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Article
Publication date: 10 August 2021

Shuqing Chen, Xitong Guo, Tianshi Wu and Xiaofeng Ju

With the advent of the Digital 2.0 era, online doctor–patient (D–P) interaction has become increasingly popular. However, due to the fact that doctors use their fragmented…

Abstract

Purpose

With the advent of the Digital 2.0 era, online doctor–patient (D–P) interaction has become increasingly popular. However, due to the fact that doctors use their fragmented time to serve patients, online D–P interaction inevitably has some problems, such as the lack of pertinence in the reply content and doctors' relative unfamiliarity with their individual patients. Therefore, the purpose of this study is to excavate whether potential D–P social ties and D–P knowledge ties accentuate or attenuate the influence of patient selection (online and offline selection).

Design/methodology/approach

The authors used the methods of text mining and empirical analysis on the structured and unstructured data of an online consultation platform in China to examine the research hypotheses.

Findings

The findings illustrate that the potential D–P social ties increase the influence on patient selection, as do the potential D–P knowledge ties. Specifically, the effect of social ties on patient selection is positively moderated by patient health literacy. Conversely, health literacy weakens the link between knowledge ties and patient selection. In addition, the doctor's title weakens the influence of social ties on patient selection, in contrast to knowledge ties (partially).

Originality/value

This study provides guidance for doctors and patients on how to communicate effectively and alleviate tension within D–P relationships. The study’s findings have both theoretical and practical implications for both doctors' and online platforms' decision-making.

Details

Internet Research, vol. 32 no. 1
Type: Research Article
ISSN: 1066-2243

Keywords

Article
Publication date: 31 December 2018

Mahmud Akhter Shareef, Yogesh K. Dwivedi, Norm Archer and Mohammad Mahboob Rahman

Stakeholders affiliated with healthcare services should understand patient attitudes and criteria that are involved in selecting a personal physician. The purpose of this…

Abstract

Purpose

Stakeholders affiliated with healthcare services should understand patient attitudes and criteria that are involved in selecting a personal physician. The purpose of this paper is to identify the factors that are significant to patients in selecting or deselecting physicians as providers of healthcare services.

Design/methodology/approach

The research structure was set to theorize the physician selection criteria (PSC) model into two phases. The first phase developed a conceptual model as revealed from healthcare consumer perceptions. The second phase was designed to test and validate the model through cause–effect statistical analysis underpinned by theoretical explanations through an empirical study.

Findings

Through an empirical study of benchmarking perceptions of people from 15 different countries, qualitative PSC were gathered and used to formulate an initial PSC model. Based on the proposed model, a validity test was conducted, and finally, the PSC model was developed, resulting in several interesting and self-explanatory outcomes.

Research limitations/implications

The model was tested in only one (relatively cosmopolitan) city. For proper generalization, it should be tested in countries with differing healthcare service systems.

Practical implications

The results of this study are interesting, important and have potential values to academics and medical professionals. The study provides strong evidence that a physician’s external approach to patients is the most significant issue for patients seeking medical services. This does not refer to basic medical services, but rather the treatment process, where the physician’s behavior and positive attitude has the strongest effect on the patient’s decision to choose one physician over others.

Originality/value

Final PSC model has identified some significant theoretical explanations for academics and professional justifications for practitioners.

Details

Benchmarking: An International Journal, vol. 26 no. 1
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 15 February 2019

Manish K. Dixit, Shashank Singh, Sarel Lavy, Wei Yan, Fatemeh Pariafsai and Mohammadreza Ostadalimakhmalbaf

The purpose of this study is to create a knowledge base for decision-making in healthcare design by seeking, analyzing and discussing the preferences of facility managers…

Abstract

Purpose

The purpose of this study is to create a knowledge base for decision-making in healthcare design by seeking, analyzing and discussing the preferences of facility managers of healthcare facilities regarding floor finishes and their selection criteria. The goal is to enable a simplified and holistic selection of floor finishes based on multiple criteria. The authors studied floor finish selection in three healthcare units: emergency, surgery and in-patient units.

Design/methodology/approach

The authors completed a literature review to identify types of floor finishes currently used in healthcare facilities and the criteria applied for their selection. Using the literature survey results, a questionnaire was designed and administered to healthcare facility managers. The descriptive statistical analysis and the Friedman and Wilcoxon signed-ranks tests were used for reporting and analyzing the survey data.

Findings

The top five floor finishes used in the healthcare sector were identified as vinyl flooring, vinyl composite tile (VCT), rubber, linoleum and ceramic flooring. The top five selection criteria for floor finishes were durability, infection control, ease of maintenance, maintenance cost and user safety. The non-parametric test results show that the floor finish rankings and selection criteria were similar in the three healthcare units under study.

Originality/value

The most significant contribution of this research is to the design decision-making process of healthcare facilities. These results offer an understanding of what floor finishes are preferred by healthcare facility managers and why. This knowledge is crucial for designers and facility managers to make informed choices and floor finish manufacturers to keep their product line relevant to the industry.

Details

Facilities, vol. 37 no. 9/10
Type: Research Article
ISSN: 0263-2772

Keywords

Article
Publication date: 30 January 2007

G.E. Glass and M. Soldin

To evaluate the impact of rationing guidelines on the practice of reduction mammaplasty, with particular reference to patient selection.

303

Abstract

Purpose

To evaluate the impact of rationing guidelines on the practice of reduction mammaplasty, with particular reference to patient selection.

Design/methodology/approach

A retrospective audit was performed. Patients who were accepted for surgery in the first nine months following the date of publication of new and explicit inclusion criteria were compared with patients who were accepted for surgery in the 15 months preceding publication.

Findings

Of 131 consecutive patients, 98 were accepted before publication of the inclusion criteria, with 33 after. A total of the 97 of 98 and 33 of 33 were symptomatic. Conformity to criteria for body mass index (BMI) increased from 65 of 98 (66 per cent) to 25 of 33 (76 per cent, p=0.143) Attendance at pre‐operative breast seminar increased from 72 of 98 (73 per cent) to 29 of 33 (88 per cent, p=0.099). Incidence of smoking increased from 18 of 98 (18 per cent) to 7 of 33 (21 per cent, p=0.799). Patients under the age of 30 accounted for this increase. The number of cases who failed on more than one criterion fell from 17 of 98 (7 per cent) to 2 of 33 (3 per cent, p=0.155).

Practical implications

Demonstrates a non‐significant reduction in the number of obese patients being accepted for surgery, and a non‐significant increase in uptake of pre‐operative nurse led seminars in the practice. Since publication of the inclusion criteria, all but one of the patients accepted for surgery with exclusion criteria failed on the basis one criterion only. Not successful in enforcing abstinence from smoking as a condition for surgery, particularly among younger patients. To help do this objective ways to assess smoking status need to be looked at. A re‐audit is required to complete the loop.

Originality/value

This is the first paper to present audit results for the new inclusion criteria for reduction mammaplasty.

Details

Clinical Governance: An International Journal, vol. 12 no. 1
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 6 June 2022

Ankit Singh, Ajeya Jha, Shankar Purbey and Priya Ravi

Elderly patients suffering from non-communicable disease face a dilemma in the selection of healthcare providers. This study attempts to identify the key variables playing…

Abstract

Purpose

Elderly patients suffering from non-communicable disease face a dilemma in the selection of healthcare providers. This study attempts to identify the key variables playing a crucial role and identify the appropriate healthcare destination with the help of a combination of Decision-making Trial and Evaluation Laboratory (DEMATEL) and analytic hierarchy process (AHP) techniques. The primary objective is to introduce the DEMATEL and AHP as efficient decision-making methods to choose the right healthcare provider for elderly patients suffering from non-communicable diseases.

Design/methodology/approach

An integrative approach utilizing DEMATEL and AHP is used to reach the ideal solution for healthcare provider selection decisions. The DEMATEL approach is used to segregate the cause and effect variables. Similarly, the AHP is used to identify the weights of the top five cause-inducing variables, and the paired comparison method is used to select the healthcare provider.

Findings

The variables such as dependency on family members, easily accessible services, and patient autonomy play a vital role in the selection decision of healthcare providers in elderly patients suffering from non-communicable diseases.

Practical implications

In terms of priority, home healthcare should be considered the preferred provider for elderly patients suffering from non-communicable diseases followed by neighbourhood registered medical practitioners and hospitals.

Originality/value

This is the first of its kind study which has attempted to solve the healthcare provider selection decision with the combined approach of DEMATEL and AHP.

Details

Journal of Integrated Care, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1476-9018

Keywords

Book part
Publication date: 21 October 2008

Patricia Drew

In this chapter I explore how conflicting discursive claims made by the medical community are consequential for bariatric weight loss surgery patients. Bariatric surgery…

Abstract

In this chapter I explore how conflicting discursive claims made by the medical community are consequential for bariatric weight loss surgery patients. Bariatric surgery has become increasingly common in the United States since the 1990s, with over 177,000 Americans undergoing surgery in 2006. Despite the surgery's growing popularity, the US medical community does not wholeheartedly endorse the surgery. Rather, different members of the medical community espouse contradictory evaluations of weight loss surgery. I broadly characterize this intra-medical community controversy and, then, discuss how conflicting claims have helped shape the bariatric surgery industry's discursive conception of an “ideal patient.” Next, I analyze actual patients’ negotiations of the ideal patient archetype, and find that patients’ responses follow three paths: embracing the ideal, having a mixed response to the ideal, and strategically complying with the ideal. As patients are compelled to grapple with the ideal archetype in order to access surgery, I conclude that the ideal archetype acts as a discursive frame connecting individual patients to broad bariatric surgery discourses.

Details

Care for Major Health Problems and Population Health Concerns: Impacts on Patients, Providers and Policy
Type: Book
ISBN: 978-1-84855-160-2

Book part
Publication date: 1 November 2007

Irina Farquhar, Michael Kane, Alan Sorkin and Kent H. Summers

This chapter proposes an optimized innovative information technology as a means for achieving operational functionalities of real-time portable electronic health records…

Abstract

This chapter proposes an optimized innovative information technology as a means for achieving operational functionalities of real-time portable electronic health records, system interoperability, longitudinal health-risks research cohort and surveillance of adverse events infrastructure, and clinical, genome regions – disease and interventional prevention infrastructure. In application to the Dod-VA (Department of Defense and Veteran's Administration) health information systems, the proposed modernization can be carried out as an “add-on” expansion (estimated at $288 million in constant dollars) or as a “stand-alone” innovative information technology system (estimated at $489.7 million), and either solution will prototype an infrastructure for nation-wide health information systems interoperability, portable real-time electronic health records (EHRs), adverse events surveillance, and interventional prevention based on targeted single nucleotide polymorphisms (SNPs) discovery.

Details

The Value of Innovation: Impact on Health, Life Quality, Safety, and Regulatory Research
Type: Book
ISBN: 978-1-84950-551-2

Open Access
Article
Publication date: 30 March 2020

Andrew Chunkil Park, Leigh Goodrich, Bobak Hedayati, Ralph Albert, Kyle Dornhofer and Erin Danielle Knox

The purpose of this paper is to illustrate delirium as a possible consequence of the application of symptom-triggered therapy for alcohol withdrawal and to explore…

Abstract

Purpose

The purpose of this paper is to illustrate delirium as a possible consequence of the application of symptom-triggered therapy for alcohol withdrawal and to explore alternative treatment modalities. In the management of alcohol withdrawal syndrome, symptom-triggered therapy directs nursing staff to regularly assess patients using standardized instruments, such as the Clinical Institute for Withdrawal Assessment of Alcohol, Revised (CIWA-Ar), and administer benzodiazepines at symptom severity thresholds. Symptom-triggered therapy has been shown to lower total benzodiazepine dosage and treatment duration relative to fixed dosage tapers (Daeppen et al., 2002). However, CIWA-Ar has important limitations. Because of its reliance on patient reporting, it is inappropriate for nonverbal patients, non-English speakers (in the absence of readily available translators) and patients in confusional states including delirium and psychosis. Importantly, it also relies on the appropriate selection of patients and considering alternate etiologies for signs and symptoms also associated with alcohol withdrawal.

Design/methodology/approach

The authors report a case of a 47-year-old male admitted for cardiac arrest because of benzodiazepine and alcohol overdose who developed worsening delirium on CIWA-Ar protocol.

Findings

While symptom-triggered therapy through instruments such as the CIWA-Ar protocol has shown to lower total benzodiazepine dosage and treatment duration in patients in alcohol withdrawal, over-reliance on such tools may also lead providers to overlook other causes of delirium.

Originality/value

This case illustrates the necessity for providers to consider using other available assessment and treatment options including objective alcohol withdrawal scales, fixed benzodiazepine dosage tapers and even antiepileptic medications in select patients.

Details

Mental Illness, vol. 12 no. 1
Type: Research Article
ISSN:

Keywords

Article
Publication date: 16 June 2022

Adnan Muhammad Shah, Wazir Muhammad and KangYoon Lee

This study examines how service feedback and physician popularity affect physician demand in the context of virtual healthcare environment. Based on the signaling theory…

Abstract

Purpose

This study examines how service feedback and physician popularity affect physician demand in the context of virtual healthcare environment. Based on the signaling theory, the critical factor of environment uncertainty (i.e. disease risk) and its impact on physician demand is also investigated. Further, the research on the endogeneity of online reviews in healthcare is also examined in the current study.

Design/methodology/approach

A secondary data econometric analysis using 3-wave data sets of 823 physicians obtained from two PRWs (Healthgrades and Vitals) was conducted. The analysis was run using the difference-in-difference method to consider physician and website-specific effects.

Findings

The study's findings indicate that physician popularity has a stronger positive effect on physician demand compared with service feedback. Improving popularity leads to a relative increase in the number of appointments, which in turn enhance physician demand. Further, the impact of physician popularity on physician demand is positively mitigated by the disease risk.

Originality/value

The authors' research contributes to a better understanding of the signaling transmission mechanism in the online healthcare environment. Further, the findings provide practical implications for key stakeholders into how an efficient feedback and popularity mechanism can be built to enhance physician service outcomes in order to maximize the financial efficiency of physicians.

Details

Information Technology & People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0959-3845

Keywords

Article
Publication date: 25 May 2021

Micaela Pinho

This paper aims to investigate the Portuguese general public views regarding the criteria that should guide critical COVID-19 patients to receive medical devices…

Abstract

Purpose

This paper aims to investigate the Portuguese general public views regarding the criteria that should guide critical COVID-19 patients to receive medical devices (ventilators and IUC beds) during the current pandemic context. Based on rationing principles and protocols proposed in ethical and medical literature the authors explore how Portuguese general public evaluates the fairness of five allocation principles: “prognosis”, “severity of health condition”, “patients age”, “instrumental value” (frontline healthcare professionals should be prioritized during the pandemic) and “lottery”.

Design/methodology/approach

An online questionnaire was used to collect data from a sample of 586 Portuguese citizens. Descriptive statistics and non-parametric tests were used to define a hierarchy of prioritization criteria and to test for the association between respondents support to them and their socio-demographic and health characteristics.

Findings

Respondents gave top priority to prognosis when faced with absolute scarcity, followed closely by the severity of health condition, patient’s age with instrumental value receiving lowest support, on average. However, when the age of the patients was confronted with survival, younger-first principle prevailed over recovery. In a pandemic context, lottery was considered the least fair allocation method. The findings suggest that respondents’ opinions are aligned with those of ethicists but are partially in disagreement with the protocol suggested for Portugal.

Originality/value

This study represents the first attempt to elicit public attitudes towards distributive criteria during a pandemic and, therefore, in a real context where the perception is that life and death decisions have to be made.

Details

Journal of Health Organization and Management, vol. 35 no. 8
Type: Research Article
ISSN: 1477-7266

Keywords

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