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This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician decisions that can influence inequalities in access and utilisation: location decisions, decisions to work in the public and/or private sector, and decisions or behaviours in the doctor–patient encounter. For each, the authors summarise the issues and empirical evidence on possible policies to help reduce inequalities in access. Future research to reduce inequalities should focus on changes to health systems that influence physician decisions, such as health insurance expansions, the public–private mix and financial incentives, as well as physician training and policies for a more diverse physician workforce.

This study aims to investigate the role of information normalization in online healthcare consultation, a typical complex human-to-human communication requiring both effectiveness and efficiency. The globalization and digitization trend calls for high-quality information, and normalization is considered an effective method for improving information quality. Meanwhile, some researchers argued that excessive normalization (standardized answers) may be perceived as impersonal, repetitive, and cold. Thus, it is not appreciated for human-to-human communication, for instance, when patients are anxious about their health condition (e.g. with high-risk disease) in online healthcare consultation. Therefore, the role of information normalization in human communication is worthy to be explored.

Data were collected from one of the largest online healthcare consultation platforms (Dxy.com). This study expanded the existing information quality model by introducing information normalization as a new dimension. Information normalization was assessed using medical templates, extracted through natural language processing methods such as Bidirectional Encoder Representations from Transformers (BERT) and Latent Dirichlet Allocation (LDA). Patient decision-making behaviors, namely, consultant selection and satisfaction, were chosen to evaluate communication performance.

The results confirmed the positive impact of information normalization on communication performance. Additionally, a negative moderating effect of disease risk on the relationship between information normalization and patient decision-making was identified. Furthermore, the study demonstrated that information normalization can be enhanced through experiential learning.

These findings highlighted the significance of information normalization in online healthcare communication and extended the existing information quality model. It also facilitated patient decision-making on online healthcare platforms by providing a comprehensive information quality measurement. In addition, the moderating effects indicated the contradiction between informational support and emotional support, enriching the social support theory.

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

This study aims to explore whether seeking recommendations for doctors from offline word-of-mouth or online reviews influences patient satisfaction after treatment, and how the source of recommendation affects this effect.

Using a unique dataset of more than three million reviews from a popular Chinese online health community, this study used the coarsened exact matching method and built fixed-effect models to conduct empirical analysis.

The results suggest that selecting doctors according to recommendations can improve patient satisfaction and mitigate their dissatisfaction when encountering service failures. However, online recommendations were found to be less effective than offline sources in improving patient satisfaction.

This study provides important insights into patient satisfaction and doctor-patient relationships by revealing the antecedents of satisfaction and the potential for improving this relationship. It also contributes to the understanding of how recommendations in the healthcare context can improve patient satisfaction and alleviate the negative impact of service failures.

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

This study aims to investigate the combined impact of pharmaceutical marketing strategies, specifically free drug samples and interactions with medical representatives, on physicians’ attitudes and prescribing behavior in Jammu and Kashmir, India.

To achieve this objective, data were collected from a sample comprising 425 physicians. A six-point forced-choice Likert scale was used for data collection, and cluster sampling techniques were used in the study design.

The study reveals significant insights into pharmaceutical marketing’s influence on physician behavior. Free drug samples exert a positive influence on both physician attitudes and prescribing behavior. Physicians’ attitudes, in turn, significantly affect their prescribing decisions. Mediation analysis demonstrates that free drug samples indirectly influence prescribing behavior through shifts in physician attitudes. Effective medical representatives amplify this influence, as stronger associations between free drug samples and physician attitudes are observed when representatives are more effective.

This research contributes by unraveling the intricate dynamics between marketing strategies, physician attitudes and prescribing behavior in Jammu and Kashmir, India. It underscores the importance of ethical pharmaceutical marketing practices, highlighting the substantial role of free drug samples and the crucial function of effective medical representatives in shaping physician behavior. Ultimately, this study sheds light on how responsible pharmaceutical marketing and adept medical representatives can improve health-care outcomes in the region.

Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of impact and context of an intervention to reduce waiting for first appointments in an outpatient epilepsy clinic.

The UK Medical Research Council framework was used as the theoretical basis for a process evaluation alongside an intervention trial. The intervention, Specific Timely Appointments for Triage (STAT), is a data-driven approach that combines a one-off backlog reduction strategy with methods to balance supply and demand. A mixed methods process evaluation synthesised routinely collected quantitative and qualitative data, which were mapped to the domains of implementation, mechanisms of impact and contextual elements.

The principles of the STAT model were implemented as intended without adaptation. The STAT model reached all patients referred, including long waiters and was likely generalisable to other medical outpatient clinics. Mechanisms of impact were increased clinic capacity and elimination of unwanted variation. Contextual elements included the complexity of healthcare systems and the two-tier triage practice that contributes to prolonged waiting for patients classified as non-urgent.

This process evaluation shows how a data-driven strategy was applied in a medical outpatient setting to manage demand. Improving patient flow by reducing waiting in non-urgent, outpatient care is a complex problem. Understanding how and why interventions work is important for improved timeliness of care, and sustainability of public health services.

Researchers have widely explored and associated corporate social responsibility with firm success. Measuring the relationship between corporate social responsibility (CSR), service quality, corporate reputation, and brand preference by drawing on the stakeholder theory in healthcare industry and developing countries remains a substantial research gap.

Based on quantitative research and convenience sampling, data for the study were collected from 320 patients who have undergone treatments in 5 different private hospitals in Tehran, Iran. We analyzed the data using the Smart PLS 3.0 structural equation modeling technique.

The survey revealed that service quality and CSR are positively linked with corporate reputation, leading to brand preference in the healthcare sector. In addition, the mediating role of brand reputation in the relationship between corporate social responsibility, service quality and brand preference were confirmed.

The survey was performed in the context of the healthcare industry; however, additional studies are necessary to extrapolate the results to other fields, such as education and food. This research helps guide policymakers, administrators, healthcare managers, and researchers by highlighting the contribution and role of service quality, corporate social responsibility, and corporate reputation in achieving a hospital’s performance.

To the best of the authors’ knowledge, this study also extends research in the diverse literature by examining the relationship between CSR, service quality, corporate reputation, and brand preference by illustrating the stakeholder theory in the context of the healthcare sector.

A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme.

A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants.

Important factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme’s intention.

The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case.

The effectiveness of a message and its attributes have become important for digital media. This study aims to investigate how different elements of a website including both argument-oriented and emotional stimuli based on the elaboration likelihood model (ELM) can affect the issue involvement and change the attitude of the website visitors of a healthcare service provider.

The Ministry of Health and Education (MOHME) website was selected to explore how its content and design can persuade visitors. An online survey was conducted on 355 adults engaging in health protection behaviors during the COVID-19 pandemic.

Structural equation modeling (SEM) analysis showed that one design element, i.e. website navigation and one social cue, i.e. social connectedness, have positive impact on issue involvement, while social presence and website satisfaction have a negative effect on issue involvement because of the random fluctuation suppressor effect. In addition, prior knowledge significantly influenced the issue's involvement. Further, website satisfaction has impacted attitudes directly. There was no significant relationship between argument quality and issue involvement.

Previous works have studied health-related behaviors in offline contexts; however, the scholars have not focused on the individuals' persuasion using ELM regarding the healthcare services provided in online communities. The results of the current study have theoretical and practical implications for scholars, website designers and policymakers.