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Expert briefing
Publication date: 10 April 2024

The same day, the government ordered an administrative intervention into one of Colombia’s largest private healthcare providers (EPSs), EPS Sanitas, citing financial mismanagement…

Details

DOI: 10.1108/OXAN-DB286344

ISSN: 2633-304X

Keywords

Geographic
Topical
Article
Publication date: 4 March 2024

Veli Durmuş

Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation…

Abstract

Purpose

Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation and Development (OECD) countries on public health security capacity and health service satisfaction.

Design/methodology/approach

Multiple linear regression analyses were employed for variables related to the level of health security capacity and satisfaction with the healthcare system while controlling for all socio-demographic variables from the European Social Survey, including over 44,000 respondents from 25 OECD countries. The Health Systems in Transition series of countries were used for assessing the decentralization level.

Findings

The result of multiple linear regression analyses showed that the level of decentralization in health systems was significantly associated with higher health security capacity (ß-coefficient 3.722, 95% confidence interval (CI) [3.536 3.908]; p=<0.001) and health service satisfaction (ß-coefficient 1.463, 95% CI [1.389 1.536]; p=<0.001) in the study. Countries with a higher level of decentralization in health policy tasks and areas were significantly likely to have higher health services satisfaction, whereas this satisfaction had a significant negative relation with the lower level of decentralization status of secondary/tertiary care services in OECD countries (ß-coefficient −5.250, 95% CI [−5.757–4.743]; p = 0.001).

Originality/value

This study contributes to a better understanding of the extent to which decentralization of health services affects public health safety capacity and satisfaction with health services, whereas the level of decentralization in OECD countries varies considerably. Overall, the findings highlight the importance of public health security and satisfaction with health care delivery in assessing the effects of decentralization in health services.

Details

Journal of Health Organization and Management, vol. 38 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 28 February 2023

Victor Pimentel and Carlo A. Mora-Monge

This study aims to benchmark the operational efficiency of fifty-eight public hospitals across Mexico between 2015 and 2018 and identifies the most critical inputs affecting their…

Abstract

Purpose

This study aims to benchmark the operational efficiency of fifty-eight public hospitals across Mexico between 2015 and 2018 and identifies the most critical inputs affecting their efficiency. In doing so, the study analyzes the impact of policy changes in the Mexican healthcare system introduced in recent years.

Design/methodology/approach

To measure the operational efficiency of Mexican public hospitals, data envelopment analysis (DEA) window analysis variable returns to scale (VRS) methodology using longitudinal data collected from the National Institute for Transparency and Access to Information (IFAI). Hospital groups are developed and compared using a categorization approach according to their average and most recent efficiency.

Findings

Results show that most of the hospitals in the study fall in the moving ahead category. The hospitals in the losing momentum or falling behind categories are mostly large units. Hospitals with initially low efficiency scores have either increased their efficiency or at least maintained a steady improvement. Finally, the findings indicate that most hospitals classified as moving ahead focused on a single care area (cancer, orthopedic care, child care and trauma).

Research limitations/implications

This study examined the technical efficiency of the Mexican healthcare system over a four-year period. Contrary to conventional belief, results indicate that most public Mexican hospitals are managed efficiently. However, recent changes in public and economic policies that came into effect in the current administration (2018) will likely have long-lasting effects on the hospitals' operational efficiency, which could impact the results of this study.

Originality/value

To the best of authors’ knowledge, this is the first study that examines the efficiency of the complex Mexican healthcare system using longitudinal data.

Details

Benchmarking: An International Journal, vol. 31 no. 2
Type: Research Article
ISSN: 1463-5771

Keywords

Open Access
Article
Publication date: 22 March 2024

Anell Anders

A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional…

Abstract

Purpose

A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional consequences. The purpose of this article is to discuss new approaches to performance management in health care services when the purpose is to support innovative changes in the delivery of services.

Design/methodology/approach

The article represents cross-boundary work as the theoretical and empirical material used to discuss and reconsider performance management comes from several relevant research disciplines, including systematic reviews of audit and feedback interventions in health care and extant theories of human motivation and organizational control.

Findings

An enabling approach to performance management in health care services can potentially contribute to innovative changes. Key design elements to operationalize such an approach are a formative and learning-oriented use of performance measures, an appeal to self- and social-approval mechanisms when providing feedback and support for local goals and action plans that fit specific conditions and challenges.

Originality/value

The article suggests how to operationalize an enabling approach to performance management in health care services. The framework is consistent with new governance and managerial approaches emerging in public sector organizations more generally, supporting a higher degree of professional autonomy and the use of nonfinancial incentives.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 9 May 2024

Claudio Rocco, Gianvito Mitrano, Angelo Corallo, Pierpaolo Pontrandolfo and Davide Guerri

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes…

Abstract

Purpose

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

Design/methodology/approach

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

Findings

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

Originality/value

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

Details

Business Process Management Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-7154

Keywords

Executive summary
Publication date: 4 April 2024

COLOMBIA: Health reform handling poses risks for Petro

Details

DOI: 10.1108/OXAN-ES286240

ISSN: 2633-304X

Keywords

Geographic
Topical
Article
Publication date: 4 November 2022

Atsushi Katsuda, Yoshiyuki Naito and Toshihiko Ishihara

In Japan, health-care systems have long been supported by physicians' long working hours. To solve this problem, there is an urgent need to improve the working environment for…

Abstract

Purpose

In Japan, health-care systems have long been supported by physicians' long working hours. To solve this problem, there is an urgent need to improve the working environment for physicians while practicing patient-centered medicine and controlling health-care costs. This paper aims to examine the effect of task shifting to nurses and discuss its usefulness from the perspective of health-care value co-creation.

Design/methodology/approach

This paper analyzes task shifting to nurses in acute care hospitals in Japan as a solution for the shortage of anesthesiologists. The authors discuss how the value was created from the perspective of the health-care ecosystem, with conceptual consideration of the value co-creation mechanism through patient-centered practices.

Findings

The study showed that task shifting initiatives in Japan can improve the motivation of nurses through human resource development while maintaining high quality. The study also suggested that task shifting from physicians to nurses may contribute to improving net income and maintaining the health-care system.

Practical implications

The findings are highly reproducible and can be immediately applied to initiatives at other medical institutions in Japan. Furthermore, it is suggested that these findings might provide some perspective on the realignment of fragmented healthcare in the USA.

Originality/value

It was confirmed in practical terms that micro-level initiatives have an impact on the macro level as well. In addition, the academic presentation of the concept has contributed to the deepening of value research.

Details

The TQM Journal, vol. 36 no. 3
Type: Research Article
ISSN: 1754-2731

Keywords

Open Access
Article
Publication date: 29 February 2024

Erlend Vik and Lisa Hansson

As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing…

Abstract

Purpose

As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.

Design/methodology/approach

This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.

Findings

The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.

Practical implications

The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.

Originality/value

This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities’ perspective and the organizational perspective to understand the manager’s role in handling the contingency of decisions and managing paradoxes in the decision-making process.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 14 August 2023

Olusola Joshua Olujobi and Tunde Ebenezer Yebisi

The purpose of this study is to examine the corruption prevalent in the distribution of COVID-19 palliatives during the lockdown and movement restrictions in the country. This…

Abstract

Purpose

The purpose of this study is to examine the corruption prevalent in the distribution of COVID-19 palliatives during the lockdown and movement restrictions in the country. This study seeks to analyse the current state of corruption in the distribution of COVID-19 palliatives and public health facilities in Nigeria while also providing a legal insight and strategic blueprint to combat corruption. To this end, this study will address the current legal framework for combating corruption and build upon this to formulate a working strategy for tackling corruption in the future.

Design/methodology/approach

Using a doctrinal legal research methodology, this study draws upon existing literature, tertiary data sources and information from the Nigeria Centre for Disease Control. The collected data is analysed and compared with current literature to identify key findings. Rent-seeking and utilitarian theories of the law were examined to guide this study. This study offers useful insights into combating corruption. The use of this method is justified, as it enhances the credibility of the findings on the importance of strategies for future emergencies. This legal research approach is consistent with the law and can be easily verified. The empirical aspect of this study involved a survey of multidimensional health-care and economic data set of 36 states in Nigeria plus the Federal Capital Territory on COVID-19 in Nigeria. A survey linearised regression model was estimated to determine the influence of government revenue and public health-care facilities in the control of the virus spread in Nigeria.

Findings

This study reveals the need for emphasis on the imperative of combating corruption in the distribution of COVID-19 palliatives and establishing economic resilience through transparent and accountable practices, supported by legal frameworks.

Research limitations/implications

Rent-seeking and utilitarian theories of law are evaluated because of their impacts on combating corruption. The limitation of this study is the intricacy of gathering data on COVID-19 palliatives corruption in Nigeria because of secrecy and the absence of reliable data on the subject.

Practical implications

Estimating the exact number of stolen palliatives and their fiscal impact on Nigeria's economy proves to be a formidable task because of the covert nature of corruption. This study equips policymakers in Nigeria with a better understanding of the legal challenges posed by corruption in the health care sector and provides an effective strategy to combat it.

Social implications

The lack of reliable data on the extent of palliative theft hinders the ability of lawmakers to enact effective legislation and strategies for combating corruption in the distribution of COVID-19 palliatives and addressing future emergencies in Nigeria. The policy implications of this study can assist policymakers in Nigeria and other countries in formulating measures to combat corruption in the distribution of COVID-19 palliatives and other future emergencies. Furthermore, it recommends the overhaul of anti-corruption laws and mechanisms in Nigeria to ensure effective measures against corruption.

Originality/value

In conclusion, this study contributes to knowledge by proposing a legal model centred on people's participation to enhance transparency and accountability in future palliative distribution processes. This study recommends legal strategies that can effectively address corruption in future emergencies or shocks. This study proposes a strategic blueprint to tackle corruption in the future. This blueprint includes an analysis of existing laws and regulations, as well as potential policy changes and legislative reform. This study also includes recommendations for improved enforcement and oversight mechanisms and for improved public awareness and education. As part of this, this study considers the potential for public–private partnerships to increase transparency and accountability in public health and health-care services.

Details

Journal of Financial Crime, vol. 31 no. 3
Type: Research Article
ISSN: 1359-0790

Keywords

Book part
Publication date: 19 April 2024

Lars Mjøset, Roel Meijer, Nils Butenschøn and Kristian Berg Harpviken

This study employs Stein Rokkan's methodological approach to analyse state formation in the Greater Middle East. It develops a conceptual framework distinguishing colonial…

Abstract

This study employs Stein Rokkan's methodological approach to analyse state formation in the Greater Middle East. It develops a conceptual framework distinguishing colonial, populist and democratic pacts, suitable for analysis of state formation and nation-building through to the present period. The framework relies on historical institutionalism. The methodology, however, is Rokkan's. The initial conceptual analysis also specifies differences between European and the Middle Eastern state formation processes. It is followed by a brief and selective discussion of historical preconditions. Next, the method of plotting singular cases into conceptual-typological maps is applied to 20 cases in the Greater Middle East (including Afghanistan, Iran and Turkey). For reasons of space, the empirical analysis is limited to the colonial period (1870s to the end of World War 1). Three typologies are combined into one conceptual-typological map of this period. The vertical left-hand axis provides a composite typology that clarifies cultural-territorial preconditions. The horizontal axis specifies transformations of the region's agrarian class structures since the mid-19th century reforms. The right-hand vertical axis provides a four-layered typology of processes of external intervention. A final section presents selected comparative case reconstructions. To the authors' knowledge, this is the first time such a Rokkan-style conceptual-typological map has been constructed for a non-European region.

Details

A Comparative Historical and Typological Approach to the Middle Eastern State System
Type: Book
ISBN: 978-1-83753-122-6

Keywords

1 – 10 of over 1000