Choice in Public Health Services: A Multilevel Analysis of Perceived Primary Care Doctor Choice in 22 Countries

2015 ◽  
Vol 49 (10) ◽  
pp. 1471-1493 ◽  
Author(s):  
Steven Van de Walle ◽  
Sofie Marien
Keyword(s):  
Primary Care ◽  
Health Services ◽  
European Social Survey ◽  
Primary Care Doctor ◽  
Public Health Services ◽  
Social Survey ◽  
Country Level ◽  
Level Of Satisfaction ◽  
Primary Care Doctors ◽  
Doctor Choice

The introduction of choice in public services, and in health services more specifically, is part of a wider movement to introduce consumerism in health care. We analyze how citizens perceive the availability of choice of primary care doctors in 22 European countries and the factors that influence their opinions using multilevel analyses and data from the European Social Survey (Round 2, 2004; 22 countries, N = 33,375). We distinguish between individual factors and structural or country-level factors. We find that perceptions of having enough choice are not influenced by the opportunity to freely choose primary care doctors, the density of doctors in a country, or the level of health expenditure. Instead, these perceptions are influenced by individual attributes, such as personal health circumstances, age, sex, location of residence (rural or urban), and level of satisfaction with the health system.

scholarly journals Impact of the Programa Mais médicos (more doctors Programme) on primary care doctor supply and amenable mortality: quasi-experimental study of 5565 Brazilian municipalities

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Thomas Hone ◽  
Timothy Powell-Jackson ◽  
Leonor Maria Pacheco Santos ◽  
Ricardo de Sousa Soares ◽  
Felipe Proenço de Oliveira ◽  
...  
Keyword(s):  
Primary Care ◽  
Human Resources For Health ◽  
Primary Care Doctor ◽  
Substitution Effects ◽  
Programme Implementation ◽  
Potential Health ◽  
The Sustainable Development ◽  
Amenable Mortality ◽  
Quasi Experimental ◽  
Primary Care Doctors

Abstract Background Investing in human resources for health (HRH) is vital for achieving universal health care and the Sustainable Development Goals. The Programa Mais Médicos (PMM) (More Doctors Programme) provided 17,000 doctors, predominantly from Cuba, to work in Brazilian primary care. This study assesses whether PMM doctor allocation to municipalities was consistent with programme criteria and associated impacts on amenable mortality. Methods Difference-in-differences regression analysis, exploiting variation in PMM introduction across 5565 municipalities over the period 2008–2017, was employed to examine programme impacts on doctor density and mortality amenable to healthcare. Heterogeneity in effects was explored with respect to doctor allocation criteria and municipal doctor density prior to PMM introduction. Results After starting in 2013, PMM was associated with an increase in PMM-contracted primary care doctors of 15.1 per 100,000 population. However, largescale substitution of existing primary care doctors resulting in a net increase of only 5.7 per 100,000. Increases in both PMM and total primary care doctors were lower in priority municipalities due to lower allocation of PMM doctors and greater substitution effects. The PMM led to amenable mortality reductions of − 1.06 per 100,000 (95%CI: − 1.78 to − 0.34) annually – with greater benefits in municipalities prioritised for doctor allocation and where doctor density was low before programme implementation. Conclusions PMM potential health benefits were undermined due to widespread allocation of doctors to non-priority areas and local substitution effects. Policies seeking to strengthen HRH should develop and implement needs-based criteria for resource allocation.

scholarly journals Democracy belief systems in Europe: cognitive availability and attitudinal constraint

2019 ◽  
Vol 11 (4) ◽  
pp. 485-502
Author(s):  
Enrique Hernández
Keyword(s):  
Belief Systems ◽  
European Social Survey ◽  
Social Survey ◽  
Complex Concept ◽  
Country Level ◽  
Mass Publics ◽  
Low Levels ◽  
Main Components ◽  
The Empirical Analysis ◽  
Constitutive Principles

AbstractThere is a growing interest in analyzing what citizens think about democracy. However, gauging citizens’ opinions about a complex concept such as democracy might be hindered by the apparent low levels of political sophistication of mass publics. This paper contributes to the emerging literature on citizens’ views and evaluations of democracy by analyzing to what extent ordinary citizens are capable of developing structured opinions about democracy and its constitutive principles. For this purpose, the paper adapts Converse’s notion of political belief systems to analyze the articulation of individuals’ democracy belief systems (DBS). The first goal of this paper is to conceptualize and operationalize the main components of individuals’ DBS: cognitive availability, horizontal constraint, and vertical constraint. Drawing on data from the sixth round of the European Social Survey, the second goal is to describe the articulation of DBS in Europe. The third and final aim of this paper is to trace the most relevant individual- and country-level correlates of the articulation of the three components of DBS. In line with recent findings about political belief systems in other policy domains, the results indicate that most Europeans have coherently structured attitudes about democracy. However, even if the results imply that Europeans have a relatively articulated DBS, the empirical analysis also reveals some individual- and country-level variation in the articulation of specific components of DBS.

Kilka uwag o obowiązku udzielania przez lekarza podstawowej opieki zdrowotnej świadczeń poza zakresem swojej specjalizacji

2017 ◽  
Vol 107 ◽  
pp. 375-387
Author(s):  
Katarzyna Maria Zoń
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Care Doctor ◽  
Basic Rule ◽  
Specific Duty

A FEW REMARKS ON A PRIMARY CARE DOCTOR DUTY TO PROVIDE HEALTH SERVICES OUTSIDE THE SCOPE OF SPECIALIZATIONFirst it should be pointed out that a doctor has a duty to provide health services within the scope of his/her specialization. This basic rule arises from both statutory and deontological regulations.The aim of this paper is to analyze the issue of a primary care doctor duty to provide health services outside the scope of his/her specialization as an exception to the above rule. In this respect it is very significant to explain the statutory and deontological regulations related to this topic, because it is necessary for further considerations. Then the exceptions to the rule are discussed. In this context the specific duty to provide health services outside the scope of specialization, concerning a primary care doctor should be highlighted.In the end the conclusions of the analysis are presented.

Willingness of cancer patients to discuss advance directives with admitting doctor or oncologists

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9539-9539
Author(s):  
L. A. Dow ◽  
T. J. Smith ◽  
R. Matsuyama ◽  
E. B. Lamont ◽  
V. Ramakrishnan ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Patients ◽  
Advance Directives ◽  
Primary Care Doctor ◽  
Structured Interviews ◽  
Common Misconception ◽  
Primary Care Doctors ◽  
Aggressive Care ◽  
Hospice Palliative Care ◽  
Seriously Ill

9539 Background: Many seriously ill cancer patients do not discuss prognosis or advance directives (ADs), which may lead to aggressive care at end of life (Harrison & Smith, JAMA 2008). Ten years ago, cancer patients did not want to discuss ADs with their oncologist (ONC), but would discuss them with an admitting doctor (Lamont JPM 2000).We assessed if this still held. Methods: We administered semi-structured interviews to cancer inpatients on the VCUHS Hematology-Oncology service. 55/63 consecutive patients accrued. Information was collected regarding ADs and knowledge of hospice/palliative care. Results: Of those enrolled, 22/55 (40%) reported having ADs. Only 2/55 had discussed ADs with their oncologist. Only 12/55 (22%) would want to discuss ADs with their ONC. But when specifically asked, 22/55 (40%) of patients would prefer to discuss ADs with their oncologist, and 40% with their primary care doctor. 86% would discuss ADs with the admitting doctor. There was no difference in doctor preference based upon prior AD completion. The preference not to discuss ADs with the oncologist was often because they felt their family could make the decisions, or that it was only necessary “If it got serious.” There was a common misconception that ADs mean death is imminent and lead to termination of care. Conclusions: Most patients (86%) are willing to discuss ADs with an admitting doctor, but only a small number (22%) want to discuss with their ONC. However, most patients will discuss ADs and 40% actually prefer their ONC if ADs are discussed. We therefore need to train primary care doctors, house staff, hospitalists, and oncologists to have these difficult discussions. [Table: see text] No significant financial relationships to disclose.

Ageism, Religiosity, and Wellbeing Among Older Adults: Evidence From the European Social Survey (ESS4)

2020 ◽  
pp. 016402752095363
Author(s):  
Harris Hyun-soo Kim ◽  
Jong Hyun Jung
Keyword(s):  
Older Adults ◽  
Protective Factor ◽  
Multilevel Models ◽  
European Social Survey ◽  
Social Survey ◽  
Country Level ◽  
Systemic Discrimination ◽  
The Relationship ◽  
Moderating Role

Research shows that ageism (systemic discrimination against people because of their age) significantly undermines physical and psychological wellbeing, particularly among older adults. Our aim is to contribute to the literature by investigating whether this negative association varies across national religious context. We estimate multilevel models by drawing on a subset of data (ages 55 and above) from the fourth round of the European Social Survey (2008/2009). We find that ageism is negatively related to measures of wellbeing (happiness, life satisfaction, self-rated health). More importantly, the relationship is less pronounced in countries with higher levels of religiosity. These findings suggest that the country’s religious environment serves as a buffer against deleterious health consequences of ageism for the older population. Our study thus provides additional evidence on ageism as a critical risk factor and sheds novel light on the moderating role of country-level religiosity as a protective factor.

scholarly journals Idea on the Clinical Services of Primary Care Physicians

2018 ◽  
Vol 1 (3) ◽  
pp. 99
Author(s):  
Adi Heru Sutomo ◽  
Fitriana Fitriana
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Direct Contact ◽  
Health Problems ◽  
Primary Care Doctor ◽  
Clinical Services ◽  
The Family ◽  
Patient Health ◽  
Primary Care Doctors

The increasing needs and health problems that exist in the community and the more critical the community-related health problems that require the ability of a primary care doctor able to handle existing health problems in the community. Primary care doctor complies with Alma Ata Declaration in 1978 as the backbone of health that makes direct contact with the community, so it is essential for a primary care doctor to involve the patient or the patient as part of the team. Patient experience information or patients given to primary care doctors is expected to further improve the quality of patient health services as individuals and is part of the family and society or community....................

scholarly journals Do managers sleep well? The role of gender, gender empowerment and economic development

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247515
Author(s):  
Xiao Tan ◽  
Leah Ruppanner ◽  
David Maume ◽  
Belinda Hewitt
Keyword(s):  
Economic Development ◽  
European Social Survey ◽  
Social Survey ◽  
Country Level ◽  
Gender Empowerment ◽  
Working Age ◽  
Context Data ◽  
Gender Development Index ◽  
Status Theory

Work demands often disrupt sleep. The stress of higher status theory posits that workers with greater resources often experience greater stress. We extend this theory to sleep and ask: do managers report more disrupted sleep and does this vary by gender and country context? Data come from the 2012 European Social Survey Programme and our sample comprised those currently employed in their prime working age (n = 27,616; age 25–64) in 29 countries. We include country level measures of the Gender Development Index (GDI) and gross domestic product (GDP). We find that workers sleep better, regardless of gender, in countries where women are empowered. For managers, women sleep better as GDI increases and men as GDP increases. Our results suggest that men experience a sleep premium from economic development and women from gender empowerment.

The relationship between fear of crime and risk perception across Europe

2018 ◽  
Vol 19 (2) ◽  
pp. 197-214 ◽  
Author(s):  
Eva Krulichová
Keyword(s):  
Risk Perception ◽  
Fear Of Crime ◽  
European Social Survey ◽  
Academic Community ◽  
Social Survey ◽  
Country Level ◽  
Victimization Risk ◽  
Victimization Rate ◽  
The Relationship

Cross-national comparisons of fear of crime have been gaining in popularity within the academic community, as they allow for the examination of both individual and country-level correlates of this phenomenon. Nevertheless, the role of perceived victimization risk in fostering fear of crime with respect to various country specifics is often neglected. Drawing on data from the European Social Survey Round 5 (ESS R5), the aim of this study is to explore the relationship between fear of crime and risk perception in the context of 23 European countries. Risk perception is positively correlated with fear of crime in all of the analysed countries, although the strength of the relationship differs. Contrary to expectations, countries with a higher victimization rate exhibit a weaker relationship between fear of crime and risk perception, while in countries with a lower victimization rate, risk perception plays a relatively important role in shaping fear of crime. No effect of unemployment rate, size of migrant population or income inequality was found in the data.

scholarly journals PENGARUH KUALITAS PELAYANAN JKN-KIS TERHADAP KEPUASAN PESERTA JKN-KIS PADA PEMANFAATAN PELAYANAN KESEHATAN DI RSUD DR. MURJANI SAMPIT

KINDAI ◽  
2020 ◽  
Vol 16 (2) ◽  
pp. 201-219
Author(s):  
Ida Bagus Made Dwi Indrawan
Keyword(s):  
Health Services ◽  
Service Time ◽  
Public Health Services ◽  
Inhibiting Factor ◽  
Service Information ◽  
Level Of Satisfaction ◽  
Time Standards ◽  
Quality Of Health Services ◽  
Staff Behavior

Abstract : JKN-KIS program has an impact on public health services. The good quality of health services in hospitals will enable many JKN participants to utilize their health services also patients will feel satisfied with their health services. This survey is to measure the satisfaction of the community as users and improve the quality of hospital as public service. This study was conducted to determine the level of satisfaction member of JKN-KIS and the factors that encourage and inhibit the satisfaction. This study used questionnaire on 100 respondents. It showed that level of satisfaction member of JKN-KIS program is in the excellent category and the encourage factor for the satisfaction was the requirements and service information while the inhibiting factor satisfaction was service time and staff behavior. The reccomendation  for RSUD Dr. Murjani Sampit is  apply service time according to time standards and pay attention to officers in providing services on time Keywords: service quality, satisfaction, JKN-KIS participants   Abstrak : Program JKN-KIS berdampak terhadap pelayanan kesehatan masyarakat. Pemberian layanan kesehatan yang baik di Rumah Sakit akan memungkinkan banyak peserta JKN yang memanfaatkan pelayanan kesehatan dan berdampak pada pasien merasa puas terhadap pelayanan kesehatan. Survey kepuasaan masyarakat terhadap penyelenggaraan pelayanan publik ini bertujuan untuk mengukur kepuasan masyarakat sebagai pengguna layanan dan meningkatkan kualitas penyelenggaraan pelayanan publik. Penelitian ini dilakukan untuk mengetahui tingkat kepuasan peserta JKN-KIK dan faktor-faktor yang mendorong dan menghambat kepuasan peserta JKN-KIS. Penelitian ini menggunakan kuesioner pada 100 responden. Hasil penelitian didapat bahwa tingkat kepuasan peserta JKN-KIS pada pemanfaatan pelayanan kesehatan dengan kategori sangat baik dan faktor pendorong dari kepuasan peserta JKN adalah persyaratan dan maklumat pelayanan sedangkan faktor penghambat dari kepuasan peserta JKN waktu pelayanan dan perilaku pelaksana. Disarankan bagi RSUD Dr. Murjani Sampit dapat menerapakan waktu pelayanan sesuai dengan standar waktu yang telah ditetapkan serta memperhatikan petugas dalam memberikan pelayanan dengan tepat waktu Kata kunci : kualitas pelayanan, kepuasan, peserta JKN-KIS

scholarly journals Health and Culture: The Association between Healthcare Preferences for Non-Acute Conditions, Human Values and Social Norms

2021 ◽  
Vol 18 (23) ◽  
pp. 12808
Author(s):  
Ingmar Leijen ◽  
Hester van Herk
Keyword(s):  
Random Effect ◽  
European Social Survey ◽  
Human Values ◽  
Social Survey ◽  
Country Level ◽  
Societal Pressure ◽  
Seeking Behavior ◽  
Healthcare Seeking Behavior ◽  
Self Transcendence ◽  
Fundamental Values

Preference for professional vs. non-professional or informal healthcare for non-acute medical situations influences healthcare use and varies strongly across countries. Important individual and country-level drivers of these preferences may be human values (the fundamental values that individuals hold and guide their behavior) and country-level characteristics such as social tightness (societal pressure for “acceptable” behavior). The aim of this study was to examine the relation of these individual and country-level characteristics with healthcare preferences. We examined European Social Survey data from 23,312 individuals in 16 European countries, using a multi-level, random effect approach, including individual and country-level factors. Healthcare preferences were explained by both human values (i.e., Schwartz values) and societal tightness (i.e., tightness-looseness scores by Gelfand). Stronger conservation increased, whereas self-transcendence and openness to change decreased preference for professional healthcare. In socially tight countries, we found a higher preference for professional healthcare. Furthermore, we found interactions between social tightness and human values. These results suggest that professional healthcare preference is related to both people’s values and societal tightness. This improved understanding is useful for both predicting and channeling healthcare seeking behavior across and within nations.

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