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The aim of this paper is to contribute a conceptualization of the information and communication needs of medical tourists from Western countries in an Asian health care context.

Multi-phase, semi-structured, in-depth interviews and observations were conducted with 27 multi-source informants who have communication experience in the international healthcare setting.

Multi-level information provision should be used to address communicative incongruence in Asian healthcare provider – Western patient encounters as was self-reported by the participants and observed by authors. The use of an informative communication model is proposed in order to facilitate interaction and the effective transfer of information with Western patients to overcome negative, underlying emotions and enable autonomous decision making by the patients.

This exploratory study is focused on Western patients and Asian practitioners in Thailand. Future research in other countries and with patients from other geographical areas could expand to generalize findings.

Fostering information sharing with Western patients by using an integrative communication model can improve patient satisfaction and health outcomes. The need for developing and implementing these improved practices for communicating with Western patients is reflected by the healthcare industry's current developmental trends helping to lead to a future of health service internationalization.

This is the first empirical study to provide insights concerning the communication needs and coping strategies of Western patients with Asian doctors in developing countries.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

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.

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.

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.

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.

The aim of this study was to describe Jordanian critical care nurses’ experiences of autonomy in their clinical practice.

A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire.

A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice.

Nurse’s autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice.

Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses’ job satisfaction. Therefore, improving nurses’ clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

Failure to rescue events, or events involving preventable deaths from complications, are a significant contributor to inpatient mortality. While many interventions have been designed and implemented over several decades, this patient safety issue remains at the forefront of concern for most hospitals. In the first part of this study, the development and implementation of one type of highly studied and widely adopted rescue intervention, algorithm-based patient assessment tools, is examined. The analysis summarizes how a lack of systems-oriented approaches in the design and implementation of these tools has resulted in suboptimal understanding of patient risk of mortality and complications and the early recognition of patient deterioration. The gaps identified impact several critical aspects of excellent patient care, including information-sharing across care settings, support for the development of shared mental models within care teams, and access to timely and accurate patient information.

This chapter describes the use of several system-oriented design and implementation activities to establish design objectives, model clinical processes and workflows, and create an extensible information system model to maximize the benefits of patient state and risk assessment tools in the inpatient setting. A prototype based on the product of the design activities is discussed along with system-level considerations for implementation. This study also demonstrates the effectiveness and impact of applying systems design principles and practices to real-world clinical applications.

Ethics is the foundation on which societies and cultures are based and are fundamental to political, social and economic decision making. Ethical dilemmas have created controversy and heated debate over the years. Disasters have been defined in public health terms as destructive events that result in the need for a wide range of emergency resources to assist and ensure the survival of the stricken population. Lack of medical resources, in conjunction with a mass casualty situation, can present specific ethical challenges. The purpose of this paper is to explore the ethics of disaster management.

In and after a disaster, ethical questions arise regarding appropriate and fair allocation of relief funds to help with recovery. Research in disaster settings poses unique ethical dilemmas. The researcher must determine how to balance the critical need for research with the ethical obligation of respect for, and protection of, the interests of research participants. Ethics as part of an educational program made available to health care providers may assist disaster responders to make the difficult ethical decisions involved in disasters. This literature review discusses these issues in conjunction with disaster response and recovery.

The cardinal virtues of disaster response are prudence, courage, justice, stewardship, vigilance, resilience, self‐effacing charity and communication. These eight virtues are not considered all inclusive, no more than Aristotle considered that his morals or virtues were all inclusive. Ongoing work in disaster management will help to ensure that such situations are managed in an ethical manner that respects the rights and privileges of all those involved.

The literature reviewed for this paper was based on peer reviewed scholarly writings. Concepts of ethics and justice are important issues in disaster situations. This paper offers ideas to prompt further discussion among disaster managers and students of disaster studies.

Social changes are reliant on an understanding of ethics and how it affects society. This paper puts forward ethical concepts to prompt discussion by disaster responders and managers with the hope of improving disaster management.

The paper is an original document that may be useful to students of disaster management and those who teach disaster management

There is anecdotal evidence that ethnic minority physicians are underrepresented in managed care contracts. The purpose of this paper, therefore, is to determine ethnic Asian‐Indian physician‐managed care organization experience and job satisfaction in the USA by age, gender, region and percent of patients in managed care organizations.

A random (nation‐wide) mail survey was conducted of 254 physicians who were American Association of Physicians of Indian Origin (AAPI) members during the period 1998 to 2000. Managed care experience was categorized into physician satisfaction; service quality rating; service limitations; difficulties acquiring and maintaining managed care contracts; and financial impact.

Physicians in solo and group practice relied heavily on managed care enrolled patients. Limitations providing care to patients was a more serious problem than for those in staff‐model health maintenance organization and hospital/clinic‐based practices. Physician satisfaction was not significantly related to board certification, practice type, region and managed care participation. However, practice staff participating in managed care had the highest number of board‐certified physicians.

There was a low response rate (37 percent) to data collection using questionnaires.

The paper underlines ethnic minority physicians' capability to get managed care contracts.

This is the first national study of Asian‐Indian physicians and their managed care organization experience. Asian‐Indian physicians are over‐represented in the medical profession and hence the paper will interest those working and dealing with managed care organizations and their patients.

The purpose of this paper is to provide the results of a case study that examined the application of platform design to improve the integration of patient care services across the continuum of care. This paper is designed to spark discussion and encourage further research in this area.

The research in the paper involved a case study of a large health care provider in a major metropolitan area. The authors of this paper worked with directors of case management departments and other managerial personnel within the enterprise to study the case management interface services between different inpatient and outpatient facilities to examine existing processes, identify deficiencies, and to recommend improvements in case management.

The paper finds that the current case management system of the provider, as structured, was not fulfilling its potential for achieving medical quality, operational cost, or patient satisfaction. A number of areas where improvements could be made were identified, and an integrated case management approach based on modular platform design was recommended as a key approach to realize such improvements.

The paper shows that this study involves only one major provider and therefore the direct application of an integrated case management approach based on platform design to other providers would have to be further researched. However, the proposed integrated, cross‐continuum model of case management appears to be a novel way to both improve care and achieve financial cost efficiencies.

The case study in this paper demonstrates how innovative thinking and the use of techniques typically associated with “Platform architectures” can have direct application in the health care sector.

The paper shows that as health care providers are continuously working to improve the quality of care within specific areas of clinical care, improvement in the interfaces between these specific areas may also improve the quality and cost of care. This case study applies modular services design to show how the planning and delivering patient services across the entire “Continuum of care”, which includes the transfer of patients, care coordination, and medical information management can achieve that desired result.

The purpose of this paper is to understand value cocreation in service ecosystems from a multilevel perspective, uncovering value cocreation factors and outcomes at the micro, meso, and macro levels.

A Grounded Theory approach based on semi-structured interviews is adopted. The sample design was defined to enable the ecosystem analysis at its different levels. At the macro level was the Portuguese Health Information ecosystem. Embedded meso level units of analysis comprised eight health care organizations. A total of 48 interviews with citizens and health care practitioners were conducted at the micro level.

Study results enable a detailed understanding of the nature and dynamics of value cocreation in service ecosystems from a multilevel perspective. First, value cocreation factors are identified (resource access, resource sharing, resource recombination, resource monitoring, and governance/institutions generation). These factors enable actors to integrate resources in multiple dynamic interactions to cocreate value outcomes, which involve both population well-being and ecosystem viability. Study results show that these value cocreation factors and outcomes differ across levels, but they are also embedded and interdependent.

The findings have important implications for organizations that are ecosystem actors (like the Portuguese Ministry of Health) for understanding synergies among value cocreation factors and outcomes at the different levels. This provides orientations to better integrate different actor roles, technology, and information while facilitating ecosystem coordination and co-evolution.

This study responds to the need for a multilevel understanding of value cocreation in service ecosystems. It also illuminates how keystone players in the ecosystem should manage their value propositions to promote resource integration for each actor, fostering resource density and ecosystem viability. It also bridges the high-level conceptual perspective of Service-Dominant logic with specific empirical findings in the very important context of health care.

Traditionally in health care and in the public sector more generally, little thought has been given to the impact of provider‐oriented incentives on the delivery of services. There has been an assumption that the language of incentives belonged to the private sector and was inappropriate in the public sector. Instead, the governance of health care has relied on the professional ethos of clinicians to direct decision making. Implicitly there has been an expectation that the ethical stance of clinicians would ensure that their actions were always in the best interest of patients. However, in the context of a heightened awareness of cost constraints there has been a greater emphasis on the active management of resources in medical organizations. This article argues that the structure of incentives in health care is highly significant in resource allocation, as medical ethics does not provide an unambiguous guide to clinical decision making. The paper defines the nature of the financial and professional incentives in medical organizations and discusses their impact on the delivery of services through an analysis of positive and negative effects. By undertaking a comparison between the UK and Canada, the paper identifies the differential nature of the incentives present in the health care systems of these two countries and discusses some of their consequences.