Thesis (M.H.S.A.)--University of Michigan, 1971.

Thesis (M.H.S.A.)--University of Michigan, 1971.

No description available.

This thesis applied the decision support mechanism, Q-Methodology, to an integrated model of issues management and strategic planning. This approach was applied at Riverview Hospital in Noblesville, Indiana in order to respond to the health care reform issue.The research approach involved the three primary stakeholder groups of the hospital: Board of Directors, physicians and managers. The three groups, representing 56 people, attended a planning retreat and identified Riverview's planning options in the form of 77 statements representing future program or service options. These 77 statements were then ranked using Q-methodology.The findings of the study included a QMETHOD computer and researcher analysis of the statements from the perspective of the total group and also the three factors.The final result was a list of statements that comprised Riverview's response to the reform issue in the form of corporate goals and objectives. The conclusions of the study show that:--The integrated approach did provide focus to the strategic planning process. The final list of objectives were all related to the health reform proposal.--Q-Methodology was an appropriate decision support mechanism. It not only provided the final list of corporate objectives but clearly identified potential support and resistance.--A viable set of corporate objectives was developed to respond to the health reform proposal.--All of the stakeholder groups unanimously approved the final list of statements (objectives) in a formal voting process. / Department of Journalism

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-10-18T12:04:30Z No. of bitstreams: 1 Glauco Monteiro Cavalcanti Manso Júnior.pdf: 638894 bytes, checksum: f83980e293c5675a74d643b8589bf2a6 (MD5) / Made available in DSpace on 2017-10-18T12:04:30Z (GMT). No. of bitstreams: 1 Glauco Monteiro Cavalcanti Manso Júnior.pdf: 638894 bytes, checksum: f83980e293c5675a74d643b8589bf2a6 (MD5) Previous issue date: 2017-09-27 / The thesis deals with the remuneration system of private hospitals in Brazil, a sector that represents a considerable part of the offer of health services in Brazil, materializing the citizen's access to his right to health. The sector has suffered financial losses and has been accumulating losses due to the remuneration policies of both the SUS managers and the operators, threatening the viability of the enterprise and, consequently, the citizen service. The research aimed to identify measures to solve the problems caused by the hospital remuneration system (risks of destruction of hospitals, especially minors, increase of tension between operators and service providers) that indirectly harm the citizen. The methodology consisted of documentary analysis and research on foreign experiences in the constitution and management of hospital compensation systems. The first part of the paper deals with the health system and the hospital organization framework in the respective system. The second one approaches the hospital remuneration system, comparing the practices and systems adopted in France, Japan, Spain, United Kingdom, United States, Australia and Canada. The third analyzes the remuneration of the private hospital sector in Brazil, whose constitution includes the relationship with the SUS, the operators and the National Supplementary Health Agency (ANS). The fourth part presents the sector's remuneration prospects and presents the author's proposal. As a result, the research showed that the actions required to solve the problem are related to the federal government (revision of the price list paid to providers, simplification of the legal and regulatory apparatus and greater control over ANS decisions) and hospital organizations regarding the adoption of Strategies and practices aimed at the effectiveness and transparency of management / A tese trata do sistema de remuneração dos hospitais privados no Brasil, setor que representa parcela considerável da oferta dos serviços de saúde no Brasil, materializando o acesso do cidadão ao seu direito à saúde. O setor tem sofrido perdas financeiras e vem acumulando prejuízos em razão das políticas remuneratórias tanto dos gestores do SUS, como das operadoras, ameaçando a viabilidade do empreendimento e consequentemente, o atendimento ao cidadão. A pesquisa objetivou apontar medidas para a solução dos problemas causados pelo sistema de remuneração hospitalar (riscos de destruição de parte dos hospitais, em particular, dos menores, aumento da tensão entre operadoras e prestadores de serviços) que indiretamente prejudicam o cidadão. A metodologia consistiu na análise documental e pesquisa sobre experiências estrangeiras na constituição e gestão dos sistemas de remuneração dos hospitais. A primeira parte do trabalho trata do sistema de saúde e o enquadramento da organização hospitalar no respectivo sistema. A segunda aborda o sistema de remuneração hospitalar, comparando as práticas e sistemas adotados na França, Japão, Espanha, Reino Unido, Estados Unidos, Austrália e Canadá. A terceira analisa a remuneração do setor hospitalar privado no Brasil, cuja constituição compreende a relação com o SUS, as operadoras e a Agência Nacional de Saúde Suplementar - ANS. A quarta parte apresenta as perspectivas remuneratórias do setor e apresentando proposta do autor. Por resultado a pesquisa mostrou que as ações necessárias à solução do problema respeitam ao governo federal (revisão da tabela de preços pagos aos prestadores, simplificação do aparato legal e regulatório e maior controle sobre as decisões da ANS) e às organizações hospitalares quanto à adoção de estratégias e práticas voltadas à eficácia e transparência da gestão

This study investigated the attitudes and perceptions of nurse managers regarding cost containment issues in selected public hospitals in the Port Elizabeth metropole of the Eastern Cape. Four hospitals participated in the study, and 211 nurse managers completed questionnaires. The results obtained from the participants’ responses indicated that: ✦ Nurse managers are ill-prepared for many responsibilities regarding cost containment, and need appropriate orientation and preparation both during their initial formal, and during their nurse management and in service training in order to fulfil their “financial” or cost containment role more effectively. ✦ Nurse managers perceived the relationship between the productivity of staff and cost containment positively, but were reportedly unable to • prevent nurses from leaving their points of duty • curb the rate of absenteeism among nurses • reduce the number of resignations ✦ Nurse managers suggested that more effective hospital cost containment efforts should ensure that • effective security checks are performed to curb losses of stock and equipment • more public telephones are installed in hospitals • stricter controls regarding wheelchairs are implemented The rationalisation of staff and services, as well as specialised equipment among the four public hospitals could enhance these hospitals’ cost containment results. However, this would necessitate reorganising these hospitals’ services at provincial level. The nurse managers required more knowledge about hospitals’ financial management and cost containment issues. Guidelines for such a course were developed addressing: analysis of monthly variance reports; budgeting for manpower; balance statement; calculations for the supplies and expenses budget; income statements; the hospital’s budgetary cycle; break-even analysis; analysis of cost-effectiveness and cost-benefit analysis. / ADVANCED NURSING SCIENCES / D.Litt. et Phil.

This study investigated the attitudes and perceptions of nurse managers regarding cost containment issues in selected public hospitals in the Port Elizabeth metropole of the Eastern Cape. Four hospitals participated in the study, and 211 nurse managers completed questionnaires. The results obtained from the participants’ responses indicated that: ✦ Nurse managers are ill-prepared for many responsibilities regarding cost containment, and need appropriate orientation and preparation both during their initial formal, and during their nurse management and in service training in order to fulfil their “financial” or cost containment role more effectively. ✦ Nurse managers perceived the relationship between the productivity of staff and cost containment positively, but were reportedly unable to • prevent nurses from leaving their points of duty • curb the rate of absenteeism among nurses • reduce the number of resignations ✦ Nurse managers suggested that more effective hospital cost containment efforts should ensure that • effective security checks are performed to curb losses of stock and equipment • more public telephones are installed in hospitals • stricter controls regarding wheelchairs are implemented The rationalisation of staff and services, as well as specialised equipment among the four public hospitals could enhance these hospitals’ cost containment results. However, this would necessitate reorganising these hospitals’ services at provincial level. The nurse managers required more knowledge about hospitals’ financial management and cost containment issues. Guidelines for such a course were developed addressing: analysis of monthly variance reports; budgeting for manpower; balance statement; calculations for the supplies and expenses budget; income statements; the hospital’s budgetary cycle; break-even analysis; analysis of cost-effectiveness and cost-benefit analysis. / ADVANCED NURSING SCIENCES / D.Litt. et Phil.