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Book part

Azizur R. Molla

This study examines the decision process of household members in visiting local health care providers. It also explores the effect of various household level socioeconomic…

Abstract

This study examines the decision process of household members in visiting local health care providers. It also explores the effect of various household level socioeconomic factors on motivating rural people to visit traditional versus modern health care providers in rural Bangladesh. I used the Population, Environment, and Poverty data collected from eight villages of rural Bangladesh in 1998 in addition to self-collected ethnographic survey information. The data suggest that a large majority of rural households attempt to visit locally available untrained health care providers first, and then trained doctors as the sickness worsens. The data also suggest that socio-cultural and economic factors are important in shaping their decision to visit traditional as opposed to modern health care providers. Training the traditional and untrained health care providers will be a wise option to ensure health care to the villagers.

Details

The Economics of Health and Wellness: Anthropological Perspectives
Type: Book
ISBN: 978-1-84950-490-4

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Article

Vikki Ann Entwistle and Oliver Quick

This paper considers some implications of recent developments relating to patient safety for understandings of trust in health care contexts.

Abstract

Purpose

This paper considers some implications of recent developments relating to patient safety for understandings of trust in health care contexts.

Design/methodology/approach

Conceptual analysis focusing on patients' trust in health care providers and health care providers' trust in patients.

Findings

Growing awareness of the scale of the problem of iatrogenic harm has prompted concerns that patients' trust in health care providers may be threatened and/or become inappropriate or dysfunctional. In principle, however, patients' trust may be both well placed and compatible with current understandings of safety problems and efforts to address these. Contemporary understandings of patient safety suggest that, to be deemed trustworthy, health care providers should make vigorous efforts to improve patient safety, be honest about safety issues, enable patients to contribute effectively to their own safety, and provide appropriate care and support after safety incidents. Patients who trust health care providers need not be ignorant of patient safety problems and may be vigilant in the course of their care. Iatrogenic harms do not necessarily reflect breeches of trust (not all such harms are yet preventable), and patients who are harmed might in some circumstances appropriately forgive and resume trusting. Health care providers may feel vulnerable to patients in several respects. From their perspective, trustworthy patients will act competently to optimise the outcomes of their health care efforts and to preserve health care providers' good reputations where those are justified. Providers' trust in patients may strengthen patients' trust in them and facilitate safety improvement work.

Originality/value

Shows how, in principle, trust can be compatible with current understandings of patient safety issues and may enhance efforts to improve patient safety.

Details

Journal of Health Organization and Management, vol. 20 no. 5
Type: Research Article
ISSN: 1477-7266

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Book part

Greg A. Greenberg

In this chapter organizational theory is used to clarify and synthesize the large and diverse literature on the relationship between managed care (MC) and ethnic…

Abstract

In this chapter organizational theory is used to clarify and synthesize the large and diverse literature on the relationship between managed care (MC) and ethnic differences in access to health services. MC practices are classified by whether they are used by health care organizations to define their boundaries or to coordinate care. MC practices used to coordinate care are further categorized as one of five types: rules and programs, authority, goal setting, culture, or client coordination. This review also presents hypotheses derived from this literature that specify the predicted effects of MC practices on ethnic differences in access to health services. It was found that few of these hypotheses had been empirically investigated and although some evidence was found that MC boundary-setting practices disadvantage minorities, there were not consistent findings with respect to those practices used to coordinate care.

Details

Inequalities and Disparities in Health Care and Health: Concerns of Patients, Providers and Insurers
Type: Book
ISBN: 978-0-7623-1474-4

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Book part

Celeste Campos-Castillo

Existing descriptions of trust in health care largely assume a straightforward association between a patient’s relationship with a regular provider and his or her trust in…

Abstract

Purpose

Existing descriptions of trust in health care largely assume a straightforward association between a patient’s relationship with a regular provider and his or her trust in health care. I extend status characteristics theory (SCT) and social identity theory (SIT) to suggest greater variability in this association by investigating the role of social differences between patients and their regular providers. Whereas the SIT extension predicts lower trust in dissimilar than similar dyads, the predictions from the SCT extension depend on status in dissimilar dyads. Further, research examining how social differences in patient–provider dyads shape trust largely emphasizes racial differences, but the theories implicate gender differences too.

Methodology/approach

I analyze a longitudinal dataset of patient–provider dyads offering a conservative test of the extensions.

Findings

Results generally support predictions from the SCT extension. Specifically, patients’ status based on differences in either race or gender: (1) is inversely related to their trust in health care and (2) influences the resiliency of their trust, whereby the degree health care met prior expectations matters less (more) for the trust of low (high) status patients than equal status patients.

Research limitations/implications

When patients and providers differ on both race and gender, findings sometimes depart from predictions. This indicates differences in two social categories is a unique situation where the contributions of each category are distinct from that of the other.

Originality/value

This research extends SCT to explain greater variability in the connection between patient–provider dyads and trust in health care, while also showing how gender compares to race.

Details

Gender, Women’s Health Care Concerns and Other Social Factors in Health and Health Care
Type: Book
ISBN: 978-1-78756-175-5

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Book part

Mary-Rose Mueller, Stergios Roussos, Linda Hill, Nadia Salas, Veronica Villarreal, Nicole Baird and Melbourne Hovell

In an effort to address health care disparities, U.S. laws mandate that health care organizations provide free language interpreting and translation anytime a patient and…

Abstract

In an effort to address health care disparities, U.S. laws mandate that health care organizations provide free language interpreting and translation anytime a patient and health care provider cannot communicate in the same language. The heretofore absence of legislative and professional oversight in health care interpreting allows for anyone to interpret. A qualitative study was conducted to understand the conditions and practices of bilingual staff who interpret as a secondary part of their job in community health clinics.

Four focus groups were conducted as part of a study on shared decision-making during interpreted medical visits in a busy, urban clinic serving a large number of limited English proficient (LEP) patients. The focus groups were designed to understand the process of interpreting and how interpreters influence medical decisions between LEP patients and their health care providers. To understand the interpreting process from multiple perspectives, one focus group was conducted with users of interpreters – monolingual health care providers (N=6), two with Spanish speaking men (N=10) who were experienced with interpreted health visits, and one with bilingual staff (N=5) who interpret as an ad hoc feature of their job, also known as dual-role medical interpreters.

Dual-role interpreters use different styles while interpreting what is communicated between health care providers and patients. In some cases, they provide near word-for-word interpretation of what is said. In other cases, they summarize and or paraphrase multiple sentences, seek clarity through questions, and deconstruct culturally laden and technical terms. In still other cases, dual-role interpreters combine interpretation styles within a single interactional exchange. Each of the three major styles of interpreting has advantages in medical settings. Specific style is influenced by health care provider preference, interpreter–health care provider trust and familiarity, and interpreter medical knowledge. Interpreters are challenged by the patients’ dialects, educational level, provider personalities, gender issues, and out of clinic relationships with the patients. Contextual conditions and contingencies of reinforcement contributed to varying methods of interpretation. These conditions included organizational policies, language and bilingual communication, and social relations with both the health care providers and the patients.

These findings demonstrate the complexity of medical interpretation and the critical involvement of health care providers and bilingual staff in facilitating interpreted encounters. Findings suggest the need for training both health care providers and interpreters and possible change in reimbursement for services.

Details

Access to Care and Factors that Impact Access, Patients as Partners in Care and Changing Roles of Health Providers
Type: Book
ISBN: 978-0-85724-716-2

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Book part

Gregory P. Shea and Bruce Gresh

This paper offers a conceptualization of two dimensions of health care markets in the US, their interaction, and implications of that interaction. The combination of the…

Abstract

This paper offers a conceptualization of two dimensions of health care markets in the US, their interaction, and implications of that interaction. The combination of the amount of consumer out-of-pocket financial responsibility and the level of information available to consumers about services and pricing (along with accompanying potential decision-making empowerment) may well determine the way in which health care consumers will interact with health insurers and providers for many years to come. This paper presents a way to model the interaction of these dimensions. The interaction yields four possible future scenarios for health care in the US. These scenarios, in turn, can assist the major stakeholders in the health care system in what may well prove to be fate-making decisions. Finally, different scenarios suggest different entrepreneurial activity.

Details

Strategic Thinking and Entrepreneurial Action in the Health Care Industry
Type: Book
ISBN: 978-1-84950-427-0

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Article

Athanasia Daskalopoulou, Josephine Go Jefferies and Alexandros Skandalis

Service research has previously documented service providers’ role in addressing the barriers of technology mediation, mostly at the service delivery level. The purpose of…

Abstract

Purpose

Service research has previously documented service providers’ role in addressing the barriers of technology mediation, mostly at the service delivery level. The purpose of this study is to enhance our understanding about the role of service providers who hold strategic and operational roles, as well as investigate the impact of coordinated, organization-wide initiatives in dealing with the demands and associated emotional ambivalence of technology-mediated services.

Design/methodology/approach

This qualitative study draws from a series of in-depth interviews with health-care service providers who hold strategic and operational roles in health-care organizations along with participant observation to develop an understanding of the broader organizational context of telehealth services.

Findings

This paper outlines the strategic sense-giving process and highlights how health-care service providers who hold strategic and operational roles enact the sense-giver role. This study illustrates that strategic sense-giving involves the recognition of sense-making gaps; identification of sense-giving opportunities; and provision of templates of action.

Originality/value

This study illustrates that sense-giving can be performed by a number of organizational members in a more formalized way which extends informal sense-giving efforts at the peer-to-peer level. The importance of strategic sense-giving in providing templates of action for service providers and consumers is highlighted. This study also shows how strategic sense-giving safeguards against confusion and errors by communicating appropriate ways of using technology. Finally, the role of strategic sense-giving in helping service providers and consumers cope with the emotional ambivalence of technology-mediated service interactions are demonstarted.

Details

Journal of Services Marketing, vol. 34 no. 7
Type: Research Article
ISSN: 0887-6045

Keywords

Content available
Article

Antti Peltokorpi, Juri Matinheikki, Jere Lehtinen and Risto Rajala

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs…

Abstract

Purpose

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.

Design/methodology/approach

A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.

Findings

Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.

Research limitations/implications

Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.

Practical implications

Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.

Social implications

For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.

Originality/value

This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.

Details

International Journal of Operations & Production Management, vol. 40 no. 4
Type: Research Article
ISSN: 0144-3577

Keywords

Content available
Article

Ik-Whan Kwon and Sung-Ho Kim

This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is…

Abstract

Purpose

This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is explored to link suppliers/manufacturers with health-care providers.

Design/methodology/approach

Existing literature on supply chain visibility in health care forms a basis to achieve the study purpose. Alignment calls also for financial health where supply chain partners’ working capital is readily available to execute joint supply chain plan.

Findings

There is a disjoint in supply chain alliance between suppliers/manufacturers and providers where providers are unable to trace the origin of supplies. Quality care suffers and cost of care rises as providers search for supplies on an emergency basis. This paper provides a framework where solution can be formulated.

Research limitations/implications

Suppliers/manufactures form a direct strategic alliance with providers where product visibility enables health-care providers with a better patient management with lower cost of supplies. Inventory management and logistics cost will be lowered as better planning/forecasting is in place. This paper does not call for testing any hypothesis. Perhaps, next move along this line will be to investigate financial health of supply chain partners based on supplier relationship management practices.

Originality/value

This paper proposes health-care supply chain as an alternative solution to achieve the following twin purposes: controlling the cost while improving quality of care through supply chain finance. As far as we know, this study is the first attempt to achieve the goals.

Details

Asia Pacific Journal of Innovation and Entrepreneurship, vol. 12 no. 2
Type: Research Article
ISSN: 2398-7812

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Article

Ashish Chandra, Roger Durand and Samantha Weaver

The purpose of this paper is to provide an understanding of the utilization, attitudes, and concerns of health care consumers and providers about biometrics.

Abstract

Purpose

The purpose of this paper is to provide an understanding of the utilization, attitudes, and concerns of health care consumers and providers about biometrics.

Design/methodology/approach

Data were analyzed from a survey of 324 adult subjects, including 167 “health care consumers” and 157 “healthcare providers.”

Findings

Health care providers were found more accepting of biometric technologies than consumers, a finding that seems to follow from more familiarity and experience with those technologies. Feelings about the potential uses and limitations of biometrics were found to be more differentiated among providers than consumers. Yet, concerns about privacy and the need for information limits were identifiable as important feelings among providers and consumers alike. Finally, demographic characteristics only weakly to modestly distinguished concerns about privacy and confidentiality among health care consumers and providers.

Research limitations/implications

The findings reported here suggest the need for additional research into the types of biometrics adopted in diverse health care settings and into the nature of innovators or early adopters.

Practical implications

If biometrics is to gain acceptance, there seems to be a need for different promotion strategies for providers and consumers. Also, concerns for personal privacy will need to be considered.

Originality/value

This paper fills an important gap in understanding the uses, feelings, and concerns about biometrics among health care consumers and providers.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 2 no. 1
Type: Research Article
ISSN: 1750-6123

Keywords

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