Marketing physician services in an academic medical center

As a result of recent environmental changes in the health care industry, marketing has become a vital necessity for the survival of most hospitals. Kotler's conceptual framework is used to study and evaluate an innovative program for marketing physician services in a large urban medical center. This program was quite successful in increasing admissions and referrals and won a national award in 1984.     

Adapting the SERVQUAL scale to hospital services: an empirical investigation.

Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified.     

Waits to see an emergency department physician: U.S. trends and predictors, 1997-2004

As emergency department (ED) patient volumes increase throughout the United States, are patients waiting longer to see an ED physician? We evaluated the change in wait time to see an ED physician from 1997 to 2004 for all adult ED patients, patients diagnosed with acute myocardial infarction (AMI), and patients whom triage personnel designated as needing "emergent" attention. Increases in wait times of 4.1 percent per year occurred for all patients but were especially pronounced for patients with AMI, for whom waits increased 11.2 percent per year. Blacks, Hispanics, women, and patients seen in urban EDs waited longer than other patients did.     

Social work services in the emergency department: a cost-benefit analysis of an extended coverage program.

Although issues relating to cost and cost containment have assumed an increasingly important role in the delivery of health care services, relatively few attempts have been made to assess the costs and benefits of social work services in a hospital setting. This article examines a program that provides social work services in a general hospital's emergency department on a 24-hour, seven-day-a-week basis. The cost of these services is assessed through the output value index, a form of cost-benefit analysis in which the estimated value of the program's output is contrasted with the estimated investment of resources to maintain the program. The results suggest that the program was operated at a marginal cost to the hospital and that cost may have been outweighed by tangible and intangible program benefits.     

Visits to the physician: an evaluation of the usual-source effect.

Having a regular or usual source for medical care has frequently been found to be an important correlate of ambulatory visits to the physician. However, it remains unclear whether having a usual source is a determinant of visits, a consequence of visits, or both. This article addresses the question, how do these alternative theoretical relationships affect estimates of the relative impact of having a usual source on illness-related visits? The empirical results of a household interview survey generally support the significance of a usual-source variable as a determinant of illness-related visits, but they indicate that use of a single equation-estimation technique may overestimate the magnitude of this effect.     

Introduction of the Balanced Scorecard into an academic department of medicine: creating a road map to success

In this paper, we describe: 1) the environmental forces driving performance measurement and management in the University of California San Diego Department of Medicine; 2) the systematic process used by the department to implement a Balanced Scorecard; 3) the initial direct and indirect outcomes of this effort; 4) the opportunities and challenges to the Balanced Scorecard as a management directive; and 5) future directions.     

Translating research to practice: using the RE-AIM framework to examine an evidence-based physical activity intervention in primary school settings

Although there has been an increase in the availability of effective, evidence-based physical activity interventions in school settings during the past decade, there is a paucity of published research focusing on the translation of these effective interventions into real-world practice. The purpose of this research was to examine the translatability of an existing school-based physical activity intervention. More specifically, this research sought to identify the barriers and facilitators in adopting, implementing, and maintaining a school-based physical activity intervention using RE-AIM as a theoretical evaluation framework. It was concluded that interventions that consider issues around complexity and compatibility with the school setting are more likely to be adopted, implemented, and maintained. It was recommended that future evaluations of physical activity interventions should not be limited to testing internal validity, but should consider external validity and ecological aspects, relevant to increasing dissemination in real-world settings.     

A postgraduate course in Primary and Community Care: impact on an academic department

An impact evaluation was undertaken to ascertain the effects of starting a Master's programme in Primary and Community Care in the University of Sheffield Department of General Practice in terms of workload, use of resources, opportunity costs and general experiences of staff members. Total staff estimates of additional workload amounted to 2758 h during the first year of the course, of which the greater part fell upon the core staff (the course director and the administrative secretary). Staff reported opportunity costs in terms of time devoted to research. Core staff reported additional responsibility, and concomitantly, increased stress. Staff also reported that the introduction of the course had provided opportunities to develop new skills and new knowledge bases, and considered that the presence of postgraduates within the department had given it a 'lift' and raised academic standards.     

Variations in the use of physician services by Medicare beneficiaries.

Variations in the utilization of physicians' services by Medicare enrollees in Michigan are examined in this article. Two measures of market-area utilization are estimated. One is the standard per capita utilization rate, which has been the common focus of many small area variation studies. The second measures the intensity with which physicians treat their patients and can be taken as an indicator of the so-called practice-style phenomenon. The results show that, although substantial intermarket variation in per capita utilization is found, the variations are not as large as one might expect and are considerably less than the variations in per capita utilization for Michigan's Blue Shield population. More important, the relationship between a market's per capita utilization and intensity of care of primary care physicians is insignificant. The relevance of these findings, especially within the context of the practice style hypothesis and policy proposals that would establish physician practice norms, are discussed.