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Article
Publication date: 28 August 2023

Sukri Paluttri

This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify…

Abstract

Purpose

This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify the main differences and provide recommendations for Indonesian and other developing countries’ health policymakers and administrators.

Design/methodology/approach

Using formative research with a conceptual approach and statute approach as method in this study. Data was gathered using the document study technique, which studies various documents, especially legal documents related to health law, linked to legal purpose theories. Moreover, the World Health Organization ranking was considered to choose the two countries (France and Singapore) with a high social health security system for comparative analysis. All data collected has been analyzed using a qualitative and theoretical basis. Content analysis was performed by analyzing the legal documents, and the regulatory framework of all three countries was deeply analyzed to draw conclusions and recommendations.

Findings

Indonesia has specific laws to implement a social security system in the health sector. However, the lack of the best medical facilities and infrastructure and weak implementation of existing laws were identified as major reasons behind the poor health security system compared to comparative countries. Also, as a developing nation Indonesian Government face budgetary pressures and huge population challenges to meet required standards. Thus, the financing approaches used by Singapore and France may help developing countries meet these challenges effectively. Therefore, there is a dire need to strengthen the social health security system all over the country with amendments to laws and ensure the implementation of prevailing laws and regulations.

Practical implications

Providing understanding related to the social security health system in Indonesia along with a detailed description of the sound social health security system in France and Singapore will further provide an avenue for the researchers to critically analyze this line of study to devise some valuable suggestions further and to draw loopholes in the system.

Originality/value

A comparative approach for legal studies in the health sector is rare. So, this research advanced the social security health system-related literature and legal studies on the health sector by using this comparative approach to develop policy insights and future research directions, which will further help the field to grow.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

Open Access
Article
Publication date: 20 November 2023

Zahra Salah Eldin, Mohamed Elsheemy and Raghda Ali Abdelrahman

Many countries around the world are facing great challenges from their ageing population with shrinking workforce, this will put more pressure on their financial system and will…

Abstract

Purpose

Many countries around the world are facing great challenges from their ageing population with shrinking workforce, this will put more pressure on their financial system and will increase the public spending on care costs provided to older people. Egypt is in the phase of establishing a new law for older people care's rights, a law that will organise how older people in need for care would benefit from access to government financial support and how will families support their older relatives financially and how the care costs will be shared between the older people, their families and the government.

Design/methodology/approach

The paper examines the suitability two cost-sharing methods and applying them to assess the effect on the individuals and families' income strain.

Findings

The preferred approach can be used for sharing costs as it applies a gradual funding withdrawal by the government and provide more fairness and flexibility for application in different regions. Besides, the parameters of this approach can be used by policy makers to control the levels of funding.

Originality/value

The paper will be the first to discuss the intergenerational fairness from a financial perspective in Egypt to avoid forcing older people into poverty or resorting to poverty trade-off.

Details

Journal of Humanities and Applied Social Sciences, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2632-279X

Keywords

Open Access
Article
Publication date: 14 November 2023

Markus Kantola, Hannele Seeck, Albert J. Mills and Jean Helms Mills

This paper aims to explore how historical context influences the content and selection of rhetorical legitimation strategies. Using case study method, this paper will focus on how…

Abstract

Purpose

This paper aims to explore how historical context influences the content and selection of rhetorical legitimation strategies. Using case study method, this paper will focus on how insurance companies and labor tried to defend their legitimacy in the context of enactment of Medicare in the USA. What factors influenced the strategic (rhetorical) decisions made by insurance companies and labor unions in their institutional work?

Design/methodology/approach

The study is empirically grounded in archival research, involving an analysis of over 9,000 pages of congressional hearings on Medicare covering the period 1958–1965.

Findings

The authors show that rhetorical legitimation strategies depend significantly on the specific historical circumstances in which those strategies are used. The historical context lent credibility to certain arguments and organizations are forced to decide either to challenge widely held assumptions or take advantage of them. The authors show that organizations face strong incentives to pursue the latter option. Here, both the insurance companies and labor unions tried to show that their positions were consistent with classical liberal ideology, because of high respect of classical liberal principles among different stakeholders (policymakers, voters, etc.).

Research limitations/implications

It is uncertain how much the results of the study could be generalized. More information about the organizations whose use of rhetorics the authors studied could have strengthened our conclusions.

Practical implications

The practical relevancy of the revised paper is that the authors should not expect hegemony challenging rhetorics from organizations, which try to influence legislators (and perhaps the larger public). Perhaps (based on the findings), this kind of rhetorics is not even very effective.

Social implications

The paper helps to understand better how organizations try to advance their interests and gain acceptance among the stakeholders.

Originality/value

In this paper, the authors show how historical context in practice influence rhetorical arguments organizations select in public debates when their goal is to influence the decision-making of their audience. In particular, the authors show how dominant ideology (or ideologies) limit the options organizations face when they are choosing their strategies and arguments. In terms of the selection of rhetorical justification strategies, the most pressing question is not the “real” broad based support of certain ideologies. Insurance company and labor union representatives clearly believed that they must emphasize liberal values (or liberal ideology) if they wanted to gain legitimacy for their positions. In existing literature, it is often assumed that historical context influence the selection of rhetorical strategies but how this in fact happens is not usually specified. The paper shows how interpretations of historical contexts (including the ideological context) in practice influence the rhetorical strategies organizations choose.

Details

Journal of Management History, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1751-1348

Keywords

Article
Publication date: 12 January 2024

Scott Fleming

This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold…

Abstract

Purpose

This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process.

Design/methodology/approach

Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software.

Findings

This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process.

Originality/value

This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge.

Details

The Journal of Adult Protection, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 23 April 2024

Margitta B. Beil-Hildebrand, Firuzan Kundt Sari, Patrick Kutschar and Lorri Birkholz

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress…

Abstract

Purpose

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

Design/methodology/approach

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

Findings

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Originality/value

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

Details

Leadership in Health Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 30 April 2024

Ruby Valerie Whitelaw

Research highlights that residential care experienced children and young people in Scotland have poorer educational outcomes than their peers within the wider population. Despite…

Abstract

Purpose

Research highlights that residential care experienced children and young people in Scotland have poorer educational outcomes than their peers within the wider population. Despite this, poor educational attainment is not inevitable, and further research is needed to increase the understanding of long-term trajectories. This paper aims to address a gap in contemporary literature that is of benefit to practitioners, academics and policymakers. Despite experiencing adversity, attachment, separation and loss, school attainment data on leaving care only reflects part of the educational journey.

Design/methodology/approach

Using a mixed methodology and social constructionist theoretical framework, a practitioner-led PhD study gathered data from questionnaires and qualitative information from 13 semi-structured interviews with young people who had experienced residential care in Scotland. Recruitment was through a gatekeeper within a national third-sector organisation. The educational trajectories for young people with experience of residential care in Scotland are complex. A lived experience perspective from a PhD study illustrates that statistical data only captures part of the journey and the author needs to reconsider how success is measured.

Findings

Of the 13 participants in the study, 12 achieved success educationally, although for the majority of those interviewed, attainment continued after leaving compulsory education. Barriers to greater success included placement uncertainty and movement, stigma, low expectations, pressure to not become a statistic, procedural obstacles and inconsistency or poor relationships.

Research limitations/implications

Supportive relationships and stable placements can create circumstances conducive to effective learning, but evidence reflects that support is necessary throughout the life course if children, young people and adults with care experience are to reach their full academic potential.

Originality/value

Research into the educational outcomes for those with experience of residential care in Scotland is limited. This paper, from a PhD, provides lived experience accounts from a practitioner-led study.

Details

Journal of Children's Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 26 March 2024

Zeba Khanam, Zebran Khan, Mohd Arwab and Ariba Khan

The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI).

Abstract

Purpose

The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI).

Design/methodology/approach

Both online and offline questionnaire was used to collect the data from 387 Indian health-care employees, and the data were analyzed using partial least squares structural equation modeling (PLS-SEM) with the help of SmartPLS 4.

Findings

The study’s findings demonstrated a significant positive association between RL and OJ and a negative association between OJ and employee TI. Furthermore, results also confirmed the mediating role of OJ between RI and TI.

Research limitations/implications

The generalizability of the study‘s data collection is limited because it is based on the responses of Indian health-care sector employees to an online and offline survey. The authors propose that the health-care sector uses RL as an approach that takes a broad view of the parties with a stake and focuses on creating fairness in acts and justice at the workplace to address the major issue of employee turnover.

Originality/value

This study expanded on previous research by demonstrating that the influence of responsible leadership on employee TI is mediated by OJ in the context of India’s health-care sector. It also contributes to the literature regarding RI, OJ and TI. The study also enriched the body of knowledge about using the PLS-SEM approach to predict employee TI.

Details

Leadership in Health Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 8 June 2023

Sobah Abbas Petersen, Tor Åsmund Evjen and John Krogstie

The main aim of this paper is to describe the potential benefits of enterprise building information models (EBIMs) for health-care institutions. The main research question…

Abstract

Purpose

The main aim of this paper is to describe the potential benefits of enterprise building information models (EBIMs) for health-care institutions. The main research question addressed is how data from EBIM could be leveraged to create value for hospitals beyond design, construction and traditional facility management.

Design/methodology/approach

Three different prototypes, which use different technologies in combination with EBIM, are described to illustrate different uses of EBIM within the context of a hospital and health-care operations. The case study approach has been used to present the prototypes.

Findings

EBIM data, in combination with other data sources, increases the potential benefits of the data with respect to many health-care-related processes, during the operation of a health-care institution. The benefits of EBIM span beyond the design and construction life cycle phases of a hospital and provide value to a variety of stakeholders in multiple health-care-related processes.

Research limitations/implications

The main limitation of this work is the limited sources of data and information such as the specific methods that were used in the design and development of each of the prototypes and a deeper insight into the design rationale and decisions. Another limitation of this paper is that the findings have not been validated.

Practical implications

This study demonstrates the value of convergence of a number of technologies such as EBIM, data and different types of technologies, throughout the life cycle of a building. This study also highlights the value of building information models (BIMs) data for supporting the design of novel educational and other types of application areas. The practical implications include the value for multiple stakeholders, such as resources planning, fleet and equipment management and contract negotiation. Benefits identified for resource planning can have strategic and financial implications at the management level. For patients, visitors and health-care personnel, there may be reduced infections, cleaner and pleasant facilities as well as a reduction of time to find relevant resources.

Social implications

Social implications" could be replaced by "For patients, visitors and health-care personnel, there may be cleaner and pleasant facilities and easy navigation support through the hospital. Furthermore, enhanced access to knowledge and information about the artefact and assets in the hospital can enhance learning and knowledge sharing.

Originality/value

This study identifies the lack of research in using BIM with other data for value-added services for multiple stakeholders in the operations phase of a hospital and addresses that research gap.

Details

Journal of Facilities Management , vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1472-5967

Keywords

Article
Publication date: 1 April 2024

Isobel Talks, Buthena Al Mobarak, Cornelius Katona, Jane Hunt, Niall Winters and Anne Geniets

Refugees and asylum seekers worldwide face numerous barriers in accessing health systems. The evidence base regarding who and what helps refugees and asylum seekers facilitate…

Abstract

Purpose

Refugees and asylum seekers worldwide face numerous barriers in accessing health systems. The evidence base regarding who and what helps refugees and asylum seekers facilitate access to and the navigation of the health system in the UK is small. This study aims to address this gap by analysing 14 semi-structured, in-depth interviews with refugees and asylum seekers of different countries of origin in the UK to identify where, when and how they came into contact with the health-care system and what the outcome of these interactions was.

Design/methodology/approach

Semi-structured, in-depth interviews were chosen as the key method for this study. In total, 14 individual interviews were conducted. A trauma-informed research approach was applied to reduce the risk of re-traumatising participants.

Findings

The paper identifies key obstacles as well as “facilitators” of refugees’ and asylum seekers’ health-care experience in the UK and suggests that host families, friends and third-party organisations all play an important role in ensuring refugees and asylum seekers receive the healthcare they need.

Originality/value

To the best of the authors’ knowledge, this is the first qualitative study in the UK that looks at comprehensive health journeys of refugees from their first encounter with health services through to secondary care, highlighting the important role along the way of facilitators such as host families, friends and third-party organisations.

Details

International Journal of Migration, Health and Social Care, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1747-9894

Keywords

Open Access
Article
Publication date: 22 April 2024

Leman Isik, Christina Nilsson, Johan Magnusson and Dina Koutsikouri

While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits…

Abstract

Purpose

While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits realization are translated into practice.

Design/methodology/approach

The authors apply a qualitative, comparative case study of two large, public-sector health care organizations in Sweden. Through document and interview data, the authors analyze the process of translation.

Findings

The study finds that practice variation is primarily caused by two types of decoupling: policy-practice and means-ends. Contrary to previous studies, coercion in policy compliance is not found to decrease practice variation.

Research limitations/implications

The limitations primarily stem from the empirical selection of two large public health-care organizations in Sweden, affecting the study’s generalizability. Reducing practice variation is more effectively achieved through goal alignment than coercion, leading to implications for the design of governance and control.

Practical implications

Policymakers should, instead of focusing on control-related compliance, work to align organizational objectives and policies to decrease practice variation for successful benefits realization.

Social implications

The study contributes to better benefits realization of digital transformation initiatives in health care. As such, the authors contribute to a better functioning and more transformative health care in times of increased demand and decreased supply of health-care services.

Originality/value

The study challenges conventional wisdom by identifying that coercion is less effective than goal alignment in reducing practice variation, thereby enhancing the understanding of policy implementation dynamics in health-care settings.

Details

Transforming Government: People, Process and Policy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1750-6166

Keywords

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