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Economists seem to be studying every nook and cranny of the field of medical care, from cost‐benefit analyses of medical technology to economies of scale in hospital size, the utilisation of non‐physician personnel to render care, the effects of pre‐paid financing and care systems, and so on, across an apparently highly divergent range of concerns. Obviously, what these studies have in common is their general subject, ‘medical care financing delivery, and utilisation’, But do they represent only a patchwork approach to understanding the economic features of the ‘real’ system of producing and consuming medical care, or are they somehow systematically, if not always clearly, related to each other? It is argued here that what seems to be a random, unrelated set of studies are indeed closely unified: and together they comprise an integrated analysis of the broad sector of medical care economics.

The purpose of this paper is to evaluate the relative importance of attributes for patient selection of a medical institution and to quantitatively evaluate the impact of different types of organizational forms upon the patient ' s selection of a medical institution.

By using a conjoint analysis, evaluation criteria in patient selection of a medical institution were examined. The paper assumed the selection of a medical institution under the situation of “being given a diagnosis of suspected diabetes with a physical examination and then visiting a medical institution”. The attributes included in the questionnaire were: quality of the medical institution, distance to the hospital, amount paid at the initial visit, amount paid at hospitalization for examinations, and organizational form of the hospital. Relative importance of the attributes and relative importance of organizational form were assessed. A total of 140 people were requested to respond to the questionnaire by way of researchers who have a connection with the authors. Completed responses were obtained from 111 subjects (79 per cent).

The results of the conjoint analysis revealed that the most important attribute was quality of the medical institution. Organizational form was the attribute with the lowest importance. The utility value of being a public hospital was the highest within the organizational form attribute for all respondents and being a private hospital was the lowest. The quality of the medical institution was considered the most important factor in selecting a medical institution and the type of organizational form was considered least important. Regarding organizational form, being a public hospital was most preferred and being a hospital managed by a company and a private hospital were least preferred respectively among healthcare professionals and other occupations.

The paper provides a relative evaluation of the factors thought to be important for patients in Japan when selecting a medical institution.

The Department of Veterans Affairs (VA) spent $500 million and the Department of Defense (DOD) spent $240 million for medical and surgical supplies in fiscal year 2001. Since the 1980s, to achieve greater efficiencies through improved acquisition processes and increased sharing of medical resources, VA and DOD signed a memorandum of agreement in 1999 to combine their buying power. VA and DOD saved $170 in 2001 by jointly procuring pharmaceuticals, by agreeing on particular drugs to be purchased, and contracting with the manufacturers for discounts based on their combined larger volume. VA and DOD have not awarded joint national contracts for medical and surgical supplies as envisioned by their memorandum of agreement, and it is unlikely that the two departments will have joint national contracts for supplies anytime soon. However, a few VA and DOD facilities have yielded modest savings through local joint contracting agreements. The lack of progress have made in jointly contracting for medical and surgical supplies has, in part, been the result of their different approaches to standardizing medical and surgical supplies. Other impediments to joint purchasing have been incomplete procurement data and the inability to identify similar high-volume, high-dollar purchases.

Medicalization is the increasing social control of the everyday by medical experts. It is a key concept in the sociology of health and illness because it sees medicine as not merely a scientific endeavor, but a social one as well. Medicalization is a “process whereby more and more of everyday life has come under medical dominion, influence, and supervision” (Zola, 1983, p. 295); previously these areas of everyday life were viewed in religious or moral terms (Conrad & Schneider, 1980; Weeks, 2003). More specifically, medicalization is the process of “defining a problem in medical terms, using medical language to describe a problem, adopting a medical framework to understand a problem, or using a medical intervention to ‘treat’ it” (Conrad, 1992, p. 211). Sociologists have used this concept to describe the shift in the site of decision-making and knowledge about health from the lay public to the medical profession.

Purpose: To demonstrate how an online coaching intervention can support well-being management (mental health and mood) of medical students, by increasing psychological awareness, emotional management, and healthy/positive action repertoires.

Design/methodology/approach: A two-group randomized control trial design using a waitlist as a control was used with a sample of 176 medical students. Half were randomly assigned the 5P© coaching intervention and the remaining half assigned to the waitlist group, scheduled to receive the intervention after the initial treatment group completed the intervention. Participant baseline data on stress, anxiety, depression, positive and negative affect, and psychological capital were obtained prior to commencing the study, after completion of the first treatment group, and again postintervention of the waitlisted group, and then at the end of the year.

Findings: Coaching the students to reflect on their emotions and make solution-focused choices to manage known stresses of medical education was shown to decrease medical student stress, anxiety, and depression, thereby increasing the mental health profiles of medical students.

Research limitations/implications: The findings suggest that an online coaching tool that increases psychological awareness and positive action can have a positive effect on mental health and mood of medical students.

Practical implications: The framework developed and tested in this study is a useful tool for medical schools to assist medical students in managing their well-being, thereby decreasing the incidence and prevalence of mental illness in medical students. The implications of this research are significant in that positively affecting the psychological well-being of medical students could have a significant effect not only on each medical student but also on every patient that they treat, and society as a whole. Better mental health in medical students has the potential to decrease dropout rates, increase empathy and professionalism, and allow for better patient care.

Originality/value: This study contributes to the literature on online coaching for improved psychological well-being and emotional regulation, mental health, and medical students. It is one of the first studies using a coaching protocol to make a positive change to the known stress, anxiety, and depression experienced by medical students worldwide.

Medical tourism demands tremendous responsiveness and accountability. The triple bottom line in medical tourism indicates that these organizations must emphasize on economic profits, environmental protection, and conservation of social resources. Developing a resilient medical tourism ecosystem is another critical necessity after the COVID-19 pandemic. The present study attempts to study the various aspects of medical tourism while synthesizing the relevant theories. This synthesis was used to propose a framework for developing a resilient medical tourism system. The outcomes of the chapter also propose the long, medium, and short-term goals. These goals focus on relevant stakeholders for developing highly integrated and resilient medical-tourism destinations.

This chapter analyzes the tourism industry from national and regional perspectives, in order to understand the past and current trends in Costa Rica’s positioning and branding attributes and strategies for tourism development. The intent here is not to provide an exhaustive comprehensive literature review of academic research on country branding; and so it is by all means a case study as it describes the evolution of the tourism industry in Costa Rica – including the transformative stages the country went through since the 1980s – as planned tourism national management programs evolved toward reaching the target of creating a nature-based tourism brand. The medical industry and then medical tourism industries are analyzed in a global basis and the US market is examined in detail because of its potential to develop a new complementary niche for Costa Rica’s tourism industry. The chapter intends to asses Costa Rica’s potential to become a country brand in medical tourism, leveraged on its natural tourism destination branding status quo.