信息不对称条件下患者的医疗消费行为

运用信息不对称理论，依据医学科学与医疗消费的特点，分析了患者医疗消费行为，以及产生的问题，并提出了应对措施。     

医院声誉与患者就医行为

患者的就医选择受医疗费用、就医的远近、医院实力、服务态度以及医院的声誉等众多因素的影响，其中，医院的声誉在信息不对称的医疗领域中，对患者的就医选择行为有重要的影响。     

就医者行为模式——从现象背后找原因

随着市场经济体制的建立,医院已成为真正的市场主体。医院要以顾客为中心,把消费者作为市场营销的出发点和归宿。为此,医院要研究消费者需求,了解就医者购买动机和购买行为,在消费者行为的各个环节上,了解分析影响消费者行为的各个因素,加以积极的影响,有针对性地满足消费者需要,从而更好地为消费者服务。     

论医疗服务市场的局部垄断性

医疗服务交易中的质量、价格和数量信息的不对称性，使得现有的概念不能有效地刻画医疗服务市场的价格决策和竞争行为。本文用局部垄断性的概念来描述医疗服务市场有别于一般商品和服务市场的特殊性，并由此说明我国高价医疗服务的形成原因以及医疗体制改革应该采取的相应措施。     

应用"就医名片" 方便群众就医

近年来医患纠纷呈高发态势，其原因是多方面的，其中医患双方信息不对称，缺乏有效沟通是一个重要方面。近几年，我院将“就医名片”作为一种医患信息沟通的手段，应用到患者就医过程中，方便了群众，受到了好评。     

医改方案之初步设计——以破解医疗市场信息不对称为切入点

医改的主要矛盾在于医患双方信息不对称。笔者试图通过医疗保险费用支付方式的设计,将现有的医疗卫生机构划分为社区与专业两种,并将社区医疗机构作为参保者的健康代理人,以医疗机构监督医疗机构的方式破解信息不对称的矛盾;并以此为切入点,设计了一个相对简单易行、成本可控、效率较高的覆盖全民的医保体系。     

城市公立医院所有权与经营权分离的经济分析

该文根据城市公立医院的特征,从理论上分析其所有权与经营权分离的经济可行性在于分工产生的收益大于代理成本.通过构建经济理论模型揭示两权分离中代理成本的决定因素,主要是经营者选择机制对经营业绩的评估,并对此进行分析,提出建议.     

医疗服务行业管理的特殊性

文章说明，因医疗服务市场的医患双方信息不对称的特殊性，导致在医疗服务行业中，一般意义上的通过引进竞争来降低医疗服务价格水平的办法会失灵。因此，如何有效地抑制过高的医疗服务价格水册成为一个世界性难题。文章同时也指出，只要我们能够有效的解决患者在就医之前的信息获得问题，就完全有可能把原本是竞争性最弱的医疗服务市场转变成为一个高度竞争性的市场，从而把我国的医疗体制改革难题转变为机遇。     

医患关系模式的委托代理分析

针对医患关系中存在的信息不对称和监督激励问题，提出构建患者～医生和患者一医院并存的委托代理关系模式的设想，并对建立这一模式所涉及的医疗卫生政策进行了探讨。     

信息不对称下公立医院过度医疗的治理

过度医疗作为医疗实践中的不良现象,是引发医疗纠纷和“看病贵”的重要原因。从信息不对称的角度,通过分析我国公立医院过度医疗治理现状,找出当前我国公立医院过度医疗治理存在的问题,提出信息不对称下公立医院过度医疗的治理模式。以期从根本上遏制公立医院过度医疗问题的发生。     

The dynamics of consumer behaviour. On habit, discontent, and other fish to fry

Recent research has drawn attention to the role of past behaviour and habit in the overall structure of consumer behaviour. We argue that in cross-sectional data past behaviour and habit must be confounded with present beliefs and attitudes when the behaviour in question has been enacted numerous times before. To disentangle the effects, longitudinal data were collected from a large panel of Norwegian consumers (effective N=4184) in 1996, 2000, and 2004. Cross-lagged panel analysis indicated that higher consumption of traditional seafood led to increasingly negative evaluations of the product supply. These negative evaluations, in turn, prompted substitution of traditional seafood with newly available, processed seafood products and an increasing dominance of aqua-cultured species. The theoretical discussion focuses on the inability of static models of consumer behaviour (in particular, the theory of planned behaviour) to capture such dynamic effects. Marketing and policy implications related to the changing structure of the seafood market are outlined.     

医患信息交互平台对患者满意度的影响

目的探讨建立医患信息交互平台对提高患者对医疗服务满意度的影响。方法选取60例患者,随机分成等例数的实验组和对照组,实验组通过新型信息交流平台进行医患沟通,对照组按传统方式进行医患沟通,比较两组患者对医疗服务的满意度。结果采用新型医患信息交流平台的实验组患者对医疗服务的满意度(90.00%)明显高于按传统方式进行医患沟通的对照组(72.50%),差异有统计学意义(χ2=4.02,P﹤0.05)。表明新型医患信息交流平台可明显提高患者对医疗服务的满意度。结论建立新型医患信息交互平台可明显提高患者对医疗服务的满意度,可有效改善医患关系。     

谈知识经济时代医院的医学情报建设

知识经济时代的到来对医院的医学情报信息服务工作提出了严峻的挑战。医院情报信息部门必须正确理解时代特征,充分认识情报信息服务面临的困境,积极研究抑接挑战的对策。把掘机遇,更新概念,加大投入,引进先进技术,提高情报信息服务能力,这是搞好医学情报事业的有力保证。     

论医患关系中的信息不对称及对策

探讨医患关系和信息不对称问题,论述了医患关系中信息不对称问题既有客观存在、也有主观原因.提出必须采取加强沟通、用法律来规范医患关系、将公证概念引入医患关系、完善我国医疗保险体制、提高医护员工的综合素质等对策,改善医患关系.     

Using the theory of planned behavior to determine factors influencing processed foods consumption behavior

BACKGROUND/OBJECTIVES

The purpose of this study is to identify how level of information affected intention, using the Theory of Planned Behavior.

SUBJECTS/METHODS

The study was conducted survey in diverse community centers and shopping malls in Seoul, which yielded N = 209 datasets. To compare processed foods consumption behavior, we divided samples into two groups based on level of information about food additives (whether respondents felt that information on food additives was sufficient or not). We analyzed differences in attitudes toward food additives and toward purchasing processed foods, subjective norms, perceived behavioral control, and behavioral intentions to processed foods between sufficient information group and lack information group.

RESULTS

The results confirmed that more than 78% of respondents thought information on food additives was insufficient. However, the group who felt information was sufficient had more positive attitudes about consuming processed foods and behavioral intentions than the group who thought information was inadequate. This study found people who consider that they have sufficient information on food additives tend to have more positive attitudes toward processed foods and intention to consume processed foods.

CONCLUSIONS

This study suggests increasing needs for nutrition education on the appropriate use of processed foods. Designing useful nutrition education requires a good understanding of factors which influence on processed foods consumption.     

Accessibility and accommodations for patients with mobility disabilities in a large healthcare system: How are we doing?

BackgroundPeople with disabilities continue to experience health disparities resulting from inaccessibility of healthcare practices and medical diagnostic equipment (MDE).ObjectiveThe purpose of this study was to evaluate the accessibility of and accommodations for patients with mobility disabilities in clinics of a large healthcare system in the South Atlantic division of the U.S., to determine if accessibility was different based on clinic type, and to identify areas for improvement to increase accessibility.MethodsThis was a cross-sectional study of 214 healthcare professionals conducted between March and June of 2018. Chi square tests and ANOVA were used to compare accessibility between primary care, hospital based, and private diagnostic clinics.ResultsA relatively high proportions of respondents reported that their clinic had implemented many accessible features. However, significant differences were found by clinic type with primary care clinics having better access to MDE including height adjustable exam tables, scales with handrails, wheelchair accessible scales, or padded leg supports. However, primary care clinics were less likely to have lifts for transferring patients. The percent of clinics with MDE was higher than that reported in previous studies which may be due to the safe patient handling and mobility program implemented at the healthcare system. Accommodations for patients when a barrier to care is encountered remain an area for improvement.ConclusionWhile accessibility for people with disabilities was greater in this healthcare system, areas for improvement were identified to help healthcare professional care for their patients with disabilities.     

A comparison of traditional and Rasch cut points for assessing clinically important change in health-related quality of life among patients with asthma

Background Patient-perceived change in health-related quality of life (HRQoL) domains has often been classified using a 15-point patient transition rating scale. However, traditional change levels of trivial ( − 1, 0, or 1), minimal (2, 3 or − 2, − 3), moderate (4, 5 or − 4, − 5) and large (6, 7 or − 6, − 7) on this scale have been arbitrarily defined and originally assumed that change related to an improvement was the same as that for a decline. Objective To compare traditional and Rasch partial credit model-derived cut points and the mean changes for each change categorization when assessing clinically important change in asthma-specific HRQoL. Methods Our sample included 396 asthmatic outpatients who completed bimonthly telephone interviews on the Asthma Quality of Life Questionnaire and transition rating items over 1 year of participation. We employed item response theory in a novel approach to identify cut points on domain-specific HRQoL change data and transition ratings. After determining natural cut points for minimal, moderate, and large differences on the transition rating anchor, we calculated mean changes under change categorizations for both improvements and declines for the two transition rating classification approaches. Results Although traditional and Rasch categorizations for small, moderate, and large changes slightly differed and displayed a lack of symmetry between improvements and declines, nearly all mean changes between classification approaches were comparable. Conclusions In this study, traditional transition rating cut points remain suitable to assess HRQoL clinical significance in outpatients with asthma. An earlier version of this paper was presented at the International Society for Quality of Life Research Symposium, June 29, 2004, in Boston, MA and at the International Society for Quality of Life Annual Meeting, October 20, 2005, in San Francisco, CA.