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1 – 10 of 954Antti Peltokorpi, Juri Matinheikki, Jere Lehtinen and Risto Rajala
To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency…
Abstract
Purpose
To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.
Design/methodology/approach
A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.
Findings
Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.
Research limitations/implications
Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.
Practical implications
Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.
Social implications
For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.
Originality/value
This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.
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This study examines entrepreneurship and assesses its relevance to health care organizations through a detailed description of the optimal environment, organizational factors, and…
Abstract
This study examines entrepreneurship and assesses its relevance to health care organizations through a detailed description of the optimal environment, organizational factors, and managerial roles in the entrepreneurship process. The article finds entrepreneurship processes to be especially useful to health care organizations as they struggle to survive in the competitive managed care environment.
This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is explored to…
Abstract
Purpose
This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is explored to link suppliers/manufacturers with health-care providers.
Design/methodology/approach
Existing literature on supply chain visibility in health care forms a basis to achieve the study purpose. Alignment calls also for financial health where supply chain partners’ working capital is readily available to execute joint supply chain plan.
Findings
There is a disjoint in supply chain alliance between suppliers/manufacturers and providers where providers are unable to trace the origin of supplies. Quality care suffers and cost of care rises as providers search for supplies on an emergency basis. This paper provides a framework where solution can be formulated.
Research limitations/implications
Suppliers/manufactures form a direct strategic alliance with providers where product visibility enables health-care providers with a better patient management with lower cost of supplies. Inventory management and logistics cost will be lowered as better planning/forecasting is in place. This paper does not call for testing any hypothesis. Perhaps, next move along this line will be to investigate financial health of supply chain partners based on supplier relationship management practices.
Originality/value
This paper proposes health-care supply chain as an alternative solution to achieve the following twin purposes: controlling the cost while improving quality of care through supply chain finance. As far as we know, this study is the first attempt to achieve the goals.
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This study examines unexplored horizontal accountability types between public, private and third sector actors within a hybrid organization. The case organization was applying a…
Abstract
Purpose
This study examines unexplored horizontal accountability types between public, private and third sector actors within a hybrid organization. The case organization was applying a novel alliance model to generate service paths for heterogeneous clientele consuming cultural, educational, health and social services. It was first to do so in Finland.
Design/methodology/approach
This research is on a case study that used documents and interviews to examine the design of the horizontal accountability. The descriptive analysis focused on identifying what type of formal accountability system was designed (i.e. who is the account holder, and who is accountable and for what and why).
Findings
An imbalanced accountability system was identified because accountability obligations were unevenly distributed between public, private and third sector actors. The private sector was the most accountable for performance, and the third sector (i.e. voluntary sector) was the least accountable. As account holders, the public, private and third sector actors were judging their conduct as account providers. This created a biased horizontal accountability system. The hybrid's accountability system was dynamic because the contracts made to establish the hybrid included opportunities to change horizontal accountability if future changes to the external environment affect too drastically the potential to achieve the hybrid's goals.
Originality/value
Three new concepts are proposed for studying dysfunctional accountability systems: dynamic, biased and horizontally imbalanced accountability.
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The family's role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric…
Abstract
The family's role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric patients. This different mindset, which views the family as an alternative to institutionalization, leads to it being seen as an essential entity in the setting up of community service dynamics. We interviewed health professionals in order to understand obstacles of collaboration between family members and mental health care workers. The goal was to uncover actions that promote collaboration and help build alliances between families and psychiatric workers. Results showed that health professionals view the family as a therapeutic resource. Despite this view, family members were rarely included in patient treatment. The reasons is: the structures have a theoretical orientation of collaboration with the family but, for nurses not are organized a few meeting spaces with family members. Services should create moments, such as multi-family groups or groups of information, managed by nurses and not only by doctors. These occasions it might facilitate the knowledge between professionals and family members.
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David Stewart Briggs, Richard Nankervis, John Baillie, Catherine Turner, Kevin Rigby and Lorin Livingstone
The purpose of this paper is to review the establishment of Primary Health Network (PHN) in Australia and its utility in commissioning Primary Health Care (PHC) services.
Abstract
Purpose
The purpose of this paper is to review the establishment of Primary Health Network (PHN) in Australia and its utility in commissioning Primary Health Care (PHC) services.
Design/methodology/approach
This study is an analysis of management practice about the establishment and development of a PHN as a case study over the three-year period. The PHN is the Hunter New England and Central Coast PHN (HNECCPHN). The study is based on “insiders perspectives” drawing from documentation, reports and evaluations undertaken.
Findings
HNECCPHN demonstrates a unique inclusive organisation across a substantial diverse geographic area. It has taken an innovative and evidence-based approach to its creation, governance and operation. HNECCPHN addresses the health challenges of a substantial Aboriginal and/or Torres Strait Islander population. It contains significant and diverse urban, coastal and distinct rural, regional and remote populations. It can be described as a “virtual” organisation, using a distributed network of practice approach to engage clinicians, communities and providers. The authors describe progress and learning in the context of theories of complex organisations, innovation, networks of practice, knowledge translation and social innovation.
Research limitations/implications
The study provides initial publication into the establishment phase of a PHN in Australia.
Practical implications
The study describes the implementation and progress in terms of relevant international practice and theoretical concepts. This paper demonstrates significant innovative practice in the short term.
Social implications
The study describes significant engagement and the importance of that with and between communities, service providers and health professionals.
Originality/value
This is the first study of the results of the implementation of an important change in the funding and delivery of PHC in Australia.
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Tuomas Hujala and Harri Laihonen
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform…
Abstract
Purpose
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.
Design/methodology/approach
The article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.
Findings
This study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.
Originality/value
This study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.
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