Treatment and provider choice in worker injury rehabilitation: A systematic literature review

BACKGROUND: In the face of significant costs for injured worker rehabilitation and its impact on society, ongoing examination of how rehabilitation is carried out is warranted. OBJECTIVE: To review recent studies that explored the impact of the worker’s choice in terms of provider and treatment on the outcome for the worker in injury rehabilitation. METHOD: A systematic literature review was conducted using searches through electronic databases, with studies retrieved then subjected to a quality appraisal. RESULTS: Nineteen studies were eligible for inclusion. Studies reviewed found that choice of provider or treatment generated more positive outcomes for workers, and workers preferred a treatment provider familiar with their care. The worker’s ability to exercise choice was affected by conflict with other stakeholders and misalignment of expectations. The relationship between choice and costs was unclear, sometimes conflicting. CONCLUSIONS: The impact of treatment and provider choice on outcomes for workers remains unclear. The worker’s ability to choose may be hampered by systemic constraints, access to preferred providers, misalignment of stakeholder expectations, and the worker’s ability to engage in decision making. Greater worker engagement in their rehabilitation could potentially reduce costs as well as improve psychosocial outcomes.

Understanding Consumer Experiences and Insurance Outcomes Following Plan Disenrollment in the Nongroup Insurance Market

Disenrollment from health plans purchased on Affordable Care Act (ACA) Marketplaces is frequent; little is known whether disenrollment from off-Marketplace plans is as common or about the experiences and consequences of disenrollment. Using longitudinal administrative data on 2017-2018 nongroup plan enrollment linked with survey data, we analyze plan disenrollment in one regional insurance carrier servicing three states. Overall, 71% of enrollees disenrolled from their 2017 plan. Disenrollment was associated with purchasing through an ACA Marketplace, the carrier making significant changes to an enrollee’s plan benefit design, being healthier, being younger, and paying a higher premium for their 2017 plan in 2018. Experiencing financial burden or poor access to preferred providers was not associated with disenrollment. Most disenrollees (93.2%) enrolled in other coverage, often at a lower premium, but lacked confidence that they could afford needed care. These results can inform policy to support enrollees through coverage transitions and foster stability in the nongroup market.

The Determinants of the Choice of Preferred Providers among the Publicly Insured in Chile: an Empirical Analysis

This paper analyses the determinants of the choice of provider among the publicly insured in Chile. The focus is on the Preferred Provider System (PPS) where public insured can opt for a more consumer-oriented environment subject to a higher level of copayments. Using a model of expected utility gain we develop a logit analysis based on a large multipurpose survey, the Encuesta de Caracterización Socioeconómica Nacional, CASEN 1992 (National Survey for Socioeconomic Characterisation). We make use of several socio-economic, demographic and access variables in our econometric estimation. As a whole, our results adjust to the hypotheses formulated. Among others, individuals’ income, the relative value of copayments, waiting time and zone of residence emerge as the most relevant determinants in the decision process. The positive effect of income would indicate some degree of segmentation within the public system, while the impact of the relative value of copayments shows that user charges can act as an important deterrent for some individuals. The unexpected negative effect of waiting time, included in our estimation as a provider’s attribute, would suggest certain level of captivity in the sense that some individuals have no real choices but purely public provision. The result for zone of residence indicates that rural residents are less likely to choose preferred providers than urban residents. This result is explained by the spatial distribution of preferred providers who tend to cluster in urban areas.

User Acceptance and Mobile Payment Security

There have been multiple studies detailing mobile payment and its market potential. There is a gap in the literature when it comes to the study of acceptance factors focusing on security and trust. The researchers asked which qualities of security have an influence on the acceptance of a mobile payment service provider. Therefore this study will focus on distinguishing security in two dimensions: objective and subjective security. Objective security represents the user's perception of existing technical safety mechanisms. Subjective security is intangible, based on the user's feelings and perception towards security (trust). The Technology Acceptance Model (TAM) was the theoretical model used in the study. About three hundred responses were collected using an online questionnaire. The study showed that despite the financial crisis banks are still the preferred providers for mobile payment services, where over 80% of the respondents would like to receive the service from a bank. In contrast, only 20% would like to receive such a service from a mobile phone producer. Additionally objective security does not substantially increase subjective security; hence the user trusts the provider rather than the technology itself.

User Acceptance and Mobile Payment Security

There have been multiple studies detailing mobile payment and its market potential. There is a gap in the literature when it comes to the study of acceptance factors focusing on security and trust. The researchers asked which qualities of security have an influence on the acceptance of a mobile payment service provider. Therefore this study will focus on distinguishing security in two dimensions: objective and subjective security. Objective security represents the user's perception of existing technical safety mechanisms. Subjective security is intangible, based on the user's feelings and perception towards security (trust). The Technology Acceptance Model (TAM) was the theoretical model used in the study. About three hundred responses were collected using an online questionnaire. The study showed that despite the financial crisis banks are still the preferred providers for mobile payment services, where over 80% of the respondents would like to receive the service from a bank. In contrast, only 20% would like to receive such a service from a mobile phone producer. Additionally objective security does not substantially increase subjective security; hence the user trusts the provider rather than the technology itself.