The surgeon-patient relationship in advanced illness.

Surgeons are relatively new to palliative care, but there is a growing recognition of the contributions they can and should make. These go as much to the psychosocial support of the patient as they do to the technical aspects of their craft. The same qualities of proactivity and mastery of technique that stand the surgeon in good stead in the operating room can be acquired and mastered to make him or her equally effective in the hitherto nontraditional arenas of palliative care.

The dying patient: pain management at the hospice level.

Hospice care has irrevocably changed the landscape of healthcare. First seen as an alternative to dying in the impersonal, highly technical environment of the hospital, it provides comprehensive palliative, supportive care in patient-oriented settings, usually at home or, in some instances, special hospice units. Now the challenges of hospice care largely go beyond the philosophic to include the organizational, demographic, and pragmatic difficulties of providing such care in various settings. This article discusses some of those challenges, including a number of principles and techniques gleaned particularly from the hospice experience for successful pain management in the home setting.

The effect of an alphanumeric paging system on patient compliance with medicinal regimens.

There are numerous actual and potential impediments to patient compliance with medicinal regimens. The implications of poor compliance include worsening disease states or symptoms, with resultant increased costs of care. Using a population of hospice patients at high risk for noncompliance, this study evaluated the use of an alphanumeric paging system as a memory prosthetic, finding that compliance rose from a mean of 56 percent to 96 percent when the system was used. We conclude that such a program is of use in this setting, and that these findings warrant study and suggest applications in other populations.

Trends and forecasts of hospital discharges for selected diseases in regional hospital markets.

Forecasts based on historical trend analyses can do much to minimize the uncertainty inherent in quantifying the number and type of hospital admissions likely to occur in regional and local markets. A study was undertaken to ascertain whether relationships for admissions and discharges for musculoskeletal disorders apply to other disease entities.

Product-market differentiation: a strategic planning model for community hospitals.

Community hospitals would seem to have every reason to identify and capitalize on their product-market strengths. The strategic marketing/planning model provides a framework for rational analysis of the community hospital dilemma and for developing sensible solutions to the complex problems of accelerating hospital price-inflation.

Cost reimbursement and price competition in the hospital industry.

Examination of price trends from 1935-1966 shows that medical care prices in the United States have not always been disproportionately high. With the enactment of Medicare and Medicaid, however, many health care costs became overpriced.

Community health markets: a portfolio perspective.

A portfolio approach to a market system can provide a simple and practical analytical base for rational strategic planning by both individual hospitals and regional health planners.