Segmenting health maintenance organizations to study productivity and profitability.

As the decade ended, health maintenance organizations (HMOs) were increasing in popularity as a means of health care delivery. These groups take many forms, so it is important for the analyst to see if the efficiency and financial results for these different forms vary. The four major forms are profit vs. not-for-profit, chain vs. non-chain, group/staff vs. individual practice association (IPA), and federally qualified vs. non-federally qualified. Using a nationwide database of all the HMOs in the United States, the article compares liquidity rates, leverage ratios, profitability ratios, marketing, and per member ratios across the four groups using paired t tests. The two classifications that showed the most differences were group/staff vs. IPA and federally qualified vs. non-federally qualified. IPAs have a better liquidity position and lower leverage ratios than group/staff but their administrative costs are higher and the time to receive payments and to pay debts is higher. Non-federally qualified have somewhat higher liquidity ratios and higher profitability ratios. These significant differences in financial outcomes indicate that studies of HMOs should segment different major forms of organizations and study them separately before trying to show the effects of different policies on HMO efficiency and effectiveness.

A ten year update on the marketing life cycle for hospital information technologies.

This is a 1999 update of an original article based on 1989-90 data published in the Journal of Hospital Marketing. The adoption of hospital information technologies shows that most of these technologies were no longer in the innovator or early adopter stages. Infrastructure building technologies such as clinical information links, PC networking with the mainframe, MD links between doctors and hospital and E-mail showed the highest percentage of increase. Bar coding for inventory (transactional) also made great increases. Opinions on barriers to the adoption of hospital information technology are ranked and are studied by age of respondent, public vs. private hospitals, and job function.

Barriers to the adoption of computerized technology in health care systems.

The increased emphasis on national health care plans, cost reduction, and additional recordkeeping has given impetus to the adoption of computerized information technologies in hospitals. A series of case studies performed in large, multihospital health care systems revealed ten important barriers to the adoption of information technologies grouped as follows: knowledge problems, approval problems, design problems, and implementation problems. These aspects were uncovered by using focus studies and interviews with chief information officers, physicians, consultants, and medical staff and by consulting numerous journals in the field. The article describes the barriers that arise because of the special conditions in hospitals and shows how some institutions are working to eliminate these barriers. The strategic issues that should be studied to overcome these barriers are also discussed.

[The effect of the type of operation and of combined pathology on the treatment results in patients with chronic disorders of duodenal patency]. / Vliianie tipa operatsii i sochetannoi patologii na rezul'taty lecheniia bol'nykh s khronicheskimi narusheniiami duodenal'noi prokhodimosti.

The work presents results of surgical treatment of 38 patients with chronic disturbance of duodenal patency. It was established that operations aimed at the improvement of the passage of food through the duodenum, gave unsatisfactory results in remote period in 30% of cases. Operations are recommended aimed at the improvement of the passage of contents of the duodenum in combination with operations excluding the duodenum from the passage of food. Surgical correction of coexistent diseases of the digestive system is recommended.

Foot growth rate in children age one to six years.

Previous guidelines suggested that children age 2 to 6 years require a shoe size change every 1 to 2 months. Our study of foot growth in 112 children enrolled in a prospective treatment protocol for flatfoot demonstrates that children age 12 to 30 months will require shoe size change every two to three months but that foot growth slows over the subsequent four years, necessitating shoe size change only every 4 months in children up to 4 years of age and every 6 months in children from age 4 to 6 years.