Economic Evaluation of an Investment in Medical Websites and Medical Web-Based Services
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Economic Evaluation of an Investment in Medical Websites and Medical Web-Based Services2014 A Thesis submitted for the degree of Doctor of Philosophy By
Faculty of Business, Economics and Law University of Surrey [Year] Table of ContentsEconomic Evaluation of an Investment in Medical Websites and Medical Web-Based Services 1 Table of Contents 3 Table of Tables 3 Table of Figures 4 Acknowledgements 5 Publications 6 Abstract 7 Chapter 1: Introduction 8 1 Research Contribution, Aims and Objectives 10 2 Research Design 10 3Thesis Outline 12 4 Challenges of the Research 14 Chapter 2: Literature Review 16 1.1 Introduction 16 5Economic Evaluation in Healthcare 16 5.1Evaluation and Accountability 18 2.2.2 Complexivity and Reflexivity in Healthcare Evaluation 19 6 Evaluation of Medical Websites and Medical Web-Based Services 20 6.1Medical Websites and Medical Web-Based Services 22 7 Cost-Benefit Analysis 28 7.1Cost-Benefit Analysis in HealthCare 30 7.2Issues Concerning Cost-Benefit Analysis Web-Based Services 31 8 Return on Investment (ROI) 39 8.1ROI in IT and Technology Investments 40 8.2ROI in Healthcare 41 8.3Benefits of ROI 42 8.4Concerns, Myths and Barriers of ROI Application 43 9 Willingness to Pay (WTP) 44 9.1Willingness to Pay vs. Human Capital Approach vs. Quality Adjusted Life Years 49 9.2Biases and Other Issues Encountered While Using WTP Approach 50 10 Concluding Remarks from the Extant Literature Examination 51 Chapter 3: Methodology 54 11 Introduction 54 1.1 Research Philosophies within the Information Systems (IS) Discipline 54 1.2 Research Methodology 55 1.2.1Investigation in Success and Failure Factors for the Market Of Medical Web-Based Services 55 1.2.2Cost-Benefit Analysis and ROI 60 1.2.3Applying Evaluation Methods 68 Chapter 4: A New Holistic Evaluation Framework 71 12Towards the Formation of a Holistic Framework for the Evaluation of an Investment on the Medical Web Interventions 71 1.2.4The Developed Holistic Evaluation Framework 78 13Concluding Remarks 81 Chapter 5: Success and Failure Factors of Medical Websites 82 14 Introduction 82 15 Sample Formation 83 16Variable Formation 84 17 Data Descriptive Metrics/Statistics 89 17.1Popular Revenue Models in the Medical Websites 91 18Factors of Excellence and Enhanced Survivability 93 18.1Searching For the Factors that Affect the Global Rank of the Medical Websites 93 18.2The Highest and Lowest Globally Ranked Medical Websites 96 18.3Factors that Affect Survivability of the Medical Websites 110 18.4Other Factors that Affect the Excellence and the Survivability of the Medical Websites 112 18.5Factors that Affect the Offering of Interactive Web Applications/ Services 125 19 Chapter’s Concluding Remarks 126 Chapter 6: Assessing the value of an investment in Medical Websites 128 20 Introduction 128 21 Key Stakeholder Identification 129 21.1Key Stakeholders’ Identification and Description 129 21.2Relationship between the Medical Websites and the Stakeholders 131 22 Assessing the “Benefits” 133 22.1WTP versus Human Capital Approach and QALYs 133 22.2Survey Formation 135 22.3Willingness to Pay Questions Formation 137 22.4Participants Recruitment 138 22.5Survey’s Data Analysis 139 22.6Analysis by Question 142 23 Assessing the “Costs” 153 24 Cost Benefit Analysis and Return on Investment Estimation 154 24.1Cost-Benefit Analysis of the Medical Websites Offering Medical Web-Based Services 154 24.2Return on Investment of the Medical Websites Offering Medical Web-Based Services 156 25 Concluding Remarks 156 Chapter 7: Discussion and Concluding Remarks 159 26 Research Summary 159 27 Research Contributions 162 28 Current Research Limitations 166 29 Future Research Directions 167 30 Personal Reflections 168 Appendix A: Statement of Ethics Approval 169 Appendix B: Willingness to Pay Survey 171 Appendix C: Medical Websites Dataset 179 References 192 Table of TablesTable of FiguresAcknowledgementsThere are many people who helped me accomplish this thesis. First of all my parents Athanasios Xydopoulos and Vasiliki Karageorgou, and my uncles Dimitrios and Konstantinos Karageorgos who supported me and funded most of my PhD studies. I would like also to thank my aunt Anastasia Karageorgou for her continuous prays that helped me to overcome every obstacle in my way. During the last four years, no one has taught me more than my first supervisor Professor Lampros Stergioulas who was the person to step-by-step observe and support the development of this research. Above all, I thank Lampros for his impact on my personality and the completeness of my apprenticeship in the ethical and professional norms of the academic world. I was also very privileged to work with Professor Terry Young who I thank for his kindness, motivation and continuous support as my second supervisor. Along with my supervisors, there are a few people whose help has been significant. Dr Munir Abbasi and my colleague Masoud Fakhimi who provided vital support and showed extremely patience when I was trying to balance among life, the work in the projects and the completion of this research thesis. Moreover, I would like to thank my colleagues in room SJ127 for their support and help. More specifically I would like to express my gratitude to Georgios (“Geeko”) Ioannou for his general support and the infinite moment of laugh that offered to me, Konstantina (“The Crazy”) Vasileiou for her emotional support as well as Konstantina (“The Cretan”) Spanaki for her patience support and delicious food and sweets. I would like to thank also my friends Chrisros (“Barclay”) Barkoukis, Alexis (“The winner”) Georgiadis, and Dimitrios (“The Roque”) Karagiozidis, Anastasia (“The Zouzou”) Goutzioti and Christos (“The Sting”) Tsibas for their support and the endless hours they spent hearing me nagging for my research. Finally, I am grateful to all the people from the Faculty of Business Economics and Law of Surrey University, and the Department of Information Systems and Computing (DISC) of Brunel University, not only for their logistic, financial and academic support, but mostly for the level of friendship and respect I was constantly experiencing during my studies.
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