An evaluation of collaborative interventions to improve chronic illness care. Framework and study design

The author's dual-purpose evaluation assesses the effectiveness of formal collaboratives in stimulating organizational changes to improve chronic illness care (the chronic care model or CCM). Intervention and comparison sites are compared before and after introduction of the CCM. Multiple data sources are used to measure the degree of implementation, patient-level processes and outcomes, and organizational and team factors associated with success. Despite challenges in timely recruitment of sites and patients, data collection on 37 participating organizations, 22 control sites, and more than 4,000 patients with diabetes, congestive heart failure, asthma, or depression is nearing completion. When analyzed, these data will shed new light on the effectiveness of collaborative improvement methods and the CCM.     

A theory of organizational response to hospital regulation: a reply to Smith and Mick

Smith and Mick identify four basic problems with the theory the present writers developed to explain organizational responses (in this case the behavior of hospitals) to regulation. They challenge the basic assumption regarding autonomy, disagree with the implied cause and effect relations between organizational response and regulation, criticize the omission of goals, and claim that the theory has only limited generality. In so doing they state that their primary concern is with "improving our understanding of the limitations and benefits of the theory." Each of the four topics they raise for consideration will receive comment.     

大开眼界看朝阳

<正>来中国留学已经一段时间了,去过的地方也不少,可是给我留下最深印象的却是一个很多人都不知道的城市——辽宁的朝阳。在辽宁生活的时间里,我一直觉得辽宁是一个很普通没有什么吸引力的地方。但参加了沈阳师范大学特色班的"留学生辽宁文化考察活动"以后,我忽然发现,原来在这     

A theory of organizational response to regulation: the case of hospitals

This paper presents a general theory of organizational response to regulation, a theory that integrates adaptation and mutual selection perspectives. Two major forms of regulation in the hospital industry, certificate of need and rate review, are examined. Hypotheses are derived concerning the nature and timing of the various adjustments hospitals make both in internal organizational arrangements and in patterns of interorganizational activity in the face of regulatory constraints. Suggestions and data sources for testing the theory are presented.     

University students' knowledge of alcoholic drinks and their perception of alcohol-related harm

A total of 371 university students were asked to estimate the amount of alcohol contained in a standard drink and to estimate the number of standard drinks contained in popular alcoholic beverages. In addition, students completed questionnaires assessing their perception of short and long term harm related to the consumption of beer, wine, spirits and pre-mixed alcopops. Results revealed that students were generally inaccurate in their estimate of alcoholic content of beverages, and national guidelines for low risk drinking. Students were also found to hold different perceptions regarding how harmful different alcoholic beverages were. While both male and female students considered spirits to be more harmful than beer, wine and pre-mixed drinks, males also believed beer to be more harmful than wine when considering the short term consequences. The pattern of beliefs reported by this sample suggest a high-risk population who are not aware of the risks they are exposing themselves to through their drinking behavior.