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Prachi Verma, Satinder Kumar and Sanjeev K. Sharma
Use of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with…
Abstract
Purpose
Use of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.
Design/methodology/approach
A questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1–5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.
Findings
The analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.
Practical implications
The results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.
Originality/value
This paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions.
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Valentina Bodrug-Lungu and Erin Kostina-Ritchey
The purpose of this paper is to provide an overview of post-Soviet and demographic challenges faced by the government in Moldova that have posed as challenges to reform of the…
Abstract
Purpose
The purpose of this paper is to provide an overview of post-Soviet and demographic challenges faced by the government in Moldova that have posed as challenges to reform of the healthcare system. Since independence from the Soviet Union in 1991, Moldova has undergone significant challenges and reforms throughout the society. Healthcare has been no exception. Changes in family structures due to migration, a decreased birthrate, and an aging population have placed strain on the healthcare system which is working to both modernize and provide specialized care. Legislation has helped to streamline and reform the healthcare system but systemic challenges are still faced by at-risk populations including the elderly, women, and rural populations.
Design
Information presented in this paper is based on a review of independent research, United Nations and government reports.
Findings
Findings show that progress has been made through legislative reform, new government programming, and most recently volunteer/nonprofit involvement in healthcare reform. Currently, the government is working to establish holistic patient centered care and to bridge the healthcare divide between rural and urban populations. Healthcare reforms include basic universal health care services and family support programming. Additionally, there has been a renewed emphasis on how environmental factors, like housing and nutrition, interact with health quality.
Value
Moldova faces an increasing challenge of caring for elderly populations at the family and societal level due to the increased number of elderly, shifts in family structures, and international migration for employment. A discussion of the developing role of nonprofit and nongovernment organizations is included.
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The countries that make up South Asia have young but rapidly aging populations. The purpose of this paper is to investigate some of the challenges that this rapid aging creates…
Abstract
Purpose
The countries that make up South Asia have young but rapidly aging populations. The purpose of this paper is to investigate some of the challenges that this rapid aging creates for societies and organizations in South Asia. It also points out how, properly managed, aging populations can create multiple opportunities for societies and organizations alike.
Design/methodology/approach
The paper uses secondary data about the aging situation globally. It pays special attention to the demographic situation in South Asian countries and uses as examples policies dealing with aging populations in other countries that have gone through demographic transitions in the recent past.
Findings
Aging populations are bringing about numerous challenges in the region, including rising costs for pensions and healthcare, higher dependency ratios, and changing family dynamics. South Asia will enjoy a one-time demographic dividend. Policy makers and managers need to put the right policies in place to ensure that they take maximum advantage of this opportunity.
Research limitations/implications
The study is based on secondary data. It is a perspectives piece and does not provide an in-depth study of the specific issues raised.
Practical implications
The study details how organizations can best manage this transition. This includes planning for a multigenerational workforce, providing accommodations for older workers, and fostering mentoring, knowledge transfer, cross-training and mixed-age work teams.
Social implications
This study analyzes some of the social issues that arise because of aging populations, such as the challenge of creating pension and healthcare systems, dealing with a rising old age dependency ratio, and dealing with a gradual transition to single-family households.
Originality/value
This is one of the first studies that look at the coming demographic transition in South Asia, and details some of the challenges and opportunities that arise both in terms of policies and managerial implications.
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Lia Patrício, Daniela Sangiorgi, Dominik Mahr, Martina Čaić, Saleh Kalantari and Sue Sundar
This paper explores how service design can contribute to the evolution of health service systems, moving them toward people-centered, integrated and technology-enabled care; the…
Abstract
Purpose
This paper explores how service design can contribute to the evolution of health service systems, moving them toward people-centered, integrated and technology-enabled care; the paper develops a research agenda to leverage service design research for healthcare transformation.
Design/methodology/approach
This conceptual study starts by analyzing healthcare challenges in terms of demographic trends and economic constraints, along with the problems of lack of people-centricity, dispersion of care and slowness in incorporating emerging technologies. Then, it examines the theoretical underpinnings of service design to develop a framework for exploring how a human-centered, transformative and service systems approach can contribute to addressing healthcare challenges, with illustrative cases of service design research in healthcare being given.
Findings
The proposed framework explores how a human-centered service design approach can leverage the potential of technology and advance healthcare systems toward people-centered care; how a transformative service design approach can go beyond explanatory research of healthcare phenomena to develop innovative solutions for healthcare change and wellbeing; and how a service systems perspective can address the complexity of healthcare systems, hence moving toward integrated care.
Originality/value
This paper systematizes and develops a framework for how service design can contribute to healthcare transformation. It identifies key healthcare application areas for future service design research and pathways for advancing service design in healthcare by using new interdisciplinary bridges, methodological developments and theoretical foundations.
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Efrat Neter, Esther Brainin and Orna Baron-Epel
Purpose: The primary purpose of this study is to examine the association between Internet use, skills, and health-related Internet activities, on the one hand, and perceived…
Abstract
Purpose: The primary purpose of this study is to examine the association between Internet use, skills, and health-related Internet activities, on the one hand, and perceived health outcomes of health-related Internet use, use of healthcare services, and self-rated health (SRH), on the other hand, the latter conceptualized as gains constituting the “third digital divide.” Secondarily, we seek to examine whether the above associations are maintained after accounting for demographic characteristics.
Methodology: A nationally representative random-digital-dial (RDD) telephone household survey of Israeli adult population (aged 21 and older, N = 819). The survey measured different dimensions of Internet use – frequency, experience, Web 1.0 general consumption and health-related activities, Web 2.0 production activities (general and health-related), and content evaluation. Potential health benefits included perceived outcomes of Internet use for health purposes, use of healthcare services and SRH.
Findings: In a multiple hierarchical regression model, adjusting for demographic variables, Internet use was associated with increased use of healthcare services and better perceived outcomes of Internet use for health purposes, but not with SRH.
Research Implications and Limitations: Health-related Internet use is associated with a sense of empowerment and enhanced use of healthcare services, but – after accounting for background variables – is not associated with SRH. Limitations include self-reports and a cross-sectional design, the latter precluding inference on causality.
Practical Implications: Internet use, specifically Web 1.0 consumption activities, is associated with increased use of healthcare services and is positively associated with perceived health outcomes. No such relationships were found for Web 2.0 activities. Future technological developments in services should take the digital divide into account and design products that will benefit disadvantaged groups.
Originality/Value: While rigorously assessing various dimensions of Internet use, the study distinguishes between various benefits of Internet use in the health domain, clarifying which benefits are associated with Internet use for health purposes.
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Tejaswi Materla, Elizabeth A. Cudney and Deborah Hopen
Healthcare providers are increasing their focus on patient satisfaction and patient-oriented services as they play a significant role in managing rising costs, elevating service…
Abstract
Purpose
Healthcare providers are increasing their focus on patient satisfaction and patient-oriented services as they play a significant role in managing rising costs, elevating service quality and establishing sustainable quality improvement strategies. In recent years, the Kano model has gained popularity in the healthcare industry and has been employed to improve patient satisfaction. The purpose of this paper is to illustrate how the Kano model can be deployed to identify a wide range of complex patient needs and convey its potential usefulness in the continuous improvement of the healthcare sector.
Design/methodology/approach
This paper provides a case study of implementing the Kano model to identify diverse patient needs and aims to eliminate the gaps identified in prior research, which include generically applying the Kano model to all service units of the healthcare system and using a predetermined service quality scale. This study emphasizes the importance of scale development and individual attention to each healthcare service unit in determining intricate patient needs. A cross-sectional study was conducted at the Student Health Services (SHS) of Missouri University of Science and Technology where the data were collected using the Kano survey. The respondents included undergraduate and graduate students that have utilized the healthcare services offered. A total of 138 patients were surveyed using a Kano model-based questionnaire that included demographics and treatment as well as service expectations.
Findings
Of the 21 quality attributes evaluated by the patients, 16 were categorized as one-dimensional, 3 as indifferent, and 2 as attractive attributes using the Kano model. None of the quality attributes showed a dominant must-be feature. The students considered the availability of appropriately qualified medical staff within 10 minutes of the check-in process and provision of after-hours care as attractive attributes that create greater satisfaction.
Research limitations/implications
The research was conducted at a university SHS center. Therefore, respondents in the survey are in a younger age group, which may affect patient expectations. In addition, expectations of an SHS center may be different than expectations of visiting a primary care physician and other healthcare units.
Originality/value
This study contributes to a better understanding of the identification of healthcare needs using the Kano model and advocates focusing on shifts in the categories over time and changes in the demographic environment.
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Sabina De Rosis, Kendall Jamieson Gilmore and Sabina Nuti
Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate…
Abstract
Purpose
Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate logistic regression models to identify factors related to users' demographics, emotional and informative support, technical and physical aspects of the provision, influencing satisfaction and willingness-to-recommend, before and during a crisis.
Design/methodology/approach
The value-in-use, defined in terms of a positive or negative value given by the experience with services, can be evaluated by users and influenced by the context of provision. The authors tested whether and how the value-in-use of services changed in a context of crisis. This study is applied to the healthcare sector during the coronavirus disease 2019 (COVID-19) epidemic, by evaluating the impact of the pandemic on hospitalisation experience.
Findings
Overall, analyses of 8,712 questionnaires found a greater value after the pandemic spread. In a time of crisis, technical and informative aspects of care were found to be most valued by patients that may recognise the extraordinary professionalism of workers during the crisis.
Research limitations/implications
This study empirically suggests that context can affect the evaluation of value-in-use by patients during unprecedented circumstances, producing additional value-in-context.
Practical implications
These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.
Social implications
The level of healthcare system distress, due to the COVID-19 epidemic, positively affects patients' propensity to recommend, which the authors suggest is driven by healthcare services' feelings of reverse compassion. These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience, which can have positive social implications. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.
Originality/value
Research based on the intersection of theoretical and empirical research regarding value-in-use, value-in-context and service quality measured through user experience is scarce, in particular in the healthcare sector. The authors' findings set the direction for future research on the influence of context on value creation and value creation's perception by users, on the concept of reverse compassion and on reverse compassion's impact on organisational well-being, particularly in times of crisis.
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The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented…
Abstract
Purpose
The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries.
Design/methodology/approach
The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people.
Findings
The author’s premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems.
Research limitations/implications
This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept.
Practical implications
Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing a growing number of problems and challenges. Being able to inquire on significant challenges in health and social care through a spatial lens has the potential to provide another, highly practical, kind of evidence in this field of work. This lens is, the author contends, very poorly integrated into either health or social care at present. However, doing so would have a variety of useful outcomes for monitoring and intervening on real problems in care integration. An example could be “frequent flyers” in emergency departments as has been done in Camden, New Jersey through patient mapping.
Social implications
The author’s position in this paper is that the challenges we face in providing integrated care to ageing and increasingly disabled (including both physical and cognitive impairments) populations will only grow in the face of variable governmental responses and increasingly complex funding and service provider arrangements. Without a geographical perspective and the concepts and tools of spatial science the author does not see an adequate response emerging. The shift to community-based care for many groups, including the aged, means that location will become more important rather than less so. This is a societal concern of major proportions and the very concept of integrated care requires of us a geographical perspective.
Originality/value
This is a short but, the author believes, conceptually rich piece with a variety of potential practical implications for health and social care service provision. Issues of equity, quality, safety and even basic access can only grow as population ageing progresses and various forms of chronic disease and disability continue to grow. Knowing where the most affected people and their social and service connections are located will support better integration. And better integration may resolve some of the financial and related resource problems that are already evident but which can only continue to increase. In this context, the author suggests that the integrated care of the future needs to be geographically informed to be effective.
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