INQUIRY IN HEALTH CARE

Inquiry in Health Care



Inquiry in Health Care

This paper is a discussion of the possible ethical dilemmas that may arise in both qualitative and quantitative research despite stringent methodological protocols. Three categories of ethical issues will be elaborated on, namely, researcher-participant relations, informed consent and confidentiality and privacy. These are of note because ethical dilemmas most often arise in these areas. Both qualitative and quantitative research types may thus present with problems associated with any, or a combination, of these categories. Methodological rigour will also be discussed as a vital component of any research study (Exworthy & Stuart, 2003). Critics of the qualitative approach have often suggested that the innate lack of methodological rigour has resulted in the preponderance of ethical issues in qualitative studies. Qualitative studies, similar to quantitative studies, have mechanisms that guarantee rigour, quality and trustworthiness. These checks are at par with those of quantitative research but based on different criteria. Both types of research, then, can be considered equal in terms of methodological rigour, regardless of the nature. As no research approach can be perfectly free from threats of ethical issues, it is the researcher's responsibility to address these in ways that will be less harmful to the participants, bearing in mind ethical problems can arise at any time during the research endeavour.

The Effects of Market Structure and Payment Rate on the Entry of Private Health Plans into the Medicare Market by Austin B. Frakt, Steven D. Pizer, and Roger Feldman - This study examined firm-level entry models for the three main types of Medicare private health plans: coordinated care plans (CCPs) such as health maintenance organizations; private fee-for-service plans (PFFPs); and prescriptions drug plans (PDPs). Findings show that entry barriers -- for instance, the establishment of exclusive provider networks -- associated with CCP market concentration affect all three product types. Results indicate competition among products and suggest that cost and demand factors make market entry of certain product combinations more likely. The authors predict that the Affordable Care Act's proposed payment reductions for Medicare Advantage plans will decrease the presence of CCPs and PFFS plans and increase entry by PDPs. This is the first study to look at the effects of market structure across multiple products and to assess entry behavior from the firm's perspective (Kunst & Mackenbach, 1994).

The Impact of Maternity Length-of-Stay Mandates on the Labor Market and Insurance Coverage by Lindsay M. Sabik and Miriam J. Laugesen - This study found that state legislation mandating minimum maternity lengths of stay affected employer-sponsored health insurance coverage and possibly wages of employees at small firms, though it did not have a statistically significant impact on labor market outcomes overall among employees at firms of all size firms. At the smallest firms in states with the mandates, employees experienced a 6.2-percentage-point decline in the likelihood of having employer-sponsored insurance. The authors say the findings illustrate the need to consider how minimum benefit standards required under the health reform law will affect firms of ...