Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W
Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.
Petrochuk, M A; Javalgi, R G
Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.
We show that when health care providers have market power and engage in Cournot competition, a competitive upstream health insurance market results in over-insurance and over-priced health care. Even though consumers and firms anticipate the price interactions between these two markets - the price set in one market affects the demand expressed in the other - Pareto improvements are possible. The results suggest a beneficial role for Government intervention, either in the insurance or the health care market.
Mindak, W A
A useful technique in assessing opportunities for international marketers is called "lead lag" analysis. It suggests that one can predict developments, such as demand patterns, in one country by looking at an analogous country. Applying such a technique to the domestic scene, what could we predict about the development and application of marketing to the health care sector if we looked at an analogous service such as banking? Many experts believe that health care is following in the footsteps of banking and point to environmental similarities such as changes in government regulation, new forms of nontraditional competition, increased concern about retail sectors, and pressures on scarce resources. Are there lessons that health care marketers can learn from bankers that might help them avoid some false starts or expensive mistakes?
The new health care system in the Netherlands introduces a free market into the health care sector. Because health care lacks some essential conditions, a free market will not provide effective resource allocation in this sector. In addition, a free market leads to more bureaucracy and less solidarity, cooperation and freedom of choice. It also impairs the autonomy of the medical professional.
In his new book, futurist Russell C. Coile Jr. presents predictions about seven aspects of health care for the next five years. Aided by a panel of health care experts, he analyzes likely developments in health care consumerism, technology, managed care, and other areas that raise a number of issues for health care marketers. Even if only a few of these predictions come true, marketers will be forced to rethink some of their techniques to adapt to this rapidly changing environment.
McKellar, Michael R; Naimer, Sivia; Landrum, Mary B; Gibson, Teresa B; Chandra, Amitabh; Chernew, Michael
To examine the relationship between insurance market structure and health care prices, utilization, and spending. Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure derived from Health Leaders Inter study data. Regression models are used to estimate the association between insurance market concentration and health care spending, utilization, and price, adjusting for differences in patient characteristics and other market-level traits. Insurance market concentration is inversely related to prices and spending, but positively related to utilization. Our results imply that, after adjusting for input price differences, a market with two equal size insurers is associated with 3.9 percent lower medical care spending per capita (p = .002) and 5.0 percent lower prices for health care services relative to one with three equal size insurers (p market might lead to higher prices and higher spending for care, suggesting some of the gains from insurer competition may be absorbed by higher prices for health care. Greater attention to prices and utilization in the provider market may need to accompany procompetitive insurance market strategies. © Health Research and Educational Trust.
Petra Došenovič Bonča
Full Text Available The following paper analyses the possibilities of forming a single European health care market. This aim is achieved by studying the impact of the differing organisational features of individual European health care systems on the efficiency of health care provision, by examining the relationship between the inputs used to produce health care services and the population’s health status in the analysedcountries and by exploring the link between the quantity of health care services and the health status. The authors hypothesise that the efficiency and organisation of health care systems determine the possibilities of forming an efficient single European health care market. The empirical methodology employed in this paper isdata envelopment analysis (DEA. The results show that differences between health care systems and in the ownership types of health care providers are not so large as to prevent the formation of a single European health care market. However, the formation of a single European health care market would reveal the characteristicsof health care systems in such a way that citizens would be in favour of the public sector in health care and the national health service model.
McKellar, Michael R; Naimer, Sivia; Landrum, Mary B; Gibson, Teresa B; Chandra, Amitabh; Chernew, Michael
Objective To examine the relationship between insurance market structure and health care prices, utilization, and spending. Data Sources Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure derived from Health Leaders Inter study data. Methods Regression models are used to estimate the association between insurance market concentration and health care spending, utilization, and price, adjusting for differences in patient characteristics and other market-level traits. Results Insurance market concentration is inversely related to prices and spending, but positively related to utilization. Our results imply that, after adjusting for input price differences, a market with two equal size insurers is associated with 3.9 percent lower medical care spending per capita (p = .002) and 5.0 percent lower prices for health care services relative to one with three equal size insurers (p prices and higher spending for care, suggesting some of the gains from insurer competition may be absorbed by higher prices for health care. Greater attention to prices and utilization in the provider market may need to accompany procompetitive insurance market strategies. PMID:24303879
Stitt, V J
Marketing in health care is a relatively new process. It is a business tool that can serve a very useful purpose. Health care management has become aware of the usefulness of marketing in long-range planning. Through a well-thought-out marketing plan, the provider will not be leaving the future to chance. A well-conceived, patient-oriented, competitor-aware marketing plan should place the medical practice at a strategic advantage as the health care industry joins other industries in the competitive marketplace for the consumer's dollar.The ever-increasing political and regulatory environment that the health care field is undergoing emphasizes the need for the inclusion of marketing skills, such as cost containment, in the medical curriculum. It should be the obligation of the training facilities as well as medical societies to respond to this need by providing the education that will enable black providers to survive in this competitive environment.
Levy, J S
The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.
Neprash, Hannah T; Wallace, Jacob; Chernew, Michael E; McWilliams, J Michael
To compare methods of price measurement in health care markets. Truven Health Analytics MarketScan commercial claims. We constructed medical prices indices using three approaches: (1) a "sentinel" service approach based on a single common service in a specific clinical domain, (2) a market basket approach, and (3) a spending decomposition approach. We constructed indices at the Metropolitan Statistical Area level and estimated correlations between and within them. Price indices using a spending decomposition approach were strongly and positively correlated with indices constructed from broad market baskets of common services (r > 0.95). Prices of single common services exhibited weak to moderate correlations with each other and other measures. Market-level price measures that reflect broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices. © Health Research and Educational Trust.
Jung, Kyoungrae; Polsky, Daniel
Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients' homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. Copyright © 2013 John Wiley & Sons, Ltd.
Rigby, J M; Backman, A M
Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment.
Hopper, J A; Busbin, J W
America is undergoing a profound age shift in its demographic make-up with people 55 and over comprising an increasing proportion of the population. Marketers may need to increase their response rate to this shift, especially in refining the application of marketing theory and practice to older age consumers. To this end, a survey of older couple buying behavior for health insurance coverage is reported here. Results clarify evaluative criteria and the viability of multiple market segmentation for health care coverage among older consumers as couples. Commentary on the efficacy of present health coverage marketing programs is provided.
Unlike the managerially oriented reforms that have brought auditing and accounting into such prominence in the UK National Health Service (NHS), and which seem alien to the culture of the caring professions, consumerist reforms may seem to complement moves towards the acceptance of wide definitions of health, and towards increasing patient autonomy. The empowerment favoured by those who support patient autonomy sounds like the sort of empowerment that is sometimes associated with the patient's charter. For this reason moral criticism of recent NHS reforms may stop short of calling consumerism into question. This, however, would be a mistake: consumerism can be objectionable both within and beyond the health care market. PMID:9134485
This report presents the main characteristics of reforms in the Swedish health services, as exemplified by the "Stockholm Model" introduced in 1992 in Stockholm county. The author discusses the motives behind these reforms, the already-evident increases in costs that are occurring, and the effect...... of these reforms on public support for the welfare state.......This report presents the main characteristics of reforms in the Swedish health services, as exemplified by the "Stockholm Model" introduced in 1992 in Stockholm county. The author discusses the motives behind these reforms, the already-evident increases in costs that are occurring, and the effect...
Hoffmann, M; Großterlinden, L G; Rueger, J M; Ruecker, A H
The progress in medical health care and demographic changes cause increasing financial expenses. The rising competitive environment on health-care delivery level calls for economisation and implementation of a professional marketing set-up in order to ensure long-term commercial success. The survey is based on a questionnaire-analysis of 100 patients admitted to a trauma department at a university hospital in Germany. Patients were admitted either for emergency treatment or planned surgical procedures. Competence and localisation represent basic criteria determing hospital choice with a varying focus in each collective. Both collectives realise a trend toward economisation, possibly influencing medical care decision-making. Patients admitted for planned surgical treatment are well informed about their disease, treatment options and specialised centres. The main source of information is the internet. Both collectives claim amenities during their in-hospital stay. Increasing economisation trends call for a sound and distinct marketing strategy. The marketing has to be focused on the stakeholders needs. Concomitant factors are patient satisfaction, the establishment of cooperation networks and maintenance/improvement of medical health-care quality. Georg Thieme Verlag KG Stuttgart · New York.
Patzer, G L; Rawwas, M Y
The current study provides guidance to hospital administrators in their effort to develop more effective marketing communication strategies. Two types of communication factors are revealed: primary and secondary. Marketers of psychiatric hospitals may use the primary factors as basic issues for their communication campaign, while secondary factors may be used for segmentation or positioning purposes. The primary factors are open wards, special treatment for adolescents, temporary absence, while patient, in-patient care, and visitation management. The secondary factors are temporary absence while a patient, voluntary consent to admit oneself, visitation management, health insurance, open staff, accreditation, physical plant, and credentials of psychiatrists.
Proctor, S R; Wright, G H
To generate thought and discussion regarding the application of key features of generic services which may influence management and marketing decisions in health care. Health care, as many other services provides benefits to the consumer, the quality of which is largely dependent on the interpersonal element of the service delivery. Services now dominate the UK economy, and consumer participation in service delivery is as important in health care as in services in the private sector. There is now an established body of research on the nature of services and the particular management and marketing challenges posed by service provision. The application of general management concepts and tools to the public services is an area of current debate. The paper firstly discusses key features of services and their application to health care contexts. Secondly, a discussion of strategic classifications of services seeks to identify common themes which exist across the diverse service sector. Nursing and midwifery managers have much to gain from understanding the use of services management frameworks, and have scope for much creativity in adapting generic frameworks for their own areas of practice.
Gehrt, K C; Pinto, M B
The impact of situational factors has typically been investigated in the context of goods marketing. Very few studies have investigated the influence of situational factors on services marketing. This study demonstrates the importance of situational influence on services marketing by delineating a consumer-based, situationally characterized competitive market structure for health care services. The competitive structure of the health care market is delineated in terms of the similarity/substitutability of the three-factor, situational characterizations of ten health care alternatives. The general marketing implications of the market-structure delineation procedure and the health care-specific implications of the findings are discussed.
Anderson, Donald G.; And Others
The health care industry in the United States has undergone tremendous change. Health care providers must view their health care delivery organizations as businesses and must use the tools of business, including marketing. Most research on health care marketing has focused on the practices of large, urban facilities. Little work has been…
Teichert, T; Mühlbach, C
Introduction: The aim of the study was to present a picture of consumers' views on the specific market of health and health products, the second German health market. Market analysis of the product categories was carried out. Methods: A large-scale representative survey (N=1 033) determined with an innovative adaptation of the repertory grid method the consumer's perspective on the specific market. Basic questions concerning attitudes to health as well as healthy behaviors completed the telephone survey. Results: In the saturated markets, market for health is growing, especially in the context of aging societies, and this is not limited to primary medical products. In this study, product categories such as "dental care", "fruit and vegetables" or "nuts" were classified as healthy products. Conclusion: The relevance of health also in the macroeconomic context has been long underestimated. Health has still a high priority for consumers. A disclosure of individual perceptions in the health context provides a significantly more relevant product design. The identification of healthy product dimensions from the consumer's perspective sheds light on the actually desired product properties and the available potential to meet these desires. © Georg Thieme Verlag KG Stuttgart · New York.
Naidu, G M; Kleimenhagen, A; Pillari, G D
Marketing research has grown to become indispensable for superior performance in packaged goods industries. While health care institutions are spending large amounts on marketing research, few studies focus upon the relationship of marketing research to health care organizational performance. Utilizing a national sample of U.S. hospitals, this article points out that marketing research and superior performance are positively associated.
Radu, G; Solomon, M; Gheorghe, C M; Hostiuc, M; Bulescu, I A; Purcarea, V L
The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future.
Naidu, G M; Narayana, C L; Pillari, G D
It is about two decades since the marketing scholars identified the need and relevance of marketing in health care organizations. The health care industry itself has been undergoing significant changes brought on by deregulation, declining demand, intraorganizational competition and growth of HMO's and PPO's. Yet, the industry has not fully implemented the marketing concept. For many health care organizations, marketing seems still to mean advertising and public relations as evidenced by an empirical study.
Cooper, R A; Aiken, L H
Arrow wrote his classic article in simpler times, as those who chance upon this article forty years hence will say of today. It was a new era in science and medicine, soon to be fueled by new resources from Medicare and the National Institutes of Health. Fiscal constraint was a stranger, physicians were in short supply, and information asymmetry was pervasive. In the intervening years, Americans have become more comfortable with health care issues. Fatal illness, which was rarely discussed with patients in 1960, is now researched by them on the Internet, and greater attention is paid to patient rights. Nonetheless, concerns about quality have, if anything, increased. Indeed, it is public concern about quality that has invited governmental regulation and induced a defensive posture among medical organizations, which are rushing to establish their own instruments of quality, and it is these same public concerns that have facilitated the ability of managed care to offer itself as the guarantor of quality. However, center stage is now held by another issue: health care costs. As a result, the focus has shifted from resolving information asymmetry by enhancing quality to controlling national health expenditures by changing the size and composition of the health care workforce. Licensure, which was restrictive in 1960, is more relaxed today, thereby reducing the entry barriers for the NPC disciplines, several of which were just beginning when Arrow wrote his article. The entry of NPCs into the realm of physician's services partially counterbalances the constraints that have been placed on physician supply, although the major contributions of NPCs are skewed to the primary care end of the spectrum while the major constraints on physician supply affect specialists. The growing presence of NPCs creates a dynamic market in which practitioners in various disciplines both compete and collaborate. It is, in fact, the perfect market that Arrow reluctantly longed for, in which
Choice and competition have been buzzwords in this year's health system reform debate, but Texans now have less of both in the health insurance market. UniCare Health Plans of Texas Inc. and UniCare Life & Health Insurance Co. are withdrawing from the commercial health insurance market in Texas.
Freitag, E M
Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level.
Lee, J M
In today's competitive health care market, product/service marketing will become the key to survival. This article introduces a new way of using an established marketing concept. Product/service marketing is based on promoting services that fulfill a number of requirements, including being highly visible and a foundation for the later development of an overall marketing plan. Choosing the products/services to be marketed and developing the marketing program are discussed.
.... Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review; Final Rule #0;#0... Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review AGENCY: Department of Health... health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and...
Endresen, K W; Wintz, J C
HealthStyles is a new psychographic segmentation system specifically designed for the health care industry. This segmentation system goes beyond traditional geographic and demographic analysis and examines health-related consumer attitudes and behaviors. Four statistically distinct "styles" of consumer health care preferences have been identified. The profiles of the four groups have substantial marketing implications in terms of design and promotion of products and services. Each segment of consumers also has differing expectations of physician behavior.
Đurđana Ozretić Došen
Full Text Available This paper deals with the reflections on the problems involved in the marketing of health care services. There are a number of particularities and limitations requiring a creative approach to the application of marketing to health care organizations. The first part of the paper summarizes theoretical contributions on specific characteristics of services marketing in health care. Exploratory research of the perceptions among surgeons of health services marketing, which is described in the second part, provides a useful insight into the possibility of applying marketing to specialist surgical services. Research was conducted among general surgeons employed at Croatian public health care organizations. Results show a discrepancy between the awareness of services marketing and its application to surgical practice. Continuous education is necessary to better acquaint surgeons with services marketing as a business philosophy, which may improve performance in the provision of health services.
Williams, Cheryl-Ann N; Khanfar, Nile M; Harrington, Catherine; Loudon, David
Since their founding in 2000, retail-based health care clinics, also called convenient care clinics, have flourished but continue to generate controversy. This article examines the literature with respect to the industry's background, establishment of industry standards, types of services offered, marketing of retail health clinics, industry growth with new target markets, and patient demographics. It also examines the growing relationship with insurers and third-party payers, quality-of-care concerns by medical associations, and legal regulations and their potential impact on industry growth nationwide.
Himmelstein, David U; Woolhandler, Steffie
The authors advocate a fundamental change in health care financing-national health insurance (NHI). NHI would reorient the way we pay for care, bringing the hundreds of billions now squandered on malignant bureaucracy back to the bedside. NHI could restore the physician-patient relationship, offer patients a free choice of physicians and hospitals, and free physicians from the hassles of insurance paperwork.
Mohammad Javad Akbarian Bafghi
Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.
Dolfsma, W.A.; Mcmaster, R.
From an institutionalist perspective, we identify five sources of policy conflict. Each may explain why policies intended to obtain particular goals for an institutionalized practice may have unintended consequences. We illustrate by analyzing attempts at introducing market-oriented reform in health
Glied, Sherry A; Altman, Stuart H
The United States relies on competition to balance costs and quality in the health care system. But concentration is increasing throughout the hospital, physician, and insurer markets. Midsize community hospitals face declining demand and growing competition from both larger hospitals and smaller freestanding diagnostic and surgical centers, leaving the midsize hospitals vulnerable to closure or merger with other facilities. Competition among insurers has been limited by the development of hospital systems that extend the bargaining power of "must-have" hospitals (those perceived to provide the best care for complex and less common conditions) across local health care markets. Government antitrust enforcement could play an important role in maintaining competition in both the hospital and insurer markets, but in many markets, the impact of that enforcement has been limited to date. Policy makers should consider supplementing antitrust activities with strategies that combine competition and regulation-for example, by regulating selected prices and structuring competition to cover entire insurance markets. Project HOPE—The People-to-People Health Foundation, Inc.
Young, S; Erdem, S A
It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research.
Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu
As reforms in publicly funded health systems rely heavily on competition, it is important to know if and how public providers react to competition. In many European countries, it is empirically difficult to study public providers in different markets, but in Finnish occupational health services, both public and private for-profit and non-profit providers co-exist. We studied possible differences in public providers' performance (price, intensity of services, service mix-curative medical services/prevention, productivity and revenues) according to the competitiveness of the market. The Finnish Institute of Occupational Health (FIOH) collected data on clients, services and personnel for 1992, 1995, 1997, 2000 and 2004 from occupational health services (OHS) providers. Employers defray the costs of OHS and apply for reimbursement from the Social Insurance Institution (SII). The SII data was merged with FIOH's questionnaire. The unbalanced panel consisted of about 230 public providers, totalling 1,164 observations. Local markets were constructed from several municipalities based on commuting practices and regional collaboration. Competitiveness of the market was measured by the number of providers and by the Herfindahl index. The effect of competition was studied by ordinary least square regression analysis and panel models. The more competitive the environment was for a public provider the higher were intensity, productivity and the share of medical care. Fixed panel models showed that these differences were not due to differences and changes in the competitiveness of the market. Instead, in more competitive markets public providers had higher unit prices and higher revenues.
Kotler , Philip . Marketing for Nonprofit Organizations. Englewood Cliffs: Prentice-Hall, Inc., 1975. MacStravic, Robin E. Marketing Health Care. Germantown...102 (17 November 1980): 68-81. Kotler , Philip . "What Consumerism Means for Marketers ." Harvard Business Review. (May-June, 1972): 50-56. and Levy...Respondents Opinion (II). These four areas addressed the four Ps’ of the marketing mix. Section lIB dealt with the "product" aspect of West Point
To examine the effects of hospital and insurer markets concentration on transaction prices for inpatient hospital services. Measures of hospital and insurer markets concentration derived from American Hospital Association and HealthLeaders-InterStudy data are linked to 2005-2008 inpatient administrative data from Truven Health MarketScan Databases. Uses a reduced-form price equation, controlling for cost and demand shifters and accounting for possible endogeneity of market concentration using instrumental variables (IV) technique. The findings suggest that greater hospital concentration raises prices, whereas greater insurer concentration depresses prices. A hypothetical merger between two of five equally sized hospitals is estimated to increase hospital prices by about 9 percent (p insurers would depress prices by about 15.3 percent (p insurer consolidation depressed prices by about 10.8 percent. Additional analysis using longer panel data and applying hospital fixed effects confirms the impact of hospital concentration on prices. The findings provide support for strong antitrust enforcement to curb rising hospital service prices and health care costs. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Evans, W Douglas; McCormack, Lauren
Social marketing uses commercial marketing strategies to change individual and organizational behavior and policies. It has been effective on a population level across a wide range of public health and health care domains. There is limited evidence of the effectiveness of social marketing in changing health care consumer behavior through its impact on patient-provider interaction or provider behavior. Social marketers need to identify translatable strategies (e.g., competition analysis, branding, and tailored messages) that can be applied to health care provider and consumer behavior. Three case studies from social marketing illustrate potential strategies to change provider and consumer behavior. Countermarketing is a rapidly growing social marketing strategy that has been effective in tobacco control and may be effective in countering pharmaceutical marketing using specific message strategies. Informed decision making is a useful strategy when there is medical uncertainty, such as in prostate cancer screening and treatment. Pharmaceutical industry marketing practices offer valuable lessons for developing competing messages to reach providers and consumers. Social marketing is an effective population-based behavior change strategy that can be applied in individual clinical settings and as a complement to reinforce messages communicated on a population level. There is a need for more research on message strategies that work in health care and population-level effectiveness studies.
Wood, V R; Robertson, K R
Numerous health care facilities, located in downtown metropolitan areas, now find themselves surrounded by a decaying inner-city environment. Consumers may perceive these facilities as "old," and catering to an "urban poor" consumer. These same consumers may, therefore, prefer to patronize more modern facilities located in suburban areas. This paper presents a case study of such a health care facility and how strategic planning and marketing research were conducted in order to identify market opportunities and new strategic directions.
The problem analysis technique is an approach to understanding salient customer needs that is especially appropriate under complex market conditions. The author demonstrates the use of the approach in segmenting markets and conducting competitive analysis for positioning strategy decisions in health care.
Lofgren, Diane Gage; Rhodes, Sonia; Miller, Todd; Solomon, Jared
One of the most elusive challenges in health care marketing is hitting on a strategy to substantially differentiate your organization in the community and drive profitable business. This article describes how Sharp HealthCare, the largest integrated health care delivery system in San Diego, has proven that focusing first on improving the health care experience for patients, physicians, and employees can provide the impetus for a vital marketing strategy that can lead to increased market share and net revenue. Over the last five years, this nonprofit health system has transformed the health care experience into tangible actions that are making a difference in the lives of all those the system serves. That difference has become Sharp's "brand essence"--a promise to the community that has been made through marketing, public relations, and advertising and then delivered through the dedicated work of Sharp's 14,000 team members. They call this performance improvement strategy The Sharp Experience. This article outlines the eight-step journey that led the organization to this brand essence marketing campaign, a campaign whose centerpiece is an award-winning 30-minute television documentary that use real-time patient stories to demonstrate Sharp's focus on service and patient-centered care against a backdrop of clinical quality and state-of-the-art technology, and documentary-style radio and television commercials.
Fulton, Brent D
Policy makers and analysts have been voicing concerns about the increasing concentration of health care providers and health insurers in markets nationwide, including the potential adverse effect on the cost and quality of health care. The Council of Economic Advisers recently expressed its concern about the lack of estimates of market concentration in many sectors of the US economy. To address this gap in health care, this study analyzed market concentration trends in the United States from 2010 to 2016 for hospitals, physician organizations, and health insurers. Hospital and physician organization markets became increasingly concentrated over this time period. Concentration among primary care physicians increased the most, partially because hospitals and health care systems acquired primary care physician organizations. In 2016, 90 percent of Metropolitan Statistical Areas (MSAs) were highly concentrated for hospitals, 65 percent for specialist physicians, 39 percent for primary care physicians, and 57 percent for insurers. Ninety-one percent of the 346 MSAs analyzed may have warranted concern and scrutiny because of their concentration levels in 2016 and changes in their concentrations since 2010. Public policies that enhance competition are needed, such as stricter enforcement of antitrust laws, reducing barriers to entry, and restricting anticompetitive behaviors. Project HOPE—The People-to-People Health Foundation, Inc.
Kennedy, M M
Physician executives are vying for top positions in health care organizations. With so many qualified candidates in the marketplace, how can you differentiate yourself as a strong contender? Recruiters search through hundreds of résumés, not the ten or 20 that many hospital and HMO CEOs have seen. Recruiters--the people who actually find specific candidates--were interviewed to find out what they are looking for. Here are the top items on their checklists: Articulated focus, documented results, competitive intelligence, professional growth, good references, appearance and social skills, responsive and timely, and technical skills.
Thomson, E M
In 1985, the ADHA, in response to the changing health care environment, identified six roles for the future of dental hygiene. The administrator/manager role, one of the six, is an expansion of dental hygiene skills to facilitate the provision of quality oral health care. Oral health care settings require personnel trained in management to accomplish practice-related goals and objectives. Dental hygiene is preparing individuals to assume managerial roles to fill this health care need. This paper discusses the skills and knowledge level required to assume managerial roles and strategies for marketing the dental hygienist as a manager.
Gehrt, K C; Pinto, M B
Competition in the health care market has intensified in recent years. Health care providers are increasingly adopting innovative marketing techniques to secure their positions in the marketplace. This paper examines an innovative marketing technique, situational segmentation, and assesses its applicability to the health care market. Situational segmentation has proven useful in many consumer goods markets but has received little attention in the context of health care marketing. A two-stage research process is used to develop a taxonomy of situational factors pertinent to health care choice. In stage one, focus group interviews are used to gather information which is instrumental to questionnaire development. In stage two, the responses of 151 subjects to a 51 item questionnaire are factor analyzed. The results demonstrate that situational segmentation is a viable strategy in the health care market.
Young, A P
Since the introduction of a marketing orientation to the NHS in 1990, arguments continue to abound as to the extent and success of the internal market. This article identifies where and how the market is operating and explores the inherent difficulties of using this model, both ethically and economically. The dangers of increasing inequality, social manipulation, continuing cost pressures, loss of professional autonomy and restricted professional collaboration have to be balanced against the potential value of marketing on performance measures and a more responsive service. The article concludes that marketing needs to be tailored to the particular culture of the NHS rather than copied from the private sector and should emphasize client needs, integrated planning, good communication and the development of agreed quality indicators.
Full Text Available The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for corporations and the small elite who lead them and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good.
Pricing is one of the key components of a successful marketing mix. Pricing objectives, strategies, and tactics cannot stand alone, however. To be effective, price must work in harmony with other marketing and management activities. Despite its importance, use of pricing as a management tool is limited in health care compared to other industries. Many factors contribute to this situation, including the structure of the health-care exchange process, limited consumer knowledge, and a limited ability to measure costs. I will provide an overview of pricing information, both within and outside health care. Specifically, we will explore the definition of pricing, nonmonetary pricing, price elasticity, classical pricing theory, and the role of pricing in a health-care setting.
Smith, Richard D
Contingent valuation (CV) has been criticised for being too hypothetical, with expressed values bearing little relation to actual values. The magnitude of this divergence, however, depends upon how realistic and believable the contingent market is. This paper presents an overview of five key aspects in the construction of the contingent market: (i) scenario development and presentation; (ii) payment vehicle; (iii) expression of risk; (iv) time period of valuation; and (v) survey administration. CV studies in health care since 1985, totalling 111, are critically reviewed with respect to these five aspects. It is concluded that CV studies in health care have performed poorly in the construction, specification and presentation of the contingent market, and that there has been little, if any, improvement in this respect over the last 15 years. Suggestions are made concerning why this may be the case, and how the construction of the contingent market may be improved in future. Copyright 2002 John Wiley & Sons, Ltd.
Welch Cline, Rebecca J; Young, Henry N
Proponents and opponents of direct-to-consumer advertising (DTCA) of prescription drugs argue that it promotes greater participation in health care by consumers with significant implications for public health and health care outcomes. This article (a). proposes a social cognitive theoretical framework to explain DTCA's effects, and (b). reports the first in a series of studies on DTCA's observational learning functions that may influence consumer behavior and the physician-patient relationship. This investigation addresses visual features of print DTCA. Results focus on the prevalence and nature of models featured in the ads and how visual cues may offer identity and relational motivators while reinforcing the value of prescription drug treatments. Further, DTCA may market disenfranchising images that increase disparity in health care information and access, despite their argued educational function.
Roth, M S; Amoroso, W P
Firms often are encouraged to develop expertise, or core competencies, that lead to innovative products and services. The authors present a market research study that enabled a health care service provider to link its core technological competencies to customer needs. Although potential customers did not explicitly value the technology itself, links could be made between technological competencies and more valued service dimensions such as communication flows, meeting deadlines, and staff responsiveness. Improving strategic marketing and service quality delivery can be realized through market research linking customer needs to a firm's core competencies.
Zasa, R J
Indisputably, marketing plays an important role in today's competitive health service industry. It is essential for every medical group manager to learn about the marketing process and his role in pursuing marketing in his medical group. Conducting internal and external assessments, developing promotional techniques and strategies, organizing and implementing a plan, and evaluating results are all critical areas in the marketing effort. When each critical area is carefully examined and steps are properly taken, a marketing approach will be totally consistent with delivery of high-quality patient care services.
J. W. De Jager
Full Text Available Purpose: The purpose of the paper is to determine the levels of satisfaction in respect of pre identified internal marketing-related variables in a large provincial hospital in South Africa. Problem investigated: Low job satisfaction is often cited as a major cause of high turnover among health care providers worldwide. Likewise the Public Health Care Industry in South Africa is facing complex employee retention issues. In determining the reasons for high turnover an interest in evaluating employee satisfaction among health care providers has increased. Measuring components of job satisfaction will assist not only the health care organisations' management to understand hospital culture, but also to compile an effective internal marketing plan and strategy. Design/Methodology/Approach: A staff satisfaction survey was conducted amongst staff members at a provincial hospital in the Tshwane region, South Africa. Attitudes of staff on pre-identified staff satisfaction variables were assessed. These variables were employed to implement an internal marketing strategy. A list of variables was formulated after an extensive literature study had been conducted. A total of 416 staff members voluntarily completed a self-administered questionnaire. A five-point Likert type scale was used to measure the levels of satisfaction on staff-related issues, with a view to addressing issues in the internal marketing strategy. Findings : It was evident that the management principles currently employed by the management team were a cause for concern among staff members. Based on the analysis that identified the satisfaction variables best it was clear that management should take immediate steps to address the following issues : Clarification of hospital goals \\ objectives; Understanding the goals of the respective departments; The functioning of the Human resource department; Functioning of the overall hospital management; andImplications: This paper aims to present a
Beauregard, T R
In any other rational market, the consumer drives demand, and the provider responds with products and services aimed at meeting individual needs. This rational market does not exist in today's group health care system. The ramifications are significant: declining consumer and provider satisfaction, out-of-control costs, a rising uninsured population, and growing employer burdens. Turning this chaotic world around requires a more active and informed consumer. Transformation is under way with solutions like Sageo, a new e-business from Hewitt Associates that is revolutionizing the way health care benefits are offered, selected, and administered. For companies that offer Sageo's services, their employees and retirees gain direct access to health care coverage and content, enabling them to research, select, and enroll in the appropriate package based on their individual needs.
Lesser, Cara S; Ginsburg, Paul B
Drawing on observations from tracking changes in local health care markets over the past ten years, this article critiques two Federal Trade Commission and Department of Justice recommendations to enhance price and quality competition. First, we take issue with the notion that consumers, acting independently, will drive greater competition in health care markets. Rather we suggest an important role remains for trusted agents who can analyze inherently complex price and quality information and negotiate on consumers' behalf. With aggregated information identifying providers who deliver cost-effective care, consumers would be better positioned to respond to financial incentives about where to seek care and thereby drive more meaningful competition among providers to reduce costs and improve quality. Second, we take issue with the FTC/DOJ recommendation to provide more direct subsidies to prevent distortions in competition. In the current political environment, it is not practical to provide direct subsidies for all of the unfunded care that exists in health care markets today; instead, some interference with competition may be necessary to protect cross subsidies. Barriers can be reduced, though, by revising pricing policies that have resulted in marked disparities in the relative profitability of different services.
Gauld, R D
This article discusses events that led up to and the aftermath of New Zealand's radical health sector restructuring of 1993. It suggests that "big bang" policy change facilitated the introduction of a set of market-oriented ideas describable as a policy prescription. In general, the new system performed poorly, in keeping with problems of market failure endemic in health care. The system was subsequently restructured, and elements of the 1993 structures were repackaged through a series of incremental changes. Based on the New Zealand experience, big bang produces change but not necessarily a predictive model, and the policy prescription has been oversold.
Schneider, Janina Anne; Holland, Christopher Patrick
Patient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics. The objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market. A new taxonomy of eHealth websites is proposed to organize the largest eHealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data are used to accurately track and analyze detailed search behavior across 100 of the largest eHealth websites in the US and UK health care markets. The health, medical, and lifestyle categories account for approximately 90% of online activity, and e-pharmacies, social media, and professional categories account for the remaining 10% of online activity. Overall search penetration of eHealth websites is significantly higher in the private (United States) than the public market (United Kingdom). Almost twice the number of eHealth users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than those in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both the markets. For all categories, the vast majority of eHealth users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on eHealth, that is, 3-7 minutes per website. The proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring eHealth behavior. The private health care system does appear to have an influence on eHealth search behavior in terms of search penetration and time spent per
Verheggen, F W; Harteloh, P P
This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of hazards in the complex process of patient care and tends to stagnate, for no real improvement takes place. Departing from this criticism, modern quality assurance in health care is marked by: defining quality in a preferential sense as "fitness for use"; the use of theories and models of trade and industry (process-control); an emphasis on analyzing the process, instead of merely inspecting it; use of the Deming problem solving technique (plan, do, check, act); improvement of the process of care by altering perceptions of parties involved. We present an experience of application and utilization of this method in the University Hospital Maastricht, The Netherlands. The successful application of this model requires a favorable corporate culture and motivation of the health care workers. This model provides a useful framework to uplift the traditional approach to quality assurance in health care.
Begun, J W; Lippincott, R C
Historically, most health occupations have developed legal and ethical restrictions on price advertising and other characteristics of "commercial" practice. Many of these regulations recently have come under critical scrutiny, on the grounds that they inhibit free-market health care delivery, thus keeping prices high, and productivity and innovation low. To help inform current health policy deliberations, we analyze the political history of anticompetitive regulations in one health occupation, optometry. Restrictions on commercial practice arose as a result of professional optometry's purge of commercial elements in the 1930s. Optometry's success in achieving commercial-practice restrictions at the state level was determined by the economic structure of the ophthalmic goods and services industry in each state in the 1930s, and by the political resources and organization of the competing interest groups. Efforts to deregulate health occupations will precipate political conflict to the extent that economic interests are threatened. Opposition to deregulation will be based overtly on the grounds that quality of care will deteriorate, and a significant political investment by proponents of free-market health care will be required to overcome such opposition.
Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina
The Affordable Care Act contains numerous consumer protections designed to remedy shortcomings in the availability, affordability, adequacy, and transparency of individual market insurance. However, because states remain the primary regulators of health insurance and have considerable flexibility over implementation of the law, consumers are likely to experience some of the new protections differently, depending on where they live. This brief explores how federal reforms are shaping standards for individual insurance and examines specific areas in which states have flexibility when implementing the new protections. We find that consumers nationwide will enjoy improved protections in each area targeted by the reforms. Further, some states already have embraced the opportunity to customize their markets by implementing consumer protections that exceed minimum federal requirements. States likely will continue to adjust their market rules as policymakers gain a greater understanding of how reform is working for consumers.
Lim, Meng-Kin; Yang, Hui; Zhang, Tuohong; Zhou, Zijun; Feng, Wen; Chen, Yude
This paper reports on a questionnaire survey and 12 focus groups conducted among doctors in three provinces of China, namely Guangdong, Shanxi, and Sichuan. The survey (N = 720) and focus group participants were drawn from both rural and urban areas, as well as public and private sectors, in equal numbers The aim was to gauge how Chinese doctors feel about themselves and what they think of the Chinese health care system. We found low satisfaction levels with own income (8%), job (27%), skill (30%), and other important aspects of their professional life. The health care system received only 32% approval rating. Quality of care and patient safety issues were major concerns, especially in the growing but poorly regulated private sector. The public sector came under criticism for its high fees and bad service quality. The feedback point to the need for an appropriate regulatory framework to guide the development of China's evolving health care market. A revitalized medical profession that is fully engaged in the reform process could also significantly impact the success of ongoing health care reform efforts.
Hall, Michael L
Persuasive messages for marketing healthcare services in general and coordinated care in particular are more important now for providers, hospitals, and third-party payers than ever before. The combination of measurement-based information and creativity may be among the most critical factors in reaching markets or expanding markets. The research presented here provides an approach to marketing coordinated care services which allows healthcare managers to plan persuasive messages given the market conditions they face. Using market respondents' thinking about product attributes combined with distance measurement between pairs of product attributes, a conceptual marketing map is presented and applied to advertising, message copy, and delivery. The data reported here are representative of the potential caregivers for which the messages are intended. Results are described with implications for application to coordinated care services. Theory building and marketing practice are discussed in the light of findings and methodology.
Shipkovenska, Elena; Vodenicharov, Tzekomir; Dyakova, Mariana
The authors analyze the basic financial principles and the regulated entrepreneurship in the healthcare systems in Europe. They point out that the European countries organize, manage and finance their health care in different ways. Thus the health systems vary not only in the financial methods used, but also in the payment scheme of the insurance institution and the healthcare providers as well as the ways in which the state regulates the health services provision and the development of marke...
Curtin, L L
The many issues managed care poses for providers and health networks are crystallized in the moral problems occasioned by its shifting of the financial risks of care from insurer to provider. The issues occasioned by market-based reform include: the problems presented by clashes between public expectations and payer restrictions; the corporatization of health service delivery and the cultural shift from humanitarian endeavor to business enterprise the depersonalization of treatment as time and money constraints stretch resources, and the culture rewards efficient "business-like" behavior the underfunding of care for the poor and uninsured, even as these populations grow the restructuring of care and reengineering of healthcare roles as the emphasis shifts from quality of care to conservation of resources rapid mergers of both health plans and institutional providers with all the inherent turmoil as rules change, services are eliminated, and support services are minimized to save money the unhealthy competition inherent in market-based reform that posits profit taking and market share as the measures of successful performance the undermining of the professional ethic of advocacy the use of incentives that pander to greed and self-interest. The costs of sophisticated technologies and the ongoing care of increasingly fragile patients have pulled many other elements into what previously were considered "privileged" professional interactions. The fact that very few citizens indeed could pay out-of-pocket for the treatment and ongoing care they might need led to social involvement (few people remember that both widespread health insurance and public programs are relatively recent phenomena--only about 30 years old). However, whether in tax dollars or insurance premiums, other people's money is being spent on the patient's care. Clearly, those "other people" never intended to give either the patient or the professional open-ended access to their collective pocketbooks
Rotimi Ayodele Gbadeyan
Full Text Available There have been increasing difficulties in providing qualitative health care services to the public in Nigeria. The development has called for the need to examine ways through which government and other stakeholders resolve these crises in the health sector. The objective of this paper is to examine the level of Government spending to total Health expenditures in Nigeria. This study basically employs secondary data for analysis. The secondary data are provided from the World Bank Development indicators and Internet. The data was analyzed using the Pearson Correlation Coefficient Statistical technique. The result revealed a strong positive Correlation (r = 0.634 between Government Health Spending and Total Health Spending. This indicates that Government Health Spending constitutes a significant proportion of the Total Health Expenditures in Nigeria; despite complains about inadequate health financing. In conclusion, the Nigerian Health sector would become more vibrant, if the Government and the Private sector are ready to give the necessary commitments required to achieve the laudable objective of qualitative health for all. The study recommends for more Government Health funding towards tackling the prevalence of some chronic diseases such as HIV, Asthma, Tuberculosis, Meningitis and Paralysis, etc.
Druguş, Daniela; Azoicăi, Doina
Marketing surveys of the health system collect useful information to develop effective management strategies. The research aim consisted in measuring patient satisfaction with health care quality. The qualitative research was based on an online SurveyMonkey open-ended questionnaire. The analysis of patient satisfaction/dissatisfaction with healthcare professionals was performed in 1838 patients. Correlation analysis allowed the identification of some determinants associated with patient satisfaction. The variable most commonly associated with satisfaction was "I got adequate information about procedures/treatment" according to 32.2% of respondents. The patients who were dissatisfied most commonly complained that they were "Not adequately informed about maneuvers and treatment", reported by 40.0% of respondents. This study provides a basis for building an original model for determining the variables of an efficient healthcare system which to ensure a high degree of patient satisfaction.
Conlon, M K
In a world of increased competition and changing consumer expectations, one of the keys to a fiscally sound health plan is having a dynamic marketing strategy that takes into account the shifting attitudes of consumers as managed care markets mature. The primary goal of any health plan marketing strategy should be the acquisition and retention of members. Providing cost-efficient and convenient service for enrollees, offering low or no deductibles, having convenient office locations, and minimizing paper-work are important elements of such a marketing strategy. Factors such as brand awareness and the perceived image of a health plan also are important considerations in acquiring and retaining market share. The relative importance of these consumer satisfaction criteria change as a managed care market evolves and matures. Financial and marketing managers, thus, should ascertain their market's stage of development and respond with appropriate marketing strategies.
Moy, E; Mazzaschi, A J; Levin, R J; Blake, D A; Griner, P F
Medical research conducted in academic medical centers is often dependent on support from clinical revenues generated in these institutions. Anecdotal evidence suggests that managed care has the potential to affect research conducted in academic medical centers by challenging these clinical revenues. To examine whether empirical evidence supports a relationship between managed care and the ability of US medical schools to sustain biomedical research. Data on annual extramural research grants awarded to US medical schools by the National Institutes of Health (NIH) from fiscal years 1986 to 1995 were obtained, and each medical school was matched to a market for which information about health maintenance organization (HMO) penetration in 1995 was available. Growth in total NIH awards, traditional research project (R01) awards, R01 awards to clinical and basic science departments, and changes in institutional ranking by NIH awards were compared among schools located in markets with low, medium, and high managed care penetration. Medical schools in all markets had comparable rates of growth in NIH awards from 1986 to 1990. Thereafter, medical schools in markets with high managed care penetration had slower growth in the dollar amounts and numbers of NIH awards compared with schools in markets with low or medium managed care penetration. This slower growth for schools in high managed care markets was associated with loss of share of NIH awards, equal to $98 million in 1995, and lower institutional ranking by NIH awards. Much of this revenue loss can be explained by the slower growth of R01 awards to clinical departments in medical schools in high managed care markets. These findings provide evidence of an inverse relationship between growth in NIH awards during the past decade and managed care penetration among US medical schools. Whether this association is causal remains to be determined.
Séror, Ann C
The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. to identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management.
Ameri, Cinzia; Fiorini, Fulvio
The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.
Garabedian, Laura F; Ross-Degnan, Dennis; Soumerai, Stephen B; Choudhry, Niteesh K; Brown, Jeffrey S
To evaluate the impact of the 2006 Massachusetts health reform, the model for the Affordable Care Act, on short-term enrollment and utilization in the unsubsidized individual health insurance market. Seven years of administrative and claims data from Harvard Pilgrim Health Care. We employed pre-post survival analysis and an interrupted time series design to examine changes in enrollment length, utilization patterns, and use of elective procedures (discretionary inpatient surgeries and infertility treatment) among nonelderly adult enrollees before (n = 6,912) and after (n = 29,207) the MA reform. The probability of short-term enrollment dropped immediately after the reform. Rates of inpatient encounters (HR = 0.83, 95 percent CI: 0.74, 0.93), emergency department encounters (HR = 0.85, 95 percent CI: 0.80, 0.91), and discretionary inpatient surgeries (HR = 0.66 95 percent CI: 0.45, 0.97) were lower in the postreform period, whereas the rate of ambulatory visits was somewhat higher (HR = 1.04, 95 percent CI: 1.00, 1.07). The rate of infertility treatment was higher after the reform (HR = 1.61, 95 percent CI: 1.33, 1.97), driven by women in individual (vs. family) plans. The reform was not associated with increased utilization among short-term enrollees. MA health reform was associated with a decrease in short-term enrollment and changes in utilization patterns indicative of reduced adverse selection in the unsubsidized individual market. Adverse selection may be a problem for specific, high-cost treatments. © Health Research and Educational Trust.
Dolinsky, A L; Stinerock, R
Culturally based values are known to influence consumer purchase decisions, but little is known about how those values affect health care choices. To rectify that situation and provide health care marketers with a framework for developing culturally based segmentation strategies, the authors undertook an exploratory research project in which Hispanic-, African-, and Anglo-Americans were asked to rate the importance of 16 different health care attributes. Those attributes can be grouped under five categories: quality of physician, quality of nurses and other medical staff, economic issues, access to health care, and nonmedically related experiential aspects. Survey responses identified distinct differences in the importance attached to the various attributes by the three cultural groups. The study also looks at the impact of six demographic and social characteristics on the evaluations made by each cultural group. Those characteristics are educational level, gender, age, health status, marital status, and number of people living in the household.
Herring, Bradley; Trish, Erin
The slowed growth in national health care spending over the past decade has led analysts to question the extent to which this recent slowdown can be explained by predictable factors such as the Great Recession or must be driven by some unpredictable structural change in the health care sector. To help address this question, we first estimate a regression model for state personal health care spending for 1991-2009, with an emphasis on the explanatory power of income, insurance, and provider market characteristics. We then use the results from this simple predictive model to produce state-level projections of health care spending for 2010-2013 to subsequently compare those average projected state values with actual national spending for 2010-2013, finding that at least 70% of the recent slowdown in health care spending can likely be explained by long-standing patterns. We also use the results from this predictive model to both examine the Great Recession's likely reduction in health care spending and project the Affordable Care Act's insurance expansion's likely increase in health care spending. © The Author(s) 2015.
textabstractThis study analyses the systemic behaviour of the dynamics of a health care system in its interraction with poverty. Specifically, this study ex- amine how urban poverty (including the spatial dimension of poverty) shapes the functioning of the commercialised health care system,
This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule clarifies the approach used to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal governmental plans. This final rule also amends the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under the federal rate review program, and revises the timeline for states to propose state-specific thresholds for review and approval by the Centers for Medicare & Medicaid Services (CMS).
W. Nonneman (Nonneman); E.K.A. van Doorslaer (Eddy)
textabstractThis article reviews some of the salient features of the Belgian health care finance and delivery system. Special attention is paid to the role played by the third-party payers, i.e. the Health Insurance Associations (HIAs) in administering the compulsory national health insurance
Mosquera, Paola A; Hernández, Jineth; Vega, Román; Labonte, Ronald; Sanders, David; Dahlblom, Kjerstin; San Sebastián, Miguel
Although Colombia has a health system based on market and neoliberal principles, in 2004, the government of the capital-Bogota-took the decision to formulate a health policy that included the implementation of a comprehensive primary health care (PHC) strategy. This study aims to identify the enablers and barriers to the PHC implementation in Bogota. The study used a qualitative multiple case study methodology. Seven Bogota's localities were included. Eighteen semi-structured interviews with key informants (decision-makers at each locality and members of the District Health Secretariat) and fourteen FGDs (one focus group with staff members and one with community members) were carried out. Data were analysed using a thematic analysis approach. The main enablers found across the district and local levels showed a similar pattern, all were related to the good will and commitment of actors at different levels. Barriers included the approach of the national policies and a health system based on neoliberal principles, the lack of a stable funding source, the confusing and rigid guidelines, the high turnover of human resources, the lack of competencies among health workers regarding family focus and community orientation, and the limited involvement of institutions outside the health sector in generating intersectoral responses and promoting community participation. Significant efforts are required to overcome the market approach of the national health system. Interventions must be designed to include well-trained and motivated human resources, as well as to establish available and stable financial resources for the PHC strategy. © 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.
Flynn, M L; Chung, Y S
Health insurance in developing nations has tended to widen rather than reduce the gulf between privileged and underprivileged and between urban and rural dwellers. Beneficiaries are typically urban industrial workers with regular jobs and adequate incomes. The case of health insurance implementation and health policy planning in Korea is of particular interest. It illustrates the dilemmas which arise out of a privatized model with decentralized administration and fragmented governmental responsibility in a rapidly industralizing economy. In this respect, Korean health care institutions and financing patterns reflect major influences from Japan, the United States, and Germany. Since 1976, when national health insurance was first implemented in Korea, problems in cost inflation, overspecialization of physicians, underutilization of hospital facilities, and maldistribution of health care resources have emerged. The consequences of waste and poor allocation in a developing nation are more severe than in developed nations and raise questions about the appropriate role of the public sector where conflicts between social welfare and economic objectives arise.
MacStravic, R S
Armed with valid information about what people expect, health care organizations can make commitments to current and prospective patients, thereby increasing their marketing success and improving patient satisfaction.
Kluge, Eike-Henner W
The shift in health care to an aggregate corporate and distributed model dominated by electronic methods of diagnosis, record-keeping and communication spanning jurisdictional boundaries raises technical, social and paradigmatic issues. The technical issues concern the material natures of the tools, devices, procedures and protocols; the social issues gravitate around abstract matters like individual rights and models of responsibility within a corporate setting and accountability in inter-jurisdictional contexts; the paradigmatic issues centre in the question of how the rights and duties of traditional and direct health care translate into the mediated context of the globally expanded corporate model of eHealth and telemedicine. The present discussion presents a brief overview of the issues and sketches some of their implications for the evolution of contemporary health care.
Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina
The Affordable Care Act protects people from being charged more for insurance based on factors like medical history or gender and establishes new limits on how insurers can adjust premiums for age, tobacco use, and geography. This brief examines how states have implemented these federal reforms in their individual health insurance markets. We identify state rating standards for the first year of full implementation of reform and explore critical considerations weighed by policymakers as they determined how to adopt the law's requirements. Most states took the opportunity to customize at least some aspect of their rating standards. Interviews with state regulators reveal that many states pursued implementation strategies intended primarily to minimize market disruption and premium shock and therefore established standards as consistent as possible with existing rules or market practice. Meanwhile, some states used the transition period to strengthen consumer protections, particularly with respect to tobacco rating.
Pralea, A. R.
The well-known marketing mix of the commercial sector has found its application and has been developing in the non-profit sector. In most of the cases, the techniques and tools of commercial marketing are used to change behaviours in order to achieve social good. The targeted behaviours range widely from environmental ones to health related behaviours. The aim of the current paper is to highlight some of the characteristics of the marketing mix when applied to change health related behaviours...
Pendzialek, Jonas B; Danner, Marion; Simic, Dusan; Stock, Stephanie
This paper investigates the change in price elasticity of health insurance choice in Germany after a reform of health insurance contributions. Using a comprehensive data set of all sickness funds between 2004 and 2013, price elasticities are calculated both before and after the reform for the entire market. The general price elasticity is found to be increased more than 4-fold from -0.81 prior to the reform to -3.53 after the reform. By introducing a new kind of health insurance contribution the reform seemingly increased the price elasticity of insured individuals to a more appropriate level under the given market parameters. However, further unintended consequences of the new contribution scheme were massive losses of market share for the more expensive sickness funds and therefore an undivided focus on pricing as the primary competitive element to the detriment of quality. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.
Dr. H.S.M. Kort; Hein Roelfsema; Roderick Udo
Full text via link One of the most important drivers of change in the health care sector is the desire of elderly people to age in place. The growing use of internet applications and communication technology together with innovations in buildings have created new commercial opportunities to cater
Bobocea, L; Spiridon, St; Petrescu, L; Gheorghe, C M; Purcarea, V L
In order to become known and attract consumers, a health care organization has to develop suitable external communication campaigns. Consequently, management instruments are employed to effectively evaluate the success of a campaign. The BCG Matrix, SWOT analysis and the Gantt Diagram were used in this paper to ensure the consistency and accuracy of the external communication process at an empirical level.
Lock, C A; Kaner, E F
Health research findings are of little benefit to patients or society if they do not reach the audience they are intended to influence. Thus, a dissemination strategy is needed to target new findings at its user group and encourage a process of consideration and adoption or rejection. Social marketing techniques can be utilized to aid successful dissemination of research findings and to speed the process by which new information reaches practice. Principles of social marketing include manipulating the marketing mix of product, price, place and promotion. This paper describes the development of a marketing approach and the outcomes from a trial evaluating the effectiveness and cost-effectiveness of manipulating promotional strategies to disseminate actively a screening and brief alcohol intervention (SBI) programme to general practitioners (GPs). The promotional strategies consisted of postal marketing, telemarketing and personal marketing. The study took place in general practices across the Northern and Yorkshire Regional Health Authority. Of the 614 GPs eligible for the study, one per practice, 321 (52%) took the programme and of those available to use it for 3 months (315), 128 (41%) actively considered doing so, 73 (23%) actually went on to use it. Analysis of the specific impact of the three different promotional strategies revealed that while personal marketing was the most effective overall dissemination and implementation strategy, telemarketing was more cost-effective. The findings of our work show that using a marketing approach is promising for conveying research findings to GPs and in particular a focus on promotional strategies can facilitate high levels of uptake and consideration in this target group.
Geyman, John P
The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record. This article compares the goals and claims of the ACA with its actual experience in the areas of access, costs, affordability, and quality of care. Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care. More fundamental reform will be needed. The country still needs to confront the challenge that our for-profit health insurance industry, together with enormous bureaucratic waste and widespread investor ownership throughout our market-based system, are themselves barriers to health care reform. Here we consider the lessons we can take away from the ACA's first five years and lay out the economic, social/political, and moral arguments for replacing it with single-payer national health insurance. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.
Reforming health care systems which are predominantly publicly provided and financed has usually been motivated as a way of increasing efficiency even if it seldom is explicit whether it is in the official sense related to individual utility or in the unofficial sense related to health outcomes. In the case of Sweden the welfare state has been made politically sustainable through a construction where cash benefits and service provision are tailored to satisfy not only the basic needs but even the more discriminating needs of the middle classes. Their loyalty with the taxes is politically crucial and therefore their evaluation of the services in the welfarist sense equally important. That loyalty was however threatened in a situation where cost-containment policies were applied while equity principles were still a strong priority. Health care utilization was increasing among the very old and chronically ill while it was decreasing for other groups. The reforms introduced in some counties during the 1990s have been focussing on a purchaser-provider split and fee-for-service payment of providers. They have increased productivity sharply, increased utilization even among the groups that previously were 'pressed out' and reduced waiting lists. Increased efficiency however, threatens equity in some specific aspects. Fee-for-service payment means increased production and so far even increased costs. If they are to be met with increased private financing, rather than with present tax financing, it will bring the risk of inequities. Payment of hospitals through DRG systems means payment to providers for medical interventions with no incentives to deal with social consequences of illness. Inequities in health care can be related to the way health care deals with inequalities in health due to inequalities in living conditions or inequalities in living conditions due to ill health. In the short perspective the reforms may threaten equity in the second aspect, in the longer
'pressed out' and reduced waiting lists. Increased efficiency however, threatens equity in some specific aspects. Fee-for-service payment means increased production and so far even increased costs. If they are to be met with increased private financing, rather than with present tax financing, it will bring......Reforming health care systems which are predominantly publicly provided and financed has usually been motivated as a way of increasing efficiency even if it seldom is explicit whether it is in the official sense related to individual utility or in the unofficial sense related to health outcomes....... In the case of Sweden the welfare state has been made politically sustainable through a construction where cash benefits and service provision are tailored to satisfy not only the basic needs but even the more discriminating needs of the middle classes. Their loyalty with the taxes is politically crucial...
De Wever, A
After the definition of the economy and its different types, we have to stress the political economy which integrates pure economy and society. The economical science will gradually introduce the health economy of which the definition urges to seek for a better distribution between public and private means to do more and better for the public health. The market economy is different from the state economy. She is principally conducted by the supply and demand law. The consumer's behaviour in a competitive market has some characteristics which favour the balance of this market. The healthcare market put also a health supply and demand forward but not with the same values. The needs, the supply, the consumption and the consumer's behaviour are different in this particular market which quickly evolves and progressively goes closer to the market economy. Is the healthcare an economical good or duty? The choices' criteria and the priorities are changeable. The role of the valuation studies in health economy is to try to clarify them and to favour a better use of the limited resources to the unlimited needs.
Brezis, Mayer; Wiist, William H
This article reviews adverse influences of for-profit enterprises on health care and public health, and examines significance for public policy. Narrative review. For-profit health-care industries may increase costs and reduce quality, leading to market failure and contributing to the USA's unflattering position in international comparisons of health-care efficiency. Drug and device corporations use strategies such as making biased inferences, influencing scientists and physicians, marketing rather than informing the public, and lobbying to control their own industry regulations to create market advantage. Successful marketing leads to the increased use of costly profit-making drugs and procedures over cheaper, nonpatented therapies. Because resources are limited, the overuse of costly modalities contributes to expensive health care, which presents a challenge to universal coverage. The free market also fosters the proliferation of industries, such as tobacco, food, and chemicals, which externalize costs to maximize profits, seek to unduly influence research by paying experts and universities, and attempt to control the media and regulatory agencies. Most vulnerable to the cumulative harm of these tactics are children, the poor, the sick, and the least educated. The free market can harm health and health care. The corporate obligation to increase profits and ensure a return to shareholders affects public health. Such excesses of capitalism pose formidable challenges to social justice and public health. The recognition of the health risks entailed by corporation-controlled markets has important implications for public policy. Reforms are required to limit the power of corporations.
Audiologists, even those with a strong acumen for business, are not traditionally taught the basics of creating a robust practice identity and dynamic marketing plan. This activity will teach learners how to create a distinct brand that separates them from others in a competitive and distracted marketplace. Additionally, learners will gain an understanding for how to blend traditional marketing tools with more modern online options and social media. Upon completion, learners will be familiar with the skills necessary to actively create, implement, and track the effectiveness of their marketing strategy using proven methodologies. PMID:28028325
Audiologists, even those with a strong acumen for business, are not traditionally taught the basics of creating a robust practice identity and dynamic marketing plan. This activity will teach learners how to create a distinct brand that separates them from others in a competitive and distracted marketplace. Additionally, learners will gain an understanding for how to blend traditional marketing tools with more modern online options and social media. Upon completion, learners will be familiar with the skills necessary to actively create, implement, and track the effectiveness of their marketing strategy using proven methodologies.
Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J
Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients.
Epstein, Richard J
The global economy is being transformed by an explosion of information unleashed by the internet, the digital revolution, communications and increased international mobility. This transformation is manifesting in many ways, including rapid development of countries such as China, commoditization of public services, mobilization of workforces, shifting of market control from suppliers to consumers, interlinked rises in product demand and customer expectations, and problems regulating international business competition. As Asia is home to half of the world's population, and offers both a large relatively low-cost workforce in some countries and a potentially huge retail market, this region could be central to the future of the global economy. Like other industries, the pharmaceutical industry faces a new array of Asia-specific opportunities and challenges. Success in meeting these challenges will go to those pharmaceutical companies that best understand the unique strengths and constraints of Asia's diverse cultures, talents and markets.
Toker, Asaf; Shvarts, Shifra; Glick, Shimon; Reuveni, Haim
The worldwide shortage of physicians is due not only to the lack of physicians, but also to complex social and economic factors that vary from country to country. To describe the results of physician workforce planning in a system with unintended policy, such as Israel, based on past experience and predicted future trends, between 1995 and 2020. A descriptive study of past (1995-2009) and future (through 2020) physician workforce trends in Israel. An actuarial equation was developed to project physician supply until 2020. In Israel a physician shortage is expected in the very near future. This finding is the result of global as well as local changes affecting the supply of physicians: change in immigration pattern, gender effect, population growth, and transparency of data on demand for physicians. These are universal factors affecting manpower planning in most industrial countries all over the world. We describe a health care market with an unintended physician workforce policy. Sharing decision makers' experience in similar health care systems will enable the development of better indices to analyze, by comparison, effective physician manpower planning processes, worldwide.
U.S. Department of Health & Human Services — This section includes useful information to help Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and 1876 Cost Plans...
Norman, O. Gene
The basic activities of marketing are discussed, including gathering information and determining needs, designing a program around the elements of the marketing mix, and managing the marketing program. Following a general discussion, applications of the marketing concepts to a health sciences library are described. The administrator of the health…
Romeo, N C
The health care marketplace is changing dramatically, even without federal reform measures. This is a volatile, yet promising, time to market a managed care plan. Before marketing the product, it is critical that the competition is thoroughly evaluated and consumer and employer needs are researched. The final product should be distinguishable from the competition and address market needs. Promotion can then begin, utilizing a proactive public relations and advertising campaign in addition to traditional methods of marketing.
Harrell, G D; Fors, M F
Although significant changes are occurring in health care delivery, in many instances the new offerings are not based on a clear understanding of market segments being served. This exploratory study suggests that important differences may exist among women with regard to health care selection. Five major women's segments are identified for consideration by health care executives in developing marketing strategies. Additional research is suggested to confirm this segmentation hypothesis, validate segmental differences and quantify the findings.
Murray, Corey; Ullman, Ellen
Those following recent employment trends have heard about the nursing shortage. A combination of increased demand and impending retirements means 1 million nurses will be needed in hospitals, homes, and medical facilities by 2018. That's good news for job seekers. But it is not just shortages in nursing. Allied health careers, including…
Grier, Sonya; Bryant, Carol A
Social marketing, the use of marketing to design and implement programs to promote socially beneficial behavior change, has grown in popularity and usage within the public health community. Despite this growth, many public health professionals have an incomplete understanding of the field. To advance current knowledge, we provide a practical definition and discuss the conceptual underpinnings of social marketing. We then describe several case studies to illustrate social marketing's application in public health and discuss challenges that inhibit the effective and efficient use of social marketing in public health. Finally, we reflect on future developments in the field. Our aim is practical: to enhance public health professionals' knowledge of the key elements of social marketing and how social marketing may be used to plan public health interventions.
Individuals who spent time in foster care as children fare on average worse than non-placed peers in early adult life. Recent research on the effect of foster care placement on early adult life outcomes provides mixed evidence. Some studies suggest negative effects of foster care placement on early adult outcomes, others find null effects. This study shows that differences in the average duration of foster care stays explain parts of these discordant findings and then test how foster care duration shapes later life outcomes using administrative data on 7220 children. The children experienced different average durations of foster care because of differences in exposure to a reform. Later born cohorts spent on average 3 months longer in foster care than earlier born cohorts. Isolating exogenous variation in duration of foster care, the study finds positive effects of increased duration of foster care on income and labor market participation. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Kash, Bita A; Deshmukh, A A
The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.
Cho, Kyoung Hee; Park, Eun-Cheol; Nam, Young Soon; Lee, Seon-Heui; Nam, Chung Mo; Lee, Sang Gyu
Ambulatory care-sensitive conditions, including asthma, can be managed with timely and effective outpatient care, thereby reducing the need for hospitalization. This study assessed the relationship between market competition, continuity of care (COC), and hospital admissions in asthmatic children according to their health care provider. A longitudinal design was employed with a 5-year follow-up period, between 2009 and 2013, under a Korean universal health insurance program. A total of 253 geographical regions were included in the analysis, according to data from the Korean Statistical Office. Data from 9,997 patients, aged ≤ 12 years, were included. We measured the COC over a 5-year period using the Usual Provider Continuity (UPC) index. Random intercept models were calculated to assess the temporal and multilevel relationship between market competition, COC, and hospital admission rate. Of the 9,997 patients, 243 (2.4%) were admitted to the hospital in 2009. In the multilevel regression analysis, as the Herfindahl-Hirschman Index increased by 1,000 points (denoting decreased competitiveness), UPC scores also increased (ß = 0.001; p Market competition appears to reduce COC; decreased COC was associated with a higher OR for hospital admissions.
Grier, Sonya A; Kumanyika, Shiriki
Targeted marketing techniques, which identify consumers who share common needs or characteristics and position products or services to appeal to and reach these consumers, are now the core of all marketing and facilitate its effectiveness. However, targeted marketing, particularly of products with proven or potential adverse effects (e.g., tobacco, alcohol, entertainment violence, or unhealthful foods) to consumer segments defined as vulnerable raises complex concerns for public health. It is critical that practitioners, academics, and policy makers in marketing, public health, and other fields recognize and understand targeted marketing as a specific contextual influence on the health of children and adolescents and, for different reasons, ethnic minority populations and other populations who may benefit from public health protections. For beneficial products, such understanding can foster more socially productive targeting. For potentially harmful products, understanding the nature and scope of targeted marketing influences will support identification and implementation of corrective policies.
Full Text Available Introduction: The international financial situation in combination with an aging population and the appropriation of health services imposes the management of hospital services as a necessity for the survival of hospitals.Aim: To examine the perceptions of 450 upper administrative hospital executives (Nursing, Medicine and Administrative services in the wider region of Attica, on marketing, communication, and public relations in health-care.Population study: Four hundred and fifty (450 higher health executives from the three basic fields of services in health institutions (medical, nursing, administration constituted the total sample of the research. These people are employed at 9 of the 36 hospitals in the 3 Health Regions of Attica (H.Re.Materials and method:The type of design that was chosen (to gather data for the study of attitudes and perceptions of the health personnel of the health institutions of G.S.H (Greek System of Health is a cross- sectional survey.Results: The participating subjects, even though expressed some reservations at first, formed a favorable attitude towards marketing and its application in the field of health-care. Statistically important correlations emerged between the perceptions of executives and their socio-demographic background including age, sex, education, and profession, work experience in health-care and specifically in their current position in the services as well as statistically important differences between doctors, nurses and administrators as to their perceptions of some issues in marketing.Conclusions: From the comments in the survey it appears there is a need to apply marketing correctly when providing quality care, respecting the patients’ rights and using human and not financial criteria as a guide. Based on the results of the research, important proposals are being submitted in the areas of health-care research, education and clinical practice.
Javier Eduardo Bejarano-Daza
Conclusion: There are significant failures in the Colombian health market which make the system inefficient and inequitable; this situation demands for reconsideration of an economic model for financing and operation under a new paradigm.
Katz, Alison Rosamund
In a two-part article (the first part in this Journal issue), the author explores the prospects for a genuine revival of the social justice project of "Health for All by the Year 2000", launched by the WHO and UNICEF in 1978 at Alma-Ata in the former Soviet Union, with reference (in Part I) to the World Health Report 2008, Primary Health Care: Now More than Ever, and the report of the WHO Commission on Social Determinants of Health, also published in 2008; and (in Part II) to Global Health Watch 2: An Alternative World Health Report and the perspectives of anti-capitalist, real socialist, environmental, and people's movements for economic and social justice. The reports are reviewed in terms of the original values and principles of Alma-Ata (social justice and human rights) and the structural foundations of the primary health care (PHC) project (a new international economic order and emancipatory development of decolonized countries). A genuine revival of the PHC project and of Health for All, which is its implicit objective, will not be possible unless the multiple crises that we are confronting today-in energy, water, food, finance, the environment, science, information, and democracy-are recognized as capitalist crises and addressed in these terms. In short, the invisible hand of the market must be replaced by the visible hand of social justice.
Cooper, P D; King, K K
Survey data were used to evaluate the role of marketing in the nonprofit arena of health promotion. Questionnaires utilizing a Likert type scale were sent to 106 marketers and 247 health educators soliciting their opinions about health care marketing. Both groups agreed that marketing was appropriate for both profit and non-profit organizations, but were not in total agreement on specific aspects of the marketing process. Marketers were adamant that marketing is not confined to promotional, advertising and communication functions, while health educators were neutral. Marketers were strong in their disagreement that marketing is selling; health educators were still neutral but in slight disagreement. Marketers did not believe that marketing uses gimmickry heavily, while health educators agreed that it does use gimmickry. A significant finding from the survey is that the major ethical issue for health educators is their view that marketing manipulates society. Both community and school health educators agreed that using marketing techniques is a step forward manipulation of a society, while the group of marketers disagreed.
Babaskin, D V
Successful introduction of modern technologies into the national health care systems strongly depends on the current pharmaceutical market situation. The present article is focused on the peculiarities of marketing research with special reference to physiotherapeutic services and commodities. Analysis of the structure and sequence of marketing research processes is described along with the methods applied for the purpose including their support by the use of Internet resources and technologies.
Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G
Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as
The political, social, and economic ideology fueling the movement toward privatization in health care may be characterized as "market populism." Whether or not public health agencies retain their traditional roles in personal health services delivery, these organizations must serve as the predominant external source for quality monitoring, oversight, enforcement, and advocacy for communities in an environment that regards the private market as a panacea.
Burau, Viola; Zechner, Minna; Dahl, Hanne Marlene
In Europe over the last two decades, marketization has become an important policy option in elder care. Comparative studies predominantly adopt an institutional perspective and analyze the politics and policies of marketization. This analysis takes a step back and examines the fundamental ideas...... to understand the ideas behind the marketization of elder care. Ideas emerge as a key leverage for making policies and practices of marketization acceptable and which decision makers and other influential political/societal actors use in policy and public debates. The importance of ideas is further underlined...... underpinning the policies of marketization, using the ‘What's the problem?’ approach by Carol Bacchi. The central question is how the market was discursively framed as the solution to the perceived problems of three different systems of elder care, and how such processes are similar or different across...
Vik, Jostein; Farstad, Maja
Green care--the utilisation of farms as the basis for health services--is seen as a promising addition to other health services, and it is seen as a viable diversification strategy for many farm families. However, the number of such services is low both in Norway and in Europe in general. The development of green care seems to have stagnated. This paper seeks to analyze and discuss the case of Norwegian green care in order to reflect on the hindrances to the further development of a viable green care sector. The paper analyzes the green care market, green care policies and the interaction of social worlds that are necessary to make the green care sector function smoothly. The conclusion is that there is a sound basis for a green care market and that there are sufficient political support and political engagement for the development of green care in Norway. The problem with the green care sector is the interaction between the "social worlds" involved in the sector--the suppliers/farmers, the users, and the (public sector) buyers. It is argued that the development of a green care market is hampered by the lack of an institutional framework and a set of market devices capable of bringing key actors together. The paper presents an analysis of the Norwegian green care sector. It shows that there are substantial cross-national differences between health service systems, and therefore comparisons between nations are difficult. However, the principal challenges--diverse social groups, the lack of institutional frames, and immature markets--are shared. Therefore, the need for further research is evident and there are lessons to be learned from cross-national comparison and case studies. Within the green care research field, there have been few social science studies that address organisational issues and the governance of this new and emerging business. Theoretically oriented and analytical contributions on organisational aspects of green care services are therefore timely
Fronstin, Paul; Ross, Murray N
HEALTH INSURANCE EXCHANGE: This Issue Brief examines issues related to managed competition and the use of a health insurance exchange for the purpose of addressing cost, quality, and access to health care services. It discusses issues that must be addressed when designing an exchange in order to reform the health insurance market and also examines state efforts at health reform that use an exchange. RISK VS. PRICE COMPETITION: The basic component of managed competition is the creation an organized marketplace that brings together health insurers and consumers (either as individuals or through their employers). The sponsor of the exchange would set "rules of engagement" for participating insurers and offer consumers a menu of choices among different plans. Ultimately, the goal of a health insurance exchange is to shift the market from competition based on risk to competition based on price and quality. ADVERSE SELECTION AND AFFORDABILITY: Among the issues that need to be addressed if an exchange that uses managed competition has a realistic chance of reducing costs, improving quality, and expanding coverage: Everyone needs to be in the risk pool, with individuals required to purchase insurance or face significant financial consequences; effective risk adjustment is essential to eliminate risk selection as an insurance business model--forcing competition on costs and quality; the insurance benefit must be specific and clear--without standards governing cost sharing, covered services, and network coverage there is no way to assess whether a requirement to purchase or issue coverage has been met; and subsidies would be necessary for low-income individuals to purchase insurance. THE PUBLIC PLAN OPTION: The public plan option is shaping up to be one of the most contentious issues in the health reform debate. Proponents also believe of a public plan is necessary to drive private insurers toward true competition. Opponents view it as a step toward government-run health
Curtice, Lisa; Fraser, Fiona
By offering people the choice of care at home, the policy of encouraging local authorities to purchase domiciliary care services from voluntary and private providers was intended to achieve a key part of the community care agenda. A study to establish the extent to which there was a mixed economy in the purchase and provision of domiciliary care in Scotland in 1996 revealed reluctance by local authority managers to divest the provision of domiciliary care to voluntary and private agencies. In a telephone survey of purchasers, some social work respondents noted a preference for voluntary over private providers and expressed concern as to whether either could take over the bulk of domiciliary care provision. These attitudes were reflected in the pattern of market development observed. Five hundred and ninety providers were identified, but a postal survey of a random sample of one in two providers (response rate 66%) found that the independent sector's share of the market, measured as the proportion of weekly care hours provided, was small compared with the position in England and Wales at that time (15 : 36%). It is concluded that understanding of the development of the quasi-market in domiciliary care in the UK must now take account of slower development in Scotland. Explanation for the difference may lie in the level of state regulation, for in Scotland there was no compulsion on local authorities to purchase from the independent sector. Paradoxically, the quasi-market in England developed through strong state regulation, whereas in Scotland the strength of policy networks may account for the persistence of a more traditional welfare state model. The paper questions whether the incentives for change were sufficient in Scotland under the quasi-market. If local partnerships do not deliver these results the government may have to take a more active role to modernise domiciliary care services.
Ameri, Cinzia; Fiorini, Fulvio
Marketing research is the systematic and objective search for, and analysis of, information relevant to the identification and solution of any problem in the field of marketing. The key words in this definition are: systematic, objective and analysis. Marketing research seeks to set about its task in a systematic and objective fashion. This means that a detailed and carefully designed research plan is developed in which each stage of the research is specified. Such a research plan is only considered adequate if it specifies: the research problem in concise and precise terms, the information necessary to address the problem, the methods to be employed in gathering the information and the analytical techniques to be used to interpret it. Maintaining objectivity in marketing research is essential if marketing management is to have sufficient confidence in its results to be prepared to take risky decisions based upon those results. To this end, as far as possible, marketing researchers employ the scientific method. The characteristics of the scientific method are that it translates personal prejudices, notions and opinions into explicit propositions (or hypotheses). These are tested empirically. At the same time alternative explanations of the event or phenomena of interest are given equal consideration.
McNamara, Courtney; Labonté, Ronald
Previous analyses indicate that there are a number of potentially serious health risks associated with the Trans-Pacific Partnership (TPP). The objective of this work is to provide further insight into the potential health impacts of the TPP by investigating labour market pathways. The impact of the TPP on employment and working conditions is a major point of contention in broader public debates. In public health literature, these factors are considered fundamental determinants of health, yet they are rarely addressed in analyses of trade and investment agreements. We therefore undertake a prospective policy analysis of the TPP through a content analysis of the agreement's Labour Chapter. Provisions of the Chapter are analyzed with reference to the health policy triangle and four main areas through which labour markets influence health: power relations, social policies, employment conditions and working conditions. Findings indicate that implementation of the TPP can have important impacts on health through labour market pathways. While the Labour Chapter is being presented by proponents of the agreement as a vehicle for improvement in labour standards, we find little evidence to support this view. Instead, we find several ways the TPP may weaken employment relations to the detriment of health.
Adverse selection as it relates to health care policy will be a key economic issue in many upcoming elections. In this article, the author lays out a 30-minute classroom experiment designed for students to experience the kind of elevated prices and market collapse that can result from adverse selection in health insurance markets. The students…
Russo, P; Mennini, F S; Siviero, P D; Rasi, G
The main purpose of this study was to identify each sequential phase followed by an oncology product, from European assessment until to patient access in each Italian region (IR). A panel of oncology products approved by the European Medicines Agency (EMA) in the period 2006-2008 was considered. The explored sequential phases included the times to market for: the EMA; pharmaceutical companies; the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA); and IRs as final providers of health care. The IR's time to market was also analyzed by a Cox regression model. The overall mean time required before patients access was 2.3 years. EMA accounted for the greater proportion of time (31.8%), followed by AIFA (28.2%). However, the duration for both pharmaceutical companies and IRs was associated with the highest variability. An oncology product authorized with a risk-sharing agreement showed an early access in the IRs. On the contrary, the introduction in IRs having a compulsory formulary was delayed. Both a high forecast of economic impact and a high oncology product price can also delay the patient access. The process before patient access to an oncology product is time and cost consuming. This study identifies the main predictors that affect the missing overlap between market and patient access in Italy.
Suarez-Almazor, M E
Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers. The "product" in social marketing is generally a behavior, such as a change in lifestyle (e.g., diet) or an increase in a desired health practice (e.g., screening). In order for people to desire this product, it must offer a solution to a problem that is weighed with respect to the price to pay. The price is not just monetary, and it often involves giving something up, such as time (e.g., exercising) or a wanted, satisfying behavior (e.g., smoking). In its development phase, social marketing incorporates qualitative methods to create messages that are powerful and potentially effective. The implementation of the programs commonly involves mass campaigns with advertisement in various media. There have been a few social media campaigns targeting bone health that have been disseminated with substantial outreach. However, these have not been systematically evaluated, specifically with respect to change in behavior and health outcomes. Future campaigns should identify target behaviors that are amenable to change such as bone mass measurement screening or exercise. Audience segmentation will be crucial, since a message for young women to increase peak bone mass would be very different from a message for older individuals who have just experienced a fracture. Campaigns should involve key stakeholders, including policy makers, health providers, and the public. Finally, success must be carefully evaluated, not just by the outreach of the campaign, but also by a change in relevant behaviors and a decrease in deleterious health outcomes.
vaccine for their children. journal of. COMMUNITY HEALTH. & PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care. 26(2) 46-58. Correspondence to: Ijadunola M.Y. Department of Community Health, Faculty of Clinical Sciences,. College of Health Sciences, Obafemi Awolowo University,.
Katz, Alison Rosamund
This second part of a two-part article explores the prospects for genuine revival of primary health care (PHC) as announced by the WHO in 2008, with reference, briefly, to Global Health Watch 2, published by the People's Health Movement, Medact, and Equity Gauge Alliance, and, in more depth, to the positions of social and people's movements most closely aligned with the original values and principles of Alma-Ata and the structural foundations of the PHC project. The author argues that the social justice struggle for health cannot be limited to curbing capitalism's excesses. The multiple crises of today--in energy, water, food, the environment, finance, science, information, and democracy--must be recognized as capitalist crises and addressed as such. Particular attention is given to ideology, including the distortion of human nature and society under neoliberal capitalism, and to moral foundations of Health for All. Not only must the invisible hand of the market be replaced by the visible hand of social justice, but the single ideology proclaiming the "end of history" and, by implication, the end of politics and political struggle must be exposed and rejected as neoliberal, totalitarian propaganda. In line with the spirit and intention of the U.N. Charter, PHC remains a political project for a fair and safe world in which Health for All is both possible and necessary.
Remco van Eijkel; Ab van der Torre; Mark Kattenberg; Evelien Eggink
Original title: De markt voor huishoudelijke hulp. Since 2007, the market for domestic help has been decentralised to the municipalities. Since then, every municipality can decide how it contracts out this help. The Netherlands Bureau for Economic Policy Analysis (CPB) and Netherlands Institute for Social Research (SCP) investigated the impact of municipal purchasing policy on the market for domestic help and on civilian use of that help. The quality of the help could not be included in the r...
Chambers, David W
There is not enough marketing of dentistry; but there certainly is too much selling of poor quality service that is being passed off as dentistry. The marketing concept makes the patient and the patients' needs the ultimate criteria of marketing efforts. Myths and good practices for effective marketing that will promote oral health are described under the traditional four "Ps" categories of "product" (best dental care), "place" (availability), "promotion" (advertising and other forms of making patients aware of available services and how to use them), and "price" (the total cost to patients of receiving care).
Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn
The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.
Robinson, James C
The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.
Much of the debate surrounding reform of the Patient Protection and Affordable Care Act (ACA) revolves around its insurance market regulation. This paper studies the impact on health insurance coverage of those provisions. Using data from the American Community Survey, years 2008-2015, I focus on individuals, ages 26 to 64, who are ineligible for the subsidies or Medicaid expansions included in the ACA to isolate the effect of its market regulation. To account for time trends, I utilize a differences-in-differences approach with a control group of residents of Massachusetts who were already subject to a similarly regulated health insurance market. I find that the ACA's regulations caused an increase of 0.95 percentage points in health insurance coverage for my sample in 2014. This increase was concentrated among younger individuals, suggesting that the law's regulations ameliorated adverse selection in the individual health insurance market. Copyright © 2017 John Wiley & Sons, Ltd.
COMMUNITY HEALTH. & PRIMARY HEALTH CARE. KEYWORDS ABSTRACT. Correspondence to: Journal of Community Medicine and Primary Health Care. 26 (2) 1-6. Facility User's Preference between the Free and the Bamako. Initiative (Drug Revolving Fund-Based) Health Services in Iwajowa Local Government, Oyo ...
Remco van Eijkel; Ab van der Torre; Mark Kattenberg; Evelien Eggink
Original title: De markt voor huishoudelijke hulp. Since 2007, the market for domestic help has been decentralised to the municipalities. Since then, every municipality can decide how it contracts out this help. The Netherlands Bureau for Economic Policy Analysis (CPB) and Netherlands Institute
Carter, M.W.; Hans, Elias W.; Kolisch, R.
Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully
In the current economic order, the basic duty of citizens is to find placements in the internationalising labour market. Internationalism has been a common educational objective throughout Europe. Previously associated as a feature of middle-class subjectivities and academic education, it is implemented in the agenda of vocational education as…
healthcare providers in south-east Nigerian. Malaria. National population commission and ORC Macro. Journal.2009;8:22. 6. Amaghionyeodiwe LA. Determinants of the. 15. World Health Organisation. The African choice of health care provider in Nigeria. Health malaria report 2003. Available at. Care Management Science.
..." for attracting and retaining more patients. Maternal/Child Health is DeWitt's second most important product line, with a target market of 25,000 female beneficiaries between the ages of 18 and 45...
... Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Vacation health care URL of this page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the ...
This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.
Bulger, R J
As prefigured in the Greek tragedy Antigone, one of the primary conflicts in contemporary health care is that between humane concern for the individual and concern for society at large and administrative rules. The computerization of the health care system and development of large data bases will create new forms of this conflict that will challenge the self-definition of health care and health care professionals.
insurance market, the elderly are at a serious disadvantage in obtaining coverage. Congress established the Medicare program to meet the health care ...not covered by Medicare, 1990a Acupuncture0 Chiropractic services Christian Science practitioners Cosmetic surgery0 Custodial care Dental care0...CRM 95-195 / November 1995 America’s Health: Recent Trends in Health Care Joyce S. McMahon • Michelle A. Dolfini-Reed • John A. Wilson 19960826
Hofer, Susanne; Honegger, Franziska; Hubeli, Jonas
This paper's purpose is to give an overview of current research regarding the concept of "health tourism" with a focus on Switzerland, and to determine whether a consensus on this concept and its embedding in existing/future markets can be found. The paper is an explorative study combining literature review, questionnaires and qualitative interviews. Grounded theory was employed. A service from the field of health care must have been provided prior to health tourism, allowing it to be classified under the health care system. Thus, health tourism is classified under the market for the sick and not under tourism which targets the healthy. Furthermore a new market for the healthy is emerging, which needs to be defined. As an example health(i)ness could help to clarify the terminology, to be seen as a gatekeeper of health and as a cultural paradigm change from cure to prevention. Further research is needed, regarding the positioning and development of health tourism and its synergies, as the cost pressures in health care increase and will continue to have a sustainable impact on health tourism. The paper provides better knowledge of the term health tourism, its general classification, and particular reference to Switzerland, and information about upcoming changes in health care. The findings add to the knowledge of how health tourism is embedded into health care and tourism, and show potential within the market for the healthy. It provides information to members of the tourism and health care market.
debut (20.8%), 40.8% had multiple sexual partners, 23.3% had sex under the influence of alcohol while. 34.2% didn't use ... PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care. 26(2) 97-106. KEYWORDS. Risky sexual behaviour, young people, ..... 2010;15(1): Art. #505[cited consistent with ...
Up to 11 (7.2%) respondents in the non-BI LGA were not satisfied with the drug services in the health centers, compared ... improvement in primary health care services,. 8 ..... Naves J O, Silver LD. Evaluation of pharmaceutical assistance in public primary care in Brasilia, Brazil. Rev. Saude Publica. 2005; 39(2): 223-30. 21.
Younger, David S
China has recently emerged as an important global partner. However, like other developing nations, China has experienced dramatic demographic and epidemiologic changes in the past few decades. Population discontent with the health care system has led to major reforms. China's distinctive health care system, including its unique history, vast infrastructure, the speed of health reform, and economic capacity to make important advances in health care, nonetheless, has incomplete insurance coverage for urban and rural dwellers, uneven access, mixed quality of health care, increasing costs, and risk of catastrophic health expenditures. Copyright © 2016 Elsevier Inc. All rights reserved.
Younger, David S
Although a stated right for all Indians, equal access to health care in India is impeded by socioeconomic barriers. With its 3-tier system of public health care centers in villages, district hospitals, and tertiary care hospitals, government expenditure in India is inordinately low, with a disproportionate emphasis on private health spending. Accordingly, the poorest receive a minority of the available subsidies, whereas the richest obtain more than a third, fostering a divide in health care infrastructure across the rich and poor in urban and rural settings. This paradigm has implications for domestic Indian public health and global public health. Copyright © 2016 Elsevier Inc. All rights reserved.
Ambrose, D M; Lennox, L
Faced with a rapidly changing market, increased legislation and intense competition, mental health service providers must be sophisticated planners and position themselves advantageously in the marketplace. They can effectively position themselves to be profitable and sustaining through market segmentation and sensitivity. The following article will address one concept of marketing that has received less attention but is of critical importance: positioning. As the market environment becomes increasingly competitive, positioning will be the key to success for mental health programs and institutions.
... Caregivers Questions to Ask about Advanced Cancer Research Managing Cancer Care Finding Health Care Services Costs & Medical ... Feelings Planning for Advanced Cancer Advanced Cancer & Caregivers Managing Cancer Care Finding Health Care Services Managing Costs ...
Beegle, Kathleen; Dehejia, Rajeev; Gatti, Roberta
Despite the extensive literature on the determinants of child labor, the evidence on the consequences of child labor on outcomes such as education, labor, and health is limited. We evaluate the causal effect of child labor participation among children in school on these outcomes using panel data from Vietnam and an instrumental variables strategy.…
Grazier, Kyle L; Metzler, Bridget
Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects.
Ameri, Cinzia; Fiorini, Fulvio
The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).
General Accounting Office, Washington, DC. Div. of Human Resources.
In response to a request by Congressman Claude Pepper, the General Accounting Office (GAO) conducted a study to examine the private long-term care insurance market. The GAO analyzed the premiums, benefits, and limitations of 33 policies offered by 25 insurers in 1986. The GAO assessed the potential for abuse in this market by surveying state…
The potential market demand for biokinetics in the private health care sector of South Africa. SJ Moss, MS Lubbe. Abstract. Objective: Biokinetics, a profession registered with the Health Professions Council of South Africa (HPCSA), address inter alia chronic diseases of lifestyle (CDL) with exercise as treatment modality.
Lipscomb, J; Douglass, C W
A theory of the dental care market is introduced which proposes that the vertically integrated (local/state/national) structure of the profession services as an organizational vehicle both for intra-professional debate and for developing provider-oriented dental care policy. We suggest that a special relationship exists between professionalism and professional regulation. Such regulation has functioned simultaneously to limit competition and to foster a prized consumption commodity for providers: professionalism and professional esteem. The organized pursuit of this commodity inherently dampens competition. Professionalism itself plays a crucial role in: 1) securing for organized dentistry a form of state regulation in which the providers themselves are the principal decision-makers; and 2) influencing provider and consumer market behavior in several significant respects, the net result being the formation of maintenance of a type of "leadership cartel" in the local market. Thus, a political-economic theory of the dental care market formally acknowledges professionalism as valued by established dentists and recent graduates as a central determining influence. Traditional models of pure competition and monopoly emerge as special, extreme cases of the general theory. Hypotheses are offered regarding consumer and provider behavior, market dynamics, and health policy and regulation. PMID:7091455
Frank, Mary, Ed.; Caldwell, Bettye M., Ed.
Contains seven papers divided into three sections addressing: (1) the application of marketing principles to child care organizations and ways of remedying the negative public image of child care; (2) training child care professionals to develop marketing skills; and (3) successful uses of five basic marketing skills illustrated through four case…
Mobley, M F; Elkins, R L
Megamarketing, as coined by Kotler (1968), is a strategic way of thinking which takes an enlarged view of the skills and resources needed to enter and operate in obstructed or protected markets. The concept of megamarketing emphasizes the mastering and coordination of economic, psychological, political, and public relation skills and suggest that organizations can take a proactive stance in shaping macroenvironmental conditions. As health care delivery is characterized by a highly regulated environment, this marketing approach has definite applications for the health care marketer.
... medicines or supplements that you are taking WHY PREVENTIVE HEALTH CARE IS IMPORTANT Even if you feel ... want to schedule a visit . Another part of preventive health is learning to recognize changes in your ...
Karuppan, Corinne M; Karuppan, Muthu
Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.
Early detection and treatment of these morbidities could prevent deterioration. The aim of the survey was to determine and compare the prevalence of ..... interventions. Increasing the detection rate of mental morbidity in the community is fundamental. The inclusion of mental health care as a component of primary health ...
large extent can reduce financial barriers to options; including government budgetary health care access ..... managers and demand-side factors, such as. International Health Conference. New adverse selection in ... patients in the scheme, and patient demand for. Information Centre. 1995. insured services. Many previous ...
... map [a-z] More VA More VA Health Health Care Information A-Z Health Topic Finder My Health ... General QUICK LIST Apply for Benefits Apply for Health Care Prescriptions My Health e Vet eBenefits Life Insurance ...
Hager, David R; Persaud, Rosemary A; Naseman, Ryan W; Choudhary, Kavish; Carter, Kristen E; Hansen, Amanda
Background: While hospital beds continue to decline as patients previously treated as inpatients are stabilized in ambulatory settings, the number of critical care beds available in the United States continues to rise. Growth in pharmacy student graduation, postgraduate year 2 critical care (PGY2 CC) residency programs, and positions has also increased. There is a perception that the critical care trained pharmacist market is saturated, yet this has not been evaluated since the rise in pharmacy graduates and residency programs. Purpose: To describe the current perception of critical care residency program directors (CC RPDs) and directors of pharmacy (DOPs) on the critical care pharmacist job market and to evaluate critical care postresidency placement and anticipated changes in PGY2 CC programs. Methods: Two electronic surveys were distributed from October 2015 to November 2015 through Vizient/University HealthSystem Consortium, American Society of Health-System Pharmacists (ASHP), Society of Critical Care Medicine, and American College of Clinical Pharmacy listservs to target 2 groups of respondents: CC RPDs and DOPs. Questions were based on the ASHP Pharmacy Forecast and the Pharmacy Workforce Center's Aggregate Demand Index and were intended to identify perceptions of the critical care market of the 2 groups. Results: Of 116 CC RPDs, there were 66 respondents (56.9% response rate). Respondents have observed an increase in applicants; however, they do not anticipate increasing the number of positions in the next 5 years. The overall perception is that there is a balance in supply and demand in the critical care trained pharmacist market. A total of 82 DOPs responded to the survey. Turnover of critical care pharmacists within respondent organizations is expected to be low. Although a majority of DOPs plan to expand residency training positions, only 9% expect to increase positions in critical care PGY2 training. Overall, DOP respondents indicated a balance of
Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda
ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care were...... assessed: Compliance with current guidelines on initiation of 1) combination antiretroviral therapy (cART), 2) chemoprophylaxis, 3) frequency of laboratory monitoring, and 4) virological response to cART (proportion of patients with HIV-RNA 90% of time on cART). RESULTS: 7097 Euro...... to North, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for East and Argentina (adjusted OR 0.16[95%CI 0.11-0.23, p HIV health care utilization...
Escarce, J J; Shea, J A; Chen, W
Commercially insured and Medicare patients who are not in health maintenance organizations (HMOs) tend to use different hospitals than HMO patients use. This phenomenon, called market segmentation, raises important questions about how hospitals that treat many HMO patients differ from those that treat few HMO patients, especially with regard to quality of care. This study of patients undergoing coronary artery bypass graft surgery found no evidence that HMOs in southeast Florida systematically channel their patients to high-volume or low-mortality hospitals. These findings are consistent with other evidence that in many areas of the country, incentives for managed care plans to reduce costs may outweigh incentives to improve quality.
Bowman, Darcia Harris
The Broad Acres clinic is one of 1,500 school-based health centers nationwide that bring a wide range of medical, nutritional, and mental-health care to millions of students and their families. The centers provide an important safety net for children and adolescents--particularly the more than 10 million today who lack health insurance, according…
The liberalization of health care in the course of three decades of ‘reform and opening up’ has given people in rural China access to a diverse range of treatment options, but the health care system has also been marred by accusations of price hikes, fake pharmaceuticals, and medical malpractice...... roads to healing. The recent introduction of new rural cooperative medicine in the township represents an attempt to bring the state back in and address popular concern with the cost and quality of health care. While superficially reminiscent of the traditional socialist system, this new state attempt...
2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, Nigeria. 1. 2. Adam V.Y , Iseh A.E. ABSTRACT. Introduction. The level of accurate knowledge adolescents have about HIV/AIDS, is important to enhance effective preventive actions, which ultimately result in a decrease in the incidence of ...
Enterobacter spp. 1. 0.6. Table V: Proportion of Respondent that enter the Ward with Handheld Device. Table VI: Proportion of Respondent that Disinfect Phones and what they Disinfect with. Table VII: Hand Hygiene Practices. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 27, NO 1, MARCH ...
globally, (Ischaemic heart diseases, Convention on Tobacco Control (FCTC), which. 5 cerebrovascular diseases, lower ... tract infections, chronic obstructive than 86% of the world's population. Tobacco pulmonary diseases ... and delivery of smoking cessation services among health care workers in Abuja. A cross sectional ...
Hayes, M V
This article contains a marketing plan that was specifically designed for The Greater Lawrence Mental Health Center in Lawrence, Massachusetts. It is a full service, non-profit mental health facility that employs 85 allied health professionals and serves Lawrence and its neighboring communities. The plan was developed by a marketing consultant, in conjunction with the agency's Executive and Administrative Directors. This article illustrates a format for developing a marketing plan, and includes specific approaches that must be considered. The concepts are generic, and can be applied to similar endeavors undertaken by a comparable agency.
Zaltman, G; Vertinsky, I
Focus is on social marketing in a health context, and attention is directed to the development of a psychosocial model of health-related behavior with emphasis on developing countries. Each component of the model is identified and defined, with some of the interactions among its components noted. There are both advantages and limitations to using the model in a social marketing context. The model's primary contribution at this stage of its development is in structuring and organizing diverse sources of knowledge and data. New relationships are suggested which were not previously considered in the literature. The relationship between risk-taking and perceived susceptibility is 1 example. The model also provides a basis for simulating health processes, providing a testing ground for health policies before their actual implementation. The model's perspective is uniquely appropriate for the development of social marketing strategies, and it promises to encompass health market behavior in various cultural settings.
Hollnagel, E.; Braithwaite, J.; Wears, R. L.
Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean...... production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have...... engineering's unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering...
Liu, Y; Hsiao, W C; Eggleston, K
This paper examines the changes in equality of health and health care in China during its transition from a command economy to market economy. Data from three national surveys in 1985, 1986, and 1993 are combined with complementary studies and analysis of major underlying economic and health care factors to compare changes in health status of urban and rural Chinese during the period of economic transition. Empirical evidence suggests a widening gap in health status between urban and rural residents in the transitional period, correlated with increasing gaps in income and health care utilization. These trends are associated with changes in health care financing and organization, including dramatic reduction of insurance cover for the rural population and relaxed public health. The Chinese experience demonstrates that health development does not automatically follow economic growth. China moves toward the 21st century with increasing inequality plaguing the health component of its social safety net system.
Connor, L R
Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management.
In future health apps may become as popular as mobile games and retail shopping apps. Some consumers even think that health app usage is more valuable than making or receiving calls. This multibillion industry of mobile software applications and especially health apps is relatively new. The main research topic was how to market health apps globally. Health apps like fitness, weight loss and wellness apps are new trend in apps business. Healthcare apps are divided into health- and medical apps...
Jarzembski, W B
Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.
Oliveira, Beatriz Rosana Gonçalves de; Collet, Neusa; Viera, Cláudia Silveira
This study aims to reflect on humanization in health care, recovering the history of understanding about mankind, the human and humanity, until humanization in humanity and health. We discuss the national humanization program in hospital care and reflect on this proposal and on the issue of humanization in Brazilian health care nowadays. Communication is indispensable to establish humanization, as well as technical and material conditions. Both users and health professionals need to be heard, building a network of dialogues to think and promote singular humanization actions. For this process to take effect, there is a need to involve the whole that makes up the health service. This group involves different professionals, such as managers, public policy makers, professional councils and education institutions.
K.J. Grit (Kor); T. Zuiderent-Jerak (Teun)
textabstractMany Western countries have introduced market principles in healthcare. The newly introduced financial instrument of “care-intensity packages” in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care
The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.
Van der Voordt, D.J.M.
Purpose Due to the transition of the Dutch health care sector from a governmentally steered domain towards regulated market forces, health care organisations have become fully responsible for their real estate. This paper explores if/how Dutch health care organisations adopt the concept of adding
In light of the ongoing debate about health care policy in the United States, including efforts to repeal and replace the Affordable Care Act, it will be critically important for the academic community to engage in the dialogue. Developing a viable approach to health care reform requires an understanding of the interaction and interdependence between choice, cost, and coverage in a competitive and functional market-based system. Some institutions have implemented models that indicate the feasibility of providing high-quality, efficient patient care while working within fixed budgets. The academic community must stay engaged in these conversations because of its moral commitment to equitable access to health care for all. Academic medical centers will also have to define and protect their roles in an evolving health care delivery system in the United States.
The article is the result of qualitative research of informal care markets in Slovenia in the field of childcare, elder care, and cleaning. The author assesses Slovenia's position in the “global care chain” and finds that “local care chains” prevail in the field of childcare and elder care, while a co-occurrence of female gender, “other” ethnicity, and poverty is typical in the field of household cleaning. The main emphasis of the article is on the analysis of hierarchization of the informal market of care work according to following two criteria: social reputation of individual type of care work and citizenship status of care workers.
This paper presents a short discussion of essential concepts in primary health care based on the Alma Ata Declaration of 1978 and a brief description of the Philippine Ministry of Health primary health program. The phrase primary health care implies that PHC is a package of goods to be delivered to people, whereas in fact it is an approach to health care which emphasizes community involvement and participation in health development. Community participation is too often taken to mean that communities should participate in programs designed, implemented, and run by health professionals. PHC however requires that health programs be designed, implemented, run by, and belong to the people of the community. External agencies and health professionals must find ways of becoming involved and participating in the community's programs. A thorough reorientation of health professionals, particularly doctors and nurses, away from technology and toward the ideals and wisdom of the people is needed if PHC is to succeed. PHC should provide the bridge between technological knowledge and indigenous wisdom. The national government is embarking on a nationwide PHC program, with structures being organized at national, regional, provincial, municipal, and barangay levels for PHC. The higher organizational levels are intended to ensure access to their available resources to complement resources at the lower levels, especially at the critical barangay level. Because over 70% of the national population lives in rural areas, the national government's effort through the Ministry of Health will stress rural needs and approaches. Different approaches will be needed for poor urban communities, and the Manila Health Department may be able to provide leadership for developing the new ideas needed to tailor health development programs to Filipino urban communities.
Weel, C. van; Schers, H.J.; Timmermans, A.
This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and
Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren
An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...
Grit, Kor; Zuiderent-Jerak, Teun
Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of "care-intensity packages" in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations and how that enables and legitimatises market development. Both providers have done various types of work that could be classified as market development, including creating accounting systems suitable for markets, redefining public values in the context of markets, and starting commercial initiatives. Paradoxically, denying the existence of markets for long-term care and thus avoiding ideological debates on the marketisation of healthcare has made the use of market devices all the more likely. Making the market invisible seems to be an operative element in making the market work. Our findings suggest that Dutch long-term care reform points to the need to study the 'making' rather than the 'liberalising' of markets and that the study of healthcare markets should not be confined to those practices that explicitly label themselves as such.
and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). Medicaid is a federal and...living care. “Medicine has been slow to confront the very changes that it has been responsible for – or to apply the knowledge we already have about how...challenge to the nation. Challenges of the Industry As already outlined, a number of challenges confront the U.S. health care industry. Below are six
Wang, H A; Wang, Y Z; Wang, S
The personal computer and the Internet have provided many useful services to both health care professionals and the general public. However, security remains a key factor that could limit their further growth potential. We reviewed and assessed the potential use of the cryptographic technique to resolve security issues. We also analyzed services available in the current market environment and determined their viability in supporting health care applications. While the cryptographic application has a great potential in protecting security of health care information transmitted over the Internet, a nationwide security infrastructure is needed to support deployment of the technology. Although desirable, it could be cost prohibitive to build a national system to be dedicated for the health care purpose. A hybrid approach that involves the government's development of a dedicated security infrastructure for health care providers and the use of commercial off-the-shelf products and services by the general public offers the most cost-effective and viable approach.
Marušič, Dorjan; Prevolnik Rupel, Valentina
In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.
Full Text Available In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.
White, K R; Thompson, J M; Patel, U B
The hospital marketing function has been widely adopted as a way to learn about markets, attract sufficient resources, develop appropriate services, and communicate the availability of such goods to those who may be able to purchase such services. The structure, tasks, and effectiveness of the marketing function have been the subject of increased inquiry by researchers and practitioners alike. A specific understanding of hospital marketing in a growing managed care environment and the relationship between marketing and managed care processes in hospitals is a growing concern. Using Kotler and Clarke's framework for assessing marketing orientation, we examined the marketing orientation of hospitals in a single state at two points in time--1993 and 1999. Study findings show that the overall marketing orientation score decreased from 1993 to 1999 for the respondent hospitals. The five elements of the Kotler and Clarke definition of marketing orientation remained relatively stable, with slightly lower scores related to customer philosophy. In addition, we evaluated the degree to which selected managed care activities are carried out as part of its marketing function. A significant (p managed care processes coordinated with the formal marketing function was evident from 1993 to 1999. With increasing numbers of managed care plan enrollees, hospitals are likely focusing on organizational buyers as important customers. In order to appeal to organizational buyers, hospital executives may be focusing more on clinical quality and cost efficiency in the production of services, which will improve a hospital's position with organizational buyers.
Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.
I consider the current state of pharmaceutical marketing vis-à-vis ethical and legal standards and advocate measures to improve it. There is abundant evidence of unethical or illicit marketing. It fuels growing concerns about undue corporate influence over pharmaceutical research, education, and consumption. The most extensive evidence of industry transgressions comes from the United States (US), where whistle-blowers are encouraged by financial rewards to help uncover illicit marketing and fraud. Outside the US increasing evidence of transgressions exists. Recently I have observed a range of new measures to align pharmaceutical marketing practices with ethical and legal standards. In the interest of public health, I highlight the need for additional and more profound reforms to ensure that information about medicines supports quality and resource-efficient care.
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Vrangbæk, Karsten; Byrkjeflot, Haldor
adjustment of such frameworks. In this article we present a framework for analyzing accountability within health care. The paper makes use of the concept of "accountability regime" to signify the combination of different accountability forms, directions and functions at any given point in time. We show...
to equalise existing discrepancies and disparities. In addition, the prospects of equalising the dispar- ... The values of racial superiority, market-justice and indi- vidualism must be played down in the health sector. At ... race in the present distribution, provision and accessibil- ity ofhealth care. 4. In accordance with the ...
Laurence, J Nathan; Kash, Bita A
Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.
The public health field exists to safeguard the general public from health risks by controlling risk factors, classically through immunization programmes that prevent or control epidemics, or through actions such as monitoring the quality of drinking water. In our post-industrialised society, risk factors other than the environment, such as diet, exercise, tobacco and alcohol use, have grown in importance. The policy response to the growing demand upon healthcare services arising from chronic...
The health care system of Chile evolved from rather unique historical circumstances to become one of the most progressive in Latin America, offering universal access to all citizens. Since the advent of the Pinochet regime in 1973, Chile has implemented Thatcherite/Reaganite reforms resulting in the privatization of much of the health care system. In the process, state support for health care has been sharply curtailed with deleterious effects on health services. As Chile emerges from the shadow of the Pinochet dictatorship, it faces numerous challenges as it struggles to rebuild its health care system. Other developing nations considering free-market reforms may wish to consider the high costs of the Chilean experiment.
Soleimani, Farzad; Zenios, Stefanos
To build enabling innovation frameworks for health care entrepreneurs to better identify, evaluate, and pursue entrepreneurial opportunities. Powerful frameworks have been developed to enable entrepreneurs and investors identify which opportunity areas are worth pursuing and which start-up ideas have the potential to succeed. These frameworks, however, have not been clearly defined and interpreted for innovations in health care. Having a better understanding of the process of innovation in health care allows physician entrepreneurs to innovate more successfully. A review of academic literature was conducted. Concepts and frameworks related to technology innovation were analyzed. A new set of health care specific frameworks was developed. These frameworks were then applied to innovations in various health care subsectors. Health care entrepreneurs would greatly benefit from distinguishing between incremental and disruptive innovations. The US regulatory and reimbursement systems favor incrementalism with a greater chance of success for established players. Small companies and individual groups, however, are more likely to thrive if they adopt a disruptive strategy. Disruption in health care occurs through various mechanisms as detailed in this article. While the main mechanism of disruption might vary across different health care subsectors, it is shown that disruptive innovations consistently require a component of contrarian interpretation to guarantee considerable payoff. If health care entrepreneurs choose to adopt an incrementalist approach, they need to build the risk of disruption into their models and also ascertain that they have a very strong intellectual property (IP) position to weather competition from established players. On the contrary, if they choose to pursue disruption in the market, albeit the competition will be less severe, they need to recognize that the regulatory and reimbursement hurdles are going to be very high. Thus, they would benefit
Chin, Jean Lau; Yee, Barbara W K; Banks, Martha E
As health care reform promises to change the landscape of health care delivery, its potential impact on women's health looms large. Whereas health and mental health systems have historically been fragmented, the Affordable Care Act (ACA) mandates integrated health care as the strategy for reform. Current systems fragment women's health not only in their primary care, mental health, obstetrical, and gynecological needs, but also in their roles as the primary caregivers for parents, spouses, and children. Changes in reimbursement, and in restructuring financing and care coordination systems through accountable care organizations and medical homes, will potentially improve women's health care.
Optimizing the technological and informational relationship of the health care process and of the communication between physician and patient. The impact of Preventive Medicine and social marketing applied in Health Care on youth awareness- preliminary study.
Petrescu, C M; Gheorghe, I R; Petrescu, G D
In this case study we wanted to find out the impact of Preventive Medicine and implicitly social marketing upon young students with the average age of 19, belonging to the academic environment in Romania. The study lasted one month and consisted of a questionnaire that was conceived and applied to 304 adolescents. The questionnaire contained demographic and personal information, such as age, origin, gender, marital status and some questions related to the respondents' attitude towards several issues that are inserted in the preventive medicine discipline, such as the date of their last consultation, if the respondents were registered to a family physician, suffered from chronic diseases, what was the rate of doing physical exercises, if they ate salty and fat meals, if they were on a diet, their rate of alcohol, caffeine and tobacco consumption. The panel was made up of more female respondents than male, with the average age rate of 19, who had medical consultations in the last 3 months, are included in the evidence of a family physician, had no chronic diseases, usually do workout exercises moderately, are not on a diet and have 3 meals per day. The meals are medium salty and rarely rich in fats. They drink 2 cups of tea per day and are non-alcohol drinkers and non-smokers. After applying several statistical tests to find a correlation between our variables, we reached the conclusion that even if the results are encouraging; there is no correlation between the impact of Preventive Medicine and the respondents' health behavior.
Aabenhus, Mette Morre; Schriver, Michael; Kallestrup, Per
Global health interventions often focus on specific diseases, thus forming vertical programmes. Studies show that vertical programmes perform poorly, which underlines the need for a horizontal basis: universal community-based primary health care, which improves health equity and outcomes. The diagonal approach supports an integrated patient-centered health-care system. The ''15% by 2015''-initiative suggests that vertical programmes invest 15% of their budgets in strengthening integrated primary health care. Strategies depend on local context.
The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.
Baranes, Edmond; Bardey, David
This article examines a model of competition between two types of health insurer: Health Maintenance Organizations (HMOs) and nonintegrated insurers. HMOs vertically integrate health care providers and pay them at a competitive price, while nonintegrated health insurers work as indemnity plans and pay the health care providers freely chosen by policyholders at a wholesale price. Such difference is referred to as an input price effect which, at first glance, favors HMOs. Moreover, we assume that policyholders place a positive value on the provider diversity supplied by their health insurance plan and that this value increases with the probability of disease. Due to the restricted choice of health care providers in HMOs a risk segmentation occurs: policyholders who choose nonintegrated health insurers are characterized by higher risk, which also tends to favor HMOs. Our equilibrium analysis reveals that the equilibrium allocation only depends on the number of HMOs in the case of exclusivity contracts between HMOs and providers. Surprisingly, our model shows that the interplay between risk segmentation and input price effects may generate ambiguous results. More precisely, we reveal that vertical integration in health insurance markets may decrease health insurers' premiums.
Schneider, John E; Li, Pengxiang; Klepser, Donald G; Peterson, N Andrew; Brown, Timothy T; Scheffler, Richard M
The objective of this paper is to describe the market structure of health plans (HPs) and physician organizations (POs) in California, a state with high levels of managed care penetration and selective contracting. First we calculate Herfindahl-Hirschman (HHI) concentration indices for HPs and POs in 42 California counties. We then estimate a multivariable regression model to examine the relationship between concentration measures and the prices paid by HPs to POs. Price data is from Medstat MarketScan databases. The findings show that any California counties exhibit what the Department of Justice would consider high HHI concentration measures, in excess of 1,800. More than three quarters of California counties exhibit HP concentration indices over 1,800, and 83% of counties have PO concentration levels in excess of 1,800. Half of the study counties exhibited PO concentration levels in excess of 3,600, compared to only 24% for plans. Multivariate price models suggest that PO concentration is associated with higher physician prices (p prices.
@hotmail.com, A.Ehigiegba@shell.com. KEYWORDS. Volunteer,. Obio Cottage. Hospital,. Participants,. Nigeria journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care.
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Kholmogorova, G T; Gladysheva, N V
At present health education programmes abroad make wide use of social marketing strategy. Unlike commercial marketing whose purpose is competition and struggle for the expansion of commodity markets, social marketing is aimed at disseminating certain ideas or introducing certain practices, using largely the technological base and strategy of commercial marketing. The authors give 8 fundamental principles of social marketing (consumer orientation, the theory of barter, the analysis of audience and segmentation, special surveys to detect the orientation of population, the choice of channels for information transmission application of "marketing mixture", control of ongoing programme and marketing management). Application fields of social marketing in public health are discussed.
Fadope, Cece Modupe; And Others
A series of articles that examine environmental health and discuss health care reform; connections between chlorine, chlorinated pesticides, and dioxins and reproductive disorders and cancers; the rise in asthma; connections between poverty and environmental health problems; and organizations for health care professionals who want to address…
Argues that lack of appropriate attitudes and skills has hampered the ability of child care practitioners to enhance the public image of child care and to use marketing strategies to serve the consumers of child care services most effectively. Recommends articulated career paths and specific interventions with practitioners to reverse this…
Gemme, E M
Traditionally, health care patients have been treated by health care professionals as people with needs rather than as customers with options. Although managed care has restricted patient choice, choice has not been eliminated. The premise of this article is that patients are primary health care consumers. Adopting such a premise and developing an active customer retention program can help health care organizations change their culture for the better, which may lead to higher customer retention levels and increased revenues. Customer retention programs based on service excellence that empower employees to provide excellent care can eventually lead to a larger market share for health care organizations trying to survive this era of intense competition.
Full Text Available The objectives of this research are to: 1 compare the effect of premium earnings products of health insurances after the launching of national social health insurance (JKN-BPJS (Badan Penyelenggara Jaminan Sosial for health; 2 analyze the internal and external factors of private/commercial health insurance companies; 3 formulate a marketing strategyy for health insurance product after the operation of JKN-BPJS for health. It is a challenge for commercial health insurance to survive and thrive with the existence of JKN-BPJS for health which is compulsory to Indonesia’s citizens to be a member. The research begins by analyzing premium earnings of the commercial health insurance company one year before and after the implementation of JKN-BPJS for health, the intensive interviews and questionnaires to the chosen resource person (purposive samplings, the analysis on Internal Factor Evaluation (IFE, External Factor Evaluation (EFE, Matrix IE and SWOT are used in the research. Then it is continued by arranging a strategic priority using Analytical Hierarchy Process (AHP. The result from the research is there is totally no decreasing premium earnings for the commercial health insurance company although the growth trend shows a slight drop. The appropriate strategy for the health insurance company in the commercial sector is the differentiation where the implication is involving customer service quality improvement, product innovation, and technology and infrastructure development. Keywords: commercial health insurance company, Marketing Strategy, AHP Analysis, national social health insurance
The Family Dental Health Care Service is a new approach that includes efforts to serve oral and dental patients that focuses on maintenance, improvement and protection. This oral and dental health approach uses basic dentistry science and technology. The vision of the Family Dental Health Care Service is the family independences in the effort of dental health maintenance and to achieve the highest oral and dental health degree as possible through family dentist care that is efficient, effecti...
McDonald, Patricia A; Mecklenburg, Robert S; Martin, Lindsay A
To tame its soaring health care costs, intel tried many popular approaches: "consumer-driven health care" offerings such as high-deductible/low-premium plans, on-site clinics and employee wellness programs. But by 2009 intel realized that those programs alone would not enable the company to solve the problem, because they didn't affect its root cause: the steadily rising cost of the care employees and their families were receiving. Intel projected that its health care expenditures would hit a whopping $1 billion by 2012. So the company decided to try a novel approach. As a large purchaser of health services and with expertise in quality improvement and supplier management, intel was uniquely positioned to drive transformation in its local health care market. The company decided that it would manage the quality and cost of its health care suppliers with the same rigor it applied to its equipment suppliers by monitoring quality and cost. It spearheaded a collaborative effort in Portland, Oregon, that included two health systems, a plan administrator, and a major government employer. So far the Portland collaborative has reduced treatment costs for certain medical conditions by 24% to 49%, improved patient satisfaction, and eliminated over 10,000 hours worth of waste in the two health systems' business processes.
Schieber, G J; Puollier, J P
Trends in health are reviewed for the member countries of the Organization for Economic Cooperation and Development (OECD) covering the following: the basic difficulties inherent in international comparative studies; the absolute levels of health expenditures in 1984; the levels and rates of growth of the health share in the gross domestic product (GDP) and the public share of total health expenditures; the elasticities of real health expenditures to real GDP for the 1960-75, 1975-84, and 1960-84 time periods; growth in health expenditures for the largest 7 OECD countries in terms of growth in population, health prices, health care prices in excess of overall prices, and utilization/intensity of services per person. International comparisons are a problem due to differences in defining the boundaries of the health sector, the heterogeneity of data, and methodological problems arising from comparing different economic, demographic, cultural, and institutional structures. The most difficult problem in international comparisons of health expenditures is lack of appropriate measures of health outcome. Exhibit 1 contains per capita health expenditures denominated in US dollars based on GDP purchasing power parities for 21 OECD countries for 1984. Per capita health expenditures ranged from less than $500 in Greece, Portugal, and Spain to over $1400 in Sweden and the US, with an OECD average of $871. After adjusting for price level differences, there still appears to be a greater than 3-fold difference in the "volume" of services consumed across the OECD countries. To determine if per capita health expenditures are related to a country's wealth as measured by its per capita GDP, the relationship between per capita health expenditures and per capita GDP for the 21 countries were examined for 1984. The data points and the "best fitting" trend line indicate a statistically significant relationship in which each $100 difference in per capita GDP is associated with a $10
Part II of Health Care Engineering begins with statistics on the occurrence of medical errors and adverse events, and includes some technological solutions. A chapter on electronic medical records follows. The knowledge management process divided into four steps is described; this includes a discussion on data acquisition, storage, and retrieval. The next two chapters discuss the other three steps of the knowledge management process (knowledge discovery, knowledge translation, knowledge integration and sharing). The last chapter briefly discusses usability studies and clinical trials.This two-
Hasman, Andreas; Hope, Tony; Østerdal, Lars Peter
The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precis......, the three interpretations provide a starting-point for further debate of what the concept means in its specific application. We discuss combined interpretations, the meaning of grading needs, and compare needs-based priority setting to social welfare maximisation...
Rose, E A
Total Quality Management is a powerful tool in health care today. The definition of quality improvement in the medical literature focuses on improving patient outcomes. However, most quality initiatives in the health care field focus on improving productivity, cost-effectiveness, market share, employee morale, and efficiencies of processes. This disparity between the medical definition of quality and the actual application of quality improvement may have the effect of alienating many physicians, the very people who must be involved. The semantics are important to address in a TQM initiative.
Lefebvre, R C; Flora, J A
The rapid proliferation of community-based health education programs has out-paced the knowledge base of behavior change strategies that are appropriate and effective for public health interventions. However, experiences from a variety of large-scale studies suggest that principles and techniques of social marketing may help bridge this gap. This article discusses eight essential aspects of the social marketing process: the use of a consumer orientation to develop and market intervention techniques, exchange theory as a model from which to conceptualize service delivery and program participation, audience analysis and segmentation strategies, the use of formative research in program design and pretesting of intervention materials, channel analysis for devising distribution systems and promotional campaigns, employment of the "marketing mix" concept in intervention planning and implementation, development of a process tracking system, and a management process of problem analysis, planning, implementation, feedback and control functions. Attention to such variables could result in more cost-effective programs that reach larger numbers of the target audience.
... Adult Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap ... Centers Hospice Care National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare ...
Rekhter, Natalia; Togunov, Igor A.
Introduction: For more than 70 years, health care management in the Soviet Union reflected a centralized directive style familiar to the Soviet political system. Market-oriented reform in post-Soviet Russia is pushing practicing physicians and physician-executives to acquire new information and skills regarding health care management. To assist…
Full Text Available The state of health of the population is one of the most important indicators of the well-being of the nation. Important directions of health care reform are optimization of management, rational distribution of limited financial resources, efficient use of material resources, introduction of health insurance, restructuring of treatment and preventive care to the people. Marketing of medical services market is one of the most complex types of marketing. Because it is medical services that are connected with the protection and maintenance of the most important values of a person - life and health. The market for medical services is a combination of socio-economic relations in the healthcare sector. The most important components of the analysis of any market, including the market of medical services, are marketing research, which is a systematic collection, processing, analysis of data and information in order to formulate proposals for effective activities on it. In the field of public health, marketing can be defined as a complex process of planning, economic substantiation and management of the process of provision of medical services, the formation of a pricing policy of the medical-preventive process, ensuring effective communication with patients. The purpose of the study is to identify the health of the population and determine the demand factors for paid health services and their demand. The main task set before market research on the health of the population is the formation and provision of benefits to consumers that meet their needs for qualified medical care and quality of life. The research methods used in the work are based on probabilistic, stratified, quota, representative samples for the entire population of Ivano-Frankivsk and Ivano-Frankivsk region. The obtained results allow us to give a realistic assessment of the main trends and allow us to assess the potential of socio-economic adaptation of the population in the
Matthews, Michael; Peters, Cara; Lawson, Stephanie
Hospice and palliative care is a recent, but fast growing, industry in healthcare. Demographics suggest that hospice care will only increase. The purpose of this article is to examine strategic marketing initiatives hospice organizations currently employ. Data were collected at a hospice regional conference, capturing opinions from hospice organizations located in North and South Carolina. The results show that many hospice organizations do not have a dedicated marketing staff person, have a limited marketing budget, do not fully utilize all strategic planning tools, and have yet to differentiate themselves via branding. Implications of these findings for hospice providers are discussed.
Client Satisfaction with Antenatal Care Services in Primary Health Care. Centres in Sabon Gari Local Government Area, Kaduna State Nigeria. journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE. 1. 1. 1. M.B Sufiyan , A.A Umar , A. Shugaba . 1Department of Community Medicine, Ahmadu Bello University, ...
Higgins, L F; Weinstein, K; Arndt, K
The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.
Culbertson, R A
This study compares the perspectives of eighteen managed care executives and twenty-four faculty practice executives on critical policy issues related to the managed care marketplace. Market sites studied in 1994 included four major metropolitan areas: Minneapolis-St. Paul, Los Angeles, Philadelphia, and Atlanta. These markets were selected as being representative of communities with descending degrees of managed care involvement, but with significant market activity. Study participants from both managed care systems and faculty practices examined five policy issues: (1) the importance of including academic medical centers in current and future health care plans for marketing purposes; (2) the provision of clinical services that are unique to the academic medical center, that is, unavailable elsewhere in the community; (3) the degree of financial supplement that employers might pay for including an academic medical center; (4) future restructuring of organizations to sustain the educational mission of academic faculty within a viable delivery system; (5) satisfaction of managed care providers with graduates of academic medical centers, as measured by the clinical skills of graduate physicians. The study findings showed little support among managed care plans for paying supplements to include faculty practices in a health care network. Most study participants from managed care systems and academic faculty practices identified limited competencies that are unique to academic centers. Moreover, managed care organizations were only willing to undertake limited restructuring at best to include faculty practices within their networks. General concern about the preparation of resident physicians (especially those in primary care disciplines) for practice within contemporary managed care organizations existed among managed care informants. The results of the study indicate that as traditional funding sources for medical education are reduced, schools require greater
This integrated review of national trends affecting the health care system is primarily intended to facilitate the planning efforts of health care providers and consumers, Government agencies, medical school administrators, health insurers, and companies in the medical market. It may also be useful to educators as a textbook to give their students…
Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...
Loaiza Quintero, Osmar Leandro
This paper aims to provide a general overview of the health care sector reform in Colombia, which introduced the market principles of competition into the sector functioning. Therefor, this article analyzes its antecedents, characteristics and consequences. Relying on the interpretation of the empirical evidence existing about this reform, the present analysis seeks to identify the key features on which it is based. The paper ends with some observations and criticism about the results and the...
G. Alan Tarr
Full Text Available President Barack Obama proposed a major overhaul of the American healthsystem, and in 2010 the U.S. Congress enacted his proposal, the PatientProtection and Affordable Care Act. Opponents of the Act challenged itsconstitutionality in federal court, claiming that it exceeds the powers grantedto the federal government under the Commerce Clause and the NecessaryProper Clause of the federal Constitution. Some courts have upheldthe law, but others have agreed with the critics, in particular ruling thatthe provision requiring citizens to buy health insurance is unconstitutional.Eventually the U.S. Supreme Court will rule on the issue. This article tracesthe controversy, surveys the interpretation of pertinent constitutional provisionsin past cases, analyzes the constitutional arguments presented byproponents and opponents of the Act, and concludes that the Act is constitutional.
Laut, Kristina Grønborg; Hjort, Jakob; Engstrøm, Thomas
system delay also impacts ability to stay in the labor market. Therefore, the aim of the study was to evaluate whether system delay is associated with duration of absence from work or time to retirement from work among patients with STEMI treated with PPCI. We conducted a population-based cohort study...... system delay and time to return to the labor market was analyzed using a competing-risk regression analysis. Association between system delay and time to retirement from work was analyzed using a Cox regression model. A total of 4,061 patients were included. Ninety-three percent returned to the labor...... market during 4 years of follow-up, and 41% retired during 8 years of follow-up. After adjustment, system delay >120 minutes was associated with reduced resumption of work (subhazard ratio 0.86, 95% confidence interval 0.81 to 0.92) and earlier retirement from work (hazard ratio 1.21, 95% confidence...
Brown, Judith Belle; French, Reta; McCulloch, Amy; Clendinning, Eric
Abstract Objective To explore the knowledge and perceptions of fourth-year medical students regarding the new models of primary health care (PHC) and to ascertain whether that knowledge influenced their decisions to pursue careers in family medicine. Design Qualitative study using semistructured interviews. Setting The Schulich School of Medicine and Dentistry at The University of Western Ontario in London. Participants Fourth-year medical students graduating in 2009 who indicated family medicine as a possible career choice on their Canadian Residency Matching Service applications. Methods Eleven semistructured interviews were conducted between January and April of 2009. Data were analyzed using an iterative and interpretive approach. The analysis strategy of immersion and crystallization assisted in synthesizing the data to provide a comprehensive view of key themes and overarching concepts. Main findings Four key themes were identified: the level of students’ knowledge regarding PHC models varied; the knowledge was generally obtained from practical experiences rather than classroom learning; students could identify both advantages and disadvantages of working within the new PHC models; and although students regarded the new PHC models positively, these models did not influence their decisions to pursue careers in family medicine. Conclusion Knowledge of the new PHC models varies among fourth-year students, indicating a need for improved education strategies in the years before clinical training. Being able to identify advantages and disadvantages of the PHC models was not enough to influence participants’ choice of specialty. Educators and health care policy makers need to determine the best methods to promote and facilitate knowledge transfer about these PHC models. PMID:22518904
Trish, Erin E; Herring, Bradley J
The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. Copyright © 2015 Elsevier B.V. All rights reserved.
Full Text Available Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE; work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care.
Tracy, Jane; McDonald, Rachael
Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…
Port Harcourt. ... Journal of Community Medicine and Primary Health Care. 25 (2) 53-58. KEYWORDS. Healer shopping,. Discharge Against. Medical Advice,. Non- communicable diseases, epidemiological transition, Port.
1Department of Paediatrics and Child Health, Faculty of Clinical Sciences, College of Health Sciences,. Obafemi Awolowo ... Younger parents less than 35years, parents with lower educational attainments and low .... staffing, availability of immunization consumables was estimated using the Computer Programme for.
financing are critical issues that continue to bother health policy makers. .... Ethical approval. Ethical approval was obtained from the. Health Research Ethics Committee of the Delta. State University Teaching Hospital, Oghara and informed written (and or verbal) ... Teachers/Religious Leaders. Indifferent. 85. 24.3%. 117.
Background: Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations and use of control measures like dust mask, with no serious attempt at comprehensive health education. The study sought to assess the effect of health education on the perception and ...
In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference
mania) and anxiety disorders (General anxiety, agoraphobia, social phobia, obsessive-compulsive disorder and post traumatic stress disorder). Conclusion: Findings suggest that there is need to consider mental and psychological care of clients with HIV/AIDS to minimise the prevalence of psychiatric disorder among HIV ...
Methodology. A cross-sectional survey of patients at the antiretroviral clinic of the Federal Medical Centre,. Makurdi, Nigeria, was conducted between June and August 2008. An adapted version of the RAND. Patient Satisfaction Questionnaire Long Form was used to assess seven dimensions of care: general satisfaction ...
Jones, W. L.
Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.
McLean, Thomas R
For the past 20 years, the federal government has reimbursed hospital services by administrating pricing. Simply put, under such a system the government dictated the prices of medical services. Not only has administrative pricing failed to control medical inflation, but such failure could have been predicted from a review of basic economics. Accordingly, to eliminate the deleterious effects of administrative pricing, it is not surprising that the government is gathering information on hospital quality and cost in anticipation of a return to a system in which the price for hospital services is determined by the market. For some hospitals, this will be good news because they will be able to negotiate a more favorable rate of reimbursement. Unfortunately, for some hospitals a market system will be bad news because the government is not going to negotiate a provider contract with every hospital. In short, when the government returns to a market system for pricing of hospital services, competition among hospitals is going to become even more competitive.
Abstract Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. TIDES social marketing approach The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Results Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Discussion and conclusion Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems. PMID:19785754
Parker Louise E
Full Text Available Abstract Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA. Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. TIDES social marketing approach The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Results Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Discussion and conclusion Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems.
The National Health Service (NHS) has been the body of the health care system in the United Kingdom (UK) for over 60 years and has sought to provide the population with a high quality service free of user charges for most services. The information age has seen the NHS rapidly transformed from a socialist, centrally planned and publicly provided system to a more market based system orientated towards patients as consumers. The forces of globalization have provided patients in the UK with greater choice in their health care provision, with NHS treatment now offered from any public or approved private provider and the possibility of treatment anywhere in the European Economic Area (EEA) or possibly further. The financial crisis, a large government deficit and austerity public spending policies have imposed a tight budget constraint on the NHS at a time of increasing demand for health care and population pressure. Hence, further rationing of care could imply that patients are incentivised to seek private treatment outside the constraints of the NHS, where the possibility of much greater choice exists in an increasingly globally competitive health care market. This chapter examines the evidence on the response of patients to the possibilities of increased choice and mobility within the internal NHS and external overseas health care markets. It also considers the relationships between patient mobility, health care provision and health policy. Patients are more mobile and willing to travel further to obtain better care outcomes and value for money, but are exposed to greater risk.
Full Text Available Özet:Sağlık hizmetleri kişilerin sağlığının korunması, teşhis,tedavi ve bakım için kişisel ve kurumsal olarak kamu veya özelşahısların vermiş olduğu hizmetler olarak tanımlanabilir.Sağlık hizmeti sunan kuruluşlarda pazarlamanın amacı;işletme amaçlarına uygun olarak hedef pazarın tatmindüzeyini geliştirerek, tüketicilerin beklentilerini karşılayandaha nitelikli hizmetleri sunmaktır.Günümüzde sağlık hizmetleri, profesyonel işletmecilikanlayışıyla şekillenmektedir. Artık sağlık yöneticilerininhedefleri arasında, daha çok hastayı çekerek gelen hastalarımemnun etmek ve hastanın tekrar aynı hastaneyi tercihetmesini sağlamak yer almaktadır.Ağızdan ağıza pazarlama ise güvene dayanan, tüketicilerinçevrelerindeki sosyal bağlantılarıyla ve diğer tüketicilerleürünler / hizmetler / markalar hakkındaki bilgi alışverişidir.Günümüzde tüketicilerin kendi aralarında bilgi vedeneyimlerini paylaşımı, geleneksel reklam ve pazarlamafaaliyetleriyle birlikte giderek artan bir öneme sahip olmayabaşlamıştır.Bu çalışmada genel anlamda ağızdan ağıza pazarlamanıntemel kavramları hakkında bilgi verilerek, sağlık sektöründeağızdan ağza pazarlamanın etkinliği anlaşılmaya çalışılmıştır.Abstract:Health care can be described as service personallyand institutionally by public or private operations in order todiagnosis, treatment and care the health of individuals. Aim ofmarketing in institutions offering health care to improve thelevel target market’s satisfaction and the institutions is toreach by presenting more qualified service to meet theexpectancy of consumersNowadays health care services are shaped by a professionalbusiness approach. Among the objectives of health caremanagers who take more satisfied patients by pulling them andthe patients prefer to allow a repetition of the same hospital islocated.Word of mouth marketing is basically sharing
Full Text Available Özet:Sağlık hizmetleri kişilerin sağlığının korunması, teşhis,tedavi ve bakım için kişisel ve kurumsal olarak kamu veya özelşahısların vermiş olduğu hizmetler olarak tanımlanabilir.Sağlık hizmeti sunan kuruluşlarda pazarlamanın amacı;işletme amaçlarına uygun olarak hedef pazarın tatmindüzeyini geliştirerek, tüketicilerin beklentilerini karşılayandaha nitelikli hizmetleri sunmaktır.Günümüzde sağlık hizmetleri, profesyonel işletmecilikanlayışıyla şekillenmektedir. Artık sağlık yöneticilerininhedefleri arasında, daha çok hastayı çekerek gelen hastalarımemnun etmek ve hastanın tekrar aynı hastaneyi tercihetmesini sağlamak yer almaktadır.Ağızdan ağıza pazarlama ise güvene dayanan, tüketicilerinçevrelerindeki sosyal bağlantılarıyla ve diğer tüketicilerleürünler / hizmetler / markalar hakkındaki bilgi alışverişidir.Günümüzde tüketicilerin kendi aralarında bilgi vedeneyimlerini paylaşımı, geleneksel reklam ve pazarlamafaaliyetleriyle birlikte giderek artan bir öneme sahip olmayabaşlamıştır.Bu çalışmada genel anlamda ağızdan ağıza pazarlamanıntemel kavramları hakkında bilgi verilerek, sağlık sektöründeağızdan ağza pazarlamanın etkinliği anlaşılmaya çalışılmıştır.Abstract:Health care can be described as service personallyand institutionally by public or private operations in order todiagnosis, treatment and care the health of individuals. Aim ofmarketing in institutions offering health care to improve thelevel target market’s satisfaction and the institutions is toreach by presenting more qualified service to meet theexpectancy of consumersNowadays health care services are shaped by a professionalbusiness approach. Among the objectives of health caremanagers who take more satisfied patients by pulling them andthe patients prefer to allow a repetition of the same hospital islocated.Word of mouth marketing is basically sharing
Merlino, James I; Raman, Ananth
The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.
Chang, Jason; Mclemore, Elisabeth; Tejirian, Talar
Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area.Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases.In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists.
Full Text Available The Family Dental Health Care Service is a new approach that includes efforts to serve oral and dental patients that focuses on maintenance, improvement and protection. This oral and dental health approach uses basic dentistry science and technology. The vision of the Family Dental Health Care Service is the family independences in the effort of dental health maintenance and to achieve the highest oral and dental health degree as possible through family dentist care that is efficient, effective, fair, evenly distributed, safe and has a good quality. To support this effort, the Ministry of Health has issued Health Care Policy and Implementation Guideline as well as the licensing standard for family dentist practice.
McDavid, Lolita M
Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. Copyright © 2015 Elsevier Inc. All rights reserved.
Nautical tourism is one of the developing branches of tourism in Europe. It differs from other forms of tourism. Conditions under which nautical tourists live are similar to those of seamen employed on vessels in costal shipping. The health care for nautical tourists should be organized according to the principles of health care for crews of merchant ships engaged in constal shipping.
communicable diseases such as hypertension and transitions currently experienced in Sub-Saharan. 96. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 26, NO 1, MARCH 2014. KEYWORDS journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE. Journal of Community Medicine ...
This editorial reviews areas of health care reform including managed health care, diagnosis-related groups, and the Resource-Based Relative Value Scale for physician services. Relevance of such reforms to people with developmental disabilities is considered. Much needed insurance reform is not thought to be likely, however. (DB)
PRIMARY HEALTH CARE. Journal of Community Medicine and Primary Health Care. 26 (1) 21-29. KEYWORDS. Household, expenditure,. Treatment, presumptive malaria,. Gimba ... A cross-sectional descriptive study conducted during community diagnosis posting of final year medical students of. Ahmadu Bello University ...
Li, Jia; Zhang, Ya; Ma, Ling; Liu, Xuan
Many markets have traditionally been dominated by a few best-selling products, and this is also the case for the health care industry. However, we do not know whether the market will be more or less concentrated when health care services are delivered online (known as E-consultation), nor do we know how to reduce the concentration of the E-consultation market. The aim of this study was to investigate the concentration of the E-consultation market and how to reduce its concentration through information disclosure mechanisms (online reputation and self-representation). We employed a secondary data econometric analysis using transaction data obtained from an E-consultation Website (haodf.com) for three diseases (infantile pneumonia, diabetes, and pancreatic cancer) from 2008 to 2015. We included 2439 doctors in the analysis. The E-consultation market largely follows the 20/80 principle, namely that approximately 80% of orders are fulfilled by nearly 20% of doctors. This is much higher than the offline health care market. Meanwhile, the market served by doctors with strong online reputations (beta=0.207, P<.001) or strong online self-representation (beta=0.386, P<.001) is less concentrated. When health care services are delivered online, the market will be more concentrated (known as the "Superstar" effect), indicating poor service efficiency for society as a whole. To reduce market concentration, E-consultation websites should provide important design elements such as ratings of doctors (user feedback), articles contributed by doctors, and free consultation services (online representation). A possible and important way to reduce the market concentration of the E-consultation market is to accumulate enough highly rated or highly self-represented doctors.
Beatty, Rebecca M.
Survey responses from 71 health professionals, benchmarking data from 8 hospitals, continuing education program evaluations, and focus groups with nursing, allied health, and primary care providers indicated a need for professional continuing education on women's health issues. Primary topic needs were identified. The data formed the basis for…
Miles, Stephen H.; And Others
A discussion of the role of academic health centers in health care reform efforts looks at the following issues: balancing academic objectivity and social advocacy; managing sometimes divergent interests of centers, faculty, and society; and the challenge to develop infrastructure support for reform. Academic health centers' participation in…
van Buul, Vincent J; Brouns, Fred J P H
European regulations mandate that only substantiated and approved statements can be used as nutrition- and health-related claims in food marketing. A thorough understanding of consumer perceptions of these approved claims is needed to assess their impact on both the purchase intention of functional foods and the development of innovative functional food concepts. In this paper, a conceptual framework on the European consumers' perception of nutrition and health claims on these functional foods is proposed. Through a literature review, common independent variables are structured, and an analysis of these variables shows that nutrition and health claims are mostly only perceived positive by specific target consumers (who need the product, accept the ingredient, understand the benefit, and trust the brand). These consumers indicate that the products with substantiated and approved claims help them in reaching overall health goals. This increased expectation in functional efficacy may mediate an increase in repurchase intent, overall liking, and the amount consumers are willing to spend. Other consumers, however, may have adverse reactions towards nutrition and health claims on functional foods. Implications for the consumer and the industry are discussed.
May 1, 2012 ... Results: The findings reveal different modes money was made available for payment for health services. On the whole, about 98% of payment was through out-of pocket spending (user-charges) with most respondents using their own money. Although this financing method shown to be associated with ...
2Department of Community Health, University of Benin Teaching Hospital, Benin City, Edo State. 1. 2. 2. Awunor N.S , Omuemu V.O , Adam V.Y. ABSTRACT. Introduction. A nation's disease control effort is often as good as the surveillance and notification system put in place, which would help to generate the much needed ...
living on each square inch of the phone. This study determined the prevalence of micro-organisms on the mobile phones of health workers and their role as a source of hospital acquired infection. The study utilised a cross-sectional design. A total of one hundred and eighty swabs were collected from the mobile phones of ...
child deaths among under-fives were due to. Childhood immunization is an effective public. VPDs, this represents 17% of global total. 1 health initiative aimed at reducing the burden mortality in children under five years of age. of vaccine preventable diseases (VPDs) and. To achieve the Millennium Developmental.
Oct 7, 2011 ... These factors include poor environmental and personal hygiene, poverty, malnutrition, unsafe water supply and ... The environment farmers live in, their standard of living and nutrition are very important to their health. ..... Globalization of food system: JOURNAL OF COMMUNITY MEDICINE AND PRIMARY ...
instruments were pretested self-administered questionnaire and observational checklist. The data generated were analyzed using .... The observational checklist (OBL) was used to. Kwara State was carried from April to ..... supervision of health workers by middle cadre Central Zonal Office). Report on Routine immunization ...
Further studies on this subject are recommended. Employees' Assessment of Leadership in a Tertiary. Hospital in South-South Nigeria. Adeleye O. A, Aduh U. Department of Community Health, .... National Institute of Standards and Technology, (where it is trying to go in the future)”; “my senior were originally designed for ...
Leanza, Francesco; Hauser, Diane
Teens are avid users of new technologies and social media. Nearly 95% of US adolescents are online at least occasionally. Health care professionals and organizations that work with teens should identify online health information that is both accurate and teen friendly. Early studies indicate that some of the new health technology tools are acceptable to teens, particularly texting, computer-based psychosocial screening, and online interventions. Technology is being used to provide sexual health education, medication reminders for contraception, and information on locally available health care services. This article reviews early and emerging studies of technology use to promote teen health. Copyright © 2014 Elsevier Inc. All rights reserved.
Monroe, C Douglas; Chin, Karen Y
The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.
Kim, Il-Ho; Muntaner, Carles; Chung, Haejoo; Benach, Joan
The authors selected nine case studies, one country from each cluster of their labor market inequalities typology, to outline the macro-political and economic roots of employment relations and their impacts on health. These countries illustrate variations in labor markets and health, categorized into a global empirical typology. The case studies illustrated that workers' health is significantly connected with labor market characteristics and the welfare system. For a core country, the labor market is characterized by a formal sector. The labor institutions of Sweden traditionally have high union density and collective bargaining coverage and a universal health care system, which correlate closely with positive health, in comparison with Spain and the United States. For a semi-periphery country, the labor market is delineated by a growing informal economy. Although South Korea, Venezuela, and El Salvador provide some social welfare benefits, a high proportion of irregular and informal workers are excluded from these benefits and experience hazardous working conditions that adversely affect their health. Lastly, several countries in the global periphery--China, Nigeria, and Haiti--represent informal work and severe labor market insecurity. In the absence of labor market regulations, the majority of their workers toil in the informal sector in unsafe conditions with inadequate health care.
Regan, Annette K; Tracey, Lauren; Gibbs, Robyn
In 2015, inactivated quadrivalent influenza vaccine (QIV) was first introduced into the Australian market. A routine vaccine safety surveillance system in Western Australia was used to conduct post-licensure surveillance of adverse events following immunization with inactivated QIV and trivalent influenza vaccines (TIV) in a sample of 1685 healthcare providers (HCPs). A similar percentage of HCPs who received QIV reported having any reaction seven days post-vaccination as HCPs who received TIV (13.6 vs. 12.8%, respectively; p=0.66). However, a slightly higher percentage of HCPs who received QIV reported pain or swelling at the injection site as compared to HCPs who received TIV (6.9% vs. 4.2%, respectively; p=0.02). No serious vaccine-associated adverse events were detected during follow-up of either vaccine. Acknowledging the study limitations, the results of this post-marketing surveillance support the safety of QIV, suggesting there is little difference in the reactogenicity of QIV as compared to TIV. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.
Notes that, with the changing job market, uncertain economy, increased competition, and higher parent expectations, child care center directors face new marketing challenges. This article discusses seven child care marketing myths and offers marketing strategies to child care directors facing potential drops or fluctuations in center enrollment.…
Miles, S H; Lurie, N; Fisher, E S; Haugen, D
There is increasing support for the proposition that academic health centers have a duty to accept broad responsibility for the health of their communities. The Health of the Public program has proposed that centers become directly involved in the social-political process as advocates for reform of the health care system. Such engagement raises important issues about the roles and responsibilities of centers and their faculties. To address these issues, the authors draw upon the available literature and their experiences in recent health care reform efforts in Minnesota and Vermont in which academic health center faculty participated. The authors discuss (1) the problematic balance between academic objectivity and social advocacy that faculty must attempt when they engage in the health care reform process; (2) the management of the sometimes divergent interests of academic health centers, some of their faculty, and society (including giving faculty permission to engage in reform efforts and developing a tacit understanding that distinguishes faculty positions on reform issues from the center's position on such issues); and (3) the challenge for centers to develop infrastructure support for health reform activities. The authors maintain that academic health centers' participation in the process of health care reform helps them fulfill the trust of the public that they are obligated to and ultimately depend on.
Dunn, Abe; Shapiro, Adam Hale
This study examines the impact of major health insurance reform on payments made in the health care sector. We study the prices of services paid to physicians in the privately insured market during the Massachusetts health care reform. The reform increased the number of insured individuals as well as introduced an online marketplace where insurers compete. We estimate that, over the reform period, physician payments increased at least 11 percentage points relative to control areas. Payment increases began around the time legislation passed the House and Senate-the period in which their was a high probability of the bill eventually becoming law. This result is consistent with fixed-duration payment contracts being negotiated in anticipation of future demand and competition. Published by Elsevier B.V.
Frank, S R
The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services.
Full Text Available With the proliferation of mobile technologies in China, the Chinese mobile medical applications market is growing rapidly. This may be particularly useful for Chinese rural populations who have limited access to quality medical care where mobile technologies can reach across geographic and socioeconomic boundaries and potentially increase access to care and improve health outcomes.
Health care spending in both the governmental and private sectors skyrocketed over the last century. This article examines the rapid growth of health care expenditures by analyzing the extent of this financial boom as well some of the reasons why health care financing has become so expensive. It also explores how the market concentration of insurance companies has led to growing insurer profits, fewer insurance providers, and less market competition. Based on economic data primarily from the Government Accountability Office, the Kaiser Family Foundation, and the American Medical Associa tion, it has become clear that this country needs more competitive rates for the business of health insurance. Because of the unique dynamics of health insurance payments and financing, America needs to promote affordability and innovation in the health insurance market and lower the market's high concentration levels. In the face of booming insurance profits, soaring premiums, many believe that in our consolidated health insurance market, the "business of insurance" should not be exempt from antitrust laws. All in all, it is in our nation's best interest that Congress restore the application of antitrust laws to health sector insurers by passing the Health Insurance Industry Antitrust Enforcement Act as an amendment to the McCarran-Ferguson Act's "business of insurance" provision.
Full Text Available Abstract Background Developments in information technology promise to revolutionise the delivery of health care by providing access to data in a timely and efficient way. Information technology also raises several important concerns about the confidentiality and privacy of health data. New and existing legislation in Europe and North America may make access to patient level data difficult with consequent impact on research and health surveillance. Although research is being conducted on technical solutions to protect the privacy of personal health information, there is very little research on ways to improve individuals power over their health information. This paper proposes a health care information directive, analogous to an advance directive, to facilitate choices regarding health information disclosure. Results and Discussion A health care information directive is described which creates a decision matrix that combines the ethical appropriateness of the use of personal health information with the sensitivity of the data. It creates a range of possibilities with in which individuals can choose to contribute health information with or without consent, or not to contribute information at all. Conclusion The health care information directive may increase individuals understanding of the uses of health information and increase their willingness to contribute certain kinds of health information. Further refinement and evaluation of the directive is required.
This rule finalizes changes that will help stabilize the individual and small group markets and affirm the traditional role of State regulators. This final rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year; standards related to network adequacy and essential community providers for qualified health plans; and the rules around actuarial value requirements.
Luck, Jeff; Hagigi, Fred; Parker, Louise E; Yano, Elizabeth M; Rubenstein, Lisa V; Kirchner, JoAnn E
Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems.
Guimarães, Luisa; Giovanella, Lígia
This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.
health care and reproductive health. It plays a major role in reducing maternal and neonatal morbidity. Access to family planning also has the and mortality. It confers important health and potential to control population growth and in the development benefits to individuals, families, long run reduce green house gas emission ...
activities in the health centres ( Table 2) The study showed that community health extension workers were responsible for ... development goals for mothers and children as distant as it was 40 years ago when primary health care strategy was adopted for ... Most of them were very experienced, 50% of. The study (Table II) ...
From an economist's perspective, cross-border reproductive care (CBRC) reflects a global market economy bringing together the needs of patients and skills of doctors at an agreed price. From this perspective CBRC is neither wrong nor right, rather it reflects rational economic behaviour of couples
Full Text Available The paper deals with conscientious objection in health care, addressing the problems of scope, verification and limitation of such refusal, paying attention to ideological agendas hidden behind the right of conscience where the claimed refusal can cause harm or where such a claim is an attempt to impose certain moral values on society or an excuse for not providing health care. The nature of conscientious objection will be investigated and an ethical analysis of conscientious objection will be conducted. Finally some suggestions for health care policy will be proposed.
Bhatti, Yosef; Gørtz, Mette; Holm Pedersen, Lene
This research examines the effects of organisational change on employee health and labour market outcomes. Previous studies looking into organisational change in the private sector indicate that the larger the size and depth of organisational change, the larger the detrimental consequences...... to the employees. This study contributes to the literature on four main dimensions. First, we extend the analysis of organisational change to a public sector setting. Second, while previous findings remain inconclusive regarding causal effects due to problems of endogeneity, our analysis contributes to research...... of causal effects of organisational change by exploiting a large scale public sector reform which can be considered as a quasi-experiment. Third, given that the reform was exogenous and implemented simultaneously in a number of Danish municipalities, we also have an objective measure of organisational...
U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.
Welton, W E; Kantner, T A; Katz, S M
As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health.
... Sloane PD, Warshaw GA, et al, eds. Ham's Primary Care Geriatrics: A Case-Based Approach . 6th ed. ... Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, ...
Full Text Available Aurel O Iuga,1,2 Maura J McGuire3,4 1Johns Hopkins Bloomberg School of Public Health, 2Johns Hopkins University, 3Johns Hopkins Community Physicians, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e-prescribing. Keywords: patient, medication, adherence, compliance, nonadherence, noncompliance, cost
Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.
Vannieuwenborg, Frederic; Van der Auwermeulen, Thomas; Van Ooteghem, Jan; Jacobs, An; Verbugge, Sofie; Colle, Didier
Due to changes in the demographic situation of most Western European countries, interest in Information and Communication Technologies (ICT)-supported care services is growing fast. eCare services that foster better care information exchange, social involvement, lifestyle monitoring services, etc., offered via ICT platforms, integrated in the homes of the elderly are believed to be cost-effective. Additionally, they could lead to an increased quality of life of both care receiver and (in)formal caregiver. Currently, adoption and integration of these eCare platforms (eCPs) is slowed down by several barriers such as unclear added value, a lack of regulations, or lack of sustainable financial models. In this work, the added value of eCPs is identified for the several involved key actors such as the care receiver, the (in)formal care providers, and the home care organizations. In a second step, several go-to-market strategies are formulated. Because the gap between the current way of providing home care and providing home care supported by a fully integrated eCP seems too big to bridge in one effort, a migration path is provided for stepwise integration and adoption of eCPs in the current way of home care provisioning.
Campbell, Robert James
This article introduces health care managers to the theories and philosophies of John Kotter and William Bridges, 2 leaders in the evolving field of change management. For Kotter, change has both an emotional and situational component, and methods for managing each are expressed in his 8-step model (developing urgency, building a guiding team, creating a vision, communicating for buy-in, enabling action, creating short-term wins, don't let up, and making it stick). Bridges deals with change at a more granular, individual level, suggesting that change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change. According to Bridges, transitions occur in 3 steps: endings, the neutral zone, and beginnings. The major steps and important concepts within the models of each are addressed, and examples are provided to demonstrate how health care managers can actualize the models within their health care organizations.
Market-oriented health care reforms have been implemented in the tax-financed Swedish health care system from 1990 to 2013. The first phase of these reforms was the introduction of new public management systems, where public health centers and public hospitals were to act as private firms in an internal health care market. A second phase saw an increase of tax-financed private for-profit providers. A third phase can now be envisaged with increased private financing of essential health services. The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions. Policy options to promote further development of a nonprofit health care system are highlighted.
Generally, of the ever tested only 85(29.5%) were tested by the help of health care providers/counselors other than self. Regarding the place where the HCWs had the test, majority 136 (69.4%) tested by themselves at the health facility and the rest were tested at their home, office, market and church. The main reason stated ...
Fontana, S A
Public health nurses must have a valid marketing orientation. Two marketing concepts, exchange relationships and channels of distribution and their application for public health nursing practice, have relevance in this context. In spite of the complexities inherent in applying them, they can be used to promote health in at-risk populations. By incorporating these concepts in planning and delivering public health nursing services, it is hoped that the health goals of a larger number of vulnerable individuals can be achieved.
JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 26, NO 1, MARCH 2014. INTRODUCTION disability from complications of pregnancy and. 1 child birth. MI in birth preparedness is. Birth preparedness by a couple ensures that indispensible in rural communities where patriarchy appropriate care ...
Jonsson, E.; Banta, H.D.
Health care in Sweden is a public sector responsibility and equity in access to care is quite important. The Swedish system is organized into several levels, with the Federation of County Councils at the top, and with regional, county, and local levels. In theory, the four hospital tiers developed
Sherertz, R J; Bassetti, S.; Bassetti-Wyss, B.
Certain bacteria dispersed by health-care workers can cause hospital infections. Asymptomatic health-care workers colonized rectally, vaginally, or on the skin with group A streptococci have caused outbreaks of surgical site infection by airborne dispersal. Outbreaks have been associated with skin colonization or viral upper respiratory tract infection in a phenomenon of airborne dispersal of Staphylococcus aureus called the "cloud" phenomenon. This review summarizes the data supporting the e...
Marasović Šušnjara, Ivana
Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.
Sortsø, Camilla; Lauridsen, Jørgen; Emneus, Martha
Understanding socioeconomic inequalities in health care is critical for achieving health equity. The aim of this paper is threefold: 1) to quantify inequality in diabetes health care service utilization; 2) to understand determinants of these inequalities in relation to socio...... differences in inequality estimates. While income, alike other measures of labor market attachment, to a certain extent is explained by morbidity and thus endogenous, education is more decisive for patients' ability to take advantage of the more specialized services provided in a universal health care system....
Ouyang, Wenjing; Hilsenrath, Peter E
Investment, especially through merger and acquisition (M&A), is a leading topic of concern among health care managers. In addition, the implications of this activity for organization and market concentration are of great interest to policy makers. Using a sample of 2256 firm-year observations in the health care industry during the period from 1985 to 2011, this article provides novel evidence that managers learn from financial markets in making capital expenditure (CAPEX) and M&A investment decisions. Within the industry, managers in the Drugs subsector are most likely to do so, whereas managers in the Medical Equipment and Supplies are least likely to do so. We find informative stock prices improve firm financial performance. This article highlights the importance of financial markets for real economic activity in the health care industry.
Simms, Mark D.; Freundlich, Madelyn; Battistelli, Ellen S.; Kaufman, Neal D.
Describes the essential features of a health care system that can meet the special needs of children in out-of-home care. Discusses some of the major recent changes brought about by welfare and health care reform. Notes that it remains to be seen whether the quality of services will improve as a result of these reforms. (Author)
Roemer, M I
Large rural areas of developing countries show severe shortages of physicians, graduate nurses, and other trained health personnel. Countries have tried to alleviate this problem in several ways, including requiring all new medical graduates to 1st undertake periods of service in rural areas, the use of mobile clinic teams from small towns to visit outlying villages on a regular basis, and the use of air ambulances to transport seriously ill persons from isolated places to hospitals in cities. Perhaps the most significant strategy has been the use of trained community workers to provide primary health care for rural and low-income urban populations. Unfortunately, weak supervision of the community workers has often led to unsatisfactory performances. Surprisingly, a recent international congress claimed that many developing countries are training too many doctors, that some developing countries have, or will soon have, 1000s of unemployed physicians. However, comparison with developed countries shows that the "diagnosis" of a country's doctor supply situation may not depend on a universal standard, but on that job market's capacity for absorption of personnel. If specific public health goals are to be reached however, commercial criteria cannot be applied to the evaluation of a nation's health manpower; instead social need must be analyzed and strategies designed to meet them. Policy is shaped by the priority public authorities give to services. Of the 7 developing countries which reported a surplus of doctors, only Colombia and Mexico reported spending more on public health than on the military. In addition, in the other 5 countries, 40% or less of the overall public and private expenditures on health came from the government. When military expenditures absorb a high share of government funds, public support for health services is adversely affected, and individuals and families must depend on their own expenditures to obtain health services. Health services
Hyman, David A; Kovacic, William E
James Robinson uses the Herfindahl-Hirschman Index (HHI) to compute the concentration of commercial health insurance markets in most of the states during the past four years. The HHI is the analytical foundation for the federal antitrust merger guidelines, so we consider his findings from an antitrust perspective. Market concentration provides an important benchmark for antitrust analysis, but it does not, standing alone, indicate the presence of problematic (anticompetitive) behavior or a problem that antitrust law can solve. Even if it did, there are major problems in treating individual states as discrete insurance markets. Unless the market is correctly defined, any analysis of market concentration is thoroughly unreliable.
... Control Preventing infections can help the respiratory home care patient stay as healthy as possible. Hand-washing is the single most important thing for patients and caregivers to perform on a routine basis. Use a liquid soap and lots of warm running water. Work up a good lather and scrub for at ...
Tiwari, S C
Social marketing has a proven role in marketing and many manufacturing establishments/ organizations have been marketing their products incorporating social marketing research. Social marketing has its root in the ground fact that the perceptions and expectations of the consumers are important in influencing buying behaviour. The principles of social marketing, therefore, have been extensively utilized in the areas of consumer products. These are also used in several other fields for modifying behaviours such as civil administration, public establishments etc. In health sector social marketing has not found appropriate application whereas it could be utilized in an effective way for creating awareness, formulating health related policies, their implementation and for preventing a variety of illnesses/abnormal behaviours etc.With this background knowledge about social marketing, the author hypothesized that abnormal behaviours could be modified, health education packages could be developed to make more acceptable and effective and desired behaviours could be induced if perceptions and expectations of the community (consumers) are known a prioriori and their expectations are incorporated in programmes and policies. Thus, the author utilizing the concepts of social marketing for understanding community's perceptions and expectations regarding issues of health, and for incorporating the same in health related programmes and policies, introduced this research concept in medical field in this country.The important findings of three research projects based on the concepts of social marketing research and their implications have been discussed.
Carlos Arturo Meza Carvajalino
Full Text Available This document studies the theoretical foundations, the different controversies regarding the health service and the conceptions adopted from the hypotheses related to the market efficiency in the provision of a public service and the consequent market failures. The author thinks that when the health public service was delegated to the market in Colombia they originated failures in the competition, externalities, preference goods and services, asymmetry and redistribution, among the most relevant ones.
... in medical offices or in the dialysis unit. Nephrology Nurse Nephrology nurses are licensed, registered nurses who ... nutritional intake to ensure the patient's optimal health. Nephrology Social Worker Most nephrology social workers have a ...
Stellefson, Michael; Eddy, James M
To make salient the striking similarities between the program planning processes used in both health education and contemporary marketing. Through a discussion of the analogous nature of both processes and a review of the literature, the authors (1) illustrate why marketing principles should be embraced and (2) suggest how marketing strategies can be integrated into health education needs assessments. Core health-marketing concepts are proposed along with 4 recommendations for future marketing activities in health education. To facilitate an advance in health education process and practice, scholars and practitioners should adopt a more consumer-centered, marketing mind-set.
Buchanan, Larry M.
It is widely recognized throughout the health care industry that the United States leads the world in health care spending per capita. However, the chilling dose of reality for American health care consumers is that for all of their spending, the World Health Organization ranks the country's health care system 37th in overall performance--right…
... Living Listen Español Text Size Email Print Share Mental Health Care: Who's Who Page Content Article Body Psychiatrist: ... degree in psychology, counseling or a related field. Mental Health Counselor: Master’s degree and several years of supervised ...
the children didnot receive BCG vaccine while spiritual homes was the pattern in 6.9 households. 22.9% did not receive measles vaccine. A total of 63 under-five deaths were reported in 53. Table VI shows the health-seeking behaviour of. 6. JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL.
This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages. Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria. Date Released: 4/25/2012.
Full Text Available Previously, the main focus of primary health care practices was to diagnose and treat patients. The identification of risk factors for disease and the prevention of chronic conditions have become a part of everyday practice. This paper provides an argument for training primary health care (PHC practitioners in health promotion, while encouraging them to embrace innovation within their practice to streamline the treatment process and improve patient outcomes. Electronic modes of communication, education and training are now commonplace in many medical practices. The PHC sector has a small window of opportunity in which to become leaders within the current model of continuity of care by establishing their role as innovators in the prevention, treatment and management of disease. Not only will this make their own jobs easier, it has the potential to significantly impact patient outcomes.
Previously, the main focus of primary health care practices was to diagnose and treat patients. The identification of risk factors for disease and the prevention of chronic conditions have become a part of everyday practice. This paper provides an argument for training primary health care (PHC) practitioners in health promotion, while encouraging them to embrace innovation within their practice to streamline the treatment process and improve patient outcomes. Electronic modes of communication, education and training are now commonplace in many medical practices. The PHC sector has a small window of opportunity in which to become leaders within the current model of continuity of care by establishing their role as innovators in the prevention, treatment and management of disease. Not only will this make their own jobs easier, it has the potential to significantly impact patient outcomes.
Magalhães, Ana Hirley Rodrigues; Parente, José Reginaldo Feijão; Silva, Maria Adelane Monteiro da; Pereira, Ivna de Holanda; Vasconcelos, Maristela Inês Osawa; Guimarães, Raquel Xavier
To analyze the health needs of street market saleswomen of the Mercado Público (Public Market) of a municipality in Northeastern Brazil. Qualitative, exploratory and descriptive study, with fifteen saleswomen in a public market. Data production means included semi-structured interviews, April-May 2016. Data were analyzed using the analysis of technical content technique, from which the following theme category emerged: "Access needs to health services and professional humanized practices." The women in the study highlighted the guarantee of access, connection and welcoming as driving practices for the recognition of health needs confronting the health-disease process and comprehensive care. Being welcomed, identifying needs and producing a bond will contribute to these women recognizing themselves as subjects of their needs, strengthening their autonomy, empowerment and self-care.
Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn
This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...
Lauxen, O; Bieräugel, R
The Hessian Care Monitor is a Web-based monitoring system of the regional care labor market. It contains information on the current labor market and on future developments. Official statistics are analyzed, primary data are collected, and forecasts are calculated. Since 2008, the demand for nurses in Hesse has been higher than the supply. In 2010, there was a lack of more than 4,400 nurses. Moreover, in 2025, around 5,500 additional nurses will be needed to meet the increasing demand arising from demographic changes. However, there are three different regional patterns: regions with high current shortages but little additional demand in the future; regions with low current shortages but large future needs; and regions with high current shortages and large future demand. Appropriate strategies for handling labor shortages have to be selected according to the different regional patterns.
Schiozer, Rafael Felipe; Saito, Cristiana Checchia; Saito, Richard
This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organizational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1) private health care providers benefit from economies of scale; (2) self-funded health plans have better financial health; (3) spending on marketing does not have a significant impact on customer satisfaction in Brazil; (4) weak empirical evidence exists showing that good financial performance enhances customer's satisfaction.
Bauer, Jan; Schiller, Jörg; Schreckenberger, Christopher
is dominating in this market, with respect to both the decision to buy a CompLTCI policy and the decision about the extent of CompLTCI coverage. We identify occupational status, residential location and the holding of further supplementary health insurance policies as unused observables contributing...... to selection effects in this market. Our results suggest that non-linearitiesin the relationship of potential sources of selection to insurance coverage and risk should be considered. A panel data analysis shows that an increase in health insurance payouts is positively correlated with the uptake of Comp......In this paper, we analyze selection effects in the German market for private complementary longterm care insurance contracts (CompLTCI) within a static and dynamic framework. Using data on more than 98,000 individuals from a German insurance company, we provide evidence that advantageous selection...
McSurely, H B; Fullerton, S
A sample of 108 members of the Academy of Health Services Marketing provided bibliographic citations of 629 sources of information which have been important to them in their jobs. The results indicate that the propensity to rely upon a source is dependent upon the topic of the information sought. The sources under scrutiny were consultants, books, journals, magazines, seminars, conferences, video tapes, and audio tapes. The topics considered included the variables of the marketing mix as well as market planning and marketing research. The discussion provides insight about where seekers of health care marketing knowledge go for specific kinds of information. It also suggests types of media that information-providers should consider for dissemination of their material.
National Environmental Education & Training Foundation, 2012
This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…
Araújo, Patricia Sodré; Costa, Ediná Alves; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Álvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair
To characterize the activities of clinical nature developed by pharmacists in basic health units and their participation in educational activities aiming at health promotion. This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015), a cross-sectional and exploratory study, of evaluative nature, consisting of a survey of information in a representative sample of cities, stratified by the Brazilian regions that constitute domains of study, and a subsample of primary health care services. The interviewed pharmacists (n=285) were responsible for the delivery of medicines and were interviewed in person with the use of a script. The characterization of the activities of clinical nature was based on information from pharmacists who declared to perform them, and on participation in educational activities aiming at health promotion, according to information from all pharmacists. The results are presented in frequency and their 95% confidence intervals. From the interviewed subjects, 21.3% said they perform activities of clinical nature. Of these, more than 80% considered them very important; the majority does not dispose of specific places to perform them, which hinders privacy and confidentiality in these activities. The main denominations were "pharmaceutical guidance" and "pharmaceutical care." The registration of activities is mainly made in the users' medical records, computerized system, and in a specific document filed at the pharmacy, impairing the circulation of information among professionals. Most pharmacists performed these activities mainly along with physicians and nurses; 24.7% rarely participated in meetings with the health team, and 19.7% have never participated. Activities of clinical nature performed by pharmacists in Brazil are still incipient. The difficulties found point out
Halfon, Neal; And Others
Outlines access to health care for children in out-of-home care under current law, reviews how health care access for these children would be affected by President Clinton's health care reform initiative, and proposes additional measures that could be considered to improve access and service coordination for children in the child welfare system.…
Cantor, Joel C; Monheit, Alan C
The individual health insurance market has played a small but important role in providing coverage to those without access to group insurance or public programs. With implementation of the Affordable Care Act (ACA), the individual market has attained a more prominent role. However, achieving accessible and affordable coverage in this market is a long-standing challenge, in large part due to the threat of adverse risk selection. New Jersey pursued comprehensive reforms beginning in the 1990s to achieve a stable, accessible, and affordable individual market. We review how adverse risk selection can pose a challenge to achieving such objectives in the individual health insurance market. We follow this discussion by describing the experience of New Jersey through three rounds of legislative reform and through the first year of the implementation of the ACA coverage provisions. While the New Jersey reforms did not require individuals to purchase coverage, its experiences with direct and indirect market subsidies and regulations guiding plan design, issuance, and rating have important implications for how the ACA may achieve its coverage goals in the absence of the controversial individual purchase mandate. Copyright © 2016 by Duke University Press.
Kotval, Jeroo S.
In a policy climate where incentives to cherry pick are minimized, Managed Care Organizations can implement practices that safeguard medical privacy to the extent that data is protected from falling into the hands of third parties who could misuse it to discriminate. To the extent that these practices have been codified into the regulatory Network of the Health Insurance Portability and Accountability Act (HIPAA) Consumers may be able to rest easy about their genetic data being revealed to third parties who may discriminate. However, there are limitations to the use of policy instruments to prevent the discrimination of an entire genre of clients by market driven managed care organizations. Policy measures, to assure that knowledge of genetic conditions and their future costs would not be used by market driven managed care organizations to implement institutional policies and products that would implicitly discriminate against a genre of clients with genetic conditions, present difficulties.
The Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care Education Reconciliation Act of 2010 makes landmark changes to health insurance markets. Individual and small-group insurance plans and markets will see the biggest changes, but PPACA also affects large employer and self-insured plans by imposing rules for benefit design and health plan practices. Over half of workers--most often those in very large firms--are covered by self-insured health plans in which employers (or employee groups) bear all or some of the risk of providing insurance coverage to a defined population of workers and their dependents. As PPACA provisions become effective, some have argued that smaller firms that offer insurance may opt to self-insure their health benefits because of new small-group market rules. Such a shift could affect risk pooling in the small-group market. This paper examines the definition and prevalence of self-insured health plans, the application of PPACA provisions to these plans, and the possible effects on the broader health insurance market, should many more employers decide to self-insure.
Young, D W
Many Western European countries are moving toward privatization of their health care systems. The United States' health care system, since it is almost entirely privatized, is therefore worthy of study. Doing so raises several questions. How is privatization being managed in the US? How could its management be improved? What management lessons must be kept in mind if it is to be used effectively? What potential pitfalls should European countries consider as they move toward greater privatization? With operating costs, European countries must avoid the mistakes that have led to dramatic increases in annual health care costs in the US, simultaneous with reductions in access and quality. Doing so requires designing systems that promote hospital behavior consistent with a country's health objectives. With capital costs, an approach must be designed that allows policy-makers to work closely with both managers and physicians in order to make strategically sound choices about access and quality. Such an approach will require physicians to incorporate their clinical judgments into community standards of care, and to adopt a regional (rather than an institutional or personal) perspective in the determination of any incremental capital expenditures. By making regulation proactive and strategic, rather than punitive, health policymakers in Western Europe can achieve the best privatization has to offer without feeling the sting of its unintended consequences. In so doing they can help to move their health systems toward achieving the multiple and illusive goals of access, quality and reasonable cost.
Evans, W Douglas; Uhrig, Jennifer; Davis, Kevin; McCormack, Lauren
Communication and marketing are growing areas of health research, but relatively few rigorous efficacy studies have been conducted in these fields. In this article, we review recent health communication and marketing efficacy research, present two case studies that illustrate some of the considerations in making efficacy design choices, and advocate for greater emphasis on rigorous health communication and marketing efficacy research and the development of a research agenda. Much of the outcomes research in health communication and marketing, especially mass media, utilizes effectiveness designs conducted in real time, in the media markets or communities in which messages are delivered. Such evaluations may be impractical or impossible, however, imiting opportunities to advance the state of health communication and marketing research and the knowledge base on effective campaign strategies, messages, and channels. Efficacy and effectiveness studies use similar measures of behavior change. Efficacy studies, however, offer greater opportunities for experimental control, message exposure, and testing of health communication and marketing theory. By examining the literature and two in-depth case studies, we identify advantages and limitations to efficacy studies. We also identify considerations for when to adopt efficacy and effectiveness methods, alone or in combination. Finally, we outline a research agenda to investigate issues of internal and external validity, mode of message presentation, differences between marketing and message strategies, and behavioral outcomes.
Hesketh, T; Wei, X Z
After the Liberation by Mao Ze Dong's Communist army in 1949, China experienced massive social and economic change. The dramatic reductions in mortality and morbidity of the next two decades were brought about through improvements in socioeconomic conditions, an emphasis on prevention, and almost universal access to basic health care. The economic mismanagement of the Great Leap Forward brought about a temporary reversal in these positive trends. During the Cultural Revolution there was a sustained attack on the privileged position of the medical profession. Most city doctors were sent to work in the countryside, where they trained over a million barefoot doctors. Deng Xiao Ping's radical economic reforms of the late 1970s replaced the socialist system with a market economy. Although average incomes have increased, the gap between rich and poor has widened.
Simunović, Vladimir J
Market-based health care reform during democratic transition in Bosnia and Herzegovina was complicated by the 1992-1995 war, that devastated the country and greater part of its health care infrastructure...
telemonitoring . In emergency cases where immediate medical treatment is the issue, recent studies conclude that early and specialized pre-hospital patient ...Lama, J Vila: “Intelligent Telemonitoring of Critical Care Patients ”, IEEE EMB Mag, Vol 18, No 4, pp 80-88, Jul/Aug 1999.  Strode S, Gustke S...Abstract- In this study we present a multipurpose health care telemedicine system, which can be used for emergency or patient monitoring cases
Bloche, M Gregg
Broad adoption of "consumer-directed health care" would probably widen socioeconomic disparities in care and redistribute wealth in "reverse Robin Hood" fashion, from the working poor and middle classes to the well-off. Racial and ethnic disparities in care would also probably worsen. These effects could be alleviated by adjustments to the consumer-directed paradigm. Possible fixes include more progressive tax subsidies, tiering of cost-sharing schemes to promote high-value care, and reduced cost sharing for the less well-off. These fixes, though, are unlikely to gain traction. If consumer-directed plans achieve market dominance, disparities in care by class and race will probably grow.
This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance. Created: 11/9/2010 by Centers for Disease Control and Prevention (CDC). Date Released: 11/9/2010.
Sahoo, Sanjeeb K
Nanomedicine: Emerging Field of Nanotechnology to Human HealthNanomedicines: Impacts in Ocular Delivery and TargetingImmuno-Nanosystems to CNS Pathologies: State of the Art PEGylated Zinc Protoporphyrin: A Micelle-Forming Polymeric Drug for Cancer TherapyORMOSIL Nanoparticles: Nanomedicine Approach for Drug/Gene Delivery to the BrainMagnetic Nanoparticles: A Versatile System for Therapeutic and Imaging SystemNanobiotechnology: A New Generation of Biomedicine Application of Nanotechnology-Based Drug Delivery and Targeting to LungsAptamers and Nanomedicine in C
Bharadwaj, Latika; Findeis, Jill; Chintawar, Sachin
The paper attempts to answer a very simple question: how does a farm household respond as a unit in the labor market when benefits or health insurance is tied to employer provided jobs. One of the major changes affecting US agriculture has been a decline in the number of farms and an increase in the multiple job-holding, especially among farm women to fulfill various objectives ranging from helping out with farm expenses or securing benefits like health insurance. In addition to this, the new health care law or "The Patient Protection and Affordable Care Act (PPACA") to be operational by 2014 requires that all individuals be covered by a health plan. Hence, it's important to understand the relationship between health insurance and labor markets to appropriately identify the impact of health policy reform for farm families.
The health promotion discourse is comprised of assumptions about health and health care that are compatible with primary health care. An examination of the health promotion discourse illustrates how assumptions of health can help to inform primary health care. Despite health promotion being a good fit for primary health care, this analysis demonstrates that the scope in which it is being implemented in primary health care settings is limited. The health promotion discourse appears largely compatible with primary health care-in theory and in the health care practices that follow. The aim of this article is to contribute to the advancement of theoretical understanding of the health promotion discourse, and the relevance of health promotion to primary health care.
... Management Education & Events Advocacy For Patients About ACOG Good Health Before Pregnancy: Preconception Care Home For Patients Search ... Pregnancy: Preconception Care FAQ056, April 2017 PDF Format Good Health Before Pregnancy: Preconception Care Pregnancy What is a ...
Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special ... for and what to ask will help you choose an organization that provides safe, quality care, treatment ...
Pfaff, H; Pförtner, T-K
Social inequalities in health and health care services represent issues of major concern. Findings in this area reveal inequalities in health and health care indicating disadvantages for individuals with a low socioeconomic background. Although the health care system plays a marginal role in the explanation of inequalities in health, health services research can be an important part in the development of equal health opportunities. The current article describes the causal associations between social inequalities, health inequalities and the health care service. Health services research can make a contribution to increasing equal opportunities in health and health care service. Against this background, we discuss the existing potential and need of research in the area of health services. © Georg Thieme Verlag KG Stuttgart · New York.
Flemmig, Thomas F; Beikler, Thomas
The adoption of new technologies for the treatment of periodontitis and the replacement of teeth has changed the delivery of periodontal care. The objective of this review was to conduct an economic analysis of a mature periodontal service market with a well-developed workforce, including general dentists, dental hygienists and periodontists. Publicly available information about the delivery of periodontal care in the USA was used. A strong trend toward increased utilization of nonsurgical therapy and decreased utilization of surgical periodontal therapy was observed. Although periodontal surgery remained the domain of periodontists, general dentists had taken over most of the nonsurgical periodontal care. The decline in surgical periodontal therapy was associated with an increased utilization of implant-supported prosthesis. Approximately equal numbers of implants were surgically placed by periodontists, oral and maxillofacial surgeons, and general dentists. Porter's framework of the forces driving industry competition was used to analyze the role of patients, dental insurances, general dentists, competitors, entrants, substitutes and suppliers in the periodontal service market. Estimates of out-of-pocket payments of self-pay and insured patients, reimbursement by dental insurances and providers' earnings for various periodontal procedures and alternative treatments were calculated. Economic incentives for providers may explain some of the observed shifts in the periodontal service market. Given the inherent uncertainty about treatment outcomes in dentistry, which makes clinical judgment critical, providers may yield to economic incentives without jeopardizing their ethical standards and professional norms. Although the economic analysis pertains to the USA, some considerations may also apply to other periodontal service markets. © 2013 John Wiley & Sons A/S.
Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio
OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949
Heller, Kathryn Wolff; Avant, Mary Jane Thompson
Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…
This is an empirical study of 7 communities among the O-kun Yoruba of Ijumu, Kogi State, Nigeria. The general objective of the study was to investigate the prioritizing pattern of the various Primary Health Care services (PHC) in the study area. Data for the study were generated mainly through multi-stage sampling ...
Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre
The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?...
Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey
The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the
Addresses the crisis in health care, considering costs, lack of access, and system ineffectiveness. Reviews "Setting Relationships Right," the Catholic Health Association's proposal for health care reform. Advocates educators' awareness of children's health needs and health care reform issues and support for the Every Fifth Child Act of…
Neil J. Buckley; Katherine Cuff; Jeremiah Hurley; Logan McLeod; Stuart Mestelman; David Cameron
This paper presents the results of a revealed-choice experiment testing the theoretical predictions of a model of a mixed system of public and private finance. In the context of a mixed system of health care finance, we investigate behavioural responses to changing the public sector allocation rule (needs-based vs. random), the supply of health care resources, and the size of the public health care budget on the following outcomes: the equilibrium market price for health care resources, the n...
Le Var, Rita M. H.
Nurses and health care professionals must be prepared for transcultural health care because society is becoming increasingly multicultural and current health services are not meeting the needs of minority ethnic groups in Britain. (SK)
Morrisey, M A
To review the empirical literature on the effects of selective contracting and hospital competition on hospital prices, travel distance, services, and quality; to review the effects of managed care penetration and competition on health insurance premiums; and to identify areas for further research. Selective contracting has allowed managed care plans to obtain lower prices from hospitals. This finding is generalizable beyond California and is stronger when there is more competition in the hospital market. Travel distances to hospitals of admission have not increased as a result of managed care. Evidence on the diffusion of technology in hospitals and the extent to which hospitals have specialized as a result of managed care is mixed. Little research on the effects on quality has been undertaken, but preliminary evidence suggests that hospital quality has not declined and may have improved. Actual mergers in the hospital market have not affected hospital prices. Much less research has been focused on managed care markets. Greater market penetration and greater competition among managed care plans are associated with lower managed care premiums. Greater HMO penetration appears to be much more effective than PPO penetration in leading to lower premiums. While workers are willing to change plans when faced with higher out-of-pocket premiums, there is little evidence of the willingness of employers to switch plan offerings. Preliminary evidence suggests that greater managed care penetration has led to lower overall employer premiums, but the results differ substantially between employers with and without a self-insured plan. Much more research is needed to examine all aspects of managed care markets. In hospital markets, particular attention should be focused on the effects on quality and technology diffusion.
Willberg, A; Heger, R
This paper reports in detail on a project of Integrated Health Care in cardiology at Potsdam, Germany. Information on the structure of the contract, the participants, the agreed claiming of benefits and provision of services are provided as well as relevant figures and contact data.
Centres in Sabon Gari Local Government Area, Kaduna State Nigeria. journal of. COMMUNITY MEDICINE. & PRIMARY HEALTH CARE. 1. 1. 1. M.B Sufiyan , A.A Umar , A. Shugaba . 1Department of Community Medicine, Ahmadu Bello University, Zaria. KEYWORDS. Assessment,. Client satisfaction, ANC,. PHC centers.
Handelsman, L; Speiser, M; Maltz, A; Kirpalani, S
Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace.
Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi
In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...
Somasundaram, D. J.; van de Put, W. A.
An effort is being made in Cambodia to involve grass-roots personnel in the integration of the care of the mentally ill into a broad framework of health services. This undertaking is examined with particular reference to the work of the Transcultural Psychosocial Organization. PMID:10212521
Somasundaram, D. J.; van de Put, W. A.
An effort is being made in Cambodia to involve grass-roots personnel in the integration of the care of the mentally ill into a broad framework of health services. This undertaking is examined with particular reference to the work of the Transcultural Psychosocial Organization.
to eat together and lying on the same bed with ocular have far reaching implications in terms of cancers patients. management, prognosis and mortality of ocular cancer. Such individuals may not access available. Further analysis indicates that respondents'. 3,9 education, gender and marital status have no health care ...
This paper reports in detail on a project of Integrated Health Care in cardiology at Nuremberg, Germany. Information on the structure of the contract, the participants, the agreed claiming of benefits and provision of services are provided as well as relevant figures and contact data.
Improving skilled attendants at birth: Experience in a primary health care facility in Rivers State, South-South Nigeria. 1. 2. Ordinioha B. , Seiyefa B. 1Community Medicine Department, University of Port Harcourt Teaching Hospital, Port Harcourt. 2Department of Family Medicine, Niger Delta University Teaching Hospital, ...
Artiklen har fokus på undervisning, planlægning, udvikling og evaluering af et internationalt tværfagligt valgfag Intercultural Health Care and Welfare, der udbydes på Det Sundhedsfaglige og Teknologiske Fakultet på Professionshøjskolen Metropol. Ifølge den tysk-amerikanske professor Iris Varner og...
Schut, Frederik T; Varkevisser, Marco
In the Netherlands in 2006 a major health care reform was introduced, aimed at reinforcing regulated competition in the health care sector. Health insurers were provided with strong incentives to compete and more room to negotiate and selectively contract with health care providers. Nevertheless, the bargaining position of health insurers vis-à-vis both GPs and hospitals is still relatively weak. GPs are very well organized in a powerful national interest association (LHV) and effectively exploit the long-standing trust relationship with their patients. They have been very successful in mobilizing public support against unfavorable contracting practices of health insurers and enforcement of the competition act. The rapid establishment of multidisciplinary care groups to coordinate care for patients with chronic diseases further strengthened their position. Due to ongoing horizontal consolidation, hospital markets in the Netherlands have become highly concentrated. Only recently the Dutch competition authority prohibited the first hospital merger. Despite the highly concentrated health insurance market, it is unclear whether insurers will have sufficient countervailing buyer power vis-à-vis GPs and hospitals to effectively fulfill their role as prudent buyer of care, as envisioned in the reform. To prevent further consolidation and anticompetitive coordination, strict enforcement of competition policy is crucially important for safeguarding the potential for effective insurer-provider negotiations about quality and price. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
McCue, Michael J; Hall, Mark A
The Affordable Care Act (ACA) transformed the market for individual health insurance, so it is not surprising that insurers' transition was not entirely smooth. Insurers, with no previous experience under these market conditions, were uncertain how to price their products. As a result, they incurred significant losses. Based on this experience, some insurers have decided to leave the ACA’s subsidized market, although others appear to be thriving. Examine the financial performance of health insurers selling through the ACA's marketplace exchanges in 2015--the market’s most difficult year to date. Analysis of financial data for 2015 reported by insurers from 48 states and D.C. to the Centers for Medicare and Medicaid Services. Although health insurers were profitable across all lines of business, they suffered a 10 percent loss in 2015 on their health plans sold through the ACA's exchanges. The top quarter of the ACA exchange market was comfortably profitable, while the bottom quarter did much worse than the ACA market average. This indicates that some insurers were able to adapt to the ACA's new market rules much better than others, suggesting the ACA's new market structure is sustainable, if supported properly by administrative policy.
U.S. Department of Health & Human Services — The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly...
Health care reform efforts have increasingly emphasized payment models that reward value (quality/cost). It seems appropriate, therefore, to examine what we value in health care, and that will require that we examine our definition of health. In spite of admonitions from the World Health Organization and others, our current health care system operates under the assumption that health represents the absence of health problems. While that perspective has led to incredible advances in medical sc...
Sanchez, P M
The acceptance and use of marketing techniques and concepts in the health care area is a phenomenon well known to most marketers. Prior to 1979, marketing in the health care field was relatively unknown. Since that time, however, the growth of health care marketing has not been accompanied by commensurate growth in marketing research efforts.
Colletti, J J
With health care reform, hospitals will be differentiated in the marketplace by how well they manage the costs of services. Because products will be market priced, hospital materiel managers will have to minimize all other related acquisition costs. The key opportunities will be in changing processes to eliminate non-value added administrative, supply chain, and process activities and their attendant costs.
McCarthy, Mark; Alexanderson, Kristina; Voss, Margaretha; Conceição, Claudia; Grimaud, Olivier; Narkauskaité, Laura; Katreniakova, Zuzana; Saliba, Amanda; Sammut, Marvic
Social innovations can contribute to health and wellbeing. PHIRE (Public Health Innovation and Research in Europe) investigated the impacts at national level of innovation projects funded by the European Union Public Health Programme. Through the European Public Health Association, experts assessed the uptake of the eight public health projects, for 30 European countries. Their reports were assembled by country and, thereafter, national public health associations reviewed the reports. Following stakeholder workshops, or internal and external consultations, 11 national reports were produced which included discussion on the impacts of the public health innovations in national product markets. In 11 countries, there were reports on the eight innovations for 45 (51%) of the possible public health markets. The innovations contributed positively to policy, practice and research, across different levels and in different ways, in 35 (39%) market, while competing innovation activities were recorded in 10 (11%) markets. The workshops also discussed contributing factors and limitations in dissemination and timing for policy cycles. The impacts of European Union social innovations in public health markets can be identified through national discussions. Further attention should be given to understanding drivers and incentives for successful public health innovations.
Kern, T; Kohnen, T
Although many health care reforms have been enacted in the last few years in Germany, many of the key points in the current social health care system have been retained from former times. All those introductions for an effective health care system from the last 150 years beginning with mandatory guild membership via Bismarck's social laws to the modern health care systems in Germany with the current problems of financing the heavy burden in the German budget are reported. Data and facts on the current health care system are provided. In the following two articles of this series ambulatory and inpatient treatment in the light of economic aspects of health care are reported.
Abstract Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good. PMID:28559677
November, Elizabeth A; Cohen, Genna R; Ginsburg, Paul B; Quinn, Brian C
Individual insurance is the only source of health coverage for people without access to employer-sponsored insurance or public insurance. Individual insurance traditionally has been sought by older, sicker individuals who perceive the need for insurance more than younger, healthier people. The attraction of a sicker population to the individual market creates adverse selection, leading insurers to employ medical underwriting--which most states allow--to either avoid those with the greatest health needs or set premiums more reflective of their expected medical use. Recently, however, several factors have prompted insurers to recognize the growth potential of the individual market: a declining proportion of people with employer-sponsored insurance, a sizeable population of younger, healthier people forgoing insurance, and the likelihood that many people receiving subsidies to buy insurance under proposed health insurance reforms would buy individual coverage. Insurers are pursuing several strategies to expand their presence in the individual insurance market, including entering less-regulated markets, developing lower-cost, less-comprehensive products targeting younger, healthy consumers, and attracting consumers through the Internet and other new distribution channels, according to a new study by the Center for Studying Health System Change (HSC). Insurers' strategies in the individual insurance market are unlikely to meet the needs of less-than-healthy people seeking affordable, comprehensive coverage. Congressional health reform proposals, which envision a larger role for the individual market under a sharply different regulatory framework, would likely supersede insurers' current individual market strategies.
Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions
Amick, Benjamin C.; McLeod, Christopher B.; Bultmann, Ute
Current work and health research is fragmented, focusing on jobs, exposures, specific worker groups, work organization, or employment contracts. An emphasis on the labor market in framing the work and health relationship conceptualizes work not only as an exposure that increases or lessens health
Whitelaw, S.; Smart, E.; Kopela, J.; Gibson, T.; King, V.
Purpose: Social marketing is increasingly being seen as a potentially effective means of pursuing health education practice generally and within various specific areas such as mental health and wellbeing and more broadly in tackling health inequalities. This paper aims to report and reflect on the authors' experiences of undertaking a health…
Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them as demands for felt care, good care, private care, and real care. I argue that although these objections cannot stand as good reasons for a general and a priori rejection of AI assistive technolog...
... html To Your Health: NLM update Transcript Four health care challenges : 10/10/2017 To use the sharing ... to follow up on weekly topics. The U.S. health care delivery system needs to address four challenges in ...
Karpf, Michael; Lofgren, Richard; Bricker, Timothy; Claypool, Joseph O; Zembrodt, Jim; Perman, Jay; Higdon, Courtney M
In response both to national pressures to reduce costs and improve health care access and outcomes and to local pressures to become a top-20 public research university, the University of Kentucky moved toward an integrated clinical enterprise, UK HealthCare, to create a common vision, shared goals, and an effective decision-making process. The leadership formed the vision and then embarked on a comprehensive and coordinated planning process that addressed financial, clinical, academic, and operational issues. The authors describe in depth the strategic planning process and specifically the definition of UK HealthCare's role in its medical marketplace. They began a rigorous process to assess and develop goals for the clinical programs and followed the progress of these programs through meetings driven by data and attended by the organization's senior leadership. They describe their approach to working with rural and community hospitals throughout central, eastern, and southern Kentucky to support the health care infrastructure of the state. They review the early successes of their strategic approach and describe the lessons they learned. The clinical successes have led to academic gains. The experience of UK HealthCare suggests that good business practices and good public policy are synergistic.
Full Text Available The world population reached 7 billion in 2012, which is 6 billion more than in 1800. This remarkable population growth is the result of several factors like advances in the medical, technological and public health systems resulting in the control and treatment of communicable diseases, the control of pandemics, the end of large-scale wars, improvements in living conditions and the revolutions in the field of agriculture. Because of all these factors, there has been a considerable improvement in the life expectancy of human beings. There is also an alarming reduction in fertility rates. The combination of declining fertility rate and augmented life expectancies has led to a change in the demographics of the population with the strata of older individuals growing faster than the younger individuals. The aging of populations is poised to become the next global public health challenge. Advances in medicine and socioeconomic development have substantially reduced mortality and morbidity rates due to infectious conditions and, to some extent, non-communicable diseases. These demographic and epidemiological changes, coupled with rapid urbanization, modernization, globalization, and accompanying changes in risk factors and lifestyles, have increased the prominence of chronic non-infective conditions. Health systems need to find effective strategies to extend health care and to respond to the needs of older adults. This review highlights the pathophysiology of aging, biological and physiological changes, impact of aging on health, epidemiological transitions, multi-morbidity in elderly and challenges for health care system.
Crall, James J
National and state-level evidence has documented ongoing disparities in children's health and utilization of oral health care services, prompting a re-examination of factors associated with poor oral health and low use of oral health services. These efforts have yielded a wide array of proposals for improving children's oral health and oral health care delivery. This paper offers a perspective on the current context of efforts to improve children's oral health and oral health care delivery.
Nowak, G; Cole, G; Kirby, S; Freimuth, V; Caywood, C
Influencing consumer behavior is a difficult and often resource-intensive undertaking, with success usually requiring identifying, describing, and understanding target audiences; solid product and/or service positioning relative to competitors; and significant media and communication resources. Integrated marketing communication (IMC) is a new way of organizing and managing persuasive communication tools and functions which involves realigning communications to consider the flow of information from an organization from the viewpoint of end consumers. Although the application of IMC to social marketing remains relatively unexplored, the IMC literature and recent efforts by the US Centers for Disease Prevention and Control suggest that integrated communication approaches have much to offer social marketing and health communication efforts. IMC, IMC and social marketing, and implications of IMC for public and private sector social marketing programs are discussed.
care reform legislation—the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA...Estimated Costs for Compliance Patient Protection and Affordable Care Act (PPACA) and Health Care and Education Reconciliation Act of 2010 (HCERA...including inpatient hospitals, home health agencies, nursing homes, hospice providers, psychiatric hospitals, long-term care hospitals, inpatient
Stiles, R A; Mick, S S; Wise, C G
Health care is, at its core, comprised of complex sequences of transactions among patients, providers, and other stakeholders; these transactions occur in markets as well as within systems and organizations. Health care transactions serve one of two functions: the production of care (i.e., the laying on of hands) or the coordination of that care (i.e., scheduling, logistics). Because coordinating transactions is integral to care delivery, it is imperative that they are executed smoothly and efficiently. Transaction cost economics (TCE) is a conceptual framework for analyzing health care transactions and quantifying their impact on health care structures (organizational forms), processes, and outcomes.
According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…
Bayer, R; Callahan, D; Caplan, A L; Jennings, B
The demands of equity and efficiency require a program of universal health insurance in the United States through which all workers will be provided by their employers with health insurance for themselves and their dependents, unemployment will no longer result in the loss of health insurance protection, and federal standards for Medicaid eligibility will be instituted. Issues raised by the assessment of insurance coverage and establishment of uniform standards are discussed within the context of the ethical foundations of medical necessity, schemes for sharing the burden of cost, and the conflict between technological advances and the limitation of resources. Cost containment measures now most prominently on the public agenda represent an unfortunate trend toward exacerbating inequalities by making the patient the main cost container. Moral priority must be given to remedying the patterns of inequality that characterize the American health care system.
Payton, F C; Ginzberg, M J
Changing business practices, customers needs, and market dynamics have driven many organizations to implement interorganizational systems (IOSs). IOSs have been successfully implemented in the banking, cotton, airline, and consumer-goods industries, and recently attention has turned to the health care industry. This article describes an exploratory study of health care IOS implementations based on the voluntary community health information network (CHIN) model.
Although hospitals are increasingly recognizing the importance of marketing, many have difficulty assimilating what has been primarily an industrial concern into a health care environment. The author explains the function of marketing in health care, the outlook and expectations of a good marketing executive, and why hospital management and the medical staff may have difficulty accepting marketing and the expectations of the marketing executive.
Marzetta, Carol A; Lee, Stephen S; Wrobel, Sandra J; Singh, Kanwarjit J; Russell, Nina; Esparza, José
An effective HIV vaccine will be essential for the control of the HIV pandemic. This study evaluated the potential global market size and value of a hypothetical HIV vaccine and considered clade diversity, disease burden, partial prevention of acquisition, impact of a reduction in viral load resulting in a decrease in transmission and delay to treatment, health care system differences regarding access, and HIV screening and vaccination, across all public and private markets. Vaccine product profiles varied from a vaccine that would have no effect on preventing infection to a vaccine that would effectively prevent infection and reduce viral load. High disease burden countries (HDBC; HIV prevalence > or = 1%) were assumed to routinely vaccinate pre-sexually active adolescents (10 years old), whereas low disease burden countries (LDBC; HIV prevalence rate vaccinate higher risk populations only. At steady state, routine vaccination demand for vaccines that would prevent infection only was 22-61 million annual doses with a potential market value of $210 million to $2.7 billion, depending on the vaccine product profile. If one-time catch-up campaigns were included (11-14 years old for HDBC and higher risk groups for LDBC), the additional cumulative approximately 70-237 million doses were needed over a 10-year period with a potential market value of approximately $695 million to $13.4 billion, depending on the vaccine product profile. Market size and value varied across market segments with the majority of the value in high income countries and the majority of the demand in low income countries. However, the value of the potential market in low income countries is still significant with up to $550 million annually for routine vaccination only and up to $1.7 billion for a one-time only catch-up campaign in 11-14 years old. In the most detail to date, this study evaluated market size and value of a potential multi-clade HIV vaccine, accounting for differences in disease
Business school curricula have traditionally emphasized functional skills for people who will work in functional departments and general management skills for people who will organize interdepartmental work. Recently, some business schools have begun to develop programs that teach cross-functional work and team skills to functional specialists. Students educated in such programs will be well prepared to meet the new challenges that health care organizations will face.
The five leading issues identified, in order of importance, were 1. The need for treatment outcome and efficacy data. 2. The need for changes in clinical and academic preparation of entry-level practitioners. 3. The lack of inclusion or use of services for communication and related disorders in public and private health care programs. 4. The need for greater professional autonomy within the health care system. 5. The need to improve services to underserved populations with communication and related disorders. This report was forwarded to key National Office staff and appropriate ASHA boards, councils, and committees for the purposes of determining its feasibility and developing a national plan for action. The feasibility and action plan will detail completed, ongoing and future activities of the Association related to each issue, recommendation, and strategy. Periodic review of the actions taken and progress achieved will be monitored by the Executive Board, other appropriate boards and councils, and designated National Office staff. The plan represents a progressive view of needed change for the professions of speech-language pathology and audiology within the context of the broader health care delivery system.
Veluchamy, S; Alder, H C
Today's progressive hospital and health care system managers look to new ways to retain or augment their market share and to position themselves in their service areas. Since diffusion of new technologies into health care is market driven, informed decisions on the adoption of certain emerging patient care technologies can place a health care organization in a favorable financial position. There is a compelling need for hospital management and the governing board to collaborate with their medical staff on the development of an acceptable process to quickly identify and implement appropriate new technologies into the patient care environment. This joint effort is vital to ensure the integration of sound clinical values and objectives with planned institutional business strategies. Mount Carmel Health, a multifaceted health care corporation in central Ohio, has met the challenge of managing patient needs, physician interests, and limited hospital resources by forming a unique entity within the organization for the effective assessment and adoption of the latest medical technology. The division, which is called the Advanced Treatment and Bionics Institute (ATBI), is charged with assessing the latest clinical technologies and managing a hospital's adoption of the most appropriate ones. It serves to organize and streamline the identification, acquisition, adoption, and implementation of innovative treatment technologies at Mount Carmel hospitals.
Porter, Michael E; Teisberg, Elizabeth Olmsted
Today's preoccupation with cost shifting and cost reduction undermines physicians and patients. Instead, health care reform must focus on improving health and health care value for patients. We propose a strategy for reform that is market based but physician led. Physician leadership is essential. Improving the value of health care is something only medical teams can do. The right kind of competition--competition to improve results--will drive dramatic improvement. With such positive-sum competition, patients will receive better care, physicians will be rewarded for excellence, and costs will be contained. Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care. Three principles should guide this change: (1) the goal is value for patients, (2) medical practice should be organized around medical conditions and care cycles, and (3) results--risk-adjusted outcomes and costs--must be measured. Following these principles, professional satisfaction will increase and current pressures on physicians will decrease. If physicians fail to lead these changes, they will inevitably face ever-increasing administrative control of medicine. Improving health and health care value for patients is the only real solution. Value-based competition on results provides a path for reform that recognizes the role of health professionals at the heart of the system.
Holland, J Brian; Malvey, Donna; Fottler, Myron D
As health care organizations expand and move into global markets, they face many leadership challenges, including the difficulty of leading individuals who are geographically dispersed. This article provides global managers with guidelines for leading and motivating individuals or teams from a distance while overcoming the typical challenges that "virtual leaders" and "virtual teams" face: employee isolation, confusion, language barriers, cultural differences, and technological breakdowns. Fortunately, technological advances in communications have provided various methods to accommodate geographically dispersed or "global virtual teams." Health care leaders now have the ability to lead global teams from afar by becoming "virtual leaders" with a responsibility to lead a "virtual team." Three models of globalization presented and discussed are outsourcing of health care services, medical tourism, and telerobotics. These models require global managers to lead virtually, and a positive relationship between the virtual leader and the virtual team member is vital in the success of global health care organizations.
U.S. Department of Health & Human Services — The Affordable Care Act (Section 1139B) requires the Secretary of HHS to identify and publish a core set of health care quality measures for adult Medicaid...
Piper, Llewellyn E
Passion in today's health care leaders is essential as health care organizations face increasing demands for survival. Leaders in health care have been educated, selected, promoted, and retained based on their analytical and creativity skills. Today's health care leaders must also have emotional intelligence. Emotional intelligence is primal for passion. Emotional intelligence, which leads to passion, is crucial to the survivability of today's health care organizations. In order for health care organizations to go from good to great, the leader must inspire followers through passion. This article encourages health care leaders to gain awareness of emotional intelligence and to use emotional intelligence as part of their leadership to inspire passion. Through passion, leaders and followers become more motivated to accomplish the health care mission of serving others.
... consider, including What your insurance covers Whether a health care provider or service is accredited The location of a service Hours ... ll find information to help you choose a health care provider or service.
Fowler, Jim; Chevannes, Mel
Nursing is a growing area of higher education, in which an introduction to statistics is an essential component. There is currently a gap in the market for a 'user-friendly' book which is contextulised and targeted for nursing. Practical Statistics for Nursing and Health Care introduces statistical techniques in such a way that readers will easily grasp the fundamentals to enable them to gain the confidence and understanding to perform their own analysis. It also provides sufficient advice in areas such as clinical trials and epidemiology to enable the reader to critically appraise work published in journals such as the Lancet and British Medical Journal. * Covers all basic statistical concepts and tests * Is user-friendly - avoids excessive jargon * Includes relevant examples for nurses, including case studies and data sets * Provides information on further reading * Starts from first principles and progresses step by step * Includes 'advice on' sections for all of the tests described.
Kovacić, L; Sosić, Z
Description and analysis of the present situation of health care system in Croatia, and its characteristics in the transitional process of restructuring. A descriptive method was used. The data from the regular statistical publications were used for the analysis. Croatia is faced with problems similar to those in other countries of the Central and Eastern Europe (CEE), such as control of health expenditure, balancing the development of different segments of health care services, stabilization of effectiveness and quality of care, transition from one-party system to pluralistic democracy, introduction of a free market economy, war devastations, etc. On the other hand, the Croatian experience in the development of a decentralized and integrated primary health care, decentralized health insurance system, education of general/family practitioners, and a tradition in the implementation and development of public health measures, have facilitated and contributed positively to the whole process of transition. In contrast to the economic difficulties, war devastations, and changing the social system, the Croatian health care system proved its stability and sustainability. The highest priority and needs are now related to coping with unhealthy behavior of the population, such as smoking, accidents, physical inactivity, and nutritional problems, which should be solved and controlled by the implementation of preventive programs, organization and management of public health services, and further focusing onto the integrated type of primary health care in the organization of services. Hospital services need more intensive and skilled management, as well as support measures for better quality of work.
This article discusses ways to lesson the restrictions on health development in sub-Saharan Africa caused by limited public health budgets. Health improvements can be funded by the implementation of health insurance, the use of foreign aid, the raising of taxes, the reallocation of public money, and direct contributions by users or households either in the form of charges for services received or prepayments for future services. Community financing, i.e. the direct financing of health care by households in villages or distinct urban communities, is seen as preferable to a national or regional plan. When community financing is chosen, a choice must then be made between direct payment, fee-for-service, and prepayment (insurance) systems. The 3 systems, using the example of an essential drugs program, are described. Theoretically, with direct payment the government receives full cost recovery, and the patients receive the drugs they need, thereby improving their health. Of course the poor may not be able to purchase the drugs, therefore a subsidy system must be worked out at the community level. Fee-for-service means charging for a consultation or course of treatment, including drugs. A sliding scale of fees or discounts for certain types of consultations (e.g. pre-and post natal) can be used. In fee-for-service the risk is shared; because the cost of drugs is financed by the fees, those who receive costly treatments are subsidized by those whose treatments are relatively inexpensive. With prepayment or health insurance the risk of illness is shifted from the patient to the insurance firm or state. 2 issues make insurance plans hard to implement. When patients are covered by insurance, they may demand "too much" medical care (moral hazard) and thus premiums may be too small to cover treatment costs. On the other hand, people in low-risk groups may be unwilling to pay a higher premium, thus leading to adverse selection. Eventually, premiums may rise to the point where
Sturmberg, Joachim P; O'Halloran, Di; Colagiuri, Ruth; Fernandez, Ana; Lukersmith, Sue; Torkfar, Ghazal; Salvador-Carulla, Luis
Framing allows us to highlight some aspects of an issue, thereby bringing them to the forefront of our thinking, talking and acting. As a consequence, framing also distracts our attention away from other issues. Over time, health care has used various frames to explain its activities. This paper traces the emergence of various health care frames since the 1850s to better understand how we reached current ways of thinking and practicing. The succession of the most prominent frames can be summarized as: medicine as a social science; the germ theory of disease; health care as a battleground (or the war metaphor); managing health care resources (or the market metaphor); Health for All (the social justice model); evidence-based medicine; and Obama Care. The focus of these frames is causal, instrumental, political/economic or social in nature. All remain relevant; however, recycling individual past frames in response to current problems will not achieve the outcomes we seek. Placing the individual and his/her needs at the centre (the attractor for the health system) of our thinking, as emphasized by the World Health Organization's International Classification of Function framework and the European Society of Person Centered Health Care, may provide the frame to refocus health and health care as interdependent experiences across individual, community and societal domains. Shifting beyond the entrenched instrumental and economic thinking will be challenging but necessary for the sake of patients, health professionals, society and the economy. © 2014 John Wiley & Sons, Ltd.
Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.
Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of
Cutler, David M.
Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…
Brink-Muinen, A. van den
Differences are investigated between female practice populations of female general practitioners providing women's health care and of women and men general practitioners providing regular health care. Women's health care in the Netherlands is provided in the general practice "Aletta" and is based
Full Text Available There is a well documented health disparity between several European countries and the United States. This health gap remains even after controlling for socioeconomic status and risk factors. At the same time, we note that the U.S. market structure is characterized by significantly more large corporations and "super-sized" retail outlets than Europe. Because big business is hierarchical in nature and has been reported to engender urban sprawl, inferior work environments, and loss of social capital, all identified as correlates of poor health, we suggest that differences in market structure may help account for some of the unexplained differences in health across Europe and North America. Using national level data, this study explores the relationship between market structure and health. We investigate whether individuals who live in countries with proportionately more small business are healthier than those who do not. We use two measures of national health: life expectancy at birth, and age-standardized estimates of diabetes rates. Results from ordinary least squares regressions suggest that, there is a large and statistically significant association between market structure (the ratio of small to total businesses and health, even after controlling income, public percent of health expenditure, and obesity rates. This association is robust to additional controls such as insufficient physical activity, smoking, alcohol disease, and air pollution.
This doctoral thesis presents an analysis of regulated markets especially focusing on the behavior of the actors, the effects of regulatory interventions on market outcome, and the necessity of the regulation itself. With respect to the particular characteristics, three different markets are analyzed: the German market for photovoltaic capacity, the German hospital sector, and the market for health insurance with respect to outpatient care. Chapter two provides an analysis of the German system of feed-in tariffs for photovoltaic power with respect to effectiveness and efficiency. To ensure a certain volume of investment in photovoltaic capacity investors receive fixed feed-in tariffs for 20 years for each unit of energy they feed into the grid. This remuneration is reduced according to a certain cut-off scheme for devices which will be installed in the future. In the past view years, an enormous volume of photovoltaic devices has been installed, especially in the weeks before the cut-offs. To analyze the efficiency and the effectiveness of the German feed-in tariff system, first, the determinants of such investment are analyzed by estimating an Error Correction model. The results of the estimation are used to simulate alternative mechanisms of adjusting the feed-in tariffs and compare them to the current regime in terms of target achievement and social costs. One of the key results is that the current system causes early investments, but does not induce over-investment. Moreover, it is shown that a system of continuously adjusted feed-in tariffs could be more appropriate than the current regime and that the adjustment should be related to the investment costs. In chapter three, the German hospital market which is characterized by regulated treatment fees and several different ownership types is analyzed. This part of the thesis tries to answer the question how the existence of non-profit hospitals influences market outcome and welfare compared to a market where
Eibner, Christine; Saltzman, Evan
The goals of the Affordable Care Act (ACA) are to enable all legal U.S. residents to have access to affordable health insurance and to prevent sicker individuals (such as those with preexisting conditions) from being priced out of the market. The ACA also instituted several policies to stabilize premiums and to encourage enrollment among healthy individuals of all ages. The law's tax credits and cost-sharing subsidies offer a "carrot" that may encourage enrollment among some young and healthy individuals who would otherwise remain uninsured, while the individual mandate acts as a "stick" by imposing penalties on individuals who choose not to enroll. In this article, the authors use the COMPARE microsimulation model, an analytic tool that uses economic theory and data to predict the effects of health policy reforms, to estimate how eliminating the ACA's individual mandate, eliminating the law's tax credits, and combined scenarios that change these and other provisions of the act might affect 2015 individual market premiums and overall insurance coverage. Underlying these estimates is a COMPARE-based analysis of how premiums and insurance coverage outcomes depend on young adults' propensity to enroll in insurance coverage. The authors find that eliminating the ACA's tax credits and eliminating the individual mandate both increase premiums and reduce enrollment on the individual market. They also find that these key features of the ACA help to protect against adverse selection and stabilize the market by encouraging healthy people to enroll and, in the case of the tax credit, shielding subsidized enrollees from premium increases. Further, they find that individual market premiums are only modestly sensitive to young adults' propensity to enroll in insurance coverage, and ensuring market stability does not require that young adults make up a particular share of enrollees.
Aschemann-Witzel, Jessica; Eulert, Federico Jose Armando Perez C.; Niedzwiedzka, Barbara
The social marketing approach – that is to say applying marketing concepts and methods for social purposes – is not yet customary in promoting a balanced diet. Key success factors for communicating health-related information were identified in a case study exploring successful commercial food...... marketing. In a subsequent Delphi expert survey, it was discussed which resources and skills are needed to successfully implement these factors in public campaigns. Most experts advocated their use, but suggested a number of conditions for their responsible use. They discussed public authorities’ strengths...
The development of the public health system between an increasing market orientation (commercialisation) and social responsibility is critically reflected by examining the medical care of those who are deprived. Poverty in Germany is dramatically increasing. There are confirmed findings on the correlation of being poor and being ill. Poverty leads to an increased number of cases of illness and a higher mortality rate. And vice versa, chronic illnesses very often cause impoverishment. This correlation has largely been ignored not only by the public but also by experts, especially when public health-care issues are on the political agenda. With reference to the current discussion about public health-care and the widespread disregard of the living conditions of the poor, the categories of "reasonable behaviour" (Kant) and "communicative behaviour" (Habermas) are reflected on in a philosophical excursion. Further interest groups affecting the political sphere, such as the pharmaceutical industry, the medical profession, patients and scientists are also examined with regard to public health-care. What are the premises of a health-care discussion that is controlled by economic considerations, particularly when keeping in mind the humanistic and Christian ethics of our society? And what does this mean for our responsibility for those who are handicapped and are in need of our help? Do decision makers and participants of the health-care discussion satisfy these ethical challenges? And what are the effects of the so-called "social peace" on social cooperation and economic power of a country? The increasing market orientation (commercialisation) of the public health sector can only be accepted on the basis of practiced humanity and social responsibility. In the light of a human public health-care, deprived people are in need of our solidarity.
Full Text Available The development of Environment Management Systems (EMS commenced as a response to global environmental issues and as a recognition of awareness that sustainable development is prerequisite for keeping the natural system in a proper balance. Transport of dangerous goods by road is quite a complex activity that poses a major potential threat to people and the environment. Therefore, the introduction of certain system tools (standardization of business contributes to a safer and better road transport operations of dangerous goods. Chemical industry combining their efforts for safety and the environment under the Responsible care program (RC. Such efforts have resulted in the development Safety and Quality Assessment System (SQAS to assess the haulers. This paper presents tools standardization of business as an opportunity to improve the market positions of dangerous goods haulers.
Full Text Available The development of Environment Management Systems (EMS commenced as a response to global environmental issues and as a recognition of awareness that sustainable development is prerequisite for keeping the natural system in a proper balance. Transport of dangerous goods by road is quite a complex activity that poses a major potential threat to people and the environment. Therefore, the introduction of certain system tools (standardization of business contributes to a safer and better road transport operations of dangerous goods. Chemical industry combining their efforts for safety and the environment under the Responsible care program (RC. Such efforts have resulted in the development Safety and Quality Assessment System (SQAS to assess the haulers. This paper presents tools standardization of business as an opportunity to improve the market positions of dangerous goods haulers.
Luca, Nadina Raluca; Suggs, L Suzanne
The existing literature suggests that theories and models can serve as valuable frameworks for the design and evaluation of health interventions. However, evidence on the use of theories and models in social marketing interventions is sparse. The purpose of this systematic review is to identify to what extent papers about social marketing health interventions report using theory, which theories are most commonly used, and how theory was used. A systematic search was conducted for articles that reported social marketing interventions for the prevention or management of cancer, diabetes, heart disease, HIV, STDs, and tobacco use, and behaviors related to reproductive health, physical activity, nutrition, and smoking cessation. Articles were published in English, after 1990, reported an evaluation, and met the 6 social marketing benchmarks criteria (behavior change, consumer research, segmentation and targeting, exchange, competition and marketing mix). Twenty-four articles, describing 17 interventions, met the inclusion criteria. Of these 17 interventions, 8 reported using theory and 7 stated how it was used. The transtheoretical model/stages of change was used more often than other theories. Findings highlight an ongoing lack of use or underreporting of the use of theory in social marketing campaigns and reinforce the call to action for applying and reporting theory to guide and evaluate interventions.
Mahdavi, Gh; Izadi, Z
Existence or non-existence of adverse selection in insurance market is one of the important cases that have always been considered by insurers. Adverse selection is one of the consequences of asymmetric information. Theory of adverse selection states that high-risk individuals demand the insurance service more than low risk individuals do. The presence of adverse selection in Iran's supplementary health insurance market is tested in this paper. The study group consists of 420 practitioner individuals aged 20 to 59. We estimate two logistic regression models in order to determine the effect of individual's characteristics on decision to purchase health insurance coverage and loss occurrence. Using the correlation between claim occurrence and decision to purchase health insurance, the adverse selection problem in Iranian supplementary health insurance market is examined. Individuals with higher level of education and income level purchase less supplementary health insurance and make fewer claims than others make and there is positive correlation between claim occurrence and decision to purchase supplementary health insurance. Our findings prove the evidence of the presence of adverse selection in Iranian supplementary health insurance market.
Shimada, Stephanie L; Zaslavsky, Alan M; Zaborski, Lawrence B; O'Malley, A James; Heller, Amy; Cleary, Paul D
Risk selection in the Medicare managed care program ("Medicare Advantage") is an important policy concern. Past research has shown that Medicare managed care plans tend to attract healthier beneficiaries and that market characteristics such as managed care penetration may also affect risk selection. To assess whether patient enrollment in Medicare managed care (MMC) or traditional fee-for-service (FFS) Medicare is related to beneficiary and market characteristics and provide a baseline for understanding how changes in Medicare policy affect MMC enrollment over time. Data sources were the 2004 Medicare MMC and FFS CAHPS surveys, the Social Security Administration's Master Beneficiary Record, MMC Market Penetration Files, and 2000 Census data. We estimated logistic regression models to assess what beneficiary characteristics predict enrollment in MMC and the moderating effects of market characteristics. Enrollees in MMC plans tend to have better health than those in FFS. This effect is weaker in areas with more competition. Latinos and beneficiaries with less education and lower income, as indicated by earnings history or local-area median income, are more likely to enroll in MMC. Enrollment in MMC is related to beneficiary characteristics, including health status and socioeconomic status, and is modified by MMC presence in the local market. Because vulnerable subgroups are more likely to enroll in MMC plans, the Centers for Medicare & Medicaid Services should monitor how changes to Medicare Advantage policies and payment methods may affect beneficiaries in those groups.
Prasad, Banuru Muralidhara; Varatharajan, D
Modern lifestyle changes led to increased dental care needs in India. Consequently, there has been a sharp rise in dentist numbers. Karnataka state alone produces 2,500 dentists annually, who are engaged in the non-government sector owing to inadequate public sector opportunities. This article aims to assess Karnataka private dental clinic quality and efficiency. Dentists were interviewed using a close-ended, structured interview schedule and their clinics were assessed using a checklist adopted from guidelines for providing machinery and equipment under the National Oral Health Care Programme (NOHCP). Dental "hotel" and clinical quality were scored based on this checklist. Clinical quality was "excellent" in 12 per cent of clinics and poor in 49 per cent. Clinics with better infrastructure charged higher price (p value for money and to achieve break-even points thereby providing quality care in a competitive market. Factors that influence dental practitioner behaviour are evaluated.
Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision
Wees, P.J. van der; Zaslavsky, A.M.; Ayanian, J.Z.
CONTEXT: Massachusetts enacted health care reform in 2006 to expand insurance coverage and improve access to health care. The objective of our study was to compare trends in health status and the use of ambulatory health services before and after the implementation of health reform in Massachusetts
Kimmey, James R.
A discussion of the implications of health care reform for academic health centers (a complex of institutions which educate health professionals) looks at problems in the current system, the role of academic health centers in the current system, financial pressures, revenue sources other than patient care, impact on health research, and human…
The main objective was to estimate sector wide disease speciﬁc cost of health care intervention at health ... [Afr J. Health Sci. 2002; 9: 69-79]. Introduction interest in the costs of health care interventions derives from the desire to undertake economic evaluation that are input in health .... accounting procedure. It is based on ...
The growth in undocumented immigration in the United States has garnered increasing interest in the arenas of immigration and health care policy reform. Undocumented immigrants are restricted from accessing public health and social service as a result of their immigration status. The Patient Protection and Affordability Care Act restricts undocumented immigrants from participating in state exchange insurance market places, further limiting them from accessing equitable health care services. This commentary calls for comprehensive policy reform that expands access to health care for undocumented immigrants based on an analysis of immigrant health policies and their impact on health care expenditures, public health, and the role of health care providers. The intersectional nature of immigration and health care policy emphasizes the need for nurse policymakers to advocate for comprehensive policy reform aimed at improving the health and well-being of immigrants and the nation as a whole. © The Author(s) 2014 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.
López-Manning, Mauricio; García-Díaz, Rocío
In 2010 Mexican health authorities enacted an antibiotic sale, prescription, and dispensation bill that increased the presence of a new kind of ambulatory care provider, the doctors adjacent to private pharmacies (DAPPs). To analyze how DAPPs' presence in the Mexican ambulatory care market has modified health care seekers' behavior following a two-stage health care provider selection decision process. The first stage focuses on individuals' propensity to captivity to the health care system structure before 2010. The second stage analyzes individuals' medical provider selection in a health system including DAPPs. This two-stage process analysis allowed us not only to show the determinants of each part in the decision process but also to understand the overall picture of DAPPs' impact in both the Mexican health care system and health care seekers, taking into account conditions such as the origins, evolution, and context of this new provider. We used data from individuals (N = 97,549) participating in the Mexican National Survey of Health and Nutrition in 2012. We found that DAPPs have become not only a widely accepted but also a preferred option among the Mexican ambulatory care providers that follow no specific income-level population user group (in spite of its original low-income population target). Our results showed DAPPs as an urban and rapidly expanded phenomenon, presumably keeping the growing pace of new communities and adapting to demographic changes. Individuals opt for DAPPs when they look for health care: in a nearby provider, for either the most recent or common ailments, and in an urban setting; regardless of most socioeconomic background. The relevance of location and accessibility variables in our study provides evidence of the role taken by this provider in the Mexican health care system. Copyright © 2017. Published by Elsevier Inc.
Udvarhelyi, I S; Relman, A S; Binder, G M; Spence, R K; Kennedy, E M; Grossman, J H; Termeer, H A; Raines, L J; Marincola, E; Pyle, T O
In "Making Competition in Health Care Work" (July-August 1994), Elizabeth Olmsted Teisberg, Michael E. Porter, and Gregory B. Brown ask a question that has been absent from the national debate on health care reform: How can the United States achieve sustained cost reductions while at the same time maintaining quality of care? The authors argue that innovation driven by rigorous competition is the key to successful reform. A lasting cure for health care in the United States should include four basic elements: corrected incentives to spur productive competition, universal insurance to secure economic efficiency, relevant information to ensure meaningful choice, and innovation to guarantee dynamic improvement. In this issue's Perspectives section, eleven experts examine the current state of the health care system and offer their views on the shape that reform should take. Some excerpts: "On the road to innovation, let us not forget to develop the tools that allow physicians, payers, and patients to make better decisions." I. Steven Udvarhelyi; "Health care is not a product or service that can be standardized, packaged, marketed, or adequately judged by consumers according to quality and price." Arnold S. Relman; "Just as antitrust laws are the wise restraints that make competition free in other sectors of the economy, so the right kind of managed competition can work well in health care." Edward M. Kennedy "Biomedical research should be considered primarily an investment in the national economic well-being with additional humanitarian benefits." Elizabeth Marincola.
Deutsch, Stephanie Anne; Fortin, Kristine
Children and adolescents in foster care placement represent a unique population with special health care needs, often resulting from pre-placement early adversity and neglected, unaddressed health care needs. High rates of all health problems, including acute and/or chronic physical, mental, and developmental issues prevail. Disparities in health status and access to health care are observed. This article summarizes the physical health problems of children in foster care, who are predisposed to poor health outcomes when complex care needs are unaddressed. Despite recognition of the significant burden of health care need among this unique population, barriers to effective and optimal health care delivery remain. Legislative solutions to overcome obstacles to health care delivery for children in foster care are discussed. Copyright © 2015 Mosby, Inc. All rights reserved.
Glassman, Amanda; Giedion, Ursula; McQueston, Kate
The use of health technology assessment research in emerging economies is becoming an increasingly important tool to determine the uses of health spending. As low- and middle-income countries' gross domestic product grows, the funding available for health has increased in tandem. There is growing evidence that comparative effectiveness research and cost-effectiveness can be used to improve health outcomes within a predefined financial space. The use of these evaluation tools, combined with a systematized process of priority setting, can help inform national and global health payers. This review of country institutions for health technology assessment illustrates two points: the efforts underway to use research to inform priorities are widespread and not confined to wealthier countries; and many countries' efforts to create evidence-based policy are incomplete and more country-specific research will be needed. Further evidence shows that there is scope to reduce these gaps and opportunity to support better incorporation of data through better-defined priority-setting processes.
Ejaz, Iram; Shaikh, Babar Tasneem
According to the World Health Organization and the United Nations Children's Fund, developing countries carry a large share of neonatal mortality in the world. According to UNICEF, almost 450 newborn children die every hour, mostly from preventable causes. Restricted access to quality and hygienic delivery services and limited knowledge about handling the newborn aggravate the situation. South Asia, and Pakistan in particular, have reduced their child and infant mortality during the last decade; however, neonatal mortality still remains unacceptably high. There are multiple reasons, mainly related to practices and behaviours of communities and traditional birth attendants. Rural and poor populations suffer most in Pakistan, where three out of five deliveries still occur at home. Traditional community practices and conservative norms drastically affect neonatal health outcomes. Preventing sepsis at the umbilical cord, keeping the baby at the correct temperature after birth and early initiation of exclusive breastfeeding are three simple strategies or messages that need to be disseminated widely to prevent many neonatal mortalities and morbidities. Since inappropriate practices in handling newborns are directly linked with persistent and unremitting behaviours among health providers and the community at large, we suggest doing robust "social marketing" for saving newborn lives. The objective of the paper is to present a social-marketing strategy and a marketing mix that will help address and surmount actual barriers and promote alternative behaviours in early neonatal care.
Context: Health care at the primary level is accepted as the model for delivering basic health care to low income populations especially in developing countries such as Nigeria. Despite all the efforts and strategiesadapted in Nigeria, there is still high level of morbidity and mortality from the diseases primary health care ...
Irwin, Charles E., Jr., Ed.; And Others
Health care reform represents a major step toward achieving the goal of improved preventive and primary care services for all Americans, including children and adolescents. Adolescence is a unique developmental age district from both childhood and adulthood with special vulnerabilities, health concerns, and barriers to accessing health care. It is…
Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...
Maria Cristina Barbaro
Full Text Available OBJECTIVE: evaluate prenatal care for adolescents in health units, in accordance with the attributes of Primary Health Care (PHC guidelines. METHOD: quantitative study conducted with health professionals, using the Primary Care Assessment Tool-Brazil to assess the presence and extent of PHC attributes. RESULTS: for all the participating units, the attribute Access scored =6.6; the attributes Longitudinality, Coordination (integration of care, Coordination (information systems and Integrality scored =6.6, and the Essential Score =6.6. Comparing basic units with family health units, the attribute scores were equally distributed; Accessibility scored =6.6, the others attributes scored =6.6; however, in the basic units, the Essential Score was =6.6 and, in the family health units, =6.6. CONCLUSION: expanding the coverage of family health units and the training of professionals can be considered strategies to qualify health care.
Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja
The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services.
Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon
Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. Copyright © 2015 Elsevier Ltd. All rights reserved.
M.Cur. (Nursing Administration) With the Declaration of Alma Ata in September, 1978, a new era in health care delivery, the primary health care era with its slogan of "health for all by the year 2000' dawned. Much thought had to be put into new legislation and reorganizing of health services in South Africa. Soweto, devastated by riots in 1976, suffered badly when all health care services collapsed. Out of this crisis was born a primary health care service that provides Soweto with prevent...
Laugesen, Miriam J; France, George
Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations.
Sorrell, Jeanne M
Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.
... available at a drop-in clinic. Some large companies provide access to virtual doctors' offices as a ... https://www.niddk.nih.gov/health-information/health-communication-programs/ndep/health-care-professionals/practice-transformation/information- ...
J.J.M. Barendregt (Jan); L.G.A. Bonneux (Luc); P.J. van der Maas (Paul)
textabstractBACKGROUND: Although smoking cessation is desirable from a public health perspective, its consequences with respect to health care costs are still debated. Smokers have more disease than nonsmokers, but nonsmokers live longer and can incur more health costs
U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...
... Groups Health and Wellness Outreach Materials Posters Safety Gun Safety Medication Safety Reproductive Health Healthy Pregnancy Preconception ... where specific authority is given to VA by law. Contact your nearest VA health care facility (found ...
Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes
.... The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health...
Health care reform efforts have increasingly emphasized payment models that reward value (quality/cost). It seems appropriate, therefore, to examine what we value in health care, and that will require that we examine our definition of health. In spite of admonitions from the World Health Organization and others, our current health care system operates under the assumption that health represents the absence of health problems. While that perspective has led to incredible advances in medical science, it now may be adversely affecting value. Problem-oriented care is clearly one of the drivers of rising costs and it could be adversely affecting the quality of care, depending upon how quality is defined. If we redefined health in terms of patient-centered goals, health care could be focused more directly on meaningful outcomes, reducing the number of irrelevant tests and treatments. Greater emphasis would be placed on prevention, meaningful activities, advance directives and personal growth and development. The role of patients within clinician-patient relationships would be elevated, strengthening therapeutic relationships. Reframing health in terms of health-related goals and directing the health care system to help people achieve them, could both improve quality and reduce costs. In the process, it could also make health care less mechanical and more humane.
Nayeri, Kamran; López-Pardo, Cándido M
This article explores the effects on access to health care in Cuba of the severe economic crisis that followed the collapse of the Soviet Union and the monetary and market reforms adopted to confront it. Economic crises undermine health and well-being. Widespread scarcities and self-seeking attitudes fostered by monetary and market relations could result in differential access to health services and resources, but the authors found no evidence of such differential access in Cuba. While Cubans generally complain about many shortages, including shortages of health services and resources before the economic recovery began in 1995, no interviewees reported systemic shortages or unequal access to health care services or resources; interviewees were particularly happy with their primary care services. These findings are consistent with official health care statistics, which show that, while secondary and tertiary care suffered in the early years of the crisis because of interruptions in access to medical technologies, primary care services expanded unabated, resulting in improved health outcomes. The combined effects of the well-functioning universal and equitable health care system in place before the crisis, the government's steadfast support for the system, and the network of social solidarity based on grassroots organizations mitigated the corrosive effects of monetary and market relations in the context of severe scarcities and an intensified U.S. embargo against the Cuban people.
Bystedt, Maria; Eriksson, Maria; Wilde-Larsson, Bodil
To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Oster, J; Melches, J
The members of the Bundesarbeitsgemeinschaft Künstlerische Therapien (BAG KT - "Working Committee of Art Therapies of the Federal Republic of Germany") decided to carry out an analysis of the occupational group of art therapists, in the form of an online inquiry. For this purpose, a questionnaire covering all fields of art therapies was developed, recording socio-demographic and qualification data, data of different fields of activity, patient characteristics, institutional conditions and setting as well as data on reimbursement. 2303 evaluable data sets are available. Here, the main focus is on art therapists in the health care sector according to SGB (N=2134). 83% of them are female, 56% work in the field of emergency medicine and curative treatment, followed by rehabilitation and youth welfare. In all sectors, specialization in music and art therapy predominates. 57% of the therapists have a special graduate degree in art therapy methods, 83% have a graduate degree. 42% have a license to work as an alternative non-medical practitioner. Nearly all of them use methods of quality management. The results highlight the implementation of art therapies in health care. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available The increasing use of natural rubber latex medical gloves in the last three decades has caused an increase in latex allergy. The majority of risk groups for allergy development include health care workers, workers in the rubber industry, atopic individuals and children with congenital malformations. Three types of pathological reactions can occur in people using latex medical gloves: irritant contact dermatitis, allergic contact dermatitis and immediate hypersensitivity. The latex allergy is caused by constituent components of latex gloves and added powders; there are also numerous latex allergens involved in cross-reactivity between latex and fruits and vegetables, the so-called latex-fruit syndrome. The diagnosis is based on an accurate history of exposure, clinical presentation and confirmatory in vivo and in vitro tests. Prevention is the easiest, most effective and least expensive way to avoid latex allergy. Powder-free latex gloves with reduced levels of proteins and chemicals, and synthetic gloves for allergic workers must be provided in the work environment. There are already many health care institutions around the world where all latex products have been replaced by synthetic material products.
We in health care are living and working in a world that, for all its technical changes, differs little in its basic assumptions, structures, payment systems, beliefs, expectations, and job titles from the world of health care a generation back. How much change can we expect over the coming years? A lot more than we are prepared for. Look at the array of new technologies headed our way, from genomic sciences to customized vaccinations. Many of the breakthroughs promise incredible abilities to prevent disease, to profile our proclivities, and to manage our genetic predispositions over long periods of time, rather than merely wait until the disease manifests in an acute phase, then treat the symptoms. Digital technologies bring physicians executives enormous opportunities for new ways of gathering, storing, and mining information, for new types of communication between medical professionals, for new communications with customers, and new ways of steering large, complex enterprises. Unprecedented opportunities for change keep piling in through the door. Vast pressures for change keep building from every side. And the rewards for anyone who can lead the change keep compounding.
American health care organizations are experiencing increasing change driven by emerging partnerships, market demographics, population health initiatives, and merger and acquisition trends. The health care business environment necessitates alterations in how companies operate on a larger scale. New regional leadership roles are being created to provide leadership to systematize networks, build market share, and strengthen market needs. It is important and necessary to explore, review, and contrast the roles, skills, and behaviors of regional leader's roles and the solo organization leaders. It is also imperative to review the benefits of new affiliations for the community and hospital entity.
Das, Biswa R.; Leatherman, John C.; Bressers, Bonnie M.
The Internet has potential for improving health information delivery and strengthening connections between rural populations and local health service providers. An exploratory case study six rural health care markets in Kansas showed that about 70% of adults use the Internet, with substantial use for accessing health information. While there are…
Full Text Available The significant gap between the quality of life and the level of health expenditure has led to the need to reconsider the modalities and the sources of collecting and redirecting the funds of the sanitary sector in such a way that sustainable medical results are generated for the entire population of the globe. Under these circumstances, the role of private health insurance is constantly increasing, even though its importance is still being influenced by the types of social policy and the dimension of the public health sector at national level. Due to the impact of these factors, the actual dimension of private health insurance market varies significantly across countries. In order to be able to realistically assess the level of development of the private health insurance market in Romania, the analysis has to be taken further than the simplistic measurement of indicators such as income and expenditure.
Nadezhda K. Serdyukova
Full Text Available The article considers major characteristics of Sochi market as a health tourism destination, analyses the structure of resort collective accommodation facilities, dynamics of tourist flows and their structure, prevailing kinds of tourism and estimates tourist flows of health tourism in Sochi in 2008-2012. The authors indicate major characteristics and trends of Sochi tourist market development and the prospects of Sochi development as a health tourism destination. The percent of health tourist flow in the general tourist flow of Sochi and the percent of domestic tourist flow in the sector of collective accommodation facilities are estimated. The authors came to the conclusion that to develop tourism in Sochi in post-Games period, it is necessary to promote Sochi as a health tourism destination.
Séror, Ann C
The Internet and telecommunications technologies contribute to national health care system infrastructures and extend global health care services markets. The Cuban national health care system offers a model to show how a national information portal can contribute to system integration, including research, education, and service delivery as well as international trade in products and services. The objectives of this paper are (1) to present the context of the Cuban national health care system since the revolution in 1959, (2) to identify virtual institutional infrastructures of the system associated with the Cuban National Health Care Telecommunications Network and Portal (INFOMED), and (3) to show how they contribute to Cuban trade in international health care service markets. Qualitative case research methods were used to identify the integrated virtual infrastructure of INFOMED and to show how it reflects socialist ideology. Virtual institutional infrastructures include electronic medical and information services and the structure of national networks linking such services. Analysis of INFOMED infrastructures shows integration of health care information, research, and education as well as the interface between Cuban national information networks and the global Internet. System control mechanisms include horizontal integration and coordination through virtual institutions linked through INFOMED, and vertical control through the Ministry of Public Health and the government hierarchy. Telecommunications technology serves as a foundation for a dual market structure differentiating domestic services from international trade. INFOMED is a model of interest for integrating health care information, research, education, and services. The virtual infrastructures linked through INFOMED support the diffusion of Cuban health care products and services in global markets. Transferability of this model is contingent upon ideology and interpretation of values such as individual
Hudak, Ronald P; Russell, Rebecca; Toland, P Paul
The evolution of governance models for the Military Health System's (MHS) large hospitals, called medical treatment facilities (MTFs), has culminated with the effort to implement Enhanced Multi-Service Markets (eMSM). The term eMSM refers to two separate concepts. First, MSM refers to those geographic areas, that is, markets, which have the following characteristics: they have MTFs that are operated by two or more Department of Defense (DoD) Services, that is, Army, Navy, or Air Force; there is a large beneficiary population; there is a substantial amount of direct care (i.e., beneficiaries are treated at MTFs instead of TRICARE's purchased care from civilian providers); and there is a substantial readiness and training platform. Second, the term "enhanced" refers to an increase in management authority over clinical and business operations, readiness, and MTF workload. A retrospective review was conducted to study the evolution of military and civilian health care delivery models for the purpose of understanding how governance models have changed since the 1980s to design and manage MTFs with overlapping catchments areas. Primary and secondary data sources were analyzed through a comprehensive literature review. Since the 1980s, the MHS governance models have evolved from testing various managed care models to a regionally focused TRICARE model and culminating with an overlapping catchment area model entitled eMSMs. The eMSM model partially fulfills the original vision because the eMSM leaders have limited budgetary and resource allocation authority. The various models sought to improve governance of overlapping catchment areas with the intent to enhance medical readiness, community health, and individual health care while reducing costs. However, the success of the current model, that is, eMSMs, cannot be fully assessed because the eMSM model was not fully implemented as originally envisioned. Instead, the current eMSM model partially implements the eMSM model. As
Ngunyulu, R N; Peu, M D; Mulaudzi, F M; Mataboge, M L S; Phiri, S S
Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care. © 2017 International Council of Nurses.
... U.S. Department of Health and Human Services Indian Health Service The Federal Health Program for American Indians and ... map can be used to find an Indian Health Service, Tribal or Urban Indian Health Program facility. This ...
Bryant, Carol A; Mayer, Alyssa B; McDermott, Robert J; Panzera, Anthony D; Trainor, John K
Social marketing applies some of the same principles used in commercial marketing for the analysis, planning, execution, and evaluation of programs designed to motivate voluntary behavioral change. It relies on consumer research for understanding the people they hope to change, including their values, aspirations, fears, lifestyle, and factors that motivate and deter them from adopting desired behaviors. Social marketing has been applied in public health settings since the 1980s for promoting such behaviors as safer sex, hypertension and cholesterol control, reduced occurrence of alcohol-impaired driving, improved utilization of public health prevention and screening services, and enactment of better school nutrition policies in schools. Although most evidence for social marketing's utility comes from interventions directed at adult audiences, its application with adolescents may help to address issues that have been challenging or unresponsive to health behavior change specialists. This article describes the basic tenets of social marketing as a behavior change process, identifies its previously successful applications with adolescent audience segments, and offers both lessons learned and projected future applications that employ emerging communication technologies.
Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them
Background: The National Health Insurance Scheme (NHIS) was formally launched in Nigeria in 2005 as an option to help bridge the evident gaps in health care financing, with the expectation of it leading to significant improvement in the country's dismal health status indices. Primary Health Care (PHC) is the nation's ...
Murphy, John W
Primary health care has received a lot of attention since the Alma Ata Conference, convened by the World Health Organization in 1978. Key to the strategy to improve health care outlined at the Alma Ata conference is citizen participation in every phase of service delivery. Although the goals of primary health care have not been achieved, the addition of narrative medicine may facilitate these ends. But a new epistemology is necessary, one that is compatible with narrative medicine, so that local knowledge is elevated in importance and incorporated into the planning, implementation, and evaluation of health programs. In this way, relevant, sustainable, and affordable care can be provided. The aim of this article is to discuss how primary health care might be improved through the introduction of narrative medicine into planning primary health care delivery.
Niiranen, S; Lamminen, H; Mattila, H; Niemi, K; Kalli, S
Personal health care has obtained increasing importance in the field of health care as the populations' age in the industrialised countries and resources available for health care remain limited. Personal health care through digital television is an exiting possibility in the realisation of new types of services answering to this demand for increased personal action and responsibility in health care. The possibilities of digital television in health care are studied in the Health Care Television (HCTV) research project of the Digital Media Institute at Tampere University of Technology. In this paper personal health care services are studied mainly from the perspective of the interactive service infrastructure of digital television. Firstly we present the general infrastructure of digital television and the different interactive service types of digital television. The usage of these service types in personal health care applications is also discussed. Finally, a web-based application based on chronic atrial fibrillation and its test use is presented. The application is used as a research platform for personal health care applications in digital television.
Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of
Stöver, Heino; Wolff, Hans
Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners. PMID:22390510
Pont, Jörg; Stöver, Heino; Wolff, Hans
Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners.
Naidu, G M; Narayana, C L
The role of marketing in a health care facility has been a focus of discussion during the past decade. Varied opinions have been expressed about the purpose and contribution of marketing within the health care industry. The authors empirically investigate (1) the extent of marketing orientation in hospitals, (2) the degree of marketing orientation as it relates to hospital characteristics, and (3) the relationship of marketing orientation to hospital performance.
Gawaine Powell Davies
Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.
Lundqvist, Pontus; Mathson, Anton
Elderly nowadays stay longer in their own home. This raises the standards on home care service to contribute to the maintenance of elderly’s general and oral health. Our objective is therefore to explore attitudes about how home care workers view oral health care and the importance of good oral health for elderly clients. 8 subjects (22 to 61 years of age) were selected for the study working in home care service, which all gave their informed consent. Semi-structured interviews were performed...
3 Austin, V. Medical Data Bases Patient Administration Systems and Biostatistics Activity (PAS&BA) (1986). In Proceedings, 198 AMEDD Forensic ...Health Care Administration, Baylor University, Waco , TX MEMBERSHIP: American Dietetic Association Phi Kappa Phi CERTIFICATION: Registered Dietitian...1986). Proceedings, 1985 AMEDD Forensic Psychology Symrosium, San Antonio, TX: U.S. Army Health Care Studies and Clinical Investigation Activity
Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A
Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt. In 1933, Franklin D. Roosevelt, a Democrat, included a publicly funded health care program while drafting provisions to Social Security legislation, which was eliminated from the final legislation. Subsequently, multiple proposals were introduced, starting in 1949 with President Harry S Truman who proposed universal health care; the proposal by Lyndon B. Johnson with Social Security Act in 1965 which created Medicare and Medicaid; proposals by Ted Kennedy and President Richard Nixon that promoted variations of universal health care. presidential candidate Jimmy Carter also proposed universal health care. This was followed by an effort by President Bill Clinton and headed by first lady Hillary Clinton in 1993, but was not enacted into law. Finally, the election of President Barack Obama and control of both houses of Congress by the Democrats led to the passage of the Affordable Care Act (ACA), often referred to as "ObamaCare" was signed into law in March 2010. Since then, the ACA, or Obamacare, has become a centerpiece of political campaigning. The Republicans now control the presidency and both houses of Congress and are attempting to repeal and replace the ACA. Key words: Health care reform, Affordable Care Act (ACA), Obamacare, Medicare, Medicaid, American Health Care Act.
Williams, Roberta G; Lu, Yang
Our cardiology community is responding to the growing number of emerging adults with often complex congenital heart disease. Collaborations are springing up between adult and pediatric cardiologists, advanced practice nurses, patients, and families to address the health care, research, and advocacy needs for this population. Workforce and institutional needs are being defined and research collaborations are being formed. Meanwhile, health care reform is evolving through fits and starts with little predictability regarding its medium and long-term impact. Since ultimately finances trump philosophy, it is essential that we understand the financial underpinnings of healthcare delivery to patients with this unique model of chronic disease in order to carry out these plans. What is unique about this population with chronic disease? The most obvious feature is that they have the potential of contributing to the GDP for 40+ years. Another is that for the more complex lesions, society has already invested a considerable amount to achieve survival into adult life. Finally, the period of early adulthood is relatively uneventful in terms of complications and resource utilization compared with early childhood and later adult life. Thus, the basic needs to maintain cardiovascular status and prevent secondary disability may be modest in comparison with treating some of the severe consequences of their disease, such as poorly managed valve regurgitation or arrhythmia that eventually requires costly solutions such as transplantation. It is important, therefore, to define the resource requirements and potential health outcomes of a healthcare system that would be designed for this population.
Bracke, Piet; van de Straat, Vera; Missinne, Sarah
Higher-educated people experience enhanced mental health. We ponder whether the mental health benefits of educational attainment are limitless. At the individual level, we look at the impact of job-education mismatch. At the societal level, we hypothesize that diminishing economic returns on education limit its mental health benefits. Using a subsample of individuals aged 20 to 65 years (N = 28,288) from 21 countries in the European Social Survey (ESS 2006), we estimate the impact on depressive symptoms of characteristics at both the employee level (years of education and job-education mismatch) and the labor market/country level (the gap between the nontertiary and tertiary educated in terms of unemployment risks and earnings). The results show that educational attainment produces mental health benefits in most European countries. However, in some of the countries, these benefits are limited or even completely eliminated by education-labor market misfit. © American Sociological Association 2014.
Lehmann, Hartmut; Wadsworth, Jonathan
Using longitudinal data from Ukraine we examine the extent of any long-lasting effects of exposure to the Chernobyl disaster on the health and labour market performance of the adult workforce. Variation in the local area level of radiation fallout from the Chernobyl accident is considered as a random exogenous shock with which to try to establish its causal impact on poor health, labour force participation, hours worked and wages. There appears to be a significant positive association between local area-level radiation dosage and perception of poor health, though much weaker associations between local area-level dosage and other specific self-reported health conditions. There is also some evidence to suggest that those who lived in areas more exposed to Chernobyl-induced radiation have significantly lower levels of labour market performance 20 years on. Copyright © 2011 Elsevier B.V. All rights reserved.
Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.
Schaeffer, Leonard D
Rising health care costs have been an issue for decades, yet federal-level health care reform hasn't happened. Support for reform, however, has changed. Purchasers fear that health care cost growth is becoming unaffordable. Research on costs and quality is questioning value. International comparisons rank the United States low on important health system performance measures. Yet it is not these factors but the unsustainable costs of Medicare and Medicaid that will narrow the window for health care stakeholders to shape policy. Unless the health care system is effectively reformed, sometime after the 2008 election, budget hawks and national security experts will eventually combine forces to cut health spending, ultimately determining health policy for the nation.
Abstract Consumers, when buying health insurance, do not know the exact value of each treatment that they buy coverage for. This leads them to overvalue some treatments and undervalue others. We show that the insurance market cannot correct these mistakes. This causes research labs to overinvest in
Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G
A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.
Beasley, J.W.; Starfield, B.; Weel, C. van; Rosser, W.W.; Haq, C.L.
A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in
be greater.'4-'6. The broad view. Many factors contribute to one's health: quality and quantity of food, shelter, plumbing, living habits and genetics. What individuals do to themselves and what risks they take determine their relationships with health care professionals and are the foundation of the demand for health care.
Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers' education on clinical patient outcomes was ...
Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes
Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…
Y.G. Pillay; H. Subedar
This paper considers indications and obstacles for the development of primary mental health care practice in both developed and under-developed countries. Both are considered as this represents the South African reality. While a significant body of literature has documented the need for primary mental health care, the obstacles (especially in terms of the commodification of health) to its fruition are seldom addressed.
Günzel-Jensen, Franziska; Jain, Ajay K.; Kjeldsen, Anne Mette
Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal, i.e. transformational, transactional...... and empowering, leadership styles affect employees’ perceived agency in distributed leadership, and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show...... that all leadership styles had a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related negatively to employees’ perceived agency in distributed leadership; however a mediatory impact of this on the formal leadership styles...
Greiner, Mary V; Beal, Sarah J
In 2012, the Comprehensive Health Evaluations for Cincinnati's Kids (CHECK) Center was launched at Cincinnati Children's Hospital Medical Center to provide health care for over 1,000 children placed into foster care each year in the Cincinnati community. This consultation model clinical program was developed because children in foster care have been difficult to manage in the traditional health care setting due to unmet health needs, missing medical records, cumbersome state mandates, and transient and impoverished social settings. This case study describes the history and creation of the CHECK Center, demonstrating the development of a successful foster care health delivery system that is inclusive of all community partners, tailored for the needs and resources of the community, and able to adapt and respond to new information and changing systems.
Brunt, Tibor M.; van Laar, Margriet; Niesink, Raymond J. M.; van den Brink, Wim
A major component of the illicit drug market can be subcategorized as the psychostimulant drug market, with cocaine and amphetamine as popular constituents. In The Netherlands, an increase in both health care outcomes addiction treatment and hospital admissions was noted for both amphetamine and
Houssemand, Claude; Meyers, Raymond
Labour market variables may moderate the link between unemployment and mental health, as has been found in numerous research papers. The aim of this study was to test, in the context of a very favorable labor market, (1) the detrimental effect of unemployment on mental health and (2) the predictive validity of mental health on further employment status. The population of the study comprised 384 newly registered unemployed persons. Mental health was assessed through four variables: self-esteem, psychological distress, perceived stress, and depressive symptoms. The results did not confirm previous studies. Using analyses of variance for repeated measures and linear regression, a negative change of mental health was not found after 6 and 12 months' unemployment, and the four measurements of mental health at registration did not predict employment status 6 and 12 months later. Results are discussed in terms of moderating variables that capture Luxembourg labor market specificities. This research was supported by the Luxembourg National Research Fund in the framework of the VIVRE Program; grant no. FNR/02/05/07. We would like to thank Mary Devine for the linguistic revision of the text.
Background: Quality of care is a complex issue influenced by many factors. It is fundamental in assessing health care delivery in health facilities in developing countries. Health care workers' perceptions help policy makers and planners to identify bottlenecks in the system to improve utilisation and sustainability of health ...
Kolltveit, Beate-Christin Hope; Gjengedal, Eva; Graue, Marit; Iversen, Marjolein M; Thorne, Sally; Kirkevold, Marit
Introducing new technology in health care is inevitably a challenge. More knowledge is needed to better plan future telemedicine interventions. Our aim was therefore to explore health care professionals' experience in the initial phase of introducing telemedicine technology in caring for people with diabetic foot ulcers. Our methodological strategy was Interpretive Description. Data were collected between 2014 and 2015 using focus groups (n = 10). Participants from home-based care, primary care and outpatient hospital clinics were recruited from the intervention arm of an ongoing cluster randomized controlled trial (RCT) (Clinicaltrials.gov: NCT01710774). Most were nurses (n = 29), but the sample also included one nurse assistant, podiatrists (n = 2) and physicians (n = 2). The participants reported experiencing meaningful changes to their practice arising from telemedicine, especially associated with increased wound assessment knowledge and skills and improved documentation quality. They also experienced more streamlined communication between primary health care and specialist health care. Despite obstacles associated with finding the documentation process time consuming, the participants' attitudes to telemedicine were overwhelmingly positive and their general enthusiasm for the innovation was high. Our findings indicate that using a telemedicine intervention enabled the participating health care professionals to approach their patients with diabetic foot ulcer with more knowledge, better wound assessment skills and heightened confidence. Furthermore, it streamlined the communication between health care levels and helped seeing the patients in a more holistic way.
Drawing on interviews with English primary care doctors (GPs), this paper examines GP responses to reforms intended to introduce a market in primary health care. GPs' reactions are conceptualised in terms of a GP habitus, which takes for granted the superiority of 'public' providers (i.e. GP partnerships) in the provision of care. GPs are actively involved in the defence of the public sphere, which is neither a neo-liberal minimalist market state, nor a wholly altruistic state, responding to consumers' wants. The public sphere they defend is one in which boundaries are drawn about entitlements and GPs are actively engaged in defining and policing these boundaries. The GP habitus can be seen as shaping responses in ways which serve GP interests. In the context of struggles involving various social actors (e.g. private providers, third-party payers, patients) with different stakes in the field of general medical practice; this public service orientation may enable GPs to reap cultural capital. At the same time, the habitus constrains action in a way which limits resistance to reforms threatening GPs' interests, with GPs responding by coping, rather than downing tools or engaging in active confrontation.
Full Text Available Abstract Background Mental health policy is needed to set the strategy and direction for the provision of mental health services in a country. Policy formulation does not occur in a vacuum, however, but is influenced by local and international factors in the health sector and other sectors. Methods This study was carried out in 1997 to examine the evolution of mental health policy in Kenya between 1965 and 1997 in the context of changing international concepts of health and development. Qualitative content analysis of policy documents was combined with interviews of key policy makers. Results The study showed that during the period 1965-1997 the generic health policy in Kenya changed from one based on the Medical Model in the 1960s and 1970s to one based on the Primary Health Care Model in the late 1970s and the 1980s and finally to one based on the Market Model of health care in the 1990s. The mental health policy, on the other hand, evolved from one based on the Medical Model in the 1960s to one based on the Primary Health Care Model in the 1990s, but did not embrace the Market Model of health care. This resulted in a situation in the 1990s where the mental health policy was rooted in a different conceptual model from that of the generic health policy under which it was supposed to be implemented. This "Model Muddlement" may have impeded the implementation of the mental health policy in Kenya. Conclusions Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway.
The average health care expenditure in infancy was estimated to be 7.92 birr and it increased with increasing level of education and monthly family income. In all treatment ... increase the power of the family to spend some of their earnings for better care. Improving and .... Because of the skewed distribution of health care ...
Motwani, J; Sower, V E; Brashier, L W
This article examines the issue of implementing TQM/CQI programs in the health care industry by grouping the prescriptive literature into four research streams. Based on the literature, a strategic programming model for implementing TQM/CQI in the health care industry is suggested. Finally, issues relating to TQM in the health care sector, which need to be addressed within each research stream in the future, are provided.
De Lima, Liliana; Radbruch, Lukas
At the May 2014 meeting of the World Health Assembly, the assembly passed a resolution intended to reduce barriers to palliative care. T4eh resolution calls for integrating palliative care into national health services. It contains recommendation on improved availability and access to such care and calls for it to be included in national health policies and budgets. The full resolution with commentary is presented.
Gelormino, Elena; Bambra, Clare; Spadea, Teresa; Bellini, Silvia; Costa, Giuseppe
Health care is widely considered to be an important determinant of health. The health care systems of Western Europe have recently experienced significant reforms, under pressure from economic globalization. Similarly, in Eastern Europe, health care reforms have been undertaken in response to the demands of the new market economy. Both of these changes may influence equality in health outcomes. This article aims to identify the mechanisms through which health care may affect inequalities. The authors conducted a literature review of the effects on health inequalities of European health care reforms. Particular reference was paid to interventions in the fields of financing and pooling, allocation, purchasing, and provision of services. The majority of studies were from Western Europe, and the outcomes most often examined were access to services or income distribution. Overall, the quality of research was poor, confirming the need to develop an appropriate impact assessment methodology. Few studies were related to pooling, allocation, or purchasing. For financing and purchasing, the studies showed that publicly funded universal health care reduces the impact of ill health on income distribution, while insurance systems can increase inequalities in access to care. Out-of-pocket payments increase inequalities in access to care and contribute to impoverishment. Decentralizing health services can lead to geographic inequalities in health care access. Nationalized, publicly funded health care systems are most effective at reducing inequalities in access and reducing the effects on health of income distribution.
Wenger, A F
Decisions about health promotion and illness prevention occur within a cultural context that is influenced by the contemporary context of community and family in addition to the ethnohistorical and language contexts, worldview and sociocultural factors of the particular culture and the available folk and professional health care resources. Using information about the health and care beliefs and values and health care decision making process in negotiating culturally congruent nursing and health care interventions is imperative, especially in a world with limited health care resources and an increasing demand for recognition of cultural diversity. This article uses data on health and health care decision-making from an ethnonursing study of the Old Order Amish to demonstrate the role of cultural context in health care practices and decision making. Leininger's cultural care theory and Hall's conceptualization of high context culture were used to investigate these phenomena. High context features of the Old Order Amish culture are used to explain how Amish are actively involved in decisions and actions taken to promote health and prevent and treat illness using a broad array of folk, alternative and professional services simultaneously. As nurses learn to involve clients in decisions and actions using the guiding principles of cultural care preservation, accommodation and repatterning they will provide culturally congruent care for Amish and other culture-specific groups.
Derose, Kathryn Pitkin; Escarce, José J; Lurie, Nicole
Immigrants have been identified as a vulnerable population, but there is heterogeneity in the degree to which they are vulnerable to inadequate health care. Here we examine the factors that affect immigrants' vulnerability, including socioeconomic background; immigration status; limited English proficiency; federal, state, and local policies on access to publicly funded health care; residential location; and stigma and marginalization. We find that, overall, immigrants have lower rates of health insurance, use less health care, and receive lower quality of care than U.S.-born populations; however, there are differences among subgroups. We conclude with policy options for addressing immigrants' vulnerabilities.
... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Celiac Disease Testing (for Health Care Professionals) Serologic tests for celiac disease provide an effective first step in identifying candidates ...