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1 – 10 of over 19000Kimball P. Marshall, Michaeline Skiba and David P. Paul
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…
Abstract
Purpose
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.
Design/methodology/approach
The paper is an assessment of literature from academic and practitioner communities.
Findings
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.
Originality/value
Insights gained from this paper can contribute to social marketing program designs needed for practitioner and consumer acceptance and effective use of CDHC.
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Debra E. Orr, Gloria Bravo Gutiérrez and Don Fette
In the USA, there has recently been an unprecedented convergence of complementary/alternative medicine (CAM) with mainstream biomedical care. This confluence may lead to a deeply…
Abstract
Purpose
In the USA, there has recently been an unprecedented convergence of complementary/alternative medicine (CAM) with mainstream biomedical care. This confluence may lead to a deeply rooted philosophical conflict. This qualitative study works to identify factors that health-care leaders can use, which will build a pathway to greater integrative practice between medical doctors and CAM practitioners – from parallel existence to partnership – by examining the tensions between biomedical medicine and naturopathic medicine. The purpose of this study is to offer short-term suggestions for partnership and long-term recommendations for better understanding.
Design/methodology/approach
An original qualitative study using semi-structured with CAM practitioners and biomedical practitioners.
Findings
Areas of conflict that are preventing synergy are identified and a pathway for health-care leaders to follow to create greater integration and partnerships is suggested.
Research limitations/implications
This is a qualitative and exploratory study that has significant limitations on generalizability.
Practical implications
This study suggest steps that both types of health-care practitioners can take to increase their success at working together on an individual level, a group level, an organizational level and on an industry-wide basis, as well as provide a specific pathway to create greater integrative practice for health-care leaders.
Social implications
The results indicate that stronger partnerships between different types of medical practitioners increase patient choice, patient satisfaction and outcomes.
Originality/value
Increasing interested in CAM modalities is driving more contact between CAM practitioners and biomedical practitioners. This contact is best established in partnership between practitioners rather than in parallel. This original research outlines the sources of conflict and provides recommendations for encouraging greater synergy.
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Due to its ability to support well-informed decision-making, business intelligence (BI) has grown in popularity among executives across a range of industries. However, given the…
Abstract
Purpose
Due to its ability to support well-informed decision-making, business intelligence (BI) has grown in popularity among executives across a range of industries. However, given the volume of data collected in health-care organizations, there is a lack of exploration concerning its implementation. Consequently, this research paper aims to investigate the key factors affecting the acceptance and use of BI in healthcare organizations.
Design/methodology/approach
Leveraging the theoretical lens of the “unified theory of acceptance and use of technology” (UTAUT), a study framework was proposed and integrated with three context-related factors, including “rational decision-making culture” (RDC), “perceived threat to professional autonomy” (PTA) and “medical–legal risk” (MLR). The variables in the study framework were categorized as follows: information systems (IS) perspective; organizational perspective; and user perspective. In Jordan, 434 healthcare professionals participated in a cross-sectional online survey that was used to collect data.
Findings
The findings of the “structural equation modeling” revealed that professionals’ behavioral intentions toward using BI systems were significantly affected by performance expectancy, social influence, facilitating conditions, MLR, RDC and PTA. Also, an insignificant effect of PTA on PE was found based on the results of statistical analysis. These variables explained 68% of the variance (R2) in the individuals’ intentions to use BI-based health-care systems.
Practical implications
To promote the acceptance and use of BI technology in health-care settings, developers, designers, service providers and decision-makers will find this study to have a number of practical implications. Additionally, it will support the development of effective strategies and BI-based health-care systems based on these study results, attracting the interest of many users.
Originality/value
To the best of the author’s knowledge, this is one of the first studies that integrates the UTAUT model with three contextual factors (RDC, PTA and MLR) in addition to examining the suggested framework in a developing nation (Jordan). This study is one of the few in which the users’ acceptance behavior of BI systems was investigated in a health-care setting. More specifically, to the best of the author’s knowledge, this is the first study that reveals the critical antecedents of individuals’ intention to accept BI for health-care purposes in the Jordanian context.
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Tara Officer, Jackie Cumming and Karen McBride-Henry
The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on mechanisms…
Abstract
Purpose
The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on mechanisms occurring across policy creation and in practice leading to successful role development.
Design/methodology/approach
The authors applied a realist approach involving interviews, document review and field log observations to create refined theories explaining how successful development occurs.
Findings
Three final mechanisms were found to influence successful advanced practitioner role development: engagement in planning and integrating roles; establishing opportunities as part of a well-defined career pathway; and championing role uptake and work to full scopes of practice.
Research limitations/implications
This research focuses on one snapshot in time only; it illustrates the importance of actively managing health workforce change. Future investigations should involve the continued and systematic evaluation of advanced practitioner development.
Practical implications
The successful development of advanced practitioner roles in a complex system necessitates recognising how to trigger mechanisms occurring at times well beyond their introduction.
Social implications
Potential candidates for new roles should expect roadblocks in their development journey. Successfully situating these roles into practice through having a sustainable and stable workforce supply provides patients with access to a wider range of services.
Originality/value
This is the first time a realist evaluation has been undertaken, in New Zealand, of similar programmes operating across multiple sites. The paper brings insights into the process of developing new health programmes within an already established system.
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Marilys Guillemin and Lynn Gillam
There has been growing interest in narrative ethics over the last three decades. However, narratology, or the study of narratives, has a much longer history dating back to Plato…
Abstract
There has been growing interest in narrative ethics over the last three decades. However, narratology, or the study of narratives, has a much longer history dating back to Plato and Aristotle.3 Structural linguistics, and its formal study of grammar and structure of language, was a major contributor to the development of the classification and interpretation of narratives.4 This structuralist period was followed by an increased interest in the relationships between narratives and social and historical dynamics and ideologies. Key social theorists, such as Derrida, Bakhtin and Ricoeur, have urged us to consider the relationship of the text to the way we understand ourselves and the worlds we inhabit. In summary, the study of narratives long preceded its association with ethics, and it was only recently that the interest in narratives has been adopted by the health-care disciplines, notably medicine and nursing.
Sarah Dodds, Sandy L. Bulmer and Andrew J. Murphy
This paper aims to explore consumer experiences of spiritual value and investigates whether it is distinct from ethical value within a large and growing private sector health-care…
Abstract
Purpose
This paper aims to explore consumer experiences of spiritual value and investigates whether it is distinct from ethical value within a large and growing private sector health-care setting. Understanding consumers’ experiences of spiritual value versus ethical value has important implications for corporate social responsibility as increasingly, consumers want their spiritual needs met.
Design/methodology/approach
The research adopts an exploratory case study approach using in-depth interviews with 16 consumers who use complementary and alternative medicine health-care services. Drawing on consumer value frameworks, a thematic analysis identified dimensions of spiritual and ethical values co-created during their consumption experiences.
Findings
From a consumer’s perspective, spiritual value is distinct from ethical value. The key finding is that participants talked about spiritual value predominantly in reactive terms (apprehending, appreciating, admiring or responding), whereas ethical value was referred to as active (taking action).
Research limitations/implications
This paper enhances the understanding of spiritual value and provides evidence that people want their spiritual needs met in a private health-care context. Furthermore, this study provides insights into the consumption experience of spiritual value that can be considered, with further research, in other health-care and service contexts.
Originality/value
This paper offers a new view on corporate social responsibility by taking a consumer’s perspective, and identifying that consumer experiences of spiritual value are important and distinct from ethical value.
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Mushira Mohsin Khan and Karen Kobayashi
The purpose of this paper is to identify the salient barriers in the uptake and effective utilization of health promotion interventions among ethnocultural minority older adults…
Abstract
Purpose
The purpose of this paper is to identify the salient barriers in the uptake and effective utilization of health promotion interventions among ethnocultural minority older adults (EMOA).
Design/methodology/approach
The paper opted for a literature review of 25 sources (peer-reviewed articles as well as documents from the grey literature). The search was primarily conducted in a database developed during a scoping review on the health and health care access and utilization of EMOA. Emphasis was placed on older ethnocultural minorities in Canada; however examples from the UK (which has a comparable health care system) and the USA and Australia (which have large, ethnically diverse populations) were also selected. The Candidacy framework was used as an analytical lens in the review.
Findings
Findings indicate that health promotion needs to be understood as comprehensive care, involving not only the provision of health care services, but also knowledge dissemination and the facilitation of access to these services. Limited health literacy, low levels of self-efficacy and autonomy, and diverse life course experiences, particularly in the case of immigrant older adults, give rise to issues around the identification of need and system navigation. Cultural beliefs on health and illness, particularly around diet and exercise, and a lack of trust in formal systems of health care, are barriers to the uptake of interventions. Similarly, service permeability is low when cultural competency is lacking.
Practical implications
The recommendations include the need for collaborative engagement with stakeholders, including family, peers, community partners and health practitioners, and the development of concise, culturally, and linguistically appropriate tools of health promotion that are targeted toward the intersecting needs of individuals in this diverse population of older adults.
Originality/value
Given the increasingly diverse nature of the older adult population in Canada over the past four decades, this paper makes an important contribution toward understanding the social, cultural, structural, biographical, and geographical factors that may optimize the effective dissemination and uptake of health promotion interventions among EMOA.
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Keith Hurst, Jackie Ford and Cath Gleeson
After briefly describing self‐managed integrated community teams, the authors explore potential and actual methods of evaluating their structures, processes and outcomes. Primary…
Abstract
After briefly describing self‐managed integrated community teams, the authors explore potential and actual methods of evaluating their structures, processes and outcomes. Primary health care staff in three comparable sites were studied using non‐participant observation, interviews, focus groups and questionnaires. After describing the fieldwork, the authors examine integrated team structures, which are characterised by a large number of barriers that integrated teams face. Processes surrounding different working practices are explored next. Ways of unifying health care professional practice in integrated teams are suggested using evidence from both the literature and fieldwork. Outcomes that emerged after one year of the new teams’ lives are discussed in detail. The difficulty in establishing acceptable outcomes, especially the validity and reliability of outcome measures, is considered. Throughout, the positive and negative aspects of integrated teams emerging from the fieldwork are compared and contrasted with issues in the literature. Finally, recommendations are made to help strengthen integrated teams in the UK.
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Muhammad Junaid, Kiane Goudarzi, Muhammad Faisal Rasheed and Gilles N’Goala
Contrary to want-based services, customer participation has got lesser attention in high-credence services like health care. Customer participation for patients with chronic…
Abstract
Purpose
Contrary to want-based services, customer participation has got lesser attention in high-credence services like health care. Customer participation for patients with chronic illnesses could be life-threatening and goes beyond the service organization’s physical environment. Realizing the importance of transformative service research in health-care services, this study aims to propose and validate the conceptualization of customer participation for patients with chronic illnesses.
Design/methodology/approach
The study uses sequential exploratory research design with mixed method research. The first phase is a qualitative exploration of the nature and meaning of customer participation by synthesizing theory and insights from semi-structured interviews (N = 75) with doctors, patients and paramedical staff. Next, survey data (N = 690) of patients with chronic illnesses is used to validate the proposed conceptualization. Finally, nomological validity was also tested on an additional survey data set (N = 362) using SEM and FsQCA.
Findings
The findings reveal that health-care customer participation is a three-dimensional behavioral construct in which a customer can participate by sharing information, involving in decision-making and ensuring compliance. The study also demonstrates that customer participation is a critical driver of satisfaction with life and perceived control on illness.
Practical implications
The research provides policy guidelines for owners and operators of health-care organizations in developing frameworks for collecting participation data, which can be used in strategies for seeking customer participation.
Originality/value
The research conceptualizes and validates “customer participation” as a multidimensional higher-order construct for patients with chronic illnesses, rarely focused in services marketing and management research on health care.
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Sebastian Maximilian Dennerlein, Vladimir Tomberg, Tamsin Treasure-Jones, Dieter Theiler, Stefanie Lindstaedt and Tobias Ley
Introducing technology at work presents a special challenge as learning is tightly integrated with workplace practices. Current design-based research (DBR) methods are focused on…
Abstract
Purpose
Introducing technology at work presents a special challenge as learning is tightly integrated with workplace practices. Current design-based research (DBR) methods are focused on formal learning context and often questioned for a lack of yielding traceable research insights. This paper aims to propose a method that extends DBR by understanding tools as sociocultural artefacts, co-designing affordances and systematically studying their adoption in practice.
Design/methodology/approach
The iterative practice-centred method allows the co-design of cognitive tools in DBR, makes assumptions and design decisions traceable and builds convergent evidence by consistently analysing how affordances are appropriated. This is demonstrated in the context of health-care professionals’ informal learning, and how they make sense of their experiences. The authors report an 18-month DBR case study of using various prototypes and testing the designs with practitioners through various data collection means.
Findings
By considering the cognitive level in the analysis of appropriation, the authors came to an understanding of how professionals cope with pressure in the health-care domain (domain insight); a prototype with concrete design decisions (design insight); and an understanding of how memory and sensemaking processes interact when cognitive tools are used to elaborate representations of informal learning needs (theory insight).
Research limitations/implications
The method is validated in one long-term and in-depth case study. While this was necessary to gain an understanding of stakeholder concerns, build trust and apply methods over several iterations, it also potentially limits this.
Originality/value
Besides generating traceable research insights, the proposed DBR method allows to design technology-enhanced learning support for working domains and practices. The method is applicable in other domains and in formal learning.
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