DISCHARGE PLANNING: A PROCESS MODEL

As the requirements for health care hospitalization have become more demanding, so has the discharge planning process become a more important part of the health services system. A thorough understanding of hospital discharge planning can, then, contribute to our understanding of the health services system. This study involved the development of a process model of discharge planning from hospitals. Model building involved the identification of factors used by discharge planners to develop aftercare plans, and the specification of the roles of these factors in the development of the discharge plan. The factors in the model were concatenated in 16 discrete decision sequences, each of which produced an aftercare plan.^ The sample for this study comprised 407 inpatients admitted to the M. D. Anderson Hospital and Tumor Institution at Houston, Texas, who were discharged to any site within Texas during a 15 day period. Allogeneic bone marrow donors were excluded from the sample. The factors considered in the development of discharge plans were recorded by discharge planners and were used to develop the model. Data analysis consisted of sorting the discharge plans using the plan development factors until for some combination and sequence of factors all patients were discharged to a single site. The arrangement of factors that led to that aftercare plan became a decision sequence in the model.^ The model constructs the same discharge plans as those developed by hospital staff for every patient in the study. Tests of the validity of the model should be extended to other patients at the MDAH, to other cancer hospitals, and to other inpatient services. Revisions of the model based on these tests should be of value in the management of discharge planning services and in the design and development of comprehensive community health services.^

Modelo para la gestión de la ordenación territorial en el Ecuador en el marco de su Constitución

Ecuador, país sudamericano, aprobó en el año 2008 una Constitución en la que subyace un modelo de desarrollo humano multidimensional y alternativo al vigente. Sus dimensiones sociales, económicas, políticas, culturales y ambientales se encuentran en los textos correspondientes a los “Derechos”, “Régimen de Desarrollo” y “Régimen del Buen Vivir”; en tanto que las dimensiones territoriales se hallan expuestas en la “Organización Territorial del Estado”, conformada por regiones, provincias, cantones y parroquias rurales, con sus respectivos gobiernos autónomos descentralizados, a los que la misma Constitución les atribuye, entre otras, las competencias exclusivas de “planificar el desarrollo” y “formular los correspondientes planes de ordenamiento territorial”, y al Estado central la “planificación nacional”. No obstante, el marco legal dictado posteriormente -que otorga al Estado central la competencia de ordenación territorial, mediante la “Estrategia Territorial Nacional”-, no logra regular con eficacia, efectividad y eficiencia este ejercicio competencial, incluyendo en esta condición a los lineamientos técnicos dictados por el organismo nacional de planificación; volviendo urgente la vigencia de una ley que lo asuma, pero que demanda previamente el diseño de un modelo de gestión de estas competencias, propósito al cual procura contribuir el presente trabajo. Su estructura es la siguiente: Capítulo 1: “La problemática, objetivos y antecedentes”, en cuya formulación se destaca el estudio del marco jurídico y técnico vigente en relación a la ordenación territorial, partiendo de una breve visión sobre los empeños previos en Ecuador por adoptarla, y que se complementa con una evaluación preliminar de la experiencia vivida por los gobiernos autónomos descentralizados al formular y gestionar sus primeros planes de desarrollo y de ordenación territorial, en acatamiento del mandato constitucional. Luego se avanza en la definición del objetivo general del trabajo y de un conjunto coherente de objetivos específicos. Concluye este capítulo con el análisis del estado de la cuestión: los antecedentes sobre la ordenación territorial en América Latina, en el marco de sus predecesoras históricas. Capítulo 2: “Diseño del modelo de gestión”, que se inicia con el planteamiento de la metodología a seguir, condicionada especialmente por los propios textos constitucionales que vinculan en la relación de “correspondencia” a la ordenación territorial con la planificación del desarrollo y en consecuencia con el ejercicio de las competencias sectoriales asignadas por ella misma a los diferentes niveles de gobierno. Efectivamente, tal relación supone básicamente que la planificación del desarrollo adquiera el carácter de global, total, vale decir integral, en el sentido de que igualmente contemple sus dimensiones territoriales y que la planificación de éstas se integre a la de las dimensiones sociales, económicas, políticas, culturales y ambientales, de manera tal que en cada uno de los niveles la planificación del desarrollo sea un proceso único y un todo. Por estas condiciones, el diseño en cuestión demanda el tratamiento previo de los aspectos contemplados por la metodología en relación con la conceptualización y ordenamiento de la planificación y gestión del modelo de desarrollo humano previsto por la Constitución para los distintos niveles territoriales, seguido del análisis y evaluación del reparto competencial. En este marco se diseña el modelo de gestión en siete componentes específicos que definen los objetivos estratégicos generales a los cuales apuntará la ordenación territorial, estructuran con sus figuras –los planes–, un sistema integrado de alcance nacional, entienden al propio territorio bajo una visión sistémica y proponen un esquema metodológico general para la redacción de tales instrumentos. Luego se aborda en calidad de tema clave, la articulación con la planificación del desarrollo, el establecimiento de las dimensiones territoriales sectoriales y globales de ordenación en cada nivel territorial, que posibilita a su vez la formulación de los contenidos de las determinaciones de los planes y la definición de un conjunto de lineamientos para su gestión. Capítulo 3. “Verificación”, que se ha concretado en la puesta a consideración de un selecto grupo de expertos nacionales en ordenación territorial, el modelo propuesto siguiendo los procedimientos recomendados para este tipo de consultas. Capítulo 4. “Conclusiones Generales”, esto es, un conjunto coherente de proposiciones que condensan los resultados alcanzados en los diferentes capítulos precedentes y que demuestran la validez del modelo propuesto. ABSTRACT Ecuador approved a constitution, by 2008, where a multidimensional human development model, different to the one in force, underlies. Its social, economic, political, cultural and environmental dimensions are at the entries for "Rights", "Development Scheme" and "Rules of Good Living"; while the territorial dimensions are given by the "Territorial Organization of the State" section, consisting of regions, provinces, cantons and rural parishes, with their respective autonomous governments, to which the Constitution conferred, inter alia, the exclusive powers of "development planning" and "land use plan formulation," while the central state has the "national planning" competence. However, the subsequent issued legal framework - which gives the central state competences over land planning, using the "National Spatial Strategy" - fails to effectively regulate this exercise of jurisdiction, including in this condition the technical guidelines dictated by the national planning agency; thus becoming urgent to put in force a law that assume it, which demands the previous design of a management model of these competences, which is the aim that seeks to contribute the present work. Its structure is as follows: Chapter 1: "The problem, objectives and background" that includes the study of the legal and technical framework in force in relation to land planning, starts with a brief overview of previous efforts to adopt it in Ecuador. The chapter is complemented with a preliminary assessment of the experience of the autonomous governments to formulate and manage their early development plans and land planning, in compliance with the constitutional mandate. Subsequently the overall objective of the work and a coherent set of objectives are defined. This chapter concludes with an analysis of the state of art: the history of land use planning in Latin America in the context of their historical predecessors. Chapter 2, "Design of a management model", which begins with the methodological approach to follow, conditioned by the constitutional texts linking the relationship of "correspondence" land planning with development planning and with the exercise of the sectorial competences assigned by itself to different levels of government. Indeed, such a relationship basically means that development planning should acquire a global, comprehensive, complete, total, character in the sense that it also provides for their territorial dimensions and that their planning is integrated to social, economic, political, cultural and environmental factors, so that in each of the levels, development planning is a unique process and a whole. For these conditions, the design in question demands pretreatment of the aspects covered by the methodology in relation to the conceptualization and management of the planning and management of human development model envisaged by the Constitution to the various territorial levels, followed by analysis and evaluation of the distribution of powers. In this framework a management model is designed into seven specific components that define the overall strategic objectives which aim to land planning, structure plans, and an integrated nationwide system, that understand the territory under a systemic vision and propose a general methodological framework to draft these instruments. Then a key issue is addressed, the coordination with development planning, the establishment of sectorial and regional and global dimensions of management at each territorial level, which in turn allows the formulation of the contents of the plans determinations and defining a set of management guidelines. Chapter 3, "Verification", It has traduced into asking for the revision of the proposed model by a select group of national experts in spatial planning by following recommended procedures for such queries. Chapter 4, "General Conclusions", a coherent set of propositions that summarize the results obtained in the different preceding chapters, which demonstrates the validity of the proposed model.

Delivering essential health care services in rural areas : an analysis of alternative models /

"May 1991."

Distribution of health services in the structure of State government, 1950.

First ed. published in 1929 by John A. Ferrell under title: Health departments of States and provinces of the United States and Canada.

Bulletin - Illinois State Geological Survey.

Mode of access: Internet.

Hazardous substances & public health : a publication of the Agency for Toxic Substances and Disease Registry.

Title from caption.

Report of Illinois Good Roads Commission to the forty-fourth General Assembly.

Mode of access: Internet.

Biennial report of the State Board of Health of Missouri.

Mode of access: Internet.

Public health statistics, State of Oklahoma.

Issues for 1944-71 in parts: pt. 1. Communicable diseases (1944-46), Reportable diseases (1947-70); pt. 2. Births and deaths (1944-71); pt. 3. Accidental deaths (1949-70).

Public health assessment, Huntington Landfill, Town of Huntington, Suffolk County, New York /

"Cerclis No. NYD980506844."

Health consultation, Hertel landfill site, Plattekill, Ulster County, New York /

"Cerclis No. NYD980780779."

Public health assessment, Al Turi Landfill, town of Goshen, Orange County, New York /

"Prepared under a Cooperative Agreement with U.S. Department of Health & Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry."

1990 census population data for Illinois counties and incorporated places /

Includes bibliographical references (p. 29-30)

$150,000,000 State of Illinois general obligation bonds, series of April 2007.

The purpose of the Official Statement Addendum is to set forth the details of sale of the $150,000,000 General Obligation Bonds, Series of April 2007 (the "Bonds"), sold by the State of Illinois (the "State") on April 16, 2007. The Bonds will mature on April 1 of each of the years in the amounts and bearing interest as follows: ... Payment of the principal of the interest on the Bonds naturing on April 1, 2013 through April 1, 2032, inclusive (the "Insured Bonds"), when due, will be guaranteed by a municipal bond insurance policy issued by Financial Guaranty Insurance Company(the "Insurer" or "FGIC") simultaneously with the delivery of the Bonds.

2000 census population for Illinois : counties and incorporated places.

This report provides April 1, 2000 population counts for Illinois, counties and incorporated places, as well as some comparison data from earlier censuses. It also presents data on race and ethnicity, components of growth, historical population trends for the state and its counties. Census 2000 data for this report are from Summary File 1 and were downloaded from the Census Bureau's American FactFinder.