Consumers’ views of breast care services in Ireland

One Irish woman in 14 develops breast cancer. There are 1700 new cases each year. These rates compare poorly with EU figures. The government indicated in 1995 that it favoured rapid, comprehensive diagnostic facilities, using the triple assessment model of clinical care, to improve survival rates and to diminish the anxiety women experience about breast cancer. Implementation of this policy was delayed until 1999, when a plan for centres of excellence in breast care was conceived. To compliment this plan, the Department of Health and Children wanted consumer views on existing breast care services. The Women’s Health Council was asked by the Department of Health and Children, through the National Cancer Forum, to conduct research on women’s views and reactions as consumers of existing services for symptomatic breast disease. The research team was asked to document women’s views on: diagnostic services; counselling; additional treatment services such as surgery and radiotherapy. The methodology consisted of four strands: questionnaires and focus groups with consumers of breast care services; postal questionnaires to clinic staff and a literature review. Striking aspects were the long delays women experienced before obtaining a completed diagnosis; often chaotic clinic settings which added greatly to women’s shock and anxiety; the lack of support if they received a diagnosis of cancer; and problems relating to limited resources for cancer treatment, including radiotherapy. We explored women’s coping mechanisms and their experiences, in the context of the model of quality of care. Finally, we argue that a centre of excellence must develop a multidimensional model of breast disease care that incorporates the full range of psycho‐social dimensions for women, if it is to earn its claim to excellence.     

Citizen and consumer involvement in UK public services

This paper is concerned with the involvement and participation of citizens and consumers in UK public services. It reflects on levels of involvement over a 30‐year period and maps this accordingly. Using models of participation, the paper reviews the citizen and consumer concepts. Conclusions are drawn about involvement and participation in practice and how this will develop in the future.     

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.     

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.     

An investigation of consumer evaluation of brand extensions

This paper deals with the effects of perceived quality, perceived fit and perceived difficulty, and interaction between perceived quality and fit on consumer evaluations of brand extension. We used multi‐item scales to measure these constructs. Data were analysed via structural equation models. Results show that both perceived quality and perceived fit have direct positive effects on consumer evaluation of extensions. We find support for the chance of transferring the positive values of a brand to an extension is greater when consumers see the extension as a good fit with the original brand and the original brand is considered as of high quality.     

An evaluation of strategic responses to consumer boycotts

This article documents the relative effectiveness of the various marketing strategies, in particular the public relations strategies, that firms use to combat the likelihood of boycotts as a politically motivated form of anti-consumption. This study focuses on boycotts that relate to corporate practices and aims to provide a rationale for appropriate publicity-based responses to the threat of corporate practice related boycotts. The purpose is to determine whether the techniques that firms use to mitigate the detrimental effects of negative publicity will be similarly effective for a boycott situation. The authors use two experiments to investigate the influence of publicity-based strategic responses to boycott requests on consumers' perceptions and behavior.     

A critical review of primary health care reform in Bulgaria: impact on consumers

The Health Care System in Bulgaria is in a period of transition and is undergoing profound changes in financing, organization and ownership. A priority of this reform is to shift the focus of healthcare to the primary sector and to emphasize general practice. New legislation in support of this health care reform has been passed over the last few years. However, this legislation, although consistent with the global aims to be achieved, has proven to be contradictory in terms of its practical implementation. This has had a negative impact on health care consumers’ interests and rights. This paper evaluates the effects of primary health care reform in Bulgaria from the perspective of patient satisfaction. For this purpose, a major task to be fulfilled is to identify the contradictions emerging between the legislation outlining the reforms and the realities of practical implementation with respect to its impact on consumers. The methods applied include: a review of the legislation, a review of the practical progression of the reform process, and an assessment of the new developments in health care consumers’ interests and rights. Considerable contradictions have been found between the legal framework of health care reform in primary care and existing experiences, traditions and expectations. The legislation is inconsistent with the existing realities of healthcare provision. This is leading to turmoil in the health care system during its present transformation and is infringing upon consumers’ rights. Problems emerging in the process of reform need to be identified, and solutions need to be found and worked out as the reforms progress. An assessment system has to be developed to monitor the overall reform process and to evaluate the effectiveness and efficiency of the changes introduced. The impact on consumer and patient satisfaction should be an area of prime concern during these assessments.     

Using response behaviour theory to solicit survey participation in consumer research: An empirical study

Abstract

The purpose of this article is to report on research that examines survey participation rates (i.e. response rates) for personal interview surveys where solicitation for participation is based on different theories of survey-response behaviour in two culturally distinct countries. Field experiments were designed to investigate the extent to which the theories of exchange, cognitive dissonance, self-perception, and involvement/commitment can influence potential respondents to participate in a personal interview survey in Australia and Hong Kong. The results show that there were significant differences in Australia with the theory of self-perception having the strongest impact on survey-response behaviour, while cognitive dissonance has the least impact. In contrast, the effects in Hong Kong were not significant. This study adds to the limited empirical research regarding why consumers participate in surveys, particularly personal interview surveys. The theories are applied at the self-introduction and invitation to participate, which is a crucial stage in the potential respondent's decision about participation.     

中国人口健康基本保障方案的评价——农村初级卫生保健的经验和教训

初级卫生保健是评价国家人口健康基本保障最重要的内容之一。建国以来我国初级卫生保健取得了卓越的成绩。伴随着人口转变过程 ,建立在原有计划经济体制下的初级卫生保健系统发生了较大的变化。以农村初级卫生保健为重点 ,探讨中国人口健康基本保障方案在提高中国人口健康水平中的作用和变化 ,反思和总结我国初级卫生保健实施过程中的经验和教训 ,为改善我国卫生保健体制提供更广阔的视角。     

流动儿童的保健状况及其影响因素——以厦门市开元区流动人口为例

利用"厦门市开元区流动儿童健康与教育状况调研课题"的抽查结果,从流动母亲的孕产期保健、分娩方式以及流动儿童出生时的体重、4个月内的喂养、系统保健、预防接种和目前的健康水平等资料详细描述了流动儿童的卫生保健状况.通过一系列标准化的卫生保健指标的计算与比较,估计了流动儿童与常住儿童在卫生保健方面存在的差距.并借助1ogistic多元回归模型,分析差距产生的主要原因.分析结果表明,流动人口的妇幼保健综合水平明显低于常住人口,其主要原因是流入地对流动人口的妇幼保健知识宣传还不很到位.     

User involvement in measuring service quality of local authority occupational therapy services; a new approach

The aim of this paper is two‐fold: (i) to describe the development of a new measuring instrument for quality of care from the perspective of the users of local authority Occupational Therapy (OT) services, and (ii) to evaluate the potential of the new instrument as a standardized approach for involving consumers in the service evaluation of home health care services. A combination of qualitative and quantitative methods was used. Focus group discussions with users of local authority OT‐services preceded a postal survey. Questionnaires were sent to a random sample of 997 users of the local authority OT Bureau in Kent, UK. The response rate was 55%. A valid and reliable instrument – the QUOTE‐OT Services questionnaire – was developed, which reflects the (expressed) needs of the users of OT services. Feasibility tests showed that information from the instrument can play an important role in follow‐up activities that aim at continuous quality improvement. The QUOTE‐OT Services instrument can be seen as an example of a new generation of questionnaires for assessing user views in quality of care research. Potentially, instruments such as the QUOTE‐OT questionnaire contribute to the empowerment of users in programmes that aim at improving the quality of home health care services.     

Embedding consumer culture in health and social care education – a university office's perspective

Health and social care services are changing – and this change is radical. Service user and carer involvement has been a key aspect of health and social care policy for a number of years. In terms of the National Health Service (NHS), this has been significantly strengthened by the report ‘High Quality Care for All’. The NHS will no longer be a monolith dictating what services it offers. It is beginning to take seriously the views of its consumers: the patients, service users and carers. The NHS is starting to put the patient experience at the centre of everything it does, and its regulators are asking for evidence of public and patient involvement. This process may yet prove to be one of the NHS' greatest challenges as it transforms to prioritize the consumer viewpoint. Social care, though further down the line in relation to involvement, is now responding to the relatively new personalization agenda. This paper will consider what the university sector can do to embed the consumer and service culture within the education of health and social care professionals. It looks at the challenges of involvement and required culture change, highlighting the key points to address in the early and middle stages of involvement from a university office's perspective. It includes examples of consumer involvement in teaching, assessment and the selection of students and how their input is starting to make a difference. Finally, the paper outlines what is needed in a development office to establish and support effective service user and carer involvement on health and social care courses in higher education. The article concludes by acknowledging that there is much more work that needs to be done in this field to embed the work of a development office, but that early steps have been promising.     

Linear processing in a semantic network: An alternative view of consumer product evaluation

While the linear model has been very successful in explaining the product evaluation process of consumers, it is quite uncertain what the model actually means in terms of underlying cognitive processes. An alternative model is developed, based on semantic network models developed in the psychology of memory, and used to explain the product evaluation process. It is shown that in certain cases this model leads to an information integration process structurally similar to the lineat model.     

Critical consumer issues in St. Lucia: an examination of consumer challenges and related learning among rural adults according to income levels

Consumer education is a relatively new and growing interest in St. Lucia. Neither the government nor the National Consumer Association has established a consumer education programme to address the growing consumer concerns in the country. The purpose of this study was to examine critical consumer issues, related learning challenges and strategies among rural adults in St. Lucia according to income levels. Rural adult consumers are most disadvantaged in terms of levels of education, income and access to resources, which may help to prevent and mediate consumer concerns. The specific research questions examined were: (1) What is the nature of problems experienced by rural St. Lucian adult consumers in the marketplace? (2) How do rural St. Lucian adult consumers solve the challenges they encounter in the marketplace? (3) What is it like for rural St. Lucian adult consumers as they go about trying to learn to solve the consumer issues they face? and (4) What do rural St. Lucian adult consumers perceive to be the requisites for effective decision making in the marketplace? Data were collected using a questionnaire comprising of 29 questions divided into four sections (problems, strategies, solving consumer problems and making effective decisions) and two biographical questions. A total of 500 rural adult consumers were surveyed verbally through door‐to‐door contact. The findings of this study revealed that middle‐income rural adult consumers experience more problems in the marketplace than those with each lower or higher level of income. Middle‐income rural adult St. Lucian consumers in particular seek more information and are comfortable with using more strategies than the lower‐ and higher‐income rural adult consumers. This research gives us a better understanding of the problems faced by rural adult consumers based on their income. Research results will be useful to the government of St. Lucia and the National Consumer Association when they decide to establish an adult consumer education programme for St. Lucia.     

The birth of the housing consumer in the United States, 1918–1960

Between 1918 and 1960, those Americans who were able to buy a home learned to think and act as housing consumers. By 1960, the typical couple purchased a finished dwelling from a speculative builder instead of hiring the services of a contractor. Builders now produced for an anonymous market. They learned how to sell, and buyers learned to expect, a comprehensive and standardized package of services that included long‐term financing. Such financing required, and buttressed, a Fordist regime of mass production and consumption, and was promoted after 1934 by a new federal agency. It stabilized the economy by pushing families to make long‐range spending plans, while shaping their pattern of monthly expenditures. Increasingly, Americans came to think of homes as commodities, as investments and as means of self‐expression. They enacted these assumptions by browsing through model homes, by making elaborate financial calculations, by borrowing and by taking on home repair and improvement projects. These changes were promoted by the real estate industry and the state, and were soon accepted for the comfort and convenience they offered.     

贫困人群医疗救助的若干关键问题

对医疗救助的理论进行了回顾与整理 ,探讨了对贫困人群实施医疗救助的概念与意义 ,讨论了医疗救助中的若干关键问题 ,包括 :医疗救助对象的确定、优先需要的确定、医疗救助中的社会性别问题、服务效果与服务质量问题以及筹资问题     

Buyer behavior in business-to-business services: The case of foreign exchange

Empirical regularities in buying behavior observed in mostly consumer markets have been linked into a comprehensive model, the Dirichlet. No attempt has yet been made to see if this model applies to services in general or to business-to-business services in particular. In this paper, we examine the purchasing behavior of large multinational corporations from four countries who purchase foreign exchange contracts from the major banks. We highlight similarities to the patterns of buying behavior observed in consumer markets. Implications for the management of business-to-business services firms are discussed.     

Moving towards consumer involvement in maternity services in the north‐east of Ireland

This article uses a case‐study approach to focus on developments in maternity services in the north‐east of Ireland where there is occurring a planned move towards active consumer involvement. In a country with a poor record of consumer involvement, this is a very welcome and innovative development. The Health Service in Ireland is in crisis, characterized by a very prolonged and difficult restructuring, extreme difficulties in recruiting and retraining staff, lack of resources, long waiting times in accident and emergency units with the media reporting daily counts of those left lying on trolleys for extended periods. The north‐east of the country has been affected by the closure of two maternity units in Monaghan and Dundalk. The region has been rocked in recent years by a major health scandal with a long‐serving obstetrician being struck off the medical register for carrying out an excessive number of caesarean hysterectomies. Out of this, there is emerging an innovative woman‐centred maternity service in the north‐east of the country. This article evaluates these developments with a particular focus on consumer involvement.     

Role of customer orientation in an integrative model of brand loyalty in services

This study attempts to model the development of brand loyalty by examining the simultaneous effects of customer orientation, perceived quality, brand associations, and satisfaction on brand loyalty. Data are used from retail banking and discount store retailing services to examine the direct and indirect effects of customer perceptions of customer orientation and quality on brand loyalty. It was found that customer orientation has a direct effect on brand loyalty and indirect effects through customer satisfaction, perceived quality, and brand associations as mediators. Further, perceived quality has a direct effect on brand loyalty as well as an indirect effect with satisfaction as a mediator. The results suggest that effective management of brand loyalty would require tracking of customer perceptions of a firm's customer orientation, quality and brand, in addition to measuring customer satisfaction.     

College Students' Perceptions of a Smoking Ban in Restaurants and Bars

Abstract

This study investigates college students' perceptions of smoking bans and their knowledge of smoking bans implemented in a college town. A total of 180 college students enrolled in two hospitality management classes participated in the study. While the majority of students were strongly supportive of smoking bans in general, results of the study indicated that significant differences were found in smoking ban perceptions based on respondents' future employment segments. The length of residency also affects how much information respondents knew about implemented smoking ban regulations.