Markov models and the utilization of mental health services: a study of endogenously depressed patients.

Patients in the mental health care system typically make more or less irregularly spaced visits to psychiatrists, both within and between episodes of a given illness. A Markov model is constructed which can predict the utilization of psychiatric services for such patients. Unlike previous Markov models of utilization, the current model takes as its starting point a model of an actual disease, specifically, endogenous depression. It is shown how one can estimate the parameters of both the model of utilization and the model of depression using data which were collected for clinical research purposes. The models provide reasonable fits to the data. Several applications of the models are worked out. In addition to predicting the utilization of mental health services, the models can be used to predict incidence, prevalence and recovery rates and to predict the changes in utilization which parallel changes in treatment regimens.     

Structural embeddedness and organizational social outcomes in a centrally governed mental health services network

Abstract

This article is an examination of the effects of network involvement, or structural embeddedness, on three organizationally based social outcomes. Specifically, we argue that in centralized, publicly funded networks an organization's structural embeddedness will be related to its trustworthiness, reputation and influence, as rated by other network members. Results from a network survey of a publicly funded health and human service network generally confirm our hypotheses and suggest additional work on the topic.     

Increasing HR's strategic participation: The effect of HR service quality and contribution expectations

Strategic participation is important for HR professionals who wish to have increased influence in their organizations. While a number of previous studies have suggested a link between strategic human resource management and firm performance, few have explored the specific factors enabling HR strategic participation. This study examines the impact of HR service quality and expectations of HR contributions on HR strategic participation. A total of 244 survey responses were received from 42 companies in Taiwan. All hypotheses were supported, thus signifying significant relationships between HR service quality, expectations of HR contributions, and HR strategic participation. The study results also indicate that HR professionals are able to proactively increase the value of HR in organizations by enhancing HR service quality and addressing potential internal customers' needs accordingly. © 2012 Wiley Periodicals, Inc.     

Communicable medicine: Cable television and health services

Cable television is here to stay. Moreover, it will develop into a widespread and sophisticated medium of communication, greatly surpassing its modest, rural beginnings. If this is so, how will the future delivery of health care be affected by this new technology? And more importantly, can the technology be harnessed to improve health services, perhaps even transform their very nature? These are the questions underlying this paper.Their discussion is separated into three potential application areas. Continuing professional education, public health information, and actual health services delivery. Specifically, the paper suggests that the most imminent applications will occur in the first area and the most consequential in the third. However, in none of the areas is the impact of cable technology likely to be insignificant. The paper also delineates many of the problems and uncertainties of implementing cable-based systems of telemedicine.     

Impact of airport green atmospherics on mental health value,image, and loyalty among visitors and workers

Nature‐based solutions (NBS) are becoming increasingly crucial as NBS brings diverse health‐related benefits to travelers and workers in the tourism business sector. This research explored the influence of green atmospherics as NBS on airport occupants' mental health value, image, and loyalty generation processes. A quantitative approach with a field survey method was employed. A structural equation modeling and metric invariance test were used as data analysis technique. Our empirical result revealed that green atmospherics as NBS significantly improve the occupants' mental health value and image of the airport, and these variables contribute to their loyalty enhancement for the airport. The effect of green spaces and natural surroundings on loyalty was maximized through mental health value and image. In addition, the linkages from natural surroundings to mental health value and image were stronger in the visitor group whereas the mental health value—loyalty relation was stronger in the worker group.     

Employment in health services: long-term trends and projections.

Demand for health services is expected to grow in response to the increasing number of elderly people; but growth prospects to 1995 for the industry's wage and salary workers are uncertain because of changes in both the financing and delivery of health care.     

Consumer behaviour and the purchasing of dental services: Influences on selection and evaluation of health care services

This paper examines the process of interaction between consumers and providers of dental services in terms of the key selection and evaluation criteria employed by consumers. Focusing on the United Kingdom, it examines the impact of changes in both pricing and provision on the utilisation and evaluation of dental services. Based on a questionnaire survey of dental patients, in the context of the evolving body of literature concerned with consumer behaviour in respect of services, the paper attempts to improve the current understanding of the key factors shaping consumer choice in respect of professional services. Specifically, it argues that the highly complex nature of professional services impacts on patterns of consumer behaviour, resulting in the relationship between the individual service professional and the consumer being the focus of consumer evaluation. This in turn has significant implications for the effective marketing of such professional services.     

Enhancing occupational health and safety in young workers: the role of social marketing

• Young workers (age 15–24) suffer work‐related injury at a much higher rate than older workers, yet research on the role and effectiveness of social marketing to influence and improve workplace safety is limited.
• A review of the relevant literature reveals that significant gaps exist in terms of effectively using social marketing to reduce young worker injury rates.
• A comprehensive, multi‐faceted social marketing approach is required to address young worker safety.
• Directing more attention toward the practice of social marketing can enhance the effectiveness of campaigns to reduce workplace injuries.

Copyright © 2007 John Wiley & Sons, Ltd.     

The market for acute hospital services and the marketing contribution: A NHS trust experience

The White Paper ‘Working for patients’ (DoH 1989)¹ and subsequent legislation, including the National Health Service and Community Care Act (1990), has facilitated the introduction of an internal market into the NHS. In particular, the establishment of provider hospitals as NHS trusts providing secondary care services, and the introduction of GP fundholders as purchasers of healthcare, has allowed the internal market to thrive, particularly where these two are in high concentration within a defined locality. One such area is southern Derbyshire. NHS trusts in this area face an unprecedented range of market factors, which threaten their long-term viability. These factors are described, as are the efforts of one trust to undertake detailed market planning. The rise of the GE/Mackinsey inatrix as a planning tool is advocated as an efective way of presenting relevant prodrict and market irtforiiiation to an NHS Trust Board, in an attempt to introduce strategic marketing planning at the highest level of the organisation.     

Occupational health: offering a spectrum of services

Hospitals must continue to explore ways in which to meet the needs of the employer market. As health care costs (workers' compensation and otherwise) account for a larger portion of a company's total expense dollars, the employer will continue to have a greater voice in how those dollars are expended. Hospitals and occupational health programs that recognize this fact will not only survive, they will prosper.     

Co-Production in Developing Countries: Insights from the community health workers experience

Abstract

Co-production nowadays ranks high in global development strategies of international and philanthropic organizations. Although long-standing experiences in developing countries can provide a relevant contribution to the co-production theory, it is necessary to verify what contextual and conceptual conditions might alter the existing theoretical models. This article makes a theoretical contribution by modelling propositions that can withstand logical and empirical scrutiny. The literature is reviewed to identify key co-production concepts, their interrelationships, and the underlying assumptions. A longitudinal case study is analyzed to expand the existing theoretical propositions. Policy implications for scaling-up programmes are drawn.     

Planning for education in the health services: a multicriterion approach.

Administrators are often confronted with problems for which there exist several distinct measures of success. Such problems can be expressed in terms of linear programming models with several linear “criterion” functions instead of a single objective function. Although a variety of techniques are available for the solution of multicriterion problems, there exists a need for one which does not assume technical sophistication on the part of the decision maker and which provides valid solutions with minimum effort. “Efficient Manifold Presentation”, the approach used here, is based on the concept that the ideal solution must be a Pareto optimal solution. A method for finding an expression for the finite set of all Pareto optimal solutions to a linear program with multiple linear criteria is presented. Two processes are involved; first, the discovery of all Pareto optimal vertices of the feasible region, and secondly a grouping of these into sets each of which defines a convex polyhedron of Pareto optimal possibilities. Alternate versions of the second process are suggested for use under varying circumstances. An example of the applicability of the method for modeling enrollment and staffing policy in an educational institution is provided.     

公共服务等值化建设与农民工——核心制度与推进路径

户籍制度及其衍生的配套政策造成了农民工不能享有与市民同等的公共服务。然而,由于积淀在户籍制度上的次生制度太多,有的已固化为社会现实,当前取消户籍制度的社会和经济成本太高,且对农民工公共服务等值化建设无实质性利好。农民工最大的问题是无力应对市场和城市生活风险,这是他们能否长期留在城市和实现市民化的关键。就此而言,农民工公共服务等值化建设的着力点并非户籍制度改革,而在于建立和完善其保障制度。     

Disaster planning and resource allocation in health services

The increasing prevalence of natural disasters, environmental tragedies, and depraved human behavior has generated excessive costs in both human and material resources at a time when cost-efficiency and control is continually emphasized by managed care contracts, business, and government agencies. As a result, increasing pressure has been placed on hospital material managers to do more with less, while also providing the necessary resources to respond efficiently and effectively during an emergency. A successful comprehensive, risk-based emergency management program of preparedness, response, and recovery will reduce the loss of life and resources.     

Human resource strategies and contingent workers: The case of safety and health in the petrochemical industry

One of the most important economic developments in recent years is the growth in the number of temporary and contract employees. Little is known, however, about the implications these contingent employees have for human resource practices. This paper presents the results of a study of one group of contingent workers, contract workers in the petrochemical industry. The primary concern of this study is the consequences contract workers have for safety, a hotly debated and politically charged issue in an industry where safety mishaps can have catastrophic consequences. We find that contract employees offer petrochemical firms an important degree of flexibility in meeting rapid fluctuations in their demand for labor. Contract employment relationships also create stresses with potentially severe adverse effects on workplace safety. Overcoming these threats to safety while maintaining flexibility will require a high level of coordination among human resource professionals, line managers, corporate executives, unions, and government agencies.     

The role of buyers justice in achieving socially sustainable global supply chains: A perspective of apparel suppliers and their workers

The absence of an effective public model (e.g., government regulations and law enforcement) in developing countries has driven clothing brands and retailers to rely on a private voluntary formal model (e.g., compliance and collaboration approaches) to manage suppliers' internal social issues (e.g., poor working conditions). However, this model has been recently criticised for falling short in addressing these issues as it overlooks their main root causes. In this study, we suggest that suppliers' internal social issues can be driven by buyers' unfair practices, and therefore, we propose and examine that buyers' justice can ensure suppliers' internal social performance. We further postulate and investigate that addressing these issues would result in advantages for buyers beyond traditional performance outcomes in the form of reduced supply operational risk. Based on a census of the 117 suppliers comprising the ready-made garment industry in a Middle Eastern country (Jordan), we received survey responses from 97 suppliers and their shop floor workers. The analysis revealed that only buyer’s distributive and procedural justice, but not interactional justice, are positively related to suppliers' internal social performance. We also found evidence that improving suppliers' internal social performance can diminish supply operational risk. This study contributes to the extant research by empirically investigating a new approach to handle the increase in suppliers' internal social issues in a developing country context. It also does by capturing suppliers' internal social performance from the workers' perspective and highlighting the role of improved suppliers' internal social performance on mitigating supply operational risk.     

Indicators for planning of health services: assessing impacts of social and health care factors on population health.

Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.     

The impact of consumer health information on the demand for health services

This paper empirically examines whether consumers use health information, from non-physician information sources, as a substitute or complement for health services – namely for physician visits and emergency room (ER) visits. An indicator of patient trust in physicians is developed and used as a proxy for potential unobserved heterogeneity that may drive both consumers’ propensity to seek information and to use physician services. The results, after correcting for sample selection bias and controlling for unobserved heterogeneity, concur with the literature, that consumer health information increases the likelihood of visiting a physician as well as the frequency of visits on average. However, low-trust consumers tend to substitute self-care through consumer health information for physician services. Further, better-informed consumers make significantly fewer ER visits suggesting that information may be improving efficiency in the market.