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61.
Research studies demonstrate wide variation in how physicians diagnose and treat patients with similar medical conditions and suggest that at least some of the variation reflects inefficiencies and unnecessary medical costs. Health care researchers are actively examining ways to reduce variations in practice through standardization of medicine to reduce the cost of treatment and ensure the quality of outcomes. The most widely accepted form of this standardization is Evidence Based Best Practices (EBBP). Furthermore, financial health care providers such as hospitals and managed care organizations are investigating methods to tie resource usage to medical protocols in their efforts to monitor and control health care costs. Such proposals are contentious because they report on physicians’ medical practice behaviors (such as the number of tests ordered, use of specific therapies, etc.) and such reports could potentially be used to influence their clinical behaviors. The intent of this exploratory study was to examine physicians’ perceptions about linking a standard costing system to EBBP guidelines. The authors interviewed nine practicing physicians asking each physician to respond to the question, ‘As a physician working in a hospital environment, what are your reactions to and concerns with combining standard costing techniques with EBBP?’ The interviews were in-depth and free form in nature. The physicians’ responses were recorded and analyzed using Grounded Theory Methodology. Using this methodology the field data was categorized into two major themes. The most important theme centered on ethics and the second theme was concerned with the implementation and use of a standard cost system in regard to EBBP. If physicians’ worries about ethical dilemmas and implementation issues are not resolved, then it is likely that doctors would be unwilling to participate in any efforts to develop or use a standard cost-reporting system in medicine. While this study was exploratory in nature, it should provide future guidance to accountants, health care researchers and health care providers about physicians’ issues with the use of standard costing methods in medicine. 相似文献
62.
Employees perception of the existence of a covenantal relationship between themselves and their employer indicates that they believe there is a mutual commitment to shared values and the welfare of the other party in the relationship. Research suggests that these types of employment relationships have positive benefits for both employees and employers. There has been little research, however, on the factors that determine whether such relationships will develop and thrive.In this paper, we suggest that the organizations ethical work climate may be an important factor affecting employees perceptions about the nature of the relational contract between themselves and their employer. Specifically, we argue that work climates emphasizing benevolence and principle will be associated with covenantal relationships. Conversely, we believe that work climates emphasizing egoism will make it less likely that covenantal relationships will develop between an employer and employee.In order to test our hypotheses, we collected data from 194 employees of a large retail department store. The employees perceived their work climates in terms of principle (laws and professional codes) and benevolence, but to a lesser extent also believed that egoism (self interest) concerns characterized their climate. After controlling for demographic and job-related variables, we found (as expected) that measures of principled and benevolence climate were positively associated with covenantal relationships and that a measure of egoistic climate was negatively associated with covenantal relationships. In the final section of the paper, we discuss the implications of these findings for research and practice. 相似文献
63.
President Donald Trump espouses “America First” positions which are commonly interpreted as protectionist. However, a closer reading of Donald Trump’s business interests, of his administration’s published trade agenda and of US trade negotiation history calls into question whether “America First” means protectionism. Trump will use large trade deficits to pressure trading partners to further open up their markets. Companies that are successful in exporting to the US market from those countries will be alarmed by protectionist announcements and will therefore most likely pressure their governments to give in to the demands of the Trump administration. 相似文献
64.
Elizabeth S. Moore 《Journal of Business Ethics》2004,52(2):161-167
Concerns about children's ability to fully comprehend and evaluate advertising messages has stimulated substantial research and heated debate among scholars, business leaders, consumer advocates, and public policy makers for more than three decades. During that time, some very fundamental questions about the fairness of marketing to children have been raised, yet many remain unresolved today. With the emergence of increasingly sophisticated advertising media, promotional offers and creative appeals in recent years, new issues have also developed. This paper provides a basis for further examination of some the key questions in this area, and suggests how children's advertising research can be employed to illuminate them. 相似文献
65.
Keith Brand Martin Gaynor Patrick McAlvanah David Schmidt Elizabeth Schneirov 《Review of Industrial Organization》2014,45(4):325-344
We discuss in this essay three of the matters on which economists in the Bureau of Economics (BE) at the Federal Trade Commission have worked this past year. BE revisited familiar ground in the first matter, a proposed merger of office supply retailers. The second part of the essay considers efficiency claims in health care mergers, with focus on the acquisition of a physician group by a health care system in Idaho. The final part of the essay discusses empirical work that was undertaken by the Bureau to investigate claims made by marketers of an alleged get-rich-quick scheme. 相似文献
66.
Through the processes of commodification and marketization, materials and human activities are brought within the domain of market exchange. The results of these accelerating processes are observed in the consumer culture centred on objects of consumption. We contend that, in addition to healthcare, health itself has become yet another object incorporated within consumption space. This contention is consistent with the perspective of consumption as the dominant social paradigm in the structuring of health and healthcare practices. In this paper we present the conceptual backdrop for our contentions, together with details of a heuristic study. Our findings support the view that people regard health as a consumption object. Furthermore, the evidence suggests a patterning of responses by social grade and gender. Given our wider interest in class‐based health inequalities, we use our results to comment on the broader policy debate concerning this phenomenon in relation to consumerism. 相似文献
67.
Annette Pritchard Nigel J. Morgan Diane Sedgley Elizabeth Khan Andrew Jenkins 《Leisure Studies》2013,32(4):267-282
This paper is an exploratory investigation of the travel motivations of gay and lesbian tourists. Based on in-depth interviews and focus groups, it investigates the interrelationships between sexuality, tourism behaviour and tourism spaces. Given that public space is controlled and heterosexualized, the paper suggests that whilst gay and lesbian people are motivated to travel for a range of reasons, such is the power of the dominant heterosexual milieu that their sexuality has a critical impact on their tourism choices. The need for safety, to feel comfortable with like-minded people, and to escape from heterosexism – often to specifically gay spaces – emerge as key influences on their choice of holiday. 相似文献
68.
AbstractCurrent research on dark tourism lacks an in-depth investigation of the relationships between the various psychological factors that influence tourist satisfaction. Using the cognitive-affective-behavior system, this paper evaluates a theoretical model that postulates relationships between four constructs, namely: motivation, perceptions of tourism impacts, place attachment, and satisfaction. The study extends the tourism literature on cultural sustainability by showing the psychological connections of domestic tourists to a dark heritage site, and the implications for perceptions of tourism impacts on this heritage. Based on a sample of 414 domestic tourists at a dark heritage site in Elmina, Ghana, PLS-SEM confirmed several inter-relationships among the four constructs. Motivation had a positive relationship with perceptions of positive and negative tourism impacts, suggesting that the tourists who were more motivated to visit the site for cultural/learning experiences were also more inclined to perceive both positive and negative tourism impacts. Implications for dark tourism and how heritage site management can influence tourists’ perceptions of impacts are offered. 相似文献
69.
Ted L. Napier Elizabeth G. Bryant 《Leisure Sciences: An Interdisciplinary Journal》2013,35(2):169-187
A research project was undertaken within a multi‐county region in southeastern Ohio to ascertain the attitudes of local residents toward future outdoor recreation development within the area. A systematic random sample of 1493 respondents was drawn from a five‐county region to test a theoretical perspective developed from selected components of social exchange theory. The findings demonstrated that the respondents held very favorable attitudes toward outdoor recreation development. Multivariate analysis of the data revealed that the theoretical model was basically supported. The findings are discussed from both applied and theoretical perspectives. 相似文献
70.
Namvar Zohoori Elizabeth Ward Georgiana Gordon Rainford Wilks Deanna Ashley Terrence Forrester 《International journal of injury control and safety promotion》2013,20(4):255-262
Using data for a one-year period from the Kingston Public Hospital (KPH) in Jamaica, we describe patterns of non-fatal violence-related injuries, and carry out simulation analysis to estimate rates of hospital admission under various injury reduction scenarios, and the potential savings that can be realized by reducing violent crimes. In this period there were 6107 registered violence-related visits to the KPH representing 11.5% of all recorded visits. Of these 16.6% (1001) were admitted. The most common methods of inflicting injury was by stabbing (52.1%), blunt injuries (37.9%) and gunshot wounds (7.3%). Multivariate analyses indicated that gunshot injuries, stab injuries, being male between the ages of 15 and 44 years, receiving the injury in November or December, and being injured by a stranger or unknown assailant, were significant correlates of a higher probability of admission. Simulation analysis with various injury reduction scenarios indicated decreases in the probability of admission ranging from 12% to 44%, with estimated savings of up to 31% of the annual supplies budget of KPH. 相似文献