Health Care Consumers Research Articles

The Effect of Climate Risk on Stock Market Performance Evidence from Sri Lanka

This study aims to identify the effect of climate risk on stock market performance in Sri Lanka. As an island, the country is frequently affected by climate change variabilities. Due to the higher climate risk exposure of Sri Lanka, it is highly needed to identify the risk at a prior stage. As, this is the first study in Sri Lanka to identify the climate risk impact on stock market performance the primary objective of this study is to identify the climate risk effect on the All-Share Price Index, Standard and Poor’s SL20 index and 20 industry groups according to the GICS classification. The considered climate risk variables are drought, flood, high wind, heavy rain, landslide, and lightning. The findings of the study revealed there is no significant impact from climate risk variables to the All-Share Price Index, and Standard and Poor’s SL20 index. However, the analysis discovered significant impact of several climate risks to certain specific sectors of CSE such as drought significantly impacts automobiles and components, banking and transportation sectors. At the same time, the high wind is a key factor for food, beverage and tobacco. The drought and high wind influence are significant in sectors like capital goods, utilities, consumer durable and apparel, consumer services, healthcare, equipment and services, materials and household and personal products. As well as drought and lightning have a significant impact on the commercial and professional service sector and energy sector while the diversified financial sector is impacted by drought, high wind and heavy rain. Apart from that, sectors like food and staples, retailing, insurance, real estate and telecommunication are unaffected by any climate risk factor. At the same time, the pharmacy and bio-tech industries are impacted by all the climate risk variables except floods. Ultimately, the study's findings will provide direction to decision-makers including potential investors to consider the climate risk in their decisions making processes.

Secure Authentication and Data Transmission for Patients Healthcare Data in Internet of Medical Things

Currently, data transmission is an expanding area in healthcare, enabling health practitioners to examine, assess, and manage patients using mobile communication technologies. To identify and analyze a patient, healthcare providers need to access the physician's Electronic Medical Record (EMR), which may contain extensive audiovisual big data such as MRIs, CT scans, PET scans, X-rays, and more. To ensure accessibility and scalability for healthcare workers and consumers, the EMR needs to be stored in large data repositories on cloud servers. However, due to the sensitive nature of medical information stored in the cloud, the healthcare profession faces numerous security challenges, with data theft attacks being one of the most critical vulnerabilities. This research focuses on protecting medically sensitive data in the cloud by leveraging cloud computing facilities. The upgraded AES approach ensures that confidential data is securely accessible and stored. In addition, improved Elliptic Curve Cryptography (ECC) is utilized for key generation and validation. A hybrid optimization approach, combining robust optimization and genetic algorithms, is employed to select unique and distinct keys. Decryption is performed using deep neural networks, and Convolutional Neural Networks (CNN) enable batch encryption of multiple documents. The comparison between old methods and the proposed approach is based on encryption time, decryption time, and security strength.

Barriers to Healthcare Across Rural Communities-Testing Telehealth as an Alternative Model of Healthcare Service Delivery

Healthcare consumers from rural areas in the United States have inadequate access to healthcare due to a lack of providers, ineffective healthcare networks, and impaired healthcare delivery models. Further, low income, insurance coverage, and transportation are significant challenges limiting rural healthcare consumers’ access to healthcare. Therefore, preventable hospitalizations are more common in rural areas. As a result, healthcare access in rural areas has become a pressing issue for healthcare leaders and the government. Therefore, the author would like to conduct a literature review to assess the barriers in rural areas and establish the framework for a pilot study to propose telehealth as an alternative healthcare service delivery model to improve healthcare accessibility and health promotion.

Using Cultural Variance Framework to Promote Vaccine Confidence among African Americans: A Qualitative Content Analysis of “We Can Do This” COVID-19 Vaccine Campaign

The study examines ways the cultural variance framework (CVF) enhances vaccine confidence messaging among African American healthcare consumers concerning coronavirus. The main emphasis lies in the “We Can Do This” campaign, which employs CVF to develop tailored social media, advertising, and televised commercials to actively involve African Americans and advocate for the advantages of the coronavirus vaccine. This qualitative study seeks to fill a gap in health communication literature by investigating how CVF, as a sub-feature of audience-centered messaging, engages with African Americans, encouraging their active engagement in vaccine participation. The findings reveal that contextual specificity, cultural identity, and characteristic features of the CVF play a significant role in fostering vaccine confidence among African Americans using culturally tailored messaging. The study explicates conceptual implications for future interventions prioritizing African Americans regarding health disparities.

How do sectoral Islamic equity markets react to geopolitical risk, economic policy uncertainty, and oil price shocks?

This study explores the impact of three major risk and uncertainty indices (Geopolitical Risk (GPR), Economic Policy Uncertainty (EPU), and Oil Market Volatility (OVX)) on the Dow Jones Islamic Market (DJIM) World and the ten major sectoral Islamic equity indices. The investigation further evaluates whether the impact of these uncertainties varies between Islamic sectoral indices and the global benchmark. Our time-varying analysis shows that most Islamic equity indices are more resilient in hedging against GPR and EPU shocks compared to OVX shocks. Furthermore, the Quantile-on-Quantile results establish a positive correlation between DJIM World and most Islamic equity indices with GPR, demonstrating their robust capabilities to hedge against GPR shocks. These hedging abilities are more pronounced in the consumer goods, oil & gas, and financial sectors. The dependence structures between extreme EPU shocks and the DJIM world and consumer goods, financials, healthcare, and industrial sectors are positive only in bearish conditions, suggesting hedging benefits are predominantly limited to lower quantiles. Yet, the basic materials and oil & gas sectors can hedge EPU shocks better than the DJIM world and other sectors, depending on market states. Notably, no Islamic equity indices show resilience against OVX shocks. Our findings have prominent portfolio risk management and policy implications for investors and policymakers. These findings hold significant implications for portfolio risk management and policy strategies for investors and policymakers.

Paper Plain : Making Medical Research Papers Approachable to Healthcare Consumers with Natural Language Processing

When seeking information not covered in patient-friendly documents, healthcare consumers may turn to the research literature. Reading medical papers, however, can be a challenging experience. To improve access to medical papers, we explore four features enabled by natural language processing: definitions of unfamiliar terms, in-situ plain language section summaries, a collection of key questions that guides readers to answering passages, and plain language summaries of those passages. We embody these features into a prototype system, Paper Plain . We evaluate Paper Plain , finding that participants who used the prototype system had an easier time reading research papers without a loss in paper comprehension compared to those who used a typical PDF reader. Altogether, the study results suggest that guiding readers to relevant passages and providing plain language summaries alongside the original paper content can make reading medical papers easier and give readers more confidence to approach these papers.

The role of health insurance literacy in the process and outcomes of choosing a health insurance policy in the Netherlands

In several countries, citizens are expected to be critical consumers when choosing a health insurance policy. However, there are indications that citizens do not always have the sufficient skills, so called health insurance literacy (HIL), to do this. We investigated whether the level of HIL among Dutch citizens is related to the way in which they experience the process of choosing a policy, and furthermore whether it is related to their health insurance choices. We obtained information by sending questionnaires to members of the Nivel Dutch Health Care Consumer Panel in 2020. Of the 1,500 approached, 806 panel members participated (response rate 54%). Our results indicate that, compared to those with a high HIL, respondents with a low HIL more often find choosing a health insurance policy difficult, not interesting, and boring, and less often consider it important and worthwhile. Furthermore, they make less use of the opportunity to switch from one health insurer to another. However, they do still opt for a supplementary insurance policy and a voluntary deductible to the same extent as citizens with a high HIL. We conclude that the HIL level among Dutch citizens is related to the way in which they experience the process of choosing a health insurance policy and to the extent to which they switch from one insurer to another. But it is not related to their health insurance choices. Follow-up research should focus on how citizens with a low HIL can be better supported when choosing a health insurance policy.

The impact of trust in healthcare and medication, and beliefs about medication on medication adherence in a Dutch medication-using population

IntroductionTrust in healthcare and medication, defined as feelings of reassurance and confidence in the healthcare system or medication, may be a key prerequisite before engaging in the use of medication. However, earlier studies have focussed on beliefs about medication rather than trust as predictors of medication adherence. This study therefore aims to simultaneously explore the relationship of trust in healthcare, medication and beliefs about medication, with medication adherence. MethodsIn a cross-sectional study, an online questionnaire was sent out to 1500 members of the Dutch Health Care Consumer Panel of Nivel in November 2018. Respondents were asked to grade their level of trust in healthcare and medication (scale 1–10). The Beliefs About Medicines Questionnaire (BMQ) for general and specific medication beliefs was used to address beliefs, the Medication Adherence Report Scale (MARS-5) to measure medication adherence. Data were analysed using structural equation modelling (SEM) with a backward stepwise approach. Out of 753 people that completed the questionnaire, 407 people used prescription medication and were included in the analyses. ResultsA positive association between trust in medication and medication adherence was found (0.044, p < 0.05). BMQ subscales Overuse (−0.083, p < 0.05), Necessity (0.075, p < 0.05) and Concerns (−0.134, p < 0.01) related with medication adherence. BMQ subscale Harm did not relate to medication adherence. ConclusionTrust in medication and beliefs about medication were both individually associated with medication adherence. Healthcare providers should therefore not only focus on patients' medication beliefs, but also on strengthening patients' trust in medication to improve medication adherence.

Co-Design of a website for women with pelvic organ prolapse: A study protocol.

Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for premenopausal women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing.Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate.Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed.The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

Social context matters: The role of social support and social norms in support for solidarity in healthcare financing.

In many European countries, including the Netherlands, the healthcare system is financed according to the principles of solidarity. It is important, therefore, that public support for solidarity in healthcare financing is sufficient in order to ensure that people remain willing to contribute towards solidarity-based systems. The high willingness to contribute to the healthcare costs of others in the Netherlands suggests that support is generally high. However, there are differences between groups. Previous research has focused on mechanisms at the individual and institutional level to explain these differences. However, people's social context may also play a role. Little research has been conducted into this. To fill this gap, we examined the role of perceived social support and social norms in order to explain differences in the willingness to contribute to other people's healthcare costs. In November 2021, we conducted a survey study in which a questionnaire was sent to a representative sample of 1,500 members of the Dutch Healthcare Consumer Panel. This was returned by 837 panel members (56% response rate). Using logistic regression analysis, we showed that people who perceive higher levels of social support are more willing to contribute to the healthcare costs of others. We also found that the willingness to contribute is higher when someone's social context is more supportive of healthcare systems that are financed according to the principles of solidarity. This effect does not differ between people who perceive low and high levels of social support. Our results suggest that, next to the individual and institutional level, the social context of people has to be taken into consideration in policy and research addressing support for solidarity in healthcare financing.

Analysis on Applicability of Market Neutral Strategies in Different Sectors

To offer returns which have low or even no correlation with the market index is one of the most widely cited benefits of the market neutral strategies. Thus, market neutral strategies can be applied to generate relative stable returns against the backdrop of increased economic uncertainty. Using market neutral strategies to construct portfolios with stocks from each of the five representative sectors: consumer cyclical sector, healthcare sector, energy sector, technology sector and financial sector, this paper analyzes the return on each portfolio and their linear correlation with the market to figure out which sectors the market neutral strategies are better suited for. The result shows that the portfolios with stocks from each of the healthcare sector, energy sector and financial sector outperformed the market, while the rest of the constructed portfolios underperformed the market. Moreover, the linear correlation analysis demonstrates that the market neutral strategy cannot effectively diversify market risk when the portfolio is from technology sector. Therefore, the market neutral strategy may be more applicable in healthcare sector and energy sector due to the higher return and better risk diversification results, while it may not be well applied to technology sector for the negative return and suboptimal risk diversification result.

Pricing information asymmetry in healthcare: stakeholder analysis and research insights

PurposeThis study aims to map and analyze health-care pricing information research. This work highlights current gap in pricing information research in health care and proposes future research avenues to academia and industry professionals.Design/methodology/approachA bibliometric method was adopted to analyze extant literature on pricing information asymmetry. Semistructured interviews were conducted with key stakeholders in health care to triangulate the findings.FindingsPricing information is crucial for all stakeholders including health-care consumers, providers and regulators. The popular research areas were the rising health-care cost, cost-saving, outcome-based pricing, price based on service supply and demand, insurance and out-of-pocket spending. Cost–quality perceived linkages, cost–demand correlation in health-care service and cost–price interlinked drivers were the dominant themes in extant literature. The study highlighted that pricing information asymmetry pushed patients from weaker sections into a debt trap due to unplanned out-of-pocket health-care expenses. The study suggests areas of research to minimize this pricing information asymmetry.Practical implicationsThe emerging themes in health pricing asymmetry will help key stakeholders to identify areas for improvement and take remedial actions in the health-care domain.Originality/valueThis study is a pioneering effort to summarize extant literature published in the health-care information pricing domain and analyze it from a bibliometric perspective. The study also triangulates the finding with primary data from key stakeholders and highlights emerging research areas.

Does healthcare consumerism serve as a barrier or facilitator to the implementation of value-based primary care? Strategies to promote synergy and success.

Value in health care is described as the measured improvement in a patient's health outcomes for the cost of achieving that improvement. In the United States, value-based care has been heralded by providers, payers, and policymakers alike, as a path to addressing the challenges facing the healthcare system and achieving the aspirational goals of the Quadruple Aim of healthcare. Primary care is often viewed as the foundational cornerstone for implementing value-based care. However, primary care is also considered as ground-zero for the rise in healthcare consumerism. In essence, consumerism refers to increasing expectations from patients (consumers) to be more active participants in decisions related to their healthcare. While much of the literature has portrayed the rise in consumerism as a barrier to the implementation of value-based primary care, some have argued that it may have potential to synergize with and facilitate the implementation of value-based primary care. This paper applies an enhanced stepwise implementation framework for value-based (equitable) care, to examine the potential for conflict and synergy between consumerism and value-based care in the emerging retail model of primary care. The application is based on the potential actions of four key stakeholder groups: (1) retail healthcare entities, (2) primary-care providers, (3) consumers (patients), and (4) healthcare payers. The analysis helps to articulate the responsibilities of each stakeholder group in ensuring synergy between consumerism and value-based primary care. In addition, it helps to identify three drivers of synergy between consumerism and value-based care: (1) trust in the patient-provider relationship, (2) connected consumer-centric technology solutions, and (3) value-based consumer-centric payment models. Overall, the application helps to articulate a comprehensive framework for implementing value-based care that incorporates both the principles of consumerism and active consideration for health equity.

Do choice tasks and rating scales elicit the same judgments?

Discrete choice (DCE) and rating scale experiments (RSE) are commonly applied procedures for eliciting preference judgments in a plethora of applied settings such as consumer choices, health care, and transport economics. An almost universal assumption is that actual “ground truth” preferences do not depend on which elicitation procedure is used. It is usually not possible to test this assumption, because typical studies feature response options for which there is no objectively correct response. To make progress on testing this assumption, we conducted a perceptual discrimination experiment where response options varied on a single attribute – stimulus saturation level – with a known objectively correct response. We had the same participants complete both a choice task (CT) and rating scale (RS) version of the experiment, allowing a direct examination of the assumption of a common representation. Our CT featured many characteristics that define a DCE, however, in order to have a known objectively correct response, it also differed in a few important ways. To test the assumption of a common representation, we developed a cognitive model with a response mechanism for both CT and RS. This enabled us to compare a model version that featured one shared latent stimulus representation across CT and RS versus a version which featured separate representations. Our results support the assumption that a single internal state supports both CT and RS responses, and also suggest that the CT method might provide more sensitive measurement of internal states than the RS method.

A Case of Liquorice-Infused Marijuana Causing Syndrome of Apparent Mineralocorticoid Excess.

First report of liquorice-laced marijuana causing syndrome of apparent mineralocorticoid excess (SAME).Since its legalisation, marijuana is reported to be the most used substance second only to alcohol. With the increased availability of marijuana, the health care providers and consumers must be cognisant of its side effects.It is a dose-dependent phenomenon. The effects vary from minor clinical symptoms to fatal arrhythmias based on the amount consumed.

FACTORS OF SUSTAINABLE COMPETITIVENESS AT COMPANY LEVEL: A COMPARISON OF FOUR GLOBAL ECONOMIC SECTORS

Built on the premise that a company’s competitiveness is given by its robust financial performance and the strength of its position on the market, but only under conditions of sustainability, this study aims to investigate the key factors of company competitiveness while considering sustainability issues. The two research objectives were: (1) to identify and analyze the key factors of sustainable competitiveness at company level (2) to find sector-related discrepancies regarding the identified factors. To achieve them, a horizontal analysis covering ten financial years (2012–2021) was performed on a sample of 1,449 companies from four global economic sectors (Consumer Cyclicals, Energy, Health Care, and Technology) – using Exploratory factor analysis (EFA) and ANOVA. Nine factors (both financial and non-financial) were found: liquidity, profitability, revenue efficiency, inventory management efficiency, ESG performance, receivables management efficiency, R&amp;D efficiency, book value, and market value. Of them, ESG performance has emerged as an independent factor based on non-financial variables, its introduction into the research model being one of the study’s novelties. Significant mean differences were found between the nine factors, depending on the sector, which allowed the ranking of sectors in terms of sustainable competitiveness, in descending order: Health Care, Technology, Consumer Cyclicals, and Energy.

Usage Behavior Intentions of Healthcare Consumers Using Healthcare Self-Service Technologies

Applications of Self-service technologies (SSTs) are changing the way healthcare organizations provide services to their patients. Although the use of SSTs has significantly changed service delivery and its use can satisfy patients' pursuit of efficient service, there is still a lack of adequate overview of research on how the use of SSTs affects healthcare consumers' experience in healthcare facility settings. Therefore, this study aimed to understand the usage intentions of healthcare consumers using healthcare self-service technologies. In this study, questionnaires were distributed in a regional hospital in Taiwan, and a total of 640 valid questionnaires were obtained. After relevant research and path analysis, it was found that the perceived usefulness of medical consumers to SSTs will affect their attitudes and behaviors. In addition, this study contributes to the literature on SSTs through the results of this study. Keywords: Self-Service Technologies, Technology Acceptance Model, Perceived usefulness, Perceived ease of use, Attitude, Usage intention

Developing a transgender and non-binary inclusive obstetrics and gynaecology undergraduate medical curriculum in Aotearoa/New Zealand: Where are we at, and where do we need to be?

Internationally, undergraduate medical education is not currently enabling early career doctors to meet the needs of trans and gender diverse (TGD) people as healthcare consumers. This review outlines inclusion of TGD education in undergraduate medical education more broadly to contextualise curriculum development needs in obstetrics, gynaecology and reproductive medicine in Aotearoa/New Zealand. Limited, and lack of integrated content, teaching capability and current absence of TGD health knowledge as graduate outcomes, compounded by pedagogy (biomedical/binary framing) and more appropriate learning resources are indicators for curricula, and workforce, development.

Building the capacity of rural allied health generalists through online postgraduate education: a qualitative evaluation.

Workforce development is a key strategy for building the capacity and capability of a workforce. Accordingly, rural and remote practising allied health professionals require relevant and accessible continuing professional development to enhance their knowledge and skills and improve consumer health outcomes. This study explored the impact of an online postgraduate allied health rural generalist education program, from the perspective of allied health professionals participating in the program and their supervisors and managers. A qualitative, exploratory descriptive study design was employed using semistructured interviews. This study formed the qualitative component of a larger convergent mixed-methods evaluation study aimed at evaluating the reach, quality and impact of an online rural generalist education program for allied health professionals in Australia. Allied health professionals from seven professions enrolled in an online postgraduate rural generalist education program, the rural generalist program (RGP). Their designated work-based supervisors and their managers who were responsible for the operational management of the study sites were invited to participate in the study. All participants were employed in rural and remote health services in 10 sites across four Australian states. Study participants' experience and perceptions of the impact of the RGP on themselves, the healthcare service and the broader community were explored using semistructured interviews. Data were thematically analysed site by site, then across sites using Braun and Clarke's (2012) systematic six-phase approach. Provisional codes were generated and iteratively compared, contrasted and collapsed into secondary, more advanced codes until final themes and subthemes were developed. Semistructured interviews were conducted with 23 allied health professionals enrolled in the RGP and their 27 work-based supervisors and managers across the 10 study sites. Three final themes were identified that describe the impact of the RGP: building capability as rural generalist allied health professionals; recruiting and building a rural workforce; enhancing healthcare services and consumer outcomes. Allied health professionals working in rural and remote locations valued the RGP because it provided accessible postgraduate education that aligned with their professional and clinical needs. Integrated into a supportive, well-structured development pathway, the experience potentiated learning and facilitated safe clinical practice that met the needs of consumers and organisations. The findings demonstrate that effective work-integrated learning strategies can enhance the development of essential capabilities for rural practice and support early-career allied health professionals' transition to rural and remote practice. These experiences can engage allied health professionals in a way that engenders a desire to remain working in rural and remote contexts.

Angiotensin Receptor Blocker-Related Sprue-like Enteropathy: Review of Food and Drug Administration Adverse Event Reporting System.

Sprue-like enteropathy (SE) related to olmesartan use was first reported in 2012. In 2017, the manufacturer of Benicar paid $300 million for 2300 claims for olmesartan-related SE. A study in 2019 suggested that SE was related to olmesartan and with the possibility of angiotensin receptor blocker (ARB) class effect. To further characterize this condition, our group examined reports of ARB-related SE to Food and Drug Administration Adverse Event Reporting System (FAERS). All reports of ARB-related SE from January 2017 to December 2021 were downloaded from the FAERS database. Gastrointestinal adverse events including SE were reviewed. Reporter categories included physicians, pharmacists, other health care professionals, consumers, and attorneys. A total of 106 590 reports of ARB-related adverse effects were analyzed. Sprue-like enteropathy was identified in 4337 cases (4.1% of total reports). Of these, 4240 cases (98.0%) of ARB-related SE were reported in patients using products with olmesartan, and 97 cases of SE were reported for all other ARBs (eprosartan, losartan, telmisartan, irbesartan, valsartan, and candesartan). Reports of olmesartan-related SE increased rapidly in 2017, continued at a high rate in 2018 and 2019, and essentially stopped in 2020 and 2021. Reports to FAERS for ARB-related SE are mostly related to olmesartan. There was a steep decline in reports of olmesartan-related SE following the lawsuit with potential of lawyer interference. There are reports of SE related to ARBs other than olmesartan, with increased physician awareness and the potential to discover a class effect with future studies.