Influences of organizational features of healthcare settings on clinical decision making: Qualitative results from a cross-national factorial experiment

Karen Lutfey, Stephen Campbell, Lisa D. Marceau, Martin Roland, John McKinlay

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians' explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed
Original languageEnglish
Pages (from-to)40-56
Number of pages17
JournalHealth (Irvine)
Volume16
Issue number1
DOIs
Publication statusPublished - 2012
Externally publishedYes

Fingerprint

decision making
experiment
medical practice
economic system
cultural difference
medical care
deficit
physician
interaction
literature

Cite this

Lutfey, Karen ; Campbell, Stephen ; Marceau, Lisa D. ; Roland, Martin ; McKinlay, John. / Influences of organizational features of healthcare settings on clinical decision making: Qualitative results from a cross-national factorial experiment. In: Health (Irvine). 2012 ; Vol. 16, No. 1. pp. 40-56.
@article{766f0619d6f549e1bed513e3e26ee9fe,
title = "Influences of organizational features of healthcare settings on clinical decision making: Qualitative results from a cross-national factorial experiment",
abstract = "A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians' explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed",
author = "Karen Lutfey and Stephen Campbell and Marceau, {Lisa D.} and Martin Roland and John McKinlay",
year = "2012",
doi = "10.1177/1363459310371079",
language = "English",
volume = "16",
pages = "40--56",
journal = "Health (Irvine)",
issn = "1949-4998",
number = "1",

}

Influences of organizational features of healthcare settings on clinical decision making: Qualitative results from a cross-national factorial experiment. / Lutfey, Karen; Campbell, Stephen; Marceau, Lisa D.; Roland, Martin; McKinlay, John.

In: Health (Irvine), Vol. 16, No. 1, 2012, p. 40-56.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Influences of organizational features of healthcare settings on clinical decision making: Qualitative results from a cross-national factorial experiment

AU - Lutfey, Karen

AU - Campbell, Stephen

AU - Marceau, Lisa D.

AU - Roland, Martin

AU - McKinlay, John

PY - 2012

Y1 - 2012

N2 - A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians' explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed

AB - A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians' explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed

U2 - 10.1177/1363459310371079

DO - 10.1177/1363459310371079

M3 - Article

VL - 16

SP - 40

EP - 56

JO - Health (Irvine)

JF - Health (Irvine)

SN - 1949-4998

IS - 1

ER -