Journal of Management in MedicineTable of Contents for Journal of Management in Medicine. List of articles from the current issue, including Just Accepted (EarlyCite)https://www.emerald.com/insight/publication/issn/0268-9235/vol/16/iss/6?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestJournal of Management in MedicineEmerald Publishing LimitedJournal of Management in MedicineJournal of Management in Medicinehttps://www.emerald.com/insight/proxy/containerImg?link=/resource/publication/journal/996f3972b79b209fa709a23121c68606/UNKNOWNhttps://www.emerald.com/insight/publication/issn/0268-9235/vol/16/iss/6?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestLabour‐management forums and workplace performancehttps://www.emerald.com/insight/content/doi/10.1108/02689230210450972/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestMany health care workplaces are adopting more cooperative labour‐management relations, spurred in part by sweeping changes in the economic environment that have occurred over the last decade. Labour‐management cooperation is seen as essential if health care organizations are to achieve their valued performance objectives. Joint labour‐management committees (LMCs) have been adopted in many health care workplaces as a means of achieving better industrial relations. Using data from a sample of Canadian union leaders in the health care sector, this paper examines the impact of labour‐management forums and labour climate on employee and organizational outcomes. Research results suggest that labour climate is less important in predicting workplace performance (and change in workplace performance) than is the number of LMCs in operation. However, labour climate is found to be at least as important in predicting union member satisfaction (and change in member satisfaction) as is the wide adoption of LMCs in operation. These findings are consistent with the notion that the greater use of LMCs is associated with augmented workplace performance (and a positive change in workplace performance), notwithstanding the contribution of the labour climate in the workplace.Labour‐management forums and workplace performance
Terry H. Wagar, Kent V. Rondeau
Journal of Management in Medicine, Vol. 16, No. 6, pp.408-421
Many health care workplaces are adopting more cooperative labour‐management relations, spurred in part by sweeping changes in the economic environment that have occurred over the last decade. Labour‐management cooperation is seen as essential if health care organizations are to achieve their valued performance objectives. Joint labour‐management committees (LMCs) have been adopted in many health care workplaces as a means of achieving better industrial relations. Using data from a sample of Canadian union leaders in the health care sector, this paper examines the impact of labour‐management forums and labour climate on employee and organizational outcomes. Research results suggest that labour climate is less important in predicting workplace performance (and change in workplace performance) than is the number of LMCs in operation. However, labour climate is found to be at least as important in predicting union member satisfaction (and change in member satisfaction) as is the wide adoption of LMCs in operation. These findings are consistent with the notion that the greater use of LMCs is associated with augmented workplace performance (and a positive change in workplace performance), notwithstanding the contribution of the labour climate in the workplace.]]>
Labour‐management forums and workplace performance10.1108/02689230210450972Journal of Management in Medicine2002-12-01© 2002 Terry H. WagarKent V. RondeauJournal of Management in Medicine1662002-12-0110.1108/02689230210450972https://www.emerald.com/insight/content/doi/10.1108/02689230210450972/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2002
Variation in coding influence across the USAhttps://www.emerald.com/insight/content/doi/10.1108/02689230210450981/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestRecent anti‐fraud enforcement policies across the US health‐care system have led to widespread speculation about the effectiveness of increased penalties for overcharging practices adopted by health‐care service organizations. Severe penalties, including imprisonment, suggest that fraudulent billing, and related misclassification of services provided to patients, would be greatly reduced or eliminated as a result of increased government investigation and reprisal. This study sought to measure the extent to which health information managers reported being influenced by superiors to manipulate coding and classification of patient data. Findings from a nationwide survey of managers suggest that such practices are still pervasive, despite recent counter‐fraud legislation and highly visible prosecution of fraudulent behaviors. Examining variation in influences exerted from both within and external to specific service delivery settings, results suggest that pressure to alter classification codes occurred both within and external to the provider setting. We also examine how optimization influences vary across demographic, practice setting, and market characteristics, and find significant variation in influence across practice settings and market types. Implications for reimbursement programs and evidence‐based health care are discussed.Variation in coding influence across the USA
Daniel P. Lorence, Michael Richards
Journal of Management in Medicine, Vol. 16, No. 6, pp.422-435
Recent anti‐fraud enforcement policies across the US health‐care system have led to widespread speculation about the effectiveness of increased penalties for overcharging practices adopted by health‐care service organizations. Severe penalties, including imprisonment, suggest that fraudulent billing, and related misclassification of services provided to patients, would be greatly reduced or eliminated as a result of increased government investigation and reprisal. This study sought to measure the extent to which health information managers reported being influenced by superiors to manipulate coding and classification of patient data. Findings from a nationwide survey of managers suggest that such practices are still pervasive, despite recent counter‐fraud legislation and highly visible prosecution of fraudulent behaviors. Examining variation in influences exerted from both within and external to specific service delivery settings, results suggest that pressure to alter classification codes occurred both within and external to the provider setting. We also examine how optimization influences vary across demographic, practice setting, and market characteristics, and find significant variation in influence across practice settings and market types. Implications for reimbursement programs and evidence‐based health care are discussed.]]>
Variation in coding influence across the USA10.1108/02689230210450981Journal of Management in Medicine2002-12-01© 2002 Daniel P. LorenceMichael RichardsJournal of Management in Medicine1662002-12-0110.1108/02689230210450981https://www.emerald.com/insight/content/doi/10.1108/02689230210450981/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2002
From home, to market, to headquarters, to homehttps://www.emerald.com/insight/content/doi/10.1108/02689230210450990/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestHealth sector restructuring has been in vogue, but no country has engaged in as much health sector restructuring as New Zealand where, in a decade, there have been four different public health sector structures. This article discusses New Zealand’s four structures with an emphasis on relocating the critical functions of health care planning and purchasing, and on the development of the present district health board system. The four structures include: an area health board system (1989‐1991) with planning and purchasing located at “home” in local areas and closely aligned with service provision; a competitive internal market system (1993‐1996) which separated planning and purchasing from service provision; a centralised system with a “headquarters” controlling planning and purchasing (1997‐1999) while maintaining the distance from provision; and the district health board system currently under development (1999‐) which sees purchasing and planning sent home again to regions and linked closely with service provision. The present system entails the devolution of considerable responsibility to the local level, within a framework of strong central government control. Based on New Zealand’s experience, the article notes that all but the market structure appear to have provided an adequate environment for effective health care planning and purchasing.From home, to market, to headquarters, to home
Robin Gauld
Journal of Management in Medicine, Vol. 16, No. 6, pp.436-450
Health sector restructuring has been in vogue, but no country has engaged in as much health sector restructuring as New Zealand where, in a decade, there have been four different public health sector structures. This article discusses New Zealand’s four structures with an emphasis on relocating the critical functions of health care planning and purchasing, and on the development of the present district health board system. The four structures include: an area health board system (1989‐1991) with planning and purchasing located at “home” in local areas and closely aligned with service provision; a competitive internal market system (1993‐1996) which separated planning and purchasing from service provision; a centralised system with a “headquarters” controlling planning and purchasing (1997‐1999) while maintaining the distance from provision; and the district health board system currently under development (1999‐) which sees purchasing and planning sent home again to regions and linked closely with service provision. The present system entails the devolution of considerable responsibility to the local level, within a framework of strong central government control. Based on New Zealand’s experience, the article notes that all but the market structure appear to have provided an adequate environment for effective health care planning and purchasing.]]>
From home, to market, to headquarters, to home10.1108/02689230210450990Journal of Management in Medicine2002-12-01© 2002 Robin GauldJournal of Management in Medicine1662002-12-0110.1108/02689230210450990https://www.emerald.com/insight/content/doi/10.1108/02689230210450990/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2002
Non‐profit multi‐hospital organizations: challenges and prospectshttps://www.emerald.com/insight/content/doi/10.1108/02689230210450007/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThis study seeks to determine the relative importance of factors non‐profit hospital administrators rely on in their decisions to join a non‐profit multihospital organization (MO) and their assessments of an MO in satisfying these motives. A related objective of the study is to determine whether or not the administrators of different types of hospitals (i.e. general vs specialty, member of a national vs non‐national MO and church‐affiliated vs non‐church affiliated) differ in their judgements. The analytical framework of the importance‐performance technique is used in analyzing the data gathered from the top administrators of a nation‐wide sample of hospitals in the USA. Results and implications of the study are discussed.Non‐profit multi‐hospital organizations: challenges and prospects
Natalia Trogen, Ugur Yavas
Journal of Management in Medicine, Vol. 16, No. 6, pp.451-462
This study seeks to determine the relative importance of factors non‐profit hospital administrators rely on in their decisions to join a non‐profit multihospital organization (MO) and their assessments of an MO in satisfying these motives. A related objective of the study is to determine whether or not the administrators of different types of hospitals (i.e. general vs specialty, member of a national vs non‐national MO and church‐affiliated vs non‐church affiliated) differ in their judgements. The analytical framework of the importance‐performance technique is used in analyzing the data gathered from the top administrators of a nation‐wide sample of hospitals in the USA. Results and implications of the study are discussed.]]>
Non‐profit multi‐hospital organizations: challenges and prospects10.1108/02689230210450007Journal of Management in Medicine2002-12-01© 2002 Natalia TrogenUgur YavasJournal of Management in Medicine1662002-12-0110.1108/02689230210450007https://www.emerald.com/insight/content/doi/10.1108/02689230210450007/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2002
Evaluating self‐managed integrated community teamshttps://www.emerald.com/insight/content/doi/10.1108/02689230210450016/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestAfter briefly describing self‐managed integrated community teams, the authors explore potential and actual methods of evaluating their structures, processes and outcomes. Primary health care staff in three comparable sites were studied using non‐participant observation, interviews, focus groups and questionnaires. After describing the fieldwork, the authors examine integrated team structures, which are characterised by a large number of barriers that integrated teams face. Processes surrounding different working practices are explored next. Ways of unifying health care professional practice in integrated teams are suggested using evidence from both the literature and fieldwork. Outcomes that emerged after one year of the new teams’ lives are discussed in detail. The difficulty in establishing acceptable outcomes, especially the validity and reliability of outcome measures, is considered. Throughout, the positive and negative aspects of integrated teams emerging from the fieldwork are compared and contrasted with issues in the literature. Finally, recommendations are made to help strengthen integrated teams in the UK.Evaluating self‐managed integrated community teams
Keith Hurst, Jackie Ford, Cath Gleeson
Journal of Management in Medicine, Vol. 16, No. 6, pp.463-483
After briefly describing self‐managed integrated community teams, the authors explore potential and actual methods of evaluating their structures, processes and outcomes. Primary health care staff in three comparable sites were studied using non‐participant observation, interviews, focus groups and questionnaires. After describing the fieldwork, the authors examine integrated team structures, which are characterised by a large number of barriers that integrated teams face. Processes surrounding different working practices are explored next. Ways of unifying health care professional practice in integrated teams are suggested using evidence from both the literature and fieldwork. Outcomes that emerged after one year of the new teams’ lives are discussed in detail. The difficulty in establishing acceptable outcomes, especially the validity and reliability of outcome measures, is considered. Throughout, the positive and negative aspects of integrated teams emerging from the fieldwork are compared and contrasted with issues in the literature. Finally, recommendations are made to help strengthen integrated teams in the UK.]]>
Evaluating self‐managed integrated community teams10.1108/02689230210450016Journal of Management in Medicine2002-12-01© 2002 Keith HurstJackie FordCath GleesonJournal of Management in Medicine1662002-12-0110.1108/02689230210450016https://www.emerald.com/insight/content/doi/10.1108/02689230210450016/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2002