"March 2003." Includes bibliographical references (leaves 340-350). Aims to develop a theory on private practice nursing and to describe the characteristics and work of the self-employed nurse in Australia. Enables nurses to provide direct information on being self-employed and enhances the profession's ability to articulate about this area of nursing. Results suggest that private practice nursing can contribute effectively to broadening the range of primary health services available to the population and to addressing the issues of retention and recruitment of nurses. Self-employed nurse entrepreneurs push the boundaries of the profession and expand the realm of nursing practice.

Private practice as a career option for nurses has been slowly increasing since the 1980's. However, the reasons for this development have not been fully investigated so that it can be understood and placed within the changing contexts of health care and health services. The expansion and extension of nurses' roles is a contemporary topic in health care reform and therefore one that deserves investigation. The aims of this study were to develop a theory on private practice nursing and to describe the characteristics and work of the self-employed nurse in Australia. Nurses working in a variety of settings have been able to provide information on being self-employed. In doing so, this study was able to describe the persona of the nurse entrepreneur, explore the reasons why nurses and midwives in Australia establish private fee-for-service practices, identify the factors which have influenced this action and describe the scope of practice of nurses and midwives in private practice. This combined Delphi technique and Grounded Theory study is the first in-depth study of Australian nurses and midwives in private practice. The study enables nurses to provide direct information on being self-employed and enhances the profession's ability to articulate about this area of nursing. The significance of the research is in increasing the understanding of this area of practice development and affords greater insight into its efforts to improve and maintain quality nursing services within the Australian health care system. One hundred and six nurses and midwives were invited to participate in the study, in which participants completed two rounds of semi-structured postal questionnaires. Delphi technique was applied to rate responses on Likert scales to ascertain respondents' consensus on certain topics. Participants were also provided the opportunity to make additional comments. Results indicated that nurses in private practice are well experienced with an average of 21 years nursing experience and hold several qualifications. Job satisfaction, being able to be more involved in achieving quality health outcomes and maximising skills and abilities are significant influences for private practice. These results suggest that private practice nursing can contribute effectively to broadening the range of primary health services available to the population and to addressing the issues of retention and recruitment of nurses. Self-employed nurse entrepreneurs push the boundaries of the profession and expand the realm of nursing practice. Entrepreneurship is a path for the future of nursing as it offers expanded career opportunities for nurses and opportunities for increased ambulatory health services. In addition, the broad, expert knowledge nurses hold on many aspects of health can be disseminated throughout the health sector to the advantage of corporate health partners. There is further development required in this innovative and expanding area of the nursing profession. / Thesis (Ph.D.)--Department of Clinical Nursing, 2003.

Professional research project (Au.D.)--University of South Florida, 2001. / Title from PDF of title page. / Document formatted into pages; contains 29 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The primary objective of the project was to survey audiologists in clinical practice setting to determine the amount of time taken to perform various audiologic tests using Current Procedural Terminology, (CPT) codes to define these tests and if these CPT codes were felt to be adequate. Audiologists were also asked to respond regarding possible impact and reimbursement changes in their clinical practices related to managed care. Responses of audiologists were analyzed to determine: a) adequacy of CPT codes; b)average time to perform various audiologic tests; c) impact managed care onclinical practice; and d) changes in reimbursement as a result of managed care. / The survey was designed to determine the type of work setting, typical job duty, average monthly caseload and hours per day spent on patient care for each respondent. The survey with a cover letter explaining the purpose was mailed to 93 audiologists in clinical setting in the state of Florida. Five were returned undeliverable, and 39 of the remaining 88 were returned either completed or partially completed. The survey results revealed over 71% of the audiologists felt the current CPT codes were adequate. Time spent performing traditional audiologic tests, such as comprehensive audiometric evaluations and impedance testing, was fairly consistent. / Greater time variability occurred in tests used to determine vestibular function. Over three-quarters of the respondents believed managed care has had a negative impact on their clinical practices, while 11% believe they have been positively impacted. Approximately 82% of the audiologists have had reductions in reimbursement as a result of managed care, while 10% have seen no change and 5% have enjoyed slightly greater reimbursement. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Private practice as a career option for nurses has been slowly increasing since the 1980's. However, the reasons for this development have not been fully investigated so that it can be understood and placed within the changing contexts of health care and health services. The expansion and extension of nurses' roles is a contemporary topic in health care reform and therefore one that deserves investigation. The aims of this study were to develop a theory on private practice nursing and to describe the characteristics and work of the self-employed nurse in Australia. Nurses working in a variety of settings have been able to provide information on being self-employed. In doing so, this study was able to describe the persona of the nurse entrepreneur, explore the reasons why nurses and midwives in Australia establish private fee-for-service practices, identify the factors which have influenced this action and describe the scope of practice of nurses and midwives in private practice. This combined Delphi technique and Grounded Theory study is the first in-depth study of Australian nurses and midwives in private practice. The study enables nurses to provide direct information on being self-employed and enhances the profession's ability to articulate about this area of nursing. The significance of the research is in increasing the understanding of this area of practice development and affords greater insight into its efforts to improve and maintain quality nursing services within the Australian health care system. One hundred and six nurses and midwives were invited to participate in the study, in which participants completed two rounds of semi-structured postal questionnaires. Delphi technique was applied to rate responses on Likert scales to ascertain respondents' consensus on certain topics. Participants were also provided the opportunity to make additional comments. Results indicated that nurses in private practice are well experienced with an average of 21 years nursing experience and hold several qualifications. Job satisfaction, being able to be more involved in achieving quality health outcomes and maximising skills and abilities are significant influences for private practice. These results suggest that private practice nursing can contribute effectively to broadening the range of primary health services available to the population and to addressing the issues of retention and recruitment of nurses. Self-employed nurse entrepreneurs push the boundaries of the profession and expand the realm of nursing practice. Entrepreneurship is a path for the future of nursing as it offers expanded career opportunities for nurses and opportunities for increased ambulatory health services. In addition, the broad, expert knowledge nurses hold on many aspects of health can be disseminated throughout the health sector to the advantage of corporate health partners. There is further development required in this innovative and expanding area of the nursing profession. / Thesis (Ph.D.)--Department of Clinical Nursing, 2003.

Thesis (D.P.H.)--University of Michigan.

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.

Dissertation (D.P.H.)--University of Michigan.

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.

M.Cur. / Managed healthcare was introduced in South Africa largely in order to control the rampant increase of medical costs, more especially in the private healthcare industry. Managed healthcare is a system of healthcare delivery, which ensures that cost effective quality care is provided to patients without jeopardising the health of the patient. Positive working relationships are necessary among the role players in the provision of cost effective quality care within the managed healthcare context. Role players experience problems in the delivery of healthcare, affecting their working relationships, which in turn affects the quality of care provided to patients. Because managed healthcare is a new concept in South Africa, little is known about the problems. As a result, there are no guidelines for the formulation of a strategy to enhance positive working relationships among the role players within the context of managed healthcare. Understanding the problems experienced by the role players will provide guidelines to the researcher to formulate a strategy to enhance positive working relationships, hence the reseacher sought to explore and describe these problems in the study. The purpose of the study is to formulate a strategy to enhance positive working relationships among the role players within the managed healthcare context in Gauteng. The specific objective is to explore and describe the problems experienced by the role players, as well as the possible solutions within the managed healthcare context in Gauteng. The relevant research questions are: * What are the problems experienced by the role players within the managed healthcare context in Gauteng, and what are the recommended solutions to counteract these problems? * What strategy can be formulated to enhance positive working relationships among the role players within the managed healthcare context in Gauteng? A qualitative, exploratory, descriptive and contextual design was followed to answer the research questions. Focus group interviews and a workshop were conducted to collect data and a content analysis was conducted as described by Tesch (1990). The results were analysed in two phases: the problems experienced and the suggested solutions to counteract these problems. A strategy to enhance positive working realtionships was suggested. The strategy, which is based on role player empowerment, staff development, staff recruitment and selection, use of advanced information technology and standardisation of methods across managed healthcare industry, was derived from a synthesis of solutions suggested by the participants. Guba and Lincoln's (1983:290) principles of trustworthiness were employed by the researcher and the ethical standards as set by DENOSA (1998) were adhered to by the researcher to facilitate the quality of the study. It was recommended that the strategy be implemented and evaluated for its effectiveness by evaluating the quality of working relationships among the role players and that ethical standards be formulated in managed healthcare.

The rising costs of health care and burgeoning government deficits have prompted new ways to control costs, while continuing to provide necessary health care. One method increasingly chosen by states to achieve these objectives is managed health care. There are many forms of managed care organization today. There are HMOs that provide the financing and delivery systems under the control of a single for-profit or non-profit organization; preferred provider organizations consisting of providers that have a pre-negotiated and usually discounted rate for services; administration service organizations that provide claims adjudication; and managed indemnity services organizations that use case management to control costs, while providing beneficiary freedom of choice.