Efficacy of Statistical Outlier Analysis for Monitoring Quality of Care

Researchers have proposed that hospitals with excessive statistically unexplained mortality rates are more likely to have quality-of-care problems. The U.S. Health Care Financing Administration currently uses this statistical “outlier” approach to screen for poor quality in hospitals. Little is known, however, about the validity of this technique, since direct measures of quality are difficult to obtain. We use Monte Carlo methods to evaluate the performance of the outlier technique as parameters of the true mortality process are varied. Results indicate that the screening ability of the technique may be very sensitive to how widespread quality-related mortality is among hospitals but insensitive to other factors generally thought to be important.     

Childless Elders in Assisted Living: Findings from the Maryland Assisted Living Study

We compared data drawn from a random sample of 399 current assisted living residents and a subsample of 222 newly admitted residents for two groups: childless residents and residents with children. The percentage of childless residents (26%) in our study was slightly higher than U.S. population estimates of childless individuals aged 65 years and older (20%). In the overall sample, the two groups differed significantly by age, race, and women's years of education. The childless group was slightly younger, had a higher percentage of African American residents, and had more years of education than the group with children. In the subsample, we looked at demographic, functional, financial, and social characteristics and found that childless residents reported fewer diagnoses of dementia and fewer visits from a relative but more reported paying less money per month for assisted living and having private insurance than residents with children. As childlessness among older adults continues to increase, it will become increasingly important to understand how child status affects the need for and experience of long-term care.     

A comparison of social work education across South Africa and Japan in relation to the Global Standards for Social Work Education and Training

Sakaguchi H, Sewpaul V. A comparison of social work education across South Africa and Japan in relation to the Global Standards for Social Work Education and Training Int J Soc Welfare 2011: 20: 192–202 © 2009 The Author(s), International Journal of Social Welfare © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article draws on a one‐year study visit to the University of KwaZulu‐Natal, South Africa, interviews with field supervisors and students in Japan and reviews of the national frameworks of education in Japan and in South Africa. In doing so, the authors identify the similarities and differences in social work education across the two countries and they explore some of the historical and socio‐cultural factors that might account for the differences. There are some identifiable peculiarities in social work education in Japan, especially with the coalescing of care work and social work education. The lack of differentiation between care work and social work makes it difficult to narrow the scope of social work education and practice. National social work standards have been approved in South Africa and regulatory frameworks for social work education and practice have been long accepted, thus rendering ‘social work’ a protected title and a profession that is more entrenched compared with social work in Japan. The codes of ethics in Japan and South Africa are discussed with specific reference to their control functions in South Africa. The article concludes by discussing these comparisons in relation to the Global Standards for Social Work Education.     

Competition and The Operational Performance of Hospitals: The Role of Hospital Objectives

We examine the effect of a hospital's objective (i.e., non‐profit vs. for‐profit) in hospital markets for elective care. Using game‐theoretic analysis and queueing models to capture the operational performance of hospitals, we compare the equilibrium behavior of three market settings in terms of such criteria as waiting times and patient costs from waiting and hospital payments. In the first setting, a monopoly, patients are served exclusively by a single non‐profit hospital; in the second, a homogeneous duopoly, patients are served by two competing non‐profit hospitals. In our third setting, a heterogeneous duopoly, the market is served by one non‐profit hospital and one for‐profit hospital. A non‐profit hospital provides free care to patients, although they may have to wait; for‐profit hospitals charge a fee to provide care with minimal waiting. A comparison between the monopolistic and each of the duopolistic settings reveals that the introduction of competition can hamper a hospital's ability to attain economies of scale and can also increase waiting times. Moreover, the presence of a for‐profit sector may be desirable only when the hospital market is sufficiently competitive. A comparison across the duopolistic settings indicates that the choice between homogeneous and heterogeneous competition depends on the patients' willingness to wait before receiving care and the reimbursement level of the non‐profit sector. When the public funder is not financially constrained, the presence of a for‐profit sector may allow the funder to lower both the financial costs of providing coverage and the total costs to patients. Finally, our analysis suggests that the public funder should exercise caution when using policy tools that support the for‐profit sector—for example, patient subsidies—because such tools may increase patient costs in the long run; it might be preferable to raise the non‐profit sector's level of reimbursement.     

积极心理学视角下大学生心理健康教育实效性研究

积极心理学是当今时代下心理学界所兴起的一种全新的研究领域,并在一定程度上应用到了大学的心理健康教育当中,从而能够在一定程度上,增加教育的时效性。通过积极心理学的教学观念,将心理学视角下的健康教育深入大学生的日常教学当中,进而能够深入挖掘以及培养大学生的积极心理品质,全面优化大学生的心理教育的环境,进而用更加先进的积极心理学理念,指导并帮助大学生构建更加完善的心理观念。     

How Employed Mothers in Australia Find Time for Both Market Work and Childcare

Time use studies find that employed mothers reduce their parental childcare time by much less than an hour for every hour they spend in market work. This paper uses data from the Australian Bureau of Statistics Time Use Survey 1997 (4,059 randomly selected households) to investigate how employed mothers manage to avoid a one-for-one trade-off between work and childcare. It compares the time allocation of employed fathers, employed mothers and non-employed mothers and finds that parents use non-parental childcare to reschedule as well as to replace their own childcare, that employed mothers reschedule activities from weekdays to weekends or to earlier or later in the day, and spend less time than other mothers in housework, childfree leisure and personal care.

孤残儿童的机构照顾与社会融合

机构照顾是我国目前孤残儿童福利服务的主要模式,对孤残儿童的衣、食、住、行、医有了较全面的保障,并为这些特殊儿童提供了安全、健康的集体环境。但随着我国改革开放的不断深入,儿童福利照顾的理念和照顾模式也在发生新的变革,跟很多发达国家的发展经历相似,在照顾模式中,改革、变化的趋势是:从大机构到小机构的转变,从机构照顾到家庭寄养和家庭收养模式的转变。本文重点探讨国外孤残儿童机构照顾的实践及其反思,以及我国孤残儿童机构照顾模式存在的问题,特别在社会融合方面存在的缺陷。试图分析孤残儿童走向社会融合的可能途径,并以上海市儿童福利院为例,从现实操作层面来看这些途径的有效性。     

论运动和营养

不良的饮食习惯和缺乏活动的现代化生活方式 ,引起了各种疾病和特殊病的发生。诸如 ,肥胖症、慢性腰部劳损、高血压、腹部肌肉衰弱和容易罹患的心血管疾病。本文概要地论述关于人体健康的两个方面———运动和营养。     

Does the availability of child care influence the employment of mothers? Findings from western Germany

There is a vast empirical literature investigating the effects of child care costson female employment. Day-care costs are usually treated as a reduction infemale wages and are supposed to reduce a woman's propensity to participatein the labor market. In this paper we argue that an analysis of the effects ofchild care on the employment of mothers in Germany should focus on theavailability rather than the affordability of care, due to peculiarities of theGerman day-care regime. Our empirical findings cast doubt on the effectivenessof the current German day-care regime. Specifically, we question the extent towhich it enables mothers to participate in the labor market.