Journal of hospital marketing最新文献

The healthcare industry in the United States is faced with many strategic challenges, because of the nation's growing culturally diverse population. Growing cultural diversity now calls for better trained medical staff that is capable of handling language, religious and cultural differences. In the rural communities, where cultural diversity is rapidly becoming a demographic fact, small hospitals with limited resources are especially confronted with medical challenges for which they seem to be least prepared. Based on an exploratory research that includes a study of small town hospitals, this paper provides insights into cross-cultural problems facing healthcare professionals in small communities. The paper highlights also the ways in which hospitals are responding to such challenges.

This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur.

This paper reviews existing literature and defines essential dimensions of a hospital's marketing strategy for each of two business strategies; using the results of a national survey, this study confirms that hospitals make different marketing decisions based on the type of business strategy adopted by the hospital.

Objective: This study investigates the reasons for hospital transfers and the role patients, their families, physicians, and payers play in the choice of a referral center.

Data sources: A thirty-three item questionnaire and clinical data from the hospital's discharge database.

Study design: A study of all 307 hospital transfer patients admitted between November 9 and December 3, 1993 was conducted to understand the factors contributing to the increase in transfers and the reasons patients were sent to CCH. Data on the transfer decision were collected by interviewing patients 48 hours after admittance to the hospital or by telephone if they were discharged before an interview could be completed. Two hundred and sixty-two (85%) patients were interviewed.

Principle findings: (1) Almost 58% of transfers were patient-initiated or -influenced; the remainder were physician- (38%) or payer-directed (4%); (2) More than 78% of the patients identified lack of clinical expertise/technology at originating hospital as the main reason for transferring. Other reasons included: established CCH patient status (43%), CCH marketing (31%), and concerns regarding quality of care at originating hospital (10%). Financial and quality dumping were not identified as reasons for the transfer. New patients to CCH were more likely to indicate that marketing and lack of clinical resources at originating hospital were reasons for selecting CCH than previous patients.

Conclusions: Patients significantly influenced the transfer decision and the transfer decision-making process can be influenced by marketing. The opinions of the consumer should not be underestimated, especially by those seeking non-marketing solutions to health care reform.

Given the increasing opportunities to practice outside the hospital setting, the role of hospital marketing in recruitment of pharmacists has increased in importance. It is the assumption of this paper that the decision behavior of prospective female recruits is different than that of male pharmacists and such perceptions influence decision behavior. It is the proposition of this paper that structural variables peculiar to hospitals must be considered when marketing strategy is set. Key literature is reviewed and conclusions reported.

The author examines the position of physicians in the health care channel on the basis of Transaction Cost Analysis. Propositions are offered that explain recent vertical integration. Moreover, a conceptual model of the future health care channel is offered for capitated pricing.

The Expanded Programme on Immunization (EPI) (changed to National Programme on Immunization (NPI) in 1996) and Oral Rehydration Therapy (ORT) were launched in Nigeria in 1979. The goal of EPI was Universal Childhood Immunization (UCI) 1990, that is, to vaccinate 80% of all children age 0-2 years by 1990, and 80% of all pregnant women were also expected to be vaccinated with Tetanus Toxoid Vaccine. The Oral Rehydration Therapy was designed to teach parents with children age 0-5 years how to prepare and use a salt-sugar solution to rehydrate children dehydrated by diarrhoea. Nigeria set up Partners-in-Health to mobilize and motivate mothers to accept the programme. In 1990 a National coverage survey was conducted to assess the level of attainment. The results show that some states were able to reach the target and some were not. It therefore became necessary to evaluate the contribution of those promotional elements adopted by Partners-in-Health to motivate mothers to accept the programme. The respondents were therefore asked to state the degree to which these elements motivated them to accept the programme. The data were collected and processed through a Likert rating scale and t-test procedure for test of significance between two sample means. The study revealed that some elements motivated mothers very strongly, others strongly, and most moderately or low, with health workers as major sources of motivation. The study also revealed that health workers alone can not sufficiently motivate mothers without the help of religious leaders, traditional leaders and mass media, etc. It was therefore recommended that health workers should be intensively used along with other promotional elements to promote the NPI/ORT programme in Nigeria.

A study evaluating whether a lay public education program caused initiation of health-related behaviors was conducted at the Cleveland Clinic Foundation. Attendees of three individual "Health Talks" were surveyed: endometriosis (n = 78), men's health (n = 62) and cancer (n = 57). Participants were surveyed at three points: (a) before the talk, (b) immediately following the talk and (c) six weeks after the talk concerning their knowledge and health behaviors. The results indicated that community health education produces a substantial improvement in health-related knowledge and after attending the seminars, 81.3% of respondents initiated a positive health behavior. Of interest to health care marketers are the 30.8% of attendees who initiated health behaviors which have marketing implications.

As organizations seek to better understand their customers, competitors, and environments, the marketing function effectively serves as the support mechanism for these activities in many industries. Accordingly, in many organizations the marketing concept has been elevated to the stature of a strategic weapon, manifested in the form of market orientation. Market-oriented firms emphasize the collection, organization, and dissemination of information regarding both customers and competitors. This strategy is especially well-suited for the health care industry where customer knowledge is of paramount importance, customer interaction is instantaneous, and customer satisfaction is essential. Results of a national study of general service hospitals suggest that firms which embrace a market orientation benefit through enhanced customer satisfaction and quality.