Search results

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 was to examine the relationship between medical malpractice claims and medical care quality in Taiwan. The Delphi technique with an expert panel was used to determine the relationship between malpractice and medical quality. A total of 371 medical malpractice claims were analyzed. Main measures included the rate and strength of malpractice cases associated with quality and the identification of the quality factors influencing the occurrence of malpractice. Results showed that malpractice claims were associated with internal medicine cases, surgery cases, pediatric cases, obstetric and gynecological cases, physicians' professional competence, non‐acceptable outcomes, complications, and poor communication. Concludes that medical malpractice cases could be avoided by increasing physicians' professional knowledge, practical skills, and communication.

Health care has become one of the paramount issues of the 21st century as governments and individuals grapple the complex problems associated with contemporary medical care such as cost, affordability, and shifting demographic trends. One response has been the growth of medical tourism (sometimes called health tourism or global healthcare). Medical tourism is an example of how the forces of globalization are re-shaping what has previously been a relatively stable localized service, medical treatment, in the face of changes to health care. While traveling to distant locations in search of health restoring locations is not new as the affluent have long traveled to spas or exotic locales to derive health benefits. What has changed is who is doing it and why they are doing it as insurers and patients alike become eager participants in the outsourcing of medical care. The rising number of uninsured and underinsured Americans, particularly in the middle class, has been coupled with effective marketing by medical tourism companies to produce growing numbers of Americans traveling to foreign countries for healthcare. China, India, Korea, Malaysia, the Philippines, South Africa, and Thailand are only a few of the competitors for overseas patients as a source for economic development. Using analytic frameworks of Immanuel Wallerstein and Anthony Giddens to provide a social analysis of this phenomenon yields an exploration of this trend.

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

This study establishes a risk management system for medical and health care integration projects to address the problem of high-risk potential and a strong correlation between risk factors.

A new fuzzy WINGS-G1 model for identifying key risk factors in medical and health care integration projects is proposed by introducing the fuzzy theory and the concept of risk incidence into the Weighted Influence Non-linear Gauge System (WINGS) method.

The authors analyze the fluidity of project risk factors through complex networks to control direct risks and cut off risk transmission paths to provide a reference for risk control and prevention of medical and health care integration projects.

(1) The integration of fuzzy theory into the WINGS method solves the problem of strong subjectivity of expert scoring in the traditional WINGS method; (2) By the different probabilities of risk factors, the concept of risk incidence is introduced in the WINGS model, which is more conducive to the identification of the critical risk factors and the rational allocation and utilization of organizational resources; (3) The use of the complex network for risk interactivity analysis fully reflects the dynamic nature of risk factors in medical and health care integration projects.

Poor quality of services in the health-care sector of the developing countries like Bangladesh forces affluent patients to seek advanced medical treatment from abroad. The purpose of this study is to explore the outbound medical tourists’ satisfaction and loyalty on the basis of the quality of the health-care service provided by foreign medical institutions.

The medical tourists from Bangladesh who have got medical services from Indian medical institutions were taken as a sample by applying a purposive sampling technique. For the measurement of outbound medical tourists’ satisfaction, the dimensions of the HEALTHQUAL model were adopted. A self-administrated questionnaire was the major tool for collecting data from the respondents. Using partial least square-structural equation model multivariate statistical technique and with the aid of SmartPLS software, primary data collected from 218 final respondents were analyzed.

The findings of this study reveal that four dimensions of the HEALTHQUAL model, namely, empathy, tangibility, efficiency, and safety have a significant positive impact on building medical tourists’ overall satisfaction, and then the overall satisfaction also has a positive level of significance on building loyalty towards foreign medical service providers.

The findings of this study can be a helpful instrument for the developing countries to rethink and reshuffle their own existing health-care system for providing quality medical services and at the same time, the medical tourists importing countries to sharpen their existing service quality as well as to attract more medical tourists in the future.

A handful of research has been carried out, especially focused on health-care service quality measurement and the relationship of health-care service quality with satisfaction and loyalty from the perspective of developing countries outbound medical tourists. Thus, this research work will give a flavor to think of health-care service quality in a different dimension.

The health care crisis in the United States has roots that reach into the nineteenth century. An examination of the cultural, social, and economic roots should warn against piecemeal and short‐range measures to correct a fragmented system which, despite all its achievements, is draining the economy while it fails to meet the needs of millions. Unlike the Western European experience, it began as a loosely organized and loosely co‐ordinated system, responding as it grew to the forces of change: research from Europe, technological advances, corporate interests, the need for a healthier labour force, and the economic stimuli of the marketplace. Throughout the centuries, the delivery of medical care was seen in the terms of the buying and selling of a commodity. Professional and corporate groups are interested in keeping it essentially as it is by emphasizing its accomplishments and predicting setbacks of all kinds if drastic change is made. Argues that if the reformers in and out of government do not recognize the roots of the problems and the pivotal points requiring radical surgery, they will be unsuccessful in bringing about a more comprehensive and efficient health care system. A final lesson of history is that health care is a much broader reality than medical care. The health of the people depends largely on the improvement of the social and natural environment.

The purpose of this paper is to examine the health sector reform toward 2040 of Japan as a super-aged society.

This paper discusses the current healthcare policies adopted in Japan and projects the challenges in future as a super-aged society.

Through Japanese experiences, it is considered that Community-based Integrated Care System is useful, which takes into account the perspective of health care users. Being a super-aged society, it is essential for Japan to have more consensus by further removing obstacles, and paying attention to the change of paradigm and the purpose of care.

Based on the case of Japan, this paper serves as a reference for other East Asian countries, which would sooner or later encounter the similar situation of becoming super-aged societies in the 21^st century.

The purpose of this paper is to propose an alternative, interdisciplinary teaching of health, health care and medical care based on three pillars: social economics, the social determinants of health (SDH) and ethics. Based on these three pillars, the global financial crisis is presented as the moment of manifestation of the SDH at individual and aggregate levels that require a critical analysis from a broader perspective that is possible with social economics and ethics.

The author designed a writing-intensive course based on four modules about definition of health, health care, medical care and determinants of health; political economy of financing and organization of medical care; policies including reform proposals; and medical ethics and moral philosophies that reflect back on the previous topics, respectively.

The course attracts students from different disciplines who found it realistic and comprehensive so that it can be related easily to other disciplines owing to its interdisciplinary design. It also helps students to improve their writing skills.

The course is taught only in US context and is still open to further development.

The theoretical pillars of the course can be adopted and experimented with in different contexts (e.g. wars, plagues, immigration, etc.) and inform the participants about the subject matters from a broader perspective.

This paper provides a successful and novel teaching experience of health and medical care by putting social economics, SDH and ethics together.

This chapter examines social variations in parent dissatisfaction with children’s medical care and tests whether greater dissatisfaction is associated with less preventive care and unmet medical need.

The 2007 National Survey of Children’s Health (NSCH) is a nationally representative cross-sectional sample of parents of U.S. children age 0–17 years (N=78,523). We use a combination of ordinary least squares (OLS) and binary logistic regression to analyze parent dissatisfaction, preventive care, and unmet medical need.

Our results indicate that parents’ dissatisfaction scores are significantly higher for racial/ethnic minorities, non-English speakers, lower socioeconomic status (SES) respondents, and the uninsured. Furthermore, parent dissatisfaction has a significant and robust association with lack of preventive care and reports of unmet medical need.

Due to the cross-sectional research design, we were unable to determine whether dissatisfaction caused parents to delay children’s medical care, thus resulting in a lack of annual preventive care and greater unmet needs.

Although there is extensive research on adult perceptions of their own medical care, few sociological studies have examined parents’ perceptions about their children’s care. Yet, there is substantial evidence that parents transmit health-related attitudes, beliefs, and behaviors to their children. As with adult patients, parent satisfaction with their child’s medical care is stratified by social characteristics; however, we also find a strong association between dissatisfaction and use of other important health services. It may be the case that when parents feel that they did not receive satisfactory care, they are more likely to delay, or to forgo, preventive and other health services.