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Results for “Consumer Behavior”

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PubMed2004

Parent/caregiver satisfaction with their child's Medicaid plan and behavioral health providers.

The experiences of children in FFS and MC managed care plans (n = 715) were examined through satisfaction ratings by their parents/caregivers about their behavioral health provider and their Medicaid behavioral health plan. Multivariate regression analyses compared satisfaction ratings among children enrolled in FFS versus MC while controlling for other known predictors of satisfaction including child and parent/caregiver demographic characteristics, behavioral health status, and child history of behavioral health service use. Caregiver satisfaction with their children's behavioral health provider did not differ significantly between those children in managed care plans and those in fee-for-service plans. However, satisfaction ratings for Medicaid FFS plans were significantly more positive than those for Medicaid MC plans.

Adolescent↗

PubMed2002

Managed behavioral health care in the public sector: will it become the third shame of the States?

Managed behavioral health care is increasingly being used in public mental health systems. While supporters cite potential benefits, critics describe dire consequences for individuals with serious, long-term mental illness. The situation has parallels with the major changes resulting from deinstitutionalization some four decades ago. Believing that analyzing history may prevent repeating some of its mistakes, the authors compare the antecedents, benefits, and negative effects of deinstitutionalization with those of the public-sector managed behavioral health care systems being developed today. Lessons learned from the earlier era include the need for careful general and technical planning; for assignment of responsibility, including monitoring, to the public sector; and for a focus on clients and the special needs generated by severe mental illnesses.

Consumer Behavior↗

PubMed2002

The influence of patient characteristics on ratings of managed behavioral health care.

Despite current emphasis on consumer-based performance measures, little is known about factors that influence consumer ratings of behavioral health care. This study examines the influence of patient characteristics, health care use, and insurance coverage on patients' ratings of their managed behavioral health care in both commercial and public plans. Older and healthier patients rated their behavioral health care and health plan more highly than did other patients. Patients with less education and those whose insurance paid all costs of care gave consistently higher plan ratings. Women and frequent users enrolled in commercial plans gave more positive care ratings. After adjusting for enrollee characteristics and coverage, there were no differences between ratings of patients in commercial and public plans. These results are consistent with other research that illustrates the importance of adjusting health care ratings for patient characteristics when comparing plans.

Adolescent↗

PubMed2004

Understanding customer reactions to brokered ultimatums: applying negotiation and justice theory.

There has been little research examining customer reactions to brokered ultimatum game (BUG) contexts (i.e. exchanges in which 1 party offers an ultimatum price for a resource through an intermediary, and the ultimatum offer is accepted or rejected by the other party). In this study, the authors incorporated rational decision-making theory and justice theory to examine how customers' bids, recommendations, and repatronage behavior are affected by characteristics of BUG contexts (changing from an ultimatum to negotiation transaction, response timeliness, and offer acceptance or rejection). Results indicated that customers attempt to be economically efficient with their bidding behavior. However, negotiation structures, long waits for a response, and rejected bids create injustice perceptions (particularly informational and distributive injustice), negatively influencing customers' recommendations to others and their repatronage. The authors then discuss the practical and theoretical implications of their results.

Adult↗

PubMed1982

Does continuous care from a physician make a difference?

Continuity of care with a personal health care provider is both an honored and controversial concept. This paper reviews the literature regarding the effect of a continuous relationship with a personal health care provider (longitudinal care) on quality of care using specific selection criteria and methodological standards. Sixteen studies were found of which four provided most of the valid information. Among the studies reviewed, the most common serious methodological problem was inconsistent definitions of continuity. Longitudinal care from a provider has been shown in certain settings to improve patient and staff satisfaction, compliance with medication and with appointments, and patient disclosure of behavioral problems. No ill effects have yet been demonstrated. There is some evidence that having an ongoing provider could reduce the costs of care. From available information, any evolution of the medical care delivery system away from reliance on an ongoing relationship between provider and patient may sacrifice important benefits.

Consumer Behavior↗

PubMed1990

Effects of moderating variables on product managers' behavior.

This study examined the moderating effects of role autonomy, need for affiliation, and tolerance of ambiguity on the relationships between role pressures of conflict and ambiguity and personal outcomes of job satisfaction, job-related tension, and perceived performance. Data from 166 product managers indicate that role autonomy and need for affiliation do have moderating effects unlike tolerance of ambiguity. Managerial implications are discussed.

Adult↗

PubMed1987

Sociodemographic and premedical school factors related to postgraduate physicians' humanistic performance.

In an extensive survey of postgraduate physicians in two teaching hospitals (N = 141) for their humanistic attitudes, values and behavior, all ratings of physicians' humanistic performance, including physicians' own scores on self-report measures, supervising faculty, nurses and patient ratings, were modestly but significantly correlated with each other. Sex, ethnic or racial background, year of training, marital status, number of children, Alpha-Omega-Alpha membership or number of articles published were unrelated to physicians' humanistic behavior. Several measures of humanism were positively correlated with having taken more courses in the social sciences and humanities, having had more early person-centered work experience and reporting that before medical school others had confided in them or sought their advice more frequently.

Attitude of Health Personnel↗

PubMedDate not supplied

Design and pilot evaluation of an internet smoking cessation program.

Relatively little is known about how to use the Internet to promote health behavioral change. This article describes a multiple-contact Internet smoking cessation program with an 8-week web-based course, online tools for self-monitoring of behaviors, and computer-tailored e-mail messages timed to enrollees' quit efforts. In a pilot study in 49 smokers, we found that enrollees returned to the website a median of 2 times and completed an average of 2 of 8 educational modules. In follow-up, respondents (n = 26) rated e-mail and web components of the intervention as equally valuable (5.9 vs. 5.5 of 10, p = 0.44). While site had potentially important effects on smoking behaviors (34% of enrollees either quit smoking or had a 50% reduction in cigarette use), we were not able hold the interest of the majority of enrollees over the intervention period. Problems with the design of the site are discussed.

Consumer Behavior↗

PubMedDate not supplied

Managing change: an overview.

As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

Consumer Behavior↗

PubMed2005

The value of experience: differences in knowledge among Medicare beneficiaries.

The Medicare Advantage program gives Medicare beneficiaries the opportunity to choose from an array of insurance options instead of receiving prescribed benefits. In 2006, beneficiaries who want prescription drug benefits will need to enroll in a Medicare managed care plan or a private prescription drug plan. To examine awareness and use of Medicare information programs, and the extent to which these programs are associated with beneficiary knowledge about Medicare and managed care, we conducted a national survey of Medicare beneficiaries six to 12 months after the nationwide mailing of the Medicare & You 2000 handbook. Beneficiary information-gathering behavior and experience with Medicare managed care were more highly associated with knowledge about Medicare managed care than formal education, age, income, or membership in a managed care plan before enrolling in Medicare. Practical life experience appears to outweigh traditional factors in beneficiary knowledge of Medicare and managed care.

Aged↗

PubMed2007

Longitudinal assessment of parental satisfaction with children's psychiatric hospitalization.

OBJECTIVE: To examine trends over time in parents' satisfaction with their children's prior psychiatric hospitalization and whether such trends are related to postdischarge outcomes. STUDY DESIGN/DATA COLLECTION: Parents of 107 child inpatients completed a satisfaction survey at discharge. Satisfaction with the same inpatient stay was re-assessed 3, 6, and 12 months after discharge. Parents also provided ratings of behavioral symptoms at admission, discharge, and at postdischarge follow-ups. PRINCIPAL FINDINGS: Random regression analyses indicated significant decline in satisfaction from discharge to follow-up. The proportion of parents reporting that they were not satisfied doubled between discharge and 3-month follow-up. Parents whose satisfaction appraisals shifted from satisfied at discharge to not satisfied at follow-up also provided mean ratings of their child's disruptive behavioral problems at follow-up that were higher than those of parents who reported satisfaction with inpatient care at both times. CONCLUSIONS: Findings suggest that appraisals of inpatient care are subject to change, and may become more negative when clinical improvement associated with hospitalization dissipates in the months following discharge.

Adolescent↗

PubMed1999

Medicare HMO marketing and information: keeping the focus on what consumers need.

Across the country, Medicare beneficiaries face complicated choices about health insurance and HMOs, but too often they lack the information they need to make good decisions. Instead, they rely on marketing information that is frequently inadequate, sometimes downright misleading. This issue of States of Health looks at efforts to improve the ways that HMOs market their Medicare plans and assesses whether "choice" really benefits beneficiaries.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1991

Pediatric asthma, a qualitative and quantitative approach to needs assessment.

This article describes an approach to needs assessment in a specific location using both focus group interviews and a written questionnaire. In this case study, the target population consists of parents of asthmatic children (0-4 years of age). Six focus group interviews were conducted with the purpose of discussing parents' experiences with health care for asthma, their beliefs and knowledge of general aspects of asthma, medication and preventive actions. As a supplement, parents completed a written questionnaire providing additional quantitative information on parental knowledge and misconceptions. Results indicated that parental knowledge of asthma in general was not adequate, especially with respect to medication, preceding signs and preventive activities. Important misconceptions, which might contribute to noncompliance with self-management behaviors, were revealed during discussions with the parents. Several differences were found between results of the interviews and the questionnaire, for instance regarding parental knowledge about preventive measures, medication and perceived parental satisfaction with health care for asthma. These differences indicate the value of using both a survey and a focus group.

Adult↗

PubMed2004

Do college students drink more than their non-college-attending peers? Evidence from a population-based longitudinal female twin study.

The association of college attendance with alcohol use and alcohol use disorders was examined in a population-based young adult female twin sample identified from a systematic search of birth records. College-attending women consumed a larger overall volume of alcohol than did their non-college-attending peers, but they were not more likely to be diagnosed with an alcohol use disorder. Significant associations between college attendance and alcohol involvement were probed using 3 different complementary research designs: multivariate cross-sectional analyses, longitudinal analyses of the precollege and college years, and cotwin-control analyses of twin pairs discordant for attending college. Although demographic and lifestyle characteristics accounted for most or all of the association between college attendance and alcohol involvement, there was 1 aspect of drinking behavior, occasionally consuming large quantities of alcohol, that remained significantly associated with college attendance even after controlling for these characteristics or for genetic and family background factors. These results are consistent with the conclusion that some aspect of the college experience may be an important environmental risk factor for this pattern of drinking among young adults.

Adult↗

PubMed1987

Relationship between malocclusion and maintenance of teeth.

The relationship between the presence of malocclusion and maintenance of teeth in adulthood was studied in a randomly drawn sample of 499 35-44-yr-old Danes. Maintenance of teeth in the past was expressed through the number of teeth present, attachment level and information of regularity of dental visits. Maintenance at present was expressed as caries present, plaque and gingivitis. The relationship of these parameters to the presence of a malocclusion symptom was analyzed directly and the indirect influence was studied through the influence of a subjectively perceived malocclusion and its impact on satisfaction. It appeared that satisfaction was significantly related to maintenance of teeth and to a positive dental behavior. A perceived malocclusion was shown to have a negative influence on satisfaction and thus indirectly on maintenance. If a public orthodontic service is aiming at lifetime maintenance of teeth, malocclusions leading to dissatisfaction with teeth and a subjectively perceived need should be taken into consideration when ranking children with regard to treatment priority.

Adult↗

PubMed1990

The use of patients as student evaluators.

Current evaluation of medical students in their clinical clerkships is usually performed by their clinical tutors, and emphasizes knowledge, skills and behavior. However, it is not at all certain that the clinical tutors adequately appreciate the behavioral aspects of the student-patient interrelationship. Since these interactions are not directly observed by the tutors, their evaluation is based largely on second hand information. In the present study, patient opinion regarding student behavior was collected and compared to tutors' evaluation of the student. One hundred and eighty one patients and 31 clinical tutors evaluated 41 medical students during a 6 week internal medicine clerkship, using a specially designed patient questionnaire and tutors' rating form. An analysis of the correlation between tutors' individual rating parameters and the global score revealed high correlation for those parameters associated with clinical knowledge and skills, but lower correlations for parameters associated with students' relationship to patients. The study reveals difficulties associated with the evaluation of students by patients. The process is time-consuming, and introduces tension between students and patients. In addition the patients appeared to be poor discriminators in evaluating medical students. Finally, the study points out that tutors do not assign sufficient importance to the student-patient relationship in the global clerkship score.

Clinical Clerkship↗

PubMed1993

Abortion.

Explore the source record for details and available documents.

Abortion, Induced↗

PubMed2003

[Development and evaluation of a psychoeducational parent group training program for families with autistic children].

In the introduction of this study, the concept of "psychoeducational parent training" is analyzed, and an outline of the research literature on "parent training in families with autistic children" is presented. Based on these findings a psychoeducational group parent training, which focused on (1) addressing issues of nature, etiology, treatment and family-related consequences of autism (2) teaching child management and education skills was developed, and the training outcomes were evaluated within a 3-months-follow-up design. A total of 24 parents of 23 autistic children (mean age: 9 yrs.) participated in the center-based training program which was performed in three small groups in different areas of Germany in 3 one-day sessions succeeding in 1-month-intervals. The outcome variables included: (a) group training assessments by parents; they evaluated quality of trainer variables, curriculum, and group atmosphere using a questionnaire format of bipolar rating scale-items (b) parental 3-months-follow-up assessments of the effects of group training on parent-child interactions and family adaptation, using a questionnaire based on rating scales, and a semi-structured questionnaire on training-related child and parent behaviors in the family. The parent training resulted in (a) a high degree of parent satisfaction with the training format and (b) positive effects on daily parent-child interactions from the perspective of parents. These findings provide some evidence for both clinical and social validity of the parent training procedure examined in this study.

Adolescent↗