scholarly journals Socio-Cultural Sustainability of Private Healthcare Providers in an Indian Slum Setting: A Bottom-of-the-Pyramid Perspective

2018 ◽  
Vol 10 (12) ◽  
pp. 4702 ◽  
Author(s):  
Federica Angeli ◽  
Shila Teresa Ishwardat ◽  
Anand Kumar Jaiswal ◽  
Antonio Capaldo
Keyword(s):  
Decision Making ◽  
Business Models ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Decision Making Process ◽  
Bottom Of The Pyramid ◽  
Social Entrepreneurs ◽  
Private Healthcare ◽  
Significant Difference

Delivery of affordable healthcare services to communities is a necessary precondition to poverty alleviation. Co-creation approaches to the development of business models in the healthcare industry proved particularly suitable for improving the health-seeking behavior of BOP patients. However, scant research was conducted to understand BOP consumers’ decision-making process leading to specific healthcare choices in slum settings, and the relative balance of socio-cultural and socio-economic factors underpinning patients’ preferences. This article adopts a mixed-method approach to investigate the determinants of BOP patients’ choice between private and public hospitals. Quantitative analysis of a database, composed of 436 patients from five hospitals in Ahmedabad, India, indicates that BOP patients visit a public hospital significantly more than top-of-the-pyramid (TOP) patients. However, no significant difference emerges between BOP and TOP patients for inpatient or outpatient treatments. Qualitative findings based on 21 interviews with BOP consumers from selected slum areas led to the development of a grounded theory model, which highlights the role of aspirational demand of BOP patients toward private healthcare providers. Overall, healthcare provider choice emerges as the outcome of a collective socio-cultural decision-making process, which often assigns preference for private healthcare services because of the higher perceived quality of private providers, while downplaying affordability concerns. Implications for healthcare providers, social entrepreneurs, and policy-makers are discussed.

scholarly journals PERAN GENDER DAN PENALARAN MORAL DALAM PENGAMBILAN KEPUTUSAN ETIS DI BIDANG MANAJEMEN DAN IMPLIKASINYA: STUDI KASUS PADA ORGANISASI NIRLABA

2005 ◽  
Vol 4 (2) ◽  
Author(s):  
Djuwari . ◽  
Tatik Suryani
Keyword(s):  
Decision Making ◽  
Moral Reasoning ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Decision Making Process ◽  
Moral Integrity ◽  
Moral Value ◽  
Non Profit ◽  
Significant Difference ◽  
Unethical Decision Making

How to make ethical decision making is very important in many aspect managerial process, because its implication can impact many other activities. Research found that many unethical behavior in business process is caused by unethical decision making. The recent research indicates that gender has important role in decision making process. The research is aimed to examine the effects of gender in decision making process in management. Beside it, the research also wants to examine the influence of moral reasoning to ethical decision making. Research involved 105 respondent from many non profit organizations located in East Java. By using t-test, the result reveals that there is significant difference between women and man in decision making. Women more ethical in decision making than men, in some aspect. Women more commit to autonomy, equality, win-win principle and moral integrity. By using simple regression analysis, the result indicates that moral reasoning influences significantly to ethical decision making. This research support the previously research that is conducted by Glover (2002) which the culture setting similarly with this research. The result can't be separated by the Indonesia cultural that expect women more ethical, obedience and respect to moral value.

O-185 Evaluation of the decision-making process of girls with Turner syndrome and their parents considering ovarian tissue cryopreservation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S. Van der Coelen ◽  
M Schleedoorn ◽  
S Nadesapillai ◽  
R Peek ◽  
D Braat ◽  
...  
Keyword(s):  
Decision Making ◽  
Focus Group ◽  
Focus Groups ◽  
Turner Syndrome ◽  
Ovarian Tissue ◽  
Healthcare Providers ◽  
Ovarian Tissue Cryopreservation ◽  
Decision Making Process ◽  
Literature Research ◽  
Tissue Cryopreservation

Abstract Study question What are the experiences with the decision-making process of girls with Turner syndrome (TS) considering ovarian tissue cryopreservation (OTC), their parents and healthcare providers? Summary answer Offering a new option to preserve fertility in TS caused unrealistic hope leading to challenges for healthcare providers to fulfil the ideal of informed consent. What is known already Due to premature ovarian insufficiency, girls with TS have only a small chance of genetic offspring. OTC might increase these odds. Healthcare providers and scientist are still cautious in offering OTC to girls with TS because of the many uncertainties regarding OTC in this patient group. Hence, OTC is now offered to girls with TS between 2 and 18 years old in a research setting: the TurnerFertility study. Study design, size, duration A retrospective qualitative study consisting of a survey and focus groups. Within a year after counselling, families (n = 132) received a survey with 30 questions regarding their experiences with the decision-making process and also an invitation for a focus group. The focus groups were conducted between January and October 2019 and lasted 51-84 minutes. The topic lists were based on literature research and survey results. Results were analysed following a thematic analysis approach. Participants/materials, setting, methods This is a sub-study of the prospective intervention study within an academical medical centre. Focus groups were composed through purposive sampling. Focus group 1 (FG1) consisted of five gynaecologists involved in counselling, FG2 with seven paediatricians who referred girls for counselling, FG3 with nine parents of girls with TS between 2 and 12 years old and FG4 with three parents of girls with TS between 13 and 17 years old. Main results and the role of chance 90% of survey respondents appreciated counselling regarding fertility options and considered it an enrichment of existing healthcare. The individual consultation was rated as most contributing by 66% of the survey respondents, followed by the information meeting (37%) and decision aid (3%). The focus groups revealed that many had not discussed options for future parenthood with a healthcare provider before. Girls with TS and their parents indicated that the option of OTC raised hope for future genetic offspring, and at once made them feel like they had no choice but to take this chance. The small chance of success did not influence the decision for families who opted for OTC. Some parents who had to decide for their young daughter accepted OTC to give their daughter the option to decide herself whether to make use of the cryopreserved tissue later in life. Gynaecologists found it challenging to truly make families grasp a realistic perspective of OTC in TS and the associated mental and physical risks. Gynaecologists and paediatricians struggled with conflicting moral principles of non-maleficence against respect for autonomy: healthcare providers recognized the scientific relevance for the TS population, while it felt inconsistent with the disproportionate burden for some individual patients. Limitations, reasons for caution Because there was no validated survey for this topic in TS, we developed a survey based on literature research and experiences of a dedicated TS team. Among the survey responders and focus group participants a greater proportion decided for OTC compared to the overall counselled group (75% vs 60%). Wider implications of the findings This study gives insight in the issues to consider when implementing new technologies regarding fertility, in which parents have to decide for their child, where it is expected that anticipated decision regret plays a major role, or where healthcare providers experience conflicting duties as scientist and physician. Trial registration number not applicable

Evidence on rationality and behavioural biases in investment decision making

2016 ◽  
Vol 8 (4) ◽  
pp. 270-287 ◽  
Author(s):  
Satish Kumar ◽  
Nisha Goyal
Keyword(s):  
Decision Making ◽  
Path Model ◽  
Decision Making Process ◽  
Individual Investors ◽  
Significant Implication ◽  
Rational Decision ◽  
Content Type ◽  
Rational Decision Making ◽  
Significant Difference ◽  
The Relationship

Purpose The purpose of this paper is to investigate the relationship between rational decision-making and behavioural biases among individual investors in India, as well as to examine the influence of demographic variables on rational decision-making process and how those differences manifest themselves in the form of behavioural biases. Design/methodology/approach Using a structured questionnaire, a total of 386 valid responses have been collected from May to October 2015. Statistical techniques like t-test, analysis of variance (ANOVA) and Fisher’s least significant difference (LSD) test have been used in this study. Structural equation modelling (SEM) has been used to analyse the relationship between rational decision-making and behavioural biases. Findings The findings show that the structural path model closely fits the sample data, indicating investors follow a rational decision-making process while investing. However, behavioural biases also arise in different stages of the decision-making process. It further explores that gender and income have a significant difference with respect to rational decision-making process. Male investors are more prone to overconfidence and herding bias in India. Research limitations/implications The findings of the study have significant implication for the individual investors. It is recommended that if individuals are aware about the biases, they may become alert before taking irrational investment decisions. Originality/value To best of the authors’ knowledge, the present study is a first of its kind to investigate the relationship between rational decision-making and behavioural biases among individual investors in India.

South African health plan will prompt more controversy

2019 ◽  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Health Coverage ◽  
Access To Health Services ◽  
Content Type ◽  
Private Healthcare ◽  
Health Rights

Subject National Health Insurance (NHI). Significance The long-awaited National Health Insurance (NHI) Bill has been released and is poised to begin its passage through parliament. The Bill contains the biggest health reforms in post-apartheid South Africa and is the first piece of enabling legislation for realising the government’s ambitions for achieving universal health coverage, called NHI. The Bill signals a sharply diminished role for medical schemes, which 8.9 million people use to pre-fund access to private healthcare services. Impacts Given the apartheid-era legacy of inequitable access to health services, opposition to NHI will be cast as being anti-black and anti-poor. With little scope to raise revenue with further tax hikes without undermining compliance, NHI funding will be a perennial problem. Anxiety about the rates government will be willing to offer private healthcare providers could trigger an exodus of doctors and nurses. The NHI Bill rolls back current health rights for migrants, raising the prospects of a future legal challenge.

PRIME MINISTER'S NATIONAL HEALTH PROGRAMME (PMNHP): A COST COMPARISON ANALYSIS

2018 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Shaikh Hussain ◽  
Rubina Hussain ◽  
Assad Hafeez ◽  
Adnan Khan
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Healthcare Providers ◽  
Caesarian Section ◽  
Insurance Companies ◽  
Public And Private ◽  
Normal Delivery ◽  
Private Healthcare ◽  
Significant Difference ◽  
Health Programme

Background: Prime Minister's National Health Programme (PMNHP) is a publically funded cashless scheme at point of service, which was initiated in December 2015 to provide access to universal healthcare to people living below poverty line for indoor secondary and tertiary healthcare services for priority diseases in Pakistan. Objective: Our study aimed to compare prices of PMNHP districts packages, compare PMNHP with average payments made to healthcare providers by various health insurance companies, and compare prices among PMNHP itself, public sector not supported by the programme, and private healthcare not supported by the programme in Islamabad Methods: We conducted this comparative descriptive cross sectional study. For first two objectives, we collected secondary data, and for the third objective, we did convenient sampling of the treated patient (n-158) from PMNHP, public and private hospitals for selected diseases. Results: PMNHP district comparisons showed no significant difference among districts except Normal Delivery (NVD) at Rahim Yar Khan had lowest cost (mean=10111.11). For Diabetes Mellitus, Muzaffarabad had lowest (mean=1733.33), and Quetta had highest (mean=5300). Average price paid to healthcare providers by various insurance companies are on higher side as compared to PMMHP. Price differences were significant among PMNHP, Public Out of Pocket Spending (OOPS) and Private For NVD, [F(2, 27)=3364, p=0.000] with PMNHP (mean=15.000, SD=0.000) Public (OOPS) (mean=2.127, SD=0.221) and Private (mean=14.702, SD=0.658) For caesarian section [F(2,27)=2850, p=0.000], and Cholecystectomy, [F(2, 28)=221, p=0.000]. While in comparison with Private, PMNHP were cost beneficial for caesarian section (mean=32.016, SD=1.31) and Cholecystectomy (m=43.133, SD=6.648). Conclusion: PMNHP district wise packages are almost same among and for all the districts. Program is fairly and competitively priced against public and private healthcare providers, and private health insurance healthcare provider payments. PMNHP design features may be used to extend program in other districts.  

scholarly journals The Hextol Foundation: Building a sustainable social enterprise business model

2019 ◽  
Vol 21 (1) ◽  
pp. 72-80 ◽  
Author(s):  
Steven Pattinson
Keyword(s):  
Business Model ◽  
Social Enterprise ◽  
Business Models ◽  
Learning Disabled ◽  
Business Model Innovation ◽  
Decision Making Process ◽  
Social Entrepreneurs ◽  
Strategic Options ◽  
Successful Business

This case focuses on how social entrepreneurs use business model thinking to create successful business models for sustainable social enterprise. It explores how the Hextol Foundation, an independent charitable company whose aim is to improve the quality of life of young people who are learning disabled, or who have mental ill health, uses business model thinking as part of a decision-making process to develop a sustainable social enterprise business model. The case provides a detailed account of the unique challenges presented to entrepreneurs who are driven by social purpose rather than solely by the need to generate a profit. The case is also useful in highlighting how business model thinking is used by entrepreneurs to identify, evaluate and pursue a range of strategic options. It advances our understanding of business model thinking and business model innovation in the context of a social enterprise.

Using threshold values for cost per quality-adjusted life-year gained in healthcare decisions

2011 ◽  
Vol 27 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Irina Cleemput ◽  
Mattias Neyt ◽  
Nancy Thiry ◽  
Chris De Laet ◽  
Mark Leys
Keyword(s):  
Decision Making ◽  
Policy Making ◽  
Threshold Value ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Quality Adjusted Life Year ◽  
Decision Making Process ◽  
Threshold Values ◽  
Social Security Systems ◽  
Policy Makers

Background: In many countries, the incremental cost-effectiveness ratio (ICER) is used to assess whether an intervention is worth its costs. At the same time, policy makers often feel uncomfortable with refusing reimbursement of any intervention purely on the basis of the fact that the ICER exceeds a specific threshold value. Reluctance to define a single threshold value for the ICER seems to have been stronger in social security systems than in national healthcare services systems. This study explores how basic differences between healthcare systems impact upon the potential usefulness of an ICER threshold value.Methods: This study is a narrative review of literature about the theoretical foundations of the ICER threshold value approach and its practical relevance in different types of healthcare systems.Results: A single ICER threshold value cannot be maintained, defined, or measured and should not be used as a policy-making tool. None of the solutions presented up until now to make the ICER threshold approach a valuable policy-making tool overcome the important weaknesses of the approach.Conclusions: ICERs and ICER threshold values are insufficient for assessing interventions' value for money. Rather, they should be considered as one element in the decision-making process. Complete rationalization of the decision-making process by means of quantitative decision criteria is undesirable and not feasible. Increasing transparency in the criteria used for a decision and explicitness about the relative importance of each criterion should, therefore, be the major goal.

scholarly journals Sick and Vulnerable Migrants in French Public Hospitals. The Administrative and Budgetary Dimension of Un/Deservingness

2021 ◽  
pp. 1-10
Author(s):  
Jérémy Geeraert
Keyword(s):  
Decision Making ◽  
Empirical Data ◽  
Healthcare Access ◽  
Access To Healthcare ◽  
Public Hospitals ◽  
Decision Making Process ◽  
Administrative Staff ◽  
Healthcare It ◽  
Health Related ◽  
Healthcare Rationing

This article explores how staff in French public hospitals are indirectly involved in the governing of migration through healthcare. It unpacks the construction of differentiated values of life assigned to specific categories of vulnerable (authorised and unauthorised) migrants according to their perceived un/deservingness in context of budgetary restrictions. This context emphasises tensions between medical and administrative staff in the decision-making process regarding access to healthcare. The analysis rests upon empirical data (participant observations and semi-directed interviews) gathered in ‘healthcare access units’ located in public hospitals. Perceptions of un/deservingness lead to both healthcare rationing and healthcare denial and are built upon entangled criteria related to both migration status and budgetary concerns. These mechanisms reveal the administrative and budgetary dimensions that underlie the perceptions of health-related un/deservingness, which is linked to the costs of healthcare: the higher the costs, the less likely patients are to be designated to be deserving of healthcare.

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