scholarly journals Impacts of Health Care Industry Consolidation in Pittsburgh, Pennsylvania: A Qualitative Study

2020 ◽  
Vol 57 ◽  
pp. 004695802097624
Author(s):  
Claire E. O’Hanlon
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Access To Care ◽  
Health Care System ◽  
Health Care Industry ◽  
Health Care Facilities ◽  
Negative Consequences ◽  
Care Industry ◽  
Industry Consolidation ◽  
Care System

While most studies of health care industry consolidation focus on impacts on prices or quality, these are not its only potential impacts. This exploratory qualitative study describes industry and community stakeholder perceptions of the impacts of cumulative hospital, practice, and insurance mergers, acquisitions, and affiliations in Pittsburgh, Pennsylvania. Since the 1980s, Pittsburgh’s health care landscape has been transformed and is now dominated by competition between 2 integrated payer-provider networks, health care system UPMC (and its insurance arm UPMC Health Plan) and insurer Highmark (and its health care system Allegheny Health Network). Semi-structured interviews with 20 boundary-spanning stakeholders revealed a mix of perceived impacts of consolidation: some positive, some neutral or ambiguous, and some negative. Stakeholders perceived consolidation’s positive impacts on long-term viability of health care facilities and their ability to adopt new care models, enhanced competition in health insurance, creation of foundations, and pioneering medical research and innovation. Stakeholders also believed that consolidation changed geographic access to care, physician referral behaviors, how educated patients were about their health care, the health care advertising environment, and economies of surrounding neighborhoods. Interviewees noted that consolidation raised questions about what the responsibilities of non-profit organizations are to their communities. However, stakeholders also reported their perceptions of negative outcomes, including ways in which consolidation had potentially reduced patient access to care, accountability and transparency, systems’ willingness to collaborate, and physician autonomy. As trends toward consolidation are not slowing, there will be many opportunities to experiment with policy levers to mitigate its potentially negative consequences.

Breast Radiologists: Extenders of Primary Care

2019 ◽  
Vol 1 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Daniel W Dahl ◽  
Phan T Huynh
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care System ◽  
Breast Imaging ◽  
Health Care Industry ◽  
Performance Model ◽  
New Era ◽  
Care Industry ◽  
Care System

Abstract The health care industry has seen many changes in recent years. Gradually, the traditional volume-based fee-for-service health care system is being replaced by the patient-centered, value-based, pay-for-performance model. In response to this, the American College of Radiology has developed an initiative coined Imaging 3.0: a blueprint to help guide our profession through this transition in health care delivery. Radiologists are an integral part of the health care system, and they greatly affect patient care; however, we have progressively become less visible as a specialty. It is time that we, as radiologists, broaden our role in patient care. As breast radiologists, we are uniquely qualified to usher in this new era of medicine. We have the skill set to provide comprehensive breast care. We are actively involved in early breast cancer detection, pre-imaging patient-care decisions, imaging work-ups, diagnosis, care coordination, treatment, and follow-up. We have set the gold standard for concise structured reporting and follow-up recommendations with the American College of Radiology Breast Imaging Reporting and Data System lexicon, which offers value to our clinician colleagues. Our broad knowledge and role in breast conditions, patient relationships, and other noninterpretive skills offers personalized care and expertise that allows for the best, safest, most cost-effective, and efficient service for the patient and health care industry. Our comprehensive care provides direct interaction and education, decreases radiation exposure, and saves patients time and money. It also benefits the health care industry by improving throughput, reducing waste, and eliminating inefficiencies in the system. As breast radiologists, we are uniquely qualified to usher in this new era of radiology.

scholarly journals Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study

2019 ◽  
Vol 35 (3) ◽  
pp. 185-191 ◽  
Author(s):  
David A. Agom ◽  
Stuart Allen ◽  
Sarah Neill ◽  
Judith Sixsmith ◽  
Helen Poole ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Qualitative Study ◽  
Health Care System ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Semistructured Interview ◽  
Design Data ◽  
Care System

Background: There is a dearth of research focusing on identifying the social complexities impacting on oncology and palliative care (PC), and no study has explored how the health-care system in Nigeria or other African contexts may be influencing utilization of these services. Aim: This study explored how social complexities and the organization of health-care influenced the decision-making process for the utilization of oncology and PC in a Nigerian hospital. Methods: This qualitative study used an interpretive descriptive design. Data were collected using semistructured interview guides with 40 participants, comprising health-care professionals, patients, and their families. Thematic analysis was conducted to generate and analyze patterns within the data. Findings: Three themes were identified: dysfunctional structural organization of the health-care delivery system, service-users’ economic status, and the influence of social networks. The interrelationship between the themes result in patients and their family members decisions either to present late to the hospital, miss their clinical appointments, or not to seek oncological health care and PC. Conclusion: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as “autoinhibitory” and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality.

scholarly journals Physicians' Perspective on Prescribing Patterns and Knowledge on Antimicrobial Use and Resistance in Penang, Malaysia: A Qualitative Study

2020 ◽  
Vol 8 ◽  
Author(s):  
Ali Akhtar ◽  
Amer Hayat Khan ◽  
Hadzliana Zainal ◽  
Mohamed Azmi Ahmad Hassali ◽  
Irfhan Ali ◽  
...  
Keyword(s):  
Health Care ◽  
Antimicrobial Resistance ◽  
Qualitative Study ◽  
Health Care System ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
Antimicrobial Use ◽  
Prescribing Practices ◽  
The Impact ◽  
Care System

Background: Unnecessary antimicrobial use is an emerging problem throughout the world. To design future interventions to ensure rational antimicrobial use and decrease the risk of antimicrobial resistance, physician's knowledge and prescribing practices of antimicrobials should be assessed. Therefore, the main objective of this study is to investigate the physician's knowledge along with their prescribing patterns of antimicrobials in their health care system.Methods: The present qualitative study was conducted in a tertiary care public hospital located at Penang island, situated in Northwest of Malaysia. A total of 12 semi-structured, face to face interviews were conducted with purposive sampling technique. Physicians recruited had different specialties. All interviews were audio recorded, then transcribed into English language and analyze by thematic content analysis.Results: Four major themes were identified: (1) prescribing patterns of physicians regarding antimicrobials; (2) physician's knowledge about antimicrobials; (3) antimicrobial resistance; (4) satisfaction with management of infections. Physicians believed in regular educational activities and updates about the latest antimicrobial guidelines may change the prescribing behavior of physicians to optimize the use of antimicrobials. This may lead to decrease in burden of antimicrobial resistance in their health care system. Physicians emphasized that stricter rules and regular monitoring of antimicrobial use should be implemented to overcome the main challenges of antimicrobial resistance.Conclusion: Different factors were identified to assist optimized use of antimicrobials and decrease the risk of antimicrobial resistance. The present study helps to design targeted future interventions to ensure rational antimicrobial use and decrease the impact of antimicrobial resistance in Malaysia.

Introduction and uptake of new medical technologies in the Australian health care system: A qualitative study

Health Policy ◽  
2011 ◽  
Vol 102 (2-3) ◽  
pp. 152-158 ◽  
Author(s):  
Gisselle Gallego ◽  
Robert Casey ◽  
Richard Norman ◽  
Stephen Goodall
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care System ◽  
Australian Health ◽  
Medical Technologies ◽  
System A ◽  
Care System

Post-Fordism's Contradictory Trends: The Case of the Israeli Health Care System

2004 ◽  
Vol 33 (3) ◽  
pp. 417-436 ◽  
Author(s):  
DANI FILC
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Political Struggle ◽  
Care Services ◽  
National Health Insurance Law ◽  
The Right ◽  
Care System

The transition from the Fordist hegemonic model to post-Fordism is a complex process. It is not the unavoidable result of technological changes, but the contingent consequence of a hegemonic, political, struggle taking place at the different spheres of the social. This article studies the transformations that took place in the Israeli health care system during the last two decades in order to exemplify the political and contradictory character of the transition to post-Fordism. The article emphasises the contradiction between the partial commodification of financing and the privatisation of certain health care facilities, and the legislation of the National Health Insurance Law, which guaranteed the right to access to public health care services.

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