James W. Begun

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CONTEXT Among patients surgically treated for colon cancer, better survival has been demonstrated in those with more lymph nodes evaluated. The presumed mechanism behind this association suggests that a more extensive lymph node evaluation reduces the risk of understaging, leading to improved survival. OBJECTIVE To further evaluate the mechanism behind(More)
Excluding skin cancers, breast cancer is the most common form of cancer in women. Due to an increased focus on early detection, many more cases of breast cancer are now diagnosed at an early stage, which makes the use of breast conserving surgery (BCS) an efficacious and often more desirable treatment choice than mastectomy. An analysis of the variation in(More)
INTRODUCTION In the 1990s, several organizations began recommending evaluation of > 12 lymph nodes during colon resection because of its association with improved survival. We examined practice implications of multispecialty quality guidelines over the past 20 years recommending evaluation of ≥ 12 lymph nodes during colon resection for adequate staging. (More)
In response to significant political, governmental, and socioeconomic changes affecting the health care industry, health care organizations are forming a wide variety of loosely coupled interorganizational arrangements. In this article, loosely coupled forms are classified according to the extent to which they are designed to achieve strategic purposes. The(More)
To survive, let alone thrive, in an increasingly competitive and threatening environment, health care organizations must skillfully manage their dependencies. Such dependencies traditionally have been managed through marketplace exchanges (buying and selling) and ownership relationships (acquisition, merger, and business development). An alternative(More)
Many common management practices in healthcare organizations, including the practice of strategic planning, have not been subject to widespread assessment through empirical research. If management practice is to be evidence-based, evaluations of such common practices need to be undertaken. The purpose of this research is to provide evidence on the extent of(More)
BACKGROUND Among surgically treated patients with colon cancer, lower long-term mortality has been demonstrated in those with 12 or more lymph nodes evaluated. We examined whether patients receiving adequate lymph node evaluation were also more likely to receive comprehensive postsurgical care, leading to lower mortality. STUDY DESIGN We used the 1992 to(More)
Social science differs from the other basic medical sciences in that its perspective for understanding illness is not centered on processes within the individual. For this reason the relevance of social science knowledge to clinical practice is not obvious to many medical educators and students. Initial efforts at the University of North Carolina to develop(More)
Catholic hospitals maintain a significant presence in delivering hospital services in the United States, but little is known about the ways they differ from other ownership forms in similar market environments. This paper analyzes characteristics of Catholic, other private nonprofit, and investor-owned hospitals in metropolitan areas of the United States to(More)