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The Effects of Managed Care and Prospective Payment on the Demand for Hospital Nurses: Evidence from California
12-01-99
OBJECTIVE: To examine the effects of managed care and the prospective payment system on the hospital employment of registered nurses (RNs), licensed practical nurses (LPNs), and aides.
DATA SOURCES: Hospital-level data from California's Office of Statewide Health Planning and Development (OSHPD)...
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Evaluation of a Preclinical, Educational and Skills-Training Program to Improve Students' Use of Blood and Body Fluid Precautions: One-Year Follow-Up
11-01-99
BACKGROUND: Little is known about long-term improvements in medical students' knowledge, attitudes, and use of blood and body fluid precautions following preclinical training.
METHODS: We evaluated an educational and skills-training program emphasizing double gloving for high-risk surgical...
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The Hidden Health Care Workforce: Recognizing, Understanding and Improving the Allied and Auxiliary Workforce
07-01-99
Allied and auxiliary health care workers play critical support roles in the health care system. Any significant reform in the way health care is delivered will require changes in their training and utilization. This comprehensive report by The California Twenty-First Century Workforce Project...
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A Snapshot of California’s Local Public Health Departments
06-01-99
This report provides a descriptive overview of local public health departments in California. Data are provided on the size and scope of agencies, characteristics of the population served, managed care interactions, partnerships in the community and the pressing issues for these agencies. This...
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Underrepresented Minorities and Medical Education in California: Recent Trends in Declining Admissions
03-01-99
The decision of the Regents of the University of California (UC) to end selective admissions for racial/ethnic minorities in 1995 and the passage of Proposition 209 in 1996 have generated great concern about the enrollment of underrepresented minorities (URMs) in UC medical schools. This report...
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Maintaining an Adequate Supply of RNs in California
01-21-99
Over the past 2 years, concerns have arisen about the adequacy of the supply of RNs in California and the rest of the United States. Nurse leaders have called upon the California State Legislature to respond to concerns by increasing funding for RN education at public colleges and universities. The...
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Recreating Health Professional Practice for a New Century
12-01-98
This fourth and final major report of the Pew Health Professions Commission comes at the end of the most dynamic decade ever faced by the nation’s health professionals. As disruptive as this period has been, however, it may only have been the prelude. The health care system in the US will continue...
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Charting A Course for the 21st Century: Physician Assistants and Managed Care
12-01-98
As managed care creates new mechanisms for the delivery of health services, it will inevitably put pressure on the role and function of health professionals. Physician assistants (PAs) will not be exempt from these changes. In fact, many of these shifts may strain the relationship between the PA...
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Strengthening Consumer Protection: Priorities for Health Care Workforce Regulation
10-31-98
Health care workforce regulation plays a critical role in consumer protection. For most of this century, the state regulation of health care occupations and professions has established a minimum standard for safe practice and removed the egregiously incompetent. To become a more viable element of...
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The Opportunity That is Nursing
10-01-98
Editorial that briefly described findings from a project on strategies for the future of nursing.
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Beyond the Balanced Budget Act of 1997: Strengthening Federal GME Policy
10-01-98
Current physician workforce trends indicate a need to reform federal graduate medical education (GME) policy to better align policy with market signals and the public interest. The transformation of health care is affecting other health professions as well, but in no other case are the gaps between...
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Physicians and Nonphysician Clinicians: Complements or Competitors?
09-02-98
Editorial accompanying an article on trends in the supplies of advanced practice nurses and physician assistants.
Full Publication
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The Task Force on Accreditation of Health Professions Education: Working Papers
06-01-98
With the rapid pace of change in the educational and health care systems today, the ability of health professions education accreditation to respond to the needs of the professions, educational institutions, students and the ultimate consumers of health services has come into question. These...
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Physician Supply and Medical Education in California: a Comparison with National Trends
05-01-98
Concerns have been voiced about an impending oversupply of physicians in the United States. Do these concerns also apply to California, a state with many unique demographic characteristics? We examined trends in physician supply and medical education in California and the United States between 1980...
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An Overview of Graduate Medical Education: Funding Streams, Policy Problems, and Options for Reform
05-01-98
In this article, we examine the financing mechanisms for graduate medical education (GME) in the United States. In so doing, we identify Medicare as the single largest contributor to GME and the most important barrier to producing a physician workforce that is appropriately sized, balanced, and...
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Hospital Employment of Nursing Personnel. Has There Really Been a Decline?
03-11-98
There was a steady increase in the number of hours worked by nursing personnel in California hospitals from 1977 through 1996, mostly due to an increase in the number of hours worked by registered nurses (RNs). The hours worked by nursing personnel and RNs per case-mix adjusted discharge and per...
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Considering the Future of Health Care Workforce Regulation
12-01-97
In December 1995 the Taskforce on Health Care Workforce Regulation released their findings and recommendations in a report entitled Reforming Health Care Workforce Regulation: Policy Considerations for the 21st Century. The report put forth ten recommendations for reform and offered policy options...
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Insights into Medical Student Career Choices Based on Third- and Fourth-Year Students' Focus-Group Discussions
07-01-97
PURPOSE: To identify previously unrecognized factors influencing medical students' career choices and to better characterize the effects of educational experiences, role models, and educational debt on career decisions.
METHOD: Fifty-two third- and fourth-year students were recruited from three...
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Strategies for Change and Improvement: Accreditation of Health Professions Education
06-01-96
Accreditation amounts to a public seal of approval - a guarantee of quality. But with the proliferation of agencies that accredit academic programs over the years, this process has become increasingly complex - to the point where many in higher education have come to question its value, especially...
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Reforming Health Care Workforce Regulation: Policy Considerations for the 21st Century
12-01-95
Though it has served us well in the past, health care workforce regulation is out of step with today’s health care needs and expectations. It is criticized for increasing costs, restricting managerial and professional flexibility, limiting access to care, and having an equivocal relationship to...
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Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century
12-01-95
American health care is experiencing fundamental change. What was recently conceived as a set of policy changes for reform is now being lent the form and weight of institutional reality by the enormous power of the trillion-dollar health care market. In five brief years the organizational,...
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Shifting the Supply of Our Health Care Workforce
10-01-95
Current physician workforce trends indicate a need to reform federal graduate medical education (GME) policy to better align policy with market signals and the public interest. The transformation of health care is affecting other health professions as well, but in no other case are the gaps between...
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Health Professions Education and Relationship-centered Care
12-01-94
The biomedical model has formed the foundation and defined the character of contemporary American medical practice and education. There is a growing perception, however, that the biomedical model cannot fully reflect the broad clinical realities of modern health care and that practitioners must...
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From Affirmative Action to Health: A Critical Appraisal of the Literature Regarding the Impact of Affirmative Action
04-01-94
Affirmative action has been used by institutions and individuals in the United States since the 1960s to increase the participation of women and racial and ethnic minorities in employment, contracting and higher education. This report utilizes a broad perspective to review the data and research...
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Charting a Course for the 21st Century: The Future of Midwifery
04-01-94
For several decades, researchers, policy analysts and consumer advocates have consistently found that the care provided by midwives differs from the medical model of care in ways that benefit women and their families in terms of quality, satisfaction and costs. In early 1998 a Taskforce on...
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Admissions, Recruitment and Retention: Finding and Keeping the Generalist-Oriented Student
04-01-94
As the country strives to produce larger numbers of generalist physicians, considerable controversy has arisen over whether or not generalist applicants can be identified, recruited, and influenced to keep a generalist-oriented commitment throughout medical training. The authors present new and...