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Article
Publication date: 12 July 2019

Augustine Adomah-Afari, Doris Doris Darkoa Mantey and Kwasi Awuah-Werekoh

The purpose of this paper is to determine the factors that influence patients’ long-term relationship with healthcare providers in healthcare delivery at hospitals.

Abstract

Purpose

The purpose of this paper is to determine the factors that influence patients’ long-term relationship with healthcare providers in healthcare delivery at hospitals.

Design/methodology/approach

Data were gathered using 170 patients in a cross-sectional survey with quantitative research methods at a public regional hospital. Results were obtained using descriptive analysis and regression analysis.

Findings

Generally, the study found that the health-related factors (the reception of staff, providers’ attitude, waiting time, competence and expertise and the hospital environment) that influence patients’ long-term relationship with the healthcare providers/hospital were statistically significant (p < 0.001). The findings showed that overall 90.0 per cent of the patients were very satisfied with the overall healthcare services at the hospital.

Research limitations/implications

Limited sample size, lack of examination of healthcare providers’ perspectives and non-application of qualitative methods make it difficult to give a true picture of how these can enhance patients’ intent to keep a long-term relationship with the healthcare providers/hospital.

Practical implications

The paper suggests that health policymakers and practitioners need to enhance measures that will make patients satisfied leading to their long-term commitment and cordial relationship with the healthcare providers/hospital.

Social implications

The study demonstrated how health-related factors will be associated with the patients’ agreement/intent to keep a long-term relationship with their service providers at hospitals. Thus, the overall hypothesis was true that there is a relationship between patients’ satisfaction with the healthcare experienced and their long-term relationship with healthcare providers/hospital.

Originality/value

This is one of the few studies conducted on the topic in the context of Ghana’s health sector. It recommends that there should be a good interpersonal relationship between healthcare providers and patients, as patients’ satisfaction is not based on only receiving treatment at the health facility.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 13 no. 3
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 19 February 2024

Yixin Liang, Xuejie Ren and Lindu Zhao

The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on…

Abstract

Purpose

The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on self-management efforts. These decisions not only impact health outcomes but also shape the demand for care, subsequently influencing care costs. Despite the significance of this interplay, current payment schemes often overlook these dynamics. The research focuses on investigating the implications of a novel behavior-based payment scheme, designed to align incentives and establish a direct connection between patients' decisions and care costs. The primary objective is to comprehensively understand whether and how this innovative payment scheme structure influences key stakeholders, including patients, care providers, insurers and overall social welfare.

Design/methodology/approach

In this paper, we propose a game-theoretical model to incorporate the performance of self-management with the demand for healthcare service, compare the patient's effort decision for self-management and provider's price decision for healthcare service under a behavior-based scheme with that under two implemented widely payment schemes, that is, co-payment scheme and co-insurance scheme.

Findings

Our findings confirm that the behavior-based scheme incentives patient self-management more than current schemes while reducing their possibility of seeking healthcare service, which indirectly induces the provider to lower the price of the service. The stakeholders' utility under various payment schemes is sensitive to the cost of treatment and the perceived health utility of patients. Especially, patient health awareness is not always benefited provider profit, as it motivates patient self-management while diminishing the demand for care.

Originality/value

We provide a novel framework for characterizing behavior-based payment schemes. Our results confirm the need for modification of the current payment scheme to incentivize patient self-management.

Details

Kybernetes, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0368-492X

Keywords

Open Access
Article
Publication date: 24 July 2020

Anu Helkkula, Alexander John Buoye, Hyeyoon Choi, Min Kyung Lee, Stephanie Q. Liu and Timothy Lee Keiningham

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with…

5863

Abstract

Purpose

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.

Design/methodology/approach

Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.

Findings

Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.

Practical implications

Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.

Originality/value

This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.

Details

Journal of Service Management, vol. 31 no. 5
Type: Research Article
ISSN: 1757-5818

Keywords

Article
Publication date: 27 August 2020

Timothy J. Vogus, Andrew Gallan, Cheryl Rathert, Dahlia El-Manstrly and Alexis Strong

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by…

1373

Abstract

Purpose

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

Design/methodology/approach

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

Findings

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

Originality/value

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

Details

Journal of Service Management, vol. 31 no. 5
Type: Research Article
ISSN: 1757-5818

Keywords

Book part
Publication date: 28 September 2020

Jessica L. Liddell

Native American (NA) women's health needs in general are underresearched, and use of holistic, community-informed, and resilience-based approaches are rare. Despite extensive…

Abstract

Native American (NA) women's health needs in general are underresearched, and use of holistic, community-informed, and resilience-based approaches are rare. Despite extensive documentation of the continuing health inequalities between NA women and the general US population, little research examines what healthcare infrastructure and healthcare provider factors most impact, and exacerbate, these health disparities. The purpose of the study was to provide insight into the healthcare experiences of NA women. A qualitative descriptive research methodology with “hues” of an ethnographic life-history approach was used. Data were collected through qualitative semi-structured life-history interviews with 31 NA women from the Gulf Coast region of the United States. All women identified healthcare obstacles and barriers. These barriers were predominately comprised of Healthcare Infrastructure Barriers, which entailed: (1) Cost and Insurance Barriers; (2) Concerns about Western Medication; (3) Language Barriers; (4) Distance to Medical Facilities or Specialists; and (5) Long-wait Times, and Negative Provider Relationships, which included: (1) Rushed or Rude Provider Interactions; (2) Providers not Listening, or Ignoring Patient Concerns; (3) Poor, Inaccurate, or Inadequate Care or Diagnosis; (4) Discrimination in Healthcare; and (5) The need for Personal Relationships with Providers. These findings suggest that healthcare infrastructure issues and poor healthcare provider relationships are important structural issues that contribute to health disparities. The findings from this study have important implications for the type of training those working in healthcare services receive to be more sensitive to the needs of NA women and suggest that NA women may need unique support when accessing healthcare.

Details

Race, Ethnicity, Gender and Other Social Characteristics as Factors in Health and Health Care Disparities
Type: Book
ISBN: 978-1-83982-798-3

Keywords

Book part
Publication date: 19 November 2021

William C. Stallings, Nik M. Lampe and Emily S. Mann

Transgender people experience significant health and healthcare disparities in comparison to cisgender people. Limited access to quality, trans-competent healthcare in the USA is…

Abstract

Transgender people experience significant health and healthcare disparities in comparison to cisgender people. Limited access to quality, trans-competent healthcare in the USA is a central social determinant of these inequities. In this chapter, we expand on the burgeoning literature on accountability structures and transgender healthcare through an analysis of individual interviews with cisgender medical providers about their and their colleagues’ capacity to provide trans-competent healthcare. First, we find that providers report unfamiliarity and uncertainty concerning transgender people, their healthcare needs, and related issues. Although providers regard such ignorance as a structural problem within medical education and practice, the solutions they proffer rely on the benevolence and personal initiative of individual providers to seek out trans-specific information and training. This upholds the boundaries between what is considered “normal” (i.e., cisgender centered) healthcare and trans-competent healthcare. Second, we find that cisgender medical providers who want to provide quality healthcare to transgender people engage in emotion work that prioritizes the comfort and ignorance of their cisgender colleagues and inhibits institutional change. In sum, we argue that, regardless of their intentions, cisgender providers engage in practices that maintain healthcare as a cisnormative accountability structure and, in turn, contribute to the persistence of transgender health and healthcare disparities.

Details

Advances in Trans Studies: Moving Toward Gender Expansion and Trans Hope
Type: Book
ISBN: 978-1-80262-030-6

Keywords

Article
Publication date: 19 June 2009

Mina Deng, Danny De Cock and Bart Preneel

Modern e‐health systems incorporate different healthcare providers in one system and provide an electronic platform to share medical information efficiently. In cross‐context…

1240

Abstract

Purpose

Modern e‐health systems incorporate different healthcare providers in one system and provide an electronic platform to share medical information efficiently. In cross‐context communications between healthcare providers, the same information can be interpreted as different types or values, so that one patient will be issued different identifiers by different healthcare providers. This paper aims to provide a solution to ensure interoperability so that multiple healthcare providers will be able to collaborate in one e‐health system.

Design/methodology/approach

This paper primarily focuses on how different healthcare providers, instead of the patients, are able to interact and share information on a common e‐health platform.

Findings

In the course of the work, it was found that previous e‐health solutions mainly have a limited view of patient information, where a user‐centric approach for identity management is usually restricted to a single healthcare provider. Interoperability in an e‐health system becomes more problematic when more actors collaborate, and hence linkability from one context to another should not be straightforward. However, some form of linkability, such as the possibility to follow up a patient's medical treatment, is desirable in the e‐health sector, even when it needs to cross different contexts. Therefore, the authors have designed an identity management mechanism to ensure semantic interoperability when data is exchanged among different authorized healthcare providers.

Research limitations/implications

The paper points out that the next generation of e‐health will move towards federated e‐health and will require user‐centricity and transparency properties so that patients are able to specify and verify the disclosure of their medical information.

Originality/value

This paper proposes a new service for cross‐context identity management in e‐health systems, improving interoperability between agencies when context‐specific information is transferred from one healthcare provider to another. How the proposed cross‐context identity management service can be integrated in an e‐health system is explained with a use case scenario.

Details

Online Information Review, vol. 33 no. 3
Type: Research Article
ISSN: 1468-4527

Keywords

Article
Publication date: 5 October 2015

Aaron Asibi Abuosi

The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s hospitals…

1396

Abstract

Purpose

The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s hospitals.

Design/methodology/approach

A cross-sectional survey of patients seeking outpatient consultations in 17 general hospitals in Ghana was conducted. A total of 818 patients and 152 hospital managers were interviewed. A 22-item quality of care scale was used in data collection. Data were analysed with the aid SPSS version 20. Summary statistics and t-test were used to analyse the data.

Findings

There was a significant difference in the overall perception of quality of care between patients and healthcare providers (Patients: M=89.11, SD=11.457; Providers: M=94.60, SD=10.922; t (845) −4.956, p < 001, two-tailed). Also, 18 items out of the 22-item quality of care scale showed significant difference between patients and providers. However, levels of quality of care is generally rated fairly favourably by both category of respondents.

Research limitations/implications

Further study is required to explore the reasons for the perceived quality gaps between patients and healthcare providers.

Practical implications

Management of hospitals need to evaluate patients’ perceptions of quality of care to inform measures aimed at improving quality of care, since what they may consider as good quality service may be rated less favourably by patients.

Originality/value

Comparing perceptions of quality between patients and healthcare providers is important in order adopt measures to address any differences in perceptions of quality between the two stakeholders. To the best of the author’s knowledge no study has been conducted in Ghana to that effect.

Details

Clinical Governance: An International Journal, vol. 20 no. 4
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 6 June 2022

Ankit Singh, Ajeya Jha, Shankar Purbey and Priya Ravi

Elderly patients suffering from non-communicable disease face a dilemma in the selection of healthcare providers. This study attempts to identify the key variables playing a…

Abstract

Purpose

Elderly patients suffering from non-communicable disease face a dilemma in the selection of healthcare providers. This study attempts to identify the key variables playing a crucial role and identify the appropriate healthcare destination with the help of a combination of Decision-making Trial and Evaluation Laboratory (DEMATEL) and analytic hierarchy process (AHP) techniques. The primary objective is to introduce the DEMATEL and AHP as efficient decision-making methods to choose the right healthcare provider for elderly patients suffering from non-communicable diseases.

Design/methodology/approach

An integrative approach utilizing DEMATEL and AHP is used to reach the ideal solution for healthcare provider selection decisions. The DEMATEL approach is used to segregate the cause and effect variables. Similarly, the AHP is used to identify the weights of the top five cause-inducing variables, and the paired comparison method is used to select the healthcare provider.

Findings

The variables such as dependency on family members, easily accessible services, and patient autonomy play a vital role in the selection decision of healthcare providers in elderly patients suffering from non-communicable diseases.

Practical implications

In terms of priority, home healthcare should be considered the preferred provider for elderly patients suffering from non-communicable diseases followed by neighbourhood registered medical practitioners and hospitals.

Originality/value

This is the first of its kind study which has attempted to solve the healthcare provider selection decision with the combined approach of DEMATEL and AHP.

Details

Journal of Integrated Care, vol. 31 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 11 April 2022

Moutasem A. Zakkar, Craig Janes and Samantha Meyer

Patient experience (PE) evaluation can identify critical issues in healthcare quality. Various methods are used for PE evaluation in the healthcare system in Ontario; however…

Abstract

Purpose

Patient experience (PE) evaluation can identify critical issues in healthcare quality. Various methods are used for PE evaluation in the healthcare system in Ontario; however, evidence suggests that PE evaluation is not systematically performed and has not received substantial buy-in from healthcare providers. This study explores the perspectives of healthcare providers, managers and policymakers in Ontario on PE evaluation methods, barriers, utility and reliability.

Design/methodology/approach

The study used a qualitative descriptive design. Twenty-one semistructured interviews were conducted with healthcare providers, managers and policymakers in Ontario between April 2018 and May 2019. The authors used thematic analysis to analyze the data. The Consolidated Criteria for Reporting Qualitative Research quality criteria were used.

Findings

Barriers to PE evaluation include evaluation cost and the time and effort required to collect and analyze the data. Several factors affect the reliability of the evaluation, resulting in an unrealistically high level of patient satisfaction. These include the inclusivity of evaluation, the subjective nature of patient feedback, patients' concerns about health service continuity and the anonymity of evaluation. Participants were skeptical about the meaningfulness of evaluation because it may only yield general information that cannot be acted upon by healthcare providers, managers and policymakers for quality improvement.

Originality/value

This paper reveals that many healthcare providers, managers and policymakers do not see a tangible value in PE evaluation, regardless of Ontario's patient-centeredness and “patient first” rhetoric. An improvement in evaluation methods and a cultural change in the healthcare system regarding the value of PE are required to foster a better appreciation of the benefits of PE evaluation.

Details

International Journal of Health Governance, vol. 27 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

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