Analysis of Factors Affecting Rural Residents’ Satisfaction with Medical Services

Abstract Having demonstrated that the traditional economic model of the market cannot be used in its present form to understand what is happening in the field of medical services, a presentation will be made of the factors affecting the behavior of physicians as purveyors of services, thus showing the importance of analyzing the influence of economic incentives on physician behavior. The analysis consists of measuring the change in the practice profiles of physicians from 1971 to 1973, and evaluating the influence of the fee schedule on this change. This research allows us to show that the personal characterictics of physicians, the characteristics associated with the organization of their practice and the area in which they practise are only very slightly related to the changes in the mix of the medical services produced by physicians; that the change in the profile of practice cannot be associated with changes in the populations' needs, and that the financial incentives incorporated in the fee schedule have been found to be mainly responsible for the shifts observed in the profiles of practice. We conclude by showing how these results are compatible with the hypothesis that physicians can influence demand for medical services.

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The Factors Affecting Happiness in Older Rural Residents

Health and Social Welfare Review ◽

10.15709/hswr.2018.38.4.98 ◽

2018 ◽

Vol 38 (4) ◽

pp. 98-128

Author(s):

박창제 ◽

Shin, Dong Ho

Keyword(s):

Rural Residents ◽

Factors Affecting

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Determining Potentially Avoidable Emergency Medical Services (EMS) Transports: A Population Level Study Using Linked Administrative Data in Alberta Health Services (AHS)

International Journal for Population Data Science ◽

10.23889/ijpds.v3i4.654 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Ping Cai ◽

Gregory Vogelaar ◽

Kim Liss ◽

Hude Quan

Keyword(s):

Emergency Medical Services ◽

Quality Care ◽

Population Level ◽

Patient Characteristics ◽

Medical Services ◽

Community Based ◽

Rural Residents ◽

Term Care ◽

Emergency Medical ◽

Alternative Settings

IntroductionTraditionally Emergency Medical Services (EMS) transports patients to Emergency Departments (EDs). However, some patients might be appropriately managed in alternative settings outside the ED. A number of non-traditional EMS programs have evolved in Alberta, in an attempt to provide quality care through a community-based care model. Objectives and ApproachThe project aimed to identify and quantify potentially avoidable EMS transports to EDs in Alberta. We identified 911 responses by ground ambulance in Alberta between September 1, 2017 and December 31, 2017. Patients 18 years and over transported to EDs were linked to Alberta Provincial Registry for more accurate demographic Information, and linked to Long Term Care (LTC) and ED data to capture patient characteristics and frequency of potentially avoidable EMS transports to EDs, defined as the Canadian Triage and Acuity Scale (CTAS) Level IV and Level V in EDs not requiring inpatient admission. ResultsWe identified 72,182 transports to EDs, of which 1 in 4 patients were rural residents. After excluding individuals<18 years and non-Alberta residents, we were able to match 58,137 of the 60,020 EMS transports to EDs (96.8%). Overall, 7,697 (13%) were triaged as less urgent with no hospital admission. Patients 65 years and over accounted for almost half (49%) of the transports in this cohort, 6% of which were for LTC clients. Percentage of potentially avoidable transports in LTC clients were similar to seniors living in the community (12%). Geographic visualization at the provincial level indicated variation across the province. In general, rural residents were more likely than urban residents to be transported to EDs with less urgent conditions (18% vs 12%). Conclusion/ImplicationsThis is the first analysis exploring potentially avoidable EMS transports to EDs in Alberta, Canada, where a comprehensive, single source of EMS system data is currently available. The project suggests opportunities for future EMS research and policies focusing on enhancing community–based care.

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The Public Procurement and the Quality of Services: The Case of Moscow Hospitals

Экономическая наука современной России ◽

10.33293/1609-1442-2020-4(91)-118-131 ◽

2020 ◽

pp. 118-131

Author(s):

Margarita  V. Kravtsova

Keyword(s):

Public Procurement ◽

Medical Services ◽

Key Factors ◽

High Quality ◽

Factors Affecting ◽

The Public ◽

Goods And Services ◽

The Difference ◽

Positive Effect

The work is devoted to the search for answers to the question: “Are there any differences in the public procurement of customers who provide services of different quality?”. The article identifies the stages of the hospital procurement process in the contract system and highlights the main customer strategies used in the auction. The results of an independent quality assessment are examined and comparative hospital characteristics with low and high quality rating are conducted. The hospital needs according to the types of purchases and their annual volumes of contracts are analyzed. The advantages of competitive procedures are determined and the key factors affecting the level of competition with possible risks of unreliable execution of contracts are identified. The empirical study is based on the database which includes 5390 contracts of 2 hospitals in Moscow for years of 2011–2017. Using the methods of econometric analysis, in particular, the method of least squares and the difference in the average, the hypothesis is tested the high competition has a positive effect on the quality of medical services. The constructed regression models show that the customer providing high quality services has low competition and small rebates at the auction. At the same time there are more contract terms, delays in the supply of goods and services as compared with the customer providing low quality services. Thus it was found that the underestimation of competition at the auction indicates the desire of the hospital to guarantee a higher quality of medical services to patients while as aggressive bids of participants lead to the supply of poor purchases. The results of the study may be useful for the competent authorities in the development of legal acts for the participants of the contract system in the field of health procurement.

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Evaluation of the Competitive Environment in the Market for Medical Services: View of Consumers

Scientific Research and Development Economics ◽

10.12737/2587-9111-2020-17-21 ◽

2020 ◽

Vol 8 (4) ◽

pp. 17-21

Author(s):

Anna Davydovich

Keyword(s):

Primary Care ◽

Consumer Choice ◽

Consumer Satisfaction ◽

The State ◽

Competitive Environment ◽

Medical Services ◽

Sociological Research ◽

Medical Organization ◽

Factors Affecting ◽

Krasnodar Region

The article presents the assessment of the competitive environment in the market of medical services (on the example of Krasnodar region) using the main criteria of consumer behaviour, such as the degree of public satisfaction with the level of prices for medical services, the quality and accessibility of health services; identified the main factors affecting consumer choice of medical organization; provided direction to improve the situation on the market of medical services. The purpose of the study is to assess the state of the competitive environment in the medical services market using the main criteria of consumer behavior (for example, in the Krasnodar region). The achievement of the research goal predetermined the formulation and consistent solution of the following interrelated tasks:  analyze the state of the competitive environment in the medical services market of the Krasnodar territory;  determine the factors that influence the consumer's choice of primary care organizations; the level of consumer satisfaction with the availability of primary care organizations, the quality and cost of medical services;  based on the results of the study, assess the state of the competitive environment in the medical services market of the Krasnodar territory. When compiling a review of literature sources on the research topic, the method of content analysis was used. Analytical results of assessing the state of the competitive environment in the medical services market of the Krasnodar territory were obtained using statistical and sociological research methods – a survey and survey of medical services consumers. The results obtained during the research will be useful in the development of strategic documents and initiatives to create a favorable competitive environment in the medical services market of the Krasnodar region.

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