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Article
Publication date: 1 December 2001

Douglas Amyx and Dennis N. Bristow

A 2 × 2 full factorial between subjects experimental design was used to examine how three elements of the health care experience (patients’ freedom to choose a physician;…

Abstract

A 2 × 2 full factorial between subjects experimental design was used to examine how three elements of the health care experience (patients’ freedom to choose a physician; patients receiving their preferred physician; health care outcome) impacted on patient satisfaction with health care service. All constructs with corresponding measurements were discussed, and their relationships with satisfaction were examined. Hypotheses were developed and tested for each relationship using a pencil and paper scenario of a patient’s first time service encounter at a health clinic. Results of the experiment indicated that given an undesirable health outcome, allowing patients a choice of physicians favorably raised patient satisfaction levels. Further, patients who were treated by a physician whom they preferred rated the health care experience more positively than did patients who received non‐preferred physicians.

Details

Marketing Intelligence & Planning, vol. 19 no. 7
Type: Research Article
ISSN: 0263-4503

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Article
Publication date: 1 December 2000

Douglas Amyx, John C. Mowen and Robert Hamm

An experiment was conducted to examine the relationship between patient satisfaction and patients’ freedom to choose a physician and the outcome of a health service…

Abstract

An experiment was conducted to examine the relationship between patient satisfaction and patients’ freedom to choose a physician and the outcome of a health service encounter. Each construct with corresponding measurements is discussed and their relationship with satisfaction is reviewed. Hypotheses were developed and tested for each relationship using pencil and paper scenarios of a patient’s service encounter at a health clinic. The study yielded four major findings. First, patients who experienced a good health outcome were significantly more satisfied than patients who received a bad health outcome. Second, patient satisfaction ratings differed significantly only in the bad outcome condition, suggesting an outcome bias. Third, patients who were given the freedom to select a physician but did not receive their chosen physician were least satisfied. Fourth, there was no difference in satisfaction between patients who had a choice of physician and those who did not.

Details

Journal of Services Marketing, vol. 14 no. 7
Type: Research Article
ISSN: 0887-6045

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Article
Publication date: 1 December 2000

Douglas Amyx, John C. Mowen and Robert Hamm

An experiment was conducted to examine the impact of patients’ freedom to choose a physician and health locus of control on patient satisfaction. The experiment was set…

Abstract

An experiment was conducted to examine the impact of patients’ freedom to choose a physician and health locus of control on patient satisfaction. The experiment was set within the scenario of a patient suffering from a lengthy viral infection after visiting a health clinic for the first time. All constructs with corresponding measurements are discussed and their relationships with satisfaction are examined. Hypotheses are developed and tested for each relationship using pencil and paper scenarios of a patient’s service encounter at a health clinic. A 2 × 2 full factorial between subjects experimental design was used with 99 subjects. Results of the experiment indicated different patterns of satisfaction among subjects based on measures of health locus of control (HLC). Individuals with an internal HLC were more satisfied with having a choice of a physician than not having a choice and were also more satisfied than external HLC individuals who had a choice. In contrast, individuals with an external HLC did not discriminate between having or not having the opportunity to choose a physician.

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Journal of Management in Medicine, vol. 14 no. 5/6
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 25 May 2010

Lars Nordgren

This paper has two purposes: one is to analyse how the policy of freedom of choice emerged and was formed in the Swedish health care discourse; the second is related to…

Abstract

Purpose

This paper has two purposes: one is to analyse how the policy of freedom of choice emerged and was formed in the Swedish health care discourse; the second is related to how free choice influences the discourse in health care and how subjects are formed within the field, i.e. what the language of choice in health care does.

Design/methodology/approach

The research strategy is inspired by a combined theoretical framework borrowed from Michel Foucault's concepts of “discursive formation” and “subjectivization” completed with Judith Butler's concept of performativity.

Findings

The language of “freedom of choice” calls to mind the rhetoric of promises, i.e. that the patient should be free and responsible, in his or her relation to health care. Since patients seem to be insufficiently informed and supported about the actual benefits of possibilities and limitations associated with the severely restricted reform of free choice, the statements concerning opportunities to make personal health decisions will lose their significance. The advocacy of discourses of freedom of choice seems therefore mostly like empty words, as they are producing weak patients instead of free and empowered people.

Research limitations/implications

As the reform was initiated in the beginning of 2000 it is rather fresh.

Originality/value

The paper produces insights into the rhetoric of political promises and the limitations of the reform dealing with freedom of choice in health care.

Details

Journal of Health Organization and Management, vol. 24 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 15 July 2006

Lisa Miller and Daryl May

From December 2005, patients in the UK needing an operation will be offered a choice of four or five. These could be NHS trusts, foundation trusts, treatment centres…

Abstract

Purpose

From December 2005, patients in the UK needing an operation will be offered a choice of four or five. These could be NHS trusts, foundation trusts, treatment centres, private hospitals or practitioners with a special interest operating within primary care. This is called “Choose and Book”. The purpose of this research is to discover how critical facilities management service factors are in influencing a choice of hospital. The aim is to find out what the most important influencing factors are to people when making a choice of which hospital to have their operation. If facilities services and the patient environment are influencing factors in the patient experience, which are considered critical.

Design/methodology/approach

Focus groups were used as the primary method of data collection.

Findings

The study finds that all three focus groups placed more importance on clinical factors than facilities factors. High standards of cleanliness and good hospital food were the two facilities factors that participants in all groups placed most importance on. Cleanliness was highlighted by all three groups as a top facilities priority for the NHS at the moment and there was a general perception that private hospitals have better standards of cleanliness.

Practical implications

By understanding how important facilities factors are in influencing patient choice and which ones have a critical impact, it will help NHS trusts focus on where they channel their resources.

Originality/value

This paper is of value to NHS trusts who want to make effective use of facilities services in order to be competitive in attracting patients through the new patient choice framework.

Details

Facilities, vol. 24 no. 9/10
Type: Research Article
ISSN: 0263-2772

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Article
Publication date: 11 May 2015

Jin Wang and Richard Y.K. Fung

– The purpose of this paper is to maximize the expected revenue of the outpatient department considering patient preferences and choices.

Abstract

Purpose

The purpose of this paper is to maximize the expected revenue of the outpatient department considering patient preferences and choices.

Design/methodology/approach

Patient preference refers to the preferred physician and time slot that patients hold before asking for appointments. Patient choice is the appointment decision the patient made after receiving a set of options from the scheduler. The relationship between patient choices and preferences is explored. A dynamic programming (DP) model is formulated to optimize appointment scheduling with patient preferences and choices. The DP model is transformed to an equivalent linear programming (LP) model. A decomposition method is proposed to eliminate the number of variables. A column generation algorithm is used to resolve computation problem of the resulting LP model.

Findings

Numerical studies show the benefit of multiple options provided, and that the proposed algorithm is efficient and accurate. The effects of the booking horizon and arrival rates are studies. A policy about how to make use of the information of patient preferences is compared to other naive polices. Experiments show that more revenue can be expected if patient preferences and choices are considered.

Originality/value

This paper proposes a framework for appointment scheduling problem in outpatient departments. It is concluded that more revenue can be achieved if more choices are provided for patients to choose from and patient preferences are considered. Additionally, an appointment decision can be made timely after receiving patient preference information. Therefore, the proposed model and policies are convenient tools applicable to an outpatient department.

Details

Industrial Management & Data Systems, vol. 115 no. 4
Type: Research Article
ISSN: 0263-5577

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Article
Publication date: 3 March 2014

Ali Mohammad Mosadeghrad

– The purpose of this study was to identify the most important influencing factors in choosing a hospital by a patient.

Abstract

Purpose

The purpose of this study was to identify the most important influencing factors in choosing a hospital by a patient.

Design/methodology/approach

This study involved a mixed research design. Focus groups and in-depth individual interviews were conducted with patients to explore reasons for choosing a hospital. In addition, this study involved survey-based research on the patient choice.

Findings

Type of the hospital, type of the service, word of mouth, cost of services, the health insurance programme, location, physical environment, facilities, providers' expertise and interpersonal behaviour, and reputation of the hospital influenced patients' choice of a hospital. Doctor recommendations and health insurance programme were the main reasons for choosing a hospital for inpatients and outpatients respectively.

Practical implications

Identifying and understanding key factors that influence a patient choice of a healthcare setting helps managers and policy makers invest their resources in those critical areas and improve those aspects of their services to attract more patients.

Originality/value

This article contributes to healthcare theory and practice by developing a conceptual framework for understanding the factors that influence a patient choice of a healthcare setting.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 2
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 4 December 2020

Hualong Yang, Helen S. Du and Wei Shang

Despite the prevalent use of professional status and service feedback in online healthcare markets, the potential interaction relationship between two types of information…

Abstract

Purpose

Despite the prevalent use of professional status and service feedback in online healthcare markets, the potential interaction relationship between two types of information is still unknown. This study used the signaling theory to examine the substitute relationship between professional status and service feedback in patients' doctor choice, as well as the moderating effect of illness severity.

Design/methodology/approach

To test the paper's hypotheses, we constructed a panel data model using 418 doctors' data collected over a period of six months from an online healthcare market in China. Then, according to the results of the Hausman test, we estimated a fixed-effects model of patients' choice in online healthcare markets.

Findings

The empirical results showed that the effect of a doctor's professional status and service feedback on a patient's doctor choice was substitutable. Moreover, patients' illness severity played a moderating role, in that the influence of professional status on a patient with high-severity illness was higher than that on a patient with low-severity illness, whereas the influence of service feedback on a patient with low-severity illness was higher than that of a patient with high-severity illness. In addition, we found that illness severity negatively moderated the substitute relationship between professional status and service feedback on a patient's choice.

Originality/value

These findings not only contribute to signaling theory and research on online healthcare markets, but also help us understand the importance of professional status and service feedback on a patient's choice when seeking a doctor online.

Details

Internet Research, vol. 31 no. 4
Type: Research Article
ISSN: 1066-2243

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Article
Publication date: 12 February 2018

An Chen, Paul Martin Lillrank, Henni Tenhunen, Antti Peltokorpi, Paulus Torkki, Seppo Heinonen and Vedran Stefanovic

In healthcare, there is limited knowledge of and experience with patient choice management. The purpose of this paper is to focus on patient choice, apply and test…

Abstract

Purpose

In healthcare, there is limited knowledge of and experience with patient choice management. The purpose of this paper is to focus on patient choice, apply and test demand-supply-based operating (DSO) logic integrated with clinical setting in clarifying choice contexts, investigate patient’s choice-making at different contexts and suggest context-based choice architectures to manage and develop patient choice.

Design/methodology/approach

Prenatal screening and testing in the Helsinki and Uusimaa Hospital District (HUS), Finland, was taken as an example. Choice points were contextualized by using the DSO framework. Women’s reflections, behaviors and experience at different choice contexts were studied by interviewing women participating in prenatal screening and testing. Semi-structured interview data were processed by thematic analysis.

Findings

By applying DSO logic, four choice contexts (prevention, cure, electives and continuous care) were relevant in the prenatal screening and testing episode. Women had different choice-making in prevention and cure mode contexts regarding choice activeness, information needs, social influence, preferences, emotion status and choice-making difficulty. Default choice was widely accepted by women in prevention mode and individual counseling can help women make informed choice in cure mode.

Originality/value

The authors apply the DSO model to contextualize the patient choice in one care episode and compare patient choice-making at different contexts. The authors also suggest the possible context-based choice architectures to manage and promote patient choice

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 1
Type: Research Article
ISSN: 0952-6862

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Abstract

Details

Health Policy, Power and Politics: Sociological Insights
Type: Book
ISBN: 978-1-83909-394-4

1 – 10 of over 17000