Patient Choice in Kidney Allocation: The Role of the Queueing Discipline

2004 ◽  
Vol 6 (4) ◽  
pp. 280-301 ◽  
Author(s):  
Xuanming Su ◽  
Stefanos Zenios
2017 ◽  
Vol 31 (3) ◽  
pp. 138-153 ◽  
Author(s):  
Sebastian Gurtner ◽  
Nadine Hietschold ◽  
María Vaquero Martín

Innovations in health care are costly and risky, but they also provide the opportunity for hospitals to increase quality of care, to distinguish themselves from competitors and to attract patients. While numerous hospitals strive to increase their innovativeness by adopting a costly innovation leader strategy, the question of whether this actually influences the patient’s choice remains unanswered. To understand the role of innovativeness from the patient perspective, this study conceptualizes the construct of innovativeness reputation of hospitals and determines its relevance in patients’ hospital choice decisions. In the pretest, we identified six dimensions of innovativeness reputation such as progressive work procedures and value added services. We then used three different quantitative multi-criteria decision-making methods to evaluate the relative importance of innovativeness reputation in patient choice. We collected data from 355 former German patients who had undergone elective non-emergency surgery. Overall, innovativeness reputation accounts for 11.6%–16.8% of the patient decision. Innovativeness reputation has a moderate influence on hospital choice and should be taken into account by managers. Since technical innovations are costly, hospitals should use other means to enhance their innovative image. Strategies such as emphasizing value added services can enable hospitals to increase their innovativeness reputation efficiently.


2015 ◽  
Vol 15 (7) ◽  
pp. 3-14 ◽  
Author(s):  
Gabriel Lázaro-Muñoz ◽  
John M. Conley ◽  
Arlene M. Davis ◽  
Marcia Van Riper ◽  
Rebecca L. Walker ◽  
...  

2019 ◽  
Vol 26 (6) ◽  
pp. 1643-1648
Author(s):  
Yuliyan Velkov

A paradox has been established in the modern healthcare industry - consumers can choose between many alternatives but with high uncertainty, while healthcare establishments have numerous possibilities, but they function in conditions of rigorous demand, globalization and large-scale technological efficiency. This requires a re-evaluation of the classical understanding of competition in value creation - healthcare effects (for patients) and financial gains (for the performance of medical and related activities). Today, competition can be explained as a competition for the creation, supply and realization of healthcare products and related services and goods. It is a dynamic process of competition and, in a more general sense, interaction between competing subjects under conditions of significant state interference. It reflects the modern perceptions of health, the improvement of biotechnology and pharmacy, the changed role of the patients - more and more informed, educated, active and united in thematic groups. For the realization with a focus on personal patient preferences, this embodies the characteristics of the interaction between the healthcare establishment and the patient. Competition integrates business logic and patient thinking. In the context of the concept of joint value creation, it covers the intense interactions between healthcare institutions and the individual. Competition in the healthcare industry is based on dialogue, access, risk assessment and transparency at every stage of value creation and realization. This is realized as a competitive interaction in the environment (network) from the influences of healthcare institutions and other producers of medical and non-medical services and goods, thematic associations and regulations. This is a rivalry in creating and offering healthcare products tailored to individual patient's views, preferences, expectations and financial capabilities. The prospects for a competitive race are a transition from competitiveness to competitive interaction. In parallel with the improvement of the operational efficiency of the medical institution, this imposes, the increasing individualization of the created healthcare products. This requires the development of an environment for shared healthcare experiences with the customer. Thus, the development of competition is connected with the realization of the competitive potential of the healthcare establishment through the prism of patient choice - joint creation of healthcare experience through many channels, through options, through transactions and at an appropriate price-to-experience ratio. Consequently, the competitiveness targeting passive patients in need of treatment is shifted from an effective healthcare establishment-to-patient interaction in order to jointly provide patient satisfaction. Competition is a race between dependant healthcare establishments; it is a rivalry between producers of healthcare effects interacting with patients among many environmental influences. Contemporary competition in the healthcare industry is a mechanism for jointly creating healthcare effects by interaction between a healthcare establishment and a patient with the active role of those in need of treatment. This is realized in the form of competition and co-operation in the course of the creation of individualized healthcare experiences. Competition combines a variety of subjective patient needs, medicinal product characteristics, and network experience qualities. As a guideline for improving competition, we can point to enhancing the quality of the environment, enhancing the possibility to take into account patient need heterogeneity, increasing adaptability to changes in demand, and enhancing capabilities to mobilize all potential competencies.


2021 ◽  
pp. 164-204
Author(s):  
Paula Blomqvist ◽  
Ulrika Winblad

This chapter provides an extended look at health politics and the tax-financed, universal health system in Sweden. It traces the historical development of the Swedish healthcare system, characterized by a shifting relationship between a powerful, interventionist state and self-governing county-level governing institutions. Starting in the late 1980s, despite broad political agreement about the need to adapt the system and make it more patient-centered, there has been debate over most health reforms, particularly over the role of markets and private actors, with legislative votes largely following the left–right political party divide. Nevertheless, reforms like the introduction of private actors, mostly publicly financed and regulated, the enhancement of patient choice, measures to reduce waiting times, and other changes in the formerly nearly all-public system have taken place without seriously undermining the health system’s fundamentally solidaristic character.


Author(s):  
Judith Daar

The need for infertility treatment brings professionals into reproductive decisions that are important private matters for patients. In medically assisted reproduction, providers are brought into roles traditionally regarded as occupied only by nature and into a position to determine which embryos are suitable for transfer in the effort to achieve pregnancy. These powers of judgment present ethical challenges for professionals providing assisted reproduction services. Among these challenges is the potential conflictual involvement of multiple patients in the process: intended parents, gamete donors, and gestational surrogates. Other challenges include the obligation to avoid discrimination in selecting embryos for transfer or in making decisions about which patients to serve. Providers must be informed by ethical discussions such as the ethics opinions of the American Society for Reproductive Medicine. Important ethical considerations include respect for patient choice, the best interests of offspring, nondiscrimination, and social justice.


2009 ◽  
Vol 195 (S52) ◽  
pp. s51-s56 ◽  
Author(s):  
Richard Gray ◽  
Rosalyn Spilling ◽  
David Burgess ◽  
Tim Newey

BackgroundA patient-centred approach to care, focusing on recovery, demands a reconsideration of how choices are made about treatment, how this affects medication adherence, and the role of long-acting antipsychotics (LAIs) in this process.AimsTo explore the role of the mental health professional (particularly nurses) in helping patients manage their medication, with a specific focus of the use and administration of LAIs.MethodA pragmatic review of the literature.ResultsPatients (by experience) and mental health professionals (by training and clinical practice) are experts in the care and treatment of psychosis. When patients and clinicians make a joint decision both are more likely to adhere to the treatment plan. In this paper we consider good practice in the administration of LAIs that focuses on where and when they should be given and administration techniques. Skills for talking with patients about their medication that include exchanging information, monitoring the effects of medication and making advance choices about treatment in the event of a crisis are also discussed.ConclusionsMental health professionals require a range of competences to help patients manage their medication effectively.


2012 ◽  
Vol 41 (3) ◽  
pp. 290-300 ◽  
Author(s):  
Fiona W. Jeffries ◽  
Paul Davis

Background: Controversy continues to exist regarding how EMDR works and whether its mechanisms differ from those at work in standard exposure techniques. Aims: To investigate first whether eye movement bilateral stimulation is an essential component of EMDR and, second, the current status of its theoretical basis. Method: A systematic search for relevant articles was conducted in databases using standard methodology. Results: Clinical research evidence is contradictory as to how essential EMs are in PTSD treatment. More positive support is provided by analogue studies. With regards to potential theoretical support, some evidence was found suggesting bilateral stimulation first increases access to episodic memories; and second that it could act on components of working memory which makes focusing on the traumatic memories less unpleasant and thereby improves access to these memories. Conclusions: The results suggest support for the contention that EMs are essential to this therapy and that a theoretical rationale exists for their use. Choice of EMDR over trauma-focused CBT should therefore remain a matter of patient choice and clinician expertise; it is suggested, however, that EMs may be more effective at reducing distress, and thereby allow other components of treatment to take place.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Amy J. C. Potappel ◽  
Maartje C. Meijers ◽  
Corelien Kloek ◽  
Aafke Victoor ◽  
Janneke Noordman ◽  
...  

Abstract Background Many countries in Europe have implemented managed competition and patient choice during the last decade. With the introduction of managed competition, health insurers also became an important stakeholder. They purchase services on behalf of their customers and are allowed to contract healthcare providers selectively. It has, therefore, become increasingly important to take one’s insurance into account when choosing a provider. There is little evidence that patients make active choices in the way that policymakers assume they do. This research aims to investigate, firstly, the role of patients in choosing a healthcare provider at the point of referral, then the role of the GP and, finally, the influence of the health insurer/insurance policies within this process. Methods We videotaped a series of everyday consultations between Dutch GPs and their patients during 2015 and 2016. In 117 of these consultations, with 28 GPs, the patient was referred to another healthcare provider. These consultations were coded by three observers using an observation protocol which assessed the role of the patient, GP, and the influence of the health insurer during the referral. Results Patients were divided into three groups: patients with little or no input, patients with some input, and those with a lot of input. Just over half of the patients (56%) seemed to have some, or a lot of, input into the choice of a healthcare provider at the point of referral by their GP. In addition, in almost half of the consultations (47%), GPs inquired about their patients’ preferences regarding a healthcare provider. Topics regarding the health insurance or insurance policy of a patient were rarely (14%) discussed at the point of referral. Conclusions Just over half of the patients appear to have some, or a lot of, input into their choice of a healthcare provider at the point of referral by their GP. However, the remainder of the patients had little or no input. If more patient choice continues to be an important aim for policy makers, patients should be encouraged to actively choose the healthcare provider who best fits their needs and preferences.


Sign in / Sign up

Export Citation Format

Share Document