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  1. Upstairs downstairs : Vertical integration of a pediatric service.

    Article - En anglais


    The combined effects of recent changes in health care financing and training priorities have compelled academic medical centers to develop innovative structures to maintain service commitments yet conform to health care marketplace demands.

    In 1992, a municipal hospital in the Bronx, New York, affiliated with a major academic medical center reorganized its pediatric service into a vertically integrated system of four interdependent practice teams that provided comprehensive care in the ambulatory as well as inpatient settings.

    One of the goals of the new system was to conserve inpatient resources.


    To describe the development of a new vertically integrated pediatric service at an inner-city municipal hospital and to test whether its adoption was associated with the use of fewer inpatient resources.


    A descriptive analysis of the rationale, goals, implementation strategies, and structure of the vertically integrated pediatric service combined with a before-and-after comparison of in-hospital resource consumption.


    A before-and-after comparison was conducted for two periods : the period before vertical integration, from January 1989 to December 1991, and the period after the adoption of vertical integration, from July 1992 to December 1994. (...)

    Mots-clés Pascal : Service hospitalier, Pédiatrie, Organisation, Soin, Amélioration, Etage, Etats Unis, Amérique du Nord, Amérique

    Mots-clés Pascal anglais : Hospital ward, Pediatrics, Organization, Care, Improvement, Stage, United States, North America, America

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0356893

    Code Inist : 002B30A04D. Création : 25/01/1999.