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AbstractIn 1968, Garrett Hardin identified a class of common goods that suffer under traditional market mechanisms. This paper describes the results of an agent‐based computer simulation used to study how institutional forces shape consumption patterns. Overall, when populations generally act in the common interest, the commons, the population and individuals all experience higher quality outcomes than when they act in generally or exclusively self‐interested ways. The results suggest common‐interested behaviours support a greater population at a higher quality of living; however, exclusively common‐interested behaviours result in underutilized commons, and the whole is generally less well off. The paper frames further applications in terms of managing growth for long‐term sustainability. Copyright © 2008 John Wiley & Sons, Ltd.

Volume 16 of AHCM presents papers that explore population health management and organizational change across various levels of the healthcare system. Aspects of health care organizations discussed in the volume include the PCMH, ACOs, integration with the public health and mental health systems, hospital-physician alignment, and resource planning

Purpose: Assessed racial disparities in health information-seeking behavior and trust of information sources from 2007 to 2017. Design: Pooled cross-sectional survey data. Setting: Health Information National Trends Survey (HINTS). Participation: Data included 6 iterations of HINTS (pooled: N = 19 496; 2007: n = 3593; 2011: n = 3959; 2013: n = 3185; Food and Drug Administration [FDA] 2015: n = 3738; 2017: n = 3285; and FDA 2017: n = 1736). Measures: Outcome variables were health information seeking, high confidence, and high trust of health information from several sources. Independent variable was race group, controlling for other sociodemographic and socioeconomic variables. Analysis: Weighted descriptive and multivariate logistic regression for the pooled sample assessed associations by race. Fully interacted models with race–survey year interactions compared differences in outcomes between years. Results: Black respondents, relative to white, had greater odds of having high confidence in their ability to attain health information, trust of health information from newspapers and magazines, radio, internet, television, government, charitable organizations, and religious organizations. Hispanic respondents, relative to white, had lower odds of seeking health information and trusting health information from doctors. They had higher odds of trusting health information from the radio, the internet, television, charitable organizations, and religious organizations. Conclusion: Disparities between races in trust of information sources remained across time. Understanding optimal information media, their reach, and credibility among racial groups could enable more targeted approaches to developing interventions. Our analytical approach minimized limitations present in the HINTS.

Shedding light on current transformations in payment mechanisms and transparency of hospital performance data and prices, this volume of Advances in Health Care Management presents findings on hospital profitability, cost, and organizational structures. Divided into two sections: 'Reimbursement, Cost and Profitability' and 'The Move Towards Transparency', the chapters employ a variety of research methodologies to explore the impact of transformation in payment and debt structures, profitability, and horizontal or vertical integration on outcomes such as price, clinical outcomes, and health plan selection. The authors examine recent changes including the redesign of the U.S. health care system to achieve higher value, and the establishment of mechanisms that transform reimbursement models and promote consumerism through transparency of data. Additionally, the volume takes a look at the emerging trend of transparency between health care stakeholders such as patients, health care staff, hospitals, insurance companies, and the government, providing a valuable insight into how the future might look.

PURPOSE: To determine correlates of rural, Appalachian, and community identity amongst a cohort of participants in the Community Initiative Towards Improving Equity and Health Status (CITIES) project. METHODS: Mixed linear and logistic regression effects models were utilized to determine correlates of 3 outcomes: 1) community identity, 2) rural identity, and 3) Appalachian identity amongst participants in the Ohio CITIES project. FINDINGS: Distinct demographic characteristics were found to be associated with each of the outcomes. For community identity while no differences were found for rural or urban participants, those who were single or never married (P < .0001) as well as those who graduated from college (P = .0005) reported significantly lower community identity scores than married individuals with less than a college education. Those who resided in an Appalachian county reported higher community identity scores (P = .0009) than non-Appalachian residents. For rural identity, those who did not identify as Christian (P = .018) as well as those who identified as Democrat (P = .027) reported significantly lower rural identity scores than others. Lastly, for Appalachian identity, county-level percentage of families in poverty (P = .06), as well as gender (P = .05), were associated with self-reported Appalachian identity, but these effects were only marginally significant. CONCLUSIONS: Although community, rural, and Appalachian identity may be viewed as similar due to their measure of attachment to a place, results from this study suggest that there are distinct individual and area-level correlates associated with community, rural, and Appalachian identity.

While current research about inpatient portals has focused largely on the patient perspective, it is also critical to consider the care team point of view, as support from these individuals is essential to successful portal implementation and use. We held brief in-person interviews with 433 care team members across a six-hospital health system to explore opinions about patients' use of an inpatient portal as perceived by care team members. Using the Inpatient Portal Evaluation Framework, we characterized benefits and challenges of portal use that care team members reported affected patients, themselves, and the collaborative work of these care teams with their patients. Interviewees noted inpatient portals can improve patient care and experience and also indicated room for improvement in portal use for hospitalized patients. Further understanding of the care team perspective is critical to inform approaches to inpatient portal implementation that best benefit both patients and providers.