Exploring managing for health
David J. Hunter in Managing for Health, 2007
As the previous section has shown, public health has, from time to time, flirted with management and in its innocence has been drawn to an inappropriate model that negates the intrinsic strengths of the speciality itself (Hunter 2002). These strengths are derived from its roots in the profession of medicine. In this profession, and others, collegiate forms of working operate in place of hierarchy and rigid levels of management. In such a context, management is founded on trust whereas the managerialism prevalent in many health services in recent years, and evident in much New Public Management thinking, is founded on distrust. Performance management is centred on providing proof of performance and on individuals and organizations answering for what they fail to do. Concepts like ‘chain of command’ and ‘centralization versus decentralization’ are essentially about exercising control.
Health care reforms and cost containment in Sweden
Elias Mossialos, Julian Le Grand in Health Care and Cost Containment in the European Union, 2019
The transfer of financial responsibility for pharmaceuticals in outpatient care from the National Social Insurance Board to the county councils fits well with the long-term trend to decentralize responsibility to the county level. There are also, however, tendencies towards centralization. In part these tendencies can be explained by the urgent need for additional savings. In the forthcoming years, ambitions to merge several county councils (or districts within county councils) into larger units, and continuing efforts to reorganize and down-scale the hospital sector will be important activities. As in several other countries, the capacity of beds and duplication of services in nearby hospitals are discussed along with the appropriate number of hospitals with full emergency services. In recent years some small hospitals have been closed for emergency care. Some of these hospitals have been further specialized, e.g. into centres for day-care surgery or nursing homes.
Is Brachytherapy Cost Effective?
William Y. Song, Kari Tanderup, Bradley R. Pieters in Emerging Technologies in Brachytherapy, 2017
Some countries in Europe, such as Denmark and the United Kingdom have policies to centralize brachytherapy and RT services which translates into larger centers but this is certainly not the case in the majority of countries (Guedea et al., 2010; Dunscombe et al., 2014; Grau et al., 2014). Centralization provides advantages in terms of economies of scale with reduced costs and increased physician expertise (Remonnay et al., 2010; Hulstaert et al., 2013), but must be balanced against the potential disadvantages of increased waiting times and reduced access (Guedea et al., 2010). Another observation ensuing from economic incentives is the increased uptake of HDR compared to LDR in case of lower welfare conditions, potentially related to the fact that HDR equipment allows a significantly larger population of patients to be treated for the same costs compared to traditional LDR (Guedea et al., 2010).
Disaster preparedness networks in rural Midwest communities: Organizational roles, collaborations, and support for older residents
Published in Journal of Gerontological Social Work, 2018
Sato Ashida, Xi Zhu, Erin L. Robinson, Audrey Schroer
Descriptive indices were used to describe the characteristics of the organizations and respondents, organizational roles, and network characteristics. For the network analyses, only the organizations that were a part of Coalition A or Coalition B (n = 55) were included. At the organizational-level, the number of organizational collaborators (i.e. size of the organization’s ego network) and the extent/strength of collaboration were calculated for the nine key areas of disaster preparedness and response listed. At the network-level, dichotomized indicators depicting organizational engagement were used to calculate network density and the degree of centralization. Density was calculated as the number of collaborative ties that exist between organizations, divided by the number of all possible ties among these organizations (Wasserman & Faust, 1994). Centralization measures are based on out-degree centrality (number of organizations one identified as collaborating with). Degree of centralization is the degree to which the centrality of the most central organizations exceeds the centrality of all other organizations, with higher values indicating more centralized networks (Freeman, 1978). Network graphs were constructed using Gephi.
Social network analysis of publication collaboration of accelerating change in MedEd consortium
Published in Medical Teacher, 2022
Sally A. Santen, Jeff Smith, Jeff Shockley, John W. Cyrus, Kimberly D. Lomis, Martin Pusic, George C. Mejicano, Luan Lawson, Bradley L. Allen, Susan Skochelak
Specific metrics of interest at the network level:Average degree describes how connected a typical organizational member is within the network. It is calculated by taking the average number of connections for each organization.Network density describes the number of connections between members. In the context of this study, a denser network would mean organizations are more directly connected to each other while a less dense network would mean fewer connections. Network density is calculated as the proportion of actual connections to all possible connections (range: 0-1).Degree centralization indicates measures of concentration of popularity, efficiency, and power in a network; namely it assesses the ability of specific organizations to serve as central hubs of information extensively involved in relationships among network members. Here, a high degree indicates that few organizations dominate the network.
From Autocracy to Empowerment: Teams with Shared Leadership Perceive their Coaches to be Better Leaders
Published in Journal of Applied Sport Psychology, 2020
Katrien Fransen, Niels Mertens, Stewart T. Cotterill, Gert Vande Broek, Filip Boen
Second, the use of network centralization has been recommended to assess the extent to which the leadership is shared among the entire team (Mayo, Meindl, & Pastor, 2003; Small & Rentsch, 2010). In essence, centralization can be considered as a measure of variance in the degree centrality measures of a network and represents a measure of compactness (for the formula, see Mayo et al., 2003, p. 204). Because this study focused on participants’ indegree (rather than outdegree) centrality in the leadership quality networks (as only the incoming ties matter for one’s leadership quality), we assessed each network’s indegree centralization. To be able to distinguish a truly vertical leadership structure (with the coach as the only leader) from structures with more shared leadership, the coach data were essential to include in the network for calculating network centralization. The values of network centralization range between 0 and 100, where 0 represents a noncentralized network (i.e., when all members are perceived to participate equally in displaying leadership behaviors) and 100 represents a highly centralized network (i.e., when leadership behaviors revolve around a single individual). Previous research examining centralization scores of leadership networks in sports teams demonstrated centralization values between 13.18% and 62.73% (Fransen et al., 2015a).
Related Knowledge Centers
- Palate
- Phoneme
- Phonetics
- Vocal Tract
- Manner of Articulation
- Place of Articulation
- Articulatory Phonetics
- Palatalization
- Vowel
- Vowel Diagram