This paper explores two mental health systems in rural North Carolina that provide services to people with severe mental disorders. Recent findings show rural people with mental disorders receive less mental health care than their urban counterparts. This study asks whether rural service systems differ from urban systems in the way that their services are coordinated and structured. A popular c...

The purpose of this article is to explain how globalization has evolved, in order to provide a context for assessing the health care restructuring that is occurring worldwide. The authors begin by defining globalization and introducing a framework for considering pathways that can affect social organization and health. They then draw attention to current trends, such as the GATS (General Agreem...

Mr. McConnaha is communication specialist, mission services, ethics, Catholic Health Association. here is nothing revelatory in saying that Catholic social justice teaching is opposed to a health care system that provides one level of service and care to certain populations while at the same time providing another, interior level to others. One need not be familiar with Catholic social justice ...

This paper reviews the rationales and evidence for horizontal and vertical integration involving hospitals. We find a disjunction between the integration rationales espoused by providers and those cited in the academic literature. We also generally find that integration fails to improve hospitals' economic performance. We offer seven lessons from hospitals' efforts to integrate and then suggest...

Migrant beer promoters in Cambodia, Laos, Thailand, and Vietnam were surveyed to determine their experiences in accessing reproductive health care services in the cities of Phnom Penh, Vientiane, Bangkok, and Hanoi. A total of 7 health care institutions were chosen as popular with migrant beer promoters. Staff at these institutions provided information on the institution, and 390 beer promoters...

Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex, competing, and political nature of health sector reform and reproduct...

In Africa, user fees constitute a financial barrier to access to health services. Increasingly, international aid agencies are supporting countries that abolish such fees. However, African decision-makers want to know if eliminating payment for services is effective and how it can be implemented. For this reason, given the increase in experiences and the repeated requests from decision-makers f...

Research has established that health care is not error free. The question facing perioperative units, as well as all health care services, is how to minimize the human factors that impact quality and safety. This two-part series on performance improvement in perioperative services was intended to help answer this question. Achieving performance excellence starts with a supportive work culture. ...

Aboriginal Community Controlled Health Services face particular management issues as they adjust to the dominant Western paradigm of managerialism and the market model of health service provision. Their cultural orientation leads to distinctive organisational features which both advantage and disadvantages them in this environment. The holistic model of health used and community control enable ...