Primary health care services through health centres

In South Madras, India, Voluntary Health Services (VHS) operates under the concepts that prevention is an important as cure, the family is the unit for medical care, and community participation. It uses a voluntary health plan as a means to provide preventive and curative health care for residents who pay a fee based on their income. Subscribing to this plan allows them access to preventive and curative services at the nearest VHS regional health center and hospital care at the VHS Medical Centre at Adyar, Madras, in India. Since the inception of this plan, VHS has expanded to rural areas using the Mini Health Centre (MHC) model. This model was developed at the St. Thomas Mount Community Development Block of Chingleput District of Tamil Nadu State in the mid-1960s and put into operation in the late 1960s. A male and female multipurpose worker in the MCH serves 5000 people. A physician is there at least 3 hours/day for 3 days/week. A lay worker staffs a health post and attends to 1000 people. The MHC provides maternal-child health, family planning, and referral services; health and nutrition education; control of communicable disease activities; curative care; and environmental sanitation. Community participation includes provision of buildings and minimal furniture, financial support (e.g., the community provides 33% of the total budget resources), and a nonpolitical local action committee. The state of Tamil Nadu and the central government provide financial incentives to other voluntary group to set up MHCs (as of June 1993, 261 MHCs existed). Vital statistics indicate that MHCs improve the health status of the population (e.g., infant mortality rate in 1977 = 134 and in 1989 = 36.5). Some weaknesses with MHCs are unmotivated medical officers, high turnover rate of staff due to low pay scales, and financial obstacles.     

Preventable hospitalizations: a tool for planning and marketing ambulatory health care services

As the health care system evolves towards increased levels of managed care, planners and managers will need to understand how the utilization of ambulatory care services influences the use of more expensive hospital care. Preventable hospitalization, an index based on Ambulatory Care Sensitive (ACS) conditions, is proposed as an indicator for identifying communities with significant ambulatory care needs. The design and marketing of ambulatory health care services functionally adapted to meet the challenges of managed care will require new forms of health care information to plan, market, monitor, and evaluate the outcomes of health care policies and programs. An example is presented of the use of preventable hospitalizations as indicators of ambulatory care needs in 48 communities in Massachusetts.     

Globalization of U.S. health care services: assessment and implementation

Globalization has become a commonly used term to describe the manner in which organizations in many industries have spread their operations and management to foreign countries. As the trend toward a global economy progresses, more and more industries, including health care, are looking to capitalize on its possible benefits. This article examines globalization in other industries and applies the tools used elsewhere to U.S. health care organizations.     

Relationship marketing for health care providers.

A relatively new concept termed "relationship marketing" is examined in terms of its usefulness for providers targeting employers as direct purchasers of health care services. The discussion includes (1) a consideration of why employers' rhetoric about health care purchasing practices has so far exceeded the reality of change and (2) ways in which relationship marketing can be adopted by providers to influence the health care purchasing practices of organizational buyers.     

An exploratory study of services marketing in global markets: major areas of inquiry for the health care services industry

It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research.     

Assessing rural community resources for health care: the use of health services catchment area economic marketing studies

A relatively simple method for estimating the ability of rural communities to support health provider personnel services, the utilization of this tool is described and illustrated. Special aspects of the approach include: (1) its application on a systematic basis to an entire state, utilizing identified economic marketing areas and local determination of data; (2) the use of the finished product, or study, as a focus for community discussion and decision making; (3) its use as a recruitment device for physicians as well as communities; and (4) its use for long term state health and educational planning. Within this broad approach, the specific figures and conclusions are less important than the interpretation, application and use of the method.     

Primary health care services for single homeless people: defects and opportunities

BACKGROUND:An innovative residential centre in west London during 1997-1998 helped older rough sleepers leave the streets and resettle in conventional homes. Many clients presented with multiple physical illnesses complicated by chronicity and poor management. The centre initially experienced difficulties in obtaining health care for the residents, briefly relied on an A&E department for treatment of serious and minor ailments, and latterly was served by a GP practice supported by special funding. OBJECTIVE:The aims of this study were to describe the problems of providing at short notice primary health care services to a high-need group, and the prospective opportunities for the delivery of the required care. METHOD:A monitoring study collected routine operational data, life histories from 88 residents using a semi-structured questionnaire and information from 61 residents about their contacts with GPs before residence in the centre. Interviews were also conducted with the centre's staff, a Health Authority officer and a GP who treated the residents. RESULTS:The medical care of the residents was a major concern. Many had physical illnesses yet three-fifths had not seen a GP for more than 5 years. Many were not registered, even among those who recently had become homeless. It was difficult to organize the residents' medical care and to access special funding at short notice. When funding was secured, there were difficulties in contracting the service. CONCLUSION:Current registration and commissioning procedures are ill fitted to provide primary care services to a high-needs group at short notice. Primary Care Groups, special funding and contractual arrangements provide opportunities for GPs and primary health care workers to provide an improved service to marginalized and special needs groups. The responsibility to identify and respond to exceptional needs should be clearly defined and allocated.     

Competitor analysis in health care marketing.

Health care providers increasingly are relying upon marketing as a means of overcoming growing competition. Competition-oriented marketing necessitates a comprehensive analysis of the competitive setting, a task which the health care marketing literature has generally given little attention. Herein the concept, perspective and tools of competitor analysis are borrowed from strategic planning and adapted for use in health care marketing.     

Linking core competencies to customer needs: strategic marketing of health care services

Firms often are encouraged to develop expertise, or core competencies, that lead to innovative products and services. The authors present a market research study that enabled a health care service provider to link its core technological competencies to customer needs. Although potential customers did not explicitly value the technology itself, links could be made between technological competencies and more valued service dimensions such as communication flows, meeting deadlines, and staff responsiveness. Improving strategic marketing and service quality delivery can be realized through market research linking customer needs to a firm's core competencies.     

Cognitive commitments in health services marketing

Armed with valid information about what people expect, health care organizations can make commitments to current and prospective patients, thereby increasing their marketing success and improving patient satisfaction.