This book explores three interlinked themes: the models and nature of organizational change; the implementation of Business Process Reengineering (BPR); and the management of contemporary public sector organizations. The authors describe and evaluate a BPR programme in a major NHS teaching hospital - its successes and its shortcomings.

This book provides a pioneering approach to modeling the human diabetic patient using a software agent. It is based on two MASc (Master of Applied Science) theses: one looking at the evolution of the patient agent in time, and another looking the interaction of the patient agent with the healthcare system. It shows that the software agent evolves in a manner analogous to the human patient and exhibits typical attributes of the illness such as reacting to food consumption, medications, and activity. This agent model can be used in a number of different ways, including as a prototype for a specific human patient with the purpose of helping to identify when that patient's condition deviates from normal variations. The software agent can also be used to study the interaction between the human patient and the health care system. This book is of interest to anyone involved in the management of diabetic patients or in societal research into the management of diabetes. The diabetic patient agent was developed using the Ackerman model for diabetes, but this model can be easily adapted for any other model subject with the necessary physiological data to support that model.

In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal. ""Your Pocket Is What Cures You"" examines qualitative shifts in health and healing spurred by these reforms, and analyzes the dilemmas they create for health professionals and patients alike. It also explores how cultural frameworks, particularly those stemming from Islam and Wolof ethnomedicine, are central to understanding how people manage vulnerability to ill health. While offering a critique of neoliberal health policies, ""Your Pocket Is What Cures You"" remains grounded in ethnography to highlight the struggles of men and women who are precariously balanced on twin precipices of crumbling health systems and economic decline. Their stories demonstrate what happens when market-based health reforms collide with material, political, and social realities in African societies.

Nearly twenty percent of Americans live today with some sort of disability, and this number will grow in coming decades as the population ages. Despite this, the U.S. health care system is not set up to provide care comfortably, safely, and efficiently to persons with disabilities. Individuals with disabilities can therefore face significant barriers to obtaining high quality health care. Some barriers result from obvious impediments, such as doors without automatic openers and examining tables that are too high. Other barriers arise from faulty communication between patients and health care professionals, including misconceptions among clinicians about the daily lives, preferences, values, and abilities of persons with disabilities. Yet additional barriers relate to health insurance limits on items and services essential to maximizing health and independence. This book examines the health care experiences of persons who are blind, deaf, hard of hearing, or who have difficulties using their legs, arms, or hands. The book then outlines strategies for overcoming or circumventing barriers to care, starting by just asking persons with disabilities about workable solutions. Creating safe and accessible health care for persons with disabilities will likely benefit everyone at some point. This book has three parts. The first part looks at the historical roots of healthcare access for persons with disabilities in the United States. The second part discusses the current situation and the special challenges for those with disabilities. The third part looks forward to discuss the ways in which healthcare quality and access can improve.

After World War II, Sweden led the Western world in social programs. By the 1970s it was considered a model of the successful welfare state, providing a broader and more elaborate system of social programs and security to more people than any other country, the centerpiece of which was its health care system. As Twaddle explains, however, by 1990 there was a significant shift in Sweden's health policy debates.

Instead of speaking about the medical care system in terms of effectiveness, solidarity, and public planning, the discussions grew focused on competition, markets, and privatization, taking on more of the characteristics of the U.S. system. Twaddle explores the nature of the proposed changes in medical care, the context in which those changes were being proposed, and the steps that were taken to implement change. He concludes that the problem of market- oriented reforms in health care seems to be almost universal.

The Internet and other technological developments are now playing increasing roles in the management of knowledge within consumer health behavior and the delivery of health services. Biomedical Knowledge Management: Infrastructures and Processes for E-Health Systems provides multidisciplinary best practices and experiences in knowledge management relevant to the healthcare industry. A useful reference for field researchers, academicians, and healthcare practitioners, this Handbook of Research presents an in-depth examination of common approaches to shared problems in the management of knowledge within e-health services.

Written by 36 Palestinian, Israeli, and international health professionals, this book is a courageous experiment, the first of its kind, made by individuals from both sides of the Israeli-Palestianian conflict, jointly examining their common history in the field of health and the future that awaits them. This is a time when their healthcare systems are separating and an independent Palestinian health care system is being established. It serves as a unique resource for understanding the processes of change in civil societies affected by political and military struggle, and during the ensuing postconflict era affected by it.

The book describes and analyzes how health policy was designed and implemented during the Palestinian-Israeli conflict (1967-1993) by both sides--at times together, at times separately, and at times through confrontation--and how they are preparing for the new era that began with the 1993 Oslo Accords. Thanks to the authors' candor and their readiness to supplement professional analyses with personal accounts, the volume presents an important human document. The combination attests to the special role played by health professionals in promoting cooperation both in conflict and postconflict eras. As such, the study will be of interest to scholars, researchers, and officials involved with Palestinian-Israeli issues and to others dealing with regional, national, and ethnic conflicts worldwide.

Written by a pediatrician for pediatric clinicians on the front line in response to the ever increasing obligations they acquire for the well being of children, this book focuses on the potential of health care to impact the social morbidities that affect children's health. Dr. Rushton does not suggest that child health practitioners must do more, but rather they must reorient their efforts in order to achieve optimal outcomes for children. As specialists in child health, pediatric clinicians have skills they can utilize to ensure better outcomes for children, but doing so will require a reorganization of health supervision and the establishment of links with other social services. Group visits, psychosocial screening, school health, public-private partnerships, home visitation, parent-child centers, and use of auxiliary anticipatory guidance specialists are all tools described in the development of a coordinated, community-based, family-centered approach to pediatric health care supervision. This is a book for private practitioners, community health professionals, academicians who support them, and all those others who want to ensure that our children are nurtured by the child health care system. The crux of this book is to provide a template for thoughtful consideration by the thousands of pediatric providers who care deeply about their profession.

This timely volume examines the health care systems of Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Sweden, the United Kingdom, and the United States. All democratic and affluent, with well-educated populations and high health standards, these countries have interacted with each other extensively over the years in commercial, cultural, and scientific affairs. The essayists, all resident health care experts, address here the ways in which their countries influence, and are influenced by, the health care systems of other countries studied here. They also examine their common problems--not least the increasing pressure to serve aging populations while maintaining economic balance.

Each covering a different country, the chapters detail the various components of national health care systems: the role, choices, and financial responsibility of the patient, physician training and influence, the organization and financing of hospitals, provisions for care of the elderly and mentally ill, public health services, the role of private health insurance, national health expenditures and efforts at cost containment, and the role of government. Each chapter is supplemented with a wealth of statistical data relevant to the respective country.

The final chapter by Marshall W. Raffel addresses some of the overarching issues that emerge from the study of these ten countries. While not proposing a solution to all of the problems of health care systems, this volume provides information and insights for those examining and addressing the organizational and financial issues in their own countries.

Contributors are Peggy Leatt, A. Paul Williams, Allan Krasnik, Signild Vallgarda, Wolfgang Greiner, J.-Matthias v.d. Schulenburg, Marie-Pascal Pomey, Jean-Pierre Poullier, Toshitaka Nakahara, J. A. M. (Hans) Maarse, Claudia Scott, Stefan Hakansson, Sara Nordling, Peter R. Hatcher, Marshall W. Raffel, and Norma K. Raffel.

A description of the social, educational, and economic impact of living with a neurological genetic disorder, neurofibromatosis 1. The many unpredictable and potentially stigmatizing possible symptoms of NF1, which range from physical disfigurement to severe learning disorders, may have serious consequences in every aspect of daily life. NF1 was for many years wrongly diagnosed as the Elephant Man's Disease.

Ablon examines the psychosocial costs of this misdiagnosis and the ways in which stage, screen, and television parlayed The Elephant Man into the personification of the grimmist extreme of ugliness. This portrayal engendered fear and anxiety for affected persons and their families and also had an impact on the scientific and medical communities. Ablon analyzes the factors that affect individual positive adaptation to NF1 and the demands of American society, and offers suggestions for families, support systems, and health care providers for treatment of affected individuals.

A medical travelogue for patient enlightenment about obtaining economical, quality medical care. There is concise disclosure of essential evaluations that are often omitted in basic examinations. There is instructive case material highlighting available medical revelations that enable the restoration of health and happiness.

This informative volume synthesizes the literatures on health economics, risk management, and health services into a concise guide to the financial and social basics of health insurance with an eye to its wide-scale upgrade. Its scope takes in concepts of health capital, strengths and limitations of insurance models, the effectiveness of coverage and services, and the roles of healthcare providers and government agencies in the equation. Coverage surveys the current state of group and public policies, most notably the effects of the Affordable Care Act on insurers and consumers and the current interest in universal coverage and single-payer plans. Throughout, the author provides systemic reasons to explain why today's health insurance fails so many consumers, concluding with reality-based recommendations for making insurance more valuable to both today's market and consumer well-being. Included among the topics: *Defining health insurance and healthcare finance. *Consuming and investing in health. *The scope of health insurance and its constraints. *Matching health insurance supply and demand. *The role of government in health insurance. *Ongoing challenges and the future of health insurance. Bringing a needed degree of objectivity to often highly subjective material, What Is Health Insurance (Good) For? is a call to reform to be read by health insurance researchers (including risk management insurance and health services research), professionals, practitioners, and policymakers.

As a result of the AIDS epidemic, many nations around the world have faced the demands of caring for a particularly vulnerable population of children, the orphans of parents who have died of AIDS or whose caregivers are terminally ill from the disease. Overcoming AIDS: Lessons Learned from Uganda offers an in-depth exploration of this global issue and provides a broad focus on evolving a constructive response to the HIV/AIDS epidemic. This collaborative resource is the fourth in the Research in Global Child Advocacy book series, and it offers readers a glimpse into the experience of HIV/AIDS infected and affected people from the perspective of researchers, policy makers, and professionals who diligently work toward crafting a framework for action that is integrated across disciplines. Despite the enormity and intensity of the problem, chapter authors share a commitment to advocate for a better world in which social and economic disparities do not preclude children from experiencing a future that is bright with potential opportunities and hope.

This book offers an elaborate and empirical look at service quality of hospitals in the emerging market of India. The poor quality of service is a major issue in a large number of hospitals (particularly in government hospitals), which forces patients to opt for private hospitals that are generally much more expensive than government hospitals. This book provides a comprehensive understanding of service quality antecedents in Indian hospitals. It focuses on patient satisfaction and includes valuable insights and implications for hospital management and government. The book is theoretically grounded in SERVQUAL literature and uses appropriate and sophisticated techniques and tools to analyse data. It highlights causal model development with Structural Equation Modelling (SEM) and introduces a classification model, developed using Artificial Neural Networks (ANNs), in order to benchmark specialty cardiac care. The book also deals with Support Vector Machines (SVMs) and compares the error rates between SVM and ANN to find the best classification technique among the two. Overall, this book is a timely and relevant work that contributes to the theory, practice and policy of service quality in hospitals.

The book deals with current issues, pertinent every healthcare relationship. Changes in medicine as well as some constant aspects over time arise within a cultural ground and generate new questions and issues that are not only purely medical, but also bioethical, social, political, economic and psychological of course. On the one hand, changes in medicine generate new questions for society, on the other hand, the society poses new questions to the medicine, new challenges, and in some cases they can conflict with consolidated models and practices. Never the progress of Western medicine and its therapeutic practices have been as significant as in the last decades but the increase of specific competence and effectiveness of medical treatments are not linearly translated into an increase of consensus, dialogue and alliance between medicine and society. How does psychology take on a position of interlocutor towards medicine and its transformations? How does Cultural Psychology, Health Psychology, Clinical Psychology confront themselves with the processes of meaning making generated by medicine? The interest of the book is aimed to grasp the construction of processes of cultural, relational and subjective meaning in the dialogical encounter between medicine and society, between doctor and patient. The book intends to focus in particular on two specific plans: on the one hand, to present a reflection and analysis on contemporary medicine and its on?going transformations of the healthcare relationship; on the other hand, to presentand discuss experiences of intervention and possible models of intervention addressed to healthcare and doctor?patient relationships during its crucial steps (consultation, formulation and communication of diagnosis, therapy, conclusion). The book's purposes are aimed to discuss crucial and current issues on the borders between medicine and psychology: consensus and sharing, decision?making and autonomy, subjectivity and narration, emotions and affectivity, medical semeiotics and cultural semiotics, training of physicians, and epistemological, theoretical and methodological issues.

This issue of Medical Clinics, guest edited by Drs. Marc Shalaby and Edward Bollard, is devoted to Quality Patient Care: Making Evidence-Based, High Value Choices. Articles in this issue include: Cardiovascular testing in asymptomatic patients: carotid duplex, cardiac stress testing, screen for PVD; Utility of echocardiogram in the evaluation of heart murmurs; Evidenced-based recommendations for the evaluation of palpitations in the primary care setting; Radiologic evaluation of common orthopedic complaints: low back pain, non-traumatic knee/shoulder/hip pain, and ankle injuries; Indications and usefulness of common injections for non-traumatic orthopedic complaints - shoulder, trochanteric bursa, epidural injections, tennis elbow, and knee; The evidence-based evaluation of chronic cough; Evaluation of uncomplicated headache; Evaluation of syncope; Pre-operative assessment: Cataract surgery, pre-operative EKG testing, screening for cardiopulmonary disease, urinalysis, coagulation studies, other lab assessments; The approach to occult GI bleed; The role of EGD surveillance for patients with Barrett's esophagus; The evidence-based evaluation of iron deficiency anemia; Cancer screening in the elderly; Utilization and safety of common over the counter dietary/nutritional supplements, herbal agents and homeopathic compounds for disease prevention; Utilization of oxygen for the patient with dyspnea; IV fluids, enteral or parenteral nutrition; and Symptom control at the end of life.

In this readable and well-researched book, Ken Terry analyzes the current state of health care reform and finds it wanting. Instead of tackling the core problems in our failing system, he argues, politicians, insurance executives, and health care leaders have embraced ideologically driven initiatives that pursue impractical objectives or will take too long to bear fruit. Among these are such widely hailed trends as disease management, pay for performance, cost and price ""transparency,"" consumer-directed care, and health information technology, none of which will reverse the rising tide of health spending. What is creating this nightmare scenario, according to Terry, is the sheer profitability of the health care industry. Insurers, physicians, hospitals, pharmaceutical companies, and device manufacturers are all striving to maximize their profits, and there is no effective competition or regulation to restrain them. Only a complete overhaul of our system for financing and delivering health care can get us out of this mess, the author maintains. In the second half of his book, he presents a bold vision of how to do this: first, he says, all primary care physicians should join group practices that are large enough to take financial responsibility for professional services. And second, competition among those physician groups, based on cost and quality, should replace competition among health plans. There should be only one government-regulated insurer per region, he says, and it should have no role in managing care. The book is introduced by Paul B. Ginsburg, President of the Center for Studying Health System Change.

The increasing fragmentation and rising costs of medical care highlight the need for new approaches, especially the need for alternatives for the delivery of a full range of services at the local level. This book is the first to offer a model for a comprehensive community-based health practice that can compete effectively in the health care market. In their analysis of a health center affiliated with New York Medical College, the authors present systematic profiles of every aspect of operation, together with anecdotal accounts contributed by physicians, nursing staff, patients, and those responsible for third-party payment.

The authors begin with an overview of the organization, its philosophy, and guiding concepts. In separate chapters they describe policies and procedures for each functional area, from patient care and staff functions to facility management and finance. Four chapters are devoted to anecdotal narratives that give a picture of the center's operation from the vantage point of those most closely involved in the delivery of medical services. The final chapter discusses the potential role of local comprehensive practice centers in solving our nation's health care dilemmas and reflects on the policy initiatives that will be required to implement such a solution. This book will be of interest to policy-makers, consumer advocacy groups, and those in the health care field, as well as to scholars and researchers in medical education, the social sciences, and public administration.

A secured system for Healthcare 4.0 is vital to all stakeholders, including patients and caregivers. Using the new Blockchain system of trusted ledgers would help guarantee authenticity in the multi-access system that is Healthcare 4.0. This is the first comprehensive book that explores how to achieve secure systems for Healthcare 4.0 using Blockchain, with emphasis on the key challenges of privacy and security. The book is organized into four sections. The first section is focused on 5G healthcare privacy and security concerns. The second section discusses healthcare architecture and emerging technologies. The third section covers the role of artificial intelligence for data security and privacy in 5G healthcare services. Finally, the last section systematically illustrates the adoption of blockchain in various applications of 5G healthcare. The book is essential reading for all involved in setting up, running, and maintaining healthcare information systems. Engineers, scientists, technologists, developers, designers, and researchers in healthcare technologies, health informatics, security, and information technology will find the content particularly useful.

When corporations claim the same citizenship rights as human citizens, they exercise an undue influence on health policy and democratic processes. Surprisingly, the same basic repertoire of tactics has been found to be employed by corporations to effect this influence, regardless of the specific industry at work. In this book, authors from around the world reveal the range of tactics used across the corporate world that ultimately favor the bottom line over the greater good.
The Bottom Line or Public Health deconstructs some of the most ubiquitous tactics at play, including public relations, political influence, legal maneuvering, and financial power, using the pharmaceutical, food and agriculture, tobacco, alcohol, and motor vehicle industries as illustration. However, there is a growing global movement to counter this corporate force. The book discusses the role of non-governmental organizations, indigenous peoples' groups, health advocates, and social justice activists, and the ways in which they are working to reduce corporate power and put control of policy back in the hands of individuals. The Bottom Line or Public Health is for scholars interested in studying the corporate entity, and for individuals and organizations who want to reclaim democracy for human citizens so that health is placed above the bottom line.