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Innovative communication processes and patient’s role: some evidence from the Tuscany Healthcare System
No full textWhy non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications
No full textObjective
To investigate structural and psychological factors that lead non-urgent patients to choose the Accidents & Emergency Department (A&ED) rather than primary care services.
Data Sources
Data were collected through interviews by means of a structured questionnaire. Data regarding the A&ED sample were also drawn from the database of the department.
Study Design
Hypotheses were tested in a survey comparing A&ED non-urgent patients and patients using GP surgeries. Different perceptions of the characteristics of A&ED and primary care services were measured and a perceptual map was created using the linear discriminant analysis (LDA).
Data Collection
Emergency services users were interviewed in the A&ED of the General Hospital of the Province of Macerata (Italy). Primary care users were interviewed in 4 GP surgeries. 527 patients were interviewed between December 2006 and February 2007.
Principal Findings
A&ED and primary care patients look for different characteristics as diagnostic and therapeutic potentialities, empathy and competence, quick access or long-lasting relationship. Information asymmetry explains part of the behaviour.
Conclusions
Use of A&ED services for non urgent care can be reduced.
The understanding of reasons underlying the choice and a change in access, timing and contents of care/services provided by GPs might provide incentives for shifting from A&ED to GPs surgeries
Applying discrete choice modelling in a priority setting: an investigation of public preferences for primary care models
No full textAbstract
Objectives The shift toward more innovative and sustainable
primary care models in Italy leads policy makers
and clinicians to face difficult decisions between options
that are all regarded as potentially beneficial. In this study,
patient preferences for different primary care models in the
Tuscany region of Italy were elicited. The relative importance
of different attributes to the surveyed respondents
was then examined, as well as the rate at which individuals
trade between attributes and the relative value of different
service configurations.
Methods A discrete choice experiment survey explored
the following attributes in a stratified random sample of
6,970 adults: primary care provider, diagnostic facilities
and waiting time for the visit.
Results Respondents (3,263) were likely to prefer a
consultation by their own general practitioner (GP) and a
practice with many diagnostic facilities. The predicted
utilities of different service configurations have shown that
a ‘‘primary care centre’’ with many diagnostic facilities
was preferable to a ‘‘solo GP’’ model or a ‘‘group general
practice’’.
Conclusions The study demonstrated how a patient
choice model could be used by decision makers for
developing successful policies that takes into account different
healthcare needs, balancing responsiveness with care continuity, equity and appropriateness. Considering that a
primary care centre would perform better than a ‘‘solo
GP’’, especially for younger respondents and for those with
minor healthcare needs, for a more rapid diffusion of this
model policymakers and managers could direct the care of
primary care centres towards these targeted subgroups, at
least in the first phase
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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