scholarly journals What Do Patients Say About Doctors Online? A Systematic Review of Studies on Patient Online Reviews (Preprint)

2018 ◽  
Author(s):  
Y Alicia Hong ◽  
Chen Liang ◽  
Tiffany A Radcliff ◽  
Lisa T Wigfall ◽  
Richard L Street
Keyword(s):  
Machine Learning ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Online Reviews ◽  
The United States ◽  
Care Quality ◽  
Small Sample ◽  
Care Providers ◽  
Study Characteristics

BACKGROUND The number of patient online reviews (PORs) has grown significantly, and PORs have played an increasingly important role in patients’ choice of health care providers. OBJECTIVE The objective of our study was to systematically review studies on PORs, summarize the major findings and study characteristics, identify literature gaps, and make recommendations for future research. METHODS A major database search was completed in January 2019. Studies were included if they (1) focused on PORs of physicians and hospitals, (2) reported qualitative or quantitative results from analysis of PORs, and (3) peer-reviewed empirical studies. Study characteristics and major findings were synthesized using predesigned tables. RESULTS A total of 63 studies (69 articles) that met the above criteria were included in the review. Most studies (n=48) were conducted in the United States, including Puerto Rico, and the remaining were from Europe, Australia, and China. Earlier studies (published before 2010) used content analysis with small sample sizes; more recent studies retrieved and analyzed larger datasets using machine learning technologies. The number of PORs ranged from fewer than 200 to over 700,000. About 90% of the studies were focused on clinicians, typically specialists such as surgeons; 27% covered health care organizations, typically hospitals; and some studied both. A majority of PORs were positive and patients’ comments on their providers were favorable. Although most studies were descriptive, some compared PORs with traditional surveys of patient experience and found a high degree of correlation and some compared PORs with clinical outcomes but found a low level of correlation. CONCLUSIONS PORs contain valuable information that can generate insights into quality of care and patient-provider relationship, but it has not been systematically used for studies of health care quality. With the advancement of machine learning and data analysis tools, we anticipate more research on PORs based on testable hypotheses and rigorous analytic methods. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42018085057; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=85057 (Archived by WebCite at http://www.webcitation.org/76ddvTZ1C)

scholarly journals Sources of Occupational Stress and their Relationship with Personal and Occupational Factors in Nurses of Rasht Teaching Hospitals in 2016

2020 ◽  
Author(s):  
Khadijeh Mobasher –Amini ◽  
Behrooz Rezaei ◽  
Mohammad Esmaeilpour- Bandboni
Keyword(s):  
Health Care ◽  
Occupational Stress ◽  
Job Stress ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Pearson Correlation ◽  
Care Quality ◽  
Teaching Hospitals ◽  
Care Providers ◽  
Occupational Factors

Introduction: Nurses experience more stress than other health care providers due to the nature of their job. Job stress has significant effects on the performance of nurses and health care organizations; it also endangers the health care quality and patients' safety. The purpose of this study was to identify the sources of occupational stress and their relationship with personal and occupational factors among nurses in teaching hospitals of Rasht, a city in north of Iran in 2016. Methods: This cross-sectional and analytical study was conducted among nurses in the teaching hospitals in Rasht City in 2016. The sample size was estimated based on the Cochran formula. The study population included 250 nurses selected via stratified randomly from the clinical wards in seven hospitals.  Data were collected by demographic questionnaire and Toft - Anderson nurses' stress scale including 34 questions in seven domains of nurses' stressors. Data were analysed with independent t, ANOVA, and Pearson correlation coefficient tests using SPSS   V21.0 software (Significance level <0.05). Results: The mean score of job stress (72.46 ± 12.47) was evaluated at the sever level. Based on the findings, 77.8% of the nurses reported that their stress was at the sever level and 21.7% reported a moderate level of stress. The most frequently mentioned sources of stress were related to "uncertainty in treatment", "suffering and death of patients", and "high workload". However, the least source of stress was related to "lack of support resources". Job stress had no significant correlation with personal and occupational characteristics (p> 0.05). Conclusion: Given the high levels of nurses' job stress, continuous interventions are needed to decrease the nurses' stress at the individual and organizational levels, especially in the highest sources of stress including "uncertainty about treatment" and "workload". In this regard, we recommend the following interventions at primary (related to reducing stressors), secondary (aimed at reducing nurses' response to stressors), and tertiary (focusing on specific assistance to nurses with high levels of stress) levels.

Pharmaceutical Manufacturers and Self-Regulation of Drug Advertising and Promotion

1992 ◽  
Vol 22 (2) ◽  
pp. 235-243 ◽  
Author(s):  
Gerald J. Mossinghoff
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Government Regulation ◽  
Care Quality ◽  
Care Providers ◽  
Care Costs ◽  
Advertising And Promotion

Contrary to critics' contentions that pharmaceutical promotion and advertising hurts medical care and raises health care costs, the opposite is true. Advertising and promotion improves health care quality by keeping health care providers up to date about the best medicines for preventing, treating and curing diseases. This knowledge reduces the need for more expensive medical care and helps restore good health, which lowers overall health care costs. The article cites a number of instances in which advertising and promotional efforts by pharmaceutical companies have increased awareness of health problems amenable to pharmaceutical intervention, with positive results. Pharmaceutical company support of medical journals and continuing medical education has been an important resource for the dissemination of new medical knowledge. Government regulation of pharmaceutical advertising and promotion is strict. The research-based pharmaceutical industry has adopted guidelines that prohibit many of the activities critics have referred to as abuses. Further government regulation would be unnecessary and unwise.

Introduction: Special Issue on Health Care and Business Ethics

2002 ◽  
Vol 12 (4) ◽  
pp. 409-412 ◽  
Author(s):  
Andrew C. Wicks
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Care Provider ◽  
Quality Care ◽  
The United States ◽  
Care Quality ◽  
Care Providers ◽  
Special Issue ◽  
Care System

Health care has been a hot topic within the United States for over a decade. Despite the many changes that have taken place, health care—and more specifically, versions of what have been termed “managed care”—continues to be a subject of intense debate and ongoing change. Whether the discussion is about access to care, quality of services, costs of care, or strains in the health care provider-patient relationship, a wide variety of stakeholders (e.g., patients, health care providers, health care organizations) have expressed frustration with the health care system. One of the central rallying cries behind the debate about health care is concern about the influence of “business” on health care. This special issue emerges out of the recognition that health care remains in flux, that health care continues to be a controversial subject among a wide array of stakeholders, and that the influence of business on health care is a key underlying source of tension.Part of this debate has to do with what constitutes a just health care system. On the one hand, people in our society want to have access to high-quality care. More specifically, they want to be able to utilize the latest technology, care that is available when they need it (especially in crisis), a highly skilled care provider they can trust and develop a relationship with, and to not have to wait to gain access. On the other hand, people want a health care system they can afford. They want a health care system that is efficient, that offers reasonably priced services, and that doesn’t unduly strain the financial resources of families or the state.

scholarly journals Patient Attitudes about Patient Portal Functions

2017 ◽  
Author(s):  
Tamara Sequeira
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Financial Incentives ◽  
Health Care Quality ◽  
Primary Care Patient ◽  
Meaningful Use ◽  
Care Quality ◽  
Patient Portal ◽  
Care Providers

As part the U.S. government’s ongoing efforts to improve health care quality, the Electronic Health Records (EHR) Incentive Program from the Centers for Medicare and Medicaid (CMS) offers financial incentives to eligible health care providers (EP) who adopt, implement, improve, and demonstrate meaningful use of EHR. Beginning 2014, the Stage 2 Meaningful Use core objectives included the ability of patients to use online patient portals to view, download and transmit their health information. As a result, many EP offer a patient portal and encourage sign up, yet not all patients have done so. How patients perceive the patient portal, whether positively or negatively, may affect their adoption and use of the portal. A survey collected attitudes and beliefs about the patient portal from adult, female, primary care patients (n=257). The beliefs of patients who signed up, along with those who had not, were considered within the framework of the theory of planned behavior (TPB) to identify methods to increase patient use of the portal. The TPB correctly predicted portal sign up behavior in attitude (p<0.05) and intention (p<0.05) subscales. Overall, patients viewed portal characteristics as useful, but patients who had signed up identified them as significantly (p<0.01) more useful, and also, were found to have significantly (p<0.05) more education than those who did not sign up. Few methods to increase patient sign up were identified apart from targeted education to promote the portal’s usability and utility. More research is needed to identify potential methods health care providers can use to increase portal use in primary care patient populations. Implications for advanced public health nurse practice, training, policy, and research were identified and recommendations given.

Patient registries from the view of health policy

2014 ◽  
Vol 155 (19) ◽  
pp. 729-731 ◽  
Author(s):  
Ildikó Kissné Horváth
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Policy ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Health Data ◽  
Care Quality ◽  
Care Providers ◽  
Critical Importance ◽  
Disease Registries

Integrated health data management and disease registries which are able to support evidence-based decision making are of critical importance for health policy. Data provided by disease registries are used for the development of health strategy, planning of preventive activities, capacity-building in health care provision, improving health care quality, and planning clinical trials. Disease registries monitoring epidemiology, natural history of diseases, treatment outcomes and the detection of adverse reactions are requested not only by policy-makers, but public health authorities and health care providers, too. Registries for rare diseases are of critical importance for developing network between reference centres and developing and evaluating new drugs. Data and information need for decision-making in public services and the protection of health data of individuals require a careful balance that needs to be taken into account when considering disease registries. Orv. Hetil., 2014, 155(19), 729–731.

Stakeholder Experiences With Gender Identity Data Capture in Electronic Health Records: Implementation Effectiveness and a Visibility Paradox

2020 ◽  
pp. 109019812096310
Author(s):  
Hale M. Thompson
Keyword(s):  
Health Care ◽  
Gender Identity ◽  
Health Care Quality ◽  
The United States ◽  
Care Quality ◽  
Data Capture ◽  
Care Providers ◽  
Quality Improvements ◽  
Extended Case Method ◽  
Electronic Health

Background Advocates have endorsed transgender visibility via gender identity (GI) data capture with the advent of the Affordable Care Act and electronic health record (EHR) requirements. Visibility in data in order to enumerate a population contrasts with ways in which other LGBT and public health scholars have deployed these concepts. Aims The article aims to assess the effectiveness of GI data capture in EHRs and implications for trans health care quality improvements and research. Method Semistructured interviews were conducted with 27 stakeholders from prominent gender-affirming care providers across the United States. A range of informants shared their experiences with GI data capture. Interviews were coded, themes were identified, and the extended case method was used to contextualize data in relation to key concepts. Results Data capture is effective for increasing patient counts and making quality improvements but limited in terms of enhancing gender-affirming care depending on provider size, type, and competencies. Many challenges were highlighted regarding use of GI data for research, sharing GI data across systems, as well the ways data capture erases the dynamism of GI. These issues create conditions for limited kinds of disclosure, capture of particular categories, and care and treatment barriers. Discussion Stakeholders exposed a visibility paradox emerging from GI data capture. While data fields are created to increase the visibility of trans persons in medical settings and in health research, they work to increase the visibility of some while reducing the visibility of other gender diverse persons, including trans, nonbinary, and cisgender. Conclusion New approaches are needed to explore implications of GI data standardization and the logics of health care in the face of gender expansiveness.

scholarly journals A Population-Based Investigation of Health-Care Needs and Preferences in American Adults With Multiple Sclerosis

2018 ◽  
Vol 7 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Chungyi Chiu ◽  
Malachy Bishop ◽  
Bradley McDaniels ◽  
Byung-Jin Kim ◽  
Lebogang Tiro
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Health Care Quality ◽  
Population Based ◽  
Care Quality ◽  
Care Providers ◽  
Care Needs ◽  
Research Committee

Background: Comprehensive and effective multiple sclerosis (MS) health care requires understanding of patients’ needs, preferences, and priorities. Objective: To evaluate priorities of patients with MS for their MS care. Methods: Participants included 3003 Americans with MS recruited through the National MS Society and the North American Research Committee on Multiple Sclerosis patient registry. Participants completed a comprehensive questionnaire on aspects of their health-care experiences. Results: Participants identified the top 3 health-care priorities as (1) the affordability of MS health care, (2) ensuring that non-MS health-care providers have more education about MS and how it can interact with other conditions, and (3) access to an MS center or specialized MS clinic with MS health-care professionals together in one place. Participants receiving care in an MS center rated the quality and their satisfaction with care higher than those receiving care in other settings. Although having the opportunity to evaluate their health-care quality was important to the participants, only 36.4% had been provided the opportunity in the past year. Conclusions: This study identifies health-care priorities and concerns for Americans with MS.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

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