Journal of health and human services administration
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Today we stand in a vortex of technological, economic, and cultural changes that altered dramatically the world of labor and with it the psychological contract between employers and employees. While the effects of the changed contract at work are usually addressed from an organizational, social or economic perspective, the current article addresses it from a psychological perspective from which one noteworthy cost of the changed psychological contract is employee burnout. The article describes burnout, differentiates it from stress, and proposes an existential perspective to explain its underlying dynamic, using the results of a cross-cultural study of Israeli and American managers as an example. Recent studies on gender differences in management are used to point in the recommended for preventing employee burnout, despite the new psychological contract, namely--a democratic, egalitarian management style.
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J Health Hum Serv Adm · Jan 2000
Comparative StudyImpact of health system factors on changes in human resource and expenditures levels in OECD countries.
In order to gain further insight into the system factors responsible for changes in the health workforce, this study undertook an empirical examination of the determinants of the size of the health workforce and overall health expenditures across fifteen OECD countries. Specifically, using the latest release of OECD data, the analysis estimated and evaluated the effects of variables such as the proportion of female physicians and the elderly, expenditures on ambulatory care, enrollment levels in training programs, level of public financing, and per capita income on the size of the health workforce and level of health spending between 1970-1991. The findings of this study help to place the problem of the changing health workforce within the context of the complexity of health systems. It confirms any understanding of what accounts for changes in the size of the health labor force and expenditures require disentangling the effects of variables which needs to be taken into account when considering health system reforms.
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J Health Hum Serv Adm · Jan 2000
Aging in America: challenges and strategies for health care delivery.
This article delineates the current and future trends related to aging in the United States. The demographic and economic forces outlined are ones that will clearly challenge health services leaders and policy-makers in the coming decades. ⋯ Shifts in caregiving patterns, the delivery of long-term care services, economics, choices in living arrangements, and managed care programs for the elderly are a few of the issues presented in this article. Health and human services for the elderly will undergo a profound change as the health system continues to adapt itself to the demands of an aging society.
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This article explores the current trends and issues surrounding physician unionization in the United States, using data from secondary sources and nine interviews with leaders of organizations at the forefront of physician unionizing efforts. Several key points are supported by these data and prior unionization research. ⋯ A second key point is that unions will find it difficult to represent self-employed physicians because of the influence of organized medicine and legal barriers to gaining collective bargaining rights for this group. This discussion is intended to raise awareness of the physician union issue among health care policy-makers and researchers.