The Impact of the Internet on Professional Relationships: The Case of Health Care

This paper considers the impact of the internet on professional services, specifically healthcare services which have been characterised as asymmetrical in information and power distribution. For complex professional services the internet is primarily an information resource offering perceived parity with professionals. Based on interviews with healthcare professionals and website managers, this paper considers how professionals perceive the internet to be changing patterns of professional–consumer interaction and the nature of professional–consumer relationships. Manifest at service encounter level and health policy level, professionals perceived the evolving parameters of the consumer role to be generating a requirement for a fundamental revision of models of service delivery and professional roles.     

新医改背景下如何评价医疗服务质量——基于通用评估框架的探索与应用

评价和改进医疗服务质量是我国新一轮医药卫生体制改革的重要目标,这需要建立在拥有一套科学和完善的评价指标体系基础之上。然而,我国现有的医疗服务质量评价指标体系滞后于医疗卫生体制改革实践,缺乏系统的理论框架,仅侧重于医院等级评价和业务考察,而没有将评价看作是一个系统的过程,也就难以促进医疗服务质量的持续改进。尝试将广泛应用于公共部门绩效评价的通用评估框架引入医疗卫生服务领域,开发了一套包含三个评价层级共27个指标的医疗服务质量评价指标体系,并以北京S医院为例进行了应用和完善。研究表明,通用评估框架可以为我国医疗卫生质量评价提供新的思路,在实际应用中具有较好的效果,可以准确地呈现医院医疗服务质量的结果和影响医疗服务质量的因素,但也需要在今后的应用中不断更新评价指标,聚焦新医改的任务,增加客观性指标。     

A dynamic forecasting model for nursing manpower requirements in the medical service industry

Today there is an increasing demand for quality health care throughout the world. Such demand requires the medical service industry to equip with high technologies and high caliber professionals (e.g., doctors and nurses), to contain cost and improve quality of care. Since the medical service industry constantly suffers from the shortage of nursing manpower, forecasting the supply and demand of nursing manpower is an important issue. This study proposes a forecasting model for nursing manpower requirement using system dynamics. Data were collected from authorized institutions in Korea and were used as inputs of the model. The results show that the demand for nursing manpower exceeded the supply during the forecasting period (2006–2020), which requires both national and the medical service industry attention for sustained quality health care.     

Burnout processes in non-clinical health service encounters

This study employs Bagozzi's (1992) reformulation of attitude theory (appraisal → emotional response → behavior), to examine the antecedents and outcomes of burnout in a healthcare environment where healthcare workers are engaged in the novel context of non-clinical health service encounters. The findings identify significant relationships between job demand stressors (role overload, role conflict, role ambiguity and interpersonal conflict), symptoms of burnout (emotional exhaustion and depersonalization), affective job outcomes (job satisfaction and organizational commitment) and behavioral job outcomes (service recovery performance and turnover intentions) and extend our understanding of these phenomena in the largely unexplored yet important context of non-clinical health service delivery. The major implication for hospital managers is to ensure that non-clinical healthcare workers have adequate information pertaining to their job-related duties and responsibilities since role ambiguity is the only characteristic of the non-clinical work environment that influences subsequent appraisal (depersonalization), emotional response (organizational commitment) and behavior (service recovery performance) in the conceptualization of appraisal → emotional response → behavior.     

Innovative healthcare delivery

Critics of the American healthcare system recite a long list of problems, including rising out-of-pocket costs, inconvenient access, overuse of emergency departments, uncoordinated medical records, and declining numbers of primary care doctors. To address these issues, some new venues have evolved, such as retail and urgent care clinics; however, the emergency department has become the only service provider available to all patients on a 24/7 basis. It is time to reinvent the system. The concept of patient-centered medical homes offers a structure for integrating innovations that can transform the delivery of healthcare. In this model, each patient develops an ongoing relationship with a primary care physician supported by a team of caregivers. An integral feature is the electronic medical record, which facilitates coordinated communication and decisions. Access expands beyond the traditional physician office visit to satellite services tailored to individual needs. Services center on whole-person care, including wellness and preventive counseling, as well as acute and chronic care. Adoption of the patient-centered medical home transforms healthcare delivery into a system that benefits everyone.     

Generational Differences in the Importance,Availability, and Influence of Work Values: A Public Service Perspective

This study uses a sample of 832 Canadian public servants to test a theoretically derived framework which hypothesizes that generational cohort: (1) predicts the importance public servants place on intrinsic and extrinsic work values, (2) predicts the perceived availability of such rewards in public service workplaces, and (3) impacts the relationship between perceived availability of important rewards, organizational commitment, and job satisfaction. Our study adds to the limited body of research on generational cohort and work values in the public service. Generational cohort had little impact on the importance of work values, but did predict perceived availability of work‐rewards and the relationship between perceived availability of important rewards, organizational commitment, and job satisfaction. Findings could help public service organizations' recruitment and retention efforts. Copyright © 2018 ASAC. Published by John Wiley & Sons, Ltd.     

Applying career concepts to strengthen the work-attitudes of service professionals

Given the nature of employment relationships today, service organizations can strengthen the organization commitment levels and reduce the turnover intentions of its professionals through providing job features important to their careers. These features include opportunities to perform challenging work, experience trusting relationships with customers/clients, and obtain extrinsic rewards. Using a sample of alumni from a hospitality business program, hypotheses that these features impact organizational commitment and turnover intentions, partially through strengthening professionals’ career commitment, are developed and tested. Findings suggest that challenging work opportunities impact these attitudes both directly and indirectly. So too trusting relationships with customers and clients indirectly impact organization commitment and intent to turnover (ITO). Results also suggest that, as a whole, satisfaction with extrinsic rewards has no effect. However, an analysis of multigroup mediation results revealed that for professionals working in professional service firms, satisfaction with pay reduces both attitudes. Implications for research in organization commitment and ITO, specifically the role and impact of career-based antecedents, are discussed.     

Overcoming the Trend Toward Healthier Foods: The Impact of Advertising and Intangibles on Investor Returns in the Packaged Food Industry

The study analyzes the impact of advertising, goodwill, and other intangibles on investor returns in the consumer packaged food and beverage industry during 2008–2012, a timeframe during which smaller brands wrestled $18 billion in sales away from large manufacturers of processed foods. The findings demonstrate that those firms that were able to allocate a greater percentage of their revenue to their ongoing advertising efforts were able to enhance investor holding period returns (HPR). In addition, those firms with a higher ratio of intangible assets other than goodwill to total assets were also able to enhance HPR. However, there was not a significant positive relationship between the ratio of acquired goodwill to total assets and HPR. Hence, packaged food and beverage manufacturers are advised to seek competitive advantages through their own brand-building efforts rather than seeking to enhance investor returns through a strategy based on company mergers and acquisitions.     

Public commitment as a motivator for weight loss

Many long‐term services, e.g., weight‐loss programs, require that customers comply with instructions, provide the inputs, and thus co‐create a major portion of the service. This article investigates the role of public commitment in influencing motivation and behavior in a weight‐loss setting. The role of susceptibility to normative influence (SNI) is also examined. The publicness with which a commitment to weight loss is made has a significant and favorable impact on long‐term weight‐loss compliance behavior. Short‐ and long‐term public commitment resulted in higher levels of weight‐loss motivation and higher levels of weight loss. Weight‐loss motivation partly mediates the effect of public commitment on weight loss, while SNI moderates the effect of public commitment on weight loss. © 2009 Wiley Periodicals, Inc.     

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.     

Organizational Citizenship Behavior and the Public Service Ethos: Whither the Organization?

Public services worldwide have been subject to externally imposed reforms utilizing tools such as financial incentives and performance targets. The adverse impact of such reforms on a public service ethos has been claimed, but rarely demonstrated. Individuals within organizations work beyond their formal contracts of employment, described as Organizational Citizenship Behavior (OCB), to further organizational interests. Given New Public Management reform and the subsequent contextual changes in the way in which public sector organizations are managed and funded, the present study theorizes that OCB directed towards the organization may be ‘crowded-out’. This article tests the relationships between public service ethos and OCB and it presents empirical evidence from a study in England (n = 433) of the ability of each dimension of this ethos to predict OCB.     

试论公立医疗机构的医疗改革

现阶段,我国公立医疗机构服务意识淡薄,服务质量欠佳,医患交流不畅,以药养医,专业素养下降。公共医疗机构的改革应该是明确工作方向,强化服务意识;规范诊疗程序,提高服务质量;畅通医患交流渠道。共创和谐医疗环境;分开管理医与药,断绝医务人员与药品的利益关联。     

负商誉问题研究

《企业会计准则2006}幅增加了商誉问题的章节，可以看出新准则对商誉问题的重视。文章将在新会计准则的背景下对负商誉的相关问题做以阐述。其中包括对负商誉存在性争论的辨析，对其性质的两种主要观点“负债观”和“是商誉的一种形式”的深入剖析，以及相关会计处理对会计报表产生的影响的分析。     

Hands-off? Lessons from high-touch professionals about going virtual

The COVID-19 crisis has fundamentally changed how many businesses operate and connect with their customers. Previously unheard-of government restrictions and sheltering-in-place requirements forced most professional services to transition to remote delivery methods (e.g., email, telephone, video consults, Shopify storefronts). Providers of low-touch services (e.g., lawyers, accountants) naturally lent themselves to remote delivery; however, those that offer high-touch services, particularly those in healthcare (e.g., doctors, chiropractors, physical therapists), experienced a drastic change in working conditions when going virtual. Despite a long history of resistance to virtual delivery, the pandemic created an unprecedented incentive for these high-touch professionals to experiment with underutilized care models such as telehealth: the provision of healthcare services remotely using telecommunications technologies. We examine the rapid adoption of telehealth during COVID-19 through the coming together or convergence of previously unrelated technologies, spaces, and practices. Our analysis reveals opportunities and challenges associated with going hands-off that apply to many other professionals providing high-trust services. Specifically, we offer nine guiding principles for building and protecting cognitive and affective trust in virtual and hybrid delivery models. This is important given the pace of compounding technology convergences that lie ahead for service professionals.     

‘I send the wife to the doctor’– Men's behaviour as health consumers

This paper explores men's behaviour and attitudes in relation to health matters. While there has been some practical and research progress in engaging with users of health services, there is less development in the area of engaging non‐users. In effect, all members of the society can be the consumers/users of health promotion, though not all are. This paper reports on the first stage of a wider project aimed at increasing the effectiveness of skin cancer awareness messages aimed at men. The project focuses on men over 50 from an area of socio‐economic disadvantage, since these men tend to have the lowest life expectancies in general, and the highest incidences of mortality for skin cancer both at a national and international level. The research was conducted through community‐based focus groups and while the sample was relatively, small it produced some interesting outcomes in terms of how this cohort audited and responded to public health promotion campaigns; how they perceive cancer and health issues in general; how they respond to health issues; and how they view both the public health service in Ireland and the ways health professionals relate to them. It confirms many theories about how men view their health and how they respond to health promotion campaigns. Among other points, it raises questions about the possible mixed benefits of testimonial‐based advertising. It also indicates that there may be further layers of complexity connected to identity, fatalism, problem solving and respectful treatment that have not been sufficiently articulated in the literature. It points to the need for greater engagement by service planners and providers with the needs of their target audience, which may require a more encompassing definition of service user.     

Product recalls and the moderating role of brand commitment

We assess attenuating and augmenting effects of brand commitment on consumer responses when product recalls occur. Consistent with our theorization, results from a laboratory experiment and an event study show that high levels of brand commitment attenuate negative consumer responses in low-severity product recalls but augment them in high-severity product recalls. Thus, while brand commitment seems to provide a reservoir of goodwill in the former case, it acts as a liability in the latter. These findings add to the extant brand and product recall literature by demonstrating that brand commitment has a complex effect on consumer responses when product recalls occur. Because product recalls are widespread, these findings also have managerial relevance.     

A cross-country study of service productivity

This study empirically examines service productivity and complements prior studies by framing service productivity as consisting of a number of key constituents. Adopting a bottom-up approach we present an integrative model proposing that resource commitment is the core from which employee readiness and customer readiness flow. These inform service productivity, which, in turn, informs job security. Our empirical examination reveals that service productivity has an impact on perceptions of job security, while resource commitment has the greatest impact on both employee readiness and customer readiness. In developing our integrative model we provide a framework that other researchers can apply, particularly where the service is highly intangible or in the public sector where service providers are being increasingly challenged to demonstrate value for money.     

Determining the antecedents and consequences of donor‐perceived relationship quality—A dimensional qualitative research approach

It is generally accepted that an understanding of quality conceptualizations is instrumental in the design and development of customer care programs. This study applies the dimensional qualitative research approach to develop a conceptual model, which demonstrates the antecedents and consequences of donor‐perceived relationship quality. This model shows that relationship benefits, service quality, trust, commitment, and satisfaction are the key antecedents of donor‐perceived relationship quality. Relationship benefits, service quality, and trust are also modeled as cognitive in nature, whereas commitment and satisfaction are modeled as affective variables. The model also highlights donor loyalty and positive word‐of‐mouth communications as the central consequences of donor‐perceived quality. The model gives rise to a useful research agenda for fund‐raising professionals. © 2007 Wiley Periodicals, Inc.     

Goodwill Capital

The concept of goodwill or brand capital is commonly employed by analysts in business and marketing to measure the asset value of a company name or a brand name, and consequently among accountants and business analysts, but is seldom used by economists. The purpose of this article is to begin to develop the concept of goodwill capital by presenting an analysis of what it is and some estimates of its likely magnitudes. We define goodwill capital, like the capital arising from R&D and advertising, as a form of intangible asset, albeit one which cannot be readily related to past investments in R&D, advertising, and capital equipment. We compute estimates of goodwill capital by deducting measures of these other three forms of capital from a firm's market value. For many companies, goodwill capital turns out to be the largest of its four capital stocks. Roughly half of our estimates of goodwill capital turn out to be negative.