Health services research using linked records: who consents and what is the gain?

Objective: To assess consent to record linkage, describe the characteristics of consenters and compare self-report versus Medicare records of general practitioner use. Method. Almost 40,000 women in the Australian Longitudinal Study on Women's Health were sent a request by mail for permission to link their Medicare records and survey data. Results: 19,700 women consented: 37% of young (18-23 years), 59% of mid-age (4550 years) and 53% of older women (70-75 years). Consenters tended to have higher levels of education and, among the older cohort, were in better health than nonconsenters. Women tended to under-report the number of visits to general practitioners. Conclusions: Record linkage of survey and Medicare data on a large scale is feasible. The linked data provide information on health and socio-economic status which are valuable for understanding health service utilisation. Implications: Linked records provide a powerful tool for health care research, particularly in longitudinal studies.

Justice strategy options for increased customer satisfaction in a services recovery setting

This study investigates the influence of justice (procedural, interactional and distributive) on measures of customer satisfaction within a hotel setting. Specifically, the study investigates the levels of satisfaction associated with various combinations of procedural, interactional, and distributive justice related service recovery strategies. Using especially designed video vignettes of a hotel service breakdown, respondents rated their levels of satisfaction for the video vignettes that depicted varying levels of. (a) level of concern shown by the service provider, (b) whether policy was adhered to, (c) degree of 'voice' given to the customer, and (d) type of compensation. Between subject MANOVA analyses revealed a number of main effects and interactions. Results clearly show that satisfaction varied significantly depending on the various combinations of recovery measures. In particular, a two-way interaction between adherence to policy and type of compensation was found. Furthermore, it was found that respondents expressed higher satisfaction with the service when a 50% refund was given, and the provider was seen to be adhering to policy, rather than doing a special favor for the customer. In contrast, when a token measure of compensation is given (i.e. giving away a couple of drink vouchers), respondents expressed higher levels of satisfaction if the service provider was doing a special favor rather than merely adhering to company policy. Implications for managers and scholars are discussed. (C) 2001 Elsevier Science Inc. All rights reserved.

Multiple impacts of the HIV/AIDS epidemic on the aged in rural Uganda

This paper reports research conducted among theaged residents of a rural, Southwestern Ugandanvillage. It documents their knowledge ofHIV/AIDS, their perceptions of their own riskof infection, and the multiple impacts of thecurrent HIV/AIDS epidemic on their lives. Mostolder individuals have a sound understanding ofthe sexual transmission of HIV, and someconsider themselves to be at risk of infectionthrough having multiple sexual partners. Theyattempt to limit their children's exposure toHIV, but many of these children have left thevillage to live in urban areas of relativelyhigh HIV prevalence. The loss of adult childrendeprives the aged of any support these childrenmight have provided as their parents'capabilities declined with advancing age.Female-headed households were more affected inthis way than were male-headed households. TheAIDS epidemic has increased the number ofburials taking place in the village, and theiraccumulated costs, both in time and money, andcreated new hardships for the aged, who alsohave to cope with grief that accompaniescontinuing deaths among their children andtheir contemporaries' children.