Commodification of Healthcare and its Consequences

Christiansen, Isaac Zvi

doi:10.13169/worlrevipoliecon.8.1.0082

Cited by 15 publications

(14 citation statements)

References 19 publications

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“…The role of the private market increasingly affects the pricing, costings, availability and distribution of healthcare [ 43 ]. As an increasingly integral element of healthcare provision, market forces have enabled patients to choose their preferred services from the providers they want, as long as they have the means to pay for them [ 44 ]. At the same time, it has allowed physicians and PHI providers to set the prices for the services they provide.…”

Section: Discussionmentioning

confidence: 99%

What motivates physicians to propose private services in a mixed private-public healthcare system? A mixed methods study

Michael

Filc

Davidovitch

2022

BMC Health Serv Res

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Background Implementation of private elements, including private insurances, in public healthcare system is now common in many countries, and its impacts have been well studied. Little, however, is known about the motives leading physicians, major role players in the system, to promote the usage of private services. The aim of this study was to explore the various motives leading physicians within public systems to propose private services to their patients, while examining the possible associations to their specialty and level of commitment. Methods A total of 197 physicians from specialisms loaded more to private/public sectors participated in a cross-sectional telephone survey regarding their attitudes on their practices, private insurances, access to healthcare, and job satisfaction. The association between the likert scale questions to their recommendation to purchase private insurance, and the commitment they felt towards patients were analyzed using Generalized Estimating Equations (GEE) as well as logistic regression models. Results Our findings suggest physicians engaged in dual practice are less likely to promote private insurances among their patients if they are satisfied with their public job (OR = 0.92, 95%CI 0.89,0.94). Physicians perceived private insurances as beneficial for patients, were found likely to promote them (OR = 1.65, %95CI 1.16, 2.35). The commitment physicians felt toward patients who paid out-of-pocket money was associated to their sense of being trusted and valued (OR = 1.99, 95%CI 1.33, 2.88; OR = 1.5, 95%CI 1.05, 2.13 respectively). Conclusion This study suggests a deeper understanding of physicians’ daily experience of the private-public mix and it’s consequences, and could provide a platform for future studies. Further studies on physician’s role in health privatization processes are needed, and could aid policymakers in their efforts to strengthen healthcare systems around the world.

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Section: Discussionmentioning

confidence: 99%

What motivates physicians to propose private services in a mixed private-public healthcare system? A mixed methods study

Michael

Filc

Davidovitch

2022

BMC Health Serv Res

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“…From the 1970s to 1980s, the new commodified nature of organizations seemed to generate increased social inequity and health inequalities (Ewert, ; Hermann, ). Market‐oriented approaches, promoted more during austerity times, introduce copayment and out‐of‐pocket mechanisms (Giovanella & Stegmüller, ; Wenzl, Naci, & Mossialos, ) and simultaneously exclude certain social groups from health services (Christiansen, ; MdM, ). For instance, in 2012, a Royal Decree Law from the Spanish government excluded all unregulated migrants from health services (Casino, ; Royo‐Boronada, Díez‐Cornell, & Llorente, ).…”

Section: Discussion Of Findingsmentioning

confidence: 99%

Construction of nursing knowledge in commodified contexts: A discussion paper

2020

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This original article outlines a theoretical path and posterior critical analysis regarding two relevant matters in modern nursing: patterns of knowing in nursing and commodification contexts in contemporary health systems. The aim of our manuscript is to examine the development of basic and contextual nursing knowledge in commodified contexts. For this purpose, we outline a discussion and reflexive dialogue based on a literature search and our clinical experience. To lay the foundation for an informed discussion, we conducted a literature search and selected relevant articles in English, Spanish, and Portuguese that included contents on patterns of knowing, commodification, and nursing published from 1978 to 2017. Globalization, commodification, and austerity measures seem to have negative effects on nursing. Work conditions are worsening, deteriorating nurse-patient relationships, and limiting reflection on practice. Nurses must develop knowledge to challenge and participate in institutional organization and public health policies. Development of nursing knowledge may be difficult to achieve in commodified environments. Consequently, therapeutic care relationships, healthcare services, and nurses' own health are compromised. However, by obtaining organizational, sociopolitical, and emancipatory knowledge, nurses can use strategies to adapt to or resist commodified contexts while constructing basic knowledge. K E Y W O R D Sglobalization, health policy, nurse-patient relationships, nursing knowledge, nursing practice improve practice and global care, contributing to the common good, and working to achieve a fair and strong society. Thus, through organizational, sociopolitical, and emancipatory knowledge, nurses are enabled to use strategies to adapt to or resist commodified contexts while constructing basic patterns of knowing.

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“…The study’s broader conceptual framework is described elsewhere [17, 22]; however, two theoretical assumptions guided this sub-analysis: the rational actor model and institutional theory. In this study, hospitals were assumed to behave as rational unitary decision-makers [23, 24] to meet the needs of their political and economic environments [25]. Institutional theory asserts that the external environment shapes organizations through a process called isomorphism which drives organizations towards homogeneity through coercion, mimicry, and normative behaviors of external stakeholders [26].…”

Section: Methodsmentioning

confidence: 99%

Making the business case for an addiction medicine consult service: a qualitative analysis

Priest

McCarty

2019

BMC Health Serv Res

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BackgroundAs the drug poisoning crisis worsens in North America and opioid use disorder (OUD)-related hospital admissions increase, policymakers and hospital administrators are beginning to recognize the important role of hospitals in the OUD care continuum. This study explores and describes how U.S. addiction medicine physicians created and presented business propositions to hospital administrators to support the development of addiction medicine consult (AMC) services.MethodsFifteen qualitative interviews were completed with board-certified or board-eligible addiction medicine physicians from 14 U.S. hospitals. The interviews occurred as part of a broader mixed methods study exploring hospital service delivery for patients admitted with OUD. Using a directed content analysis, the transcribed interviews were coded, analyzed, and final themes consolidated.ResultsSemi-structured interviews completed with addiction medicine physicians from established (n = 9) and developing (n = 5) AMC services at 14 U.S. hospitals explored how clinical champions persuaded hospital administrators to support AMC service development. Four elements were foundational to making the “business case”: 1) describing the prevalence of substance use disorder (SUD) or OUD in the hospital; 2) identifying the negative financial impacts of not treating SUDs during hospitalization; 3) highlighting the ongoing care quality and treatment gap for hospitalized patients with SUDs; and 4) noting the success of other institutional AMC services. Study findings informed the creation of tools to support AMC service development: 1) an AMC service business case template, and 2) an AMC service design and operations resource list.ConclusionsOUD-related hospital admissions are unlikely to abate. Hospital administrators should consider innovative care delivery mechanisms to improve care for persons with OUD. AMC services may be a promising delivery mechanism to achieve this aim. For clinical and administrative champions, understanding how to communicate the potential effectiveness of this intervention to hospital leaders is an essential first step to AMC service creation.

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Commodification of Healthcare and its Consequences

Cited by 15 publications

References 19 publications

What motivates physicians to propose private services in a mixed private-public healthcare system? A mixed methods study

What motivates physicians to propose private services in a mixed private-public healthcare system? A mixed methods study

Construction of nursing knowledge in commodified contexts: A discussion paper

Making the business case for an addiction medicine consult service: a qualitative analysis

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