Manpower Resource Research Articles

HMOs and Managed Care: Implications for Rural Physician Manpower Planning*

American health care is changing dramatically. Health maintenance organizations (HMOs) and other managed care plans are central to this change. Today, the majority of Americans living in metropolitan areas receive their care from these types of plans. The goal of this article is two-fold. First, it will discuss the potential implications of HMOs and managed care for physician needs and supply in rural regions. Second, it will derive insight into alternative approaches for meeting rural health manpower needs by analyzing HMO staffing patterns. As HMOs and other managed care plans expand, rural physicians, their practices, and their patients will almost certainly be affected. As described in this paper, most of these effects are likely to be positive. The staffing patterns used by HMOs provide an interesting point of comparison for those responsible for rural health manpower planning and resource development. HMOs appear to meet the needs of their enrollees with significantly fewer providers than are available nationally or suggested by the federal standards. Moreover, HMOs make greater use of nonphysician providers such as nurse practitioners and physician assistants.

HMOs and Managed Care: Implications for Rural Physician Manpower Planning*

ABSTRACT: American health care is changing dramatically. Health maintenance organizations (HMOs) and other managed care plans are central to this change. Today, the majority of Americans living in metropolitan areas receive their care from these types of plans. The goal of this article is two‐fold. First, it will discuss the potential implications of HMOs and managed care for physician needs and supply in rural regions. Second, it will derive insight into alternative approaches for meeting rural health manpower needs by analyzing HMO staffing patterns.As HMOs and other managed care plans expand, rural physicians, their practices, and their patients will almost certainly be affected. As described in this paper, most of these effects are likely to be positive.The staffing patterns used by HMOs provide an interesting point of comparison for those responsible for rural health manpower planning and resource development. HMOs appear to meet the needs of their enrollees with significantly fewer providers than are available nationally or suggested by the federal standards. Moreover, HMOs make greater use of nonphysician providers such as nurse practitioners and physician assistants.

HMOs and Managed Care: Implications for Rural Physician Manpower Planning

American health care is changing dramatically. Health maintenance organizations (HMOs) and other managed care plans are central to this change. Today, the majority of Americans living in metropolitan areas receive their care from these types of plans. The goal of this article is two-fold. First, it will discuss the potential implications of HMOs and managed care for physician needs and supply in rural regions. Second, it will derive insight into alternative approaches for meeting rural health manpower needs by analyzing HMO staffing patterns. As HMOs and other managed care plans expand, rural physicians, their practices, and their patients will almost certainly be affected. As described in this paper, most of these effects are likely to be positive. The staffing patterns used by HMOs provide an interesting point of comparison for those responsible for rural health manpower planning and resource development. HMOs appear to meet the needs of their enrollees with significantly fewer providers than are available nationally or suggested by the federal standards. Moreover, HMOs make greater use of nonphysician providers such as nurse practitioners and physician assistants.

Centralized versus Decentralized Manpower Resource Planning: The Case of a Hong Kong Company

Centralized versus Decentralized Manpower Resource Planning: The Case of a Hong Kong Company

Centralized versus Decentralized Manpower Resource Planning: the Case of a Hong Kong Company

This paper considers the problem of planning effective servicing support of a Hong Kong-based company by providing sufficient technicians to repair/service copier machines at numerous customer sites throughout the city. As quality of service depends on its operational responsiveness, there is an urgent need to address the company's present and projected staffing.

Centralized versus Decentralized Manpower Resource Planning: the Case of a Hong Kong Company

Centralized versus Decentralized Manpower Resource Planning: the Case of a Hong Kong Company

Bi-objective min-flow problem with capacity and flow constraints

A network flow algorithm for a bi-criteria version of the manpower scheduling and resource allocation problem is developed. In such a study it is desired to find the ‘minimum’ total ‘flow’ through the network, where ‘flow’ is represented by a two-component cost vector and ‘minimum’ is interpreted in the sense of a vector-minimum. Thus, a set of non-dominated solutions is obtained. The method efficiently generates both individual (criterion) optima and bi-criteria solutions in a single pass. A simple example is presented.

Macro Manpower Planning: Some International Comparisons

Throughout the world over the past forty years there has emerged an almost universal practice among natons to plan for the development and employment of their labour forces. For most, the practice is called manpower planning. Those troubled by the sexist connotations call the practice human resource planning. However, there is somewhat more, but not much more, to the differences between manpower and human resource planning. The human resources concept tends to encompass all productive uses of human energy, thought and talent in collective enterprise, including those for which the compensation is intrinsic. Manpower is ordinarily limited in meaning to externally motivated non‐voluntary activities, whether coerced by force or by monetary compensation.

Part III: Future Career Intentions of Psychiatric Residents

The future career intentions of more than half (N=241) the total of psychiatric residents in Canada were surveyed. General adult psychiatry continued to attract the majority of interest. A definite increase in interest in the subspecialties of child and adolescent psychiatry, geriatrics, forensics and mental retardation seemed to have occurred since 1975. There would also appear to have been an increase in interest in working in psychiatric hospitals. In contrast, a decrease in interest in the area of addictions has occurred. There were no differences found between the career intentions of male and female residents suggesting that the increase in the number of female physicians may not markedly change the pattern of practice of psychiatry in the future. Foreign medical graduates were found to be more interested in working for the government than Canadian medical graduates, thus remaining a valuable manpower resource for provincial psychiatric hospitals. A comparison with previous surveys revealed the above changes in interest as well as the worsening of the problem of maldistribution. Residents trained in smaller programs were more likely to be interested in practising in smaller towns than those trained in larger centres. These results suggest the need for postgraduate programs to emphasize training experiences in areas of manpower shortages and create opportunities for training in smaller towns and rural areas. Finally, a method for creating an ongoing data gathering system is suggested.

A network flow algorithm for optimal resource allocation

Abstract This paper introduces a network flow method for manpower scheduling and resource allocation. The network formulation of the problem permits the development of an algorithm that determines the minimal flow of resources through the network. The method presented here corresponds to the Simplex method, for in both methods the value of the objective function is optimized while the capacity limitations are preserved. The procedure proposed here, however, uses a more economical problem representation and is computationally more efficient. The efficacy of the minimal flow algorithm and its use is illustrated for a production system but the applicability of the procedure is sufficiently broad for it to work in other problem situations just as well.

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.

C.E.T.A. personnel as a manpower resource for mental health agencies.

Historically federal monies for job training and public service employment were administered and allocated through catagorical programs. These programs were inefficient, overlapping, unresponsive to local needs, and expensive to administer. In 1967, there were seventeen separate federal employment programs each with their own administration, funding procedures and eligibility requirements. The Comprehensive Employment and Training Act (CETA) of 1973 (P.L. 93-203) was the proposed solution to these problems. This legislation transferred the control of a large portion of federal revenues for manpower programs to state and local jurisdictions. The state and local governments were given flexible guidelines for use of the money as opposed to dealing with a variety of categorical federal programs that may, or may not, have met local needs.

Can the Parr curve help with manpower distribution and resource estimation problems?

This paper analyzes the resource utilization curve devel oped by Parr. The curve is compared with several other curves, including the Rayleigh curve, a parabola, and a trapezoid, with respect to how well they fit manpower uti lization. The evaluation is performed for several projects developed in the Software Engineering Laboratory of the 6–12 man-year variety. The conclusion drawn is that the Parr curve can be made to fit the data better than the other curves. However, because of the noise in the data, it is difficult to confirm the shape of the manpower distri bution from the data alone and therefore difficult to vali date any particular model. Also, since the parameters used in the curve are not easily calculable or estimable from known data, the curve is not effective for resource estimation.

Conflicting perceptions of the healthprovider domain by new health professionals

The definition of appropriate roles and functions for “New Health Professionals” (NHPs) has been widely debated in the health services literature since the introduction of this new manpower resource in the United States in the mid-1960's. While the emergence of these new practitioners has been well documented from a legal and educational standpoint, little research has focused upon the evolution of these roles in practice, specifically in relation to their position in the domain of health providers. In this report a survey of four types of NHPs documents and compares how each type classifies themselves in relation to the other types of NHPs as well as to the traditional health care providers (physicians and nurses). Multidimensional scaling techniques provide perceptual models of the health provider domain for Health Associates, Physician's Assistants, and Adult and Pediatric Nurse Practitioners; three general perspectives are derived. The principle difference in the solutions are in the conceptions of the Nurse Practitioner role. The findings challenge a major premise found in the literature: the concept of the NHP as a single professional role subsuming all types of NHPs. This premise was validated only for Health Associates and Physician's Assistants, not for Nurse Practitioners. These data provide the needed empirical basis for understanding the emerging role identities of NHPs:

Conflicting perceptions of the health provider domain by new health professionals.

Abstract The definition of appropriate roles and functions for “New Health Professionals” (NHPs) has been widely debated in the health services literature since the introduction of this new manpower resource in the United States in the mid-1960's. While the emergence of these new practitioners has been well documented from a legal and educational standpoint, little research has focused upon the evolution of these roles in practice, specifically in relation to their position in the domain of health providers. In this report a survey of four types of NHPs documents and compares how each type classifies themselves in relation to the other types of NHPs as well as to the traditional health care providers (physicians and nurses). Multidimensional scaling techniques provide perceptual models of the health provider domain for Health Associates, Physician's Assistants, and Adult and Pediatric Nurse Practitioners; three general perspectives are derived. The principle difference in the solutions are in the conceptions of the Nurse Practitioner role. The findings challenge a major premise found in the literature: the concept of the NHP as a single professional role subsuming all types of NHPs. This premise was validated only for Health Associates and Physician's Assistants, not for Nurse Practitioners. These data provide the needed empirical basis for understanding the emerging role identities of NHPs:

Manpower Resource Supplement Published

Manpower Resource Supplement Published

Manpower Resource Supplement Published

Manpower Resource Supplement Published

Manpower Resource Supplement Published

Manpower Resource Supplement Published

Manpower resources for research.

Several trends in medical education affect our supply of future physicians. The number of new physicians has increased so that each year there is an excess of about 6000 over the number of physicians produced per year a decade ago. Increasing numbers of women and members of minority groups are entering the profession as well. These new students are being subjected to increased social pressures to elect primary-care careers, and although there is ample evidence that a significant portion will continue to choose subspecialty careers, fewer of them may be interested in traditional academic and research careers. We must make academic and research careers sufficiently attractive so that an adequate manpower resource of physicians is maintained for the future. This can be done by improving the structure of training programs and by fostering research opportunities for young investigators.

The physicians assistant: a new breed of dental educator

This article presents the concept of the physicians assistant as a new manpower source for teaching physical diagnosis in the dental school curriculum, and describes the role of the physicians assistant at The University of Oklahoma College of Dentistry. The education and training of the physicians assistant are explored, and his or her qualifications for teaching this type of course are considered. The advantages and cost effectiveness of using this type of educator, rather than a physician, are discussed. Finally, the positive impact of these new educators at Oklahoma is reviewed. Based on our experience, we suggest that other colleges of dentistry investigate this new manpower resource.