scholarly journals How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities (Preprint)

2019 ◽  
Author(s):  
Wei Lu ◽  
Hong Wu
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Empirical Work ◽  
Basic Research ◽  
Online Reviews ◽  
Difference In Difference ◽  
Online Services ◽  
Outpatient Visits ◽  
Channel Effects ◽  
The Impact

BACKGROUND Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions. OBJECTIVE In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects. METHODS We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities. RESULTS We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits. CONCLUSIONS This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.

scholarly journals How Online Reviews and Services Affect Physician Outpatient Visits: Content Analysis of Evidence From Two Online Health Care Communities

10.2196/16185 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e16185
Author(s):  
Wei Lu ◽  
Hong Wu
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Empirical Work ◽  
Basic Research ◽  
Online Reviews ◽  
Difference In Difference ◽  
Online Services ◽  
Outpatient Visits ◽  
Channel Effects ◽  
The Impact

Background Online healthcare communities are changing the ways of physician-patient communication and how patients choose outpatient care physicians. Although a majority of empirical work has examined the role of online reviews in consumer decisions, less research has been done in health care, and endogeneity of online reviews has not been fully considered. Moreover, the important factor of physician online services has been neglected in patient decisions. Objective In this paper, we addressed the endogeneity of online reviews and examined the impact of online reviews and services on outpatient visits based on theories of reviews and channel effects. Methods We used a difference-in-difference approach to account for physician- and website-specific effects by collecting information from 474 physician homepages on two online health care communities. Results We found that the number of reviews was more effective in influencing patient decisions compared with the overall review rating. An improvement in reviews leads to a relative increase in physician outpatient visits on that website. There are channel effects in health care: online services complement offline services (outpatient care appointments). Results further indicate that online services moderate the relationship between online reviews and physician outpatient visits. Conclusions This study investigated the effect of reviews and channel effects in health care by conducting a difference-in-difference analysis on two online health care communities. Our findings provide basic research on online health care communities.

scholarly journals Consumption Responses to In-Kind Transfers: Evidence from the Introduction of the Food Stamp Program

2009 ◽  
Vol 1 (4) ◽  
pp. 109-139 ◽  
Author(s):  
Hilary W Hoynes ◽  
Diane Whitmore Schanzenbach
Keyword(s):  
Theoretical Model ◽  
Empirical Work ◽  
Food Stamps ◽  
Cash Income ◽  
Food Stamp Program ◽  
Difference In Difference ◽  
Food Expenditures ◽  
Theoretical Predictions ◽  
Difference Methods ◽  
The Impact

Economists have strong theoretical predictions about how in-kind transfers, such as providing vouchers for food, impact consumption. Despite the prominence of the theory, there is little empirical work on responses to in-kind transfers, and most existing work fails to support the canonical theoretical model. We employ difference-in-difference methods to estimate the impact of program introduction on food spending. Consistent with predictions, we find that food stamps reduce out-of-pocket food spending and increase overall food expenditures. We also find that households are inframarginal and respond similarly to one dollar in cash income and one dollar in food stamps. (JEL D12, H23, I38)

scholarly journals Back to the Future: Principles on Resuming Outpatient Services in the COVID-19 Era

2020 ◽  
Vol 163 (4) ◽  
pp. 705-706 ◽  
Author(s):  
Taher S. Valika ◽  
Kathleen R. Billings
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Outpatient Services ◽  
Drastic Reduction ◽  
The Public ◽  
Outpatient Visits ◽  
The Future ◽  
Care Systems

The rapidly changing health care climate related to coronavirus disease 2019 (COVID-19) has resulted in numerous changes to health care systems and in practices that protect both the public and the workers who serve in hospitals around the country. As a result, these past few months have seen a drastic reduction in outpatient visits. With phased reopening and appropriate guidance, health care systems are attempting to return to normal. The experiences and lessons learned are described, and we provide guiding principles to allow for a safe and effective return to outpatient care.

scholarly journals Health care utilization among patients with oesophageal and gastric cancer: the impact of initial treatment strategy and assignment of a contact nurse

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karin Dalhammar ◽  
Marlene Malmström ◽  
Magnus Sandberg ◽  
Dan Falkenback ◽  
Jimmie Kristensson
Keyword(s):  
Gastric Cancer ◽  
Health Care ◽  
Treatment Strategy ◽  
Outpatient Care ◽  
Initial Treatment ◽  
Palliative Treatment ◽  
Health Care Use ◽  
Curative Treatment ◽  
Hospital Stays ◽  
The Impact

Abstract Background Patients diagnosed with oesophageal and gastric cancer face a poor prognosis and numerous challenges of symptom management, lifestyle adjustments and complex treatment regimens. The multifaceted care needs and rapid disease progression reinforce the need for proactive and coherent health care. According to the national cancer strategy, providing coherent health care and palliative support is an area of priority. More knowledge is needed about health care utilization and the characteristics of the health care service in order to understand the readiness, accessibility and quality of current health care. The aim of this study was to describe individuals’ health care use from the time of treatment decision until death, and investigate the impact of the initial treatment strategy and assignment of a contact nurse (CN) on health care use among patients with oesophageal and gastric cancer. Methods This population-based cohort study included patients who died from oesophageal and gastric cancer in Sweden during 2014–2016. Through linking data from the National Register for Oesophageal and Gastric Cancer, the National Cause of Death Register, and the National Patient Register, 2614 individuals were identified. Associations between the initial treatment strategy and CN assignment, and health care use were investigated. Adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated using Poisson regression. Results Patients receiving palliative treatment and those receiving no tumour-directed treatment had a higher IRR for unplanned hospital stays and unplanned outpatient care visits compared with patients who received curative treatment. Patients receiving no tumour-directed treatment also had a lower IRR for planned hospital stays and planned outpatient care visits compared with patients given curative treatment. Compared with this latter group, patients with palliative treatment had a higher IRR for planned outpatient care visits. Patients assigned a CN had a higher IRR for unplanned hospital stays, unplanned outpatient care visits and planned outpatient care visits, compared with patients not assigned a CN. Conclusions A palliative treatment strategy and no tumour-directed treatment were associated with higher rates of unplanned health care compared with a curative treatment strategy, suggesting that a proactive approach is imperative to ensure quality palliative care.

scholarly journals Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Ramana Appireddy ◽  
Sana Khan ◽  
Chad Leaver ◽  
Cally Martin ◽  
Albert Jin ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Outpatient Care ◽  
Stroke Prevention ◽  
Personal Experience ◽  
Access To Health Care ◽  
Virtual Visits ◽  
The Impact ◽  
Prevention Clinic

BACKGROUND Timely, in-person access to health care is a challenge for people living with conditions such as stroke that result in frailty, loss of independence, restrictions in driving and mobility, and physical and cognitive decline. In Southeastern Ontario, access is further complicated by rurality and the long travel distances to visit physician clinics. There is a need to make health care more accessible and convenient. Home virtual visits (electronic visits, eVisits) can conveniently connect physicians to patients. Physicians use a secure personal videoconferencing tool to connect to patients in their homes. Patients use their device of choice (smartphone, tablet, laptop, or desktop) for the visit. OBJECTIVE This study aimed to assess the feasibility and logistics of implementing eVisits in a stroke prevention clinic for seniors. METHODS A 6-month eVisit pilot study was initiated in the Kingston Health Sciences Centre stroke prevention clinic in August 2018. eVisits were used only for follow-up patient encounters. An integrated evaluation was used to test the impact of the program on clinic workflow and patient satisfaction. Patient satisfaction was evaluated by telephone interviews, using a brief questionnaire. Access and patient satisfaction metrics were compared with concurrent standard of care (patients’ prior personal experience with in-person visits). Values are presented as median (interquartile range). RESULTS There were 75 subjects in the pilot. The patients were aged 65 (56-73.5) years, and 39% (29/75) resided in rural areas. There was a shorter wait for an appointment by eVisit versus in-person (mean 59.98 [SD 48.36] days vs mean 78.36 [SD 50.54] days; <italic>P</italic>&lt;.001). The eVisit was also shorter, taking on an average of only 10 min to deliver follow-up care with a high degree of patient satisfaction versus 90 (60-112) min for in-person care. The total time saved by patients per eVisit was 80 (50-102) min, 44 (21-69) min of which was travel time. Travel distance avoided by the patients was 30.1 km (11.2-82.2). The estimated total out-of-pocket cost savings for patients per eVisit was Can $52.83 (31.26-94.53). The estimated savings (opportunity cost for in-person outpatient care) for our eVisit pilot project was Can $23,832-$28,584. The patient satisfaction with eVisits was very good compared with their prior personal experience with in-person outpatient care. CONCLUSIONS The eVisit program was well received by patients, deemed to be safe by physicians, and avoided unnecessary patient travel and expense. It also has the potential to reduce health care costs. We plan to scale the project within the department and the institution.

Can the "Yelp Effect" Be Reversed? Dealing with Patients' Expectations for Antibiotics (Preprint)

2020 ◽  
Author(s):  
Monique Mitchell Turner ◽  
Hyeson Choung ◽  
Quoc-Ha Hannah Mai Bui ◽  
Paige Beck ◽  
Hera Ashraf
Keyword(s):  
Health Care ◽  
Antibiotic Resistance ◽  
Online Reviews ◽  
Care Staff ◽  
Antibiotics Resistance ◽  
Care Providers ◽  
Unrealistic Expectation ◽  
Emotional Appeals ◽  
Online Feedback ◽  
The Impact

BACKGROUND The overuse of antibiotics has rapidly made antimicrobial resistance a global public health challenge. There is an emerging trend where providers who perceive that their patients expect antibiotics are more likely to prescribe antibiotics unprompted or upon request.1 Particularly, health care providers have expressed concern that dissatisfied patients will provide disparaging online reviews therefore threatening the reputation of the practice.2 To better deal with the negative reviews and inform patients, some health care staff directly respond to patients' online feedback.3 Engaging with patients’ online reviews gives providers an opportunity to prevent reputational damage and improve patients’ understanding of the antibiotic resistance problem. OBJECTIVE We aim to suggest and test the effectiveness of different response strategies to the negative patient online reviews on the readers’ perceptions of the health care provider and their perceptions related to antibiotics resistance. METHODS Two experimental surveys were conducted to examine the impact of message tactics (apologizing, inducing fear or guilt) that can be employed by healthcare providers when responding to patients’ negative online feedback related to not receiving an antibiotic. RESULTS Overall, our results demonstrated positive impacts of responding to patients’ online reviews. In Study 1, we found an apologetic messaging and using emotional appeals in the response were effective in making readers feel more favorable toward the message. Readers also expressed greater credibility perception toward the provider when emotional appeals were used. Findings from study 2 largely supported the effectiveness of fear-inducing response in improving the readers’ misconception and unrealistic expectation for antibiotics. CONCLUSIONS This paper demonstrated that a strategic response to patient online complaints can prevent reputational damage and help to minimize the potential negative impacts of the review. The results also glean insight into the step toward developing a novel intervention--crafting a persuasive response to patients’ negative feedback that can help to improve the understanding of antibiotic resistance problems.

scholarly journals Geriatric syndromes and subsequent health-care utilization among older community dwellers in Stockholm

2021 ◽  
Author(s):  
Jette Möller ◽  
Christian Rausch ◽  
Lucie Laflamme ◽  
Yajun Liang
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Cox Regression ◽  
Baseline Survey ◽  
Care Utilization ◽  
Geriatric Syndromes ◽  
Outpatient Visits ◽  
The Impact ◽  
Community Dwellers

AbstractLittle is known about the long-term effect of geriatric syndromes on health-care utilization. This study aims to determine the association between geriatric syndromes and health-care utilization during a four-year period among older community dwellers. Based on the Stockholm Public Health Cohort study, a total number of 6700 community dwellers aged ≥65 years were included. From a baseline survey in 2006, geriatric syndromes were defined as having at least one of the following: insomnia, functional decline, urinary incontinence, depressive symptoms and vision impairment. Health-care utilization was identified by linkages at individual level with register data with a four-year follow-up. Cox regression was performed to estimate the associations. Compared to those without geriatric syndromes, participants with any geriatric syndromes had a higher prevalence of frequent hospitalizations, long hospital stays, frequent outpatient visits and polypharmacy in each of the follow-up years. After controlling for covariates, having any geriatric syndromes was associated with higher levels of utilization of inpatient and outpatient care as well as polypharmacy. The association was stable over time, and the fully adjusted hazard ratio (95% confidence interval) remained stable in frequent hospitalizations (from 1.89 [1.31, 2.73] in year 1 to 1.70 [1.23, 2.35] in year 4), long hospital stay (from 1.75 [1.41, 2.16] to 1.49 [1.24, 1.78]), frequent outpatient visits (from 1.40 [1.26, 1.54] to 1.33 [1.22, 1.46]) and polypharmacy (from 1.63 [1.46, 1.83] to 1.53 [1.37, 1.71]). Having any geriatric syndromes is associated with higher levels of health-care utilization among older community dwellers, and the impact of geriatric syndromes is stable over a four-year period.

scholarly journals THE IMPACT OF HEALTH SUBSIDY ON HEALTH CARE UTILIZATION IN INDONESIA

2021 ◽  
Vol 3 (2) ◽  
pp. 16-37
Author(s):  
Renosa Tosca Zamaro
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Insurance Premium ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Care Utilization ◽  
Poor People ◽  
Outpatient Visits ◽  
Care Facilities ◽  
The Impact

Equal opportunity and access to health care services regardless of one’s socio-economic background is important for health equity. To achieve this, the Indonesian government introduced a national health insurance program named Jaminan Kesehatan Nasional in 2014 and provided insurance premium subsidies for poor people. The current study evaluates the health subsidy policy’s impact on the utilization of different kinds of health care facilities, both public and private. Two waves of Indonesian socio-economic surveys, namely 2013 and 2018, and two analysis methods, namely logistic regression, and difference-in-differences, were applied in this study. The results show that in first-level health care facilities, the health subsidy improves the probability of outpatient visits in public health centers and polyclinics but decreases the probability of outpatient visits in medical practices. Then, in secondary-level health care facilities, the health subsidy was found to increase the likelihood of outpatient visits in public hospitals; however, it lowers the probability of outpatient visits in private hospitals.

scholarly journals The Prevalence of Metabolic Disease Multimorbidity and Its Associations With Spending and Health Outcomes in Middle-Aged and Elderly Chinese Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Yang Zhao ◽  
Puhong Zhang ◽  
John Tayu Lee ◽  
Brian Oldenburg ◽  
Alexander van Heusden ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Activities Of Daily Living ◽  
Outpatient Care ◽  
Daily Living ◽  
Service Use ◽  
Health Care Service ◽  
National Level ◽  
Chinese Adults ◽  
The Impact

Objective: Metabolic diseases have been a clinical challenge worldwide and a major public health issue. Very few studies from China investigated the impact of metabolic multimorbidity on healthcare and health outcomes at the national level. This study aims to examine the association of metabolic multimorbidity with health service utilization, spending, functional and mental health.Materials and Methods: This is a nationally representative cross-sectional study, utilizing the data from the China Health and Retirement Longitudinal Study in 2015, including 11,377 participants aged 45 years and older. Multivariable regression models were used to assess the association of metabolic multimorbidity with healthcare, out-of-pocket expenditure (OOPE), the activities of daily living (ADL) limitation, the instrumental activities of daily living (IADL) limitation, and depression.Results: Overall, 30.50% of total participants had metabolic multimorbidity in 2015 in China. Compared with single disease, metabolic multimorbidity were associated with the number of outpatient visits [incident rate ratio (IRR) = 1.30, 95% CI = 1.05, 1.62] and days of inpatient care (IRR = 1.52, 95% CI = 1.28, 1.81). Metabolic multimorbidity was positively associated with the OOPE on outpatient care (coefficient = 82.99, 95% CI = 17.70, 148.27) and physical functional difficulties, including ADL limitation (odds ratio = 1.36, 95% CI = 1.18, 1.57).Conclusions: Metabolic multimorbidity is associated with higher levels of health-care service use, greater expenditure for outpatient care, and more difficulties in ADL among Chinese adults. China's health-care systems need to shift from single-disease models to new financing and service delivery models to effectively manage metabolic multimorbidity.

scholarly journals Impact of Informal Care on Health Care Utilization Among Older People in China

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 334-334
Author(s):  
Yixiao Wang
Keyword(s):  
Health Care ◽  
Older People ◽  
Informal Care ◽  
Outpatient Care ◽  
Inpatient Care ◽  
Health Care Expenditures ◽  
Chinese Government ◽  
Term Care ◽  
Variable Approach ◽  
The Impact

Abstract Population aging has become a challenge to long-term care and health care for the society. Using China as a case study, this paper assesses allocative efficiency of resources in informal care and health care, to explore the effectiveness of the policy, i.e., encouraging informal care as a more cost-effective way to reduce public health care spending. Drawing data from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, this study examines the impact of informal care on utilization of health care as well as amount of health care expenditures among older people with functional limitations in China. Using random effects model with instrumental variable approach, our findings suggest that informal care significantly reduces the utilization of health care, primarily by reducing the utilization of outpatient care. However, informal care significantly increases the amount of inpatient care expenditures for inpatient care users. We do not observe significant association between informal care and amount of outpatient care expenditures for outpatient care users. This study highlights a pressing need for the Chinese government to support informal caregivers by taking economic values of informal caregiving into consideration, and to improve efficiency in inpatient care by a more integrated resource allocation mechanism

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