The influence of hospitable design and service on patient responses

ABSTRACT

A study of 216 respondents examined a medical center environment’s influence on patient responses. A stimulus–organism–response (S-O-R) model was adapted to the theory that more hospitable healthcare servicescape elements will affect patients’ overall satisfaction with healthcare experience, loyalty intentions, and willingness to pay out-of-pocket expenses for healthcare services. Servicescape elements included atmospherics of the healthcare environment, service delivery by healthcare staff, physical design of the healthcare environment, and wayfinding. Results of structural equation modeling confirmed that the four servicescape elements – had a significant impact on patients’ overall satisfaction with the healthcare experience. Furthermore, overall satisfaction with the healthcare experience predicted patients’ loyalty intentions and willingness to pay out-of-pocket expenses for healthcare services. The study makes a significant contribution to the empirical modeling of patients’ behavioral responses to hospitable healthcare environments.     

Consumer Sovereignty in Healthcare: Fact or Fiction?

We pose the question: Is consumer sovereignty in the healthcare market fact or fiction? Consumer sovereignty in healthcare implies that society benefits at large when healthcare organizations compete to develop high quality healthcare products while reducing the cost of doing business (reflected in low prices), and when consumers choose wisely among healthcare products by purchasing those high quality products at low prices. We develop a theoretical model that encourages systematic empirical research to investigate whether consumer sovereignty in healthcare is fact or fiction. In doing so, we develop a series of theoretical propositions that may demonstrate that consumer sovereignty is more fiction than fact. Specifically, healthcare consumers lack the ability, motivation, and opportunity to choose healthcare products that are high in quality and low in price. Similarly, healthcare firms lack the ability, motivation, and opportunity to compete in ways to develop and market higher quality products at lower prices.     

农村医疗供应链下游主体行为的系统模型分析与对策研究

农村医疗问题是当前国家高度重视的热点问题,而农村医疗效率的高低取决于医疗服务供应链的效率。基于对江西省W镇的实地调研,对作为下游供应链主体的W镇医院医疗供应链系统存在的问题进行分析,提出了系列优化农村医疗供应链的相应政策措施。     

Healthcare reform and its implications for the U.S. economy

U.S. healthcare is currently a poor value proposition in relation to its cost. This must change. Driven by the fundamental forces of financing, consumer preferences, and technology, the U.S. is heading for a profound revolution in healthcare, one that will affect not only the system itself but also the larger U.S. business community. This new healthcare system will create vast opportunities and commensurately large risks for healthcare innovators. The outcomes of the present healthcare reform debate will either liberate or further shackle these innovators. Reforms that depend on governmental controls are more likely to dampen innovation than those achieved through control by consumers, and given the profound ramifications of healthcare reform outcomes, policy makers would be well-advised to harness the forces of consumerism in fashioning reform.     

How policy is shaping the macro healthcare delivery supply chain: The emergence of a new tier of retail medical clinics

The healthcare industry continues to face substantial pressure to simultaneously improve costs and patient centricity. Much of the focus to date has concerned policy interventions capable of improving these performance measures for traditional healthcare providers, such as hospitals. But recently, nontraditional healthcare providers like Walmart Health and Amazon have made forays into the industry by establishing retail medical clinics (RMCs). These efforts constitute a redistribution of how services are organized across the macro healthcare delivery supply chain. While RMCs stand to bring innovative models of service delivery to patients, the policy environment can both enable and inhibit their involvement in the industry. We develop a framework that explains how structural and conduct regulations have historically influenced demand for and supply of healthcare services. We then describe how these regulatory factors can support nontraditional healthcare providers as they launch innovative service delivery models aimed at efficiency and customer centricity.     

Applications of business analytics in healthcare

The American healthcare system is at a crossroads, and analytics, as an organizational skill, figures to play a pivotal role in its future. As more healthcare systems capture information electronically and begin to collect more novel forms of data, such as human DNA, how will we leverage these resources and use them to improve human health at a manageable cost? In this article, we argue that analytics will play a fundamental role in the transformation of the American healthcare system. However, there are numerous challenges to the application and use of analytics: the lack of data standards, barriers to the collection of high-quality data, and a shortage of qualified personnel to conduct such analyses. There are also multiple managerial issues, such as how to get end users of electronic data to employ it consistently to improve healthcare delivery and how to manage the public reporting and sharing of data. In this article, we explore applications of analytics in healthcare, barriers and facilitators to its widespread adoption, and ways in which analytics can help us achieve the goals of the modern healthcare system: high-quality, responsive, affordable, and efficient care.     

Paperless healthcare: Progress and challenges of an IT-enabled healthcare system

For most Americans, a trip to the doctor's office or a hospital stay necessitates that medical personnel search through paper charts and records as care is administered. This remains the status quo, despite the increasingly large role that electronic communication plays in other aspects of our business and personal lives. The elevated use of information technology (IT) in healthcare settings—primarily via utilization of electronic health records (EHRs), which allow information to be readily communicated and shared among healthcare providers—has been advocated as a means of improving quality of care and helping to control healthcare costs over the long term. Yet, hastened implementation of healthcare IT will require considerable cost incursion in the near term, and will present various other challenges that must be addressed. Herein, we examine the merits and benefits of healthcare IT, as well as the costs and other challenges that may serve as obstacles to its wider implementation and use. We conclude with a set of recommendations designed to increase the likelihood that extensive expansion in the use of healthcare IT will yield the desired benefits.     

Market-testing Healthcare: Managed Care, Market Evolution and the Search for Regulatory Principles

The growing costs of healthcare as a percentage of GDP in the industrial countries are causing considerable problems for these economies, but any attempt to change the existing healthcare system in any given country is usually accompanied by hefty political debate. A system needs to be found that rations healthcare efficiently and effectively, and which is also politically acceptable. The following article examines recent changes in the healthcare systems in the UK and USA and discusses the extent to which they meet these criteria.     

Trends in rural healthcare delivery in the United States, 1990-1999

This article describes the results of a literature search of pertinent professional literature written on issues important to rural healthcare delivery in the United States. The purpose of the literature review was to provide journal articles to practicing rural healthcare leaders who, because of time and economic constraints, claimed they were unable to research their own relevant journal articles. The authoring team is composed of individuals who work as full-time faculty members at institutions that offer courses in health administration. Because the nature of their professional work and research dictates that they focus on areas of rural health, the authoring team offered to share their findings with rural administrators as a means to assist them. The intent was to form a working collaboration between health services management professionals in academia, representatives of the state's healthcare organizational affiliate associations, and professionals practicing in the industry. This ten-year collaboration resulted in a unique wedding of resources that helped both in the delivery of rural healthcare services in a western state and in the advancement of the field of health services administration through original research. Thus, the product of this literature search is a comprehensive study of the trends in rural healthcare delivery. The variety of topics discussed were gleaned from over 500 articles found in and summarized from 70 professional healthcare journals published between 1990 and 1999.     

Dimensions of service quality and satisfaction in healthcare: a patient’s satisfaction index

The assessment of patients’ satisfaction levels, and the knowledge of what factors influence satisfaction are very important for healthcare managers as it influences healthcare results and healthcare institutions financial results. The objective of this research is to analyse patients’ satisfaction levels in a set of four Portuguese primary Healthcare Centres, through the estimation of a satisfaction index, which simultaneously explains which dimensions of healthcare quality influence that satisfaction the most. For that, a conceptual model of patients’ satisfaction in primary healthcare was tested using data from a sample of 414 patients. Partial Least Squares path modelling (PLS) was the technique chosen to evaluate the proposed model. The results show that patients’ satisfaction is 60.887 in a scale from 1 to 100, revealing only a medium level of satisfaction. It is also possible to conclude that the most important positive effects on satisfaction are the ones linked to the patient/doctor relationship, the quality of facilities and the interaction with administrative staff, by this order.     

我国医疗保健行业股指收益率波动特征与杠杆效应

本文运用SWARCH模型分析了我国医疗保健板块收益率的波动,并将医疗保健板块收益率与上证综指、深证成指收益率的SWARCH模型的估计结果进行比较,得出以下结论:医疗保健指数收益率序列呈现出低、中、高三种波动状态,样本区间主要分布于中波动状态,低波动状态的平均持续期最长、中波动状态的平均持续期居中、高波动状态的平均持续期最短,医疗保健指数收益率波动杠杆效应显著;我国股市医疗保健板块收益率波动状态之间的差异高于沪深综指波动状态的差异,医疗保健指数收益率与沪深综指收益率区制转移趋同,但存在着细微差异;医疗保健指数收益率各区制间转移相对频繁,每种波动状态的平均持续期较短,股市医疗保健板块收益率对新信息的反应更为敏感。     

Conceptual and mathematical model for quality improvement in health care

Numerous studies have shown that implemented models for quality assurance or improvement in healthcare facilities differ, even those models that are based on the same guidelines, i.e. standards, regulations or concepts. The cause of diversity in implemented quality models could be found in the process of translating guidelines into the implemented model for quality assurance or improvements in healthcare facilities, while neglecting processes of healthcare facilities that are not clinical processes, but still responsible for the quality of healthcare services. Therefore, this research recommends a conceptual model that should be a link between guidelines, implemented models and mathematical models derived from the conceptual model, which could provide a means of evaluating quality values of any part of the healthcare organization.     

Health Information on the Internet

Electronic Health (e-Health) increasingly strives to provide health information and services to healthcare stakeholders via the Internet, and to actively involve patients in their care. One major chance for these participatory healthcare and patient-centered approaches that integrate patients in healthcare are the phenomena and ideas associated with providing information and healthcare on the Internet. This paper examines the existing body of knowledge on online health information and explores the current state of research through a review of literature as well as past and current research projects. The fundamental categories of the analysis represent the stakeholders in the healthcare sector, the connecting information flows, the information-transferring technological applications, as well as the categories of the TEMPEST model. Based on these findings, causes and future research fields are discussed. The technological category has the largest share of all categories. Based on these findings, causes and future research fields are discussed.     

How blockchain will transform the healthcare ecosystem

Blockchain has the potential to fundamentally transform the healthcare ecosystem, impacting all healthcare participants. In this article, we study the potential impact of blockchains on patient-centered care delivery by looking at the ecosystem of blockchain-based solutions being developed for key stakeholders: patients, pharmaceutical firms, hospital systems, and insurance providers. Building from our interviews with senior managers, our actual experience in the healthcare industry, and our academic research, we outline how blockchain will transform healthcare, and we provide guidance as to how those in healthcare need to start thinking about engaging with blockchain technology.     

Employee involvement in ideation and healthcare service innovation quality

ABSTRACT

This study hypothesizes and empirically tests the influence of involvement of (1) frontline employees and (2) top managers in ideation process on healthcare service innovation quality. Based on data from 168 service innovation projects in Dutch healthcare organizations, the empirical results indicate that frontline employee involvement and top management involvement in, respectively, idea generation and idea application both improve the quality of healthcare service innovation. We find that the positive effect of frontline employee involvement is stronger under the condition of higher service innovativeness. In the direct relationship of top management involvement and healthcare service innovation quality, our data do not show such a moderating effect. The key and general managerial implication of the findings is that healthcare organizations are inspired to involve frontline employees in the idea generation processes and involve top managers in the idea application processes of service innovation projects, in order to improve innovation quality.     

Digitalisierung im Gesundheitswesen — zwischen Datenschutz und moderner Medizinversorgung

The digital transformation of the healthcare branch is important and unstoppable. The enormous possibility of digitalisation to redesign and enhance processes has been shown in other branches. Digital technologies offer the similarly large potential to improve the quality and efficiency of healthcare services. However, in terms of digitalisation, the German health system lags behind other European countries. But given a lack of available evidence, the effects of the digitalisation of the healthcare system cannot be reliably evaluated. Digital access to patient data necessitates constructive error cultures in organisations in order to limit defensive medicine. And digital access to health information necessitates individual competence in searching and using this information for participatory decision-making. As with all technological progress, information security is very important in order to gain citizens’ confidence in a digital healthcare system. Thus, it is necessary to simultaneously pursue both enhanced privacy standards and state-of-the-art medical technology.     

Rating healthcare services: consumer satisfaction vs. health system performance

The complex healthcare services and the consumer’s lack of technical knowledge to assess them engender a debate over using consumer satisfaction ratings as a quality-of-care marker. This paper aims firstly to investigate the effect of socio-demographic, socio-economic and spatial characteristics on the perception of quality of healthcare and secondly to evaluate the relationship between consumer satisfaction and health system performance. Reporting a Eurobarometer survey and the scores of the Euro Health Consumer Index, the finding is that some socio-demographic groups are more likely to get unsatisfied with healthcare services than others (e.g. women, those over 24 years old, those who self-define themselves as working class). Moreover, a strong relationship is revealed between consumer satisfaction and health system performance. The higher the performance of a health system, the higher the propensity to have consumers with positive perception of the healthcare services (satisfied consumers). The implications of the findings are then discussed.     

市场竞争性和我国的医疗体制改革——经济学视角下的医疗体制改革模式

市场的竞争性不仅取决于市场结构,还取决于价格信息在消费者之间的传播速度。由于医疗服务的价格信息在患者之间的传播是一个缓慢的时间过程,所以医疗服务市场看似有竞争而实际上竞争程度远比一般商品和服务市场低得多。在说明医疗服务市场的高价格水平形成机制的同时,指出政府只要能够改变医疗服务价格信息的传播机制,就能够建立一个以市场机制为基础的高效率的医疗卫生体制。     

Leveraging the Existing US Healthcare Structure for Consumer Financial Well-Being: Barriers,Opportunities, and a Framework toward Future Research

Healthcare exchange often contains peril for consumers because of numerous barriers to financial well-being (FWB). Rather than ruing specific agendas of healthcare policy, we embrace a neutral and immediately actionable approach. The authors promote gains in healthcare's current composition by empowering consumers to be proactive, where possible, in reducing power inequities and improving their own FWB. As such, the authors identify primary barriers to the FWB of healthcare consumers and propose individual opportunities within the existing healthcare structure that are likely to improve fiscal outcomes. Moreover, the current research demonstrates collaborative paths wherein power-holders (i.e., practitioner, researcher, consumer, government) can collaborate toward and/or contribute to the same financial health. A proposed theoretical framework, with foundations of power-responsibility equilibrium and transformative service research, gives rise to future research directions. This research is intended to provide a foundation for healthcare and FWB thought/action, and to guide coming scholarly offerings.     

Understanding the drivers of organizational innovations

Organizational innovations involve the implementation of significant changes in business practices, the workplace organization, and external relations. The article reports an analysis of organizational innovations' objectives and adoption in 240 Spanish healthcare businesses. Statistical tests find a dynamic behavior in healthcare organizations with 40.8% having developed an organizational innovation in the period from 2007 to 2009. The main objectives pursued are related to improved knowledge sharing and innovation skills. Results also reveal a close relationship between organizational and product/process innovations. Specifically, healthcare companies developing new organizational methods to improve innovation skills and knowledge sharing are more successful in adopting product and process innovations.