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Article
Publication date: 31 December 2024

Thomas T.H. Wan and George J. Wan

This commentary presents the analytic development of patient classification, health resource use and outcome research and identifies opportunities to perform longitudinal research.

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Abstract

Purpose

This commentary presents the analytic development of patient classification, health resource use and outcome research and identifies opportunities to perform longitudinal research.

Design/methodology/approach

The authors use a transdisciplinary framework to formulate multilevel models for ascertaining the causal relationship between hospital efficiency and effectiveness in panel data analysis.

Findings

The longitudinal design of organization research enables to delineate the relationship between hospital performance and quality of care in future research.

Research limitations/implications

The inclusion of multivariates in health organization research and modeling is pivotal to the identification of a comprehensive set of predictor variables. The authors signify the need to build a systems-oriented theoretical framework to integrate micro- and macro-level predictor variables in conducting data analysis.

Practical implications

The authors signify the need to build a theoretical framework to integrate micro- and macro-level predictor variables in conducting data analysis.

Social implications

Health organization research is essential to broaden the scope of health services research and policy development, particularly related to global health as noted in the promotion of sustainable development and health goals.

Originality/value

Health organization research should include a complex set of exogenous and endogenous variables in designing and modeling the determinants of hospital performance and patient care outcomes.

Details

Journal of Health Organization and Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1477-7266

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Book part
Publication date: 28 September 2020

Matt T. Bagwell and Thomas T. H. Wan

Purpose – This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4…

Abstract

Purpose – This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4.

Methodology/approach – A prospective, longitudinal design was employed to analyze health disparities that potentially exist among RHC Medicare beneficiary patients (+65) in terms of ER use. The years of investigation were 2010 through 2012, using mixed multilevel, binary logistic regression.

Findings – This study found that dual eligible RHC patients utilized ER services at higher rates than nondual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively.

Research limitations/implications – Regarding limitations, cohort data observations within the window of 3 years were only analyzed; regarding generalizability, in different CMS regions, results will likely vary; and linking other variables together in the study was limited by the accessible data. Future research should consider these limitations, and attempt to refine. The findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socioeconomic status, and race continue to influence higher rates of ER utilization in CMS Region 4.

Originality/value – In terms of ER utilization disparities, persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 years and over may be twice as likely to utilize ER services for care than their counterparts in the Southeastern United States.

Details

Race, Ethnicity, Gender and Other Social Characteristics as Factors in Health and Health Care Disparities
Type: Book
ISBN: 978-1-83982-798-3

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Book part
Publication date: 26 November 2002

Hong K. Lo, C. W. Yip and K. H. Wan

Abstract

Details

Advanced Modeling for Transit Operations and Service Planning
Type: Book
ISBN: 978-0-585-47522-6

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Book part
Publication date: 5 September 2018

Wylie H. Wan, Sarah N. Haverly and Leslie B. Hammer

This chapter focuses on military couples and factors that affect their experiences of work, stress, and health using a life course perspective. An introduction to the definition…

Abstract

This chapter focuses on military couples and factors that affect their experiences of work, stress, and health using a life course perspective. An introduction to the definition of military couples is provided followed by a brief review of previous research on marital quality and divorce among military couples. The core of the chapter describes the advantages of using a life course perspective to examine the military life course for couples, and two critical transitions of military life are more fully examined. Specifically, periodic relocation and deployment and their impacts on military couples are reviewed in detail. Future directions for research on military couples are provided, and the use of the Convoy Model of Social Relations as an integrative approach to examine military personnel and family members’ stress and health across the military life course is introduced.

Details

Occupational Stress and Well-Being in Military Contexts
Type: Book
ISBN: 978-1-78756-184-7

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Book part
Publication date: 8 August 2016

Thomas T. H. Wan, Yi-Ling Lin and Judith Ortiz

This study is to examine factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient…

Abstract

Purpose

This study is to examine factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient characteristics is being simultaneously considered by applying a risk adjustment method.

Methodology/approach

A longitudinal analysis of COPD and asthma hospitalization of rural Medicare beneficiaries in 427 rural health clinics (RHCs) was conducted utilizing administrative data and inpatient and outpatient claims from Region 4. The repeated measures of risk-adjusted COPD and asthma admission rate were analyzed by growth curve modeling. A generalized estimating equation (GEE) method was used to identify the relevance of selected predictors in accounting for the variability in risk-adjusted admission rates for COPD and asthma.

Findings

Both adjusted and unadjusted rates of COPD admission showed a slight decline from 2010 to 2013. The growth curve modeling showed the annual rates of change were gradually accentuated through time. GEE revealed that a moderate amount of variance (marginal R 2 = 0.66) in the risk-adjusted hospital admission rates for COPD and asthma was accounted for by contextual, ecological, and organizational variables.

Research limitations/implications

The contextual, ecological, and organizational factors are those associated with RHCs, not hospitals. We cannot infer how the variability in hospital practices in RHC service areas may have contributed to the disparities in admissions. Identification of RHCs with substantially higher rates than an average rate can portray the need for further enhancement of needed ambulatory or primary care services for the specific groups of RHCs. Because the risk-adjusted rates of hospitalization do not vary by classification of rural area, future research should address the variation in a specific COPD and asthma condition of RHC patients.

Originality/value

Risk-adjusted admission rates for COPD and asthma are influenced by the synergism of multiple contextual, ecological, and organizational factors instead of a single factor.

Details

Special Social Groups, Social Factors and Disparities in Health and Health Care
Type: Book
ISBN: 978-1-78635-467-9

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Book part
Publication date: 15 September 2014

Thomas T. H. Wan, Maysoun Dimachkie Masri and Judith Ortiz

The implementation of the Patient Protection and Affordable Care Act has facilitated the development of an innovative and integrated delivery care system, Accountable Care…

Abstract

Purpose

The implementation of the Patient Protection and Affordable Care Act has facilitated the development of an innovative and integrated delivery care system, Accountable Care Organizations (ACOs). It is timely, to identify how health care managers in rural health clinics (RHCs) are responding to the ACO model. This research examines RHC managers’ perceived benefits and barriers for implementing ACOs from an organizational ecology perspective.

Methodology/approach

A survey was conducted in spring of 2012 covering the present RHC network working infrastructures – (1) Organizational social network; (2) organizational care delivery structure; (3) ACO knowledge, perceived benefits, and perceived barriers; (4) quality and disease management programs; and (5) health information technology (HIT) infrastructure. One thousand one hundred sixty clinics were surveyed in the United States. They cover eight southeastern states (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) and California. A total of 91 responses were received.

Findings

RHC managers’ personal perceptions on ACO’s benefits and knowledge level explained the most variance in their willingness to join ACOs. Individual perceptions appear to be more influential than organizational and context factors in the predictive analysis.

Research limitations/implications

The study is primarily focused in the Southeastern region of the United States. The generalizability is limited to this region. The predictors of RHCs’ participation in ACOs are germane to guide the development of organizational strategies for enhancing the general knowledge about the innovativeness of delivering coordinated care and containing health care costs inspired by the Affordable Care Act.

Originality/value of chapter

RHCs are lagged behind the growth curve of ACO adoption. The diffusion of new knowledge about pros and cons of ACO is essential to reinforce the health care reform in the United States.

Details

Technology, Communication, Disparities and Government Options in Health and Health Care Services
Type: Book
ISBN: 978-1-78350-645-3

Keywords

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Book part
Publication date: 26 November 2002

Jing Zhou and William H. K. Lam,

Abstract

Details

Advanced Modeling for Transit Operations and Service Planning
Type: Book
ISBN: 978-0-585-47522-6

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Book part
Publication date: 2 May 2015

Frank May, Alokparna Basu Monga and Kartik Kalaignanam

Very little research addresses whether the values that consumers bring to a situation can affect their reactions to a brand failure. This paper suggests the interesting…

Abstract

Purpose

Very little research addresses whether the values that consumers bring to a situation can affect their reactions to a brand failure. This paper suggests the interesting possibility that consumers may react very differently to the same brand failure depending upon their values. Here, the authors introduce a new construct to the marketing literature – honor values – and demonstrate its effect on responses to brand failures.

Methodology

Three experiments and one secondary data study were utilized.

Findings

Across four studies, honor values are shown to aggravate consumers’ desire for vengeance following a brand failure. That is, as honor values increase, so too does desire for vengeance in the face of a brand failure. Additionally, this desire can be attenuated by allowing the consumer to play a role in resolving the failure or by giving a heartfelt apology.

Practical implications

High-honor consumers are a major obstacle for firms facing a brand failure. To overcome this challenge, the authors offer strategies, including (1) allowing high-honor consumers to suggest ways to punish the offending employee, and (2) offering simple, heartfelt apologies to high-honor consumers, which are as effective as monetary compensations.

Details

Brand Meaning Management
Type: Book
ISBN: 978-1-78441-932-5

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Book part
Publication date: 25 November 2003

Thomas T.H. Wan and Blossom Y.J. Lin

Understanding the determinants of health services use is essential for planning for effective services, particularly health care policies in a newly independent state, the…

Abstract

Understanding the determinants of health services use is essential for planning for effective services, particularly health care policies in a newly independent state, the Republic of Kazakhstan. The main purpose of this study is to examine the relative importance of social capital factors in affecting the variation in health status and use of health services, using structural equation modeling. The results show that health status is a strong predictor of health services use when the effect of social capital is held constant; and that social capital is directly linked with health status.

Details

Reorganizing Health Care Delivery Systems: Problems of Managed
Type: Book
ISBN: 978-1-84950-247-4

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Article
Publication date: 27 October 2020

Mengjie Zeng and Jianjun Lu

Motivated by the apparent presence of the “productivity paradox” of information technology (IT) in agri-food supply chain (SC), the purpose of this paper is to explore how IT…

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Abstract

Purpose

Motivated by the apparent presence of the “productivity paradox” of information technology (IT) in agri-food supply chain (SC), the purpose of this paper is to explore how IT capabilities affect agri-food supply chain performance (SCP). Specifically, this paper investigates the direct and indirect impacts of IT capabilities on agri-food SCP through interorganizational relationships.

Design/methodology/approach

This paper employs the questionnaire survey method based on relevant literatures. Data are collected from Chinese 265 core firms' agri-food SC. Structural equation modelling (SEM) is mainly employed for hypothesis testing and analysis.

Findings

The main findings are as follows. First, IT capabilities have significant direct impact on agri-food SCP. Second, IT capabilities enhance interorganizational relationships in the agri-food SC. Third, interorganizational relationships positively influence agri-food SCP. Last, interorganizational relationships are important path factors and mediate the indirect impact of IT capabilities on agri-food SCP.

Research limitations/implications

This research is limited to a particular sample, that is, agriculture-related firms in Chinese agri-food SC. The results need to be generalized to encompass wider samples. Future research could in greater detail study the links among IT capabilities, interorganizational relationships and agri-food SCP.

Practical implications

The study's findings could provide practical reference value for agriculture-related firms to design appropriate strategies to solve the IT “productivity paradox” and improve agri-food SCP from the perspectives of IT capabilities and interorganizational relationships.

Originality/value

This paper constructs a newly developed framework based on the resource-based view (RBV) and relational view to examine the links among IT capabilities, interorganizational relationships and agri-food SCP, and innovatively verifies the mediating effect of interorganizational relationships on the impact of IT capabilities on agri-food SCP.

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