ABSTRACT
Public hospitals face mounting challenges posed by the rise of managed care, increasing hospital competition, growing responsibilities in indigent care, and stagnant public sector revenues. Privatization exists as a viable strategy for reengineering the structure and operation of public hospitals to meet the new demands of quality and efficiency imposed by a rapidly changing health care environment.
Subject(s)
Hospital Restructuring , Hospitals, Municipal/organization & administration , Privatization/organization & administration , Delivery of Health Care, Integrated/organization & administration , Economic Competition , Efficiency, Organizational , Hospitals, Municipal/trends , Humans , Models, Organizational , New Jersey , Organizational Culture , Power, Psychological , Total Quality ManagementABSTRACT
The presence of large numbers of former mental patients in the community has forced municipal governments to become aware of the deinstitutionalization process. Many, such as in Asbury Park, New Jersey, have voiced strong criticism of the process and have resisted the influx of patients. In 1979 the city was selected by the state mental health authority to work with the Urban Health Institute, a nonprofit health care consulting firm, in a project designed to encourage local planning and resource development for deinstitutionalized mental patients. The authors describe how the project, using traditional community organizing techniques, worked to reduce conflict and to create an atmosphere in which positive local planning for these patients became possible.