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The purpose of this paper is to report on the success of an initiative involving the transformation of a group of small substance use treatment only or mental health treatment only provider agencies serving uninsured adults into providers of co-occurring disorder treatment.

The paper uses a case study narrative to describe the initiative and the transformation of the participant agencies from being providers of mental health or substance use treatment to providers of co-occurring disorders.

Six agencies serving uninsured adults expanded their scope of patient treatment services to include the capacity to treat adults with co-occurring disorders. This was achieved with modest support funding from a local foundation. The initiative has been ongoing for five years.

The outcome of this initiative demonstrates the financial and practical feasibility of improving and expanding treatment services to low-resourced patient populations. The participating agencies were able to improve their capacity to treat patients with substance use or mental health issues that previously they were not prepared to treat and thus increased their ability to provide integrated care.

The initiative described here shows that the treatment of concomitant substance use and mental health disorders is within the range of many small-scale treatment providers, if provided the leadership and support. Delivery of effective treatments to populations experiencing co-occurring disorders that are underserved and undertreated are achievable in community-based clinical practices. This has implications for developing treatment capacity outside of hospital settings to enable treatment of co-occurring disorders to become more accessible.

This paper aims to give an insight into the process behind Payment by Results (PbR) by looking at the detail involved in the pilot areas for Recovery PbR for drug services. Questions asked include how PbR could work in practice, the national outcomes by which providers will be measured, the Co‐design process and a brief comparison to PbR in alcohol and mental health. An illustrative case study from one of the PbR pilots is included to provide further detail.

The paper was written by a member of the Co‐design group for the PbR pilots and used first‐hand anecdotal knowledge of the process and a former government civil servant with first‐hand experience of PbR in development. The minutes of previous co‐design and steering group meetings were referred to for further details and the NTA was consulted to ensure factual accuracy. The approach was to provide a factual breakdown of PbR and let readers come to their own conclusions about the topic. PbR is still in early stages and it would be inappropriate to pre‐judge the success at this stage.

A number of discussion points centered around the differences between the pilot areas, i.e. whether they were a prime provider or multiple provider model, whether they are including tier 4 (residential rehab), and if pilots are choosing to include an employment outcome. As mentioned before, it is too early to pre‐judge the success of PbR and the pilots – the paper aims to provide information for the reader, who may draw their own conclusions.

This is a substantial paper looking at PbR from the perspective of the pilot areas – a lot of the information is as up‐to‐date as possible in terms of where pilots are in their development. It is a valuable starting point for anyone who wants to understand PbR and its wider implications. It also provides practical information for commissioners and providers who are interested in what PbR will look like in practice.

The authors seek to better understand the critical incidents and factors that influence the switching behaviours of back pain sufferers who use mainstream and/or complementary and alternative medicine (Edvardsson, 1998). That is, the purpose of this paper is to uncover how they switch between treatments and treatment providers; in particular, this research investigates two issues: the triggers of their switching and their switching paths, and how their emotions are involved in that switching. The contribution is the first empirical foundation for an understanding of these two issues in the context of back pain.

The qualitative technique of convergent interviewing was used. It involved conducting a series of long, initially rather unstructured interviews to converge on the important topic areas to the back pain sufferers and why they engage in their treatment behaviour.

This study investigated the triggers and categories of triggers that impact upon switching behaviours between bio-medical and CAT healthcare. Four main areas of findings were identified. First, although the literature identified four categories of triggers for switching, namely, situational, reactional, influential and personal characteristics, the findings of this research confirmed only two of these: reactional and situational triggers. The influential category of triggers was found to be more of a moderating factor between switching triggers and switching behaviours rather than a trigger factor on its own. Further, no evidence came to light that could confirm or disconfirm the roles of personal characteristics on switching behaviour and so this issue remains unresolved.

The methodology used in this research was an exploratory one and so the findings must be used with caution. Further research, using a more quantitative methodology, is warranted to confirm the findings of this research. Also, this research focused on a subset of switching issues and so might not provide a holistic framework. Future investigations should therefore consider and clarify the role of emotion, time and voice in the switching model devised from this study.

This paper provides new evidence on the reasons for back pain sufferers consuming different treatment modes and the reasons for their switching and includes an exploratory investigation of the role of emotions in this decision making.

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 dynamic landscape of healthcare has seen significant changes in marketing by the various types of healthcare providers. This research aims to explore the impact of emotions in healthcare advertising.

Two consumer panel experiments investigate the role of hope and empathy appeals in fostering positive evaluations toward healthcare providers (medical centers for serious illnesses).

Study 1 shows that two types of emotion-based healthcare appeals are more effective than non-emotional appeals. Study 2 compares the relative effectiveness of hope versus empathy appeals with medical expert or typical person (patient) testimonials.

Findings demonstrate that in a healthcare context, an expert testimonial enhanced the persuasiveness of a hope-based appeal, whereas testimonials from unknown patients were not effective.

Understanding the role of emotions in healthcare advertising is increasingly important as healthcare providers compete on care and quality outcomes and advertising agencies vie for the attention of consumers.

Purpose – This study tracks the legal control of the problem of substance abuse.

Methodology/Approach – The chapter explores the “natural history” of the evolution of the social construction of drug use and our collective response to it. Over the past 100 years, our understanding of drug use/abuse and the system for handling drug problems have gone through a series of changes. In the past 20 years or so, provision of treatment for drug offenders within the criminal justice system has rapidly expanded. California's recently enacted Proposition 36 (Prop 36) initiates for the first time on a mass basis the court-supervised drug treatment that began a decade earlier on a much smaller scale with the original drug courts. This chapter compares the Prop 36 program for diverting nonviolent drug offenders into court-supervised treatment with the original drug courts.

Findings – The research shows how court-supervised drug treatment has evolved from a personalized care program in the original drug courts to a mass processing operation under Prop 36. The research finds that the social problem solution of offering treatment to more drug defendants created its own unanticipated consequences and problems, including significant standardization in the operations of the court and a dilution of many useful features that defined the early drug courts.

Practical implications – “Farming out” drug defendants to probation and treatment makes case-processing and treatment potentially less effective therapeutically. The chapter raises questions about how social control can extend its domain without “breaking the bank” and what the consequences are for how social problems are handled.

The purpose of this paper is to apply Lean in the workers’ compensation industry. It focuses on identifying patterns of repetitive non-value-added transnational activities for physical-therapy patients and healthcare providers. It addresses the research gap in this field.

In this study, we designed and deployed multiple case studies to better understand the journey of an injured worker within the worker compensation system in the United States of America. We partnered with Concentra Inc., a leading national healthcare provider in the field of workers’ compensation having 520 medical centers in 44 states. Both case studies included conducting direct observations, Gemba walk, in five clinics in two states: Florida and Pennsylvania. We analyzed the data of 263 injured workers with 8 or more physical therapy visits who got admitted to Concentra clinics in both states over the period of 31 days.

The results revealed that the time intervals at which activities associated with physical therapy treatment pre-authorization accounted for 91.59% of the total non-value-added activities and are thus the key administrative factor leading to process inefficiency in the state of Florida. The Process Cycle Efficiency of Pennsylvania was 75.36% compared to 53.16% of Florida. The injured workers in Florida needed 39.58 days on average to complete eight physical therapy visits compared to 27.92 days in Pennsylvania (a median of 34.09 vs 22.15 days).

This study is limited as it only focuses on processes on the healthcare provider side. An expanded value stream map that includes the treatment pre-authorization process on the insurance side would be beneficial for generating more potential solutions to streamline the process.

This study shows that Lean could play a critical role in identifying and quantifying continuous improvement opportunities that could accelerate patient’s treatment, reduce administrative burden on healthcare providers and improve the overall claim cost of insurance companies. It provides data-driven argument for insurance companies to consider eliminating physical therapy pre-authorization.

This is the first study to apply Lean methodology in the workers’ compensation field.

The purpose of the study was to empirically validate the linkages between IoT adoption and how it overarched influenced the patient care service engagement. This contributes to the body of knowledge and helps hospital managers to understand the relationship and relevance of IoT adoption; otherwise healthcare sector are late movers towards technology adoption. This gives a nuanced framework towards establishing empirically validated framework which will motivate healthcare services providers to be motivated to adopt and implement IoT enabled care delivery. The physician patient interaction and alignment during decision making will foster positive word of mouth, superior care service and reduce extra overheads for healthcare providers without compromise or rather with increment in service delivery proposition.

The study theoretically and empirically describes that with the adoption of internet of things (IoT) devices in health care, better services can be provided to patients by using partial least square – structure equation modelling-based robust technique and explains the better understanding of the health-care process with the help of information pervasiveness, physician-patient orientation and improved patient and physician involvement in the decision-making process.

This study shows that wearable IoT device adoption in health-care service delivery opens new opportunities and disrupts the conventional and traditional way of health-care service delivery by empowering the patient to take part in decision-making and enhancing their engagement in health-care service delivery.

The study might influence by generalizability. Perception-based cross-examination knowledge from the patient’s perspective. It is likely that patients who use these devices will grow accustomed to using them and become more capable of using them. Thus, time-series tests have not been used to catch enhanced skills. New patients’ experiences will be altered over time. Regardless, non-response bias and traditional process bias received excessive interest.

The study aims at unravelling how the adoption of IoT enabled practices and usage of IoT devices bolsters the available data points in the context of healthcare especially with respect to patient care delivery. The study conceptualizes and empirically validates how the usage of IoT interface enabled technology enables better patient treatment and caregiver participation. The study puts forth a nuanced understanding regarding how pervasively available ubiquitous care information fosters shared decision making. This study further emphasizes that importance of ensuring a reliable computing environment devoid of privacy and security risks. The study attempts at Emphasizing empirically how the enhanced information pervasiveness catapults the patient-provider interactions, through health data exchange. Highlighting the importance of search feature in cloud storage and recovery mechanisms. The study not only fulfills the overarching linkage between enhanced service engagement with IoT adoption, it provides a mental map and ready to refer framework for hospital and healthcare experts to refer to, which prescribes thar care providers must build new methods aimed at empowerment of patients to participate and take more inclusive role. This unique confluence between patients and physicians will unravel the sync; helping not only avoid costly decision errors, but also improve patient care delivery environment. Patients should be permitted to participate in decision-making,inspire patients to be participatory.

The study efforts to empirically investigate and discover the link between how wearable sensor-based IoT enhances health-care service engagement is underway. Using primary data this linkage validation allows the community and readers at large to gain a nuanced understanding of how superior interaction is enabled by a digital-health-care process with the help of IoT-enabled information pervasiveness, physician-patient orientation and empowered involvement.

Physician profiling is the comparison of physician practice patterns to determine the existence and effects of significant differences in outcomes. To optimize care quality, these comparisons can be used to influence provider behavior through awareness when outcomes are poor or do not warrant provider expenditures. To maximize the value of such a technique, the underlying bases for comparison and the uses of derived data must be understood. Several factors must be considered or controlled for when determining comparable providers. Additionally, the worth or significance of findings must also be understood. This paper seeks to provide information in these two areas for the benefit of those responsible for managing care at all levels.

Effective treatments for juvenile sexual offenders are needed to reduce the societal impact of sexual crimes. The purpose of this paper is to review the empirical literature on treatments for this clinical population.

The authors searched PsycInfo and MEDLINE (via PubMed) for studies that evaluated outcomes of treatments with juvenile sexual offenders.

There are a small but growing number of treatment studies (n=10) with juvenile sexual offenders, and all of these studies evaluated cognitive-behavioral therapy or multisystemic therapy for problem sexual behaviors. The results of these studies are promising, although conclusions about treatment effectiveness have been frequently limited by methodological problems.

The authors provide recommendations for treatment providers and policymakers to consider in their decisions about interventions for juvenile sexual offenders. Furthermore, the authors offer suggestions for researchers who seek to develop effective interventions targeting this clinical population.