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1 – 10 of over 1000Antti 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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Daan Kabel, Jason Martin and Mattias Elg
The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it…
Abstract
Purpose
The integration of industry 4.0 has become a priority for many organizations. However, not all organizations are suitable and capable of implementing industry 4.0 because it requires a dynamic and flexible implementation strategy. The implementation of industry 4.0 often involves overcoming several tensions between internal and external stakeholders. This paper aims to explore the paradoxical tensions that arise for health-care organizations when integrating industry 4.0. Moreover, it discusses how a paradox lens can support the conceptualization and proposes techniques for handling tensions during the integration of industry 4.0.
Design/methodology/approach
This qualitative and in-depth study draws upon 32 semi-structured interviews. The empirical case concerns how two health-care organizations handle paradoxical tensions during the integration of industry 4.0.
Findings
The exploration resulted in six recurring technology tensions: technology invention (modularized design vs. flexible design), technology collaboration (automation vs. human augmentation), technology-driven patient experience (control vs. autonomy), technology uncertainty (short-term experimentation vs. long-term planning), technology invention and diffusion through collaborative efforts among stakeholders (selective vs. intensive collaboration) and technological innovation (market maintenance vs. disruption).
Originality/value
A paradox theory-informed conceptual model is proposed for how to handle tensions during the integration of industry 4.0. To the best of the authors’ knowledge, this is the first paper to introduce paradox theory for quality management, including lean and Six Sigma.
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Rocco Palumbo, Capolupo Nicola and Paola Adinolfi
Promoting health literacy, i.e. the ability to access, collect, understand and use health-related information, is high on the health policy agenda across the world. The…
Abstract
Purpose
Promoting health literacy, i.e. the ability to access, collect, understand and use health-related information, is high on the health policy agenda across the world. The digitization of health-care calls for a reframing of health literacy in the cyber-physical environment. The article systematizes current scientific knowledge about digital health literacy and investigates the role of health-care organizations in delivering health literate health-care services in a digital environment.
Design/methodology/approach
A literature review was accomplished. A targeted query to collect relevant scientific contributions was run on PubMed, Scopus and Web of Science. A narrative approach was undertaken to summarize the study findings and to envision avenues for further development in the field of digital health literacy.
Findings
Digital health literacy has peculiar attributes as compared with health literacy. Patients may suffer from a lack of human touch when they access health services in the digital environment. This may impair their ability to collect health information and to appropriately use it to co-create value and to co-produce health promotion and risk prevention services. Health-care organizations should strive for increasing the patients’ ability to navigate the digital health-care environment and boosting the latter’s value co-creation capability.
Practical implications
Tailored solutions should be designed to promote digital health literacy at the individual and organizational level. On the one hand, attention should be paid to the patients’ special digital information needs and to avoid flaws in their ability to contribute to health services’ co-production. On the other hand, health-care organizations should be involved in the design of user-friendly e-health solutions, which aim at engaging patients in value co-creation.
Originality/value
This contribution is a first attempt to systematize extant scientific knowledge in the field of digital health literacy specifically focused on the strategies and initiatives that health-care organizations may take to address the limited digital health literacy pandemic.
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Sherali Zeadally, Farhan Siddiqui, Zubair Baig and Ahmed Ibrahim
The aim of this paper is to identify some of the challenges that need to be addressed to accelerate the deployment and adoption of smart health technologies for ubiquitous…
Abstract
Purpose
The aim of this paper is to identify some of the challenges that need to be addressed to accelerate the deployment and adoption of smart health technologies for ubiquitous healthcare access. The paper also explores how internet of things (IoT) and big data technologies can be combined with smart health to provide better healthcare solutions.
Design/methodology/approach
The authors reviewed the literature to identify the challenges which have slowed down the deployment and adoption of smart health.
Findings
The authors discussed how IoT and big data technologies can be integrated with smart health to address some of the challenges to improve health-care availability, access and costs.
Originality/value
The results of this paper will help health-care designers, professionals and researchers design better health-care information systems.
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Linda Höglund, Maria Mårtensson and Pia Nylinder
The purpose of this paper is to conceptualise our understanding of public value accounting (PVA) by studying the use and usefulness of performance measurements (PM) as a…
Abstract
Purpose
The purpose of this paper is to conceptualise our understanding of public value accounting (PVA) by studying the use and usefulness of performance measurements (PM) as a management tool. The authors do this from a perspective in which they address the complexity of various (sometimes conflicting) assessments of performance measurement and management (PMM) by different stakeholders.
Design/methodology/approach
An interpretative case study using qualitative methods. The paper is based on 30 interviews conducted in 2018 and 2019 with respondents working with PMM at different levels, such as politicians, officials and health-care professionals. The study context was Region Stockholm (RS) in Sweden and its health-care division.
Findings
PMs become an instrumental tool for PMM, which led to output being promoted above outcome. The authors show that there is a conceptual shortcoming in the discussion of PVA, as the effort needed to achieve outcome-based information might exceed the ability of an organisation to deliver it. The authors address the importance of studying the interaction among different stakeholders, including politicians, the public and media, in research on PVA, as well as possible power relationships among stakeholders.
Originality/value
The authors contribute to the growing research on PVA and its call for more empirical research by offering a more nuanced interpretation of PVA activities. The authors do this by studying PMM and the nature of these activities in a public sector organisation from a multiple-stakeholder perspective.
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Danielle Jansen, Johanna P. M. Vervoort, Annemieke Visser, Sijmen A. Reijneveld, Paul Kocken, Gaby de Lijster and Pierre-André Michaud
Models of Child Health Appraised (MOCHA) defines school health services (SHSs) as those that exist due to a formal arrangement between educational institutions and primary health…
Abstract
Models of Child Health Appraised (MOCHA) defines school health services (SHSs) as those that exist due to a formal arrangement between educational institutions and primary health care. SHSs are unique in that they are designed exclusively to address the needs of children and adolescents in this age group and setting.
We investigated SHSs have been provided to schools and how they contribute to primary healthcare services for school children. We did this by mapping the national school health systems against the standards of the World Health Organization, and against a framework measuring the strength of primary care, adapting this from an existing, adult-focused framework.
We found that all but two countries in the European Union and European Economic Area have SHSs. There, however, remains a need for much greater investment in the professional workforce to run the services, including training to ensure appropriateness and acceptability to young people. Greater collaboration between SHSs and primary care services would lead to better coordination and the potential for better health (and educational) outcomes. Involving young people and families in the design of SHSs and as participants in its outputs would also improve school health.
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Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…
Abstract
Purpose
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.
Design/methodology/approach
Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.
Findings
The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.
Originality/value
There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.
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Russell Mannion, Frederick Hassan Konteh and Rowena Jacobs
This study aims to compare and contrast the core organisational processes across high and low performing mental health providers in the English National Health Service (NHS).
Abstract
Purpose
This study aims to compare and contrast the core organisational processes across high and low performing mental health providers in the English National Health Service (NHS).
Design/methodology/approach
A multiple case study qualitative design incorporating a full sample of low and high performing mental health providers.
Findings
This study suggests that the organisational approaches used to govern and manage mental health providers are associated with their performance, and the study’s findings give clues as to what areas might need attention. They include, but are not limited to: developing appropriate governance frameworks and organisational cultures, ensuring that staff across the organisation feel “psychologically safe” and able to speak up when they see things that are going wrong; a focus on enhancing quality of services rather than prioritising cost-reduction; investing in new technology and digital applications; and nurturing positive inter-organisational relationships across the local health economy.
Originality/value
Highlights considerable divergence in organisation and management practices that are associated with the performance of mental health trusts in the English NHS
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Raghav Upadhyai, Neha Upadhyai, Arvind Kumar Jain, Gaurav Chopra, Hiranmoy Roy and Vimal Pant
This study integrates the providers' perspective as well as the patient's perspective in developing and validating a scale to measure hospital service quality in multispecialty…
Abstract
Purpose
This study integrates the providers' perspective as well as the patient's perspective in developing and validating a scale to measure hospital service quality in multispecialty hospitals.
Design/methodology/approach
An exploratory sequential mixed-method approach was used in this study. The strategies used included a thematic literature review, semi-structured interviews, modified Delphi and confirmatory factor analysis.
Findings
The reliability coefficient of 41 item scale was 0.963 with each attribute, that is, pivotal, core and peripheral, having a Cronbach's alpha of 0.907, 0.91 and 0.891, with scale content validity (S-CVI Ave) of 0.9151. The composite reliability scores of all constructs were greater than 0.7, with an Average Variance Explained (AVE) of all items greater than 0.5.
Originality/value
The instrument can be used to measure the difference between what service providers believe customers expect and customers’ actual needs and expectations. The scale can be used to measure the difference between what is delivered (as perceived by the provider) and what customers perceive they have received (because they are unable to accurately evaluate service quality). The dyadic approach of administering this questionnaire in measuring hospital service quality will lead to the identification of a knowledge gap and a perception gap in delivering hospital service quality.
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Robyn Ramsden, Richard Colbran, Tricia Linehan, Michael Edwards, Hilal Varinli, Carolyn Ripper, Angela Kerr, Andrew Harvey, Phil Naden, Scott McLachlan and Stephen Rodwell
While one-third of Australians live outside major cities, there are ongoing challenges in providing accessible, sustainable, and appropriate primary health care services in rural…
Abstract
Purpose
While one-third of Australians live outside major cities, there are ongoing challenges in providing accessible, sustainable, and appropriate primary health care services in rural and remote communities. The purpose of this paper is to explore a partnership approach to understanding and addressing complex primary health workforce issues in the western region of New South Wales (NSW), Australia.
Design/methodology/approach
The authors describe how a collaboration of five organisations worked together to engage a broader group of stakeholders and secure commitment and resources for a regional approach to address workforce challenges in Western NSW. A literature review and formal interviews with stakeholders gathered knowledge, identified issues and informed the overarching approach, including the development of the Western NSW Partnership Model and Primary Health Workforce Planning Framework. A stakeholder forum tested the proposed approach and gained endorsement for a collaborative priority action plan.
Findings
The Western NSW Partnership Model successfully engaged regional stakeholders and guided the development of a collaborative approach to building a sustainable primary health workforce for the future.
Originality/value
Given the scarcity of literature about effective partnerships approaches to address rural health workforce challenges, this paper contributes to an understanding of how to build sustainable partnerships to positively impact on the rural health workforce. This approach is replicable and potentially valuable elsewhere in NSW, other parts of Australia and internationally.
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