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1 – 10 of over 38000Vasco Eiriz and José António Figueiredo
To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables…
Abstract
Purpose
To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically.
Design/methodology/approach
Systematic review of the literature.
Findings
Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non‐technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence).
Originality/value
This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing‐oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.
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Patrick Asubonteng Rivers and Saundra H. Glover
As the health‐care industry undergoes major change, a method of “accounting for quality” has become a key factor in health services delivery and fiscal accountability. This…
Abstract
As the health‐care industry undergoes major change, a method of “accounting for quality” has become a key factor in health services delivery and fiscal accountability. This article examines several aspects of health care that inhibit the development of common methods of defining and accounting for quality. Key issues and characteristics of the health‐care market are addressed and the article provides a synthesis of these obstacles to the process of deriving common measures and standards of quality that may be utilized by the health‐care industry for financial decisions.
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Oti Amankwah, Weng Wai Choong, Naana Amakie Boakye-Agyeman and Ebenezer Afrane
Patient-centred strategies should be applied in health-care facilities management (HcFM) to guarantee service quality to meet patients’ needs and ensure quality patient health-care…
Abstract
Purpose
Patient-centred strategies should be applied in health-care facilities management (HcFM) to guarantee service quality to meet patients’ needs and ensure quality patient health-care experience. This paper aims to examine the intervening influence of the quality of health-care administrative process (QAP) on the association between health-care facilities service quality and patients’ experiences with medical care.
Design/methodology/approach
A quantitative technique was used for this cross-sectional study in three Ghanaian teaching hospitals. A total of 622 relevant questionnaires were used for the analysis of the study using SEM-PLS.
Findings
The intervening influence of the QAP on the relationship between HcFM service quality (empathy and tangibility) and patients’ health-care experience (PHcE) were reinforced whilst that of reliability, responsiveness and assurance were not reinforced. The association between the QAP and PHcE was also established.
Research limitations/implications
A high-quality health-care workforce (both core and supporting) and quality work environment provided by the FM department and QAP are essential during quality-of-care delivery, to reduce threats to patient safety to achieve exceptional PHcE. The constraint on the study is that information was gathered from only Ghana. Hence, the generalisation of the findings will be a challenge. Thus, in future, it is proposed that a comparative study across a developed country and a developing country can be conducted. Future research can assess the influence of the health-care internal appearance on patients’ satisfaction.
Practical implications
Practically, the administrative system can be improved by reducing patients overall waiting time. Steps must also be taken to reduce the problem of needless administrative tasks and practices to simplify administrative practices and improve patients’ total health-care experience (core health-care delivery and HcFM), as this influence patients’ total health-care experience.
Originality/value
To the best of the authors’ knowledge, this empirical validation is one of the initial studies in service quality and FM to examine how health-care administrative process quality affects the relationship between FM service quality and patients’ experiences with medical care. This framework can be adapted for research in different countries to extend knowledge.
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Oti Amankwah, Weng-Wai Choong and Naana Amakie Boakye-Agyeman
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always…
Abstract
Purpose
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always managed and maintained with the attention required. This is due mainly to the complexity of health-care infrastructure and equipment and shortage of maintenance budget. This study aims to determine if patient’s satisfaction of core health-care business is mediated by the quality of health-care infrastructure and equipment.
Design/methodology/approach
This cross-sectional study comprises 622 adult patients at the Physician OPD and Polyclinic of Komfo Anokye Teaching hospital, Tamale Teaching hospital and Cape Coast Teaching hospital in Ghana. Structural equation model Smart PLS was used to analyse the data.
Findings
The study results showed that the quality of health-care infrastructure and equipment has a positive significant influence (mediation) on the relationship between health-care delivery and patient’s satisfaction as well as the relationship between adequacy of health-care resources and patient’s satisfaction. However, it was shown not to have a positive significant influence (mediation) on the relationship between quality of health-care personnel and patients’ satisfaction as well as health-care administrative process and patient’s satisfaction.
Research limitations/implications
First, the study findings are centred on cross-sectional data, which capture the opinion of the patients at a specific time period instead of over a period of time. Consequently, in future, though difficult to achieve, a longitudinal study can be piloted to provide more insight. Second, the data was collected from only one country (Ghana); thus, the ability to generalise the results may be a challenge.
Practical implications
The implication of this study is that there is the need to prudently maintain hospital infrastructure and equipment in good working condition as it has a positive effect on patients’ satisfaction of their overall health-care experience.
Originality/value
Most studies have concentrated on patient’s health-care experience. This study extends the knowledge of patient’s health-care experience by determining the mediating role of quality of health-care infrastructure and equipment on the relationship between patient’s satisfaction and core health-care business. There are limited studies of such nature in Ghana. Therefore, this study will provide invaluable empirical data for the health-care sector of a developing African country.
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Oti Amankwah, Weng Wai Choong and Naana Amakie Boakye-Agyeman
With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care…
Abstract
Purpose
With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience has become of strategic importance in public health-care delivery. This paper aims to investigate the mediating effect of adequacy of health-care resources on the relationship between the quality of health-care FM services and patient’s health-care experience.
Design/methodology/approach
This cross-sectional study adopts a quantitative approach based on a questionnaire survey conducted on 660 patients of three teaching hospitals in Ghana. In total, 622 valid questionnaires were used for data analysis using partial least squares structural equation modelling.
Findings
The mediating effect of adequacy of health-care resources on the relationship between responsiveness and tangibility and patients’ health-care experience were supported, while that of empathy, reliability and assurance were not supported. The relationship between and adequacy of health-care resources and patients’ health-care experience was also supported.
Research limitations/implications
The study limitation is that it was only the teaching hospitals that were surveyed. In future studies, a comparative analysis can be conducted between both public and private hospitals. Other constructs and relationships such as the mediating effect of the quality of health-care administrative process on the relationship between FM service quality and patients’ health-care experience as well as the moderation effect of adequacy of health-care resource on the relationship between FM service quality and patients’ health-care experience can also be tested. Future studies on the same subject can use health-care workers as the respondents of the study.
Practical implications
The result should inspire health-care managers to prioritize attention on health-care FM to create and sustain a decent health-care environment. Facilities managers should ensure standards are not compromised by keeping health-care resources in good condition through the organisation and management of resources.
Originality/value
To the best of the authors’ knowledge, this paper is one of the pioneer studies to test the mediating effect of adequacy of health-care resources on the relationship between patient’s health-care experience and health-care FM service quality. The proposed framework can be adapted to various sectors and countries as this empirical validation extends knowledge.
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This paper aims to measure the perception of patients towards quality of services in public health care centres in rural India.
Abstract
Purpose
This paper aims to measure the perception of patients towards quality of services in public health care centres in rural India.
Design/methodology/approach
A 23‐item scale that tested well for reliability and construct validity was employed for the study. Mixed sampling technique was employed to select the sample. A total of 500 respondents from Eastern, Western and Central regions of Uttar Pradesh were surveyed.
Findings
The survey instrument had an overall Cronbach's alpha value of 0.96 and was able to discern differences across various socio‐demographic characteristics of the respondents. The opinions of the respondents towards health care quality were not very favourable. Negative scores were obtained on items, “availability of adequate medical equipments” and “availability of doctors for women”. Education, gender and income were found to be significantly associated with user perception.
Research limitations/implications
The current study was limited to measuring the perceived quality of health care services in public centres only. Moreover, as the study was confined to the state of Uttar Pradesh so caution has to be exercised in making generalisations for the entire nation.
Practical implications
Valuable insights into the quality of services at public health care centres in rural India have been provided by the study.
Originality/value
Knowledge about the patients' perception towards health care quality is one of the most important steps towards introducing reforms in the health care sector. Identification of areas that require immediate improvement in public health care centres provides valuable guidance to the policy makers who can devise suitable strategies to make these centres more sensitive and responsible to the needs of the rural population. This can lead to restoration of faith in public health care centres and subsequently their increased consumption.
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This paper aims to examine the major factors affecting patients’ satisfaction and loyalty at a health-care organization in India.
Abstract
Purpose
This paper aims to examine the major factors affecting patients’ satisfaction and loyalty at a health-care organization in India.
Design/methodology/approach
A conceptual model has been developed that includes the behavioural dimensions of total quality management (TQM), patient satisfaction and loyalty. This study is exploratory in nature and has used the existing literature to build the conceptual model.
Findings
A solution for improving the quality of health-care services can be found in the application of total relationship management and TQM, together with a customer orientation strategy.
Practical implications
The results can be used creatively by hospitals to re-engineer and redesign their quality management processes and reorient the future directions of their more effective health-care quality strategies.
Originality/value
In this research, a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented.
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Sreenivas R. Sukumar, Ramachandran Natarajan and Regina K. Ferrell
The current trend in Big Data analytics and in particular health information technology is toward building sophisticated models, methods and tools for business, operational and…
Abstract
Purpose
The current trend in Big Data analytics and in particular health information technology is toward building sophisticated models, methods and tools for business, operational and clinical intelligence. However, the critical issue of data quality required for these models is not getting the attention it deserves. The purpose of this paper is to highlight the issues of data quality in the context of Big Data health care analytics.
Design/methodology/approach
The insights presented in this paper are the results of analytics work that was done in different organizations on a variety of health data sets. The data sets include Medicare and Medicaid claims, provider enrollment data sets from both public and private sources, electronic health records from regional health centers accessed through partnerships with health care claims processing entities under health privacy protected guidelines.
Findings
Assessment of data quality in health care has to consider: first, the entire lifecycle of health data; second, problems arising from errors and inaccuracies in the data itself; third, the source(s) and the pedigree of the data; and fourth, how the underlying purpose of data collection impact the analytic processing and knowledge expected to be derived. Automation in the form of data handling, storage, entry and processing technologies is to be viewed as a double-edged sword. At one level, automation can be a good solution, while at another level it can create a different set of data quality issues. Implementation of health care analytics with Big Data is enabled by a road map that addresses the organizational and technological aspects of data quality assurance.
Practical implications
The value derived from the use of analytics should be the primary determinant of data quality. Based on this premise, health care enterprises embracing Big Data should have a road map for a systematic approach to data quality. Health care data quality problems can be so very specific that organizations might have to build their own custom software or data quality rule engines.
Originality/value
Today, data quality issues are diagnosed and addressed in a piece-meal fashion. The authors recommend a data lifecycle approach and provide a road map, that is more appropriate with the dimensions of Big Data and fits different stages in the analytical workflow.
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Jitesh J. Thakkar, Shashank Thanki and Sunita Guru
The present situation of COVID-19 pandemic has put the health-care systems under tremendous stress and stringent tests for their ability to offer expected quality of health-care…
Abstract
Purpose
The present situation of COVID-19 pandemic has put the health-care systems under tremendous stress and stringent tests for their ability to offer expected quality of health-care services, as it decides the sustainability and growth of health-care service providers. This study aims to deliver a quantitative framework for service quality assessment in the health-care industry by classifying the health-care service quality parameters into four balanced scorecard (BSC) perspectives.
Design/methodology/approach
To determine the service quality for the Indian health-care system, decision-making trial and evaluation laboratory and analytical network process are integrated in a fuzzy environment to contemplate the interaction among BSC perspectives and respective performance measures.
Findings
The results indicate “internal processes” perspective assumes the key role within BSC perspectives, while performance measures “nursing staff turnover” and “staff training” play the key roles. The results also signify that “patient satisfaction” is the most vital issue and can be strongly influenced by measures belonging to the “learning and growth” perspective. In “learning and growth” perspective, “staff training” is the most decisive criteria, very highly influencing “patient satisfaction”, highly influencing “profitability,” “change of cost per patient (both in and out patients)” and “outpatient waiting time” while moderately influencing “staff satisfaction,” “bed occupancy” and “nursing staff turnover”. Moreover, “staff training” criteria have a positive influence on “nursing staff turnover.”
Originality/value
The contributions of this study are in two folds in the domain of quantification of service quality for the health-care system. First, it delivers an assessment framework for Indian health-care service quality. Second, it demonstrates an application of the framework for a case situation and validates the proposed framework.
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The purpose of this paper is to gauge the health-care services from a patient’s perspective in five private hospitals in the Syrian capital Damascus.
Abstract
Purpose
The purpose of this paper is to gauge the health-care services from a patient’s perspective in five private hospitals in the Syrian capital Damascus.
Design/methodology/approach
The five dimensions-SERVQUAL model (tangibility, empathy, assurance, reliability and responsiveness) was implemented to measure the gap between patient’s perception and expectation in health-care service quality.
Findings
The SERVQUAL tool proved to be reliable and valid in assessing service quality in Syrian health-care setting. The assessment of the service quality from a patient’s perspective shows that all SERVQUAL dimensions were negative except for tangible element that scored (+0.57) gap. Based on patient’s expectation, empathy scored the highest score with (4.37), followed by responsiveness (4.17), reliability (3.90), tangibility (3.82) and assurance (3.45). The widest negative gaps among the 22 SERVQUAL items were related to listening skills of hospital staffs (−1.52) and for spending enough time with patient (−1.81). This study indicated that tangible dimension plays a significant role in balancing the deficiency in other service quality dimensions. In addition, communication skills of medical and paramedical staff should be improved to ameliorate patient’s perception about health-care services.
Research limitations/implications
This study provides valuable insights into the patient’s perception, but the feedback from hospital staffs (doctor, nurses) and hospital’s senior managers also considered potential rich information sources. This survey is conducted in the capital, and future research should include replication of this study in the other 13 Syrian governorates before generalizing the findings of this research.
Practical implications
Hospital administrator could use SERVQUAL model to improve their operational performance as well as to benchmark their behavior against other competitors in the health-care market in Damascus. This paper provides valuable information to policymakers and top hospital management to understand patient-centered care and to improve health-care system in Syria. Besides, this research provides a marketing insight to realize what patient expects and how she/he assesses the care service.
Originality/value
To the author’s knowledge, this is one of very few studies conducted to assess service quality in private health-care sector in Damascus. The main contribution of this study is providing the empirical evidence that the five dimensions-SERVQUAL scale proved to be reliable and valid instrument for measuring and analyzing health-care service quality in Syria.
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