scholarly journals What Influences the Outcome of Active Disinvestment Processes in Healthcare? A Qualitative Interview Study on five Recent Cases of Active Disinvestment

2020 ◽  
Author(s):  
Adriënne Henderika Rotteveel ◽  
Mattijs S. Lambooij ◽  
Joline J.A. van de Rijt ◽  
N.J.A. van Exel ◽  
Karel G.M. Moons ◽  
...  
Keyword(s):  
The Netherlands ◽  
Healthcare Providers ◽  
Policy Decision ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Dutch Health ◽  
Financial Interests ◽  
Care Assistance ◽  
Insight Into

Abstract Background: Recent attempts of active disinvestment (i.e. withdrawal of reimbursement by means of a policy decision) of reimbursed healthcare interventions in the Netherlands have differed in their outcome: some were successful, with interventions actually being disinvested, while others were terminated at some point, implying continuation of reimbursement. This study aimed to obtain insight into recent active disinvestment processes, and to explore what aspects affect their outcome.Methods: Semi-structured interviews were conducted from January to December 2018 with stakeholders (e.g. patients, policymakers, physicians) who were involved in the policy process of five cases for which the full or partial withdrawal of reimbursement was considered in the Netherlands between 2007 and 2017: benzodiazepines, medication for Fabry disease, quit smoking programme, psychoanalytic therapy and maternity care assistance. These cases covered both interventions that were eventually disinvested and interventions for which reimbursement was maintained after consideration. Interviews were transcribed verbatim, double coded and analyzed using thematic analysis.Results: The 37 interviews showed that support for disinvestment from stakeholders, especially from healthcare providers and policymakers, strongly affected the outcome of the disinvestment process. Furthermore, the institutional role of stakeholders as legitimized by the Dutch health insurance system, their financial interests in maintaining or discontinuing reimbursement, and the possibility to relieve the consequences of disinvestment for current patients affected the outcome of the disinvestment process as well. No evidence was found of a consistent role of the formal Dutch package criteria (i.e. effectiveness, cost-effectiveness, necessity and feasibility) in active disinvestment processes.Conclusions: Contextual factors as well as the possibility to relieve the consequences of disinvestment for current patients are important determinants of the outcome of active disinvestment processes. These results provide insight into active disinvestment processes and their determinants, and provide guidance to policymakers for a potentially more successful approach for future active disinvestment processes.

scholarly journals What influences the outcome of active disinvestment processes in healthcare? A qualitative interview study on five recent cases of active disinvestment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adriënne H. Rotteveel ◽  
Mattijs S. Lambooij ◽  
Joline J. A. van de Rijt ◽  
Job van Exel ◽  
Karel G. M. Moons ◽  
...  
Keyword(s):  
The Netherlands ◽  
Healthcare Providers ◽  
Policy Decision ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Dutch Health ◽  
Financial Interests ◽  
Care Assistance ◽  
Insight Into

Abstract Background Recent attempts of active disinvestment (i.e. withdrawal of reimbursement by means of a policy decision) of reimbursed healthcare interventions in the Netherlands have differed in their outcome: some attempts were successful, with interventions actually being disinvested. Other attempts were terminated at some point, implying unsuccessful disinvestment. This study aimed to obtain insight into recent active disinvestment processes, and to explore what aspects affect their outcome. Methods Semi-structured interviews were conducted from January to December 2018 with stakeholders (e.g. patients, policymakers, physicians) who were involved in the policy process of five cases for which the full or partial withdrawal of reimbursement was considered in the Netherlands between 2007 and 2017: benzodiazepines, medication for Fabry disease, quit smoking programme, psychoanalytic therapy and maternity care assistance. These cases covered both interventions that were eventually disinvested and interventions for which reimbursement was maintained after consideration. Interviews were transcribed verbatim, double coded and analyzed using thematic analysis. Results The 37 interviews showed that support for disinvestment from stakeholders, especially from healthcare providers and policymakers, strongly affected the outcome of the disinvestment process. Furthermore, the institutional role of stakeholders as legitimized by the Dutch health insurance system, their financial interests in maintaining or discontinuing reimbursement, and the possibility to relieve the consequences of disinvestment for current patients affected the outcome of the disinvestment process as well. A poor organization of patient groups may make it difficult for patients to exert pressure, which may contribute to successful disinvestment. No evidence was found of a consistent role of the formal Dutch package criteria (i.e. effectiveness, cost-effectiveness, necessity and feasibility) in active disinvestment processes. Conclusions Contextual factors as well as the possibility to relieve the consequences of disinvestment for current patients are important determinants of the outcome of active disinvestment processes. These results provide insight into active disinvestment processes and their determinants, and provide guidance to policymakers for a potentially more successful approach for future active disinvestment processes.

Addressing food loss and waste prevention

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Burcu Kör ◽  
Adriana Krawczyk ◽  
Ingrid Wakkee
Keyword(s):  
The Netherlands ◽  
Food Waste ◽  
Household Consumption ◽  
Resource Scarcity ◽  
Advanced Technology ◽  
Waste Prevention ◽  
Structured Interviews ◽  
Content Type ◽  
Food Loss

PurposeFood waste is one of the most challenging issues humanity is currently facing. Therefore, there has been a growing interest in the prevention of food waste because of world hunger, environmental impacts, resource scarcity and economic costs. The purpose of the study is to investigate the factors that influence food waste and the role of technology in tackling food waste in India and the Netherlands.Design/methodology/approachIn order to explore differences in food loss and waste further this study will examine a number of practices on both the production and the consumer side, in a developing country and a developed country with different culture/economic backgrounds: India and the Netherlands. The factors that influence food waste were examined with a preliminary qualitative study, which consists of semi-structured interviews, and quantitative research that comprises a survey. Semi-structured interviews were conducted in both India and the Netherlands, which consists of five interviews. The survey data was collected from 78 individuals from India and 115 individuals from the Netherlands.FindingsOne of the main findings of the research is food waste is divided into waste within agricultural production (i.e. food loss) and final household consumption (i.e. food waste). Different factors influence food loss in different stages in the supply chain. Some of these factors include wastage during processing, storage, transportation and at the market-place. New technologies can utilize food loss for new purposes, so food loss is reduced to the minimum. Food waste is mainly influenced by food passing expiry date, food that is left too long in the fridge and consumers buying too much food. In final household consumption, technologies such as digital platforms enable individuals or organizations to share and donate their food, thereby creating awareness on food waste prevention and the environmental and ethical benefits.Originality/valueThe authors examine to what extent and in which ways supporting consumers to minimize food waste can be achieved via three stages: (1) understanding and evaluating food loss and waste, (2) identifying the factors that influence food loss and waste, (3) understanding consumer behaviors to encourage food waste reduction and (4) identifying the technological impact that would reduce food waste. As such, this paper contributes to ongoing debates about food waste by looking at the role of context and culture and by exploring differences between developed and developing countries. Also, the authors advance the debate by exploring both the role of advanced technology such as blockchain and drones in both preventing loss and waste as well as non-technological mechanisms.

scholarly journals Self-regulation strategies of smartphone use during university self-study

2020 ◽  
Author(s):  
Rebecca L. Barron ◽  
Linda Katherine Kaye
Keyword(s):  
Undergraduate Students ◽  
Learned Helplessness ◽  
Self Regulation ◽  
Structured Interviews ◽  
Fear Of Missing Out ◽  
Self Study ◽  
Smartphone Use ◽  
Regulation Strategies ◽  
Insight Into

The role of smartphones within education has received a lot of media and academic attention. This has typically focused on their use in the classroom, within tutor-directed sessions. However, less has been focused on how smartphone use is negotiated within self-study. Using semi-structured interviews, the current study sought to explore final year undergraduate students’ (N = 6) strategies for smartphone self-regulation during self-study time and the extent to which these strategies were effective. IPA revealed three main themes: “Urgency, Context and Consistency”, “Learned Helplessness” and “Fear of Missing out (FoMO)”. The findings extend our understanding of how conceptual frameworks such as self-regulation apply to smartphone regulation during self-study, and provide insight into the barriers for effective regulatory behaviour. Implications for both self-study efficacy and smartphone regulation are discussed.

Peruvian small and medium-sized enterprises and COVID-19: Time for a new start!

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Susanne Durst ◽  
Mariano Martin Genaro Palacios Acuache ◽  
Guido Bruns
Keyword(s):  
Latin America ◽  
Crisis Management ◽  
Structured Interviews ◽  
Content Type ◽  
Qualitative Research Design ◽  
The People ◽  
Starting Point ◽  
The Difference ◽  
Insight Into

Purpose Crises of any type have become an integral part of business activity and responses to them could make the difference between survival and failure. This applies in particular to small and medium-sized enterprises (SMEs). Taking the coronavirus (COVID-19) pandemic as a starting point, this study aims to investigate how Peruvian SMEs have been coping with COVID-19 so far. Based on that a conceptual framework is proposed which highlights the practice of SMEs trying to deal with a new type of crisis. Design/methodology/approach The study is based on an exploratory qualitative research design involving 25 semi-structured interviews conducted in Peruvian SMEs. Findings The findings demonstrate how the Peruvian firms studied to adapt to the new situation and initiate responses to increasing the chance of survival. Furthermore, the role of the companies’ decision-makers, as well as the role of crisis management and other related approaches in the companies are shown. Research limitations/implications The paper expands the underdeveloped body of knowledge regarding crisis management in Latin America in general and crisis management in SMEs by providing insight into how Peruvian SMEs perceive and adapt to the COVID-19 pandemic. Practical implications The findings presented in this paper have implications for both managers and managerial staff of SMEs but also for the people in charge of the curricula at universities and other teaching-focused institutes. Originality/value To the authors’ knowledge, this is the first empirical study of crisis management on the impacts of COVID-19 with a dedicated focus on SMEs from Latin America. It provides fresh insight into current reactions to the Pandemic.

scholarly journals Operational failures and how they influence the work of GPs: a qualitative study in primary care

2020 ◽  
Vol 70 (700) ◽  
pp. e825-e832
Author(s):  
Carol Sinnott ◽  
Alexandros Georgiadis ◽  
Mary Dixon-Woods
Keyword(s):  
Primary Care ◽  
Work Environment ◽  
Information Transfer ◽  
Healthcare Providers ◽  
Comparison Method ◽  
Care Work ◽  
System Level ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Operational Failures

BackgroundOperational failures, defined as inadequacies or errors in the information, supplies, or equipment needed for patient care, are known to be highly consequential in hospital environments. Despite their likely relevance for GPs’ experiences of work, they remain under-explored in primary care.AimTo identify operational failures in the primary care work environment and to examine how they influence GPs’ work.Design and settingQualitative interview study in the East of England.MethodSemi-structured interviews were conducted with GPs (n = 21). Data analysis was based on the constant comparison method.ResultsGPs reported a large burden of operational failures, many of them related to information transfer with external healthcare providers, practice technology, and organisation of work within practices. Faced with operational failures, GPs undertook ‘compensatory labour’ to fulfil their duties of coordinating and safeguarding patients’ care. Dealing with operational failures imposed significant additional strain in the context of already stretched daily schedules, but this work remained largely invisible. In part, this was because GPs acted to fix problems in the here-and-now rather than referring them to source, and they characteristically did not report operational failures at system level. They also identified challenges in making process improvements at practice level, including medicolegal uncertainties about delegation.ConclusionOperational failures in primary care matter for GPs and their experience of work. Compensatory labour is burdensome with an unintended consequence of rendering these failures largely invisible. Recognition of the significance of operational failures should stimulate efforts to make the primary care work environment more attractive.

The utility of relationships in the creation and maintenance of an event portfolio

2018 ◽  
Vol 36 (2) ◽  
pp. 260-275 ◽  
Author(s):  
Donna M. Kelly ◽  
Sheranne Fairley
Keyword(s):  
Process Model ◽  
Structured Interviews ◽  
Content Type ◽  
Key Stakeholders ◽  
Strategic Goals ◽  
The Creation ◽  
Practical Implications ◽  
Insight Into

Purpose Event portfolios promote synergies among events and stakeholders within a destination in order to maximise resources. The purpose of this paper is to examine the role of relationships in the creation and maintenance of an event portfolio using the four stages of Parvatiyar and Sheth’s (2000) process model of relationship marketing: formation, management and governance, performance evaluation, and evolution. Design/methodology/approach Nine semi-structured interviews were conducted with tourism and government stakeholders involved in the creation and maintenance of an event portfolio within a single destination. Findings The destination outlined clear strategic goals through an event strategy. An Events Board was established to bring together key stakeholders from tourism, events, and government to oversee the development of an event portfolio. The Events Board gave advice to relevant tourism and government stakeholders on which events they should provide funding. Developing relationships was not a stated objective, but the Events Board realised the importance of relationships to create and maintain the destination’s event portfolio. Long-term funding contracts were used as a mechanism to establish relationships and were an impetus for interaction. Relationships were also maintained through dedicated staff who managed the relationships between the destination stakeholders and the events. Practical implications Understanding factors that contribute to the successful creation and maintenance of event portfolios can inform destination stakeholders who are responsible for generating tourism through events. Originality/value Limited research has examined the creation and maintenance of event portfolios. This study provides insight into the central importance of relationships in creating and maintaining an event portfolio.

Perspectives of health care providers on the role of culture in the self-care of patients with chronic heart failure: a qualitative interview study conducted in Israel

2020 ◽  
Author(s):  
Adam Joensson ◽  
Emilie Cewers ◽  
Jean Marc Weinstein ◽  
Tuvia Ben Gal ◽  
Anna Stromberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Self Care ◽  
Cultural Background ◽  
Care Providers ◽  
Qualitative Interview Study ◽  
Specific Barriers

Abstract Background: Self-care is recognized as important behaviour in chronic diseases such as heart failure (HF). The cultural background of patients with HF is one of the factors that can be considered to affect their adherence to self-care. The cultural background of the health care providers might also influence their view on self-care behaviour and the education they provide. The aim of this study was to describe health care providers' perceptions of the role of culture in self-care and how those perceptions shape their experiences and their practices.Methods: A qualitative study was performed in Israel, a country with a culturally diverse population. Data was collected using semi-structured interviews with 12 healthcare providers from different cultural backgrounds, selected by purposeful sampling, from two hospitals in Israel. Interviews were audio recorded and transcribed verbatim. Data was analysed using content analysis.Results: Healthcare providers experienced cultural background influenced their patients’ self-care behaviour. Perceived cultural-specific barriers to self-care such as: dietary traditions interfering with the recommended HF diet, willingness to undertake self-care and beliefs conflicting with medical treatment were identified. Healthcare providers described that they adapted their patient education and care based on the cultural background of the patients. Shared cultural background, awareness and knowledge of differences were described as positively influencing self-care education, while cultural differences could complicate this process. These findings are encapsulated within four categories regarding perceptions of health care providers: ‘Culture permeates self-care behaviours’, ‘Culture influence the way care is provided’, ‘Mutual cultural background impacts the mindset to address self-care’ and ‘Culture is only a small piece of the puzzle...’Conclusions: Cultural-specific barriers for self-care were perceived by health care providers and they identified that their own cultural background shapes their experiences and their practices.

scholarly journals Strategic complexities and opportunities in Welsh youth justice: exploring YJB Cymru

2014 ◽  
Vol 13 (3) ◽  
pp. 109-119 ◽  
Author(s):  
Stephen Case
Keyword(s):  
Structured Interviews ◽  
Youth Justice ◽  
Policy And Practice ◽  
England And Wales ◽  
Content Type ◽  
Documentary Analysis ◽  
Key Stakeholders ◽  
Practice Development ◽  
Insight Into

Purpose – The paper presents and discusses the findings of a Strategic Insight Programme placement that explored the Youth Justice Board for Wales (YJB Cymru), a division of the YJB for England and Wales since the abolition of the regional structure in April 2012. The focus of the placement was on exploring the role of YJB Cymru in the development of youth justice policy and practice in the unique, partially devolved context of Wales. The paper aims to discuss these issues. Design/methodology/approach – The research was conducted over a six-month period from February to July 2013. A multiple methods design was adopted, consisting of semi-structured interviews with key stakeholders (YJB Cymru staff, Welsh Government staff and Youth Offending Team staff), observations of policy and practice mechanisms (YJB Cymru meetings, YOT projects) and documentary analysis of YJB Cymru publications. Findings – Thematic analyses demonstrated that YJB Cymru has an increasingly important role in policy and practice development structures and processes in England and Wales more broadly (e.g. within the YJB for England and Wales) and in the Welsh national context specifically. YJB Cymru fulfills a role of dual influence – working both with government (UK and Welsh) and youth justice practitioners (mainly YOT managers and staff) to mediate and manage youth justice tensions in the partially devolved Welsh policy context through relationships of reflective and critical engagement. Originality/value – This study draws inspiration from the groundbreaking research of Souhami (2011) and builds on those findings to provide a unique insight into the organisation and role YJB Cymru in the complex and dynamic context of youth justice in Wales.

What can a municipality offer to its residents? Value propositions and interactions in a place context

2016 ◽  
Vol 10 (1) ◽  
pp. 24-37 ◽  
Author(s):  
Lisa Källström ◽  
Christer Ekelund
Keyword(s):  
Design Methodology ◽  
Geographical Location ◽  
Abductive Reasoning ◽  
Place Marketing ◽  
Structured Interviews ◽  
Content Type ◽  
Essential Services ◽  
Value Propositions ◽  
Insight Into

Purpose – The purpose of this paper is to explore the role of the municipality in the place marketing context and to describe how municipalities work on making their place good to live in. The study rests on abductive reasoning whereby service-based logic forms the study and offers a theoretical framework for how to approach the phenomena. Design/methodology/approach – A qualitative study in the form of 20 semi-structured interviews with leading elected officials and civil servants is used to let us understand how two typical municipalities in southern Sweden work on making their municipality a good place for their residents to live in. Content analysis is used to analyze the data. Findings – The study reveals how municipalities work on creating opportunities for interactions between themselves and their residents, as well as offers insight into what value propositions the municipalities believe they offer their residents. The current study shows that the geographical location and the natural environment, basic and essential services, accommodations, urban quality, recreation and leisure and ambience constitute important dimensions in the place offering. Originality/value – Service-based logic is used as a backdrop to facilitate the analysis in this study, which emphasizes value propositions offered by the municipality and interactions between the municipality and its residents, which increase our understanding of how municipalities work on making their place good to live in. The service-based logic help shed new light on the place marketing context and allows us to understand the context in a new way.

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