Thesis (MBA (Business Management))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: In the field of Economics, the term “competition” refers to the method involved in steering an increase in supply, which leads to a decrease in equilibrium price and an increase in equilibrium quantity. However, competition involves more than just an increase in supply. In any economy, competition can affect factors, such as innovation, efficiency and the accessibility to goods and services. In some cases, the effect might not be positive, if the goods and services only benefit certain parties involved, rather than the general population. Traditionally, there are four basic types of market structure, with each structure displaying unique market power characteristics, which are initiated by an organisation’s profit motives. All market structures, other than that of perfect competition, are forms of imperfect competition. One such imperfect market structure is oligopoly, which has certain unique characteristics (Doyle, 2005:198). In the private health care sector, cost increases can be related to the increased market concentration, due to the increase of market power by hospital groups. Therefore, the prevalence of competition in the private health care sector should be monitored. That health care functions in a dynamic environment has been historically proven and can also be seen in the latest trends. A bundle of factors, rather than a single factor, determines success. Any overview of the international health care industry should demonstrate the rapid development of the industry. The industry, compared with the relatively elementary and experimental health care system of a few decades ago, is currently super specialised. A shift has taken place in the market from the role of the industry as a government-funded health care provider to that of a private hospital provider. In South Africa, the complexity of the health care sector is made even more complex by the many role-players and the interaction between the different private and public health providers. The cost of access to hospitals should be prioritised. Research shows that the private health care sector caters for the health needs of almost seven million people, who comprise only 15% of the total population. However, the sector has spent more money than the entire public sector, with the per capita expenditure exceeding that of the public sector eightfold. The increase in the cost of private hospitals in South Africa has been caused by changes in the market concentration. Such expenditure has given the private hospitals greater market power and has influenced their behaviour. / AFRIKAANSE OPSOMMING: In ekonomie verwys die term “kompetisie” na die metode betrokke om ’n toename in aanbod te veroorsaak, wat weer ’n verlaging in die ewewigsprys en ’n verhoging in die ewewigshoeveelheid tot gevolg het. Kompetisie behels egter meer as net ’n verhoging in aanbod. In enige ekonomie kan kompetisie faktore soos innovasie, doeltreffendheid en toegang tot goedere en dienste beïnvloed. In sommige gevalle is die effek egter nie positief nie, soos wanneer goedere en dienste slegs sekere belanghebbendes bevoordeel in plaas van die algemene publiek. Daar is, tradisioneel gesproke, vier basiese markstrukture wat elkeen unieke markbeherende eienskappe toon wat deur die organisasie se winsmotiewe geïnisieer word. Alle markstrukture, behalwe volmaakte kompetisie, is vorms van onvolmaakte kompetisie. Een so ’n markstruktuur is oligopolie wat sekere unieke eienskappe toon. In die privaat–gesondheidsorgsektor, is kosteverhogings gekoppel aan verhoogde markkonsentrasie as gevolg van die toename in privaat hospitaalgroepe. Kompetisie in die privaat-gesondheidsorgsektor moet dus gemonitor word. Dat gesondheidsorg in ’n dinamiese omgewing funksioneer is reeds bewys en kan ook in die nuutste tendense gesien word. Dit is egter ‘n hele groep faktore, nie slegs een faktor nie, wat sukses waarborg. ’n Oorsig van die internasionale gesondheidsorgindustrie toon dat ontwikkelinge in die industrie baie vinnig vorder. Vandag is gesondheidsorg uiters gespesialiseerd in vergelyking met dekades terug, toe dit relatief elementêr en eksperimenteel was. Die rol van die industrie het verskuif van ’n staats-gesubsidieerde diens na waar dit vandag grootliks deur privaat instansies gelewer word. In Suid-Afrika word ’n reeds komplekse gesondheidsorgsektor meer gekompliseer deur die baie rolspelers in die sektor asook die interaksie tussen die verskillende privaat- en staatsgesondheidsorgvoorsieners. Die koste van toegang tot hospitale behoort ’n prioriteit te wees. Navorsing toon dat die die privaatgesondheidsorgsektor dienste aan sewe miljoen mense bied wat slegs 15% van die totale populasie is. Hierdie sektor spandeer egter baie meer as die met ’n per capita uitgawe byna agt keer meer as staatsgesondheidsorg. Die oorsaak van koste verhogings in privaatgesondheidsorg in Suid-Afrikaanse hospitale is veroorsaak deur veranderinge in die konsentrasie van die privaatgesondheidsorgsektor. Dit gee privaathospitale groter markmag en beïnvloed dus hul optrede.

atisfaction with diabetes care, perceived feelings of empowerment to participate in self-care management, and glycemic control in a sample of older African American men and women with diabetes. A descriptive correlational quantitative design was used. The participants in this study were 73 men and women of African descent who were at least 50 years, English speaking, and diagnosed with diabetes for at least one year. The participants were asked to complete three survey instruments: the Patient Satisfaction Questionnaire-18 (PSQ-18), which measured how satisfied the participants were with their medical care; the Diabetes Empowerment Scale-Short Form (DES-SF), which measured attitudes towards diabetes and self-management of diabetes; and a demographic form, which collected data on the demographics of each participant. The most recent hemoglobin A1c (HbA1c) of each participant was obtained from the medical records. The correlations between HbA1c, DES, and the PSQ-18 subscales were exam ined. The study data indicated all correlations were statistically significant and negative with one exception. There was no correlation between HbA1c and time spent, a satisfaction subscale. Approximately half the participants were high school graduates, married, and reported being born in the Caribbean. Most had primary care physicians, but less than half reported attending a diabetes education program. The average BMI was 33.0. The findings of this study indicated older African adults who reported higher satisfaction with the care provided by their health care provider reported feeling more empowered to participate in diabetes self-care and reported lower HbA1c levels, suggesting better glycemic control (R2 = .39; P=<.001). / The implications of this study are that feeling empowered to participate in diabetes self-care management may result in improved glycemic control. Positive diabetes outcomes have been linked in the literature with persons feeling empowered to participate in diabetes self-care. The significance of the findings from this study is that given the relationship between empowerment and glycemic control, nurses should support the empowerment model of diabetes teaching. Diabetes education should provide written materials that are culturally sensitive for African American elders. / by Bridgette M. Johnson. / Thesis (Ph.D.)--Florida Atlantic University, 2012. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2012. Mode of access: World Wide Web.

University of Macau / Institute of Chinese Medical Sciences

xiii, 123 p. : ill. (some col.) A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / To complement a varied and growing literature in health economics, this dissertation is conducted in three substantive parts. First, I investigate the effect of public policy on health use and health outcomes, exploiting variation in the generosity of Medicaid eligibility to low income pregnant women across states and over time to identify an effect on common, yet costly, pregnancy complications. I provide new evidence on this important question from a nationally representative sample of hospital discharges for 12 states between 1989 and 2001. Second, I explore heterogeneity in individual demand for health risk reductions. Utilizing individual stated-preference data from matching surveys conducted in both Canada and the United States, I employ the Value of a Statistical Illness Profile framework to investigate differences in average willingness-to-pay (WTP) for health risk reductions across the two different cultures. Although existing literature has allowed for systematic variation in age to explain differences in health care demand, the differences in WTP have not been explained through systematic variation across other socio-demographic characteristics, subjective risks of the diseases in question, or differences between the Canadian and U.S. health care systems. I extend the literature by controlling for an expanded set of observable individual heterogeneity and comment on the degree to which estimates can be applied across cultures to inform varying policy decisions. The third paper studies factors affecting adolescent health risk behavior. Previous study finds that community size and the degree to which social networks are interconnected affect three economically significant outcomes: the frequency of adolescent misbehavior in school, degree of perceived safety in school, and grade performance. Other research has suggested peer effects on smoking behavior and drinking behavior. I investigate the degree to which social connectedness impacts adolescent health, specifically looking at outcomes for drinking and smoking, and the degree to which these effects can be disentangled from more commonly studied "peer effects" in health behavior. / Committee in charge: Trudy Cameron, Co-Chairperson, Economics; Glen Waddell, Co-Chairperson, Economics; Anne van den Nouweland, Member, Economics; Jessica Greene, Member, Planning Public Policy & Mgmt; David Levin, Outside Member, Mathematics

This dissertation examined an implementation gap through a case study on implementing a District Health System (DHS) in the Western Cape Province of South Africa between October 2001 and April 2006. The research project explored why this implementation gap existed and what could be learnt about public policy implementation from studying this implementation gap. The main data collection methods included interviews, public and other documents and observations on the public health system in the Western Cape Province. I argue that implementation gaps could be interpreted as a signal of policy change instead of implementation failure. The key finding is that the Provincial Government of the Western Cape shifted its intentions regarding DHS implementation. The initial intention was to decentralise primary health care services to a metropolitan municipality. The decision, which was actively implemented, however centralised these services within the provincial government and started the process of the provincialisation of personal primary health care services in the Western Cape Province. This dissertation contributes to public policy implementation and public policy process literatures. It demonstrates why policy change is an alternative interpretation of implementation gaps to implementation failure and how policy change occurs during implementation. Policy change and public policy implementation are commonly two separate research themes within Public Policy Studies. The persuasion framework developed through this research project is an analytical tool that may be applied in research on implementation processes to examine whether an implementation gap is signalling policy change. The central theoretical elements in this framework that link policy change and implementation processes are the interactive effects of ideas and interests and the role of argument as a persuading factor that leads to policy change. The dissertation emphasises the role of language in public policy processes and argument and persuasion were deemed important elements in public policy processes.

No description available.

This study is based on a survey of over 900 respondents living in Tigray, Ethiopia and is intended to assist the Ethiopian government as well as other interested parties in analyzing the factors affecting the incidence of malaria in Tigray and those affecting people's choice of health care provider. / Two models were designed to answer these two questions. The first was a multinomial logit model in which socio-economic indicators were related to the incidence of malaria. The second model was specified as a conditional logit model aimed at determining people's choice between seeking treatment at a hospital/clinic or at a pharmacy/community health worker. / Economic development is the key to eradication of the major parasitic diseases, particularly malaria. An interesting result was obtained on the gender of the respondent; women in Tigray are less likely to report having had malaria than men. / Education level was found to be positively correlated with the likelihood of choosing the Hospital/Clinic option over the Pharmacy/Community Health Worker. / The Hospital/Clinic option was less likely to be chosen with increasing cost of treatment. (Abstract shortened by UMI.)

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 1992. / Typescript. Includes bibliographical references (leaves 112-117).

Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0967. Adviser: Luisa Franzini. Includes bibliographical references.

Thesis (Ph. D.)--RAND Graduate School, 2000. / Includes bibliographical references (p. 123-131).