Fear of disasters within the risk communication network of foreign students in Japan amid the COVID-19 pandemic crisis: A cohort design.

The main objective of this study is to examine the role of risk communication during the COVID-19 crisis, which is often neglected in studies investigating the outbreak of the pandemic. The study is based on survey data from a group of international (non-Japanese) students in Japan and the theoretical foundation of fear appeal theory. The results, which are based on the panel data structure, show that individually, (1) the act of seeking out others to discuss risks in depth in the current pandemic context or (2) the observed adoption of advocated precautionary health behaviours is not necessarily a good indicator of mental management, but (3) the combined effect of (1) and (2) unexpectedly suggests a conciliatory effect on the fear of disasters. Moreover, this evidence-based finding (3) suggests that a reciprocal relationship exists between threat and efficacy in terms of mediating fear under the framework and theory of fear appeals, indirectly challenging the fear control response proposition of the extended parallel process model. Our empirical findings emphasize the role of risk discourse and information sharing combined with preventive health behaviours adopted within a community in the context of global health crises.

The Emergence of Risk Communication Networks and the Development of Citizen Health-Related Behaviors during the COVID-19 Pandemic: Social Selection and Contagion Processes.

Amid the novel coronavirus pandemic, a variety of public health strategies have been implemented by governments worldwide. However, the fact that strict government mandates focus on physical distancing does not mean that social connectedness for voluntary risk communication among citizens should be sacrificed. Furthermore, we lack an understanding of citizens' behaviors regarding the voluntary adoption of public health measures and the control of mental wellbeing in the age of physical distancing. Key variables in the response to the global pandemic are the emergence of risk deliberation networks, voluntary compliance with government guidelines, and the restoration of citizens' subjective health. However, little is known about how citizens' health-related behaviors coevolve with social connections for sharing information and discussing urgent pandemic issues. The findings show that selection and social influence mechanisms coexist by affecting each citizen's health-related behaviors and community-led risk discourses in the face of the urgent health crisis.

Expelled uninsured patients in a less-competitive hospital market in Florida, USA.

BACKGROUND: This research evaluates the effect of hospital competition on inward and outward patient transfers for different types of payers including the uninsured. Although it is a less spotlighted issue, an equally important topic is the likelihood of inter-hospital patient transfers of the insured and the uninsured. This study attempts to fill a gap in the research about the relationship between hospital competition and patient transfers. METHODS: By developing the payer-specific level of hospital competition, this research evaluates the effect of hospital competition on inward and outward patient sharing (or patient transfers) for different types of payers including the uninsured. For patient transfers, instead of focusing on whether a patient is transferred from one hospital to another hospital at the patient level, we measure the numbers of patient transfers between hospitals (both inward and outward) at the hospital level. These dependent variables-the numbers of outward and inward patient transfers by the principal payers-are count variables, and we employ either a Poisson regression model or a negative binomial regression model. RESULTS: Controlling for hospital characteristics, when the uninsured Hirschman-Herfindahl Index (HHI) increased by 0.01, the uninsured were 593 % more likely to be transferred to another hospital. When a hospital dominates its market, it tends to expel uninsured patients to other hospitals. CONCLUSION: If patient transfers are medically unnecessary and primarily due to financial incentives, health administrators and policymakers should minimize such events. Since the uninsured who are admitted to a hospital that dominates its hospital market are likely to be much more vulnerable in their access to health care services, the state government of Florida needs to move toward increased health insurance coverage for eligible Floridians.

Has competition increased hospital technical efficiency?

Hospital competition and managed care have affected the hospital industry in various ways including technical efficiency. Hospital efficiency has become an important topic, and it is important to properly measure hospital efficiency in order to evaluate the impact of policies on the hospital industry. The primary independent variable is hospital competition. By using the 2001-2004 inpatient discharge data from Florida, we calculate the degree of hospital competition in Florida for 4 years. Hospital efficiency scores are developed using the Data Envelopment Analysis and by using the selected input and output variables from the American Hospital Association's Annual Survey of Hospitals for those acute care general hospitals in Florida. By using the hospital efficiency score as a dependent variable, we analyze the effects of hospital competition on hospital efficiency from 2001 to 2004 and find that when a hospital was located in a less competitive market in 2003, its technical efficiency score was lower than those in a more competitive market.

To whom do bureaucrats need to respond? Two faces of civil society in health policy.

The South Korean government implemented a law that separates the dispensing and prescribing (SDP) of drugs in July 2000. It was one of the most controversial issues in the Korean healthcare delivery system. Drawing on the conflict-cycle view and stakeholder analysis, which was used to examine how multiple stakeholders influenced this policymaking process, this study examines 1) the role of Korean civil society (i.e., civic and special interest groups) in SDP reform and 2) why SDP reform led to unintended consequences. We argue that bureaucrats in the Ministry of Health and Welfare (MoHW) should have played a central role in accommodating the public interest. Because they failed to do so, civic groups assumed major mediating and moderating roles. Due to the civic groups' lack of technical knowledge and professional experience, however, they played a limited role. In finalizing the proposal, therefore, bureaucrats were captured by strong interest groups, leading to unintended consequences, such as the increased use of non-covered services and higher healthcare expenditures. To ensure that the government serves the authentic public interest rather than special interest groups, bureaucrats should be responsible to the public rather than these interest groups. Moreover, civic groups should be strengthened (in relation to strongly organized interest groups) and included systematically in creating health policy.