Financial Scarcity Research Articles

Notes of a traveller

Notes of a traveller

The present situation of Rare Diseases in Central/Eastern Europe? The role of patient organisations

Our goal was to introduce the limited available comparative data to characterise the situation in Central/Eastern Europe in the field of rare diseases. We collected the most important observations of current international surveys which were performed with or without the involvement of member associations of EURORDIS. Results 1, At the level of medical and social services: It is still “incidental” to get to the appropriate expert or centre for diagnosis or treatment. It is difficult to find even the services, because of the lack of suitable “pathways” and referral. There are long delays in obtaining the first appointment, resulting in defencelessness and regional irregularity. The overall consequence is the lack of access to medical and to social services. We also have difficulties with the supply of orphan medication and with the long duration of hospitalisations. 2, At the level of patient organisations: financial scarcity and uncertainty is typical and combined with inappropriate infrastructural background and human resources. Conclusions We need to continue our efforts for the formation of Centres of Expertise and their Networks together with the development of our National Plans. We also want to improve habilitation and rehabilitation services to compensate the social disadvantages. The relative low organisation level of patient organisations and the unsatisfactory level of their cooperation is also characteristic. More effective, professional operations associated with strategic approaches, with the help of national and international cooperation is necessary!

Experiences in psychosocial support in disaster situations from developing countries: the Ica - Peru earthquakes of 2008

Background After a disaster event, little or no attention is paid to mental and psychosocial implications mainly due to the lack of guidelines and resources for work in the field of mental health in many countries. Advances have been made in developed countries with the capacity to afford research and logistic innovations. In developing countries there has been a constant effort to develop affordable, community-based practices, adjusted to financial and logistic scarcity, and in accordance with the existing cultural barriers.

Suboptimal R&D Investments, Financing Resources and the R&D Market Valuation

The aim of this paper is to propose an instrument for identification of RD this is the case when investors apprehend a value-destroying overinvestment situation. On the contrary, an increased R&D market valuation should reflect an underinvestment situation, in which any new investment is interpreted as a sign of firm performance enhancement. Finally, it seems that overinvestment situations exist and are met in cases of financial resources abundance, and for equity issuing young firms, whereas underinvestment situations are encountered, predictably, in case of financial resources scarcity.

The Meaning of Money

A sociocultural understanding of affordability is essential to understanding the college cost deliberations of low-income African American and Latino students and their families. Habitus shapes and informs college affordability decisions for students and their families. Using interviews with 63 college counselors in urban secondary schools, low-income underrepresented students’ assessments of affordability were framed by a highly individualized assessment of need, an internalized calculation of costs versus benefits, and an acute awareness of the competing demands resulting from financial scarcity. The perceptual differences concerning college affordability are an unintended consequence of differential tastes between middle-income counselors and low-income families.

The emergence of modern genetics in Spain and the effects of the Spanish Civil War (1936-1939) on its development.

The aim of this paper is to show how modern genetics reached Spain through the Junta para la Amplición de Estudios e Investigaciones Científicas (JAE) during the decade of 1920s, the role played by key persons, and the level of development this discipline achieved from its different points of inception and under the conditions of financial scarcity and political turmoil that prevailed during the Spanish Civil War (1936-1939). In addition, the effect of the war on the continuity of the lines of research already began is outlined, identifying the main area in which genetics first reappeared: agronomy.

Between Mind, Brain, and Managed Care: The Now and Future World of Academic Psychiatry

Back to table of contents Previous article Next article Book ReviewFull AccessBetween Mind, Brain, and Managed Care: The Now and Future World of Academic PsychiatryMarshall R. Thomas, M.D.Marshall R. ThomasSearch for more papers by this author, M.D.Published Online:1 Jan 2000https://doi.org/10.1176/ps.51.1.120AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail In recent years, psychiatrists have become increasingly and understandably preoccupied with the impact of managed care on psychiatry and psychiatric practice. Although discussion of this topic is ubiquitous, much of the discourse amounts to emotionally charged rhetoric that offers little in the way of substance, facts, or solutions. I am pleased to report that Between Mind, Brain, and Managed Care is different.In this book, the authors provide a detailed and informative analysis of how academic psychiatry is being affected by and is adapting to the changes brought about by managed care. The senior editor and author, Dr. Roger Meyer, is uniquely suited to make this analysis, having spent more than two decades in roles that include department chair, director of a faculty practice plan, executive dean of a school of medicine, and vice-president for health affairs at a health sciences center. The book, which was written as part of a project funded by the MacArthur Foundation, benefits from Dr. Meyer's detailed understanding of the complex functioning of departments and academic health centers. Dr. Meyer adds to his own experiences by including data from surveys of departments of psychiatry around the country and in-depth case studies of six departments, outlining their specific attempts to adapt and thrive.What emerges is a sophisticated and well-informed view of how departments of psychiatry function as complex organizations that are imbedded in and interdependent with schools of medicine and academic health science centers. Departments use diverse sources of funding to support a range of departmental missions, such as clinical innovation, research, medical student education, resident training, and junior faculty development. During periods of financial abundance, department chairs use cross-subsidies that enable all of the department's multiple missions to peacefully coexist.Periods of financial scarcity and funding shifts, such as those brought about by managed care, create challenges in how a department employs its limited fiscal resources to serve its multiple missions. At the same time, other departments within the school of medicine and the academic health center are also engaged, and sometimes at odds, in a Darwinian struggle to adapt to and survive the changing financial conditions brought about by managed care. These stresses are compounded because the financial management, the administrative, and the personnel systems at most universities are not geared to cope with the demands of a rapidly changing, more entrepreneurial health care environment.It's about here that Dr. Meyer's administrative maturity and therapeutic neutrality serve to soothe and calm the reader. Although he agrees that academic psychiatry must change and adapt to survive, he reminds us that the field has faced paradigm shifts in the past, and that each time the field has adapted and emerged stronger than before. He goes on to describe how, during these times of paradigm shift, visionary leaders attend to both the structure and the culture of their department to help shape its destiny.I would highly recommend Between Mind, Brain, and Managed Care to current or aspiring leaders in academic psychiatry. The seventh and final chapter is a particularly useful summary of the core issues and essential ingredients of successful adaptation. For those of us involved in or mired in these system changes, this book turns out to be a surprisingly good read.Dr. Thomas is associate professor of psychiatry at the University of the Colorado Health Sciences Center in Denver and medical director of Colorado Psychiatric Health and Access Behavioral Care.edited by Roger E. Meyer, M.D., and Christopher J. McLaughlin; Washington, D.C., American Psychiatric Press, 1998, 264 pages, $38 FiguresReferencesCited byDetailsCited byNone Volume 51Issue 1 January 2000Pages 120-121 Metrics History Published online 1 January 2000 Published in print 1 January 2000

The Market Turn Without Neoliberalism

world financial crisis provides an opportunity to rethink the way forward to freedom and prosperity all over the planet, in richer countries as well as in poorer ones. The essential meaning of the crisis is that in an age of financial volatility, scarcity, and skepticism, most countries will have to walk on their own legs more than their governments and elites had wanted or expected. In societies as different as Russia and Brazil, the call has gone out for a mobilization of national resources. The global capital market has been revealed as no savior, and the plain truth that countries must first help themselves in order to profit from help from abroad has been painfully driven home.

The Market Turn Without Neoliberalism

world financial crisis provides an opportunity to rethink the way forward to freedom and prosperity all over the planet, in richer countries as well as in poorer ones. The essential meaning of the crisis is that in an age of financial volatility, scarcity, and skepticism, most countries will have to walk on their own legs more than their governments and elites had wanted or expected. In societies as different as Russia and Brazil, the call has gone out for a mobilization of national resources. The global capital market has been revealed as no savior, and the plain truth that countries must first help themselves in order to profit from help from abroad has been painfully driven home.

Restructuring medical schools to better manage their three missions in the face of financial scarcity

The leaders of schools of medicine face a major financial and management challenge as they approach the end of the twentieth century. The new environment for the practice of medicine is diminishing the clinical income that schools have used for so long to supplement their operations. Deans and their staffs must discover new ways to manage their schools and their schools' finances. In particular, schools that continue to rely on subsidies from their health care operations will very likely face the prospect of having to defend themselves as pressures for more cost-effective operations increase and clinical and other subsidies dwindle. In sum, for deans to remain captains of their own ships, preserve their schools' three missions, and balance their books, it is essential that they lead their schools in change toward better administrative, information, and financial management systems. Stritch School of Medicine at Loyola University of Chicago is reinventing itself in response to this challenge. The organizational and management models being used there have been partially guided by the two approaches to redesigning schools of medicine described in detail in this article, the service line management matrix (SLMM) and the fractal management (FM) method. In turn, the experience of implementing the education and research service lines at Loyola has permitted a refinement of the approaches, reflected in the descriptions in this article. These approaches constitute a new model that provides for the development of three administrative service lines-teaching, research, and clinical service (not implemented at Loyola). Each service line has its own leaders and managers, who are responsible for balancing income against expenses. Each service line is a profit-and-loss center, an approach that highlights how effectively the service line is being managed and leads to greater accountability and productivity of faculty and staff. This new approach makes it possible for the school to answer the question, "Can research and teaching pay for themselves?" If they cannot, any subsidies that are needed from clinical income are identified as such. This businesslike approach supplants the traditional one of commingling all income streams to pay for operations, a strategy that worked well enough when research and clinical income constantly increased but now places medical schools in harm's way.

Ethical considerations in an era of financial scarcity

Americans live, work, and learn. It is no longer a question of how long resources will be limited. It is a question of how to manage the resources that remain. As Coombs (1990) states, Today change is more rapid and more all-pervading than in the times when those institutions were developed. From the economic point of view the most important contemporary change is ... the to scarcity (p. 2). The return to scarcity is applicable to all components of contemporary society: federal and state governments, businesses, and social agencies. As a result, the competition for remaining resources is often marked by acrimonious debate with little, if any, agreement on resource distribution. Instead, the debate is frequently settled at the macro level through the ballot box, the courtroom, or legislative settings. Examples abound: Proposition 13 in California, Proposition 2 1/2 in Massachusetts, and court cases in more than half of the states (Odden & Picus, 1992). This behavior has sent two strong messages to legislators: one, the taxpayer refuses to be an unlimited source of revenue, and two, traditionally disfranchised groups are demanding the restructuring of how resources have previously been distributed.

HOSPITAL ADMINISTRATOR FELT NEEDS FOR INTERORGANIZATIONAL COOPERATION AND ACTUAL COOPERATIVE OUTCOMES BY THEIR HOSPITALS

This paper presents an empirical analysis of the determinants of interorganizational cooperation among hospitals. Hospital administrator felt needs for programs of interhospital cooperation and actual cooperative outcomes by their hospitals are examined. A combination of survey and archival data is used to test several research hypotheses. Results support separating the interorganizational activities of hospitals into those related to medical and those related to ancillary service areas. Felt needs to cooperate in both service areas are influenced by administrators' concerns for hospital autonomy and image in interorganizational relations. Perceived availability of cooperation partners affects felt needs to cooperate only in the area of medical services. Actual levels of cooperative activity in medical services are related to perceived manpower resource scarcity, historical levels of cooperation, and concerns for hospital image in interorganizational relations. In ancillary services, actual levels of cooperation were related to perceived financial resource scarcity, historical levels of cooperation, and perceived availability of cooperation partners. Felt needs to cooperate were not associated with actual cooperative outcomes in either service area. The results contain implications for future research into the decision processes that give rise to interorganizational relationships of cooperation.