Research Proposal 2
With this research, my project
hopes to meet at least one of the three critical objectives in the Institute
for Healthcare Improvement’s Triple Aim framework. It is the project’s
hope to at least meet the 3rd objective of reducing the per
capita cost of dental care who seek out such treatment. This will be
addressed by data collection of the different pricing in the respective
markets. Achieving Triple Aim’s other
two objectives might also be achieved as a consequence of the meeting the 3rd
objective. If members of the population are able to receive dental care
that they might not otherwise have had due to the cost savings, this would
improve the health of such members, ie. the 1st objective of Triple
Aim. Triple Aim’s 2nd objective might be more difficult in its
achievement as comparing the patient care experience between my studied
populations might show less variation.
How is this project hoping to
achieve the above; some background first. With U.S. healthcare costs
reaching $3.2 trillion dollars (in 2015), one component of this figure includes
the sector of dental health care. Researching the price discrepancies of
such dental care in the U.S. versus Sonora, Mexico market might be of some
interest for the local Tucson population. This research would focus on
the service prices in the three distinct regions of Tucson, Nogales and
Hermosillo. Dental care prices are figured to be lower in Nogales, MX
than in Tucson, US; and maybe even lower in Hermosillo, MX, 4 hours south of
Nogales. The further distance and perceived unknown of interior Mexico
may provide a barrier for many in Tucson to attempt dental care services.
The has already begun to collect
primary data of pricing for various dental services in each of the above
three-mentioned markets. That summary
descriptive data will be analyzed for broad differences/similarities. Inferential
statistics will then be performed to test for differences, including two-way
ANOVA tests. A survey will also be created. The response data will help in performing an
analysis of local U.S. views on having dental work done in U.S vs. Sonora, MX.
Also, exploring what price points might be attractive enough to have a patient
make a trip to either Nogales or Hermosillo. I would also attempt to
frame the survey questions with certain wording similar to how the health care
advertising industry frames its arguments in order to manipulate consumer
purchasing of health care. Would different wording of the survey
questions make local resident less likely to have dental work in Mexico
compared to controlled survey wording? Would it change their price point
(make it lower) before considering such a trip?
Both uninsured and insured dental care patients would be considered for
this survey and would be appropriately screened. Overall, does the further distance and being
in Mexico provide a barrier to attempt such dental care services?
Dental services achieved the
highest acceleration (almost double) of spending from 2014, versus any other
health care sector, with an increase of 4.2% from the previous year’s 2.4%
growth.1 This translates to $117.5 billion, or 4% of the health care
market.1 With an astronomical 40% of these services paid for
out-of-pocket1, exorbitant pricing has an immediate direct impact on
the patient. Where many people might have a perception of dental care as
a teeth cleaning or something aesthetic, untreated dental care can result in a
great deal of pain and even death. Untreated dental care can also lead to
health problems not just contained in the human mouth. Research has
linked treating periodontal disease with lower medical costs for diabetes and
heart disease, among other conditions.2 One of the
populations most greatly affected by poor dental is that of senior population,
with more than a third of such incomes below 200 percent of the federal poverty
level (about $23,000 annually) and suffering from untreated tooth decay.3
Traditional Medicare generally does
not cover dental care services unless it is related to services received in a
hospital. Medicare managed care plans provide some general dental care, but the
coverage can vary, and often is minimal with the plans often being a loss
leader.3 It gets “people in the door”, but the coverage
is extremely limited.3 Trying to purchase private
dental insurance may not even provide a good value for the consumer.
"When you add up the premiums and copays, for the vast majority of adults
it's not worthwhile to have dental insurance".3
Other fundamental concerns for
funding of dental services come from many states’ dental health system not
being able to provide proper appropriations for their state’s fund leading to a
deficiency of services for their state’s poorest.2
Overall, this has led many U.S. citizens to consider other alternatives for
their dental care. An estimated 1.3 million Americans left the US for
medical care in 2016; about 50 percent went to Mexico for dental procedures.
The total value of the global medical tourism market is expected to climb
to over $32 billion by 2019.5
Literature has indicated that
healthcare information can be framed in such a way as to influence how
individuals process advertising information6 and how they respond
with their purchase decisions.7 One specific study divided
health-care customers into two groups, prevention-focused individuals and
promotion-focused individuals.8 The study found that how an
advertiser frames its advertisement about health-care significantly affects how
a group decides to purchase a health-care service. In turns out that
applying a negatively framed healthcare advertising strategy to
prevention-focused individuals will enhance the advertising effectiveness.8
Specifically, for the target market consisting of prevention-focused
individuals, advertisers should highlight that those who refuse to follow the
advocacy in the negatively-framed healthcare advertising messages may not
maintain their health and may suffer from health losses.8 To
persuade promotion-focused individuals, on the contrary, advertisers are
advised to frame their healthcare advertising messages positively, which
emphasize that the positively framed advocacy benefits to make them healthier.8
It would be interesting to conduct
a similar statistical study and show how manipulation of the wording of
questions in a survey will impact how a person views dental care in the foreign
country of Mexico and how much it could potentially limit them to seek such
care even at a significantly lower price. Difficulties might present
themselves in obtaining very similar representative samples across all of the
different survey groups, both control and uncontrolled. Predetermination
of a person’s attribute of prevention-focused vs promotion-focused may be
impossible to determine before grouping them according to certain group
variables. It may also be difficult to obtain pricing for certain dental
services in Tucson.
6
Kiviniemi, M. T., & Rothman, A.
J. (2006). Selective Memory Biases in Individuals’ Memory for Health-Related
Information and Behavior Recommendations. Psychology and Health, 21(2),
247-272.
7
Kolodinsky, J. M., & Narsana,
R. T. (2003). Factors Influencing the Search for Information about Genetically
Modified Food Products. International Journal of Consumer Studies, 27(3),
218-251.
8
www.scholink.org/ojs/index.php/jbtp
Journal of Business Theory and Practice Vol. 1, No. 1;
March 2013, 104. Published by SCHOLINK CO., LTD
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