Search results

1 – 10 of over 8000
Article
Publication date: 9 May 2023

Baraka Israel

The problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of…

103

Abstract

Purpose

The problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of technological aspects in the procurement of health commodities and health service delivery system requires in-depth exploration. This study bridges this gap by examining the mediating effect of an integrated health commodities procurement system on the relationship between responsiveness and health service delivery.

Design/methodology/approach

Data for this study were collected from 274 respondents, comprising procurement staff and pharmacists using a cross-sectional questionnaire survey. A total of 28 government-owned hospitals from 6 regions in the Southern Highland of Tanzania were sampled for observation. Confirmatory factor analysis (CFA) and structural equation modelling (SEM) were used for data analysis.

Findings

The results of the study revealed a positive and significant relationship between responsiveness and integrated health commodities procurement system (β = 0.572, p < 0.001). Responsiveness positively and significantly affects health service delivery (β = 0.175, p = 0.004). The results also show that integrated health commodities procurement system is positive and significantly related to health service delivery (β = 0.264, p < 0.001). Lastly, the bootstrapping confidence intervals revealed that an integrated health commodities procurement system significantly mediates the relationship between responsiveness and health service delivery.

Practical implications

To strengthen the health service delivery system, the study recommends enforcing internal control mechanisms and supporting policies that will monitor and evaluate the effectiveness of the integrated health commodities procurement system and service practitioners' responsiveness. Moreover, health service managers should ensure that the planning, procurement and distribution of health commodities are fully and effectively integrated at each node of the health supply chain.

Originality/value

The study contributes to the body of knowledge which examines the efficacy of health service delivery from procurement perspective. To the best of the author's knowledge, this is the first study that offers empirical evidence for the mediating effect of integrated health commodities procurement system on the link between responsiveness and health service delivery.

Details

International Journal of Health Governance, vol. 28 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 19 January 2021

Roya Malekzadeh, Samereh Yaghoubian, Edris Hasanpoor and Matina Ghasemi

Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of…

Abstract

Purpose

Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran.

Design/methodology/approach

The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section.

Findings

All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy.

Originality/value

In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.

Details

International Journal of Human Rights in Healthcare, vol. 14 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 9 October 2017

Sadegh Ahmadi Kashkoli, Ehsan Zarei, Abbas Daneshkohan and Soheila Khodakarim

Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the relationship…

Abstract

Purpose

Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the relationship between the eight dimensions of responsiveness and overall patient satisfaction in public and private hospitals in Tehran, Iran.

Design/methodology/approach

This cross-sectional study was conducted in 2015. In all, 500 patients were selected by the convenient sampling method from two public and three private hospitals. All data were collected using a valid and reliable questionnaire consisted of 32 items to assess the responsiveness of hospitals across eight dimensions and four items to assess the level of overall patient satisfaction. Data analysis was performed using descriptive statistics and multivariate regression was performed by SPSS 18.

Findings

The mean score of hospital responsiveness and patient satisfaction was 3.48±0.69 and 3.54±0.97 out of 5, respectively. Based on the regression analysis, around 65 percent of the variance in overall satisfaction can be explained by dimensions of responsiveness. Seven independent variables had a positive impact on patient satisfaction; the quality of basic amenities and respect for human dignity were the most powerful factors influencing overall patient satisfaction.

Originality/value

Hospital responsiveness had a strong effect on overall patient satisfaction. Health care facilities should consider including efforts to responsiveness improvement in their strategic plans. It is recommended that patients should be involved in their treatment processes and have the right to choose their physician.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Open Access
Article
Publication date: 30 March 2021

Blender Muzvondiwa and Roy Batterham

Gweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and…

Abstract

Purpose

Gweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and management of NCDs. Despite numerous initiatives, reorienting health services has been slow in many countries. Gweru District has similar challenges. The purpose of this paper is to explore what the health systems in Zimbabwe have done, and are doing to respond to increasing numbers of NCD cases in adults in the nation, especially in the district of Gweru

Design/methodology/approach

The study employed a descriptive narrative review of the academic and grey literature, supplemented by semi-structured key informant interviews with 14 health care staff and 30 adults living with a disease or caring for an adult with a disease in Gweru District.

Findings

Respondents identified many limitations to the response in Gweru. Respondents said that screening and diagnosis cease to be helpful when it is difficult securing medications. Nearly all community respondents reported not understanding why they are not freed of the diseases, showing poor understanding of NCDs. The escalating costs and scarcity of medications have led people to lose trust in services. Government and NGO activities include diagnosis and screening, provision of health education and some medication. Health personnel mentioned gaps in transport, medication shortages, poor equipment and poor community engagement. Suggestions include: training of nurses for a greater role in screening and management of NCDs, greater resourcing, outreach activities/satellite clinics and better integration of diverse NCD policies.

Originality/value

This research offers an understanding of NCD strategies and their limitations from the bottom-up, lived experience perspective of local health care workers and community members.

Details

Journal of Health Research, vol. 36 no. 3
Type: Research Article
ISSN: 0857-4421

Keywords

Open Access
Article
Publication date: 21 February 2024

Tina Bedenik, Claudine Kearney and Éidín Ní Shé

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and…

Abstract

Purpose

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Design/methodology/approach

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Findings

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Originality/value

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

Details

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

Keywords

Article
Publication date: 13 May 2019

Moutasem Zakkar

Patient experience is a complex multidimensional phenomenon that has been linked to constructs that are also complex to conceptualize, such as patient-centeredness, patient…

Abstract

Purpose

Patient experience is a complex multidimensional phenomenon that has been linked to constructs that are also complex to conceptualize, such as patient-centeredness, patient expectations and patient satisfaction. The purpose of this paper is to shed light on the different dimensions of patient experience, including those that receive inadequate attention from policymakers such as the patient’s lived experience of illness and the impact of healthcare politics. The paper proposes a simple classification for these dimensions, which differentiates between two types of dimensions: the determinants and the manifestations of patient experience.

Design/methodology/approach

This paper uses a narrative review of the literature to explore select constructs and initiatives developed for theorizing or operationalizing patient experience. Literature topics reviewed include healthcare quality, medical anthropology, health policy, healthcare system and public health.

Findings

The paper identifies five determinants for patient experience: the experience of illness, patient’s subjective influences, quality of healthcare services, health system responsiveness and the politics of healthcare. The paper identifies two manifestations of patient experience: patient satisfaction and patient engagement.

Originality/value

The paper proposes a classification scheme of the dimensions of patient experience and a concept map that links together heterogeneous constructs related to patient experience. The proposed classification and the concept map provide a holistic view of patient experience and help healthcare providers, quality managers and policymakers organize and focus their healthcare quality improvement endeavors on specific dimensions of patient experience while taking into consideration the other dimensions.

Details

International Journal of Health Governance, vol. 24 no. 2
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 14 June 2011

Sameer Kumar, Neha S. Ghildayal and Ronak N. Shah

The fundamental concern of this research study is to learn the quality and efficiency of US healthcare services. It seeks to examine the impact of quality and efficiency on…

11888

Abstract

Purpose

The fundamental concern of this research study is to learn the quality and efficiency of US healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the US healthcare system with those of other developed nations.

Design/methodology/approach

The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e. GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in US healthcare.

Findings

At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The US healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology‐induced costs and consumer behavior.

Practical implications

Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the “waste” from the system. Trend analyses are presented that display the crucial relationship between economic growth and healthcare spending.

Originality/value

There are many articles and reports published on the US healthcare system. However, very few articles have explored, in a comprehensive manner, the links between the economic indicators and measures of the healthcare system and how to reform this system. As a result of the US healthcare system's complex structure, process map and cause‐effect diagrams are utilized to simplify, address and understand. This study linked top‐level factors, i.e. the societal, government policies, healthcare system comparison, potential reformation solutions and the enormity of the recent trends by presenting serious issues associated with US healthcare.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 15 February 2013

Bridget Roberts, Darryl Maybery and Rebecca Jones

The integration of health or social services is an enduring challenge and especially so in relation to people experiencing “dual diagnosis”, the co‐occurrence of mental health and…

272

Abstract

Purpose

The integration of health or social services is an enduring challenge and especially so in relation to people experiencing “dual diagnosis”, the co‐occurrence of mental health and substance use problems. The emergence of the “dual diagnosis” concept has highlighted the tension between specialist treatment for single problems and complex, individualised care. The purpose of this paper is to examine the evolving nature of dual diagnosis initiatives in an Australian state during recent decades.

Design/methodology/approach

Interpretive, case study analysis of policy documents and key informant interviews (19) illuminates the experience of dual diagnosis initiatives.

Findings

In the case of Victoria, dual diagnosis responsiveness has evolved slowly over the last 20 years, delayed by the inherent difficulty of practice change, a weak perception of need, interprofessional tensions and shortcomings in data collection, coordination and resources. Key enablers have been champions and leaders in policy, management and clinical practice, directive government policy and targeted funding. Achieving a wrap‐around service system entails investment in interpersonal relationship‐building and stigma reduction, as well as technical or structural changes.

Originality/value

The paper presents a unique and independent view of a 20‐year period and indicates progress in attitudinal change that merits wider acknowledgement and application to other settings throughout health and social care.

Article
Publication date: 11 June 2018

Saleh Mollahaliloglu, Sahin Kavuncubasi, Fikriye Yilmaz, Mustafa Z. Younis, Fatih Simsek, Mustafa Kostak, Selami Yildirim and Emeka Nwagwu

Turkish Ministry of Health (MoH) has Health Transformation Program (HTP). The purpose of this program has been to modify the structure of the current system in order to enhance…

Abstract

Purpose

Turkish Ministry of Health (MoH) has Health Transformation Program (HTP). The purpose of this program has been to modify the structure of the current system in order to enhance health system productivity, quality, and access in the Turkish health system. The paper aims to discuss these issues.

Design/methodology/approach

To measure the productivity, a data envelopment analysis-based Malmquist index approach was employed.

Findings

Results showed that the overall HTP have had a considerable positive impact on the productivity of general hospitals.

Research limitations/implications

The limitation is the availability of some data that might not be collected or reported to the MoH in Turkey.

Practical implications

This research’s findings will have an impact on reforming the health care system in Turkey to be competitive and efficient as possible.

Social implications

The research will have implication on reducing cost and provide value to the Turkish population.

Originality/value

This is one of the very few articles that targeted the efficiency of hospital system in Turkey.

Details

International Journal of Organization Theory & Behavior, vol. 21 no. 2
Type: Research Article
ISSN: 1093-4537

Keywords

Article
Publication date: 1 October 2005

Suzanne Wait and Ellen Nolte

The pupose of this paper is to present an overview of the main conceptual and methodological issues that underlie our current understanding of benchmarking initiatives in the…

3140

Abstract

Purpose

The pupose of this paper is to present an overview of the main conceptual and methodological issues that underlie our current understanding of benchmarking initiatives in the field of health.

Design/methodology/approach

The paper is based on a pragmatic review of the literature and policy reports. It outlines some of the major conceptual problems associated with the use of benchmarking indicators and discusses how health policy research and practice is evolving to address the challenges raised, drawing examples from national and international benchmarking initiatives.

Findings

Benchmarking has become an intrinsic part of most developed health care systems, yet the impact of benchmarking initiatives on improvements in system performance and their integration within existing policy processes still need to be elucidated. Several methodological challenges remain in the field of benchmarking, many of them related to the selection and quality of indicators used to make comparisons both within and between health care systems. Further research and applications are needed to ensure that benchmarking in health fulfils its objective, namely to further our understanding of where to focus policy efforts in order to improve the performance of health care systems.

Originality/value

This paper poses the timely question of whether benchmarking initiatives are in fact guiding health policy towards the improvement of health care system performance. It draws from the policy literature and existing frameworks to offer an outline for the future evaluation of benchmarking initiatives by policy‐makers.

Details

Benchmarking: An International Journal, vol. 12 no. 5
Type: Research Article
ISSN: 1463-5771

Keywords

1 – 10 of over 8000