The Positive Impact of Individual Core Values

The role of values in organizations has been a highly researched topic (Collins in Good to Great, HarperCollins, New York, 2001; Collins and Porras in Built to Last: Successful Habits of Visionary Companies, HarperCollins, New York, 1997; Frederick and Weber 1990; Kouzes and Posner, The Leadership Challenge, 4th ed, Jossey-Bass, San Francisco, 2007; Pattison et al. Emerging Value in Health Care: The Challenges for Professionals, Jessica Kingsley Publishers, Philadelphia, 2010). However, little research has focused on values in health care settings. In addition, the research that has been done has focused on values from an organizational perspective, not from an individual perspective. Based on these two factors, in addition to the maturation and growth of the hospice industry and the researcher’s prior studies on hospice leadership and organizational practices, a research study was conducted to evaluate the core values of hospice professionals. Another key driver of the research was the expressed difference identified by leaders within the hospice industry that values of individuals new to hospice were different than those who have worked in the industry longer. A web-based survey was utilized to gather core values and demographic data from hospice professionals. Data were collected over a one-year period and involved 531 hospice professionals from 33 states. The demographic information collected was similar to comparative data from previous hospice studies. The top three core values identified in the study were family, faith, and love, and represented 76 % of all responses. No statistically significant identifiable differences, based on demographic variables, were found. Based on the findings, no support was found for the perceived differences noted by leaders working in the hospice industry. However, it identified that hospice professionals regardless of demographic characteristics appear to hold similar values as being important. Based on the findings, core values appear to be an area of commonality versus difference among hospice professionals and could serve as a focal point for building a positive organizational culture. Further research is suggested to evaluate the unique meaning of the key values identified by hospice professionals in the study. In addition, replication of the study in other health care settings would be encouraged.     

"Ethics and Geography –Impact of Geographical Cultural Differences on Students Ethical Decisions"

Conceptually, entrepreneurship is seen as the engine that drives a robust economy, promotes a favorable quality of life, and assures the availability of the attributes needed for meaningful living. However, like many popular concepts in this world, its limitations are normally not well acknowledged. A grouping of entrepreneurial ventures which has recently come into existence deals with the personal fiscal issues associated with the end-of-life phase of the human cycle. While generally praised as humanitarian services for society, that are assuredly within legal bounds, these activities have potentially significant negative implications. When examined from an ethical perspective, some questionable practices became apparent. Three such undertakings in particular have to do with the terminally ill and are examined in this paper. The first, viatical transactions, is defined as the transfer of a life insurance policy's ownership to someone who does not have an insurable interest in the life of the insured individual. The second, creative tax shelters for wealthy people involved in estate planning, involves hiring unrelated parties, particularly those who are young and in failing health, to do the dying for the principal. The third, mind games, involves curtailing the use of medical resources for the dying. The justification for this is rationing scarce medical resources.     

医疗护理服务可及性对居家老人照料服务选择的影响研究——基于北京市的实证研究

利用课题组2018年在北京市的抽样调查数据,运用Logistic回归方法考察医疗护理服务可及性对居家老人照料服务选择的影响。结果发现,医疗护理服务的便捷性、可支付性与老人照料服务的选择显著相关。住所附近有医疗卫生机构、有提供上门护理服务的机构或是与家庭医生签约的老人,更倾向于选择社会照料服务;支付能力对照料服务的选择呈现"U"型效应:家庭支付能力较强或者经济自评相对不足的老人更倾向于选择社会照料服务。应通过优化医疗护理资源布局、建立并完善社会照料服务的价格机制等措施,推进高效、可持续的社会照料服务体系的构建。     

Technology as culprit and benefactor

Technologies can be viewed as a mixed blessing: rising health care costs versus improved diagnosis, treatment, and health status. This article briefly discusses the influence of key factors on the demand for technology and its utilization. These factors include rising health expenditures, changes in populations, and the development of cost containment strategies. Resulting shifts in incentives and utilization are examined. Because of the difficult and complex issues associated with the increasing use of medical technologies, hard choices will need to be made about quality of life, technology assessment, and the allocation of health resources to the terminally ill.     

Complementary and alternative medicine: Consumers in search of wellness or an expression of need by the sick?

The provision of health care in Western societies is examined in relation to the arrival of complementary and alternative medicine (CAM) as a serious provider in the latter half of the 20th century. This article examines the underlying components of the increasing uptake of CAM and attempts to cluster health‐care consumers according to their attitudes and motivation toward the use of health‐care products and services. The analysis does not support the idea of a widespread uptake of CAM practitioner treatments on the part of the general public except for particular segments of that public, including the seriously ill. There is also little evidence of exclusive use of CAM for personal health care. On the other hand, there is significant evidence for an uptake of non‐practitioner‐based CAM by wider segments of the population. The findings raise issues regarding the evidence for the efficacy of CAM and the methodology for testing it. These are discussed. © 2004 Wiley Periodicals, Inc.     

Demographics,Personality Traits,Roles, Motivations,and Attrition Rates of Hospice Volunteers

ABSTRACT

The authors conducted a review of prior research on hospice volunteering. The results show that, in most cases, the hospice volunteer is a white, married, middle-aged, financially comfortable, unemployed, female who has some college education, strong religious beliefs and has experienced the loss of someone close (see Tables 1 and 2). The results also show that hospice volunteers tend to share certain personality traits reflecting compassion, tolerance, empathy and sensitivity among others. Volunteers tend to fulfill four roles: direct patient support, education, clerical assistance, and professional services (Bunn 1985). Motivations for volunteering and for continuing one's work as a volunteer appear to be for both personal and altruistic reasons. Primary reasons for discontinuing volunteer service include burnout, communication problems, unrealistic expectations, and insufficient use of the volunteer staff. Gaps in this area of research are identified and topics for further research are presented.     

The establishment of injury surveillance in Thailand

The Provincial Injury Surveillance System was initiated in Thailand in 1993 to establish a database for assessment of the quality of acute care and referral services provided to the injured at the provincial level, and to facilitate injury prevention and control at both local and national levels. An injury surveillance system model that adopted a trauma registry as the record form, was established in five selected large hospitals, one from Bangkok and four from major regions of Thailand. Data analysis was undertaken and utilized at both local and national levels. The Epidemiology Division of the Ministry of Public Health supervised and assessed the data quality. Evaluators from the School of Public Health identified problems in operating the system at the provincial level and assessed the feasibility of expanding the project. The data of 66,895 injuries including 1,755 deaths reported in 1995; revealed fundamental problems in the emergency medical services. Causes of major injuries were identified and their epidemiology described. The coverage of reporting was over 90%. The completeness and reliability of recording ranged from 80.6–100%. This model of sentinel surveillance is appropriate for injury problems, which are of large magnitude and are at the early phase of problem solving. Development of the information systems administration and human resource in computer technology are necessary to cope with the problems of increased workload in data collecting and processing. This model of surveillance is feasible for expansion but its data system has to be appropriately integrated into the existing systems of the hospitals.     

The ethical impacts of managed care

In an attempt to gain some control over ever escalating health care cost, many organizations have moved to a managed care concept of health benefits. Managed care health benefit strategies account for well over 90 percent of all employer sponsored health benefit programs.In essence, managed care coverage usually demands, at a minimum, some form of utilization review in regard to provider services. Thus the privacy of the traditional doctor patient relationship must inevitably be modified when managed care enters the picture.This paper provides a framework for analyzing the managed care phenomenon as well as surfacing ethical questions and issues that will continue to arise as managed care grows.George W. Rimler is Professor of Management at Virginia Commonwealth University. He has published numerous articles in academic and practitioner journals. His particular areas of interest are in entrepreneurship and organizational effectiveness.Richard A. Morrison is the Executive Director of the Virginia Department of Health Professions. He has been active in numerous National Professional Associations.     

Therapy,Enhancement, and Medicine: Challenges for the Doctor–Patient Relationship and Patient Safety

There are ethical guidelines that form the foundation of the traditional doctor–patient relationship in medicine. Health care providers are under special obligations to their patients. These include obligations to disclose information, to propose alternative treatments that allow patients to make decisions based on their own values, and to have special concern for patients’ best interests. Furthermore, patients know that these obligations exist and so come to their physicians with a significant level of trust. In this sense, therapeutic medicine significantly differs from straightforward business practices such as the buying and selling of houses, cars, cell phones, etc. However, we argue that this relationship differs when medicine is used for enhancement rather than therapy. When patients seek enhancements they are not as vulnerable as when they are ill. And in an enhancement setting, physicians have little role outside of medical risks to discuss motivation and alternatives. Therefore, we conclude that a more reasonable alternative may be for doctors and patients to use ethical norms associated more with straightforward business practices, specifically sales. We believe that full disclosure of this different set of norms will benefit both physicians and patients.     

Multiple sclerosis patients as counsellors and evaluators of rehabilitation

The article is concerned with multiple sclerosis (MS) patients’ experiences of rehabilitation services. Customers choose and assess the rehabilitation services they want. In the spring of 1999, group interview data were collected as part of an evaluation study of outpatient activities organized by the Finnish MS Society. Illness experience, changes in functional capacity and experience of health care services provided by both the public and voluntary sectors were all shown to have an effect on how customers chose services. When customers guide their own rehabilitation, their wishes and decisions concerning rehabilitation should be heard and respected. This indicates that customers make choices taking account of the opportunities provided by society.     

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.     

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.     

Health and Sickness: A Buddhist View and Implications for Social Marketing

It is known that while health-care issues are highly important consumer concerns and closely tied to well‐being and quality of life, the perspective on the consumer often becomes clouded amid increasingly complex processes. This paper explores how Buddhist principles can permeate the marketing strategies of health-care organizations to deliver a positive, healing influence and thoughtful and sensitive services with an ethnographic study of a Nichiren Buddhist organization. It offers a vision for health-care marketing in crafting a message for severely ill patients to find meaning in life and live as fully as possible while accepting the presence of the illness.     

Patient payment for emergency medical services treatment and its impact on injury control: an Alberta case

A province-wide qualitative study on emergency medical services (EMS) in Alberta was initiated to better understand the extent to which patient billing influences EMS performance. After completing lengthy interviews with 108 EMS-related subjects it was learned through qualitative research methods that billing patients for EMS treatment (ambulatory care) has subtle or determined influences on EMS providers' emergency actions. Furthermore the act of billing patients can and does have an impact on patient care. It often leads to patients and/or their representatives refusing treatment and transportation. Testimony indicates that the final result can be and is troublesome to, patient outcomes. The findings support the generalization that in Alberta the patient's responsibility to pay for needed EMS treatment can be a major obstacle for inclusive injury control.     

Segmenting Subgroups of Volunteers for Target Marketing: Differentiating Traditional Hospice Volunteers from Other Volunteers

SUMMARY

The research objective was to investigate if hospice volunteers could be differentiated from other volunteers using determinant variables from multiple conceptual domains (i.e., personality variables, social/lifestyle variables, demographic variables, and terminal values). Another purpose was to determine if higher performing hospice volunteers could be differentiated from lower performing hospice volunteers.

Lifestyle, demographic, personality, social influence, and terminal value measures were obtained from a sample of 63 hospice volunteers and 950 volunteers from other organizations. Survey respondents were derived from over 40 nonprofit organizations in two Midwestern cities.

In comparing hospice volunteers to volunteers serving in other types of organizations, hospice volunteers are differentiated by 11 determinant variables. One demographic variable (age), one social/lifestyle variable (the number of organizations to which the volunteer donates time for), and one personality variable (self-esteem) were significant. The remaining eight significant predictors of hospice volunteering were values.

An aspect of performance examined in this study is the average monthly hours hospice volunteers serve in their organizations. Because volunteers may serve in either single or multiple organizations, multiple analyses were performed using three different dependent variables (time volunteered in all organizations, time volunteered in primary organization, and number of organizations for which volunteer serves).     

Exploring quality perceptions of health care operations: a study of public hospitals of Mauritius

Patient care has become increasingly important in the health care environment of Mauritius. Patients' satisfaction and their expectations of health care are valid indicators of quality health care. The present paper reports the results of a survey of patient satisfaction with heath care, administered by face-to-face interview to 300 in-patient adults discharged from five main regional hospitals based in Mauritius. It examines the predictors and level of patients' satisfaction across the five regional hospitals of Mauritius. In this study, a modified version of HEALTHQUAL scale was used for determining patient satisfaction with health care in the regional public hospitals. Multiple regression analysis was conducted to understand the relationships among patients' perceptions of in-patient services and their overall perceptions of health care quality, and also satisfaction with their care and willingness to return or recommend the same hospital's services to others. The dimensions labelled as "Patients' perceptions of ward/hospital environment" and "Patients' perceptions of medical and nursing staff" served a significant impact on nearly all measures of patient satisfaction in the regional public hospitals of Mauritius.     

Mature Consumer Awareness and Attitudes Toward Retirement Housing and Long-Term Care Alternatives

The retirement housing and long-term care industries have been responding to the needs of aging consumers by developing a wide range of housing facilities and personal care services. The increasing variety of long-term care options is expected to better satisfy the heterogeneous needs of older consumers. Results of a national study and qualitative research suggest that many present and potential consumers of supportive housing and long-term care services do not have a good understanding of these offerings. Many are unaware of the alternatives available. Mature consumers often perceive all long-term care negatively as nursing homes. The proliferation in the variety of housing and long-term care services and the lack of standardization in labeling products may be contributing to the misunderstanding of various options. This misunderstanding leads to consumers not obtaining the housing and long-term care services best suited to their needs. Government agencies, consumer interest groups, and housing and long-term care providers can help to differentiate products and educate consumers to better serve their needs.     

精神病老年人养老服务研究

在目前中国养老服务体系建设中,精神病老年群体的机构照料服务迄今处于民政、卫生、残联等部门未管到的"真空地带"。以北京为例,调查了市区、郊区、农村地区50岁以上老年精神病患者居家养老的现状。精神病老人以及他们的家庭社会处境不利,需要社会保护,需要政府提供社会服务。现阶段,政府应将这一群体的养老服务纳入国家公共卫生投资的视野。为精神病老年人提供社会照料服务,应列为民生工程的重要组成部分。     

基础设施投入对服务贸易结构影响的实证研究——来自跨国面板数据的证据

本文基于要素禀赋理论和动态比较优势理论,将基础设施投入引致的要素积累效应纳入H.Oniki和H.Uzawa(1965)的分析框架,探讨了广义基础设施投入影响服务贸易结构的理论作用机制,并在此基础上建立动态面板模型,采用系统GMM两步法对80个不同收入水平国家及其分群组在1996-2010年的数据进行了实证分析。研究发现,交通、能源和通讯等经济性基础设施变量与服务贸易结构水平呈显著正相关;社会性基础设施变量中,研发基础设施具有正向作用,医疗、教育和环保基础设施却呈负向作用,同时研发、医疗和教育基础设施变量均有显著的滞后效应;进口贸易有利于服务贸易结构优化,而FDI和服务业发展水平作用不显著。对于不同收入水平的国家,不同基础设施投入的影响作用存在差异。