Suchergebnisse

STUDY QUESTIONS: To determine factors that distinguish effective rural hospital consortia from ineffective ones in terms of their ability to improve members' financial performance. Two questions in particular were addressed: (1) Do large consortia have a greater collective impact on their members? (2) Does a consortium's economic environment determine the degree of collective impact on members? DATA SOURCES AND STUDY SETTING: Based on the hospital survey conducted during February 1992 by the Robert Wood Johnson Hospital-Based Rural Health Care project of rural hospital consortia. The survey data were augmented with data from Medicare Cost Reports (1985-1991), AHA Annual Surveys (1985-1991), and other secondary data. STUDY DESIGN: Dependent variables were total operating profit, cost per adjusted admission, and revenue per adjusted admission. Control variables included degree of group formalization, degree of inequality of resources among members (group asymmetry), affiliation with other consortium group(s), individual economic environment, common hospital characteristics (bed size, ownership type, system affiliation, case mix, etc.), year (1985-1991), and census region dummies. PRINCIPAL FINDINGS: All dependent variables have a curvilinear association with group size. The optimum group size is somewhere in the neighborhood of 45. This reveals the benefits of collective action (i.e., scale economies and/or synergy effects) and the issue of complexity as group size increases. Across analyses, no strong evidence exists of group economic environment impacts, and the environmental influences come mainly from the local economy rather than from the group economy. CONCLUSION: There may be some success stories of collaboration among hospitals in consortia, and consortium effects vary across different collaborations. RELEVANCE/IMPACT: When studying consortia, it makes sense to develop a typology of groups based on some performance indicators. The results of this study imply that government, rural communities, and ...

Background: The Hong Kong government has proposed legislation for smoke-free policies in all restaurants and bars. This is opposed by certain sections of the catering industry.

Background: The Hong Kong government has proposed legislation for smoke-free policies in all restaurants and bars. This is opposed by certain sections of the catering industry. Objective: To assess public opinion on smoke-free restaurants and to estimate changes in patronage. Design: A population based, cross sectional random digit dialling telephone survey conducted from November 1999 to January 2000. Setting and participants: 1077 randomly selected subjects age 15 years or over (response fraction of 81.6%). Results: 68.9% (95% confidence interval (Cl) 66.2% to 71.7%) supported a totally smoke-free policy in restaurants. Experiences of discomfort or symptoms from second hand smoke in restaurants were common. The majority (77.2%, 95% Cl 74.7% to 79.7%) anticipated no change in their frequency of use of restaurants after a smoke-free policy. Increased use was predicted by 1 9.7% (95% Cl 17.3% to 22.1%) of respondents, whereas 3.2% [95% Cl 2.2% to 4.4%) stated that they would dine out less often. In multivariate analyses, non-smokers (adjusted odds ratio (OR) 4.9), people who ate three times or less per week in restaurants as compared to those who ate >10 times per week (OR 2.1), those who had previous experience of discomfort from exposure to passive smoking in restaurants (OR 2.8), or who had avoided restaurants in the past because of smoking (OR 1.9), were more likely to support a totally smoke-free policy in restaurants. Smoke-free policies do not appear to have an adverse effect on restaurants, and may increase business by a considerable margin. Conclusion: This comprehensive survey - the first in Asia - shows strong community support for smoke-free dining and predicts an overall increase in the patronage of restaurants after the introduction of legislation for totally smoke-free restaurants. ; published_or_final_version