Information asymmetry and performance tilting in hospitals: a national empirical study

Wang, Jong-Yi; Probst, Janice C.; Stoskopf, Carleen H.; Sanders, Jimy M.; McTigue, James F.

doi:10.1002/hec.1689

Cited by 19 publications

(13 citation statements)

References 59 publications

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“…This suggests that the healthcare reform policy may not achieve the initial goal for reducing health care costs, and that failure to manage potential conflicts of interest among different sectors and stakeholders may undermine health policy [ 22 ]. Indeed, information asymmetry among medical industry, health care providers, and consumers may cause inappropriate prescriptions and overuse of medical services, which may place health care providers and pharmaceutical industry in an advantageous position to maximize profit [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

The economic burden of mental disorders in China, 2005–2013: implications for health policy

et al. 2016

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BackgroundMental disorders represent a major contributor to disease burden worldwide. We sought to quantify the national economic burden of mental disorders in China.MethodsWe used a prevalence-based, bottom-up approach to estimate the economic costs of mental disorders in 2005–2013 in China. Prevalence data were derived from a national survey. Cost data were derived from the electronic health records of two psychiatric hospitals that consisted of 25,289 outpatients (10 %) and inpatients (90 %) who were diagnosed with a mental disorder. Cost items included direct medical costs, direct non-medical costs, and indirect costs.ResultsThe total annual costs of mental disorders in China increased from $1,094.8 in 2005 to $3,665.4 in 2013 for individual patients, and from $21.0 billion to $88.8 billion for the whole society. The total costs of mental disorders in 2013 accounted for more than 15 % of the total health expenditure in China, and 1.1 % of China’s gross domestic product. If the needs of the professional care for all patients with mental illnesses were fully met, the potential economic costs would have been almost five times higher than the actual estimated costs.ConclusionsMental disorders imposed a huge economic burden on individuals and the society in China. A nation-wide strategic action plan for preventing mental disorders and promoting mental health and well-being is in urgent need to reduce the individual and societal costs of mental illnesses.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0839-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The economic burden of mental disorders in China, 2005–2013: implications for health policy

et al. 2016

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“…However, information sharing and acquisition is a transaction cost [ 59 , 60 ] in which some health care providers may not decide to invest. As a fundamental peculiarity in health care [ 61 ], asymmetric information remains in this Internet age and continues to affect the effectiveness and efficiency of care [ 62 ]. To deliver improved care and to enhance patient benefits, systematic research that examines the effective schemes of promoting medical information sharing and exchange involving IT, behavioral and social sciences, and other disciplines should be prioritized.…”

Section: Discussionmentioning

confidence: 99%

Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients

Wang

Chen

et al. 2015

BMC Health Serv Res

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BackgroundIn this era of ubiquitous information, patient record exchange among hospitals still has technological and individual barriers including resistance to information sharing. Most research on user attitudes has been limited to one type of user or aspect. Because few analyses of attitudes toward electronic patient records (EPRs) have been conducted, understanding the attitudes among different users in multiple aspects is crucial to user acceptance. This proof-of-concept study investigated the attitudes of users toward the inter-hospital EPR exchange system implemented nationwide and focused on discrepant behavioral intentions among three user groups.MethodsThe system was designed by combining a Health Level 7-based protocol, object-relational mapping, and other medical informatics techniques to ensure interoperability in realizing patient-centered practices. After implementation, three user-specific questionnaires for physicians, medical record staff, and patients were administered, with a 70 % response rate. The instrument showed favorable convergent construct validity and internal consistency reliability. Two dependent variables were applied: the attitudes toward privacy and support. Independent variables comprised personal characteristics, work characteristics, human aspects, and technology aspects. Major statistical methods included exploratory factor analysis and general linear model.ResultsThe results from 379 respondents indicated that the patients highly agreed with privacy protection by their consent and support for EPRs, whereas the physicians remained conservative toward both. Medical record staff was ranked in the middle among the three groups. The three user groups demonstrated discrepant intentions toward privacy protection and support. Experience of computer use, level of concerns, usefulness of functions, and specifically, reason to use electronic medical records and number of outpatient visits were significantly associated with the perceptions. Overall, four categories of independent variables were associated with the mean difference in the perceptions.ConclusionsDiscrepant attitudes toward privacy and support among the three user groups are identified. Patients may require further education and communication regarding the system. Culturally fit e-Consent should be incorporated into the system to fully utilize the computing power of the Internet when also considering workload. The concern for misuse of EPRs might lead to low support among physicians. Highly readable EPR documents and managerial incentives for information exchange may improve system use.

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“…Previous studies have shown that information asymmetry presents challenges to the marketisation of public services (e.g. Wang et al ., ) and, in discussions of higher education, Del Ray () uses the term in its broadest sense to refer not only to asymmetry between buyer and seller, but also between different types of buyer.…”

Section: Information Asymmetrymentioning

confidence: 99%

Expressions of student debt aversion and tolerance among academically able young people in low‐participation English schools

Jones

2015

British Educational Res J

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The 2012 rise in student fees, from £3375 to £9000 per year, made England one of the costliest places to attend university in the world. Drawing on evidence from higher attaining young people attending low-participation schools, this paper renews established types of student debt aversion and tolerance, with sensitivity towards whether they reflect the (financial) 'price' of participation or the (cultural, social) 'cost' of participation. Findings point to a complex web of inter-related factors informing a decision-making process that is rational, but often lacking detailed knowledge of key variables, such as the range of bursaries and grants available and the terms of the loan repayment. The Ellsburg Paradox is invoked to explain the tendency of some young people to self-exclude, contrary to rational choice theory. For those without family support or precedent, participation is not greatly incentivised by assumed lifestyle and identity gains, and generous repayment concessions for low-earning graduates do not necessarily ease anxiety about debt. Data point to a heightened awareness of labour market alternatives and of continued disquiet, both academic and non-academic, about 'fitting in' at university. Naturally, higher fees demand a recalculation of return-on-investment estimates for all young people. However, the participation 'bet' of those from low-participation schools is framed in ways unacknowledged by (and sometimes discordant with) dominant public discourses.

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Information asymmetry and performance tilting in hospitals: a national empirical study

Cited by 19 publications

References 59 publications

The economic burden of mental disorders in China, 2005–2013: implications for health policy

The economic burden of mental disorders in China, 2005–2013: implications for health policy

Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients

Expressions of student debt aversion and tolerance among academically able young people in low‐participation English schools

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