No description available.

Thesis (M.A.)--State University, Iowa.

Thesis (M.S.)--Purdue University, 2002. / Includes bibliographical references (leaves 66-68).

Thesis. 1976. M.S.--Massachusetts Institute of Technology. Alfred P. Sloan School of Management. / Microfiche copy available in Archives and Dewey. / Bibliography: leaves 123-127. / M.S.

Universiẗat, Diss., 2006--Frankfurt (Main).

INTRODUCTION : Les soins de première ligne au Québec vivent depuis quelques années une réorganisation importante. Les GMF, les cliniques réseaux, les CSSS, les réseaux locaux de service, ne sont que quelques exemples des nouveaux modes d’organisation qui voient le jour actuellement. La collaboration interprofessionnelle se trouve au cœur de ces changements. MÉTHODOLOGIE : Il s’agit d’une étude de cas unique, effectuée dans un GMF de deuxième vague. Les données ont été recueillies par des entrevues semi-dirigées auprès du médecin responsable du GMF, des médecins et des infirmières du GMF, et du cadre responsable des infirmières au CSSS. Les entrevues se sont déroulées jusqu’à saturation empirique. Des documents concernant les outils cliniques et les outils de communication ont aussi été consultés. RÉSULTATS : À travers un processus itératif touchant les éléments interactionnels et organisationnels, par l’évolution vers une culture différente, des ajustements mutuels ont pu être réalisés et les pratiques cliniques se sont réellement modifiées au sein du GMF étudié. Les participants ont souligné une amélioration de leurs résultats cliniques. Ils constatent que les patients ont une meilleure accessibilité, mais l’effet sur la charge de travail et sur la capacité de suivre plus de patients est évaluée de façon variable. CONCLUSION : Le modèle conceptuel proposé permet d’observer empiriquement les dimensions qui font ressortir la valeur ajoutée du développement de la collaboration interprofessionnelle au sein des GMF, ainsi que son impact sur les pratiques professionnelles. / INTRODUCTION: Primary care in the Province of Quebec has undergone a substantial reorganisation over the last several years, on several fronts. Family Medicine Groups (FMG's), designated medical clinics, regional health boards, and local health networks, are only a few examples of new health care delivery components which have been created during this reorganisation. METHODS: This is a case study based on a single Family Medicine Group created during a second wave of innovation. Data was collected via semi-directed interviews with the head physician of the FMG, the group of physicians and nurses within the FMG, the nursing director of the FMG, and the director of nursing at the regional health board. Interviews were conducted until all available contacts were exhausted. The author also accessed the clinical guidelines and the documents used for communication within the FMG. RESULTS: Practice activities in the FMG did evolve over time as a result of mutual clinical and administrative interactions between nurses and physicians. Participants noted a visible improvement in health outcomes as well as increased accessibility to health care by patients. The impact on physician workload, and overall capacity in terms of number of patients followed, after creation of the FMG, were inconsistent. CONCLUSION: This proposed analytic model allows empiric measurement of the added value of FMG's for the development of inter-professional cooperation, and its impact on professional practices.

INTRODUCTION : Les soins de première ligne au Québec vivent depuis quelques années une réorganisation importante. Les GMF, les cliniques réseaux, les CSSS, les réseaux locaux de service, ne sont que quelques exemples des nouveaux modes d’organisation qui voient le jour actuellement. La collaboration interprofessionnelle se trouve au cœur de ces changements. MÉTHODOLOGIE : Il s’agit d’une étude de cas unique, effectuée dans un GMF de deuxième vague. Les données ont été recueillies par des entrevues semi-dirigées auprès du médecin responsable du GMF, des médecins et des infirmières du GMF, et du cadre responsable des infirmières au CSSS. Les entrevues se sont déroulées jusqu’à saturation empirique. Des documents concernant les outils cliniques et les outils de communication ont aussi été consultés. RÉSULTATS : À travers un processus itératif touchant les éléments interactionnels et organisationnels, par l’évolution vers une culture différente, des ajustements mutuels ont pu être réalisés et les pratiques cliniques se sont réellement modifiées au sein du GMF étudié. Les participants ont souligné une amélioration de leurs résultats cliniques. Ils constatent que les patients ont une meilleure accessibilité, mais l’effet sur la charge de travail et sur la capacité de suivre plus de patients est évaluée de façon variable. CONCLUSION : Le modèle conceptuel proposé permet d’observer empiriquement les dimensions qui font ressortir la valeur ajoutée du développement de la collaboration interprofessionnelle au sein des GMF, ainsi que son impact sur les pratiques professionnelles. / INTRODUCTION: Primary care in the Province of Quebec has undergone a substantial reorganisation over the last several years, on several fronts. Family Medicine Groups (FMG's), designated medical clinics, regional health boards, and local health networks, are only a few examples of new health care delivery components which have been created during this reorganisation. METHODS: This is a case study based on a single Family Medicine Group created during a second wave of innovation. Data was collected via semi-directed interviews with the head physician of the FMG, the group of physicians and nurses within the FMG, the nursing director of the FMG, and the director of nursing at the regional health board. Interviews were conducted until all available contacts were exhausted. The author also accessed the clinical guidelines and the documents used for communication within the FMG. RESULTS: Practice activities in the FMG did evolve over time as a result of mutual clinical and administrative interactions between nurses and physicians. Participants noted a visible improvement in health outcomes as well as increased accessibility to health care by patients. The impact on physician workload, and overall capacity in terms of number of patients followed, after creation of the FMG, were inconsistent. CONCLUSION: This proposed analytic model allows empiric measurement of the added value of FMG's for the development of inter-professional cooperation, and its impact on professional practices.

Made available in DSpace on 2015-12-03T18:35:28Z (GMT). No. of bitstreams: 1 Isabel_Cristina_Barbosa_Pinheiro.pdf: 2622902 bytes, checksum: 749431cab43b468b437e27cb0f5a0567 (MD5) Previous issue date: 2014-01-24 / The Brazilian public health system is deficient and doesn't fully meet the needs of the population. As a result, the private health care market has grown in recent years, which has changed the role of the state from executive to regulator of that sector. Regulation includes tackling the economic and financial issue. Our study aimed to identify the behavior of financing strategies adopted by medical cooperatives and group medicines to meet the regulatory benchmarks of the supplementary health care sector in Brazil. The survey results show that the mandatory Guaranteeing Assets (Ativos Garantidores, AG), 1st regulatory moment, resulted in a significant increase of both the overall and the long term indebtedness indexes, which reveals the use of Third-party capital instead of Equity capital. Only the Medical Cooperatives featured increased Overall Indebtedness, which means that the Medical Cooperatives, unlike Group Medicines, are capitalized by third party funds rather than by Equity Capital. Both modalities adopted the strategy of increasing their long-term debt and reducing their short term debt (debt composition). With the introduction of the Health Guarantor Fund (Fundo Garantidor da Sa??de, FGS), 2nd regulatory moment, the Overall and Current Liquidity indexes decreased, showing that the goal of the FGS program to reduce financial guarantees and to improve working capital wasn't met. Medical Cooperatives managed to reduce their overall debt, whereas the overall debt of Group Medicines increased. We conclude that there was a balance between the Indebtedness indexes and Liquidity over the period and that operators who wish to remain in the market must comply with the rules, adapting and improving the quality of their management / A rede p??blica de sa??de no Brasil ?? prec??ria e n??o atende de forma plena ??s necessidades da popula????o. Consequentemente, o mercado privado de assist??ncia ?? sa??de tem crescido nos ??ltimos anos e com isso a fun????o do Estado vem se alterando, passando de executor para regulador deste setor de atividade. Um alvo da regula????o ?? a quest??o econ??mico-financeira. Nesse sentido, este trabalho tem como objetivo identificar o comportamento das estrat??gias de financiamento adotadas pelas cooperativas m??dicas e medicinas de grupo frente aos marcos regulat??rios do setor de sa??de suplementar no Brasil. Os resultados da pesquisa indicam que com a obrigatoriedade dos Ativos Garantidores - AG, 1?? momento regulat??rio, os ??ndices de Endividamento, tanto geral quanto de longo prazo tiveram um aumento significativo, o que indica a utiliza????o de Capital de Terceiros ao inv??s do Capital Pr??prio. Observou-se que apenas as Cooperativas M??dicas apresentaram um aumento no Endividamento Geral. Isso indicou que as Cooperativas M??dicas, diferentemente, das Medicinas de Grupo, se capitalizaram com recursos de terceiros ao inv??s do Capital Pr??prio. Notou-se que ambas as modalidades adotaram a estrat??gia de aumentar a d??vida de longo prazo e reduzir as de curto prazo (composi????o do endividamento). Com a institui????o do Fundo Garantidor da Sa??de - FGS, 2?? momento regulat??rio, os ??ndices de Liquidez Geral e Corrente diminu??ram, indicando que a proposta do programa FGS, de reduzir as garantias financeiras e melhorar o capital de giro, n??o ocorreu. Observou-se que para as Cooperativas M??dicas o endividamento geral diminuiu e em contrapartida para as Medicinas de Grupo aumentou. Contudo, conclui-se que houve um equil??brio entre os ??ndices de Endividamento e Liquidez ao longo do per??odo e que para as operadoras se manterem no mercado ter??o que atender as regras, adaptando-se e melhorando a qualidade da sua gest??o