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Zo Ramamonjiarivelo, Larry Hearld, Josué Patien Epané, Luceta Mcroy and Robert Weech-Maldonado

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The…

Abstract

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The purpose of this chapter was to investigate the impact of public hospitals' privatization on community orientation (CO). This longitudinal study used a national sample of nonfederal acute-care public hospitals (1997–2010). Negative binomial regression models with hospital-level and year fixed effects were used to estimate the relationships. Our findings suggested that privatization was associated with a 14% increase in the number of CO activities, on average, compared with the number of CO activities prior to privatization. Public hospitals privatizing to for-profit status exhibited a 29% increase in the number of CO activities, relative to an insignificant 9% increase for public hospitals privatizing to not-for-profit status.

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Article

David S. Martin, Zo Ramamonjiarivelo and Warren S. Martin

The purpose of this paper is to use a theoretical model to create a scale to predict medical tourism (MT) intentions.

Abstract

Purpose

The purpose of this paper is to use a theoretical model to create a scale to predict medical tourism (MT) intentions.

Design/methodology/approach

The theory of planned behavior (TPB) model was applied to MT by creating a 49‐item questionnaire and collecting data from a convenience sample of 453 undergraduate students enrolled in a university located in the USA. Factor analysis was used to evaluate the results, and yielded a MEDTOUR scale containing 29 items.

Findings

A regression of the three variables on an intentions scale of participation in MT had an R‐value of 0.587. The model was able to explain around 35 percent of the variance in intentions. Given the general nature of the model and the first attempt at predicting MT, the results are positive.

Research limitations/implications

This research is limited due to the use of a convenience sample of undergraduate students. Further research utilizing additional samples is needed to verify the MEDTOUR scale. In addition, future research can focus on demographic or other areas of interest in relation to the intention to participate in MT.

Originality/value

The creation of the MEDTOUR scale represents a new application of the TPB to the area of MT. This theory‐based scale is offered as a new tool for future research.

Details

Tourism Review, vol. 66 no. 1/2
Type: Research Article
ISSN: 1660-5373

Keywords

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Article

Douglas J. Ayers, Nir Menachemi, Zo Ramamonjiarivelo, Michael Matthews and Robert G. Brooks

This paper aims to examine the role of network effects (defined as increased utility for users of a technology that occurs when adoption increases among other users) in…

Abstract

Purpose

This paper aims to examine the role of network effects (defined as increased utility for users of a technology that occurs when adoption increases among other users) in the adoption of electronic medical records (EMR) systems. EMR systems, which have experienced slow adoption rates, promise to improve the efficiency of the healthcare system by facilitating information exchange among physicians caring for the same patients.

Design/methodology/approach

Survey responses from physicians are used to test several hypotheses. The authors are interested in how market level EMR adoption was related to physician adoption intentions. The authors also test the “strong ties” notion of network effects by examining whether EMR adoption among generalists, and specialist physicians, had differing influences on adoption intentions in a given market.

Findings

Support for network effects is found; each one unit increase in market‐level EMR adoption is associated with a significant increase in overall physician adoption intention in that market. Secondary analyses suggest adoption of EMRs by specialists is significantly predictive of generalists' adoption intentions in a given market. However, as predicted, EMR among generalists does not influence other generalists' intentions; nor does EMR adoption by a specialists influence other specialists' intentions.

Research implications

Network effects play a role in the EMR adoption among physicians. Decision‐makers wanting to influence adoption should target defined market segments in an effort to build a critical mass of adoption then move to adjacent segments once network effects take hold.

Originality/value

This paper applies network effects theory to help explain the suboptimal adoption rates of an important healthcare technology.

Details

Journal of Product & Brand Management, vol. 18 no. 2
Type: Research Article
ISSN: 1061-0421

Keywords

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Book part

Abstract

Details

Transforming Health Care
Type: Book
ISBN: 978-1-83982-956-7

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