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Article ; Online: Grateful Patient Philanthropy: A Challenge to Organizational Ethics.

Culbertson, Richard

2022 Volume 12, Issue 1, Page(s) 47–52

Abstract: An examination of organization development in health care reveals a pattern of increasing reliance of academic medical centers toward new sources of revenue in support of operations. This trend is partly in response to the reduction of traditional ... ...

Abstract	An examination of organization development in health care reveals a pattern of increasing reliance of academic medical centers toward new sources of revenue in support of operations. This trend is partly in response to the reduction of traditional funding sources such as public appropriations and tuition. Clinical income from faculty earnings and hospital transfer payments have supplanted heritage funding sources and are now predominantly institutional transactions rather than physician-patient interactions. Grateful patient philanthropy can be viewed as moving toward transactional status, with challenging ethical questions for the involved physician and patient as institutional control increases.
MeSH term(s)	Academic Medical Centers ; Ethics, Institutional ; Fund Raising ; Humans ; Physicians
Language	English
Publishing date	2022-08-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2632728-4
ISSN	2157-1740 ; 2157-1732
ISSN (online)	2157-1740
ISSN	2157-1732
DOI	10.1353/nib.2022.0016
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Attaining the quadruple aim of worker well-being in the CovID-19 crisis: Competing ethical priorities

Culbertson, R. A.

Journal of Health Care Finance

Abstract: The COVID-19 pandemic presents ethical challenges to health care organizations and society as a whole regarding protection from a lethal communicable disease In traditional medical ethics, we make an appeal to the duty of the professional to serve in the ...

Abstract	The COVID-19 pandemic presents ethical challenges to health care organizations and society as a whole regarding protection from a lethal communicable disease In traditional medical ethics, we make an appeal to the duty of the professional to serve in the face of personal peril At the same time, health care organizations are obligated to furnish protective equipment and provide a safe workplace in order to mitigate risk The ethical calculus of utility, or greatest good for the greatest number, supplies some guidance in situations of scarce resources by sustaining as large a presence of front line workers through prevention or therapeutic intervention to combat disease Determinations of utility do not absolve health care organizations of a duty to protect and avert future crises through better planning A misguided pursuit of efficiency has resulted in excessive burden of risk for health workers providing direct patient care and for workers in supporting roles There is an important duty to plan to lessen such risk in future pandemics
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #619016
Database	COVID19

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Article: The Ethics of Big Data. There's a fine line between patient privacy and identifying better forms of treatment.

Culbertson, Richard

Healthcare executive

2015 Volume 30, Issue 6, Page(s) 44, 46–7

MeSH term(s)	Confidentiality ; Data Collection/ethics ; Information Management/ethics ; Quality of Health Care
Language	English
Publishing date	2015-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	639495-4
ISSN	0883-5381
ISSN	0883-5381
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 2395: Show issues

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Article: Ethics in clinical research. Executives must ensure trial participants' protection and the public's best interest.

Culbertson, Richard

Healthcare executive

2013 Volume 28, Issue 3, Page(s) 60–61

MeSH term(s)	Biomedical Research/ethics ; Health Facility Administrators ; Humans ; Professional Role ; Research Subjects ; United States
Language	English
Publishing date	2013-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	639495-4
ISSN	0883-5381
ISSN	0883-5381
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Zs.A 2395: Show issues

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Article: Exploring Successful Implementation of Organizational Supports at the Worksite Environment: A Mixed Methods Approach.

Underwood, Renee A / Wood, Ralph J / Tomchek, Alexandra D / Celestin, Michael D / Culbertson, Richard / Phillippi, Stephen / Broyles, Stephanie T

Health promotion practice

2022 Volume 25, Issue 2, Page(s) 188–195

Abstract: While there is evidence that organizational supports may lead to better employee health, research on implementing such organizational supports is lacking. This research sought to understand organizational supports and implementation of those supports ... ...

Abstract	While there is evidence that organizational supports may lead to better employee health, research on implementing such organizational supports is lacking. This research sought to understand organizational supports and implementation of those supports using an Explanatory Sequential Mixed Methods design approach. Employee survey responses (
MeSH term(s)	Humans ; Communication ; Health Behavior ; Health Promotion ; Leadership ; Workplace
Language	English
Publishing date	2022-11-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2036801-X
ISSN	1552-6372 ; 1524-8399
ISSN (online)	1552-6372
ISSN	1524-8399
DOI	10.1177/15248399221127045
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A U.S. perspective on AHSCs: a future of increased diversification.

Culbertson, Richard

HealthcarePapers

2003 Volume 2, Issue 3, Page(s) 66–72; discussion 111–4

Abstract: Academic Health Sciences Centres (AHSCs) have long been viewed much as the historic battleship - possessing great force, power and bulk, but increasingly vulnerable to forays of lighter and more agile competitors. This commentary reviews the efforts of ... ...

Abstract	Academic Health Sciences Centres (AHSCs) have long been viewed much as the historic battleship - possessing great force, power and bulk, but increasingly vulnerable to forays of lighter and more agile competitors. This commentary reviews the efforts of leaders of AHSCs in the United States to reposition their institutions at the centre of integrated delivery systems, partly as a result of greatly increased reliance on clinical revenue to support the historic teaching mission. While Lozon and Fox point to increased involvement of AHSCs in broad regional systems of care financed through a coordinated strategy, integrated systems in the United States may be fragmenting as marketplace-driven financial schemes actually discourage integrated care. From the perspective of organizational theory, the future seems to imply a diversification of organizational forms for the AHSCs in the United States, with a corresponding strategy of lessening reliance on clinical revenues through enhancement of research funding.
MeSH term(s)	Academic Medical Centers/organization & administration ; Academic Medical Centers/trends ; Delivery of Health Care, Integrated/organization & administration ; Economic Competition ; Financing, Organized/organization & administration ; Hospital Restructuring ; Humans ; Leadership ; Models, Organizational ; Organizational Objectives ; Regional Medical Programs ; Research Support as Topic ; United States
Language	English
Publishing date	2003-06-10
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2141700-3
ISSN	1488-917X
ISSN	1488-917X
DOI	10.12927/hcpap..17207
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Best practice considerations on the assessment of robotic assisted surgical systems: results from an international consensus expert panel.

Erskine, Jamie / Abrishami, Payam / Charter, Richard / Cicchetti, Americo / Culbertson, Richard / Faria, Eliney / Hiatt, Jo Carol / Khan, Jim / Maddern, Guy / Patel, Anita / Rha, Koon Ho / Shah, Paresh / Sooriakumaran, Prasanna / Tackett, Scott / Turchetti, Giuseppe / Chalkidou, Anastasia

International journal of technology assessment in health care

2023 Volume 39, Issue 1, Page(s) e39

Abstract: Background: Health technology assessments (HTAs) of robotic assisted surgery (RAS) face several challenges in assessing the value of robotic surgical platforms. As a result of using different assessment methods, previous HTAs have reached different ... ...

Abstract	Background: Health technology assessments (HTAs) of robotic assisted surgery (RAS) face several challenges in assessing the value of robotic surgical platforms. As a result of using different assessment methods, previous HTAs have reached different conclusions when evaluating RAS. While the number of available systems and surgical procedures is rapidly growing, existing frameworks for assessing MedTech provide a starting point, but specific considerations are needed for HTAs of RAS to ensure consistent results. This work aimed to discuss different approaches and produce guidance on evaluating RAS. Methods: A consensus conference research methodology was adopted. A panel of 14 experts was assembled with international experience and representing relevant stakeholders: clinicians, health economists, HTA practitioners, policy makers, and industry. A review of previous HTAs was performed and seven key themes were extracted from the literature for consideration. Over five meetings, the panel discussed the key themes and formulated consensus statements. Results: A total of ninety-eight previous HTAs were identified from twenty-five total countries. The seven key themes were evidence inclusion and exclusion, patient- and clinician-reported outcomes, the learning curve, allocation of costs, appropriate time horizons, economic analysis methods, and robotic ecosystem/wider benefits. Conclusions: Robotic surgical platforms are tools, not therapies. Their value varies according to context and should be considered across therapeutic areas and stakeholders. The principles set out in this paper should help HTA bodies at all levels to evaluate RAS. This work may serve as a case study for rapidly developing areas in MedTech that require particular consideration for HTAs.
MeSH term(s)	Humans ; Robotic Surgical Procedures ; Ecosystem ; Consensus ; Research Design ; Learning Curve
Language	English
Publishing date	2023-06-05
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	632573-7
ISSN	1471-6348 ; 0266-4623
ISSN (online)	1471-6348
ISSN	0266-4623
DOI	10.1017/S0266462323000314
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Article ; Online: Androgen-deprivation therapy versus radical prostatectomy as monotherapy among clinically localized prostate cancer patients

Liu J / Shi L / Sartor O / Culbertson R

OncoTargets and Therapy, Vol 2013, Iss default, Pp 725-

2013 Volume 732

Abstract: Jinan Liu,1 Lizheng Shi,2,3 Oliver Sartor,3 Richard Culbertson2,31HealthCore, Wilmington, DE, USA; 2School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; 3School of Medicine, Tulane University, New Orleans, LA, ... ...

Abstract	Jinan Liu,1 Lizheng Shi,2,3 Oliver Sartor,3 Richard Culbertson2,31HealthCore, Wilmington, DE, USA; 2School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; 3School of Medicine, Tulane University, New Orleans, LA, USABackground: The most recent randomized controlled trial in a predominantly prostate-specific antigen-detected prostate cancer (PC) population found a nonsignificant reduction in mortality from radical prostatectomy (RP) compared to conservative management. The optimal treatment for clinically localized prostate cancer is anything but clear. The PC-specific mortality and all-cause mortality were compared between primary androgen-deprivation treatment (PADT) and RP, both as monotherapy, among clinically localized PC patients.Methods: A retrospective cohort study among PC patients in Surveillance, Epidemiology and End Results-Medicare data with a median follow up of 2.87 years in the PADT cohort and 2.95 years in the RP cohort. Propensity score-matching was employed to adjust for the observed selection bias. PC-specific mortality and all-cause mortality were modeled using the Fine and Gray competing risk model and Cox proportional hazards model, respectively. The independent variables in these models included age, race, Gleason score risk groups, T-score, prostate-specific antigen, Charlson comorbidity, and index year of treatment initiation.Results: After propensity score-matching, there were 1624 in the PADT cohort and 1624 in the RP cohort. All baseline values were comparable (all P-values >0.35). There were a total of 266 deaths (16.38%) and 60 (3.69%) PC-specific deaths among PADT recipients, while there were 56 (3.45%) deaths and four (0.25%) PC-specific deaths among RP recipients. According to the Kaplan–Meier estimation, the 8-year survival rate was 43.39% in the PADT cohort and 79.62% in the RP cohort. PADT was associated with increased risk of overall mortality (hazard ratio = 2.98, 95% confidence interval 2.35–3.79; P < 0.001) and increased risk of PC-specific mortality (hazard ratio = 12.47, 95% confidence interval 4.48–34.70; P < 0.001).Conclusion: With adjustment for the observed selection bias, PADT was associated with increased all-cause mortality and PC-specific mortality when compared to RP.Keywords: prostate cancer, primary androgen-deprivation treatment, radical prostatectomy, survival
Keywords	Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Oncology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	310
Language	English
Publishing date	2013-06-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Androgen-deprivation therapy versus radical prostatectomy as monotherapy among clinically localized prostate cancer patients.

Liu, Jinan / Shi, Lizheng / Sartor, Oliver / Culbertson, Richard

OncoTargets and therapy

2013 Volume 6, Page(s) 725–732

Abstract: Background: The most recent randomized controlled trial in a predominantly prostate-specific antigen-detected prostate cancer (PC) population found a nonsignificant reduction in mortality from radical prostatectomy (RP) compared to conservative ... ...

Abstract	Background: The most recent randomized controlled trial in a predominantly prostate-specific antigen-detected prostate cancer (PC) population found a nonsignificant reduction in mortality from radical prostatectomy (RP) compared to conservative management. The optimal treatment for clinically localized prostate cancer is anything but clear. The PC-specific mortality and all-cause mortality were compared between primary androgen-deprivation treatment (PADT) and RP, both as monotherapy, among clinically localized PC patients. Methods: A retrospective cohort study among PC patients in Surveillance, Epidemiology and End Results-Medicare data with a median follow up of 2.87 years in the PADT cohort and 2.95 years in the RP cohort. Propensity score-matching was employed to adjust for the observed selection bias. PC-specific mortality and all-cause mortality were modeled using the Fine and Gray competing risk model and Cox proportional hazards model, respectively. The independent variables in these models included age, race, Gleason score risk groups, T-score, prostate-specific antigen, Charlson comorbidity, and index year of treatment initiation. Results: After propensity score-matching, there were 1624 in the PADT cohort and 1624 in the RP cohort. All baseline values were comparable (all P-values >0.35). There were a total of 266 deaths (16.38%) and 60 (3.69%) PC-specific deaths among PADT recipients, while there were 56 (3.45%) deaths and four (0.25%) PC-specific deaths among RP recipients. According to the Kaplan-Meier estimation, the 8-year survival rate was 43.39% in the PADT cohort and 79.62% in the RP cohort. PADT was associated with increased risk of overall mortality (hazard ratio = 2.98, 95% confidence interval 2.35-3.79; P < 0.001) and increased risk of PC-specific mortality (hazard ratio = 12.47, 95% confidence interval 4.48-34.70; P < 0.001). Conclusion: With adjustment for the observed selection bias, PADT was associated with increased all-cause mortality and PC-specific mortality when compared to RP.
Language	English
Publishing date	2013-06-17
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2495130-4
ISSN	1178-6930
ISSN	1178-6930
DOI	10.2147/OTT.S44144
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Doctoral education in executive format, or fitting the Procrustean Bed: an exercise in organizational change.

Culbertson, R A

The Journal of health administration education

2001 Volume 19, Issue 3, Page(s) 341–358

Abstract: Doctoral education in health administration has been heavily influenced by the model of the traditional academic research Doctor of Philosophy. This powerful traditional template has been appropriate for the advancement of research and scholarship in ... ...

Abstract	Doctoral education in health administration has been heavily influenced by the model of the traditional academic research Doctor of Philosophy. This powerful traditional template has been appropriate for the advancement of research and scholarship in health systems administration, but not necessarily for the advancement of the field of practice. With the advent of executive doctoral programs that feature larger student cohorts, routinized curricula, and student bodies comprised of experienced professionals, the expectations for doctoral study in health systems administration are being tested as new models evolve. Faculty are reluctant to depart from the traditional doctoral forum, but will do so based upon demonstrated advantages in the area of publication opportunities, student responsiveness, and financial inducements. This paper examines the program in an executive format conforming to the existing degree offerings of the School of Public Health, and the process of balancing the traditional academic expectations with the executive format of content delivery.
MeSH term(s)	Education, Graduate/organization & administration ; Education, Graduate/trends ; Health Services Administration ; Humans ; Louisiana ; Models, Educational ; Motivation ; Organizational Innovation ; Research ; Schools, Public Health
Language	English
Publishing date	2001
Publishing country	United States
Document type	Journal Article
ZDB-ID	635242-x
ISSN	0735-6722
ISSN	0735-6722
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