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1 – 10 of over 6000The growth of the healthcare industry since the middle of the nineteenth century has offered medical doctors a broad range of opportunities to develop their private practice…
Abstract
The growth of the healthcare industry since the middle of the nineteenth century has offered medical doctors a broad range of opportunities to develop their private practice. However, a major challenge was accessing the new medical technology at the core of this growth, as operation rooms, X-ray machines, laboratories and sterilization equipment were mostly centred in hospitals. Based on the case of Geneva, Switzerland, this chapter discusses the various strategies adopted by medical doctors to benefit from hospital infrastructure for their work. It demonstrates that collective entrepreneurship emerged at the end of the nineteenth century, when groups of doctors started to open collective clinics in response to the impossibility of using the infrastructure of the local public hospital linked to the University of Geneva. This heyday of collective private clinics lasted until the 1990s when listed companies and private investors took over and reorganized these private healthcare organizations.
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Chanita Tantipoj, Narin Hiransuthikul, Sirirak Supa-amornkul, Vitool Lohsoonthorn and Siribang-on Piboonniyom Khovidhunkit
Diabetes mellitus (DM) is an important health problem throughout the world. Association between DM and oral diseases has been reported and dental clinic is indicated to be one of…
Abstract
Purpose
Diabetes mellitus (DM) is an important health problem throughout the world. Association between DM and oral diseases has been reported and dental clinic is indicated to be one of the suitable venues for the screening of DM. The purpose of this paper is to determine patients’ attitude toward DM screening in dental clinics.
Design/methodology/approach
The anonymous, self-administered questionnaires of five-point response scale questions were distributed to convenience samples of adult patients (⩾25 years) attending one of the dental settings. These dental settings were divided into the university/hospital-based dental clinics (encompassing two university-based and five hospital-based dental clinics) or the private dental clinics (encompassing two private, and one special (after office hour) clinic of a faculty of dentistry). The questions could be categorized into three groups regarding importance, willingness, and agreement of DM screening in dental settings. Results are presented as percentage by respondents based upon the number of responses for each question. The favorable outcomes which were defined as responses of either scale of 4 or 5 were also summarized according to dental settings. The χ2 test for comparison was used to compare the favorable outcomes between the two settings.
Findings
A total of 601 completed questionnaires were collected; 394 from university/hospital-based dental clinics and 207 from two private clinics and a special (after office hour) clinic of a faculty of dentistry. Overall, the majority of respondents in both university/hospital-based and private practice settings felt that it is important to have a dentist conduct a screening (84.8 vs 79.5 percent). The majority of patients in both groups were willing to receive blood pressure examination (95.0 vs 92.0 percent), weight and height measurements (94.7 vs 94.0 percent), saliva/oral fluid investigation (86.4 and 86.9 percent) and finger-stick blood test (83.8 vs 83.9 percent). More than 75 percent of all respondents agreed with diabetes screening in dental clinics.
Originality/value
The majority of respondents supported the screening of DM in dental settings and they were willing to have a screening test by the dentist. Patient acceptance is an important key to be successful in the screening of DM in dental settings.
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Muhammad Khalilur Rahman, Md Shah Newaz, Mina Hemmati and S M Yusuf Mallick
The purpose of this study is to explore the private general practice (GP) clinics' service environment, patients' satisfaction and their impact on word of mouth (WoM) for others…
Abstract
Purpose
The purpose of this study is to explore the private general practice (GP) clinics' service environment, patients' satisfaction and their impact on word of mouth (WoM) for others for future treatment in GP clinics.
Design/methodology/approach
Data are collected from 367 respondents using a paper-based survey questionnaire. Partial least square (PLS) is used to evaluate the proposed model and hypotheses relationships.
Findings
The findings reveal that ambience and service delivery have a high significant influence on patients' emotional satisfaction (β = 0.27, t = 4.31, p = 0.00) and (β = 0.26, t = 4.81, p = 0.00), respectively, while interior décor has a positive and significant influence on satisfaction (β = 0.13, t = 1.98, p = 0.04). The results indicate that exterior design and cleanliness are not associated with satisfaction. Patients' emotional satisfaction is highly related to WoM (β = 0.55, t = 13.44, p = 0.00). The results also show that emotional satisfaction has a significant mediating effect on the relationship between clinic service environments (ambience, interior décor, service delivery) and WoM (β = 0.15, t = 3.94, p = 0.00), (β = 0.073, t = 3.94, p = 0.04), (β = 0. 0.143, t = 4.13, p = 0.00), respectively.
Originality/value
The study will provide insights regarding Malaysian health consumers' perceptions toward GP clinics' service environment, whether they remain utilitarian or have evolved to entail hedonic appreciations. The contribution to the service environment could be adopted by future health-care studies, particularly those intended to examine GP clinics and other clinic-based institutions.
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Sheilagh M. Resnick and Mark D. Griffiths
The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic.
Abstract
Purpose
The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic.
Design/methodology/approach
Data were gathered via interviews with two groups of participants using the SERVQUAL questionnaire. The first group comprised 32 patients and the second 15 clinic staff. The SERVQUAL instrument measures service quality expectations and perceptions across five service dimensions and identifies gaps between service expectations and perceptions of what was delivered.
Findings
Patients' service quality expectations were exceeded on four of five dimensions. However, staff members felt services fell below expectations on four of five dimensions with the “reliability” service dimension emerging as the common service element falling below expectations for both participant groups. It was concluded that achieving consistent service delivery and increasing empathy between staff and patients improves overall service quality perceptions.
Research limitations/implications
The paper relies on self‐report methods from a relatively small number of individuals.
Originality/value
There have been limited research studies measuring alcohol treatment service quality in the private sector.
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Ajantha Sisira Kumara and Ramanie Samaratunge
The purpose of this paper is to explore the determinants of health insurance ownership of individuals in the Sri Lankan labor force and to examine how insurance ownership impacts…
Abstract
Purpose
The purpose of this paper is to explore the determinants of health insurance ownership of individuals in the Sri Lankan labor force and to examine how insurance ownership impacts healthcare utilization.
Design/methodology/approach
The authors first used logit model to explore determinants of health insurance ownership. The authors then employed propensity score matching method to estimate impact of insurance ownership on healthcare utilization. Data were obtained from national survey of self-reported health in Sri Lanka – 2014 (n=59,276). National survey of self-reported health in Sri Lanka – 2014 was conducted by the Department of Census and Statistics from January to December 2014.
Findings
Results showed that individuals with higher educational attainments, headed by literate-heads, based in urban sector, employed in formal sector, and with health adversities and higher degree of risk propensity are more inclined to have a health cover. Health insurance ownership reduces the likelihood of utilizing public facilities while increasing the likelihood of utilizing private facilities for non-communicable diseases (NCDs) and acute illnesses. Welfare consequences of expanding insurance ownership are doubtful due to oligopolistic private healthcare market and adverse selection issue faced by insurers in Sri Lanka.
Originality/value
This is the first study examining health insurance–healthcare utilization nexus based on Sri Lanka-wide microdata. Also, the study applies bias-corrected matching methods to establish causal links between two constructs. Without being so generalized, healthcare utilization is examined in terms of NCD care and Acute illnesses care, which improves robustness of results and leads to evidence-based healthcare policies.
Peer review
The peer review history for this paper is available at: https//publons.com/publon/10.1108/IJSE-05-2019-0333.
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Assesses the health care system in Greece since 1970 through examination of its output and inputs. Concerning output, the country ranks well with regard to adult life expectancy…
Abstract
Assesses the health care system in Greece since 1970 through examination of its output and inputs. Concerning output, the country ranks well with regard to adult life expectancy but relatively low in infant mortality. The increasing number of citizens seeking health care abroad does not portend well for quality of care. On the input side, the total number of hospitals has decreased over time, public hospitals have increased and private facilities decreased. There has also been unused hospital capacity; in rural areas there are shortages of health manpower including physicians, as well as equipment. Cultural factors seem to have adversely affected the supply of nurses nationally. Fakellaki , an informal means of paying health‐care providers, is a distinctive and negative feature.
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Charlotte Kroløkke, Thomas Søbirk Petersen, Janne Rothmar Herrmann, Anna Sofie Bach, Stine Willum Adrian, Rune Klingenberg and Michael Nebeling Petersen
Tim Calkins, Kara Palamountain, Aniruddha Chatterjee, Robert Frantz, Elizabeth Hart, Sean Mathewson and Gabriela Perez-Hobrecker
It is January 2014, and the case protagonist, David Milestone (senior advisor at the Center for Accelerating Innovation and Impact at the U.S. Agency for International…
Abstract
It is January 2014, and the case protagonist, David Milestone (senior advisor at the Center for Accelerating Innovation and Impact at the U.S. Agency for International Development's Global Health Bureau), is preparing for a meeting of global stakeholders and pharmaceutical manufacturers who are interested in reducing mortality caused by childhood pneumonia and are prepared to donate $10 million to support this effort.
Milestone's goal is to propose a strategy to address childhood pneumonia in Uganda, toward which the $10 million donation would go. In addition to effectively and sustainably reducing childhood pneumonia deaths, the plan must align the interests of various stakeholders behind the problem. A successful strategy in Uganda could be a model for interventions elsewhere. The United Nations Commission on Lifesaving Commodities for Women and Children recently identified Uganda as a “pathfinder” country, meaning it could serve as the example for other countries wrestling with the same issues. This is a remarkable opportunity to change the lives of children in Uganda—and all around the world.
After reading and analyzing the case, students will be able to:
Perform a stakeholder analysis
Appreciate the challenges involved in improving public health, especially in developing countries
Create a patient journey and use it to identify potential impact points
Perform a stakeholder analysis
Appreciate the challenges involved in improving public health, especially in developing countries
Create a patient journey and use it to identify potential impact points
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Alexander Styhre and Rebecka Arman
Institutional theorists treat law and regulations as external factors that is part of the organization’s environment. While institutional theory has been criticized for its…
Abstract
Purpose
Institutional theorists treat law and regulations as external factors that is part of the organization’s environment. While institutional theory has been criticized for its inability to recognize the role of agents and to theorize agency, the growing literature on institutional work and institutional entrepreneurship, partially informed by and co-produced with practice theory, advances a more dynamic view of processes of institutionalization. In order to cope with legal and regulatory frameworks, constituting the legal environment of the organization, there are evidence of organizational responses in the form of bargaining, political negotiations, and decoupling of organizational units and processes. The purpose of this paper is to report how legal and regulatory frameworks both shape clinical practices while at the same time they are also informed by the activities and interests of professional communities and commercial clinics.
Design/methodology/approach
This paper reports an empirical study of the Swedish-assisted conception industry and is based on a case study methodology including the use of interviews and formal documents and reports issues by governmental agencies.
Findings
The empirical material demonstrates how scientists in reproductive medicine and clinicians regard the legal and regulatory framework as what ensures and reinforces the quality of the therapies. At the same time, they actively engage to modify the legal and regulatory framework in the case when they believe it would benefit the patients. The data reported presents one successful case of how PGD/PGS can be used to develop the efficacy of the therapy, and one unsuccessful case of regulatory change in the case of patient interest groups advocating a legalization of commercial gestational surrogacy. In the former case, scientific know-how and medicinal benefits served to “push” the new clinical practice, while in the latter case, the “demand-pull” of patient interest groups fails to get recognition in regulatory and policy-making quarters.
Originality/value
The study contributes to the literature on agency in institutional theory (e.g. the emerging literature on institutional work) by emphasizing how legal and regulatory frameworks are in a constant process of being modified and negotiated in the face of novel technoscientific practices and social demands. More specifically, this process include many scientific, technological, economic, political and social relations and resources, making the legal environment of organizations what is the outcome from joint negotiations and agreements across organizational and professional boundaries.
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