NATIVE AMERICAN HEALTH care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations.
These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding.
The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced.
The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate.
The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.
Mots-clés Pascal : Soin santé primaire, Historique, Enquête publique, Facteur qualité, Aspect social, Environnement programmation, Ethnie, Article synthèse, Etats Unis, Amérique du Nord, Amérique, Homme, Organisation santé
Mots-clés Pascal anglais : Primary health care, Case history, Public inquiry, Q factor, Social aspect, Programming environment, Ethnic group, Review, United States, North America, America, Human, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0196623
Code Inist : 002B30A03C. Création : 11/09/1998.