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11 – 20 of over 10000Larry R. Hearld, Kristine R. Hearld and Tory H. Hogan
Longitudinally (2008–2012) assess whether community-level sociodemographic characteristics were associated with patient-centered medical home (PCMH) capacity among primary care…
Abstract
Purpose
Longitudinally (2008–2012) assess whether community-level sociodemographic characteristics were associated with patient-centered medical home (PCMH) capacity among primary care and specialty physician practices, and the extent to which variation in PCMH capacity can be accounted for by sociodemographic characteristics of the community.
Design/methodology/approach
Linear growth curve models among 523 small and medium-sized physician practices that were members of a consortium of physician organizations pursuing the PCMH.
Findings
Our analysis indicated that the average level of sociodemographic characteristics was typically not associated with the level of PCMH capacity, but the heterogeneity of the surrounding community is generally associated with lower levels of capacity. Furthermore, these relationships differed for interpersonal and technical dimensions of the PCMH.
Implications
Our findings suggest that PCMH capabilities may not be evenly distributed across communities and raise questions about whether such distributional differences influence the PCMH’s ability to improve population health, especially the health of vulnerable populations. Such nuances highlight the challenges faced by practitioners and policy makers who advocate the continued expansion of the PCMH as a means of improving the health of local communities.
Originality/value
To date, most studies have focused cross-sectionally on practice characteristics and their association with PCMH adoption. Less understood is how physician practices’ PCMH adoption varies as a function of the sociodemographic characteristics of the community in which the practice is located, despite work that acknowledges the importance of social context in decisions about adoption and implementation that can affect the dissemination of innovations.
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Caroline Biron, Jean‐Pierre Brun, Hans Ivers and Cary Cooper
Many studies have shown that an unfavourable psychosocial environment increases the risk of mental and physical illness, as well as absenteeism, or sickness absence. However, more…
Abstract
Many studies have shown that an unfavourable psychosocial environment increases the risk of mental and physical illness, as well as absenteeism, or sickness absence. However, more costly than absenteeism is presenteeism, where a person is present at work even though disabled by a mental or physical illness. We sought to identify factors explaining why workers would come to work even when their health is impaired. In a cross‐sectional design data were collected from 3825 employees of a Canadian organisation. The results show a high occurrence of presenteeism: workers went to work in spite of illness 50% of the time. Presenteeism propensity (the percentage of days worked while ill over total number of sick days) was higher for workers who were ill more often. Heavier workloads, higher skill discretion, harmonious relationships with colleagues, role conflict and precarious job status increased presenteeism, but decision authority did not. Workers reporting high psychological distress and more severe psychosomatic complaints were also more likely to report higher rates of presenteeism. These results suggest that stress research should not only include absenteeism as an outcome indicator, but also consider presenteeism.
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Pouyan Esmaeilzadeh, Spurthy Dharanikota and Tala Mirzaei
Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients…
Abstract
Purpose
Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.
Design/methodology/approach
The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).
Findings
The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.
Originality/value
The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.
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Chapter X of The Social System is often cited as the “charter” for the specialty field of medical sociology. A notable feature of its analysis is the argument that the physician…
Abstract
Chapter X of The Social System is often cited as the “charter” for the specialty field of medical sociology. A notable feature of its analysis is the argument that the physician is an agent of social control in relation to the patient. This argument grounds the application to medical practice of Parsons’ general conception that social control is an aspect of all social relationships. Parsons started by addressing the situation of a patient who assumes the sick role and then becomes the patient of a physician. The sick role involves a suspension of at least some of the performance expectations associated with a person's everyday social life, such as expectations of working productively at one's job, attending the meeting of a civic association, or caring for one's family members. But in assuming the sick role, an individual encounters new expectations that he or she should try to get well. For minor illnesses this may involve only resting, drinking fluids, and avoiding stress. For more serious illnesses, given our culture's valuation of scientific medicine, it typically involves placing oneself in the care of a physician. It then becomes the physician's duty to offer treatment and guidance to restore one's health and enable one to return to meet expectations of everyday roles. Thus the physician becomes an agent of social control.
Reimbursement of the Israeli sick funds, whose status as both insurers and providers of health care is unique, warrants much attention. The paper deals with the issue in detail…
Abstract
Reimbursement of the Israeli sick funds, whose status as both insurers and providers of health care is unique, warrants much attention. The paper deals with the issue in detail. Four main channels for reimbursement are discussed: premium payment from members, co‐payments from members, parallel tax payments from the members' employer, and direct government subsidies. For each source, pros and cons are evaluated and suggestions are made for improvement of the reimbursement process in the future.
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The medicalization thesis derives from a classic theme in the field of medical sociology. It addresses the broader issue of the power of medicine – as a culture and as a…
Abstract
The medicalization thesis derives from a classic theme in the field of medical sociology. It addresses the broader issue of the power of medicine – as a culture and as a profession – to define and regulate social behavior. This issue was introduced into sociology 50 years ago by Talcott Parsons (1951) who suggested that medicine was a social institution that regulated the kind of deviance for which the individual was not held morally responsible and for which a medical diagnosis could be found. The agent of social control was the medical profession, an institutionalized structure in society that had been given the mandate to restore the health of the sick so that they could resume their expected role obligations. Inherent in this view of medicine was the functionalist perspective on the workings of society: the basic function of medicine was to maintain the established division of labor, a state that guaranteed the optimum working of society. For 20 years, the Parsonian interpretation of how medicine worked – including sick-role theory and the theory of the profession of medicine – dominated the bourgeoning field of medical sociology.
Purpose – This study seeks to answer the question of whether donations to the Dutch Heart Association are a form of solidarity of the healthy with the sick. In doing so, I test…
Abstract
Purpose – This study seeks to answer the question of whether donations to the Dutch Heart Association are a form of solidarity of the healthy with the sick. In doing so, I test hypotheses on the origins of charitable donations in awareness of need in conjunction with dispositional empathic concern, social networks and own health.
Methodology – I report probit, tobit and multinomial regression analyses on data from the Giving in the Netherlands Panel Survey (2002–2004; n=1,246) on donations to the Dutch Heart Association and other health charities.
Findings – I find that experience with cardiovascular diseases is associated with a higher likelihood of donating to the Dutch Heart Association, especially among those with higher levels of empathic concern and social responsibility, and among those who are not in excellent health themselves. Support for the Dutch Heart Association comes from those who are aware of the need for contributions and more easily imagine themselves in a situation similar to those of heart patients.
Research limitations/implications – The results confirm the role of empathic concern, explore the role of own health and seem to reject the role of ties to family members. The study is limited to the Dutch Heart Association. Future research should test whether these results can be generalized to donations to other charitable causes.
Originality/value of chapter – This study contributes to our knowledge on charitable donations, revealing new insights on the influence of awareness of need.
Helen Edwards and Helen Chapman
This paper contends that dysfunctional patterns of communication can develop in family aged care dyads in response to stereotypical role expectations in the…
Abstract
This paper contends that dysfunctional patterns of communication can develop in family aged care dyads in response to stereotypical role expectations in the caregiving‐carereceiving relationship, thus giving rise to a role predicament of caring. If this argument holds it follows that more productive and effective forms of communication and relationship are dependent upon both members of the aged care dyad understanding the expectations of their role and if necessary reconstructing them. Part 1 of this two part conceptual paper develops the Communication Predicament of Ageing Model to include role expectations. The conceptions are grounded in important conclusions drawn from data contained in a large comprehensive study of older people and their family caregivers. Part 2 of the paper (to be published in the next issue of Quality in Ageing) introduces the health promoting communication model which was developed as a framework for guiding both prevention and intervention strategies to prevent or transform a role predicament of caring.
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Fay Giæver and Lise Tevik Løvseth
The purpose of this paper is to seek a deeper understanding of presenteeism by utilising the perspective of job crafting to explore how a selected group of physicians make sense…
Abstract
Purpose
The purpose of this paper is to seek a deeper understanding of presenteeism by utilising the perspective of job crafting to explore how a selected group of physicians make sense of their decision to attend work while ill and of their experience of doing so. Job crafting implies that employees not only respond to their job description, but also proactively change tasks, relationships and perceptions in order to experience work in meaningful ways.
Design/methodology/approach
A narrative methodological framework involving interviews was adopted to explore the ways in which a selected group of 20 Norwegian hospital physicians engaged in job crafting during presenteeism. The resulting data were analysed using theory-led thematic analysis utilizing the theoretical perspective of job crafting.
Findings
It was evident that physicians were indecisive and insecure when evaluating their own illness, and that, via task, relational and cognitive crafting, they trivialised, endured and showcased their illness, and engaged in presenteeism in various ways. Furthermore, physicians to some extent found themselves caught in dysfunctional circles by contributing to the creation of a work environment where presenteeism was maintained and seen as expected.
Research limitations/implications
Future research should address a wider range of contexts, and use longitudinal methods to explore the multifaceted, context-specific and evolving nature of presenteeism and job crafting in more depth. Interventions aimed at countering the negative implications of presenteeism should address the issue from both a social and a systemic point of view.
Originality/value
The findings extend the current understanding of presenteeism by demonstrating the multifaceted and evolving nature of the ways in which personal illness and presenteeism are perceived and enacted over time.
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