Distribution of Health Services in the Structure of State Government

OVERVIEWPublic hospitals have been defined by some as those owned by government entities and by others as those controlled (operated) by governments. At the non-federal levels, at least, the two definitions are almost, but not entirely, synonymous. Some publicly owned hospitals are operated by private entities, and some privately owned hospitals are operated by governments. In this review the term "local public general hospitals" refers only to those owned by local governments-general purpose governments like counties, cities, and joint city-county arrangements, and special purpose governments chartered by the state like special hospital districts or authorities. The focus is further restricted to those local public-general hospitals whose primary function is to serve low income populations. These comprise mainly the large urban public hospitals, but also those rural hospitals that serve primarily the poor because there are other hospitals in their vicinity that serve primarily paying patients.The types and numbers of the various publicly owned hospitals, as well as the justification for this restriction of focus, are discussed in further detail toward the end of the chapter.The literature dealing with the development and recent trends in the evolu tion of the local public hospital serving the poor reflects the fact that it has for many years posed a special problem for local governments. The special nature of this problem stems, in large measure, from the ambiguous status of the local government's responsibility for maintaining such a public general hospital. 53

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Methods and Management: NIH Administrators, Federal Oversight, and the Framingham Heart Study

Patel¹

2012

bhm

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Summary This article explores the 1965 controversy over the Framingham Heart Study in the midst of growing oversight into the management of science at the National Institutes of Health (NIH). It describes how, beginning in the early 1960s, federal overseers demanded that NIH administrators adopt particular management styles in administering programs and how these growing pressures led administrators to favor investigative pursuits that allowed for easy prospective accounting of program payoffs, especially those based on experimental methods designed to examine discrete interventions or outcomes of interest. In light of this changing managerial culture within the NIH, the Framingham study and other population laboratories—with their bases in observation and in open-ended study designs—became harder for NIH administrators to justify and defend.

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Distribution of Health Services in the Structure of State Government

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AirPollution ProblemsandControl Programsin the United States

AirPollution ProblemsandControl Programsin the United States

Early Developments and Recent Trends in the Evolution of the Local Public Hospital

Methods and Management: NIH Administrators, Federal Oversight, and the Framingham Heart Study

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