The marriage of medicine and computers

Although computers, in one form or another have been around for several decades, they have only recently acquired the power, the simplicity of operation, and the cost-effectiveness to make their widespread application in health care a reality. But a reality it is, and no manager can be successful without a working understanding of how computers and information technology mesh with the information needs of health care delivery. Computer literacy is no longer a nice add-on--it is a basic weapon in every health care professional's armamentarium.     

The marriage of risk management and the processes of patient care

So, your organization is considering taking on a capitation contract. Or you have already done so. Sooner or later, most physician executives with whom I have worked have asked the question: "How the hell are we going to manage this thing so we don't go broke?" Good question. Here, in brief, is the answer: Accepting capitated contracts without having the resources to manage both insurance-like risk and the process of caring for capitated patients is roughly equivalent to flying through mountains shrouded by clouds: Sooner or later, a mountainside is likely to appear in your windshield, close up and closing rapidly, at a point where it is too late to do anything about it!     

Trends in Marital Instability in Italy in the 1980s

ABSTRACT The authors describe the most recent trends in separation and divorce in Italy using ISTAT data for the 1980–1991 period. The analysis shows a rising instability of marriage and thus a lessening of the gap between Italy and other western countries. The total divorce rate rose from three percent in the early 1980s to eight percent at the end of the 1980s. The analysis shows that the increasing breakdown of marriages is not due to “changes in timing” but to a real trend of ending marriages. Older couples have contributed more than younger couples to more unstable marriages over the past decade. Other variables continue today, as in the past, to be closely related to the instability of marriage in Italy.     

St Christopher's and the future

The founding vision of St Christopher's Hospice was based on a recognition that permeating mainstream health care services would be essential and an emphasis on an adaptable philosophy rather than a building. Today, demographic and disease related changes mean that need and demand for end-of-life care will inevitably outstrip professional and financial resource. Hospices must engage with the development of cost-effective models of service delivery and rational planning. Only partnership working with the National Health Service, care homes, and others will ensure that appropriate care is available to everyone wherever the bed in which they die, regardless of diagnosis. Only collaboration and active engagement will ensure that future strategy in end-of-life care retains the original insight that its focus rightly includes not only patients but also the social context that will be affected by their death. Cost and patient choice dictate an emphasis on care at home. Health-promoting, public education and family-focused strategies will be essential. At a pivotal moment for the delivery of health care generally, hospices can play a vital part by marrying the role of "insistent conscience" of the health care service with continued cost-effective clinical innovation.     

Approximation algorithms for hard variants of the stable marriage and hospitals/residents problems

When ties and incomplete preference lists are permitted in the Stable Marriage and Hospitals/Residents problems, stable matchings can have different sizes. The problem of finding a maximum cardinality stable matching in this context is known to be NP-hard, even under very severe restrictions on the number, size and position of ties. In this paper, we describe polynomial-time 5/3-approximation algorithms for variants of these problems in which ties are on one side only and at the end of the preference lists. The particular variant is motivated by important applications in large scale centralised matching schemes. A preliminary version of this paper appeared in the Proceedings of COCOON 2007, LNCS, vol. 4598, pp. 548–558. This work was supported by EPSRC grant EP/E011993/1.     

Models of the future

Existing world models are criticized for the omission of feedback effects. Modifications to existing models are considered implausible, and a very simple structure representing the system by stocks and flows of energy is proposed. The planning implications of such simple models are explored in terms of risk evaluation. The analysis of a possible risk situation yields a dimensionless quantity relating capital investment, depletion rate, investment fraction and efficiency. This quantity is shown to be critical in determining the existence of discontinuities in the growth curve, independent of the desired level of growth.     

Spinning the future

You may not be able to predict the future, but you can create scenarios to help you think about the future proactively. Instead of attempting to tell the future, tell stories about it. Here are eight steps to help you zero in on the future--they are designed to take you through the process of spinning scenarios in order to make decision-making, long-term planning, and thinking about the future more fruitful. Spinning scenarios is a highly sophisticated, singularly useful, and imminently practical way to think about the future. Yet, it is simple enough that you can do it yourself.     

Marital Instability,Reproductive Behaviour and Women's Labour Force Participation Decisions

ABSTRACT The subject of this paper is the relationship between female labour force participation, fertility decisions and marital instability and pursues a two-fold objective: to explain the nature of the interdependences between participation and procreation decisions; and to look for, through empirical evidence, an explanation for women's labour force participation and fertility dynamics over the last 20 years. The empirical evidence, based on a panel of 19 countries over the period 1965–1989, shows that variables representing marital instability have an important role in woman's labour supply and fertility dynamics during this period.     

GIM and logistics in the factory of the future

Abstract

In the future, the competitive strength of industry will depend on its ability to realize flexible production systems, to install intelligent EDP-systems and to link them to a goal-orientated logistic system. Currently, a lot of new strategies, concepts and approaches for production arc being promoted and discussed, often in a spirit of controversy: CIM (computer integrated manufacturing), 'production logistics’, and JIT (just-in-time production) have become familiar concepts which have one thing in common: new structures in production will be necessary. However, the overall effect of CIM is often very small in comparison to the investment for realizing this concept. The main reason is that such projects are missing a logistic orientation. A continuous flow of information and material as envisaged by the logistics principle requires not only that all automation components can be integrated on the technical level, but also that all relevant functions and sectors can be integrated organizationally.     

The physician executive and the future.

In summary, physician managers have a bright future. They are working on one of the most exciting professional interfaces--medicine and management. The future of medicine is both high-tech and low-tech. It will challenge all physician executives. For a few years, health care organizations will experience turbulence and stress. The name of the game for physician managers will be organizational survival. The nation will then move into an era of abundance in medical care, and the management game will switch from survival to thrival. Managers are key players in the world of tomorrow. The physician executive is a manager and therefore a key player. One of the best things about the future of the physician is that he has one.     

Toward the library of the future.

Over the past decade libraries have become increasingly aware of the revolutionary impact of developments in information technology on their key function. The new developments challenge the library's traditional role as electronic information products and services open up a previously unimaginable array of options. The author contemplates a vision of the future in which the unpredictability of the human mind interacts with an expanding array of new technologies and libraries strive to develop an information infrastructure to serve teaching and research in universities.     

Shaping the future of retail banking

The first half of this article considers recent developments in the retail banking market and, with the aid of tables, describes the present state of the market. Emphasis is placed on the increased competitiveness of the market with more institutions involved in providing more products than ever before, and with more attention being focused on the unbanked sector of the population. The second half of the article considers the factors which are most likely to influence the ruture development of the market—both external influences such as the political, economic and regulatory environment and factors which lie more directly under the control of the banks themselves, such as the introduction of new services and branching policy. The article ends by stressing the scope for individual banks to pursue distinctive policies in this market in future.     

The future of the stock exchange

What is the future of the Stock Exchange? In this article the author considers the question from the point of view of the U.K. His analysis will be of interest to planners in many types of organization. He concludes that provided the British economy remains one where private enterprises, funded by private savings voluntarily dispersed, the Stock Exchange will have a central part to play. At the same time, as the business of securities trading becomes more and more international so will the business of the Stock Exchange.