Y2K: ready or not ... survey: millennium bug is sapping time and resources, but execs are glancing beyond 2000

Healthcare systems looking to power their networks with state-of-the-art information systems have been stung by the millennium bug. But if there is a silver lining to this infestation, it's that senior executives have come to find out the real value of their computer networks.

Chock-full of change. Opportunities, and perils, abound as industry continues to evolve

Tighten your belt and hold onto your wallet: Another year of change looms for healthcare. In a 1999 outlook report, our staff tells all about Medicare cutbacks, managed-care turbulence and a looming crisis in skilled nursing. And everyone is braced for the appearance of that ugly year-2000 computer bug.

All benchmarked out. Even the top 100 hospitals can't find many more ways to be more productive

The nation's best-performing hospitals, as determined by two healthcare management and consulting firms, still register results that separate them from the pack. The hospitals' successes are chronicled in 100 Top Hospitals: Benchmarks for Success, an annual analysis that uses nine measures of clinical, operational and financial performance to rate hospitals.

See you in court. Damage inflicted by the Y2K bug threatens to become a dream for litigators but a nightmare for healthcare executives

Most hospitals and health systems perceive and treat the year-2000 faulty computer code as a technical problem, but it is a high-level management problem. If hospitals don't start preparing comprehensively, they will face a host of consequences. Experts say spillover will extend into business issues, finances and liability. But providers must choose their most important priorities and develop contingency plans.

Healthcare international

How people are treated when they need medical care depends on where in the world they are. In deciding which tools of the medical trade are used to treat disease and when they're used, location is paramount. A country's social policy, healthcare payment systems and cultural factors bear heavily on the utilization of medical technology. The cover story kicks off the magazine's third international healthcare section.

Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness

OBJECTIVES

This study evaluated the hypothesis that greater integration and coordination between agencies within service systems is associated with greater accessibility of services and improved client housing outcomes.

METHODS

As part of the Access to Community Care and Effective Services and Supports program, data were obtained on baseline client characteristics, service use, and 3-month and 12-month outcomes from 1832 clients seen at 18 sites during the first year of program operation. Data on interorganizational relationships were obtained from structured interviews with key informants from relevant organizations in each community (n = 32-82 at each site).

RESULTS

Complete follow-up data were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superior housing outcomes at 12 months, and this relationship was mediated through greater access to housing agencies.

CONCLUSIONS

Service system integration is related to improved access to housing services and better housing outcomes among homeless people with mental illness.

Transcription factor NF-kappaB regulation of renal fibrosis during ureteral obstruction

Irrespective of the etiology, many kidney diseases result in inflammation and fibrosis of the tubulointerstitium, with the subsequent loss of renal function. To initiate any disease process or for any disease process to progress, there must be changes in the transcription of genes within the affected tissue. The nuclear factor-kappa B (NF-kappaB) family of transcription factors regulates genes involved in inflammation, cell proliferation, and cell differentiation. This review discusses the NF-kappaB transcription factor family in general and the association of NF-kappaB activation with cellular/molecular events of renal inflammation and fibrosis.