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Article

Shih-Chuan Chen

This study aims to explore the information-seeking behavior of female patients engaged in doctor shopping. An investigation was conducted on the following aspects: the…

Abstract

Purpose

This study aims to explore the information-seeking behavior of female patients engaged in doctor shopping. An investigation was conducted on the following aspects: the reasons for doctor-shopping behavior (DSB), patients’ information needs and sources, patients’ use of the obtained information and the degree of satisfaction with the information collected.

Design/methodology/approach

In-depth interviews were conducted in this study. In total, 30 female participants who lived or worked in the Taipei metropolitan area, Taiwan, were recruited.

Findings

Dissatisfaction with treatment, confirmation of illness conditions, inconvenient treatment locations and hours and dissatisfaction with doctor’s attitude were the main reasons for DSB. Family members, friends, the internet and mass media were sources of information for participants when they sought second and successive doctors. In most cases, the degree of satisfaction toward the obtained information increased after each visit to a doctor during the doctor-shopping journey. However, not all participants shared information with doctors. The participants suggested that detailed explanations provided by doctors and better communication with doctors may reduce the occurrence of doctor shopping.

Originality/value

The findings of this study help medical personnel better understand DSB. The findings revealed the significance of information to patients and indicated that the information collected during doctor shopping is beneficial for patients.

Details

The Electronic Library , vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0264-0473

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Article

Marie Claire Van Hout

The misuse of pharmaceutical opioid analgesics is identified as a global public health concern. Codeine represents an interesting quandary in terms of its regulated…

Abstract

Purpose

The misuse of pharmaceutical opioid analgesics is identified as a global public health concern. Codeine represents an interesting quandary in terms of its regulated status, with individuals varying in their metabolism of codeine, estimation of safe dosages, risk of adverse health consequences and abuse potential. Efforts to quantify and address hidden non-compliant medical codeine use, overuse and intentional misuse is compromised by availability to the public in prescribed and over the counter forms. The paper aims to discuss these issues.

Design/methodology/approach

A review of literature on codeine use, misuse and dependence, and associated innovative medical and pharmacy interventions is presented, and was conducted as part of a larger scoping review on codeine.

Findings

The review highlights the complexities associated with monitoring public health awareness of codeine's abuse potential, and customer/patients trends in non-compliant codeine use for therapeutic and recreational purposes. Aberrant codeine behaviours centre on visiting multiple doctors for prescriptions, repeated lost or stolen prescriptions, forging prescriptions and use of multiple pharmacies. Innovations to monitor misuse of codeine include national prescription databases and recent developments in real-time monitoring of dispensing activity.

Practical implications

Further development of real-time monitoring processes with process evaluation is advised.

Originality/value

This viewpoint is intended to demonstrate how efforts to quantify and address codeine use are compromised by its availability. It intends to encourage further policy and practitioner dialogue on how to monitor, support and intervene with consumers misusing codeine.

Details

Drugs and Alcohol Today, vol. 14 no. 4
Type: Research Article
ISSN: 1745-9265

Keywords

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Article

Heli Marjanen

Reviews the trends in Finland towards greater concentration and more hypermarkets, power centres and out‐of‐town centres. Provides the background for a mail survey of 857…

Abstract

Reviews the trends in Finland towards greater concentration and more hypermarkets, power centres and out‐of‐town centres. Provides the background for a mail survey of 857 householders residing in rural areas surrounding the small municipality of Aura. These residents are subject to the attractions of two nearby shopping developments and three cities. The results revealed that not only the disadvantaged but also affluent, mobile, middle‐aged people very often use the retail facilities located in their home areas. Aura has the greatest market share among the alternative shopping destinations, especially when grocery shopping is involved. The market shares of two nearby shopping developments, but also the market share of Turku CBD, were smaller than expected. Shopping preferences for the nearby developments and cities are greatest for products such as clothes and shoes.

Details

International Journal of Retail & Distribution Management, vol. 28 no. 4/5
Type: Research Article
ISSN: 0959-0552

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Article

Charles Musselwhite

Travel and mobility for older people has typically focussed on the practical benefits to the individual, for example, in meeting utilitarian needs of shopping

Abstract

Purpose

Travel and mobility for older people has typically focussed on the practical benefits to the individual, for example, in meeting utilitarian needs of shopping, appointments and staying connected to family and friends. However, previous research has hinted that travel for its own sake, to get out and about and feel and experience mobility, may be just as important for older people and is especially missed when individuals give-up driving. The paper aims to discuss these issues.

Design/methodology/approach

This paper examines travel for its own sake, usually referred to as discretionary travel, interviewing 20 older people in each of three different contexts: for drivers, for community transport users and for non-drivers who receive lifts from family and friends.

Findings

Older people not only enjoy discretionary travel, but also feel it is beneficial to their health and wellbeing. The car and especially driving, is seen as the best way to fulfil discretionary travel. Community transport users do fulfil discretionary travel needs but these are over formalised and lack spontaneity affecting feelings of control and identity. Receiving lifts from family and friends can often result in older people feeling a burden to the providers of the lifts especially when travel is viewed as discretionary.

Practical implications

More needs to be done to ensure discretionary travel needs are met for those without cars, highlighting the importance of such travel to community transport providers and helping reduce the feeling of being a burden to family and friends.

Originality/value

Policy, practice and research has tended to focus on transport as a means to an end. However, older people themselves value mobility just as much for its own sake and just to view nature. Such discretionary reasons for mobility are actually very important for health and wellbeing of older people and need more attention.

Details

Working with Older People, vol. 21 no. 1
Type: Research Article
ISSN: 1366-3666

Keywords

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Article

Sue Llewellyn, Ron Eden and Colin Lay

Traditionally in health care and in the public sector more generally, little thought has been given to the impact of provider‐oriented incentives on the delivery of…

Abstract

Traditionally in health care and in the public sector more generally, little thought has been given to the impact of provider‐oriented incentives on the delivery of services. There has been an assumption that the language of incentives belonged to the private sector and was inappropriate in the public sector. Instead, the governance of health care has relied on the professional ethos of clinicians to direct decision making. Implicitly there has been an expectation that the ethical stance of clinicians would ensure that their actions were always in the best interest of patients. However, in the context of a heightened awareness of cost constraints there has been a greater emphasis on the active management of resources in medical organizations. This article argues that the structure of incentives in health care is highly significant in resource allocation, as medical ethics does not provide an unambiguous guide to clinical decision making. The paper defines the nature of the financial and professional incentives in medical organizations and discusses their impact on the delivery of services through an analysis of positive and negative effects. By undertaking a comparison between the UK and Canada, the paper identifies the differential nature of the incentives present in the health care systems of these two countries and discusses some of their consequences.

Details

International Journal of Public Sector Management, vol. 12 no. 1
Type: Research Article
ISSN: 0951-3558

Keywords

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Article

Gil‐Soo Han

The paper aims to analyse how the medical profession, the pro‐competition organisation, and the rural community have responded to the rural doctor shortage with reference…

Abstract

Purpose

The paper aims to analyse how the medical profession, the pro‐competition organisation, and the rural community have responded to the rural doctor shortage with reference to international medical graduates (IMGs) as reported in Australian newspapers.

Design/methodology/approach

Utilising the commercially available database LexisNexis during 2003, the author keyed in “overseas trained doctors” and retrieved 641 Australian newspaper articles. The qualitative data analysis software NVivo2 has assisted the author to organise the data, informed by critical realism and narrative analysis.

Findings

While the medical profession is undoubtedly committed to serving the health needs of the Australian public, the medical community is less than united in addressing the rural doctor shortage, especially through the employment of large numbers of IMGs. The handling of IMGs has led to tensions not only between the locally trained and IMGs, but also between rural and non‐rural doctors, and between younger and established doctors. The medical professional institutions seemed relatively detached from the adverse consequences of the shortage of doctors in the rural community. This contrasts the efforts demonstrated by the Rural Doctors Association and the rural community.

Originality/value

This paper concludes with a critical realist and narrative analysis and resolving of the rural doctor shortage and recommends close communication and consultation among the diverse interest groups rather than their engaging in blaming one another. This would be an obvious starting point to address the rural doctor shortage, which may partly be achieved by the effective use of services by IMGs.

Details

Journal of Health Organization and Management, vol. 24 no. 3
Type: Research Article
ISSN: 1477-7266

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Article

Lynda M. Maddox

Looks at how consumers used a pharmaceutical Web site to learn about a particular disease or product. Probes whether visitors used the Web site to decide which drug was…

Abstract

Looks at how consumers used a pharmaceutical Web site to learn about a particular disease or product. Probes whether visitors used the Web site to decide which drug was right for them and whether they actually planned to request the product from their doctor. Gender and age differences in the use of Web site information were also examined. Increasing use of the Internet and data that show that direct‐to‐consumer advertising of prescription drugs empowers the patient to take a more active role in his/her choice of medications makes this article important for marketers as well as regulators.

Details

Journal of Product & Brand Management, vol. 8 no. 6
Type: Research Article
ISSN: 1061-0421

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Article

Husayn Al Mahdy

Bangladesh has an outdated healthcare system that has not changed since its independence in 1971. The aim of this paper is to look into how the Bangladesh healthcare…

Abstract

Purpose

Bangladesh has an outdated healthcare system that has not changed since its independence in 1971. The aim of this paper is to look into how the Bangladesh healthcare system can be reformed.

Design/methodology/approach

This paper is literature‐based and a personal reflection on one country's health system.

Findings

Widespread dissatisfaction exists in the population and amongst doctors about healthcare delivery.

Practical implications

Major issues causing healthcare user dissatisfaction are discussed and recommendations for reform are suggested.

Originality/value

The paper provides an independent account of one country's healthcare policy and practice.

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 4
Type: Research Article
ISSN: 0952-6862

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Article

Sue Llewellyn, Ron Eden and Colin Lay

Management accounting, inter alia, gives information on how resources are allocated within organisations. If managers wish to change patterns of resource allocation…

Abstract

Management accounting, inter alia, gives information on how resources are allocated within organisations. If managers wish to change patterns of resource allocation, accounting knowledge is pivotal to any change processes. In health care organisations resources follow decisions made by clinicians, hence to have an impact on resource allocations managers must influence them. Direct managerial control over clinicians is not possible or desirable in health care organisations. This article suggests that incentives are an alternative to control in health care and investigates the impact of financial incentives within hospitals, utilising a naturally occurring experimental situation that has arisen between the UK and Canada.

Details

Journal of Accounting & Organizational Change, vol. 1 no. 1
Type: Research Article
ISSN: 1832-5912

Keywords

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Abstract

Details

Delivering Sustainable Transport
Type: Book
ISBN: 978-0-08-044022-4

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