Market Research in Health and Social Care

Mike Luck, Rob Pocock, Mike Tricker

• Publisher: Routledge
• Year: 2003
• eBook ISBN: 9781134621842
• Topic: Business
• Subtopic: Business generale
• Index: Business

The shift to managed markets has meant that whilst planners and purchasers of health and social services seek information on needs, managers who provide these services seek information on performance and response. Market research contributes to both.

This text is a comprehensive and rigorous introduction to the relevance, planning and management of market research in the areas of health and social care that have developed in Britain and most other industrialised countries. It features:

* an explanation of how managed markets provide the context for market research
* a comprehensive guide to choosing the appropriate survey method
* recommendations for commissioning, monitoring and implementing results
* practical advice on producing successful student projects
* a comparative international perspective.

Intended for managers and students of public sector management and marketing, this outstanding book contains instruction on research methods, practical advice for managers and professionals on how to commission, monitor and implement the results of market research, and an excellent selection of case studies.

Part 1
Markets and market research

The three chapters in Part 1 describe the social and political context of the markets in health and social care and how this provides opportunities for market research. There is a comparative international perspective and an overview of recent developments.

Chapter 1 explains the purpose of the book and its structure and shows how different readers can make best use of it. The chapter also explains why market research is becoming more relevant for health and social care. It includes the essential definitions of health and social care and of market research.

Chapter 2 starts by describing the structures of welfare states and the main transitions which have led to planned markets in health and social care. The role of market research is explained in some detail and recent applications in the British public sector are described. Alternative definitions of ‘need’ are debated and the relevance of market research is discussed. How market research relates to social research is explained. Finally, the most recent developments in British health and social care markets brought about by the Labour government elected in 1997 are described.

Chapter 3 moves in from the international and national perspectives of the previous chapters to show how health and social care organizations in Britain have been affected by public sector reforms, in particular becoming market oriented. The way in which marketing is used for strategic and tactical applications is explained. This leads into suggestions as to how managers and professionals should commission market research and supervise its implementation in order to inform and evaluate their marketing plans.

Chapter 1
The relevance of market research for health and social care

Mike Luck

In this chapter the reader will gain an understanding of:

• the purpose of the book

• the structure of the book

• who the book is intended for and how they may make best use of it

• why market research is becoming more relevant for health and social care

• definitions of health and social care

• definitions of market research.

1.1 Purpose

The book will show the relevance of market research in health and social care within the rapidly changing political and social context and give a comprehensive and rigorous introduction to research methods and how they should be used in planning and management of research projects.

In England, the Secretary of State for Health has recently announced the introduction of a national survey of patients and users which will be repeated annually. He said:

It is quite extraordinary that the National Health Service has been in existence for half a century, without patients and users having an automatic right to a voice at the heart of the service… For the first time the NHS will have systematic evidence to enable the health service to measure itself against the aspirations and experience of the people who use it. The new NHS will listen and learn from what patients say… It will mean that local NHS managers and health professionals can take direct account of patients’ views and opinions when deciding how best to deliver better services.

(Department of Health, 1998b)

Many countries are considering major strategic revisions to health and welfare structures. In Britain, for example, changes are taking place from the previous government’s reliance on market mechanisms, principally in financial terms, to the present government’s emerging proposals for a more complex purchaser-provider split balancing health needs, equity, quality and cost.

In Europe there is a growing sharing of ideas between health services and between professionals and academics (see OECD (1995) and Ham (1997)). Many countries in the Asia Pacific region look to the UK for models of effective public service management.

The book will be based on a wider range of practical experience, teaching at postgraduate and undergraduate levels, and field testing. The examples used in the book are all based on practical experience and can be used as examples of good practice by health and social care students in Britain and other countries.

1.2 Who the book is for

The evolution of national economies from the previous industrial base towards a service base means that teaching in business schools and in departments of public administration are taking on a stronger orientation towards developing, managing and marketing services. Boundaries between private and public sector courses are much less rigid than they used to be.

At the undergraduate student level, market research is widely taught in business courses either as part of obligatory marketing modules or in specialist options. The majority of these modules now link private and public sector applications and students are aware of the opportunities for project work and future employment.

Postgraduate business MBAs include a heavy concentration on marketing including awareness of and application of market research. Public Service MBA and MSc courses include modules on quality and customer care which cover market research. Almost all postgraduate courses require a module on research methods prior to a research project which forms the basis of the dissertation. Three of the chapters in this book, by Parkes, Kimberley and Flynn, are based on MBA dissertations.

There are an increasing number of tailored (continuing professional education) courses for health and social service employees involving accreditation: managers, public health professionals, nurses, general practitioners and practice managers.

We believe that there are an increasing number of managers and professionals who are keen to expand their knowledge and skills to cope with their ever-changing world of work and who aspire to a public service ethic of excellent service. Whether or not they attend formal courses we believe that this book can be useful to them.

1.3 Defining health and social care

We need a starting definition in order to provide focus but do not want to be restricted by arbitrary boundaries based on out-of-date configurations.

What is meant by health has concentrated people’s minds for some considerable time. There are some widely agreed international definitions:

The extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs and on the other hand, to change or cope with the environment. Health is therefore seen as a resource for every day life, not the objective of living: it is a positive concept emphasizing social and personal resources as well as physical capacities.

(WHO, 1985, p. 36)

The WHO Regional Office for Europe published Targets for Health for All (WHO, 1985), arising out of the Alma Ata Conference and Health for All by the Year 2000. The European targets reflect the industrial base of the member countries and have three main foci: the promotion of lifestyles conducive to health, the reduction of preventable conditions, and the provision of care which is adequate, accessible and acceptable to all.

The dimensions of health proposed by Ewles and Simnett (1992) are:

Physical Health: concerned with the mechanistic functioning of the body.

Mental Health: the ability to think clearly and coherently—distinguished from emotional and social health, although there is a close association between the three.

Emotional (Affective) Health: the ability to recognize emotions such as fear, joy, grief and anger and to express such emotions appropriately—also means of coping with stress, tension, depression and anxiety.

Social Health: the ability to make and maintain relationships with other people.

Spiritual Health: connected to religious beliefs and practices for some people; for others it is to do with personal creeds, principles of behaviour and ways of achieving peace of mind.

Societal Health: personal health is inextricably related to everything surrounding that person and it is impossible to be healthy in a sick society.

The social model proposed by Dahlgren and Whitehead (1991) relates behavioural and social influences on health and is being widely used. It emphasizes interactions between these different levels, for example, the way in which individual lifestyles are embedded in social and community networks and in living and working conditions, which are themselves related to the broader social, cultural and economic environment.

The Birmingham Public Health Report (Birmingham HA, 1995) uses the Dahlgren and Whitehead model to explain the different policy levels at which action can be taken to improve health and explores the role of the Health Authority at these levels. For example:

Level 1. Advocacy of broader health policies.

Level 2. Commitment to local health strategy in partnership with other agencies.

Level 3. Developing the capability of local communities and individuals.

Level 4. Screening for preventable risk factors.

As well as the frameworks proposed by professionals and researchers it is important to understand what lay people mean when they talk of ‘health’ and how this influences their behaviour. Lay concepts of health have been researched (Blaxter, 1990). The main findings are that concepts of health have three main dimensions:

• health as absence of disease

• health as the ability to cope with daily living and physical and mental stress

• health as a positive state of well-being.

But people cannot be expected to be completely consistent. A person may have contradictory views on their health at the same time.

1.3.1 Markets and customers

The definition of market research given below by McQuarrie (1996) refers to ‘markets and customers’. In the case of health and social care there are a profusion of terms to refer to which need to be clarified and related:

• customer—implies someone who has financial resources to make their own decision whether or not to purchase a good or service

• client—in Britain used by social services to indicate a person for whom a service is being provided. The decision to start to provide and when to discontinue the service is usually taken by the social service professional who is employed by local government

• patient—indicates a person in receipt of medical or nursing care. The decision to start to provide and when to discontinue the service is usually taken by the health service professional, in Britain employed by a National Health Service (NHS) trust

• consumer—a person who receives a service

• citizen—a person, usually an adult, with the democratic right to vote who may, in some countries, have a constitutional right to receive some health or social care services

In health and social care we need to think of markets which are stratified in relevant ways such as by age, sex, ethnicity, class; in health care by primary, secondary and tertiary needs; in social care by residential and domiciliary needs. We shall find substantial differences between, for example, markets for mental illness, acute surgery, learning difficulties, child care.

1.3.2 Regions and countries

We attempt to make this book relevant internationally. Although our basis is in our British experience and in applying market research in British health and social care we try wherever possible to draw comparisons with situations in other countries. We set up structures for description and analysis which are relevant to different countries and give a number of comparisons and discussions of relevance to other countries. We want to develop and use concepts which are not country specific such as the actual and feasible forms of national welfare state, and also to show how applications of market research do have to be tailored to be country specific.

1.4 Defining market research

In this section we provide a preliminary definition which will evolve throughout the book. As with defining health and social care in the previous section, we need a starting definition in order to provide focus but do not want to be restricted by arbitrary boundaries based on current or even out-of-date configurations.

Market research is defined by the British Market Research Society as:

The means used by those who provide goods and services to keep themselves in touch with the needs and wants of those who buy and use those goods and services.

(Chisnall, 1986, p. 6)

In the case of health and social care the definition needs to be expanded beyond ‘those who prov...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Contents
• List of Figures
• List of Tables
• List of contributors
• Acknowledgements
• Part 1 Markets and market research
• Part 2 Market research methods
• Part 3 Applications of market research
• Part 4 Prospects for market research
• Bibliography
• Index