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Our approach was done within the VA health care system, which functions largely as a staff model health maintenance organization.
Our finding of concordance on many indicators between the Group and Staff Model divisions suggests that a less tightly organized provider system may perform as well as a staff model HMO.
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It was begun in 1981 as Harvard Community Health Plan, a Staff Model HMO that at the time of this study comprised about 300,000 members at fourteen health centers in the greater Boston area.
O'Malley et al. [64] referred to this diversity as a multispecialty staffing model.
The literature is peppered with unreferenced comments that certain types of managed care arrangements, such as staff model HMOs and IPAs lack pediatric subspecialty care providers in their networks [ 48, 49].
MBI-PE scores were higher in agents (as opposed to supervisors/technical staff) (model 1) and in officers with lower emotional stability (model 2), and were associated with higher demand, higher effort, higher overcommitment and lower reward (models 3 5).
This approach originated in the western United States in the form of staff model plans such as Kaiser Permanente which employed physicians and other caregivers directly.
Second, the impact of telemedicine likely depends on characteristics of the environment in which it is deployed, including ICU organization (such as physician-staffing model and use of protocols) and patient case mix.
For example some of the differences seen in our study between the Group and Staff Model were probably due to organizational processes and systems in place in the Staff Model, such as physician reminder systems for preventive services leading to higher rates of breast cancer screening.
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4. In order for students to regard using an online community as professionally valuable they must see senior staff modelling a collective approach to its use.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com