Notes from the Book Review Editor

Book Reviews Notes from the Book Review Editor Three of the books reviewed in this issue of Health Services Research deal with the efficiency with which hospitals operate and relate to one another in community health services systems. Reviewed by Jack Kasten, Peterson, Manchester, and Toan's book provides a useful descriptive overview of current techniques for enhancing hospital efficiency. William Stratmann and Ralph Ullman recount the effort of Rochester's Genesee Hospital to develop a hospital-based, full-time salaried group medical practice; Sidney J. Lee recommends the book for its description of a long-term evaluation of a hospital initiative in ambulatory care. A new book by Murray Milner presents a sociological analysis of the interorganizational linkages among three urban hospitals and a comprehensive primary health care clinic. Odis Bigus sees Milner's work as an example of how qualitative case-study material can illuminate some of the more important policy issues in health care. A somewhat related book, reviewed by Jerry Weston, is a summary of a conference on automated hospital nursing information systems edited by Harriet Werley and Margaret Grier. It should prove useful to those interested in the research implications and adoption of automated systems. Another group of books examines the economic and social costs of chronic illness care and the care of the terminally ill. In a collection of ten papers on the Social and Economic Impacts of Coronary Artery Disease edited by Edgar Charles and Jennie Kronenfeld, John P. Bunker discovers thought-provoking information on the impact of new medical technology on both medical practice and public policy for health care. Billy Philips' review of Howard Greenwald's sociological study of the problem of cancer control raises questions about our society's technical and social capacity to deal with a disease of this complexity. Paul DuBois' new book describes the attempt to develop hospice care as an alternative institutional arrangement for the care of dying patients. Martita Marx provides not only a detailed critique of DuBois' work, but an overview of current developments in the field of terminal care and other recent books on the subject of hospice. Address communications and requests for reprints to Gordon H. DeFriese, Health Services Research Center, University of North Carolina, Chase Hall 132-A, Chapel Hill, NC 27514. Health Services Research 0017-9124/81/1604-0477/$02.50/0

478

Health Services Research 16:4 (Winter 1981)

Finally, we have included a review, by James E.C. Walker, of a new text by Alan Dever that synthesizes some of the latest methods of data analysis and presentation for community health planning and organizes the discussion of these techniques with respect to a comprehensive (or holistic) theoretical framework. GORDON H. DEFRIESE

ON HOSPITALS, THEIR EFFICIENCY, ANDTHEIR COMMUNITY SETrINGS Enhancing Hospital Efficiency. John Peterson, David Manchester, and Arthur Toan. Washington, D.C.: AUPHA Press, 1980. viii + 142 pp. The authors have provided an extensive description of techniques used by fourteen institutions visited as part of the long-range planning process by representatives of the Valley Hospital of Ridgewood, New Jersey. The focus is on extending the resources of institutions to cover larger numbers of patients. The book focuses on case handling by physicians and the interaction of hospital resources in the process of case handling. The organization of the book is sensible because it separately describes clusters of techniques surrounding the scheduling process, support services and their contribution to effective patient handling, and the impact of physician practices on lengths of stay. The authors also explore alternatives to hospital care and effective use of other community resources. Chapters on education and regulation consider strategies for achieving improved effi-

ciency. Chapter 2 focuses on the throughput with good descriptions of programs for increasing the availability of resources, leveling out peaks and valleys, and managing the admission and discharge process. It is particularly useful because it treats cancellation of admission or surgery in a straightforward manner. There is a section on outpatient or one-day surgery that describes this program's contribution to regularizing patient flow. Chapter 3 describes programs in the support services which contribute to efficient delivery through maximizing responsiveness to the diagnostic and therapeutic needs of patients as they are processed through the hospital system. It treats such issues as availability of diagnostic and therapeutic modalities on short notice when necessary and prompt reporting systems to assure that lack of information does not interfere with the critical path in patient care. Included in this grouping is a section on the availability of consultants, demonstrating that there are physicians' services as well as