The four Visegrad states — Poland, the Czech Republic, Slovakia (until 1993 Czechoslovakia) and Hungary — form a compact area between Germany and Austria in the west and the states of the former USSR in the east. They are bounded by the Baltic in the north and the Danube river in the south. They are cut by the Sudeten and Carpathian mountain ranges, which divide Poland off from the other states. Poland is an extension of the North European plain and like the latter is drained by rivers that flow from south to north west — the Oder, the Vlatava and the Elbe, the Vistula and the Bug. The Danube is the great exception, flowing from its source eastward, turning through two 90-degree turns to end up in the Black Sea, forming the barrier and often the political frontier between central Europe and the Balkans. Hungary to the east of the Danube is also an open plain. The region is historically and culturally part of western Europe, but its eastern Marches now represents a vital strategic zone between Germany and the core of the European Union to the west and the Russian zone to the east.

Economy and Society

The Theory of Communicative Action, Vol. 1, Reason and the Rationalization of Society

Evaluating the quality of medical care.

http://nurmandi.staff.umy.ac.id/files/2012/02/10.1.1.108.71611.pdf

An institutional perspective on performance measurement and management in the `new public sector'

Access to good-quality health services is crucial for the improvement of many health outcomes, such as those targeted by the Millennium Development Goals (MDGs) adopted by the international community in 2000. The health-related MDGs cannot be achieved if vulnerable populations do not have access to skilled personnel and to other necessary inputs. This paper focuses on the geographical dimension of access and on one of its critical determinants: the availability of qualified personnel. The objective of this paper is to offer a better understanding of the determinants of geographical imbalances in the distribution of health personnel, and to identify and assess the strategies developed to correct them. It reviews the recent literature on determinants, barriers and the effects of strategies that attempted to correct geographical imbalances, with a focus on empirical studies from developing and developed countries. An analysis of determinants of success and failures of strategies implemented, and a summary of lessons learnt, is included.

/pdf/not-enough-there-too-many-here-understanding-geographical-3q7y0w7v6z.pdf

Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce.

Organizational performance remains an elusive concept despite its importance to health care organizations' (HCOs') management and analysis. This paper uses Parsons' social system action theory to develop a comprehensive theoretically grounded framework by which to overcome the current fragmented approach to HCO performance management. The Parsonian perspective focuses on four fundamental functions that an HCO needs to ensure its survival. Organizational performance is determined by the dynamic equilibrium resulting from the continual interaction of, and interchange among, these four functions. The alignment interchanges allow the creation of bridges between traditional models of organizational performance that are usually used as independent and competing models. The attraction of the Parsonian model lies in its capacity to: (1) embody the various dominant models of organizational performance; (2) present a strong integrative framework in which the complementarity of various HCO performance perspectives are well integrated while their specificity is still well preserved; and (3) enrich the performance concept by making visible several dimensions of HCO performance that are usually neglected. A secondary objective of this paper is to lay the foundation for an integrative process of arbitration among competing indicators and perspectives which is absolutely necessary to make operational the Parsonian model of HCO performance. In this matter, we make reference to the theory of communicative action elaborated by Habermas. It offers, we think, a challenging and refreshing perspective on how to manage HCO performance evaluation processes.

A conceptual framework for the analysis of health care organizations' performance.

As health care organizations look for ways to ensure cost-effective, high quality service delivery while still meeting patient needs, organizational performance assessment (OPA) is useful in focusing improvement efforts. In addition, organizational performance assessment is essential for ongoing management decision-making, operational effectiveness and strategy formulation. In this paper, the roles and impact of OPA models in use in health care are reviewed, and areas of potential abuse, such as myopia, tunnel vision and gaming, are identified. The review shows that most existing OPA models were developed primarily as sources of information for purchasers or consumers, or to enable providers to identify areas for improvement. However, there was little conclusive evidence evaluating their impact. This review of existing OPA models enabled the establishment of principles for the development, implementation and prevention of abuse of OPA specific to health care. The OPA models currently in use in health care may provide managers with false confidence in their ability to monitor organizational performance. To further enhance the field of OPA, areas for future research are identified.

A review of organizational performance assessment in health care.

https://isiarticles.com/bundles/Article/pre/pdf/8297.pdf

Evaluation of the implementation fidelity of an ergonomic training program designed to prevent back pain

An in-depth review found that only 15 Canadian youth suicide programs had been evaluated over the last decades Most of these were conducted in schools; general education on suicide was the most common strategy used The descriptions of the programs were incomplete, and their theoretical bases never presented All evaluations looked at program effects in accordance with the predominant experimental paradigm in evaluative research Only two of the programs led to a reduction in suicidal behavior Future evaluative research should place greater emphasis on the content of programs, especially their theoretical bases

Is evaluative research on youth suicide programs theory-driven? The Canadian experience.

A literature search (restricted to Australia, Canada and the USA) finds out 37 papers dealing with the topic. The factors are grouped into 3 areas : personal, occupational and environmental. In each area, the search tries to identify the determinants of attraction, of installation and of retention. However, more works are needed to better understand how these factors interact at the various stages (attraction, installation, retention) of the decision-making process of a medical doctor. Undoubtedly, the weight of each factor varies when the health system undergoes profound changes (e.g. drastic increase of the female doctors within the profession) or when the society itself changes its values regarding work, family, leisure...

Henriette Bilodeau

Papers

A conceptual framework for the analysis of health care organizations' performance.

A review of organizational performance assessment in health care.

Evaluation of the implementation fidelity of an ergonomic training program designed to prevent back pain

Is evaluative research on youth suicide programs theory-driven? The Canadian experience.

Recension des principaux facteurs d'attraction, d'installation et de maintien des médecins en régions éloignées.