scholarly journals PHP5 DECISION MAKING IN ITALIAN HEALTH CARE: ARE ECONOMIC STUDIES USED BY DECISION MAKERS?

2004 ◽  
Vol 7 (6) ◽  
pp. 710
Author(s):  
G Fattore ◽  
A Torbica
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Decision Makers ◽  
Economic Studies

scholarly journals Social Determinant of Home Delivery among Ever-Married Women in Khyber Pakhtunkhwa Pakistan

2020 ◽  
Vol 20 (1) ◽  
pp. 55-72
Author(s):  
Dr. Hussain Ali
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Rural Women ◽  
Home Delivery ◽  
Married Women ◽  
Maternal Health Care ◽  
Decision Makers ◽  
Domestic Sphere ◽  
Khyber Pakhtunkhwa

The poor maternal health is one of the public health issues facing by rural women in Pakistan. There are various socio-demographic and cultural factors which confine women to domestic sphere. The main objective of this research is to study various social factors as determinants of home delivery among ever-married women in Khyber Pakhtunkhwa province of Pakistan. In the present study researchers used the quantitative research design in which the data are collected through household survey in the pakhtun society. The data are collected from 503 ever married women in District Malakand, from May 1, to November 30, 2016. The results show that nearly two third 62.3 percent men’s are key decision maker about antenatal care utilization, more than third forth 76 percent of the husbands are key decision makers about the home delivery due to their women subordinate position within household. The researchers concluded that men’s are key decision makers and their decision affect women maternal health care. In order to achieve Sustainable Development Goal No. 3, the study recommends mainstreaming women in the decision making process in domestic sphere as well as their involvement is decision making about accessing and utilizing of maternal health care services. Keywords: Home delivery, men’s decision, subordinate position, women

scholarly journals Organizational and Individual Innovation Decisions in an Interorganizational System: Social Influence and Decision-Making Authority

2020 ◽  
Vol 70 (4) ◽  
pp. 497-521
Author(s):  
Jiawei Sophia Fu ◽  
Michelle Shumate ◽  
Noshir Contractor
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Social Norms ◽  
Social Influence ◽  
Health Care Workers ◽  
Social Information Processing ◽  
Innovation Adoption ◽  
Decision Makers ◽  
Care Workers ◽  
Interorganizational System

Abstract This study examines the processes of complex innovation adoption in an interorganizational system. It distinguishes the innovation adoption mechanisms of organizational-decision-makers (ODMs), who make authority adoption decisions on behalf of an organization, from individual-decision-makers (IDMs), who make optional innovation decisions in their own work practice. Drawing on the Theory of Reasoned Action and Social Information Processing Theory, we propose and test a theoretical model of interorganizational social influence. We surveyed government health-care workers, whose advice networks mostly span organizational boundaries, across 1,849 state health agencies in Bihar, India. The collective attitudes of coworkers and advice network members influence health-care workers’ attitudes and perceptions of social norms toward four types of innovations. However, individuals’ decision-making authority moderates these relationships; advisors’ attitudes have a greater influence on ODMs, while perceptions of social norms only influence IDMs. Notably, heterogeneity of advisors’ and coworkers’ attitudes negatively influence IDMs’ evaluations of innovations but not ODMs’.

scholarly journals Reference Case Methods for Expert Elicitation in Health Care Decision Making

2021 ◽  
pp. 0272989X2110282
Author(s):  
Laura Bojke ◽  
Marta O. Soares ◽  
Karl Claxton ◽  
Abigail Colson ◽  
Aimée Fox ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Expert Elicitation ◽  
Decision Makers ◽  
Alternative Methods ◽  
Consensus Methods ◽  
Reference Case ◽  
Case Methods ◽  
Health Care Decision ◽  
Care Decision

Background The evidence used to inform health care decision making (HCDM) is typically uncertain. In these situations, the experience of experts is essential to help decision makers reach a decision. Structured expert elicitation (referred to as elicitation) is a quantitative process to capture experts’ beliefs. There is heterogeneity in the existing elicitation methodology used in HCDM, and it is not clear if existing guidelines are appropriate for use in this context. In this article, we seek to establish reference case methods for elicitation to inform HCDM. Methods We collated the methods available for elicitation using reviews and critique. In addition, we conducted controlled experiments to test the accuracy of alternative methods. We determined the suitability of the methods choices for use in HCDM according to a predefined set of principles for elicitation in HCDM, which we have also generated. We determined reference case methods for elicitation in HCDM for health technology assessment (HTA). Results In almost all methods choices available for elicitation, we found a lack of empirical evidence supporting recommendations. Despite this, it is possible to define reference case methods for HTA. The reference methods include a focus on gathering experts with substantive knowledge of the quantities being elicited as opposed to those trained in probability and statistics, eliciting quantities that the expert might observe directly, and individual elicitation of beliefs, rather than solely consensus methods. It is likely that there are additional considerations for decision makers in health care outside of HTA. Conclusions The reference case developed here allows the use of different methods, depending on the decision-making setting. Further applied examples of elicitation methods would be useful. Experimental evidence comparing methods should be generated.

Participation in health care priority-setting through the eyes of the participants

2002 ◽  
Vol 7 (4) ◽  
pp. 222-229 ◽  
Author(s):  
Douglas Martin ◽  
Julia Abelson ◽  
Peter Singer
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Priority Setting ◽  
Decision Makers ◽  
Medical Specialist ◽  
Committee Chair ◽  
The Public ◽  
Health Care Priority Setting ◽  
Patient Representative

Objectives: The literature on participation in priority-setting has three key gaps: it focuses on techniques for obtaining public input into priority-setting that are consultative mechanisms and do not involve the public directly in decision-making; it focuses primarily on the public's role in priority-setting, not on all potential participants; and the range of roles that various participants play in a group making priority decisions has not been described. To begin addressing these gaps, we interviewed individuals who participated on two priority-setting committees to identify key insights from participants about participation. Methods: A qualitative study consisting of interviews with decision-makers, including patients and members of the public. Results: Members of the public can contribute directly to important aspects of priority-setting. The participants described six specific priority-setting roles: committee chair, administrator, medical specialist, medical generalist, public representative and patient representative. They also described the contributions of each role to priority-setting. Conclusions: Using the insights from decision-makers, we have described lessons related to direct involvement of members of the public and patients in priority-setting, and have identified six roles and the contributions of each role.

Guardianships, Conservatorships, and Alternative Forms of Substitute Decision Making

2017 ◽  
Author(s):  
Ronald Schouten ◽  
Rebecca W. Brendel
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Medical Treatment ◽  
Decision Maker ◽  
Advance Directives ◽  
Family Members ◽  
Adult Life ◽  
Decision Makers ◽  
Financial Decisions ◽  
Alternative Decision

To protect individuals who can no longer make the decisions and carry on the activities of adult life, society has provided processes including the appointment of alternative decision makers, traditionally referred to as guardians of the person (for personal decisions such as medical treatment) and conservators of the estate (for financial decisions). When a person has lost capacity, appointing an alternative decision maker can be problematic, as the person may not have previously expressed preferences regarding health care or financial matters, and there may be disagreement among interested parties such as family members. Advance directives, such as health care proxies, help alleviate these problems by providing a method for the person in question to document his or her preferences and appoint someone to act on their behalf in the event of incapacity. This chapter discusses traditional protections for incapacitated persons, advance directives, and capacities to engage in various decision-making activities.

scholarly journals Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

2010 ◽  
Vol 10 ◽  
pp. 1520-1529
Author(s):  
Said Shahtahmasebi ◽  
Luis Villa ◽  
Helen Nielsen ◽  
Hilary Graham-Smith
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Evidence Based Practice ◽  
Local Level ◽  
Policy Formation ◽  
Decision Makers ◽  
Evidence Based ◽  
Holistic Model ◽  
Local Evidence ◽  
External Evidence

In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors) with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com).

scholarly journals ICER is good for us—Possibly not for you, he or she

2011 ◽  
Vol 27 (1) ◽  
pp. 98-98
Author(s):  
Markku Pekurinen
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Healthcare Systems ◽  
Incremental Cost Effectiveness Ratio ◽  
Decision Makers ◽  
Cost Effectiveness Ratio ◽  
Sufficient Criterion ◽  
Important Ingredient

Cleemput et al. make a point that the incremental cost-effectiveness ratio (ICER) alone is not a sufficient criterion to guide decision making in health care, and needs many other supplementary inputs. This is nothing new, it has been well known for years to researchers and decision makers alike. ICER serves as an important ingredient to guide decision making, at least in some healthcare systems.

scholarly journals Medicine and interest politics a study of decision-making processes in the area of vascular surgery in Norway

2020 ◽  
Vol 34 (4) ◽  
pp. 427-447
Author(s):  
Kjersti Wendt ◽  
Bjørn Erik Mørk ◽  
Ole Trond Berg ◽  
Erik Fosse
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Vascular Surgery ◽  
Public Involvement ◽  
Local Level ◽  
Clinical Care ◽  
Decision Makers ◽  
Content Type ◽  
Rational Distribution ◽  
Decision Making Processes

PurposeThe purpose of this paper is to increase the understanding of organizational challenges when decision-makers try to comply with technological developments and increasing demands for a more rational distribution of health care services. This paper explores two decision-making processes from 2007–2019 in the area of vascular surgery at a regional and a local level in Norway.Design/methodology/approachThe study draws upon extensive document analyses, semi-structured interviews and field conversations. The empirical material was analyzed in several steps through an inductive approach and described and explained through a theoretical framework based on rational choice (i.e. bounded rationality), political behavior and institutionalism. These perspectives were used in a complementary way.FindingsBoth decision-making processes were resource-intensive, long-lasting and produced few organizational changes for the provision of vascular services. Stakeholders at both levels outmaneuvered the health care planners, though by different means. Regionally, the decision-making ended up in a political process, while locally the decision-making proceeded as a strategic game between different departments and professional fields.Practical implicationsDecision-makers need to prepare thoroughly for convincing others of the benefits of new ways of organizing clinical care. By providing meaningful opportunities for public involvement, by identifying and anticipating political agendas and by building alliances between stakeholders with divergent values and aims decision-makers may extend the realm of feasible solutions.Originality/valueThis paper contributes to the understanding of why decision-making processes can be particularly challenging in a field characterized by rapid technological development, new treatment options and increasing demands for more rational distribution of services.

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