The impact of demographic and perceptual variables on a young adult's decision to be covered by private health insurance.

Background: The large number of uninsured individuals in the United States creates negative consequences for those who are uninsured and for those who are covered by health insurance plans. Young adults between the ages of 18 and 24 are the largest uninsured population subgroup. This subgroup warrants analysis.

Can inbound and domestic medical tourism improve your bottom line? Identifying the potential of a U.S. tourism market.

In large part due to current economic conditions and the political uncertainties of healthcare reform legislation, hospitals need to identify new sources of revenue. Two potentially untapped sources are inbound (international) and domestic (within the United States) medical tourists. This case study uses data from a large, urban healthcare system in the southeastern United States to quantify its potential market opportunities for medical tourism.

The fear factor in healthcare: employee information sharing.

This study looks at employee information sharing among hospitals, a topic that is underresearched, underreported, and under the radar for most healthcare leaders. We initiated the research under the assumption that executives in healthcare are reluctant to share employment reference information about staff beyond the employee's name, dates of employment, and position held. We believed executives take this precaution because they fear being sued by the employee for defamation.

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.

Determinants of health insurance coverage rates for young adults: an analytical literature review.

This chapter summarizes the major determinants of health insurance coverage rates among young adults. Socioeconomic status, demographics, actual and perceived health status, perceived value, and perceived need are all examined in order to determine what the literature reveals regarding each variable and how each variable impacts a young adult's decision to purchase health insurance. Results indicate that socioeconomic status, demographics, perceived value, and perceived need were the most significant determinates of health insurance status of young adults.

The effect of work environment on intent to leave the nursing profession: a case study of bedside registered nurses in rural Florida.

The purpose of this research was to explore the effect work environment has on the intent to leave the profession for rural hospital bedside registered nurses (RNs). Subscales of autonomy, control over the practice setting, nurse-physician relationship and organizational support were incorporated into the analysis to determine which aspects of work environment directly affect the intent to leave the profession. An explanatory cross-sectional survey was distributed to 259 direct care bedside RNs employed at a rural system-affiliated hospital in Central Florida between February 2007 and June 2007.

Health care globalization: a need for virtual leadership.

As health care organizations expand and move into global markets, they face many leadership challenges, including the difficulty of leading individuals who are geographically dispersed. This article provides global managers with guidelines for leading and motivating individuals or teams from a distance while overcoming the typical challenges that "virtual leaders" and "virtual teams" face: employee isolation, confusion, language barriers, cultural differences, and technological breakdowns. Fortunately, technological advances in communications have provided various methods to accommodate geographically dispersed or "global virtual teams.

Valuing volunteers: the impact of volunteerism on hospital performance.

Background: Volunteers have been present in health care settings for centuries. However, there is little empirical evidence regarding the impact that volunteers make on hospital performance. Since the 1990s, hospitals in the United States have had a great deal of pressure to produce high-quality care at minimum expense.

Hidden workplace violence: what your nurses may not be telling you.

Violence in the health care workplace is occurring in a covert fashion; it is occurring at the patient bedside. However, data on workplace violence tend to be underreported and relatively scarce. This article identifies and examines the phenomenon of unreported and underreported workplace violence against nursing staff that is virtually hidden.

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.

The relationship of health-care managers' spirituality to their self-perceived leadership practices.

This exploratory survey examines the relationship between selected dimensions of spirituality and self-perceived effective leadership practices of health-care managers. Kouzes and Posner's Leadership Practices Inventory and Beazley's Spiritual Assessment Scale were administered to a sample of health-care managers. Significant statistical relationships were found between and among the dimensions of both subscales.

Determinants of hospital choice of rural hospital patients: the impact of networks, service scopes, and market competition.

Among 10,384 rural Colorado female patients who received MDC 14 (obstetric services) from 2000 to 2003, 6,615 (63.7%) were admitted to their local rural hospitals; 1,654 (15.9%) were admitted to other rural hospitals; and 2,115 (20.

Re-prioritizing doctoral education in health administration and policy.

Among health administration programs, doctoral education has been a low priority for decades. Programs which are profitable from an economic perspective tend to be maintained or expanded while less profitable programs tend to be reduced. For a variety of reasons, doctoral programs tend to be viewed as less profitable than other programs.

The status of national and health administration doctoral education: issues for the 21st century.

Doctoral education is gaining increasing attention as new programs proliferate and enrollment grows. Presently there is no standardization of degrees programs, limited aggregated information about health administration education doctoral programs, and an absence of national policy. The general, doctoral education literature presents a variety of issues and challenges for doctoral health administration education including data trends, supply and demand for doctoral graduates, credential inflation, attrition and degree completion, organizational efforts to improve doctoral education, and strategies for the future.

Consumer determinants of the use of health plan information in plan selection.

One of the major issues in achieving optimum levels of performance in health-care markets is to enhance consumer understanding of their health plan choices in order to facilitate the expansion of 'high-value' health plans at the expense of 'low-value' health plans. The Federal government offers employees many choices of health plans and provides large amounts of information on all of these options through (1) comparative written health plan information, (2) information from the health plans themselves, and (3) comparative health plan information on the Internet. The present study examines the degree to which 1722 Federal employees in the Department of Health and Human Services utilized health plan information from the above three sources in making their annual health plan selection.

Proposed hub-network model for tissue procurement: the case of Arizona.

A single institution is not well positioned to manage the process of tissue donations to maximize utility and minimize the costs associated with such transactions. The proposed creation of a 'hub' organization to service the needs and demands associated with tissue procurement and utilization is outlined. The case of Arizona is used as a case study for the proposed model building on existing network in tissue donation and research.

Aligning internal organizational factors with a service excellence mission: an exploratory investigation in health care.

In today's competitive health care environment, service excellence is rapidly becoming a major differentiating advantage between health care providers. Too often, senior executives talk about their commitment to a mission statement that extols the virtues of providing world class service to their patients only to undermine those statements with what they do, write, and say. This article presents an exploratory investigation into a new application of an internal mission alignment instrument that seeks to assess the extent to which an organization's internal processes are aligned with its service mission.

The retail revolution in health care: Who will win and who will lose?

Retailers are expected to profoundly affect health care delivery by providing an alternative site for basic medical care. Retail health services are described together with their potential impacts on patient's health care providers and payors. This article concludes with implications for health care executives.

E-service learning: A pedagogic innovation for healthcare management education.

This paper proposes an innovation in service learning that we identify as e-service learning. By adding the "e" to service learning, we create a service learning model that is dynamic, mediated by technology, and delivered online. This paper begins by examining service learning, which is a distinct learning concept.

Patient turnover and nursing staff adequacy.

Objective: To assess the relative validity of patient turnover adjustments and the difference in nurse staffing using measures that adjust for patient turnover and severity versus those that do not.

Data Sources: Numbers of registered nurses (RNs), adjusted patient days of care (APDC), length of stay, and patient severity information from acute care general hospitals in Pennsylvania 1994-2001, obtained from the Pennsylvania Department of Health, the American Hospital Association, and the Atlas MediQual system.

Study Design: After examining the trends in patient turnover and severity and their relationship to RN staffing, we apply two-patient turnover indices, with and without patient severity adjustments, to RN staffing measures, and test the difference between the original and adjusted measures using paired sample t-tests.

Bringing human resources to the table: utilization of an HR balanced scorecard at Mayo Clinic.

Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions.

Projections and trends in RN supply: what do they tell us about the nursing shortage?

This article presents an analysis of trends in the supply of RNs. When weighted for population growth, the U.S.

Comparing hospital staff and patient perceptions of customer service: a pilot study utilizing survey and focus group data.

The measurement of patient satisfaction is crucial to enhancing customer service and competitive advantage in the health-care industry. While there are numerous approaches to such measurement, this paper provides a case study which compares and contrasts patient and staff perceptions of customer service using both survey and focus group data. Results indicate that there is a high degree of correlation between staff and patient perceptions of customer service based on both survey and focus group data.

Environmental assessment of the Indian health service.

The Indian Health Service (IHS), an agency within the U.S. Department of Health and Human Services, was responsible for providing federal health services to 1.