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Article
Publication date: 5 December 2016

Chhavi Sodhi and Pushpendra Singh

The purpose of this paper is to present a historical overview of the health service sector in India. The development in the healthcare sector from the late eighteenth century into…

Abstract

Purpose

The purpose of this paper is to present a historical overview of the health service sector in India. The development in the healthcare sector from the late eighteenth century into current times is examined from the prism of the role played by British and US healthcare systems in influencing change in the Indian setup.

Design/methodology/approach

Online databases searched were PubMed and JSTOR, using the search terms, “Indian health service system in transition”, “British influence on the Indian healthcare setup” and “American neo-liberal influence on Indian healthcare sector”. The authors then examined titles and abstracts of selected articles for short-listing relevant articles. Reference lists of selected articles were examined for further locating related studies. While this constituted the secondary literature for the current paper, reports by governmental and non-governmental organisation reports on the Indian health service system too were utilised as primary data sources.

Findings

Influenced by the British and later by the American healthcare system, the Indian healthcare network has undergone numerous changes. In the present era, the Indian healthcare system is increasingly veering towards the American model of healthcare delivery. Health is increasingly being conceived of as a commodity to be traded in the market, with the state’s role curtailed towards provisioning for and facilitating access of the weakest sections of the society through a means-tested insurance system. This has happened without adequate checks and balances on the private sector to ensure that the needs of the people accessing the system are adequately met.

Social implications

By tracing the development of the health service sector in India and the motives that guide such change, the paper depicts how the thrust of the system has altered from one providing universal healthcare services to the people, irrespective of their ability to pay, at the time of independence to commercialisation in present times. With the marketisation of healthcare, the focus has shifted from serving people to profiting from the provisioning of healthcare.

Originality/value

The paper throws light on the underlying inadequacies of the Indian healthcare setup and the need for more active participation by the government in this sector in the future if it aims to make healthcare more equitably accessible to its vast population.

Details

International Journal of Health Governance, vol. 21 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 1 July 2003

James E. Hosking and Robert J. Jarvis

With ageing hospital facilities spanning the USA, the healthcare construction business continues to grow. Today, questions about replacing existing facilities are becoming more…

Abstract

With ageing hospital facilities spanning the USA, the healthcare construction business continues to grow. Today, questions about replacing existing facilities are becoming more common in hospital boardrooms. Given the above situation, TriBrook Healthcare Consultants were recently retained to determine the market, operational and financial impact which facility redevelopment has had on other hospitals and health systems. Out of that effort came this paper. This paper assesses: the factors which are fuelling replacement facility growth; the impact that redevelopment has on market, operational and financial performance; an integrated development process to help organisations determine the feasibility of designing a new facility; and lessons learned working with clients who have pursued a replacement facility strategy. The objective of this effort is to provide hospital executives and board leaders with information that will be useful in reaching a final decision regarding execution of a replacement strategy.

Book part
Publication date: 5 April 2019

Gina Dokko, Amit Nigam and Daisy Chung

The emergence of an evidence-based medicine logic represents a major change in the large and complex field of American healthcare. In this analytical case study, the authors show…

Abstract

The emergence of an evidence-based medicine logic represents a major change in the large and complex field of American healthcare. In this analytical case study, the authors show that the intellectual school of evidence-based medicine became an important meso-structure that facilitated the growth of the new logic in American healthcare. The new intellectual school was a community of scholars who generated shared rules and resources through intergenerational mentoring. The school engaged in advocacy to advance new intellectual paradigms for conceptualizing healthcare quality that, when connected with material practices in the field of American healthcare, came to form a new institutional logic.

Details

Agents, Actors, Actorhood: Institutional Perspectives on the Nature of Agency, Action, and Authority
Type: Book
ISBN: 978-1-78756-081-9

Keywords

Book part
Publication date: 16 July 2015

Laura Senier, Matthew Kearney and Jason Orne

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

Abstract

Purpose

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

Methodology/approach

We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.

Findings

Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.

Research/Policy Implications

Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.

Originality/Value

There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.

Article
Publication date: 15 August 2019

Hossam Elamir

The growing importance of risk management programmes and practices in different industries has given rise to a new risk management approach, i.e. enterprise risk management. The…

2140

Abstract

Purpose

The growing importance of risk management programmes and practices in different industries has given rise to a new risk management approach, i.e. enterprise risk management. The purpose of this paper is to better understand the necessity, benefit, approaches and methodologies of managing risks in healthcare. It compares and contrasts between the traditional and enterprise risk management approaches within the healthcare context. In addition, it introduces bow tie methodology, a prospective risk assessment tool proposed by the American Society for Healthcare Risk Management as a visual risk management tool used in enterprise risk management.

Design/methodology/approach

This is a critical review of published literature on the topics of governance, patient safety, risk management, enterprise risk management and bow tie, which aims to draw a link between them and find the benefits behind their adoption.

Findings

Enterprise risk management is a generic holistic approach that extends the benefits of risk management programme beyond the traditional insurable hazards and/or losses. In addition, the bow tie methodology is a barrier-based risk analysis and management tool used in enterprise risk management for critical events related to the relevant day-to-day operations. It is a visual risk assessment tool which is used in many higher reliability industries. Nevertheless, enterprise risk management and bow ties are reported with limited use in healthcare.

Originality/value

The paper suggests the applicability and usefulness of enterprise risk management to healthcare, and proposes the bow tie methodology as a proactive barrier-based risk management tool valid for enterprise risk management implementation in healthcare.

Details

Business Process Management Journal, vol. 26 no. 3
Type: Research Article
ISSN: 1463-7154

Keywords

Article
Publication date: 27 November 2007

Avinandan Mukherjee and John McGinnis

Healthcare is among the fastest‐growing sectors in both developed and emerging economies. E‐healthcare is contributing to the explosive growth within this industry by utilizing…

3107

Abstract

Purpose

Healthcare is among the fastest‐growing sectors in both developed and emerging economies. E‐healthcare is contributing to the explosive growth within this industry by utilizing the internet and all its capabilities to support its stakeholders with information searches and communication processes. The purpose of this paper is to present the state‐of‐the‐art and to identify key themes in research on e‐healthcare.

Design/methodology/approach

A review of the literature in the marketing and management of e‐healthcare was conducted to determine the major themes pertinent to e‐healthcare research as well as the commonalities and differences within these themes.

Findings

Based on the literature review, the five major themes of e‐healthcare research identified are: cost savings; virtual networking; electronic medical records; source credibility and privacy concerns; and physician‐patient relationships.

Originality/value

Based on these major themes, managerial implications for e‐healthcare are formulated. Suggestions are offered to facilitate healthcare service organizations' attempts to further implement and properly utilize e‐healthcare in their facilities. These propositions will also help these stakeholders develop and streamline their e‐healthcare processes already in use. E‐healthcare systems enable firms to improve efficiency, to reduce costs, and to facilitate the coordination of care across multiple facilities.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 1 no. 4
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 19 December 2022

Juliano Endrigo Sordan, Clésio Aparecido Marinho, Pedro Carlos Oprime, Márcio Lopes Pimenta and Roy Andersson

This paper aims to characterize a sample of Lean Six Sigma (LSS) projects in healthcare settings and discuss some specificities of operational excellence (OPEX) initiatives in…

Abstract

Purpose

This paper aims to characterize a sample of Lean Six Sigma (LSS) projects in healthcare settings and discuss some specificities of operational excellence (OPEX) initiatives in hospitals and healthcare organizations in the USA.

Design/methodology/approach

A content analysis involving a sample of 23 documents shared by US hospitals was performed in order to achieve the research objectives. Such analysis was based on a conceptual framework developed from the literature review. It was also applied to a quantitative approach, including descriptive statistics, hypothesis testing and correspondence analysis that supported the research.

Findings

Most LSSH projects were focused on business transformation and strategic improvements. Simple techniques and tools were predominant such as descriptive statistics, process mapping, 5S and spaghetti charts, usually implemented by Green Belts and Black Belts through the define, measure, analyze, improve and control (DMAIC) method. In addition to the expressive findings reported, these projects' results have been aligned with lead time and operational cost reduction, quality improvement and capacity increase.

Research limitations/implications

The study adds knowledge to the OPEX literature by analyzing the Lean Six Sigma healthcare (LSSH) in hospitals and healthcare institutions in the USA. It also demonstrates that different approaches, such as the kaizen event and DMAIC project show different results according to some techniques and tools applied in the hospital environment.

Originality/value

The empirical evidence presented in this study provides scenery of the LSS practices in the healthcare settings, highlighting the implementation areas, outcomes, tools and techniques mostly used in the North American healthcare institutions.

Details

Benchmarking: An International Journal, vol. 30 no. 10
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 11 October 2018

Courtney Suess and Makarand Amrish Mody

The study aims to examine how features that foster a sense of control, create positive distractions and provide access to social support influence patients’ well-being and…

1202

Abstract

Purpose

The study aims to examine how features that foster a sense of control, create positive distractions and provide access to social support influence patients’ well-being and, subsequently, their likelihood to choose hotel-like hospital rooms and their willingness to pay higher out-of-pocket expenses for such rooms. While there is increasing evidence to suggest the importance of the provision of hospitality in healthcare settings, research on these developments remains under-represented, particularly in the hospitality literature. In response, the present study builds on Ulrich’s (1991) theory of supportive design to examine patient responses to hotel-like features in a hospital room.

Design/methodology/approach

Using data from a survey of 406 patients, the authors used structural equation modeling to test the model.

Findings

Consistent with supportive design principles, the infusion of hotel-like features that foster a sense of control for patients, create positive distractions and provide access to social support was found to positively impact patients’ physical and mental well-being, which, in turn, increased their likelihood to choose a hospital room with hotel-like features and their willingness to pay for such rooms.

Practical Implications

Findings attest to the need for healthcare providers to make the necessary investment in hotel-like features and to leverage the communicative power of these environmental cues. Social support in the form of hospitality-trained and certified healthcare staff was found to be the most important hotel-like feature, which also presents significant commercial opportunities for hospitality companies and professionals.

Originality Value

The study represents one of the first attempts to empirically develop a structured model to examine the infusion of hospitality into healthcare. It provides researchers with a theoretically supported framework for future inquiry into the domain. It also makes a significant contribution to advancing the research on patient well-being in healthcare settings and demonstrates the importance of hospitality to such endeavors.

Details

International Journal of Contemporary Hospitality Management, vol. 30 no. 10
Type: Research Article
ISSN: 0959-6119

Keywords

Abstract

Details

The Digital Pill: What Everyone Should Know about the Future of Our Healthcare System
Type: Book
ISBN: 978-1-78756-675-0

Article
Publication date: 8 June 2023

Jean C. Essila and Jaideep Motwani

This study aims to focus on the supply chain (SC) cost drivers of healthcare industries in the USA, as SC costs have increased 40% over the last decade. The second-most…

Abstract

Purpose

This study aims to focus on the supply chain (SC) cost drivers of healthcare industries in the USA, as SC costs have increased 40% over the last decade. The second-most significant expense, the SC, accounts for 38% of total expenses in a typical hospital, while most other industries can operate within 10% of their operating cost. This makes healthcare centers supply-chain-sensitive organizations with limited facilities for high-quality healthcare services. As the cost drivers of healthcare SC are almost unknown to managers, their jobs become more complex.

Design/methodology/approach

Guided by pragmatism and positivism paradigms, a cross-sectional study has been designed using quantitative and deductive approaches. Both primary and secondary data were used. Primary data were collected from health centers across the country, and secondary data were from healthcare-related databases. This study examined the attributes that explain the most significant variation in each contributing factor. With multiple regression analysis for predicting cost and Student's t-tests for the significance of contributing factors, the authors of this study examined different theories, including the market-based view and five-forces, network and transaction cost analysis.

Findings

This study revealed that supply, materials and services represent the most significant expenses in primary care. Supply-chain cost breakdown results in four critical factors: facility, inventory, information and transportation.

Research limitations/implications

This study examined the data from primary and secondary care institutions. Tertiary and quaternary care systems were not included. Although tertiary and quaternary care systems represent a small portion of the healthcare system, future research should address the supply chain costs of highly specialized organizations.

Practical implications

This study suggests methods that can help to improve supply chain operations in healthcare organizations worldwide.

Originality/value

This study presents an empirically proven methodology for testing the statistical significance of the primary factors contributing to healthcare supply chain costs. The results of this study may lead to positive policy changes to improve healthcare organizations' efficiency and increase access to high-quality healthcare.

Details

Benchmarking: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-5771

Keywords

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