Search results

Standing Medical Advisory Committee (SMAC) guidance for prevention of coronary heart disease (CHD) and the National Service Framework – Coronary Heart Disease both require the identification of patients at high risk of CHD for targeted treatment with statins. Since the best method of identifying these patients is unknown, we compared population screening with opportunistic case finding in a discrete event computer simulation model of the population aged 45‐64 in one local health group in Wales. The main outcome measures were numbers of CHD and all‐cause deaths and extra patient‐years of drug treatment. Screening and case finding were of similar effectiveness in identifying high risk individuals to prevent CHD and all‐cause mortality during the five years simulated. The extra patient‐years of drug treatment required by a population screening programme suggests that screening would not be cost effective. Concludes that opportunistic case finding is the method of choice in primary care.

Measures of patient satisfaction are used in the assessment of quality of healthcare, but the influence of patient‐based factors on reported satisfaction has been little described. This paper aims to quantify associations between reported satisfaction with GP services and measures of socio‐demographic and health status and the effect of adjusting for these factors in comparing satisfaction measured at the level of primary care organisations (PCOs).

Cross‐sectional analysis of the 1998 Welsh Health Survey, response rate 61 per cent. The 20,380 respondents, aged between 18 and 74 years reporting contact with their GP in the previous 12 months formed the study population. Satisfaction was defined as being “very” or “fairly satisfied” with GP services. Crude odds ratios were calculated(95 per cent confidence intervals) for reported satisfaction for the 22 PCOs in Wales and adjusted odds ratios were calculated for socio‐demographic variables and LLTI in logistic regression.

Satisfaction varied with age, gender, employment status, marital status, and reported LLTI. The rank order of reported satisfaction for PCOs changed by up to five places after adjusting for these factors.

The generalisability of this study should be assessed through further research on the impact of adjusting for patient based factors when using other validated measures of satisfaction.

Comparing measures of satisfaction between organisations to assess relative performance may not be valid unless differences in socio‐demographic composition are taken into account.

Highlights the importance of caution in using measures of patient satisfaction to assess performance.

The purpose of this paper is to determine the dimensions of service quality in Indian hospitals, from the perspectives of patients and their family members/friends (referred to as “attendants”).

Based on the existing models and the literature on healthcare services, a framework is proposed to conceptualize and measure hospital service quality.

Two instruments for measuring the dimensions of hospital service quality, one each from the perspective of patients and attendants, are proposed.

This framework enables hospital managers to understand how patients and their attendants evaluate the quality of healthcare provided in respect of every dimension. A comparison of perceptions between patients and attendants would aid them to allocate resources to various aspects of healthcare, with respect to these two customer groups. Hospital administrators can use the instruments proposed to obtain feedback on their performance on service quality parameters so that they can benchmark themselves with their competitors.

This paper contributes to research on healthcare services by the development of a comprehensive framework for customer (both patient and attendant)‐perceived healthcare quality.

Social support from different sources is beneficial for health and often helps individuals to cope with stress and illness. The aim of this paper is to simultaneously examine the effects of social support from personal, professional, and community networks and other factors in relation to health.

A cross sectional postal and web‐based survey was undertaken to examine these relationships in a random sample of 10,000 households in Wandsworth, London. Social support variables were standardized by calculating Z‐scores and the relationship with health was modelled using a series of regression models.

The response rate was 22.8 per cent. This study found that “social support from family”, “social support from friends”, “social support at work”, and “civic participation” were associated with a lower likelihood of poor self‐rated health, but that social support from neighbours was associated with a higher likelihood of reporting poor health. The results suggest that most of the health effects of social support are supplementary. However, the finding that the health effects of social support from family disappear after controlling for the other social support variables, suggests that it can be compensated for by support from other sources. Socio‐economic variables such as gender, age, being married, employment, and home ownership were also associated with better self‐rated health.

This paper extends previous analyses by demonstrating a range of interactions between self‐rated health, social support (from personal, professional, and community networks), civic participation, and socio‐economic variables. These factors have not previously been studied simultaneously.

Use of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.

A questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1–5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.

The analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.

The results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.

This paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions.

The purpose of the paper is to extend prior research on the psychological effects of the Deepwater Horizon oil spill disaster by developing and testing a conceptual model in which exposure to the oil spill through clean-up activity, physical symptoms, worry about the impact of the oil spill on health, and the disruption of the gulf/ocean-related lifestyle were hypothesized as predictors of depressive symptoms.

The analysis included a randomly selected sample of 354 subjects from the three most Southern Mississippi counties. The Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms.

Results indicated that physical symptoms since the oil spill were related to depressive symptoms directly and indirectly through worry about the impact of the oil spill on health and the disruption of the gulf/ocean-related lifestyle. Worry about the impact of the oil spill on health was related to depressive symptoms directly and indirectly through the disruption of the gulf/ocean-related lifestyle.

Study results highlight that uncertainty and worry about the impact of the disaster played a critical role in understanding the psychological effects of the oil spill disaster, especially among coastal residents whose lifestyles were bound up with the gulf/ocean.

Patriotism is often described as the “love of country” that individuals display in the acclamation of their national community. Despite the prominence of this sentiment in various societies around the world, organizational research on patriotism is largely absent. This omission is surprising because entrepreneurs, human resource (HR) divisions, and firms frequently embrace both patriotism and patriotic organizational practices. These procedures include (among other interventions) national symbol embracing, HR practices targeted toward military members and first responders, the adulation of patriots and celebration of patriotic events, and patriotic-oriented corporate social responsibility (CSR). Here, the authors argue that research on HR management and organization studies will likely be further enhanced with a deeper understanding of the national obligation that can spur employee productivity and loyalty. In an attempt to jumpstart the collective understanding of this phenomenon, the authors explore the antecedents of patriotic organizational practices, namely, the effects of founder orientation, employee dispersion, and firm strategy. It is suggested that HR practices such as these lead to a patriotic organizational image, which in turn impacts investor, customer, and employee responses. Notably, the effect of a patriotic organizational image on firm-related outcomes is largely contingent on how it fits with the patriotic views of other stakeholders, such as investors, customers, and employees. After outlining this model, the authors then present a thought experiment of how this model may appear in action. The authors then discuss ways the field can move forward in studying patriotism in HR management and organizational contexts by outlining several future directions that span multiple levels (i.e., micro and macro). Taken together, in this chapter, the authors introduce a conversation of something quite prevalent and largely unheeded – the patriotic organization.

The evolution of risk management has placed some emphasis on the language of risk management practices. The classic categories risk control and risk financing, as umbrella terms for the range of risk management tools that may be employed, are still widely used – but as has been pointed out elsewhere in this book, the broadening of risk management has led to a reconsideration of the continuing accuracy and usefulness of the older terminology. For example, historically the term insurance-buying was expanded to include risk financing, which allowed recognition of newer, non-insurance tools. Similarly, loss prevention became risk control to include risk reduction, risk distribution, hedging, and more. More recently, risk treatment has emerged as a term that encompasses both the control and financing categories.

One of the significant changes in practice is the inclusion of opportunities that may arise from risks. Here the terminology has not quite kept pace with changes in the field. Additionally, while assessment and analysis has long captured the idea of evaluating risks and uncertainties, the more explicit inclusion of uncertainty, along with emergent phenomena, complexity, and the unknown/unknowable has led to questions about whether risk control meaningfully conveys the essence of these activities. The search for an alternative terminology is ongoing, but for the time being the term adaptive response (AR) is used here, which refers to a range of actions that could be taken to capture the full range of exposures.

Chapters Nine and Ten continue to use the term risk financing. This is more of a concession to practicality as, in any other setting, financial measures logically are ARs. Nevertheless, there are technical and substantive reasons to maintain some separation. But even here, the pressures of change are being felt. For example, while most risk financing arrangements focus on addressing the costs of risk (e.g. indemnifying an organisation for losses), the role of financial measures in encouraging or discouraging certain practices – including paying the risk manager’s salary, or incentivising certain desired practices – has historically not been considered in discussions