New approaches to academic health center affiliations: public hospitals and the Department of Veterans Affairs.

Boufford, J. I., Gage, L., Kizer, K. W., Marcos, L. R., Short, J. H., & Garrett, K. E.

Publication year

1999

Journal title

Issue brief (Commonwealth Fund)

Issue

330

Page(s)

1-5

Crisis, leadership, consensus: The past and future federal role in health

Boufford, J. I.

Publication year

1999

Journal title

Journal of Urban Health

Volume

76

Issue

2

Page(s)

192-206
Abstract
This paper touches on patterns of federal government involvement in the health sector since the late 18th century to the present and speculates on its role in the early decades of the 21st century. Throughout the history of the US, government involvement in the health sector came only in the face of crisis, only when there was widespread consensus, and only through sustained leadership. One of the first health-related acts of Congress came about as a matter of interstate commerce regarding the dilemma as to what to do about treating merchant seamen who had no affiliation with any state. Further federal actions were implemented to address epidemics, such as from yellow fever, that traveled from state to state through commercial ships. Each federal action was met with concern and resistance from states' rights advocates, who asserted that the health of the public was best left to the states and localities. It was not until the early part of the 20th century that a concern for social well-being, not merely commerce, drove the agenda for public health action. Two separate campaigns for national health insurance, as well as a rapid expansion of programs to serve the specific health needs of specific populations, led finally to the introduction of Medicaid and Medicare in the 1960s, the most dramatic example of government intervention in shaping the personal health care delivery system in the latter half of the 20th century. As health costs continued to rise and more and more Americans lacked adequate health insurance, a perceived crisis led President Clinton to launch his 1993 campaign to insure every American - the third attempt in this century to provide universal coverage. While the crisis was perceived by many, there was no consensus on action, and leadership outside government was missing. Today, the health care crisis still looms. Despite an economic boom, 1 million Americans lose their health insurance each year, with 41 million Americans, or 15% of the population, lacking coverage. Private premiums are going up again as federal programs are capped and the lack of a federal framework for quality assurance leads to growing problems of access and quality that will need to be addressed as we enter the 21st century. What role will government play?.

Residency program in social medicine and family practice.

Boufford, J.

Publication year

1979

Journal title

Journal of Ambulatory Care Management

Volume

2

Issue

2

Page(s)

66-71

One person's health care perspective from both sides of the Atlantic.

Boufford, J. I.

Publication year

1990

Journal title

Michigan hospitals

Volume

26

Issue

9

Page(s)

20-21

Primary care residency training: the first five years

Boufford, J. I.

Publication year

1977

Journal title

Annals of Internal Medicine

Volume

87

Issue

3

Page(s)

359-368
Abstract
The training of physicians for the delivery of primary care is becoming a national priority. The period of residency training is viewed by many as the focal point for educational change to meet this demand. The Residency Program in Social Medicine at Montefiore Hospital and Medical Center was begun in 1970 and offers primary care residency training toward board eligibility in internal medicine, pediatrics, or family practice. The pairing concept of scheduling guarantees the resident a continuity of care experience for his own panel of patients at the ambulatory site. The hospital and the ambulatory site share the cost of residents' salaries. Primary care curriculum for clinical and clinical-support areas, delivery-site design, and faculty-utilization models must all be uniquely suited to the training of the future primary care practitioner. Resident recruitment and selection and the involvement of residents in the management of the residency program are crucial features of program success and training for future practice.

Evaluating self-help support groups for medical students

Goetzel, R. Z., Croen, L. G., Shelov, S., Boufford, J. I., & Levin, G.

Publication year

1984

Journal title

Journal of Medical Education

Volume

59

Issue

4

Page(s)

331-340
Abstract
Self-help support groups for medical students represent one strategy for dealing with the emotional stresses of medical training and the diminished human sensitivity of students that often accompanies that experience. Support groups at the Albert Einstein College of Medicine were evaluated by 26 students who completed a nine-part questionnaire. The respondents indicated that they were primarily drawn to these groups because of a desire for social affiliation and an opportunity to express their feelings in a “safe” environment. Members shared in the leadership responsibilities of the group and dealt with external personal problems of the students rather than with the internal group dynamics. The gains derived from participation in these groups included opportunities for nonprofessional contact with faculty members, getting help and support from fellow students, and participation in stimulating discussions about the medical field. Students rated the groups as “meaningful” and expressed a desire for more frequent meetings.

Marijuana: current federal law remains in effect.

Boufford, J. I., & Richard, M. M.

Publication year

1997

Journal title

Connecticut medicine

Volume

61

Issue

4

Page(s)

229-230

Innovating healthcare delivery to address noncommunicable diseases in low-income settings: The example of hypertension

Piot, P., Aerts, A., Wood, D. A., Lamptey, P., Oti, S., Connell, K., Dorairaj, P., Boufford, J. I., Caldwell, A., & Perel, P.

Publication year

2016

Journal title

Future Cardiology

Volume

12

Issue

4

Page(s)

401-403
Abstract
London Dialogue event, The Hospital Club, 24 Endell St, London, WC2H 9HQ, London, UK, 1 December 2015 Hypertension is a global health issue causing almost 10 million deaths annually, with a disproportionate number occurring in low- and middle-income countries. The condition can be managed effectively, but there is a need for innovation in healthcare delivery to alleviate its burden. This paper presents a number of innovative delivery models from a number of different countries, including Kenya, Ghana, Barbados and India. These models were presented at the London Dialogue event, which was cohosted by the Novartis Foundation and the London School of Hygiene & Tropical Medicine Centre for Global Noncommunicable Diseases on 1 December 2015. It is argued that these models are applicable not only to hypertension, but provide valuable lessons to address other noncommunicable diseases.

Managing the unmanageable: Public hospital systems

Boufford, J. I.

Publication year

1991

Journal title

The International Journal of Health Planning and Management

Volume

6

Issue

2

Page(s)

143-154
Abstract
There are significant challenges to those who work in large public health care delivery systems: political imperatives; resource constraints; sometimes rigid personnel systems; and, the reality that everything occurs in a public forum. The fact that many nations are reviewing and, in some instances, restructuring their national health care systems, has added to the complexity and feeling of continual turbulence experienced by their managers. State run systems like that in the United Kingdom are introducing market forces to increase effectiveness and value for money; while market systems, like that in the United States, are increasing regulatory interventions to achieve the kind of cost control available to countries with large public systems which operate with global budgets. Public hospitals in the United States offer examples of public institutions operating in a highly competitive market environment. A decade of management changes undertaken to enhance the efficiency and effectiveness of the New York City Health and Hospitals Corporation (HHC), the largest public hospital system in the United States, is presented as a case study of public health services and public management in a market environment.

US and UK health care reforms: reflections on quality.

Boufford, J. I.

Publication year

1993

Journal title

Quality in health care : QHC

Volume

2

Issue

4

Page(s)

249-252
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