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Statistical evidence shows that medication errors are a major cause of injuries that concerns all health care oganizations. Despite all the efforts to improve the quality of care, the lack of understanding and inability of management to design a robust system that will strategically target those factors is a major cause of distress. The paper aims to discuss these issues.

Achieving optimum organizational performance requires two key variables; work process factors and human performance factors. The approach is that healthcare administrators must take in account both variables in designing a strategy to reduce medication errors. However, strategies that will combat such phenomena require that managers and administrators understand the key factors that are causing medication delivery errors.

The authors recommend that healthcare organizations implement the Toyota Production System (TPS) combined with human performance improvement (HPI) methodologies to eliminate medication delivery errors in hospitals.

Despite all the efforts to improve the quality of care, there continues to be a lack of understanding and the ability of management to design a robust system that will strategically target those factors associated with medication errors. This paper proposes a solution to an ambiguous workflow process using the TPS combined with the HPI system.

Although the United States Congress has attempted to ameliorate some of the adverse impacts of the Balanced Budget Act through the 1999 Balanced Budget Refinement Act, the final results of the reforms to Medicare remain to be seen. This article provides an update and examines the impacts of the Balanced Budget Act on health providers and medical education. The authors also discuss the implications of these impacts for further policy adjustment.

Despite the biological and clinical advances in oral health, dental disease is still a problem for those of low socioeconomic (SE) status, as well as racial and ethnic minorities. In this study, we use the Andersen Behavioral Model of predisposing, enabling, and need factors to examine the effects of race, ethnicity, and income on dental care utilization. Using the Medical Expenditure Panel Survey (MEPS) household component and dental event data (n=8,685), we tested the hypothesis that longer survival or delay in dental care utilization is associated with both minority and lowered SE statuses. Analyses confirm that minority status, income, and education, are predictive of the delay in dental care utilization. This study lends support to the theorized assumption that there are racial and ethnic differences in the pattern of dental care utilization and that these differences as well as other factors contribute to disparity in dental care utilization.

The purpose of this chapter is to examine geographic variations in utilization and need for mental health services. Data for this study were obtained from the 2002 National Survey of American Families. The total sample size was 23,327 adults of aged 18 years and older. Both logistic and linear regression were used to test the possibility of geographical variations. Disparities were found among the 13 U.S. states examined in this study. Results also showed that the percentage of African Americans, state mental health budgets, and mean length of stay in psychiatric hospitals in the state are important predictors of variations in mental health utilization and need variables. These findings suggest that although individual sociodemographic characteristics are important in examining mental health utilization, state characteristics (especially percentage of African Americans, state mental health laws, and mean length of stay in psychiatric hospitals) are also important predictors of variation in utilization of mental health services.

Poor people often experience a delay in meeting their healthcare needs due to their economic situation. As a result, delayed diagnoses and treatment may increase disease severity, increase the risk of death, and enhance disease transmission in the community. The purpose of this paper is to provide important information about health service delays among the poorest people in Turkey.

A field study is conducted among the 92 poorest households in the Etimesgut region of Ankara in order to ascertain any delays in health services among the poor, as well as the factors related to those delays.

The results of the study show that 87 percent of the households lived on a daily income of US$2.15, and that household member's delay seeking healthcare services an average of 4.66±1.17 times in the past year. Reasons for delaying or not seeking healthcare services included the following: participants thought they would get better without doing anything (7.6 percent), by using traditional herbs (12.7 percent), by using pharmaceuticals already on hand (11.4 percent), the health facility was too far away (5.1 percent), and inability to pay (63.3 percent). Significant associations are found between the delaying behaviors, socioeconomic characteristics of households, and health status.

At the end of the study, policy suggestions are provided for improving medical care seeking behaviors and treatment compliance among the poor.

Poverty is a complex and multidimensional phenomenon that consists of income insufficiency, lack of education, malnutrition, and poor health. The relationship between poverty and poor health impacts those who live in poverty as well as communities, organizations and entire countries. Reducing health disparities and decreasing delays and difficulties in access to health care among poor households are important goals.

A primary reason for the increase in uninsured Americans is due to the rising costs of health care that has caused a decline of employment‐based coverage for individuals working for small firms. According to the 1997 US Census Bureau figures, 43 percent of uninsured worked full‐time, and eight out of ten of the uninsured or their dependents were full‐time workers. While significant improvements at the state‐level have occurred to address the unmet health insurance needs of children, less emphasis has been placed on ways to improve access and utilization of health services for uninsured adults. This paper revisits where the health care debate has been over the last decade, system stresses currently being felt by providers in caring for the uninsured population, and the adequacy of the care which they receive. In addition, several incremental strategies for extending Medicaid coverage for children and their families, costs and financing projections, and implications for providers are examined.

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers This paper aims to develop a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the health care industry.

A literature review was conducted. A total of 50 items of literature related to the subject were reviewed.. Various perspectives of competition, the nature of service quality, health system costs, and patient satisfaction in health care are examined

A model of the relationship among these variables is developed. The model depicts patient satisfaction as an outcome measure directly dependent on competition. Quality of care and health care systems costs, while also directly dependent on the strategic mission and goals, are considered as determinants of customer satisfaction as well. The model is discussed in the light of propositions for empirical research.

Empirical studies based on the model proposed in this paper should help identify areas with significant impact on patient satisfaction while maintaining high quality of service at lower costs in a competitive environment.

The authors develop a research model which included propositions to examine the complex issues of competition in the health care industry.

Latinos comprise 12.5 percent of the overall population in the USA, and are the fastest‐growing minority, among which the Mexican‐origin population makes up about 66 percent. Undocumented Latino immigrants are a small, yet important group within the immigrant population. The purpose of this paper is to review the literature and discuss the most important factors that prevent immigrants from accessing health care.

Literature review was conducted from the library database. A total of 50 items of literature related to the subject were reviewed.

Border states have the highest concentration of Mexican‐origin people. The concentration of immigrants in the border has unique health and economic implications due to the vital role they have in US society, contributing both to the economy and diversity of the USA. Despite their important role, they disproportionately lack health insurance, and receive fewer health care services than US‐born citizens. This lack of insurance puts a burden on the nation's economy, and their health status deteriorates as they become more prone to chronic health conditions, and their complications due to lack of primary medical attention.

Tailored public health interventions that address the health needs of Latino immigrants in the USA need to be based on reliable data and statistics in order to effectively place resources, and to track achievements and flaws.