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People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Traditional case management approaches are not always able to provide the intense and direct interventions required to adequately address the psychiatric, medical and social needs of this unique population. This article describes a Medicare Advantage Chronic Special Needs Program that provides a Medical Home, Active Community Treatment, and Integrated Care. A comparison of utilization and patient outcome measures of this program with fee for service Medicare found significant reduction in utilization and costs, as well as increased adherence to the management of chronic medical conditions and preventative services.

The purpose of this paper is to examine the health sector reform toward 2040 of Japan as a super-aged society.

This paper discusses the current healthcare policies adopted in Japan and projects the challenges in future as a super-aged society.

Through Japanese experiences, it is considered that Community-based Integrated Care System is useful, which takes into account the perspective of health care users. Being a super-aged society, it is essential for Japan to have more consensus by further removing obstacles, and paying attention to the change of paradigm and the purpose of care.

Based on the case of Japan, this paper serves as a reference for other East Asian countries, which would sooner or later encounter the similar situation of becoming super-aged societies in the 21^st century.

Strong leadership in primary care is necessary to coordinate an effective pandemic response; however, descriptions of leadership roles for family physicians are absent from previous pandemic plans. This study aims to describe the leadership roles and functions family physicians played during the COVID-19 pandemic in Canada and identify supports and barriers to formalizing these roles in future pandemic plans.

This study conducted semi-structured qualitative interviews with family physicians across four regions in Canada as part of a multiple case study. During the interviews, participants were asked about their roles during each pandemic stage and the facilitators and barriers they experienced. Interviews were transcribed and a thematic analysis approach was used to identify recurring themes.

Sixty-eight family physicians completed interviews. Three key functions of family physician leadership during the pandemic were identified: conveying knowledge, developing and adapting protocols for primary care practices and advocacy. Each function involved curating and synthesizing information, tailoring communications based on individual needs and building upon established relationships.

Findings demonstrate the need for future pandemic plans to incorporate formal family physician leadership appointments, as well as supports such as training, communication aides and compensation to allow family physicians to enact these key roles.

The COVID-19 pandemic presents a unique opportunity to examine the leadership roles of family physicians, which have been largely overlooked in past pandemic plans. This study’s findings highlight the importance of these roles toward delivering an effective and coordinated pandemic response with uninterrupted and safe access to primary care.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

Open source software (OSS) communities devoted to the development of electronic medical records (EMRs) have grown in recent years. The purpose of this paper is to focus on the challenge the leaders of these communities face in terms of building perceptions of psychological ownership among community members.

Surveys (n = 50) and brief interviews (n = 56) with individual members of an open source EMR community (most of whom are based in African nations) were used.

Among community members, normative commitment (in comparison to extrinsic motivation and affective commitment) was the strongest predictor of psychological ownership. Interviews revealed that community members tended to feel a greater sense of ownership toward the end user (i.e. hospitals and clinics) than toward the community itself.

To foster engagement and retention – and enhance the worldwide impact of their community on healthcare practices – leaders of open source EMR communities can offer incentives related to certifications and status-based rewards, hold annual meetings to allow members to develop a better understanding of the community and encourage members to “pay it forward” by involving end users (i.e. hospital and clinic employees) within the community, thus furthering public health initiatives.

OSS communities experience unique challenges compared to traditional organizations. This necessitates a reconsideration of the applicability of commonly accepted principles, tenets and recommendations from the management literature.

Disaster management and humanitarian logistics (HT) play crucial roles in large-scale events such as earthquakes, floods, hurricanes and tsunamis. Well-organized disaster response is crucial for effectively managing medical centres, staff allocation and casualty distribution during emergencies. To address this issue, this study aims to introduce a multi-objective stochastic programming model to enhance disaster preparedness and response, focusing on the critical first 72 h after earthquakes. The purpose is to optimize the allocation of resources, temporary medical centres and medical staff to save lives effectively.

This study uses stochastic programming-based dynamic modelling and a discrete-time Markov Chain to address uncertainty. The model considers potential road and hospital damage and distance limits and introduces an a-reliability level for untreated casualties. It divides the initial 72 h into four periods to capture earthquake dynamics.

Using a real case study in Istanbul’s Kartal district, the model’s effectiveness is demonstrated for earthquake scenarios. Key insights include optimal medical centre locations, required capacities, necessary medical staff and casualty allocation strategies, all vital for efficient disaster response within the critical first 72 h.

This study innovates by integrating stochastic programming and dynamic modelling to tackle post-disaster medical response. The use of a Markov Chain for uncertain health conditions and focus on the immediate aftermath of earthquakes offer practical value. By optimizing resource allocation amid uncertainties, the study contributes significantly to disaster management and HT research.

Social entrepreneurship literature acknowledges that social capital is vital to the success of social entrepreneurship efforts and trust is integral to the process of building social capital. However, there has been limited research on trust itself in social entrepreneurship literature. This article aims to begin filling this gap by utilizing a specific social entrepreneurship initiative to illustrate the role of trust in social entrepreneurship efforts. It describes the model of trust developed by Sheppard and Sherman and the social entrepreneurship initiative, Global Brigades. The article discusses the relationships between the parties involved in the initiative and applies Sheppard and Sherman's model to these relationships. It illustrates the importance of trust to social entrepreneurship efforts, as well as the need for additional research regarding social entrepreneurship and trust.

In many UK mental health services, in-patient psychiatric care is being separated from community care by having dedicated in-patient medical team. We evaluated staff satisfaction in this functionalised in-patient care. A survey was conducted amongst multidiscipli-nary staff from various teams using a questionnaire survey. On an average 14.3% of staff returned a satisfactory response for function-alisation, 57.3% had unsatisfactory response and others were undecided or perceived no change. There was no difference in responses amongst age, gender and professional groups. Mean scores of all groups were within unsatisfactory domain; however community staff compared to in-patient staff and staff with more than 5 years of experience compared to those with 1-5 years of experience returned significantly more unsatisfactory responses regarding functionalisation. Many positive and negative aspects of functionalisation were raised. The results of this evaluation suggest the need for further studies on the effectiveness of in-patient functionalisation. Short and long term clinical outcomes and the satisfaction of the patients should also be studied.

This paper explores how exaptive innovation process might be considered a useful innovation model in constraint-based environments. Through an in-depth case study, it illustrates clearly the antecedents of exaptation processes, which are particularly relevant in rapidly changing environments requiring new solutions under time and resource constraints.

The authors adopt a single case study approach that is particularly suitable in case of an inductive research design, which is required because of the novelty of the topic. The research is inspired by the use of the snorkeling mask EASYBREATH, commercialized by the giant Decathlon, as a medical device, a respirator to treat patients affected by coronavirus in Italy. The authors organized the evidence according to a novel taxonomy grounded in the literature.

The case study stimulates reflections on the existence of some antecedents to the exaptive innovation process in constraint-based environments: (1) the availability of specific actors in the innovation process; (2) the creation of platforms of interaction between people with different competences, nurtured by collective bottom-up financing systems; (3) the role of the community of makers, in particular, and of the 4th industrial revolution, in general, for creating enabling technologies; (4) multidisciplinary individual background of key actors in the innovation process is crucial to ensure the exaptive path to be in place.

This work has some limitations, due to the choice of limiting the analysis to a single case, nevertheless, it offers a first glance on a new technological trajectory available in constraint-based environments.

The case study results underline the importance of new digital collaboration platforms as knowledge multipliers, and illuminate on the potential of the fourth manufacturing revolution, which, through new technologies, creates opportunities for distributed forms of innovation that cross long distances.