Search results

Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor.

We collected the financial information of health care providers in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects.

The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability.

The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial book-tax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

The purpose of this study was to undertake a diagnostic investigation of the international health care logistical environment to determine if regulatory policies or industry procedures have hindered the implementation of just‐in‐time systems. The analysis was conducted in a systematic manner and compared the anticipated benefits with those validated in other industries from the implementation of just‐in‐time. The study also compared the health care industry environments of the USA, UK, and Germany with the manufacturing industry. The author focussed on answering: first, why has the health care industry not implemented just‐in‐time; second, is it feasible for a healthcare provider to implement a just‐in‐time logistical system; and third, what benefits will a health care provider achieve by implementing just‐in‐time. Concludes that controlling health care pricing requires reducing product cost or continues to place limits on product prices, quantities of services, or both. An alternative approach to controlling prices is to restructure the market for health services to encourage greater price competition among providers.

Discussion of health care costs has expanded beyond the technical domains of accountancy and entered the realms of public discourse. Analyses this discourse through an examination of all the stories published in The New York Times between 1 April 1992 and 1 May 1993 which contained the phrase “health care costs”. Describes the current discourse and examines how antagonostic social interests strive to inscribe the concept of health care cost with conflicting meanings and ideological accents.

After discussing the high and rising health care costs in the USA, its disparities, and the suggested demand, supply, and managed competition‐side strategies to contain health care costs and their ethical implications, this paper seeks to explore whether or not these strategies will further aggravate the existing health care disparities.

This conceptual paper utilizes various appropriate exiting economic and ethical theories. The economic and ethical theories utilized are relevant to the problem of rising health care costs; to the proposed demand, supply, and managed competition‐side cost containment strategies; and to the existing health care disparities.

This paper demonstrates that the suggested cost containment strategies do in fact aggravate existing health care inequities and are not always ethical.

Given the present health care reform debate in the USA and various misconceptions about it, the author believes that the paper and its findings should in fact be viewed as a contribution.

The purpose of this paper is to enhance the knowledge about the use of online communication between patients and health-care professionals in public health care. The study explores digital divide gaps and the impacts of online communication on the overall costs of health care.

This study focuses on online health care in Denmark. The authors rely on population data from 3,500 e-visits (e-mail consultations) between patients and general practitioners (GPs) from 2009 to 2015. Additionally, they include survey data on the use of the internet to search for health-related information.

The analysis of the Danish data reveals a rapid uptake in the use of the internet to search for health-related information and a three-fold increase in e-visits from 2009 to 2015. The results show that the digital divide gaps exist also in the online health-care communication. Further, the study findings suggest that enforced supply of online communication between GPs and patients does not alleviate the costs. Rather, the number of visits to GPs has not been decreased significantly and health-care costs showing a marginal increase.

Further data should be collected and analyzed to explore the impacts of other institutional factors and population cohort on the digital divide and healthcare costs. Also, it is difficult to estimate whether the increased use of online health care in the long run lead to lowering overall health-care costs. While the internal validity of the study is high due to the use of population data, the external validity is lower as the study results are based on the data collected in Denmark only.

The study offers important input for practice. First, leaders in government might reconsider how they can control the health-care costs when opening online channels for communication between patients and doctors. Second, concerns about digital divide issues remains, but the study suggests that the uptake of e-visits does not widen the socio-economic, gender or age gaps. For health policy concern, this is encouraging news to lead to an increasing push of online communication.

The dynamics of online health-care communication may lead to mixed results and unexpected impacts on overall health-care costs.

The paper offers new insights in the impacts of mandatory supply of digital services. The Danish push-strategy has led to an enforced supply of e-visits and a rapid growing use of the online health care without widening digital divide but at the risk of potential increasing the overall costs.

Consumer‐driven health care (CDHC) has been proposed to reduce the USA health care costs through greater free market economic exposure. The purpose of this paper is to review the USA health care system, insurance plans, and CDHC plan elements and assumptions regarding patients, service providers, and insurers, in order to identify research and social marketing needs of CDHC.

The paper is an assessment of literature from academic and practitioner communities.

Social marketing programs can contribute to preparing consumers and practitioners for CDHC. However, the degree to which CDHC can reduce health care costs is uncertain. More research is needed comparing CDHC plans with traditional plans and comparing CDHC enrollees with enrollees in other types of plans to determine the true benefits and costs of CDHC and to identify consumers' information needs. Research is needed into how to gather and provide understandable health care provider quality and cost‐effectiveness information, and into how current insurers can help consumers make effective CDHC decisions. Research is needed as to how CDHC is perceived by consumers, providers, and insurers, and the use of CDHC reimbursement accounts and their effect on behavior and costs. Research is also needed into which decisions can be made by consumers without specialized professional knowledge. Provider research is needed into outcome risk adjustments, how practitioners view CDHC, how willing practitioners are to participate in a more open‐free market, and how CDHC may affect professional practices.

Insights gained from this paper can contribute to social marketing program designs needed for practitioner and consumer acceptance and effective use of CDHC.

Health care spending in the U.S. continues to outpace inflation and wage growth, which is likely to keep the burden of rising health care costs in the spotlight. As health care costs increase, health insurers face the challenges of providing quality health care at a reasonable cost. Some health care providers and insurers use economic measures such as return on investment to assess the effectiveness of health care. How does one measure the value of health? What are some of the advantages and disadvantages of using economic measures to evaluate health care?

This paper looks health care costs and who pays for them. What portion of health care costs is borne by employers? What portion by employees? Who does or should pay for health care of people who are uninsured? What is the role of insurance? If people do not have health care insurance, does it matter whether the reason they are uninsured is because they cannot afford it or because they choose not to be insured?

Selvam (2002) belives that the number one ethical dilemma in the U.S. is how to address the almost 40 million Americans who lack health care coverage. With rising hospital costs, even the hardest-working and most prudent persons are at risk. Many workers do not have health insurance and even if they are covered, they may not get what they need. What are some of the ethical issues facing patients, health care providers and insurers? What role should government have in assuring that all people receive quality health care?

This paper aims to focus on the role of hospital business models by examining the innovative business model of Moheb Hospitals, which have successfully achieved the goal of reducing costs and delivering high-quality health-care services in Iran by encouraging public–private partnership.

This paper is a single case study.

The study results illustrate the hospital’s current business model and its underlying elements. After presenting the findings, this paper is concluded by presenting the standing issues that should also be addressed and how improvements and adjustments can be made.

This study offers new insight to identify and analyze the shortcomings of health-care sector in Iran and introduces new methods to efficiently use current competencies.

Integrated health care delivery (IHCD), as a major issue of managed care, was considered the panacea to rising health care costs. In theory it would simultaneously provide high-quality and continuous care. However, owing to the backlash of managed care at the turn of the century many health care providers today refrain from using further integrative activities. Based on transaction cost economics, this chapter investigates why IHCD is deemed appropriate in certain circumstances and why it failed in the past. It explores the new understanding of IHCD, which focuses on actual integration through virtual integration instead of aggregation of health care entities. Current success factors of virtually integrated hybrid structures, which have been evaluated in a long-term case study conducted in the San Francisco Bay Area from July 2001 to September 2002, will elucidate the further development of IHCD and the implications for other industrialized countries, such as Germany.

This special “Anbar Abstracts” issue of Journal of Management in Medicine is split into 6 sections covering abstracts under the following headings: General Management; Personnel and Training; Quality in Health Care; Health Care Marketing; Financial Management; and Information Technology.