Two Decades of Research Comparing For‐Profit and Nonprofit Health Provider Performance in the United States*

Objective. This article reports on a systematic review of data‐based, peer‐reviewed scientific assessments of performance differences between private for‐profit and private nonprofit U.S. health care providers published since 1980. Methods. Computerized bibliographic searches of all relevant databases yielded 149 studies (179 assessments) that compared the performance of for‐profit and nonprofit health care providers on four performance criteria (access, quality, cost/efficiency, and/or amount of charity care). Reported findings on performance were coded in one of three ways: for‐profit superiority, nonprofit superiority, or no difference/mixed results. Results. Overall, the nonprofits were judged superior 59 percent of the time, the for‐profits superior only 12 percent of the time, and for the rest (29 percent), no difference was found or results were mixed. Conclusions. Caution is warranted on policies that encourage private for‐profit entities to replace private nonprofit providers of health care services in the United States.     

How much do OECD countries spend on social protection and how redistributive are their tax/benefit systems?

The global economic crisis has reignited interest in social policy and public spending on different types of social benefits. Public social spending‐to‐GDP ratios are often used to consider the magnitude of welfare systems in international perspective, but such comparisons alone give an incomplete picture of social effort across countries. This article looks at these different factors, before briefly considering the redistributive nature of tax/benefit systems in different member countries of the Organisation for Economic Co‐operation and Development (OECD). The article also considers trends in social spending and compares spending in the late 2000s with the early 1990s when the previous economic crisis played out. The article ends by illustrating the profound effect the recent global economic crisis had on social spending trends across OECD countries.     

How to support families of children with disabilities? An exploratory study of social support services

Support services to families of children with disabilities have previously been documented. While the effectiveness and consequences of some support strategies have been defined, their comparison remains problematic primarily because of the diversified existing definitions. The present study aimed to elaborate and validate a typology to describe different types of support that can be offered to families of children with disabilities. A review of literature highlighted a variety of support services and allowed a categorical grouping. Content analysis ensured that each category was defined distinctively. Afterwards, a panel of experts and representatives of organizations from seven developed countries (Australia, Belgium, Canada, Denmark, France, Sweden and Switzerland) validated the typology. A database of services offered in these countries was created. The resulting typology was divided into four categories related to the family needs: support, respite, child minding and emergency support. Each type of support can be illustrated within organizations in the database. As such, social workers can use the defined typology to identify the needs of families of children with disabilities and suggest alternatives when services are not available. Overall, the described typology should facilitate discussion between stakeholders and families by providing a common communication system.     

An alternative estimator for randomized response sampling with continuous distributions from a dichotomous population

In this paper, we introduce an alternative estimator of a population proportion from a dichotomous population when using randomized response sampling with continuous randomizing distributions. We also propose the alternative use of exponential randomizing densities. The estimator is obtained by method of moments and is compared with Franklin's (1989) estimator using normal and exponential distributions. The proposed estimator is more efficient than Franklin's (1989) estimator under suitable conditions for the two distributions.     

The Use of Switching Point and Protection Levels to Improve Revenue Performance in Order‐Driven Production Systems

In a multiproduct order‐driven production system, an organization has to decide how to selectively accept orders and allocate capacity to these orders so as to maximize total profit (TP). In this article, we incorporate the novel concept of switching point in developing three capacity‐allocation with switching point heuristics (CASP_a‐c). Our analysis indicates that all three CASP heuristics outperform the first‐come‐first‐served model and Barut and Sridharan's dynamic capacity‐allocation process (DCAP) model. The best model, CASP_b, has an 8% and 6% average TP improvement over DCAP using the split lot and whole lot policies, respectively. In addition, CASP_b performs particularly well under operating conditions of tight capacity and large price differences between product classes. The introduction of a switching point, which has not been found in previous capacity‐allocation heuristics, provides for a better balance between forward and backward allocation of available capacity and plays a significant role in improving TP.     

Healing loss, ambiguity, and trauma: a community-based intervention with families of union workers missing after the 9/11 attack in New York City

A team of therapists from Minnesota and New York worked with labor union families of workers gone missing on September 11, 2001, after the attack on the World Trade Center, where they were employed. The clinical team shares what they did, what was learned, the questions raised, and preliminary evaluations about the multiple family meetings that were the major intervention. Because of the vast diversity, training of therapists and interventions for families aimed for cultural competence. The community-based approach, preferred by union families, plus family therapy using the lens of ambiguous loss are proposed as necessary additions to disaster work.     

Spouse-aided Therapy and Psychiatric Nursing: A Preliminary Report

The training of psychiatric nurses as behavioural nurse therapists has been successfully established in the U.K. by Marks et al. However, their approach has a number of theoretical and practical limitations, such as a rigid adherence to an illness model of psychiatric disorder. This paper describes and evaluates an approach to the training of psychiatric nurses based on systems theory. Four nurses were trained in the use of Spouse-aided Therapy, a time-limited, goal-orientated outpatient approach to the treatment of married psychiatric patients with persisting psychological disorders. Patients' spouses are involved throughout therapy, with the aim of making full use of resources within marriage which may facilitate patients' recovery. Questionnaire and anecdotal data from 12 patients showed a mean fall of 30% in patients' symptoms and a mean fall of 20% in marital dissatisfaction after therapy. The pattern of results supported a systems theory interpretation of outcome.     

Ramadan Fasting and Diabetes Management among Muslims in the United States: An Exploratory Study

There is a lack of knowledge and awareness among health care providers (HCPs) about how a member of the Islamic faith manages diabetes while fasting during Ramadan, which often leads to inadequate health advice and guidance, especially in Muslim-minority countries. The purpose of this study was to explore diabetes management practices among Muslims who chose to fast during Ramadan in the United States. Data were collected from 47 participants using a self-administered questionnaire that included measures on participants’ characteristics and diabetes management practices. The majority of the participants were males (61%), had type 2 diabetes (90%), and reported they fast during Ramadan (76%). Approximately, 26% of fasting participants reported they decreased the number of finger-stick glucose monitoring performed. Compared to non-fasting participants, fasting participants were more likely to change the dose and/or timing of their medications, but also more likely to include their HCPs in their health decisions. Almost 90% of fasting participants reported no increase in the amount of food consumed and no change in the consumption of concentrated sweets, greasy foods, and sugary drinks. This study supports the need to develop educational programs that involve religious leaders as well as HCPs to ensure patients receive health advice combining religious and medical directives.