Positioning health services: a mapping approach

The proliferation of different kinds of health services has created a "clutter" in the industry making it difficult to distinguish between different product/service offerings. This often leads to fuzzy positioning in the market which helps neither the firm providing a health service nor the potential consumers. In this paper we propose the use of map representations to provide health care managers with diagnostic information about the market and to assist them in their service design and positioning tasks. Empirical analysis of a real-life objective data set is employed to illustrate the appropriateness of the proposed mapping approach for the health insurance industry. The paper also emphasizes the difference in the characteristics and implications of non-price scaled vs. price scaled maps in the context of health care marketing.     

健康服务业内涵、属性分析及政策启示

目前国内对健康服务业的内涵、属性等问题研究仍不够深入,认识尚不统一,发展定位也不清晰。本文通过综述健康服务业理论研究和政策实践的进展,提出了健康服务业是以维护和促进健康为目的,主要由提供健康服务的消费性和相关生产性服务业组成,广义上也可以包含产品制造等相关支撑产业和其他服务关联产业。通过深入分析健康服务业所具有的服务业、医疗卫生行业、福利性、产业经济、公共服务业等属性和特点,提出如下政策启示:发展健康服务业要遵循服务业和经济产业发展的一般规律,注重发挥政府在政策规制等方面的主导作用,充分发挥市场机制在优化资源配置、激发行业活力等方面的独特优势,大力推动健康服务提供主体的多元化发展等。     

基于患者群市场细分的医疗市场营销策略

随着医疗市场竞争日益剧烈,医疗服务需求日趋多样化,越来越多的市场营销理念和策略被引入到医疗行业。笔者以患者到医院就诊的状态为标准对医院患者群进行细分,并针对各细分市场,采取不同的营销策略。     

Industry distinctiveness: implications for strategic management in health care organizations.

The health care industry is characterized at its core by the requirement that the organization and financing of services recognize the concept of need for health care. This requirement is reflected in industry characteristics of market failure, professional dominance of physicians, and public concern with equal access to care. While market failure is decreasing as a result of the emergence of insurance companies as the "new consumers" of health services, physician dominance and concerns for access continue to be strong. These characteristics mean that successful health care organizations will be local-market focused, decentralized, and tied to community cultures. With regard to training of health services administrators, education should be strengthened in the area of strategy development, with appropriate recognition given to the distinctiveness of the health care industry.     

Medicaid's role in the many markets for health care

To illuminate Medicaid's growing role as a health care purchaser, we estimated Medicaid spending and market shares for 30 markets defined by provider category of service. For approximately 15 markets, our estimates are more detailed than the data available from standard sources. Two-thirds of Medicaid spending occurs in markets where the program has a modest market share. The other one-third occurs in markets that Medicaid dominates, especially in the areas of long-term care (LTC), mental retardation, and mental health. We explore the implications of the different roles for payment policy, industry organization, data availability, and quality of care.     

Competition and despecialization: an analytical study of occupational health services in San Diego, 1974-1984

Occupational health care services are changing in response to rapid changes in health care organization generally; this trend is not reflected in the occupational medicine literature. San Diego is a large and rapidly developing metropolitan area with a balance of heavy, light, and service industries and is relatively isolated and self-contained in health services, making it useful for monitoring health services trends. We examined local trends in the supply of health services as reflected by facilities, manpower, and other indicators between 1974 to 1984. We also assembled findings of local market surveys and certain other sources into a profile of occupational health care resources in the metropolitan area. Corporate medical departments did not keep up with the growth of industry over the decade; freestanding "industrial medicine clinics," by contrast, began with a single facility and proliferated to 13. In the last three years, freestanding "urgent care centers" entered the health care market in force and now outnumber industrial medicine clinics. Despite an overall massive increase in the number of physicians in the area, occupational physicians with specialty credentials or eligibility remained few and primarily based in institutions, while the number of uncertified physicians and of medical groups accepting occupational medicine referrals increased considerably. Employers reported approval of acute care, traditional screening, and employee assistance services far more often than of preventive services, but if they approved of a service, they usually provided it, except in the case of employee assistance services. We conclude that the role of preventive services and of trained personnel in delivering occupational health care is declining, rather than increasing, in the face of competition and changes in the general health care system. Corporate and in-plant medical services are not keeping up with the growth of industry, and no class of health facility matched the growth of industrial medical clinics except urgent care centers, with which they are beginning to compete. The implications of this study for occupational medicine as a specialty, for the standards of patient care, and for the role of prevention is a matter of grave concern if they reflect national trends. Further studies of occupational health services are urgently needed to assess the significance of these findings.     

中医药医养结合助力健康老龄化产业发展探讨

随着我国人口老龄化速度的加快,传统的养老方式已不能满足老年人日益增长的多层次、多元化健康养老需求,因此,为老龄化人口提供医疗和健康养老双重保障的“医养结合”服务模式及“健康老龄化产业”应运而生。文章在简要梳理中医药医养结合服务模式与健康老龄化产业发展现状的基础上,重点阐述了中医药医养结合在健康老龄化产业中的作用及其优势,并在描绘中医药医养结合发展前景的基础上提出了几点建议。     

The cost-shift payment 'hydraulic': foundation, history, and implications

The cost-shift payment "hydraulic" is an integral component of the fragmented U.S. health care financing system. If private payers' acceptance of the cost-shifting burden were to erode, our system of health care financing could become unstable. This is especially true for the hospital industry. In this paper we provide a series of examples of cost shifting and a historical profile of the cost shift in the hospital industry since 1980, noting that cost-shifting pressures seem to fluctuate over time and across health care markets. Cost shifting need not be dollar per dollar, as hospitals can absorb some degree of cost-shifting pressure through increased efficiency and decreases in service provision.     

澳大利亚卫生服务经验的启示

该文通过对澳大利亚卫生服务系统的分析，提出对中国卫生改革有意义的几点启示。（1）服务提供以目标为导向；（2）明确各级政府职能，实行全行业管理；（3）政府与市场可以共同干预医疗卫生服务市场；（4）兼顾资金配置的公平与效率；（5）建立医疗服务守门人制度；（6）构建医疗机构伙伴关系与网络组织；（7）实施连续性质量改进；（8）进行连续性保健。     

Service-level selection by HMOs in Medicare

In the federal Medicare program, contracting health maintenance organizations (HMOs) are paid on a capitated basis. There has long been concern that an "adverse selection" of risks remain in the traditional fee-for-service (FFS) sector, since beneficiaries with low costs may leave the FFS sector and join the HMOs. The distortion associated with this form of selection is that health plans may design their mix of health care services in order to effectuate favorable selection. This paper scrutinizes patterns of HMO membership and costs by service in the FFS sector for evidence consistent with the hypothesis that HMOs engage in service-level product distortion. We develop a multi-service model of choice between FFS and HMOs and show that if the HMO sector is underproviding (overproviding) a service relative to the FFS sector, we should observe a positive (negative) correlation between the HMO market share and average costs of those remaining in the FFS sector. We estimate the correlation between the HMO market share and the average FFS costs for different health care services using Medicare data for 1996. We find evidence indicating that there exists significant service-level selection by HMOs.     

公私伙伴关系促进医疗服务供给侧改革的国际经验及其启示

基于公私伙伴关系(PPP)的相关理论与概念,本文从管理理念的变革,财政预算的压力,技术创新与服务模式的转变及健康服务业的发展等方面系统阐述了PPP模式在医疗服务领域的发展动力,并结合国际社会在医疗服务领域引入PPP模式的实践,总结了部分国家在改革实践中所取得的效果与存在的风险;研究发现,在医疗服务领域引入PPP模式对促进政府职能转变,缓解政府的筹资压力,特别是推进医疗服务供给侧的结构性改革,提升医疗服务系统对消费者需求的反应性,实现其"物有所值"的最大化等具有一定的促进作用与现实意义;但是,在实践中要处理好政府角色的定位,趋利行为与公益性,垄断与监管等方面的关系。相关的启示是,在深化医改的实践中要树立开放、包容、共享的创新发展理念,并进一步完善相关的政策法规,提升监督管理能力。     

山东省青岛市健康服务业发展的SWOT分析

目的：了解青岛市健康服务业的发展环境,为推进青岛健康服务业发展提供理论依据。方法：采用定量与定性相结合的方法收集资料,运用SWOT分析法探析青岛发展健康服务业的优势和劣势,分析其面临的机遇和挑战。结果：青岛市发展健康服务业优势和劣势、机遇和挑战并存,但机遇大于挑战。区位、环境、经济及产业优势明显,但也面临着人力、优质医疗资源及多样化健康服务动力不足等问题;经济、政策及老龄化带来良好机遇,但健康认识、市场定位、政策法律及产业链等方面也存在诸多挑战。建议：青岛市健康服务业的发展需要抓住机遇,利用自身优势,规避劣势与威胁。因此,应加大宣传力度,提高社会认识,明确市场定位。合理规划布局,完善政策,加强人员培训等。     

面向“互联网+医疗健康”的医药电商服务业务流程分析

为缓解医药健康市场专业性不强、质量难以控制和未与医药系统对接等问题,本文构建了面向“互联网+医疗健康”的医药电子商务服务运营模式,探索一种将医疗服务、医保服务、医药服务、物流服务融合的新型医药电商服务模式,并借助统一建模语言UML对业务流程良好的表现力进行“互联网+医疗健康”医药电商服务流程建模与分析,以期助推“互联网+”医药行业的深度融合,促进我国医药电商领域的进一步发展。     

From home,to market,to headquarters,to home. Relocating health services planning and purchasing in New Zealand

Health sector restructuring has been in vogue, but no country has engaged in as much health sector restructuring as New Zealand where, in a decade, there have been four different public health sector structures. This article discusses New Zealand's four structures with an emphasis on relocating the critical functions of health care planning and purchasing, and on the development of the present district health board system. The four structures include: an area health board system (1989-1991) with planning and purchasing located at "home" in local areas and closely aligned with service provision; a competitive internal market system (1993-1996) which separated planning and purchasing from service provision; a centralised system with a "headquarters" controlling planning and purchasing (1997-1999) while maintaining the distance from provision; and the district health board system currently under development (1999-) which sees purchasing and planning sent home again to regions and linked closely with service provision. The present system entails the devolution of considerable responsibility to the local level, within a framework of strong central government control. Based on New Zealand's experience, the article notes that all but the market structure appear to have provided an adequate environment for effective health care planning and purchasing.     

连续—碎片—整合——我国农村三级医疗卫生网络服务提供模式的历史演变及启示

几十年来,经济社会的巨大变革所引起的政府卫生决策意识改变导致我国农村卫生服务网络提供连续性卫生服务呈现明显的波动性：计划经济时代,＂分级分工,就近就医＂的服务模式曾是我国连续性服务的理念萌芽和初始实践;改革开放以来则形成了＂自由择医,碎片化提供＂的非连续服务模式;2009年公共卫生服务均等化实施后则呈现＂基层就医,连续综合＂的整合服务模式的发展趋势。上述三个阶段服务提供模式的波动特征背后隐含着不同时期政府意识形态对卫生服务治理的深刻影响,充分证明了基本医疗保健服务具有明显的政治脆弱性。这种历史演化特征的政策动因为我国以及转型国家维持卫生服务网络延续连续性服务模式提供了诸多政策经验和启示：重视基本保健策略,建立完整的基层卫生体系框架和系统的、整合的运行机制以及重视以人为中心的服务提供理念等。     

Health demography comes of age

The U.S. health care industry has been hampered in the development of a mature marketing function in part due to characteristics unique to the industry. These characteristics include a lack of market data, poorly developed market research techniques, and a poor understanding of consumer behavior within the industry. Some of the deficiencies are being addressed through the development of an emerging field that is being referred to as "health demography." Health demography and those who have begun to refer to themselves as health demographers are drawing from the fields of demography, epidemiology, biostatistics, and the social sciences to formulate a new discipline uniquely related to the needs of today's health care marketers and planners. Those involved with health demography are developing databases and models for application to concrete problems in health care delivery. The development of this field is contributing to the advancement of the state of marketing in health care and serving to reduce many of the barriers that have retarded the development of a mature marketing function within the health care industry.     

The health of the health care industry: a report card from American consumers

This article reports on the public perceptions of the quality of health care services offered by three categories of provider professionals (physicians, dentists, and pharmacists) and three categories of hospitals (public, private, and those with religious affiliations). The authors examine quality along two dimensions: the quality of "cure" vs. the quality of "caring." Results show that, although the health care industry does a fairly decent job in delivering quality service, there is uneven performance across different providers. Data also show the quality of caring to be lagging the quality of cure; importantly, however, the former is more influential in earning patient loyalty. The role of the two types of quality in patient retention are presented, along with implications for health care industry managers.     

我国健康检查市场目前架构及发展方向

从健康检查市场的历史沿革,市场运作,检查市场与各社会机构的合作,与健康管理的关系等方面对我国检查市场的架构未来发展趋势进行探讨。未来我国的体检机构将会独立于医院成为新的服务行业,体检市场将会细分为客户→中介机构→保险公司→体检机构→医院的标准的服务模式。健康检查市场将在国家法律法规的范畴内,作为一种新兴的服务行业,提供更加专业化、人性化、个性化、标准化的服务,满足社会各消费阶层的多种需求。     

新时期中古卫生改革比较研究及启示

古巴和中国在社会制度、政治体制以及在卫生改革历程方面有很多共同点,但也存在一些差异。本研究比较了新的历史时期,古巴和中国的卫生改革情况,借鉴古巴卫生改革的基本原则和思路,为中国卫生体制改革提出了政府应重新理解和定位社区卫生服务,确立医疗卫生主导地位,调动医务人员积极性,坚持医学教育规划与卫生资源市场调研以及要将市场和政府监管结合起来等建议。     

我国健康旅游产业发展对策研究

在我国政府大力推进健康服务业发展的政策背景下,我国健康旅游产业正迎来发展的黄金时期。本研究在综合国内外文献的基础上,理清健康旅游的定义和分类,指出了当前我国健康旅游产业重点关注老年人、女性、高端医疗以及国际市场。在此基础上分析了我国健康旅游产业发展存在的问题,主要包括缺乏权威的行业统计标准、资源整合不足、缺乏明确定位、复合型人才缺乏、相关法律法规有待完善。为推动我国健康旅游产业的发展,建议应当制定行业发展规划与统计标准、整合相关资源、明确自身优势、建立信息共享机制、加强自身宣传、人才培养和科学研究。