Network Development and Application in Health Care

Abstract

Service quality is important to health care. The research took advantage of a unique opportunity to study health care from the perspective of all relevant stakeholders. The major results of this research were insights concerning the structures and processes that characterise successful professional health care services and, more broadly, professional services generally. Rather than just communicating in a system prescribed way, successful professionals combine an ambiguous system with extensive interaction with other stakeholders to develop networks. In this way they achieve superior service quality for their patients.     

Process Coordination Within a Health Care Service Supply Network

There are two manifestations of supply chains in health care. One involves the supply of equipment and materials used in health care delivery. The other supply chain involves the delivery of health care itself, wherein patients supply their physical conditions and service suppliers deliver health care services. This article considers the latter supply chain, analyzing a case study in which patients have comorbidities and thus require the services of a network of multiple health care providers. In the case study, we examine three schemes for coordination of care. In the first scheme, the patient herself is expected to manage the coordination. In the second scheme, physicians are expected to coordinate the care. In the third scheme, a third‐party coordinator manages care across network members. We examine these three possible coordination alternatives using a technique known as Process‐Chain‐Network (PCN) Analysis. PCN Analysis helps us document how coordination schemes are implemented and where they may fail. Our analysis of the case study leads us to the development of ex post theory about who should initiate coordination and how it should take place under conditions of comorbidities. Empirical data coming from the case study support the theory. We describe possible applications of the theory inside and outside of health care, and show how the PCN approach can guide process innovation.     

Broadband in Telework,Health and Safety: The User Perspective

ABSTRACT

Broadband potentially has strong influence on social issues such as mobility (telework), health, and public and personal safety. To understand and to predict the adoption of broadband services in these domains, it is necessary to ask (potential) users of those services about their actual usage and expectations. Our research is an exploration of these issues. Results show that broadband connections, applications and services do not yet play an important role in the social issues covered in this research. This is understandable, since many real broadband services are not yet offered on a large scale. When looking at the perceived positive aspects of broadband services and applications, especially in telework and health care, it seems socially desirable, for example, government and employers to stimulate telework and the development of broadband health care services. In the public and personal safety domain the role of broadband is not so self-evident for the potential users of broadband services.     

FOCUS: Not-for-profit Health Services and the German Health Care System

Reforms in the German health care system in the attempt to bring more competition into health care have increased the sovereignty of the insured or patients, who have finally been allowed to make choices. "The start of a reorientation of the statutory health insurance system and hospital care are to be welcomed as first steps towards a supply of health services that reflects individual preferences." The authors can be contacted care of Prof. Dr. Oberender at Rechts- und Wirtschafswissenschaftliche Fakulät, Universität Bayreuth, 95440 Bayreuth, Germany, where Dr Oberender is Professor in the Faculty of Law and Economics, and Ansgar Hebborn is his Assistant. The authors wish to record their gratitude to Jan Hacker for translating this article.     

Connecting U.S. Health Expenditures with the Health Sector Workforce

The National Health Expenditure Accounts (NHEA) produced by the Centers for Medicare and Medicaid Services report that U.S. health care spending was $2.6 trillion in 2010. More recent estimates from Altarum Institute confirm that the health sector represents 17.9 percent of our national output. The data from the Bureau of Labor Statistics show that the health sector continued to create jobs throughout the recession and recovery and now accounts for nearly one in nine jobs. For the first time, we link the workforce by occupation to national spending on health care services by aligning data sets from the BLS and Bureau of Economic Analysis with the NHEA. We find $1 trillion, or 57 percent of the $1.78 trillion spent on personal health care services, went to health sector labor. Characterizing the health sector workforce and its contribution to health expenditures informs the potential for spending reductions and the implications of such reductions on employment.     

Current Issues in the Provision of Health Care Services

Our society is developing the consensus that adequate health care is the right of all citizens, rather than a privilege of the wealthy or a welfare benefit of the poor. At the same time, the current crisis in health care seems to question the feasibility of making this consensus a reality. A vast array of complex and interrelated issues are involved in the problem of providing health care services. This paper reviews these issues from the consumer's perspective.     

Health Care Matters: Supply Chains In and Of the Health Sector

Providing health care involves a complex enterprise, and the trade‐off between quality and cost has been particularly stark compared to other industries. However, a recent focus on health sector supply networks is now producing significant innovations and improvements. This Special Topic Forum illustrates for the academic and practitioner community how health care supply chain research can benefit from our evolving understanding of supply chains and help push that understanding even further. We classify health care supply chain research into two broad categories—supply chain in health care and supply chain of health care—to set an agenda for future research.     

Examining the Landscape of Managed Behavioral Health Care Through the Market Paradigm

ABSTRACT

The purpose of this article is to examine the market paradigm's impact on private practicing social workers, psychologists and psychiatrists who are reimbursed for services by managed behavioral health care organizations (MBHCOs). Five hundred eighty-two private practitioners from across the nation responded to a mailed survey in which they were asked a series of questions concerning changes in their business practices subsequent to joining MBHCO provider panels. Results indicate that despite the concerns about MBHC, these practitioners have sustained their practices. The market paradigm's use in explaining MBHC's impact on the private practitioners was found to have limited utility.     

贫困人口的健康服务：人口与发展的一个新领域

较系统地阐述了人口、发展及贫困的关系,重点阐述了我国农村地区贫困人口健康服务的状况及问题.应在社会可持续发展框架下全面审视和统筹解决贫困人口健康服务不公平的问题.在目前中国现实国情下,对贫困人口应实施医疗救助计划,改善其健康服务,以促进社会发展,实现公平.展望了贫困人口健康问题研究的前景及其与其它学科在医疗救助领域中的合作问题.     

Implementation of quality programs in health care organizations

Any organization??s efforts to achieve continuous quality improvements must involve applying various quality related programs and tools. Such efforts are important for improving quality of products and/or services and increasing business performance. It is especially important for health care organizations as quality of care and service is a top priority. The focus of this study is on the implementation of quality programs which are based on tools, awards criteria, or standards to improve quality of care in the health care industry. Two hundred fifty-four hospitals with more than 100 beds that have quality programs were used to collect data for this study. Two of the most widely used quality programs were quality control (61.8?%) and total quality management (60.6?%). As widely known quality programs have shown to play a role in improving quality of care in the global health care market, some hospitals implement a combination of various quality programs to get certification or an award that helps them enter the international market such as medical tourism.     

How do you feel today? Managing patient emotions during health care experiences to enhance well-being

Health care customers (patients) experience heightened emotions due to high stakes from risks to life, health, and well-being. Understanding and managing emotions during service experiences is an important area of inquiry because emotions influence customer perceptions, future intentions and behaviors. Yet despite its significance, research focusing on the impact of emotions on customer experiences remains fragmented, lacking a theoretically based conceptual framework. The authors attempt to fill this gap by addressing two important research questions contextualized in health care: (1) How can health care organizations better understand patient and family emotions during health care experiences? and (2) How should health care organizations use this understanding to design and better manage patient experiences to enhance patient well-being? The authors propose a new theoretically based framework on emotional responses following triggering events to enhance outcomes. Recommendations designed to enhance health care customer well-being are provided, as are directions to guide future work.     

Toward a Model of Word-of-Mouth in the Health Care Sector

An important source of health information is word of mouth (WOM). Nevertheless, a model describing WOM in the health care sector does not exist. The aim of this paper is to contribute to research by providing concrete suggestions for a model of word of mouth in the health care sector. A conceptual framework comprising the theory of cognitive dissonance, the theory of the strength of weak ties, and the theory of perceived risk are used as a theoretical anchor. In order to gain a more precise knowledge of WOM in the health care sector, a literature review of leading health care journals is conducted. The findings are summarized in the form of a model proposal describing the creation, spread, and impact of WOM in the health care sector. As the model summarizes the current WOM literature, it seems to be a good starting point for further research by scholars. The paper also helps practitioners to better understand WOM and integrate the WOM aspects described into their daily work.     

The Impact of the Rhode Island Catastrophic Health Insurance Plan

Under Rhode Island's statewide Catastrophic Health Insurance Plan (CHIP) in effect since January, 1975, and similar to the Long-Ribicoff National Health Insurance Proposal, Rhode Island pays catastrophic medical expenses over and above a “personal resource payment” (out-of-pocket expenses) that varies with income and amount and type of health insurance coverage. Those with qualified plans (plans providing more services) pay less out-of-pocket. Benefits accrue mainly to some middle income households. CHIP has increased demand for and prices for health insurance with qualifying coverage, and utilization of medical care. Similar impacts on a larger scale may be expected from any national health insurance program.     

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.     

Consumer Attitudes Toward Health and Health Care: A Differential Perspective

Measures of attitudes of health care consumers toward their own health behaviors and health care institutions reveal the overall pattern of their views as well as their segmented views. Results suggest that some consumers may take a more scientific approach to health care and prevention than others and that demographics, health status, and health consciousness are partial predictors of that consumer approach. Policy makers for health care should formulate and target programs with different segments of the population in mind.     

Health Care Entrepreneurship in the Democratic Republic of the Congo: An Exploratory Study

In this empirical study, the authors explore entrepreneurship in the health care business in the Eastern Kasai Province of the Democratic Republic of the Congo (DRC) using cross-cultural literature and the resource-based view to ground its analyses. The data were collected using a questionnaire targeted toward the health care entrepreneurs in Mbuji Mayi, the capital city of the Eastern Kasai Province in July 2010, which yielded 68 responses. The results indicated that the entrepreneurs were predominantly middle-aged Congolese men with backgrounds in the health services field who had raised their startup capital mostly from personal savings or friends and family. Their businesses, which were mostly in the form of sole proprietorships, were likely to be located in areas underserved by public medical facilities and usually provided both curative and preventative medical services.     

What do we really know about services?

The inherent characteristics of services are well-known but do we really understand what services are, how services form an essential part of most products produced and delivered today, how services can enhance differentiation, competitiveness and help drive innovation and regional economic development? Sadly despite some 30 years of endeavour the answer is no, and so we need to consider how this problem can realistically be addressed by identifying the key services themes which need intensive long-term research.     

The Regulation of Professional Migration: Insights from the Health and IT Sectors in ASEAN

This paper develops several indicators to measure the extent and depth of rules governing international migration. It is set in the context of moves towards further liberalisation of services trade and associated labour mobility (Mode 4) under GATS and related regional trading arrangements. Ten Southeast Asian countries at various stages of economic development are examined as a case study, with special reference to health care and information technology. These sectors are priority sectors for regional cooperation in services trade in ASEAN, but were expected to represent opposite extremes in terms of the regulation of migration. The study finds that the more advanced countries tend to have more liberal regimes for international movements of skilled manpower, although there were smaller differences regarding general visa and work permit arrangements. Generic restrictions on mobility were related to trade policies, as well as to direct barriers (often country‐specific) to migration. They included minimum salary requirement, levies on foreign workers, economic needs tests, and limitations related to language, education and job experience. Controls were more extensive in the health care sector, related to social considerations as well as professional organisational interests.     

International Trade and Health Policy: Implications of the GATS for US Healthcare Reform

This paper examines the implications of the General Agreement on Trade in Services (GATS), the World Trade Organization’s agreement governing trade in health-related services, for health policy and healthcare reform in the United States. The paper describes the nature and scope of US obligations under the GATS, the ways in which the trade agreement intersects with domestic health policy, and the institutional factors that mediate trade-offs between health and trade policy. The analysis suggests that the GATS provisions on market access, national treatment and domestic regulation, which are designed to eliminate ‘regulatory barriers’ to global trade in health services, limit the range of options that state and federal regulators and legislative bodies can employ to regulate the health sector and implement healthcare reforms. As such, the paper identifies the broader social and ethical implications of free trade policy.     

The Relationship of Demographic Characteristics and Importance of Services Offered to Unaided Awareness and Recommendation of Public and Private Mental Health Care Providers

The extent to which demographic characteristics and importance of services offered by mental health providers are related to unaided awareness and recommendation of public and private mental health care providers was assessed. Awareness and recommendation of private providers was found to be stronger among men and among higher income groups. Relative to public providers, these factors were stronger among women and lower income groups. While the services offered do not appear to be strongly related to awareness or recommendation of provider types, some differences were found. Those who are aware of and would recommend a private provider gave higher importance ratings to counseling for suicide and life changes - those who are aware of and would recommend a public provider gave higher ratings to counseling for spouse abuse, depression, and eating disorders, and treatment for major mental illness.