kastor presents an insider’s view of why university medical centers decide to sell teaching hospitals, why the decision might be a good one, and how such transitions are received by the faculty and administration. Kastor tells the story of two universities that, under financial duress for more than a decade, chose to sell their teaching hospitals. George Washington University sold to a national, for-profit corporation, Universal Health Services, Inc., and Georgetown University sold to a not-for-profit, local company, MedStar Health. Through interviews with key players involved in and affected by these decisions, Kastor examines the advantages and disadvantages of selling and describes the problems that can afflict medical schools that separate from their faculty practice plans. For the current leaders of medical schools facing similar financial challenges, Kastor analyzes how much it costs to teach clinical medicine and offers valuable advice on how to reduce expenses and increase surpluses.
What forces lead to changes in governance among medical schools and their associated teaching hospitals? To what extent do such changes affect how well those schools and hospitals do their work? In this book, John A. Kastor, M.D., focuses on the academic medical centers of the University of Pennsylvania and the Johns Hopkins University, two institutions that underwent dramatic change in governance during the late 1990s. Drawing on extensive interviews with more than three hundred administrators, physicians, and other medical professionals at Penn, Hopkins, and elsewhere, Kastor identifies the factors that influenced changes in governance at these two institutions. Chief among these, he finds, are structure, personality conflicts, and current events. This book will be of interest to administrators of teaching hospitals as well as professionals in health policy and management.
The Fifth Edition of this best-selling health policy text is updated with a collection of new articles on various health policies. Health Policy provides a basic overview of the health policy and political process as it relates to thte health status of the US, the organization and issues of the healthcare system, and healthcare economics.
Underlying America's robust private health care industry is an indispensible partner that has guided and supported it for over half a century: the government. This book demonstrates how government initiatives created American health care as we know it today and places the Obama plan in its true historical and political context.
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Regulation shapes all aspects of America's fragmented health care industry. While the health and lives of patients as well as almost one-sixth of the national economy depend on its effectiveness, health care regulation in America is bewilderingly complex. 'Health Care Regulation in America' is a guide to this regulatory maze.
Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland Clinic and the University Hospitals of Cleveland, to learn what these institutions are doing to survive in the current era. Using the findings of more than two hundred interviews with physicians, administrators, investigators, and trustees, the author describes in detail these rival organizations, their individual struggles against the economic pressures presented by managed care, and their sometimes bitter competition for patients.
This groundbreaking book weaves together three important themes. It describes major developments in the diagnosis and treatment of heart disease in the twentieth century, explains how the Mayo Clinic evolved from a family practice in Minnesota into one of the world's leading medical centers, and reveals how the invention of new technologies and procedures promoted specialization among physicians and surgeons. Caring for the Heart is written for general readers as well as health care professionals, historians, and policy analysts. Unlike traditional institutional or disease-focused histories, this book places individuals and events in national and international contexts that emphasize the interplay of medical, scientific, technological, social, political, and economic forces that have resulted in contemporary heart care. Patient stories and media perspectives are included throughout to help general readers understand the medical and technological developments that are described. The book is a synthetic study, but it is written so that readers may pick and choose the chapters of most interest to them. Another feature of the book is that readers may follow the stories without looking at the notes. Those who are interested in delving deeper into the main topics will find a wealth of carefully chosen references that offer greater detail and additional perspectives. The descriptions and interpretations that fill the book benefit from the fact that the author has been a practicing cardiologist and medical historian for almost four decades. This is mainly a twentieth-century story, but it begins earlier--before there were physicians who were identified as cardiologists and at a time when medical specialization was just emerging in America. The final chapter, which addresses present-day concerns about health care costs, counterbalances earlier ones that might be read as celebrations of new technologies.
The nineteenth century was a period of science and imagery: when scientific theories and discoveries challenged longstanding boundaries between animal, plant, and human, and when art and visual culture produced new notions about the place of the human in the natural world. Just as scientists relied on graphic representation to conceptualize their ideas, artists moved seamlessly between scientific debate and creative expression to support or contradict popular scientific theories—such as Darwin’s theory of evolution and sexual selection—deliberately drawing on concepts in ways that allowed them to refute popular claims or disrupt conventional knowledges. Focusing on the close kinship between the arts and sciences during the Victorian period, the art historians contributing to this volume reveal the unique ways in which nineteenth-century British and American visual culture participated in making science, and in which science informed art at a crucial moment in the history of the development of the modern world. Together, they explore topics in geology, meteorology, medicine, anatomy, evolution, and zoology, as well as a range of media from photography to oil painting. They remind us that science and art are not tightly compartmentalized, separate influences. Rather, these are fields that share forms, manifest as waves, layers, lines, or geometries; that invest in the idea of the evolution of form; and that generate surprisingly kindred responses, such as pain, pleasure, empathy, and sympathy.