Cancellation Of Services Research Articles

Intraconsumer Price Discrimination with Credit Refund Policies

Consumers often receive a full or partial refund for product returns or service cancellations. Much of the existing literature studies cash refunds, where consumers get the money back minus a fee upon a product return or service cancellation. However, not all refunds are issued in cash. Sometimes consumers receive credit that can be used for future purchases, oftentimes with an expiration term after which the credit is forfeited. We study the optimal design of credit refund policies. Different from models that consider cash refunds, we explicitly model repeated interactions between the seller and consumers over time. We assume that consumers’ valuation for the product/service varies over time and that there is an exogenous probability for product returns. Several interesting results emerge. First, a credit refund policy facilitates intraconsumer price discrimination for a single type of consumers with stochastic valuation. Second, an optimal policy often involves an intermediate credit expiration term, under which a consumer with a high product valuation always makes a purchase, whereas a consumer with a low product valuation may be induced to make a purchase as the credit approaches expiration, leading to a demand induction effect. Finally, a credit refund policy can be more profitable than a cash refund policy and can lead to a win-win outcome for both the firm and consumers under certain conditions. We also consider several extensions to check the robustness of our findings. This paper was accepted by Jeannette Song, operations management. Funding: Y. Liu was substantially supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. PolyU15502420). Y. Liu was also supported by a grant from NSFC [72293564/72293560]. Supplemental Material: The data and online appendices are available at https://doi.org/10.1287/mnsc.2020.03042 .

South Asian women’s views on and experiences of maternity care services in Hong Kong: A qualitative study

BackgroundHealth disparities among ethnic minority and migrant women can lead to adverse maternal and neonatal outcomes. This study explores the maternity care experiences of South Asian women in Hong Kong, providing insights for woman-centred and culturally responsive care in the East Asia. ObjectiveTo understand South Asian women’s views and experiences regarding maternity care services in Hong Kong. MethodsA qualitative descriptive study was conducted with 20 English-speaking South Asian women who had used maternity care services in Hong Kong within the past 5 years. Data were analysed by thematic analysis. FindingsFour themes were identified: 1) Comparing maternity care services in their home country versus Hong Kong; birth location, mode of birth and care. 2) Navigating Hong Kong maternal medical care system; including private public dual care and learning information from other South Asians. 3) The discrepancy in perception of optimum care; including a preferring for assistance with daily tasks, epidural anaesthesia, doctor-led care, and priority to infants’ health. 4) The impact of the COVID-19 pandemic on maternity care experiences, including the cancellation of translation services and limited visiting hours. DiscussionSouth Asian appreciate Hong Kong’s public maternity services due to its perceived greater cost-effectiveness. The major incongruence between expectations and services provided being women-staff communication. ConclusionThe quality of healthcare in Hong Kong is appreciated. Individualized care should be offered to cater to diverse needs. Improvements in staff attitude and provision of detailed information should help alleviate feelings of differential treatment.

Assessing metro network vulnerability with turn-back operations: A Monte Carlo method

Metro network disruptions caused by accidents or maintenance can significantly impact its serviceability. Traditionally, graph theory and complex network methods are utilized to examine topological properties by removing nodes, links, or entire lines. However, in practice, it is the turn-back operation that determines the service cancellations and the affected area. This study assesses metro network vulnerability by considering the turn-back section as the Vulnerability Analysis Unit (VAU). Indicators for evaluating topological accessibility and operational robustness are proposed to assess network performance under disruptions. Monte Carlo method is applied to generate scenarios, involving the removal of various combinations of VAUs. A case study is conducted on Shanghai Metro system. The results indicate that on average, when one VAU is damaged, the travel time will increase by 2.39 minutes and 1.75 % of passengers will move to other transport modes. The critical vulnerable sections are mainly located in radial lines connecting to the loop lines, while those located in or inside the loop line exhibit higher robustness.

When and why does customization reduce booking cancellations? Field evidence from two hotels

PurposeThis study employs S-D Logic to examine the hotel booking behaviors of individuals, with a focus on the impact of service customization on service cancellation. Additionally, the moderating role of social co-creation is explored to provide further insight.Design/methodology/approachThe paper draws on booking data from two hotels: a resort hotel with 40,060 recorded bookings, including 11,122 cancellations, and bookings from a city hotel with 79,330 bookings, including 33,102 cancellations.FindingsThe result reveals that bookings with higher levels of initial customization, such as special requests, are more likely to be modified later and less likely to be canceled. Interestingly, while multi-adult bookings were found to have a higher cancellation rate than individual bookings, the effects of customization commitment were more pronounced for multi-adult bookings.Originality/valueThis paper is the first to establish a connection between service customization, the number of adults on a booking and the likelihood of cancellation, thus providing new empirical evidence for the emergence of customization effects in services. Additionally, the study identifies important contingencies based on the number of consumers in a booking.

Financial Freedom in PAYTREN Multi Level Marketing Practice

Financial freedom is a process to obtain passive income, cancellation, receipt and sale of goods or services, then there is someone who is involved in the Multi Level Marketing business. One company that provides passive financial freedom with a Multi Level Marketing system as PT. Veritra Sentosa Internasional by creating a product called PayTren. PayTren is a mobile transaction application created.The purpose of this study is to find out how the forms and ways of obtaining financial freedom in the practice of Multi Level Marketing PayTren and know the review of the theory of maṣlahah and mafsadah on the forms and ways of obtaining financial freedom Multi Level Marketing PayTren. This research uses descriptive qualitative method. Data sources are taken from primary and secondary data. The acquisition and form of financial freedom achieved leads to greater mafsadah, the main cause is the company making the dominant market opportunity for success it is not clear so it leads to gambling, fraud, usury and tyranny. While the basic services of the PayTren application such as electricity, bpjs, top up the balance, speedy payment and others are not included at all from the main purpose of this contract.

Analysis Of Factors Affecting The Use Of Smartphone Digital Applications By Tourists In Yogyakarta When Traveling In The New Normal Period

The covid-19 epidemic has severely harmed the pariwisata sector, resulting in the cancellation of several events and services due to the requirement to quarantine a sizable region to stop the virus from spreading. A new form of worker compromise is required in this new normal, and that is the use of technology. The purpose of this study is to determine the variables that have the most impact on students' use of digital smartphone applications to be ready for the new normal. To give a more thorough knowledge of the difficulties encountered when employing pariwisata digital apps during pandemics, this study makes use of TAM and TPB. While the TPB offers work-related information, the TAM describes aspects of application usability and perception.

Satisfaction With Telepsychiatry in Child and Adolescent Psychiatry: A Brief Review of the Literature and the Impact of COVID-19

Telepsychiatry use has been increasing over the past two decades and has shown to be a feasible and effective method for psychiatric intervention in pediatric populations.1 The COVID-19 pandemic resulted in the abrupt cancellation of routine and non-essential services and an urgent transition to telepsychiatry. Reports suggested 45.2%-86% of mental health clinics remained open during the pandemic utilizing telehealth methods,2,3 and telepsychiatry use has remained high even after the initial months of the pandemic.4

Impact of pausing elective hip and knee replacement surgery during winter 2017 on subsequent service provision at a major NHS Trust: a descriptive observational study using interrupted time series

ObjectivesTo explore the impact of a temporary cancellation of elective surgery in winter 2017 on trends in primary hip and knee replacement at a major National Health Service (NHS) Trust,...

Heatmap-Based Decision Support for Repositioning in Ride-Sharing Systems

In ride-sharing systems, platform providers aim to distribute the drivers in the city to meet current and potential future demand and to avoid service cancellations. Ensuring such distribution is particularly challenging in the case of a crowdsourced fleet, as drivers are not centrally controlled but are free to decide where to reposition when idle. Thus, providers look for alternative ways to ensure a vehicle distribution that benefits users, drivers, and the provider. We propose an intuitive mean to improve idle ride-sharing vehicles’ repositioning: repositioning heatmaps. These heatmaps highlight driver-specific earning opportunities approximated based on the expected future demand, current and expected future fleet distribution, and the location of the specific driver. Based on the heatmaps, drivers make decentralized yet better-informed repositioning decisions. As our heatmap policy changes the driver distribution in the future, we propose an adaptive learning algorithm for designing our heatmaps in large-scale ride-sharing systems. We simulate the system and generate heatmaps based on the previously learned policy in every iteration. We then update the policy based on the simulation’s outcome and use it in the next iteration. We test our heatmap design in a comprehensive case study on New York ride-sharing data. We show that carefully designed heatmaps reduce service cancellations and therefore, revenue loss for the platform and drivers significantly while leading to a better service level for the users and to a fairer treatment of drivers. History: This paper has been accepted for the Transportation Science Special Issue on Machine Learning Methods and Applications in Large-Scale Route Planning Problems. Funding: This research is funded by the German Research Foundation (Deutsche Forschungsgemeinschaft) [Grant 494812908]. M. W. Ulmer’s work is funded by the German Research Foundation Emmy Noether Programme [Grant 444657906]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2023.1202 .

Hearing healthcare utilisation among older adults with self-reported hearing loss during the COVID-19 pandemic in the United States

Objective To ascertain the prevalence, causes, and risk factors of hearing healthcare delays in older people with self-reported hearing loss in the United States. Design This cross-sectional study used data from the National Health and Ageing Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries. A supplemental COVID-19 survey was mailed to the participants from June to October 2020. Study sample By January 2021, 3257 participants had returned completed COVID-19 questionnaires, with the majority having been self-administered between July and August 2020. Results The participants in the study represented 32.7 million older adults in the US, with 29.1% reporting hearing loss. Among over 12.4 million older adults who put off needed or planned medical care, 19.6% of those with self-reported hearing loss and 24.5% of hearing aid or device users stated they delayed hearing appointments. Approximately 629,911 older adults with hearing devices were impacted by the COVID-19 outbreak for audiological services. The top three reasons were deciding to wait, service cancellation, and fear of going. Education and race/ethnicity were associated with delaying hearing healthcare. Conclusions The COVID-19 pandemic impacted hearing healthcare utilisation among older adults with self-reported hearing loss in 2020, with both patient- and provider- initiated delays.

Partial and complete replanning of an intermodal logistic system under disruptions

The exclusive and excessive use of long-distance road transportation is not suitable way to reduce the negative environmental impacts of logistics systems. Intermodal transport, combining road with other transport modes, has the potential to reduce both operating costs and carbon footprints. One of the reasons for the low share of intermodal transport is its requirement for the coordination of scheduled transport services that can result in reducing reliability in case of disruptions due to the arrival of new shipment orders, fluctuations in shipment quantities, delays, and service cancellations within the network. This calls for reliable and efficient algorithms to replan the shipments’ distribution. In this paper, the replanning problem is formulated as a path-based multi-commodity network flows. We provide two different network topologies, one of which is based on a time–space network, while the other embeds time aspect in a highly scalable alternative structure to large transportation networks. We propose a column generation method whose pricing sub-problems are presented as resource constrained shortest path problem solved via a tailored label-correcting algorithm. We look at the pros and cons of complete and partial replanning in case of disruption and provide managerial insights for intermodal networks. An extensive set of computational experiments is presented on realistic instances being generated with the consultation of our industrial partners for a logistic network including railways, waterways, and roads. The promising outcomes validate the efficiency of the proposed approach that can be easily adjusted to real-time intermodal logistic replanning.

Strengthening container shipping network connectivity during COVID-19: A graph theory approach

A container shipping network connects coastal countries with each other and facilitates most of the world merchandise trade. Reliable maritime connectivity ensures the availability of commodities and economic growth. The global spread of COVID-19 has led to port failures and service cancellations, resulting in decreased connectivity level of container ports. To mitigate the impact of the pandemic, a graph theory approach is proposed to strength the container shipping network connectivity by considering topology and the possibility of opening new shipping links between ports. It is designed to maximize network connectivity with limited addable routes. The network connectivity is measured by algebraic connectivity, and the possibility of opening new shipping links is estimated by an extended gravity model. A heuristic algorithm based on Fiedler vector is introduced to obtain the optimal solutions. The performance of the proposed model and algorithm are verified by testing on a real-world container shipping network based on the Alphaliner database. Experimental results illustrate that the presented model is efficient and effective for strengthening the connectivity. Policy makers can refer to the suggested optimal shipping links to facilitate better shipping network connectivity in the context of the COVID-19 pandemic.

Visits to the emergency department by community-dwelling people with dementia during the first 2 waves of the COVID-19 pandemic in Ontario: a repeated cross-sectional analysis.

Background:Community-dwelling people with dementia have been affected by COVID-19 pandemic health risks and control measures that resulted in worsened access to health care and service cancellation. One critical access point in health systems is the emergency department. We aimed to determine the change in weekly rates of visits to the emergency department of community-dwelling people with dementia in Ontario during the first 2 waves of the COVID-19 pandemic compared with historical patterns.Methods:We conducted a population-based repeated cross-sectional study and used health administrative databases to compare rates of visits to the emergency department among community-dwelling people with dementia who were aged 40 years and older in Ontario during the first 2 waves of the COVID-19 pandemic (March 2020–February 2021) with the rates of a historical period (March 2019–February 2020). Weekly rates of visits to the emergency department were evaluated overall, by urgency and by chapter from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. We used Poisson models to compare pandemic and historical rates at the week of the lowest rate during the pandemic period and the latest week.Results:We observed large immediate declines in rates of visits to the emergency department during the COVID-19 pandemic (rate ratio [RR] 0.50, 95% confidence interval [CI] 0.47–0.53), which remained below historical levels by the end of the second wave (RR 0.88, 95% CI 0.83–0.92). Rates of both nonurgent (RR 0.33, 95% CI 0.28–0.39) and urgent (RR 0.51, 95% CI 0.48–0.55) visits to the emergency department also declined and remained low (RR 0.68, 95% CI 0.59–0.79, RR 0.91, 95% CI 0.86–0.96), respectively. Visits for injuries, and circulatory, respiratory and musculoskeletal diseases declined and remained below historical levels.Interpretation:Prolonged reductions in visits to the emergency department among people with dementia during the first 2 pandemic waves raise concerns about patients who delay seeking acute care services. Understanding the long-term effects of these reductions requires further research.

Assessment of the impact of the COVID-19 pandemic on health services use

ObjectivesThe coronavirus disease of 2019 (COVID-19) pandemic declared by the World Health Organization on March 11, 2020 impacted healthcare services with provider and patient cancellations, delays, and patient avoidance or delay of emergency department or urgent care. Limited data exist on the population proportion affected by delayed healthcare, which is important for future healthcare planning efforts. Our objective was to evaluate the impact of the COVID-19 pandemic on healthcare service cancellations or delays and delays/avoidance of emergency/urgent care overall and by population characteristics. Study designThis was a cross-sectional study. MethodsOur sample (n = 2314) was assembled through a phone survey from 8/12/2020–10/27/2020 among non-institutionalized St. Louis County, Missouri, USA residents ≥18 years. We asked about provider and patient-initiated cancellations or delays of appointments and pandemic-associated delays/avoidance of emergency/urgent care overall and by participant characteristics. We calculated weighted prevalence estimates by select resident characteristics. ResultsHealthcare services cancellations or delays affected ∼54% (95% CI 50.6%–57.1%) of residents with dental (31.1%, 95% CI 28.1%–34.0%) and primary care (22.1%, 95% CI 19.5%–24.6%) being most common. The highest prevalences were among those who were White, ≥65 years old, female, in fair/poor health, who had health insurance, and who had ≥1 medical condition. Delayed or avoided emergency/urgent care impacted ∼23% (95% CI 19.9%–25.4%) of residents with a higher prevalence in females than males. ConclusionsHealthcare use disruptions impacted a substantial proportion of residents. Future healthcare planning efforts should consider these data to minimize potential morbidity and mortality from delayed care.

ASD Diagnosis and Treatment Experiences Among Mexican Heritage Families

To understand the ASD diagnosis and treatment pathways for US families, N = 38 Mexican-heritage mothers were interviewed about how and when they obtained an ASD diagnosis for their children. Most children (84%) were diagnosed between two and three years old. One-third of mothers reported receiving four to seven referrals before diagnosis. Mothers identified multiple diagnosis circumstances including two diagnoses and services offered before diagnosis. A multiple case study design documented the diagnosis and treatment experiences of four representative participants. As compared to previous studies that utilized a deficit lens to rationalize barriers to diagnosis and treatment (e.g., parents not knowledgeable about ASD), these findings revealed a complex understanding of how structural barriers (e.g., immigration status), initial diagnosis rejection among caregivers, and abrupt service cancellation complicated the diagnosis and treatment process. Implications identified suggestions to optimize and streamline ASD diagnosis and treatment pathways for Mexican heritage families.

Restrictions on healthcare utilization and psychological distress among patients with diseases potentially vulnerable to COVID-19; the JACSIS 2020 study

ABSTRACT Background Patients with comorbidity are at higher risk of deteriorating COVID-19, but they need to access healthcare services regularly for their primary disease. This study aimed to investigate whether patients restricted healthcare utilization due to the COVID-19 pandemic and to understand the relations between restriction of healthcare utilization and psychological distress of patients with a disease potentially vulnerable to COVID-19. Methods Participants were a sub-sample of 6,360 individuals suffering from chronic diseases with hypertension, diabetes, respiratory diseases, cerebrovascular disease, and cancer from the nationally representative cross-sectional internet survey data of Japan. Participants reported healthcare utilization during the first state of emergency, as well as psychological distress (K6: The Kessler Psychological Distress Scale 6) in three months after the state of emergency was ended. Multivariate linear regression analyses were performed to examine the correlation between psychological distress and healthcare utilization. Results In total, 16% restrained from visiting a hospital as scheduled or canceled a doctor visit. Approximately less than 2% experienced cancellation or delay of hospitalization, treatment, or nursing-care services. After controlling for confounders, multivariate linear regression analysis showed that those who lacked medicines, experienced deteriorated health conditions, and could not visit a hospital during the state of emergency reported severe psychological distress three months later among the patients with all disease types except cancer (β = 0.10∼0.25). Conclusions The study indicated the restriction in healthcare utilization might be a risk factor for psychological distress among patients. Careful attention to the mental status of patients, especially those who were restricted in healthcare utilization, is necessary.

Non-communicable disease care and management in two sites of the Cape Town Metro during the first wave of COVID-19: A rapid appraisal.

BackgroundNon-communicable diseases (NCDs), including type-2 diabetes and hypertension, have been associated with increased morbidity and mortality rates because of coronavirus disease 2019 (COVID-19). Maintaining quality care for these conditions is important but data on the impact of COVID-19 on NCD care in South Africa are sparse.AimThis study aimed to assess the impact of COVID-19 on facility and community-based NCD care and management during the first COVID-19 wave.SettingTwo public health sector primary care sites in the Cape Town Metro, including a Community Orientated Primary Care (COPC) learning site.MethodsA rapid appraisal with convergent mixed-methods design, including semi-structured interviews with facility and community health workers (CHWs) (n = 20) and patients living with NCDs (n = 8), was used. Interviews were conducted in English and Afrikaans by qualified interviewers. Transcripts were analysed by thematic content analysis. Quantitative data of health facility attendance, chronic dispensing unit (CDU) prescriptions and routine diabetes control were sourced from the Provincial Health Data Centre and analysed descriptively.ResultsQualitative analysis revealed three themes: disruption (cancellation of services, fear of infection, stress and anxiety), service reorganisation (communication, home delivery of medication, CHW scope of work, risk stratification and change management) and outcomes (workload and morale, stigma, appreciation and impact on NCD control). There was a drop in primary care attendance and an increase in CDU prescriptions and uncontrolled diabetes.ConclusionThis study described the service disruption together with rapid reorganisation and change management at primary care level during the first COVID-19 wave. The changes were strengthened by the COPC foundation in one of the study sites. The impact of COVID-19 on primary-level NCD care and management requires more investigation.

Perception of the COVID-19 pandemic among people with spinal cord injury: an Italian survey.

Study designAn observational study based on an online survey to explore if the participant had experienced (1) cancellation or delay of scheduled health services (2) reduction of assistance provided by a caregiver (3) barriers to social participation and recreational activities. Three validated questionnaires to investigate well-being and symptoms of anxiety and depression were also administered.ObjectivesOur main aim was to quantify the obstacles experienced by adults living with SCI in Italy during COVID-19 pandemic, to explore the presence of depression and anxiety symptoms and to quantify subjective well-being.SettingOutpatient clinic of a Spinal Unit in Italy.MethodsOnline survey via direct contact and by e-mail lists.ResultsIn total, 101 individuals completed the survey. Of, 82.2% participants reported a history of deferment or cancellation of non-COVID-19 health services. The majority (56.4%) revealed that, at least seldom, they have chosen to reduce their usual everyday activities and more than one third (37.6%) affirmed that they had been forced to renounce to one or more of their occupations. Discontinuation of assistance by caregivers was uncommon. The median score of questionnaires measuring depression and anxiety symptoms do not differ significatively when compared with prior studies. The variable that explored the limitations experienced in everyday activities showed a significant correlation with the results of the questionnaires measuring well-being and symptoms of anxiety.ConclusionsWe believe that our results could contribute to the discussion ongoing inside our community on how to answer to the new challenges of this pandemic period and of the post-pandemic future.

133 THE RELATIONSHIP BETWEEN DELAYED HEALTHCARE UTILISATION AND CHRONIC CONDITIONS AMONG OLDER ADULTS DURING THE COVID-19 PANDEMIC IN IRELAND

BackgroundThe coronavirus 2019 (COVID-19) pandemic impacted significantly on the lives of older adults in Ireland, including the cancellation or postponement of healthcare services. This study examined the relationship between healthcare delay and older adults (50 years and over) with chronic conditions in Ireland.MethodsThis study used data from the Irish Longitudinal Study on Ageing (TILDA) COVID-19 study and previous waves of TILDA. The COVID-19 study data was collected between July 2020 and November 2020. Taking existing healthcare demand into account, logistic regression analysis was used to examine the relationship between healthcare delay and older adults with chronic conditions. Additional analysis, using multinomial logit regression, explored the reasons for healthcare delay, whether the delays were on the participants behalf or the health service provider.ResultsIn total, 31.6% of participants reported healthcare delay. Older adults with two or more chronic conditions were more likely to experience healthcare delay than those with no chronic conditions. In the second analysis, older adults with two or more chronic conditions were more likely to have healthcare delayed by the provider and were also more likely to delay their own healthcare than those with no chronic conditions. Additionally, some other groups were more likely to experience healthcare delay such as: people aged 70 years and over, females, those with problematic alcohol consumption, those with third-level education, those who had visited the GP and those who reported polypharmacy. While older adults living with others and those living outside Dublin were less likely to experience healthcare delay.ConclusionThe findings suggest that some groups of older adults may have been impacted more than others by healthcare delay during the pandemic. Policy and practice should focus on effective strategies to support the healthcare needs of these older adults going forward. Additionally, future research should examine the implications of healthcare delay on health outcomes.

1159 Ring-Fenced Arthroplasty Unit: The Need of The Hour During Winter and A Pandemic Crisis

AimWinter pressures along with the COVID-19 pandemic, have caused cancellation of elective services, prolonged waiting times, patient dissatisfaction and financial implications. Length of stay (LOS) following joint replacements is variable. The availability of ring-fenced beds and enhanced recovery protocol (ERP) can improve these outcomes. The performance of a stand-alone arthroplasty unit in an acute NHS Trust was assessed regarding safety, LOS and complications.MethodPatient data was collected for total hip & knee replacements (TJAs) between the months of December to March of 2018-19 and 2019-20. Demographics, ASA, transfusion rates, LOS and 90-day reattendance was analysed. Modified ERP implemented in late 2019 included changes in analgesia and early post-operative mobilisation. The performance was then compared with DGHs within the region.ResultsIn 2019-20, of 280 TJAs performed, there was a mean LOS of 43 hours. This shows a reduction compared with LOS of 69 hours in 2018-19, where 288 TJAs were performed. In 2019-20, 74% of cases had early discharge within 36 hours of surgery, versus 24% in 2018-19. This accumulates to 333 inpatient days saved. Note that following ERP modification, 6 patients were discharged on the day of surgery. Surgery related complications within 3 months which required reattendance, were seen in only 2 patients. This unit performed an average of 335 TJA’s in these winter months, the highest average in comparison to other DGHs in the East Midlands region, which had an overall average of 165 cases.ConclusionsA ring-fenced arthroplasty service with adherence to ERP significantly decreases LOS and increases productivity.