Introduction Sufficient infrastructure for information and communications technology (ICT) and a well-established policy are necessary factors for smooth implementation of telemedicine. However, despite these necessary conditions being met, there are situations where telemedicine still fails to be accepted as a system due to the low receptivity of stakeholders. In this study, we analyse stakeholders' resistance to an organization's implementation of telemedicine. Focusing on the physicians' interests, we propose a strategy to minimize conflicts and improve acceptance. Methods The Delphi study involved 190 telemedicine professionals who were recommended by 485 telemedicine-related personnel in South Korea. Results Out of 190 professionals, 60% of enrolled participants completed the final questionnaires. The stakeholders were categorized into four groups: policy-making officials, physicians, patients, and industrialists. Among these, the physicians were most opposed to the adoption of telemedicine. The main causes of such opposition were found to be the lack of a medical services delivery system and the threat of disruption for primary care clinics. Very little consensus was observed among the stakeholders, except on the following points: the need for expansion of the national health insurance budget by the government, and the need for enhancement of physicians' professional autonomy to facilitate smooth agreements. Discussion Our analysis on the causes of the resistance to telemedicine, carried out with the groups mentioned above, has important implications for policy-makers deriving strategies to achieve an appropriate consensus.
The purpose of this study is to determine the moderating effects of the timing of reward determination and performance standards on the relationship between pay-for-performance and self-efficacy. It is an experimental study; the sample included 352 participants from Amazon Mechanical Turk, and an online experiment was conducted on an external website. The model was tested for mediation and moderation processes using regression analysis and analysis of variance (ANOVA). The results showed a mediating effect of self-efficacy between pay-for-performance and intrinsic motivation. A moderating effect of performance standards (absolute, relative, ambiguous) on the relationship between pay-for-performance and self-efficacy was also found. Moreover, performance standards were found to be more important moderators than the timing of reward determination. The theoretical contribution of this paper was to observe the concept of timing of reward determination and empirically validate self-determination theory. The results also infer that people measure their own efficacy or competence by comparing themselves with others more than with other performance standards. The use of absolute performance standards is recommended for sustainable self-efficacy and intrinsic motivation of employees. This study introduced the concept of the timing of reward determination (i.e., before or after completion of a performance-related task) and verified the moderating effect of performance standards.
Following the coronavirus disease-2019 pandemic, this study aimed to evaluate the overall effects of remote blood pressure monitoring (RBPM) for urban-dwelling patients with hypertension and high accessibility to healthcare and provide updated quantitative summary data. Of 2721 database-searched articles from RBPM’s inception to November 2020, 32 high-quality studies (48 comparisons) were selected as primary data for synthesis. A meta-analysis was undertaken using a random effects model. Primary outcomes were changes in office systolic blood pressure (SBP) and diastolic blood pressure (DBP) following RBPM. The secondary outcome was the BP control rate. Compared with a usual care group, there was a decrease in SBP and DBP in the RBPM group (standardized mean difference 0.507 (95% confidence interval [CI] 0.339–0.675, p < 0.001; weighted mean difference [WMD] 4.464 mmHg, p < 0.001) and 0.315 (CI 0.209–0.422, p < 0.001; WMD 2.075 mmHg, p < 0.001), respectively). The RBPM group had a higher BP control rate based on a relative ratio (RR) of 1.226 (1.107–1.358, p < 0.001). RBPM effects increased with increases in city size and frequent monitoring, with decreases in intervention duration, and in cities without medically underserved areas. RBPM is effective in reducing BP and in achieving target BP levels for urban-dwelling patients with hypertension.
In this article, we examine the effect of workforce ageing on company productivity, using an analysis based on Korean firms. We found that an increase in the ratio of workers aged over 50 years to total workers had a negative effect on value added per worker, which was consistent with the findings of most previous studies based on European data. However, the results of the analysis, including various classifications such as size, industry and several financial conditions, revealed that an increase in the ratio of older workers had positive effects on value added per worker in large manufacturing firms under risky or growing conditions. As the productivity of older workers may vary, future research may determine under what conditions – size, industry, region and financial conditions – older workers contribute positively to productivity. Firms with financial troubles or those planning to downsize should be cautious about laying off older workers as an approach to improving organisational performance because these workers contribute positively to productivity under certain conditions. JEL Codes: J24, J54, N3
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