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At least 19 recordsLinked to original sources

Market--what market? A review of Health Authority purchasing in the NHS internal market.

This paper argues that the British NHS Reforms (the 'Reforms') set out in Working for Patients [1] largely failed to create a market, to achieve the changes that market forces might have been expected to achieve or to meet the objectives set for the NHS in Working for Patients. It draws on the available literature and the author's experience of work with the NHS during the 6 years after Working for Patients. It is hampered, as are all such reviews of the UK Reforms, by the lack of a detailed and systematic research appraisal of the internal market. Many small changes, resulting from market mechanisms, may have occurred throughout the NHS without being publicized or well documented. But overall, there is little convincing evidence that the Reforms have achieved their goals or met the objectives of the politicians who initiated them. The argument here is necessarily limited by the space available (but see [2] for a detailed analysis of the NHS Reforms). The initial sections of the paper examine the characteristics of markets and market power and the extent to which the NHS Reforms created a market, with health authorities and fund-holders as its buyers. The paper concentrates in particular on health authorities. Later sections then examine the extent to which the Reforms met the objectives set out in Working for Patients.

Choice Behavior↗

Micro determinants of female migration in a developing country: labor market, demographic marriage market and economic marriage market incentives.

A micro study of inter-regional migration by women in Nicaragua is presented. The authors "explore three sets of migratory incentives: (1) labor market factors such as usually are emphasized; (2) 'demographic marriage market' considerations (i.e., the probability of having a male companion)...; and (3) 'economic marriage market' considerations (i.e., the expected earnings from a companion given regional labor market conditions and assortative mating)....[They] use estimates of expected outcomes in origin, destination and third regions--conditional upon the woman's characteristics and upon regional differences in labor and marriage markets--to explore the consistency of actual migratory flows with these three sets of migratory incentives." Data are from a sample of approximately 4,000 women aged 15-45 who were interviewed in 1977-1978.

Americas↗

The Turning Point Social Marketing National Excellence Collaborative: integrating social marketing into routine public health practice.

Social marketing can be an effective tool for achieving public health goals. Social marketing uses concepts from commercial marketing to plan and implement programs designed to bring about behavior change that will benefit individuals and society. Although social marketing principles have been used to address public health problems, efforts have been dominated by message-based, promotion-only strategies, and effective implementation has been hampered by both lack of understanding of and use of all of the components of a social marketing approach and lack of training. The Turning Point initiative's Social Marketing National Excellence Collaborative (SMNEC) was established to promote social marketing principles and practices to improve public health across the nation. After 4 years, the Collaborative's work has resulted in improved understanding of social marketing among participating members and the development of new tools to strengthen the social marketing skills among public health practitioners. The Collaborative has also made advances in incorporating and institutionalizing the practice of social marketing within public health in participating states.

Cooperative Behavior↗

Nurse education in competitive markets: the case for relationship marketing.

Since the National Health Service reforms of the late 1980s, nurse education has been increasingly subject to market forces. This new competitive environment presents not only threat, but also challenge and opportunity. Providers of nurse education who recognize the need for market orientation and develop responsive marketing strategies will maximize their potential for market retention and growth. Traditional marketing strategies have considerable limitations for public sector services. The new and growing field of relationship marketing offers nurse education an opportunity to retain and develop profitable relationships with both internal and external markets. This paper reviews the marketing arena in nurse education and proposes context-based qualitative research to ascertain definitive constructs of service quality. Such constructs might then be rooted in a theoretical framework of service quality measurement, and be measured within the disconfirmation paradigm of relationship marketing.

Economic Competition↗

A natural experiment in the organization of entry-level labor markets: regional markets for new physicians and surgeons in the United Kingdom.

The histories of seven regional markets for new physicians and surgeons in the United Kingdom are considered. Like the American market, these markets have experienced failures that led to the adoption of centralized market mechanisms. Because different regions employ different centralized mechanisms, these markets provide a test of the hypothesis that the success of the American market is related to the fact that it produces matches which are stable in the sense that no two agents mutually prefer to be matched to one another than to their assigned partners. Even in the more complex U.K. markets, this kind of stability plays an important role. Centralized markets that produced unstable matches in environments in which agents could act upon instabilities fared no better than the decentralized markets they replaced.

Algorithms↗

Effective managed care marketing strategies for evolving markets.

In a world of increased competition and changing consumer expectations, one of the keys to a fiscally sound health plan is having a dynamic marketing strategy that takes into account the shifting attitudes of consumers as managed care markets mature. The primary goal of any health plan marketing strategy should be the acquisition and retention of members. Providing cost-efficient and convenient service for enrollees, offering low or no deductibles, having convenient office locations, and minimizing paper-work are important elements of such a marketing strategy. Factors such as brand awareness and the perceived image of a health plan also are important considerations in acquiring and retaining market share. The relative importance of these consumer satisfaction criteria change as a managed care market evolves and matures. Financial and marketing managers, thus, should ascertain their market's stage of development and respond with appropriate marketing strategies.

Community Participation↗

Differences in perceptions of hospital marketing orientation between administrators and marketing officers.

Hospital administrators have been struggling for more than a decade to determine the role and proper position for marketing and marketers within their organizations. Results of a study now confirm the expected--administrators and their chief marketing officers do not see the same marketing actions being conducted for their hospitals. The consequence of such perceptual differences in marketing orientation for the role of marketers within the hospital are significant and are discussed in this article. Of particular importance is the finding that the marketing behaviors of the organization as identified by line managers correlate strongly with both revenues (r = .6r for inpatient revenue) and occupancy levels (r = .44). Additionally, it was found that as little as a 10 percent improvement in a hospital's marketing orientation is associated with a $25 million increase in total net patient revenues and an 8 percentage point increase in occupancy rate.

Attitude of Health Personnel↗

The impact of health insurance market reforms on market competition.

OBJECTIVES: To assess the impact of state and federal health insurance market reforms on the nature and extent of market competition. STUDY DESIGN: Qualitative, comparative case studies in 7 states. METHODS: Two rounds of in-depth interviews were conducted with over 100 key informants from the insurance industry. In each state, these sources included 2 to 4 regulators, 5 to 6 independent agents, and several sources at each of 4 to 5 of the top insurers. Extensive documentary data relating to market activity were also collected. These multiple sources of information and data were analyzed with both qualitative and quantitative techniques. RESULTS: (1) Small-group health insurance markets are highly competitive, both in price and in product innovation and diversity. (2) In some of the more heavily regulated states, there is very little competition in less-populated areas, especially for indemnity insurance. (3) The rapid growth of managed care in the small-group market may have been precipitated by these reforms. (4) Standardized benefit plans have not achieved their objectives. (5) Competitive forces still focus to a considerable extent on risk selection techniques. CONCLUSION: Small-group market reforms have not harmed market competition and may have improved competition in several respects. However, these reforms do not alter the fundamental orientation of competitive insurance markets, which is to focus on risk selection factors and techniques to the extent feasible.

Economic Competition↗

Food marketing to children in the context of a marketing maelstrom.

Childhood obesity is a major public health problem in the United States, yet US children are targeted as never before with marketing for foods high in sugar, fat, salt, and calories. Food marketing to children is highly sophisticated, increasingly well-funded, and takes place within the context of a barrage of other kinds of child-targeted marketing. The proliferation and sophistication of electronic media, the escalation of marketing in schools, changing families, and a political climate that favors deregulation have allowed marketers unprecedented access to children, including babies and toddlers. The notion--promulgated by the food industry--that parents can "just say no" to requests for highly marketed snacks and junk food is simplistic at best and cynical at worst. Instead of being viewed as a familial problem, the current marketing maelstrom should be viewed as a societal issue and addressed as such. Restriction of advertising to children is common in industrial democracies other than the United States--and is just one of many corrective actions that could be taken by our governments.

Adolescent↗

The status of marketing in the health care industry: perspectives of marketing practitioners.

To assess the scope and status of the marketing function in the health care industry, a mail survey of marketing professionals in health care organizations in the Greater Baltimore region was undertaken. Questions were designed to identify important responsibilities, required skills, evaluation factors, and major problems in the practice of health care marketing. Analytic ability was the skill identified as being most necessary to perform their job while quality of service was factor most used to evaluate their performance. Planning, service and the development of products/services were indicated as being their most important responsibility. Inadequate budget and top management's lack of knowledge of marketing were cited as the most important hindrances to effectiveness in marketing jobs. Failure of marketing in the health care industry appears to be internal to the organizations themselves, that is, in terms of how it is interpreted and applied in practice. Solutions require greater understanding of and commitment to the varied roles of marketing professionals.

Attitude of Health Personnel↗

In the market for ethics. Marketing begins with values.

High-quality care and concern for the poor are among the core values that all Catholic healthcare facilities share. And marketing is a proven tool for extending those values. In times past, healthcare providers, including Catholic facilities, were concerned about whether healthcare marketing was ethical. Much of the concern focused on advertising and promotion. A number of ethical violations do appear in hospital advertising. But government and professional organizations have established guidelines for ethics in advertising. Hospitals should encourage their marketing professionals to personally adhere to these codes. To ensure marketing activities are conducted ethically, a hospital must clearly articulate its commitment to ethical marketing; ensure that marketing professionals adhere to this commitment; and monitor activity. These steps should extend to a hospital's strategic plan, particularly its mission statement. Although strategic planning has many critical elements, the heart of the plan and the process is the mission statement, the expression of an organization's distinctiveness. For a Catholic hospital, this distinctiveness is found in two tiers of value: the core Catholic values, as articulated by its religious sponsors, and the institution's specific values flowing from its history, location, and services. If a religious healthcare provider is really committed to its values, it will actively affirm them in its marketing.

Catholicism↗

The Chinese medicines market: moving towards a market system?

This paper presents a review of the Chinese pharmaceutical policy in order to analyse the forms of effective market competition introduced or not in the system. Registration, pricing and trade are three areas showing the limits on competition. The government limits the duration of the registration procedure to three years, which leaves some opportunities for challengers to market similar products afterwards. The pricing system in place is a maximum price ceiling. The price structure reveals a net difference of treatment between foreign products and domestic products. With respect to trading policy, the government applies a selective licensing policy for exports and imposes variable custom taxes on a product-by-product basis on imports. At a micro level, the Chinese market has instant market conditions with fair trade where manufacturers, importers and distributors can meet. Different cost-sharing experiments between the state, the working units and the patients also introduce more sensitivity to prices from the consumer. Such a duality between the limits imposed on competition by public policy tools and the experiments or market conditions in place at the level of the organisations underlines the ambiguity of the move towards a market economy in the Chinese pharmaceutical market.

China↗

Money, men and markets: economic and sexual empowerment of market women in southwestern Uganda.

Market trading requires access to cash, independent decision-making, mobility and social interaction. This study sought to explore whether market work empowers women with respect to spending decisions and negotiation over sex and condom-use. A semi-structured questionnaire was administered to 212 market women; and 12 focus group discussions and 52 in-depths interviews were conducted among market women in southwestern Uganda. Market women reported high levels of independence, mobility, assertiveness and social interaction. Access to cash was not synonymous with control over it, however. Spending decisions were limited by men's ability to selectively withdraw finances for expenditures central to women's concerns including household and children's needs. Trading in markets earns women masculine labels such as kiwagi, characterized variously as independent, rebellious and insubordinate. Earning money does not change expectations of correct behaviour for wives, making it difficult for women to initiate, deny sex or ask for condoms. Independence and income from market work may make it easier for women to enter and exit new sexual relationships. However, unable to protect themselves within partnerships, HIV risk may increase as a result.

Condoms↗

Hospital market share: the declining share of small players in the market.

Analysis of a set of isolated hospital markets reveals that low-market-share hospitals have experienced a consistent decline in their market share for the last five years. The challenges presented by such a decline in market share are compounded by the overall decline in the total market (in terms of number of hospital discharges) for the markets studied. It is suggested that significant strategy changes may be required if low-market-share hospitals are to survive.

Catchment Area, Health↗

Marketers don't wear plaid: marketing and health care administration in the Canadian context.

Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment.

Canada↗

Marketing social marketing: getting inside those "big dogs' heads" and other challenges.

Social marketing provides a powerful process for planning and implementing public health programs. Although often applied to the promotion of healthier lifestyles, social marketing can also be used to promote utilization of direct services or policy changes. Despite growing popularity among public health professionals, resistance by senior management, community advocates, policy makers, and others can create barriers to the use of the social marketing model. This article draws on the authors' observations, practice experiences, extensive training interactions, and qualitative studies with public health practitioners across the nation. It examines some of the key reasons that public health practitioners encounter resistance to using social marketing and discusses how a logic model can be used to market social marketing in organizations and communities.

Administrative Personnel↗