Patients' Rights in Managed Care -- Exit, Voice, and Choice

Annas, George J.

doi:10.1056/nejm199707173370323

Cited by 31 publications

(15 citation statements)

References 4 publications

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“…Hirschman's theory of exit, voice and loyalty [31] has sometimes been applied in health services research [32] and, more pertinently, to health services delivery in developing countries [33]. The theory suggests that giving users greater voice in the delivery of health services should help to reduce desertion rates.…”

Section: Discussionmentioning

confidence: 99%

Use of social audits to examine unofficial payments in government health services: experience in South Asia, Africa, and Europe

Paredes-Solís

Andersson

Ledogar³

et al. 2011

BMC Health Serv Res

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BackgroundUnofficial payments in health services around the world are widespread and as varied as the health systems in which they occur. We reviewed the main lessons from social audits of petty corruption in health services in South Asia (Bangladesh, Pakistan), Africa (Uganda and South Africa) and Europe (Baltic States).MethodsThe social audits varied in purpose and scope. All covered representative sample communities and involved household interviews, focus group discussions, institutional reviews of health facilities, interviews with service providers and discussions with health authorities. Most audits questioned households about views on health services, perceived corruption in the services, and use of government and other health services. Questions to service users asked about making official and unofficial payments, amounts paid, service delivery indicators, and satisfaction with the service.ResultsContextual differences between the countries affected the forms of petty corruption and factors related to it. Most households in all countries held negative views about government health services and many perceived these services as corrupt. There was little evidence that better off service users were more likely to make an unofficial payment, or that making such a payment was associated with better or quicker service; those who paid unofficially to health care workers were not more satisfied with the service. In South Asia, where we conducted repeated social audits, only a minority of households chose to use government health services and their use declined over time in favour of other providers. Focus groups indicated that reasons for avoiding government health services included the need to pay for supposedly free services and the non-availability of medicines in facilities, often perceived as due to diversion of the supplied medicines.ConclusionsUnofficial expenses for medical care represent a disproportionate cost for vulnerable families; the very people who need to make use of supposedly free government services, and are a barrier to the use of these services. Patient dissatisfaction due to petty corruption may contribute to abandonment of government health services. The social audits informed plans for tackling corruption in health services.

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Section: Discussionmentioning

confidence: 99%

Use of social audits to examine unofficial payments in government health services: experience in South Asia, Africa, and Europe

Paredes-Solís

Andersson

Ledogar³

et al. 2011

BMC Health Serv Res

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“…When clients are dissatisfied or perceive a service failure, they can choose one of several courses of action (Hirschman, 1970;Schneider & Bowen, 1995;Weiser, 1995;Annas, 1997), that is, voice a concern by complaining to the service provider or to the relevant authorities or, by negative word of mouth, to others; they can exit, that is, cease to use the service provider; or opt for silence. Several studies show that in diverse industries only a portion of those who have a cause to complain actually do so.…”

Section: Complaints In the Health Care Systemmentioning

confidence: 98%

Immigration and Health Services: Immigrant Complaint Patterns Regarding the Primary Health Care System in Israel

Shavit

Weisberg

Gal

et al. 2009

Journal of Immigrant & Refugee Studies

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Complaints are a potentially important source of information regarding health care quality in societies which face constant immigration. The purpose of this study was to examine the prevalence and patterns of complaints about health services from immigrants who are clients of Health Maintenance Organizations (HMOs) in Israel, to compare them with the complaint patterns of other Israelis, and to examine the contribution of sociodemographic variables to this comparison. Primary data were collected from the pooled responses of subjects who participated in two national phone surveys conducted in 2005 and 2007. The responses of 375 persons who immigrated to Israel after 1989 were compared to those of 824 persons who had immigrated earlier or were born in Israel. All respondents were screened for having had a reason to complain against their HMO. Respondents reported on whether they complained the pattern of their complaint, their awareness of their rights, and other socioeconomic characteristics. Of the immigrants who reported having a grievance, 19% of immigrants (as compared to 35% of other Israelis) had actually complained. Structural problems, such as payments, administrative matters, etc., were the most prevalent reasons for complaining. The main reasons for not Downloaded by [Flinders University of South Australia] at 23:22 03 January 2015 420 M. Shavit et al.complaining were lack of motivation and/or knowledge about the complaint process. In logistic regression analysis, immigration status, age, and income were significantly associated with making a complaint.

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“…8 Of course, this is why liability appeals to patients. 10,11 ERISA protects employer-provided health plans (known as ERISA plans) from liability for negligent S injury to patients under state laws because ERISA prohibits the application of state law in any form, including the common law of torts, to ERISA plans if the law "relates to" an ERISA plan. 9 With health plans tied to employment and the consolidation of the managed-care industry, consumers are frequently unable to choose or change plans.…”

Section: Liability and Erisamentioning

confidence: 99%

What Recourse? — Liability for Managed-Care Decisions and the Employee Retirement Income Security Act

Mariner

2000

N Engl J Med

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Patients' Rights in Managed Care -- Exit, Voice, and Choice

Cited by 31 publications

References 4 publications

Use of social audits to examine unofficial payments in government health services: experience in South Asia, Africa, and Europe

Use of social audits to examine unofficial payments in government health services: experience in South Asia, Africa, and Europe

Immigration and Health Services: Immigrant Complaint Patterns Regarding the Primary Health Care System in Israel

What Recourse? — Liability for Managed-Care Decisions and the Employee Retirement Income Security Act

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